Scientists assessed monocular visual field loss and binocular VF loss in primary angle-closure, primary open-angle and normal-tension glaucoma, in an observational, cross-sectional study.

A total of 250 individuals with glaucoma and 31 healthy participants were assigned to groups by stages of monocular VF loss in both eyes; normal, early, moderate or severe. (Binocular VF assessments were determined via integrated VF and Esterman binocular visual evaluations.) Monocular and binocular VF parameters were compared within and between groups.

• Average integrated mean deviation (SD) in individuals with one eye at the normal or early stage was -1.67 (1.39) dB, or -3.27 (2.05) dB in individuals with one eye at the severe stage.
• Average Esterman scores were >95 percent: 99.17 percent (1.89 percent) in individuals with one eye at the normal or early stage, and 96.08 percent (3.99 percent) with one eye at the severe stage.
• In cases where both eyes had progressed to moderate or severe damage (moderate/moderate, moderate/severe or severe/severe), the average integrated mean deviations were worse than -6 dB, and the mean Esterman scores in the moderate/moderate (94.20 percent [5.96 percent]) and moderate/severe damage groups (94.32 percent [4.95 percent]) were >90 percent, but dropped rapidly from >90 percent to 68.44 percent (26.27 percent) when both eyes were at the severe stage.

Scientists wrote that the binocular VF could remain relatively intact provided one eye was at the normal or early stage. They wrote further that significant binocular VF defects measured by integrated mean deviation were evident when both eyes had progressed to the moderate or severe stage, and significant Esterman binocular VF defects were only detected when both eyes had advanced to the severe stage.

Researchers evaluated the efficacy and safety of sarilumab, a human anti-interleukin-6 receptor antibody, for the treatment of noninfectious uveitis of the posterior segment, as part of a randomized, double-masked, placebo-controlled, Phase II study. Participants included 58 eyes with noninfectious intermediate, posterior or pan-uveitis. Eyes were randomized 2:1 to treatment q2 weeks for 16 weeks with subcutaneous sarilumab 200 mg or placebo. The primary endpoint was the proportion of individuals with ≥2-step reduction in vitreous haze (VH) on the Miami scale, or reduction of systemic corticosteroids (prednisolone or equivalent) to a dose of <10 mg/day at week 16. The primary endpoint was based on VH evaluation by a central reading center. Investigator evaluation of VH was a pre-specified, secondary analysis.

• At week 16, the proportion of cases with ≥2-step reduction in VH or corticosteroid dose <10 mg/day was 46.1 percent using sarilumab vs. 30 percent on placebo (p=0.2354), based on central reading center assessments of VH; and 64 percent using sarilumab vs. 35 percent on placebo (p=0.0372) based on investigator assessment of VH.
• In eyes with VH ≥grade 2 at baseline, the mean VH reduction from baseline to week 16 was significantly greater with sarilumab (-2.1 [n=11]) vs. placebo (-1.7 [n=3])(p=0.0255), regardless of assessments by central reading centers; and regardless of assessments by investigators: -2.5 (n=19) for sarilumab vs. -1.2 (n=11) for placebo (p=0.0170).
• The mean best-corrected visual acuity gain from baseline to week 16 was greater with sarilumab (8.9 letters) vs. placebo (3.6 letters)(p=0.0333) in the overall population and in the subgroup of eyes with central subfield thickness ≥300 μm: 12.2 letters (n=13) in sarilumab vs. 2.1 letters (n=7) in placebo (p=0.0517).
• Corresponding changes in CST were: -46.8 with sarilumab vs. +2.6 μm in controls (p=0.0683) in the overall population; and -112.5 (n=13) with sarilumab vs. -1.8 (n=6) μm in controls (p=0.1317) in eyes with CST ≥300 μm at baseline.
• The most common ocular adverse events were worsening of uveitis (three individuals on sarilumab) and retinal infiltrates (two on sarilumab and one taking placebo).

Researchers determined that subcutaneous sarilumab might provide clinical benefits in the management of non-infectious uveitis of the posterior segment, especially in eyes with uveitic macular edema.