Ophthalmologica最新文献

{"title":"Changes in Serum Concentrations of Vascular Endothelial Growth Factors-A and B after Intravitreal Injection of Ranibizumab and Conbercept for Retinopathy of Prematurity.","authors":"Haitao Zhang,&nbsp;Xin Yang,&nbsp;Fangfang Zheng,&nbsp;Suhua Wan,&nbsp;Yingying Xu","doi":"10.1159/000529393","DOIUrl":"https://doi.org/10.1159/000529393","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to compare the changes in serum concentrations of vascular endothelial growth factor (VEGF)-A and B after intravitreal injection of ranibizumab (IVR) or conbercept (IVC) for retinopathy of prematurity (ROP).</p><p><strong>Methods: </strong>In this prospective study, infants with type 1 ROP in both eyes were recruited in our hospital from September 2021 to February 2022, randomly assigned to the ranibizumab and conbercept groups and administered IVR or IVC (0.25 mg/0.025 mL). Blood samples were collected before the operation and 1 and 4 weeks after the operation to measure the concentrations of serum VEGF-A and B.</p><p><strong>Results: </strong>A total of 20 ROP infants were randomly assigned to the ranibizumab (n = 10) and conbercept groups (n = 10). In the ranibizumab group, the serum VEGF-A concentrations before operation and 1 and 4 weeks after the operation were 73.55 ± 40.78, 11.47 ± 7.00, and 75.36 ± 30.87 pg/mL, respectively (p &lt; 0.01). Least Significant Difference (LSD) pairwise comparison did not show any significant difference in the groups between 4 weeks postoperatively and preoperatively (p &gt; 0.05). In the conbercept group, the serum VEGF-A concentrations before operation and 1 and 4 weeks after the operation were 86.69 ± 55.06, 14.68 ± 10.11, and 43.55 ± 57.92 pg/mL, respectively (p &lt; 0.01). LSD comparison showed significant differences between 1 week and 4 weeks postoperatively and preoperatively (p &lt; 0.05), but no significant differences were observed between 1 and 4 weeks postoperatively (p &gt; 0.05). Regarding serum VEGF-B concentrations before the operation and 1 and 4 weeks after the operation, no significant differences were detected in the ranibizumab group (p &gt; 0.05), but significant differences were observed in the conbercept group (7.26 ± 2.34, 3.09 ± 2.41, and 4.55 ± 3.37 ng/mL, respectively; p &lt; 0.01). LSD showed significant differences between 1 or 4 weeks postoperatively and preoperatively (p &lt; 0.05), but no significant difference was detected between 1 and 4 weeks postoperatively (p &gt; 0.05).</p><p><strong>Conclusions: </strong>Serum VEGF-A levels in infants with ROP were suppressed after IVR or IVC but returned to preoperative levels at 4 weeks after IVR and remained lower than the preoperative levels at 4 weeks after IVC. Serum VEGF-B was not affected by IVR but was suppressed by IVC for 4 weeks.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":"246 2","pages":"81-89"},"PeriodicalIF":2.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9872098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Diagnostic Findings of Acute Macular Neuroretinopathy and Paracentral Acute Middle Maculopathy in the COVID-19 Era.","authors":"Elias Premi, Roberto Acampora, Davide Salmi, Ingrid Ilie, Nadia Pagnoncelli, Francesco Germano, Greta Gandolfi, Melvin Sanicas, Adam Seed, Benedict Michael, Simone Donati, Claudio Azzolini, Francesco Lanfranchi","doi":"10.1159/000533530","DOIUrl":"10.1159/000533530","url":null,"abstract":"<p><strong>Background: </strong>Growing evidence suggests an association between the infection from the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and eye disorders. The aim of this review was to analyze the clinical presentation and diagnostic features of acute macular neuroretinopathy (AMN) and paracentral acute middle maculopathy (PAMM) associated with COVID-19 infection. The features are then compared with previous reports regarding these retinal disorders, to recognize possible specific characteristics and to assess the role of multimodal ophthalmic imaging.</p><p><strong>Summary: </strong>A literature search was performed by consulting PubMed, Scopus, and Embase. The following terms were searched: \"(COVID-19 OR SARS-CoV-2 OR coronavirus) AND ([acute macular neuroretinopathy] OR [paracentral acute middle maculopathy]).