Scientists evaluated changes in the ocular surface of individuals post-trabeculectomy, in addition to associations with conjunctival inflammatory gene expression, as part of a single-arm, interventional cohort study performed at a tertiary referral center.

They recruited 33 predominantly male participants ages 66.88 ±9.76 at baseline. And they assessed dry-eye symptom questionnaires, tear osmolarity, Schirmer's tests, noninvasive tear breakup times, conjunctival redness and corneal fluorescein staining results. They performed conjunctival impressions using the Eyeprim device and, after RNA extraction, analyzed transcripts of 255 inflammatory genes using the Nanostring nCounter assay.

Scientists noted significant decreases in inferior corneal staining at six months (p<0.05)(n=22) and tear osmolarity at 12 months (p<0.01)(n=27). No individuals required glaucoma eyedrops post-surgery up to three years. At baseline, 31/33 transcript profiles passed quality control, and after normalization scientists analyzed 249 transcripts. They recorded the following findings:

• Increased discomfort was associated with higher levels of the protein tyrosine kinase 2 at the cross-sectional analysis at baseline.
• Lower baseline complement factor D levels and higher levels of Mitogen associated kinase 8, MAP3K1 and MyD88 were associated with the presence of corneal staining at six months.
• Nine genes, including the proinflammatory lipo-oxygenase, showed a significantly reduced level at three years (n=5).

Scientists reported that glaucoma surgery (if anti-glaucoma eyedrops were no longer necessary) might confer long-term benefits to the ocular surface due to reduced expression of conjunctival pro-inflammatory and immune-related genes.

Researchers explored various methods to assess the early response to vascular endothelial growth factor inhibitors for neovascular age-related macular degeneration, and investigated associations with three-year visual acuity outcomes, as part of an observational study.

The study included 2,051 treatment-naïve eyes from 1,828 individuals in the Fight Retinal Blindness! outcomes registry receiving anti-VEGF therapy between Jan. 1 2007, and March 1, 2014, and specifically injections within the first three months.

Researchers defined early response as occurring until the fourth injection. They analyzed various early response metrics, including continuous and categorical variables such as:
• good VA (≥70 letters [20/40]);
• absolute change in VA from baseline;
• inactivity during time to first grading of the choroidal neovascular lesion; and
• maximum rate of VA change between successive injections.
Main outcome measures included the proportion of eyes achieving ≥70 letters at three years.

Achieving good vision at three years was significantly associated with:
• having good vision by the fourth injection (OR [CI]: 9.8 [6.5, 14.7] for VA ≥70 vs. VA <70 letters);
• small (1 to 5 letters) or large (>5 letters) early VA gains (1.8 [1.2, 2.6], p=0.002 and 1.8 [1.3, 2.5], p<0.001 vs. eyes with early VA loss);
• fewer injections until grading of lesion inactivity (1.6 [1.2, 2.1], p<0.001 for ≤3 vs. >3 injections); and
• gradual change (between -4 and 4 letters) or rapid (>5 letters) gains between successive injections (1.7 [1.1, 2.6], p=0.015 and 1.6 [1.1, 2.3], p=0.018 for gradual change and rapid gain vs. rapid loss).
• Eyes that achieved small or large early gains (65 letters) achieved similar vision at three years (64.7 letters), and had better vision than eyes with early VA loss (57.2 letters).

Attainment of good vision by the fourth injection was strongly associated with three-year visual outcomes, while other early response parameters had a moderate association. Researchers determined that the early response during the initial three monthly loading doses could be a useful guide for subsequent treatment decisions.