Ophthalmologica highlights

Evidence supports anti-VEGF for CME secondary to BRVO A new meta-analysis appears to confirm the safety and efficacy of anti-vascular endothelial growth factor (anti-VEGF) therapies for patients with cystoid macular oedema secondary to branch retinal vein occlusion (BRVO). The meta-analysis included a total of 1,236 eyes from 22 peer-reviewed randomised controlled trials and observational studies identified using PubMed, Embase and Cochrane electronic databases. The analysis showed that, overall, anti-VEGF treatment improved best-corrected visual acuity at 12 months by a mean of 14 letters (p<0.001) and reduced central foveal thickness by a mean of 228 µm (p<0.001). Furthermore, the BCVA gains persisted at 24 months with a mean gain of 12.5 letters (p<0.001) as401 well as reduction of CFT of 238 µm (p<0.001) compared to baseline values. No cases of endophthalmitis or glaucoma were reported in any study. K Spooner et al, “Current Outcomes of Anti-VEGF Therapy in the Treatment of Macular Oede0ma Secondary to Branch Retinal Vein Occlusions: A Meta-Analysis”, Ophthalmologica 2019, Volume 242, Issue 1. Bilateral same-day intravitreal anti-VEGF injections appears safe Same-day bilateral intravitreal anti-VEGF injections have a low rate of complications and are well tolerated, according to the authors of a retrospective study. The single-centre study included 524 eyes of 262 patients who underwent an average of 18.7 concomitant bilateral intravitreal anti-VEGF injections. The incidence of endophthalmitis was 0.01%, and there were two episodes of acute intraocular inflammation among the 9,798 injections (0.02%). There were two deaths (0.76%) due to non-vascular causes but no vascular-related systemic adverse events were reported. VR Juncal et al, “Same-Day Bilateral Intravitreal Anti-Vascular Endothelial Growth Factor Injections: Experience of a Large Canadian Retina Center”, Ophthalmologica 2019, Volume 242, Issue 1. No excess IOL tilt or decentration after combined cataract surgery and vitrectomy Compared to balanced salt solution, air tamponade does not induce significantly more tilt or decentration of the IOL in combined phacoemulsification and vitrectomy procedures, according to the findings of a new randomised study. In 34 patients scheduled for the combined procedure, tilt of the IOL was on average 4.1±1.9°, without significant differences between the balanced salt solution and air tamponade groups (p=0.462). There were also no significant differences between the groups regarding decentration, which had an overall mean value of 0.31mm (p=0.42). C Leisser et al, “Effect of Air Tamponade on Tilt of the Intraocular Lens after Phacovitrectomy” Ophthalmologica 2019, Volume 242, Issue 1.

Tags: anti-VEGF, intravitreal injections, phaco-vitrectomy