Comparison of The Results of Sponsored Genetic Testing Panels for Inherited Retinal Diseases.

: Gene therapy's emergence has made molecular diagnosis for inherited retinal diseases clinically significant. Free genetic testing panels have improved testing access in clinical practice, yet the interpretation of results, especially variants of unknown significance (VUS), remains challenging and requires expertise. This study shares our experience in utilizing sponsored IRD panel tests by Invitae and Blueprint Genetics (BG), reporting their positivity rates, and comparing their reclassification of variants through amendments.

Impact of anti-VEGF treatment on development of proliferative diabetic retinopathy in routine clinical practice.

Background: This study evaluated impact of anti-vascular endothelial growth factor (VEGF) treatment on proliferative diabetic retinopathy (PDR) development among patients with non-proliferative diabetic retinopathy (NPDR) in US real-world clinical practice.

Methods: This was a retrospective analysis of electronic medical records (Vestrum Health; January 2013 to June 2019) of eyes with baseline NPDR, without DME, and naïve to anti-VEGF treatment at index DR diagnosis. Eyes that received anti-VEGF and/or laser treatment over the course of study before development of PDR constituted the treated cohort while the remaining including those treated with laser constituted the anti-VEGF naïve cohort.

Epidemiology of rhegmatogenous retinal detachment in commercially insured myopes in the United States.

Myopia is a known risk factor for rhegmatogenous retinal detachment (RRD). Given global trends of increasing myopia, we aimed to determine the absolute risk (incidence rate) of RRD in non-myopes, myopes and high myopes in the United States over ten years. We performed a retrospective cohort study of 85,476,781 commercially insured patients enrolled in the Merative™ Marketscan Research Database.

Simulation of long-term impact of intravitreal anti-VEGF therapy on patients with severe non-proliferative diabetic retinopathy.

Objective: A simulation model was constructed to assess long-term outcomes of proactively treating severe non-proliferative diabetic retinopathy (NPDR) with anti-vascular endothelial growth factor (anti-VEGF) therapy versus delaying treatment until PDR develops.

Methods And Analysis: Simulated patients were generated using a retrospective real-world cohort of treatment-naive patients identified in an electronic medical records database (IBM Explorys) between 2011 and 2017. Impact of anti-VEGF treatment was derived from clinical trial data for intravitreal aflibercept (PANORAMA) and ranibizumab (RISE/RIDE), averaged by weighted US market share.

Factors associated with diabetic macular edema in patients with proliferative diabetic retinopathy.

Purpose: To identify factors associated with diabetic macular edema (DME) and to characterize the types of DME present in eyes with proliferative diabetic retinopathy (PDR).

Methods: Observational, retrospective case series of PDR patients reviewed for demographic information, general medical history, ophthalmologic history, optical coherence tomography (OCT), and fluorescein angiogram image characteristics. DME and vitreomacular interface (VMI) status were determined using OCT images.

Capillary density and caliber as assessed by optical coherence tomography angiography may be significant predictors of diabetic retinopathy severity.

Purpose: To validate retinal capillary density and caliber associations with diabetic retinopathy (DR) severity in different clinical settings.

Methods: This cross-sectional study assessed retinal capillary density and caliber in the superficial retinal layer of 3-mm OCTA scans centered on the fovea. Images were collected from non-diabetic controls and subjects with mild or referable DR (defined DR worse than mild DR) between February 2016 and December 2019 at secondary and tertiary eye care centers.

Relating Retinal Vascular Oxygen Saturation and Microvasculature Morphology at Progressive Stages of Diabetic Retinopathy.

Purpose: Diabetic retinopathy (DR) is a common cause of vision loss in working age adults and presents changes in retinal vessel oxygenation and morphology. The purpose of this study was to test the hypothesis that there is an association of retinal vessel oxygen saturation with vessel density (VD) and tortuosity in DR.

Methods: Ninety-five subjects were classified in the following groups: nondiabetic control (N = 25), no DR (N = 28), mild nonproliferative DR (NPDR; N = 21), moderate to severe NPDR (N = 14), or treated proliferative DR (PDR; N = 7).

Increasing Incidence and Prevalence of Common Retinal Diseases in Retina Practices Across the United States.

Background And Objective: To provide an updated estimate of incidence and prevalence of the foremost retinal diseases in the U.S.

