Ophthalmology. Retina最新文献

{"title":"Choroidal Folds in Checkpoint Inhibitor-Induced Vogt-Koyanagi-Harada-Like Uveitis.","authors":"Pedro Carreira, Mariana Vaz, Diogo Cabral","doi":"10.1016/j.oret.2024.10.002","DOIUrl":"https://doi.org/10.1016/j.oret.2024.10.002","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583843","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":"Association between Systemic Methotrexate Therapy and Proliferative Vitreoretinopathy.","authors":"Xinyi Chen, Jeremy D Keenan, Jay M Stewart","doi":"10.1016/j.oret.2024.10.023","DOIUrl":"10.1016/j.oret.2024.10.023","url":null,"abstract":"<p><strong>Objective: </strong>Proliferative vitreoretinopathy (PVR) is a major cause for failure of retinal detachment (RD) repair. We sought to determine if patients taking systemic methotrexate (MTX) therapy had a lower incidence of PVR.</p><p><strong>Design: </strong>Multicenter retrospective cohort study.</p><p><strong>Participants: </strong>Patients aged ≥18 years who were documented in the Sight Outcomes Research Collaborative (SOURCE) repository to have received a diagnosis of RD and have undergone RD repair surgery between 2004 and 2024. We only included patients who had been in the SOURCE system for at least 6 months before the diagnosis date and had no prior record of RD repair surgery. We excluded patients with an unknown laterality of the primary RD repair, history of PVR, proliferative diabetic retinopathy, serous RD, retinal dialysis, or ocular trauma.</p><p><strong>Methods: </strong>The exposure variable of interest was systemic MTX use, as documented from the medication list. The outcome of interest was the presence of new-onset PVR within 6 months of surgery. Incident PVR was modeled in log binomial regression models that included terms for systemic MTX use and method of primary RD repair. Regression models included inverse probability weights based on propensity scores for systemic MTX use. We conducted similar analyses for other antimetabolite agents (e.g., azathioprine and mycophenolate mofetil).</p><p><strong>Main outcome measures: </strong>Cumulative incidence of PVR and adjusted risk ratio (RR) of developing PVR within 6 months of the initial RD.</p><p><strong>Results: </strong>Of the 2674 eligible patients, 48 (1.8%) were taking systemic MTX at the time of RD repair. The 6-month cumulative incidence of PVR after the primary RD was 4.2% for patients taking systemic MTX compared with 9.2% for those not taking MTX (adjusted RR, 0.58; 95% confidence interval [CI], 0.47-0.71). Similar results were found for azathioprine (adjusted RR, 0.28; 95% CI, 0.22-0.37) but not mycophenolate mofetil (adjusted RR, 0.93; 95% CI, 0.77-1.11).</p><p><strong>Conclusions: </strong>Patients taking systemic MTX or azathioprine were significantly less likely to develop PVR within 6 months of primary RD compared with those not taking MTX or azathioprine.</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":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591336","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 Exudative Retinal Detachments due to Primary Hyperoxaluria in a Child.","authors":"Blanca Casado-Pelaez, Sara Khanji Fustek, Honorio Barranco Gonzalez","doi":"10.1016/j.oret.2024.09.012","DOIUrl":"https://doi.org/10.1016/j.oret.2024.09.012","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583834","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":"Myopic Tractional Maculopathy and Retinoschisis with Telangiectasia.","authors":"Livia Faes, K Bailey Freund","doi":"10.1016/j.oret.2024.09.015","DOIUrl":"https://doi.org/10.1016/j.oret.2024.09.015","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583858","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":"Electron Microscopy to Confirm Rhegmatogenous Cause of Retinal Detachments.","authors":"Shivesh Varma, Chris Van Vliet, Chandrakumar Balaratnasingam","doi":"10.1016/j.oret.2024.09.014","DOIUrl":"https://doi.org/10.1016/j.oret.2024.09.014","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583847","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":"Do Treatment Patterns for Endophthalmitis after Cataract Surgery Follow the Endophthalmitis Vitrectomy Study Recommendations?","authors":"Maurizio Tomaiuolo PhD ,&nbsp;Jordan Deaner MD ,&nbsp;Brian L. VanderBeek MD ,&nbsp;Binod Acharya MS ,&nbsp;Zeba A. Syed MD ,&nbsp;Qiang Zhang MD, PhD ,&nbsp;Joel S. Schuman MD ,&nbsp;Leslie Hyman PhD","doi":"10.1016/j.oret.2024.07.014","DOIUrl":"10.1016/j.oret.2024.07.014","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate whether treatment patterns for endophthalmitis after cataract surgery in American Academy of Ophthalmology IRIS® (Intelligent Research in Sight) Registry patients are in line with evidence-based guidelines established by the 1995 Endophthalmitis Vitrectomy Study (EVS), which showed that patients who present with light perception (LP) vision have better visual outcomes with immediate vitrectomy (VIT) compared with vitreous tap with antibiotic injection (TAP).</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Subjects</h3><div>Intelligent Research in Sight Registry patients undergoing cataract surgery between 2014 and 2022 (identified by Current Procedural Terminology codes), presenting with endophthalmitis (identified by International Classification of Diseases 10 codes) within 42 days postcataract surgery, and having a record of being treated with VIT or TAP on the same or 1 day after endophthalmitis diagnosis were identified.