Stereotactic radiotherapy for neovascular age-related macular degeneration (STAR): a pivotal, randomised, double-masked, sham-controlled device trial.

Background: Neovascular age-related macular degeneration (nAMD) is a leading cause of blindness. The first-line therapy is anti-vascular endothelial growth factor (anti-VEGF) agents delivered by intravitreal injection. Ionising radiation mitigates key pathogenic processes underlying nAMD, and therefore has therapeutic potential.

Myopia in late adolescence and subsequent multiple sclerosis among men.

Background: Risk factors such as low vitamin D level has been implicated in the etiology of multiple sclerosis (MS) and may be relevant to myopia, such that there may be an association between myopia and MS.

Methods: Using linked Swedish national register data, we conducted a cohort study of men who were born in Sweden between 1950 and 1992, lived in Sweden between 1990 and 2018, and enrolled in military conscription assessment (n = 1,847,754). Myopia was defined based on the spherical equivalent refraction measured at conscription assessment, around age 18 years.

Retinal toxicity secondary to subconjunctival cefuroxime following pars plana vitrectomy: A case report and literature review.

Purpose: To present a case of inadvertent retinal toxicity induced by a standard dose of subconjunctival cefuroxime after epiretinal membrane surgery. Narrative review of cefuroxime overdose or toxicity after intraocular surgery was carried out to describe characteristics of cefuroxime toxicity and their relationship to visual outcome.

Observations: A 64-year-old man underwent pars plana vitrectomy (PPV) with epiretinal membrane peel and received a standard dose of subconjunctival cefuroxime as endophthalmitis prophylaxis.

Epimacular brachytherapy for previously treated neovascular age-related macular degeneration: month 36 results of the MERLOT randomised controlled trial.

Background/aim: To assess the long-term safety and efficacy of epimacular brachytherapy (EMB) for chronic, active, neovascular age-related macular degeneration (nAMD).

Methods: This pivotal, randomised, controlled surgical device trial recruited patients with chronic nAMD receiving intravitreal ranibizumab from 24 UK hospitals. Participants were randomised to either pars plana vitrectomy with 24 Gray EMB and (PRN) ranibizumab (n=224) or PRN ranibizumab monotherapy (n=119).

The Effect of Intravitreal Ocriplasmin on Hue Discrimination.

Significance: We report 13 patients who received ocriplasmin for symptomatic vitreomacular adhesion. Farnsworth-Munsell 100 (FM 100) hue test total error score (TES) increased from baseline to month 1, before recovering at year 1. Ocriplasmin may alter hue discrimination.

Confidence of UK Ophthalmology Registrars in Managing Posterior Capsular Rupture: Results from a National Trainee Survey.

Introduction: To establish the level of confidence amongst UK ophthalmology specialist registrars (residents) in managing posterior capsule rupture (PCR) during cataract surgery.

Methods: An online nine-item questionnaire was distributed to all registrars, recruited nationwide via regional representatives. Data collected included stage of training, number of completed cataract operations, cumulative PCR rate, number of PCRs independently managed, understanding of vitrectomy settings and fluidic parameters and access to simulation.

Diagnostic sensitivity of vitrectomy and vitreous biopsy for vitritis.

Purpose: To investigate sensitivity of diagnostic vitrectomy and vitreous biopsy for patients with vitritis of unknown aetiology.

Methods: Retrospective analysis of all vitrectomies and vitreous biopsies, performed at St Thomas' Hospital, London, UK, for vitritis between February 2001 and February 2019. Patients were identified using the VITREOR database and records were reviewed.

Re: Concept and application of relaxing radial retinectomy for retinal detachment with advanced proliferative vitreoretinopathy.

The following is a response to the recent review article by Girsang and colleagues (Int J Retina Vitreous. 2020;6:46), who describe concept and application of relaxing radial retinectomy for retinal detachment with advanced proliferative vitreoretinopathy. We discuss the distribution of the retinal nerve fiber layer, an aspect not touched on by the authors, and the importance of its consideration in determining visual field outcomes when performing retinectomy.

Effect of Aqueous Dynamics on Gas Behavior Following Retinal Reattachment Surgery.

Background And Objective: To determine how the gas concentration in air required to achieve full postoperative vitreous cavity fill varies in different aqueous outflow states.

Materials And Methods: A mathematical model was used to estimate gas dynamics. The change in gas bubble volume over time was calculated in an eye with normal aqueous outflow, ocular hypertension (OHT), and OHT with apraclonidine treatment.

Evaluation of Month-24 Efficacy and Safety of Epimacular Brachytherapy for Previously Treated Neovascular Age-Related Macular Degeneration: The MERLOT Randomized Clinical Trial.

