Publications by authors named "Neil M Bressler"
Importance: Intraocular pressure (IOP) elevations of clinical relevance have been observed after the commonly used 0.05-mL volume for intravitreous injections. However, more recently approved intravitreous agents involve volumes from 0.
View Article and Find Full Text PDFPurpose: To identify baseline factors associated with 1-year outcomes when treating neovascular age-related macular degeneration (nAMD) with ranibizumab biosimilar SB11 or reference ranibizumab (rRBZ), and to compare efficacy of the two products within subgroups judged to be clinically relevant.
Design: Post hoc analysis of a prospective, equivalence phase 3 randomized clinical trial (RCT) METHODS: 705 patients with nAMD were randomized 1:1 to receive SB11 or rRBZ for 48 weeks. Pooled and randomized groups were used to identify baseline factors associated with clinical outcomes at Week 52 using multiple linear regression models.
Article Synopsis
- The introduction of biologic medicines that target VEGF has greatly enhanced treatment outcomes for patients with retinal diseases, but their high costs can limit access to care.
- Biosimilars, which are cheaper alternatives that are proven to be clinically equivalent to branded agents, offer a potential solution to financial barriers in treatment.
- Since 2022, anti-VEGF biosimilars have begun to emerge in the US ophthalmology market, prompting a review of their regulatory background, development challenges, and the implications for patient care.
Importance: Monitoring for and reporting potential cases of intraocular inflammation (IOI) in clinical practice despite limited occurrences in clinical trials, including experiences with relatively new intravitreal agents, such as brolucizumab, pegcetacoplan, or faricimab, helps balance potential benefits and risks of these agents.
Objective: To provide descriptions of 3 initially culture-negative cases of acute, severe, posterior-segment IOI events occurring within the same month following intravitreal faricimab injections at a single institution.
Design, Setting, And Participants: In this case series, 3 patients manifesting acute, severe IOI following intravitreal injection of faricimab were identified between September 20, 2023, and October 20, 2023.
Article Synopsis
- The study aimed to create and validate a specialized database to help differentiate between high myopia (HM) and highly myopic glaucoma (HMG) by measuring the thickness of the peripapillary retinal nerve fiber layer (pRNFL).
- It involved 1367 participants, analyzing pRNFL thickness using advanced optical coherence tomography (OCT) and included robust quality control measures to ensure reliability in results.
- The findings showed that the HM-specific normative database could accurately detect HMG, achieving high accuracy and specificity rates, especially when using the fifth percentile as a threshold for pRNFL thickness.
Importance: Best-corrected visual acuity (BCVA) is a measure used to manage diabetic macular edema (DME), sometimes suggesting development of DME or consideration of initiating, repeating, withholding, or resuming treatment with anti-vascular endothelial growth factor. Using artificial intelligence (AI) to estimate BCVA from fundus images could help clinicians manage DME by reducing the personnel needed for refraction, the time presently required for assessing BCVA, or even the number of office visits if imaged remotely.
Objective: To evaluate the potential application of AI techniques for estimating BCVA from fundus photographs with and without ancillary information.
To assess the correlation between the change in central subfield thickness (CST) and change in best-corrected visual acuity (BCVA) in eyes with diabetic macular edema (DME) treated with fixed-dosing intravitreal aflibercept injection (IAI). This post hoc analysis of the VISTA and VIVID randomized controlled clinical trials, in which 862 eyes with central-involved DME were randomly assigned to IAI 2 mg every 4 weeks (2q4; 290 eyes), IAI 2 mg every 8 weeks after 5 initial monthly doses (2q8; 286 eyes), or macular laser (286 eyes) and followed through 100 weeks. Correlations between the change in CST and change in BCVA from baseline to weeks 12, 52, and 100 were assessed using the Pearson correlation.
View Article and Find Full Text PDFObjective: To assess 'time in range' as a novel measure of treatment response in diabetic macular oedema (DMO).
Methods: This post hoc analysis of the Protocol T randomised clinical trial included 660 individuals with centre-involved DMO and best-corrected visual acuity (BCVA) letter score ≤78-≥24 (approximate Snellen equivalent 20/32-20/320). Study participants received intravitreal aflibercept 2.
Objective: Investigate retinal characteristics of pathologic myopia (PM) among patients self-identifying as Black.
Design: Retrospective cohort single-institution retrospective medical record review.
Methods: Adult patients between January 2005 and December 2014 with International Classification of Diseases (ICD) codes consistent with PM and given 5-year follow-up were evaluated.
Importance: SB11 and reference ranibizumab (RBZ) are monoclonal anti-vascular endothelial growth factor (VEGF)-A antibodies approved for the treatment of neovascular age-related macular degeneration (nAMD) and other retinal diseases. The association of ranibizumab immunogenicity and treatment outcomes in patients with nAMD is unclear but relevant regarding concerns about immunogenicity of anti-VEGF biological products.
Objective: To examine the association of immunogenicity to ranibizumab products (SB11 and RBZ) with efficacy, safety, and pharmacokinetics.