Sandra Hoyek, Celine Chaaya, Muhammad Abidi, Francisco Altamirano Lamarque, Ryan S Meshkin, Varsha Giridharan, Kavach Shah, Efren Gonzalez, Eugene Pinsky, Nimesh Patel
{"title":"Artificial Intelligence for the Detection of Maculopathy in Pediatric Patients with Sickle Cell Disease.","authors":"Sandra Hoyek, Celine Chaaya, Muhammad Abidi, Francisco Altamirano Lamarque, Ryan S Meshkin, Varsha Giridharan, Kavach Shah, Efren Gonzalez, Eugene Pinsky, Nimesh Patel","doi":"10.1097/IAE.0000000000004663","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004663","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the feasibility of developing an artificial intelligence (AI) algorithm based on optical coherence tomography (OCT) images as an automated screening tool for diagnosing retinal thinning in children with sickle cell disease (SCD).</p><p><strong>Methods: </strong>This retrospective consecutive series included Children with SCD who had an ophthalmic examination at a Pediatric Tertiary Care Hospital, including OCT imaging between January 1998 and August 2022. Three different machine learning algorithms were evaluated: logistic regression, K-Nearest Neighbors (KNN), and random forest.</p><p><strong>Results: </strong>A total of 348 OCT scans from 174 eyes of 87 patients (54% males) were included. Using the original dataset, KNN algorithm outperformed both the random forest and logistic regression algorithms when using two OCT scans per patient. However, with cross-validation, this model's accuracy dropped to 77.11%. When duplicating the dataset's values, the random forest algorithm performed best, demonstrating the highest accuracy after cross-validation of 96.0%, AUC, sensitivity, specificity, and a F1 score all reaching 1, when using one OCT scan per patient.</p><p><strong>Conclusions: </strong>AI-based analysis of OCT imaging is a promising tool in the early detection of sickle cell maculopathy in the pediatric population.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Angela S Li, Paula Morales Moreno, Cesar Estrada Puente, Ramiro S Maldonado
{"title":"Factors Influencing the Delayed Diagnosis of Stargardt Disease and Impact on Therapeutic Opportunities.","authors":"Angela S Li, Paula Morales Moreno, Cesar Estrada Puente, Ramiro S Maldonado","doi":"10.1097/IAE.0000000000004691","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004691","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the delay between symptom onset and diagnosis in patients with early, intermediate, and late-onset Stargardt Disease (STGD) and identify possible factors contributing to this delay.</p><p><strong>Methods: </strong>Chart review was conducted for patients with confirmed STGD molecular diagnosis seen by an inherited retinal disease (IRD) specialist at a tertiary academic institution.</p><p><strong>Results: </strong>Eighty-seven patients were included. Average time from symptom onset to first IRD specialist visit was 10.95 years (SD=12.74). Average time between seeing a sub-specialist and IRD specialist was 8.09 years (SD=12.2), with the intermediate-onset group having a significantly longer delay (mean 13.1 years) compared to early-onset (mean 5.01 years, p=0.025) and late-onset group (mean 3.1 years, p=0.02). Visual acuity significantly decreased between seeing a sub-specialist and IRD specialist (p=0.047). Late-onset STGD patients were more likely to have intact subfoveal ellipsoid zone compared to early and intermediate-onset patients.</p><p><strong>Conclusions: </strong>STGD patients face long delays from symptom onset to molecular diagnosis, with progressive vision loss and missed opportunities for clinical trial enrollment. Contributing factors include age of onset, types of initial symptoms, and transitions in care from sub-specialist to IRD specialist. Multimodal screening, more streamlined referral pathways, expedited genetic testing, and greater awareness of highly variable STGD phenotypes may mitigate these delays.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jun Li, Chonglin Chen, Sufen Lu, Xiaoyang Ding, Chun Zhang
