Lehigh Valley Center For Sight

This prospective trial compared the healing times of clear corneal incisions after femtosecond laser-assisted versus steel bevel knife-assisted cataract surgery. Study design The study included 58 eyes with 2.2-mm femtosecond laser-assisted biplanar clear corneal incisions, and 34 eyes with 2.2-mm manual single-plane clear corneal incisions. All patients were evaluated on postoperative day 1, week 1, month 1 and month 3 using spectral-domain OCT (RTVue-XR Avanti, Optovue Inc). The authors assessed the rates of Descemet's membrane detachment, posterior wound gape and posterior wound retraction in each group. Outcomes Compared with the control group, the femtosecond group had a lower rate of posterior wound gape on day 1 and a lower rate of Descemet's membrane detachment at all time points. However, the posterior wound retraction rates at months 1 and 3 were significantly higher in the femtosecond group than in the control group. Posterior wound gape and Descemet's deta

The authors compared real-world visual acuity in neovascular AMD patients who were treated with a single anti–VEGF drug for 1 year. https://www.aao.org/editors-choice/iris-registry-analysis-reveals-anti-vegf-monothera

The American Society of Cataract and Refractive Surgery (ASCRS) announced that Stephen H. Speares will succeed David Karcher as the society’s executive director later this year. https://www.aao.org/headline/stephen-speares-appointed-executive-director-of-as

Swiss-based Novartis Pharmaceuticals has acquired rights to commercialize Luxturna—Spark Therapeutics’ gene therapy for inherited retinal dystrophy—outside of the United States. https://www.aao.org/headline/novartis-invests-170-million-ex-u-s-rights-to-luxt

This week, a father creates a brilliant game to help his daughter learn Braille before she goes blind, Novartis and Roche duke it out in Italian courts and a new OCT technology scans the entire eye in unprecedented detail. https://www.aao.org/headline/week-in-review-heroic-dad-anti-vegf-wars-super-sca

A patient with atrophic dry AMD and severe vision loss has regained central visual perception after receiving Prima, a vision restoration system by Pixium Vision. https://www.aao.org/headline/first-successful-implantation-of-bionic-vision-sys

This prospective trial compared the healing times of clear corneal incisions after femtosecond laser-assisted versus steel bevel knife-assisted cataract surgery. https://www.aao.org/editors-choice/femtosecond-laser-assisted-incisions-minimize-woun

JAN 17, 2018 Neuro-Ophthalmology/Orbit, Pediatric Ophth/Strabismus This retrospective review compares the modified Dandy with the new pseudotumor cerebri syndrome (PTCS) criteria for diagnosing children with intracranial hypertension (IH). Study design The study included 50 consecutive patients who were examined in the pediatric IH clinic at Nationwide Children's Hospital (Columbus, Ohio) between May 2010 and June 2013. Of these patients, 40 had primary IH and 10 had secondary IH, according to modified Dandy criteria. The authors retrospectively applied PTCS criteria to all 50 patients and assessed how many met the criteria for IH. Outcomes Following application of the PTSC criteria, children were categorized into 3 groups: definite PTCS (n=31, 62%), probable PTCS (n=10, 20%) and insufficient evidence for diagnosis of PTCS (n=9, 18%). Limitations Non-compliance to treatment and/or poor follow-up may have complicated the retrospective analysis. Lumbar punctures wer

JAN 19, 2018 Oculoplastics/Orbit The first prospective study to evaluate the visual function and optical quality in patients with epiphora before and after lacrimal surgery. Study design This prospective study investigated functional visual acuity, higher order aberrations, lower tear meniscus and tear clearance in 30 patients (34 eyes) who underwent lacrimal passage intubation by a single surgeon. All patients had a canalicular obstruction, nasolacrimal duct obstruction or partial nasolacrimal duct obstruction. Outcomes Investigators observed significant improvements in visual function as shown by improved functional visual acuity and visual maintenance ratio. There was a significant decrease in tear meniscus dimension, which correlated with decreased blinking frequency. Optical quality significantly improved as indicated by a decrease in coma-like aberrations, spherical-like aberrations and total higher order aberrations. Stability index increased and fluctuation ind

JAN 25, 2018 Cornea/External Disease This study compared the incidence of epithelial erosions 1 year after transepithelial photorefractive keratectomy (PRK) versus alcohol-assisted PRK. Study design Researchers matched 189 eyes that had undergone transepithelial PRK with 189 eyes that had undergone alcohol-assisted PRK. They retrospectively evaluated the incidence and symptoms of epithelial erosions in each group using data gathered from a post hoc patient questionnaire. Outcomes Compared with the alcohol-assisted group, the transepithelial group reported less frequent symptoms of subclinical recurrent epithelial erosion, including soreness to touch (6.6% vs. 26.0%), sharp pain (7.9% vs 32.5%) and eyelid sticking (6.6% vs 26.0%; P≤0.002). Furthermore, the mean time for contact lens removal after treatment was shorter in the transepithelial group (2.6 days) than in the alcohol-assisted group (3.7 days; P<0.001). Only 1% (1/100) of the transepithelial group reported t

