Nancy Groves

To clarify whether total intracranial CSF volume increases in IIH, researchers prospectively studied MRI-derived measures of total cranial, ventricular, and extraventricular CSF volumes in patients with IIH and controls. Results showed that the extraventricular CSF space was significantly greater in the patient group versus the controls. The ventricular volume was the same between the two groups.

Certain eye movement patterns seem to be associated with better face recognition performance in patients with central glaucomatous visual field loss.

The 256+ channel Boston subretinal prosthesis is on track for in vivo validation of function and an FDA investigational device exemption application.

Many ophthalmologists may be dropping the ball when treating moderate dry eye, which could result in progression to more severe stages of disease.

Male gender and younger age were identified as risk factors for IOP elevation after dexamethasone implant treatment in retinal vein occlusion in a recent subset analysis, but the elevated IOP did not seem to affect improvement in visual acuity or anatomic outcomes evaluated with optical coherence tomography.

A multicolor pattern scan laser should help laser therapy maintain or potentially expand its role in the treatment of certain retinal diseases even with the availability of effective new injectable pharmaceutical products, according to retinal specialists.

Loteprednol etabonate ophthalmic suspension 0.2% is a safe and effective first-line therapy for the treatment of seasonal and perennial allergic conjunctivitis.

Analysis of data from two bilateral conjunctival allergen challenge studies of olopatadine hydrochloride ophthalmic solution 0.2% showed that ocular itching was prevented in a higher percentage of eyes treated with olopatadine when compared with vehicle.

Since the 2009 approval of bepotastine besilate ophthalmic solution 1.5% for ophthalmic use in the United States, further analysis of clinical trial data and new information from additional studies have revealed more about the drug's clinical utility.

The FDA has delayed approval of Alimera Sciences' investigational fluocinolone acetonide intravitreal insert for the treatment of diabetic macular edema associated with diabetic retinopathy and requested two additional clinical trials.

The pivotal study of a sustained-release dexamethasone intravitreal implant showed that it was a safe, effective option for the treatment of noninfectious intermediate and posterior uveitis.

A novel ocular surface interferometer may help physicians more accurately diagnose and monitor lipid-deficient evaporative dry eye.

Should anticoagulants be discontinued before oculofacial surgery?

Ophthalmic surgical instrument manufacturers and distributors work in a constantly evolving and increasingly global marketplace, and in late 2009, are meeting challenges posed by new procedures and changing government regulations.

New software (MatchedFlicker, EyeIC) uses time series retinal photographs to convert change into motion and could improve the accuracy and speed of detecting glaucomatous progression.

An investigational compound for the treatment of dry eye disease consisting of a proprietary formulation of sodium hyaluronate ophthalmic solution 0.18% (Vismed, Lantibio Inc.) was shown to be safe and effective in a multicenter phase III trial conducted in the United States. A new drug application has been filed for the solution, which is already marketed in parts of Europe and Asia as a viscoelastic lubricant eye drop.

Implantation of a trabecular micro-bypass (iStent, Glaukos Corp.) in patients with open-angle glaucoma who are undergoing cataract surgery represents an alternative surgical approach that can provide clinically significant reductions in IOP and use of ocular hypotensive medications.

Longer duration of use of monotherapy with prostaglandin analogues may be associated with lower annual costs of glaucoma treatment because adjunctive therapy is one of the primary factors affecting the cost of care, suggest findings of a retrospective analysis of a pharmacy claims database.

Anti-vascular endothelial growth factor monotherapy appears to be an effective treatment for retinal angiomatous proliferation, according to results of a small, retrospective chart review. Although the results indicate that in most cases repeated injections would be needed to achieve improvement or stable vision, treatment based on ocular coherence tomography-confirmed presence of fluid could achieve outcomes similar to monthly injections.

Non-penetrating Schlemm's canaloplasty may be a safe and effective alternative to standard trabeculectomy. A retrospective comparison study found no statistically significant differences in IOP reduction or medication usage at up to 1 year of follow-up. Adjunctive procedures and complications were similar in the two groups of patients, although no long-term hypotony was seen in the canaloplasty group.

Bepotastine besilate 1.0% (Bepreve, ISTA Pharmaceuticals), an ocular allergy compound under new drug application review by the FDA, is effective in reducing ocular itching associated with allergic conjunctivitis and also seems to improve other allergy symptoms.

Complex visual hallucinations experienced by visually impaired patients are often indicative of Charles Bonnet syndrome. Individuals who experience these hallucinations usually understand that they are not real but will benefit from a doctor's explanation that they are associated with their vision loss and are unlikely to be a sign of mental illness.

One year follow-up results of a small study of ranibizumab (Lucentis, Genentech) in patients with nonischemic retinal vein occlusion show that all treated patients gained VA or that VA remained stable, although this improvement was accompanied by decreases in contrast sensitivity and reading ability.

Antagonists of vascular endothelial growth factor provide a benefit for choroidal neovascularization and are promising for other retinal diseases, but they represent only the beginning of a transformation in the treatment of certain eye diseases, according to one ophthalmologist.

Using a mathematical model, investigators have estimated that people with ocular hypertension have a nearly 30% risk of developing glaucoma over 20 years, adjusting for the competing risk of mortality. Among ocular hypertensive patients aged more than 70 years, however, a 90% risk of mortality exists over that 20-year period, suggesting that preventive treatment would have little benefit.

Both subjective and objective evaluation of diabetic macular edema (DME) can produce good results. In a recent study, the initial results of objective evaluation with retinal imaging technology (Heidelberg Retina Tomograph Retina Module, Heidelberg Engineering) showed good sensitivity and moderate specificity, whereas subjective evaluation by two expert assessors produced high sensitivity and specificity. Nevertheless, with optimization, the results of the two forms of evaluation became more evenly matched, suggesting that the retinal imaging technology can aid clinicians in detecting DME.

Visual acuity gains occurring in a 12-week, fixed-dose period were maintained throughout the 52-week trial of a novel agent (VEGF Trap-Eye, Regeneron Pharmaceuticals) for neovascular age-related macular degeneration. During the 9-month, as-needed dosing phase, the mean number of injections for all patients was two, and gains in visual acuity of up to nine letters were reported.

A collaborative effort to design an intracortical visual prosthesis has progressed to the point that tests of a prototype in a human volunteer are being planned. The results of psychophysical testing in normal volunteers indicate that the prosthesis could provide sufficient visual functionality to enable users to perform useful visual tasks.

Experiments in nanotechnology labs have been successful in potential ophthalmic applications such as using nanoparticles to create scaffolding that can repair damaged tissue and subsequently restore vision, as well as to produce instantaneous hemostasis in eye injuries.

Advances have been made recently in both structural and functional tools for glaucoma diagnosis, producing better and faster results.