The authors of this Brazilian study investigated changes in central corneal thickness (CCT) and intraocular pressure (IOP) in children following congenital cataract surgery, as well as risk factors associated with these changes.

They prospectively recruited 37 eyes of 26 children with congenital cataract undergoing surgery and performed IOP and CCT measurements before the surgery and six, 12, 18, 24 and 36 months after the procedure.

Among the 37 eyes, 15 became aphakic and 22 pseudophakic, the authors reported. They also found that mean CCT significantly increased from 556.24 ± 44.19 to 585.07 ± 56.45 µm (p=0.003) after three years, whereas mean IOP significantly increased from 12.05 ± 2.3 to 13.89 ± 2.96 mmHg (p=0.037). The authors also reported that aphakic eyes underwent surgery at an early age (15.16 ± 32.02 months) compared with pseudophakic eyes (71.48 ± 53.14 months) (p<0.001). After three years, they found that mean CCT change in aphakic eyes (56.10 ± 46.97 µm) was significantly higher than in pseudophakic eyes (12.71 ± 38.41 µm) (p=0.015). Age at the time of surgery was inversely correlated to CCT change (r=–0.34, p=0.04), but not to IOP change (r=–0.18, p=0.27). When surgery was performed between zero and one year of age, mean CCT change at three years was 70.11 ± 42.3 µm, compared with 6.27 ± 28.09, –17.0
± 8.04 and 48.33 ± 34.99 µm when surgeries were performed at 1–5, 5–10 and >10 years old, respectively (p<0.001). IOP change was not correlated to CCT change (r=0.31, p=0.06).

In conclusion, CCT increases in eyes undergoing congenital cataract surgery, especially when the surgery is performed at an early age.

The purpose of this report was to evaluate the effects of intravitreal ranibizumab on diabetic retinopathy (DR) severity over time in two Phase III clinical trials (RIDE and RISE) of ranibizumab for diabetic macular edema (DME).

Participants with DME (n=759) were randomized to monthly sham, 0.3-mg ranibizumab or 0.5-mg ranibizumab intravitreal injections. Macular laser was available per protocol-specified criteria. Fundus photographs, taken at baseline and periodically, were graded by a central reading center; clinical examinations were performed monthly. The main outcome measures of this report are secondary/exploratory analyses including a two-step or more and three-step or more change on the Early Treatment Diabetic Retinopathy Study severity scale in the study eye and a composite DR progression outcome including photographic changes plus clinically important events such as occurrence of vitreous hemorrhage or need for panretinal laser.

At two years, it was reported that the percentage of participants with DR progression (worsening by ≥2 or ≥3 steps) was significantly reduced in ranibizumab-treated eyes compared with sham-treated eyes, and DR regression (improving by ≥2 or ≥3 steps) was significantly more likely. The cumulative probability of clinical progression of DR as measured by the composite outcome at two years was 33.8% of sham-treated eyes compared with 11.2% to 11.5% of ranibizumab-treated eyes.

Intravitreal ranibizumab reduced the risk of DR progression in eyes with DME, and many ranibizumab-treated eyes experienced improvement in DR severity. Because these results are exploratory, the use of intravitreal ranibizumab specifically to reduce DR progression or cause DR regression requires further study.

In this prospective, placebo-controlled, randomized and multi-center study, Austrian investigators sought to compare the surgical outcomes and evaluate the effectiveness of two treatments for central retinal vein occlusion (CRVO), radial optic neurotomy (RON) and intravitreal triamcinolone (IVT), in comparison to natural history.

They treated patients with CRVO in three groups: with either RON, a single intravitreal injection of 4 mg triamcinolone acetonide or a placebo treatment. The main outcome measures were change of visual acuity (VA) and proportion of eyes with a significant improvement (defined as <3 lines logMAR scale) of VA from baseline to month 12.

The investigators included 90 patients; they excluded seven due to insufficient data. They reported that 47% (n=18) of patients treated with RON showed an increase in VA, in comparison to 10% (n=2) of placebo-treated patients and 20% (n=5) of patients treated with IVT. According to the study investigators, significantly more patients showed an improvement in VA following RON than in the placebo group (p=0.009) and significantly more patients showed an improvement in VA following RON than in the IVT group (p=0.034). They found no significant difference when directly comparing improvement in VA following IVT and placebo (p=0.667) treatment. Futhermore, they noted that significantly more (p=0.007) patients in the placebo group (35%, n=7) showed a deterioration (defined as >3 lines logMAR scale) in VA than patients in the RON group (8%, n=3).

To conclude, this study showed that following treatment with RON, patients with CRVO display a significantly better long-term VA than untreated patients and patients treated with a single dose of IVT.