Using data from the Gutenberg Health Study, researchers examined the effect of systemic anti-hypertensive medications on IOP. Study design This population-based, prospective cohort study included 13,527 patients who were on a wide range of cardiovascular medications: peripheral vasodilators, diuretics, β-blockers (overall, selective and non-selective), calcium channel blockers, renin–angiotensin blockers (overall, ACE inhibitors and angiotensin-receptor blockers), nitrates, other antihypertensive medications, aspirin and statins. IOP was measured using a non-contact tonometer. Any patient on topical IOP-lowering medications or with a history of any ocular surgery was excluded. Outcomes A multivariate analysis found no statistically significant association between the use of oral anti-hypertensive medications and IOP in non-glaucomatous patients. Specifically, in contrast to prior studies, the authors found no association between β-blockers and lower IOP, though there was a slight

JAN 25, 2018 Cornea/External Disease This study compared the incidence of epithelial erosions 1 year after transepithelial photorefractive keratectomy (PRK) versus alcohol-assisted PRK. Study design Researchers matched 189 eyes that had undergone transepithelial PRK with 189 eyes that had undergone alcohol-assisted PRK. They retrospectively evaluated the incidence and symptoms of epithelial erosions in each group using data gathered from a post hoc patient questionnaire. Outcomes Compared with the alcohol-assisted group, the transepithelial group reported less frequent symptoms of subclinical recurrent epithelial erosion, including soreness to touch (6.6% vs. 26.0%), sharp pain (7.9% vs 32.5%) and eyelid sticking (6.6% vs 26.0%; P≤0.002). Furthermore, the mean time for contact lens removal after treatment was shorter in the transepithelial group (2.6 days) than in the alcohol-assisted group (3.7 days; P<0.001). Only 1% (1/100) of the transepithelial group reported t

JAN 26, 2018 By Anni Griswold Cataract/Anterior Segment, Comprehensive Ophthalmology, Cornea/External Disease, Pediatric Ophth/Strabismus, Retina/Vitreous A weekly roundup of ophthalmic news from around the web. A Massachusetts engineer has created a Braille-learning game for his 2-year-old daughter , who has Usher syndrome and is gradually losing her vision. “We knew the world was not going to adapt to her,” he said, so he designed a game to prepare her to take on the world. WBUR Chinese researchers expect to release the first-ever day lenses to reduce short-sightedness in children later this year. Existing orthokeratology contacts are worn at night and cost almost US$2,000 per year. The new day lenses are projected to cost 40% less. Scientists estimate that the lenses could reduce myopia by 60% over 10 years of wear. South China Morning Post A new imaging system could allow doctors to capture whole-eye images in marvelous detail without switching between ins

JAN 26, 2018 By Keng Jin Lee Business Wire Retina/Vitreous, Vision Rehabilitation In a groundbreaking feat, a patient with atrophic dry AMD and severe vision loss has regained central visual perception after receiving Prima, a vision restoration system by Pixium Vision. “Following activation, the patient reported a first perception of light from the central zone where there was none previously,” said Yannick Le Mer, MD, the retinal surgeon who performed the procedure as part of a feasibility study. “The patient now proceeds to the important re-education phase to learn to interpret the elicited light signals and evaluate the performance of the Prima system.” Developed in conjunction with scientists at Stanford University and the Vision Institute in Paris, the micrometer-sized retinal implant contains an electrode array that wirelessly connects to a pocket-sized computer, which performs virtual retinal processing. A pair of glasses serves as a portable visual i

January is National Glaucoma Awareness Month –                                    An important time to raise awareness for this sight-robbing disease. Glaucoma is an age-related disease and is the second leading cause of irreversible blindness in people over 40. Glaucoma is 6 to 8 times more common in African Americans than Caucasians. If you have a close blood relative with glaucoma, it raises your risk of getting it. Glaucoma is the sneak thief of sight, since there are no symptoms and once vision is lost, it’s permanent. As much as 40% of vision can be lost without a person noticing.  More than 3 million people in the United States  and over 60 million people worldwide, have glaucoma. Experts estimate that half of them don’t know they have it. Combined with our aging population, we can see an epidemic of blindness looming if we don’t raise awareness about the importance of regular eye examinations to preserve vision. How to Help Raise Awareness In the United States, approximat