\" Inclusion criteria were as follows: (1) publication date from January 31, 2020 to January 31, 2022; (2) English language; (3) original research or case report; (4) free full-text availability.Optical coherence tomography (OCT) findings in AMN patients were hyper-reflectivity (HR) of the outer plexiform layer, of the outer nuclear layer, and ellipsoid or interdigitation zones (EZ and IZ, respectively) disruption. In most cases, the presence of HR and EZ/IZ abnormalities resulted combined. When performed, OCT angiography (OCTA) identified attenuation of signal of the deep capillary plexus (DCP). The most common OCT finding in PAMM was an alteration of the inner nuclear layer, associated with other areas of HR, while no signs of EZ/IZ disruption were detected. When performed, OCTA showed the attenuation of signal of both the DCP and the superficial capillary plexus.</p><p><strong>Key messages: </strong>In this review, we reported a case series of AMN and PAMM in patients with a previous or concomitant infection from SARS-CoV-2. The microvascular changes in these cases are highlighted by the OCTA scans. Even if we are far from the determination of a direct link between COVID-19 and these retinal disorders, we could hypothesize that the vascular alterations associated with SARS-CoV-2 infection could be a possible risk factor for both AMN and PAMM.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"181-191"},"PeriodicalIF":2.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10614461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9987904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of 2-Field and 5-Field Mydriatic Handheld Retinal Imaging in a Community-Based Diabetic Retinopathy Screening Program.","authors":"Lizzie Anne C Aquino, Recivall P Salongcay, Glenn P Alog, Kaye B Locaylocay, Aileen V Saunar, Tunde Peto, Paolo S Silva","doi":"10.1159/000530903","DOIUrl":"10.1159/000530903","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to compare 2-field (2F) and 5-field (5F) mydriatic handheld retinal imaging for the assessment of diabetic retinopathy (DR) severity in a community-based DR screening program (DRSP).</p><p><strong>Methods: </strong>This was a prospective, cross-sectional diagnostic study, evaluating images of 805 eyes from 407 consecutive patients with diabetes acquired from a community-based DRSP. Mydriatic standardized 5F imaging (macula, disc, superior, inferior, temporal) with handheld retinal camera was performed. 2F (disc, macula), and 5F images were independently assessed using the International DR classification at a centralized reading center. Simple (K) and weighted (Kw) kappa statistics were calculated for DR. Sensitivity and specificity for referable DR ([refDR] moderate nonproliferative DR [NPDR] or worse) and vision-threatening DR ([vtDR] severe NPDR or worse) for 2F compared to 5F imaging were calculated.</p><p><strong>Results: </strong>Distribution of DR severity by 2F/5F images (%): no DR 66.0/61.7, mild NPDR 10.7/14.4, moderate NPDR 7.9/8.1, severe NPDR 3.3/5.6, proliferative DR 5.6/4.6, ungradable 6.5/5.6. Exact agreement of DR grading between 2F and 5F was 81.7%, within 1-step 97.1% (K = 0.64, Kw = 0.78). Sensitivity/specificity for 2F compared 5F was refDR 0.80/0.97, vtDR 0.73/0.98. The ungradable images rate with 2F was 16.1% higher than with 5F (6.5 vs. 5.6%, p &lt; 0.001).</p><p><strong>Conclusions: </strong>Mydriatic 2F and 5F handheld imaging have substantial agreement in assessing severity of DR. However, the use of mydriatic 2F handheld imaging only meets the minimum standards for sensitivity and specificity for refDR but not for vtDR. When using handheld cameras, the addition of peripheral fields in 5F imaging further refines the referral approach by decreasing ungradable rate and increasing sensitivity for vtDR.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"203-208"},"PeriodicalIF":2.