Importance: Although anti-vascular endothelial growth factor (VEGF) treatment offers better outcomes than the natural history of neovascular age-related macular degeneration (ARMD), a less burdensome, less expensive, and more durable treatment is needed.

Objective: To assess the efficacy and safety of epimacular brachytherapy (EMB) for chronic, active, neovascular ARMD.

Design, Setting, And Participants: The Macular Epiretinal Brachytherapy vs Ranibizumab (Lucentis) Only Treatment (MERLOT) pivotal device trial was conducted at 24 National Health Service hospitals across the UK.

Improved Diagnosis of Retinal Laser Injuries Using Near-Infrared Autofluorescence.

Purpose: To assess whether near infrared autofluorescence (NIR-AF) imaging is a useful imaging modality in the diagnosis of handheld laser retinal injuries.

Design: Retrospective observational case series.

Methods: Twelve patients identified to have handheld laser retinal injuries were included at 2 academic centers.

Handheld laser devices and laser-induced retinopathy (LIR) in children: an overview of the literature.

Handheld laser devices are easily available to purchase through the internet and unregulated marketplaces at a relatively low cost. They are particularly attractive to children as they are seen as 'high tech', brightly coloured, and known to be able to burn holes in objects such as balloons. There is a widespread lack of knowledge about the risks of viewing the beam emanating directly from handheld lasers, and particularly those with high-output powers.

Considerations for using Natalizumab treatment in patients with a history of choroidal melanoma.

Natalizumab is a monoclonal antibody licensed for the treatment of relapsing-remitting multiple sclerosis (RRMS). It is known to increase the potential risk of developing progressive multifocal leukoencephalopathy (PML). There is current debate in the literature regarding its association with malignant melanoma.

INTRAOPERATIVE AND POSTOPERATIVE COMPLICATIONS IN PHACOVITRECTOMY FOR EPIRETINAL MEMBRANE AND MACULAR HOLE: A Clinical Audit of 1,000 Consecutive Eyes.

Purpose: The aim of this study was to report the intraoperative and postoperative complications of phacovitrectomy for epiretinal membrane (ERM) and macular hole (MH).

Methods: This was a retrospective audit of 1,052 phacovitrectomy operations (410 for ERM and 642 for MH) by the same surgical team between 1998 and 2017. Outcome measures included rates of intraoperative anterior segment and posterior segment complications such as posterior capsule rupture and retinal breaks.

THE ROLE OF INTRAOCULAR GAS TAMPONADE IN RHEGMATOGENOUS RETINAL DETACHMENT: A Synthesis of the Literature.

Purpose: To review the literature regarding intraocular gas tamponade after vitrectomy for rhegmatogenous retinal detachment.

Methods: The history and evolution of the use of gas is described. The theories explaining gas tamponade are discussed, and efficacy and safety studies in human and animal models are covered.

Ocriplasmin for symptomatic vitreomacular adhesion.

Background: Symptomatic vitreomacular adhesion (sVMA) is a recognised cause of visual loss and by tradition has been managed by pars plana vitrectomy (PPV). A less invasive alternative to surgery in some people is enzymatic vitreolysis, using an intravitreal injection of ocriplasmin.

Objectives: To assess the efficacy and safety of ocriplasmin compared to no treatment, sham or placebo for the treatment of sVMA.

Intravitreal gas for symptomatic vitreomacular adhesion: a synthesis of the literature.

Symptomatic vitreomacular adhesion (sVMA) is defined as visual loss secondary to foveal damage from vitreomacular traction (VMT) and includes isolated VMT, impending macular hole (MH), and full-thickness MH with persisting vitreous attachment. Management options include pars plana vitrectomy (PPV), intravitreal ocriplasmin, intravitreal gas injection or observation. This synthesis of the literature aimed to assess the safety and efficacy of intravitreal gas for sVMA.

StereoTactic radiotherapy for wet Age-Related macular degeneration (STAR): study protocol for a randomised controlled clinical trial.

Background: The standard of care for neovascular age-related macular degeneration (nAMD) involves ongoing intravitreal injections of anti-angiogenic drugs targeting vascular endothelial growth factor (VEGF). The most commonly used anti-VEGF drugs are ranibizumab, bevacizumab and aflibercept. The main objective of the STAR trial is to determine if stereotactic radiotherapy can reduce the number of anti-VEGF injections that patients with nAMD require.

Ethnic variation in vitreoretinal surgery: differences in clinical presentation and outcome.

Purpose: The true prevalence of retinal detachment and other vitreoretinal disorders in different ethnic groups is not well-established. Understanding differences in vitreoretinal disease prevalence is important to appropriately allocate resources to meet demand where ethnic variation in the community exists. The aim of this study is to provide hospital-based data on the proportion of people with vitreoretinal disorders in the 3 main ethnic groups in the United Kingdom: Caucasian, Afro-Caribbean, and South Asian.