Ophthalmology. Retina最新文献

{"title":"Alcohol Consumption and Risk of Age-Related Macular Degeneration and Geographic Atrophy Progression: AREDS2 Report 34.","authors":"Cameron Duic, Emily Vance, Elvira Agrón, Tiarnan D L Keenan","doi":"10.1016/j.oret.2024.11.006","DOIUrl":"https://doi.org/10.1016/j.oret.2024.11.006","url":null,"abstract":"<p><strong>Purpose: </strong>To examine potential relationships between alcohol consumption and age-related macular degeneration (AMD) progression, including progression to late AMD and geographic atrophy (GA) enlargement rate.</p><p><strong>Design: </strong>Post hoc analysis of cohorts within the Age-Related Eye Diseases Study 2 (AREDS2).</p><p><strong>Participants: </strong>6670 eyes (of 3673 participants) with no late AMD at baseline; 1143 eyes (of 841 participants) with GA at ≥2 consecutive visits.</p><p><strong>Methods: </strong>Color fundus photographs were collected at annual study visits and graded centrally for late AMD, GA area, and GA proximity. Alcohol consumption was calculated by food frequency questionnaire. Regression analyses of disease progression were performed according to alcohol consumption.</p><p><strong>Main outcome measures: </strong>Progression to late AMD and its subtypes; GA area-based progression; GA proximity-based progression.</p><p><strong>Results: </strong>Over mean follow-up of 3.8 years, 40.2% of eyes progressed to late AMD. In men, with alcohol tertile 1 (no regular consumption) as reference, hazard ratios for progression to late AMD were 0.69 (95% CI 0.55-0.87, p=0.0015) for tertile 2 and 0.85 (0.71-1.02, p=0.079) for tertile 3. In women, hazard ratios were 1.12 (0.95-1.31, p=0.17) and 0.85 (0.72-1.00, p=0.046), respectively. Over mean follow-up of 3.1 years, GA area-based progression was significantly faster in women than men, at 0.295 (95% CI 0.278-0.311) and 0.260 mm/year (0.241-0.279), respectively (p=0.007). In men, area-based progression differed significantly by alcohol tertile (p=0.0001), at 0.275 (0.248-0.303), 0.183 (0.143-0.223), and 0.280 mm/year (0.254-0.306) in tertiles 1-3, respectively. In women, the area-based rate did not differ significantly by alcohol tertile (p=0.11). In men only, CDC-defined heavy drinking was associated with faster progression (p=0.024), at 0.306 (0.262-0.349) vs 0.252 mm/year (0.233-0.270). In 808 eyes with non-central GA, GA proximity-based progression did not differ significantly by alcohol tertile (p=0.55).</p><p><strong>Conclusions: </strong>Moderate alcohol consumption is associated with decreased risk of progression to late AMD in men. GA progression is faster in women, but its relationship with alcohol consumption is much stronger in men. In men, moderate consumption is associated with slower GA progression and higher consumption with faster progression. Although some of these associations may also relate to confounding, they might suggest that individuals with GA should avoid high alcohol consumption.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639458","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":"Disparities in US retinoblastoma presentation, management and local recurrence in the National Cancer Database, 2004-2016.","authors":"Jodi Y So, Suzann Pershing, Erqi Liu Pollom, Susan M Hiniker, Armin R Afshar","doi":"10.1016/j.oret.2024.11.005","DOIUrl":"https://doi.org/10.1016/j.oret.2024.11.005","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate patient-level differences in retinoblastoma presentation, treatments, and outcomes within the United States.</p><p><strong>Design: </strong>Retrospective registry-based analysis.</p><p><strong>Participants: </strong>1,404 retinoblastoma cases in the National Cancer Database, 2004-2016, a US-based cancer registry.</p><p><strong>Methods: </strong>Patient characteristics and treatments were investigated over time. Primary treatment was classified as enucleation, local tumor destruction, chemotherapy, and/or radiation. Multivariable logistic regression models evaluated extraocular disease at presentation, treatment, and local recurrence following primary globe-sparing therapy.</p><p><strong>Main outcome measures: </strong>Odds ratios for extraocular disease at presentation; primary treatment modality; local recurrence after primary globe-sparing therapy.