AAO 2022 recap: Research updates, innovations on the horizon presented at the Annual Meeting

A combination of posters, podium presentations, and instructional courses provided invaluable revelations to the ophthalmic community.

The 2022 American Academy of Ophthalmology (AAO) Annual Meeting took place in Chicago, Illinois, from September 30-October 3. A combination of posters, podium presentations, and instructional courses provided invaluable revelations to the ophthalmic community.

Gene Therapy

Late-breaking: Janssen announces data from 2 gene therapy programs

On Friday, the Janssen Pharmaceutical Companies of Johnson & Johnson announced the primary results from the Phase 1/2 study evaluating the investigational gene therapy botaretigene sparoparvovec (formerly AAV-RPGR) in patients with the inherited retinal disease X-linked retinitis pigmentosa (XLRP) associated with the retinitis pigmentosa GTPase regulator (RPGR) gene.

The announcement was made on Friday during the late-breaking oral presentations at the Retina Subspecialty Day at the American Academy of Ophthalmology’s 2022 annual meeting at McCormick Place in Chicago.

According to the company, treatment with botaretigene sparoparvovec was found to have an acceptable safety profile, and efficacy assessments in this proof-of-concept study demonstrated encouraging improvements in retinal sensitivity, visual function and functional vision.

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Diabetic Macular Edema

YOSEMITE, RHINE treat-and-extend data show favorable results for faricimab for the treatment of DME

Roger A. Goldberg, MD, MBA, discusses his 2022 AAO poster: "T&E-Based Personalized Treatment Interval Dynamics in the YOSEMITE/RHINE Trials of Faricimab in DME."

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AMD

Understanding fluid dynamics in wet macular degeneration

At AAO 2022, Justis Ehlers, MD, presented a talk entitled, "Defining the Fluid Problem in Neovascular AMD: To Dry or Not to Dry?"

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Faricimab for nAMD: Safe, effective, lower treatment burden compared with aflibercept in pooled TENAYA, LUCERNE Phase 3 trials

The 2-year results of the TENAYA and LUCERNE studies indicated that faricimab (Vabysmo, Genentech), the first intraocular bispecific antibody that inhibits both angiopoietin-2 and vascular endothelial growth factor-A was safe and efficacious for treating neovascular age-related macular degeneration (AMD).

Rishi Singh, MD, FASRS, reported the highlights of the pooled results of the trials on behalf of the study investigators.

TENAYA and LUCERNE were Phase 3 global, randomized, double-masked 112-week trials designed to assess the efficacy, safety, and durability of faricimab in treatment-naïve patients with neovascular AMD.

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Retinal Surgery

Risk of rhegmatogenous retinal detachment rises following cataract surgery

Michael Morano, MD, and colleagues identified the factors that put patients at higher risk of development of a rhegmatogenous retinal detachment (RRD) after cataract surgery. Morano is from Stanley Kimmel Medical College, Thomas Jefferson University, Philadelphia.

The investigators undertook a study to determine the incidence of RRDs 1 year after cataract using the IRIS Registry data and to determine the demographic features, ocular comorbidities, and intraoperative factors associated with an increased risk of detachment development.

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Acute retinal necrosis: Retinal detachment rates are unaffected by early treatment with intravitreal antivirals, vitrectomy

Ines Lains, MD, PhD, and colleagues from the Massachusetts Eye and Ear, Harvard Medical School, Boston, reported that adjunct treatment with intravitreal antivirals or early pars plana vitrectomy (PPV) did not improve the rates of retinal detachment (RD) in patients with acute retinal necrosis (ARN).

ARN is rare but can have devastating visual consequences, Lains explained. Over time, patients with ARN have a high risk of developing retinal traction and necrotic retinal breaks, which can lead to the development of a RD.

“RD is one of the most common consequences of ARN,” she said. Systemic antivirals are the mainstay treatment for ARN, and even though clinicians may empirically add intravitreal antivirals or early PPV, data on this topic remains controversial.

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Identifying risk factors for development of rhegmatogenous retinal detachments in fellow eyes

William Kearney, MS, Dan Gong, MD, and colleagues from Massachusetts Eye and Ear, Harvard Medical School, Boston, identified risk factors for the development of rhegmatogenous retinal detachments (RRDs) in the fellow eye of patients who developed an RRD in one eye.

RRDs are sight-threatening conditions associated with potential morbidity, and patients with a unilateral retinal detachment frequently ask about the risk of developing an RRD in their fellow eye.

The investigators pointed out that this question is clinically relevant for identifying fellow eyes with an increased risk of developing an RRD and may help improve the ability to diagnose RRDs earlier. “This early diagnosis is essential since early repair increases the success rate of retinal reattachment surgery and improves visual outcomes,” Kearney said.

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Pediatrics

Pediatric patients have higher incidence of new strabismus following tube shunt surgery than adult patients

Maria A. Guzman Aparicio, MD, and Teresa C. Chen, MD, from Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, found that pediatric patients have a significantly higher incidence of new-onset strabismus after tube shunt surgery for glaucoma compared with adults.

According to past literature, adults who undergo Ahmed (New World Medical) and Baerveldt (Abbott Medical Optics) tube shunt surgeries have postoperative strabismus 2% to 12.7% of the time after 1 to 5 years; in children, the percentages range from 3% to 4.2% with Ahmed valve surgery after 16 to 24 months of follow-up.

In their current study with longer follow-up periods, Guzman Aparicio and Chen sought to compare the frequency of strabismus after tube shunt surgery in the adult versus pediatric populations and to identify risk factors for strabismus after tube shunt surgery.

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Ophthalmology

Continuous range-of-motion IOL scores high in patient satisfaction

David Teenan, MD, from Optical Express, and colleagues reported that the safety and efficacy of the Tecnis Synergy intraocular lens (IOL) model ZFR00V indicates that it may be a good option for patients who desire meaningful gains in uncorrected visual acuity (VA) at all distances.

Teenan and co-authors Jan Venter, MD, and Stephen Hannan, MCOptom, conducted a study in which the participating patients completed a minimum of 1 follow-up visit within 1 year of the primary implant.

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IRIS Registry: Comparing dry eye disease in adult and pediatric populations

A study of dry eye disease (DED) in children found that the average age of onset of DED is at 12.51 years compared with the average of 61.06 years in adults. The highest prevalence in children was seen between 12 to 15 years of age, according to lead author Vivian Paraskevi Douglas, MD, DVM, MBA, MSc, and colleagues from Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston.

Although DED is highly prevalent in adults, with rates ranging from 5% to 50%, little is known about the disorder in pediatric patients, which sparked the interest in this study.

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Fewer ocular symptoms linked to e-cigarettes than traditional cigarettes

Investigators from McGill University, Quebec, Canada, and Stanford University, Palo Alto, CA, reported that young smokers had more ocular symptoms resulting from cigarette smoking than those who smoked electronic cigarettes. However, those who used both reported severe to very severe ophthalmic symptoms, according to Anne Xuan-Lan Nguyen, from McGill University, Quebec, Canada, first author of the study.

The investigators conducted an observational, cross-sectional online survey to determine the frequency and severity of ocular symptoms in young e-cigarette and cigarette users.

A total of 4,351 Americans aged 13 to 24 years responded to the survey questions regarding the use or non-use of nicotine e-cigarettes and cigarettes and the use during the previous 7 and30 days.

Dual users were defined as those who used both products. The outcomes included the general vision status and frequency and severity of ocular symptoms that included ocular discomfort, pain, burning, itching, redness, dryness, glare, blurry vision, eye strain, and headaches.

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