• McHugh Cote posted an update 6 months, 3 weeks ago

    BACKGROUND AND OBJECTIVE To evaluate impact of baseline systemic dipeptidyl peptidase-4 (DPP-4) inhibitor use in diabetic macular edema (DME). PATIENTS AND METHODS This was a post hoc exploratory analysis of previously completed randomized, controlled clinical trials (VISTA and VIVID) in patients with DME evaluating intravitreal aflibercept injection (IAI) every 4 weeks (2q4) or every 8 weeks (2q8) or macular laser photocoagulation. RESULTS Overall, a small number of patients (12.2% , 9.7% , and 15.4% ) in the laser control, 2q4, and 2q8 groups reported baseline DPP-4 inhibitor use. There were no differences in changes from baseline in best-corrected visual acuity, central subfield thickness, or rates of 2-or-greater-step improvement in Diabetic Retinopathy Severity Scale score based on DPP-4 inhibitor use within each treatment group. CONCLUSION DPP-4 inhibitor use at baseline did not influence the magnitude of visual and anatomic benefit in patients with DME being treated with IAI or laser. . Copyright 2020, SLACK Incorporated.BACKGROUND AND OBJECTIVE To assess neurodevelopmental outcomes of infants with treatment-warranted retinopathy of prematurity (TW-ROP) treated with intravitreal bevacizumab (IVB) plus diode laser photocoagulation (DLP) compared to DLP alone. PATIENTS AND METHODS A retrospective review was performed of infants who underwent treatment for TW-ROP with IVB+DLP or DLP alone from 2010 to 2017. Baseline characteristics and coexisting medical comorbidities were recorded. The presence of neurodevelopmental delay (NDD) at 2-year follow-up and composite Bayley-III scores were recorded. RESULTS Sixty-six infants were included in the study; 18 received IVB+DLP, and 48 received DLP alone. Average Bayley-III scores for cognition, language, and motor, as well as rates of documental NDD, did not differ between the groups. CONCLUSION This study does not demonstrate an increased risk of NDD in infants with TW-ROP treated with IVB+DLP compared with DLP alone. . Copyright 2020, SLACK Incorporated.BACKGROUND AND OBJECTIVE To compare early and long-term visual responses to ranibizumab in patients with diabetic macular edema. PATIENTS AND METHODS Retrospective analysis of RIDE (NCT00473382) and RISE (NCT00473330). Vision outcomes over 36 months were compared between limited early gainers (gained ≤ 5 Early Treatment Diabetic Retinopathy Study letters), early 1-line gainers (gained 6 to 9 ETDRS letters), and early 2-or-more-line gainers (gained ≥ 10 ETDRS letters) at Month 3. RESULTS Among 235 ranibizumab-treated patients, 42.6%, 20.0%, and 37.4% were limited early gainers, early 1-line gainers, and early 2-or-more-line gainers, respectively. At Month 36, 71.3% of limited early gainers achieved 6 to 9 and 10 or more ETDRS letter gains. Mean ETDRS letter scores at Month 36 were comparable between limited early gainers (67.8), early 1-line gainers (73.4), and early 2-or-more-line gainers (71.6). CONCLUSION Clinically meaningful vision outcomes were achieved with long-term ranibizumab treatment, irrespective of early visual acuity response. . Copyright 2020, SLACK Incorporated.BACKGROUND AND OBJECTIVES To assess the percentage of vitreous adherence to the posterior pole in patients with diabetic macular edema (DME) with ocular ultrasonography (US) and establish a comparison with spectral-domain optical coherence tomography (SD-OCT). PATIENTS AND METHODS Cross-sectional consecutive analysis of patients followed in a diabetic retinopathy consultation. Vitrectomized eyes and patients with epiretinal membranes were excluded. A comparison between macular SD-OCT 20 × 20°, SD-OCT 55 × 35°, and ocular US for the vitreous status was performed. A subanalysis of the percentage of eyes with thickened posterior hyaloid and focal vitreous macular adhesion (VMA) was determined with SD-OCT 20 × 20° and SD-OCT 55 × 35°. RESULTS From 78 eyes of 39 patients, 55 eyes were included. All patients had type 2 diabetes mellitus with a median duration of 20 years (range 3 to 40 years); 60% were phakic, and 61.8% were male. Previous treatments included intravitreal injections in 54.5% eyes, macular laser in 67.3%, and panretinal photocoagulation in 56.4%. All eyes had a non-posterior vitreous detachment (PVD) status on US. The 55 × 35° SD-OCT detected a non-PVD status in 96.4% (100% in video display mode) and a VMA in 87.3%. The 20 × 20° SD-OCT only detected a VMA in 43.6% of cases, with a thickened posterior hyaloid in 40% and a focal VMA in 18.2%. CONCLUSIONS In the authors’ DME patients, vitreous adherence to the posterior pole was highly prevalent, with a total agreement between US and SD-OCT 55 × 35° video display mode. SD-OCT 20 × 20° is not an accurate method to diagnose VMA compared to SD-OCT 55 × 35°. . Copyright 2020, SLACK Incorporated.BACKGROUND AND OBJECTIVE The purpose of this article is to review the role of anti-vascular endothelial growth factor (VEGF) therapy in treating patients with radiation retinopathy (RR). STO-609 chemical structure PATIENTS AND METHODS RR can be associated with a significant decrease in visual acuity (VA) related to the development of cystoid macular edema, macular ischemia, and proliferative retinopathy leading to neovascular glaucoma. RESULTS Anti-VEGF therapy is effective at stabilizing VA in around 80% of patients and achieving reductions in central macular thickness when it is administered using a constant algorithm. Furthermore, consistent prophylactic anti-VEGF therapy reduces the risk of development of RR, neovascularization of the iris, and neovascularization glaucoma. CONCLUSION Future studies are needed to determine the optimal regimen for anti-VEGF therapy according to patient risk factors and likelihood of developing RR. . Copyright 2020, SLACK Incorporated.BACKGROUND AND OBJECTIVE To compare conventional microscope-integrated intraoperative optical coherence tomography (iOCT) and digitally enabled microscope-integrated iOCT in vitreoretinal surgery. PATIENTS AND METHODS In this post-hoc analysis of the DISCOVER prospective iOCT study, two surgical groups were compared (1) conventional iOCT and (2) digitally enabled iOCT. Surgeon questionnaires were collected immediately following surgery. RESULTS A total of 187 subjects were included in the study 91 in the conventional iOCT group and 96 in the digitally enabled iOCT group. There were no differences in surgeon-perceived iOCT utility between the two groups. There was significantly higher surgical field-based visualization of the iOCT datastream in the digitally enabled iOCT group (67.7% vs. 3.3%; P less then .0001). Reported significant back discomfort (1.0% vs. 18.7%; P less then .0001) and headaches (5.2% vs. 20.9%; P less then .002) were lower in the digitally enabled iOCT group. CONCLUSIONS Feasibility and utility of iOCT were similar in both groups.

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