Diabetic Retinopathy Current Pharmacologic Treatment and Emerging Strategies 1st edition by Michael Stewart 9789811035098 9811035091

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• ISBN 10:9811035091 

• ISBN 13:9789811035098

• Author:Michael Stewart 

Diabetic Retinopathy
Current Pharmacologic Treatment and Emerging Strategies
A well-illustrated and comprehensive analysis of the treatment of diabetic retinopathy, this book covers current treatment options and guidelines, whilst also providing a detailed discussion of emerging therapeutic targets.  Existing therapeutic options are covered in depth, with a major focus on anti-vascular endothelial growth factor drugs and sustained release corticosteroids, including a review of trial results supporting current treatment guidelines. The use of agents off-label is also discussed. Controversial topics are discussed in detail with an emphasis on helping the reader make informed decisions, particularly when treating patients for which several treatment approaches may be appropriate because trial data does not clearly define the best option. Emerging therapeutic areas are evaluated, as work continues to identify agents that produce superior morphologic responses and visual acuity gains by targeting other molecules that contribute to diabetic retinopathy. Promising new drugs, targets and delivery systems are identified, and their development analysed 

Diabetic Retinopathy Current Pharmacologic Treatment and Emerging Strategies 1st Table of contents:

Chapter 1: Diabetes and Diabetic Retinopathy: Overview of a Worldwide Epidemic
1.1 Introduction
1.2 Incidence of Diabetes
1.3 Incidence of Diabetic Retinopathy
1.4 Comorbidities for Diabetes and Diabetic Retinopathy
1.5 Conclusions
References
Chapter 2: The Diabetic Retina: Anatomy and Pathophysiology
2.1 Introduction
2.2 The Retina
2.2.1 History
2.2.2 Anatomy
2.2.3 Microanatomy of the Retina Neurons
2.2.4 Intercellular Spaces
2.2.5 Internal Limiting Membrane
2.2.6 Circulation
2.2.7 Arteries
2.2.8 Veins
2.2.9 Capillaries
2.3 Hemodynamics, Macular Edema, and Starling’s Law
2.4 Biochemical Basis for Diabetic Retinopathy
2.4.1 Increased Polyol Pathway Flux
2.4.2 Advanced Glycation End Products (AGEs)
2.4.3 Activation of Protein Kinase C (PKC)
2.4.4 Increased Hexosamine Pathway Flux
2.5 Early Pathophysiology of Diabetic Retinopathy
2.6 Macular Edema
2.6.1 Blood-Retinal Barrier
2.6.2 Biochemical Abnormalities Responsible for Diabetic Retinopathy
2.6.3 Mechanism of Blood-Retinal Barrier Breakdown
2.6.4 Renin/Angiotensin System
2.7 Development of Proliferative Diabetic Retinopathy
2.8 Clinical Findings of Diabetic Retinopathy
2.9 Conclusions
References
Chapter 3: Treatment of Diabetic Retinopathy: A Historical Perspective
3.1 Introduction
3.2 Pituitary Ablation
3.3 Interferon
3.4 Laser Photocoagulation
3.4.1 Techniques for Performing Laser Photocoagulation
3.5 Treatment of Background Diabetic Retinopathy
3.6 Treatment of Proliferative Diabetic Retinopathy (PDR)
3.7 New Laser Technologies
3.7.1 Micropulse Laser
3.7.2 Navigated Laser
3.8 Pars Plana Vitrectomy
3.9 Conclusion
References
Chapter 4: Targeting Vascular Endothelial Growth Factor
4.1 Introduction
4.2 Vascular Endothelial Growth Factor
4.3 Anti-VEGF Drugs
4.3.1 Pegaptanib
4.3.2 Bevacizumab
4.3.3 Ranibizumab
4.3.3.1 Ranibizumab Clinical Trials
