
This article was reviewed by Alanna D. Nattis, DO, FAAO

An artificial tear based on nanodroplet technology may improve content lens comfort in patients.

nanodroplet technology-based tear (Systane Complete, Alcon) significantly improved contact lens comfort in patients with 

 signs and symptoms related to contact lens wear.


Making dry eye manageable for patients working from home


The rationale behind these drops is that the nanodroplet technology combines technology indicated for aqueous deficient 

and meibomian gland dysfunction and evaporative dry eye. 

The formulation contains polyquaternium-1 is a preservative that is considered less irritating than benzalkonium chloride, according to Alanna D. Nattis, DO, FAAO, a cornea, cataract and refractive surgeon, and director of Clinical Research at SightMD, Babylon, New York.


Nattis and colleagues undertook a study to test the effectiveness of this artificial tear for relieving lens discomfort in patients who wear daily disposable soft contact lenses.

The randomized investigator-masked clinical study ran for 2 weeks at 3 sites and included 46 symptomatic patients with

 who wore daily disposable contact lenses and had a best-corrected visual acuity (BCVA) of 20/30 or better. 

The inclusion criteria required the presence of substantial symptoms that were related to the contact lens wear.

Glaucoma 360: Drug delivery contact lens technology

All patients completed the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) to determine the degree of eye discomfort that was related to the contact lenses. The patients were randomly assigned to treatment with artificial tears (n = 22) or no treatment (n = 24). 

Patients in the active treatment group were instructed to instill 1 drop into the eye before wearing their contact lenses followed by 1 drop in each eye after removing the contact lenses. 

The untreated patients were instructed not to use artificial tears during the study, Nattis explained.

The baseline signs and symptoms were compared with those at the end of the 2-week period.

The investigators measured the BCVA, the tear breakup time (TBUT), and the extent of corneal staining and performed Schirmer testing and evaluated meibum quality and expression.

Myths and misconceptions about autologous serum for dry eye

The investigators also evaluated the patients based on the CLDEQ-8 questionnaire score, the standardized patient evaluation of eye dryness (SPEED) score, the contact lens log review completed daily by the treated patients, and the self-reporting by the treated patients regarding improvement.


Nattis reported that 95% of the patients were compliant in the treatment group.

“Compared with the controls, significant improvements were seen in the treatment group in the end-of-day comfort (

 = .045) at 2 weeks and comfortable contact lens wear time at 1 and 2 weeks (

Significant improvements also were seen in the questionnaire score (

 = .006) and in the self-perceived eye comfort (

The treated and untreated groups did not differ in the SPEED score, TBUT, corneal staining extent, or meibum expression.

Nattis pointed out that the results serve as an educational tool for patients in that the Systane Complete formulation may help increase contact lens tolerance and improve ocular health by potentially preventing contact lens–related complications and have implications for therapeutic contact lens wear.


Nattis is a consultant and researcher for Alcon and Glaukos.

Articles

Nanodrop technology improves lens comfort

Artificial tears offer a path to contact lens comfort

This article was reviewed by Scott E. LaBorwit, MD



Practitioners can decrease the treatment burden for patients through the use of available generic and low-cost intraoperative medications that negate the need for patients to purchase medications postoperatively, according to Scott E. LaBorwit, MD.

For example, practitioners can compound antibiotics and steroids and administer them perioperatively via a transzonular or a pars plana approach; however, 

surgeons might not be comfortable with such a procedure. 

Another costly option is steroids that can be deposited in the lacrimal system or under the iris.


Dropless, hands-free regimen key for patients


LaBorwit and Robert Stutman, OD, MBA, conducted a retrospective chart review to identify safe generic or low-cost medications for use at surgery to eliminate patient expenses after surgery.

The sample size was 5400 patients who underwent 

by 1 surgeon from July 2016 to January 2020. The study’s end point was the absence of the need for patient medication purchases after 

The study’s hypothesis was that use of perioperative antibiotic drops, povidone-iodine 5% during the surgical prep, anterior chamber generic moxifloxacin, and sub-Tenon triamcinolone will eliminate the need for preoperative or postoperative drops.