Patients And Methods: Retrospective study of the Vestrum Health Database evaluating eyes with diagnoses of wet or dry age-related macular degeneration (AMD), diabetic macular edema (DME), diabetic retinopathy (DR), branch or central retinal vein occlusion (BRVO; CRVO) from January 2014 to December 2019 across 58 retina practices.

Five-Year Patterns of Diabetic Retinopathy Progression in US Clinical Practice.

Purpose: To characterize the natural course of diabetic retinopathy (DR) in contemporary clinical practice.

Patients And Methods: This was a retrospective analysis of US claims data collected between January 1, 2006, and April 30, 2017. Patients aged ≥18 years with continuous medical and prescription insurance coverage for 18 months before DR diagnosis (index date) and for a follow-up period of 5 years were included (N=14,490).

Visual Acuity Outcomes in Patients Receiving Frequent Treatment of Neovascular Age-Related Macular Degeneration in Clinical Practice.

Purpose: This work evaluates dosing frequency with intravitreal antivascular endothelial growth factor (anti-VEGF) agents over 2 years and visual acuity (VA) outcomes in neovascular age-related macular degeneration (nAMD).

Methods: This retrospective analysis assesses electronic medical record data (Vestrum Health treatment and outcomes database) of newly diagnosed nAMD in patients who were initiated on intravitreal anti-VEGF treatment at US clinical sites. Eyes were divided into 2 injection frequency subcohorts (≤ 6 or > 6 injections/y); treatment frequency and change in mean VA (Early Treatment Diabetic Retinopathy Study letters) were evaluated.

Evaluation of Patients Receiving Intravitreal Antivascular Endothelial Growth Factor for Diabetic Macular Edema in Clinical Practice in the United States.

Purpose: We assessed the effect of treatment frequency with intravitreal antivascular endothelial growth factor (anti-VEGF) agents on visual acuity (VA) in diabetic macular edema (DME).

Methods: This retrospective analysis assessed electronic medical records of eyes newly diagnosed with DME and treated with an anti-VEGF agent at US clinics using the Vestrum Health (Naperville, Illinois) treatment and outcomes database. Eyes were divided into 2 injection frequency subcohorts (≤ 6 vs > 6 injections/y); treatment frequency and change in mean VA (Early Treatment Diabetic Retinopathy Study letters) were evaluated.

Digital Nullification of Visual Distortion to Quantify Metamorphopsia: A Pilot Study.

Background And Objective: To evaluate a novel digital method of metamorphopsia quantification in patients with symptomatic visual distortion as determined by M-CHARTS.

Patients And Methods: In this institutional review board-approved, prospective, cross-sectional observational study, subjects were presented with an objectively straight dotted line that bisects a central fixation point. The subjects digitally altered the line's contour until it appeared straight.

Outcomes in Patients with Diabetic Macular Edema Requiring Cataract Surgery in VISTA and VIVID Studies.

Purpose: To evaluate the impact of cataract surgery on visual and anatomic outcomes in patients with diabetic macular edema treated with intravitreal aflibercept injection (IAI) or laser control and who did not require rescue therapy.

Design: Post hoc analysis of 2 phase 3 trials, Study of Intravitreal Aflibercept Injection in Patients with Diabetic Macular Edema (VISTA) and Intravitreal Aflibercept Injection in Vision Impairment Due to DME (VIVID).

Participants: Fifty-four patients (laser treatment, n = 11; IAI, n = 43) who underwent cataract surgery during the study period.

Elimination of a False-Negative Result With the M-CHARTS Metamorphopsia Assessment Tool Achieved Through Sampling Oblique Axes.

Standard implementation of the M-CHARTS metamorphopsia tool presents patients with only vertical and horizontal lines, potentially overlooking distortions not occurring within those precise meridians. The authors propose rotating the M-CHARTS testing booklet about the central fixation point until maximal distortion is perceived, after which sequential M-CHARTS testing can take place along that same axis. In a symptomatic patient with residual parafoveal fluid cysts after release of vitreomacular traction, M-CHARTS testing yielded standard testing scores of 0 (false-negative); upon rotating the reference test line, a score of 0.

FAILED LASER RETINOPEXY IN A PATIENT UNDERGOING PAZOPANIB THERAPY.

