OPHTHALMOLOGICA

VITRECTOMISED EYES HAVE SLOWER BUT EQUAL 
RESPONSE TO INTRAVITREAL ANTI-VEGF A history of vitrectomy is not a contraindication for anti-VEGF therapy in eyes with diabetic macular oedema (DME), new research suggests. In a prospective study, there were no statistically significant differences between the safety and efficacy of intravitreal ranibizumab in 10 vitrectomised and 15 non-vitrectomised eyes with DME. After six months of treatment, the non-vitrectomised eyes had significant improvement in terms of both mean best corrected visual acuity (BCVA) and mean central macular thickness (CMT). The vitrectomised eyes also had a significant improvement in mean CMT, although their improvement in BCVA did not reach statistical significance. In addition, the treatment response was slower in the vitrectomised eyes. However, at six months there was no significant difference between the groups in terms of improvement in either BCVA or CMT. Y Koyanagi et al, “Comparison of the Effectiveness of Intravitreal Ranibizumab for Diabetic Macular Edema in Vitrectomized and Nonvitrectomized Eyes”; Ophthalmologica 2016, Volume 236, Issue 2. FRAGMENTED DEXAMETHASONE INTRAVITREAL IMPLANTS STILL AS EFFECTIVE Fragmentation of the Ozurdex® (Allergan) dexamethasone intravitreal implant does not influence the implant’s efficacy or safety in eyes with macular oedema (ME) secondary to branch retinal vein occlusion (BRVO), a new study indicates. It showed that the implants were broken in six (8.8 per cent) of 68 consecutive patients undergoing treatment for BRVO-induced ME. However, the two groups did not differ in BCVA at any time point (all p>0.05). There were also no differences in the ME recurrence rate, frequency of intraocular pressure elevation, or cataract progression between the two groups (p>0.05). JC Im et al, “Does Intravitreal Dexamethasone Implant Fragmentation Affect Clinical Outcomes in Macular Edema from Branch Retinal Vein Occlusion”; Ophthalmologica 2016, Volume 236, Issue 2. CHF VARIANTS A DETERMINANT OF TREATMENT RESPONSE The variant of CFH haplotype a patient has can significantly influence their response to ranibizumab in the treatment of neovascular age-related macular degeneration (nAMD), a prospective cohort study suggests. Seventy treatment-naive nAMD patients were included in the study. All were genotyped for CFH haplotypes, single nucleotide polymorphisms (SNPs) in the C3 chromosome, the ARMS2 gene, and mitochondrial DNA genes. After six months of treatment with intravitreal ranibizumab, patients expressing protective CFH haplotypes were more likely to have gained 15 or more letters of visual acuity compared to those expressing the high risk CFH haplotypes (OR 6.58). V Chaudhary et al, ”Genetic Risk Evaluation in Wet Age-Related Macular Degeneration Treatment Response”; Ophthalmologica 2016, Volume 236, Issue 2.