Volume 19, Number 32Monday, August 19, 2019AUGUST IS CHILDREN’S EYE HEALTH/SAFETY MONTH Anti-VEGF vs. Dexamethasone Implant for Center-involved DMEResearchers compared the efficacy and safety of intravitreal anti-vascular endothelial growth factor injection vs. dexamethasone implant (Ozurdex) for the treatment of center-involved DME.This prospective, randomized, comparative study included 40 eyes (38 individuals) with center-involved DME. Researchers randomized subjects into two groups: Individuals in group A received the intravitreal anti-VEGF injection (bevacizumab 1.25 mg or ranibizumab 0.5 mg) after four weeks, and those in group B received the dexamethasone implant (0.7 mg) pro re nata after three months. The primary outcome, measured at three months from baseline, included improvement in BCVA, reduction in CFT and adverse effects during follow-up. Here are some of the findings: • Mean best-corrected visual acuity improved from 0.51 ±0.275 logMAR units (20/63) to 0.20 ±0.185 logMAR units (20/32) in group A, and from 0.56 ± 0.213 logMAR units (20/80) to 0.141 ±0.177 logMAR units (20/32) in group B at three months. • There was no significant difference in mean BCVA between both groups (p=0.27). • The mean central foveal thickness improved from 443.55 ±131.536 µm to 277.66 ±76.184µm in group A, and from 460.95 ±125.462 µm to 233.25 ±37.552 µm at three months in group B (p=0.02). Researchers determined that both groups had similar visual outcomes. However, they noted that the superior anatomical result was observed in dexamethasone implant group during this short follow-up. SOURCE: Sharma A, Bellala K, Dongre P, et al. Anti-VEGF versus dexamethasone implant (Ozurdex) for the management of centre involved diabetic macular edema (CiDME): A randomized study. Int Ophthalmol 2019; Aug 3. [Epub ahead of print].
Ranibizumab and Polypoidal Choroidal VasculopathyInvestigators evaluated the real-world effectiveness and safety of intravitreal ranibizumab 0.5 mg in treatment-naive individuals with and without polypoidal choroidal vasculopathy.
Lamellar Dissection Technique for DMEK Graft PreparationScientists described a novel lamellar dissection technique for Descemet’s membrane endothelial keratoplasty graft preparation, and evaluated the rate of endothelial cell loss and graft preparation failure associated with this technique.They conducted an ex vivo laboratory-based study comparing ECL between the lamellar dissection and peeling techniques. Eight pairs of human donor corneas underwent calcein acetoxymethyl staining—all right eyes underwent the peeling technique, and all left eyes underwent the lamellar dissection technique. ECL was quantified by image analysis with trainable segmentation software and compared between groups. Scientists also conducted a retrospective analysis of 161 consecutive DMEK graft preparations by a single surgeon using the lamellar dissection technique from 2010 to 2018. Data on donor characteristics and graft preparation failures were obtained. Here are some of the findings: • Baseline donor characteristics were comparable in both arms of the laboratory-based study. • Mean ECL with the lamellar dissection and peeling techniques was 13.8 percent ±4.2 percent and 11.2 percent ±6.1 percent, respectively. • There was no significant difference between the two (p=0.327). • In the clinical series, there were two graft preparation failures in 161 cases (1.2 percent). • Among cases performed on diabetic donor tissue, the rate of graft preparation failure was 4.7 percent. Scientists found that the lamellar dissection technique had a similar rate of ECL compared with the peeling technique for DMEK graft preparation. They added that the technique also had a low rate of graft preparation failure and might be a useful technique for diabetic donor tissue. SOURCE: Tan TE, Devarajan K, Seah XY, et al. Lamellar dissection technique for Descemet membrane endothelial keratoplasty graft preparation. Cornea 2019; Jul 31. [Epub ahead of print]. Older Drivers and Glaucoma in IndiaResearchers analyzed driving habits of individuals with glaucoma and compared their driving behavior, driving difficulties and accident rates with non-glaucoma controls.Glaucoma patients over 40 years old were recruited. Subjects with best-corrected visual acuity ≤6/24 in the better-seeing eye and those having a primary eye disorder other than glaucoma were excluded. Age-matched non-glaucoma controls were recruited. Subjects with clinically significant cataract and/or with best-corrected visual acuity ≤6/24 in both eyes were excluded. All cases and controls were legally licensed to drive. This study used the Driving Habits Questionnaire. Researchers statistically analyzed the collected data using SAS version 9.2 (GLM procedure) and IBM SPSS version 22. P-values <0.05 were considered statistically significant. Here are some of the findings: • All controls, and 84 percent (n: 84/100) of cases involved current drivers. • Among them, 16 percent (n: 16/100) of individuals had stopped driving, of which 31.25 percent (n: 5/16) had stopped because of self-reported ocular causes. • Individuals drove a lesser number of days per week (p=0.001) and had more driving dependence on other drivers (44 percent, n: 37/84) compared with controls. • Glaucoma was significantly associated with driving difficulty in the rain, in rush-hour traffic and at night. • Comparing driving difficulty scores and visual field index within the glaucoma group showed statistical significance [F(1,82)=22.12, p<0.001]. • Composite scores of driving difficulty (p<0.001) and driving space (p=0.003) between the two groups showed strong statistical significance. • Controls had a higher number of self-reported accidents (p<0.001). Researchers wrote that individuals with glaucoma showed greater driving difficulty. They also self-regulated driving behavior and restricted their driving. Researchers added that older patients with glaucoma in India weren’t involved in higher rates of on-road crash risks compared with non-glaucoma drivers. Source: Deshmukh AV, Murthy GJ, Reddy A, et al. Older drivers and glaucoma in india: driving habits and crash risks. J Glaucoma. 2019; Aug 2. [Epub ahead of print]. BRIEFLY Research to Prevent Blindness & AAO Award Grants for Big Data Research Glaukos & Avedro Announce Definitive Acquisition Agreement Kala Dry-eye Application Needs More Efficacy Data Eyenuk’s EyeArt Artificial Intelligence System Studied Macular Degeneration Panel Recommends Paradigm Shift
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