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Volume 14, Number 4
Monday, January 27, 2014
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JANUARY IS NATIONAL GLAUCOMA AWARENESS MONTH




In this issue: (click heading to view article)
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######### Determining Progression of VF Loss by Baseline Thickness of Macular Ganglion Cell Complex

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######### Refractive Changes Following Pharmacologic Resolution of DME

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######### Genetic Polymorphisms of the Prostaglandin F2α Receptor Gene and Response to Latanoprost in Patients with Glaucoma and Ocular Hypertension
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######### Multiple Subretinal Fluid Blebs Following Successful Retinal Detachment Surgery
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Determining Progression of VF Loss by Baseline Thickness of Macular Ganglion Cell Complex

Previous studies reported that the thickness of the macular ganglion cell complex (mGCC) showed good diagnostic ability for detecting glaucoma. However, its impact on the progression of visual field loss in primary open angle glaucoma (POAG) is unknown. In this study, researchers assessed whether baseline mGCC thickness was associated with the progression of visual field loss in POAG. They determined that baseline mGCC thickness can be predictive of progressive visual field loss in patients with POAG.

They included 56 patients with POAG in the study, all of whom were followed for more than two years after baseline optical coherence tomography (OCT) measurements. They had at least five reliable Humphrey visual field tests with 30–2 Swedish Interactive Threshold Algorithm standard tests during the follow-up period. The researchers divided subjects into two groups according to the slope of the mean deviation (MD): the fast progression group (MD slope < –0.4 dB/y) and the slow progression group (MD slope ≥ –0.4 dB/y). Factors compared between the groups were as follows: age, baseline intraocular pressure (IOP), mean IOP during the follow-up, refraction, baseline MD, pattern standard deviation (PSD), and baseline OCT measurements.

The study researchers found no significant differences between the two groups in age, baseline IOP, mean IOP during the follow-up, refraction, baseline MD or PSD, average thickness of retinal nerve fiber layer (RNFL), or disc parameters. However, they did note that the baseline mGCC thickness (average and inferior hemifield) was significantly thinner in the fast progression group than in the slow progression group (74.0 ± 7.2 µm vs. 80.3  ± 8.6 µm; 68.0  ± 6.6 µm vs. 78.2  ± 11.6 µm, respectively). Moreover, global loss volume and focal loss volume, which are parameters of mGCC, showed significantly higher rates in the fast progression group than in the slow progression group. In multivariate analysis, only mGCC thickness of the inferior hemifield was associated with disease progression (p=0.007).

SOURCE: Anraku A, Enomoto N, Takeyama A, et al. Baseline thickness of macular ganglion cell complex predicts progression of visual field loss. Graefes Arch Clin Exp Ophthalmol. 2014;252(1):109–115.



Refractive Changes Following Pharmacologic Resolution of DME

To determine precisely the mean change in refractive power induced by treatment in patients with diabetic macular edema (DME), 50 eyes of 50 consecutive patients with clinically significant macular edema received all three types of current state-of-the-art treatment with intravitreal anti-edematous substances (ranibizumab, bevacizumab or triamcinolone) in this prospective, randomized study.

Patients were followed up at monthly intervals and were treated following a standardized pro re nata regimen according to protocol. Best-corrected visual acuity (BCVA) was determined by certified visual acuity examiners and the refractive power of the treated eyes was determined using a push-plus technique. The change in refraction between baseline and the visit when the macula was completely dry or when the central subfield thickness (CST) measured by optical coherence tomography had reached the thinnest level was analyzed. The main outcome measure was spherical equivalent refraction (SER) and CST.

A total of 50 eyes of 50 patients received intravitreal therapy using ranibizumab (n=11), bevacizumab (n=20) or triamcinolone (n=9). Mean BCVA was 0.33 ± 0.23 logarithm of the minimum angle of resolution (logMAR) and mean CST was 492 ± 130 µm. The mean SER was 0.41 ± 2.06D at baseline. The BCVA at the time of optimal retinal morphologic features was 0.24 ± 0.2 logMAR, mean CST was 300 ± 78 µm, and mean change in SER was –0.01 ± 0.46D. Furthermore, changes in BCVA and CST were statistically significant (p<0.0001), but the SER change was not (p=0.824).

SOURCE: Sakurai M, Higashide T, Ohkubo S, et al. Association between genetic polymorphisms of the prostaglandin F2a receptor gene, and response to latanoprost in patients with glaucoma and ocular hypertension. Br J Ophthalmol. 2014; Jan 23. [Epub ahead of print].

SOURCE: Deák GG, Lammer J, Prager S, et al.; Diabetic Retinopathy Research Group Vienna. Refractive changes after pharmacologic resolution of diabetic macular edema. Ophthalmology. 2014; Jan 21. [Epub ahead of print].

 

Genetic Polymorphisms of the Prostaglandin F2α Receptor Gene and Response to Latanoprost in Patients with Glaucoma and Ocular Hypertension

In the following Japanese study, the authors examined whether intraocular pressure (IOP) reduction by latanoprost correlates with single nucleotide polymorphisms (SNPs) of the prostaglandin F2α (FP) receptor gene in patients with glaucoma and ocular hypertension (OH).

They determined the genotype of nine SNPs in the FP receptor gene by direct DNA sequencing, or other techniques, in 82 patients with glaucoma or OH who were treated with latanoprost monotherapy in one eye. The IOP reduction was evaluated by the percent IOP reduction (%Δ IOP), estimated by subtracting IOP fluctuations in the untreated fellow eye. The authors classified subjects by %ΔIOP into low responders (%ΔIOP<10%) and others (%ΔIOP ≥10%) and analyzed the correlation between %ΔIOP and SNPs in the FP receptor gene.

