Laser in situ keratomileusis in adult patients with anisometropic amblyopia

AIM: To evaluate the increase in corrected distance visual acuity (CDVA) after laser in situ keratomileusis (LASIK) in adults with anisometropic amblyopia. · METHODS: The medical records of consecutive patients diagnosed with anisometropic amblyopia at the time of refractive evaluation who underwent LASIK were retrospectively reviewed. Patients with at least a two-line difference of visual acuity (VA) between the eyes with a spherical refractive error difference of at least 3.00 diopters (D) or an astigmatic difference of at least 2.00D were included. Patients with any other possible reason for amblyopia other than anisometropia or those who had undergone previous amblyopia treatment were excluded. Amblyopic eyes with myopia or myopic astigmatism were considered as group 1, hypermetropia or hypermetropic astigmatism constituted group 2, and mixed astigmatism patients comprised group 3. Uncorrected distance visual acuity (UDVA), subjective manifest refraction, and CDVA were analyzed at 1 week and 1 month, 3, and 6 months. ·RESULTS: The study included 57 eyes of 57 patients. There were 33 eyes in group 1, 12 eyes in group 2, and 12 eyes in group 3. The preoperative mean values for spherical equivalent of subjective manifest refraction (SE) in groups 1, 2, and 3 were (-4.66±1.97)D, (4.40±1.00)D, and (0.15±1.05)D, respectively. Mean CDVA improved 0.1 log units (1 line LogMAR) at 6 months (P 【0.05). Sixteen eyes (28%) exhibited an improvement in CDVA in week 1. Fourteen eyes (25% ) experienced two or more lines of CDVA improvement at month 6. There were no statistically significant differences among the groups in terms of CDVA (P 】0.05). Moreover, age, the amount ofpreoperative refractive error, and the levels of preoperative corrected and UDVA had no effect on postoperative CDVA improvement (P 】0.05). · CONCLUSION: Correction of refractive errors with LASIK produced significant CDVA improvement in adult patients with anisometropic amblyopia and no previous amblyopia treatment.

Comparison of two different treatment regimens’ efficacy in neovascular age-related macular degeneration in Turkish population—based on real life data-Bosphorus RWE Study Group

AIM: To compare two different anti-vascular endothelial growth factor(anti-VEGF) treatment regimens'-a priori pro re nata(PRN) and PRN regimen following^(th)e loading phaseanatomical and functional results in neovascular agerelated macular degeneration(n AMD) patients. METHODS: Totally 544 n AMD patients followed and treated with aflibercept(n=135) and ranibizumab(n=409)at 9 different centers between 2013 and 2015 were enrolled into^(th)is retrospective multicenter study. Patients with initial best corrected visual acuity(BCVA) interval of 1.3-0.3(log MAR) and a minimum follow-up of 12 mo were included. Patients under two different regimens-a priori pro re nata(1+PRN) or 3 consecutive intravitreal injections followed by a PRN regimen(3+PRN)-were compared in BCVA at 3^(th), 6^(th) and 12^(th) months, and in central macular^(th)ickness(CMT) at 6^(th) and 12^(th) months. The total study group, intravitreal ranibizumab(IVR) and intravitreal aflibercept(IVA) groups were evaluated separately. RESULTS: The mean CMT decreased in^(th)e 1+PRN(n=101) regimen from 407 to 358 and 340 μm and in^(th)e 3+PRN(n=443) group from 398 to 318 and finally to 310 μm at months 6 and 12, respectively. Anatomically,^(th)e CMT reduction at 6^(th) month(48.5 vs 76.4;P<0.05) was statistically significant in favor of 3+PRN group. BCVA changed in 1+PRN group from 0.77 to 0.78, 0.75 and 0.75;in 3+PRN group from 0.81 to 0.69, 0.72, and 0.76 at months 3, 6, and 12, respectively. Visual gain was statistically better in 3+PRN group at 3^(th) month(-0.01 vs 0.12;P<0.001). In IVR group, CMT reduction was in greater in 3+PRN at 6^(th)(44 vs 72) and 12^(th) month(61 vs 84), but statistically insignificant. The 3+PRN group revealed statistically better visual results at 3^(th) month(-0.02 vs 0.11, P<0.05). In IVA group, although statistically insignificant, CMT reduction(61 vs 89, 6^(th) month;85 vs 97, 12^(th) month) and visual gain(0.02 vs 0.16;0.02 vs 0.14;0.05 vs 0.11) was found in favor of 3+PRN group at all visits.CONCLUSION: The loading dose of anti-VEGF treatments in n AMD leads to significantly better anatomical and functional results, regardless of the agent, specially in early follow-up interval.