Ophthalmology. Retina最新文献

{"title":"Outcomes and Need for Additional Interventions after Intravitreal Bevacizumab for Retinopathy of Prematurity.","authors":"Ally J Sun, Brisa Y Garcia, Hank Patrick, Yu-Guang He, Angeline L Wang","doi":"10.1016/j.oret.2024.11.014","DOIUrl":"10.1016/j.oret.2024.11.014","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the outcomes of premature infants diagnosed with retinopathy of prematurity (ROP) that were treated with intravitreal bevacizumab (IVB), as well as the need for further treatment after injection.</p><p><strong>Design: </strong>Retrospective case series.</p><p><strong>Participants: </strong>Seventy-three premature infants born between 2016 and 2020 at a large county hospital and children's hospital.</p><p><strong>Methods: </strong>Chart review was performed and patient demographics, neonatal intensive care unit (NICU) course, ROP exams, and treatment were collected.</p><p><strong>Main outcome measures: </strong>Rates of recurrent ROP disease, complete vascularization, persistent avascular retina (PAR), as well as rates of secondary and tertiary laser photocoagulation, IVB, or pars plana vitrectomy.</p><p><strong>Results: </strong>Infants included in this study were born at a median gestational age (GA) of 24.6 weeks (range, 23.0-30.1) and a median birth weight of 670 g (range, 370-1080). Patients received their IVB injection at a median postmenstrual age (PMA) of 36.4 weeks (range, 16.0-87.9). Five patients died during their NICU course and did not have long-term follow-up. Of the remaining patients, 24 (33%) experienced complete vascularization after 1 injection; 13 (18%) experienced regression followed by disease recurrence necessitating additional interventions; 5 (7%) had persistent disease and did not experience any regression requiring laser treatment or a second IVB injection; and 26 (36%) experienced regression with PAR. Patients with persistent or recurrent ROP had a significantly lower GA than other patients in the study (P < 0.05).</p><p><strong>Conclusions: </strong>For one-third of premature patients, 1 IVB injection was sufficient for ROP regression and complete vascularization of the retina. The remaining patients required some form of additional intervention after their injection, with a majority receiving laser for PAR. One-fifth of patients experienced disease recurrence up to 58 weeks PMA. Future studies should be performed on PAR prevalence and presentations to explore how long patients with PAR should be monitored.</p><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Duration of Exposure to Intraretinal Fluid on Visual Outcomes in Neovascular Age-Related Macular Degeneration.","authors":"Nathan C Steinle, April J McCullough, Fabiana Q Silva, Weiming Du, Hadi Moini, Rishi P Singh","doi":"10.1016/j.oret.2024.12.018","DOIUrl":"https://doi.org/10.1016/j.oret.2024.12.018","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of total duration of intraretinal fluid (IRF) exposure on visual acuity and vision-related quality of life in patients with neovascular age-related macular degeneration (nAMD).</p><p><strong>Design: </strong>A post hoc analysis of integrated data from the VIEW 1 and VIEW 2 trials.</p><p><strong>Participants: </strong>Patients with nAMD.</p><p><strong>Methods: </strong>Patients receiving intravitreal ranibizumab 0.5 mg every 4 weeks (Rq4) or intravitreal aflibercept injection 2 mg every 4 weeks (IAI 2q4) or every 8 weeks (IAI 2q8) were evaluated. Data were pooled across treatment groups, and the duration of IRF exposure was assessed by quartiles (Q1: ≤2 weeks; Q2: 3-≤8 weeks; Q3: 9≤18 weeks; Q4: >18 weeks). Changes from baseline in visual acuity and vision-related quality of life were evaluated by quartiles of duration of IRF exposure in the pooled treatment group and each treatment group.</p><p><strong>Main outcome measures: </strong>Mean changes from baseline in best-corrected visual acuity (BCVA) and improvement in vision-related quality of life as assessed via National Eye Institute Visual Function Questionnaire-25 (VFQ-25) composite and subscale scores at Week 52.</p><p><strong>Results: </strong>A total of 1804 patients were evaluated. In the pooled analysis, mean BCVA gains from baseline at Week 52 for Q1, Q2, Q3, and Q4 were +10.9, +10.1, +9.4, and +6.6 letters, respectively (LS mean difference Q4-Q1 [95%CI]; -4.3 [-6.1, -2.5]). Mean changes from baseline to Week 52 in VFQ-25 composite score for Q1, Q2, Q3, and Q4 were +5.9, +6.6, +6.1, and +4.0 points, respectively (-1.9 [-3.6, -0.2]). A similar trend was observed across VFQ-25 subscales, with patients in Q4 generally experiencing less improvement versus Q1. When BCVA gains were assessed by quartiles of duration of IRF exposure within each treatment group, mean BCVA gains for Q1, Q2, Q3, and Q4 were +11.0, +11.1, +9.3, and +5.8 letters for Rq4 (nominal P<0.05; Q4 vs. Q1); +10.7, +9.7, +9.2, and +7.7 letters for IAI 2q4; and +11.3, +11.2, +8.6, and +6.3 letters for IAI 2q8 (nominal P<0.05; Q4 vs. Q1), respectively.</p><p><strong>Conclusions: </strong>Increasing duration of IRF exposure was associated with lower visual gains and less improvement in vision-related quality of life in patients with nAMD.