Volume 20, Number 26Monday, June 15, 2020JUNE IS FIREWORKS EYE SAFETY & CATARACT AWARENESS MONTH
Evaluation of a POAG Prediction ModelResearchers assessed whether long-term intraocular pressure variability data improved a prediction model for the development of primary open-angle glaucoma in individuals with untreated ocular hypertension. The post hoc secondary analysis of two randomized clinical trials included data from 709 of 819 participants in the observation group of the Ocular Hypertension Treatment Study followed up from February 28, 1994, to June 1, 2002, and 397 of 500 participants in the placebo group of the European Glaucoma Prevention Study followed up from January 1, 1997, to September 30, 2003. Data analyses were completed between January 1, 2019, and March 15, 2020. The original prediction model for the development of POAG included the following baseline factors: age, IOP, central corneal thickness, vertical cup-disc ratio and pattern SD. This analysis tested whether substitution of baseline IOP with mean follow-up IOP, SD of IOP, maximum IOP, range of IOP or coefficient of variation IOP would improve predictive accuracy. Researchers used the C statistic to compare the predictive accuracy of multivariable landmark Cox proportional hazards regression models for the development of POAG. Data from the OHTS consisted of 97 POAG endpoints from 709 of 819 participants (416 [58.7 percent] women; 177 [25 percent] African American and 490 [69.1 percent] white; mean age, 55.7 ±9.59 years; median [range] follow-up, 6.9 [0.96 to 8.15] years). Data from the EGPS consisted of 44 POAG endpoints from 397 of 500 participants in the placebo group (201 [50.1 percent] women; 397 [100 percent] white; mean age, 57.8 ±9.76 years; median [range] follow-up, 4.9 [1.45 to 5.76] years). Here were some of the findings:
Researchers determined that evidence from the OHTS and the EGPS suggested that long-term variability didn’t add substantial explanatory power to the prediction model as to which individuals with untreated ocular hypertension would develop POAG. SOURCE: Gordon MO, Gao F, Beiser Huecker J, et al. Evaluation of a primary open-angle glaucoma prediction model using long-term intraocular pressure variability data: A secondary analysis of 2 randomized clinical trials. JAMA Ophthalmol 2020; June 4. [Epub ahead of print].
Results from the Duke Glaucoma Registry StudyInvestigators analyzed rates of structural and functional change in a large clinical population of glaucoma and glaucoma suspect patients, as part of a retrospective cohort from the Duke Glaucoma Registry, a large database of electronic medical records of patients from the Duke Eye Center and satellite clinics. A total of 29,548 spectral-domain optical coherence tomography, and 19,812 standard automated perimetry (SAP) tests from 6,138 eyes of 3,669 patients with at least six months of follow-up, two good-quality SD-OCT peripapillary retinal nerve fiber layer tests and two reliable SAP tests were included. Investigators obtained rates of change for the two metrics using linear mixed models, categorized according to pre-established cutoffs, and analyzed according to the severity of the disease. Here were some of the findings:
Investigators wrote that although most individuals under routine care had slow rates of progression, a substantial proportion had rates that could potentially result in major losses if sustained over time. They added that both structural and functional tests should be used to monitor glaucoma, and SD-OCT still has a relevant role in detecting fast progressors in advanced disease. SOURCE: Jammal AA, Thompson AC, Mariottoni EB, et al. Rates of glaucomatous structural and functional change from a large clinical population: The Duke Glaucoma Registry Study. Am J Ophthalmol 2020; May 22. [Epub ahead of print]. Changes in Choroidal Thickness from CNVScientists evaluated topographic changes in choroidal thickness during development of choroidal neovascularization in treatment-naive age-related macular degeneration and tested the value of such changes as a predictive tool of CNV development. This retrospective cohort included 86 eyes that developed CNV from intermediate AMD, 43 eyes with intermediate AMD and 36 eyes without AMD. Patients with intermediate AMD underwent spectral-domain optical coherence tomography using enhanced depth imaging mode every six months until CNV was detected. Choroidal neovascularization was localized to one of the subfields of the Early Treatment of Diabetic Retinopathy Study grids on fluorescein angiography. The average choroidal thickness of each subfield was calculated. Here were some of the findings:
Scientists found that choroidal neovascularization development accompanied choroidal thickening of the corresponding subfield. They added that regular measurement of choroidal thickness may assist in prediction of CNV. SOURCE: Park JY, Kang M-J, Kim BGi, et al. Topographic changes in choroidal thickness in age-related macular degeneration during the development of active choroidal neovascularization. Ophthalmology Retina 2020; May 18. [Epub ahead of print]. Association of CRP Levels with ARMS2 and CFH Variants in AMDResearchers assessed whether plasma high-sensitivity C-reactive protein (hs-CRP) levels were associated with exudative age-related macular degeneration as well as variants of ARMS2 A69S and CFH I62V in patients with exudative AMD. They conducted a case-control study comparing CRP with exudative AMD including individuals with polypoidal choroidal vasculopathy, typical AMD, retinal angiomatous proliferation and CRP. Researchers measured plasma CRP from peripheral blood using latex nepherometry for all participants. They performed genotyping of ARMS2 A69S and CFH I62V for all patients with exudative AMD using TaqMan technology. Here were some of the findings:
Researchers found that plasma hs-CRP was elevated independent of variants of ARMS2 A69S and CFH I62V in patients with exudative AMD. Source: Shijo T, Sakurada Y, Fukuda Y, et al. Association of CRP levels with ARMS2 and CFH variants in age-related macular degeneration. Ophthalmology Retina 2020; June 7. [Epub ahead of print]. BRIEFLY ARVO 2020: Genentech Presents Second Wave of Data FDA Grants 510(k) Clearance for Vasoptic's Retinal Imaging Device J&J Vision to Present First Pediatric Myopia Findings at ARVO’s Virtual Annual Meeting Aerie Pharmaceuticals Appoints Dr. McDonnell to Board FDA Approves New Therapy for Rare Disease Affecting Optic Nerve and Spinal Cord 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. |