Purpose: To report a case of failed endolaser retinopexy in patient taking pazopanib and possible association with impaired retinal remodeling.

Methods: Case report.

Results: A 68-year-old man with a history of radiation-induced high-grade metastatic mediastinal leiomyosarcoma, on pazopanib 600 mg daily, presented with a superior retinal tear 2 months after initiating pazopanib.

Thomas A. Swift's Electric Rifle Injuries to the Eye and Ocular Adnexa: The Management of Complex Trauma.

Purpose: To report the ocular and adnexal injuries sustained by patients with Thomas A. Swift's electric rifles (TASER; TASER International, Scottsdale, AZ), review the literature, and discuss the management of this complex trauma.

Design: Multicenter, retrospective case series and literature review.

Outer Retinal Defects Represent a Normal Recovery Pathway Following Internal Limiting Membrane Peeling in Macular Hole Surgery.

Background And Objective: To examine perioperative factors associated with the development of outer retinal defects (ORDs) following surgical repair of macular holes (MHs).

Patients And Methods: An institutional review board-approved, retrospective, interventional cohort study was conducted. Patients who underwent MH repair during a 5-year period were identified.

LONG-TERM VISUAL OUTCOMES AND CLINICAL FEATURES AFTER ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR INJECTION-RELATED ENDOPHTHALMITIS.

Purpose: To determine long-term visual outcomes in patients who developed endophthalmitis after intravitreal anti-vascular endothelial growth factor injections and to correlate visual outcomes with clinical features.

Methods: This is a retrospective, multicenter, consecutive case series of patients diagnosed with anti-vascular endothelial growth factor injection-related endophthalmitis who were treated at Mid Atlantic Retina, the Retina Service of Wills Eye Hospital, Philadelphia, PA, and the University of Southern California Roski Eye Institute, Los Angeles, CA. Patients were included if they had at least 1 year of follow-up.

A novel classification of high myopia into anterior and posterior pathologic subtypes.

Purpose: High myopia and pathologic myopia are common causes of visual morbidity. Myopic pathology can affect all regions of the retina, though there is currently no classification system to distinguish anterior (peripheral) and posterior (macular) pathology. We hypothesize that these classifications are characterized by distinct demographic and refractive features, highlighting the disparity in types of pathologic myopia.

Ocular Tolerance of Contemporary Electronic Display Devices.

Electronic displays have become an integral part of life in the developed world since the revolution of mobile computing a decade ago. With the release of multiple consumer-grade virtual reality (VR) and augmented reality (AR) products in the past 2 years utilizing head-mounted displays (HMDs), as well as the development of low-cost, smartphone-based HMDs, the ability to intimately interact with electronic screens is greater than ever. VR/AR HMDs also place the display at much closer ocular proximity than traditional electronic devices while also isolating the user from the ambient environment to create a "closed" system between the user's eyes and the display.

Impact of Cataract Surgery during Treatment with Ranibizumab in Patients with Diabetic Macular Edema.

Purpose: To determine how best-corrected visual acuity (BCVA) was affected by cataract surgery in patients with diabetic macular edema (DME) who were treated with ranibizumab during the RIDE/RISE phase III trials.

Design: Post hoc analysis of data from RIDE and RISE, 2 phase III, parallel, randomized, multicenter, double-masked trials (clinicaltrials.gov identifiers, NCT00473382 and NCT00473330).

The Epidemiology of Retinopathy of Prematurity in the United States.

Background And Objective: Retinopathy of prematurity (ROP) is a leading cause of blindness in premature and low birth weight infants. Here, the authors examine the incidence of ROP in the United States and evaluate risk factors associated with ROP development.

Patients And Methods: The National Healthcare Cost and Utilization Project Kids' Inpatient Database was queried for all newborns with and without ROP.

Trends in Hospitalization and Incidence Rate for Syphilitic Uveitis in the United States From 1998 to 2009.

Purpose: This study evaluates the annual incidence of syphilitic uveitis in the US and trends in hospital admissions over time.

Design: Retrospective, longitudinal incidence rate analysis of the National Inpatient Sample (NIS) data from 1998 to 2009.

Methods: The NIS is a de-identified, random sample dataset of inpatient hospitalizations from 46 states.