</div></div><div><h3>Methods</h3><div>Potential covariates of age, sex, race, ethnicity, geographic region, insurance status, and visual acuity on the day of endophthalmitis diagnosis were evaluated using multivariable logistic regression.</div></div><div><h3>Main Outcome Measures</h3><div>Treatment with VIT or TAP.</div></div><div><h3>Results</h3><div>Of the 2425 patients who met the inclusion criteria, 14% (345) underwent VIT and 86% (2080) underwent TAP. Notably, 80% of patients (1946) presented with endophthalmitis within 14 days from cataract surgery (median = 6 days). Notably, 66% (173/263) of the patients presenting with LP vision underwent TAP instead of VIT. In a multivariable logistic regression model, receiving VIT instead of TAP was positively associated with poor vision at endophthalmitis presentation (LP – odds ratio [OR] = 5.4; confidence interval [CI], 2.9–10.6; counting fingers, hand motions – OR = 1.9; CI, 1.1–3.6) versus (20/20–20/40) vision; Asian versus White race (OR = 2.6; CI, 1.3–5.2); Hispanic versus non-Hispanic ethnicity (OR = 1.9; CI, 1.1–3.2); living in the West (OR = 1.6; CI, 1.1–2.2) and Midwest (OR = 1.5; CI, 1.1–2.0) (vs. South), but not with age, sex, and insurance coverage (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>In the IRIS Registry, treatment patterns for postcataract surgery endophthalmitis did not match evidence-based recommendations of the EVS, a randomized controlled clinical trial. More work is needed to evaluate whether the current treatment patterns are optimal for patients with postcataract surgery endophthalmitis.</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":"8 11","pages":"Pages 1035-1043"},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760160","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":"Vitreous Veils in a Patient with Marfan Syndrome","authors":"","doi":"10.1016/j.oret.2024.04.001","DOIUrl":"10.1016/j.oret.2024.04.001","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"8 11","pages":"Page e41"},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852636","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":"Screen Failures in Clinical Trials in Retina","authors":"","doi":"10.1016/j.oret.2024.05.014","DOIUrl":"10.1016/j.oret.2024.05.014","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Disparities in clinical trials are a major problem because of significant underrepresentation of certain gender, racial, and ethnic groups. Several factors including stringent eligibility criteria and recruitment strategies hinder our understanding of retinal disease. Thus, we aimed to study the various reasons of screen failures and specific patient and study characteristics among screen failures.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;This is a cross-sectional retrospective study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Screening data of 87 trials from 6 centers were analyzed. Study characteristics (disease studied, phase of trial, and route of drug administration) and patient demographics (age, gender, race, ethnicity, and employment status) were compared among different causes of screen failures. Screen failures were broadly classified into 6 categories: exclusion because of vision-based criteria, exclusion because of imaging findings, exclusion because of other factors, patient-related criteria, physician-related criteria, and miscellaneous. Descriptive statistics, Pearson chi-square test, and analysis of variance were used for statistical analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;Prevalence of various reasons for screen failures in multiple trials and its trend among different study and patient characteristics.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among 87 trials and 962 patients, 465 (48.2%) patients were successfully randomized and 497 (51.8%) patients were classified as screen failures. The trials were conducted for various retinal diseases. Mean age was 76.50 ± 10.45 years and 59.4% were females. Predominantly White patients (93.4%) and unemployed/retired patients (66.6%) were screened. Of the 497 screen failures, most were because of patients not meeting inclusion criteria of imaging findings (n = 221 [44.5%]) followed by inclusion of vision-based criteria (n = 73 [14.7%]), exclusion because of other factors (n = 75 [15.1%]), patient-related (n = 34 [6.8%]), physician-related (n = 28 [5.6%]), and miscellaneous reasons (n = 39 [7.8%]). Reason for screen failure was not available for 27 (5.4%) patients. A higher proportion of patients screened for surgical trials (15%) declined to participate in the study compared with noninvasive trials involving topical drugs and photobiomodulation (0%) (&lt;em&gt;P&lt;/em&gt; = 0.02).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Patients not meeting the imaging and vision-cased criteria were the most common reasons for screen failures. White patients and unemployed patients predominantly participated in clinical trials. Patients are more inclined to continue participation in noninvasive clinical trials compared with surgical trials. Better recruitment strategies and careful consideration of study criteria can aid in decreasing the rate of screen failures.