JAN 24, 2018 Ocular Pathology/Oncology, Uveitis Primary intraocular lymphoma is a great masquerader and can be mistaken for uveitis, often delaying diagnosis. In this study, the authors explored whether metagenomic deep sequencing (MDS) of ocular fluid could replace  biopsy as a diagnostic test for primary intraocular lymphoma. Study design Aqueous fluid samples from 2 patients—one with vitreal lymphoma and another with intraocular B-cell lymphoma—were sent for MDS. The high-throughput sequencing approach can detect pathogens as well as common and rare cancer mutations. Outcomes  The first patient was HIV positive. Sequencing detected the presence of Epstein-Barr virus (HHV-4/EBV) and human herpes virus 8 (HHV-8) RNA, both implicated in a type of HIV-related lymphoma. Vitrectomy in this case was suggestive of lymphoma. In the second patient, a rare mutation was found in the MYD88 gene—an uncommon mutation associated with B-cell lymphoma. Vitrectomy, performed 1 ye

JAN 18, 2018 Pediatric Ophth/Strabismus This prospective study ties slow reading to frequent saccades and fixation instability in school-age children with anisometropic amblyopia. Study design Researchers compared 40 anisometropic children, 25 of whom had amblyopia, with 25 healthy controls. The children ranged in age from 7 to 12 years. Participants were monitored using the ReadAlyzer eye movement recording system and a video binocular eye tracker while they silently read a grade-appropriate paragraph under binocular viewing conditions. Outcomes Previous studies have linked strabismic amblyopia to slow reading. This study examines amblyopic children without strabismus, and finds that they also have slow reading. Affected children with amblyopia read 24% slower than those without amblyopia, and 22% slower than controls. Amblyopic anisometropic children also had more forward saccades compared with children in the other two groups. Limitations The study included only

JAN 17, 2018 American Society of Cataract and Refractive Surgery Cataract/Anterior Segment, Comprehensive Ophthalmology, Refractive Mgmt/Intervention The American Society of Cataract and Refractive Surgery (ASCRS)  announced that Stephen H. Speares will become the society’s executive director later this year. Mr. Speares succeeds David Karcher, who will retire in December after leading the ASCRS for 38 years. “I am excited to lead ASCRS and build on Dave’s incredible track record of leadership, dedication to ophthalmology and unwavering commitment to those in the profession,” said Speares. “As we move into this new era, I look forward to leveraging the society’s founding vision, rooted in innovation, to identify new opportunities to increase the value ASCRS brings to anterior segment surgeons, and the patients they serve.” An accomplished ophthalmology executive, Speares is currently the vice president, Europe and Middle East, at Glaukos. He previously worked at A

JAN 17, 2018 Neuro-Ophthalmology/Orbit, Pediatric Ophth/Strabismus This retrospective review compares the modified Dandy with the new pseudotumor cerebri syndrome (PTCS) criteria for diagnosing children with intracranial hypertension (IH). Study design The study included 50 consecutive patients who were examined in the pediatric IH clinic at Nationwide Children's Hospital (Columbus, Ohio) between May 2010 and June 2013. Of these patients, 40 had primary IH and 10 had secondary IH, according to modified Dandy criteria. The authors retrospectively applied PTCS criteria to all 50 patients and assessed how many met the criteria for IH. Outcomes Following application of the PTSC criteria, children were categorized into 3 groups: definite PTCS (n=31, 62%), probable PTCS (n=10, 20%) and insufficient evidence for diagnosis of PTCS (n=9, 18%). Limitations Non-compliance to treatment and/or poor follow-up may have complicated the retrospective analysis. Lumbar punctures wer

Using longitudinal data from a prospective study, investigators compared detection rates of glaucoma progression using OCT and visual field (VF) testing. Study design The cohort comprised 356 glaucoma suspect (GS)/preperimetric glaucoma (PPG) eyes and 153 perimetric glaucoma (PG) eyes from the multicenter Advanced Imaging for Glaucoma Study. OCT progression was defined as a downward trend in average retinal nerve fiber layer (RNFL) or ganglion cell complex (GCC) thickness. VF progression was classified as event-based (Guided Progression Analysis) or trend-based (downward slope of mean deviation and/or visual field index). Outcomes OCT detected RNFL or GCC progression in 59.8% of GS/PPG eyes and 62.1% PG eyes. In contrast, the rate of progression detected using VF (event or trend) was significantly lower: 27.3% GS/PPG eyes and 41.8% PG eyes. The discrepancy in detecting progression was most pronounced in mild glaucoma, but there were no significant differences between detection of

