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The National Ophthalmic Disease Genotyping Network (eyeGENE), developed in 2007 by the National Eye Institute, is a repository of inherited eye disease DNA samples that can be used anonymously for research. The hope is that eyeGENE will facilitate discovery of new ophthalmic disease genes, help researchers identify genetic modifiers of disease, and enhance patient enrollment in clinical trials.

Both subconjunctival and intravitreal injection of the broad-acting, small molecule sirolimus were shown to be safe in a phase I study of patients with diabetic macular edema. Promising efficacy signals also were observed.

The development of endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor drugs is a rare event, with an incidence of 0.03% for treated cases and 0.02% for culture-positive cases.

Three monthly injections of ranibizumab, 0.3 and 0.5 mg, appear to provide benefit to patients with macular edema due to central retinal vein occlusion or branch retinal vein occlusion. Foveal thickness decreased significantly with both doses, and there was a concomitant increase in the visual acuity. Most patients require more than three injections to maintain the benefit. The average duration of treatment and the final visual outcomes are not yet known.

Berlin, Germany, will host the XXVI Congress of the European Society of Cataract and Refractive Surgeons from Sept. 13 to 17. The annual meeting will feature a diverse agenda that includes symposia, a workshop on visual optics, training courses, and exhibits.

Neovascular age-related macular degeneration treated with long-term use of intravitreal ranibizumab (Lucentis, Genentech) was safe and well tolerated in a group of patients participating in an extension study. Between the original studies and the extension trial, patients were followed for approximately 4 years, during which no safety signals were observed. Although problems linked to vascular endothelial growth factor inhibition were suggested, the lack of a control group makes proving a correlation difficult.

An immediate vitrectomy should be considered in patients with retained intravitreal fragments of the crystalline lens after complicated cataract surgery. Eyes that underwent immediate vitrectomy had better visual acuity and a lower retinal detachment rate than eyes that underwent delayed vitrectomy.

Before prescribing alpha blocker treatment, a primary care physician (PCP) should consider involving the cataract surgeon when treating a patient with a known diagnosis of cataract. So says an educational statement that is part of an initiative by the American Society of Cataract and Refractive Surgery and the American Academy of Ophthalmology launched to further educate PCPs about the connection between alpha blockers, such as tamsulosin (Flomax, Boehringer Ingelheim Pharamceuticals), and intraoperative floppy iris syndrome during cataract surgery.

Results of a recent survey by the American Society of Cataract and Refractive Surgery Cataract Clinical Committee provide insight into the clinical issues facing cataract surgeons and their patients taking alpha blocker drugs. Intraoperative floppy iris syndrome continues to challenge cataract surgeons and especially seems to be associated with tamsulosin (Flomax, Boehringer Ingelheim Pharmaceuticals), according to respondents.

To reduce the risk of endophthalmitis after cataract surgery a multimodal approach is needed. Assuring a water-tight wound closure without the use of stromal hydration and use of a fourth-generation fluoroquinolone are two important factors. An analysis of data from patients undergoing clear corneal cataract extraction at the University of Texas Southwestern Medical Center supports these recommendations.

Congress was able to block a pay cut for physicians who serve Medicare patients. Even though the American Society of Cataract and Refractive Surgery (ASCRS) and the American Academy of Ophthalmology (AAO) are pleased for the delay in the pay cut they maintain that the hard work is just beginning.

An immediate vitrectomy should be considered in patients with retained intravitreal fragments of the crystalline lens after complicated cataract surgery. Eyes that underwent immediate vitrectomy had better visual acuity and a lower retinal detachment rate than eyes that underwent delayed vitrectomy.

The first in vivo tests of a wireless, soft contact lens sensor demonstrate that the device's measurements correspond with those taken via Goldmann tonometry. The contact lens sensor, which is designed to detect the tiny changes in corneo-scleral curvature induced by IOP changes, could be used potentially to monitor a patient's IOP changes over 24 hours.

The long-running Ocular Hypertension Treatment Study has produced many important clinical findings. Among them is the conclusion that African-American and white patients have similar responses to treatment with topical beta-blockers and prostaglandin analogs. The study also found that optic disk hemorrhages are a risk factor for progression from ocular hypertension to primary open-angle glaucoma.

A retrospective chart review of 200 charts from three centers found that physicians do not adhere consistently to the American Academy of Ophthalmology's Preferred Practice Patterns for glaucoma management. As the world's leading cause of irreversible blindness, the stakes are high to ensure that the patterns are being followed to maximize positive outcomes for patients with glaucoma.

It is possible to remodel filtering blebs, but much like a home remodeling project, a bleb remodeling should only be undertaken with a plan, a careful review of options, and the realization that it may become more involved than initially expected.

Combination therapy to treat age-related macular degeneration seems to be a promising avenue of research. The gain in visual acuity can be sustained with fewer intravitreal injections. This approach might also reduce the overall cost of treatment.

The systemic complications associated with anti-vascular endothelial growth (VEGF) factor therapy for colon cancer are well documented. Those associated with intravitreal injection of anti-VEGF agents to treat neovascular age-related macular degeneration (AMD) seem to occur infrequently. Monitoring of these events has been limited thus far, however. Good methods need to be developed for post-marketing surveillance of anti-VEGF agents used to treat patients with AMD.

The 2-year results of the PrONTO Study indicated that intravitreal injections of ranibizumab (Lucentis, Genentech) produces rapid improvements in visual acuity (VA) and optical coherence tomography (OCT) outcomes in patients treated for neovascular age-related macular degeneration. The changes on OCT are visible before the changes in VA and allow ophthalmologists to determine each patient's need for additional dosing of ranibizumab.

A hydroxypropyl cellulose ophthalmic insert (Lacrisert, Aton Pharma), a once-daily, preservative-free insert that helps to retain moisture, stabilize the tear film, lubricate the eye, and increase tear break-up time, may be beneficial in the treatment of patients with dry eye due to lid function abnormalities, closure problems, or thyroid disease.