Journal of VitreoRetinal Diseases最新文献

{"title":"Anatomic and Visual Outcomes of Scleral Buckle in Primary Rhegmatogenous Retinal Detachment in the Era of Pars Plana Vitrectomy.","authors":"Naresh Babu Kannan, Kulsum J Sayyad, Muthu Krishnan Vallinayagam, Chitaranjan Mishra, Keya Chakrabarti, Priyalaxmi Chakpram, Kim Ramasamy","doi":"10.1177/24741264241275009","DOIUrl":"10.1177/24741264241275009","url":null,"abstract":"<p><p><b>Introduction:</b> To determine the presenting clinical characteristics of patients with rhegmatogenous retinal detachment (RRD) who underwent scleral buckling and the impact on final visual outcomes and to determine the postoperative primary attachment rate, complications, and subsequent management. <b>Methods:</b> This retrospective observational study comprised patients with RRD who had scleral buckling surgery from January 2016 to December 2021 with a minimum follow-up of 6 months. <b>Results:</b> The study comprised 307 eyes of 290 patients; 97% of eyes were phakic. Primary anatomic attachment was achieved in 93% of eyes. Macula-on detachment had a significant relationship with visual gain, while age, refractive status, number of breaks, configuration of the detachment, traumatic etiology, and lens status did not. Eyes with recurrent detachment did not have a significant visual gain after subsequent pars plana vitrectomy (PPV). <b>Conclusions:</b> Most eyes that underwent scleral bucking were phakic. Macular status played a significant role in the visual prognosis. The primary anatomic attachment rate after scleral buckling surgery is comparable to that after PPV. Thus, scleral buckling is far from being a procedure of the past. Multiple breaks, inferior detachments, and traumatic etiology do not appear to adversely affect the visual outcomes. Multiple vitreoretinal surgeries may not result in a visual gain in cases of recurrent detachment.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264241275009"},"PeriodicalIF":0.5,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622784","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":"Serial OCT Imaging of Spontaneous Closure of a Pediatric Traumatic Macular Hole.","authors":"Andrew S H Tsai, Aaron R Kaufman, R V Paul Chan","doi":"10.1177/24741264241275275","DOIUrl":"10.1177/24741264241275275","url":null,"abstract":"<p><p><b>Purpose:</b> To describe a case of spontaneous closure of a pediatric traumatic macular hole (MH) using serial optical coherence tomography (OCT) imaging. <b>Methods:</b> A single case was evaluated. <b>Results:</b> An 8-year-old girl developed a full-thickness MH in the right eye after sustaining blunt trauma from a bungee cord. She was observed monthly. By 3 months, the MH spontaneously closed, at which time an epiretinal membrane (ERM) developed. Spontaneous release of the posterior hyaloid and ERM at 5 months resulted in a relatively normal foveal contour. At the patient's last follow-up, the visual acuity in the right eye had improved from 20/80 to 20/30. <b>Conclusions:</b> Observation of a pediatric traumatic MH is a viable initial treatment option. Serial OCT imaging was useful in observing the natural history and mechanism behind spontaneous closure of a traumatic MH.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264241275275"},"PeriodicalIF":0.5,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623040","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":"Bilateral Endogenous Endophthalmitis As a First Presentation of <i>Streptococcus pneumoniae</i> Endocarditis.","authors":"Sayena Jabbehdari, Ahmed Sallam","doi":"10.1177/24741264241277306","DOIUrl":"10.1177/24741264241277306","url":null,"abstract":"<p><p><b>Purpose:</b> To present a case of bilateral endogenous endophthalmitis as the first presentation of endocarditis. <b>Methods:</b> A single case was evaluated. <b>Results:</b> A 64-year-old Black woman presented with rapidly progressive bilateral vision loss. The visual acuity was no light perception (NLP) OD and LP OS. The initial diagnosis of infectious endophthalmitis was confirmed by a blood culture positive for <i>Streptococcus pneumoniae</i> and an echocardiogram that indicated endocarditis. Despite treatment with intravitreal antibiotics and vitrectomy, the patient's visual prognosis remained poor. <b>Conclusions:</b> Although in general the visual prognosis for <i>S pneumoniae</i>-related endogenous endophthalmitis is poor, early detection and identification of the primary infection source are crucial and can significantly improve the chance of the patients' survival.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264241277306"},"PeriodicalIF":0.5,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622966","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":"Drusen Disappearance After Retinal Detachment Repair.","authors":"Ishrat Ahmed, David M Wu","doi":"10.1177/24741264241276603","DOIUrl":"10.1177/24741264241276603","url":null,"abstract":"<p><p><b>Purpose:</b> To describe a case of a drusenoid pigment epithelial detachment that resolved after retinal detachment (RD) repair using multimodal imaging. <b>Methods:</b> A single case was evaluated. <b>Results:</b> An 83-year-old woman with intermediate age-related macular degeneration had repair of a rhegmatogenous RD with subsequent resolution of macular drusen and improved visual acuity and metamorphopsia. <b>Conclusions:</b> RD repair may be associated with resolution of drusen, leading to improved functional outcomes.