</p><p><strong>Results: </strong>Extraocular disease affected 13% of patients at presentation (N=178). All-cause mortality among the entire cohort was 3.1% (n=44) at last follow-up Those who were non-white, uninsured or had government-funded insurance, or with non-metropolitan residence had significantly greater odds of extraocular disease (OR 2.21-3.64 for non-white vs. white non-Hispanic patients, OR 2.05-2.95 for uninsured or Medicaid/Medicare/government-funded vs. private/commercial insurance, and OR 1.80 for non-metropolitan vs. metropolitan residence). Between 2004-2016, utilization of chemotherapy (55% to 73%) and local tumor destruction (17% to 27%) increased. Enucleations remained over-represented among Hispanic patients (63% received enucleation in 2016, vs. 35% non-Hispanic patients; OR=1.83, (95% CI 1.22-2.75) for enucleation among Hispanic vs. white, non-Hispanic patients). Patients with Medicaid/Medicare/government insurance and non-metropolitan residence also had higher odds of enucleation, and non-metropolitan patients had higher odds of local recurrence after primary globe-sparing therapy.</p><p><strong>Conclusions: </strong>Despite overall decline in enucleation and increase in globe-sparing therapy between 2004-2016, Hispanic, Medicaid/Medicare/government-insured, and non-metropolitan patients continued to have higher odds of extraocular disease at presentation and higher odds of undergoing enucleation as primary therapy. This suggests limitations in access to care and that shifts towards globe-sparing treatment (chemotherapy and local tumor destruction) did not occur equally across all patient groups. Further investigations into these disparities is warranted.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625298","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":"Bilateral Anti VEGF on Same Day-Investigation on Safety in Retinopathy of Prematurity (BASISROP)- A Multicenter retrospective study.","authors":"Anil Babanrao Gangwe, Anjali Agrawal, Subhadra Jalali, Alay Banker, Tapas Padhi, Parag Shah, Renu P Rajan, Sucheta Kulkarni, Shilpi Shah, Rekha Singhal, Pranab Das, Ajay Kapoor, Anand Vinekar, Snehal Bavaskar, Vasumathy Vedantham, Gaurav Sanghi, Shashwat Bhattacharya, Ahan Banker, Anita Gaikwad, Shivani Shrivastava, Sameera Nayak, Bhavik Panchal, Deepshikha Agrawal, Raj Vardhan Azad","doi":"10.1016/j.oret.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.oret.2024.11.004","url":null,"abstract":"<p><strong>Purpose: </strong>To report incidence of procedure related complications in preterm infants with ROP treated with intravitreal anti vascular endothelial growth factors (anti VEGF) injection in both eyes on same day DESIGN: Retrospective, multicenter case series SUBJECTS: Preterm infants with ROP treated with anti VEGF bilaterally on same day METHODS: Intervention: All included infants underwent intravitreal anti VEGF injection in both eyes under aseptic precautions in ophthalmic operation theatre (OT) or neonatal intensive care unit (NICU). Postoperative examination was performed to look for procedure related complications MAIN OUTCOME MEASURES: Incidence of procedure related complication (Presumed endophthalmitis, intraocular inflammation, lens injury, vitreous hemorrhage, retinal tear) in the study cohort. To study association of indication, type of anti VEGF, type of needle used, setting of procedure, site of injection (distance from limbus) and experience of the treating ophthalmologist with the complications.</p><p><strong>Results: </strong>9984 eyes of 4992 infants were analysed. The procedure was most commonly performed in ophthalmic OT (8258, 82.7%) using 29G (4514, 45.2%) needle between 1-1.5 mm (9984, 100%) from limbus. Aggressive retinopathy of prematurity was the most common indication for anti VEGF use (4866, 48.7%) while Bevacizumab was the most commonly used anti VEGF agent (8642, 86.6%). Overall, 26 eyes (0.3%) had procedure related complications. Lens injury (15, 0.15%) and presumed endophthalmitis (7, 0.07%) were most common complications. One eye had culture proven endophthalmitis with Pseudomonas aeruginosa. No case of bilateral endophthalmitis was noted. Endophthalmitis was not associated with setting of procedure or type of anti VEGF used, while risk of lens injury was seven times higher when performed in NICU and 30 times higher when performed by an ophthalmologist with < 1year of experience in injecting anti VEGF in preterm infants.</p><p><strong>Conclusions: </strong>The incidence of presumed endophthalmitis after bilateral same day anti VEGF in infants with ROP is 0.07%. These infants can be treated in both eyes on same day with the anti VEGFs and needles (29-32G) evaluated in this study, with emphasis on the direction of needle parallel to visual axis. Extra precaution is advocated if the procedure is planned in NICU or by an ophthalmologist with limited experience.