Growth factor restriction impedes progression of wound healing following cataract surgery: identification of VEGF as a putative therapeutic target

Secondary visual loss occurs in millions of patients due to a wound-healing response, known as posterior capsule opacification (PCO), following cataract surgery. An intraocular lens (IOL) is implanted into residual lens tissue, known as the capsular bag, following cataract removal. Standard IOLs allow the anterior and posterior capsules to become physically connected. This places pressure on the IOL and improves contact with the underlying posterior capsule. New open bag IOL designs separate the anterior capsule and posterior capsules and further reduce PCO incidence. It is hypothesised that this results from reduced cytokine availability due to greater irrigation of the bag. We therefore explored the role of growth factor restriction on PCO using human lens cell and tissue culture models. We demonstrate that cytokine dilution, by increasing medium volume, significantly reduced cell coverage in both closed and open capsular bag models. This coincided with reduced cell density and myofibroblast formation. A screen of 27 cytokines identified nine candidates whose expression profile correlated with growth. In particular, VEGF was found to regulate cell survival, growth and myofibroblast formation. VEGF provides a therapeutic target to further manage PCO development and will yield best results when used in conjunction with open bag IOL designs

Choroideremia associated with choroidal neovascularization treated with intravitreal bevacizumab

Neal V Palejwala, Andreas K Lauer, Richard G Weleber Oregon Retinal Degeneration Center (ORDC), Ophthalmic Genetics Service and Retina-Vitreous Service, Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA Purpose: To report a rare case of central vision loss in a patient with choroideremia.Patients and methods: A retrospective, interventional case report.Results: A 13-year-old male with history of choroideremia presented with subacute loss of central acuity in his left eye. Examination and diagnostic testing revealed subretinal fibrosis secondary to a choroidal neovascular membrane (CNVM). A trial of anti-vascular endothelial growth factor (VEGF) therapy with the injection of intravitreal bevacizumab was attempted. Mild improvements in acuity and anatomy were noted.Conclusion: Choroideremia is a rare hereditary choroidal dystrophy that predominantly affects males in the first and second decades of life. Visual acuity is usually spared until later in life. CNVM is a rare manifestation of choroideremia with only a handful of case reports presented in the literature. This case is unique in that it is the first reported case that received treatment with intravitreal anti-VEGF therapy. Keywords: anti-VEGF therapy, choroideremia, choroidal neovascular membrane, chorioretinal degeneration, hereditary choroidal dystrophy, intravitreal bevacizumab injectio

OCT Angiography: an Upcoming Non-invasive Tool for Diagnosis of Age-Related Macular Degeneration

To review the most recent findings, characteristics, faults and future perspectives of optical coherence tomography angiography (OCTA) in age-related macular degeneration (AMD). In dry AMD, OCTA is useful on the evaluation of choriocapillaris perfusion and detection of naïve quiescent non-exudative choroidal neovascularization (CNV). In wet AMD, OCTA can provide detailed anatomic and morphologic information of CNVs, which may help to understand why and how they develop and become active. In other hand, the many artifacts present in OCTA images may lead to misinterpretation and misdiagnosis. OCTA is a still developing technology that is able to provide a large amount of anatomic, functional and morphologic information in macular diseases and, particularly, AMD. As the technology evolves, the need of dye-based modalities tends to decrease