Ophthalmologica

Vitrectomy successful in cases where vitreolysis fails Vitrectomy with internal limiting membrane peeling leads to closure of macular holes even in cases of prior failure to close them by injection of the vitreolytic agent, ocriplasmin, new research suggests. In a retrospective case series study involving three eyes of three consecutive patients who had enlargement of macular holes following ocriplasmin intravitreal injection, the performance of vitrectomy, internal limiting membrane peeling and gas injection a few months later resulted in closure of the macular holes in all eyes. In addition, visual acuity ranged from 20/80 to 20/40 before ocriplasmin injection and from 20/32 to 20/25 18 months after vitrectomy. A Benarous et al, “Long-Term Results of Vitrectomy for Macular Holes after Failure of Vitreolysis”, Ophthalmologica 2018, volume 240, issue 1. Eyes with dry AMD benefit from sildenafil Treatment with the phosphodiesterase inhibitor, sildenafil, offers significant potential to patients for vision retention following macular degeneration, a new report suggests. In a study involving four patients with macular changes associated with age-related macular degeneration, such as soft and hard and acquired vitelliform lesions in the fovea, and a patient with Best vitelliform macular dystrophy disease, all eyes appeared to benefit from PDE6. In addition, the patient with Best disease had a significant improvement in vision as well as in photoreceptor and ellipsoid layers. DJ Coleman, “Treatment of Macular Degeneration with Sildenafil: Results of a Two-Year Trial”, Ophthalmologica 2018, volume 240, issue 1. Monthly anti-VEGF dosing better for neovascular AMD without PVD In eyes with neovascular age-related macular degeneration but lacking a posterior vitreous detachment (PVD), pro-re-nata (PRN) anti-VEGF regimens appear to be less effective than monthly dosing, a new study suggests. A retrospective sub-analysis of 64 eyes from 64 neovascular patients from two prospective clinical trials showed that eyes without PVD gained a mean of only 0.3 letters, compared to 9.2 letters among those with PVD. The difference between PVD and non-PVD groups was highly significant (p = 0.003). among those treated on a PRN basis, which had a mean loss of five letters and a mean gain of 11.9 letters, respectively. However, there was no significant difference in letters gained or lost between the PVD and non-PVD groups who received monthly dosing, with respective mean gains of 4.3 letters and 7.8 letters (p = 0.424). P Gil et al “Influence of the Vitreoretinal Interface on the Treatment with Anti-VEGF for Exudative Age-Related Macular Degeneration”, Ophthalmologica 2018, volume 240, issue 1.