Microsoft Word - Abstracts Vol. 27, 2,11


116 

Abstracts 
Edited By Dr. Qasim Lateef Chaudhry 

 
 
Antagonism of Vascular Endothelial Growth 
Factor for Macular Edema Caused by Retinal 
Vein Occlusions: Two-Year Outcomes 
 
Hafiz G, Channa R, Shah SM, Nguyen QD, Ying 
H, Do DV, Zimmer – Galler I, Solomon SD, Sung 
JU, Syed B. 
Ophthalmology 2010; 117: 2387-94. 
 
A study by Campochiaro et al suggests that anti-
vascular endothelial growth factor (VEGF) 
treatment provides long-term benefit in patients 
with macular edema due to branch retinal vein 
occlusion (BRVO) or central retinal vein occlusion 
(CRVO). In this small prospective, randomized 
clinical trial, 20 patients with macular edema due 
to BRVO and 20 patients with CRVO received 
injections of anti-VEGF agents at 4 weekly 
intervals for 3 months. After month 3, the patients 
were seen every 2 months and received injections 
as needed for recurrent edema. At 2 years, the 
BRVO patients experienced a mean improvement 
of 18.8 letters, while the CRVO patients 
experienced a mean improvement of 8.5 letters. 
However, frequent injections were required in 
some of the patients with BRVO and most patients 
with CRVO. According to the authors, this latter 
finding suggests that excessive VEGF production 
represents a long-term problem in many patients 
with CRVO. They calls for additional studies to 
determine the long-term effects of frequent-
possibly monthly-injections and/or the use of 
higher doses of anti-VEGF agents 

 
Randomized Evaluation of the Trabecular Micro-
Bypass Stent with Phacoemulsification in 
Patients with Glaucoma and Cataract 
 
Samuelson TW,  Katz LJ,  Wells JM,  Pharm D, 
Duh YJ, Giamporcaro JE. 
Ophthalmology 2011; 118: 459-67. 
 
Samuelson et al conducted a large-scale rando-
mized, controlled, multicenter study comparing 
cataract surgery with a glaucoma drainage device 

versus cataract surgery alone in patients with mild 
to moderate open - angle glaucoma. The investi-
gators found the cataract surgery patients who 
received the stent demonstrated clinically and 
statistical improvement in terms of IOP reduction 
with less medication use compared with those 
undergoing cataract surgery alone. The 
investigators enrolled 240 eyes in the study, 
randomizing them into 2 groups: the treatment 
group, who underwent cataract surgery with 
trabecular micro-bypass stent (iStent) implant-
tation, and the control group who underwent 
cataract surgery only. At 1 year, 66% of treatment 
eyes versus 48% of control eyes achieved ≥20% 
IOP reduction without medication. Incidence of 
adverse events was similar between the groups. 
The researchers assert the iStent demonstrates a 
positive benefit-risk intervention in patients with 
mild to moderate glaucoma undergoing cataract 
surgery, and may represent a novel therapeutic 
approach that may avoid the lifelong risk of 
complications, which can be associated with 
filtering blebs. 

 
Central serous chorioretinopathy: an update on 
phathogenesis and treatment 
 
Gemenetzi M, Salvo GD, Lotery AJ. 
Eye 2010; 24: 1743–56. 
 
Central serous chorioretinopathy (CSC) is a 
chorioretinal disease, incompletely understood 
with systemic associations, a multifactorial 
aetiology, and a complex pathogenesis. Increased 
permeability from the choriocapillaris leads to 
focal or diffuse dysfunction of the retinal pigment 
epithelium causing a detachment of the neuro-
sensory retina. CSC has been described in patients 
with endogenously high levels of corticosteroids 
as well as in patients with hypercortisolism due to 
the treatment of ocular or systemic diseases. It is 
therefore the only‘ inflammatory’ choroiditis, not 
proven to be associated with infection that is 
precipitated or worsened by glucocorticoids. 
Foveal attenuation, chronic macular oedema, and 



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damage of the foveal photoreceptor layer have 
been reported as causes of visual loss in CSC. 
Photoreceptor atrophy in the fovea, despite 
successful retinal reattachment, typically occurs 
after a duration of symptoms of approximately 4 
months. Treatment should therefore be considered 
after 3 months if there is angiographic evidence of 
ongoing foveal leakage in recurrent chronic CSC 
or in a single CSC episode accompanied by signs 
of chronic CSC alterations. Based on results of 
trials conducted so far, it appears that photody-

namic therapy with verteporfin is effective and 
safer than argon laser treatment and should be 
considered as the treatment of choice, whereas 
micropulse diode laser photocoagulation seems to 
be an effective alternative. Glucocorticoid 
inhibitors are an interesting alternative treatment. 
Clinical trials are ongoing to test their efficacy. In 
addition, it is important, where possible, to 
discontinue any corticosteroid treatment. The 
possible association of CSC with stress should also 
be discussed with patients.