International Journal of Retina and Vitreous最新文献

{"title":"Semaglutide, type 2 diabetes, and the risk of nonarteritic anterior ischemic optic neuropathy.","authors":"Fernando K Malerbi, Marcello C Bertoluci","doi":"10.1186/s40942-024-00622-9","DOIUrl":"10.1186/s40942-024-00622-9","url":null,"abstract":"<p><p>In the last months, conflicting evidence on a possible association between the use of semaglutide and incident nonarteritic anterior ischemic optic neuropathy (NAION) has emerged. A recently published study, which evaluated all patients with type 2 diabetes in Denmark, has shown with robustness that once-weekly semaglutide doubles the five-year risk of NAION. In this comment, the new evidence is discussed, along with practical implications for type 2 diabetes patients. The possibility of ophthalmological evaluation regarding optic disc morphology is suggested, before initiation of semaglutide treatment or, for those patients already under treatment, during a follow-up ophthalmological visit. If a disc-at-risk pattern is detected, such information could be brought to the attention of the attending clinician involved with diabetes control and discussed with patients for a shared decision-making approach. A new risk-benefit discussion weighing the undoubted benefits of semaglutide in reducing cardiovascular mortality and cardiovascular events, heart failure hospitalization, and renal protection must be started and carefully balanced against a rare but devastating condition such as NAION.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"8"},"PeriodicalIF":1.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravitreal dexamethasone implant (Ozurdex®) findings over time: ultrasound and ultra-widefield fundus photography.","authors":"Gabriela Assumpção Brito Pereira Pellegrini, Arnaldo Furman Bordon, Norma Allemann","doi":"10.1186/s40942-024-00625-6","DOIUrl":"10.1186/s40942-024-00625-6","url":null,"abstract":"<p><strong>Background: </strong>Ozurdex® (Allergan®, AbbVie Company, North Chicago, Illinois, EUA), is composed of 0.7 mg of dexamethasone, fused in a solid biodegradable PLGA polymer, whose degradation occurs naturally in the vitreous cavity, usually in six months after its application.</p><p><strong>Methods: </strong>In this study, we included patients aged ≥ 18 years with one or two eyes who had an indication for Ozurdex^® implants. Eyes submitted to Ozurdex^® application were evaluated in the first hour after the injection via transpalpebral contact B-scan ocular ultrasonography (Aviso® or Compact Touch^®, Quantel^®) and non-mydriatic ultra-widefield fundus photography (California^®, Optos^®) performed sequentially. The exams were executed using similar parameters and techniques, by the same ophthalmologist, after every 45 days, until the end of 180 days. The programed visits were the initial (tagged D0) and sequential (D45, D90, D135, and D180) visits, with a possible variance of seven days, before or after. The ultrasonographic Ozurdex^® findings evaluated were: non-quantitative: structure, height, reflectivity, artifact production, location, and movement; and quantitative: length and thickness. Ultra-widefield fundus photography parameters were: Ozurdex^® visualization, location, and structure.</p><p><strong>Results: </strong>The B-scan showed the implant initially, at the D0 visit, as a well-delimited and homogeneously highly reflective linear and continuous structure. On D45, Ozurdex^® implants presented with low internal reflectivity and irregularity in the limits. On D90, D135, and D180, reductions in the length and thickness progressively lessened, leading to the final appearance of a small highly reflective clust. Over time, all the implants presented reductions in length and thickness. The mean length at D0 was 7.42 ± 0.39 mm and at the final visit (D180) it was 1.50 ± 0.47 mm. The mean thickness at D0 was 0.77 ± 0.13 mm and at the final visit (D180) it was 0.44 ± 0.18 mm.</p><p><strong>Conclusions: </strong>Considering implant dimensions, the change in length over time was more evident than the change in thickness. In all the cases where visualization was possible, positive correlations with B-scan findings were found despite changes in patient position. These alterations evidenced in the Ozurdex® implant over time may be related to the degradation of the glucose polymer structure.