From the editors of Review of Ophthalmology:
MARCH IS WORKPLACE EYE WELLNESS MONTH
In this issue: (click heading to view article)
Higher Intake of Poly- and Monounsaturated Fatty Acid Inversely Associated with AMD
Researchers evaluated the association between dietary fat intake and the presence of age-related macular degeneration, as part of a cross-sectional, observational study with cohorts prospectively recruited from the United States and Portugal.
AMD was diagnosed based on color fundus photographs with the AREDS classification. Researchers used a validated food frequency questionnaire to calculate the percent energy intake of trans fat, saturated fat, monounsaturated fatty acid (MUFA) and polyunsaturated fatty acid (PUFA). For quintiles, they calculated odds ratios and 95% confidence intervals or amount of FA. They used multiple logistic regression to estimate the OR.
A total of 483 participants—386 individuals with AMD and 97 controls were included. Here were some of the findings:
• Higher intake of trans fat was associated with a 2.3-fold higher odds of presence of AMD (p
=0.0156), whereas a higher intake of PUFA (OR, 0.25; p
=0.006) and MUFA (OR, 0.24; p
<0.0001) presented an inverse association.
• Subgroup analysis showed that a higher quintile of trans fat was associated with increased odds of having intermediate AMD (OR, 2.26; p
=0.02); and a higher quintile of PUFA and MUFA were inversely associated with intermediate AMD (OR, 0.2 [p
=0.0013]; OR, 0.17 [p
<0.0001]) and advanced AMD (OR, 0.13 [p
=0.02]; OR, 0.26 [p
• A statistically significant effect modification by country was noted, with a significant inverse association between MUFA and AMD (OR, 0.04; p
<0.0001) for the Portugal population only.
Researchers wrote that their study showed that higher dietary intake of trans fat was associated with the presence of AMD, and a higher intake of PUFA and MUFA was inversely associated with AMD.
SOURCE: Roh M, Shin HJ, Laíns I , et al. Higher intake of polyunsaturated fatty acid and monounsaturated fatty acid is inversely associated with AMD. Invest Ophthalmol Vis Sci. 2020;61:2:20.
Impact of IOP Fluctuations on Ocular Hypertension Conversion to POAG
Investigators looked at the role of intraocular pressure fluctuations and other factors on conversion of ocular hypertension to open-angle glaucoma, as part of a retrospective, longitudinal cohort study.
The study population included individuals with ocular hypertension, defined as IOP >21 mmHg, with normal appearing optic discs and no visual field defect. IOP fluctuation, mean and maximum, were examined in 61 eyes over a follow-up period of 36 months (standard deviation 24). All individuals underwent at least two 48-hour IOP profiles, including night-time IOP measurements in the supine position, VF exams, Heidelberg retina tomograph analyses and optic disc photographs.
Investigators performed regression analyses to demonstrate the impact of IOP parameters, myopia, gender, cup/disc ratio and VF results on conversion to glaucoma. Here were some of their findings:
• While IOP fluctuation and mean IOP didn’t impact conversion, myopia proved to be a risk factor (HR, 14.4; CI, 3.9 to 53; p≤0.001).
• Over an average of three years, 6/61 converted to OAG.
• The study yielded a mean long-term IOP over all available pressure profiles of 18.1 mmHg (SD 3.2) and an IOP fluctuation of 1.9 mmHg (SD 1.1) within a mostly treated cohort.
• The conversion-free five-year rate was 59.8 percent.
Investigators reported that the amount of fluctuation measured in their study sample didn’t result in the development of glaucoma in treated ocular hypertension patients. They added that myopic subjects with ocular hypertension were at a higher risk for glaucoma conversion than non-myopic ocular hypertensive subjects were.
Source: Hopf S, Schwantuschke D, Pfeiffer N, et al. The impact of intraocular pressure fluctuations and other factors on conversion of ocular hypertension to primary open-angle glaucoma. Int Ophthalmol 2020 Feb 17. [Epub ahead of print.]
Topical NSAIDS for Pain from Intravitreal Injections: A Meta-analysis
Scientists explored the role of topical non-steroidal anti-inflammatory agents for the reduction of ocular pain after intravitreal injections (IVIs). They initiated a meta-analysis of randomized controlled trials (RCTs) to provide clarity on the evidence for these agents.
They conducted a systematic literature search on Ovid Medline, Embase and Cochrane Central from inception to July 2019. RCTs that treated patients with a topical NSAID and assessed post-procedural pain were included. Risk of bias was assessed using the Cochrane guidelines. For all analyses, weighted mean differences (WMDs) with 95% confidence intervals were reported. Scientists used random effects models for all analyses.
The primary analysis evaluated pain on a zero to 10-point visual analogue scale. Scientists categorized literature estimates into the following post-procedure timepoint groups: ≤one hour; one to 24 hours (though data was only available at six hours); and ≥24 hours. A subgroup analysis stratified studies based on agent and pre- vs. post-procedure administration. All study endpoints were formulated before data collection.
