Month: September 2013

Relationship between Systemic Cytokines and Complement Factor H Y402H Polymorphism in Patients With Dry Age-Related Macular Degeneration – Corrected Proof

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Purpose: To investigate the relationship between systemic cytokines, the complement factor H (CFH) Y402H polymorphism, drusen load, and subfoveal choroidal thickness in patients with dry age-related macular degeneration (AMD).Design: Cross-sectional study.Methods: Forty-four dry AMD patients under care of the Retina Service at the University of British Columbia were enrolled. Drusen load was measured with an automated software algorithm in spectral-domain optical coherence tomography; subfoveal choroidal thickness was measured manually using enhanced depth imaging. Bio-Plex suspension assays (Bio-Rad Laboratories) were used to analyze cytokines in plasma and CFH Y402H was genotyped. Statistical analyses included analysis of covariance and Pearson correlation, corrected (Read more...)

Evaluation of Telemedicine for Screening of Diabetic Retinopathy in the Veterans Health Administration – Corrected Proof

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Objective: To explore the cost-effectiveness of telemedicine for the screening of diabetic retinopathy (DR) and identify changes within the demographics of a patient population after telemedicine implementation.Design: A retrospective medical chart review (cohort study) was conducted.Participants: A total of 900 type 1 and type 2 diabetic patients enrolled in a medical system with a telemedicine screening program for DR.Methods: The cost-effectiveness of the DR telemedicine program was determined by using a finite-horizon, discrete time, discounted Markov decision process model populated by parameters and testing frequency obtained from patient records. The model estimated the progression of DR and determined average quality-adjusted (Read more...)

Risk of Geographic Atrophy in the Comparison of Age-related Macular Degeneration Treatments Trials – Corrected Proof

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Purpose: To describe risk factors for geographic atrophy (GA) in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT).Design: Cohort within a randomized clinical trial.Participants: We analyzed 1024 CATT patients with no GA visible on color fundus photographs (CFPs) and/or fluorescein angiograms (FAs) at enrollment.Methods: Eyes were assigned to ranibizumab (0.5 mg) or bevacizumab (1.25 mg) treatment and to a 2-year monthly or pro re nata (PRN) injection regimen, or monthly injections for 1 year and PRN for 1 year. Demographic, genetic, and baseline ocular characteristics and lesion features of CFP/FA and optical coherence tomography (OCT) were evaluated as risk (Read more...)

Intravitreal Aflibercept Injection for Macular Edema Resulting from Central Retinal Vein Occlusion: One-Year Results of the Phase 3 GALILEO Study – Corrected Proof

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Purpose: To evaluate the efficacy and safety of intravitreal aflibercept injections for treatment of macular edema secondary to central retinal vein occlusion (CRVO).Design: A randomized, multicenter, double-masked phase 3 study.Participants: A total of 177 treatment-naive patients with macular edema secondary to CRVO were randomized in a 3:2 ratio.Methods: Patients received either 2-mg intravitreal aflibercept or sham injections every 4 weeks for 20 weeks. From week 24 to 48, the aflibercept group received aflibercept as needed (pro re nata [PRN]), and the sham group continued receiving sham injections.Main Outcome Measures: The primary efficacy end point was the proportion of patients who (Read more...)

Intravitreal Aflibercept Injection for Neovascular Age-Related Macular Degeneration: Ninety-Six–Week Results of the VIEW Studies – Corrected Proof

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Purpose: To determine efficacy and safety of intravitreal aflibercept in patients with neovascular age-related macular degeneration (AMD) during a second year of variable dosing after a first-year fixed-dosing period.Design: Two randomized, double-masked, active-controlled, phase 3 trials.Participants: Two thousand four hundred fifty-seven patients with neovascular AMD.Methods: From baseline to week 52, patients received 0.5 mg intravitreal ranibizumab every 4 weeks (Rq4), 2 mg aflibercept every 4 weeks (2q4), 0.5 mg aflibercept every 4 weeks (0.5q4), or 2 mg aflibercept every 8 weeks (2q8) after 3 monthly injections. During weeks 52 through 96, patients received their original dosing assignment using an as-needed (Read more...)

Physicians prepare to answer patient questions about new insurance marketplaces

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Physicians may find themselves in the unfamiliar role of health insurance advisors when the new insurance marketplaces open Tuesday for business.The exchanges — key components of the — are Internet-based portals for patients to compare the costs and benefits of health coverage available in their state. But physicians, regardless of their own views on the contentious issues of health care reform, will likely be seen as trusted sources of guidance as so-called Obamacare unfolds.

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Parallel trials show aflibercept superior to laser in DME treatment

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HAMBURG — Results of two phase III multicentered  trials, first disclosed here at the Euretina meeting, showed superior efficacy of aflibercept compared to conventional  laser photocoagulation in the treatment of diabetic macular edema.    The two studies,  VISTA-DME and VIVID-DME, involved  54 centers in the United States and 73 centers in Europe, Japan and Australia and included 865 patients.

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Euretina Medal Lecturer lauds proton beam irradiation

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HAMBURG — Proton beam irradiation has been a major breakthrough in the treatment of uveal melanoma, overcoming several limitations of previous systems and providing  tumor control over 10 years in 98% of cases, a speaker said here.Leonidas Zografos, MD, this year’s Euretina Medal Lecturer, said that since the introduction of proton beam irradiation in the United States in 1975 and in Europe in 1984, about 25,000 to 30,000 uveal melanoma cases have been treated in more than 10 major units worldwide with this modality.

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Retrospective analysis gives insights on natural history of vitreomacular traction

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HAMBURG — Retrospective analysis of patient records carried out at the Department of Ophthalmology of Leuven, Belgium, provided  information on the natural  history of untreated vitreomacular traction with or without macular hole.“We looked back at our records between 2009 and 2012 when ocriplasmin was not yet available and ‘wait and see’ was the primary strategy.  We found 509 patients with vitreomacular interface diseases, including vitreomacular adhesion, VMT and macular hole with or without traction,” Peter Stalmans, MD, said at the Euretina meeting here.

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Specialist gives pearls on ocriplasmin use

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HAMBURG — Clinical trials on ocriplasmin, including subgroup analysis of best responders, have shown patient selection plays a crucial role in the success of the therapy and may account for discrepancies in response rate from site to site, according to a speaker here.“Ocriplasmin is not the same as other intravitreal injections we are currently utilizing in clinical practice. Who and how we inject may be important,” Baruch Kuppermann, MD, said at the Euretina meeting. 

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