Improvement In Best-corrected Visual Acuity Research Articles

Predictive factors of long-term visual outcomes after primary Descemet's membrane endothelial keratoplasty (DMEK): retrospective study.

To determine predictive factors of higher levels of best-corrected visual acuity (BCVA) in the long-term after primary Descemet's membrane endothelial keratoplasty (DMEK). Retrospective, single-surgeon case series of 129 successful primary DMEK eyes without graft failure and with a minimum postoperative follow-up of 12months. Mixed effect model for repeated measurements (MMRM) analysis was performed to determine recipient, donor, surgical and postoperative factors associated with BCVA ≤ 0.10 logMAR (≥ 20/25 Snellen). After primary DMEK, there was a statistically significant improvement in BCVA with a global reduction in logMAR BCVA (p < 0.00001). There was also a global tendency towards increasing proportion of eyes with BCVA ≤ 0.10 logMAR at all time points (p < 0.00001), from 1.6% before DMEK to 64.4% in eyes with more than 5years of F-U. Absence of retinal disease was associated with a decrease of 0.10 logMAR in postoperative BCVA after primary DMEK, maintaining constant the rest of variables (p < 0.001). The variables age (OR 0.960), postoperative time (OR 1.083), preoperative BCVA ≥ 0.375 logMAR (OR 0.162) and indication for DMEK (OR 5.412) were included in the predictive MMRM model of BCVA ≤ 0.10 logMAR. Primary DMEK is associated with statistically and clinically significant improvement in BCVA that occur early in the postoperative period and are continuous over time. Eyes with retinal comorbidities have increased risk of worse postoperative BCVA after DMEK. Younger recipient age, Fuchs' dystrophy eyes and eyes with better preoperative BCVA are more likely to achieve postoperative BCVA ≤ 0.10 logMAR.

Eccentric Superficial Anterior Lamellar Keratoplasty for Bilateral Limbal Stem Cell Deficiency

Purpose: To describe and report the outcomes of allogeneic eccentric superficial anterior lamellar keratoplasty (SALK), a novel surgical technique, in the management of total bilateral limbal stem cell deficiency (LSCD). Methods: Data were collected retrospectively on all patients with total bilateral LSCD who underwent SALK. Previous surgery, preexisting glaucoma, conjunctivalization, vascularization, lens status, and preoperative best-corrected visual acuity (BCVA) were collected from medical notes. Results: Fifteen eyes underwent eccentric SALK between November 2018 and October 2021. The average age of patients at the time of SALK was 50.3 (SD ± 21.0). There were 4 male and 11 female patients, 9 left eyes and 6 right eyes. The mean difference between pre- and post-BCVA scores were 0.43 LogMAR (95% CI, 0.23–0.63). Ten patients noted an improvement in the features of LSCD with an improvement in BCVA. Five cases were deemed a complete success with a complete resolution of corneal epithelium, no recurrence of LSCD features and an improvement in BCVA. Patients who developed fungal keratitis had poor outcomes. Conclusions: This study describes a new surgical technique of eccentric SALK to treat anterior stromal opacity and restore limbal stem cell function without systemic immunosuppression. The surgery improves the vision in most patients. However, in this complicated patient group, close postsurgical management is vital to recognize complications and intervene with treatment as needed.

CATARACT SURGERY RESULTS IN BRAIN TUMOR DIAGNOSIS: A CASE REPORT

The article outlines a diagnostic investigation following phacoemulsification of early age-related cataract in patients who exhibited no improvement in best-corrected visual acuity and reported “floating spots” in the postoperative period. Optical coherence tomography of the optic disc showed a lesion in the peripapillary nerve fiber layer, symmetrically located on the temporal side of both eyes. Computer perimetry revealed bitemporal hemianopsia. Neuroimaging (MRI with intravenous contrast) confirmed the presence of a lesion in the chiasmatic-sellar region. In this article, we present a variant of postoperative management and additional examination of a patient as an example of differential diagnostic search for a possible non-ophthalmological cause of decreased visual acuity. It demonstrates the importance of an interdisciplinary approach as a key to early diagnosis of brain tumors.