From 241 results, a total of nine RCTs and 598 eyes were included. There was a low-to-medium risk of bias across the included studies. Here were the findings:
• The mean pain score on a zero to 10 visual analogue scale was significantly lower following topical NSAID administration relative to control at:
o ≤one hour (WMD=-1.01 units, CI, -1.38 to -0.65; p
o six hours (WMD=-2.17 units, CI, -2.67 to -1.68; p
o threshold met for clinical significance, defined as WMD >1.2 units; and >24 hours after IVI (WMD=-0.75 units, CI, -1.11 to -0.38; p
• A greater effect was seen with administration of NSAIDs before vs. after IVIs, as well as topical nepafenac relative to ketorolac or diclofenac.
Scientists concluded that, at six hours post-procedure, NSAIDs provided a clinically meaningful reduction in pain relative to control. They added that the administration of topical nepafenac pre-procedure was associated with the greatest improvement in pain relative to control. Scientists advised that the findings, given the lack of diversity of studies and associated sample size, should be regarded as hypothesis-generating.
SOURCE: Popovic MM, Muni RH, Nichani P, et al. Topical non-steroidal anti-inflammatory drugs for pain from intravitreal injections: A meta-analysis. Ophthalmology Retina 2020; Feb 13. [Epub ahead of print].
“Double-Bubble” DMEK Unfolding in Eyes with Deep Anterior Chambers & ACIOLs
Researchers described a standardized technique for Descemet’s membrane endothelial keratoplasty unfolding in eyes with deep anterior chambers and anterior chamber intraocular lenses.
Two air bubbles were used simultaneously: the first placed on top of the graft and the second one underneath. The two bubbles worked in concert, with the bubble on top propping the tissue partially open, and the bubble underneath levitating the graft away from the ACIOL and providing support for subsequent unfolding maneuvers.
Researchers found that, by sandwiching the graft between two bubbles, unfolding proceeded away from physical contact with the ACIOL, even in eyes with hyper-deep chambers.
SOURCE: Parker JS, Parker JS, Melles GRJ, et al. "Double-bubble" Descemet membrane endothelial keratoplasty unfolding in eyes with deep anterior chambers and anterior chamber intraocular lenses. Cornea 2019; Dec 27. [Epub ahead of print].
RIBOMIC Announces First Injection in Phase II RBM-007 Clinical Trial
Ribomic announced that the first U.S. patient received injection in the Phase II trial of RBM-007 for the treatment of exudative age-related macular degeneration. RBM-007 is an oligonucleotide-based aptamer with anti-FGF2 (fibroblast growth factor 2) activity. Ribomic hopes that the dual action of RBM-007 (anti-angiogenic and anti-scarring) will be effective as an additive or alternative therapy to anti-VEGF treatments for wet AMD. Read more.
ReNeuron Announces Data in Stem Cell Trial
ReNeuron Group announced long-term data from the ongoing Phase I/IIa clinical trial of its hRPC stem cell therapy candidate in retinitis pigmentosa. Since its October 2019 announcement of positive interim efficacy data from the Phase IIa segment in which post-procedure subjects had sustained clinically relevant improvements in visual acuity compared with baseline, the company says that long-term efficacy data continue to show a meaningful clinical effect from the therapy at all time points out to 12 months post-treatment. ReNeuron’s clinical RP program was granted FDA Orphan Drug and Fast Track designations. Read more.
IRIDEX Updates MicroPulse P3 Device for Glaucoma
Iridex recently introduced the second generation of the MicroPulse P3 Device, used by physicians to perform Transscleral Laser Therapy (TLT), a non-incisional, laser-based glaucoma procedure. The company says the device has been redesigned to deliver greater stability, visualization and fit. Among the new MicroPulse P3's design improvements are a recessed fiber tip with added fluid channel to enable consistent fiber immersion in fluid during treatment to improve light coupling to the tissue, a concave “scleral-matching” footplate plate to improve stability and an elongated stem to improve visualization of the treatment area. Read more.
Cambium Announces Orphan Drug Designation for Dry Eye Indication
Cambium Medical Technologies announced the FDA granted the company Orphan Drug Designation for its fibrinogen-depleted human platelet lysate for the treatment of ocular graft-versus-host disease. Orphan Drug Designation is a special status given to drugs or biologics demonstrating the potential to treat rare diseases or conditions. Learn more about the company.
Leo Lens Pharma Focuses on Myopia Management
Leo Lens Pharma received a notice of allowance from the United States Patent and Trademark Office for a patent for the use of its proprietary MediPrint process to manufacture a contact lens capable of providing enhanced myopia management. The novel product is designed to deliver a drug, such as atropine, to the eye. The MediPrint process is compatible with a variety of base contact lenses, the company says. Read more.
J&J Vision Issues Worldwide Call to Prioritize Your Eyes in 2020
Johnson & Johnson Vision announced the launch of Prioritize Your Eyes, a worldwide effort to raise awareness about the connection of eye health to overall health. Prioritize Your Eyes encourages patients to get eye exams and is part of the company’s collaboration with various partners and professional organizations to elevate eye health awareness. Read more.
Eyevance Appoints Speed as Chief Commercial Officer
Eyevance Pharmaceuticals announced the appointment of Julie Speed as chief commercial officer. Speed will be responsible for developing the commercial strategy and overseeing growth of Eyevance’s product portfolio. Speed previously worked at Johnson & Johnson Vision, TearLab and Alcon. Read More.
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