Compared with intravitreous ranibizumab, the decreases in the plasma-free VEGF levels were greater with intravitreous aflibercept and bevacizumab in patients with diabetic macular edema.
Most commercially available OCT and OCTA devices can provide widefield OCTA through a combination of faster speeds, tracking, and the ability to montage images. This may revolutionize clinicians’ ability to assess and quantify retinal vascular disease.
With the first ocular gene therapy approved in the United States, Szilard Kiss, MD, points out that the gene therapy era for retinal disease has arrived, “and hopefully it will arrive for age-related macular degeneration.”
Although the phase III Chroma and Spectri studies for lampalizumab (Genentech), an investigational compound for the treatment of geographic atrophy secondary to age-related macular degeneration (AMD), failed to meet their primary endpoints, numerous lessons can be learned from the study data.
Among a subset of patients in the phase IV PALADIN study, there was improved visual acuity, improved macular thickness, and reduced treatment burden among patients treated with the intravitreal fluocinolone acetonide 0.2 µg (Iluvien implant) for DME.
Lamellar holes usually don’t require treatment, but it is important to recognize the eyes that may benefit from vitrectomy.
Using ultrasonic power to actuate a vitrectomy probe (hypersonic vitrectomy) allows for a “smooth steady flow of vitreous into a port that is oscillating at 1.7 million cycles per minute,” according to Carl C. Awh, MD.
The addition of dexamethasone implant (Ozurdex, Allergan) to a continuing regimen of ranibizumab (Lucentis, Genentech) did not produce results in visual acuity outcomes that differed from those achieved with ranibizumab alone at 6 months. However, there was an improvement in the central macular thickness on OCT in patients.
The use of aflibercept led to greater improvement in macular perfusion status in a phase III trial with DME patients. Those with baseline nonperfusion tended to have more advanced disease.
Although a proven treatment therapy, age-related macular degeneration (AMD) requires frequent, costly anti-vascular endothelial growth factor (anti-VEGF) injections. Some pharmaceutical companies do have patient-assistance programs to help alleviate the financial burden.