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"7"},"PeriodicalIF":1.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supervised machine learning statistical models for visual outcome prediction in macular hole surgery: a single-surgeon, standardized surgery study.","authors":"Kanika Godani, Vishma Prabhu, Priyanka Gandhi, Ayushi Choudhary, Shubham Darade, Rupal Kathare, Prathiba Hande, Ramesh Venkatesh","doi":"10.1186/s40942-025-00630-3","DOIUrl":"10.1186/s40942-025-00630-3","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the predictive accuracy of various machine learning (ML) statistical models in forecasting postoperative visual acuity (VA) outcomes following macular hole (MH) surgery using preoperative optical coherence tomography (OCT) parameters.</p><p><strong>Methods: </strong>This retrospective study included 158 eyes (151 patients) with full-thickness MHs treated between 2017 and 2023 by the same surgeon and using the same intraoperative surgical technique. Data from electronic medical records and OCT scans were extracted, with OCT-derived qualitative and quantitative MH characteristics recorded. Six supervised ML models-ANCOVA, Random Forest (RF) regression, K-Nearest Neighbor, Support Vector Machine, Extreme Gradient Boosting, and Lasso regression-were trained using an 80:20 training-to-testing split. Model performance was evaluated on an independent testing dataset using the XLSTAT software. In total, the ML statistical models were trained and tested on 14,652 OCT data points from 1332 OCT images.</p><p><strong>Results: </strong>Overall, 91% achieved MH closure post-surgery, with a median VA gain of -0.3 logMAR units. The RF regression model outperformed other ML models, achieving the lowest mean square error (MSE = 0.038) on internal validation. The most significant predictors of VA were postoperative MH closure status (variable importance = 43.078) and MH area index (21.328). The model accurately predicted the post-operative VA within 0.1, 0.2 and 0.3 logMAR units in 61%, 78%, and 87% of OCT images, respectively.</p><p><strong>Conclusion: </strong>The RF regression model demonstrated superior predictive accuracy for forecasting postoperative VA, suggesting ML-driven approaches may improve surgical planning and patient counselling by providing reliable insights into expected visual outcomes based on pre-operative OCT features.</p><p><strong>Clinical trial registration number: </strong>Not applicable.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"5"},"PeriodicalIF":1.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy & safety of brolucizumab 6.0 mg versus 3.6 mg in diabetic macular edema.","authors":"Sanjay Kumar Mishra, Pradeep Kumar, Amrita Joshi, Aman Saraf, Abhijeet Awasthi, Supriya Dhar, Khaleel M, Atul Kumar, Vipin Rana, Ravi D","doi":"10.1186/s40942-025-00628-x","DOIUrl":"10.1186/s40942-025-00628-x","url":null,"abstract":"<p><strong>Background: </strong>Management of Diabetic Macular edema (DME) requires repeated injections. Therefore newer Anti-VEGFs like Brolucizumab with longer durability have been introduced. We compared two different dosages of Brolucizumab, 6.0 mg and 3.6 mg, for their safety & efficacy in treatment of DME, in treatment naïve patients over 52 weeks.</p><p><strong>Method: </strong>A prospective, pilot randomised controlled, single centre, double blinded, two arm comparative study was conducted between Dec 2022 to Apr 2024. The study recruited 82 patients of DME who were randomised into two groups of 41 patients each, one group to be treated with Brolucizumab 6.0 mg in 50 μL and the other to receive 3.6 mg in 30 μL. All patients received the first dose of Brolucizumab at 0 week and were then followed up at every 4 weeks for detailed ophthalmic and OCT macula examination. Those who met the pre-defined re-treatment criteria were re-injected with Brolucizumab, the dose being fixed for each group throughout the study. All patient receiving an injection were further followed up on Day 1, Day 7 and Day 28 to look for any adverse reactions. The efficacy parameters included change in best corrected visusal acuity (BCVA), contrast and central macular thickness (CMT) on Optical Coherence Tomography. The average number of injections recd in each group were also calculated.