The 2010 joint meeting of the American Academy of Ophthalmology and the Middle East Africa Council of Ophthalmology took place Oct. 16 to 19 in Chicago and attracted over 26,000 participants from around the world. The conference highlighted advances in the diagnosis, prevention, management, and treatment of ocular conditions, including cataracts, "wet" and "dry" age-related macular degeneration (AMD), presbyopia, retinitis pigmentosa, and glaucoma.
In a phase II study, Jason S. Slakter, M.D., of the New York University School of Medicine in New York City, and colleagues compared the effectiveness of 100 mg of fenretinide, 300 mg of fenretinide, and placebo on slowing the progression of atrophy associated with dry AMD over a two-year period.
"At a planned interim analysis (when the last patient enrolled reached one year), a group of patients who had reached 18 months on 300 mg of fenretinide showed a trend towards reduced lesion growth. However, by 24 months, this therapeutic effect seemed to have disappeared. Interestingly, an analysis of the 24-month lesion growth in the cohort of patients who showed a treatment effect at 18 months uncovered the therapeutic effect. It was found that patients within the 300 mg cohort, which showed a positive treatment response -- or those patients who had enrolled earlier in the trial -- had a sustained reduction in RBP [retinol binding protein] levels of at least 60 percent throughout the trial," Slakter said.
The manufacturer of the drug was changed approximately one year into the trial, and upon further assessment, the investigators hypothesized that this made a difference in the treatment effect.
"Patients who had a sustained reduction of RBP of about 60 percent had a median lesion size growth of only 30 percent from baseline, compared to a median lesion size growth of about 50 percent in the placebo arm. In addition, these same patients had greater visual acuity preservation. The visual acuity stabilized from 12 to 24 months at six letters lost, while patients in the placebo arm showed progressive loss throughout the trial, reaching an average loss of 11 letters at 24 months," Slakter continued. "In addition, we saw a surprising effect. Approximately 22 percent of the placebo group converted from dry AMD to wet AMD, but only 13 percent of those in the fenretinide groups converted from dry to wet AMD. While this was not significant, fenretinide may reduce the rate of conversion from dry to wet AMD."
The research was supported by a grant to the Digital Angiography Reading Center. Slakter disclosed financial relationships with various pharmaceutical companies, including Sirion Therapeutics.
Among patients with wet AMD, Jaclyn L. Kovach, M.D., of the University of Miami Miller School of Medicine, and colleagues found that high-risk genetic factors and smoking history were not significantly associated with response to anti-vascular endothelial growth factor (abti-VEGF) therapy. The researchers reviewed medical records of 36 individuals with wet AMD who participated in the Unifying Genetic Epidemiology of Macular Degeneration Study and were treated with bevacizumab and/or ranibizumab for at least one year.
"Although limited by its sample size, this is one of the first studies to test whether the presence of high-risk genetic polymorphisms for AMD are associated with response to anti-VEGF treatment," Kovach said. "Further elucidation of the relationship between genetic risk factors and response to treatment may bring us closer to gene-guided therapy and personalized medicine."
In another study, Jonathon Q. Ng, M.D., of the University of Western Australia in Perth, and colleagues found that cataract surgery not only improves impaired vision but also reduces automobile crashes. The investigators assessed automobile accident rates for Western Australian residents prior to and after cataract surgery on the first eye. The study involved 27,827 patients who underwent cataract surgery for one eye between 1997 and 2006.
"After accounting for potential confounding factors such as age and gender, we found that cataract surgery reduced the risk of all crashes by nearly 13 percent," Ng said. "The cost savings associated with this reduction further strengthen the cost-effectiveness of cataract surgery. While some would argue that a randomized controlled trial is required, this is not feasible and [is] unethical."
Ng said that it is fairly common for residents of Australia and other countries to experience a delay between diagnosis and cataract.
"Policies and initiatives to reduce waiting times for cataract surgery will not only benefit patients by improving their quality of life but by also reducing automobile accidents, which will also improve public safety and save on the costs of crashes," Ng added.
AAO: New Presbyopia Treatment Options Highlighted
TUESDAY, Oct. 19 (HealthDay News) -- New treatment options for presbyopia currently available in Europe may soon be available in the United States, according to clinical research presented at the joint meeting of the American Academy of Ophthalmology and Middle East Africa Council of Ophthalmology, held from Oct. 16 to 19 in Chicago.
AAO: PM Blood Pressure Tied to Glaucoma in Migraineurs
MONDAY, Oct. 18 (HealthDay News) -- Low diastolic blood pressure at night appears to be associated with glaucoma risk in patients who suffer from migraines, according a study presented at the joint meeting of the American Academy of Ophthalmology and the Middle East Africa Council of Ophthalmology, held from Oct. 16 to 19 in Chicago.
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