JAN 22, 2018 Pediatric Ophth/Strabismus This study explored whether a home-based binocular video game is an effective strategy for improving visual acuity in older children and adults with unilateral amblyopia. Study design Researchers enrolled 115 children and adults, ranging in age from 7 to 55 years, in a multicenter, double-masked, randomized clinical trial. All participants had unilateral amblyopia (anisometropic or strabismic) with visual acuity between 20/40 and 20/200. The intervention consisted of a falling-blocks video games, which participants played at home on an iPod Touch for 1 hour per day for 6 weeks. The treatment group worse special glasses that enabled a dichoptic contrast offset: The amblyopic eye saw a subset of game elements at 100% contrast, and the fellow eye saw the remaining game elements at a lower contrast. The placebo video game presented identical images to both eyes. Visual acuity was rechecked in 6 weeks. Outcomes The active video gam

JAN 03, 2018 Valeant Comprehensive Ophthalmology, Cornea/External Disease Canadian drugmaker Valeant Pharmaceuticals  announced the approval of the first over-the-counter medication containing low-dose brimonidine tartrate (Lumify) for the treatment of eye redness. While existing eyedrops constrict blood vessels in the eye, Lumify increases the availability of oxygen to surrounding tissue, thereby reducing the potential of side effects such as tolerance, loss of effectiveness and rebound redness. "With today's approval of Lumify, consumers have a new and unique treatment option to relieve red, irritated eyes," said Joseph C. Papa, chairman and CEO of Valeant. "Lumify is the first and only OTC eye drop with low-dose brimonidine, which has been clinically proven to be safe and effective since its initial approval as a prescription medication in 1996." Lumify (brimonidine tartrate ophthalmic solution 0.025%) is made by Valeant's eyecare co

Investigators evaluated demographic and geographic patterns in the use of ranibizumab versus bevacizumab for newly diagnosed neovascular AMD among Medicare beneficiaries in the US. Study design The cohort comprised 195,812 beneficiaries who had Medicare coverage for at least 12 months prior to filing an index claim for wet AMD, and for at least 6 months thereafter. All claims took place between July 2006 and June 2009. The authors assessed the link between demographic factors and the first treatment decision (ranibizumab vs. bevacizumab) after initial diagnosis. The zip code for each index claim was linked to 1 of 9 census regions in the US. Outcomes The odds of receiving ranibizumab as a first treatment declined over time (OR 0.39 in 2009 vs. 2006) and was lowest among Blacks (OR 0.55 vs. non-Blacks) and individuals enrolled in both Medicare and Medicaid (OR 0.67). Four factors increased the odds of receiving ranibizumab: urban areas (OR 1.12 vs. isolated rural towns), higher med

JAN 19, 2018 The first prospective study to evaluate the visual function and optical quality in patients with epiphora before and after lacrimal surgery. Study design This prospective study investigated functional visual acuity, higher order aberrations, lower tear meniscus and tear clearance in 30 patients (34 eyes) who underwent lacrimal passage intubation by a single surgeon. All patients had a canalicular obstruction, nasolacrimal duct obstruction or partial nasolacrimal duct obstruction. Outcomes Investigators observed significant improvements in visual function as shown by improved functional visual acuity and visual maintenance ratio. There was a significant decrease in tear meniscus dimension, which correlated with decreased blinking frequency. Optical quality significantly improved as indicated by a decrease in coma-like aberrations, spherical-like aberrations and total higher order aberrations. Stability index increased and fluctuation index decreased. Limitatio

JAN 19, 2018 The first prospective study to evaluate the visual function and optical quality in patients with epiphora before and after lacrimal surgery. Study design This prospective study investigated functional visual acuity, higher order aberrations, lower tear meniscus and tear clearance in 30 patients (34 eyes) who underwent lacrimal passage intubation by a single surgeon. All patients had a canalicular obstruction, nasolacrimal duct obstruction or partial nasolacrimal duct obstruction. Outcomes Investigators observed significant improvements in visual function as shown by improved functional visual acuity and visual maintenance ratio. There was a significant decrease in tear meniscus dimension, which correlated with decreased blinking frequency. Optical quality significantly improved as indicated by a decrease in coma-like aberrations, spherical-like aberrations and total higher order aberrations. Stability index increased and fluctuation index decreased. Limitatio