The investigators evaluated the safety outcomes, which included the incidence rates of infection, IOP elevations resulting from steroids, rebound iritis, and cystoid macular edema, LaBorwit recounted.

They used generic moxifloxacin 1 mg/mL from a commercially available bottle (cost, $47.50 per bottle) with 0.3 cc instilled into the anterior chamber; the moxifloxacin was diluted with balanced saline solution in a 1:4 ratio. The cost per patient of this approach was $1.06, LaBorwit noted. 

For the steroid component of the treatment, the investigators injected 0.3 cc of triamcinolone 7 mm posterior to the limbus into the superonasal sub-Tenon space; the dose was later decreased to 0.1 cc. The triamcinolone cost $43 per vial and $1.07 per patient.

Topical moxifloxacin: Best choice before cataract surgery?


No intraocular complications occurred as a result of the medication placement. Endophthalmitis did not develop in any cases. Three corneal ulcers developed that resolved with topical and anterior chamber treatment, LaBorwit explained.

The study results showed steroid-induced elevations in the IOP in 102 patients (1.9%), and these were treated with topical antiglaucoma medications. 

With reduction of the dose from 0.3 to 0.1 cc, the incidence rate of elevated IOP decreased to 0.67%. Nine (0.17%) patients had persistently elevated IOPs that exceeded 30 days postoperatively.

Predictable, branded steroids offer control over surgery

Cystoid macular edema developed in 1.5% of patients for an average of 35 days. All resolved with drops over time. 

Rebound iritis occurred in about 5% of patients, which increased to 6.67% when the steroid volume was decreased, LaBorwit noted.

“The results indicated that generic and low-cost intraoperative medications use is safe and effective and eliminates the need for patients to buy drops postoperatively. The total cost to the surgical center was less than $3 per patient,” LaBorwit concluded.

LaBorwit has no financial interest in this subject matter. Dr LaBorwit is an assistant professor at Wilmer Eye Institute, The Johns Hopkins Hospital, Baltimore, Maryland. Robert Stutman, OD, MBA, is an optometrist in Towson, Maryland.

Options can reduce the treatment burden for patients, leading to improved outcomes


Perioperative medications can eliminate postoperative drops after cataract surgery



This article was reviewed by Caroline R. Baumal, MD, and David Eichenbaum, MD, FAAO

The introduction of anti-VEGF therapy in the early 2000s revolutionized modern retina practice, forever altering the treatment paradigm and improving the prognosis of common blinding conditions such as 

wet age-related macular degeneration (AMD)

, the leading cause of visual impairment in Americans over age 60.

“It is remarkable how medical retina went from being a field that was mostly sad and with poor prognoses to a field where we have relative happiness, success, and safety, albeit with some significant burdens and inconveniences related to treatment,” said David Eichenbaum, MD, FAAO, a partner with Retina Vitreous Associates of Florida in Tampa.

ASRS 2020: Trial shows faricimab blocks Ang-2 and VEGF-A

Substantial sight-saving strides have been made in the past 15 years, but the retina field has not fully evolved. 

Anti-VEGF therapy may be effective — 95% of patients with neovascular 

 are able to stay within 3 lines of their baseline vision 2 years after beginning treatment

— but its treatment burden is significant, requiring an often older patient population with comorbidities to travel to the clinic for frequent injections for the remainder of their lives.

The next step in the retina revolution involves easing that burden through new agents with greater durability. In 2020, against the backdrop of a pandemic, this goal holds more weight than ever. 

Retinal specialists face uncharted waters and impossible questions: How do you continue to save the sight of

patients with in-office injections while limiting their exposure to 

Caroline R. Baumal, MD, professor of ophthalmology at Tufts University School of Medicine in Boston, Massachusetts, and Eichenbaum recently discussed these issues and more.


Characterizing localized retinal layer changes in AMD

 increases with each decade of age, and patients with underlying health conditions such as obesity, heart conditions, chronic kidney disease, and chronic obstructive pulmonary disease are considered at high risk of 

 

Because of concerns about exposure, retinal specialists must be prepared for patients’ reluctance to come in for in-office treatments.

