OPHTHALMOLOGICA

Rituximab effective in refractory non- infectious ocular inflammation

A growing body of evidence suggests that the monoclonal antibody, rituximab, can reduce both external and internal non-infectious ocular inflammation, according to a review of the literature. Numerous series have been published demonstrating that a single course of rituximab reduced the inflammation to a state of quiescence without the need for other immunosuppressive agents for periods ranging from 18 months to several years in eyes with refractory autoimmune disease with ocular involvement and eyes with intraocular lymphoma .

- O.Tomkins-Netzer et al Ophthalmologica “Can Rituximab Induce Long-Term Disease Remission in Patients with Intra-Ocular Non- Infectious Inflammation” 2013 October; Vol 230, Issue 4, DOI:10.1159/000351426.

MS thins retinal nerve fibre layer

Measurements carried out with spectral domain OCT indicate that multiple sclerosis (MS) may have a significant thinning effect on patients’ retinal nerve fibre layer (RNFL), especially in cases where there is also optic neuritis, according to the results of a retrospective study. In 24 eyes of 12 MS patients the average peripapillary RNFL thickness, as measured by OCT was 81.9 μm, compared to the control value of 102.1 μm (p = 0.001). In MS patients with a history of optic neuritis, RNFL was thinner than that of MS patients without optic neuritis (71.8 μm vs. 92.0 μm, p = 0.001).

- L Feng ey al . Ophthalmologica • The Evaluation of the Retinal Nerve Fiber Layer in Multiple Sclerosis with Special- Domain Optical Coherence Tomography 2013 October; Vol 230, Issue 4, DOI:10.1159/000351862.

Triple therapy stabilises refractory AMD

Triple therapy with ranibizumab, triamcinolone and reduced fluence PDT can stabilise vision in eyes with exudative AMD that has not responded to anti- VEGF therapy alone, according to the results of a prospective study involving 30 patients. Three groups of 10 patients each received one of three variations of triple therapy. At six months follow-up, the groups that underwent PDT with reduced fluence and either reduced or standard irradiance had slight but insignificant improvements in visual acuity, but in the group that underwent standard fluence PDT the visual acuity decreased by 0.29 (p < 0.05) logMAR.

- Veritti D. • Ophthalmologica Triple Therapy for Anti-Vascular Endothelial Growth Factor Nonresponders in Neovascular Age-Related Macular Degeneration: Impact of Different Photodynamic Therapy Parameters 2013 October; Vol 230, Issue 4, DOI:10.1159/000351651.

Indocyanine green slows recovery

A retrospective analysis of spectral- domain optical coherence tomography images in 34 eyes of 34 patients who had undergone macular hole surgery with or without indocyanine green staining of the inner limiting membrane showed that the inner segment/ outer segment defect was significantly worse at one and three months in those who underwent surgery with ICG. Moreover, the changes in BCVA were significantly better in the non-ICG group at one and three months, but the groups did not differ significantly at six months.

- Shiono A., “Ophthalmologica Effects of Indocyanine Green Staining on the Recovery of Visual Acuity and Macular Morphology after Macular Hole Surgery”, 2013 October; Vol 230, Issue 4, DOI:10.1159/000351661.