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625275","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":"Novel Finding of Focal Scleral Defects in a Sclerochorioretinal Coloboma.","authors":"Savithiri Palanivel, Anand Rajendran","doi":"10.1016/j.oret.2024.10.011","DOIUrl":"https://doi.org/10.1016/j.oret.2024.10.011","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625301","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":"Widefield Swept-Source OCT Angiography of Takayasu Retinopathy.","authors":"Yanping Zhou, Jinhui Dai, Yongjin Zhang","doi":"10.1016/j.oret.2024.10.008","DOIUrl":"https://doi.org/10.1016/j.oret.2024.10.008","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625308","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":"CLINICAL AND HISTOPATHOLOGICAL FINDINGS IN JALILI SYNDROME.","authors":"Maria Franca, Joana Providência, Guilherme Castela, Daniela Patrício, Inês Santos Sousa, António Francisco Ambrósio, Celso Henrique Alves, João Pedro Marques","doi":"10.1016/j.oret.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.oret.2024.11.002","url":null,"abstract":"<p><strong>Purpose: </strong>To correlate histopathological findings in an eye with Jalili syndrome with clinical and imaging results available before enucleation.</p><p><strong>Design: </strong>Case report with histopathological analysis.</p><p><strong>Subjects: </strong>Histopathological analysis of an enucleated eye from a 63-year-old woman diagnosed with Jalili syndrome.</p><p><strong>Methods: </strong>Age at diagnosis, symptoms, personal and family history, as well as genetic testing results and previous retinal imaging were retrieved from the patient file. The ocular specimen was dissected, retinal sections prepared, and analysis with Hematoxylin Eosin staining and Fluorescent Immunohistochemistry was performed. The histopathological findings were compared with the patient's imaging results available before enucleation.</p><p><strong>Results: </strong>The ocular specimen analyzed belonged to a 63-year-old woman with Jalili Syndrome, homozygous for the likely pathogenic c.971T>C p.(Leu324Pro) variant in the CNNM4 gene (NM_020184.3). This patient had no light perception bilaterally and suffered from bilateral painful, severe dry eye, refractory to conservative treatment for seven years before enucleation. At one month follow-up after enucleation and orbital implant placement, the socket was fully recovered, and a custom ocular prosthesis was adapted. The patient experienced total pain relief, improved quality of life, and a good cosmetic result. The histopathological analyses revealed loss of photoreceptor cells, accumulation of autofluorescent material in the subretinal space, partial preservation of the inner retinal lamination, Müller glial cell disorganization and increased number of microglial cells in the nuclear layers.</p><p><strong>Conclusion: </strong>Our findings highlight the severe nature of this inherited retinal degenerative disease with significant damage to the outer retinal layers, absence of synaptic terminals, and loss of photoreceptors, indicating an advanced disease stage. The presence of microglial cells in the remaining nuclear layers suggests a role in photoreceptor degeneration. This study represents the first comprehensive description of clinical, genetic, imaging, and histopathological findings in Jalili Syndrome.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625277","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":"Clinical Evaluation of a Novel CRISPR-Cas12a-Based RID-MyC Assay for the Diagnosis of Fungal Endophthalmitis.","authors":"Hanith Raj Deivarajan, Prabhakara SethupathyR, Vignesh Elamurugan, Akshayaa Vs, Reega P, Dharani Chelliah, Hari Vignesh S, Elakkiya Nandhini Gr, Kanmani M, Dharsini N, Karvannan Sevugamurthi, Saravanan Vr, Anuradha K, Parag K Shah, Ram Rammohan, Abhishek Nair, Krutin Shah, Anju Jose, Jaishree Pandian, Lalitha Prajna, Venkatesh N Prajna, Siddharth Narendran","doi":"10.1016/j.oret.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.oret.2024.11.003","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the RID-MyC (Rapid Identification of Mycoses using CRISPR) assay, a CRISPR/Cas12a-based diagnostic tool, for its efficacy in diagnosing fungal endophthalmitis (FE), comparing it with panfungal PCR and culture methods.</p><p><strong>Design: </strong>A comparative cross-sectional study assessing the performance of the RID-MyC assay against established diagnostic modalities for FE.</p><p><strong>Subjects: </strong>The study included 133 intraocular samples from 117 patients with suspected microbial endophthalmitis.</p><p><strong>Methods: </strong>The study compared the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the RID-MyC assay against panfungal PCR and culture. The Limit of Detection (LoD) for Aspergillus flavus and Candida albicans was determined for both RID-MyC and panfungal PCR across three different media: nuclease-free water (NFW), aqueous humor (AH), and vitreous humor (VH). Discrepancy analysis was conducted for discordant results, incorporating clinical outcomes and responses to antifungal treatment.