Volume 20, Number 35Monday, August 17, 2020AUGUST IS CHILDREN’S EYE HEALTH AND SAFETY MONTH
In this issue: (click heading to view article)
Quantification of Fluid Resolution and VA Gain in Patients with DME Using Deep LearningResearchers wrote that optical coherence tomography can acquire large amounts of data on diabetic macular edema, but many morphologic features have yet to be identified and quantified. In their study, they aimed to examine the volumetric change of intraretinal and subretinal fluid in DME during anti-vascular endothelial growth factor treatment using deep learning algorithms. One of the authors received fees from Novartis and Roche/Genentech, and has a patent to analyze optical coherence tomographic images pending. Another author received grants from Regeneron and Genentech during the conduct of the study The post hoc analysis of a randomized clinical trial, the Diabetic Retinopathy Clinical Research Network (protocol T), assessed 6,945 spectral-domain OCT volume scans of 570 eyes from 570 study participants with DME. The original trial was performed from August 21, 2012, to October 18, 2018. The current analysis was performed from December 7, 2017, to January 15, 2020. Participants were treated according to a predefined, standardized protocol with aflibercept, ranibizumab or bevacizumab, with or without deferred laser. Main outcomes and measures included the association of treatment with IRF and SRF volumes, and best-corrected visual acuity during 12 months using deep learning algorithms. Of 570 study participants (302 [53 percent] male; 369 [65 percent] white; mean age, 43.4 ±12.6 years), here were some of the findings:
Researchers found that automated segmentation of fluid in DME revealed that the presence of SRF was associated with a lower baseline BCVA but with good response to anti-vascular endothelial growth factor therapy. They added that such automated spectral-domain OCT analyses may be used clinically to assess anatomical change during therapy. SOURCE: Roberts PK, Vogl W, Gerendas BS, et al. Quantification of fluid resolution and visual acuity gain in patients with diabetic macular edema using deep learning: A post hoc analysis of a randomized clinical trial. JAMA Ophthalmol 2020; July 23. [Epub ahead of print.]
Predicting Adherence with the Glaucoma Treatment Compliance Assessment ToolInvestigators used a questionnaire called The Glaucoma Treatment Compliance Assessment Tool (GTCAT), developed by physicians at the Devers Eye Institute in Portland, Oregon, to identify multiple patient-specific factors associated with adherence that could help inform personalized interventions to optimize glaucoma adherence. They studied health behavior factors related to glaucoma adherence in individuals with self-reported poor adherence. A research coordinator used the Chang Adherence Measure and the Morisky Medication Adherence Scale to identify subjects with poor self-reported glaucoma medication adherence, and enrolled them in a three-month study to electronically monitor medication adherence. At enrollment, the coordinator administered the GTCAT. Investigators calculated the percentage of prescribed doses taken over a three-month period using an electronic dose monitor (AdhereTech). They used Rasch analysis, and univariate and multivariable regression to determine the GTCAT statements that predicted electronically monitored adherence. Here were some of the findings:
Investigators noted that the GTCAT identified multiple factors associated with adherence. They suggested that clinicians and researchers could use the tool to identify specific barriers to adherence and potentially develop interventions to improve adherence. SOURCE: Sanchez FG, Mansberger SL, Newman-Casey PA. Predicting adherence with the Glaucoma Treatment Compliance Assessment Tool. J Glaucoma 2020; July 29. [Epub ahead of print].
