Guías de práctica clínica de la SERVTratamiento de la degeneración macular asociada a la edad (DMAE) exudativa

  1. J.M. Ruiz-Moreno
  2. L. Arias-Barquet
  3. F. Armadá-Maresca
  4. A. Boixadera-Espax
  5. A. García-Layana
  6. F. Gómez-Ulla-de-Irazazábal
  7. J. Monés-Carilla
  8. A. Piñero-Bustamante
  9. M. Suárez-de-Figueroa
Journal:
Archivos de la Sociedad Española de Oftalmologia

ISSN: 0365-6691

Year of publication: 2009

Volume: 84

Issue: 7

Pages: 333-344

Type: Article

DOI: 10.4321/S0365-66912009000700004 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Archivos de la Sociedad Española de Oftalmologia

Sustainable development goals

Abstract

Objective: Age related macular degeneration (ARMD) in its neovascular form is a serious disease which produces legal blindness in many patients with poor prognosis if left untreated. We intend to establish a clinical guide with the different therapeutic options that exist nowadays, which may help the ophthalmologists in their clinical practice. Methods: A group of medical retina experts selected by SERV have evaluated the results of different published studies with the drugs currently available, obtaining an evidence-based consensus. Some recommendations have been established for diagnosis, treatment and monitoring of patients with neovascular ARMD. Results: The intravitreal injection of ranibizumab at a dosage of 0.5 mg produces significant improvement of visual acuity in subfoveal lesions, according to data obtained from studies with the highest level of evidence. It should be considered as a first choice drug. The use of bevacizumab, a drug with not approved indication for intraocular use, nor for the treatment of neovascular ARMD can reach a result which is closer to the ones obtained with ranibizumab than to those obtained with photodynamic therapy (PDT) and pegaptanib. The use of intravitreal pegaptanib sodium in intravitreal injection at a dosage of 0.3 mg as a treatment for subfoveal lesions can obtain similar results to the TFD, but with a wider range of injuries. Conclusion: The results of the evidence-based studies are a good guide for the treatment of this disease.