JAN 11, 2018 By Anni Griswold Comprehensive Ophthalmology, Glaucoma, Pediatric Ophth/Strabismus A weekly roundup of ophthalmic news from around the web. Five undergrads from Lithuania traveled to California last week to unveil a promising invention:  dissolving contact lenses  that continuously release glaucoma medication. Their NanoLens technology aims to boost drug absorption, negating the need for highly concentrated eyedrops. The aspiring engineers took home second prize at the Silicon Valley Innovation Challenge. LABIOTECH Ohr Pharmaceutical’s CEO was “ very disappointed ” with results of the phase 3 MAKO trial, which tested a combo therapy for people with wet AMD. Topical squalamine combined with monthly ranibizumab injections failed to improve visual acuity beyond ranibizumab monotherapy, Ohr reported. Nasdaq Elsewhere, two phase 3 trials of  Kala Pharmaceutical’s KPI-121 , a twice-daily nanoparticle corticosteroid eyedrop, produced mixed results. Heal

DEC 19, 2017 Pediatric Ophth/Strabismus This retrospective study evaluated outcomes of retinoblastoma treated with intravitreal melphalan as salvage for vitreous seeding. Study design The retrospective review included 28 eyes of 25 patients who were treated at Children's Hospital Los Angeles over a 5-year period. All patients received systemic intravenous chemotherapy followed by intravitreal melphalan as salvage treatment for persistent or recurrent vitreous seeding. Outcomes Overall, intravitreal chemotherapy was very successful at treating all types of vitreous seeds (dust, spheres, cloud). Clouds required the most injections and took more time to regress than dust or spheres. However, spheres were more likely to recur. There was 100% regression of vitreous seeds after intravitreal melphalan, and no eye was treated with radiation or enucleated for seeding. Of the 28 treated eyes, the overall globe salvage rate was 68%. Nine eyes were eventually enucleated: 6 eye

The authors compared real-world visual acuity in neovascular AMD patients who were treated with a single anti–VEGF drug for 1 year. Study design This retrospective, non-randomized, comparative study of real-world visual acuity assessed outcomes after 1 year of treatment with a single anti-VEGF agent (aflibercept, bevacizumab or ranibizumab) for neovascular AMD. The analysis included IRIS Registry data from 13,859 patients, of which 6,723 received bevacizumab, 2,749 received ranibizumab and 4,387 received aflibercept. Outcomes Overall, there were no statistical differences in the age-adjusted or multivariate-adjusted mean vision change among treatment groups. The mean number of injections over the 1-year study period was higher in the ranibizumab (6.4) and aflibercept groups (6.2), compared with the bevacizumab group (5.9; P < 0.0001). Limitations This study uses electronic medical records from the IRIS Registry, which contains a tremendous amount of patient data, but these rec

Investigators evaluated demographic and geographic patterns in the use of ranibizumab versus bevacizumab for newly diagnosed neovascular AMD among Medicare beneficiaries in the US. Study design The cohort comprised 195,812 beneficiaries who had Medicare coverage for at least 12 months prior to filing an index claim for wet AMD, and for at least 6 months thereafter. All claims took place between July 2006 and June 2009. The authors assessed the link between demographic factors and the first treatment decision (ranibizumab vs. bevacizumab) after initial diagnosis. The zip code for each index claim was linked to 1 of 9 census regions in the US. Outcomes The odds of receiving ranibizumab as a first treatment declined over time (OR 0.39 in 2009 vs. 2006) and was lowest among Blacks (OR 0.55 vs. non-Blacks) and individuals enrolled in both Medicare and Medicaid (OR 0.67). Four factors increased the odds of receiving ranibizumab: urban areas (OR 1.12 vs. isolated rural towns), higher med

JAN 19, 2018 By Anni Griswold Comprehensive Ophthalmology, Glaucoma, Vision Rehabilitation A weekly roundup of ophthalmic news from around the web. The FDA is asking big pharma to voluntarily release clinical trial findings that are normally kept under wraps. The agency hopes their new pilot program will enhance the transparency of drug approval decisions , which came under fire last week when STAT reported that only 72% of required results are actually disclosed on ClinicalTrials.gov. FDA/STAT Spark Therapeutics should slash the price of Luxturna by 75%, according to an economic analysis by the Institute for Clinical Evaluation and Review (ICER). The independent nonprofit evaluated the long-term societal benefits of reversing inherited blindness and came up with a ballpark range of $153,000 to $217,000 — a fraction of the gene therapy’s actual $850,000 price . Forbes/PBS Scientists say prolonged exposure to sex hormones can alter cells in a decidedly nonr

JAN 19, 2018 The first prospective study to evaluate the visual function and optical quality in patients with epiphora before and after lacrimal surgery. Study design This prospective study investigated functional visual acuity, higher order aberrations, lower tear meniscus and tear clearance in 30 patients (34 eyes) who underwent lacrimal passage intubation by a single surgeon. All patients had a canalicular obstruction, nasolacrimal duct obstruction or partial nasolacrimal duct obstruction. Outcomes Investigators observed significant improvements in visual function as shown by improved functional visual acuity and visual maintenance ratio. There was a significant decrease in tear meniscus dimension, which correlated with decreased blinking frequency. Optical quality significantly improved as indicated by a decrease in coma-like aberrations, spherical-like aberrations and total higher order aberrations. Stability index increased and fluctuation index decreased. Limitatio