{"title":"Visual and Anatomic Outcomes of Vitrectomy for Myopic Maculoschisis with and without Macular Detachment: A Case-Control Study.","authors":"Jun Li, Chonglin Chen, Sufen Lu, Xiaoyang Ding, Chun Zhang","doi":"10.1097/IAE.0000000000004689","DOIUrl":"10.1097/IAE.0000000000004689","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the visual and anatomic outcomes of pars plana vitrectomy (PPV) between myopic maculoschisis with and without macular detachment (MD).</p><p><strong>Methods: </strong>This retrospective comparative study included 38 eyes of 38 patients who received PPV for myopic maculoschisis between July 2021 and July 2022. Two groups were identified based on whether preoperative MD was detected via optical coherence tomography (OCT): 16 eyes with MD and 22 eyes without MD. Surgical effects were assessed by the final best-corrected visual acuity (BCVA), ellipsoid zone (EZ) state, and the rate of complete fovea relief.</p><p><strong>Results: </strong>The postoperative follow-up were 15.25 ± 3.70 and 15.55 ± 3.39 months in the groups with and without MD, respectively ( P = 0.800). The preoperative logMAR BCVA was 1.21 ± 0.65 and 0.55 ± 0.37 in the groups with and without MD, respectively ( P = 0.001). Nevertheless, no difference existed in the postoperative BCVA at final visit between the groups with and without MD (0.51 ± 0.29 logMAR, ∼20/64 VS . 0.40 ± 0.41 logMAR, ∼20/50, P = 0.345). During the follow-up period, the rates of EZ band reconstruction were 40.00% (6/15) and 33.33% (2/6) in the groups with and without MD, respectively ( P = 0.590). Finally, a total of 33 eyes achieved complete fovea relief, including 13 eyes (81.25%) in the group with MD and 20 eyes (90.91%) in the group without MD ( P = 0.701).</p><p><strong>Conclusion: </strong>In myopic maculoschisis eyes, the presence of MD did not significantly affect postoperative visual or anatomical outcomes in our cohort.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association between Antibiotic Prophylaxis and Endophthalmitis Following Intravitreal Injection: A Systematic Review and Meta-analysis.","authors":"Xiao Liu, Ping Li, Jiawei Wang, Zhihui Song","doi":"10.1097/IAE.0000000000004687","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004687","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the incidence of endophthalmitis following intravitreal injection (IVI) with versus without topical antibiotic prophylaxis.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and the Cochrane Library from each database's inception through August 2024. The primary outcome measure was the endophthalmitis rates after IVI, while the secondary outcomes included the distribution and quantity of microorganisms and best-corrected visual acuity (BCVA) changes. Study quality was assessed using the Newcastle-Ottawa Scale. For the meta-analysis, pooled summary estimates were calculated using a random-effects model.</p><p><strong>Results: </strong>Eighteen studies (3,138,778 IVIs; 1,426 endophthalmitis cases) showed no significant difference in endophthalmitis incidence between prophylaxis and no-prophylaxis groups (Odds Ratio (OR) 1.85, 95% credible interval (CI) 0.72-4.76; P=0.2). For microbial analysis, we selected eleven studies that demonstrated no significant difference in culture-positive rates between prophylaxis and non-prophylaxis groups (OR, 1.23; 95%CI, [0.53, 2.84]; p = 0.63). Four studies provided best-corrected visual acuity (BCVA) changes from baseline to final follow-up, antibiotic prophylaxis group showed a decrease by 4.5 ETDRS letters compared to the no-prophylaxis group, although this difference was not statistically significant (p=0.65).</p><p><strong>Conclusion: </strong>Topical antibiotics did not reduce endophthalmitis risk or improve visual outcomes post-IVI. Given potential risks, routine prophylaxis is not recommended.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marcus Yamamoto, Justin Hanson, Alejandro Itzam Marin, Bradley Gundlach, Adrian Au, Kirk Hou, Hamid Hosseini, Moritz Pettenkofer, Colin McCannel, Pradeep Prasad, Judy Chen, Edmund Tsui, Irena Tsui
