EW Weekly, April 17, 2020

Study: Long-term intravitreal injections could lead to retinal damage
According to a first-of-its-kind study, OCT-angiography (OCT-A) was used to evaluate the potential for retina damage associated with long-term intravitreal injections. The study included 39 patients receiving intravitreal bevacizumab or aflibercept injections for a variety of sight-threatening conditions. OCT-A measured blood flow after these injections, identifying a significant, temporary reduction in blood flow; a significant, temporary spike in eye pressure was also observed. According to the researchers, some areas of the macula and optic nerve were stressed more than others. Regular intravitreal injections, the study authors wrote in the paper published in the journal Retina, could lead to “perfusion-related injury to ocular structures that may produce glaucomatous damage to the macula and optic nerve.” Further monitoring of structures in patients receiving regular intravitreal injections and possibly pretreating them could have a protective effect, a press release about the research said.

Safety review of Phase 1/2 trial for gene therapy/optogenetics treatment for retinitis pigmentosa
A planned safety review of the ongoing PIONEER Phase 1/2 clinical trial for GS030 (GenSight) for retinitis pigmentosa yielded a positive report. According to a company press release, the safety review for the second cohort of patients (n=3) who received the combination gene therapy and optogenetics treatment (an intravitreal injection of 1.5e11 viral genomes and wearing a visual stimulation device afterward) did not see any adverse safety event, leading to a recommendation to continue the study protocol and recruitment of the third cohort. According to GenSight, enrollment should be completed in the second half of the year.

Phase 1/2a results for subretinal implant that could treat geographic atrophy
Sixteen patients with advanced, non-neovascular age-related macular degeneration were enrolled in a Phase 1/2a study to receive an investigational implant consisting of human embryonic stem cell-derived retinal pigment epithelium on a synthetic substrate, according to a press release from the University of Southern California. The study described intraoperative measures involved with placement of the California Project to Cure Blindness-Retinal Pigment Epithelium 1 (CPCB-RPE1) implant. The researchers found that the surgery, which took on average 160 minutes, was feasible on an outpatient basis, and while intraoperative OCT was not necessary, it was useful to confirm where the implant should be placed. The findings are published in the journal Retina.

Eyecelerator launches live stream sessions
Eyecelerator, the ASCRS and AAO partnership for innovation, held its first live stream session this week as part of the series “Ophthalmology 2.0: ReBooting the Ophthalmology Marketplace Post-COVID-19,” featuring panel discussions with ophthalmic leaders, entrepreneurs, and KOLs in the eyecare business space. Wednesday’s discussion included an introduction to Eyecelerator from ASCRS Executive Director Steve Speares, AAO CEO David Parke II, MD, and InterWest Partners’ Managing Partner Gil Kliman, MD. Eric Donnenfeld, MD, moderated the panel discussion with ophthalmic industry leaders—Alcon CEO David Endicott, Allergan Sr. Vice President of Specialty Therapeutics Jag Dosanjh, Johnson & Johnson Vision Surgical Division Worldwide President Warren Foust, and Zeiss Ophthalmic Devices Global President Jim Mazzo—on the opportunities, challenges, and impact COVID-19 is having on innovation. Future live stream topics include “RePlan: Financial Survival and Growth Opportunities” on April 22 from noon–1 p.m. PDT and “ReInvent: Innovation for Companies and Practices Post-COVID-19” on April 29 noon–1 p.m. PDT. These events are supported by Eyecelerator’s major founding sponsors Alcon, Allergan, Johnson & Johnson Vision, STAAR Surgical, and Zeiss. More information can be found here.

ASCRS: Virtual meeting and COVID-19: News You Can Use
ASCRS announced that the 2020 Annual Meeting will be held virtually on May 16–17. The 2020 ASCRS Virtual Meeting will be tailored to the new digital space and will include a variety of live and on-demand educational sessions, as well as a special session featuring former FDA Commissioner Scott Gottlieb, MD, discussing COVID-19 and the roadmap to reopening. The virtual meeting will include a selection of symposia and instructional courses in a live stream format. Paper sessions, posters, films, and a selection of pre-recorded instructional courses will be available on-demand with full slides, video, and audio. There will also be opportunities for interaction with industry through corporate-sponsored educational sessions and a full digital exhibit hall. For those already registered for the 2020 ASCRS Annual Meeting, registration will automatically be transferred to the 2020 ASCRS Virtual Meeting. Visit annualmeeting.ascrs.org for updates and information. ASCRS also continues its COVID-19: News You Can Use series, a repository of information including links, tips, and resources to help navigate the fluid COVID-19 landscape. The e-newsletter is published as new information relevant to its members emerges.

Research briefs
  • Trends in ocular microorganism antibiotic resistance have not changed for the most part in the last 10 years, according to the latest from the Antibiotic Resistance Monitoring in Ocular Microorganisms (ARMOR) study, an ongoing, nationwide, prospective, lab-based surveillance study. Penny Asbell, MD, and coresearchers reported analysis from nearly 6,100 isolates of Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Streptococcus pneumoniae, Pseudomonas aeruginosa, and Haemophilus influenzae collected from 88 U.S. sites from January 2009–December 2018. Nearly 35% of S. aureus and 49.3% of CoNS isolates were methicillin resistant. These methicillin-resistant isolates were also likely to exhibit multidrug resistance (75.4% of S. aureus and 73.7% of CoNS). S. pneumoniae isolates showed the highest antibiotic resistance with azithromycin (36.3%). The study authors noted differences in antibiotic resistance based on patient age and geographic region. The findings are published in JAMA Ophthalmology.
  • A retrospective, cross-sectional analysis of 51 eyes (41 patients) who had glaucoma and limbal stem cell deficiency (LSCD) showed unique clinical features of the LSCD compared to patients with LSCD for other reasons, Yuzhao Sun, MD, and coinvestigators reported. According to the research, the site of glaucoma surgery was significantly correlated with the location of LSCD, and there was a trend (not statistically significant) of increased LSCD severity in eyes with more than one glaucoma surgery. Topical glaucoma mediations were correlated with LSCD severity as well. The researchers reported “uniquely featured sectoral replacement of corneal epithelium by conjunctival epithelium, without corneal neovascularization or pannus” in the LSCD of patients who had glaucoma surgery. The research is published in Cornea.

This issue of EyeWorld Weekly was edited by Stacy Jablonski and Vanessa Caceres.

EyeWorld Weekly (ISSN 1089-0319), a digital publication of the American Society of Cataract and Refractive Surgery (ASCRS), is published every Friday, distributed by email, and posted live on Friday.

Medical Editors: Eric Donnenfeld, MD, Chief Medical Editor; Rosa Braga-Mele, MD, Cataract Editor; Clara Chan, MD, Cornea Editor; Nathan Radcliffe, MD, Glaucoma Editor; and Vance Thompson, MD, Refractive Editor

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