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endophthalmitis After Bilateral Same-Day vs Unilateral Intravitreal Injection.","authors":"Brendan K Tao, Ryan S Huang, Andrew Mihalache, Jiwon Hwang, Mariam Issa, Sumana Naidu, Marko M Popovic, Charles C Wykoff, Bryon McKay, Peter J Kertes, Peng Yan, David T Wong, Radha P Kohly, Rajeev H Muni","doi":"10.1016/j.oret.2024.12.005","DOIUrl":"https://doi.org/10.1016/j.oret.2024.12.005","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eroded Gore-Tex Scleral Sutures and Endophthalmitis in Atopic Keratoconjunctivitis.","authors":"Joseph Colcombe, Leela Raju, Yasha Modi","doi":"10.1016/j.oret.2024.11.001","DOIUrl":"https://doi.org/10.1016/j.oret.2024.11.001","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ophthalmological manifestations in a diverse pediatric population with Type I and Type II Stickler syndrome.","authors":"Andy Drackley, Hantamalala Ralay Ranaivo, Valerie Allegretti, Alexander Y Ing, Safa Rahmani, Michael P Blair, Michael J Shapiro, Brenda L Bohnsack, Jennifer L Rossen","doi":"10.1016/j.oret.2024.12.014","DOIUrl":"https://doi.org/10.1016/j.oret.2024.12.014","url":null,"abstract":"<p><strong>Objective: </strong>To characterize and compare our cohorts of pediatric patients with type I and type II Sticker syndrome, with a focus on ophthalmological features.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Subjects: </strong>Twenty-six patients (22 families) with clinical and genetic diagnoses of types I or II Stickler syndrome.</p><p><strong>Methods: </strong>Review of clinical notes and molecular diagnoses.</p><p><strong>Main outcome measures: </strong>Ophthalmic and systemic features and responses to laser treatment.</p><p><strong>Results: </strong>Our cohorts had an equal number of patients with COL2A1-related/Type I and COL11A1-related/Type II Stickler syndrome (n=13; 50%) and include 12 previously unpublished variants. Patients in Type I and II cohorts had similar average ages at presentation and length of follow-up. There were more self-identifying Hispanic patients among the Type II cohort compared to Type I (69% versus 39%, p = 0.145). Individuals with Type II on average had significantly higher myopia compared to those with Type I (p=0.008). Retinal detachment in at least one eye was diagnosed in 39% of the Type I cohort (7 eyes, 5 patients) and 46% of the Type II (7 eyes, 6 patients). Laser prophylaxis was utilized in 69% of patients with Type I and 85% with Type II. Unilateral retinal detachment following laser prophylaxis occurred in one patient with Type I and two with Type II. All identified COL2A1 variants in the Type I cohort are expected to cause disease through haploinsufficiency, and 92% of COL11A1 variants in the Type II cohort are presumed to be in-frame and exert a dominant negative effect, consistent with historical reporting.</p><p><strong>Conclusions: </strong>The proportion of Types I and II Stickler syndrome are equal in our pediatric population, and patients self-identifying as Hispanic comprised the majority of Type II, supporting the need for additional study of possible under-detection of Type II in diverse populations. Our Type II cohort showed higher myopia and incidence of Pierre Robin sequence, and similar rates of retinal detachment and systemic manifestations compared to the Type I cohort. Our datasets provide important data regarding the safety and short-term effectiveness of laser prophylaxis, but larger and longer-term studies are needed, especially for those with Type II Stickler syndrome.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foveal avascular zone enlargement correlates with visual acuity decline in patients with diabetic retinopathy.","authors":"Brandon V Duffy, Daniela Castellanos-Canales, Nicole L Decker, Hunter Jung-Ah Lee, Taffeta C Yamaguchi, Elizabeth Pearce, Amani A Fawzi","doi":"10.1016/j.oret.2024.12.015","DOIUrl":"https://doi.org/10.1016/j.oret.2024.12.015","url":null,"abstract":"<p><strong>Purpose: </strong>The foveal avascular zone (FAZ) area has been explored as a measure of macular ischemia in diabetic retinopathy (DR) but is limited by its wide variability even in healthy individuals. We hypothesized that FAZ enlargement, which we defined as the difference between the functional FAZ (on optical coherence tomography angiography; OCTA) and structural FAZ (en face OCT), may be a more accurate metric of macular ischemia. In this study, we test the hypothesis that FAZ enlargement is associated with decreased best-corrected visual acuity (BCVA) and low luminance visual acuity (LLVA) and performs better than the functional FAZ as a marker of vision loss.</p><p><strong>Design: </strong>Cross-sectional study SUBJECTS: Patients with diabetes mellitus (DM) and a wide range of DR severity METHODS: For 264 eyes from 174 patients, we measured BCVA and LLVA using ETDRS letter scores. Averaged en face OCT and OCTA scans identified the structural and functional FAZ areas, respectively. Spearman's rho quantified relationships between FAZ enlargement and VA, which were further assessed with linear mixed-effects models that accounted for potential confounders, which were identified as significant factors on univariate analysis.