</p><p><strong>Results: </strong>The change in BCVA from baseline in 6.0 mg group was 0.54 LogMAR units and 3.6 mg group was 0.59 LogMAR units, which was not statistically significant. The reduction in CMT from baseline in 6.0 mg group was 133.2 µm (μ) and 3.6 mg group was 110.6 μ, which was not statistically significant. The improvement in contrast from baseline in 6.0 mg group was 0.74 and 3.6 mg group was 0.95, with p value of 0.0002. The re-injection interval was 14.21 weeks in 6.0 mg group and 15.56 weeks for 3.6 mg subgroup. The total number of adverse events in both groups were similar at 70 in 6.0 mg group and 47 in 3.6 mg group with only one grade 4 adverse event occurring in each group.</p><p><strong>Conclusion: </strong>The results of present study show that the safety and efficacy of both doses of Brolucizumab, i.e. 6.0 mg and 3.6 mg, for treating diabetic macular edema is similar. Trial registration Study was registered with Clinical trials registry of India (CTRI ref no. CTRI/2023/06/054105), registered on 14 Nov 2022.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"6"},"PeriodicalIF":1.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of intravitreal dexamethasone implant (Ozurdex^®) in patients with post-surgical macular edema - a real-world scenario.","authors":"Elder Ohara de Oliveira Júnior, Isabel Ahn, Rodrigo Antonio Brant Fernandes, Arthur Gustavo Fernandes","doi":"10.1186/s40942-024-00626-5","DOIUrl":"10.1186/s40942-024-00626-5","url":null,"abstract":"<p><strong>Background: </strong>Clinically significant macular edema (CME) is the leading cause of visual loss after ophthalmologic surgery due to the release of inflammatory mediators promoted by the procedures. We aimed to evaluate the outcomes of intravitreal Ozurdex^® (700 µg dexamethasone) implants as a primary therapeutical option for post-surgical macular edema cases.</p><p><strong>Methods: </strong>Patients with post-surgical macular edema diagnosed by optical coherence tomography (Cirrus SD-OCT) and treated with Ozudex were selected for the current study. Data was retrospectively collected from medical records from January 2020 to December 2022 and included sex, age, laterality, and timeline of treatment (i.e. implant alone or at the time of silicon oil removal in cases requiring vitreorretinal surgery). Complications associated with treatment were also noted as well as the need of further treatments. The structural analysis focused on measuring central macular thickness (CMT-average thickness within the 1 mm circle of the ETDRS) from the internal limiting membrane to the Bruch's membrane complex, as well as the average total macular thickness including parafoveal and perifoveal regions determined by the device (CAT). The functional evaluation was based on the best-corrected visual acuity (VA) measured in logMAR.</p><p><strong>Results: </strong>A total of 46 participants were included (56.2% males, mean age: 60.9 ± 11.2 years old). A statistically significant change was observed in the postoperative versus the preoperative period for all parameters (p < 0.05). The mean VA difference was - 0.17 ± 0.24; CMT was - 109.22 ± 124.85 and CAT was - 14.76 ± 58.95. We observed a significant effect of the moment of Ozurdex implantation on VA improvement, so that cases with implantation at the time of oil removal showed lower improvement than cases with implantation at a distinct timing (Coef. 0.19, 95%CI: 0.02 to 0.36, p = 0.027). Eleven cases (23.9%) required further treatment such as new Ozurdex implantation (8 cases) or surgery (3 cases). Only one case (2.17%) showed increased intraocular pressure and underwent glaucoma surgery.</p><p><strong>Conclusions: </strong>Intravitreal Ozurdex implants significantly improved functional and structural aspects in post-surgical macular edema. The timing of implantation influenced VA improvement, with a distinct step approach showing better outcomes than at the time of oil removal.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"4"},"PeriodicalIF":1.