These guidelines were developed jointly by the American Society of Health-System Pharmacists (ASHP), the Infectious Diseases Society of America (IDSA), the Surgical Infection Society (SIS), and the Society for Healthcare Epidemiology of America (SHEA). This work represents an update to the

/pdf/clinical-practice-guidelines-for-antimicrobial-prophylaxis-1gq1adk8ux.pdf

Clinical practice guidelines for antimicrobial prophylaxis in surgery

Background Retinopathy of prematurity is a leading cause of childhood blindness worldwide. Peripheral retinal ablation with conventional (confluent) laser therapy is destructive, causes complications, and does not prevent all vision loss, especially in cases of retinopathy of prematurity affecting zone I of the eye. Case series in which patients were treated with vascular endothelial growth factor inhibitors suggest that these agents may be useful in treating retinopathy of prematurity. Methods We conducted a prospective, controlled, randomized, stratified, multicenter trial to assess intravitreal bevacizumab monotherapy for zone I or zone II posterior stage 3+ (i.e., stage 3 with plus disease) retinopathy of prematurity. Infants were randomly assigned to receive intravitreal bevacizumab (0.625 mg in 0.025 ml of solution) or conventional laser therapy, bilaterally. The primary ocular outcome was recurrence of retinopathy of prematurity in one or both eyes requiring retreatment before 54 weeks' postmenstru...

/pdf/efficacy-of-intravitreal-bevacizumab-for-stage-3-retinopathy-57b87nermn.pdf

Efficacy of Intravitreal Bevacizumab for Stage 3+ Retinopathy of Prematurity

Antiangiogenesis Strategies Revisited: From Starving Tumors to Alleviating Hypoxia

/pdf/clinical-practice-guidelines-for-antimicrobial-prophylaxis-yxd0y9e4ks.pdf

Clinical practice guidelines for antimicrobial prophylaxis in surgery.

Optical coherence tomography angiography.

Telemedicine in the Management of Exudative Age-Related Macular Degeneration within an Integrated health care System.

Case report: A 59-year-old patient with a coexisting primary choroidal melanoma and colorectal cancer was treated with external beam radiation (EBR) of his choroidal melanoma and systemic chemotherapy with leukovorin/5 fluorouracil (FU) for treatment of his metastatic colorectal cancer. Eight months following EBR, he showed evidence of radiation retinopathy with macular edema. Optical coherence tomography (OCT) showed macular edema and subretinal fluid. Subsequently, systemic bevacizumab (5 mg/kg) was added to his leukovorin/5FU chemotherapy. After the addition of bevacizumab, OCT showed complete resolution of the macular edema and subretinal fluid. Comments: Bevacizumab may have a role in the treatment of radiation retinopathy, but further investigation is needed before any definitive conclusions can be made.

Regression of radiation-induced macular edema after systemic bevacizumab.

A review of the literature showed no published cases using a combination of intravitreal triamcinolone and anti-VEGF agents for macular edema due to central retinal vein occlusion (CRVO). We present a case refractory to each treatment modality separately but which responded to their combination.

/pdf/intravitreal-triamcinolone-and-bevacizumab-combination-59h28upjf9.pdf

Intravitreal triamcinolone and bevacizumab combination therapy for macular edema due to central retinal vein occlusion refractory to either treatment alone.

Purpose: To report patient acceptance and safety of repeated intravitreal injections of anti-VEGF agents for exudative AMD, by retina specialists, without an eye examination before every injection.Methods: Retrospective chart review. 115 eyes (110 patients) with exudative AMD underwent repeated intravitreal anti-VEGF injections with limited interval examination and diagnostic testing. Medication, laterality, number of injection cycles started and completed, number of injections per injection cycle, subjective visual changes, pre- and post-injection visual acuity (VA), pre- and post-injection intraocular pressure (IOP), nurse- and patient-initiated phone calls, emergency (non-scheduled) clinic visits, complications, new diagnoses, and patient complaints after each injection were recorded. The main outcome measures were complications and patient complaints.Results: 396 injections were administered in the injection clinic to 110 patients in 175 injection cycles (range: 0 to 5 injections per cycle). Of 175 in...

Administration of Repeat Intravitreal Anti-VEGF Drugs by Retina Specialists in an Injection-only Clinic for Patients with Exudative AMD: Patient Acceptance and Safety

This is a summary of current and emerging pharmacologic therapies utilized in the treatment of diabetic retinopathy (DR). Current therapies, such as ranibizumab, bevacizumab, triamcinolone acetonide, and fluocinolone acetonide, inhibit angiogenesis and inflammation and may be used alone or in combination with laser treatment. Emerging therapies aim to reduce oxidative stress or inhibit other signal transduction pathways, including the protein kinase C cascade and aldose reductase pathway. Future therapies may target other molecules crucial to the pathogenesis of DR, including hepatocyte growth factors and matrix metalloproteinase 9. Finally, the emergence of novel mechanisms of medication delivery may also be on the horizon.

Sophie J. Bakri

Papers

Telemedicine in the Management of Exudative Age-Related Macular Degeneration within an Integrated health care System.

Regression of radiation-induced macular edema after systemic bevacizumab.

Intravitreal triamcinolone and bevacizumab combination therapy for macular edema due to central retinal vein occlusion refractory to either treatment alone.

Administration of Repeat Intravitreal Anti-VEGF Drugs by Retina Specialists in an Injection-only Clinic for Patients with Exudative AMD: Patient Acceptance and Safety

Novel pharmacotherapies in diabetic retinopathy.