Using a simple gray filter to stress patients’ eyes, ophthalmologists are able to predict visual acuity change during anti-vascular endothelial growth factor A (anti-VEGF) therapy for wet age-related macular degeneration (AMD), according to a new study.

“Now we are able to tell patients with a high degree of accuracy how they will do with anti-VEGF injections,” Dr. Ronald E.P. Frenkel, who led the study, told Reuters Health by phone. “The method is so elegant and it has incredible predictability. We couldn’t tell patients before what to expect.”

He noted that previously, the test had proved helpful in patients with dry AMD, but this is the first time anyone has tested it in patients with wet AMD.
Dr. Frenkel, of Bascom Palmer Eye Institute, Miami, and colleagues conducted the HARBOR trial, a two-year, phase 3 randomized trial of intravitreal ranibizumab (Lucentis) 0.5 or 2.0 mg monthly or as needed in wet AMD patients. A total of 1,084 patients were enrolled in the trial. Their mean age was 78.7 years and about 60 percent were women. In a Nov. 5 online paper in the British Journal of Ophthalmology, Dr. Frenkel and colleagues report change in best corrected visual acuity (BCVA) under optimal illumination over the course of the two-year study. The researchers also evaluated low-luminance visual acuity (LLVA).

Dr. Frenkel discovers a way to predict prognosis for Wet Macular Degeneration patients.
Ronald Frenkel, MD, FACS, FICS has discovered a new way to let patients with Wet Macular Degeneration know the prognosis of treatment before they start it. Dr. Frenkel has been awarded this presentation at the annual meeting of ARVO, the Association for Research in Vision and Ophthlalmology, the largest eye research meeting in the world. Dr. Frenkel served as Principal Investigator at the East Florida Eye Institute in Stuart. He headed up the portion of the colossal national multi-center HARBOR clinical trial for Wet Macular.
Degeneration treatment that discovered how to predict the patient’s prognosis and response to treatment, when one is first diagnosed with the disease. The study had 99 participating centers from across the United States and enrolled 1097 patients with newly diagnosed Wet Macular Degeneration. This will have a significant impact on patients and their families as such a prognosis does not currently exist.

Avoiding blood pressure dips helps prevent worsening of glaucoma
Current risk factors for glaucoma include high eye pressure, age, family history, and thin corneas. Through our research, we have discovered a new risk factor for glaucoma: nighttime dips in blood pressure. By having patients wear a blood pressure monitor for a 24-hour period, we have found that patients with worsening glaucoma despite “controlled” eye pressures have significant drops in their blood pressure at night. Decreased blood pressure causes decreased blood flow to the optic nerve, resulting in glaucomatous nerve damage. We work with patients’ medical doctors to diminish this risk so that glaucoma can be prevented or stabilized. (Presented at the Annual Meeting of the American Academy of Ophthalmology)