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Ophthalmologica highlights

Sebastian Wolf

Posted: Friday, November 1, 2019

Aflibercept effective in retinal angiomatous proliferation
In eyes with retinal angiomatous proliferation (RAP), an aggressive subtype of neovascular age-related macular degeneration (nAMD), aflibercept produces outcomes comparable to those reported in eyes with type 1 and type 2 nAMD in the pivotal VIEW Study. The patients in the 96-week trial followed the same treatment protocol as in the VIEW study. Of 46 patients who completed the study, 13 (28%) patients had gained 15 or more letters and had a mean reduction in central macular thickness (CMT) of 162μm (p=<0.0001). Furthermore, univariate analysis showed no significant difference between any of the visual and anatomical outcome measures and number of injections required in this study and those of the pivotal VIEW study.

AC Browning et al, “Intravitreal Aflibercept for Retinal Angiomatous Proliferation: Results of a Prospective Case Series at 96 Weeks”, Ophthalmologica 2019, Volume 242, Issue 4.

Longer eyes less responsive to re-vitrectomy with APC
Patients with persistent full-thickness idiopathic macular holes respond less well to re-vitrectomy with autologous platelet concentrate (APC) if they have long eyes or a long interval between the initial and second surgery, according to the findings of a retrospective study. In 103 eyes with persistent MHs after vitrectomy, re-vitrectomy with APC and endotamponade resulted in a macular hole closure rate of 60.2%. There was negative correlation between the closure and axial length, time between first and second surgery, and there was a positive correlation between the closure rate and the experience of the surgeon (p<0.05).

V Degenhardt et al, “Prognostic Factors in Patients with Persistent Full-Thickness Idiopathic Macular Holes Treated with Re-Vitrectomy with Autologous Platelet Concentrate”, Ophthalmologica 2019, Volume 242, Issue 4.

Free flap grafting closes macular holes in complicated retinal detachment cases
Perfluorocarbon-assisted neurosensory retinal free flap transplantation may be a good option in closing macular holes in eyes with concomitant macular hole and complicated retinal detachment, a retrospective study suggests. It involved consecutive case series of seven patients with concomitant macular hole and complicated retinal detachment with proliferative vitreoretinopathy. All eyes underwent free neurosensory retinal flap transplantation into the macular hole, and subretinal fluid drainage through iatrogenic retinectomy/retinotomy followed by air-fluid exchange with gas or silicone oil tamponade. In all eyes the retina was successfully reattached and the macular hole was closed.

S Chen et al, “Perfluorocarbon Liquid-Assisted Neurosensory Retinal Free Flap for Complicated Macular Hole Coexisting with Retinal Detachment”, Ophthalmologica 2019, Volume 242, Issue 4.