</p><p><strong>Main outcome measures: </strong>The study primarily assessed the sensitivity, specificity, PPV, and NPV for clinical samples. Time to diagnosis was also evaluated.</p><p><strong>Results: </strong>The RID-MyC assay demonstrated a sensitivity of 88.24% (CI: 63.56% to 98.54%) and specificity of 93.1% (CI: 86.86% to 96.98%), with PPV and NPV of 65.22% (CI: 48.45% to 78.91%) and 98.18% (CI: 93.62% to 99.50%), respectively. Discrepancy analysis enhanced sensitivity to 90.48% (CI: 69.62% to 98.83%) and specificity to 96.43% (CI: 91.11% to 99.02%). The RID-MyC assay was 10 to 1000-fold more sensitive than panfungal PCR in detecting Aspergillus flavus and Candida albicans in intraocular specimens. The time to diagnosis with the RID-MyC assay was consistently under two hours.</p><p><strong>Conclusions: </strong>The RID-MyC assay may advance the rapid and precise diagnosis of FE, with possible relevance to other invasive fungal conditions.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625279","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":"A novel management challenge in age-related macular degeneration: Artificial intelligence and expert prediction of geographic atrophy.","authors":"Gregor S Reiter, Dmitrii Lachinov, Wolf Bühl, Günther Weigert, Christoph Grechenig, Julia Mai, Hrvoje Bogunović, Ursula Schmidt-Erfurth","doi":"10.1016/j.oret.2024.10.029","DOIUrl":"https://doi.org/10.1016/j.oret.2024.10.029","url":null,"abstract":"<p><strong>Purpose: </strong>The progression of geographic atrophy (GA) secondary to age-related macular degeneration (AMD) is highly variable among individuals. Prediction of the progression is critical to identify patients who will benefit most from the first treatments currently approved. The aim of this study was the investigation of the value and difference in predictive power between ophthalmologists and artificial intelligence (AI) to reliably assess individual speed of GA progression.</p><p><strong>Design: </strong>Prospective, expert and AI comparison study.</p><p><strong>Participants: </strong>Eyes with natural progression of GA from a prospective study (NCT02503332).</p><p><strong>Methods: </strong>Ophthalmologists predicted yearly growth speed of GA, as well as selecting the potentially faster growing lesions from two eyes based on fundus autofluorescence (FAF), near-infrared reflectance (NIR), and optical coherence tomography (OCT). A deep learning algorithm predicted progression solely on the baseline OCT (Spectralis, Heidelberg Engineering, Germany).</p><p><strong>Main outcome measures: </strong>Accuracy, weighted kappa (κ), and concordance index (c-index) between the prediction made by ophthalmology specialists, ophthalmology residents and the AI.</p><p><strong>Results: </strong>A total of 134 eyes of 134 patients from a phase II clinical trial were included, among those 53 were from the sham arm and 81 from untreated fellow eyes. 2880 gradings were performed by four ophthalmologists. Human experts reached an accuracy of 0.37, 0.43, 0.41 and a κ of 0.06, 0.16, 0.18 on FAF, NIR+OCT and FAF+NIR+OCT, respectively. On a pairwise comparison task, human experts achieved a c-index of 0.62, 0.59 and 0.60. Automated AI-based analysis reached an accuracy of 0.48 and a κ of 0.23 on the first task, and a c-index of 0.69 on the second task solely utilizing OCT imaging.</p><p><strong>Conclusions: </strong>Prediction of individual progression will become an important task for patient counseling, most importantly with treatments becoming available. Human gradings improved with the availability of OCT. However, automated AI performed better than ophthalmologists in several comparisons. AI-supported decisions improve clinical precision, access to timely care for the community, and socioeconomic feasibility in the management of the leading cause for irreversible vision loss.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625262","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":"Pneumatic Retinopexy for Rhegmatogenous Retinal Detachment Outcomes: IRIS® Registry (Intelligent Research in Sight) Analysis.","authors":"Shane Griffin, Lawrence Chan, Kayne McCarthy, Xuan Peng, Charles Li, Linda D Harrison, Flora Lum, Gaurav Shah","doi":"10.1016/j.oret.2024.10.025","DOIUrl":"https://doi.org/10.1016/j.oret.2024.10.025","url":null,"abstract":"<p><strong>Purpose: </strong>To determine treatment patterns and outcomes of pneumatic retinopexy (PnR) for rhegmatogenous retinal detachments (RRD).