Prevalence of Persistent Corneal Epithelial Defects in Chronic Ocular Graft- Versus-Host DiseaseScientists established the prevalence, clinical characteristics and risk factors for persistent corneal epithelial defects (PEDs) in individuals with chronic ocular graft-versus-host disease (oGVHD) and determined visual outcomes after healing, as part of a retrospective cohort study. They performed a chart review of individuals diagnosed with chronic oGVHD between January 2011 and December 2018, and recorded demographic and clinical characteristics. They analyzed the data to determine prevalence of PEDs, and performed multivariate logistic regression to determine the risk factors associated with them. Here were some of the findings:
Scientists found the prevalence rates of the following in chronic oGVHD to be: PEDs (8.1 percent); corneal ulceration (6.2 percent); and corneal perforation (4 percent). They determined that oGVHD patients with diabetes, LSCD, filamentary keratitis, subconjunctival fibrosis and a high NIH score were at higher risk of developing severe corneal disease. SOURCE: Sinha S, Singh RB, Dohlman TH, et al. Prevalence of persistent corneal epithelial defects in chronic ocular graft-versus-host disease. Am J Ophthalmol 2020; Jul 24. [Epub ahead of print.] Timing of Large Submacular Hemorrhage Secondary to AMD Relative to Anti-VEGF TherapyResearchers characterized the timing of large submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration relative to anti-vascular endothelial growth factor therapy, as part of a retrospective, consecutive case series. A total of 46 eyes of 46 individuals with large SMH due to neovascular AMD selected to undergo pars plana vitrectomy with subretinal tissue plasminogen activator at the Mid Atlantic Retina group of the Wills Eye Hospital were included. Main outcome measures included the timing of SMH in relation to the last anti-VEGF injection, anti-VEGF treatment status (i.e., naïve, stable or recently extended/shortened were each sub-groups of the main 46-patient group) at the time of SMH and the length of the anti-VEGF treatment interval at the time of bleeding. Here were some of the findings:
Researchers concluded that large SMH in neovascular AMD in a treat-and-extend regimen didn’t appear to be associated with prolonged dosing intervals or recent interval extension. They added that a large proportion of such hemorrhages were likely to be the result of mechanisms other than loss of effective VEGF inhibition. Source: Matsunaga DR, Su D, Sioufi K, et al. The timing of large submacular hemorrhage secondary to age-related macular degeneration relative to anti-VEGF Therapy. Ophthalmol Retina 2020; Aug. 4. [Epub ahead of print]. BRIEFLY RegenxBio Provides Phase I/IIa Trial Update BVI Partners with Haywood to Provide PPE RETINA-AI Health Raises $5.2M for AI Detection of DR RETINA-AI Health, which is developing AI technology to enable the diabetic retinal exam to be done in the primary-care setting, raised $5.2 million in a series A financing for artificial intelligence screening of diabetic retinopathy. The capital was raised from private investors, 80 percent of whom are physicians. The company's HUMMINGBIRD DR 100 is a cloud-based AI detector of diabetic retinopathy that interprets the retinal image and returns a PDF report. Read more.
Sight Sciences Announces First Patients Enrolled in ORION Sight Sciences enrolled the first patients in its ORION multicenter clinical trial, which will build upon clinical evidence for the use of the Omni Surgical System for glaucoma in pseudophakic eyes. The primary effectiveness endpoint is the proportion of eyes with at least a 20-percent decrease in unmedicated mean diurnal intraocular pressure at 12 months. Read more. Ocugen Receives Fourth FDA Orphan Drug Designation for Gene Therapy Ocugen announced the FDA granted a fourth Orphan Drug Designation for OCU400 in the treatment of PDE6B gene mutation-associated retinal diseases. Ocugen’s Modifier Gene Therapy Platform addresses multiple diseases, and its novel gene therapy product candidate, OCU400, has the potential to be broadly effective in restoring retinal integrity and function across genetically diverse inherited retinal diseases, the company says. Read more. Kubota Demonstrates 3-D Imaging Capabilities Using AI on PBOS Kubota Vision says that it demonstrated 3-D imaging capabilities using artificial intelligence on its Patient Based Ophthalmology Suite (PBOS) in-home optical coherence tomography device. The PBOS is a home-based, self-monitoring miniature OCT device designed to detect disease progression. Read more. FDA Accepts Investigational New Drug Application for Clearside CLS-AX Clearside Biomedical announced the FDA accepted its Investigational New Drug application for CLS-AX (axitinib injectable suspension), paving the way for a Phase I/IIa clinical trial of CLS-AX in neovascular age-related macular degeneration by the end of 2020. The trial is expected to be an open-label, dose-escalation study. Read more. Review of Ophthalmology® Online is published by the Review Group, a Division of Jobson Medical Information LLC (JMI), 11 Campus Boulevard, Newtown Square, PA 19073. |