Skip to main content
Erschienen in: International Ophthalmology 1/2017

06.05.2016 | Original Paper

Subfoveal choroidal thickness changes after intravitreal bevacizumab injection for neovascular age-related macular degeneration and diabetic macular edema

verfasst von: Cihan Ünlü, Gurkan Erdogan, Betul Onal Gunay, Esra Kardes, Betul Ilkay Sezgin Akcay, Ahmet Ergin

Erschienen in: International Ophthalmology | Ausgabe 1/2017

Einloggen, um Zugang zu erhalten

Abstract

The purpose of this study was to investigate the changes in subfoveal choroidal thickness (SFCT) after intravitreal injection of bevacizumab (IVB) for neovascular age-related macular degeneration (AMD) and diabetic macular edema (DME). This retrospective, consecutive, interventional case series study included 43 eyes [21 affected eyes with neovascular AMD (AMD group) and 22 affected eyes with DME (DME group)] which were treated with 1.25 mg/0.5 ml IVB and 43 untreated fellow eyes of 43 patients. SFCT was measured in all 86 eyes at baseline before IVB injection and at day 1, week 1, and month 1 after injection by use of enhanced depth imaging optical coherence tomography (EDI OCT). Central foveal thickness (CFT) and best-corrected visual acuity were analyzed at baseline and during follow-up visits. Main outcome measure was change in SFCT in 1 month after treatment. All 43 eyes treated with IVB showed a significant reduction in SFCT. Mean SFCT in treated eyes decreased from 237.1 ± 75.3 µm at baseline to 214.0 ± 65.7 µm at day 1, 205.4 ± 59.7 at week 1, and 222.7 ± 73.3 at month 1, whereas SFCT in fellow eyes changed from 228.4 ± 63.6 at baseline to 224.5 ± 68.5 at day 1, 220.4 ± 72.1 at week 1, and 226.9 ± 74.0 at month 1. SFCT demonstrated a similar trend toward decrease in both groups. CFT decreased significantly and visual acuity improved significantly. SFCT decreased significantly in AMD and DME eyes following injection. The decreasing effect of bevacizumab on choroidal thickness was highest at first week and continued to the end of first month after injection.
Literatur
2.
Zurück zum Zitat Friedman DS, O’Colmain BJ, Munoz B et al (2004) Prevalence of age-related macular degeneration in the United States. Arch Ophthalmol 122:564–572CrossRefPubMed Friedman DS, O’Colmain BJ, Munoz B et al (2004) Prevalence of age-related macular degeneration in the United States. Arch Ophthalmol 122:564–572CrossRefPubMed
4.
Zurück zum Zitat Cao J, McLeod S, Merges CA, Lutty GA (1998) Choriocapillaris degeneration and related pathologic changes in human diabetic eyes. Arch Ophthalmol 116:589–597CrossRefPubMed Cao J, McLeod S, Merges CA, Lutty GA (1998) Choriocapillaris degeneration and related pathologic changes in human diabetic eyes. Arch Ophthalmol 116:589–597CrossRefPubMed
5.
Zurück zum Zitat Fryczkowski AW, Sato SE, Hodes BL (1988) Changes in the diabetic choroidal vasculature: scanning electron microscopy findings. Ann Ophthalmol 20:299–305PubMed Fryczkowski AW, Sato SE, Hodes BL (1988) Changes in the diabetic choroidal vasculature: scanning electron microscopy findings. Ann Ophthalmol 20:299–305PubMed
6.
Zurück zum Zitat Lutty G, Grunwald J, Majji AB et al (1999) Changes in choriocapillaris and retinal pigment epithelium in age-related macular degeneration. Mol Vis 5:35PubMed Lutty G, Grunwald J, Majji AB et al (1999) Changes in choriocapillaris and retinal pigment epithelium in age-related macular degeneration. Mol Vis 5:35PubMed
7.
Zurück zum Zitat Querques G, Lattanzio R, Querques L et al (2012) Enhanced depth imaging optical coherence tomography in type 2 diabetes. Invest Ophthalmol Vis Sci 53:6017–6024CrossRefPubMed Querques G, Lattanzio R, Querques L et al (2012) Enhanced depth imaging optical coherence tomography in type 2 diabetes. Invest Ophthalmol Vis Sci 53:6017–6024CrossRefPubMed