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suprachoroidal injection of triamcinolone acetonide as adjuvant to surgical treatment of epiretinal membrane.","authors":"Francesco Morescalchi, Federico Gandolfo, Vito Romano, Andrea Baldi, Francesco Semeraro","doi":"10.1186/s40942-024-00623-8","DOIUrl":"10.1186/s40942-024-00623-8","url":null,"abstract":"<p><strong>Background: </strong>To analyse the effect of suprachoroidal injection (SChI) of triamcinolone acetonide (TA) on macular thickness (CRT), ectopic inner foveal layer thickness (EIFL-T) and best corrected visual acuity (BCVA) in pseudophakic patients undergoing vitrectomy for epiretinal membrane (iERM) compared to intravitreal injection of TA (IVTA).</p><p><strong>Methods: </strong>Prospective matched comparison of patients undergoing vitrectomy for Govetto stage 3 and 4 iERM. 25 eyes receiving IVTA (G-1) were compared to 23 eyes receiving SChI-TA (G-2) during vitrectomy. Primary outcome was change in BCVA, CRT, EIFL-T before surgery and 1, 3 and 6 months after surgery. Secondary outcome was the incidence of cystoid macular edema (CME).</p><p><strong>Results: </strong>Six months after surgery, G2 had a greater mean reduction in CRT (-222 µm vs -131 µm) and EIFL-T (-200 µm vs -104 µm) than G1. BCVA improved more in G2 than in G1 (p = 0.02). Foveal depression reformed in 43% of cases in G-2 and 16% of cases in G-1. Incidence of postoperative CME was 16% in G-1 and 4.3% in G-2.</p><p><strong>Conclusions: </strong>During vitrectomy for iERM, SChI-TA was more effective than IVTA in reducing CRT and EIFL-T and improving BCVA. SChI-TA was effective in preventing postoperative CME. SChI-TA treatment was safe and reproducible and did not affect postoperative IOP. Trial registration NP6289-June 18th, 2024 (retrospectively registered).</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"2"},"PeriodicalIF":1.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11720571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faricimab efficacy in type 1 macular neovascularization: AI-assisted quantification of pigment epithelium detachment (PED) volume reduction over 12 months in Naïve and switch eyes.","authors":"Jennifer Cattaneo, Paolo Forte, Giovanni Forte, Chiara M Eandi","doi":"10.1186/s40942-025-00629-w","DOIUrl":"10.1186/s40942-025-00629-w","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the efficacy of intravitreal Faricimab in reducing pigment epithelium detachment (PED) and fluid volumes in both treatment-naïve eyes and eyes unresponsive to anti-VEGF mono-therapies, all diagnosed with type 1 macular neovascularization (T1 MNV) over a period of 12-month.</p><p><strong>Methods: </strong>A retrospective, single-center cohort study was conducted at the Jules Gonin Eye Hospital, Lausanne, Switzerland. Clinical records of treatment-naïve and non-responder switch patients presenting T1 MNV secondary to neovascular age-related macular degeneration (nAMD) from September 2022 to March 2023 were reviewed. Patients received a loading dose of three monthly Faricimab injections followed by a treat-and-extend (T&E) regimen. Multimodal imaging, including structural OCT and AI-assisted analysis, was used to quantify PED volumes and related fluid biomarkers at baseline, 3-month, 6-month, and 12-month follow-up. Statistical analyses included linear mixed models to evaluate differences and trends in intraretinal (IRF), subretinal fluid (SRF) and PED volumes.</p><p><strong>Results: </strong>65 eyes of 65 patients were enrolled (female: 70.7%; mean age = 80.7yrs, SD = 6.9yrs). 80% had received anti-VEGF treatment (Switch group) and 20% were treatment-Naïve at baseline. At 12 months, intravitreal treatments were more frequent in the Switch group (mean number = 8.3 vs. 6.0; p = 0.009). BCVA improved at the 12-month follow-up in Naïve eyes (+ 6.9 ETDRS letters from baseline, p = 0.053) and was maintained in Switch eyes. No cases of intraocular inflammation were observed. Significant reduction in SRF and IRF volumes were noted in both groups. A significant reduction in PED volume was observed over the follow-up period in both groups (mean slope = -206 nL, 95%CL = -273/-138; p-value < 0.001).</p><p><strong>Conclusions: </strong>Intravitreal Faricimab significantly reduced PED volumes in both treatment-Naïve and non-responder Switch patients over 12 months. The study highlights Faricimab's potential as an effective treatment option for T1 MNV in nAMD, offering significant improvements in PED volume and related fluid biomarkers.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"3"},"PeriodicalIF":1.