JAN 18, 2018 Glaucoma In this multicenter study, investigators evaluated the performance and safety of the Xen 45 ab interno gelatin stent (Allergan) for refractory glaucoma through a 12-month follow-up period. Study design The single-arm, open-label clinical trial enrolled 65 patients who experienced a failed filtering or cilioablative procedure (84.6%), or uncontrolled IOP (20–35 mm Hg) on maximum medical treatment (15.4%). They were followed for 12 months after stent implantation. Outcomes Approximately 76% of the patients had IOP reductions of at least 20% compared with baseline, on the same or fewer medications. The average drop in IOP was 6.4 mm Hg, and patients were on 2 fewer IOP-lowering medications than they were at baseline. Almost 40% of patients did not require IOP lowering medications following stent placement. No intraoperative or unexpected postoperative complications were reported. Additional surgical intervention was required in 13.8% of patients d

DEC 19, 2017 By Anni Griswold Stealth BioTherapeutics Retina/Vitreous Stealth BioTherapeutics has gained the fast-track designation for elamipretide , an eye drop for Leber’s hereditary optic neuropathy (LHON). If approved, the treatment could benefit an estimated 35,000 people who carry the mitochondrial DNA mutation worldwide, according to Stealth. "Elamipretide offers hope for patients suffering from this rare ophthalmic disease, for which there is no FDA-approved treatment. The loss of vision can be sudden and devastating, often occurring in both eyes within a few weeks' time. Unfortunately, the resulting vision loss is usually permanent, underscoring the desperate need for effective treatment options," said Alfredo Sadun, MD, PhD, UCLA Doheny Eye Institute, the primary investigator for the study. Elamipretide uniquely targets the inner mitochondrial membrane to restore electron transport, improve cellular energy production and reduce oxidative

The authors compared real-world visual acuity in neovascular AMD patients who were treated with a single anti–VEGF drug for 1 year. Study design This retrospective, non-randomized, comparative study of real-world visual acuity assessed outcomes after 1 year of treatment with a single anti-VEGF agent (aflibercept, bevacizumab or ranibizumab) for neovascular AMD. The analysis included IRIS Registry data from 13,859 patients, of which 6,723 received bevacizumab, 2,749 received ranibizumab and 4,387 received aflibercept. Outcomes Overall, there were no statistical differences in the age-adjusted or multivariate-adjusted mean vision change among treatment groups. The mean number of injections over the 1-year study period was higher in the ranibizumab (6.4) and aflibercept groups (6.2), compared with the bevacizumab group (5.9; P < 0.0001). Limitations This study uses electronic medical records from the IRIS Registry, which contains a tremendous amount of patient data, but these rec

JAN 17, 2018 American Society of Cataract and Refractive Surgery Cataract/Anterior Segment, Comprehensive Ophthalmology, Refractive Mgmt/Intervention The American Society of Cataract and Refractive Surgery (ASCRS)  announced that Stephen H. Speares will become the society’s executive director later this year. Mr. Speares succeeds David Karcher, who will retire in December after leading the ASCRS for 38 years. “I am excited to lead ASCRS and build on Dave’s incredible track record of leadership, dedication to ophthalmology and unwavering commitment to those in the profession,” said Speares. “As we move into this new era, I look forward to leveraging the society’s founding vision, rooted in innovation, to identify new opportunities to increase the value ASCRS brings to anterior segment surgeons, and the patients they serve.” An accomplished ophthalmology executive, Speares is currently the vice president, Europe and Middle East, at Glaukos. He previously worked at A

JAN 16, 2018 Retina/Vitreous Investigators have found that standard OCT protocols may be inadequate for detecting hydroxychloroquine (HCQ) retinopathy in some Asian patients. Study design This was a prospective study on 48 eyes of 24 Asian patients with HCQ retinopathy. Participants underwent imaging with spectral domain OCT (6 mm line and 6×6-mm 2  volume scans) and swept-source OCT (9-mm line scans, 6×6-mm 2  and 12x9-mm 2  volume scans). Outcomes Approximately one-third of eyes had photoreceptor defects that were greater than 3 mm away from the fovea. These peripheral lesions were not covered by standard OCT scans, and were seen only on wide-field line or volume scans. The 9-mm line scans showed significantly better sensitivity than 6-mm scans in detecting HCQ retinopathy (P<0.001). Wide volume scan also showed greater sensitivity over standard volume scans (P=0.001). Limitations This study was limited by a relatively small sample size with varying degrees o

