OPHTHALMOLOGICA

OPHTHALMOLOGICA
Arthur Cummings
Published: Thursday, January 29, 2015

Good prognosis for macular hole fellow eyes 
The results of a retrospective study indicate that the healthy fellow eye of patients with macular eye surgery is not at high risk of developing macular holes in the years that follow. The study included 153 patients with a mean age of 65.5 years and a mean follow-up of 33.5 months. OCT detected the vitreomacular attachments in 52 per cent (80 eyes) at initial examination, and 23 per cent at three years. Of the remaining 40 eyes in which vitreomacular separation occurred during follow-up, 11 (28 per cent) developed macular holes at mean interval of 45 months after the surgery. None of the eyes with vitreomacular separation at presentation developed a macular hole. F Otsuji et al, “Long-Term Observation of the Vitreomacular Relationship in Normal Fellow Eyes of Patients with Unilateral Idiopathic Macular Holes”, Ophthalmologica 2014; Volume 232, No 4 (DOI:10.1159/000362460).

Factors predictive of success with dexamethasone implant
There appears to be several factors that are predictive of visual outcomes in eyes which undergo implantation with Ozurdex dexamethasone intravitreal implants, according to the findings of a retrospective study. The study’s authors analysed the medical records of 43 consecutive treatment-naïve eyes that underwent repeated Ozurdex injections on a PRN basis for macular oedema secondary to recent onset retinal vein occlusion. Both mean BCVA and central macular thickness improved significantly by the end of the 12 to 22 weeks of follow-up (p = 0.0001), and more than 30 per cent of the eyes gained three or more lines within three months of repeated injections. Presence of foveal serous retinal detachment and macular ischaemia were predictive of poor visual outcomes. Improvements were significantly associated with baseline BCVA and the integrity of the ellipsoid zone. E Maggio et al, “Intravitreal Dexamethasone Implant for Macular Edema Secondary to Retinal Vein Occlusion: 12-month Follow-Up and Prognostic Factors”, Ophthalmologica 2014; Volume 232, No 4 (DOI:10.1159/000364956).

Implant provides a quick fix
The Ozurdex dexamethasone implant is effective in controlling posterior segment inflammation and reduces central retinal thickness quickly and effectively, say the findings of a new study. Among 84 patients who received a dexamethasone intravitreal implant for intraocular inflammation of various aetiologies, 61 per cent achieved clearance of vitreous haze after four weeks (p < 0.001) which persisted until week 24 (p < 0.001). There was a concurrent reduction of central retinal thickness and improvements in BCVA. U Pleyer et al, “Fast and Successful Management of Intraocular Inflammation with a Single Intravitreal Dexamethasone Implant”, Ophthalmologica 2014; Volume 232, No 4 (DOI: 10.1159/000368987).

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