{"title":"Atypical Central Retinal Vein Occlusion in an Older Man With Multiple Myeloma: A Case Report.","authors":"Matthew J Finn, John B Miller","doi":"10.3928/23258160-20240718-02","DOIUrl":"10.3928/23258160-20240718-02","url":null,"abstract":"<p><p>This report aims to describe the clinical presentation of a patient with an atypical central retinal vein occlusion (CRVO) in the setting of multiple myeloma. The patient was a 72-year-old man with an extensive hematologic-oncologic history and cardiovascular risk factors who presented with new-onset blurry vision and visual acuity (VA) of 20/40 in the left eye. The VA worsened to 20/60 two months after the initial presentation. By the 6-month follow-up visit, a series of three intravitreal bevacizumab injections for macular edema improved VA from 20/60 to 20/40. This case demonstrates the importance of fluorescein angiography in diagnosing a CRVO and exemplifies an atypical presentation on exam and imaging studies. <b>[<i>Ophthalmic Surg Lasers Imaging Retina</i> 2024;55:730-733.]</b>.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"730-733"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018249","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}
Hejin Jeong, Jacqueline K Shaia, Katherine E Talcott, Rishi P Singh
{"title":"Investigating the Relationship Between Lipid-Lowering Agents and the Complications of Diabetic Retinopathy.","authors":"Hejin Jeong, Jacqueline K Shaia, Katherine E Talcott, Rishi P Singh","doi":"10.3928/23258160-20240729-03","DOIUrl":"10.3928/23258160-20240729-03","url":null,"abstract":"<p><strong>Background and objective: </strong>As the therapeutic efficacy of lipid-lowering agents (LLA) against diabetic retinopathy (DR) remains controversial, this study aimed to evaluate whether various LLA therapies are associated with a reduced risk of DR progression.</p><p><strong>Patients and methods: </strong>This retrospective study of the medical records of adults with type 2 diabetes mellitus and DR compared the risk of adverse progression of DR between patients who received statins, fibrates, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, and no LLA (control).</p><p><strong>Results: </strong>Patients in the statin cohort had a reduced rate of progression to proliferative DR compared to controls (HR = 0.30, CI = 0.11 to 0.83). The PCSK9 inhibitor cohort had a reduced risk of progressing to other secondary complications of DR compared to the control (RR = 0.52, CI = 0.43 to 0.64), statin (RR = 0.69, CI = 0.61 to 0.79), and fibrate (RR = 0.67, CI = 0.59 to 0.77) cohorts.</p><p><strong>Conclusions: </strong>These findings suggest use of statins and PCSK9 inhibitors are associated with a reduced risk of adverse progression of DR. <b>[<i>Ophthalmic Surg Lasers Imaging Retina</i> 2024;55:706-713.]</b>.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"706-713"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133404","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}
Alexandra Warter, Anna Heinke, Melina Cavichini, Carlo Miguel B Galang, Fritz Gerald P Kalaw, Dirk-Uwe Bartsch, Lingyun Cheng, William R Freeman
{"title":"Simultaneous Intravitreal Steroid and Anti-VEGF Therapy for Monotherapy-Resistant Chronic Wet Age-Related Macular Degeneration.","authors":"Alexandra Warter, Anna Heinke, Melina Cavichini, Carlo Miguel B Galang, Fritz Gerald P Kalaw, Dirk-Uwe Bartsch, Lingyun Cheng, William R Freeman","doi":"10.3928/23258160-20240705-03","DOIUrl":"10.3928/23258160-20240705-03","url":null,"abstract":"<p><strong>Background and objective: </strong>The purpose of this study was to analyze the safety and efficacy of combined intravitreal anti-vascular endothelial growth factor (anti-VEGF) and steroid therapeutic agents for resistant choroidal neovascularization (CNV). A retrospective observational clinical study was performed assessing anatomic and visual changes in a consecutive cohort of patients with refractory chronic wet age-related macular degeneration resistant to high-dose aflibercept therapy.</p><p><strong>Patients and methods: </strong>Twelve eyes of 12 patients with unresponsive CNV despite aggressive monthly anti-VEGF (4-mg aflibercept [mean: 43.75 ± SD23.08]) were included. Combination consisted of simultaneous administration of anti-VEGF and corticosteroids. Study measures evaluated visual acuity, central retinal thickness (CRT), and intraocular pressure.</p><p><strong>Results: </strong>Paired tests revealed significant CRT reduction from the baseline at the 1-month (388.58 ± 89.31 versus 334.00 ± 92.88, <i>P</i> = 0.0117), 2-month (388.58 ± 89.31 versus 312.08 ± 75.61, <i>P</i> = 0.0185), and 3-month (388.53 ± 89.31 versus 304.56 ± 53.28, <i>P</i> = 0.046) visit. The Kaplan-Meier curve showed a median time of remission (no retinal fluid) of 70 days (95% CI 53, 147 days).</p><p><strong>Conclusion: </strong>Combination treatment demonstrated clear anatomic improvement in eyes with anti-VEGF-resistant CNV. <b>[<i>Ophthalmic Surg Lasers Imaging Retina</i> 2024;55:698-704.]</b>.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"698-704"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133407","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}