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11720305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the reliability of a microperimetry-based method for assessing visual function in the junctional zone of geographic atrophy lesions.","authors":"A Yasin Alibhai, Eric M Moult, Muhammad Usman Jamil, Khadija Raza, Marco U Morales, Ramiro Ribeiro, Caroline R Baumal, James G Fujimoto, Nadia K Waheed","doi":"10.1186/s40942-024-00624-7","DOIUrl":"10.1186/s40942-024-00624-7","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the repeatability of a microperimetry methodology for quantifying visual function changes in the junctional zone of eyes with geographic atrophy (GA) in the clinical trial context.</p><p><strong>Methods: </strong>A post hoc analysis of the OAKS phase III trial was conducted, which enrolled patients with GA secondary to age-related macular degeneration. Microperimetry using a standard 10 - 2 fovea centered grid was performed at baseline and follow-up visits. GA regions were traced on fundus autofluorescence (FAF) images. Two graders independently registered baseline microperimetry images with baseline FAF images in a sampling of 30 eyes from the OAKS study. Agreement between the two graders' assessments of mean sensitivity and the number of scotomatous points within a ± 250 𝜇m GA junctional zone was assessed.</p><p><strong>Results: </strong>The intraclass correlation (ICC) and coefficient of repeatability (CoR) for the mean junctional zone sensitivity were 0.987 and 0.214 dB, respectively. The ICC and CoR for the total number of scotomatous points within the junctional zone were 0.991 and 1.42, respectively.</p><p><strong>Conclusions: </strong>The repeatability of the methodology and its compatibility with standard MP acquisitions appear to make it well-suited for identifying and analyzing retinal sensitivity within high-risk areas of the retina. We present a microperimetry-based methodology for assessing visual function changes in the junctional zone of geographic atrophy lesions using a standard 10 - 2 fovea centered grid in a clinical trial context. The approach's repeatability and compatibility with standard microperimetry grids may make it useful for assessing the effects of GA therapeutics.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of topical conjunctival microbiotic cultures in patients treated with intravitreal injections using antibiotic prophylaxis with 0.3% ofloxacin eye drops.","authors":"Luca Bongiovanni de Miranda Gonçalves, Maria Leticia Lasca Sales Campos, Guilherme Feltrin Barros, Glaucia Luciano da Veiga, Juliana Antoniali Silva, Fernando Luiz Affonso Fonseca, Thaís Moura Gascón, Samantha Sanches de Carvalho, Andrea Karla Ribeiro de Carvalho, Greicy Ellen Pinheiro Fernandes, Vagner Loduca Lima, Tiago Mirco Lima","doi":"10.1186/s40942-024-00604-x","DOIUrl":"10.1186/s40942-024-00604-x","url":null,"abstract":"<p><strong>Background: </strong>Intravitreal injections, a relatively recent treatment in ophthalmology, is being adopted rapidly worldwide and becoming one of the most common therapies in the field. Numerous complications are associated with this treatment, ranging from minor inflammatory ailments to endophthalmitis. We analyzed the conjunctival flora of patients treated with intravitreal injections and topical antibiotics.</p><p><strong>Methods: </strong>The study was a longitudinal prospective analysis of cultures and antibiograms collected from patients who underwent intravitreal injections and topical antibiotics afterwards at the retina clinic in ABC's Medical University.</p><p><strong>Results: </strong>A total of 148 swabs obtained from 98 patients were cultured and underwent antibiotic sensitivity testing. All bacteria were sensitive to vancomycin, and with the exception of Escherichia coli samples, they were also sensitive to a third-generation cephalosporin (ceftriaxone-same class and generation as ceftazidime), both of which are important antibiotics for the treatment of endophthalmitis. The bacteria species were specifically coagulase-negative Staphylococcus sp. 92% of which was penicillin-resistant and 56.9% was resistant to ciprofloxacin, a second-generation fluoroquinolone. The culture results were similar to that described in the literature and showed the same higher prevalence of coagulase-negative Staphylococcus sp. and S. epidermidis. Regarding the antibiotic resistance profiles, vancomycin, a third-generation cephalosporin, and penicillin showed almost identical results to those reported previously. Regarding fluoroquinolones, the incidence of resistant coagulase-negative Staphylococcus sp. was lower than the findings worldwide, but the resistance rates found were: S. aureus (26.7%), S. epidermidis (61.3%), and Staphylococcus sp. (coagulase negative, 56.9%).