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9524163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"En Face\" Spectral-Domain Optical Coherence Tomography versus Multifocal Electroretinogram in Hydroxychloroquine Retinopathy Screening.","authors":"Martine Mauget-Faÿsse,&nbsp;Georges Sukkarieh,&nbsp;Hajar Jebrane,&nbsp;Justine Lafolie,&nbsp;Anne Sophie Alonso,&nbsp;Elsa Laumonier,&nbsp;Sabine Derrien,&nbsp;Veronique Le Guern,&nbsp;Francine Behar-Cohen,&nbsp;Sophie Thevenin,&nbsp;Emmanuel Augé,&nbsp;Jessica Guillaume,&nbsp;Vivien Vasseur,&nbsp;Nathalie Costedoat-Chalumean","doi":"10.1159/000528146","DOIUrl":"https://doi.org/10.1159/000528146","url":null,"abstract":"<p><strong>Introduction: </strong>The performance of \"en face\" optical coherence tomography (OCT) in screening for chloroquine (CQ) or hydroxychloroquine (HCQ) retinopathy has not been largely explored. The aim of this study was to determine the concordance of \"en face\" OCT with multifocal electroretinography (mfERG) in screening for CQ/HCQ retinopathy.</p><p><strong>Methods: </strong>This is a prospective cohort study conducted at the Rothschild Foundation Hospital, Paris, between August 2016 and February 2021. Patients taking HCQ were followed up over 2 consecutive years and received an \"en face\" OCT and a mfERG on each visit.</p><p><strong>Results: </strong>A total of 91 patients (182 eyes) were analyzed. mfERG and \"en face\" OCT were concordant in 147 eyes (86.3%). Cohen's kappa coefficient for concordance between mfERG and \"en face\" OCT was considered weak with a value 0.61 (95% CI: 0.50-0.72). The sensitivity and specificity of \"en face\" OCT were 70% (95% CI: 59-79%) and 91% (95% CI: 83-96%), respectively, relatively to mfERG. Proportion of abnormal R2/R5 and R3/R5 ratios did not differ between patients with normal and abnormal \"en face\" OCT (p = 0.2).</p><p><strong>Discussion: </strong>\"En face\" OCT and mfERG have low concordance and cannot be used interchangeably as each investigation evaluates a different facet of CQ/HCQ retinopathy. \"En face\" OCT could be used as a complement in screening for CQ/HCQ retinal toxicity if the anomalies detected on \"en face\" OCT are confirmed by B-scan OCT sections.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":"246 1","pages":"14-23"},"PeriodicalIF":2.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9550039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Treatment Regimen on the Initial Management of Macular Neovascularization Subtypes in Age-Related Macular Degeneration.","authors":"Kenny Kodaday,&nbsp;Laurent Kodjikian,&nbsp;Etienne Gadiollet,&nbsp;Nicolas Chirpaz,&nbsp;Olivier Loria,&nbsp;Audrey Feldman,&nbsp;Flore De Bats,&nbsp;Carole Burillon,&nbsp;Philippe Denis,&nbsp;Pierre Pradat,&nbsp;Thibaud Mathis","doi":"10.1159/000529409","DOIUrl":"https://doi.org/10.1159/000529409","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the effect of initial treatment regimen individualization (pro re nata or treat-and-extend [TAE]), according to macular neovascularization (MNV) subtype, on the functional and anatomical response in neovascular age-related macular degeneration (nAMD). The secondary objective was to compare the treatment burden between each MNV subtype.</p><p><strong>Methods: </strong>Consecutive treatment-naïve nAMD patients were retrospectively included. MNV subtype was graded by 2 independent blinded investigators on multimodal imaging. Functional and anatomical outcomes were analysed according to treatment regimen and MNV subtypes.</p><p><strong>Results: </strong>A total of 281 eyes from 243 patients were included in the study. According to the treatment regimen, there was no significant difference in best-corrected visual acuity gain within the first 2 years of treatment for type 1 (p = 0.106) and type 3 MNV (p = 0.704). Conversely, there was a significant difference in favour of TAE regimen for type 2 (p = 0.017) and type 4 MNV (p = 0.047). Type 1 MNV had a higher proportion of visits with subretinal fluid (p = 0.0007) but not with intraretinal fluid (p = 0.22). The mean interval between the last 2 injections was significantly shorter for type 1 MNV (p = 0.0045).</p><p><strong>Conclusion: </strong>The individualization of the initial treatment protocol according to MNV subtype can improve the functional outcome and may decrease the treatment burden.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":"246 2","pages":"113-122"},"PeriodicalIF":2.