Search

To investigate tissue changes induced by the implantation of a silicone band coated with expanded polytetrafluoroethylene (S/e-PTFE) used as scleral buckling, an experimental and histopathological study was performed in rabbits. The right eyes of eight rabbits were implanted for 28-85 days with S/e-PTFE. No complications were encountered in any of the eyes, so histopathological examinations could be performed. Encapsulations combined with numerous giant cells were found to be surrounding the implants in seven eyes, and deposits from the mineral salts of calcium were found in three eyes, forming granulomas possibly caused by irregularities of the implant surface. The porous structure allowed a peripheral colonization by fibrovascular tissue. Taking into account the histological results, the use of this material does not appear suitable. However, this inflammation was limited and did not merge on surrounding tissues.

Purpose To evaluate visual acuity outcomes in patients (pts) with myopic CNV receiving intravitreal aflibercept (IVT-AFL) or sham injection in the international, 48 week, Phase 3 MYRROR trial (NCT01249664). Methods Pts were randomised 3:1 to IVT AFL or sham/IVT-AFL (sham to Week 20; IVT-AFL from Week 24 to Week 48). We report on exploratory post hoc analyses evaluating proportions of pts achieving visual gains (ETDRS letters) and the associated time course. Results 121 pts were analysed (IVT-AFL, n=90/ sham/IVT-AFL, n=31). At Week 24, 63.3% and 38.9% of IVT-AFL pts had gained ≥10 or ≥15 letters from baseline. In the sham/IVT-AFL group, 12.9% and 9.7% had gained ≥10 or ≥15 letters from baseline. By Week 48, the proportion of IVT-AFL pts gaining ≥10 or ≥15 letters was 68.9% and 50.0%, respectively. At Week 48 in the sham/IVT-AFL group (i.e., 24 weeks after IVT-AFL initiation), 41.9% and 29.0% of pts had gained ≥10 or ≥15 letters from baseline, respectively. Ocular AEs were mainly mild and occurred at a similar rate with IVT-AFL and sham/IVT-AFL (37.4% vs 38.7%; most common, respectively: conjunctival haemorrhage [11.0%] and punctate keratitis [12.9%]). 7 (5.7%) pts had a serious AE (all IVT-AFL; only one SAE in study eye [macular hole]). No deaths were reported. Conclusion The proportion of IVT-AFL pts who gained ≥10 or ≥15 letters by Week 24 was well maintained and even slightly increased at Week 48. Clinically meaningful benefits from IVT-AFL were also observed at Week 48 in the sham/IVT-AFL group. However, the proportion of gainers did not reach the extent seen in the initial IVT-AFL group, suggesting that earlier IVT-AFL treatment should be recommended. Commercial interest

Purpose Age-related Macular Degeneration (AMD) is the leading cause of blindness and visual impairment in industrialized countries.STARS questionnaire was developed as a fast and simple tool for detecting individuals at high risk of AMD. A study performed with first version included more than 12,000 people and confirmed the relevance of different items. Some limits were also noticed and corrected in the present questionnaire named STARS 2.0. Methods All patients over 55 years examined by eighty French ophthalmologists were included during one week selected at clinicien disctretion between March 2013 and March 2014. AMD risks factors were collected with a statistical weight assigned to each risk factors. A composite score given by the sum of each risk factors was calculated. Fundus examination to detect macular disease was performed in the same time. Results 6837 Patients with 60% of female were included. 31%, 29.6%, 29.6% and 9.9% of the patients were respectively between [55 and 65] ,[65 and 74], [75 and 85], and over 85. Fundus exam found that 71% of the patient did not suffer from AMD on both sides while 10.3% of the patients presented with an advanced AMD on at least one eye. Conclusion STARS 2.0 questionnaire can help ophthalmologists to identify AMD risk factors to prevent AMD in clinical practice. It should be used also in general population to detect patients at high risk for AMD. Commercial interest

To investigate the effects of focal implantation of expanded polytetrafluoroethylene (e-PTFE) episcleral implants (i.e., explants or exoplants) on surrounding ocular tissues, an experimental and histopathological study was performed. Twenty-seven Fauve de Bourgogne rabbits eyes were implanted for a period of 3-11 months with oval-shaped e-PTFE episcleral implants. A newly formed capsule constantly encased the implants. Affected by the only two severe complications observed, 2 eyes had an endocapsular acute inflammation and could not be included in the study. Finally, 25 eyes were studied histopathologically. Neither intrusion nor extrusion of episcleral implants was observed. Other changes were related to implant characteristics. The inner surface of the capsule was often covered with numerous giant cells attesting to a foreign-body granuloma developed against the irregular outline of the episcleral implants. The porosity of the material was closely related to its surface irregularity, and also allowed its colonization by a fibrovascular and inflammatory tissue mainly in its peripheral layers. Under episcleral implants, sclera was both thinned and invaginated. Expanded PTFE hydrophobia was the other factor that might have suscitated granuloma. These microscopic changes are in contrast with an overall good apparent experimental tolerance to the material. However, additional studies on the long term behavior of this material would be helpful.

Purpose To compare macular pigment optical density (MPOD) measured by two techniques (autofluorescence, reflectometry) in healthy subjects at high risk for age-related macular degeneration (AMD). Methods The Limpia Study is a double-blind, placebo controlled, prospective randomized clinical trial performed in 120 subjects with at least one parent affected by neovascular AMD. Subjects having used supplements containing lutein and/or zeaxanthin in the preceding year were not included. MPOD was measured using two methods: the two-wavelength autofluorescence method with a modified scanning laser ophthalmoscope (Heidelberg Retinal Analyzer Results At baseline, mean MPOD within 0.51°, measured with the modified HRA method, was 0.5 (standard deviation 0.2). Maximal MPOD, measured with Visucam, was 0.4 (standard deviation 0.1). Parameters from the modified HRA (optical density within 0.5°, 1°, 2° and 6°) and from the Visucam method (volume, area, mean and maximum optical density) were weakly correlated. The best correlations were observed for MPOD within 2° and 6° with volume from Visucam(r=0.21 and r=0.22, respectively), and mean MPOD from Visucam (r=0.21 and r=0.18). Conclusion The two methods propose different parameters to evaluate macular pigment, which overall correlated weakly in this population of middle-aged healthy subjects at high risk for AMD. Further research is needed to characterize the differences between the methods and identify the best parameters and techniques to measure macular pigment. Commercial interest