OPHTHALMOLOGICA

A study comparing 139 patients with central (CRVO) and branch retinal vein occlusion (BRVO) with 40 healthy controls showed that those with the retinal conditions were also more likely to have known risk factors for blood clots. That is, the CRVO/BRVO patients were significantly more likely than the controls to be homozygous for the methylene tetrahydrofolate reductase (MTHFR) C677T mutation and to have elevated factor VIII activity. They also were more likely to have anticardiolipin antibodies (ACA), as well as elevated fibrinogen levels. F Risse et al, “Thrombophilia in Patients with Retinal Vein Occlusion: A Retrospective Analysis”, Ophthalmologica 2014; DOI: 10.1159/000360013.

Immune response to anti-VEGF therapy

A new study suggests that a proportion of patients who receive intravitreal ranibizumab will develop an immune response to the anti-VEGF agent, and the likelihood of an immune response may increase with the number of injections. The study showed that anti-ranibizumab immunoglobulin was present in the blood of 14 (17 per cent) of 82 patients who had received the injections, but was absent from the blood of nine patients who had not received the injections. Furthermore, the immunoglobulin was present in only four (11.1 per cent) of 36 patients who had received 10 or fewer injections, compared to 10 (21.7 per cent) of 46 patients who had received more than 10 injections.

N Leveziel et al, “Detection of Antiranibizumab Antibodies among Patients with Exudative Age-Related Macular Degeneration”, Ophthalmologica 2014; DOI:10.1159/000360186.

Anti-VEGF improvements sustained for five years

Anti-VEGF therapy results in a sustained improvement in best-corrected visual acuity over the medium to long term in eyes with neovascularisation secondary to pathologic myopia, according to the findings of a retrospective study. The authors of the study analysed the two-year results of the treatment in 67 eyes, the three-year results in 52 eyes, the four-year results in 28 eyes and the five-year results in 13 eyes at two years. The mean change from baseline BCVA was a gain of (+8.6 letters (p < 0.001) and this gain remained stable for a period of five years. In addition, the mean central retinal thickness was significantly decreased throughout follow-up and reached its nadir at two years (-104.0 μm; p < 0.001). The mean number of injections performed during the first year was 5.2, with fewer injections in subsequent years (p < 0.001).

P Freitas-da-Costa et al “Anti-VEGF Therapy in Myopic Choroidal Neovascularization: Long-Term Results”, Ophthalmologica 2014; DOI:10.1159/000360307.