Ophthalmologica highlights

RANIBIZUMAB WORKS BETTER IN CAUCASIANS The findings of a new study suggest that Caucasian patients may have an improved response to intravitreal ranibizumab than non-Caucasians. Prospective data was collected from 434 eyes of 217 patients with wet AMD receiving intravitreal ranibizumab on a treat-and-extend basis. At 24 months follow-up, the percentage of eyes that maintained or improved vision was 91% in Caucasian patients and 83% in non-Caucasian patients. Correspondingly, at 24 months, the percentage of visual loss was 9% for Caucasian patients and 17% for non-Caucasian patients. And although Caucasian patients required fewer overall injections (14.1), they gained an average four letters of logMAR visual acuity. However, non-Caucasian patients required 14.6 injections to gain only 0.5 letters of logMAR visual acuity. R Mohamed et al, “What Effect Does Ethnicity Have on the Response to Ranibizumab in the Treatment of Wet Age-Related Macular Degeneration?”, Ophthalmologica 2018, Volume 240, Issue 3. MACULAR HOLES IN FELLOW EYES Among patients with macular holes, one in five will develop macular holes (MH) in their fellow eyes within five years and one in three fellow eyes with vitreomacular traction will develop the complication in the same period. The 77 fellow eyes included had a mean follow-up of 34.11 ± 22.3 months (6–78.4). At baseline, 31 eyes had vitreomacular traction (VMT), 35 vitreomacular adhesion and 11 no posterior vitreous detachment. MH occurred in 19.5% of the cases (15/77). The rate of MH was significantly higher among the eyes with VMT than among the eyes without VMT at baseline (35.5 vs. 8.7%; p = 0.009). E Philippakis et al, “Incidence of Macular Holes in the Fellow Eye without Vitreomacular Detachment at Baseline”, Ophthalmologica 2018, Volume 240, Issue 3. OBSERVATIONAL STUDY OF MYOPIC CNV INITIATED A long-term observational study is now under way to assess the natural disease progression of high myopia in Caucasians considered at risk for the development of myopic choroidal neovascularization (mCNV). Called the HELP study, it involves 150 participants (66% females) recruited in 25 clinical sites between June 2014 and June 2016. All have an axial length of 26 mm, best-corrected decimal equivalent visual acuity 0.05 or better and presence of at least one out of five predefined morphological disease risk criteria. Baseline findings included a reduced incidence of enhanced choroidal curvature length compared with Asian series, and a significantly more common occurrence of patchy atrophy among older patients (p = 0.0012). C Melzer et al, “Design and Baseline Characteristics of the HELP Study: An Extended and Long-Term Observation of Pathological Myopia in Caucasians”. Ophthalmologica 2018, Volume 240, Issue 3.