Month: September 2013

‘Observe and plan’ treatment regimen allows customized management of AMD

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HAMBURG — A new “observe and plan” treatment regimen may allow for the creation of effective, customized follow-up and retreatment schedules, reducing the burden of age-related macular degeneration care, according to a speaker at the Euretina meeting.  Several studies and a long experience with intravitreal anti-VEGF have shown the need for AMD retreatment is highly variable among patients,  but relatively stable among individuals, Irmela Mantel, MD, said at Euretina.

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Radiotherapy reduces anti-VEGF injections for neovascular AMD, study confirms

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HAMBURG — Two-year results of the INTREPID study evaluating IRay Stereotatic Radiotherapy for neovascular age-related macular degeneration confirmed significant overall reduction in anti-VEGF injections and helped define best responders.  In the study, 230 patients were randomized to receive radiation in two different doses (16 Gy and 24 Gy) or sham. All groups received an injection of ranibizumb at baseline followed by monthly review for retreatment as needed.   

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BLOG: Outsider’s view of the FDA approval process

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Last week I had the unique opportunity to present before the FDA Ophthalmic Devices Panel the clinical results and experience with the ReSure ocular sealant proposed for approval for sealing leaking cataract wounds.  Some background:  When a company’s first-in-class drug or device seeks approval from the U.S. Food and Drug Administration, the FDA works with the company, called the “sponsor,” to design a trial to determine its safety and effectiveness. Before approval, a panel of experts, independent from the FDA, is convened in Washington to hear both the FDA’s interpretation of (Read more...)

Study suggests link between macular pigment optical density and glaucoma

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Macular pigment optical density was markedly lower in patients with glaucoma than in healthy controls, according to a study.The study included 40 patients with open-angle glaucoma and 54 healthy individuals without ocular disease. Mean age was 69 years in the glaucoma group and 66 years in the control group.Investigators examined biomicroscopy, fundoscopy, Goldmann tonometry and visual fields and collected data on age, gender, smoking history, presence of glare and years diagnosed with glaucoma. Heterochromatic flicker photometry was used to gauge macular pigment optical density at 0.5° of retinal eccentricity.

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BLOG: Want better vision after cataract surgery? Then flex that wrist, doctor

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Across the United States, about two-thirds of cataract surgeons perform refractive cataract surgery, offering astigmatism correction, toric implants or presbyopia-correcting IOLS.But many of us miss out on an opportunity to refine our patients’ astigmatic outcomes simply by moving our main cataract incision to approximate the steep axis of preoperative corneal astigmatism.Moving your main incision to the appropriate axis works whether you are using a femtosecond laser or traditional instruments to perform surgery. It takes us only slightly outside our comfort zone, and it can make a real difference to patients.

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Treatment of Persistent Corneal Epithelial Defect With Overnight Wear of a Prosthetic Device for the Ocular Surface – Corrected Proof

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Purpose: To report experience in the treatment of persistent corneal epithelial defect using overnight wear of a prosthetic device for the ocular surface.Design: Retrospective interventional case series.Methods: A clinical database of patients who underwent prosthetic replacement of the ocular surface ecosystem (PROSE) treatment from March 2003 to August 2008 was searched to identify patients treated for persistent corneal epithelial defect. In early 2003, overnight wear of a PROSE device and addition of commercially available, nonpreserved, topical ophthalmic moxifloxacin to the saline in the device reservoir became standard practice at this center when treating persistent corneal epithelial defect. Medical records were (Read more...)

Detection and Influencing Factors of Capsular Bag Distention Syndrome after Cataract Surgery Using the Pentacam Scheimpflug System – Corrected Proof

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Purpose: To investigate the prevalence and morphologic changes of capsular bag distention syndrome after cataract surgery using the Pentacam and to analyze its clinical characteristics and influencing factors.Design: Retrospective, cross-sectional study.Methods: Clinical records of 239 consecutive patients who underwent cataract surgery were reviewed. Demographic data, use of intraoperative ophthalmic viscosurgical devices, type of intraocular lens implanted, axial length, and white-to-white corneal diameter were recorded. One month after surgery, dilated Scheimpflug imaging was performed. Prevalence, morphologic changes, and characteristic clinical findings of this syndrome were evaluated.Results: Using Scheimpflug imaging, the prevalence of capsular bag distention syndrome was high at 26.8% (64/239), (Read more...)

Prognostic Factors of Eyes With Naïve Subfoveal Myopic Choroidal Neovascularization After Intravitreal Bevacizumab – Corrected Proof

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Purpose: To determine the efficacy of 1 intravitreal bevacizumab injection followed by pro re nata (1 + PRN) injection in cases of subfoveal myopic choroidal neovascularization (CNV) and to identify CNV-recurrence–related prognostic factors.Design: Retrospective observational case series.Methods: In total, 103 eyes of 89 consecutive naive patients who had subfoveal myopic CNV and had been followed-up for at least 2 years were included. Of those eyes, 24 had recurrences. The remaining eyes were stable after the initial treatment.Results: The average patient age was 51.1 ± 15.2 years. The average follow-up duration was 44.1 ± 12.7 months. At baseline and at the 1-year, 2-year, (Read more...)

Evaluating the Accuracy of the Visual Field Index for the Humphrey Visual Field Analyzer in Patients with Mild to Moderate Glaucoma – Corrected Proof

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Purpose: To evaluate the accuracy of the visual field index (VFI) for the Humphrey Visual Field Analyzer in a population of patients with mild to moderate glaucoma.Design: Retrospective cohort study.Methods: The study included 42 patients (61 eyes) with at least 11 years of follow-up, and annual automated visual fields (VFs). Patients with mean deviations ≤−20 dB were excluded. All unreliable fields were omitted (fixation losses ≥20%, false-positive ≥15%, false-negative ≥33%). The VFs were divided into two 5-year series and the data were analyzed by the new Humphrey Visual Field Analyzer software. Projected VFIs from the first 5 years were compared (Read more...)

The Effect of Enoxaparin-Containing Irrigation Fluid Used During Cataract Surgery on Postoperative Inflammation in Patients With Diabetes – Corrected Proof

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Purpose: To investigate effects of enoxaparin on postoperative inflammation in patients with moderate nonproliferative diabetic retinopathy (NPDR) and nuclear cataract.Design: Prospective masked controlled trial.Methods: setting: Institutional practice. study population: The study included 51 eyes of 51 diabetes mellitus (DM) patients with moderate NPDR and grade 2-3 nuclear cataracts. Group 1 included randomly selected patients who received enoxaparin in balanced salt solution (BSS) during cataract surgery, while standard BSS was used in Group 2. observation procedure: Patients were followed up 1 day, 1 week, and 1 and 2 months after the surgery. main outcome measures: Anterior chamber cell and flare.Results: Postoperatively, 20 patients from (Read more...)