From the editors of Review of Ophthalmology:
APRIL IS SPORTS EYE SAFETY MONTH
In this issue: (click heading to view article)
ICGA-guided Focal Navigated Laser Photocoagulation for DME
Researchers evaluated the efficacy of indocyanine-green angiography-guided navigated focal laser photocoagulation for diabetic macular edema, as part of a
prospective, interventional case series.
Six individuals (eight eyes) were enrolled in the study. Researchers performed fluorescein angiography and ICGA using the Heidelberg Retina Angiogram 2. They delivered navigated focal laser photocoagulation to the microaneurysms on ICGA using the Navilas system (OD-OS). Researchers measured central retinal thickness and macular volume by the Cirrus HD-OCT (Carl Zeiss Meditec). At six months, they compared the best-corrected visual acuity, CRT and MV to the values measured prior to procedures. They measured distances from the center of the fovea to the closest microaneurysms on pre-planned Navilas images. All eyes had a previous treatment history. Here were some of the findings:
• At six months, ICGA-guided navigated focal laser photocoagulation significantly reduced the CRT and MV (p<
0.05), and improvement was found in the BCVA (p<
• At three months, five out of eight eyes (63 percent) underwent additional ICGA-guided navigated focal laser photocoagulation due to remnants of MAs that had been confirmed by ICGA.
• No observed recurrence of edema was found after the ICGA-guided navigated focal laser photocoagulation during the six-month follow-up.
• The mean distance from the center of the fovea to the closest MAs was 624.8 ±377.7 μm (range, 336 to 1438.9 μm).
Researchers determined that their data suggests that ICGA-guided navigated focal laser photocoagulation might be effective for the treatment of DME.
SOURCE: Nozaki M, Kato A, Yasukawa T, et al. Indocyanine green angiography-guided focal navigated laser photocoagulation for diabetic macular edema. Jpn J Ophthalmol 2019; Feb 26. [Epub ahead of print].
Emulsified Silicone Oil Droplets in Schlemm’s Canal
Investigators evaluated the presence of emulsified silicone oil droplets in Schlemm’s canal, using anterior-segment optical coherence tomography.
They reviewed AS-OCT images from eyes that had undergone retinal detachment surgeries three years ago. At the time of surgery, SO had been used as the tamponading agent.
The AS-OCT images demonstrated that minute emulsified SO droplets were present in Schlemm’s canal.
Investigators wrote that retention of SO in the eye for an extended period of time after RD surgery led to secondary glaucoma. They added that presence of minute emulsified SO droplets in Schlemm’s canal might contribute to this process.
SOURCE: Madanagopalan VG, Velis G, Devulapally S, et al. Emulsified silicone oil droplets in the canal of Schlemm. Int Ophthalmol. 2019; Apr;39:4:925-6.
Features of RPE & Chorioretinal Characteristics in Eyes with Early AMD & Subretinal Drusenoid Deposits
Researchers assessed the features of the retinal pigment epithelium on optical coherence tomography in eyes with early age-related macular degeneration and subretinal drusenoid deposits.
They classified the eyes into three types: nonundulating RPE; undulating RPE; and wedge-shaped RPE. And they compared the retinal vessel densities, retinal thickness and choroidal thickness of a 3-mm-diameter zone. Here were some of the findings:
• A total of 33 eyes were classified as nonundulating RPE, 27 eyes were classified as undulating RPE and 20 eyes were identified as wedge-shaped RPE eyes.
• The vascular densities of the superficial and deep capillary plexus showed differences: nonundulating RPE group (23.93 ±2.26 percent and 23.54 ±1.78 percent); undulating RPE group (22.29 ±2.80 percent and 21.94 ±2.42 percent); and wedge-shaped RPE group (21.93 ±2.7 percent and 20.63 ±2.42 percent, p=0.010 and p<0.001).
• Mean retinal thicknesses and choroidal thicknesses were also different. The respective findings were: nonundulating RPE group (298.26 ±13.81 µm and 180.08 ±55.49 µm); undulating RPE group (285.29 ±21.88 µm and 148.45 ±55.08 µm); and wedge-shaped RPE group (274.86 ±20.62 µm and 135.75 ±39.77 µm) (p=0.001 and p=0.007).
Researchers reported that altered features of the RPE on optical coherence tomography might indicate advancement in disease and be part of an overall degeneration process in these eyes.
