Ophthalmology

Suprachoroidal triamcinolone acetonide (CLS-TA, Clearside Biomedical) injection resulted in visual and anatomic improvements in eyes with diabetic macular edema, particularly in those that were treatment-naïve. Multiple injections of the investigational treatment were well-tolerated and associated with a low incidence of IOP elevation.

Quantitative assessment of retinovascular features on ultra-widefield angiography images showed significant improvements in leakage and ischemia following treatment with aflibercept in patients with diabetic macular edema and retinal vein occlusion.

Computerized testing of contrast sensitivity function using the Sentio Platform (Adaptive Sensory Technology) may better quantify the visual limitations of patients than traditional letter acuity after retinal detachment repair.

RGX-314 gene therapy offers patients the potential for a lower treatment burden with one subretinal injection of a gene therapy delivering an anti-vascular endothelial growth factor protein.

Advances in optical coherence tomography (OCT) and OCT angiography (OCTA) may enable more objective and accurate diagnosis of ROP in the future.

Early results of a phase Ib/II study investigating light-activated AU-011 (Aura Biosciences) for treatment of small-medium choroidal melanoma show good safety and evidence of efficacy for this novel tumor-targeted therapy.

Management of patients with loss of light perception after open-globe injury has historically been to observe or enucleate the eye with the goal of reducing the risk of sympathetic ophthalmia. Existing data, however, support rethinking that paradigm and instead considering surgery for carefully selected patients who have a chance for recovering vision.

OCT angiography (OCTA) is a revolutionary new tool that adds value to clinical practice. It provides unique insights about retinal and choroidal vasculature compared with conventional OCT along with the advantages of conventional dye-based techniques, said Philip J. Rosenfeld, MD, PhD, at the 2017 Retina Subspecialty Day meeting.

Clinical trials are an indispensable ordeal that are the gold standard for assessing risks and benefits of treatments, said Frederick L. Ferris III, MD.

Development of technologies for sustained drug delivery is a topic of great interest among retina specialists considering the number of chronic conditions that are managed with repeated intravitreal injections.

Results from 3 years of follow-up in the phase III trial investigating treatment with adeno-associated viral vector delivery of human RPE65 (voretigene neparvovec, Spark Therapeutics) show this gene therapy has an acceptable safety profile.

The fluocinolone acetonide 0.2 mcg/day implant (Iluvien, Alimera Sciences) offers an additional option for treating diabetic macular edema that reduces the need for subsequent therapy with anti-vascular endothelial growth factor or steroid treatment.

The visual outcomes after anti-VEGF therapy administered to treat diabetic macular edema in the “real world” do not achieve those reported in randomized clinical trials. Eyes with better baseline visual acuity are disproportionately affected.

Take-Home Message: A pearl for preventing endophthalmitis following intravitreal injections: avoid eyelid contact with the injection site after the last application of povidone iodine.

Brimonidine Drug Delivery System (Brimo DDS) in an intravitreally administered, sustained-release implant (Allergan) shows promise as a treatment for geographic atrophy (GA), secondary to age-related macular degeneration in a phase IIa clinical trial.

Topline results from phase III studies investigating intravitreal brolucizumab (Novartis) for treatment of neovascular age-related macular degeneration (nAMD) support the potential of this novel anti-VEGF antibody to meet the real-world need for an alternative agent with a sustainable therapeutic regimen.

Take-Home Message: The Telescopic Intra-Ocular Lens for Visually Impaired People Revolution system is promising to improve the vision in patients with maculopathies.

ALG-1001 (Luminate, Allegro Ophthalmics) has a number of different mechanisms of action that benefit patients chronically treated with anti-vascular endothelial growth factor drugs and those who are treatment naïve.

Patients with diabetic retinopathy have a high risk of developing macular edema after cataract surgery. Intravitreal injections of aflibercept might result in fewer patients developing macular edema in this patient population.

Adaptive optics (AO) is providing new insights about retinal structure and may help to identify potential areas for treatment of retinal diseases, said Mina Chung, MD.

There is no doubt that inflammation is a component of age-related macular degeneration (AMD), and yet the role of corticosteroid treatment in the management of eyes with AMD remains uncertain, said Marc de Smet, MD, PhD.