Pre-op SD-OCT can predict vitreolysis outcomes
Spectral domain optical coherence tomography (SD-OCT) can confirm the therapeutic morphological effect of ocriplasmin injections. In a series of 40 patients in a retrospective study who received intravitreal ocriplasmin, 13 of these 40 benefited from treatment. Statistical analysis revealed that higher baseline foveal thickness (p = 0.018) and non-tractional epiretinal membranes (p = 0.05) resulted in a worse outcome. Eyes with treatment success gained nine letters, compared to a gain of only one line in treatment failures. However, the researchers found no correlation between pre-injection SD-OCT findings and visual outcomes.
C Wertheimer et al, “Impact of Preinjection Spectral Domain Optical Coherence Tomography Findings in the Use of Intravitreal Ocriplasmin in a Clinical Setting”, Ophthalmologica 2017, Volume 238, Issue 5.
Morphological response to anti-VEGF most pronounced in first two weeks
New research suggests that the greatest proportion of the morphological effects on the retina induced by intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections in eyes with neovascular age-related macular degeneration (AMD) occurs within the first week after the injection. The prospective study involved 50 patients with active choroidal neovascularisation secondary to AMD. Twenty-two patients received bevacizumab, 15 received ranibizumab and 13 received aflibercept. Spectral-domain optical coherence tomography showed that mean central retinal thickness was 391.22µm at baseline, but was reduced by 26.15µm (p<0.001) after one week, by 12.54µm (p<0.001) after two weeks, but by only 3.52µm (p=0.09) after three weeks. Mean intraretinal layer thickness changed significantly only between baseline and week one (p<0.001).
P Enders et al, “Early Changes of Retinal Morphology in Therapy of Neovascular Age-Related Macular Degeneration with Three Commonly Used Anti-VEGF Agents”, Ophthalmologica 2017, Volume 238, Issue 5.
Autologous blood concentrate effective in refractory macular hole
Re-vitrectomy with autologous platelet concentrate (APC) and gas is a very effective treatment in persistent macular hole after vitrectomy with ILM peeling and gas. The retrospective study of 75 eyes whose MH did not resolve following vitrectomy with ILM peeling and gas and underwent re-vitrectomy with gas and APC or whole blood. Closure rate after revitrectomy was 85.2% (52/61) in the APC group and 7.1% (1/14) in the WB group.
Purtskhvanidze K et al, “Persistent Full-Thickness Idiopathic Macular Hole: Anatomical and Functional Outcome of Revitrectomy with Autologous Platelet Concentrate or Autologous Whole Blood”, Ophthalmologica 2017, Volume 238, Issue 5.
