OPHTHALMALOGICA – Peer-reviewed journal of EURETINA, edited by Sebastian Wolf

Vol:236 Issue:4

Sebastian Wolf

Posted: Wednesday, February 1, 2017

Patients with neovascular age-related macular degeneration (AMD) who are slow to respond initially to intravitreal ranibizumab catch up on the more rapid responders in terms of letters of visual acuity (VA) gained within a year, according to a retrospective review of the results of the MARINA, ANCHOR, HARBOR, and CATT studies. Among the 1,631 patients participating in the studies, 18-29% were early responders, gaining 15 or more letters within three months. A further 15-16% were delayed responders, gaining 15 or more letters by 12 months but not by three months. By 12 months, delayed gainers reached nearly the same level of response as early gainers who maintained their response. The only statistically significant predictive factor was baseline VA, which was lower among early responders. R Gale et al, “Characteristics and Predictors of Early and Delayed Responders to Ranibizumab Treatment in Neovascular Age-Related Macular Degeneration: A Retrospective Analysis from the ANCHOR, MARINA, HARBOR, and CATT Trials”; Ophthalmologica 2016, Volume 236, Issue 4.

The intravitreal dexamethasone implant (Ozurdex®, Allergan) is an effective therapy for postoperative macular oedema, a new study suggests. In 12 eyes of 12 patients with macular oedema after cataract surgery or vitrectomy who underwent injection of the steroid implant, the mean VA improved from 0.74 logMAR to 0.49 logMAR (p<0.01) after a mean of 437 days and one month after the last injection. Furthermore, mean central macular thickness decreased from 608µm to 300µm. In addition, four patients had no recurrence, and recurring macular oedema was completely reduced by re-injection in the remaining eight patients. Seven patients required topical antiglaucomatous therapy. A Klamann et al, “Intravitreal Dexamethasone Implant for the Treatment of Postoperative Macular Edema”; Ophthalmologica 2016, Volume 236, Issue 4.

A treat-and-extend regimen of aflibercept appears to be effective for all subtypes of exudative AMD, according to a retrospective study. In 37 eyes receiving the treat-and-extend regimen for either typical choroidal neovascularisation (CNV) or retinal angiomatous proliferation (RAP) secondary to exudative AMD, best corrected visual acuity improved significantly from 0.6 to 0.4 logMAR after one year. The final mean numbers of injections and the numbers of visits did not differ significantly between the different subtypes of CNV (p>0.05). Castro-Navaro et al, “One-Year Outcomes of the Treat-and-Extend Approach with Aflibercept in Age-Related Macular Degeneration: Effects on Typical Choroidal Neovascularization and Retinal Angiomatous Proliferation”; Ophthalmologica 2016, Volume 236, Issue 4.