OPHTHALMOLOGICA

Spectral-domain optical coherence tomography (SD-OCT) appears to have a reliability comparable to that of fundus fluorescein angiography (FFA) in the diagnosis of choroidal neovascularisation (CNV) subtypes in neovascular AMD, according to the results of a retrospective, observational study. In 100 eyes initiated on ranibizumab for neovascular AMD, SD-OCT showed high sensitivity (85.7- 98.3 per cent) and specificity (84.2-100 per cent) compared to FFA in the diagnosis of the CNV subtype. The area under the receiver-operating characteristic curve ranged from 0.9 to 0.93 (p value <0.0001) for the different CNV subtypes. Moreover, weighted kappa statistics showed a nearperfect agreement of 0.85 between the diagnostic procedures.

Mathew R et al Ophthalmologica, “Correlation of Fundus Fluorescein Angiography and Spectral-Domain Optical Coherence Tomography in Identification of Membrane Subtypes in Neovascular Age-Related Macular Degeneration” (DOI:10.1159/000355091)

Implant shows sustained effect

Intravitreal treatment with a dexamethasone implant (OzurdexR) is safe and effective in the treatment of long-standing refractory DME, according to a retrospective study. A review of the medical records of 58 patients showed that, following injection of the implant, the mean BCVA improved baseline 0.66 to 0.52 logMAR (p = 0.0001) after one month, and 0.44 logMAR (p = 0.0001) after three months. At the six-month follow-up visit, the mean BCVA increased to 0.51 Â} 0.31 logMAR (p = 0.0001). In addition, the reduction of mean foveal thickness compared to baseline was significant (p = 0.0001) at every follow-up visit. The mean foveal thickness decreased from a baseline value of 543.24 μm to 346.82 μm at one month, and to 341.12 29.64 μm at three months, but increased slightly to 420.16 μm at six months.

M Dutra Medeiros et al, Ophthalmologica, “Dexamethasone Intravitreal Implant for Treatment of Patients with Persistent Diabetic Macular Edema” (DOI:10.1159/000356413)

Telemedicine screening for AMD

Nonmydriatic colour fundus photography and telemedicine is an effective means of screening for AMD, according to the results of a prospective study. The study involved 1,022 patients from whom a total of 1,363 color fundus photographs were obtained, without mydriasis, at a health examination centre and interpreted by telemedicine at an ophthalmology department. Eighty per cent of images were gradable and among these, 83.7 per cent had no AMD (grade 0), eight per cent had grade 1 AMD, 5.6 per cent had grade 2, 2.3 per cent were grade 3, and 0.4 per cent were grade 4.

F De Bats et al Ophthalmologica, “Age- Related Macular Degeneration Screening Using a Nonmydriatic Digital Color Fundus Camera and Telemedicine” (DOI:10.1159/000356695).

PDT more effective in juxtafoveal myopic CNV

In myopic CNV patients, photodynamic therapy (PDT) has limited long-term effect on subfoveal CNV but can achieve satisfactory results in eyes with juxtafoveal, according to a retrospective study. The 10-year analysis of PDT’s effect on 19 eyes with subfoveal and juxtafoveal CNV showed that during 10 years of follow-up mean BCVA progressively worsened, from 0.68 to 0.80, in seven eyes with subfoveal, but improved from 0.59 to 0.33 logMAR in 12 eyes with juxtafoveal CNV.

M Varano et al, Ophthalmologica, “Photodynamic Therapy in Subfoveal and Juxtafoveal Myopic Choroidal Neovascularization: A 10-year Retrospective Analysis” (DOI:10.1159/000357504)