Ophthalmology News
Levodopa-carbidopa May Improve Vision loss in Indirect Traumatic Optic Neuropathy
To compare the effect of levodopa-carbidopa on the visual outcome of patients with indirect traumatic optic neuropathy (ITON), this randomized, double-blind, placebo-controlled study was conducted on 32 patients with ITON within 6 days after trauma. In the levodopa group the visual acuity improved significantly after treatment, but not in the placebo group. In those who had visual acuity ≤ figure count, significant improvement in the visual acuity was observed in the levodopa group but not in the placebo group. However, the final visual acuity in these patients was comparable after treatment (p=0.21). Nine patients (56.2 %) in the levodopa group and 1 (10%) in the placebo group experienced improvement in visual acuity (p=0.02). The frequency of unrecordable PVEPs were comparable in both groups (p=0.09). Patients treated with levodopa within 6 days of onset of ITON were more likely to experience improvement in visual acuity than those in the placebo group.
Local Intra-arterial Fibrinolysis in Central Retinal Artery Occlusion versus Conservative Treatment Doesn't Show Benefit
The reported outcomes of central retinal artery occlusion (CRAO) with or without treatment vary considerably. Although local intra-arterial fibrinolysis (LIF) using recombinant tissue plasminogen activator (rtPA) is a promising treatment, outcomes have not been compared in randomized trials. This Prospective randomized multicenter clinical trial (the European Assessment Group for Lysis in the Eye Study) to compare treatment outcome after conservative standard treatment (CST) and LIF for acute nonarteritic CRAO. In light of these 2 therapies' similar outcomes and the higher rate of adverse reactions associated with LIF, we cannot recommend LIF for the management of acute CRAO.
Comparison of Natamycin and Voriconazole for the Treatment of Fungal Keratitis
An article out of the Archives of Ophthalmology conducted a therapeutic exploratory clinical trial comparing clinical outcomes of treatment with topical natamycin vs topical voriconazole for fungal keratitis. There were no significant differences in visual acuity, scar size, and perforations between voriconazole- and natamycin-treated patients with a trend toward scraping being associated with worse outcomes.
The Correlation Between Visual Acuity and Color Vision as an Indicator of the Cause of Visual Loss
This article explored the correlation between visual acuity (VA) and color vision and to establish a guide for the diagnosis of the cause of visual loss based on this correlation. total of 259 patients with visual impairment caused by 1 of 4 possible disease categories were included. Patients were divided into 4 groups according to the etiology of visual loss: 1) optic neuropathies, 2) macular diseases, 3) media opacities, and 4) amblyopia. This study found that diseases of the optic nerve affect color vision earlier and more profoundly than other diseases. When the cause of visual loss is uncertain, the correlation between the severity of color vision and VA loss can imply the possible etiology of the visual loss.
Ranibizumab for Macular Edema following Central Retinal Vein Occlusion
An article in this month's Journal of Opthalmology assessed the efficacy and safety of intraocular injections of 0.3 mg or 0.5 mg ranibizumab in patients with macular edema after central retinal vein occlusion (CRVO). This prospective, randomized, sham injection-controlled, double-masked, multicenter clinical trial included atotal of 392 patients with macular edema after CRVO. The primary efficacy outcome measure was mean change from baseline best-corrected visual acuity (BCVA) letter score at month 6. Secondary outcomes included other parameters of visual function and central foveal thickness (CFT). Mean change from baseline BCVA letter score at month 6, was better in the ranibizumab groups than in the sham group. The percentage of patients who gained ≥15 letters in BCVA at month 6 was 46.2% (0.3 mg) and 47.7% (0.5 mg) in the ranibizumab groups and 16.9% in the sham group (P<0.0001 for each ranibizumab group vs. sham). At month 6, significantly more ranibizumab-treated patients (0.3 mg = 43.9%; 0.5 mg = 46.9%) had BCVA of ≥ 20/40 compared with sham patients (20.8%; P<0.0001 for each ranibizumab group vs. sham). The median percent reduction in excess foveal thickness at month 6 was 94.0% and 97.3% in the 0.3 mg and 0.5 mg groups, respectively, and 23.9% in the sham group. Intraocular injections of 0.3 mg or 0.5 mg ranibizumab provided rapid improvement in 6-month visual acuity and macular edema following CRVO, with low rates of ocular and nonocular safety events.
Cost Benefit of Treating Ocular Hypertension Questioned
Treating people who are at low risk for glaucoma for ocular hypertension is not cost-effective unless they have a life-expectancy of at least 18 additional years, according to research published in the May issue of the Archives of Ophthalmology. Steven M. Kymes, Ph.D., of Washington University in St. Louis, and colleagues used a Markov simulation model to estimate both costs and benefits of treating a patient with ocular hypertension over his remaining lifespan. The influence of age at the initiation of treatment, as well as the influence of predicted remaining lifespan were evaluated.
Twelve-Month, Randomized, Controlled Trial of Bimatoprost 0.01%, 0.0125%, and 0.03% in Patients with Glaucoma or Ocular Hypertension
An article in this month's American Journal of Ophthalmology evaluated the intraocular pressure (IOP)-lowering efficacy and safety of ophthalmic formulations of bimatoprost 0.01% and 0.0125% compared with bimatoprost 0.03%. Overall it showed that Bimatoprost 0.01% was equivalent to bimatoprost 0.03% in lowering IOP throughout 12 months of treatment and demonstrated improved tolerability, including less frequent and severe conjunctival hyperemia. Bimatoprost 0.01% demonstrated a better benefit-to-risk ratio than bimatoprost 0.0125%.
