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Impact of intravitreal pharmacotherapies including antivascular endothelial growth factor and corticosteroid agents on diabetic retinopathy.

Abstract Diabetic retinopathy is common and increasing in prevalence. Pharmacologic management of diabetic macular edema (DME) has improved tremendously over the last decade with the use of two families of intravitreally administered medications: antivascular endothelial growth factor-specific agents and corticosteroids. Clinical evaluation of these pharmaceuticals has demonstrated that they can have a substantial impact on diabetic retinopathy severity levels and the underlying retinal vasculature itself.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title current opinion in ophthalmology
Publication Year Start




PMID- 28376510
OWN - NLM
STAT- MEDLINE
DA  - 20170404
DCOM- 20170418
LR  - 20170418
IS  - 1531-7021 (Electronic)
IS  - 1040-8738 (Linking)
VI  - 28
IP  - 3
DP  - 2017 May
TI  - Impact of intravitreal pharmacotherapies including antivascular endothelial
      growth factor and corticosteroid agents on diabetic retinopathy.
PG  - 213-218
LID - 10.1097/ICU.0000000000000364 [doi]
AB  - PURPOSE OF REVIEW: Diabetic retinopathy is common and increasing in prevalence.
      Pharmacologic management of diabetic macular edema (DME) has improved
      tremendously over the last decade with the use of two families of intravitreally 
      administered medications: antivascular endothelial growth factor-specific agents 
      and corticosteroids. Clinical evaluation of these pharmaceuticals has
      demonstrated that they can have a substantial impact on diabetic retinopathy
      severity levels and the underlying retinal vasculature itself. RECENT FINDINGS:
      Phase 3 trials employing ranibizumab, aflibercept, and fluocinolone acetonide
      enrolling eyes with center-involving DME causing visual acuity loss have
      demonstrated impressive alteration of the natural history of progressive diabetic
      retinopathy worsening over time through blunted progression to proliferative
      diabetic retinopathy, improving diabetic retinopathy severity levels, and slowing
      progressive retinal nonperfusion, the underlying disease process central to
      diabetic retinopathy itself. SUMMARY: Accumulating data indicate that the
      threshold to initiate ocular-specific pharmacologic treatment for diabetic
      retinopathy, previously predominately limited to eyes with visual loss because of
      center-involved DME or proliferative diabetic retinopathy, is being lowered to
      earlier stages of diabetic retinopathy. Ongoing clinical trials and secondary
      analyses continue to further explore the impact and durability of vascular
      endothelial growth factor blockade and corticosteroids on modification of
      diabetic retinopathy and the underlying retinal vasculature itself.
FAU - Wykoff, Charles C
AU  - Wykoff CC
AD  - Retina Consultants of Houston, Blanton Eye Institute, Houston Methodist Hospital,
      Greater Houston Retina Research Foundation, Weill Cornell Medical College,
      Houston, Texas, USA.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Opin Ophthalmol
JT  - Current opinion in ophthalmology
JID - 9011108
RN  - 0 (Angiogenesis Inhibitors)
RN  - 0 (Glucocorticoids)
RN  - 0 (Recombinant Fusion Proteins)
RN  - 0 (VEGFA protein, human)
RN  - 0 (Vascular Endothelial Growth Factor A)
RN  - 0CD5FD6S2M (Fluocinolone Acetonide)
RN  - 15C2VL427D (aflibercept)
RN  - EC 2.7.10.1 (Receptors, Vascular Endothelial Growth Factor)
RN  - ZL1R02VT79 (Ranibizumab)
SB  - IM
MH  - Angiogenesis Inhibitors/*therapeutic use
MH  - Diabetic Retinopathy/*drug therapy
MH  - Fluocinolone Acetonide/therapeutic use
MH  - Glucocorticoids/*therapeutic use
MH  - Humans
MH  - Intravitreal Injections
MH  - Ranibizumab/therapeutic use
MH  - Receptors, Vascular Endothelial Growth Factor/therapeutic use
MH  - Recombinant Fusion Proteins/therapeutic use
MH  - Vascular Endothelial Growth Factor A/*antagonists & inhibitors
EDAT- 2017/04/05 06:00
MHDA- 2017/04/19 06:00
CRDT- 2017/04/05 06:00
AID - 10.1097/ICU.0000000000000364 [doi]
AID - 00055735-201705000-00003 [pii]
PST - ppublish
SO  - Curr Opin Ophthalmol. 2017 May;28(3):213-218. doi: 10.1097/ICU.0000000000000364.

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