Slow responders to anti-VEGF for DME
catch up with quick responders over time
Eyes with persistent diabetic macular oedema (DME) that have a delayed morphological response to anti-vascular endothelial growth factor (anti-VEGF) treatment tend to have a similar visual outcome in the longer term to those with an immediate morphological response, according to the results of a retrospective study. The study showed that, among 20 DME patients, those with a 25% or less reduction in central macular thickness (CMT) in the first three months of anti-VEGF treatment had an improvement in best corrected visual improvement that was not significantly different at 12 months from those with more than a 25% reduction of CMT in the first three months. However, those with no visual improvement in the first three months also had significantly less visual improvement at 12 months than those with an early visual improvement.
Y Koyanagi et al, “Visual Outcomes Based on Early Response to Anti-Vascular Endothelial Growth Factor Treatment for Diabetic Macular Edema”, Ophthalmologica 2018, Volume 239, Issue 1-2.
Triamcinolone beats anti-VEGF in improving retinal morphology in DR
Ranibizumab, bevacizumab and triamcinolone all appear to provide similar improvement in visual acuity in eyes with diabetic retinopathy, but triamcinolone provides better anatomical improvements, according to a new study. In 275 eyes of 208 consecutive diabetic retinopathy patients, the mean changes in visual acuity after six months’ treatment was a gain of 4.9 letters in eyes receiving bevacizumab, 4.3 letters in eyes receiving ranibizumab and 4.6 letters in eyes receiving triamcinolone (p=0.911). The triamcinolone group had significantly better improvement of central macular thickness at six and 24 months, but also had significantly more cataract and glaucoma.
İ Koç et al, “Real-World Results of Intravitreal Ranibizumab, Bevacizumab, or Triamcinolone for Diabetic Macular Edema”, Ophthalmologica 2018, Volume 239, Issue 1-2.
Silicone oil thins the choroid
Silicone oil tamponade appears to thin the subfoveal choroid, and the longer the tamponade is in place the thinner the choroid becomes, new research suggests. The study showed that in 60 patients with unilateral pseudophakic macula-off rhegmatogenous retinal detachment, the mean difference in thickness of the subfoveal choroid between silicone oil-treated eyes and fellow eye was -14.8, -25.5 and -62.1µm for those three-to-six months, six-to-nine months and nine-to-18 months of the tamponade, respectively. Moreover, choroidal thinning did not improve three months after silicone removal.
S Karimi et al, “Effects of Intravitreal Silicone Oil on Subfoveal Choroidal Thickness,” Ophthalmologica 2018, Volume 239, Issue 1-2.