This article is more than 5 years old. Information may no longer be current.
Anecortave acetate found to lower IOP
FORT LAUDERDALE, Fla. — A study in Brazil has concluded that an anterior juxtascleral depot of anecortave acetate can significantly reduce IOP for at least 3 months in several types of glaucoma.
“These are all severe cases, all patients without controlled IOP, despite using medication,” Tiago S. Prata, MD, told Primary Care Optometry News in an interview at his poster at the Association for Research in Vision and Ophthalmology meeting here. “Most of them required surgery or additional medication, and instead of doing the surgery, we enrolled them in the study.”
The prospective, nonrandomized open-labeled clinical trial treated 25 eyes of uncontrolled glaucoma patients with a single anterior juxtascleral depot of 30 mg of anecortave acetate under topical anesthesia. The eyes were assessed after 1 week, 1 month and 3 months. A mild subconjunctival hemorrhage was observed in four cases. One eye developed a small and transient corneal dellen at the first week, according to the poster abstract.
“We didn’t have any major complications with the injections; [there was] no pain because the patients are under anesthesia, no decrease in visual acuity and only mild foreign body sensation,” Dr. Prata said.
The mean IOP of the study patients was 30.9 (± 9.2) mm Hg at baseline, 20.9 (± 7.5) mm Hg at the first month, 21.5 (± 7.6) mm Hg at the second month and 19.1 (± 5.2) mm Hg at the third month.
Those eyes with angle-closure glaucoma showed a mean IOP of 17.4 mm Hg, and open-angle glaucoma cases showed a mean IOP of 20.7 mm Hg.
“It’s a huge IOP decrease with only one injection and no need for additional medication,” Dr. Prata said.
Stress triggers and uveitis
Stress may be a modifiable risk factor for acute anterior uveitis flare-ups, according to another poster.
“It was our clinical impression that many patients with HLA-B27 positive uveitis related the recurrences to stress and stressful life events,” Saskia M. Maca, MD, of the Medical University of Vienna, told Primary Care Optometry News during a poster session.
Questionnaires were sent to nearly 400 patients of the uveitis unit at the university, and 171 responded to a standardized psychological questionnaire, as well as a sociodemographic data sheet, and questions about stress and trigger situations, according to the abstract.
About 58% of the respondents said their flare-ups were triggered by stressful life events, including a death in the family, separation or divorce, illness and difficulties at work.
Clinicians should be aware of the relationship between stress and flare-ups and advise patients appropriately. Doing so may help their quality of life, Dr. Maca said.
“We tell our patients about this theory, especially the ones who are new with this disease,” she said. “A lot of patients later on tell us, now that they know stress might be a trigger, they look out for the situations and try to better deal with them.”
Dr. Maca said her next goal is to look at how hormones influence flare-ups. “It might be interesting to look at serotonin levels in the future,” she said.
Soft contacts lens myth unfounded
Despite many clinicians’ long-held concerns, the use of soft contact lenses does not increase the rate of myopia progression in children, according to the results of a large scale 3-year study presented here.
“Concerns about increasing myopia progression in young children and having them ultimately become more myopic by fitting them with contact lenses at early ages are not necessarily true,” Jeffrey J. Walline, OD, PhD, said during a presentation. “Maybe doctors should consider fitting children with contact lenses at earlier ages, especially those active children or the children who are concerned about their appearance with glasses, because we’ve found these are the children who benefit the most from contact lens wear.”
Children between ages 8 to 11 years with -1.00 DS to -6.00 DS cycloplegic autorefraction were randomly assigned to wear either spectacles or contact lenses as a part of the Adolescent and Child Health Initiative to Encourage Vision Empowerment (ACHIEVE) study. The study tracked the myopia progression of the 484 children at five clinics throughout the United States.
“There was not a clinically meaningful difference in change of refractive error, axial length or corneal curvature between soft contact lens wearers and spectacle wearers,” Dr. Walline reported.
According to the abstract, the spectacle wearers progressed -1.08 ± 0.71 D, and the contact lens wearers progressed -1.27 ± 0.72 D. The axial growth of the spectacle wearers was 0.59 ± 0.37 mm and 0.63 ± 0.34 mm for the contact lens. The change in the steep corneal meridian was 0.05 ± 0.69 D for the spectacle wearers and 0.10 ± 0.70 D for the contact lens wearers.
See next month’s issue or go to PCONSuperSite.com for more ARVO coverage.
A note from the editors:
To facilitate bringing news to readers rapidly, for Primary Care Optometry News and PCONSuperSite.com meeting wrap-up articles, PCON departs from its editorial policy and typically does not send these items out for source review.