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AIM: To compare two different anti-vascular endothelial growth factor (anti-VEGF) treatment regimens'-a priori pro re nata (PRN) and PRN regimen following the loading phase-anatomical and functional results in neovascular age-related macular degeneration (nAMD) patients. METHODS: Totally 544 nAMD patients followed and treated with aflibercept (n=135) and ranibizumab (n=409) at 9 different centers between 2013 and 2015 were enrolled into this retrospective multicenter study. Patients with initial best corrected visual acuity (BCVA) interval of 1.3-0.3 (logMAR) and a minimum follow-up of 12mo were included. Patients under two different regimens-a priori pro re nata (1+PRN) or 3 consecutive intravitreal injections followed by a PRN regimen (3+PRN)-were compared in BCVA at 3(th), 6(th) and 12(th) months, and in central macular thickness (CMT) at 6(th) and 12(th) months. The total study group, intravitreal ranibizumab (IVR) and intravitreal aflibercept (IVA) groups were evaluated separately. RESULTS: The mean CMT decreased in the 1+PRN (n=101) regimen from 407 to 358 and 340 µm and in the 3+PRN (n=443) group from 398 to 318 and finally to 310 µm at months 6 and 12, respectively. Anatomically, the CMT reduction at 6(th) month (48.5 vs 76.4; P

Objectives: To evaluate the real-world outcomes of intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment in neovascular age-related macular degeneration (nAMD) patients. Materials and Methods: Multicenter, retrospective, interventional, non-comparative study. The records of nAMD patients treated with an anti-VEGF agent on a pro re nata treatment regimen basis between January 2013 and December 2015 were reviewed. The patients who completed a follow-up period of 12 months were included. Primary outcome measures of this study were the visit and injection numbers during the first year. Results: Eight hundred eighty eyes of 783 patients met the inclusion criteria for the study. Mean number of visits at month 12 was 6.9±2.5 (range: 1-15). Mean number of injections at month 12 was 4.1±1.9 (range: 1-11). Mean visual acuity at baseline and months 3, 6, and 12 was 0.90±0.63 LogMAR (range: 0.0-3.0), 0.79±0.57 LogMAR (range: 0.0-3.0), 0.76±0.57 LogMAR (range: 0.0-3.0), and 0.79±0.59 LogMAR (range: 0.0-3.0), respectively. Mean central retinal thickness at baseline and months 6 and 12 was 395±153 μm (range: 91-1582), 330±115 μm (range: 99-975), and 332±114 μm (range: 106-1191), respectively. Conclusion: The numbers of visits and injections were much lower than ideal and were insufficient with the pro re nata treatment regimen.

PURPOSE To evaluate the safety and efficacy of intravitreal dexamethasone (IVD) implants in eyes with diabetic macular edema that did not respond to previous treatment. METHODS We included 46 eyes of 46 patients in this retrospective study. Each month, we recorded patient visual acuity with logarithm of the minimum angle of resolution using the Early Treatment Diabetic Retinopathy Study chart, central macular thickness measurements with optical coherence tomography, intraocular pressure (IOP), and posttreatment complication occurrence. RESULTS The mean follow-up time was 8.95 ± 1.33 months (range, 6 to 12). Best-corrected visual acuity improved significantly in the first 4 months after IVD, but no statistically significant change was observed over the following 2 months. Although a statistically significant decrease in central macular thickness was observed in the first 3 months, the change was not statistically significant in the following 3 months. There was a statistically significant increase in IOP in the first 2 months, but no statistically significant change was observed in the following months. IOP was controlled with medication in all patients with elevated IOP. Of the 26 phakic patients, two had cataracts requiring surgery. CONCLUSIONS Cases of refractory diabetic macular edema that did not respond to previous treatment, such as anti-vascular endothelial growth factor injections and laser photocoagulation, exhibited improvements in visual acuity and decreases in retinal thickness after IVD implantation. Both functional and anatomical effects were observed in the first 3 months after injection. Repeat injections and frequent examination might be required for continued improvement. Side effects, such as cataracts and elevation of IOP, may require medical or surgical treatment.

To compare subfoveal choroidal thickness (SFCT) between patients with nanophthalmos and age-matched controls.This prospective, cross-sectional and comparative study included 31 eyes from 31 patients with nanophthalmos (study group) and 31 eyes from 31 healthy subjects (control group). SFCT and central macular thickness (CMT) were measured with spectral domain optical coherence tomography. All participants underwent a standardised ocular examination including best corrected visual acuity (BCVA), central corneal thickness (CCT), anterior chamber depth (ACD) and refractive error (RE) measurements.Mean SFCT in the nanophthalmic eyes and in the control eyes were 551.3 ± 87 µm and 330.5 ± 46 µm, respectively (p0.001). Mean BCVA, RE, CMT, axial length (AL), ACD, CCT values were 0.4 ± 0.28 logMAR Unit, +10.6 (3.06), 331.9 ± 78 µm, 18.8 ± 1.5 mm, 2.42 ± 0.4 mm and 577.2 ± 32 µm, respectively, in nanophthalmic eyes and there was a statistically significant difference between groups (p0.001 for each). There were negative correlations between SFCT with AL (r=-0.836, p0.001) and ACD (r=-0.597, p0.001) for the entire study population. SFCT was significantly correlated with CCT (r=0.471, p0.001) and CMT (r=0.585, p0.001), RE (r=0.836, p0.001).SFCT was significantly higher in nanophthalmic eyes. Further studies are needed to evaluate the role of SFCT to explain the pathophysiology of nanophthalmos.