“This pandemic has led to a setback in treatment for some patients,” Baumal said.

She recommends tailoring treatments even more than usual to determine if injections could be delayed.

Baumal described her work at the height of the pandemic stay-at-home orders: 

“There was a lot of chart reviewing, evaluating the patients’ prior images, and calling patients on the phone to ask if there were changes in visual acuity or on the Amsler grid to determine if treatment could be delayed a few weeks,” she said. “There are some patients I need to inject every 4 to 6 weeks or they will recur. I talked with those patients directly, asked if they felt safe to come in, and expedited the injection procedure. We extended any patient we could, for their comfort.”

Intravitreal gene therapy holds promise for novel wet AMD treatment

If treatment cannot be delayed, Baumal and Eichenbaum recommend maximizing the efficiency of office visits through undilated and/or bilateral injections so nervous patients are not lingering.

“I would see the patient in one room, do their examination and treatment, and make the appointment for follow-up at the same time in the examination room, so they were able to leave directly without stopping at a checkout desk,” Baumal said. “I think that this level of efficiency made my patients feel much more comfortable to come in during the pandemic.”

Telemedicine has replaced in-office visits for many specialties during the pandemic, but Baumal and Eichenbaum said they do not see retinal specialists employing telehealth yet for 

“Almost all my medical retina decisions have an imaging component,” Eichenbaum said. “I do not think retina is ready for telemedicine in prime time.”

Although telemedicine in the traditional sense may not be realistic for this patient population, Baumal and Eichenbaum do see a place for home-based 

, in which patients use a simple digital diagnostic to send imaging to their physician between office visits. The daily scan takes about 6 minutes.

Impact of baseline OCT on response to risuteganib for treatment of intermediate AMD (ASRS 2020)

“I love the idea of home-based monitoring,” Baumal said. “I think it will help us treat our patients better with a more effective treat-and-extend protocol. Patients will need an examination of the entire retina at certain intervals so we don’t miss peripheral pathology, uveitis, or glaucoma. But we can use this type of device to help us better direct our patients.”

Trials investigating the utility of home-based 

 system (Notal Vision; Manassas, VA) was granted breakthrough status by the US Food and Drug Administration (FDA) in 2018.


Determining how to increase the durabili

 treatments and thereby reduce the treatment burden is “the billion-dollar question” in retina today, Eichenbaum said. The average patient receives about 8 injections in the first year of treatment.

“I typically start off treating patients every 4 weeks until the lesion is dry,” Baumal said. “Then I’ll slowly start to extend the patient to 8 weeks and gradually to 3 months, depending on patient factors.”

Retinal specialists know from clinical trials such as CATT (NCT00593450), HORIZON, and SEVEN-UP (NCT01256827) that more frequent dosing leads to better visual outcomes.

The challenge involves translating those outcomes into the clinic, without a clinical trial coordinator to shepherd a patient through frequent visits.

Vision-related quality of life: Impacts of advanced AMD

“We consistently see a correlation to decreased acuity at the time we convert patients from randomized controlled trial protocol dosing to extension trials with real-world style dosing or investigator-directed dosing,” Eichenbaum said. “More injections of our current agents are better.”

Clinical trial outcomes don’t translate to real-world scenarios, Baumal noted. “It is very hard for most people to maintain long-term 4-week dosing,” she said. “Our patients are getting older. “Their visual needs change with their coexisting health problems and other demands on their lives.”

New agents and drug-delivery platforms aim to resolve these issues. 

For example, brolucizumab was recently approved by the FDA based on the strength of the phase 3 HAWK (NCT02307682) and HARRIER (NCT02434328) trials.

Adverse events such as inflammation and vasculitis are a concern, however.

