OPHTHALMOLOGICA

New potential biomarker

Microaneurysm turnover analysed using the RetmarkerDR software (Critical Health SA, Coimbra, Portugal), could have a potential role as biomarker for responsiveness to ranibizumab in the treatment of diabetic macular oedema, a new study suggests. Analysis of images obtained with nonmydriatic ultra-widefield scanning laser ophthalmoscopy (Optomap) prior to ranibizumab treatment and one month later showed that eyes treated with ranibizumab had a reduction in the number of microaneurysms, with the amount of disappearing aneurysms out-pacing the appearance of new ones. In contrast, an analysis of untreated control eyes with diabetic retinopathy but without macular oedema showed that over the same period there was an increase in the number of microaneurysms. SF Leicht et al “Microaneurysm Turnover in Diabetic Retinopathy Assessed by Automated RetmarkerDR Image Analysis - Potential Role as Biomarker of Response to Ranibizumab Treatment. • Ophthalmologica 2014 ; DOI:10.1159/000357505.

PDT achieves its best results in subfoveal CNV

In eyes with CNV secondary to pathological myopia, photodynamic therapy (PDT) appears to provide a more persistent benefit in those with juxtafoveal CNV than it does in those with subfoveal CNV, according to a 10-year retrospective analysis of 19 eyes of patients who underwent the treatment. That is, in seven eyes with subfoveal CNV, mean visual acuity progressively worsened from 0.68 to 0.80 logMAR, during the 10-year follow-up. In contrast, in the 12 eyes with juxtafoveal CNV the mean visual acuity improved from 0.59 to 0.33 logMAR. In addition, the prevalence and extension of chorioretinal atrophy (CRA) were greater in eyes with subfoveal compared with juxtafoveal CNV. M Varano et al, “Photodynamic Therapy in Subfoveal and Juxtafoveal Myopic Choroidal Neovascularisation: A 10-year Retrospective Analysis”, Ophthalmologica 2014; DOI:10.1159/000357504.

Predictive disease characteristics

The long-term functional outcome of eyes with myopic CNV may depend more on their baseline pathological characteristics and consequent progression of macular atrophy than on the treatment they receive, whether it is PDT, intravitreal ranibizumab or the combination of the two, according to a retrospective study. It showed that in 54 eyes that received PDT and IVR, the two combined, or no treatment, macular atrophy progressed significantly in the three active treatment groups (p < 0.05) and the amount of atrophy was predictive of visual acuity. Factors predictive of progression included age, the degree of myopia and the presence of staphyloma. The choice of treatment had no predictive value. CL Farinha et al, “Progression of Myopic Maculopathy after Treatment of Choroidal Neovascularisation” Ophthalmologica 2014; DOI: 10.1159/000357290.