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10230771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Same-Day Bilateral Intravitreal Dexamethasone Implants for the Treatment of Diabetic Macular Edema.","authors":"Tai-Chi Lin, Po-Chen Tseng, Tsui-Kang Hsu, Hsin-Wei Huang, Yi-Ming Huang, Wen-Jung Lo, Chen-Yu Chao, Yu-Chien Chung","doi":"10.1159/000532056","DOIUrl":"10.1159/000532056","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the outcomes and complications associated with the use of same-day bilateral intravitreal dexamethasone (DEX) implants for the treatment of diabetic macular edema (DME).</p><p><strong>Methods: </strong>This retrospective analysis of an open-label, multicenter, consecutive case series included 130 eyes of 65 patients with bilateral DME who were treated with intravitreal DEX implants. The patients were divided into two groups: a control group (comprising 40 eyes treated with an alternating unilateral regimen) and a study group (comprising 90 eyes treated with concomitant bilateral DEX implants). All patients were followed up monthly after implantation. The changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) from baseline to sixth month after implantation, and ocular adverse effects such as intraocular pressure, cataract, and tolerability of bilateral implantation were reviewed. The primary endpoint was to assess the safety of the same-day bilateral treatment protocol. The secondary endpoints focused on evaluating the functional and anatomical changes associated with bilateral simultaneous or alternating implantations.</p><p><strong>Results: </strong>At 6 months after implantation, mean BCVA increased and CRT decreased in both groups. Moreover, no serious ocular adverse effects were observed. In addition, no differences were observed between the two groups in the number of patients who required extra follow-up visits or the number of extra visits made in addition to the treatment schedule.</p><p><strong>Conclusions: </strong>Same-day bilateral intravitreal DEX implants are associated with a low complication rate and are well tolerated by patients. This safe practice may optimize efficiency and reduce the burden on both the health-care system and patients, when used to treat bilateral DME.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"238-244"},"PeriodicalIF":2.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10316571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Presentations, Management, and Factors Affecting Outcomes in Posterior Segment Open Globe Injuries: An Analysis of 2,360 Eyes.","authors":"Vivek Pravin Dave,&nbsp;Anthony Vipin Das,&nbsp;Sameera Nayak,&nbsp;Bhavik Panchal,&nbsp;Ferenc Kuhn","doi":"10.1159/000529680","DOIUrl":"https://doi.org/10.1159/000529680","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to report the clinical presentations, management, and factors affecting the outcomes of posterior segment open globe injuries in 2,360 consecutive eyes.</p><p><strong>Methods: </strong>This was a retrospective, consecutive, non-comparative interventional case series. All cases with scleral and corneoscleral wounds presenting to these centers from January 2014 to January 2021 were included. The cases were defined according to the Birmingham Eye Traumatology Terminology system (BETTs) classification. The Ocular Trauma Score (OTS) was applied to the dataset.</p><p><strong>Results: </strong>Mean age of presentation was 36.63 ± 19.92 years (median 35 years). Penetrating trauma accounted for 70.92%, rupture for 18.6%, perforation for 4.60%, and IOFB in 5.88% eyes. In 76.60%, the location of injury involved zone 1 extending till zone 2, while in 23.40% it involved zone 2 and/or zone 3. Vision at presentation was logMAR 3.03 ± 0.99 and at the last visit was logMAR 2.47 ± 1.42 (p &lt; 0.0001). Time interval between presentation to the treatment center and globe repair was 13.93 ± 19.56 h (median 7.60 h). Favorable functional outcomes were seen in 29.20% eyes and favorable anatomic outcomes in 66.90%. Decreasing age at presentation, penetrating injury instead of rupture or perforating injury, a higher OTS, absence of corneal involvement, absence of retinal detachment at presentation, and absence of concurrent orbital fracture were associated with a favorable functional outcome (&gt;20/200). Final visual acuity in logMAR correlated with the OTS value calculated at presentation.