The safe lowest effective power of subthreshold micropulse laser treatment in Chinese patients with acute or chronic central serous chorioretinopathy

PurposeTo assess the safe, lowest effective laser power of subthreshold micropulse laser (SML) for treating acute and chronic central serous chorioretinopathy (CSC) in Chinese patients.MethodsPatients were distinguished with acute or chronic CSC based on focal or diffuse retinal pigment epithelium (RPE) leakage on fundus fluorescein angiography (FFA), with or without widespread RPE decompensation. Patients were categorized into five groups and treated with 577 nm yellow SML according to 50% titration power. The change of best-corrected visual acuity (BCVA) and central macular thickness (CMT) were set as primary outcomes. A linear regression model assessed the correlation between different factors and outcome indicators.ResultsA total of 103 patients with 127 eyes (61 with acute CSC and 66 with chronic CSC) were enrolled. The baseline characteristics were balanced between the five groups (all p &amp;gt; 0.05). The decrease of CMT and the improvement of BCVA were related to the CMT at baseline (all p &amp;lt; 0.05). We found that the lowest effective laser power for acute CSC was 425 mW (−225.50 μm vs. −171.24 μm vs. −114.50 μm vs. −130.54 μm vs. −68.00 μm, p &amp;lt; 0.001), showing a significant CMT reduction at this power, but no significant increase in BCVA (−0.15 ± 0.10 logMAR vs. −0.20 ± 0.16 logMAR vs. −0.14 ± 0.11 logMAR vs. −0.17 ± 0.30 logMAR vs. −0.11 ± 0.14 logMAR, p &amp;gt; 0.05). For chronic CSC, the lowest effective laser power was 375 mW (p = 0.01), the change of CMT was significant in 375 mW (−93.91 ± 109.06 μm, −119.32 ± 105.56 μm, −88.67 ± 67.26 μm, −60.89 ± 106.86 μm, and −99.11 ± 157.32 μm, p = 0.04). The change of BCVA was similar trend (−0.54 ± 0.66 logMAR vs. −0.17 ± 0.23 logMAR vs. −0.10 ± 0.21 logMAR vs. −0.02 ± 0.30 logMAR vs. 0.05 ± 0.19 logMAR, p &amp;lt; 0.001).ConclusionIn this study, our results suggested 425 mW and 375 mW laser power is the lowest effective SML power for treating acute and chronic CSC in Chinese patients respectively, And the power of SML for chronic CSC requires lower power than acute CSC.

Safety and Efficiency of Anti-VEGF with Dexamethasone Intravitreal Implant for Non-Ischemic Retinal Vein Occlusion: A Prospective, Case-controlled, Cohort Study.

This study aimed to assess the efficacy and safety of anti-VEGF combined with dexamethasone implant for the retinal vein occlusion patients with macular edema. In this prospective, case-controlled, cohort clinical trial (Register ID: ChiCTR2400080048), patients with non-ischemic retinal vein occlusion were enrolled from the Sanmenxia Central Hospital from August 2020 to April 2023. The patients were randomized into two groups. All the patients received ranibizumab intravitreal injection in the first 3 consecutive months. For the ranibizumab group, anti-VEGF injections were as needed thereafter in case of recurrence of macular edema; For the combination group, the patients received an intravitreal dexamethasone implant injection at 15 days after the first ranibizumab injection. The primary outcome measurements were improvement in best corrected visual acuity (BCVA) and reduction in central macular thickness (CMT). The secondary outcomes were recurrence of macular edema, number of intravitreal injections, and injection interval. Safety profiles were also recorded. A total of 124 patients were included, of which 73 patients completed all follow-ups. Both the ranibizumab monotherapy and the combination therapy significantly improved BCVA at all time points, compared to the baseline. The combined group achieved more BCVA improvement in 3 months, 6 months, and 12 months, compared to the ranibizumab alone group. Compared to the baseline, both groups achieved significant reductions in CMT at all follow-ups. However, the combination group showed more CMT reduction at 1 week post injection, compared to the ranibizumab group. The combination group had a significantly longer injection interval, lower injection time, and recurrence of macular edema. Ocular hypertension was the most common adverse events. Lastly, intraocular pressure was all well controlled by 1-3 glaucoma medications without surgical intervention. The combination therapy could significantly improve the BCVA and reduce the CMT with a good safety profile.

