Ophthalmology. Retina最新文献

{"title":"Endophthalmitis Incidence After Intravitreal Injection of Anti-VEGF Agents with Povidone-Iodine vs. Aqueous Chlorhexidine Antisepsis.","authors":"Brandon Bates, John Fitzpatrick, Caroline Rosanky, Jared Moon, Edward Wood, Philip Storey","doi":"10.1016/j.oret.2025.03.022","DOIUrl":"https://doi.org/10.1016/j.oret.2025.03.022","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the incidence of post injection endophthalmitis (PIE) following intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents in eyes prepared with topical 5% povidone-iodine (PI) or 0.05% aqueous chlorhexidine (AqCHX) as antisepsis.</p><p><strong>Design: </strong>Retrospective, single-center, comparative cohort study PARTICIPANTS: Individuals who received at least one intravitreal anti-VEGF injection with use of PI or AqCHX as antisepsis.</p><p><strong>Methods: </strong>For all patients receiving intravitreal anti-VEGF injections at Austin Retina Associates between March 1, 2015 and November 1, 2023, all injections and cases of suspected PIE were identified with billing codes and confirmed with review of electronic medical record data. Eyes that presented following injection with pain and/or decreased vision warranting treatment with intravitreal antibiotics were considered suspected PIE cases. Eyes were grouped based on preparation with PI or AqCHX.</p><p><strong>Main outcome measures: </strong>The primary outcomes were incidence of suspected and culture-positive PIE and visual acuity at 3 months post endophthalmitis.</p><p><strong>Results: </strong>A total of 302,474 intravitreal injections were administered during the study period. Within the PI group, 59 cases of suspected PIE occurred following 267,190 injections (0.022%; 1 in 4,529 injections) compared to 5 cases following 35,284 injections (0.014%; 1 in 7,057 injections) in the AqCHX group (p=0.34). For the PI group, there were 10 culture-positive PIE cases (0.0037%, 1 in 26,719 injections) compared to 0 cases in the AqCHX group (p=0.25). At 3-months post-infection, average visual acuity in the PI group was 0.97 (∼20/200) and 1.4 (∼20/500) in the AqCHX group (p=0.41). When controlling for prefilled syringe status, there was no difference in rates of PIE between antisepsis groups (p=0.23).</p><p><strong>Conclusions: </strong>The incidence of endophthalmitis following intravitreal injection is low with no difference in the rates of infection with eyes prepared with topical PI compared to AqCHX. Topical AqCHX is a safe and effective antiseptic alternative to PI for the prevention of endophthalmitis following intravitreal injection.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753761","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":"Epstein-Barr Virus Lymphoproliferative Disorder in a Patient with Acute Lymphoblastic Leukemia.","authors":"Lydia Zhong, Michael Ip, Kirk K Hou","doi":"10.1016/j.oret.2025.02.026","DOIUrl":"https://doi.org/10.1016/j.oret.2025.02.026","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701101","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":"One-year outcomes after switching to faricimab in eyes with pre-treated neovascular age-related macular degeneration: a Swiss Retina Research Network report.","authors":"Gabriela Grimaldi, Aude Ambresin, Isabel B Pfister, Christin Schild, Christina Plasencia, Katja Hatz, Richard Stillenmunkes, Marion R Munk, Arianna Paris, Moreno Menghini, Dmitri Artemiev, Andreas Ebneter, Jennifer Cattaneo, Eva C de Oliveira Figueiredo, Chiara M Eandi, Jacqueline Fröhlich, Nicolas Feltgen, Tahm Spitznagel, Gábor Márk Somfai, Mariano Cozzi, Sandrine Zweifel, Andreas Weinberger, Justus G Garweg","doi":"10.1016/j.oret.2025.03.015","DOIUrl":"https://doi.org/10.1016/j.oret.2025.03.015","url":null,"abstract":"<p><strong>Purpose: </strong>To report the efficacy and safety of switching to faricimab in a real-world, Swiss cohort of patients with pre-treated neovascular age-related macular degeneration (nAMD).</p><p><strong>Design: </strong>Retrospective, multicenter, longitudinal observational study conducted at 11 centers of the Swiss Retina Research Network.