8.
Zurück zum Zitat Regatieri CV, Branchini L, Carmody J et al (2012) Choroidal thickness in patients with diabetic retinopathy analyzed by spectral-domain optical coherence tomography. Retina 32:563–568CrossRefPubMedPubMedCentral Regatieri CV, Branchini L, Carmody J et al (2012) Choroidal thickness in patients with diabetic retinopathy analyzed by spectral-domain optical coherence tomography. Retina 32:563–568CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Vujosevic S, Martini F, Cavarzeran F, Pilotto E, Midena E (2012) Macular and peripapillary choroidal thickness in diabetic patients. Retina 32(9):1781–1790CrossRefPubMed Vujosevic S, Martini F, Cavarzeran F, Pilotto E, Midena E (2012) Macular and peripapillary choroidal thickness in diabetic patients. Retina 32(9):1781–1790CrossRefPubMed
10.
Zurück zum Zitat Manjunath V, Goren J, Fujimoto JG, Duker JS (2011) Analysis of choroidal thickness in age-related macular degeneration using spectral-domain optical coherence tomography. Am J Ophthalmol 152:663–668CrossRefPubMedPubMedCentral Manjunath V, Goren J, Fujimoto JG, Duker JS (2011) Analysis of choroidal thickness in age-related macular degeneration using spectral-domain optical coherence tomography. Am J Ophthalmol 152:663–668CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Jonas JB, Forster TM, Steinmetz P et al (2014) Choroidal thickness in age-related macular degeneration. Retina 34:1149–1155CrossRefPubMed Jonas JB, Forster TM, Steinmetz P et al (2014) Choroidal thickness in age-related macular degeneration. Retina 34:1149–1155CrossRefPubMed
12.
Zurück zum Zitat Linsenmeier RA, Padnick-Silver L (2000) Metabolic dependence of photoreceptors on the choroid in the normal and detached retina. Invest Ophthalmol Vis Sci 41:3117–3123PubMed Linsenmeier RA, Padnick-Silver L (2000) Metabolic dependence of photoreceptors on the choroid in the normal and detached retina. Invest Ophthalmol Vis Sci 41:3117–3123PubMed
13.
Zurück zum Zitat Mrejen S, Spaide RF (2013) Optical coherence tomography: imaging the choroid and beyond. Surv Ophthalmol 58:387–429CrossRefPubMed Mrejen S, Spaide RF (2013) Optical coherence tomography: imaging the choroid and beyond. Surv Ophthalmol 58:387–429CrossRefPubMed
14.
Zurück zum Zitat Nicholson B, Noble J, Forooghian F, Meyerle C (2013) Central serous chorioretinopathy: update on pathophysiology and treatment. Surv Ophthalmol 58:103–126CrossRefPubMedPubMedCentral Nicholson B, Noble J, Forooghian F, Meyerle C (2013) Central serous chorioretinopathy: update on pathophysiology and treatment. Surv Ophthalmol 58:103–126CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Solomon SD, Lindsley K, Vedula SS et al (2014) Anti-vascular endothelial growth factor for neovascular age-related macular degeneration. Cochrane Database Syst Rev 8:CD005139 Solomon SD, Lindsley K, Vedula SS et al (2014) Anti-vascular endothelial growth factor for neovascular age-related macular degeneration. Cochrane Database Syst Rev 8:CD005139
16.
Zurück zum Zitat El-Mollayess GM, Noureddine BN, Bashshur ZF (2011) Bevacizumab and neovascular age related macular degeneration: pathogenesis and treatment. Semin Ophthalmol 26:69–76CrossRefPubMed El-Mollayess GM, Noureddine BN, Bashshur ZF (2011) Bevacizumab and neovascular age related macular degeneration: pathogenesis and treatment. Semin Ophthalmol 26:69–76CrossRefPubMed
17.
Zurück zum Zitat Abouammoh M, Sharma S (2011) Ranibizumab versus bevacizumab for the treatment of neovascular age-related macular degeneration. Curr Opin Ophthalmol 22:152–158CrossRefPubMed Abouammoh M, Sharma S (2011) Ranibizumab versus bevacizumab for the treatment of neovascular age-related macular degeneration. Curr Opin Ophthalmol 22:152–158CrossRefPubMed