“From the phase 3 HAWK and HARRIER studies, there was about a 4% rate of inflammation in brolucizumab-treated eyes,” Baumal said. “Based on the HAWK and HARRIER [trials], most of these cases of inflammation were mild and resolved with treatment. Brolucizumab is an excellent drying agent with potential to extend the treatment interval in some individuals. However, the potential for inflammation or vasculitis would need to be discussed with patients. Further research may be able to elucidate more information about the pathogenesis of these findings.”

ASRS 2020: What Aviceda’s lead candidate AVD-104 may mean for dry AMD

Eichenbaum and Baumal both see potential advancements in treatment durability through devices that can deliver a high dose of a drug over a longer period. The ranibizumab port-delivery system (PDS) could be one such tool. 

This permanent, refillable drug reservoir can hold up to 100 mg/mL of ranibizumab. The port is surgically placed through a 3.5-mm scleral incision in the pars plana. 

Top-line data from the phase 3 Archway trial (NCT03677934) were recently released, showing that patients who received PDS refills every 6 months had visual acuity outcomes equivalent to those of patients on monthly ranibizumab injections.

“We’re superbly excited about the potential for a device that may significantly reduce treatment burden,” Dr Eichenbaum said. “[The PDS is] filled with concentrated ranibizumab solution, a reliable agent that we’ve had for almost 15 years.”

The PDS “holds great promise,” according to Baumal: “This will allow a surgical treatment for a medical disease. I’m excited to see the final clinical trial results and to be able to potentially treat my patients by refiling a port once or twice a year.”

Both physicians also note that gene therapies could play a role in future 

management but that it is too soon to tell, given that data have been reported on fewer than 20 patients.

“Gene therapy is exciting, but I have to balance my excitement by knowing we have only completed phase 1 trials,” Eichenbaum said. “The graveyard is full of successful phase 1 drugs, whereas the PDS now shows positivity in phase 3. We’re almost certainly going to get our hands on it in the real world and be able to bring some of these medical conditions back to the operating room—hopefully, with very good success, minimal risk, and a reduced overall burden to patients.”

ASRS 2020: PDS with ranibizumab signals paradigm shift in treatment of neovascular AMD


Despite their optimism for the future of 

 treatment, Eichenbaum and Baumal emphasize the need for context when assessing new agents and drug-delivery methods.

“It is very important not to throw the baby out with the bathwater as we see new agents come to market,” Eichenbaum concluded. “We have 9 years of data in the real world on aflibercept, almost 15 years of data on ranibizumab, and over 15 years of data on repackaged bevacizumab. We’re going to see new things, some of which will have new problems, and we’re going to have to figure out how to mitigate new issues and where we can use new products best if we want to move forward.” 


Baumal is a professor of ophthalmology at Tufts University School of Medicine in Boston, Massachusetts.


Eichenbaum is a partner with Retina Vitreous Associates of Florida in Tampa. He is a fellow of the American Academy of Ophthalmology and has been a clinical assistant professor of ophthalmology at the University of South Florida since 2007. 


1.  O’Shea JG. Age-related macular degeneration: a leading cause of blindness. 

2.Ho AC, Albini TA, Brown DM, Boyer DS, Regillo CD, Heier JS. The potential importance of detection of neovascular age-related macular degeneration when visual acuity is relatively good. 

. 2017;135(3):268-273. doi:10.1001/jamaophthalmol.2016.5314

3. Zlateva GP, Javitt JC, Shah SN, Zhou Z, Murphy JG. Comparison of comorbid conditions between neovascular age-related macular degeneration patients and a control cohort in the Medicare population. 

. 2007;27(9):1292-1299. doi:10.1097/01.iae.0000300915.81866.b8

4. Get the facts about coronavirus. Centers for Disease Control and Prevention. Accessed TK. 

https://www.cdc.gov/coronavirus/2019-ncov/index.html

5. Notal Vision announces FDA grants breakthrough device designation for pioneering patient-operated home optical coherence tomography (OCT) system. News release. Notal Vision, Ltd. December 3, 2018. 

https://www.prnewswire.com/news-releases/notal-vision-announces-fda-grants-breakthrough-device-designation-for-pioneering-patient-operated-home-optical-coherence-tomography-oct-system-300758956.html

6. Maguire MG, Martin DF et al; Comparison of Age-related Macular Degeneration Treatments Trials Research Group. Five-year outcomes with anti-vascular endothelial growth factor treatment of neovascular age-related macular degeneration: the comparison of age-related macular degeneration treatments trials. 

