Volume 20, Number 19Monday, May 4, 2020
In this issue: (click heading to view article)Human Amniotic Membrane Plug to Restore AMD Photoreceptor DamageDespite available treatments for wet age-related macular degeneration, one group of researchers note that if the retinal pigmented epithelium is damaged, medical treatments alone can’t restore acceptable visual acuity. Because of this, the investigators have begun looking for other means to restore vision in these cases. Researchers wrote that the study supported the feasibility and safety of hAM to promote partial retinal function restoration six months after surgery, with VA improvement. They added that the findings also helped demonstrate the interaction between hAM and photoreceptors, and suggested that photoreceptor regeneration may occur. Serum Apelin & Asymmetric Dimethylarginine Levels in XFS or XFGInvestigators wrote that apelin and asymmetric dimethylarginine (ADMA) concentrations affecting the NO pathway may have significance for vascular pathologies and a possible role in vascular comorbidities in exfoliation syndrome (XFS)/exfoliative glaucoma (XFG). Corneal Topography to Evaluate Ablation Zones After SMILE & FS-LASIKScientists evaluated the ablation zone diameter (AZD) using six modes of corneal topography after small-incision lenticule extraction and femtosecond laser-assisted in situ keratomileusis for myopia, and compared programmed and postoperative AZDsThe retrospective, comparative study included 86 right eyes in 86 individuals who underwent SMILE or FS-LASIK at Qingdao, China’s Shandong Eye Institute between June 2016 and August 2017. Data was collected preoperatively, and at one, three and six months postoperatively using the Pentacam system. AZD was determined using six modes of corneal topography: • postoperative axial curvature topography (PACT); • postoperative tangential curvature topography (PTCT); • difference-axial curvature topography (DACT); • difference-tangential curvature topography (DTCT); • postoperative front elevation topography (PFET); and • difference-corneal thickness topography (DCTT). Scientists compared the difference between the programmed and postoperative AZDs between the groups. Here were some of the findings: • At three months, AZDs measured by PTCT, DTCT and PFET post-SMILE showed a significant decrease, while AZD by DACT revealed an increase (p<0.001). • At three months, AZDs measured by PACT, PTCT, DACT, DTCT, PFET and DCTT post-FS-LASIK were significantly decreased (p<0.001), compared with programmed ablation zone values. • AZDs measured by DACT and DTCT after three months were larger in the SMILE group (p<0.001); likewise, the differences between the programmed and postoperative AZDs were lower in the SMILE group (p<0.001). • PACT, PTCT, DACT, DTCT and PFET indicated acceptable inter-observer reliability (ICC >0.75). Scientists determined that, in the treatment of myopia, the achieved topographic ablation zones post-FS-LASIK were smaller than the theoretically designed ones. They also reported that AZDs post-SMILE were larger than those post-FS-LASIK, with an equivalent programmed value. Scientists concluded that DACT may be more suitable for measuring postoperative ablation zones with clearer borders and favorable repeatability. Furthermore, they wrote, this method may have potential for the measurement of ablation zones and further research on visual quality post-refractive surgery. SOURCE: Li H, Peng Y, Chen M, et al. Six modes of corneal topography for evaluation of ablation zones after small-incision lenticule extraction and femtosecond laser-assisted in situ keratomileusis. Graefes Arch Clin Exp Ophthalmol 2020; April 24. [Epub ahead of print]. Adherence to the Mediterranean Diet & Progression to Late AMD in AREDS 1 and 2Researchers aimed to determine whether closer adherence to a Mediterranean diet was associated with altered risk of progression to late age-related macular degeneration and its subtypes. Other objectives assessed interactions with AMD genotype and analyzed progression to large drusen.This was a retrospective analysis of two controlled clinical trial cohorts: the Age-Related Eye Disease Study (AREDS; recruitment 1992-1998) and AREDS2 (recruitment 2006-2008). Participants included eyes with no late AMD at baseline in AREDS participants (n=4,255) and AREDS2 participants (n=3,611)—a total of 13,204 eyes (7,756 participants). The mean age was 71 years (SD 6.6); 56.5 percent were female. Color fundus photographs were collected at annual study visits and graded centrally for late AMD. A Modified Alternative Mediterranean Diet Index (aMedi) scores was calculated for each participant from food frequency questionnaires. Main outcome measures included progression to late AMD, geographic atrophy and neovascular AMD. Progression to large drusen was evaluated in a separate analysis. Here were some of the findings: • Over median 10.2-year follow-up, of 13,204 eyes, 34 percent progressed to late AMD. • Hazard ratios for progression in aMedi tertile 3 vs. 1 were: o 0.78 (CI, 0.71 to 0.85, p<0.0001) for late AMD; o 0.71 (CI, 0.63 to 0.80, p<0.0001) for GA; and o 0.84 (CI, 0.75 to 0.95, p=0.005) for neovascular AMD. • For fish consumption, HRs for late AMD, in quartile 4 vs. 1, were: o 0.69 (CI, 0.58 to 0.82, p<0.0001; AREDS) vs. 0.92 (CI, 0.78 to 1.07, p=0.28; AREDS2), respectively. • In AREDS, both aMedi and its fish component interacted with CFH rs10922109 for late AMD (p=0.01 and p=0.0005, respectively); higher aMedi and fish intake were associated with decreased risk in participants with protective alleles. • In separate analyses (n=5,029 eyes of 3,026 AREDS participants), the HR for progression to large drusen in aMedi tertile 3 vs. 1 was 0.79 (CI, 0.68 to 0.93, p=0.004). Researchers found that closer adherence to a Mediterranean-type diet was associated with lower risk of progression to late AMD and that the signal was greater for GA than neovascular AMD. In addition, they wrote, fish intake contributed to this protective association, and CFH genotype strongly influenced these relationships. Furthermore, researchers added, closer adherence to a Mediterranean-type diet was associated with decreased progression to large drusen. The researchers concluded that these findings may help inform evidence-based dietary recommendations. SOURCE: Keenan TD, Agrón E, Mares J, et al. Adherence to the Mediterranean diet and progression to late age-related macular degeneration in the Age-Related Eye Disease Studies 1 and 2. Ophthalmology 2020; April 26. [Epub ahead of print]. 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