Intravitreal ranibizumab for the treatment of choroidal neovascularizations associated with pathologic myopia: a prospective study.

PURPOSE: It was the aim of this study to determine the efficacy of intravitreal ranibizumab as treatment of choroidal neovascularizations associated with pathologic myopia. MATERIALS AND METHODS: In an uncontrolled, prospective time series cohort study, 65 eyes of 64 consecutive patients with choroidal neovascularization associated with pathologic myopia were treated with intravitreal ranibizumab and observed over 12 months. The change in best-corrected visual acuity (BCVA) at 6 and 12 months served as primary end point. Safety, central retinal thickness, neovascularization activity on fluorescein angiography and the number of ranibizumab injections were secondary end points. RESULTS: BCVA improved significantly throughout the follow-up (p = 0.001). The mean BCVA was 0.2 at baseline (SD 0.13) and 0.4 at 12 months (SD 0.21). Improvement was strongest within the first 3 months (p = 0.0001). The mean central retinal thickness showed a reduction from 313 µm (SD 82) to 243.5 µm (SD 31; p = 0.0001). CONCLUSION: Intravitreal ranibizumab offers a safe and effective treatment for choroidal neovascularizations in pathologic myopia.

Device Development for Ocular Surface Temperature and Heat Flux Density Measurement.

PURPOSE: Currently, much attention is paid to measuring the temperature of the ocular surface in various ophthalmic diseases. However, for a comprehensive assessment of heat transfer of the eye, it is advisable to measure both the ocular surface temperature and the heat flux (HF) density. This will expand our knowledge of the physiology of the eye and create new possibilities for diagnosing ocular pathology. The present study aimed to develop a thermoelectric device to study rabbits' ocular surface temperature and HF density. METHODS: The multichannel thermoelectric device was developed to measure the ocular surface temperature and HF density. This study included ten rabbits (20 eyes). In all animals, the temperature and the HF density were measured on the surface of the central cornea of both eyes. The measurement was repeated after pupils' dilation. RESULTS: The corneal surface temperature of rabbits was 33.1 ± 0.8 °C, and the HF density of the surface of the cornea was 8.3 ± 0.6 mW/cm2. Our results revealed a high degree of interocular symmetry in the surface HF density in healthy rabbits. After pupil dilation, an increase in the HF density on the surface of the rabbit cornea compared with the initial data and control eye was noted. CONCLUSIONS: The application of the developed device showed that it is safe and allows for the measurement of the ocular surface temperature and the HF density. We believe that further studies on the ocular surface HF density measurement in various eye diseases will allow us to evaluate the possibilities of this device and technique for diagnostic purposes.

Vitreoretinal Surgery with Temperature Management: A Preliminary Study in Rabbits.

The present study aimed to evaluate the structure of the rabbit retina after vitreoretinal surgery using prolonged irrigation with solutions of different temperatures. Thirty-six rabbits (72 eyes) were included in this study and randomly divided into 3 equal groups according to the temperature of the intraocular irrigating fluid they received during vitrectomy. Vitreoretinal surgery was performed with a 5°C irrigation solution in group 1 (12 rabbits, 24 eyes), a 22°C irrigation solution in group 2 (12 rabbits, 24 eyes), and a 36°C irrigation solution in group 3 (12 rabbits, 24 eyes). In each group of animals, the mean irrigation/aspiration time was 30 minutes for left eyes and 60 minutes for right eyes. Histological examination of the retina was performed 1, 7, and 30 days after surgery. During surgery, the temperature in the vitreous cavity of the eyes of rabbits of groups 1, 2, and 3 dropped by 26.0°C, 11.2°C (deep hypothermia), and 1.0°C (mild hypothermia), respectively. The highest rewarming rate was detected in group 1 (0.9°C/min) compared with group 2 (0.7°C/min) and group 3 (0.2°C/min). After 60 minutes of irrigation, retinal structural changes were detected in the animals of groups 1 and 2 (in contrast to the animals of group 3). After surgery with irrigation lasting 30 minutes, no retinal structural changes were observed. This study showed that temperature management, avoidance of intraoperative deep hypothermia, and prevention of rapid uncontrolled rewarming may protect the retinal morphology and increase the safety of prolonged vitreoretinal surgery.

Intravitreal aflibercept for the treatment of choroidal neovascularization associated with pathologic myopia: a pilot study.

PURPOSE: To determine the efficacy of intravitreal aflibercept injections for the treatment of patients with choroidal neovascularization (CNV) associated with pathologic myopia. METHODS: In this uncontrolled, prospective cohort study, 31 eyes of 30 consecutive patients affected by CNV associated with pathologic myopia were treated with intravitreal aflibercept (2 mg) as needed following two initial monthly doses and observed over a 12-month follow-up period. The primary endpoint was change in best-corrected visual acuity (BCVA) at month 12, while central retinal thickness (CRT) on optical coherence tomography (OCT), neovascularization activity on fluorescein angiography, the number of aflibercept injections administered, and safety were examined as secondary endpoints. RESULTS: Patients received a mean of 2.6 intravitreal aflibercept injections over the 12-month study period. Compared with baseline, BCVA improved significantly at all time points (P<0.05). Mean (standard deviation [SD]) decimal BCVA was 0.2 (0.1) at baseline and 0.35 (0.16) at month 12. The greatest improvement in BCVA was seen within the first 2 months (P=0.01). Mean (SD) CRT on OCT decreased from 285 (62) µm at baseline to 227 (42) µm (P=0.01) at month 12. There was a continuous decrease in mean CRT on OCT over time. No cases of endophthalmitis, uveitis, stroke, or retinal detachment were noted. No patient demonstrated an intraocular pressure >20 mmHg during any study visit. CONCLUSION: The 12-month results of intravitreal aflibercept for myopic CNV using an as-needed regimen were positive, showing benefits in visual and anatomic outcomes and an acceptable tolerability profile.

Serous pigment epithelium detachment associated with age-related macular degeneration: a possible treatment approach.

To evaluate the effects of intravitreal triamcinolone acetonide (TA) as a monotherapy of serous Pigment Epithelial Detachment (PED) associated with AMD (Age-Related Macular Degeneration), this study has been performed. Seventeen patients (19 eyes) with serous PED associated with AMD were observed. All patients received 0.1ml (4mg) of intravitreal TA. The mean follow-up period was 18 months. Re-attachment of serous PED was observed in 37% of cases to the end of follow-up. In other cases, the height and length of serous PED significantly decreased. Visual acuity remained stable in all cases. No evidence of RPE tear or CNV development were noted. Before TA administration, intraocular pressure (IOP) was 20.18 ± 2.58 mmHg however, after intravitreal TA, IOP increased gradually and reached its maximum of all period of observation (23.25±1.85mmHg) six months after injection (P=0.031). In 7 (37%) of the cases, progression to cataract was observed after treatment. After surgery, the visual acuity in all cases increased by 0.2 to 0.5. As a conclusion, intravitreal TA decreases of both the height and length of serous PED associated with AMD after 18 months follow-up in most cases. The presented data provides support for the hypothesis regarding the possibility of monotherapy of serous PED with intravitreal TA.