18.
Zurück zum Zitat Sivaprasad S, Crosby-Nwaobi R, Heng LZ et al (2013) Injection frequency and response to bevacizumab monotherapy for diabetic macular oedema (BOLT Report 5). Br J Ophthalmol 97:1177–1180CrossRefPubMed Sivaprasad S, Crosby-Nwaobi R, Heng LZ et al (2013) Injection frequency and response to bevacizumab monotherapy for diabetic macular oedema (BOLT Report 5). Br J Ophthalmol 97:1177–1180CrossRefPubMed
19.
Zurück zum Zitat Rajendram R, Fraser-Bell S, Kaines A et al (2012) A 2-year prospective randomized controlled trial of intravitreal bevacizumab or laser therapy (BOLT) in the management of diabetic macular edema: 24-month data: report 3. Arch Ophthalmol 130:972–979CrossRefPubMed Rajendram R, Fraser-Bell S, Kaines A et al (2012) A 2-year prospective randomized controlled trial of intravitreal bevacizumab or laser therapy (BOLT) in the management of diabetic macular edema: 24-month data: report 3. Arch Ophthalmol 130:972–979CrossRefPubMed
20.
Zurück zum Zitat Thomas BJ, Shienbaum G, Boyer DS, Flynn HW Jr (2013) Evolving strategies in the management of diabetic macular edema: clinical trials and current management. Can J Ophthalmol 48:22–30CrossRefPubMed Thomas BJ, Shienbaum G, Boyer DS, Flynn HW Jr (2013) Evolving strategies in the management of diabetic macular edema: clinical trials and current management. Can J Ophthalmol 48:22–30CrossRefPubMed
21.
22.
Zurück zum Zitat Nishijima K, Ng YS, Zhong L et al (2007) Vascular endothelial growth factor-A is a survival factor for retinal neurons and a critical neuroprotectant during the adaptive response to ischemic injury. Am J Pathol 171:53–67CrossRefPubMedPubMedCentral Nishijima K, Ng YS, Zhong L et al (2007) Vascular endothelial growth factor-A is a survival factor for retinal neurons and a critical neuroprotectant during the adaptive response to ischemic injury. Am J Pathol 171:53–67CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Blaauwgeers HG, Holtkamp GM, Rutten H et al (1999) Polarized vascular endothelial growth factor secretion by human retinal pigment epithelium and localization of vascular endothelial growth factor receptors on the inner choriocapillaris. Evidence for a trophic paracrine relation. Am J Pathol 155:421–428CrossRefPubMedPubMedCentral Blaauwgeers HG, Holtkamp GM, Rutten H et al (1999) Polarized vascular endothelial growth factor secretion by human retinal pigment epithelium and localization of vascular endothelial growth factor receptors on the inner choriocapillaris. Evidence for a trophic paracrine relation. Am J Pathol 155:421–428CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Pournaras CJ, Rungger-Brändle E, Riva CE et al (2008) Regulation of retinal blood flow in health and disease. Prog Retin Eye Res 27:284–330CrossRefPubMed Pournaras CJ, Rungger-Brändle E, Riva CE et al (2008) Regulation of retinal blood flow in health and disease. Prog Retin Eye Res 27:284–330CrossRefPubMed
25.
Zurück zum Zitat Ferrara N (2000) Vascular endothelial growth factor and the regulation of angiogenesis. Recent Prog Horm Res 55:15–35PubMed Ferrara N (2000) Vascular endothelial growth factor and the regulation of angiogenesis. Recent Prog Horm Res 55:15–35PubMed
26.
Zurück zum Zitat Laíns I, Figueira J, Santos AR et al (2014) Choroidal thickness in diabetic retinopathy: the influence of antiangiogenic therapy. Retina 34:1199–1207CrossRefPubMed Laíns I, Figueira J, Santos AR et al (2014) Choroidal thickness in diabetic retinopathy: the influence of antiangiogenic therapy. Retina 34:1199–1207CrossRefPubMed
27.
