OPHTHALMOLOGICA

TPA’s efficacy

Recombinant tissue plasminogen activator (rtPA) in the treatment of recent-onset submacular haemorrhage in patients with age-related macular degeneration (AMD) appears to be equally effective whether it is injected submacularly with vitrectomy or intravitreally without vitrectomy, according to a review of the literature. The authors analysed the findings of 38 studies involving a total of 1,185 patients, and 28 patients from the Rotterdam Eye hospital. They could find no clear difference in complete displacement or complication rate between the two treatment groups. n (van Zeeburg et al, Ophthalmologica 2013; DOI: 10.1159/000343066)

Pathology of RP

The retinal nerve fibre layer of eyes with retinitis pigmentosa (RP) appears to have characteristic thickness abnormalities which are detectable with scanning laser polarimetry with enhanced corneal compensation (GDxECC) and RTVue-optical coherence tomography (OCT), according to a new study. The investigation compared the findings of the two technologies in 52 eyes of 26 RP patients with those of 50 eyes of 25 patients without the disease. The RNFL measured by GDxECC was significantly thicker in RP patients than in controls and the RNFL thickness measured by RTVue- OCT was significantly greater in RP patients than in controls in the superior, inferior and temporal regions. The authors said their findings may provide some additional clues to the disease's underlying pathology. n (Xue et al, Ophthalmologica 2013; DOI: 10.1159/000337227)

Microcannula-guided vitrectomy safe option

Intraoperative retinal breaks during vitrectomy are reduced in the microcannulaguided techniques compared to 20-gauge vitrectomy. In this historical cohort study, a total of 221 eyes with a follow-up of at least 30 days were analysed. All patients had undergone vitrectomy with epiretinal or internal limiting membrane peeling performed by one surgeon between January 2005 and March 2009.The incidence of intraoperative retinal break formation was 25.2 per cent (n = 28/111) for the 20-gauge group, compared to only 12.7 per cent (n = 14/110) for the 23-/25-gauge group. The reduction in retinal breaks among those treated with microcannula-guided techniques may be attributed to the protection of the vitreous base during surgery, the authors said. n (Neuhann et al, Ophthalmologica 2013; DOI: 10.1159/000343710)

Hyperreflective dots

Hyperreflective dots in the retina visible through Spectral-domain optical coherence tomography (SD-OCT) may represent a new clinical marker for prognosis and follow-up in eyes with exudative AMD, according to the findings of a prospective study. The study’s authors examined 100 exudative AMD patients with SD-OCT prior to treatment and at monthly intervals thereafter. In their initial examinations they found previously unseen hyperreflective dots, mainly in the outer retinal layers. Following treatment there was a regression of the dots which reached statistical significance by one month (p<0.04) and became more pronounced by three months (p<0.001). Furthermore, although regression was evident in all visual acuity and morphological subsets, resolution of the dots was significantly associated with better final visual acuity (p < 0.001). n (Coscas et al, Ophthalmologica 2013; DOI: 10.1159/000342159).