Journal
RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES
Volume 32, Issue 4, Pages 776-784Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/IAE.0b013e3182278b0e
Keywords
hard subfoveal exudates; suprachoroidal infusion; pars plana vitrectomy
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Funding
- iScience Interventional Corporation, Menlo Park, California
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Purpose: To evaluate the safety, feasibility, and preliminary efficacy of suprachoroidal drug delivery with a microcatheter for the treatment of severe subfoveal hard exudates (SHE) in retinal vasculopathies. Definitive treatments for SHE have not yet been identified and prognosis is unfavorable. Methods: In this prospective, interventional pilot study, six eyes of six patients with central or branch retinal vein occlusion or diffuse diabetic macular edema accompanied by massive refractory SHE underwent a single treatment with bevacizumab and triamcinolone administered to the submacular suprachoroidal space via a microcatheter introduced at the pars plana and advanced posteriorly. The main outcome measures included best-corrected visual acuity, vascular leakage, macular thickness, extent of SHE, and complications. Results: Mean follow-up was 12 months. Three eyes had central retinal vein occlusion, one had branch retinal vein occlusion, and two had chronic diabetic macular edema. Best-corrected visual acuity improved by >= 2 lines in 4 eyes and remained stable in 2 eyes. At 1 month to 2 months postprocedure, SHE was almost completely resolved in all eyes and macular edema was significantly reduced. There were no surgical or postoperative complications. Conclusion: Suprachoroidal infusion of drugs can be effective in reabsorbing massive SHE. RETINA 32: 776-784, 2012
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