</p><p><strong>Design: </strong>Retrospective cohort analysis using IRIS® Registry (Intelligent Research in Sight) database.</p><p><strong>Participants: </strong>Patients with RRD treated by PnR from 2013-2022.</p><p><strong>Methods: </strong>Cases were identified using International Classification of Diseases, Ninth and Tenth Revisions (ICD-9, ICD-10) diagnostic codes. Surgical procedures were identified using Current Procedural Terminology (CPT) codes for type of RRD repair. Baseline demographic information included age, sex, race and ethnicity, geographic region, smoking status, and health insurance type.</p><p><strong>Main outcome measures: </strong>Primary outcomes for PnR included single-operation success (SOS) and failure (SOF), change in visual acuity at 9-12 months, rates of complications, rates of secondary procedure following SOF, and outcome by phakic status.</p><p><strong>Results: </strong>13,302 unique eyes were analyzed (median age, 64 years, 61.56% male). Overall SOS for primary PnR was 59.82%. The mean BCVA at 9-12 months following PR was LogMAR 0.44 (95% CI: 0.42, 0.46) for SOF eyes, compared to 0.23 (95% CI: 0.22, 0.25) for SOS eyes (P < 0.001). Complications of PR included vitreous hemorrhage (9.1%), ERM (45.17%), proliferative vitreoretinopathy (0.98%), and endophthalmitis (0.14%). Of the 40.18% of eyes with SOF, 81% required either secondary PnR, scleral buckle (SB), vitrectomy (VTX), or complex detachment repair (CDR), whereas the remaining eyes required more than one of these secondary procedures. SOS for phakic eyes was 64.50% versus 53.93% for pseudophakic eyes (P < 0.001).</p><p><strong>Conclusions: </strong>IRIS Registry data reveal real-world outcomes and utilization patterns of PnR for RRD. Overall SOS for primary PnR was 59.82%, which is lower than other cited rates in the literature. Pseudophakic eyes were more likely to fail primary PnR. It is important to counsel patients on risks of the procedure when obtaining informed consent.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625305","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":"Diagnostic Accuracy of B-scan Ultrasonography in Detecting Vitreoretinal Pathology after Open-Globe Injury.","authors":"Mahsaw Mansoor, Matthew S Hunt, Elaine M Binkley, Timothy M Boyce, Ian C Han, Elliott H Sohn, Stephen R Russell, H Culver Boldt, Jonathan F Russell","doi":"10.1016/j.oret.2024.10.028","DOIUrl":"https://doi.org/10.1016/j.oret.2024.10.028","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the diagnostic accuracy of B-scan ultrasonography (echography) after open-globe injury (OGI) repair in detecting vitreoretinal pathology, as confirmed by intraoperative inspection during subsequent pars plana vitrectomy (PPV).</p><p><strong>Design: </strong>Retrospective, single-center, consecutive case series.</p><p><strong>Participants: </strong>Patients with OGI treated at the University of Iowa Hospitals and Clinics (UIHC) from February 2018 through December 2023 who underwent OGI repair and had at least one B-scan performed post-repair but prior to subsequent PPV.</p><p><strong>Methods: </strong>B-scans were performed by an experienced echographer and reviewed by the managing vitreoretinal surgeon for the presence of vitreous hemorrhage (VH), retinal tear (RT), retinal detachment (RD), choroidal detachment, and vitreoretinal incarceration. B-scan findings were compared to findings on direct inspection during PPV, which served as the gold standard.</p><p><strong>Main outcome measures: </strong>Sensitivity, specificity, and positive/negative predictive value of B-scan findings.</p><p><strong>Results: </strong>The study included 62 eyes of 61 patients, predominantly with severe OGIs (mean presenting logMAR VA of 2.52 ± 0.41; 75% with Ocular Trauma Score of 1 or 2). B-scan had excellent diagnostic accuracy for VH, but for every other type of vitreoretinal pathology there were significant false positives, false negatives, or both. B-scan sensitivity was particularly low for vitreoretinal incarceration (11%), RT (32%), and RD (78%).</p><p><strong>Conclusions: </strong>This study identified much lower diagnostic accuracy of B-scan ultrasonography after OGI for all vitreoretinal pathologies except VH compared to previous, smaller studies that reported perfect accuracy (100% sensitivity and specificity). Ultrasonography provides useful clinical information but should not be solely relied upon to diagnose or rule out severe vitreoretinal pathology that may prompt vitreoretinal referral and/or PPV after OGI.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625281","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}