Investigators evaluated intravitreal bevacizumab every two weeks in refractory neovascular age-related macular degeneration as part of a retrospective study of consecutive individuals with nAMD unresponsive to monthly intravitreal anti-vascular endothelial growth factor switched to three to four biweekly injections.

Twenty-seven eyes of individuals ages 82.08  ±6.85 were included. Prior to the two-week interval bevacizumab injections, 74.1 percent (n=20) were treated with bevacizumab and ranibizumab, 11.1 percent (three eyes) also received aflibercept and 14.8 percent (four eyes) had prior treatment of monthly bevacizumab (average number of injections 21.5 ±6.7).

• Best-corrected visual acuity remained stable between baseline (logMAR 0.72 ±0.60) and follow-up (0.76 ±0.66) (p=0.41).
• Mean central macular thickness and macular volume didn’t change significantly between baseline (p=0.35) and follow-up (p=0.60).
• Six eyes (22.2 percent) showed morphologic anatomic improvements, while 19 eyes (70.4 percent) were stable and two eyes (7.4 percent) deteriorated from baseline.
• Subretinal fluid completely resolved in three eyes and improved in the other three eyes; in the latter eyes (22.2 percent) central macular thickness (326.2 ±101.4 vs. 297.5 ±97.2, p=0.002) and macular volume (8.69 ±1.69 vs. 8.22 ±1.43, p=0.03) were significantly reduced.
• No adverse events were observed in any treated eyes.

The study demonstrated that biweekly bevacizumab injections were effective in nearly one-quarter of nAMD non-responders, with no adverse events reported. Investigators found that switching earlier, rather than later, to the low-cost modality might be of benefit for some non-responders to conventional treatment.

Scientists assessed the role of swept-source anterior segment optical coherence tomography in the diagnosis and management of laser in situ keratomileusis flap-related complications.

The prospective study included 25 eyes with LASIK flap-related complications that were imaged using swept-source AS-OCT between February and August 2016, at Alforsan Eye Centre, Assiut, Egypt. The images were acquired using a 6-mm line scan.

Imaging flap-related LASIK complications using AS-OCT revealed specific and nonspecific findings:

• Epithelial ingrowth appeared as highly reflective lesions below the LASIK flap in the form of islands, nests or a continuous sheet, with or without changes in the overlying flap.
• Macrostriae manifested as dome-shaped irregularities on the stromal surface with regular overlying epithelium, whereas microstriae appeared as corrugations on the stromal surface with regular overlying epithelium.
• Less-common complications included multiple flap macrostriae accompanied by a traumatic folded flap with a flap edge at the interface.
• Interface debris appeared as a highly reflective interface lesion with or without a surrounding reaction.
• One eye with a flap that was torn and lost intraoperatively showed epithelialization over a thin residual stroma underlying a contact lens with no stromal infiltration on the second postoperative day.

Scientists wrote that AS-OCT was useful for the assessment of flap thickness and planning of the new flap thickness in the event of an incomplete cut. They added that it was useful for diagnosis and management of eyes with LASIK flap-related complications by enabling noninvasive, noncontact, real-time acquisition of cross-sectional AS images.

Researchers evaluated the effectiveness of selective laser trabeculoplasty compared with argon laser trabeculoplasty in a randomized clinical trial for individuals with medically uncontrolled open-angle glaucoma who previously received 360 degree SLT.

In an active-equivalence, parallel-armed, randomized control trial, subjects with OAG including pigmentary dispersion syndrome and pseudoexfoliation syndrome were enrolled from seven sites across Canada. One setting of 180 degrees of either SLT or ALT was assigned randomly and applied to each participant. Main outcome measures included the change in intraocular pressure from baseline to 12 months.

A total of 130 individuals completed the study per the protocol. The IOP decrease at one year compared with baseline for SLT vs. ALT was found to be different by 0.33 mmHg among the two groups (3.16 for SLT and 2.83 for ALT) and wasn’t statistically significant (p=0.71). Further analysis showed that SLT had a significantly lower IOP reduction at early time points—one week and one month, but this effect was lost by three months. Corresponding with this finding was the strong trend for ALT to fail more quickly than SLT. Although repeatable, the first repeat SLT reduced IOP to about half compared with initial SLT treatments.

Researchers found that the 12 month-comparison following laser therapy revealed that both modalities lowered the IOP by approximately 3 mmHg, yet essentially all time-to-failure analyses favored SLT over ALT; the repeat SLT effect was found to be half of the initial treatment.