Efficacy and safety of 'dropless vitrectomy surgery' and comparison of outcomes to standard of care topical therapy.

Objective/background: To compare the effectiveness of intravitreal injection of triamcinolone acetonide/moxifloxacin (Tri-Moxi) with the standard eye drop regimen for controlling postoperative inflammation, intraocular pressure, infections, macular thickness, and visual acuity (VA) in patients undergoing pars plana vitrectomy for various retinal disorders.

Subject/methods: In this retrospective longitudinal study, patients who underwent vitrectomy using intravitreal Tri-Moxi at the end of surgery (Group 1) were compared with those who received standard topical steroid antibiotics (Group 2) in terms of intraocular inflammation, intraocular pressure, macular thickness based on optical coherence tomography, and visual acuity.

Results: In total, 162 consecutive eyes (group 1 [81 eyes]; group 2 [82 eyes]) were included.

An Artificial Intelligence Driven Approach for Classification of Ophthalmic Images using Convolutional Neural Network: An Experimental Study.

Background: Early disease detection is emphasized within ophthalmology now more than ever, and as a result, clinicians and innovators turn to deep learning to expedite accurate diagnosis and mitigate treatment delay. Efforts concentrate on the creation of deep learning systems that analyze clinical image data to detect disease-specific features with maximum sensitivity. Moreover, these systems hold promise of early accurate diagnosis and treatment of patients with common progressive diseases.

Successful closure of a refractory giant (15 sq mm) macular hole with amniotic membrane graft.

The management of macular hole defects has undergone a significant transformation with the advent of advanced diagnostic tools and surgical techniques. These developments have enabled the effective treatment of macular holes that were previously considered untreatable. Although the majority of patients exhibit a positive response to initial treatment, a subset of patients may develop refractory macular holes that necessitate multiple surgeries for closure.

Recent Advances in Imaging Macular Atrophy for Late-Stage Age-Related Macular Degeneration.

Age-related macular degeneration (AMD) is a leading cause of blindness worldwide. In late-stage AMD, geographic atrophy (GA) of dry AMD or choroidal neovascularization (CNV) of neovascular AMD eventually results in macular atrophy (MA), leading to significant visual loss. Despite the development of innovative therapies, there are currently no established effective treatments for MA.

Faricimab Effectively Resolves Intraretinal Fluid and Preserves Vision in Refractory, Recalcitrant, and Nonresponsive Neovascular Age-Related Macular Degeneration.

Purpose: To evaluate the functional and anatomic outcomes of faricimab treatment in patients with neovascular age-related macular degeneration (nAMD) who are unresponsive to other anti-vascular endothelial growth factor (VEGF) therapies.

Methods: A retrospective interventional study was conducted on patients with refractory nAMD who were initially treated with intravitreal bevacizumab, ranibizumab, or aflibercept. These patients were switched to monthly faricimab injections.

Opacification of a scleral-sutured Akreos AO60 intraocular lens in the absence of concurrent or subsequent surgery: a case series.

Scleral-fixated intraocular lenses (SCIOLs) are an increasingly used option to place intraocular lenses in patients with compromised capsules. Akreos A060 is an acrylic hydrophilic lens that is commonly used for patients in need of SCIOL. As with other hydrophilic lenses, the Akreos A060 lens is associated with a risk of developing postoperative opacifications.

Photodynamic Therapy-Induced Acute Exudative Maculopathy (PAEM): Prevalence, Impact and Management Strategies.

Photodynamic therapy (PDT) has a niche role in treating various choroidal pathologies. PDT-induced acute exudative maculopathy (PAEM) is an uncommon complication of PDT that results in exudative retinal detachment and mild to severe decrease in vision. Successful management strategies include observation, local or systemic corticosteroids, and intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections.

Successful management of a rare case of endogenous endophthalmitis from soft tissue (gluteal) abscess.

Endophthalmitis, an ophthalmic emergency carries poor visual prognosis without prompt diagnosis and treatment. Endophthalmitis is often exogenous and rarely endogenous. In this report, we describe a rare case of bacterial endogenous endophthalmitis in an immunocompetent 51-year-old patient due to methicillin-resistant staphylococcus aureus septicemia from a gluteal abscess.

