To investigate the potential association between glaucoma prevalence and supplemental intake, as well as serum levels of vitamins A, C and E, this cross-sectional study included 2,912 participants in the 2005 to 2006 National Health and Nutrition Examination Survey, age ≥40 years, who self-reported a presence or absence of glaucoma.

Participants were interviewed regarding the use of dietary supplements during the preceding 30-day period and underwent serum measurements of vitamins A, C and E (both alpha- and gamma-tocopherol). Information on the primary outcome measure, presence or absence of glaucoma, as well as demographic information, comorbidities and health-related behaviors, was assessed via interview.

It was reported that multivariate odds ratios for self-reported glaucoma, comparing the highest quartile of consumption to no consumption, and adjusted for potential confounding variables were 0.48 (95% confidence interval (CI) 0.13–1.82) for vitamin A, 0.47 (95% CI 0.23–0.97) for vitamin C and 2.59 (95% CI 0.89–7.56) for vitamin E. It was also noted that adjusted odds ratios for self-reported glaucoma comparing the highest versus the lowest quintiles of vitamin serum levels were 1.44 (95% CI 0.79–2.62) for vitamin A, 0.94 (95% CI 0.42–2.11) for vitamin C, 1.40 (95% CI 0.70–2.81) for alpha-tocopherol and 0.64 (95% CI 0.24–1.70) for gamma-tocopherol.

In conclusion, neither supplementary consumption nor serum levels of vitamins A and E were found to be associated with glaucoma prevalence. While low- and high-dose supplementary consumption of vitamin C was found to be associated with decreased odds of glaucoma, serum levels of vitamin C did not correlate with glaucoma prevalence.

The authors of the following clinic-based, cross-sectional study sought to characterize peripheral fundus autofluorescence (FAF) abnormalities in patients with age-related macular degeneration (AMD), correlate these with clinical findings, and identify risk factors associated with these FAF abnormalities.

They recruited 119 consecutive patients (100 patients with AMD [200 eyes] and 19 patients without AMD [38 eyes]). In a prospective study performed at the Doheny Eye Institute, University of Southern California, widefield 200-degree FAF and color images were obtained by the Optos 200Tx Ultra-Widefield device using a standardized imaging protocol. According to the authors, the FAF images were captured centered on the fovea, and additional images were captured after steering the field of view inferiorly and superiorly. All FAF and color images were graded independently by two masked ophthalmologists with respect to the presence, location, extent and type of peripheral (defined as outside the central 30 degrees) FAF abnormality. Main outcome measures were presence and type of peripheral FAF abnormalities.

Peripheral FAF abnormalities were evident in 164 eyes (68.9%), with several distinct FAF patterns identified: granular (46.2%), mottled (34.0%) and nummular (18.1%), the authors found. Additionally, they observed a 90% concordance of FAF patterns between both eyes. They also noted that abnormal FAF occurred more frequently in neovascular compared with non-neovascular AMD or normal eyes (86% vs. 72.8% vs. 18.4%, respectively, p<0.001). Significant risk factors for peripheral FAF abnormalities were AMD type (neovascular AMD odds ratio [OR], 12.7 and non-neovascular AMD OR, 6.2 compared with normal eyes, p<0.001), older age (OR, 6.5; 95% confidence interval [CI], 2.4–17.8; p<0.001 for the oldest quartile compared with the youngest), and female sex (OR, 4.1; 95% CI, 1.9–8.9; p<0.001). The study authors detected clinical features on color photography in 174 eyes (73.1%): peripheral drusen (51.7%), retinal pigment epithelium (RPE) depigmentation (34.9%), RPE hyperpigmentation (branching reticular pigmentation) (22.7%) and atrophic patches (16.8%). They also reported a high correlation between specific FAF and clinical findings: granular FAF with peripheral drusen (p<0.001) and mottled FAF with RPE depigmentation (p<0.001).

Several distinct patterns of peripheral FAF abnormalities were observed in 68.9% of patients, with AMD type, female sex and age being independent risk factors. The peripheral FAF patterns correlate strongly with specific clinical features seen in eyes with AMD.

Researchers conducted this randomized controlled trial to evaluate intravitreal aflibercept injections (IAI; also called VEGF Trap-Eye) for patients with macular edema secondary to central retinal vein occlusion (CRVO). They found that monthly injections of 2 mg intravitreal aflibercept for patients with macular edema secondary to CRVO resulted in a statistically significant improvement in visual acuity at week 24, which was largely maintained through week 52 with intravitreal aflibercept p.r.n. dosing.

In this multicenter study, 189 patients (one eye/patient) with macular edema secondary to CRVO were randomized to receive six monthly injections of either 2 mg intravitreal aflibercept (IAI 2Q4) (n=115) or sham (n=74). The study researchers reported that from week 24 to week 52, all patients received 2 mg intravitreal aflibercept as needed (IAI 2Q4 + p.r.n. and sham + IAI p.r.n.) according to retreatment criteria. The primary endpoint was the proportion of patients who gained ≥15 ETDRS letters from baseline at week 24. Additional endpoints included visual, anatomic and quality-of-life NEI VFQ-25 outcomes at weeks 24 and 52.

At week 24, the researchers noted that 56.1% of IAI 2Q4 patients gained ≥15 letters from baseline compared with 12.3% of sham patients (p<.001). They noted that at week 52, 55.3% of IAI 2Q4 + p.r.n. patients gained ≥15 letters compared with 30.1% of sham + IAI p.r.n. patients (p<.001). At week 52, IAI 2Q4 + p.r.n. patients gained a mean of 16.2 letters of vision versus 3.8 letters for sham + IAI p.r.n. (p<.001). Intravitreal aflibercept injection was generally well-tolerated. The most common adverse events for both groups were conjunctival hemorrhage, eye pain, reduced visual acuity and increased intraocular pressure.