Suprachoroidal Umbilical Cord-Derived Mesenchymal Stem Cell Transplantation for the Regeneration of Glaucomatous Optic Neuropathy: A Preliminary Investigation

Objective: This preliminary research presents clinical findings from patients with advanced Glaucomatous Optic Neuropathy (GON) who underwent transplantation of Umbilical Cord-Derived Mesenchymal Stem Cells (UCMSCs) into the suprachoroidal space. Methods: This prospective, single-center study included 17 eyes of 17 patients diagnosed with GON, who received suprachoroidal UCMSC implantation. Patients were registered if their visual acuity and/or Visual Field (VF) deteriorated despite maintaining good intraocular pressure control with anti-glaucomatous treatments. Evaluations were conducted at baseline, on the first postoperative day and at 1 month, 6 months and 1 year after surgery. Best Corrected Visual Acuity (BCVA), anterior segment and fundus examination, color photography, Optical Coherence Tomography (OCT), Retinal Nerve Fiber Layer (RNFL) analysis, VF testing and Pattern Visual Evoked Potential (PVEP) assessments were performed at baseline and during follow-up visits. Results: All 17 participants completed the 12-month follow-up period. No systemic or serious ocular complications were recorded. The study showed significant improvements in BCVA, VF results, RNFL measurements and PVEP amplitudes at the end of the follow-up period. Conclusion: Although the sample size is limited, suprachoroidal UCMSC therapy appears to be safe, with encouraging improvements. Further studies with larger patient groups and longer follow-up periods are required to assess the impact of stem cell delivery on visual acuity and quality of life in glaucoma patients.

Micropulse Laser versus Eplerenone for Chronic Central Serous Chorioretinopathy: A 12-Month Comparison.

To compare the long-term efficacy of navigated subthreshold micropulse laser (NSML) and continuous oral eplerenone (EPL) in chronic central serous chorioretinopathy (cCSC). This retrospective observational study included 44 eyes with cCSC (EPL: n = 26; NSML: n = 18). Best-corrected visual acuity (BCVA), central macular thickness (CMT), subretinal fluid (SRF) height, and subfoveal choroidal thickness (SFCT) were evaluated over 12months. Both groups showed significant improvements in BCVA and CMT (p < 0.05). Complete SRF resolution was achieved in both groups by 12months, with NSML showing faster resolution (2.77 ± 1.43 vs. 6.34 ± 2.17months, p < 0.001). The EPL group demonstrated significant SFCT reduction at 6 and 12months (p = 0.001), while the NSML group showed no significant SFCT changes (p > 0.05). Both NSML and EPL improved retinal morphology and visual function in patients with cCSC. NSML achieved faster SRF resolution, while EPL resulted in more significant choroidal thickness reduction. These findings suggest distinct mechanisms of action: NSML primarily affects the retinal pigment epithelium, while EPL modulates choroidal vasculature. Treatment choice may depend on individual patient characteristics and treatment goals.

Traumatic Optic Neuropathy Treatment Trial 2 (TONTT-2): evaluating the efficacy of different doses of erythropoietin – a multicentre, randomised, double-blind clinical trial

AimThe aim is to compare the efficacy and safety of three different weight-adjusted intravenous erythropoietin (EPO) doses in patients with indirect traumatic optic neuropathy (TON).MethodsThis study is a multicentre, randomised,...