</p><p><strong>Subjects: </strong>We included 353 eyes of 325 patients who were switched to intravitreal faricimab after prior anti-vascular endothelial growth factor (anti-VEGF) therapy and followed for a minimum of 12 months between May 1, 2022 and October 30, 2024.</p><p><strong>Methods: </strong>Demographic characteristics, baseline functional and optical coherence tomography findings, treatment history, and outcomes at 12 months post-switch to faricimab were extracted from the patients' electronic case report forms.</p><p><strong>Main outcome measures: </strong>Change in best-corrected visual acuity (BCVA), central subfield thickness (CST), presence of retinal fluid (RF) and pigment epithelial detachment, treatment intervals and safety signals.</p><p><strong>Results: </strong>Twelve months after switch, mean BCVA remained unchanged while mean CST decreased from 315.3 μm to 263.9 μm (p<0.01). Fast drying (absence of RF) after 1 faricimab injection was observed in 134 eyes (38%) and correlated positively with the treatment interval at 12 months (r(301)=0.24, p<0.01). After 12 months,169 (47.9%) eyes demonstrated absence of retinal fluid compared to 10.2% at switch. Mean treatment interval increased from 5.8 ± 2.5 weeks at switch to 8.3 ± 4.2 weeks at 12 months, whereas extended treatment intervals (≥12-week) were achieved in 20% of patients. Mild intraocular inflammation was reported in 1.7% of cases.</p><p><strong>Conclusions: </strong>Switching to faricimab in pre-treated nAMD led to sustained anatomical improvements and stabilization of BCVA, with a substantial reduction in RF compared to baseline. Our results suggest the potential benefits of this switch strategy based on real-world data.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730880","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":"Genetic counselor integration improves genetic eye disease diagnostics.","authors":"Mark Lindquist, Jennifer Cech, Amanda Peterson, Jennifer Huey, Debarshi Mustafi","doi":"10.1016/j.oret.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.oret.2025.03.016","url":null,"abstract":"<p><p>This study establishes a framework for genetic counselor integration into retina clinics without requiring ophthalmology-specific training, enabling more efficient and accurate diagnostics for inherited retinal disease patients.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710848","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":"US vs non-US Retreatment Rates After Intravitreal Anti-VEGF Injections for ROP.","authors":"Nimesh A Patel, Luis A Acaba-Berrocal, Sandra Hoyek, Celine Chaaya, Kenneth C Fan, Maria Ana Martinez-Castellanos, Caroline R Baumal, C Armitage Harper, Audina M Berrocal","doi":"10.1016/j.oret.2025.03.013","DOIUrl":"https://doi.org/10.1016/j.oret.2025.03.013","url":null,"abstract":"<p><p>This multicenter study determines the differences in retreatment rates after intravitreal anti-VEGF treatment for Retinopathy of Prematurity between the United States (US) and non-US sites. Ranibizumab was associated with significantly more retreatment compared to bevacizumab.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710852","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":"Anti-VEGF Use for Conditions without Food and Drug Administration Approval.","authors":"Ravi Parikh, Elias H Kahan, Casey Zhang, Rhiya Mittal, Arjun Watane, Flora C Lum, Scott M Friedman","doi":"10.1016/j.oret.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.oret.2025.03.014","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710845","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":"Ophthalmic Artery Chemosurgery for Retinoblastoma Babies Less than 3 months old or under 6 KG Weight.","authors":"David H Abramson, Jasmine H Francis, Jared Knopman, Ira J Dunkel, Y Pierre Gobin","doi":"10.1016/j.oret.2025.03.008","DOIUrl":"https://doi.org/10.1016/j.oret.2025.03.008","url":null,"abstract":"<p><strong>Importance: </strong>Children younger than 3 months of age and/or weighing less than 6kg have not been treated with Ophthalmic Artery Chemosurgery (OAC) because of concerns about causing scarring in the tiny femoral artery. Instead, they receive systemic chemotherapy.