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264241276603"},"PeriodicalIF":0.5,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622990","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":"Bevacizumab First in DRCR Protocol AC vs Real-World Physician Treatment Choice for Diabetic Macular Edema: Two-Year Cost Analysis.","authors":"Dilraj S Grewal, Ella Leung, Miguel Busquets, Philip Niles, Dan A Gong, Anton M Kolomeyer, Nitika Aggarwal, Nick Boucher, Jill Blim, Judy E Kim, Reginald Sanders, Paul Hahn","doi":"10.1177/24741264241275283","DOIUrl":"10.1177/24741264241275283","url":null,"abstract":"<p><p><b>Purpose:</b> To compare the modeled costs of the Protocol AC bevacizumab-first treatment protocol (with a switch to aflibercept for sub-responders) with real-world costs for treatment-naïve patients with diabetic macular edema (DME) over a 2-year period. <b>Methods:</b> Published data from the Diabetic Retinopathy Clinical Research Network (DRCR) Protocol AC bevacizumab-first arm (154 eyes) were used to model 2-year treatment costs. Real-world costs were modeled using data from the Vestrum Health electronic medical records database from a 2016 to 2018 cohort of treatment-naïve eyes with DME (n = 1062) treated with antivascular endothelial growth factor monotherapy. The visual acuity (VA) before treatment in the real-world cohort was matched to Protocol AC. A secondary cost analysis further matched VA gains after treatment in the real-world cohort (n = 346) to Protocol AC. <b>Results</b>: In Protocol AC, the modeled 2-year DME treatment cost in the bevacizumab-first arm was $18,952, with a mean of 16.1 injections over 22.5 visits and 70% of eyes being switched to aflibercept by year 2. (Within 2 years, 57% of injections were bevacizumab and 43% were aflibercept.) Over the same period, the modeled 2-year real-world cost ($11,459) was 40% lower, with a mean of 8.6 injections over 13.8 visits (42% bevacizumab, 45% aflibercept, 13% ranibizumab). Even when matched for baseline VA and a 14-letter VA gain over 2 years, the real-world cost ($15,394) was still 19% lower than the modeled cost in the Protocol AC bevacizumab-first arm. <b>Conclusions:</b> The real-world cost of treating DME over 2 years was significantly lower than the Protocol AC bevacizumab-first cost. Application of Protocol AC findings into real-world utilization, as with step therapy mandates, should only be considered if the same intensive protocol could be followed. These data suggest that existing real-world costs that reflect physician choice are already significantly lower than protocol-mandated step therapy, even when controlling for similar VA outcomes.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264241275283"},"PeriodicalIF":0.5,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622847","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":"Isolated Recurrence of Diffuse Large B-Cell Lymphoma Predominantly in the Iris and Ciliary Body.","authors":"Amit V Mishra, Shangjun Jiang, Matthew T S Tennant, Mark E Seamone","doi":"10.1177/24741264241276602","DOIUrl":"10.1177/24741264241276602","url":null,"abstract":"<p><p><b>Purpose:</b> To describe a single case of systemic lymphoma recurring in the iris and ciliary body. <b>Methods:</b> A retrospective case review was performed. <b>Results:</b> A 75-year-old woman presented to the retina service with an iris mass in the left eye. Her medical history was significant for previous systemic diffuse large B-cell lymphoma treated with systemic chemotherapy. Aqueous sampling was significant for recurrence of the disease. Local therapy with intravitreal (IVT) methotrexate was initiated. Although there was initial improvement, an increased interval between injections led to disease recurrence. External beam radiation to the left eye was then applied, leading to a complete clinical remission. <b>Conclusions:</b> Systemic lymphoma presenting in the iris is a rare manifestation that should be considered on the differential for an amelanotic iris lesion. Although monotherapy with IVT methotrexate did not control the ocular disease in this patient, subsequent external beam radiation resulted in complete clinical remission.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264241276602"},"PeriodicalIF":0.5,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623035","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":"Improvement in Cystoid Macular Edema Secondary to Systemic Bevacizumab in a Patient With Coats Plus Syndrome.","authors":"Saima Khan, Cole A Martin, Shannon Scarboro, Edward Wood, Clio A Harper","doi":"10.1177/24741264241276601","DOIUrl":"10.1177/24741264241276601","url":null,"abstract":"<p><p><b>Purpose:</b> To report a pediatric case of Coats plus syndrome that initially presented resembling familial exudative vitreoretinopathy (FEVR). <b>Methods:</b> A single case was analyzed. <b>Results:</b> A pediatric patient was referred at 2 years of age to the retina clinic for exotropia and decreased visual acuity in the right eye and was found to have a dense vitreous hemorrhage. She later developed persistent gastrointestinal bleeding requiring regular blood transfusions and intravenous bevacizumab. Treatment with systemic bevacizumab resolved the patient's cystoid macular edema (CME). Although her presentation and examination were initially suggestive of FEVR, genetic analysis revealed heterozygous biallelic mutations in the <i>STN1</i> gene, mutations that are known to be associated with Coats plus syndrome. <b>Conclusions:</b> Coats plus syndrome is a rare and life-threatening microangiopathy that affects the retina, central nervous system, and gastrointestinal system. The patient's resulting CME significantly improved with intravenous bevacizumab.