News

Preclinical results for two new compounds (Sirion) that may be used for the treatment of retinal diseases will be presented during the 2008 annual meeting of the Association for Research in Vision and Ophthalmology.

Study of the use of collagen crosslinking with riboflavin has been limited. Early experience with this technique, however, suggests it safely increases corneal rigidity and limits ectasia progression.

The Collaborative Initial Glaucoma Treatment Study (CIGTS) showed that substantially lowering IOP, whether through medication or surgery, can prevent vision loss. One of the major trials of recent years, CIGTS also showed that surgery was an effective first-line treatment and had important findings on quality of life.

The European Glaucoma Prevention Study (EGPS) has produced reports on baseline factors that predict development of primary open-angle glaucoma as well as intercurrent factors also associated with development of the disease. The study also confirmed the importance of IOP reduction and identified systemic diuretics as a risk factor.

An anterior chamber diffractive multifocal IOL (Vision Membrane, Vision Membrane Technologies) designed as a phakic implant has been used successfully to treat ametropia and presbyopia in pseudophakic eyes. The technology, its benefits, and the outcomes achieved are described in this article.

Optic pathway gliomas occur frequently in children with neurofibromatosis 1 (NF1). As not all patients with these tumors are symptomatic, regular examination of NF1 patients is important, and a nonsurgical treatment algorithm should be followed if a tumor is found.

Fundus autofluorescence imaging, one of the modes available in a new instrument (Spectralis HRA+OCT, Heidelberg Engineering), enhances its utility as a diagnostic device and a tool for monitoring therapy of patients with retinal and macular diseases.

An analysis of the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) results from a large clinical trial of ranibizumab (Lucentis, Genentech) in patients with age-related macular degeneration has shown that an improvement of 5 to 10 points on the VFQ-25 score correlated with meaningful clinical improvement in vision.

Outcomes of fluorescein angiography and optical coherence tomography show that patients who received intravitreal injections of a fusion protein (VEGF Trap-Eye, Regeneron Pharmaceuticals) had reductions in retinal thickness, lesion size, and area of choroidal neovascularization. These results support positive visual acuity findings in the same group of patients.

Results of a phase II study evaluating pegaptanib sodium (Macugen, OSI Eyetech/Pfizer) intravitreal injection in eyes with macular edema (ME) secondary to nonischemic central retinal vein occlusion suggest a potential role for vascular endothelial growth factor blockade to reduce ME and improve visual acuity.

Spectral domain, three-dimensional (3-D), high-resolution optical coherence tomography (OCT) represents a step forward in OCT technology, with precise registration, complete data set acquisition, and improved coverage of the retina being the major advantages.

A feasibility study of a novel beta radiation epiretinal brachytherapy system for age-related macular degeneration produced favorable 1-year results. The radiation was administered in combination with bevacizumab in two study arms. Patients had a mean improvement in visual acuity of 13.1 lines.

Arteriolarization, with a large artery feeding many branching arterioles, may explain why some eyes with choroidal neovascularization fail to respond to anti-vascular endothelial growth factor treatment. Dynamic high-speed indocyanine green angiography can identify this morphology and be used to direct photodynamic therapy toward the feeder artery. Initial results with this intervention are promising.

Three prestigious Association for Research in Vision and Ophthalmology (ARVO) awards will be presented to clinical researchers at the ARVO 2008 Annual Meeting (April 27–May 1) in Fort Lauderdale, FL. The awardees also will present lectures focusing on their research.

The American Academy of Ophthalmology (AAO) and the American Society of Cataract and Refractive Surgery (ASCRS) have joined with the FDA and the National Eye Institute to form a joint task force to discuss the design of a study to identify dissatisfied post-LASIK patients, define their significant symptoms, and examine the effects of those symptoms on quality of life.

The National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) is correlated with reading speed and restricted activity days.

Fewer retinal redetachments were reported following combined vitrectomy and scleral buckling procedures than with either procedure alone in a retrospective study. Factors such as the surgeon's skill and preoperative preparations also influence the outcome of retinal detachment surgery, however.

Postmenopausal hormones taken by women actually may decrease the risk of developing advanced stages of age-related macular degeneration (AMD), especially if women took oral contraceptives previously, according to a report in the April issue of Archives of Ophthalmology.

Torsional phacoemulsification may be more efficient than standard phaco. In an experiment in which beads were aspirated or rejected inside a cell serving as an anterior chamber, longitudinal ultrasound phaco was less than 50% aspiration efficient as demonstrated by bead rejection from the phaco tip, whereas torsional phaco had nearly the aspiration efficiency of irrigation/aspiration alone.

Dr. McDonnell discusses whether futures markets, which are sometimes more accurate in their predictions than experts, could possibly be used to identify promising therapies to explore.

After completing its review of safety and efficacy data currently available, an independent data safety monitoring board once again has recommended that two pivotal phase III clinical trials, known collectively as the Fluocinolone Acetonide in Diabetic Macular Edema Study, continue under the current protocol, without change.

Reichert Inc. has received 510(k) clearance from the FDA to market its spectral optical coherence tomography (OCT) system (Optopol SOCT Copernicus) in the United States.

University of Rochester researchers recently put to test the bias against corneas from older donors.

Deep anterior lamellar keratoplasty resulted in satisfactory best spectacle-corrected visual acuity levels after 18 months follow-up. The rate of graft clarity was almost 90% and the rate of stromal rejection was low. However, the rate of endothelial cell loss at 18 months postoperatively was high.

The off-label use of intravitreal drugs may have a promising future for treating patients with diabetic retinopathy, but currently the dosing of these drugs is suboptimal. There is no solid track record for the drugs because controlled clinical trials are lacking and all follow-up periods have been too short to reach any definitive conclusions about safety and efficacy.

The periodic assessment of vision function with visual field testing is a standard and important part of the management of primary open-angle glaucoma (POAG). Automated achromatic static threshold perimetry is the preferred technique, although other static and kinetic techniques are acceptable alternatives in patients who are unable to complete automated perimetry reliably or when the technology is not available.

Epi-LASIK provides slightly better refractive outcomes 3 months postoperatively compared with standard LASEK, which may be due to the quicker and smoother separation of the epithelial layer from Bowman's membrane and the absence of alcohol with its negative effect on energy absorption of the excimer laser.

A long-term study of 292 eyes found that LASEK is a safe and effective treatment for patients with low to moderate levels of myopia. A significant difference was seen in spherical equivalent and uncorrected vision acuity preoperatively to postoperatively.

Treatment of substantial levels of coma and trefoil using wavefront-guided excimer surface ablation resulted in very good visual outcomes. These patients fared well when compared with patients who underwent LASIK early after the introduction of the procedure and compared with those with atypical topographies who underwent LASIK in the late 1990s. The results still fell slightly short of the outcomes achieved in patients with normal corneal topographies.

Four femtosecond laser microkeratomes have received FDA approval. An ophthalmologist reviews differences between the devices, why they may be important, and considerations for building a next-generation laser microkeratome.