</p><p><strong>Conclusions: </strong>In the absence of retinal detachment and orbital fracture, posterior open globe injuries typically have a favorable functional outcome. OTS correlated with the final visual acuity.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":"246 2","pages":"150-157"},"PeriodicalIF":2.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9787496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Management of Subretinal Hemorrhage in Neovascular Age-Related Macular Degeneration.","authors":"Damla Oncel, Deniz Oncel, Kapil Mishra, Murat Oncel, J Fernando Arevalo","doi":"10.1159/000534440","DOIUrl":"10.1159/000534440","url":null,"abstract":"<p><p>Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss among individuals aged 65 years and older in the USA. For individuals diagnosed with AMD, approximately 12% experience varying levels of subretinal hemorrhage (SRH), which can be further classified by size into small, medium, and massive measured in disc diameters. SRH is an acute and rare sight-threatening complication characterized by an accumulation of blood under the retina arising from the choroidal or retinal circulation. Released iron toxins, reduced nutrient supply, fibrin meshwork contraction, and outer retinal shear forces created by SRH contribute to visual loss, macular scarring, and photoreceptor damage. SRH treatment strategies aim to displace hemorrhage from the foveal region and prevent further bleeding. Although there are no standardized treatment protocols for SRH, several surgical and nonsurgical therapeutical approaches may be employed. The most common surgical approaches that have been utilized are pars plana vitrectomy (PPV) combined with multiple maneuvers such as the removal of choroidal neovascularization lesions, macular translocation, retinal pigment epithelium patch repair, SRH drainage, intravitreal injection of recombinant-tissue plasminogen activator (tPA), expansile gas and air displacement, and anti-vascular endothelial growth factor (anti-VEGF) injections. Nonsurgical therapeutical approaches include intravitreal anti-VEGF monotherapy, intravitreal tPA administration without PPV, and photodynamic therapy. This review article aims to explore the current treatment strategies and supporting literature regarding both surgical and nonsurgical, of SRH in patients with AMD. Moreover, this article also aims to highlight the distinct treatment modalities corresponding to different sizes of SRH.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"295-305"},"PeriodicalIF":2.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41127837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractive Outcomes of Combined Cataract Surgery and Vitrectomy Compared to Cataract Surgery Alone.","authors":"Gregg T Kokame, Tarin T Tanji, Ryan T Yanagihara, Jessica G Shantha, Rajinder S Nirwan, Troy M Tanji","doi":"10.1159/000526039","DOIUrl":"10.1159/000526039","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to evaluate the refractive outcomes of combined cataract surgery and vitrectomy compared to cataract surgery alone.</p><p><strong>Methods: </strong>This retrospective chart review study included two groups: (1) combined surgery in 103 eyes (101 patients) who underwent cataract surgery with posterior chamber intraocular lens (PCIOL) placement by a single cataract surgeon and vitrectomy by a single vitreoretinal surgeon at the same surgical setting; (2) cataract surgery alone by the same surgeon in 107 eyes (84 patients). Refractive outcomes and complications between the combined and cataract surgery alone group were compared. The predicted refractive error was compared to postoperative refractive outcomes in both groups, surgically induced astigmatism (SIA), intraoperative or postoperative complications of either cataract surgery or vitrectomy, and cystoid macular edema.