Promie R Faruque, Baichun Hou, Jin Kyun Oh, Stephen H Tsang
{"title":"A Novel CEP78 Variant Presenting as Cone Dystrophy and Hearing Loss.","authors":"Promie R Faruque, Baichun Hou, Jin Kyun Oh, Stephen H Tsang","doi":"10.3928/23258160-20240717-01","DOIUrl":"10.3928/23258160-20240717-01","url":null,"abstract":"<p><p>Mutations in CEP78 lead to abnormal production of cilia and have previously been identified to cause cone-rod dystrophy (CRD) with progressive sensorineural hearing loss. The authors describe a case of cone dystrophy (CD) with sensorineural hearing loss in a variant that had previously been reported to be of unknown significance and associated with CRD only. This report corroborates the pathogenicity of this variant and highlights that different phenotypes may be associated with one genotype. <b>[<i>Ophthalmic Surg Lasers Imaging Retina</i> 2024;55:742-746.]</b>.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"742-746"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018248","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}
Michael Balas, Mariam Issa, Marko M Popovic, Chris Zajner, Lana Moayad, Paola Oquendo Aponte, Hesham Hamli, Peng Yan, Tom Wright, Isabela M Melo, Rajeev H Muni
{"title":"Correlation Between Photoreceptor and Vascular Parameters in Diabetic Retinopathy Using Adaptive Optics.","authors":"Michael Balas, Mariam Issa, Marko M Popovic, Chris Zajner, Lana Moayad, Paola Oquendo Aponte, Hesham Hamli, Peng Yan, Tom Wright, Isabela M Melo, Rajeev H Muni","doi":"10.3928/23258160-20241015-03","DOIUrl":"https://doi.org/10.3928/23258160-20241015-03","url":null,"abstract":"<p><strong>Background and objective: </strong>This study aimed to investigate correlations between photoreceptor and vascular parameters in varying stages of diabetic retinopathy (DR) using adaptive optics (AO) imaging.</p><p><strong>Patients and methods: </strong>In this single-center, prospective cohort study, 29 participants (46 eyes) were classified into control/mild non-proliferative DR (NPDR), moderate/severe NPDR, and proliferative DR. AO images of photoreceptors and retinal vasculature were analyzed, and Spearman's correlation (ρ) was used to assess relationships between photoreceptor density and vascular parameters.</p><p><strong>Results: </strong>Higher cone density was inversely associated with total vessel (ρ = 0.22, <i>P</i> = 0.03) and lumen diameters (ρ = -0.24, <i>P</i> = 0.01), while higher dispersion was associated with total vessel (ρ = 0.19, <i>P</i> = 0.06) and lumen diameters (ρ = 0.21, <i>P</i> = 0.04). These associations were primarily significant in mild NPDR. No significant correlations were found in advanced DR stages.</p><p><strong>Conclusion: </strong>This study underscores intricate neurovascular correlations in early-stage DR, suggesting these parameters may aid in early disease detection. Further research is needed to understand whether similar correlations exist in advanced DR. <b>[<i>Ophthalmic Surg Lasers Imaging Retina</i> 2024;55:XX-XX.]</b>.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"1-9"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625290","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":"Injectable Fluocinolone Implant for the Management of Cystoid Macular Edema in Coats' Disease.","authors":"Kishan G Patel, Ashkan M Abbey","doi":"10.3928/23258160-20240621-03","DOIUrl":"10.3928/23258160-20240621-03","url":null,"abstract":"<p><p>A six-year-old boy with history of Coats' disease and cystoid macular edema (CME) was treated with a combination of peripheral retinal laser, anti-vascular endothelial grown factor injections, and short-acting injectable steroids to control his disease process. Given the excellent response to shorter acting steroids and the need for general anesthesia for each procedure, the patient underwent placement of the injectable fluocinolone acetonide implant 0.18 mg (YUTIQ) with control of his CME at 30 months of follow-up. The authors conclude that a long-acting steroid implant may be beneficial in select patients with Coats' disease. <b>[<i>Ophthalmic Surg Lasers Imaging Retina</i> 2024;55:679-681.]</b>.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"679-681"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971562","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":"Retinal Vascular Changes in a Case of Straatsma Syndrome.","authors":"Efe Koser, Rukiye Aydin Arslan, Merve Ozbek","doi":"10.3928/23258160-20241101-02","DOIUrl":"https://doi.org/10.3928/23258160-20241101-02","url":null,"abstract":"<p><p>A 34-year-old asymptomatic woman with a history of amblyopia in her right eye presented for a routine examination. Fundus examination revealed broad myelinated nerve fibers along with telangiectatic vessels. Wide-field fluorescein angiography revealed no evidence of ischemia or active retinal neovascularization. However, myelinated nerve fibers can infrequently exhibit cooccurring retinal vascular anomalies, harboring the potential for sight-threatening complications. Patients should be carefully monitored for the development of neovascularization and secondary complications. <b>[<i>Ophthalmic Surg Lasers Imaging Retina</i> 2024;55:XX-XX.]</b>.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"1-3"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731246","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}