. 2016;123(8):1751-1761. doi:10.1016/j.ophtha.2016.03.045

7. Rofagha S, Bhisitkul RB, Boyer DS, Sadda SR, Zhang K; SEVEN-UP Study Group. Seven-year outcomes in ranibizumab-treated patients in ANCHOR, MARINA, and HORIZON: a multicenter cohort study (SEVEN-UP). 

. 2013;120(11):2292-2299. doi:10.1016/j.ophtha.2013.03.046

8. Singer MA, Awh CC, Sadda S, et al. HORIZON: an open-label extension trial of ranibizumab for choroidal neovascularization secondary to age-related macular degeneration. 

. 2012;119(6):1175-1183. doi:10.1016/j.ophtha.2011.12.016

9. Dugel PU, Koh A, Ogura Y, et al. HAWK and HARRIER: phase 3, multicenter, randomized, double-masked trials of brolucizumab for neovascular age-related macular degeneration. 

. 2020;127:72-84. doi:10.1016/j.ophtha.2019.04.017

10. Roche’s port delivery system with ranibizumab shows positive phase III results in neovascular age-related macular degeneration. News release. Roche. May 27, 2020. Accessed June 30, 2020. 

https://www.roche.com/media/releases/med-cor-2020-05-27.htm

11. Regenxbio announces additional positive interim phase I/IIa trial update for RGX-314 for the treatment of wet AMD at the American Academy of Ophthalmology 2019 Annual Meeting. News release. Regenxbio Inc. October 11, 2019. Accessed June 30, 2020. https://www.prnewswire.com/news-releases/regenxbio-announces-additional-positive-interim-phase-iiia-trial-update-for-rgx-314-for-the-treatment-of-wet-amd-at-the-american-academy-of-ophthalmology-2019-annual-meeting-300937385.html

12. Adverum Biotechnologies reports additional clinical data from first cohort of OPTIC phase 1 trial of ADVM-022 intravitreal gene therapy for wet AMD at the American Academy of Ophthalmology 2019 Annual Meeting. News release. Adverum Biotechnologies, Inc. News release. October 11, 2109. Accessed June 30, 2020. https://www.globenewswire.com/news-release/2019/10/11/1928842/0/en/Adverum-Biotechnologies-Reports-Additional-Clinical-Data-from-First-Cohort-of-OPTIC-Phase-1-Trial-of-ADVM-022-Intravitreal-Gene-Therapy-for-Wet-AMD-at-the-American-Academy-of-Ophth.html?print=1

Pandemic highlights need for longer-lasting agents to reduce treatment burden in evolving field.

Experts review state of AMD in 2020


This article was reviewed by Royce Chen, MD

 came to the United States insidiously and in a number of guises. No one has been spared, and no one, including health care workers, gets a pass because of religion, politics, gender, or age.

Royce Chen, MD, contracted the virus in early March, when physicians still knew very little about the disease. At that time, before the pandemic was declared, Chen suspected he had a bad cold.

“My symptoms were a little more than those associated with a cold and a little less than those of a flu,” he said.

He described his condition as less than 100%, but he was not incapacitated. His symptoms included a low fever (temperature, 99.5º F) for 2 days, a light headache and fatigue, dry cough, and a red eye, all of which were so mild that they normally would not have kept him from work.

COVID-19 linked to an increase in mental health issues

“At this point, we knew that this was a very contagious virus,” he said. “Because we were aware that affected individuals could be asymptomatic or have minor symptoms, based on data from China, I considered it important to rule out the virus through testing. If I tested positive with these symptoms, it would be important to communicate that to the people in my department so that the residents and fellows would not keep reporting to work if they had similar symptoms.”

Chen has 2 young children, so runny noses and low-grade fevers are commonplace in his household.