DEC 19, 2017 By Keng Jin Lee Aerie Pharmaceuticals Glaucoma Aerie Pharmaceuticals announced that the FDA has approved their once-daily glaucoma drop, Rhopressa , for lowering IOP in patients with open-angle glaucoma or ocular hypertension. The approval, which has been anticipated ever since an FDA advisory panel voted 9-1 in Rhopressa’s favor, comes 2 months ahead of the expected date. Rhopressa (netarsudil ophthalmic solution 0.02%) is a first-in-class therapy that lowers pressure by targeting the trabecular meshwork. “The approval of once-daily Rhopressa represents the single greatest achievement in Aerie’s history to date, and represents exciting news for patients with open-angle glaucoma or ocular hypertension, and physicians,” said Vicente Anido, Jr., PhD, chairman and CEO at Aerie. “We will hire our sales force of 100 sales representatives early in the first quarter of 2018, and plan to launch by mid-second quarter of 2018.” Aerie also announced that a n

DEC 19, 2017 By Anni Griswold Stealth BioTherapeutics Retina/Vitreous Stealth BioTherapeutics has gained the fast-track designation for elamipretide , an eye drop for Leber’s hereditary optic neuropathy (LHON). If approved, the treatment could benefit an estimated 35,000 people who carry the mitochondrial DNA mutation worldwide, according to Stealth. "Elamipretide offers hope for patients suffering from this rare ophthalmic disease, for which there is no FDA-approved treatment. The loss of vision can be sudden and devastating, often occurring in both eyes within a few weeks' time. Unfortunately, the resulting vision loss is usually permanent, underscoring the desperate need for effective treatment options," said Alfredo Sadun, MD, PhD, UCLA Doheny Eye Institute, the primary investigator for the study. Elamipretide uniquely targets the inner mitochondrial membrane to restore electron transport, improve cellular energy production and reduce oxidative

JAN 03, 2018 Valeant Comprehensive Ophthalmology, Cornea/External Disease Canadian drugmaker Valeant Pharmaceuticals  announced the approval of the first over-the-counter medication containing low-dose brimonidine tartrate (Lumify) for the treatment of eye redness. While existing eyedrops constrict blood vessels in the eye, Lumify increases the availability of oxygen to surrounding tissue, thereby reducing the potential of side effects such as tolerance, loss of effectiveness and rebound redness. "With today's approval of Lumify, consumers have a new and unique treatment option to relieve red, irritated eyes," said Joseph C. Papa, chairman and CEO of Valeant. "Lumify is the first and only OTC eye drop with low-dose brimonidine, which has been clinically proven to be safe and effective since its initial approval as a prescription medication in 1996." Lumify (brimonidine tartrate ophthalmic solution 0.025%) is made by Valeant's eyecare co

The authors compared real-world visual acuity in neovascular AMD patients who were treated with a single anti–VEGF drug for 1 year. Study design This retrospective, non-randomized, comparative study of real-world visual acuity assessed outcomes after 1 year of treatment with a single anti-VEGF agent (aflibercept, bevacizumab or ranibizumab) for neovascular AMD. The analysis included IRIS Registry data from 13,859 patients, of which 6,723 received bevacizumab, 2,749 received ranibizumab and 4,387 received aflibercept. Outcomes Overall, there were no statistical differences in the age-adjusted or multivariate-adjusted mean vision change among treatment groups. The mean number of injections over the 1-year study period was higher in the ranibizumab (6.4) and aflibercept groups (6.2), compared with the bevacizumab group (5.9; P < 0.0001). Limitations This study uses electronic medical records from the IRIS Registry, which contains a tremendous amount of patient data, but these rec

DEC 19, 2017 By Keng Jin Lee Aerie Pharmaceuticals Glaucoma Aerie Pharmaceuticals announced that the FDA has approved their once-daily glaucoma drop, Rhopressa , for lowering IOP in patients with open-angle glaucoma or ocular hypertension. The approval, which has been anticipated ever since an FDA advisory panel voted 9-1 in Rhopressa’s favor, comes 2 months ahead of the expected date. Rhopressa (netarsudil ophthalmic solution 0.02%) is a first-in-class therapy that lowers pressure by targeting the trabecular meshwork. “The approval of once-daily Rhopressa represents the single greatest achievement in Aerie’s history to date, and represents exciting news for patients with open-angle glaucoma or ocular hypertension, and physicians,” said Vicente Anido, Jr., PhD, chairman and CEO at Aerie. “We will hire our sales force of 100 sales representatives early in the first quarter of 2018, and plan to launch by mid-second quarter of 2018.” Aerie also announced that a n