Zurück zum Zitat Yiu G, Manjunath V, Chiu SJ et al (2014) Effect of anti-vascular endothelial growth factor therapy on choroidal thickness in diabetic macular edema. Am J Ophthalmol 158:745–751CrossRefPubMedPubMedCentral Yiu G, Manjunath V, Chiu SJ et al (2014) Effect of anti-vascular endothelial growth factor therapy on choroidal thickness in diabetic macular edema. Am J Ophthalmol 158:745–751CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Yamazaki T, Koizumi H, Yamagishi T, Kinoshita S (2012) Subfoveal choroidal thickness after ranibizumab therapy for neovascular age-related macular degeneration: 12-month results. Ophthalmology 119:1621–1627CrossRefPubMed Yamazaki T, Koizumi H, Yamagishi T, Kinoshita S (2012) Subfoveal choroidal thickness after ranibizumab therapy for neovascular age-related macular degeneration: 12-month results. Ophthalmology 119:1621–1627CrossRefPubMed
29.
Zurück zum Zitat Ellabban AA, Tsujikawa A, Ogino K et al (2012) Choroidal thickness after intravitreal ranibizumab injections for choroidal neovascularization. Clin Ophthalmol 6:837–844PubMedPubMedCentral Ellabban AA, Tsujikawa A, Ogino K et al (2012) Choroidal thickness after intravitreal ranibizumab injections for choroidal neovascularization. Clin Ophthalmol 6:837–844PubMedPubMedCentral
30.
Zurück zum Zitat Branchini L, Regatieri C, Adhi M, Flores-Moreno I, Manjunath V, Fujimoto JG, Duker JS (2013) Effect of intravitreous anti-vascular endothelial growth factor therapy on choroidal thickness in neovascular age-related macular degeneration using spectral-domain optical coherence tomography. JAMA Ophthalmol 131:693–694CrossRefPubMedPubMedCentral Branchini L, Regatieri C, Adhi M, Flores-Moreno I, Manjunath V, Fujimoto JG, Duker JS (2013) Effect of intravitreous anti-vascular endothelial growth factor therapy on choroidal thickness in neovascular age-related macular degeneration using spectral-domain optical coherence tomography. JAMA Ophthalmol 131:693–694CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Early Treatment Diabetic Retinopathy Study research group (1985) Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol 103:1796–1806CrossRef Early Treatment Diabetic Retinopathy Study research group (1985) Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol 103:1796–1806CrossRef
32.
Zurück zum Zitat Koizumi H, Kano M, Yamamoto A et al (2015) Short-term changes in choroidal thickness after aflibercept therapy for neovascular age-related macular degeneration. Am J Ophthalmol 159(4):627–633CrossRefPubMed Koizumi H, Kano M, Yamamoto A et al (2015) Short-term changes in choroidal thickness after aflibercept therapy for neovascular age-related macular degeneration. Am J Ophthalmol 159(4):627–633CrossRefPubMed
33.
Zurück zum Zitat Maruko I, Iida T, Oyamada H et al (2013) Choroidal thickness changes after intravitreal ranibizumab and photodynamic therapy in recurrent polypoidal choroidal vasculopathy. Am J Ophthalmol 156:548–556CrossRefPubMed Maruko I, Iida T, Oyamada H et al (2013) Choroidal thickness changes after intravitreal ranibizumab and photodynamic therapy in recurrent polypoidal choroidal vasculopathy. Am J Ophthalmol 156:548–556CrossRefPubMed
34.
Zurück zum Zitat Cao XS, Peng XY, You QS et al (2014) Subfoveal choroidal thickness change after intravitreal ranibizumab for idiopathic choroidal neovascularization. Retina 34:1554–1559CrossRefPubMed Cao XS, Peng XY, You QS et al (2014) Subfoveal choroidal thickness change after intravitreal ranibizumab for idiopathic choroidal neovascularization. Retina 34:1554–1559CrossRefPubMed
35.
Zurück zum Zitat Nishide T, Hayakawa N, Nakanishi M et al (2013) Reduction in choroidal thickness of macular area in polypoidal choroidal vasculopathy patients after intravitreal ranibizumab therapy. Graefes Arch Clin Exp Ophthalmol 251:2415–2420CrossRefPubMedPubMedCentral Nishide T, Hayakawa N, Nakanishi M et al (2013) Reduction in choroidal thickness of macular area in polypoidal choroidal vasculopathy patients after intravitreal ranibizumab therapy. Graefes Arch Clin Exp Ophthalmol 251:2415–2420CrossRefPubMedPubMedCentral
