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Biomedical subjects

J-F Korobelnik

Publications and source records attributed to J-F Korobelnik.

5 recordsLinked to original sources

[How to perform intravitreal injections].

Drugs to treat retinal diseases are often injected intravitreally. This procedure can cause severe complications. We present ways to minimize the risk for complications. Rigorous preoperative antisepsis with povidone iodine, a sterile environment (using gloves and a mask for the injector, a lid speculum, and a drape on the eye to be injected), and immediate follow-up after injection are key issues of the injection technique.

Humans↗

Evolving European guidance on the medical management of neovascular age related macular degeneration.

BACKGROUND: Until recently, only two options were available for the treatment of choroidal neovascularisation (CNV) associated with age related macular degeneration (AMD)-thermal laser photocoagulation and photodynamic therapy with verteporfin (PDT-V). However, new treatments for CNV are in development, and data from phase III clinical trials of some of these pharmacological interventions are now available. In light of these new data, expert guidance is required to enable retina specialists with expertise in the management of AMD to select and use the most appropriate therapies for the treatment of neovascular AMD. METHODS: Consensus from a round table of European retina specialists was obtained based on best available scientific data. Data rated at evidence levels 1 and 2 were evaluated for laser photocoagulation, PDT-V, pegaptanib sodium, and ranibizumab. Other treatments discussed are anecortave acetate, triamcinolone acetonide, bevacizumab, rostaporfin (SnET2), squalamine, and transpupillary thermotherapy. RESULTS: PDT-V is currently recommended for subfoveal lesions with predominantly classic CNV, or with occult with no classic CNV with evidence of recent disease progression and a lesion size <or=4 Macular Photocoagulation Study (MPS) disc areas (DA). The new classes of anti-angiogenic agents-namely, pegaptanib sodium and ranibizumab (the latter when peer reviewed phase III data become available) are recommended for subfoveal lesions with any proportion of classic CNV or occult with no classic CNV. For juxtafoveal classic CNV, PDT-V or anti-angiogenic therapy should be considered if the new vessels are so close to the fovea that laser photocoagulation would almost certainly extend under the centre of the foveal avascular zone. For all other well demarcated juxtafoveal lesions and for extrafoveal classic lesions, laser photocoagulation remains the standard treatment. Therapy should be undertaken within 1 week of the fluorescein angiogram on which the clinical decision to treat is based. At each follow up, fluorescein angiography should be performed and best corrected visual acuity measured as a minimum requirement. CONCLUSIONS: These recommendations provide evidence based guidance for the choice and use of non-surgical therapies for the management of neovascular AMD. Revisions of the recommendations may be required as new data become available.

Antibodies, Monoclonal↗

[The Mydriasert insert: an alternative to eye drops for preangiographic mydriasis].

PURPOSE: Mydriasert is an insoluble ophthalmic insert, gradually releasing two well-known active ingredients: phenylephrine and tropicamide. It is indicated in presurgical mydriasis. The purpose was to evaluate its efficacy in obtaining mydriasis required for fluorescein angiography. MATERIAL AND METHODS: The ability of Mydriasert to provide mydriasis (defined by a pupillary diameter of at least 7 mm) compatible with a bilateral angiographic examination in optimal conditions was evaluated by a comparative, randomised versus active treatment (eye drops) open trial in 72 patients. RESULTS: All the patients obtained a stable mydriasis allowing angiography. In the Mydriasert group, mydriasis preparation required a mean of 10 min more (Student t test: p<0.001); however, near eyesight recovery was 15 min shorter on average (log-rank test<0.01%) and amounts of active ingredients administered to provide mydriasis were 5-10 times higher in the eye drops reference group. Cardiovascular parameters remained in the normal range in both groups. Three patients of the Mydriasert group presented one ocular symptom of local intolerance, which disappeared in 15 min (exact Fisher test not significant between the treatment groups, p=0.2394). No superficial punctate keratitis was detected during the trial. CONCLUSION: The treatment by Mydriasert can prepare preangiographic mydriasis as well as the reference treatment. The time required for mydriasis is slightly longer. Near eyesight recovery, faster with Mydriasert, could provide an improvement in patient safety and comfort at the end of the ophthalmologic visit.

Angiography↗

[Delayed discovery of a metallic intraocular foreign body: diagnostic and therapeutic stakes].

Ocular siderosis is a serious and rare complication when a penetrating ocular injury with a metallic foreign body goes unnoticed. The foreign body must be urgently removed from the eye. If it is located on the ciliary body or the zonule, it may be difficult to visualize clinically. In this case, high-frequency ultrasound biomicroscopy can pinpoint its precise location and guide the surgical intervention.

Adult↗