Myopic Eyes Less Likely to Have Diabetic Retinopathy
Eyes with myopia may be less likely to develop diabetic retinopathy (DR). The relationship between refractive error, ocular biometry, and DR therefore was investigated in the Journal of Ophthalmology that showed Myopic refraction and longer Axial Length are associated with a lower risk of DR, particularly vision-threatening retinopathy, without any evidence of a threshold.
Eye test that spots Alzheimer's 20 years before symptoms
It exploits the fact that the light-sensitive cells in the retina at the back of the eye are a direct extension of the brain. Using eye drops which highlight diseased cells, the UCL researchers showed for the first time in a living eye that the amount of damage to cells in the retina directly corresponds with brain cell death. They have also pinpointed the pattern of retinal cell death characteristic of Alzheimer's. So far their diagnosis has been right every time.
Idiopathic Intracranial Hypertension Is Associated with Lower Body Adiposity
The disease commonly occurs in women who are overweight. The role of obesity in this disorder is unclear. In some instances, obesity and idiopathic intracranial hypertension may be familial.To characterize the obesity phenotype(s) in 44 patients with idiopathic intracranial hypertension (IIH).This study showed that In IIH, fat tends to preferentially accumulate in the lower body relative to other obese women of the same range. Whereas most complications of obesity, such as hypertension, diabetes, dyslipidemia, and the metabolic syndrome, are linked to upper body adiposity, IIH may represent a unique condition potentially induced by nonvisceral fat-related mechanisms.
The Association of Smoking and Alcohol Use With Age-related Macular Degeneration in the Oldest Old
A study to estimate the incidence of age-related macular degeneration (AMD) and the association of smoking and alcohol in a population of older women was conducted. After confounder adjustment, alcohol consumption was significantly associated with an elevated risk of incident early AMD (odds ratio [OR], 1.57; 95% CI, 1.18 to 2.11). There was an increased risk of early AMD among subjects aged 80 years or older who were smoking compared to those younger than 80 years who were not smoking (OR, 5.49; 95% CI, 1.57 to 19.20; P for interaction = .026).
High-dose vitamin C may boost women's cataract risk
Among nearly 24,600 adult women followed for more than 8 years, those who reported regular or occasional vitamin C supplementation of about 1000 milligrams per serving were about 25 percent more likely than those who did not take supplements to have age-related cataracts removed. Women who took extra vitamin C for 10 years or longer; or in combination with being 65 years and older, or taking hormone replacement or corticosteroid medications had even greater risk, researchers found.
AMD Patients Benefit From Cataract Surgery, Study
A new US study found that cataract surgery is likely to benefit pateints with all stages of age-related macular degeneration (AMD), from mild to advanced. The multicenter study, which is published in the November issue of Ophthalmology, was the work of Dr Emily Y Chew, Deputy Director, Division of Epidemiology and Clinical Applications at the National Eye Institute (NEI), in Bethesda, Maryland, and colleagues. Opthalmology Abstract
Three-Year Follow-up of the Tube Versus Trabeculectomy Study
American Journal of Opthalmology Abstract
Tube shunt surgery had a higher success rate compared to trabeculectomy with MMC during the first 3 years of follow-up in the TVT Study. Both procedures were associated with similar IOP reduction and use of supplemental medical therapy at 3 years. While the incidence of postoperative complications was higher following trabeculectomy with MMC relative to tube shunt surgery, most complications were transient and self-limited.
Intravitreal Triamcinolone Better than Observation to Treat Vision Loss Associated With Macular Edema Secondary to Central Retinal Vein Occlusion
Archives of Opthalmology Abstract
To compare the efficacy and safety of 1-mg and 4-mg doses of preservative-free intravitreal triamcinolone with observation for eyes with vision loss associated with macular edema secondary to perfused central retinal vein occlusion (CRVO), a study was done showing t odds of achieving the primary outcome were 5.0 times greater in the 1-mg group than the observation group and 5.0 times greater in 4-mg group than the observation group. Although there was no difference identified between the 1-mg and 4-mg groups, the rates of elevated intraocular pressure and cataract were similar for the observation and 1-mg groups, but higher in the 4-mg group.
Anti-VEGF found to improve vision when used for patients with macular edema
In a study conducted by the Pan-American Collaborative Retina Study Group, treatment of diffuse diabetic macular edema (DDME) with bevacizumab (Avastin, Genentech) was shown to improve vision. Bevacizumab is an anti-vascular endothelial growth factor (anti-VEGF) that inhibits abnormal blood vessels. Improvement was detected after one month. .
Assessing the Efficacy of Latanoprost vs Timolol in Controlling Intracocular Pressure
Compared with timolol, treatment with latanoprost results in significantly fewer patients with a high IOP fluctuation. The impact of reducing high IOP fluctuation on progressive glaucomatous damage deserves further investigation in prospective studies.
Study Reiterates Eye Risks Linked to Flomax
Men taking Flomax to treat an enlarged prostate face more than double the risk for serious complications should they need cataract surgery, a new Canadian study has found.
JAMA Full Text
Key Nutrients Lower Risk of Macular Degeneration
The intake of certain key nutrients can reduce the risk of age-related macular degeneration (AMD) and that risk can be correlated with a nutrient compound score devised by researchers and reported in the May issue of Ophthalmology.
