New Orleans -- The American Academy of Ophthalmology (AAO) annual meeting included more than 500 poster presentations over 4 days. Here is a sample of some of the research highlighted during the poster rounds.
Visual Improvement Similar Between Anti-VEGF Agents in AMD
Anti-vascular endothelial growth factor (VEGF) treatments improved vision similarly in patients with age-related macular degeneration (AMD), according to real-world data obtained from the IRIS (Intelligent Research in Sight) registry maintained by the AAO.
The records of 13,859 patients with new or established AMD who were treated with at least three injections of either bevacizumab, ranibizumab or aflibercept for 1 year without switching drugs were reviewed.
The mean change in visual acuity was -0.048 in those treated with bevacizumab, -0.053 in those treated with ranibizumab and -0.040 in those treated with aflibercept (P=0.46 for differences between groups). Final visual acuity was 20/70, 20/63 and 20/61 in the three groups, respectively. The patients treated with bevacizumab did have better odds of achieving a 3-line gain in vision compared with aflibercept.
Tele-Glaucoma Screening Correlates Well with Physician Exam
A tele-glaucoma screening program in which a physician has remote access to patient data and images was found to be feasible. Researchers at Rutgers University enrolled 107 subjects who presented to a hospital glaucoma clinic into a study comparing the performance of tele-glaucoma screening to traditional evaluation by a physician.
The subjects provided a health history and underwent noncontact assessment of intraocular pressure (IOP) with an auto tonometer and optical coherence tomography (OCT) of the anterior segment, optic nerve and posterior pole; and had anterior segment, fundus and auto fluorescence images captured using a non-mydriatic retinal camera. These images and data were captured by persons with varying levels of experience, which were then analyzed by a physician who made therapeutic recommendations. The subjects then had assessments in a glaucoma clinic by a physician to be used as a comparison of the accuracy of tele-glaucoma.
There was strong correlation between the results for IOP, optic nerve cup-to-disc ratio and glaucoma diagnosis between the tele-glaucoma screening and the assessment performed by a physician. Return-to-clinic time was shortened from 3.9 months to 2.7 months with the use of tele-glaucoma screening. Tele-glaucoma did not, however, pick up anterior segment pathology as well as physical examination.
Many Completed Trials in Dry Eyes Go Unpublished
More than 90% of dry eye interventional clinical trials are never published, found researchers at Brown University.
They examined the ClinicalTrials.gov registry dating back to 1999 and found that 328 of 342 registered trials of dry eye interventions were completed but only 25 had been published. Fourteen of the 342 were discontinued early; none of these were published. Only 72 (24%) of unpublished trials had their results posted on ClinicalTrials.gov. Industry-sponsored trials had 3.6-fold greater odds of nonpublication compared with trials funded by academia.
Nonpublication "dilutes the quality and decreases the comprehensive nature of the medical literature," the presenters concluded.
Phone App Test Predicts Need for Anti-VEGF Therapy in Wet AMD
Patients can use a smartphone-based application to identify worsening of wet AMD that requires early anti-VEGF therapy. Swiss researchers tested the ability of 60 patients with 88 AMD eyes to perform the Alleye test on themselves using a smartphone. The Alleye test is performed by aligning randomly misaligned dots on phone screens while patients wear their glasses. Mean age of the participants was 73.9 years.
Sensitivity of the test to detect worsening before it was detected in the clinic was 90.8%, and the positive predictive value of receiving an anti-VEGF injection at the next clinical visit was 53.9%.