</p><p><strong>Objective: </strong>To determine the feasibility, safety and efficacy of OAC for very young children who have unilateral and bilateral retinoblastoma.</p><p><strong>Design: </strong>Retrospective, consecutive review of all children with retinoblastoma (unilateral and bilateral) treated with OAC in the first 3 months of life or if weighing less than 6 kg. treated at Memorial Sloan Kettering Cancer Center (MSKCC).</p><p><strong>Setting: </strong>Single tertiary referral cancer center.</p><p><strong>Participants: </strong>All children with retinoblastoma (unilateral or bilateral) treated with OAC (17 patients) in the first 3 months of life or weighing less than 6 kg.</p><p><strong>Exposures: </strong>OAC delivered by microcatheter inserted in the femoral artery and through the internal carotid artery. Combinations of Melphalan, Carboplatin and Topotecan were delivered in 60 sessions via the ophthalmic artery in 17 patients.</p><p><strong>Main outcome measure: </strong>Ocular salvage, serial ERG's, patient survival, second cancers, fever/neutropenia, transfusion of any blood product, groin bleeding or femoral artery occlusion and anesthetic complications CONCLUSION AND RELEVANCE: Very young children (< 3 months old and <6kg weight) with unilateral or bilateral retinoblastoma can be safely and effectively treated with OAC (intraarterial chemotherapy) without significant complications despite the fact that the majority had advanced intraocular disease (Reese-Ellsworth (RE)Vb or International Classification of Retinoblastoma (ICRb) \"D\" and \"E\"). This includes treating both eyes in the same session and as young as 5 weeks and weighing 3.6kg. This eliminates the need for systemic chemotherapy which is well known to be toxic to the youngest children.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693079","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":"Exploring clinical features of polypoidal choroidal vasculopathy in black patients: a cross-sectional study and a comprehensive review.","authors":"Adam Lazrak, Martin Bonnafous, Albert Jean-Charles, Katia Ouamrane, Alizée Tabouillot, Yanice Chaoui-Boudghane, Harold Merle","doi":"10.1016/j.oret.2025.02.030","DOIUrl":"https://doi.org/10.1016/j.oret.2025.02.030","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the clinical and angiographic presentation of polypoidal choroidal vasculopathy (PCV) in a large cohort of Black patients.</p><p><strong>Design: </strong>We conducted a descriptive cross-sectional analysis.</p><p><strong>Participants: </strong>Out of 283 patients followed for PCV in our department, 167 cases were confirmed by ICG. The remaining patients lacked ICG imaging. Among the 167 confirmed cases, 57 patients were excluded due to significant ophthalmological comorbidities, leaving 160 affected eyes in 110 patients for analysis.</p><p><strong>Methods: </strong>We reviewed the most recent retinophotography, optical coherence tomography (OCT), fluorescein, and indocyanine green angiography (ICGA) images in our database. All analyzed patients were followed and underwent their examinations at the University Hospital Center of Martinique, a referral center in Fort-de-France primarily serving a Black population. An exploratory analysis of choroidal features was made in those who underwent enhanced depth imaging spectral-domain OCT (EDI-SD-OCT). In parallel, a literature review on PCV was performed to contextualize our findings.</p><p><strong>Main outcomes and measures: </strong>We measured visual acuity, sex ratio, patient age, characteristics of exudative phenomena, polyp location, and PCV type according to Kawamura classification.</p><p><strong>Results: </strong>Most patients were women (62.7%), with an average age of 72.2 ± 10.1 years. Among the 160 eyes, 81.9% exhibited idiopathic Type 2 PCV and 52.4% showing peripapillary polyp distribution. The mean visual acuity was 0.29 ± 0.3 LogMAR. Soft drusen were present in 15% of eyes and 44.5% of patients had bilateral involvement. Black patients seem to have distinctive PCV characteristics compared to other ethnic groups, with a low incidence of macular polyps (23.1%), a high incidence of peripapillary polyps (52.4%) and high incidence of bilateral involvement (42.8%).