{"title":"Efficacy and Safety of Suprachoroidal Triamcinolone Acetonide in Mixed Etiology Non-Infectious Cystoid Macular Edema.","authors":"Marcus Yamamoto, Justin Hanson, Alejandro Itzam Marin, Bradley Gundlach, Adrian Au, Kirk Hou, Hamid Hosseini, Moritz Pettenkofer, Colin McCannel, Pradeep Prasad, Judy Chen, Edmund Tsui, Irena Tsui","doi":"10.1097/IAE.0000000000004688","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004688","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the efficacy and safety of suprachoroidal triamcinolone acetonide (SCS-TA) in the management of non-infectious cystoid macular edema (CME) of various etiologies.</p><p><strong>Methods: </strong>Retrospective observational study of 61 eyes of 56 patients with non-infectious CME who received SCS-TA injection. Primary outcomes were treatment response, central subfield thickness (CST), visual acuity (VA) and intraocular pressure (IOP) at baseline, one-month, and three months post-injection.</p><p><strong>Results: </strong>CME etiology included post-operative, uveitis, diabetes mellitus, and retinal vein occlusion. Complete resolution of CME occurred in 34 eyes (58.6%) at 1 month and 23 eyes (50.0%) at 3 months. Median CST improved from 430.0 µm (IQR, 366.0-547.5) to 297.0 µm (IQR, 277.0-392.0) at 1 month (p<0.001) and 326.5 µm (IQR, 263.9-380.6) at 3 months (p<0.001). VA improved from logMAR 0.60 (IQR, 0.40-0.88) [20/80] at baseline to 0.48 (IQR, 0.30-0.70) [20/60] at 1 month (p=0.002) and logMAR 0.44 (IQR, 0.18-0.88) [20/60] at 3 months (p=0.019). Significant IOP elevation was noted in 7 eyes (11.5%) overall, with no occurrences of infection, cataract progression, or suprachoroidal hemorrhage.</p><p><strong>Conclusion: </strong>SCS-TA demonstrated significant anatomical and functional improvements in eyes with non-infectious CME and a reassuring side effect profile.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Novel Intraoperative Use of an Ultra-widefield Imaging for Retinoblastoma.","authors":"Young Je Choi, Tae Young Kim, Min Kim","doi":"10.1097/IAE.0000000000004676","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004676","url":null,"abstract":"","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carol L Shields, Robert J Medina, Taweevat Attaseth, Sara E Lally
{"title":"Lack of Complications of High-Dose Intravitreal Topotecan for Recurrent Retinoblastoma in 81 Consecutive Injections.","authors":"Carol L Shields, Robert J Medina, Taweevat Attaseth, Sara E Lally","doi":"10.1097/IAE.0000000000004678","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004678","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the safety of high-dose intravitreal topotecan (HD-IvitTopo) for recurrent retinoblastoma management in human eyes.</p><p><strong>Methods: </strong>There were 81 consecutive injections of HD-IvitTopo (90 micrograms (µg)/0.18cc-100 µg/0.20cc on a monthly basis) in 25 eyes with recurrent retinoblastoma. Tumor control and injection-related complications were assessed at each visit. Each tissue was reviewed for complication-associated alterations and systemic evaluation for myelosuppression, infection, metastasis, and death was assessed.</p><p><strong>Results: </strong>At the time of injection, the mean patient age was 26 months and in all cases the injection was for recurrent retinoblastoma (n=24 eyes, 100%) involving intraretinal tumor (n=6 eyes, 24%), vitreous seeds (n=3 eyes, 12%), subretinal seeds (n=13 eyes, 52%), or multiple tumor types (n=3 eyes, 12%). The mean intraretinal tumor thickness was 2.2 mm, vitreous seed thickness varied from pinpoint to confluent seeds, and subretinal seed was 0.9 mm. The total number of HD-IvitTopo injections was 81 (mean 3.2 per eye) with 39 (48%) injections given without concurrent chemotherapy and 42 (52%) given with concurrent intravenous or intra-arterial chemotherapy. At mean follow-up of 10 months after first injection, tumor control was achieved in all cases (n=81 injections, 100%) and there was no local or systemic complication in any of the 81 injections. There was no case of extraocular tumor extension, myelosuppression, infection, metastasis, or death.</p><p><strong>Conclusions: </strong>Based on this analysis, HD-IvitTopo is safe and effective in the management of recurrent small retinoblastoma in humans. Further investigation of the limits of this therapy is warranted.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Edward Barayev, Mor Krubiner, Timna Leshchinski, Alon Tiosano, Orly Gal-Or, Jerzy Nawrocki, Zofia Anna Nawrocka, Rita Ehrlich