Optics and Utility of Low-Cost Smartphone-Based Portable Digital Fundus Camera System for Screening of Retinal Diseases.

Purpose: To describe optical principles and utility of inexpensive, portable, non-contact digital smartphone-based camera for the acquisition of fundus photographs for the evaluation of retinal disorders.

Methods: The digital camera has a high-quality glass 25 D condensing lens attached to a 21.4-megapixel smartphone camera.

Coronavirus disease 2019 vaccination in patients with psoriasis: A position statement from India by SIG psoriasis (IADVL Academy).

Coronavirus disease 2019 (COVID-19) pandemic has affected every sphere of life including management of psoriasis. The availability of COVID-19 vaccines has given rise to hope and at the same time some apprehensions as well. With the general population becoming eligible for vaccination, there is some confusion, on the eligibility of patients with different medical conditions and patients on immunosuppressive or immunomodulating medications for COVID-19 vaccination.

Baseline retinal thickness measurements with a novel integrated imaging system (concurrent optical coherence tomography and fundus photography) positively correlates with spectralis optical coherence tomography.

Background: Traditionally fundus photographs and optical coherence tomography (OCT) are obtained separately during evaluation of retinal pathology. We describe a novel integrated imaging system (Monaco, Optos) that records both OCT as well as fundus photography concurrently. The present study aims to measure retinal thickness and compare it to OCT obtained with traditional spectral domain OCT in subjects without known retinal disease to establish normative data for clinical use.

Conversion of Central Subfield Thickness Measurements of Diabetic Macular Edema Across Cirrus and Spectralis Optical Coherence Tomography Instruments.

Purpose: Develop equations to convert Cirrus central subfield thickness (CST) to Spectralis CST equivalents and vice versa in eyes with diabetic macular edema (DME).

Methods: The DRCR Retina Network Protocol O data were split randomly to train (70% sample) and validate (30% sample) conversion equations. Data from an independent study (CADME) also validated the equations.

Successful Management of Complex Rhegmatogenous Retinal Detachment in Congenital Glaucoma.

Retinal detachment in congenital glaucoma is rare and often associated with a poor prognosis. In this report, we describe ocular manifestations of congenital glaucoma, pre- and post-operative ophthalmic findings, and overall anatomic and functional outcomes after successful rhegmatogenous retinal detachment repair along with a review of the literature. Rhegmatogenous retinal detachment in a 45-year-old monocular patient with congenital glaucoma was successfully repaired with small gauge pars plana vitrectomy, intra-operative perfluorocarbon use and 1,000 centistoke silicone oil tamponade.

Successful delivery of subretinal aflibercept (new surgical technique) for the treatment of submacular hemorrhage in idiopathic polypoidal choroidal vasculopathy.

Submacular hemorrhage (SMH) is often a result of trauma, wet age-related macular degeneration or IPCV and frequently leads to blindness secondary to extreme toxicity of hemoglobin products on photoreceptors. We describe a new technique of subretinal aflibercept injection during pars plana vitrectomy for the treatment of SMH in idiopathic polypoidal choroidal vasculopathy (IPCV). A 55-old male presented with sudden loss of vision (HM) secondary to massive subretinal hemorrhage associated with IPCV.

Pembrolizumab dramatically resolves choroidal metastatis from esophageal adenocarcinoma and restores vision: a case report.

Esophageal adenocarcinoma historically is an aggressive cancer with poor long-term survival. Ocular metastasis secondary to gastrointestinal malignancy is rare. In managing patients with ocular metastasis, quality of life (specifically vision preservation) is one of the most important factors patients and providers consider when deciding on a treatment regimen.

The role of oral steroids in the treatment of photodynamic therapy-associated exudative maculopathy, a case report and review of the literature.

Background: Photodynamic therapy (PDT) is an effective treatment of pachychoroid spectrum disease. PDT can cause a rare complication known as PDT-associated exudative maculopathy (PAEM). Treatments including intravitreal anti-vascular endothelial growth factor (anti-VEGF) medications, local or systemic steroids, and observation have been attempted with variable success to address this complication.