DEC 19, 2017 By Anni Griswold Stealth BioTherapeutics Retina/Vitreous Stealth BioTherapeutics has gained the fast-track designation for elamipretide , an eye drop for Leber’s hereditary optic neuropathy (LHON). If approved, the treatment could benefit an estimated 35,000 people who carry the mitochondrial DNA mutation worldwide, according to Stealth. "Elamipretide offers hope for patients suffering from this rare ophthalmic disease, for which there is no FDA-approved treatment. The loss of vision can be sudden and devastating, often occurring in both eyes within a few weeks' time. Unfortunately, the resulting vision loss is usually permanent, underscoring the desperate need for effective treatment options," said Alfredo Sadun, MD, PhD, UCLA Doheny Eye Institute, the primary investigator for the study. Elamipretide uniquely targets the inner mitochondrial membrane to restore electron transport, improve cellular energy production and reduce oxidative

JAN 03, 2018 Valeant Comprehensive Ophthalmology, Cornea/External Disease Canadian drugmaker Valeant Pharmaceuticals  announced the approval of the first over-the-counter medication containing low-dose brimonidine tartrate (Lumify) for the treatment of eye redness. While existing eyedrops constrict blood vessels in the eye, Lumify increases the availability of oxygen to surrounding tissue, thereby reducing the potential of side effects such as tolerance, loss of effectiveness and rebound redness. "With today's approval of Lumify, consumers have a new and unique treatment option to relieve red, irritated eyes," said Joseph C. Papa, chairman and CEO of Valeant. "Lumify is the first and only OTC eye drop with low-dose brimonidine, which has been clinically proven to be safe and effective since its initial approval as a prescription medication in 1996." Lumify (brimonidine tartrate ophthalmic solution 0.025%) is made by Valeant's eyecare co

The authors compared real-world visual acuity in neovascular AMD patients who were treated with a single anti–VEGF drug for 1 year. Study design This retrospective, non-randomized, comparative study of real-world visual acuity assessed outcomes after 1 year of treatment with a single anti-VEGF agent (aflibercept, bevacizumab or ranibizumab) for neovascular AMD. The analysis included IRIS Registry data from 13,859 patients, of which 6,723 received bevacizumab, 2,749 received ranibizumab and 4,387 received aflibercept. Outcomes Overall, there were no statistical differences in the age-adjusted or multivariate-adjusted mean vision change among treatment groups. The mean number of injections over the 1-year study period was higher in the ranibizumab (6.4) and aflibercept groups (6.2), compared with the bevacizumab group (5.9; P < 0.0001). Limitations This study uses electronic medical records from the IRIS Registry, which contains a tremendous amount of patient data, but these rec

JAN 12, 2018 By Keng Jin Lee Glaukos Glaucoma Interim findings from a phase 2 trial hint that Glaukos’ travapost intraocular implant may maintain reduced IOP in patients with glaucoma. Injected through a clear corneal incision and secured in the anterior chamber, the iDose delivery system releases a steady stream of travapost over an extended time. Once the medication is depleted, the titanium implant can be removed and replaced in a separate procedure. The multicenter, randomized, double-masked trial enrolled 154 patients who received fast or slow versions of the iDose delivery system, or a control solution of 0.5% topical timolol. During the trial’s first 12 months, 49 patients in the implant group achieved an approximately 30% reduction in mean IOP from baseline. The mean number of glaucoma medications ranged from 0.54 to 0.56 at 12 months in both iDose arms, compared with 0.72 in the timolol arm. The implant’s safety profile remains favorable, with no ad

JAN 11, 2018 Comprehensive Ophthalmology, Neuro-Ophthalmology/Orbit This phase 2 clinical trial (ReBUILD) evaluated the use of clemastine fumarate—a first-generation antihistamine capable of inducing oligodendrocyte differentiation—as a remyelinating therapy for patients with multiple sclerosis. Study design Researchers enrolled 50 patients with chronic multiple sclerosis in this single center, double-blind, randomized, placebo-controlled, crossover trial. They randomly assigned participants to clemastine fumarate for 90 days followed by placebo for 60 days (25 patients), or to a placebo for 90 days followed by clemastine fumarate for 60 days (25 patients).  The primary outcome was shortening of P100 latency delay on visual evoked potentials (VEP). Outcomes Clemastine fumarate reduced the latency delay by 1.7 ms/eye on VEP (p=0.0048).  There was a trend toward improvement in low-contrast letter acuity. This trend reached significance in a post-hoc delayed-treatment a