Volume 20, Number 14Monday, March 30, 2020MARCH IS WORKPLACE EYE WELLNESS MONTH In this issue: (click heading to view article)
FAZ Measurement Via OCTA and its Relationship with VF in OAGResearchers wrote that the foveal avascular zone in optical coherence tomography angiography is significantly correlated with retinal inner layer thickness, Humphrey Field Analyzer 10-2 sensitivity threshold and mean deviation value in open-angle glaucoma patients. They aimed to measure the FAZ area using OCTA, and investigate its relationship with retinal inner layer thickness and visual field defects in eyes with open-angle glaucoma.A total of 52 eyes with OAG from 52 individuals were included in this study. FAZ area was measured using OCTA in angio-macula mode. Researchers determined thicknesses of retinal nerve fiber layer, ganglion cell layer plus inner plexiform layer (GCL+IPL) and ganglion cell complex (GCC) using a 7 mm × 7 mm macular (V) map via 3D-OCT. They analyzed correlations of FAZ area with sensitivity threshold measurements, foveal threshold (FT), and mean deviation value in the HFA 10-2 VF for each inner retinal layer. Here were some of the findings: • FAZ area was 0.26 ±0.07 mm2. • Overall mean thicknesses were: 19.14 ±6.55 μm (RNFL); 57.34 ±5.93 µm (GCL+IPL); and 75.87 ±10.96 μm (GCC). • Mean FT was 35.23 ±3.15 dB. • Sensitivity threshold was 20.81 ±7.22 dB in the HFA 10-2 VF. • FAZ area was significantly correlated with thickness of individual retinal layers in the entire field (RNFL, p<0.001; GCL+IPL, p<0.001; GCC, p<0.001); sensitivity threshold (p=0.01); FT (p<0.001) and MD value (p=0.011). Researchers concluded that FAZ area was significantly negatively correlated with retinal inner layer thickness, sensitivity threshold, FT and MD value in the HFA 10-2 visual field. SOURCE: Igarashi R, Ochiai S, Togano T, et al. Foveal avascular zone measurement via optical coherence tomography angiography and its relationship with the visual field in eyes with open-angle glaucoma. J Glaucoma. 2020; Mar 19. [Epub ahead of print]. Incidence & Progression of Non-geographic Atrophy in CATTInvestigators wrote that retinal hypopigmentation and hyperpigmentation are precursors of geographic atrophy. They added that incidence and progression to GA in eyes treated with anti-vascular endothelial growth factor for neovascular age-related macular degeneration haven’t been investigated. So the investigators aimed to determine the incidence and progression of non-GA (NGA)— also known as “incipient atrophy" since they usually precede GA and are more likely to develop soft drusen and choroidal neovascularization—and associated risk factors. Source: Daniel E, Maguire MG, Grunwald JE, et al. Incidence and progression of nongeographic atrophy in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT) Clinical Trial. Ophthalmology 2020; March 19. [Epub ahead of print.] Differential Diagnosis of Sjögren’s vs. Non-Sjögren’s Dry Eye Through Tear-film BiomarkersScientists wrote that systemic implications necessitate the identification of dry-eye patients with Sjögren’s syndrome (SS). Their study looked at the utility of tear MUC5AC and inflammatory cytokine levels in the differential diagnosis of SS-related dry eye.Scientists conducted a prospective, observational, case-control study on 62 individuals (those with a definitive diagnosis of SS dry eye, non-SS dry eye and age-matched healthy controls with no dry eye). Clinical evaluations included the following tests in this order: noninvasive tear break-up time, osmolarity, tear sampling, Schirmer test without anesthesia and ocular surface staining (lissamine green for conjunctiva and fluorescein for cornea). Tear MUC5AC levels were assessed with enzyme-linked immunosorbent assay, and cytokines [interferon-gamma, tumor necrosis factor alpha, interleukin (IL)-6, IL-17a, IL-1β, IL-8, IL-10 and IL-12p70] were measured using a Luminex assay in a masked fashion. Here were some of the findings: • The bulbar conjunctival lissamine green staining score was significantly greater in patients or controls with SS vs. non-SS dry eye. • This