{"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}
{"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}
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}
Jade Y Moon, Ian Seddon, Jared T Sokol, Rebecca Zeng, Cassie A Ludwig, Frances Wu, Ehsan Rahimy, Steven K Houston, John B Miller
{"title":"Comparison of Ergonomics in Vitreoretinal Surgery With Heads-up Visualization Versus the Standard Operating Microscope as Measured by a Wearable Device.","authors":"Jade Y Moon, Ian Seddon, Jared T Sokol, Rebecca Zeng, Cassie A Ludwig, Frances Wu, Ehsan Rahimy, Steven K Houston, John B Miller","doi":"10.3928/23258160-20240508-02","DOIUrl":"10.3928/23258160-20240508-02","url":null,"abstract":"<p><strong>Background and objective: </strong>Three-dimensional heads-up display (HUD) systems have emerged as an alternative to standard operating microscope (SOM) in the operating room. The goal of this study was to quantitatively measure vitreoretinal surgeon posture across visualization methods.</p><p><strong>Methods: </strong>Ergonomic data was collected from 64 cases at two tertiary eye care centers. Surgeons wore an Upright Go 2<sup>TM</sup> posture training device while operating either using the NGENUITY 3D heads-up display visualization system or the SOM.</p><p><strong>Results: </strong>Total percentage of time with upright posture as primary surgeon was significantly higher in surgeries performed using HUD (median 100%, interquartile range [IQR], 85.1% to 100.0%) as compared to surgeries performed using the SOM (median 60.0%, IQR 1.8% to 98.8%) (<i>P</i> = 0.001, Wilcoxon rank-sum test). Percent time with upright posture was significantly higher in surgeries performed using HUD for two of the three surgeons when assessed independently across systems. Results remained significant when accounting for length of surgery (<i>P</i> < 0.001, multiple linear regression).</p><p><strong>Conclusions: </strong>Ergonomic positioning was improved for surgeons operating using HUD. Given the high prevalence of back and neck pain among vitreoretinal surgeons, increased use of HUD systems may limit musculoskeletal pain and long-term disability from poor ergonomics. <b>[<i>Ophthalmic Surg Lasers Imaging Retina</i> 2024;55:638-645.]</b>.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"638-645"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734771","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":"Letter to the Editor: PCSK9 Inhibitors and Lipid Lowering: Viewpoint on Diabetic Retinopathy.","authors":"Maria S Varughese, Ananth U Nayak","doi":"10.3928/23258160-20241101-05","DOIUrl":"https://doi.org/10.3928/23258160-20241101-05","url":null,"abstract":"","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"1-2"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731224","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":"What Is Private Equity and Why Should Its Increasing Presence in Ophthalmology Matter?","authors":"Sean T Berkowitz, Esther Lee Kim, Avni P Finn","doi":"10.3928/23258160-20240705-02","DOIUrl":"10.3928/23258160-20240705-02","url":null,"abstract":"","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"625-627"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018255","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}
Abdulmohsen Jameel Alshammari, Rakan Abu Alqam, Maram Abdulaziz Aldeej, Abdullah Mohammed Al-Omair, Lamar Abed Wazira, Jumana Abdullah Shafei, Abdulrahman Abdulaziz Kaki, Lina Hassan Raffa
{"title":"Retinal Detachment Following Cataract Surgery: A Systematic Review and Meta-analysis of Incidence, Preoperative Risk Factors, and Postoperative Complications.","authors":"Abdulmohsen Jameel Alshammari, Rakan Abu Alqam, Maram Abdulaziz Aldeej, Abdullah Mohammed Al-Omair, Lamar Abed Wazira, Jumana Abdullah Shafei, Abdulrahman Abdulaziz Kaki, Lina Hassan Raffa","doi":"10.3928/23258160-20240625-02","DOIUrl":"10.3928/23258160-20240625-02","url":null,"abstract":"<p><p>Cataract surgery is the most common surgical operation in the developed world, for treating cataracts, currently the leading cause of blindness worldwide. Retinal detachment (RD) is a potentially sight-threatening adverse effect of cataract surgery. The overall RD case numbers are high due to the common practice of cataract surgery. The Medline, Scopus, and Directory of Open Access Journals databases were searched for relevant articles using the keywords (phacoemulsification OR cataract surgery) AND (retinal detachment, detached retina). The included studies involved 5,480,448 patients, where 36,886 had RD (pooled incidence: 0.66 events per 100 patients, 95% CI 0.43 to 1.00). Male patients had significantly higher odds of developing RD than female patients (odds ratio = 1.73, 95% CI 1.68 to 1.78, <i>P</i> < 0.001). The RD incidence rate across locations was not significantly different. RD is one of the most significant complications following cataract surgery. <b>[<i>Ophthalmic Surg Lasers Imaging Retina</i> 2024;55:668-674.]</b>.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"668-674"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018253","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}