36.
Zurück zum Zitat Sizmaz S, Kucukerdonmez C, Kal A et al (2014) Retinal and choroidal thickness changes after single anti-VEGF injection in neovascular age-related macular degeneration: ranibizumab vs bevacizumab. Eur J Ophthalmol 24:904–910CrossRefPubMed Sizmaz S, Kucukerdonmez C, Kal A et al (2014) Retinal and choroidal thickness changes after single anti-VEGF injection in neovascular age-related macular degeneration: ranibizumab vs bevacizumab. Eur J Ophthalmol 24:904–910CrossRefPubMed
38.
Zurück zum Zitat Saint-Geniez M, Maldonado AE, D’Amore PA (2006) VEGF expression and receptor activation in the choroid during development and in the adult. Invest Ophthalmol Vis Sci 47:3135–3142CrossRefPubMed Saint-Geniez M, Maldonado AE, D’Amore PA (2006) VEGF expression and receptor activation in the choroid during development and in the adult. Invest Ophthalmol Vis Sci 47:3135–3142CrossRefPubMed
39.
Zurück zum Zitat Marneros AG, Fan J, Yokoyama Y et al (2005) Vascular endothelial growth factor expression in the retinal pigment epithelium is essential for choriocapillaris development and visual function. Am J Pathol 167:1451–1459CrossRefPubMedPubMedCentral Marneros AG, Fan J, Yokoyama Y et al (2005) Vascular endothelial growth factor expression in the retinal pigment epithelium is essential for choriocapillaris development and visual function. Am J Pathol 167:1451–1459CrossRefPubMedPubMedCentral
41.
Zurück zum Zitat Funk M, Karl D, Georgopoulos M et al (2013) Neovascular age-related macular degeneration: intraocular cytokines and growth factors and the influence of therapy with ranibizumab. Ophthalmology 116:2393–2399CrossRef Funk M, Karl D, Georgopoulos M et al (2013) Neovascular age-related macular degeneration: intraocular cytokines and growth factors and the influence of therapy with ranibizumab. Ophthalmology 116:2393–2399CrossRef
42.
Zurück zum Zitat Hurwitz H, Fehrenbacher L, Novotny W et al (2004) Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 350:2335–2342CrossRefPubMed Hurwitz H, Fehrenbacher L, Novotny W et al (2004) Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 350:2335–2342CrossRefPubMed
43.
Zurück zum Zitat Avery RL, Castellarin AA, Steinle NC et al (2014) Systemic pharmacokinetics following intravitreal injections of ranibizumab, bevacizumab or aflibercept in patients with neovascular AMD. Br J Ophthalmol 98:1636–1641CrossRefPubMedPubMedCentral Avery RL, Castellarin AA, Steinle NC et al (2014) Systemic pharmacokinetics following intravitreal injections of ranibizumab, bevacizumab or aflibercept in patients with neovascular AMD. Br J Ophthalmol 98:1636–1641CrossRefPubMedPubMedCentral
44.
Zurück zum Zitat Zhu Q, Ziemssen F, Henke-Fahle S et al (2008) Tübingen Bevacizumab Study Group, Grisanti S. Vitreous levels of bevacizumab and vascular endothelial growth factor-A in patients with choroidal neovascularization. Ophthalmology 115:1750–1755CrossRefPubMed Zhu Q, Ziemssen F, Henke-Fahle S et al (2008) Tübingen Bevacizumab Study Group, Grisanti S. Vitreous levels of bevacizumab and vascular endothelial growth factor-A in patients with choroidal neovascularization. Ophthalmology 115:1750–1755CrossRefPubMed
45.
Zurück zum Zitat Heiduschka P, Fietz H, Hofmeister S et al (2007) Tübingen Bevacizumab Study Group. Penetration of bevacizumab through the retina after intravitreal injection in the monkey. Invest Ophthalmol Vis Sci 48:2814–2823CrossRefPubMed Heiduschka P, Fietz H, Hofmeister S et al (2007) Tübingen Bevacizumab Study Group. Penetration of bevacizumab through the retina after intravitreal injection in the monkey. Invest Ophthalmol Vis Sci 48:2814–2823CrossRefPubMed
