Reflections on current intravitreal therapies

Overall, about 10% of patients in a study in The Netherlands were classified as non-responders to any anti-VEGF therapy. Inadequate response to anti-VEGF therapy is described by the Royal College of Ophthalmology as the presence of fluid in any compartment after a three-month loading phase. In the CATT trial, persistence of intra-retinal fluid at greater than 80% of visits between month 1 and month 12 was deemed an inadequate or sub-optimal (anatomical) treatment response.

  • A good visual (functional response) is described as greater than 5 ETDRS letters gain.
  • Sub-optimal/partial response is described as 0-5 ETDRS letters gain.
  • Poor response is described as 0-4 ETDRS letters loss.
  • Non-response is described as greater than 5 ETDRS letter loss. 

Adult strabismus management

Over the last two decades, there has been an upward trend in the incidence of adult strabismus attending strabismus clinics. In children, approximately 1% have strabismus, however, according to the American Academy of Ophthalmology’s recently published Adult Strabismus Preferred Practice Pattern, strabismus is common among adults, with an estimated incidence of 4% in people over the age of 15 years.

Case Study:

Bilateral sequential optic disc swelling evolving to a diagnosis of idiopathic intracranial hypertension

On general examination an elevated body mass index with short stature was noted. Ocular examination was remarkable for a brisk RAPD of her left eye with Snellen best corrected visual acuity (VA) 6/5 in her right eye and 6/60 left eye. Anterior segment examination of both eyes were unremarkable. Fundus exam of her left eye was significant for a grossly swollen optic nerve head, parapapillary oedema and a large star – shaped configuration of exudates radiating from the fovea. There was an associated vasculitis complicated by an inferotemporal vein occlusion with accompanying scattered retinal haemorrhages in the affected sector.  


Health Professions Council of South Africa


2 Clinical 


Attempts allowed: 2

70% pass rate

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Ophthalmic Opinion - Vol 6 No 2 - 2023