Researchers from Brazil, the United States and Scotland aimed to determine whether patients with glaucoma with preserved central vision had impaired reading performance compared with healthy controls. The cross-sectional study included 35 patients with glaucoma and 32 similar-age controls, all with visual acuity better than 0.4 logMAR in both eyes.
Each participant had a detailed ophthalmological exam followed by a five-chart reading performance test using a Portuguese version of the Minnesota Low Vision Reading Test (MNREAD). Correlation between reading performance (reading speed) and ocular parameters was investigated.
Participants had an average age of 63 ±12.6 years. Here are some of the findings:
- In the glaucoma group, mean deviation (MD) in the better eye was -6.29 ±6.36 dB; in the worse eye it was -11.08 ±0.23 dB.
- No significant difference was found in age, gender, race, education, visual acuity or systemic comorbidities between the groups.
- Participants with glaucoma had significantly slower reading speeds, with an average of 83.2 ±25.12 words per minute compared with 102.29 ±29.57 wpm in controls (p=0.006); reading speed was slower for all five charts.
- The odds of having glaucoma increased by 1.29 (CI, 1.07 to 1.56, p=0.009) for each 10 wpm decrease in average reading speed, with this relationship maintained after accounting for age, level of education and sharpness of visual acuity.
Researchers found that patients with mild-to-moderate glaucoma had worse reading performance compared with similar-age controls, despite both having preserved central vision.
J Glaucoma 2021; Feb 3. [Epub ahead of print].
Ikeda MC, Bando AH, Hamada KU, et al.
Risk Factors for Fellow-Eye Treatment in Protocol T
Investigators from the Boston University School of Medicine and the Veterans Affairs Boston Healthcare System identified risk factors for needing fellow-eye treatment of
diabetic retinopathy with vascular endothelial growth factor injections, in the Diabetic Retinopathy Clinical Research Network (DRCR.net) Protocol T trial, as part of a post hoc analysis of randomized clinical trial data.
Cox regression analysis was performed at 52 and 104 weeks to determine risk factors for treatment in 360 fellow eyes. Survival analysis was performed to determine mean time to treatment based upon medication used.
Here are some of the findings:
- Of 360 fellow eyes, 142 (39.4 percent) required treatment between weeks four and 104.
- Risk factors that the authors say predicted a lower likelihood of year-one treatment included older subject age (HR=0.98; CI, 0.96 to 0.99; p=0.02) and higher baseline study eye ETDRS score (HR=0.98; CI, 0.97 to 0.99; p=0.04).
- Center-involving DME at baseline in the fellow eye was predictive of a higher treatment need at 52 weeks (HR=1.89; CI, 1.42 to 2.51, p<0.0001) and 104 weeks (HR=2.68; CI, 1.75 to 4.11, p<0.0001).
- Subjects treated in the study eye with aflibercept (HR=0.574; CI, 0.371 to 0.887, p=0.013) and ranibizumab (HR=0.58; CI, 0.36 to 0.94, p=0.03) were less likely to require first-year fellow-eye injection than subjects treated with bevacizumab, although they note that this difference was no longer statistically significant at week 104 (aflibercept HR=0.77; CI, 0.52 to 1.16; p=0.21; ranibizumab HR=0.66; CI, 0.43 to 1.00, p=0.05).
- Mean time to treatment in the study was significantly shorter in the group of patients who received bevacizumab injections (bevacizumab 25.83 weeks, aflibercept 38.75 weeks, ranibizumab 34.70 weeks [p=0.012]).
The study’s investigators reported that bilateral treatment with intravitreal anti-vascular endothelial growth factor injections was common during the DRCR.net Protocol T study. They added that, based on their analysis, the choice of medication may impact the risk of needing fellow-eye treatment.
Graefes Arch Clin Exp Ophthalmol 2021; Feb 10. [Epub ahead of print].
Ness S, Green M, Loporchio D, et al.