 He kept in mind the potential for the common cold but wanted to rule out 

Even though the number of cases in New York was rapidly increasing, testing was limited at that time to individuals with high fevers or shortness of breath or who had recently returned from a trip to an area with known

infection was confirmed 5 days later; he had stopped seeing patients and self-quarantined since the start of his symptoms. His wife developed similar symptoms after his cleared, and his children had runny noses—he noted that it is challenging to completely isolate in an apartment. 

At the time of Chen’s illness, the guidelines called for returning to work 7 days after the onset of symptoms in concert with improved symptoms and no fever; because of a persistent cough, it was 2.5 weeks before he could return.

Undercutting severe COVID-19 with inhaled interferon beta


As time passed, more was learned about COVID-19’s impact on all aspects of everyday medical life; ie, clinical practices, residents, subspecialties, and personal protective equipment (PPE).

During his quarantine, Chen was involved in what he called seemingly endless Zoom meetings to develop protocols for his residents and his department to keep patients, trainees, and staff safe.

“When I was able to return to work, we were in a much different place regarding the approach to PPE,” he said. “Patients and doctors were now required to wear masks. Practice activity decreased to about 10% of the normal volume.”

 and developing antibodies to the virus has given Chen a more secure feeling about resuming practice with at least a modicum of immunity, he said.

Even so, he initially had reservations about returning; he was concerned about how his colleagues felt about his presence and about patient safety.

“Would my wearing an N95 mask be enough to prevent me from spreading it to other people? Was I still infectious?” he wondered.

Amid pandemic, friendly bugs can help protect the eye from infection

“Having the virus gave me a firsthand perspective about the fears and anxieties that patients may have during this pandemic,” he said. “I am able to share my experience and my own fears with patients, and this sharing has allowed me to connect with them on a deeper level. It provides them with both reassurance and more understanding about what the virus can look like, with its many different faces.”

Chen said the silver lining is a reinforcement of the doctor-patient relationship:

“Sometimes you forget how it truly is a relationship, and that patients do not simply present problems that you are trying to solve,” he said.

In light of this, the practice performed many telehealth visits and called several thousand patients to check in, assess their status, and convey the safety and efficiency measures that the practice instituted.

Emerging opportunities — and risks — with telehealth in a pandemic

“Many lonely patients were extremely anxious and were grateful to hear someone asking how they were doing,” Chen said. “Since May, our practice volumes have increased significantly. It has been good to see that the patients recognize that a visit to the eye doctor is a completely different experience now, which alleviates their fears, and it is nice to reconnect with them and share our stories from this crazy time.” 


Chen is the Helen and Martin Kimmel Assistant Professor of Ophthalmology at Columbia University Medical Center and attending ophthalmologist at NewYork-Presbyterian in New York, New York. He has no financial interest in this subject matter.

A New York City physician describes how he coped with the disease in the early days of its US appearance as well as the silver lining in his diagnosis: a reinforcement of the doctor-patient relationship.

An ophthalmologist faces down COVID-19


Investigators find value in screening for macular disease in preoperative evaluation

This article was reviewed by Maria S. Romero, MD

Findings from a review of a prospective consecutive surgical series of patients reinforce the value of incorporating 

 to screen for macular disease in the preoperative evaluation of candidates for 

ASCRS 2020: Assessing effectiveness of intracameral phenylephrine/ketorolac post-cataract surgery

The research was presented by Maria S. Romero, MD, at the 2020 

American Society of Cataract and Refractive Surgery (ASCRS) 

According to Romero, findings from imaging performed with a spectral-domain (SD)-

 platform showed that previously undiagnosed macular abnormalities were common among patients who had been referred to her for 

were referred to a retina specialist prior to cataract surgery for further evaluation and treatment.

Evaluations performed at 1 and 3 months after cataract surgery showed that good visual outcomes were achieved overall, and there was no evidence that any existing vitreomacular disease worsened after cataract surgery.