</p><p><strong>Conclusions: </strong>The current results showed that the typical conjunctival bacteria had higher resistance to fluoroquinolones (although they were not tested specifically to ofloxacin), suggesting a possible selection of resistant bacteria that should not be taken for granted in clinic. However, the same bacteria did not exhibit cross-resistance in the analysis of vancomycin and third-generation cephalosporins. This real-world, longitudinal, prospective study on conjunctival flora analyzed bacterial resistance profiles and contemporary antibiotic use, offering deeper insights into this subject.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"10 1","pages":"99"},"PeriodicalIF":1.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of panretinal photocoagulation versus intravitreal bevacizumab injection on optic disc microcirculation in patients with diabetic retinopathy.","authors":"Hassan Khojasteh, Mohammad Ahadi Fard Moghadam, Masoud Rahimi, Arash Mirzaei, Fariba Ghassemi, Alireza Takzare, Hooshang Faghihi, Elias Khalili Pour, Hamid Riazi-Esfahani","doi":"10.1186/s40942-024-00621-w","DOIUrl":"10.1186/s40942-024-00621-w","url":null,"abstract":"<p><strong>Background: </strong>This retrospective study aimed to compare optic disc vasculature changes in 1 and 3 months after treatment with either panretinal photocoagulation (PRP) or Intravitreal bevacizumab (IVB) in patients with diabetic retinopathy.</p><p><strong>Methods: </strong>A total of 50 eyes of 29 diabetic patients without severe complications were included in this comparative case series. Of these, twenty-eight eyes (15 patients) were assigned to the PRP group, while twenty-two eyes (14 patients) were treated with the biosimilar (IVB) (Stivant^® CinnaGen Co., Iran). Optical tomography angiography (OCTA) was performed to measure optic disc vascular density (VD) as well as retinal nerve fiber layer (RNFL) thickness.</p><p><strong>Results: </strong>The mean age of the enrolled patients was 62.1 ± 8.3 years (40 to 78 years). During follow-up, whole disc VD, inside disc VD and peripapillary VD decreased significantly in the PRP group at month 1 (p = 0.032, p = 0.32, and p = 0.016, respectively) and month 3 (p = 0.004, p = 0.001 and p = 0.011, respectively). There was an insignificant and slight increase for these parameters in the IVB group. (p > 0.05 for all) A comparison of two treatment arms based on mean whole disc VD, inside disc VD, and peripapillary VD changes revealed a significant difference at month 1 (p = 0.009, p = 0.019, and p = 0.002, respectively) and month 3 (p = 0.002, p = 0.015, and p = 0.009, respectively). Peripapillary RNFL thickness increased in the PRP group at month 1 (p = 0.002) and then decreased at month 3 (p = 0.001). During three months of follow-up, the peripapillary RNFL thickness decreased significantly in the IVB group (p = 0.001). Peripapillary RNFL thickness changes were significantly different between treatment groups at month 1 and month 3. (p = 0.001 for both) The RNFL changes during the study did not significantly correlate with peripapillary VD changes in each group (p = 0.231 and p = 372, for PRP and IVB group, respectively).</p><p><strong>Conclusion: </strong>This study demonstrated that IVB and PRP treatments produced distinct short-term microvascular changes in the optic nerve of diabetic retinopathy patients. PRP treatment significantly reduced vascular density in the optic disc and peripapillary region over 3 months, with an initial increase in RNFL thickness followed by a decrease by month 3. In contrast, IVB treatment led to a slight increase in optic disc vascular density while significantly reducing RNFL thickness. No significant correlation was found between changes in RNFL thickness and peripapillary vascular density within either treatment group.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"10 1","pages":"98"},"PeriodicalIF":1.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}