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Financial Disclosure(s)&lt;/h3&gt;&lt;div&gt;Proprietary or commercial disclosure may be found after the references i","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"8 11","pages":"Pages 1093-1099"},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176009","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":"Pachy-Reticular Pseudodrusen","authors":"","doi":"10.1016/j.oret.2024.05.020","DOIUrl":"10.1016/j.oret.2024.05.020","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize the features of a peculiar association between reticular pseudodrusen (RPD) and pachychoroid (pachy-RPD) and to compare them with eyes affected by RPD and normal/leptochoroid.</div></div><div><h3>Design</h3><div>Observational, retrospective, case–control study.</div></div><div><h3>Participants</h3><div>Among a cohort of patients with intermediate age-related macular degeneration (AMD), we selected eyes with RPD and pachychoroid (i.e., choroidal thickness of &gt;50 μm). A control group of RPD eyes but without pachychoroid (i.e., a choroidal thickness of &lt;250 μm) was included.</div></div><div><h3>Methods</h3><div><span>Number and stages of RPD were evaluated in each ETDRS subfield. Furthermore, choroidal perfusion was investigated using the choroidal vascularity index (CVI), and choriocapillaris perfusion density (PD) on structural </span>OCT<span> and OCT angiography.</span></div></div><div><h3>Main Outcome Measures</h3><div>Description of the multimodal imaging features of pachy-RPD and differences with RPD associated with normal/leptochoroid.</div></div><div><h3>Results</h3><div>Among 111 RPD eyes, 37 were included in the pachy-RPD group and 74 in the control group. Patients with pachy-RPD were significantly younger than patients with RPD and normal/leptochoroid (mean age, 75 ± 16 and 82 ± 7 years, respectively; <em>P</em> = 0.002). Total RPD number was comparable between the 2 groups (<em>P</em> = 0.220). However, pachy-RPD eyes showed a significantly higher number of stage 1 RPD in comparison to the controls (<em>P</em> &lt; 0.001), and a lower number of stage 3 (<em>P</em> &lt; 0.001) and stage 4 RPD (<em>P</em> = 0.052). The CVI and choriocapillaris PD were greater in pachy-RPD than in the control group (<em>P</em> &lt; 0.001 and <em>P</em>= 0.010, respectively).</div></div><div><h3>Conclusions</h3><div>Pachy-RPD are characterized by a different distribution of RPD stages (i.e., more early stages and fewer advanced stages) in comparison to RPD with normal/leptochoroid. Furthermore, pachy-RPD eyes showed greater perfusion indices of the choroid. These features suggest that the presence of pachychoroid could be a protective factor in the RPD evolution to the advanced AMD forms.</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":"8 11","pages":"Pages 1066-1073"},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284371","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":"Long-term Treatment Patterns for Diabetic Macular Edema","authors":"","doi":"10.1016/j.oret.2024.05.017","DOIUrl":"10.1016/j.oret.2024.05.017","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize anti-VEGF intravitreal therapy (IVT) patterns and long-term visual outcomes among patients with diabetic macular edema (DME) in routine clinical practice in the United States.</div></div><div><h3>Design</h3><div>Retrospective analysis of the American Academy of Ophthalmology’s IRIS® (Intelligent Research in Sight) Registry.</div></div><div><h3>Participants</h3><div>Treatment-naïve patients with DME (no previous IVT in the past 12 months) initiating anti-VEGF IVT from January 1, 2015, to March 31, 2021.</div></div><div><h3>Methods</h3><div>Baseline characteristics, treatment patterns, and long-term visual acuity (VA) outcomes were reported for up to 6 years of follow-up.</div></div><div><h3>Main Outcome Measures</h3><div>Outcomes included the annualized number of injections, change in VA, and anti-VEGF agents.</div></div><div><h3>Results</h3><div>A total of 190 345 eyes met the inclusion criteria. After 1 year of anti-VEGF IVT initiation, eyes received a mean of 3.9 (±2.8) injections and gained +3.2 (±16.4) letters of vision. Of the 1236 eyes with year 6 data, eyes received a mean of 2.9 (±2.1) injections in year 6 and gained +0.5 (±19.7) letters from baseline. The number of injections decreased, and injection intervals increased year over year up to 6 years regardless of baseline VA initiation. The average injection interval was 10 weeks in year 1 and increased to 13.2 weeks in year 2 before plateauing in years 3 to 6 (12.6, 12.3, 12.2, and 12.3 weeks, respectively). Improvements in VA from baseline were greatest in eyes that received 5 or more injections each year. At the end of follow-up, eyes with good baseline vision (&gt;20/25) lost vision, whereas those with worse baseline vision (&lt;20/25) gained vision. Although 51.7% of patients with DME discontinued IVT after a mean of 6 months, 32.8% reinitiated anti-VEGF IVT. Worse VA outcomes were associated with patients of Hispanic ethnicity (–1.08; 95% confidence interval: –1.34, –0.83] compared with non-Hispanic), Medicaid insurance (–1.15; 95% confidence interval: –1.48, –0.81 compared with commercial), and older age (–0.06; 95% confidence interval: –0.07, –0.05] each additional year).</div></div><div><h3>Conclusions</h3><div>Patients with DME in routine clinical settings receive fewer injections than those in clinical trials and fewer than recommended per the label of US Food and Drug Administration-approved anti-VEGF IVT.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found after the references in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"8 11","pages":"Pages 1074-1082"},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}