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Therapeutic effect of oral bisphosphonates on choroidal neovascularization in the human eye.

Honda S, Nagai T, Kondo N, Fukuda M, Kusuhara S, Tsukahara Y, Negi A - J Ophthalmol (2010)

Bottom Line: The mean BCVA of the patients was significantly improved after a months with the treatment in the AMD group.The mean lesion size was significantly decreased by 3 months in both groups.The averages of foveal thickness and total macular volume were significantly reduced after 1 month of treatment in the AMD group.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan.

ABSTRACT
Purpose. Choroidal neovascularization (CNV) is often associated with age-related macular degeneration (AMD) and pathological myopia (PM). Bisphosphonates, the drug of choice to treat osteoporosis, have been recently reported to have anti-angiogenic effects. The purpose of this study is to investigate the therapeutic effects of oral bisphosphonates for CNV in humans. Methods. Thirty-six consecutive cases with CNV due to AMD or PM who declined anti-VEGF therapy were recruited. The patients were prescribed 5 mg of oral alendronates daily for 6 months. The best-corrected visual-acuity (BCVA), the lesion size in fundus photographs and fluorescein angiography, foveal thickness and total macular volume in optical coherence tomography were compared between pre- and post-treatment. Results. The mean BCVA of the patients was significantly improved after a months with the treatment in the AMD group. In the PM group, the mean BCVA was maintained up to 6 months with the treatment. The mean lesion size was significantly decreased by 3 months in both groups. The averages of foveal thickness and total macular volume were significantly reduced after 1 month of treatment in the AMD group.Conclusions. Oral bisphosphonate should be further investigated as a possible therapeutic and preventive drug for CNV due to AMD and PM.

No MeSH data available.


Related in: MedlinePlus

A 79-year-old male who received PDT for 27 months ago showed a recurrence of CNV (arrowheads), mainly at the temporal edge of the old scar (arrows) (a). Fluorescein angiography (FA) showed predominantly classic CNV (c), and optical coherence tomography (OCT) revealed a subretinal lesion before treatment (e). After the oral administration of alendronate for three months, the CNV became subretinal fibrosis (b) and no leakage was observed using FA (d). A remarkable decrease in the size of the subretinal lesion was observed using OCT (f).
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fig6: A 79-year-old male who received PDT for 27 months ago showed a recurrence of CNV (arrowheads), mainly at the temporal edge of the old scar (arrows) (a). Fluorescein angiography (FA) showed predominantly classic CNV (c), and optical coherence tomography (OCT) revealed a subretinal lesion before treatment (e). After the oral administration of alendronate for three months, the CNV became subretinal fibrosis (b) and no leakage was observed using FA (d). A remarkable decrease in the size of the subretinal lesion was observed using OCT (f).

Mentions: The mean BCVA of the patients was significantly improved after a month with the treatment in the AMD group (Figure 1). Comparing the proportions of BCVA between pretreatment and after 6 months of the treatment, the number of eyes in which BCVA improved more than 0.2 LogMAR,, changed within 0.2 LogMAR and deteriorated more than 0.2 LogMAR were 5 (24%), 15 (71%), and 1 (5%) eyes, respectively in the AMD group, whereas those in the pathological myopia group were 2 (14%), 9 (64%), and 3 (22%) eyes, respectively. The mean lesion sizes determined in FA and fundus photograph were significantly decreased after 3 months of the treatment in both groups (Figure 2). The mean foveal thickness (Figure 3) and total macular volume (Figure 4) measured by OCT were significantly decreased in the AMD group after a month with the treatment. No adverse systemic side effects were found or self-reported in any of the present cases. The detailed findings from selected cases of the responders are shown in Figures 5, 6, and 7.


Therapeutic effect of oral bisphosphonates on choroidal neovascularization in the human eye.

Honda S, Nagai T, Kondo N, Fukuda M, Kusuhara S, Tsukahara Y, Negi A - J Ophthalmol (2010)

A 79-year-old male who received PDT for 27 months ago showed a recurrence of CNV (arrowheads), mainly at the temporal edge of the old scar (arrows) (a). Fluorescein angiography (FA) showed predominantly classic CNV (c), and optical coherence tomography (OCT) revealed a subretinal lesion before treatment (e). After the oral administration of alendronate for three months, the CNV became subretinal fibrosis (b) and no leakage was observed using FA (d). A remarkable decrease in the size of the subretinal lesion was observed using OCT (f).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2913841&req=5

fig6: A 79-year-old male who received PDT for 27 months ago showed a recurrence of CNV (arrowheads), mainly at the temporal edge of the old scar (arrows) (a). Fluorescein angiography (FA) showed predominantly classic CNV (c), and optical coherence tomography (OCT) revealed a subretinal lesion before treatment (e). After the oral administration of alendronate for three months, the CNV became subretinal fibrosis (b) and no leakage was observed using FA (d). A remarkable decrease in the size of the subretinal lesion was observed using OCT (f).
Mentions: The mean BCVA of the patients was significantly improved after a month with the treatment in the AMD group (Figure 1). Comparing the proportions of BCVA between pretreatment and after 6 months of the treatment, the number of eyes in which BCVA improved more than 0.2 LogMAR,, changed within 0.2 LogMAR and deteriorated more than 0.2 LogMAR were 5 (24%), 15 (71%), and 1 (5%) eyes, respectively in the AMD group, whereas those in the pathological myopia group were 2 (14%), 9 (64%), and 3 (22%) eyes, respectively. The mean lesion sizes determined in FA and fundus photograph were significantly decreased after 3 months of the treatment in both groups (Figure 2). The mean foveal thickness (Figure 3) and total macular volume (Figure 4) measured by OCT were significantly decreased in the AMD group after a month with the treatment. No adverse systemic side effects were found or self-reported in any of the present cases. The detailed findings from selected cases of the responders are shown in Figures 5, 6, and 7.

Bottom Line: The mean BCVA of the patients was significantly improved after a months with the treatment in the AMD group.The mean lesion size was significantly decreased by 3 months in both groups.The averages of foveal thickness and total macular volume were significantly reduced after 1 month of treatment in the AMD group.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan.

ABSTRACT
Purpose. Choroidal neovascularization (CNV) is often associated with age-related macular degeneration (AMD) and pathological myopia (PM). Bisphosphonates, the drug of choice to treat osteoporosis, have been recently reported to have anti-angiogenic effects. The purpose of this study is to investigate the therapeutic effects of oral bisphosphonates for CNV in humans. Methods. Thirty-six consecutive cases with CNV due to AMD or PM who declined anti-VEGF therapy were recruited. The patients were prescribed 5 mg of oral alendronates daily for 6 months. The best-corrected visual-acuity (BCVA), the lesion size in fundus photographs and fluorescein angiography, foveal thickness and total macular volume in optical coherence tomography were compared between pre- and post-treatment. Results. The mean BCVA of the patients was significantly improved after a months with the treatment in the AMD group. In the PM group, the mean BCVA was maintained up to 6 months with the treatment. The mean lesion size was significantly decreased by 3 months in both groups. The averages of foveal thickness and total macular volume were significantly reduced after 1 month of treatment in the AMD group.Conclusions. Oral bisphosphonate should be further investigated as a possible therapeutic and preventive drug for CNV due to AMD and PM.

No MeSH data available.


Related in: MedlinePlus