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264241276601"},"PeriodicalIF":0.5,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623009","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":"Early Presentation of Successive Acute Retinal Necrosis Decades After Initial Infection.","authors":"Hao-Tinh Le, Natasha Kesav, Ankur Mehra, Mohamed Soliman, Warren Sobol","doi":"10.1177/24741264241276606","DOIUrl":"10.1177/24741264241276606","url":null,"abstract":"<p><p><b>Purpose:</b> To describe the early presentation of successive acute retinal necrosis (ARN) decades after the initial infection. <b>Methods:</b> A single case and its findings were analyzed. <b>Results:</b> A 62-year-old man with a remote history of left-sided ARN presented for evaluation of right-sided blurry vision. An examination showed 1+ anterior chamber cells and mild vitritis with multiple small patches of white retinitis. The lesions progressed despite treatment with oral antivirals, eventually requiring multiple doses of intravitreal antiviral agents and hospitalization for intravenous antiviral therapy. Despite a characteristic clinical picture consistent with ARN, multiple aqueous samples tested negative for viral etiologic agents. <b>Conclusions:</b> ARN is a rapidly progressive disease, and the diagnosis is clinical. Our patient was treated aggressively with antiviral therapy on the basis of the clinical picture without confirmatory testing, which remained negative. The lesions responded well to treatment and 20/25 visual acuity was maintained. Regardless of confirmatory testing, timely treatment is critical in cases of suspected ARN.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264241276606"},"PeriodicalIF":0.5,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622994","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":"Macular Edema Causing Spontaneous Closure of a Macular Hole After Unsuccessful Primary Surgical Repair.","authors":"Cuneyt Ozkardes, Riley N Sanders, H Logan Brooks, Ahmed Shakarchi","doi":"10.1177/24741264241271733","DOIUrl":"10.1177/24741264241271733","url":null,"abstract":"<p><p><b>Purpose:</b> To describe the spontaneous closure of a chronic, persistent, stage 4 full-thickness macular hole (FTMH) that did not respond to surgical treatment but closed after an episode of cystoid macular edema (CME) secondary to acute iritis. <b>Methods:</b> A single case was evaluated. <b>Results:</b> A 71-year-old woman presented with decreased vision in the left eye for 6 months. A chronic stage 4 FTMH was identified. Surgical treatment consisting of pars plana vitrectomy and internal limiting membrane peeling was unsuccessful, and the patient declined a repeat operation. Two months later, she presented with acute iritis and CME. Imaging showed incidental closure of the FTMH. The iritis resolved after a sub-Tenon triamcinolone injection. At the 3-month follow-up, the FTMH remained closed without CME or iritis. <b>Conclusions:</b> This case highlights the potential importance of CME in the closure of a chronic FTMH after unsuccessful primary surgical repair and suggests clinicians should consider this mechanism in the management of chronic FTMH.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264241271733"},"PeriodicalIF":0.5,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623037","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":"Unified Approach to Treating Exogenous Endophthalmitis With Immediate Vitrectomy.","authors":"Graeme K Loh, Amit V Mishra, Mark Seamone, Matthew Tennant","doi":"10.1177/24741264241275246","DOIUrl":"10.1177/24741264241275246","url":null,"abstract":"<p><p><b>Purpose:</b> To analyze the outcomes and complications of immediate (within 24 hours) small-gauge (23-gauge, 25-gauge) pars plana vitrectomy (PPV) for all causes of exogenous endophthalmitis. <b>Methods:</b> A retrospective case series was evaluated. <b>Results:</b> The study included 107 patients who had immediate PPV for exogenous endophthalmitis between 2016 and 2022. The primary outcome measures were the change from baseline best-corrected visual acuity (BCVA) to the final follow-up and the complications after PPV. Causes of exogenous endophthalmitis included intravitreal injections (62.6%), PPV (18.7%), cataract surgery (11.2%), glaucoma surgery (5.6%), and trauma (1.9%). The most common complications were retinal detachment (17.8%) and secondary glaucoma (9.3%). The mean logMAR BCVA improved significantly from the initial diagnosis to the final follow-up (2.26 vs 1.21) (<i>P</i> < .0001). <b>Conclusions:</b> In most cases, immediate small-gauge vitrectomy for exogenous endophthalmitis leads to an improvement in VA, regardless of the VA at presentation. Patients should be counseled about the potential risks associated with PPV surgery.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264241275246"},"PeriodicalIF":0.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623133","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}