Zeynep Kayaarasi Öztürker, Kadir Eltutar, Belma Karini, Sezin Özdogan Erkul, Özen Ayrancı Osmanbaşoğlu, Pınar Sultan Ophthalmology Department, Istanbul Research and Training Hospital, Istanbul, Turkey Purpose: To compare optic nerve head parameters, the thicknesses of the peripapillary retinal nerve fiber layer (pRNFL), the macular retinal nerve fiber layer (mRNFL), the ganglion cell complex (GCC), and the ganglion cell–inner plexiform layer (GCIPL) in macrodisks and normal-sized healthy disks using spectral domain optical coherence tomography. Patients and methods: A total of 88 healthy eyes (42 macrodisks and 46 normal-sized disks) were prospectively enrolled in the study. Optic nerve head parameters as well as pRNFL, mRNFL, GCC, and GCIPL thicknesses were measured in all subjects. Optic disk areas (ODAs) >2.70mm2 were defined as macrodisks. All spectral domain optical coherence tomography parameters were compared between normal-sized disks and macrodisks. Results: The mean age of the participants was 49.4±5.7years in the normal size group and 51.55±6.3years in the macrodisk group (P=0.65). The average ODAs were 2.23±0.29mm2 and 3.30±0.59mm2 in the normal size and the macrodisk groups, respectively. ODA (P

To evaluate the efficacy of intravitreal ranibizumab for the treatment of neovascular age-related macular degeneration (nAMD) patients with a visual acuity (VA) of ≥ 20/40 and to investigate the predictive factors for visual outcomes.The present study is a retrospective analysis of patients with VA ≥ 20/40. Injections were given monthly for the first 3 months and thereafter as needed. The patients were divided into two groups; group 1, patients not receiving further injections beyond the 3 loading doses, and group 2, those who received further injections. Next, group 2 was divided into two subgroups; group 2A, patients who did not experience VA loss, and group 2B, those who experienced VA loss. Data collected for each patient included VA and central retinal thickness (CRT) measured at baseline, months 3, 6, 9, and 12.The study included 96 eyes of 96 patients. Change in VA showed a significant inverse correlation with total number of injections at month 12 (r=-0.34, P=0.001), and the presence of pigment epithelial detachment (PED) at baseline (r=-0.35, P0.01). VA outcomes were better in group 1 than group 2 at all time points (P0.001 for all). Change in VA at month 3 was not significantly different between groups 2A and 2B (P=0.26); however, change in VA at month 6, 9, and 12 were statistically different between the two groups (P0.001 for all).Intravitreal ranibizumab is an effective treatment for nAMD patients with good VA. The presence of PED, need for reinjection, and VA loss were unfavorable prognostic factors.

Purpose. To determine the effect of epiretinal membranes (ERM) on the treatment response and the number of intravitreal bevacizumab injections (IVB) in patients with neovascular age-related macular degeneration (nAMD).Methods. A retrospective chart review was performed on 63 eyes of 63 patients. The patients were divided into AMD group (n=35) and AMD/ERM group (n=28). Best corrected visual acuity (BCVA) and central retinal thickness (CRT), as well as the number of injections, were evaluated.Results. There was a significant improvement in BCVA at 3 months for the AMD and AMD/ERM groups (P=0.02,P=0.03, resp.). At 6, 12, and 18 months, BCVA did not change significantly in either of the groups compared to baseline (P>0.05for all). At 3, 6, 12, and 24 months, the AMD group had an improvement in BCVA (logMAR) of 0.09, 0.06, 0.06, and 0.03 versus 0.08, 0.07, 0.05, and 0.03 for the AMD/ERM group (P=0.29,P=0.88,P=0.74,P=0.85, resp.). A significant decrease in CRT occurred in both groups for all time points (P<0.001for all). The change in CRT was not statistically different between the two groups at all time points (P>0.05for all). The mean number of injections over 24 months was 8.8 in the AMD group and 9.2 in the AMD/ERM group (P=0.76).Conclusion. During 24 months, visual and anatomical outcomes of IVB in nAMD patients were comparable with those in nAMD patients with ERM with similar injection numbers.