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Ali Hafezi-Moghadam, Ramin Nourinia, Souska Zandi, Shintaro Nakao, Hamid Ahmadieh; Beneficial Effects of Intravitreal Fasudil in Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2389.
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© ARVO (1962-2015); The Authors (2016-present)
New treatments of diabetic macular edema (DME) are highly desired in cases that are refractory to anti-VEGF treatment. Recently, the key role of the ROCK pathway in diabetic retinopathy was elucidated. Here, we investigate the efficacy of intravitreal fasudil, a potent pan ROCK inhibitor, together with bevacizumab in anatomical and visual outcomes of patients with DME resistant to previous treatments.
This prospective interventional small case series included 5 patients (59-76 years), who had persistent DME after macular laser photocoagulation and multiple intravitreal bevacizumab (IVB) injections (2.8±1.3). Fasudil (0.025 mg/0.05 ml, Asahi Kasei Pharma, Japan) and Avastin (1.25mg/0.05ml, Roche, Switzerland) were injected at two separate sites. Anterior chamber paracentesis was performed. Best Corrected Visual Acuity (BCVA), central macular thickness (CMT) by OCT (SD-OCT Cirrus, Zeiss, Germany), and electroretinograph (ERG, Roland Consult, Germany) were recorded before and 6 weeks after the injections.
The mean BCVA before intervention, 0.82±0.34 logMAR, significantly improved to 0.34±0.26 logMAR (P<0.05), six weeks after combined treatment. Mean CMT (409±74µm) significantly decreased (314±29µm) six weeks after treatment (P<0.05), while ERG showed no sign of toxicity.
These results may pave the way for the use of fasudil in treatment of DME cases refractory to current therapies.
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