Intraoperative Retinal Changes May Predict Surgical Outcomes After Epiretinal Membrane Peeling.

Purpose: To investigate whether intraoperative retinal changes during epiretinal membrane (ERM) peeling affect anatomic or functional outcomes after surgery.

Methods: We measured retinal thickness using an intraoperative optical coherence tomography (iOCT) device in patients undergoing pars plana vitrectomy with membrane peeling for idiopathic ERM. Changes in intraoperative central macular thickness (iCMT) were compared with postoperative improvements in CMT and best-corrected visual acuity (VA).

Phase I/II randomized study of proton beam with anti-VEGF for exudative age-related macular degeneration: long-term results.

Background/objective: To determine if treatment of exudative age-related macular degeneration (eAMD) using proton beam therapy (PBT) combined with intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is safe and effective long term.

Subject/methods: Thirty eyes with newly diagnosed eAMD were enrolled in a phase I/II prospective, sham-controlled double-masked university study. Eyes were randomized 1:1:1-24 GyE, 16 GyE or sham radiation, and treated with three initial monthly intravitreal ranibizumab or bevacizumab.

Application of Clinical Trial Results to Clinical Practice.

Two critical questions one must answer as one applies the results of a clinical trial to clinical practice are: (1) Regardless of whether the trial result is likely to be replicated or reproduced in a second large-scale trial, are the results likely to be reproduced in one's practice? (2) Regardless of whether the experimental treatment was better than the alternative on average for a population of patients, are the results clinically important for a given patient in one's practice? To determine if a study result is likely to be reproduced in one's clinical practice, it may be helpful to answer 5 questions: (1) Have steps been taken to minimize bias? (2) Is the result likely due to the treatment? (3) Is the result unlikely due to chance? (4) Is the study population representative of one's patients? (5) Is the totality of evidence consistent? If the answer to all 5 questions is "yes," then we posit that the trial result is likely to be reproduced in one's practice. If not, the likelihood of reproducibility is low. If the answer is yes to all questions except the last, then reproducibility in one's practice is not clear and depends on the strength of the prior versus the current evidence.

Posterior Segment Intraocular Foreign Bodies: A 10-Year Review.

Purpose: To describe the characteristics of open-globe injuries with posterior segment intraocular foreign bodies (IOFBs).

Design: Retrospective chart review study.

Participants: Patients treated for posterior segment IOFB injuries.

Multimodal imaging in a severe case of hydroxychloroquine toxicity.

Retinal toxicity from hydroxychloroquine (HCQ) can be detected most readily on fundus autofluorescence, spectral-domain optical coherence tomography, and multifocal electroretinogram. The authors describe a case of a 60-year-old woman with a history of systemic lupus erythematosus undergoing HCQ treatment for 30 years who presented with visual loss over several years. Examination and multimodal imaging showed bilateral retinal pigment epithelium (RPE) changes in a bull's-eye distribution associated with cystoid macular edema.