Long-Term Outcomes of Cataract Surgery: Analysis of Visual Acuity and Intraocular Pressure in a Tertiary Care Center

Abstract: Posterior capsule opacity (PCO) is a common complication following cataract surgery, caused by the proliferation of residual lens epithelial cells. This study aimed to evaluate the long-term effects of Nd:YAG laser capsulotomy on intraocular pressure (IOP) and visual acuity in PCO patients. This was a retrospective descriptive study. Samples were 24 patients diagnosed with PCO who underwent Nd:YAG laser capsulotomy at Prof. Dr. R. D. Kandou Hospital, Manado, from January 1, 2022, to January 1, 2024. The study recorded pre- and post-procedure IOP and best-corrected visual acuity (BCVA) data. Descriptive analysis, including paired t-tests, was used to assess changes in IOP and BCVA over an average follow-up period of 19.2 months. The results showed a statistically significant improvement in BCVA (p=0.000), with mean values improving from 0.72 to 0.27 LogMAR. A significant reduction in IOP was also observed (p=0.015), with long-term IOP remaining stable. A weak correlation was found between follow-up duration and IOP variation (p=0.02). In conclusion, Nd:YAG laser capsulotomy significantly improves visual acuity and stabilizes intraocular pressure in the long term for PCO patients, suggesting its effectiveness in managing post-cataract surgery complications. Keywords: posterior capsule opacity; Nd:YAG laser capsulotomy; intraocular pressure; visual acuity; cataract surgery Methods: A retrospective descriptive study was conducted on 24 patients diagnosed with PCO who underwent Nd capsulotomy at RSUP Prof Dr. R. D. Kandou Central Hospital, Manado, from January 1, 2022, to January 1, 2024. The study recorded pre- and post-procedure IOP and Best-Corrected Visual Acuity (BCVA) data. Descriptive analysis, including paired t-tests, was used to assess changes in IOP and BCVA over an average follow-up period of 19.2 months. Results: The study revealed a statistically significant improvement in BCVA (p = 0.000), with mean values improving from 0.72 to 0.27 LogMAR. A significant reduction in IOP was also observed (p = 0.015), with long-term IOP remaining stable. A weak correlation was found between follow-up duration and IOP variation (p = 0.02). Conclusion: Nd capsulotomy significantly improves visual acuity and stabilizes IOP in the long term for PCO patients, suggesting its effectiveness in managing post-cataract surgery complications.

Dexamethasone implant for refractory macular edema secondary to diabetic retinopathy and retinal vein occlusion.

To evaluate the efficacy, timing of retreatment and safety of dexamethasone (DEX) implant on macular edema (ME) secondary to diabetic retinopathy (DME) and retinal vein occlusion (RVO-ME) patients who were refractory to anti-vascular endothelial growth factor (VEGF) treatment. This retrospective study included 37 eyes received at least one DEX implant treatment for DME or RVO-ME between January 1, 2019, and January 1, 2023. These refractory DME and RVO-ME cases received at least 5 anti-VEGF injections and failure to gain more than 5 letters or a significant reduction in central retinal thickness (CRT). The best corrected visual acuity (BCVA) and CRT were measured at baseline, and at 1, 3, 4 and 6mo post-DEX implant injection. Adverse events such as elevated intraocular pressure (IOP) and cataract were recorded. For RVO cases (n=22), there was a significant increase in BCVA from 0.27±0.19 to 0.35±0.20 at 6mo post-DEX injection (P<0.05) and CRT decreased from 472.1±90.6 to 240.5±39.0 µm at 6mo (P<0.0001). DME cases (n=15) experienced an improvement in BCVA from 0.26±0.15 to 0.43±0.20 at 6mo post-DEX implant injection (P=0.0098), with CRT reducing from 445.7±55.7 to 271.7±34.1 µm at 6mo (P<0.0001). Elevated IOP occurred in 45.9% of patients but was well-controlled with topical medications. No cases of cataract or other adverse events were reported. DEX implants effectively improve BCVA and reduce CRT in refractory DME and RVO-ME. Further research with larger cohorts and longer follow-up periods is needed to confirm these findings and assess long-term outcomes.

Evaluation of postoperative outcomes after cataract surgery in patients with Juvenile Idiopathic Arthritis-Associated Uveitis.