</p><p><strong>Results: </strong>There was no statistically significant difference between predicted and actual postoperative refractive outcomes between the combined and cataract surgery alone groups (within ±0.5 diopters [D], p = 0.099; within ±1.0 D, p = 0.721). There was no difference in SIA refractive outcomes between the two groups (p = 0.509). The use of intraoperative gas for retina tamponade did not significantly affect postoperative refractive outcomes. Both cataract surgery and vitrectomy were successfully performed without unexpected complications from either procedure affecting the other.</p><p><strong>Discussion/conclusion: </strong>Combined cataract surgery and vitrectomy allows excellent refractive outcomes equal to cataract surgery alone, allowing each procedure to be performed independently by separate anterior and posterior segment surgeons. Combined procedures can be performed in eyes with a variety of retinal indications and can include fluid-gas exchange with minimal risk of PCIOL malposition or change in targeted refraction.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":"246 1","pages":"39-47"},"PeriodicalIF":2.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10906474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9882697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term Safety and Efficacy of Intravitreal Brolucizumab Injections for Neovascular Age-Related Macular Degeneration: A Multicenter Retrospective Real-World Study.","authors":"Dong Ju Kim, Ki Won Jin, Jeong Mo Han, Seung Hyun Lee, Yong Seok Park, Joo Yong Lee, Eun Kyoung Lee, Jun Sung Lee, Seong Taeck Kim, Min Ho Shin, Christopher Seungkyu Lee, Hyun Ho Jung, Jae Yong Jang, Min Kim, Yung Hui Kim, Jae Hui Kim, Kyu Hyung Park, Sang Jun Park, Kwangsic Joo, Yong Sok Ji, Min Sagong, Se Joon Woo","doi":"10.1159/000529410","DOIUrl":"10.1159/000529410","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to determine the short-term real-world safety and efficacy of intravitreal brolucizumab injections in Korean patients with neovascular age-related macular degeneration (nAMD).</p><p><strong>Methods: </strong>This multicenter retrospective study involved 294 eyes (treatment naïve 20 eye [6.8%] and nontreatment naïve 274 eyes [93.2%]) of 290 patients from 13 hospitals or retinal centers in South Korea. Patients with nAMD who received brolucizumab injection(s) between April 1 and November 30, 2021, with a follow-up ≥1 month, were included. Primary outcomes were safety, incidence of intraocular inflammation (IOI), and potential risk factors. The secondary outcome was efficacy, i.e., change in best-corrected visual acuity (BCVA) and optical coherence tomography-measured macular thickness and retinal fluid.</p><p><strong>Results: </strong>The mean age was 71.63 ± 8.66. The follow-up period was 2.38 ± 0.79 months. The mean number of brolucizumab injections during the follow-up was 1.52 ± 0.58. The overall incidence of IOI was 13.9% (n = 41 eyes). Most IOI cases were of anterior uveitis (8.8%, 26 eyes), followed by retinal vasculitis (2.4%, seven eyes) and occlusive retinal vasculitis (0.3%, one eye). Most eyes showed IOI resolution (n = 40, 97.5%) and BCVA restoration (n = 39, 95.1%) with or without corticosteroid treatment during the follow-up. Age, sex, IOI history, or other anti-vascular endothelial growth factor injection histories were not associated with the occurrence of IOI. However, only thin subfoveal choroidal thickness (SFCT) was associated with the occurrence of IOI (odds ratio = 0.995, p = 0.020). BCVA at 1 month improved from baseline (baseline 0.518 ± 0.356 vs. 1 month 0.503 ± 0.383, p = 0.023), but the improvement was not maintained. Anatomical improvement was significant after 3 months.</p><p><strong>Conclusion: </strong>In Korean patients with nAMD, the incidence of IOI following brolucizumab injections was 13.9%. IOI was well-controlled with or without steroid treatment. Most IOI eyes (95.1%) were restored to the level of vision before. IOI occurrence and occlusive vasculitis was rare. In the short term, brolucizumab injection effectively improved vision at 1 month and dried retinal fluid for 3 months.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"192-202"},"PeriodicalIF":2.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9158486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}