AAO 2007 : Subspecialty Days

Pour ceux qui n’ont pas la chance d’être à la Nouvelle-Orleans pour le congrès de l’American Academy of Ophthalmology, Ophthalmology Times fait un compte-rendu quotidien des communications.

Voilà donc quelques informations intéressantes présentées pendant les « Subspecialty Days » :

• Un score afin de déterminer les cornées à risque d’ectasie après chirurgie réfractive
  

  The Ectasia Risk Score System appears to be a valid method to determine eyes at risk for ectasia, said J. Bradley Randleman, MD, assistant professor of ophthalmology, Emory University, Atlanta, at Refractive Surgery Subspecialty Day.

• Association du laser femto-seconde et du « cross-linking » en traitement du kératocône
  

  Creation of a pocket for intracorneal riboflavin instillation using the femtosecond laser (IntraLase, Advanced Medical Optics) appears to be a safe and effective method for assisting cornea collagen cross-linking, said A. John Kanellopoulos, MD, at Refractive Surgery Subspecialty Day.

• Nouvelles méthodes diagnostiques du glaucome et état des lieux des traitements en cours d’investigation :
  

  Advances have been made recently in both structural and functional technologies for evaluating glaucoma. While many of these tools appear to perform better than earlier technologies, well-designed studies of their diagnostic abilities are still lacking, said Felipe A. Medeiros, MD, assistant professor of ophthalmology, University of California, San Diego.

  The drug development pipeline is bursting with new pharmaceutical products that may one day be useful in glaucoma therapy. At least 50 novel treatments are under investigation or not yet available in all major markets, according to one presenter at Glaucoma Subspecialty Day.

• Les nouveaux OCT :
  

  Spectral domain optical coherence tomography (SD-OCT), the latest generation of the technology, is a breakthrough because it has dramatically cut the time required to obtain images by eliminating the moving mirror that was a component of standard OCT, according to Cynthia Toth, MD.
  In addition to being 50 times faster than conventional OCT, SD-OCT has improved resolution because of improved processing. Another benefit is decreased patient movement artifact, especially in pediatric patients.

• Résultats décevants d’un implant sous-rétinien :
  

  The visual acuity improvements from implantation of the Artificial Silicon Retina (ASR device, Optobionics Corp.) for treatment of vision loss associated with retinitis pigmentosa were « underwhelming, » with the 2-year data showing that only 8% of implanted eyes gained 10 letters or more, according to John Pollack, MD.

• Dernières innovations pour la délivrance de médicaments :
  

  New extended delivery methods are under development and in the future should facilitate more effective administration of numerous types of ocular agents, said William F. Mieler, MD, professor and chairman, department of ophthalmology and visual science, University of Chicago.

• Traitement de la rétinopathie des prématurés par anti-VEGF :
  

  Anti-angiogenic therapy for aggressive posterior retinopathy of prematurity (ROP) may be a feasible therapy for these children with this form of ROP, which develops in profoundly immature neonates. The BLOCK-ROP study, which is slated to begin soon, will add to the limited knowledge of the safety and efficacy of an anti-vascular endothelial growth factor (VEGF) drug in treating posterior ROP, Anthony Capone Jr., MD, reported during Retina Subspecialty Day at the annual meeting of the American Academy of Ophthalmology.

• Intérêt du dorzolamide (topique) en traitement de l’oedème maculaire :
  

  Topical dorzolamide (Trusopt, Merck Sharp & Dohme) may offer hope for the treatment of macular edema in some patients with retinitis pigmentosa and X-linked retinoschisis. Rebound phenomenon after treatment needs to be addressed, Gerald Fishman, MD, reported.

• Confirmation de la supériorité de Lucentis sur la PDT à 2 ans (étude ANCHOR), de l’intérêt de l’OCT pour les décisions de retraitement (étude PrONTO)… et le souhait de Genentech de travailler en coopération aec les ophtalmologistes (!) :
  

  Visual acuity endpoints in the ANCHOR Study showed that ranibizumab (Lucentis, Genentech) surpassed photodynamic therapy (PDT) with verteporfin, (Visudyne, Novartis Ophthalmics/QLT) for treating predominantly classic choroidal neovascularization lesions in age-related macular degeneration, reported Jeffrey Heier, MD, reported during Retina Subspecialty Day.

  The results of the PrONTO Study, an exploratory open-label trial, indicated that intravitreal injection of ranibizumab (Lucentis, Genentech) produces rapid improvements in visual acuity and findings on optical coherence tomography (OCT) in patients treated for neovascular age-related macular degeneration, said Philip Rosenfeld, MD, PhD, during Retina Subspecialty Day.

  In a special session held immediately after the close of the American Academy of Ophthalmology (AAO) Retina Subspecialty Day program, Susan Desmond-Hellmann, MD, MPH, president, product development, Genentech, implored the ophthalmology community to work in collaboration the company in the interest of achieving the common goal of better patient care.

• Actualités sur les futurs traitement de la DMLA (VEGF-Trap et collyres) en développement :
  

  VEGF Trap (Regeneron Pharmaceuticals) has been seen in two studies (CLEAR-IT AMD 1 and CLEAR-IT AMD 2) to be safe, bioefficacious, and tolerated in the eyes of patients with neovascular age-related macular degeneration. The 2- and 4-mg doses demonstrated more bioactivity than lower doses evaluated, according to Quan Dong Nguyen, MD.

  Topical therapy to treat posterior segment disease is possible despite the limitations of the blood-retinal barrier. The effective route of drug penetrance of topical therapy is either by the transcorneal route or by the transscleral/conjunctival route, said Baruch Kuppermann, MD, PhD, at Retina Subspecialty Day. He is chief of the Retina Service, Department of Ophthalmology, University of California, Irvine.

Vivement que nos collègues soient de retour pour nous raconter plus en détails tout cela !

A lire aussi :

1. AAO 2007 : posters, cours et vidéos en ligne
2. Liens 2007-04-28
3. ARVO 2008
4. Comparaison Macugen et triamcinolone, en association avec PDT (VERITAS) : problème de puissance…
5. Liens 2007-05-10