4.3.3.2 READ-2 and READ-3 Trials
4.3.3.3 RISE and RIDE
4.3.3.4 Resolve
4.3.3.5 Restore
4.3.3.6 DRCR.net Protocol I
4.3.3.7 Retain
4.3.3.8 Ranibizumab for PDR
4.3.4 Aflibercept
4.3.4.1 Pilot Study
4.3.4.2 DA VINCI
4.3.4.3 VIVID and VISTA
4.4 Other Studies
4.5 Comparison Trials
4.6 Conclusions and Outstanding Questions
References
Chapter 5: Corticosteroids: Targeting Multiple Cytokines and Chemokines
5.1 Introduction
5.2 Characteristics of Corticosteroids
5.3 Corticosteroid Delivery to the Eye
5.4 Triamcinolone
5.5 Dexamethasone
5.6 Fluocinolone
5.7 Conclusions
References
Chapter 6: Current Treatment Recommendations
6.1 Introduction
6.2 General Medical Care
6.2.1 Diabetes Mellitus
6.2.2 Systemic Arterial Hypertension
6.2.3 Hyperlipidemia
6.2.4 Sleep Apnea
6.3 Screening Guidelines
6.3.1 Screening Methods
6.4 Imaging
6.5 Treatment of Diabetic Macular Edema
6.5.1 Non-Center-Involving Diabetic Macular Edema
6.5.2 Center-Involving Diabetic Macular Edema
6.6 Treatment Failures
6.7 Cataract Surgery and DME
6.8 Proliferative Diabetic Retinopathy
6.9 Pregnancy
6.10 Conclusions
References
Chapter 7: Vitreolysis: Targeting the Vitreoretinal Interface
7.1 Introduction
7.2 Vitreous Anatomy
7.3 Posterior Vitreous Detachment
7.4 Anomalous Posterior Vitreous Detachment
7.5 Association Between Posterior Hyaloid and Diabetic Retinopathy
7.6 Treatment of Vitreomacular Traction
7.6.1 Streptokinase
7.6.2 Hyaluronidase
7.6.3 Nattokinase
7.6.4 Chondroitinase
7.6.5 Plasmin
7.6.6 Tissue Plasminogen Activator (tPA)
7.6.7 Autologous Plasmin Enzyme (APE)
7.6.8 Vitreosolve
7.6.9 Ocriplasmin
7.7 Conclusions
References
Chapter 8: Investigational Medications
8.1 Corticosteroid-Related Molecules
8.1.1 Danazol
8.1.2 Dexamethasone-Cyclodextrin Microparticle Drops
8.1.3 Difluprednate Ophthalmic Emulsion
8.1.4 EGP-437
8.1.5 Loteprednol Etabonate
8.2 Vascular Endothelial Growth Factor Inhibitors
8.2.1 Abicipar Pegol
8.2.2 Conbercept
8.2.3 Encapsulated Cell Technology
8.2.4 Gene Therapy
8.2.5 Implantable Drug Delivery Pump (PMP)
8.2.6 PAN-90806
8.2.7 Ranibizumab Sustained Release Reservoir
8.2.8 RTH258
8.2.9 Ziv-Aflibercept
8.3 Tumor Necrosis Factor-α Inhibitors
8.3.1 Adalimumab
8.3.2 Etanercept
8.3.3 Infliximab
8.3.4 Pegsunercept
8.4 Nonsteroidal Anti-inflammatories
8.4.1 Aspirin
8.4.2 Diclofenac
8.5 Other
8.5.1 Adenosine Kinase Inhibitor
8.5.2 Ang2 Inhibition
8.5.3 Antioxidants
8.5.4 ASP8232
8.5.5 Darapladib
8.5.6 Epalrestat
8.5.7 Fasudil
8.5.8 iCo-007
8.5.9 Luminate (ALG-1001)
8.5.10 Mecamylamine
8.5.11 Microspheres
8.5.12 Minocycline
8.5.13 PF-04523655
8.5.14 Plasma Kallikrein Inhibitor
8.5.15 Ruboxistaurin
8.5.16 Sirolimus
8.5.17 Squalamine
8.5.18 Tie2 Agonist (AKB-9778)
8.5.19 Tocilizumab
8.5.20 Teprotumumab
8.6 Future Therapies
References
Chapter 9: Safety Considerations of Pharmacotherapy
9.1 Introduction
9.1.1 Intravitreal Injections
9.2 Ocular Complications
9.3 Elevated Intraocular Pressure (IOP) and Glaucoma
9.4 Cataracts
9.5 Endophthalmitis
9.6 Counterfeit Drugs
9.7 Other Complications
9.8 Systemic Complications
9.9 Conclusion
References
Chapter 10: Socioeconomic Cost of Diabetic Retinopathy and Therapy
10.1 Introduction
10.2 National Costs
10.3 Cost-Effectiveness of Treating Diabetic Macular Edema
10.4 Comparative Cost-Effectiveness Models
10.5 Future Considerations
References
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