Richmond Woodward, Todd L Fleming, Cason B Robbins, Delaram Mirzania, Henry L Feng, Sharon Fekrat
{"title":"Clinical Features Associated With Return to Pre-endophthalmitis Visual Acuity Following Presumed Infectious Endophthalmitis.","authors":"Richmond Woodward, Todd L Fleming, Cason B Robbins, Delaram Mirzania, Henry L Feng, Sharon Fekrat","doi":"10.3928/23258160-20241015-02","DOIUrl":"https://doi.org/10.3928/23258160-20241015-02","url":null,"abstract":"<p><strong>Background and objective: </strong>This study aimed to investigate clinical characteristics associated with return to pre-endophthalmitis visual acuity (VA) following treatment for presumed infectious endophthalmitis.</p><p><strong>Patients and methods: </strong>This was a retrospective study of 74 eyes with endophthalmitis and VA recorded ≤ 12 weeks before presentation and 6 months after presentation between 2009 and 2018.</p><p><strong>Results: </strong>Thirty-six of 74 eyes (49%) returned to preendophthalmitis VA. Eyes with a positive intraocular fluid culture had 71.5% lower odds of returning to pre-endophthalmitis VA. Nine of 10 eyes (90%) treated with initial pars plana vitrectomy failed to return to pre-endophthalmitis VA. Endophthalmitis following cataract surgery was a characteristic of eyes that returned to pre-endophthalmitis VA. Symptom duration, time to presentation, and treatment with systemic corticosteroids were not significant predictors of visual recovery.</p><p><strong>Conclusion: </strong>Just under 50% of eyes with presumed infectious endophthalmitis returned to preendophthalmitis VA. A positive intraocular culture is associated with failure to return to pre-endophthalmitis VA. <b>[<i>Ophthalmic Surg Lasers Imaging Retina</i> 2024;55:XX-XX.]</b>.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"1-5"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625284","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}
Arjan S Hura, Moshe A Mizrahi, Charu D Eluvathingal, John G Quinlan, Robert W Neel, Christopher D Riemann
{"title":"Intraoperative Electromyogram Analysis of Postural Musculature With Three-dimensional Screen Display Versus Operating Microscope in Ophthalmic Surgery: A Clinical Methods Study.","authors":"Arjan S Hura, Moshe A Mizrahi, Charu D Eluvathingal, John G Quinlan, Robert W Neel, Christopher D Riemann","doi":"10.3928/23258160-20240624-02","DOIUrl":"10.3928/23258160-20240624-02","url":null,"abstract":"<p><strong>Background and objective: </strong>To objectively analyze the effect of three-dimensional screen-based surgery (3D SBS) versus traditional operating microscope (TOM) on operating surgeon posterior chain postural musculature during ophthalmic surgery. We hypothesized an increase in median amplitude of electromyography (EMG) signals when using a TOM compared to 3D SBS. The goal was to assess surgical ergonomics that may contribute to cervical and lumbar spine pathology. EMG analysis was conducted at the University of Cincinnati Medical Center Epilepsy Monitoring Unit. Data were collected in the private practice setting at Cincinnati Eye Institute.</p><p><strong>Materials and methods: </strong>This was an institutional review board exempt, nonrandomized, prospective, single center, <i>n</i> = 1 clinical methods study. EMG surface electrodes were affixed to the bilateral splenius capitis, sternocleidomastoid, upper trapezius, anterior deltoid, and quadratus lumborum musculature. EMG data were collected across four sessions consisting of one day each using 3D SBS or a TOM, and two cross-over days. A survey regarding surgeon comfort was administered before, during, and after each surgery, and at the end of each day.</p><p><strong>Results: </strong>EMG cross-over data demonstrated an increase in muscle activation in all measured muscles except the anterior deltoids and right quadratus lumborum with use of a TOM. Survey data showed increased fatigue when using a TOM relative to 3D SBS.</p><p><strong>Conclusion: </strong>EMG demonstrated increased postural muscle activation when utilizing TOM relative to 3D SBS. Similar to previous studies, our survey data suggest inferior ergonomics of TOM relative to 3D SBS. <b>[<i>Ophthalmic Surg Lasers Imaging Retina</i> 2024;55:628-636.]</b>.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"628-636"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292841","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}