To evaluate the postoperative outcomes of cataract surgery and intraocular lens (IOL) implantation on visual outcomes and complications in pediatric patients with Juvenile Idiopathic Arthritis-Associated Uveitis. This study included 25 patients (30 eyes) with uveitis and cataracts who underwent cataract surgery. The study was conducted as a retrospective study. Patients were divided into two groups based on their preoperative treatment: those who received immunomodulatory therapy (IMT) along with systemic corticosteroids and those who received IMT in combination with a biologic therapy. Best corrected visual acuity (BCVA), intraocular pressure (IOP), central macular thickness (CMT), macular volume (MV), and postoperative complications were assessed at various time points up to 12 months. All surgeries were performed by a single surgeon. Significant improvement in BCVA were observed postoperatively in both study groups, with approximately 80% of eyes showing improvement. Mean BCVA improved from 0.89 ± 0.63 to 0.37 ± 0.33 in group 1and from 0.82 ± 0.68 to 0.35 ± 0.31 in group 2 after 12 months. Postoperatively, there was a decrease in mean IOP, with no significant variance observed between the two groups. Complications were observed in 73% of cases, including posterior capsular opacification (PCO), secondary glaucoma, and macular edema (ME), but did not significantly differ between groups. Cataract surgery in children with uveitis associated with JIA presents significant challenges due to the risk of postoperative complications, even with adequate preoperative and postoperative care. The similar improvement in BCVA observed in both groups suggests that different systemic therapies were sufficient for satisfactory control of inflammation before and after surgery.

Influence of foveal glial tissue after macular hole surgery on outer retinal restoration and visual acuity

Purpose: To investigate the impact of foveal glial tissue on the anatomical and functional results after macular hole (MH) surgery. Methods: This study included 141 consecutive eyes that underwent successful vitrectomy for full-thickness MH between January 2015 and December 2022. The best-corrected visual acuity (BCVA) and the length of outer retinal defects were evaluated preoperatively and at 6 months postoperatively. MH with retinal detachment, recurrent MH, and traumatic MH were excluded. Multiple regression analyses were conducted on outer retinal restoration and visual acuity using foveal glial tissue size, surgical technique of internal limiting membrane (ILM) peeling or inverted ILM flap, and high myopia as explanatory variables. Results: Analyses revealed that the foveal glial tissue significantly limited the outer nuclear layer (ONL), external limiting membrane (ELM) restoration, and ellipsoid zone (EZ) restoration as well as BCVA improvement (r = −0.380, p &lt; 0.001; r = −0.314, p = 0.035; r = −0.530, p = 0.015; r = −0.00027, p = 0.001; respectively). Meanwhile, the surgical technique and high myopia did not significantly affect the restoration of ONL, ELM, EZ, and BCVA after surgery. Conclusion: Foveal glial tissue after MH surgery attenuated ONL, ELM, and EZ restoration as well as BCVA improvement.

Comprehensive combined analysis of physician-initiated phase II and III clinical trials on a cultured human corneal endothelial cell product for treating bullous keratopathy.

To evaluate the efficacy and safety of a cultured human corneal endothelial cell (cHCEC) product in eyes with bullous keratopathy (BK). Combined analysis of multicenter phase II and III clinical trials. This analysis involved 15 BK eyes in the phase II trial and 12 BK eyes in the phase III trial that underwent cHCEC transplant therapy. Safety was assessed in all the cases. Efficacy was assessed in 17 cases with exclusion of the low- and medium-dose groups in the phase II trial. The primary endpoint was a corneal endothelial cell density of 1000 cells/mm2 or more at 24 weeks post-transplant, which was attained in 94.1% of the eyes (16 of 17), with a 95% CI of 71.3-99.9%. Additionally, 82.4% of the eyes (14 of 17) met the secondary endpoint of reduction in corneal thickness to less than 630 µm without corneal epithelial edema within the same time frame, with a 95% CI of 56.6-96.2%. The mean decrease in corneal thickness from baseline to 24 weeks post-transplant was -187.4 µm (95% CI, -240.2 µm to -134.5 µm). Furthermore, all the eyes exhibited improvement in best-corrected visual acuity from baseline to 24 weeks post-transplant (95% CI, 80.5-100.0%). By 24 weeks post-transplant, 88.9% of the patients (24 of 27) had experienced adverse events, which were mostly local, mild, and transient. The cHCEC product of this study reconstitutes the corneal endothelial layer with high cellular density and restores corneal thickness and improves visual acuity.

Efficacy and Safety of an Indian Bevacizumab BIOSimilar (BEVATAS) for Retinal Vein Occlusion (BIOS-RVO Study).