According to the authors, multiple regression analysis demonstrated that the rs12093097 was the only significant factor that correlated with %ΔIOP (p=0.039). They found that, among estimated haplotypes, one haplotype that contained the minor allele only in rs3753380 was significantly correlated with low responders even after correction for multiple test (permutation test, p=0.037).

An association was found between SNPs of the FP receptor gene and the response to latanoprost in patients with glaucoma or OH. The FP receptor genetic polymorphism may influence the degree of IOP reduction by latanoprost in these patients.


SOURCE: Sakurai M, Higashide T, Ohkubo S, et al. Association between genetic polymorphisms of the prostaglandin F2a receptor gene, and response to latanoprost in patients with glaucoma and ocular hypertension. Br J Ophthalmol. 2014; Jan 23. [Epub ahead of print].

 

Multiple Subretinal Fluid Blebs Following Successful Retinal Detachment Surgery

Investigators in South Korea studied the incidence and the clinical factors associated with the occurrence of multiple subretinal fluid (SRF) blebs after successful rhegmatogenous retinal detachment (RD) repair in this retrospective observational case series.

They retrospectively investigated the medical records of 185 eyes of 184 patients who had undergone successful RD surgery either vitrectomy or scleral buckling. Each patient had undergone spectral domain optical coherence tomography (SD-OCT) combined with infrared reflectance (IR) imaging every three months postoperatively. They carefully examined postoperative SD-OCT and fundus IR images, in an effort to identify any SRF blebs present.

The investigators observed multiple (≥3) SRF blebs in 40 (21.6%) of 185 cases. SRF blebs were first detected 1.7 ± 1.8 months postoperatively. In 22 cases that could be fully followed up, SRF blebs were completely absorbed 13.1 ± 6.1 months postoperatively. Multiple logistic regression analysis showed that only young age (<30 years) was significantly associated with the occurrence of multiple SRF blebs (odds ratio, 5.1; 95% confidence interval, 1.5 to 17.6; p=0.010). Serial measurements of SRF bleb size using SD-OCT showed that SRF bleb height was greatest at postoperative 2.9 ± 0.9 months, while SRF bleb width tended to decrease gradually over time. The SRF blebs typically spared large retinal vessels.

To conclude, multiple SRF blebs are commonly found after successful RD surgery, especially in young patients. The serial morphological features evaluated in this study indicate that multiple SRF blebs may result from the active reattachment of retinal pigment epithelium and photoreceptors during the resolution of RD.

SOURCE: Kim YK, Ahn J, Woo SJ, et al. Multiple subretinal fluid blebs after successful retinal detachment surgery: incidence, risk factors, and presumed pathophysiology. Am J Ophthalmol. 2014;Jan 21. [Epub ahead of print].


  • ADENOPLUS TEST APPROVED IN CANADA TO DIAGNOSE PINK EYE. Health Canada granted Rapid Pathogen Screening Inc. (RPS) a Medical Device License for AdenoPlus, a point-of-care test to help quickly and accurately determine whether a conjunctivitis infection is caused by adenovirus. The Medical Device License allows the AdenoPlus test to be marketed and sold in Canada and follows the product's successful release in Europe, Asia and the United States. As per a worldwide licensing agreement signed in 2012, AdenoPlus' distribution rights in Canada were granted to Nicox, who currently distributes AdenoPlus to eye-care professionals in the United States. Learn more about the AdenoPlus test or other RPS products by clicking here.
  • ALDEN OPTICAL DEBUTS ASTERA PRACTICE FINDER. In a recent press release, Alden Optical announced the new Astera Multifocal Toric Practice Locator Tool, which allows patients to easily locate practices fitting the company's Astera Multifocal Toric. The map-based tool is featured prominently on Alden Optical's website.
  • DR. MILLICENT KNIGHT APPOINTED AS HEAD OF PROFESSIONAL AFFAIRS AT JOHNSON & JOHNSON VISION CARE, NORTH AMERICA. Johnson & Johnson Vision Care Inc. has appointed Millicent Knight, OD, to the role of Head of Professional Affairs, Johnson & Johnson Vision Care, North America, effective April 7, 2014. In her new role, she will lead the development and deployment of the company's professional strategy across the United States and Canada. Dr. Knight will also direct its professional and education platform through The Vision Care Institute LLC and other educational outreach programs

  • ST. PETER TO JOIN CHECKEDUP'S STRATEGIC ADVISORY BOARD. CheckedUp welcomes Jerry St. Peter, executive vice president and general manager of Nicox, as part of the mobile health startup's Strategic Advisory Board. He will play a key role as CheckedUp advances toward the implementation of its mobile health app in ophthalmic practices nationwide. Mr. St. Peter joins other health-care and business leaders on the board, including Brent Saunders, CEO of Forest Laboratories; Casey McGlynn, partner at Wilson Sonsini Goodrich & Rosati; the Honorable Robert Keith Gray, chairman and founder of Gray and Company; and Vince Anido, CEO of Aerie Pharmaceuticals.

  • SAUFLON INTRODUCES FAMILY OF SILICONE HYDROGEL DAILY DISPOSABLE CONTACT LENSES. Sauflon is entering the U.S. contact lens market with its clariti 1day silicone hydrogel daily disposable contact lenses. As the first and only family of sphere, toric and multifocal silicone hydrogel daily disposable contact lenses, the company says clariti 1day is able to satisfy the broad range of practitioner and patient needs. And Sauflon's AquaGen technology produces high-quality silicone hydrogel lenses that provide exceptional comfort and affordable convenience for wearers. To learn more about the company and register for updates, visit www.sauflonusa.com or call (800) 682-3240. NOTE: In last week's edition of the newsletter, we inadvertently ran this news with a typo (clarity 1day rather than clariti 1day). We apologize for the error.


 

 

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