SOURCE: Jang S, Park SY, Ahn SM, et al. Morphologic features of the retinal pigment epithelium and associated chorioretinal characteristics in eyes with early age-related macular degeneration and subretinal drusenoid deposits. Retina. 2019; Apr 2. [Epub ahead of print].
SS-OCT for Evaluating Lamina Cribrosa: Report by the AAO
Scientists reviewed the published literature on the use of swept-source optical coherence tomography for evaluating the lamina cribrosa in glaucoma.
They undertook a PubMed and Cochrane Library literature search on March 3, 2017, and updated it on June 26, 2018—yielding a total of 64 articles, with 29 fitting inclusion criteria. The panel methodologist assigned an evidence level rating to each study. Fifteen studies were rated level III, 14 studies were rated level II and no studies were rated level I.
Different aspects of the LC were studied using SS-OCT, including anterior LC curvature, depth and insertions; laminar thickness, focal LC defects and LC microarchitecture. Here were some of the findings:
• In general, imaging of the anterior lamina could be achieved reliably, although shadowing from blood vessels at the neuro-retinal rim remained an issue.
• Imaging of the posterior lamina could be achieved with varying levels of success.
• Glaucoma exhibited posterior migration of anterior LC insertions, as well as increased thinning and posterior curvature of the LC.
• FLCDs appeared more commonly in glaucoma, potentially indicating pathogenesis of axonal damage.
• Remodeling of the microarchitecture of the lamina was possible, resulting in more variable laminar pores.
• A limited number of studies compared the lamina on SS-OCT vs. spectral-domain OCT, but the difference in image quality between enhanced-depth imaging with SD-OCT and SS-OCT appeared to be minimal.
Scientists concluded that imaging the LC with SS-OCT has demonstrated that the LC is likely biomechanically active and that significant structural changes occur in glaucoma. They added that the diagnostic utility of SS-OCT for LC imaging was promising, but that standardized nomenclature, automated measurements and longitudinal studies with larger and more diverse sample sizes would be needed.
SOURCE: Takusagawa HL, Hoguet A, Junk AK, et al. Swept-source optical coherence tomography for evaluating the lamina cribrosa: A report by the American Academy of Ophthalmology. Ophthalmology 2019; Apr 3. [Epub ahead of print].
J&J Vision’s Investigational Antihistamine-releasing CLs Demonstrate Positive Phase III Results
Johnson & Johnson Vision announced that the results from two Phase III clinical studies, published in Cornea, evaluating the company’s investigational antihistamine-releasing daily-disposable contact lens (etafilcon A with 0.019 mg ketotifen) demonstrated that patients wearing the lens had lower mean itching scores after their eyes were exposed to allergens compared with those wearing non-medicated control lenses. The two multicenter, double-masked, randomized, placebo-controlled trials included 244 patients and used the conjunctival allergen challenge model (Ora-CAC) to measure efficacy. Read more.
Clearside Appoints Lasezkay as Interim CEO
Clearside Biomedical announced that its board of directors appointed biopharmaceutical executive George Lasezkay, PharmD, JD, to the position of interim chief executive officer, effective immediately. Lasezkay, a member of the Clearside board of directors, succeeds Daniel H. White, who resigned as president and CEO and as a member of the board of directors to pursue other opportunities. The board is initiating a search to identify a permanent CEO. Read more.
Allegro Appoints Carlson and Colbert to Board
Allegro Ophthalmics announced that two new independent members—Marc Carlson and Rebecca Colbert—were appointed to the company's board of directors, with Colbert serving as chairperson of the board's Audit Committee. Carlson brings more than 35 years of experience commercializing products in various industries. Colbert is chief financial officer at Vertos Medical, and has more than 15 years of experience working in senior level positions for medical device companies. Read more.
Asepticys Files 510(k) Submission for TriFlect Disinfection Technology
Asepticys announced the successful completion of multi-site human clinical trials for Asepticys' novel contact lens care solution containing TriFlect technology in addition to its 510(k) application submission to the FDA. The trials involved more than 320 patients at 12 sites. Read more.
Avedro Reaches Reimbursement Milestone
Avedro announced that four new providers—Providence Health Plan in the Pacific Northwest, Health New England, HealthPartners Minnesota and Public Employees Health Plan in Utah—issued positive coverage policies for the company’s corneal cross-linking procedure. This brings the total number of commercial plans covering the KXL system and its associated Photrexa drug formulations to more than 65. Read more.
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