46.
Zurück zum Zitat Gaudreault J, Fei D, Beyer JC et al (2007) Pharmacokinetics and retinal distribution of ranibizumab, a humanized antibody fragment directed against VEGF-A, following intravitreal administration in rabbits. Retina 27:1260–1266CrossRefPubMed Gaudreault J, Fei D, Beyer JC et al (2007) Pharmacokinetics and retinal distribution of ranibizumab, a humanized antibody fragment directed against VEGF-A, following intravitreal administration in rabbits. Retina 27:1260–1266CrossRefPubMed
47.
Zurück zum Zitat Avery RL, Pearlman J, Pieramici DJ, et al (2006) Intravitreal bevacizumab (Avastin) in the treatment of proliferative diabetic retinopathy. Ophthalmology 113:1695.e1-15 Avery RL, Pearlman J, Pieramici DJ, et al (2006) Intravitreal bevacizumab (Avastin) in the treatment of proliferative diabetic retinopathy. Ophthalmology 113:1695.e1-15
48.
Zurück zum Zitat Bakri SJ, Snyder MR, Reid JM et al (2007) Pharmacokinetics of intravitreal bevacizumab (Avastin). Ophthalmology 114:855–859CrossRefPubMed Bakri SJ, Snyder MR, Reid JM et al (2007) Pharmacokinetics of intravitreal bevacizumab (Avastin). Ophthalmology 114:855–859CrossRefPubMed
49.
Zurück zum Zitat Ternant D, Paintaud G (2005) Pharmacokinetics and concentration-effect relationships of therapeutic monoclonal antibodies and fusion proteins. Expert Opin Biol Ther 5(Suppl 1):S37–S47CrossRefPubMed Ternant D, Paintaud G (2005) Pharmacokinetics and concentration-effect relationships of therapeutic monoclonal antibodies and fusion proteins. Expert Opin Biol Ther 5(Suppl 1):S37–S47CrossRefPubMed
50.
Zurück zum Zitat Xu L, Lu T, Tuomi L et al (2013) Pharmacokinetics of ranibizumab in patients with neovascular age-related macular degeneration: a population approach. Invest Ophthalmol Vis Sci 54:1616–1624CrossRefPubMed Xu L, Lu T, Tuomi L et al (2013) Pharmacokinetics of ranibizumab in patients with neovascular age-related macular degeneration: a population approach. Invest Ophthalmol Vis Sci 54:1616–1624CrossRefPubMed
51.
Zurück zum Zitat CATT Research Group, Martin DF, Maguire MG, Ying GS et al (2011) Ranibizumab and bevacizumab for neovascular age-related macular degeneration. N Engl J Med 364:1897–1908CrossRef CATT Research Group, Martin DF, Maguire MG, Ying GS et al (2011) Ranibizumab and bevacizumab for neovascular age-related macular degeneration. N Engl J Med 364:1897–1908CrossRef
52.
Zurück zum Zitat IVAN Study Investigators, Chakravarthy U, Harding SP, Rogers CA et al (2012) Ranibizumab versus bevacizumab to treat neovascular age-related macular degeneration: one-year findings from the IVAN randomized trial. Ophthalmology 119:1399–1411CrossRef IVAN Study Investigators, Chakravarthy U, Harding SP, Rogers CA et al (2012) Ranibizumab versus bevacizumab to treat neovascular age-related macular degeneration: one-year findings from the IVAN randomized trial. Ophthalmology 119:1399–1411CrossRef
Metadaten
Titel
Subfoveal choroidal thickness changes after intravitreal bevacizumab injection for neovascular age-related macular degeneration and diabetic macular edema
verfasst von
Cihan Ünlü
Gurkan Erdogan
Betul Onal Gunay
Esra Kardes
Betul Ilkay Sezgin Akcay
Ahmet Ergin
Publikationsdatum
06.05.2016
Verlag
Springer Netherlands
Erschienen in
International Ophthalmology / Ausgabe 1/2017
Print ISSN: 0165-5701
Elektronische ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-016-0242-3

Weitere Artikel der Ausgabe 1/2017

International Ophthalmology 1/2017 Zur Ausgabe

Neu im Fachgebiet Augenheilkunde

Update Augenheilkunde

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.