Ophthalmologica highlights

Vol: 242 Issue: 3

Sebastian Wolf

Posted: Tuesday, October 1, 2019

Meta-analysis confirms anti-VEGF efficacy for branch retinal vein occlusion
A new meta-analysis appears to confirm the comparable safety and efficacy of anti-VEGF therapies for patients with cystoid macular oedema (CME) secondary to branch retinal vein occlusion (BRVO). The meta-analysis included a total of 1,236 eyes from 22 studies randomised controlled trials with aflibercept, bevacizumab and ranibizumab. It showed that anti-VEGF treatment demonstrated an overall mean improvement in BCVA at 12 months of 14 letters (p<0.001) and a reduction in central foveal thickness of 228 µm (p<0.001). In addition it showed that the 12-month gains at 12 months were maintained to month 24, with a mean gain of 12.5 letters (p<0.001), as was the reduction of CFT (238µm, p<0.001). No cases of endophthalmitis or glaucoma were reported in any study. The authors suggest that randomised controlled trials are needed to compare the efficacy of the different ant-VEGF agents.

K Spooner et al, “Current Outcomes of Anti-VEGF Therapy in the Treatment of Macular Oedema Secondary to Branch Retinal Vein Occlusions: A Meta-Analysis”, Ophthalmologica 2019, Volume 242 Issue 3.

Global strategy suggested for earlier intervention in diabetic retinopathy
This month’s issue includes the text of the 2018 EURETINA Lecture, which calls for a paradigm shift in the management of diabetic retinopathy with the accent on early intervention. Noting that diabetic retinopathy is the leading cause of blindness in working-aged adults and that diabetes is projected to affect 642 million adults by 2040, with 75% residing in low- and middle-income countries, the authors suggest that newer strategies like telemedicine and artificial intelligence should be developed to intervene with secondary and primary prevention measures in a multi-pronged whole-of-society approach at regional and national levels.

TY Wong et al, “Strategies to Tackle the Global Burden of Diabetic Retinopathy: From Epidemiology to Artificial Intelligence”, Ophthalmologica 2019, Volume 242 Issue 3.

Robust evidence needed for genetic testing and gene therapy for hereditary retinopathies
This month’s issue also includes the text of the Ophthalmologica Lecture delivered at the 18th EURETINA Congress. The lecture discusses the barriers that remain to translate gene testing for monogenetic hereditary retinal diseases into a clinically useful tool. The author stresses the importance of precisely and consistently capturing phenotypic information, including natural history data, in order to accelerate the implementation of clinical genetic interventions.

PI Sergouniotis, “Inherited Retinal Disorders: Using Evidence as a Driver for Implementation”, Ophthalmologica 2019, Volume 242, Issue 3.