{"title":"Prognostic factors for development of gliosis after internal limited membrane flap for idiopathic macular holes.","authors":"Edward Barayev, Mor Krubiner, Timna Leshchinski, Alon Tiosano, Orly Gal-Or, Jerzy Nawrocki, Zofia Anna Nawrocka, Rita Ehrlich","doi":"10.1097/IAE.0000000000004685","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004685","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the prognostic factors for development of gliosis after idiopathic macular hole (IMH) surgery, and its relationship to functional and anatomical success.</p><p><strong>Methods: </strong>This retrospective study included patients with IMH that underwent PPV using internal limiting membrane (ILM) flap technique. OCT examinations were done at baseline, 1 month and 6 months postoperatively. Postoperative parameters on OCT included hole closure, outer retinal layers continuity and development of gliosis.</p><p><strong>Results: </strong>Sixty-five patients with IMH were included in the study. Forty-three underwent temporal flap and 22 an inverted flap 360° around the hole. Gliosis was present at 8 (12.3%) eyes at 1 and 6 months postoperatively. Patients with gliosis at 6 months had larger minimal hole diameter at presentation (622µm ± 140 vs 423 ± 178, p=0.004). Gliosis was associated with worse BCVA at presentation (0.86± 0.49 logMAR (20/145) vs 0.43 ± 0.37 (20/54), p=0.008) and 1 month postoperatively (0.91 ± 0.59 logMAR (20/160) vs 0.42 ± 0.48 (20/53), p=0.013) but not at 6 months postoperatively (0.55 ± 0.31 logMAR (20/70) vs 0.43 ± 0.33 (20/54), p=0.222).</p><p><strong>Conclusion: </strong>Our study supports the use of inverted ILM flap for IMH as a primary procedure. No gliosis was shown in small macular holes undergoing this technique. Even in large IMH where gliosis has developed, an improvement in visual acuity was shown after surgery.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evita Evangelia Christou, Yingjia Yang, Imran H Yusuf, Helen Mi, Amanda Ie, Katharina Eibenberger, Peter Charbel Issa, Robert E MacLaren, Jasmina Cehajic-Kapetanovic
{"title":"Direct posterior retinal injury caused by intravitreal injections: management and outcomes from a vitreoretinal perspective.","authors":"Evita Evangelia Christou, Yingjia Yang, Imran H Yusuf, Helen Mi, Amanda Ie, Katharina Eibenberger, Peter Charbel Issa, Robert E MacLaren, Jasmina Cehajic-Kapetanovic","doi":"10.1097/IAE.0000000000004679","DOIUrl":"10.1097/IAE.0000000000004679","url":null,"abstract":"<p><strong>Purpose: </strong>To report the clinical presentation, management, complications and outcomes after retinal injuries caused by intravitreal injections.</p><p><strong>Methods: </strong>Retrospective case series of twelve eyes presenting with visual deterioration due to vitreoretinal complications secondary to trauma caused by intravitreal injections. Detailed ocular history, clinical examination, vitreoretinal complications, management, final anatomical and visual outcomes are documented.</p><p><strong>Results: </strong>We observed 12 cases of direct retinal trauma by the needle tip of intravitreal injection. All retinal injuries were located in the temporal mid-periphery, usually near the inferior arcade. Of the twelve patients, four eyes developed a retinal detachment, all with proliferative vitreoretinopathy, six had vitreous hemorrhage, and two eyes presented with a focal chorioretinal atrophic lesion. The patients either underwent surgical procedure or were closely monitored after the injury. The surgical intervention was successful in terms of anatomical outcomes in all cases. Ten eyes had a final visual acuity similar to baseline while two eyes experienced visual deterioration during a follow up of at least 6 months.</p><p><strong>Conclusion: </strong>Direct retinal injury with the intravitreal injection needle is a rare but possibly underreported adverse event. Early detection of these complications, especially if associated with retinal detachment, is important for timely and appropriate management to avoid permanent loss of vision.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}