“Macular disease can compromise the visual acuity, not only quantitatively but also [in terms of] the quality of vision, by decreasing contrast sensitivity, leading to patient dissatisfaction after cataract surgery,” said Romero, who is the medical director at Precision Eye Care in Baltimore, Maryland.

“In most of the cases in this study, the macular disease revealed by 

 imaging was subtle and overlooked by the referring providers, [who were] performing a standard clinical exam through the cataractous lens,” she said. “These findings are very important not only for advising the patients about intraocular lens technology that would benefit and improve their quality of life and to set appropriate outcome expectations, but also for proper monitoring for progression of the macular disease per se and prevention of loss of vision.”

The study included 42 consecutive eyes of 33 patients. Patients with any known retinal or 
macular pathology or prior history of 

Romero performed all the cataract surgeries, and the patients received a standard postoperative management regimen for preventing infection and treating pain and inflammation.

The patients in the series had a mean age of 73 years. Glaucoma was present in 21 eyes, and trabeculectomy and selective laser trabeculoplasty had each been performed in 4 eyes. 

was also common (21 eyes), 1 eye had a history of strabismus surgery, and high myopia was present in 2 eyes.


3D cataract surgery: Keeping the eye in focus

Of the 42 eyes, 27 (64%) were found on the SD-OCT imaging to have a previously undiagnosed macular abnormality. 

An epiretinal membrane was the most common pathology followed by posterior vitreous detachment, drusen, macular hole, retinal pigment epithelium hypertrophy, and vitreomacular traction.

“The relatively high incidence of vitreomacular disease in this series of patients is likely explained by the high prevalence of ocular comorbidities, including glaucoma,” Romero said.

Among eyes found to have a macular abnormality on SD-OCT, mean BCVA improved from 0.31 logMAR preoperatively to 0.07 logMAR at 3 months following surgery.

“Thepreoperative and postoperative visual acuity in the study was impacted by the pre-existing conditions,” Romero said.

Romero reported that a change in the SD-OCT from baseline to 3 months after surgery indicating worsening or new onset of macular pathology was found in only 1 eye, which developed cystoid macular edema after 

 in a patient with glaucoma and uncontrolled diabetes.

Dropless, hands-free regimen key for patients

According to Romero, a limitation was that the study included a relatively small number of patients. 

Additionally, Romero said she observed that not all surgeons have access to 

within their practice setting because of financial limitations in the developing world or institutional constraints. In those cases, she recommends that surgeons work closely with their retinal colleagues.


e: msromemd@gmail.com 
Dr. Romero has no relevant financial interests to disclose

Investigators find value in screening for macular disease in preoperative evaluation


Macular OCT imaging is vital in work-up of cataract surgery patients

This article was reviewed by Arshad M. Khanani, MD, MA



Analyses of data from OPTIC (NCT03748784), a dose-ranging phase 1 study, show that intravitreal ADVM-022 (AAV.7m8-aflibercept gene therapy, Adverum Biotechnologies), a gene therapy vector designed to provide long-term aflibercept expression, shows promise for treating neovascular age-related macular degeneration (nAMD) with a greatly reduced injection burden compared with existing options, according to Arshad M. Khanani, MD, MA.

Candidate continues to demonstrate encouraging safety, tolerability, and efficacy

Ophthalmology Times: August 2020

Artificial tears offer a path to contact lens comfort

Perioperative medications can eliminate postoperative drops after cataract surgery

Experts review state of AMD in 2020

An ophthalmologist faces down COVID-19

Macular OCT imaging is vital in work-up of cataract surgery patients

Phase 1 trial investigating novel gene therapy for neovascular AMD

Study results show that surgical system decreases IOP in patients with POAG

Performing follow-up perfects surgical technique

Working with optometrists is winning strategy

COVID-19: ASRS survey details impact on retinal patients, practices

Physicians’ treatment decisions are reinforced with good data

Impact of aflibercept on retinal nonperfusion in DME

Pearls to educate patients about ocular telemedicine options

Photobiomodulation shows the power of light

“It took a pandemic to get me to reprioritize my life”

Research shows promising results for LHON gene therapy