Featured Research

from universities, journals, and other organizations

Cancer Treatment Controls Macular Edema Related To Diabetes And To Cataract Surgery

Date:
July 31, 2009
Source:
American Academy of Ophthalmology
Summary:
Researchers report on bevacizumab (Avastin), aimed to benefit diabetic patients with macular edema as well as people who develop cystoid macular edema after cataract surgery. Bevacizumab is also used to treat some cancers. Another study describes methods that could make cataract surgery safer for diabetic retinopathy (DR) patients. DR is the major threat to vision in working-age people, a problem that will only intensify if cases triple by 2050 as predicted.

The journal Ophthalmology reports on use of bevacizumab (Avastin), to benefit diabetic patients with macular edema as well as people who develop cystoid macular edema after cataract surgery. Bevacizumab is also used to treat some cancers. Another study describes methods that could make cataract surgery safer for diabetic retinopathy (DR) patients. DR is the major threat to vision in working-age people, a problem that will only intensify if cases triple by 2050 as predicted.

Related Articles


New Treatment Succeeds after Laser Fails in Diabetic Patients; Treatment also Controls Cystoid Macular Edema after Cataract Surgery

DR damages the light-sensitive retina at the back of the eye, the area that transmits images to the optic nerve. In type 2 diabetes patients, retinopathy vision loss most often results from macular edema (DME), swelling and thickening of the macula in the retina's center. Laser treatment is usually able to reduce vision loss, but widespread, diffuse DME (DDME) is often resistant to laser and other standard treatments.

Treating DMME with bevacizumab (Avastin), an anti-vascular endothelial growth factor (anti-VEGF) medication that inhibits abnormal blood vessels, was studied in115 patients (139 eyes) by the Pan-American Collaborative Retina Study Group, led by J. Fernando Arevalo, MD, of the Caracas Central Ophthalmologic Clinic, Venezuela. Within one month of the initial intravitreal bevacizumab (IVB) injections, improvement could be detected. By the end of the 24 month follow-up period vision had improved in 51.8 percent of eyes, and 97.1 percent of eyes were either stable or improved. No serious adverse effects occurred.

The Pan-American Collaborative Retina Study Group also reviewed the use of bevacizumab in patients with post-cataract surgery cystoid macular edema (CME) who had not responded to standard treatment. Twenty to 30 percent of all cataract surgery patients develop CME, in which the macula swells as fluid-filled cysts form. Usually the condition resolves without treatment and causes no permanent vision loss, but in a small percentage of patients vision remains worse than 20/40 and treatment is needed. Standard treatments include steroids, non-steroidal anti-inflammatories (NSAIDs), other medications, or surgery.

The researchers reviewed the records of 31 patients (36 eyes) who were treated with at least one IVB injection and followed for 12 months between 2005 and 2007. At the study's outset the mean best-corrected visual acuity was 20/200, and at 12 months the mean was 20/80. Most eyes (72.2 percent) improved and the rest remained stable (27.8 percent). Macular thickness also decreased in most eyes. Patients who received two or more injections were significantly more likely to improve. No adverse systemic or vision side effects or outcomes were reported.

"Large, randomized controlled clinical trials are needed to confirm IVB's efficacy and safety in treating these conditions," Dr. Arevalo said. "The results for DMME are very promising and suggest that combining anti-VEGF treatment with laser therapy may prove useful." He added, "Also, once further study is completed, unresolved CME post-cataract surgery should be considered for inclusion as an indication for use of IVB." "

Extra Precautions Needed with Cataract Surgery for DR Patients

Before 1996, retinopathy often developed or progressed rapidly in diabetic patients following cataract surgery. In the past decade the less-invasive phacoemulsification method has reduced cataract surgery complications in general, but the impact on diabetic retinopathy has been unclear. A clinic-based cohort study (2004 to 2006) led by Jie Jin Wang, MMed, PhD, at the Centre for Vision Research, University of Sydney, Australia, followed 169 diabetic patients aged 65 years and older for 12 months post-cataract surgery. Forty-five of these patients had surgery in just one eye.

Overall, DR developed or progressed in about one-third of operated eyes compared with about one-fifth of non-operated eyes. In the 45 patients for whom fellow eye comparisons were made, DR progressed in 35.6 percent of operated eyes versus 20 percent of non-operated eyes. Research on older cataract surgery methods had reported DR progression in 37 to 38 percent of eyes within 12 to 18 months of surgery; phacoemulsification is somewhat less likely to stimulate DR progression, the new study suggests. Dr. Wang cautions that patients who need cataract surgery may simply be at greater risk for DR progression, because both conditions are related to poor control of diabetes. Cataract may be a marker for greater DR severity or increased risk of progression.

"Although our results should not argue against cataract surgery in older people with diabetes, clinicians need to recognize the DR risk, treat active DR preoperatively–for example, use laser treatment to control macular edema¬–and closely monitor diabetes and DR after cataract surgery," Dr. Wang said.


Story Source:

The above story is based on materials provided by American Academy of Ophthalmology. Note: Materials may be edited for content and length.


Cite This Page:

American Academy of Ophthalmology. "Cancer Treatment Controls Macular Edema Related To Diabetes And To Cataract Surgery." ScienceDaily. ScienceDaily, 31 July 2009. <www.sciencedaily.com/releases/2009/07/090731121000.htm>.
American Academy of Ophthalmology. (2009, July 31). Cancer Treatment Controls Macular Edema Related To Diabetes And To Cataract Surgery. ScienceDaily. Retrieved October 24, 2014 from www.sciencedaily.com/releases/2009/07/090731121000.htm
American Academy of Ophthalmology. "Cancer Treatment Controls Macular Edema Related To Diabetes And To Cataract Surgery." ScienceDaily. www.sciencedaily.com/releases/2009/07/090731121000.htm (accessed October 24, 2014).

Share This



More Health & Medicine News

Friday, October 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Doctor in NYC Quarantined With Ebola

Doctor in NYC Quarantined With Ebola

AP (Oct. 24, 2014) — An emergency room doctor who recently returned to the city after treating Ebola patients in West Africa has tested positive for the virus. He's quarantined in a hospital. (Oct. 24) Video provided by AP
Powered by NewsLook.com
Breakfast Debate: To Eat Or Not To Eat?

Breakfast Debate: To Eat Or Not To Eat?

Newsy (Oct. 23, 2014) — Conflicting studies published in the same week re-ignited the debate over whether we should be eating breakfast. Video provided by Newsy
Powered by NewsLook.com
Ebola Fears Keep Guinea Hospitals Empty

Ebola Fears Keep Guinea Hospitals Empty

AP (Oct. 23, 2014) — Fears of Ebola are keeping doctors and patients alike away from hospitals in the West African nation of Guinea. (Oct. 23) Video provided by AP
Powered by NewsLook.com
Despite Rising Death Toll, Many Survive Ebola

Despite Rising Death Toll, Many Survive Ebola

AP (Oct. 23, 2014) — The family of a Dallas nurse infected with Ebola in the US says doctors can no longer detect the virus in her. Despite the mounting death toll in West Africa, there are survivors there too. (Oct. 23) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins