Ophthalmology. Retina最新文献

{"title":"Impact of Epiretinal Membrane on Anatomical and Visual Outcomes in Patients with Full-Thickness Macular Holes.","authors":"Masanori Iwasaki, Hiroyuki Nakashizuka, Naoki Nezu, Mai Omori, Koji Tanaka, Ryusaburo Mori, Hiroyuki Shimada","doi":"10.1016/j.oret.2025.05.009","DOIUrl":"10.1016/j.oret.2025.05.009","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the impact of an epiretinal membrane (ERM) on the postoperative outcomes of full-thickness macular hole (MH) repair, focusing on anatomical closure rates, postoperative visual acuity (VA), and recovery of the outer retinal layers.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Participants: </strong>A total of 605 eyes from 594 patients who underwent MH surgery from 2015 to 2023.</p><p><strong>Methods: </strong>Patients were divided into 2 groups (MH with ERM [254 eyes] and MH without ERM [351 eyes]). Multiple regression analysis was employed to evaluate surgical outcomes, adjusting for minimum hole size and high myopia in relation to the initial MH closure rate and for preoperative VA and concurrent cataract surgery in relation to postoperative VA at 3 months. In all cases, ERM and internal-limiting membrane (ILM) peeling were performed, and the inverted ILM flap cover technique was added at the discretion of the surgeon. Patients with MH-associated retinal detachment, myopic foveoschisis and recurrent or traumatic MH were excluded.</p><p><strong>Main outcome measures: </strong>The initial MH closure rate and postoperative VA at 3 months were evaluated using multiple regression analysis.</p><p><strong>Results: </strong>Our results indicated that ERM did not significantly impact MH closure rates (97.2% vs. 98.3%, P = 0.554), which was consistent with the findings of the multiple regression analysis (r = -0.310, P = 0.666). The inverted ILM flap technique effectively promoted MH closure even in the presence of an ERM (P = 0.021). The MH with ERM group had significantly worse postoperative VA at 3 months (P = 0.004) and significantly lower restoration rates of the outer nuclear layer (64.4% vs. 75.1%, P = 0.006) and external limiting membrane (82.2% vs. 90.1%, P = 0.007).</p><p><strong>Conclusions: </strong>An ERM does not significantly affect anatomical MH closure. The inverted ILM flap technique is effective for MH closure, even in the presence of an ERM. An ERM negatively impacted postoperative VA and outer retinal layer restoration.</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":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974431","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":"Outcomes by Faricimab Treatment Interval at Week 48 of TENAYA-LUCERNE Phase 3 Trials in Neovascular Age-Related Macular Degeneration.","authors":"Nikolas J S London, Chui Ming Gemmy Cheung, Stephan Michels, Aachal Kotecha, Philippe Margaron, Audrey Souverain, Jeffrey R Willis, Timothy Y Y Lai","doi":"10.1016/j.oret.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.oret.2025.05.004","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the visual and anatomic outcomes by individualized treatment intervals at week 48 in patients with neovascular age-related macular degeneration (nAMD) treated with the dual angiopoietin-2/vascular endothelial growth factor (VEGF)-A inhibitor faricimab in a post hoc analysis of pooled data from TENAYA/LUCERNE.</p><p><strong>Design: </strong>TENAYA/LUCERNE (NCT03823287/NCT03823300) were identically designed, randomized, double-masked, active comparator-controlled, noninferiority phase 3 trials.</p><p><strong>Participants: </strong>Treatment-naïve patients ≥ 50 years of age with nAMD randomized to the faricimab up to every 16 weeks (Q16W; n = 665) arm.</p><p><strong>Methods: </strong>Patients in the faricimab arm received 4 initial Q4W doses through week 12. At weeks 20 and 24, they were assigned to fixed Q8W, Q12W, or Q16W treatment intervals through week 60, based on prespecified central subfield thickness (CST) or best-corrected visual acuity (BCVA) disease activity criteria or presence of new macular hemorrhage, per investigator clinical examination. The primary analysis was at week 48.</p><p><strong>Main outcome measures: </strong>Mean changes from baseline in BCVA and CST through week 48 by treatment interval group.</p><p><strong>Results: </strong>At week 48, the proportion of faricimab-treated patients on each treatment interval was 45.3% (Q16W), 33.4% (Q12W), and 21.2% (Q8W). The baseline patient characteristics were well balanced across faricimab treatment intervals. However, patients assigned to treatment at Q16W and Q12W had less severe disease at baseline versus patients assigned to Q8W. All patients showed sustained BCVA gains and CST reductions through week 48. Mean (95% confidence interval) change from baseline in BCVA was +7.9 letters (6.6, 9.2), +4.0 letters (2.2, 5.7), +5.3 letters (2.4, 8.2); and in CST was -142.9 μm (-156.9, -128.9), -112.5 μm (-131.0, -94.1), and -165.1 μm (-193.8, -136.4) for Q16W, Q12W, and Q8W, respectively.</p><p><strong>Conclusions: </strong>Vision and anatomic improvements were achieved and maintained in all faricimab individualized treatment interval groups, with patients treated at longer intervals having more stable outcomes with fewer injections. The clinically relevant disease activity criteria based on vision or anatomy allowed treatment of patients with nAMD to be rapidly extended after the initial dosing phase while maintaining visual gains through week 48 of TENAYA/LUCERNE.</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":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040122","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 Intraretinal Hemorrhages in VEXAS Syndrome.","authors":"Shiyu Cheng, Huan Chen, Youxin Chen","doi":"10.1016/j.oret.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.oret.2025.04.006","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031434","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":"Risk of Adverse Systemic Events in Retinal Vein Occlusion.","authors":"Emily A Albrecht, Priya Shukla, Alison H Zhao, Jonathan C Markle, Christopher M Maatouk, Rishi P Singh, Katherine E Talcott","doi":"10.1016/j.oret.2025.05.005","DOIUrl":"10.1016/j.oret.2025.05.005","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Conflicting data exists on whether central and branch retinal vein occlusion (CRVO and BRVO) are linked to systemic adverse events. This study examines this association using the TriNetX US Collaborative Network, encompassing &gt;110 million patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Retrospective population-based cohort design.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Subjects and controls: &lt;/strong&gt;Central and branch retinal vein occlusion cohorts were compared with control cataract cohorts and between high and low-intensity treatment defined by ≥10 compared with ≤5 anti-VEGF injections.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study used deidentified data from a national database (2006-2024), using International Classification of Diseases,10th Revision, codes for CRVO and BRVO. Patients were propensity score matched on demographics, medications, and comorbidities. Risk ratios (RRs) were generated for systemic events in patients with CRVO and BRVO compared with controls and between patients with high and low-intensity treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;Risk ratios (RRs) and 95% confidence intervals (CIs) of death, myocardial infarction (MI), hemorrhagic stroke, ischemic stroke, and carotid disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Central retinal vein occlusion was associated with increased risk of death (RR, 1.30; 95% CI, 1.26-1.35), MI (RR, 1.24; 95% CI, 1.16-1.32), hemorrhagic stroke (RR, 1.35; 95% CI, 1.21-1.51), ischemic stroke (RR, 1.49; 95% CI, 1.4-1.59), and carotid disease (RR, 1.69; 95% CI, 1.59-1.79). Branch retinal vein occlusion was associated with increased risk of death (RR, 1.27; 95% CI, 1.23-1.32), MI (RR, 1.39; 95% CI, 1.30-1.49), hemorrhagic stroke (RR, 1.57; 95% CI, 1.41-1.75), ischemic stroke (RR, 1.66; 95% CI, 1.56-1.77), and carotid disease (RR, 1.67; 95% CI, 1.57-1.77). Central retinal vein occlusion with high-intensity treatment was associated with increased risk of MI (RR, 1.47; 95% CI, 1.12-1.93) compared with low-intensity CRVO treatment, but there were no significant differences in risk of death (RR, 0.98; 95% CI, 0.86-1.11), hemorrhagic stroke (RR, 1.00; 95% CI, 0.63-1.58), ischemic stroke (RR, 1.31; 95% CI, 1.03-1.66), or carotid disease (RR, 1.34; 95% CI, 1.06-1.70). For BRVO with high compared with low-intensity treatment, no significant differences in rates of death (RR, 1.12; 95% CI, 0.96-1.31), MI (RR, 1.30; 95% CI, 0.93-1.81), hemorrhagic stroke (RR, 0.96; 95% CI, 0.60-1.53), ischemic stroke (RR, 1.05; 95% CI, 0.80-1.38), or carotid disease (RR, 1.17; 95% CI, 0.85-1.60) were identified.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Central and branch retinal vein occlusion are associated with increased risk of death, MI, hemorrhagic stroke, ischemic stroke, and carotid disease. High-intensity treatment of CRVO may be associated with increased risk of MI. These results from this data set demonstrate the importance of systemic evaluation after retinal vein occlusion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Financial disclosure(s): ","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006996","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":"Risk Factors for Reoperation in Vitrectomy for Stage 4A Retinopathy of Prematurity.","authors":"Masaki Fukushima, Chiharu Iwahashi, Tomoki Kurihara, Kazuki Kuniyoshi, Fukutaro Mano, Takao Endo, Atsushi Hayashi, Shunji Kusaka","doi":"10.1016/j.oret.2025.05.008","DOIUrl":"10.1016/j.oret.2025.05.008","url":null,"abstract":"<p><strong>Purpose: </strong>To determine risk factors for reoperation after vitrectomy for stage 4A retinopathy of prematurity (ROP).</p><p><strong>Design: </strong>Retrospective, comparative case series.</p><p><strong>Participants: </strong>The selected patients had undergone vitrectomy for stage 4A ROP with a minimum follow-up period of 6 months between 2010 and 2023.</p><p><strong>Methods: </strong>Data collected from patients' charts included gender, gestational age at birth (GA), birth weight (BW), stage of ROP, postmenstrual age (PMA) at vitrectomy, extent of fibrovascular membrane (FVM), preoperative fluorescein angiography, surgical procedure, and subsequent reoperation during the follow-up period.</p><p><strong>Main outcome measures: </strong>Anatomical success rate, incidence of postoperative vitreous hemorrhage (VH) and redetachment caused by reproliferation, and risk factors for reoperation to treat these postoperative complications.</p><p><strong>Results: </strong>We included 132 consecutive eyes (42 bilateral and 48 unilateral) of 90 patients (48 female and 42 male). The mean GA, BW, and PMA at surgery were 24.6 ± 1.6 weeks, 623.3 ± 180.3 g, and 41.6 ± 4.1 weeks, respectively. Final anatomic success was achieved in 128 eyes (97%). Reoperations were necessary because of postoperative VH in 31 eyes (23%), redetachment caused by reproliferation in 8 eyes (6%), and both VH and redetachment caused by reproliferation in 4 eyes (3%). Multivariable logistic regression analysis showed that plus disease (P = 0.007; odds ratio [OR], 3.681; 95% confidence interval [CI], 1.43-9.46) was a risk factor for reoperation due to postoperative VH, and greater extent of fibrovascular membrane (FVM) (P = 0.047: OR, 1.335; 95% CI, 1.004-1.776) and higher grade of fluorescein leakage (P = 0.033; OR, 5.675; 95% CI, 1.149-28.040) were risk factors for reoperation because of redetachment caused by reproliferation. In eyes with plus disease, anti-VEGF therapy as a preoperative adjunct significantly reduced the rate of reoperation for postoperative VH (20.0% vs. 60.7%, P = 0.002).</p><p><strong>Conclusions: </strong>High anatomical success rates could be achieved by vitrectomy for stage 4A ROP. However, eyes with plus disease, greater extent of FVM, or higher grade of fluorescein leakage may have an increased risk of reoperation. In addition, preoperative anti-VEGF therapy may reduce reoperations because of postoperative VH in patients with plus disease.</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":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006348","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":"Predictive Factors and Tumor Dynamics in Choroidal Osteoma: A Multimodal Imaging-Based Longitudinal Analysis.","authors":"Ninan Jacob, Vishal Raval, Swathi Kaliki, Manasi Ketkar, Anasua Ganguly Kapoor, Niroj Kumar Sahoo","doi":"10.1016/j.oret.2025.05.010","DOIUrl":"10.1016/j.oret.2025.05.010","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate longitudinal multimodal imaging changes in choroidal osteoma (CO) and analyze factors predisposing to sequelae.</p><p><strong>Design: </strong>Retrospective, observational study.</p><p><strong>Participants: </strong>Patients with a diagnosis of CO.</p><p><strong>Methods: </strong>Baseline clinical characteristics and agewise distribution of various multimodal imaging parameters, such as total osteoma area, area of retinal pigment epithelium (RPE) atrophy, and area of decalcified choroidal atrophy (d-CA), were analyzed. Eyes with well-documented longitudinal follow-up were also analyzed.</p><p><strong>Main outcome measures: </strong>Multimodal imaging features of CO in the calcified and decalcified areas and identification of changes in the CO lesion parameters and factors predisposing to CO sequelae.</p><p><strong>Results: </strong>The study included 92 eyes of 73 patients (37 men and 36 women) with a mean age of 32 ± 13.6 years. At baseline, uncomplicated CO was noted in 17.4% of eyes, whereas d-CA was seen in 39.1% of eyes, and RPE atrophy without underlying d-CA was noted in 35.9% of eyes. Choroidal neovascular membrane (CNVM) was seen in 47.8% of eyes. Subretinal fluid (SRF) without CNVM was present in 14 eyes (15.2%). Thirty-five eyes were included for longitudinal analysis. On regression analysis, factors associated with the presence of CNVM at baseline were the presence of d-CA (P = 0.04), RPE atrophy (P = 0.04), and macular involvement (P = 0.001). A higher rate of increase in the d-CA area was associated with a higher total baseline area of the osteoma (P = 0.02). The presence of CNVM (P = 0.04) and retinal pigment epithelium atrophy (P = 0.03) was associated with a faster rate of reduction of osteoma thickness. A faster increase in osteoma thickness was associated with SRF appearance (P = 0.04). Three zones could be identified clinically in eyes with d-CA (i.e., a calcified area with no RPE atrophy, a transition zone of calcified area with overlying RPE atrophy, and a d-CA area).</p><p><strong>Conclusions: </strong>Retinal pigment epithelium atrophy and d-CA are clinically important and quantifiable prognostic factors in the natural history of CO lesions. Three different CO subtypes and zones could be identified that had unique clinical significance.</p><p><strong>Financial disclosure(s): </strong>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031198","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":"Visual Field Changes in Diabetic Retinopathy: Natural History and after Pan-Retinal Photocoagulation in the Diabetic Retinopathy Study and the ETDRS.","authors":"Debora H Lee, Susan Vitale, Elvira Agrón, Tiarnan D L Keenan, Catherine A Cukras, Emily Y Chew","doi":"10.1016/j.oret.2025.04.021","DOIUrl":"10.1016/j.oret.2025.04.021","url":null,"abstract":"<p><strong>Objective: </strong>To examine visual field (VF) changes in untreated diabetic retinopathy (DR) and compare them to those in DR treated with pan-retinal photocoagulation (PRP).</p><p><strong>Design: </strong>Post hoc analyses of the DR Study (DRS) and ETDRS, historical multicenter randomized controlled trials designed to assess the treatment effects of argon laser PRP for DR.</p><p><strong>Participants: </strong>A total of 1660 DRS eyes (830 participants) with severe nonproliferative DR (NPDR) or proliferative DR (PDR), and 5416 ETDRS eyes (2708 participants) with mild-severe NPDR or early PDR.</p><p><strong>Methods: </strong>Each DRS and ETDRS participant had 1 eye randomized to immediate PRP and the fellow eye to deferred PRP. Visual field scores (VFSs) were obtained with the Goldmann perimeter using the IV/4e stimulus in the DRS and the I/4e stimulus in the ETDRS. Eyes in the deferred PRP arm that later received PRP were censored at treatment initiation.</p><p><strong>Main outcome measures: </strong>The outcomes of mean VFS and change from baseline VFS over time were estimated with multivariable regression models with repeated measures.</p><p><strong>Results: </strong>Among untreated eyes (n = 830 [DRS] and n = 2,706 [ETDRS]), VFS change from baseline was -152.0 (95% confidence interval [CI], -215.4 to -88.5) at 6 years (DRS) and -79.2 (-90.9 to -67.6) at 7 years (ETDRS). Compared with untreated eyes with NPDR, untreated eyes with PDR + high-risk characteristics had VFS change of -50.2 (-65.9 to -34.6) and -38.8 (-69.2 to -8.5) in the DRS and ETDRS, respectively. Among untreated eyes, the presence of macular edema (ME) was associated with a VFS change of -12.9 (-25.4 to -0.5) and -6.2 (-10.4 to -1.9) in the DRS and ETDRS, respectively. The difference in VFS between PRP-treated versus untreated eyes was significant at 4 months (-31.4 [95% CI, -38.6 to -24.2]), but no longer apparent by year 3 (-1.4 [-17.0 to 14.1]) in the paired DRS analyses.</p><p><strong>Conclusions: </strong>The natural history of untreated DR involved significant VF decline over time. Increased DR severity and presence of ME were associated with greater field loss. Pan-retinal photocoagulation was associated with a rapid initial decline in the VF; however, VFs in PRP-treated versus untreated eyes became similar by year 3.</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":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037162","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":"Real-Time Adverse Events in Pediatric Fluorescein Angiography: IV versus Oral.","authors":"Osama Sorour, Naira Ikram, Scott Shuldiner, Samet Gulkas, Francisco Altamirano, Ryan S Meshkin, Celine Chaaya, Amanda Rich, Efren Gonzalez, Nimesh A Patel","doi":"10.1016/j.oret.2025.04.020","DOIUrl":"10.1016/j.oret.2025.04.020","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971945","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 United States Retinoblastoma Presentation, Management, and Local Recurrence in the National Cancer Database, 2004–2016","authors":"Jodi Y. So MD ,&nbsp;Suzann Pershing MD, MS ,&nbsp;Erqi Liu Pollom MD, MS ,&nbsp;Susan M. Hiniker MD ,&nbsp;Armin R. Afshar MD, MBA","doi":"10.1016/j.oret.2024.11.005","DOIUrl":"10.1016/j.oret.2024.11.005","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate patient-level differences in retinoblastoma presentation, treatments, and outcomes within the United States (US).</div></div><div><h3>Design</h3><div>Retrospective registry-based analysis.</div></div><div><h3>Participants</h3><div>One thousand, four hundred and four retinoblastoma cases in the National Cancer Database, 2004–2016, a US-based cancer registry.</div></div><div><h3>Methods</h3><div>Patient characteristics and treatments were investigated over time. Primary treatment was classified as enucleation, local tumor destruction, chemotherapy, and radiation. Multivariable logistic regression models evaluated extraocular disease at presentation, treatment, and local recurrence after primary globe-sparing therapy.</div></div><div><h3>Main Outcome Measures</h3><div>Odds ratios (ORs) for extraocular disease at presentation; primary treatment modality; local recurrence after primary globe-sparing therapy.</div></div><div><h3>Results</h3><div>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, who were uninsured or had government-funded insurance, or with nonmetropolitan 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 nonmetropolitan vs. metropolitan residence). Between 2004 and 2016, utilization of chemotherapy (55%–73%) and local tumor destruction (17%–27%) increased. Enucleations remained overrepresented among Hispanic patients (63% received enucleation in 2016, vs. 35% non-Hispanic patients; OR = 1.83 (95% confidence interval [CI] 1.22–2.75) for enucleation among Hispanic vs. White, non-Hispanic patients). Patients with Medicaid/Medicare/government insurance and nonmetropolitan residents also had higher odds of enucleation, and nonmetropolitan patients had higher odds of local recurrence after primary globe-sparing therapy.</div></div><div><h3>Conclusions</h3><div>Despite an overall decline in enucleation and increase in globe-sparing therapy between 2004 and 2016, Hispanic, Medicaid/Medicare/government-insured, and nonmetropolitan 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 toward globe-sparing treatment (chemotherapy and local tumor destruction) did not occur equally across all patient groups. Further investigations into these disparities are warranted.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 5","pages":"Pages 465-475"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","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":"Pneumatic Retinopexy for Rhegmatogenous Retinal Detachment Outcomes","authors":"Shane Griffin MD, MCR ,&nbsp;Lawrence Chan MD ,&nbsp;Kayne McCarthy MD, MPH ,&nbsp;Xuan Peng MS ,&nbsp;Charles Li BA ,&nbsp;Linda D. Harrison PhD ,&nbsp;Flora Lum MD ,&nbsp;Gaurav Shah MD","doi":"10.1016/j.oret.2024.10.025","DOIUrl":"10.1016/j.oret.2024.10.025","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine treatment patterns and outcomes of pneumatic retinopexy (PnR) for rhegmatogenous retinal detachments (RRDs).</div></div><div><h3>Design</h3><div>Retrospective cohort analysis using IRIS® Registry (Intelligent Research in Sight) database.</div></div><div><h3>Participants</h3><div>Patients with RRD treated by PnR from 2013 to 2022.</div></div><div><h3>Methods</h3><div>Cases were identified using International Classification of Diseases, Ninth and Tenth Revisions, diagnostic codes. Surgical procedures were identified using Current Procedural Terminology codes for type of RRD repair. Baseline demographic information included age, sex, race and ethnicity, geographic region, smoking status, and health insurance type.</div></div><div><h3>Main Outcome Measures</h3><div>Primary outcomes for PnR included single-operation success (SOS) and single-operation failure (SOF), change in visual acuity at 9 to 12 months, rates of complications, rates of secondary procedure after SOF, and outcome by phakic status.</div></div><div><h3>Results</h3><div>A total of 13 302 unique eyes were analyzed (median age, 64 years; 61.56% male). Overall SOS for primary PnR was 59.82%. The mean best-corrected visual acuity at 9 to 12 months after PnR was logarithm of the minimum angle of resolution 0.44 (95% confidence interval, 0.42–0.46) for SOF eyes, compared with 0.23 (95% confidence interval, 0.22–0.25) for SOS eyes (<em>P</em> &lt; 0.001). Complications of PR included vitreous hemorrhage (9.1%), epiretinal membrane (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, vitrectomy, or complex detachment repair, whereas the remaining eyes required more than one of these secondary procedures. Single-operation success for phakic eyes was 64.50% versus 53.93% for pseudophakic eyes (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>IRIS Registry data reveal clinical 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.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 5","pages":"Pages 437-443"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","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}