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P. H. B. Kok, F. D. Verbraak, A. J. Nederveen, C. B. Hoyng; A New Counter Pressure Device to Reduce Reflux During Administration of Anecortave Acetate Depot, Visualized With Magnetic Resonance Imaging. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4538.
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Improved control of reflux during administration of Anecortave Acetatate depot, visualized with 3T Magnetic Resonance Imaging, using a newly developed counter pressure device.
To visualize the location and extent of the injected depot, in 7 patients with a subfoveal neovascularization treated with Anecortave Acetate, MR images were acquired before (figure A,C) and after (figure B,D) administration of the drug. A 3T MRI scanner was used, equipped both with a standard headcoil (figure A,B) and a a microcoil (figure C,D) with a diameter of 5 cm. T2-weighted images were scanned in transverse, sagittal and coronal planes. Anecortave acetate (30mg) was administered under Tenon’s capsule as a posterior juxtascleral depot using a counter pressure device (CPD), according to the standard procedure as dictated by Alcon. Two types of CPDs were used, the standard CPD (figure E, Alcon Inc.2004) and a new CPD (figureF), developed by one of the authors (C.H.).
During administration of Anecortave Acetate the new CPD was easy to handle and showed a better control of reflux compared to standard CPD. Using the standard CPD, the juxtascleral Anecortave Acetate depot was clearly visualized; the depot was located along the line of the injecting cannula and not exactly on top of the macular area. Using the new CPD, we were not able to clearly discern the boundaries of the depot. The transverse images, acquired with the high resolution microcoil, suggest a more posteriorly and centrally located thin layer of the injected drug.
At least part of the Anecortave Acetate juxtascleral depot does not seem to reach the most posterior macular area using the standard CPD. The newly developed CPD shows better control of reflux during administration of Anecortave Acetate depot, furthermore the depot seems to spread out into a thin layer more posteriorly.
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