To evaluate the efficacy and safety of Bevatas®, an Indian bevacizumab biosimilar, in the management of both Central Retinal Vein Occlusion (CRVO) and Branch Retinal Vein Occlusion (BRVO) (BIOS-RVO). The BIOS-RVO study was a retrospective interventional study conducted at a single tertiary eye care facility in India. 154 treatment-naïve eyes with RVO (CRVO: 62 eyes; BRVO: 92 eyes) received intravitreal bevacizumab biosimilar (IVBb) therapy. Data on best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) were collected at baseline and at 3, 6, and 12 months post-therapy. The average age of participants was approximately 55.99 (+12.56) years, with a nearly equal gender distribution (M:F = 49.4:50.6). Age differences between BRVO and CRVO groups were not significant (P=0.501), but gender distribution varied significantly (P=0.035), with more males in the CRVO group. Significant improvements in BCVA were observed in both CRVO and BRVO groups at 3 months, 6 months, and 1 year compared to baseline (P<0.001). Both groups showed significant reductions in CMT throughout the follow-up period (P<0.001). The mean number of injections was higher in the CRVO group (5.27[±1.45]) compared to the BRVO group (4.27 [±1.28]) (P<0.001). Significant IOP increases were observed at 1 month (P<0.001) and 6 months (P<0.001) in both BRVO and CRVO groups, although not clinically significant. Safety analysis revealed no additional ocular or systemic adverse events during the study period. The BIOS-RVO study demonstrates that Bevatas is an effective and safe treatment option for both CRVO and BRVO. These findings support the use of Bevatas as a cost-effective alternative to branded anti-VEGF agents, particularly in resource-limited settings.

Evaluating Faricimab in Treatment-Naive Neovascular Age Related Macular Degeneration: A Retrospective Analysis of Real-World Data.

To evaluate the efficiency and safety of Faricimab on treatment-naive neovascular age related macular degeneration (nAMD) in a real world UK clinic. This single centre, retrospective note review was conducted on treatment-naive patients with nAMD. The data collected included demographics, best corrected visual acuity (BCVA), central macular thickness (CMT), total retinal fluid (TRF), the presence of intraretinal fluid (IRF) and subretinal fluid (SRF). A total of 66 eyes from 62 patients were analysed. The average age was 77 years (range 36-91) and 54% of patients were female. After the first dose of faricimab, the average BCVA improved by 0.05 LogMAR (+2.5 letters), the average CMT decreased by 65.9μm and 41% of patients were found to be inactive. The follow-up intervals after the third loading dose were divided into 2 subsets of 4 and 8week extensions. The 4week extension subset saw a smaller improvement in BCVA (+3 letters) than the 8week extension (+6 letters) while both had an average decrease in CMT by 86.6μm. The total retinal fluid decreased by 45% and 70.7%, leaving only 30% and 12.2% residual intraretinal fluid (IRF) and 30% and 24.4% residual subretinal fluid (SRF), respectively. Over a ten-month period, the average number of injections received was 6.6, including 3 initial loading doses. There was only one reported case of an adverse event out of 66 eyes (1/66, 1.5%). Three loading doses of Faricimab appear efficacious and safe for the treatment of nAMD.

Significance of binocular fusion in enhancing visual acuity during amblyopia treatment.