Bibliographic References

  • (1991). Argon laser photocoagulation for neovascular maculopathy: Five-years results from randomized clinical trials. Arch Ophthalmol. 109. 1109-1114
  • (1994). Argon laser photocoagulation for juxtafoveal choroidal neovascularization: Five-years results from randomized clinical trials. Arch Ophthalmol. 112. 500-509
  • (1991). Laser photocoagulation of subfoveal neovascular lesions in age-related macular degeneration.: Results of a randomized clinical trials. Arch Ophthalmol. 109. 1220-1231
  • Bhatt, NS, Al-Shirawi, NM, Diamond, JG. (1999). Krypton laser photocoagulation of peripapillary choroidal neovascular membrane. Ophthalmic Surg Lasers. 30. 56-58
  • Lai, TY, Chan, WM, Lam, DS. (2004). Laser photocoagulation of indocyanine green aniographically identified feeder vessels to idiopathic polypoidal choroidal vasculopathy. Am J Ophthalmol. 138. 693-694
  • Johnson, TM, Glaser, BM. (2006). Focal laser ablation of retinal angiomatous proliferation. Retina. 26. 765-772
  • Roth, DB, Scott, IU, Gloth, JM, Green, SN, Yarian, DL, Wheatley, M. (2007). Micropulsed laser photocoagulation and intravitreal triamcinolone acetonide injection for the treatment of retinal angiomatous proliferation. Retina. 27. 1201-1204
  • Merrill, PT, LoRusso, FJ, Lomeo, MD, Saxe, SJ, Khan, MM, Lambert, HM. (1999). Surgical removal of subfoveal choroidal neovascularization in age-related macular degeneration. Ophthalmology. 106. 782-789
  • Kokame, GT, Yamaoka, S. (2005). Subretinal surgery for peripapillary subretinal neovascular membranes. Retina. 25. 564-569
  • (1999). Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one-year results of 2 randomized clinical trials - TAP report. Arch Ophthalmol. 117. 1329-1345
  • (2001). Photodynamic Therapy of Subfoveal Choroidal Neovascularization in Pathologic Myopia with Verteporfin: one-year results of a randomized clinical trial - VIP report no. 1. Ophthalmology. 108. 841-852
  • Bressler, NM. (2002). Verteporfin therapy of subfoveal choroidal neovascularization in age-related macular degeneration: two-year results of a randomized clinical trial including lesions with occult with no classic choroidal neovascularization-verteporfin in photodynamic therapy report 2. Am J Ophthalmol. 133. 168-169
  • Ruiz-Moreno, JM, Montero, J, Barile, S, Zarbin, M. (2006). Photodynamic therapy and high doses intravitreal triamcinolone to treat exudative age-related macular degeneration: One year outcome. Retina. 26. 602-612
  • Arias, L, Garcia-Arumi, J, Ramon, JM, Badia, M, Rubio, M, Pujol, O. (2006). Photodynamic therapy with intravitreal triamcinolone in predominantly classic choroidal neovascularization: one-year results of a randomized study. Ophthalmology. 113. 2243-2250
  • Kaiser, PK. (2003). Five-year results of verteporfin therapy for subfoveal CNV due to AMD: third year of an open-label extension of the TAP Investigation. Invest Ophthalmol Vis Sci. 44.
  • Chakravarthy, U, Soubrane, G, Bandello, F, Chong, V, Creuzot-Garcher, C, Dimitrakos, SA. (2006). Evolving European guidance on the medical management of neovascular age related macular degeneration. Br J Ophthalmol. 90. 1188-1196
  • Gragoudas, ES, Adamis, AP, Cunningham, ET Jr, Feinsod, M, Guyer, DR. (2004). Pegaptanib for neovascular age-related macular degeneration. N Engl J Med. 351. 2805-2816
  • Chakravarthy, U, Adamis, AP, Cunningham, ET Jr, Goldbaum, M, Guyer, DR. (2006). Year 2 efficacy results of 2 randomized controlled clinical trials of pegaptanib for neovascular age-related macular degeneration. Ophthalmology. 113. 1508-1521
  • Heier, JS, Boyer, DS, Ciulla, TA, Ferrone, PJ, Jumper, JM, Gentile, RC. (2006). Ranibizumab combined with verteporfin photodynamic therapy in neovascular age-related macular degeneration: year 1 results of the FOCUS Study. Arch Ophthalmol. 124. 1532-1542
  • Antoszyk, AN, Tuomi, L, Chung, CY, Singh, A. Ranibizumab combined with verteporfin photodynamic therapy in neovascular age-related macular degeneration (FOCUS): year 2 results. Am J Ophthalmol. 145. 862-874
  • Rosenfeld, PJ, Brown, DM, Heier, JS, Boyer, DS, Kaiser, PK, Chung, CY. (2006). Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 355. 1419-1431
  • Brown, DM, Kaiser, PK, Michels, M, Soubrane, G, Heier, JS, Kim, RY. (2006). Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med. 355. 1432-1444
  • Kaiser, PK. (2006). Antivascular endothelial growth factor agents and their development: therapeutic implications in ocular diseases. Am J Ophthalmol. 142. 660-668
