BERLIN — A study examining a link between dietary factors and IOP
found that higher polyunsaturated fatty acids and fiber consumption were linked
to lower IOP in schoolchildren.
According to Laurence S. Lim, MBBS, and Seang-Mei Saw, MBBS, PhD, it was
the first population-based study to make an association between nutrient
consumption and IOP.
“Higher total daily PUFA (polyunsaturated fatty acids) intake was
associated with lower IOP,” they said in a poster study presented here at
the World Ophthalmology Congress. “As dietary PUFA are an important source
of endogenous prostaglandins (PGs), these variations may be mediated via the PG
pathway.”
In addition, the study authors found that high fiber consumption could
be connected to lower glycemic indices and “reduced postprandial glucose
elevations.”
The cross-sectional study looked at a subset of healthy schoolchildren
from the Singapore Cohort Study of Risk Factors for Myopia. According to the
poster, adults were not studied because of the possibility of confounding by
systemic comorbidities.
A validated semi-quantitative food frequency questionnaire determined
diet, while IOP and central corneal thickness were measured by the Ocular
Response Analyzer (Reichert).
Glycemic control, anti-hyperlipidemic agents may prevent macular edema
progression
Anti-hyperlipidemic agents could play a role in halting macular edema in
some diabetic patients with hypertension, a study of diabetic patients taking
those agents found.
“These data indicated that intense glycemic control and
administration of anti-hyperlipidemic agents may be effective to prevent the
progression of macular edema in diabetic patients with hypertension,”
Noriko Miyamoto, MD, and colleagues said in a poster study.
They presented results of 84 diabetic patients with retinopathy and
hypertension who were taking anti-hypertensive agents. In the study, multiple
linear regression evaluated the correlation of factors including sex, age,
HbA1c, diabetic nephropathy, number of anti-hypertensive agents, insulin and
systemic anti-coagulants with clinically significant macular edema.
“Significant factors for macular edema were HbA1c and
anti-hyperlipidemic agents, but no correlation was found between diabetic
macular edema and anti-hypertensive agents and other factors in diabetic
patients with hypertension,” Dr. Miyamoto and colleagues said.
Study: Cataract surgery not a risk factor for retinal detachment in
high myopia
Cataract surgery is not a demonstrated risk factor for retinal
detachment in highly myopic eyes, and the risk profile for postoperative
retinal detachment is the same as the risk profile for idiopathic retinal
detachment, according to a study on a large cohort of patients.
“We performed a retrospective analysis of 1,519 consecutive
patients (2,356 eyes) with an axial length greater than 27 mm who had planned
phacoemulsification. Postoperative incidence of retinal detachment was
approximately 2%, with a follow-up of 2 years in 84% of the cases,”
Irmingard Neuhann, MD, reported.
This relatively high incidence confirms the results of the majority of
the studies published in literature. However, no large epidemiological study
has ever demonstrated that this rate is different from that of spontaneous
retinal detachment in myopes with comparable axial length, she said.
“In our study, we found that the rate of idiopathic retinal
detachment, occurred before surgery, was equally high. Consequently, it is
difficult to demonstrate whether cataract surgery is actually a risk factor for
[retinal detachment] in high myopes,” Dr. Neuhann said.
Retinal detachment is a predisposition that comes with myopia.
“I tell my patients that the risk of having retinal detachment
following cataract surgery is not greater than the risk they would have anyhow.
There is no evidence or scientifically plausible mechanism that should make
cataract surgery an additional risk factor for retinal detachment,” she
said.
Clinician: Fixed-combination drugs a compelling proposition in glaucoma
therapy
More controlled studies must be performed to establish efficacy of
fixed-combination medications for glaucoma treatment, a clinician said here.
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Anastasios Konstas
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“Fixed combinations ... do work in real-life practice by keeping
medical therapy practicable. I think that fixed combinations are a compelling
proposition in the management of glaucoma. They provide important benefits in
most patients ... especially in real-life practice,” Anastasios Konstas,
MD, PhD, said. “But we still need to see controlled evidence in the future
to prove the clinical advantages.”
Dr. Konstas recommended that physicians not compare fixed combinations
and monotherapy agents. He said it is more helpful to regard adjunctive therapy
separately or together.
He said fixed therapy has been shown in other medical fields to decrease
rates of nonadherence. Fixed combination drugs also offer fewer bottles needed
for glaucoma therapy and less potential for toxicity from preservative
exposure.
Large study bolsters correlation between thin corneas, glaucoma damage
A large multicenter survey of German glaucoma patients shows that thin
central corneas as measured by optical coherence pachymetry may correlate with
advanced stages of the disease, according to a poster presented here.
The German MoviX survey of 121,634 eyes of 62,060 patients found that
patients with thinner corneas as measured by optical coherence pachymetry by
Heidelberg Engineering tended to have greater visual field loss, according to
the study.
“This large number of patients shows that visual field damage
increases the smaller the thickness is,” Richard Stodtmeister, MD,
co-author of the study, said in an interview.
Visual field loss was found to be higher in patients with thinner
corneas, according to the poster. Eyes without visual field loss were found to
have a median thickness of 547 µm, compared with 523 µm in eyes
with Aulhorn stage 3 or greater visual field loss.
“The correlation between thin corneas and visual field damage has
never been shown before on such a large scale,” Dr. Stodtmeister said.
Dr. Stodtmeister said optical coherence pachymetry was a highly reliable
method of measuring central corneal thickness.
The study was supported by Pfizer Pharma GmbH.
DMEK shows good visual results at 6 months
Descemet’s membrane endothelial keratoplasty shows a high rate of
success, according to a surgeon speaking here.
“In our series of 133 patients, we had an 86% success rate.
Fourteen percent of the cases were unsuccessful due to graft detachment or
failure to clear up but underwent secondary ... surgery with positive
outcomes,” Gerrit Melles, MD, said.
Successful eyes had good visual acuity results, with 96% of the patients
achieving 20/40 or better and 74% achieving 20/25 or better at 6 months.
“Almost half of the patients reached BCVA 20/25 or better within 1
month,” Dr. Melles said.
These results show the superior potential of DMEK compared with
Descemet’s stripping endothelial keratoplasty. “The thinner, the
better,” he said. “By adding stromal tissue, you degrade the
image.”
In his busy practice, Dr. Melles has had several patients who asked him
to remove a previous DSEK graft and have DMEK.
“Patients talk to each other, and DMEK patients are obviously
reporting better outcomes,” he said.