Successful repair of spontaneous indirect bilateral carotid-cavernous fistula with coil embolization.

Bilateral carotid-cavernous fistula (CCF) is a rare disease process, which portends poor visual outcome with delayed diagnosis and treatment. An 82-year-old woman presented with sudden onset of proptosis and decreased vision. A complete ophthalmologic examination along with magnetic resonance (MR) imaging of the brain and orbits, and MR angiography and venography of the brain confirmed the diagnosis of bilateral CCF.

Multimodal Imaging Characteristics of ADRP in a Family with p.Thr58Arg Substituted RHO Mutation.

Background: Autosomal dominant retinitis pigmentosa (adRP) is a rare cause of progressive visual impairment in young patients and is frequently a result of RHO gene mutations. p.Thr58Arg rhodopsin mutation leads to misfolding of rhodopsin, subsequent accumulation in the endoplasmic reticulum, and leads to consecutive atrophy of photoreceptor cells through apoptosis.

Successful repair of combined tractional and rhegmatogenous retinal detachment with pars plana vitrectomy without scleral buckle in severe Behçet's disease.

Behçet's disease (BD) is a multisystemic, immune-mediated occlusive vasculitis of unknown etiology with a chronic, relapsing remitting course. Ocular involvement is characterized by recurrent nongranulomatous uveitis with necrotizing obliterative vasculitis affecting both the anterior and posterior segments of the eye and often leads to blindness. We describe successful surgical management of a rare case of combined rhegmatogenous retinal detachment (RRD) and tractional retinal detachment (TRD) in a patient with Behçet's disease.

Allergic fungal sinusitis masquerading as cavernous sinus thrombosis.

Allergic fungal sinusitis (AFS), a noninvasive form of fungal sinusitis, is rarely seen in immunocompetent patients. Involvement of sphenoid sinus can result in proptosis and loss of vision. We report AFS masquerading as posterior cavernous sinus syndrome.

Ultra wide field angiography documented peripheral retinal eovascularization as cause of vitreous hemorrhage after scleral buckle surgery.

We describe an unusual case of ultra wide fluorescein angiography (UWFA) documented peripheral retinal neovascularization (NVE) with delayed vitreous hemorrhage after placement of an encircling scleral buckle (a common procedure for repair of retinal detachment). Anterior segment ischemia is a rare complication after scleral buckle surgery for the treatment of retinal detachment and results from altered choroidal flow through the impingement of the anterior and long posterior ciliary arteries. UWFA performed for the evaluation of vitreous hemorrhage confirmed ischemia anterior to the scleral buckle and consequential NVE.

Bilateral retinal detachment after chimeric antigen receptor T-cell therapy.

CAR T-cell targeting of leukemic infiltrates in the optic nerve and retina caused retinal detachment as a presentation of pseudoprogression. Treatment of this intraocular inflammation with intravitreal triamcinolone and orbital radiation led to marked improvement in visual acuity.

Pazopanib Selectively Inhibits Choroidal Vascular Endothelial Cell Proliferation and Promotes Apoptosis.

Exudative age related macular degeneration (AMD) is related to active choroidal neovascularization (CNV) and formation of disciform scars. Vascular endothelial growth factor (VEGF) mediated choroidal vascular endothelial cell (CVECs) proliferation is characteristic of CNV. Intravitreal injections of bevacizumab, ranibizumab and aflibercept (anti-VEGF monoclonal antibodies) are used to treat exudative AMD.

SUDDEN VISION LOSS FROM CENTRAL RETINAL ARTERY OCCLUSION AS A PRESENTING SYMPTOM OF MITRAL VALVE PAPILLARY FIBROELASTOMA.

Purpose: We describe a central retinal artery occlusion with cilioretinal sparing in a young male patient who was found to have mitral valve papillary fibroelastoma.

Methods: At the initial examination, a 33-year-old Hispanic man had visual acuity of 20/200 in his left eye, and 2 weeks later, visual acuity improved to 20/20. Diagnosis required transesophageal echocardiography to localize the lesion.