  • Kim, KJ, Li, B, Houck, K, Winer, J, Ferrara, N. (1992). The vascular endothelial growth factor proteins: identification of biologically relevant regions by neutralizing monoclonal antibodies. Growth Factors. 7. 53-64
  • Chen, Y, Wiesmann, C, Fuh, G, Li, B, Christinger, HW, McKay, P. (1999). Selection and analysis of an optimized anti-VEGF antibody: crystal structure of an affinity-matured Fab in complex with antigen. J Mol Biol. 293. 865-881
  • Rosenfeld, PJ, Schwartz, SD, Blumenkranz, MS, Miller, JW, Haller, JA, Reimann, JD. (2005). Maximum tolerated dose of a humanized anti-vascular endothelial growth factor antibody fragment for treating neovascular age-related macular degeneration. Ophthalmology. 112. 1048-1053
  • Dalton, Michelle. Lucentis at one year. Eyeworld.
  • Ip, MS, Scott, IU, Brown, GC, Brown, MM, Ho, AC, Huang, SS. (2008). Anti-vascular endothelial growth factor pharmacotherapy for age-related macular degeneration: a report by the American Academy of Ophthalmology. Ophthalmology. 115. 1837-1846
  • Michels, S, Rosenfeld, PJ, Puliafito, CA, Haraus, EN, Venkatraman, AS. (2005). Systemic bevacizumab (Avastin) therapy for neovascular age-related macular degeneration twelve-week results of an uncontrolled open-label clinical study. Ophthalmology. 112. 1035-1047
  • Rosenfeld, PJ, Fung, AE, Puliafito, CA. (2005). Optical coherence tomography findings after an intravitreal injection of bevacizumab (Avastin) for macular edema from central retinal vein occlusion. Ophthalmic Surg Lasers Imaging. 36. 336-339
  • Rosenfeld, PJ, Moshfeghi, AA, Puliafito, CA. (2005). Optical coherence tomography findings after an intravitreal injection of bevacizumab (Avastin) for neovascular age-related macular degeneration. Ophthalmic Surg Lasers Imaging. 36. 331-335
  • Spaide, RF, Laud, K, Fine, HF, Klancnik, JM Jr, Meyerle, CB, Yannuzzi, LA. (2006). Intravitreal bevacizumab treatment of choroidal neovascularization secondary to age-related macular degeneration. Retina. 26. 383-390
  • Aisenbrey, S, Ziemssen, F, Volker, M, Gelisken, F, Szurman, P, Jaissle, G. (2007). Intravitreal bevacizumab (Avastin) for occult choroidal neovascularization in age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol. 245. 941-948
  • Chen, E, Kaiser, RS, Vander, JF. (2007). Intravitreal bevacizumab for refractory pigment epithelial detachment with occult choroidal neovascularization in age-related macular degeneration. Retina. 27. 445-450
  • Rich, RM, Rosenfeld, PJ, Puliafito, CA, Dubovy, SR, Davis, JL, Flynn, HW Jr. (2006). Short-term safety and efficacy of intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration. Retina. 26. 495-511
  • Emerson, MV, Lauer, AK, Flaxel, CJ, Wilson, DJ, Francis, PJ, Stout, JT. (2007). Intravitreal bevacizumab (Avastin) treatment of neovascular age-related macular degeneration. Retina. 27. 439-444
  • Wu, L, Martinez-Castellanos, MA, Quiroz-Mercado, H, Arevalo, JF, Berrocal, MH, Farah, ME. (2007). Twelve-month safety of intravitreal injections of bevacizumab (Avastin®): results of the Pan-American collaborative retina study group (PACORES). Graefes Arch Clin Exp Ophthalmol. 246. 81-87
  • Cleary, CA, Jungkim, S, Ravikumar, K, Kelliher, C, Acheson, RW, Hickey-Dwyer, M. (2008). Intravitreal bevacizumab in the treatment of neovascular agerelated macular degeneration, 6- and 9-month results. Eye. 22. 82-86
  • Bashshur, ZF, Haddad, ZA, Schakal, A, Jaafar, RF, Saab, M, Noureddin, BN. (2008). Intravitreal bevacizumab for treatment of neovascular age-related macular degeneration: a one-year prospective study. Am J Ophthalmol. 145. 249-256
  • Chen, CY, Wong, TY, Heriot, WJ. (2007). Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration: a short-term study. Am J Ophthalmol. 143. 510-512
  • (1993). Laser photocoagulation of subfoveal neovascular lesions of age-related macular degeneration: Update findings from two clinical trials. Ophthalmology. 111. 1200-1209
  • Fung, AE, Lalwani, GA, Rosenfeld, PJ, Dubovy, SR, Michels, S, Feuer, WJ. (2007). An optical coherence tomography-guided, variable dosing regimen with intravitreal ranibizumab (Lucentis) for neovascular age-related macular degeneration. Am J Ophthalmol. 143. 566-583
  • Regillo, CD, Brown, DM, Abraham, P, Yue, H, Ianchulev, T, Schneider, S. (2008). Randomized, double-masked, sham-controlled trial of ranibizumab for neovascular age-related macular degeneration: PIER Study year 1. Am J Ophthalmol. 145. 239-248
Data source: Dialnet