greater conjunctival staining was associated with a reduction in tear MUC5AC (B=-17.8 ng/mL; CI, -31.8 to -3.9; p=0.01). • Among the tear cytokines, a significant association was found between IL-8 levels (hazard ratio [HR]=1.002; CI,1.000 to 1.003; p=0.03) and SS diagnosis. • When individuals were stratified based on tear MUC5AC levels, scientists detected significantly increased tear IL-8 levels in SS dry eye but not non-SS dry eye, compared with healthy control eyes. Scientists reported that tear levels of goblet cell-specific MUC5AC combined with IL-8 may potentially serve as a useful biomarker for differential diagnosis of SS dry eye from non-SS dry eye. SOURCE: Akpek EK, Wu HY, Karakus S, et al. Differential diagnosis of Sjögren versus non-Sjögren dry eye through tear film biomarkers. Cornea 2020; March 13. [Epub ahead of print]. Application of Automated Quantification of Fluid Volumes to Anti-VEGF Therapy of nAMDIn a study of wet AMD, researchers say a better way to quantify the disease might help with its treatment. Although researchers wrote that poor outcomes reported from clinical practice are multifactorial, they suggested that the availability of reliable, reproducible and quantitative evaluation tools to accurately measure the fluid response, i.e. a “VEGF meter,” may be a better means of monitoring and treating than the current solely qualitative evaluation used in clinical practice.This post-hoc analysis of a Phase III, randomized, multicenter study evaluated study eyes of 1,095 treatment-naive subjects receiving pro-re-nata or monthly ranibizumab therapy, according to protocol-specified criteria in the HARBOR study. A deep learning method for localization and quantification of fluid in all retinal compartments was applied for automated segmentation of fluid with every voxel classified by a convolutional neural network (CNN). Three-dimensional volumes (nl) for intraretinal (IRF), subretinal fluid (SRF) and pigment epithelial detachment (PED) were determined in 24,362 volume scans obtained from 1,095 individuals treated over 24 months in a Phase III clinical trial with randomization to two drug dosages (0.5- and 2-mg ranibizumab) and two regimens (monthly and PRN). A multivariable mixed-effects regression model was used to test for differences in fluid between the arms and for fluid/function correlation. Main outcome measures included fluid volume in nanoliters (nl), structure-function as Pearson’s correlation coefficient and as a coefficient of determination (R2). Fluid volumes were quantified in all visits of all patients. Here were some of the findings: • Automated segmentation demonstrated characteristic response patterns for each fluid compartment individually: IRF showed the greatest and most rapid resolution, followed by SRF and PED the least. • The loading dose treatment achieved resolution of all fluid types close to the lowest levels attainable. • Dosage and regimen parameters correlated directly with resulting fluid volumes. • Fluid/function correlation showed a volume-dependent negative impact of IRF on vision and a weak positive prognostic effect of SRF. Researchers reported that automated quantification of the fluid response may improve therapeutic management of neovascular AMD, avoid discrepancies between clinicians/investigators and establish structure/function correlations. SOURCE: Schmidt-Erfurth U, Vogl W-D, Jampol LM, et al. Application of automated quantification of fluid volumes to anti-VEGF therapy of neovascular age-related macular degeneration. Ophthalmology 2020; March 17. [Epub ahead of print]. BRIEFLY Regeneron to Extend Payment Terms for Eylea Reichert Signs Exclusive Deal for CATS Reusable Tonometer Prisms ImprimisRx Enters Into Agreement with Doxy.me for Telemedicine Services HORAMA Signs Agreement with Leiden University to Target CRB1 Gene Mutations to Treat Inherited Retinal Dystrophies Heidelberg Brings Back In Vivo Corneal Microscope Due to High Demand IVERIC bio Delays Enrollment for Zimura’s Second Trial in GA Secondary to Dry AMD 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. |