News

It appears that diabetic retinopathy is not the only eye disease associated with diabetes, according to a study, which found that women with diabetes have about a 70% increased risk of developing the most common form of glaucoma-primary-open angle glaucoma-compared with women without diabetes.

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.

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.

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.

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.

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.

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.

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.

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.