Irish investigators reported the secondary outcomes in the Carotenoids with Coantioxidants in Age-Related Maculopathy trial.

Participants in this randomized, double-masked, placebo-controlled clinical trial included 433 adults 55 years of age or older with early age-related macular degeneration (AMD) in one eye and late-stage disease in the fellow eye (group one) or early AMD in both eyes (group two). Intervention consisted of an oral preparation containing lutein (L), zeaxanthin (Z), vitamin C, vitamin E, copper and zinc or placebo. The investigators performed best-corrected visual acuity (BCVA), contrast sensitivity (CS), Raman spectroscopy, stereoscopic color fundus photography and serum sampling every six months with a minimum follow-up time of 12 months. Secondary outcomes included differences in BCVA (at 24 and 36 months), CS, Raman counts, serum antioxidant levels and progression along the AMD severity scale (at 12, 24 and 36 months).

According to the study investigators, the differential between active and placebo groups increased steadily, with average BCVA in the former being approximately 4.8 letters better than the latter for those who had 36 months of follow-up, and this difference was statistically significant (p=0.04). In the longitudinal analysis, for a 1-log-unit increase in serum L, visual acuity was better by 1.4 letters (95% confidence interval, 0.3–2.5; p=0.01), and a slower progression along a morphologic severity scale (p=0.014) was observed.

To conclude, the investigators observed functional and morphologic benefits in key secondary outcomes after supplementation with L, Z and coantioxidants in persons with early AMD.

The following Japanese study compared macular pigment in three types of macular telangiectasia (MacTel).

A total of 26 eyes of 16 patients (mean age, 62 years) with MacTel were examined. The macular pigment optical density (MPOD) was obtained by autofluorescence spectrometry using two wavelengths (488 nm, 514 nm). The density of the central macular pigment within 0.5 degree around the foveal center (MPODc) was measured from a MPOD map.

It was reported that eight eyes of seven patients were classified as type one, 16 eyes of eight patients as type two, and two eyes of one patient as type three. The macular pigment signal was seen in the area of fluorescein leakage in type one and the occlusive area in type three; the macular pigment signal decreased in the area of fluorescein leakage in type two. The mean MPODc (± standard deviation) was 0.40 ± 0.16 density unit (DU) (range, 0.17–0.57) in type one; –0.08 ± 0.15 DU (range, –0.29–0.25) in type two; and 0.32 ± 0.08 DU (range, 0.26–0.37) in type three. Significant differences were seen between types one and two (p<0.001) and types two and three (p=0.007). No significant difference was noted between types one and three (p=0.765). In 30 age-matched normal eyes, the MPODc was 0.58 ± 0.11 DU (range, 0.38–0.79). Furthermore, there were significant differences between normal eyes and each MacTel subtype (type one, p=0.007; type two, p<0.001; type three, p=0.043).

It was determined that the macular pigment values and distributions, including leakage or occlusion, differed in each MacTel type compared with fluorescein angiography findings. The capillary occlusion in type three is not associated with reduced MPOD.

To compare the therapeutic effect of a single intravitreal bevacizumab (IVB) injection in eyes with diabetic macular edema (DME) of different patterns determined by optical coherence tomography (OCT), the authors of this Turkish study retrospectively analyzed the medical records of patients who had a single IVB injection for DME.

They included eyes with clinically significant DME and a central foveal thickness (CFT) of 250 µm or more determined by OCT in the analysis. They also recorded best-corrected visual acuity (BCVA), CFT and total macular volume values before and after the injection. Finally, they divided eyes into sponge-like diffuse retinal thickening (DRT), cystoid macular edema (CME) and serous retinal detachment (SRD) groups according to the morphology on OCT.

The authors reported that 92 eyes (42 with DRT, 31 with CME and 19 with SRD) were included in the study. They noted no statistically significant variation between the three groups regarding the change in BCVA (p=0.695). They also found that CME and SRD groups had greater reductions in their mean CFT, and that the amount of reduction showed statistically significant variation between three groups (p=0.048). However, they found no statistically significant difference between groups in terms of percentage of change in CFT (p=0.278).

CME and SRD subtypes are associated with a greater reduction in the CFT than the DRT subtype. Although the change in BCVA was not significantly different between groups, the DRT group showed markedly better visual improvement in proportion to the decrease in CFT.