</p><p><strong>Conclusions and relevance: </strong>This is the largest series of Afro-descendant patients with polypoidal choroidal vasculopathy (PCV) ever described in the literature. PCV in our population is primarily type 2 PCV according to Kawamura's classification, predominantly affecting women, often bilateral, with a preferentially extramacular location of the polyps. These observations may be explained by the fact that PCV in these patients is not the result of neovascularization but rather linked to a generalized disease of the choroid, such as pachychoroid.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693074","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":"Faricimab Treat-and-Extend Dosing for Macular Edema due to Retinal Vein Occlusion: 72-Week Results From the BALATON and COMINO Trials.","authors":"Carl J Danzig, Christiana Dinah, Faruque Ghanchi, Lars-Olof Hattenbach, Arshad M Khanani, Timothy Y Y Lai, Masahiko Shimura, Francis Abreu, Pablo Arrisi, Ying Liu, Liliana P Paris, Anne-Cecile Retiere, Jeffrey R Willis, Patricio G Schlottmann","doi":"10.1016/j.oret.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.oret.2025.03.005","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the efficacy, durability, and safety of dual angiopoietin-2/vascular endothelial growth factor inhibition with faricimab dosed per a modified treat-and-extend (T&E)-based regimen in patients with retinal vein occlusion (RVO).</p><p><strong>Design: </strong>Single-arm treatment period after a randomized, double-masked, active comparator-controlled period in the phase 3 BALATON/COMINO (NCT04740905/NCT04740931) trials.</p><p><strong>Participants: </strong>Patients with treatment-naïve foveal center-involved macular edema due to branch (BALATON; N=553) or central/hemiretinal (COMINO; N=729) RVO.</p><p><strong>Methods: </strong>Patients randomized to faricimab 6.0 mg every 4 weeks (Q4W) or aflibercept 2.0 mg Q4W up to week 20 received faricimab 6.0 mg dosed per a modified T&E-based regimen from week 24-72. Dosing frequency was adjusted Q4W-Q16W based on changes in central subfield thickness (CST) and best-corrected visual acuity (BCVA).</p><p><strong>Main outcome measures: </strong>Change from baseline through week 72 in BCVA and CST; durability and safety through week 72.</p><p><strong>Results: </strong>Visual acuity gains and CST reductions achieved at week 24 were maintained through week 72. Adjusted mean BCVA (95.03% CI) changes from baseline averaged over weeks 64/68/72 in the prior faricimab Q4W and prior aflibercept Q4W arms were +18.1 letters (16.9 to 19.4) and +18.8 letters (17.5 to 20.0), respectively, in BALATON and +16.9 letters (15.2 to 18.6) and +17.1 letters (15.4 to 18.8), respectively, in COMINO. Adjusted mean (95.03% CI) CST changes from baseline averaged over weeks 64/68/72 in the prior faricimab Q4W and prior aflibercept Q4W arms were -310.9 μm (-315.6 to -306.3) and -307.0 μm (-311.7 to -302.3), respectively, in BALATON and -465.9 μm (-472.5 to -459.3) and -460.6 μm (-467.2 to -453.9), respectively, in COMINO. In the prior faricimab Q4W and prior aflibercept Q4W arms, 64.1% and 56.9% of patients from BALATON and 45.5% and 50.1% from COMINO, respectively, were on ≥Q12W dosing at week 68. Faricimab continued to be well tolerated from week 24-72; the safety profile was consistent with that established for diabetic macular edema and neovascular age-related macular degeneration.</p><p><strong>Conclusions: </strong>These findings support the sustained efficacy and safety of faricimab in patients with macular edema due to RVO up to 72 weeks, with the potential for reduced treatment burden due to response durability.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664058","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":"Subhyaloid Air Bubble Post Intravitreal Injection.","authors":"Mariana Vaz, Ana Mafalda Pereira, Diogo Cabral","doi":"10.1016/j.oret.2025.02.014","DOIUrl":"https://doi.org/10.1016/j.oret.2025.02.014","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634372","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}