</p><p><strong>Main outcome measures: </strong>Relationship between FAZ enlargement (or functional FAZ area) and visual function RESULTS: Age, axial length, lens status (phakic or pseudophakic), hypertensive status, ischemic heart disease, cerebrovascular disease, renal disease, dyslipidemia, DR severity, and functional FAZ area correlated with BCVA on univariate analysis. Age, BMI, hypertension, ischemic heart disease, renal disease, dyslipidemia, smoking status, DR severity, and functional FAZ area correlated with LLVA on univariate analysis. FAZ enlargement demonstrated a weak negative correlation with BCVA (ρ = -.364, p < .001) and LLVA (ρ = -.306, p < .001), which remained significant in mixed-effects regression analysis. Functional FAZ area was not a significant predictor of BCVA or LLVA in models where FAZ enlargement was also included as a predictor. Model comparison using ANOVA indicated that inclusion of FAZ enlargement improved the prediction of BCVA (χ²=5.62, p = .018) and LLVA (χ² = 4.99, p = .025).</p><p><strong>Conclusion: </strong>FAZ enlargement performed better than the functional FAZ providing an improved imaging metric of the influence of foveal ischemia on vision impairment in DR.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yasunari Nodules: A Diagnostic Criterion for Neurofibromatosis Type 1.","authors":"Alba Gómez-Benlloch, Julia N Widmer-Pintos, Stephany Carrillo","doi":"10.1016/j.oret.2024.11.012","DOIUrl":"https://doi.org/10.1016/j.oret.2024.11.012","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cell-Free DNA from Aqueous and Dilute Vitreous Improves Detection of Vitreoretinal Lymphoma.","authors":"Noah A Brown, Daniel A Balikov, Daniel Boyer, Bryan L Betz, Amir Behdad, Thérèse M Sassalos, Hakan Demirci, Rajesh C Rao","doi":"10.1016/j.oret.2024.12.010","DOIUrl":"https://doi.org/10.1016/j.oret.2024.12.010","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the Editor: Reverse Pupillary Block after Implantation of a Sutureless Scleral Fixation Carlevale Intraocular Lens.","authors":"","doi":"10.1016/j.oret.2024.12.013","DOIUrl":"https://doi.org/10.1016/j.oret.2024.12.013","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local OCT Structural Correlates of Deep Visual Sensitivity Defects in Early Atrophic Age-Related Macular Degeneration.","authors":"Abera Saeed, Callum Gin, Lauren A B Hodgson, Maxime Jannaud, Xavier Hadoux, Emily K Glover, Erin E Gee, Peter van Wijngaarden, Robyn H Guymer, Zhichao Wu","doi":"10.1016/j.oret.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.oret.2024.12.007","url":null,"abstract":"<p><strong>Purpose: </strong>To determine local OCT structural correlates of deep visual sensitivity defects (threshold of ≤10 decibels on microperimetry) in early atrophic age-related macular degeneration (AMD).</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Participants: </strong>Forty eyes from 40 participants, with at least incomplete retinal pigment epithelium (RPE) and outer retinal atrophy (iRORA), or more advanced atrophic lesion(s).</p><p><strong>Methods: </strong>Participants underwent at least two targeted, high-density microperimetry tests of atrophic lesions of interest in one eye, and high-density 3×3 mm volume scans of that region on a swept-source OCT angiography device, all at a single visit. Seven OCT-defined features of atrophy were manually annotated: hypertransmission, RPE attenuation/disruption, complete RPE loss, ellipsoid zone (EZ) disruption, external limiting membrane (ELM) disruption, subsidence of the outer plexiform layer (OPL) and inner nuclear layer (INL), and/or hyporeflective wedge-shaped band, and outer nuclear layer (ONL) thickness.</p><p><strong>Main outcome measures: </strong>Association between OCT-defined features of atrophy and presence of a deep visual sensitivity defect at a local, pointwise level.</p><p><strong>Results: </strong>All OCT-defined features of atrophy were individually associated with the presence of a deep visual sensitivity defect at a pointwise level in univariable mixed-effects logistic regression analyses (P < 0.001 for all). However, only hypertransmission, complete RPE loss, ELM disruption, and ONL thickness remained significantly and independently associated with deep visual sensitivity defects in a multivariable analysis (P ≤ 0.011). A prediction model incorporating these four OCT features (partial area under the curve [pAUC] at ≥90% specificity = 0.80) outperformed models using any single feature alone in predicting the presence of deep visual sensitivity defects (pAUC = 0.65 to 0.78 respectively; P ≥ 0.040).</p><p><strong>Conclusions: </strong>The study identified hypertransmission, complete RPE loss, ELM disruption, and ONL thickness as key OCT-defined features of atrophy independently associated with deep visual sensitivity defects. These findings are important when considering anatomical outcome measures for evaluating interventions for early atrophic AMD that are most likely to capture beneficial treatment effects that will be accompanied by evidence of functional preservation if measured directly.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}