Vol: 243 Issue 6 December 2020
OCT-detected nascent geographic atrophy potential endpoints for preventative trials
The onset of nascent geographic atrophy (nGA) detected by optical coherence tomography (OCT) imaging warrants consideration for use in age-related degeneration AMD preventative trials once it has been established that its characteristic features can be reproducibly graded, according authors of a review article. They note that research has identified a number of anatomical signs of nGA detectable on OCT that could act as evidence of photoreceptor loss, including subsidence of the inner nuclear layer (INL) and outer plexiform layer (OPL) and/or, a hypo-reflective wedge-shaped bands within Henle’s fibre layer.
Z Wu et al, “Can the Onset of Atrophic Age-Related Macular Degeneration Be an Acceptable Endpoint for Preventative Trials?” Ophthalmologica 2020; 243:399–403
Rebound macular oedema phenomenon following IVTA injection
Around one-in-10 patients with macular oedema (ME) secondary to diabetic retinopathy or retinal vein occlusion (RVO) may develop a rebound phenomenon following intravitreal triamcinolone (IVTA) injection, a new study suggests. The retrospective analysis showed that in 268 eyes of 211 consecutive ME patients, 9.7% had a greater than 10% increase in central retinal thickness from baseline at two months after IVTA injection. The incidence of the rebound phenomenon was 9.5% among those with diabetic retinopathy, 5.2% among those with central retinal vein occlusion and 15.4% among those with branch vein retinal occlusion. The mean number of prior injections of vascular endothelial growth factor inhibitor or corticosteroid agent was statistically significantly higher in the rebound group (6.8 vs. 5.3) than in the non-rebound group (p = 0.01).
O Diketmas et al “Rebound Phenomenon after Intravitreal Injection of Triamcinolone Acetonide for Macular Edema” Ophthalmologica 2020; 243:420–425
C-reactive protein levels a biomarker for proliferative diabetic retinopathy
A cross-sectional, case control study involving 240 type 1 diabetes patients showed that serum levels of C-reactive protein were higher among 80 who had proliferative diabetic retinopathy (PDR) than among 160 controls without diabetic retinopathy. The patients were matched for gender and duration of diabetes C-reactive protein was the only inflammatory biomarker that was positively related to PDR (OR 1.96; 95% CI 1.01–3.78, p = 0.0045). The study found no link between PDR and serum levels of VEGF, TNF-α or IL-6 but did find an association between PDR and high glycated haemoglobin levels, the use of angiotensin-converting enzyme inhibitor and low glomerular filtration rate.
Melo L.G.N. et al, “Relationship between Proliferative Diabetic Retinopathy and Inflammatory Markers in Patients with Type 1 Diabetes in Brazil: A Nested Case Control Study” Ophthalmologica 2020;243:471–478