Currently, the exploration of amblyopia treatment methods is gradually shifting to the restoration of binocular visual perceptual function. Binocular fusion function, as an important component of binocular visual function, mainly reflects the patient's ability to integrate the signals received from both eyes. In this study, we investigated the relationship between binocular fusion function and improvement in visual acuity during amblyopia treatment. A retrospective analysis was conducted on a cohort of patients with amblyopia, aged 3-14 years old, who visited an outpatient clinic in Shenzhen Eye Hospital between May 2021 and January 2023. The investigation included 105 patients (210 eyes) with isometropic or anisometropic amblyopia. All participants underwent cycloplegic refraction examination and binocular fusion function measurement. All patients underwent standard amblyopia treatment, and those with the best-corrected visual acuity (BCVA) of 0.6 or higher in the amblyopic eye of both eyes received binocular fusion training using a computer platform. A statistically significant negative correlation (-0.263, P=0.007) was observed between the absolute difference in binocular BCVA and binocular fusion function at the start of treatment (baseline). Linear regression analysis revealed that the improvement in BCVA in the amblyopic eye exhibited correlations with several factors, including the baseline binocular BCVA difference, baseline BCVA of the amblyopic eye, improvement in binocular fusion function, and the number of fusion training sessions (regression coefficients: -0.463, -0.771, 0.007, and 0.063, respectively; all P<0.05). Two patterns of binocular fusion function development during treatment were identified using group-based trajectory modeling (GBTM): the slow growth pattern and the rapid growth pattern. The results of a multivariate logistic regression model indicated a statistically significant link between fusion training and the development pattern of binocular fusion function [odds ratio (OR): 5.219, 95% confidence interval (CI): 2.045-13.323]. Enhancing binocular fusion function may result in an improvement of BCVA in the amblyopic eye of patients with amblyopia. The frequency of binocular fusion training is crucial for rapid improvement in binocular fusion function.

Real-World Assessment of Second-Generation Trabecular Micro-Bypass Stents in Open-Angle Glaucoma Patients

Background/Purposes/Objective: To assess the safety and efficacy of iStent inject placement in individuals with glaucoma with open angles in real world clinical settings. MethodsA review was conducted on the medical records of individuals who received iStent inject implants starting from March 2018. The analysis focused on reductions in intraocular pressure (IOP) and glaucoma medication usage. Safety assessments encompassed intraoperative and postoperative issues, additional surgeries, and improvements in best-corrected visual acuity (BCVA). ResultsAnalysis of 55 eyes of 48 patients that underwent iStent implantation revealed a mean age of 77 years (range: 51-97). The initial average intraocular pressure (IOP) in these eyes was 20.2 ± 6.4 mm Hg. Following surgery, IOP decreased by ≥ 20% compared to preoperative levels in 21 eyes (43.8%) over the 12-month follow-up period. Notably, there was a significant reduction in medication usage by the 12-month mark (p < 0.0042). Among the evaluated eyes, 9 exhibited a response to steroids, 3 had stents that were improperly positioned, 5 had stents that were over implanted, and 1 eye experienced an episode of iris prolapse. ConclusionsThe findings from the 12-month follow-up of iStent inject implants in standard clinical settings demonstrate a notable decrease in both intraocular pressure (IOP) and medication usage in eyes with concurrent open-angle glaucoma.

Efficacy and Safety of Ranibizumab Biosimilar QL1205 in Neovascular Age-Related Macular Degeneration: A Phase III Randomized Trial

This study aimed to demonstrate the clinical equivalence of biosimilar QL1205 and reference ranibizumab, Lucentis®, in patients with neovascular age-related macular degeneration (nAMD). This was a multi-center, double-blinded, randomized controlled phase 3 trial. Treatment-naïve patients with active nAMD were randomly assigned to receive QL1205 or reference ranibizumab. Patients received intravitreal injection of QL1205 or reference ranibizumab at a dose of 0.5 mg in the study eye once every four weeks for 48 weeks. The primary endpoint was change in best-corrected visual acuity (BCVA) by Early Treatment Diabetic Retinopathy Study (ETDRS) letters at week 8 compared to baseline level. Biosimilarity of QL1205 to reference ranibizumab was assessed with an equivalence range for the difference in BCVA letters between -3.49 and +3.49. Between June 27, 2019 and June 8, 2021, 616 patients were randomized to the QL1205 group (n=308) and the reference ranibizumab group (n=308). The mean improvement of BCVA was +6.3±9.13 ETDRS letters in the QL1205 group and +7.3±8.82 ETDRS letters in the reference ranibizumab group at week 8. Both the 90% confidence interval (CI) [-2.23, 0.13] and 95% CI [-2.46, 0.36] of the difference between the two treatment groups (P=0.1434) were within the predefined equivalence range. Safety profiles were manageable in both groups. QL1205 was biosimilar to reference ranibizumab regarding clinical efficacy, ocular and systemic safety, as well as immunogenicity and pharmacokinetics profiles in the treatment of patients with nAMD.

