Morphological Predictive Features on Spectral-Domain Optical Coherence Tomography for Visual Outcomes in Neovascular Age-Related Macular Degeneration Treated with Ranibizumab.

PURPOSE: To identify spectral-domain optical coherence tomography (SD-OCT) predictive morphological features for the outcome of Ranibizumab therapy for neovascular age-related macular degeneration (AMD). METHODS: This is a retrospective multicentric study that involved 64 eyes with naïve AMD. Patients who received three monthly intravitreal injections of Ranibizumab were stratified into (1) "responders" [≥ 5 letters gain on Early Treatment Diabetic Retinopathy Study (ETDRS) scale] and (2) "nonresponders" (< 5 letters gain). Best-corrected visual acuity (BCVA) and SD-OCT morphological features were compared at baseline and one month after three consecutive injections of Ranibizumab. Univariate and multivariate analyses were carried out to correlate these morphological features with the change in BCVA. RESULTS: Among the 64 patients enrolled, 40 (62.5%) were "responders" and 24 (37.5%) "nonresponders". Age, sex, and BCVA were comparable between both groups. A multivariate correlational analysis found that subfoveal choroidal thickness (SFCT) and the presence of pigment epithelial detachment (PED) > 250 µm at baseline were two independent prognostic indicators of final BCVA. No other SD-OCT morphological studied features seem to affect final BCVA after Ranibizumab treatment. CONCLUSION: SFCT and the presence of PED > 250 µm are two significant biomarkers that may predict improvement after Ranibizumab therapy for AMD. These markers may guide ophthalmologists' treatment decision under financial constraints and limited time.

Comparative study of aspheric intraocular lenses with negative spherical aberration or no aberration.

PURPOSE: To compare the quality of vision with an aspheric intraocular lens (IOL) with no aberration and an IOL with negative spherical aberration. SETTING: Bretonneau University Hospital, Tours, France. METHODS: Patients scheduled for cataract surgery were randomly chosen to bilaterally receive a SofPort Advanced Optics IOL with no aberration (no-aberration IOL group) or a Tecnis Z9000 IOL with negative spherical aberration (negative-aberration IOL group). Six-month postoperative outcomes included patient-centered visual disability assessed with the Activities of Daily Vision Scale (ADVS), contrast sensitivity testing, and wavefront aberration analysis. RESULTS: There was no difference in the overall ADVS score between the 2 groups (P = 0.07); however, the negative-aberration IOL group had a better night-driving score (mean 82.7 +/- 15.1 [SD] versus 66.4 +/- 7.6) (P<.001) and the no-aberration IOL group had a better corrected near-vision score (mean 96.5 +/- 6.2 versus 86.2 +/- 13.2) (P<.001). Mesopic contrast sensitivity was significantly better in the negative-aberration IOL group at intermediate and high frequencies; the no-aberration IOL group performed better under photopic conditions at intermediate frequencies. There was significantly higher spherical aberration (mean 0.11 +/- 0.05 microm versus 0.01 +/- 0.06 microm; P = .001) and lower 3rd-order coma (mean 0.09 +/- 0.06 microm versus 0.15 +/- 0.06 microm; P<.001) in the no-aberration IOL group than in the negative-aberration IOL group, which had better MTF. CONCLUSIONS: Bilateral implantation of an IOL with no aberration resulted in better quality of near vision. A negative spherical aberration IOL provided better night-driving vision and improvements in mesopic contrast sensitivity and MTF.