Ophthalmologica highlights

Müller cells and retinal disease

A better understanding of the protective and toxic reactions of glial Müller cells to pathogenic stimuli may open up new therapeutic strategies in the treatment of retinal disease, according to a review of current research. Müller cells have a range of functions which are essential to the health and functionality of the retina. In reaction to retinal trauma, Müller cells exert both protective and toxic effects on photoreceptors and neurons. Moreover, Müller cells de-differentiate into cells with properties similar to pluripotent retinal progenitor/stem cells and express neuronal and photoreceptor proteins. They therefore might be used in the future to restore retinas damaged by disease and trauma.

(Bringmann et al, Ophthalmologica 2012; 227:1-19).

Vitreolenticular interface and cataract surgery

A more careful documentation of the status of the vitreous before and after cataract extraction can enable surgeons to more accurately assess the risk of subsequent retinal complications, particularly in cases where disruption of the vitreolenticular interface occurs, note Carsten Framme and Sebastian Wolf. The likelihood of complications following capsular rupture or Nd:YAG laser capsulotomy will vary according to whether the posterior vitreous remains attached or whether a posterior vitreous detachment is rhegmatogenous or non-rhegmatogenous in nature. For example, when a rhegmatogenous PVD occurs it is likely to lead to an anterior shift of the vitreous base, increasing the risk of retinal detachment.

(Carsten et al, Ophthalmologica 2012; 227:20-33).

Near-infrared autofluorescence imaging for CSC

Near-infrared autofluorescence (NIR-AF) imaging may provide a safer and less invasive way to detect central serous chorioretinopathy (CSC) than fluorescein angiography, the current gold standard. In a study involving 19 eyes of 17 patients with confirmed CSC who underwent testing with fluorescein indocyanine green angiography, blue-light autofluorescence imaging, and NIR-AF imaging using a confocal scanning laser ophthalmoscope NIR-AF demonstrated CSC in 94.7 per cent of the cases. Fluorescein angiography had the best contrast of the different approaches, however, the study’s authors noted that fluorescein angiography is associated with moderate adverse events in about 1.5 per cent of cases and serious adverse events occur in about one in 1,900 case.

(E. Lindner et al. Ophthalmologica 2012; 227: 34-38).

Long-term results of ranibizumab in myopic CNV

A study into the long-term efficacy of ranibizumab in the treatment of myopic CNV indicates that the effect of the therapy can increase over time and can continue even when the injections are ceased. In the retrospective, non-randomised study, 40 eyes of 39 patients with myopic CNV received intravitreal ranibizumab for three years. The researchers found that mean visual acuity improved from 55.4 (ETDRS) letters at baseline to 59.7 letters at 12 months (p = 0.07), 61.8 letters at 24 months (p = 0.008) and 63.4 letters at 36 months (p = 0.039). The proportion gaining three lines or more was 25 per cent at 12 months, 30 per cent at 24 months and 35 per cent at 36 months. Patients received a mean of 4.1 injections in the first year, 2.4 in the second year and 1.1 in the third year and 53 per cent of the eyes required no further treatment during the third year of follow-up.

(Franqueira et al, Ophthalmologica 2012;227:39-44).