Short pulse grid and subthreshold micropulse laser (the sandwich grid) plus intravitreal ranibizumab for the treatment of diabetic macular edema

ObjectiveTo investigate the effects of two laser treatment procedures combined, short pulse grid laser (SP) and subthreshold micropulse laser (MP) (the sandwich grid [SWG] technique), plus intravitreal ranibizumab (IVR) on central subfield thickness (CSFT), best-corrected visual acuity (BCVA) and macular sensitivity in patients with diabetic macular edema (DME).MethodsForty-five eyes (of 33 patients) with center-involving DME were treated with the SWG laser technique plus IVR and followed for 12 months. Laser treatment was performed at baseline: SP laser spots were placed in a grid pattern in the macular area (500 µm from the fovea) according to the extension of DME; subsequently, MP laser was delivered up to the edge of the fovea. MP laser re-treatment sessions could be performed every 3 months if DME was present and CSFT was ≥ 300 μm on SD-OCT. IVR injection was performed at baseline and repeated monthly if CSFT > 300µm. Preoperatively and monthly, ophthalmological examination was performed including measurements of BCVA, CSFT, and macular sensitivity.ResultsOne-year follow-up data is available for 37 eyes of 27 patients. Mean ± SE CSFT (µm) was 509.36 ± 25.14 and 325.76 ± 15.34 at baseline and 12 months, respectively. A significant reduction in mean CSFT was observed at all study visits compared to baseline (p < 0.001). Mean ± SE BCVA (logMAR) was 0.62 ± 0.04 and 0.45 ± 0.04 at baseline and 12 months, respectively. A significant improvement in mean BCVA was observed at all study visits compared to baseline (p < 0.001). Mean ± SE macular sensitivity (dB) was 17.85 ± 0.80 and improved to 19.05 ± 0.59 after one year of follow-up (p = 0.006). The mean number of IVR injections was 8.29 ± 0.63. The mean number of MP laser procedures including the initial SWG laser session was 3.67 ± 0.22. No ocular or systemic adverse effects were observed.ConclusionThe SWG laser technique plus IVR was associated with significant improvement in macular edema, BCVA, and macular sensitivity in patients with center-involving DME.Clinical Trial Number (CAAE)22969019.4.0000.5440.

Predictive Factors for Functional and Anatomical Outcomes After Anti-VEGF Treatment for Macular Edema in Patients with Branch Retinal Vein Occlusion.

This study aimed to identify predictive factors for the improvement of best-corrected visual acuity (BCVA) and reduction of central macular thickness (CMT) after treatment of macular edema (ME) due to branch retinal vein occlusion (BRVO) in a real-world setting. This retrospective study included patients with ME secondary to BRVO who were treated with intravitreal injection of bevacizumab as the first-line therapy and were followed up for 12 months. Demographic and clinical data, in addition to baseline spectral domain optical coherence tomography (SD-OCT) features, were considered as possible biomarkers of final BCVA and CMT. We also collected the data concerning the need for additional treatment including sectorial laser photocoagulation, change to another anti-VEGF agent, or intravitreal corticosteroid injection. A total of 161 eyes were analyzed. BCVA significantly improved from baseline to 12-month follow-up (0.6 and 0.4 logMAR, respectively; P 0.01). CMT decreased significantly during the follow-up period (from 498.0 to 325.0 m; P 0.01). Final BCVA correlated positively with baseline BCVA (P 0.01, r = 0.57). Older age at diagnosis and baseline SD-OCT findings including CMT, disruption of the retinal inner layers, retinal pigment epithelium (RPE) damage, and impairment of the ellipsoid zone and external limiting membrane negatively affected final BCVA (P 0.01). Multiple regression analysis identified age and BCVA at baseline as the only independent predictors of final BCVA (P = 0.001 and P 0.01, respectively). No association was found between clinical data, SD-OCT parameters, and final CMT. Various clinical and SD-OCT parameters are prognostically relevant for visual improvement in ME secondary to BRVO. Age at diagnosis and baseline BCVA were found to be independent predictors of visual outcome.