MANAGEMENT OF LARGE FULL-THICKNESS MACULAR HOLES: Long-Term Outcomes of Internal Limiting Membrane Flaps and Internal Limiting Membrane Peels.

Background/purpose: To determine and compare the efficacy of a surgical internal limiting membrane (ILM) flap technique with the traditional ILM peel on long-term visual and anatomical outcomes for large (>400 µm) full-thickness macular holes.

Methods: From October 2016 to July 2022, patients undergoing initial full-thickness macular hole repair with the ILM flap or ILM peel technique were reviewed. Final outcomes were recorded and based on size in microns: 401 to 800, 801 to 1,200, and >1,200.

EVALUATION OF FULL-FIELD ELECTRORETINOGRAM REDUCTIONS AFTER OCRIPLASMIN TREATMENT: Results of the OASIS Trial ERG Substudy.

Purpose: To explore a possible association between full-field electroretinograms with vitreomacular adhesion resolution and best-corrected visual acuity as part of the prospective, randomized, double-masked, sham-controlled Ocriplasmin for Treatment for Symptomatic Vitreomacular Adhesion Including Macular Hole (OASIS) trial studying ocriplasmin.

Methods: The ERG substudy enrolled 62 of 220 OASIS subjects (randomized 2:1) and analyzed full-field electroretinograms and their association with both vitreomacular adhesion resolution and best-corrected visual acuity from baseline through Month 24. Electroretinogram reductions were defined as acute full-field electroretinogram reductions in amplitude of ≥40% from baseline occurring at postinjection Day 7 or Day 28.

ENDOPHTHALMITIS AFTER INTRAVITREAL INJECTION: Role of Prophylactic Topical Ophthalmic Antibiotics.

Purpose: To determine the rate of postintravitreal injection endophthalmitis and to assess microbiological features and outcomes with and without the use of peri-intravitreal injection topical ophthalmic antibiotics.

Methods: Consecutive series of endophthalmitis cases retrospectively identified after intravitreal injection at a multicenter, retina-only referral practice (Retina Consultants of Houston) from January 1, 2011 to December 31, 2014. Prophylactic peri-intravitreal injection topical antibiotics were routinely used during the initial 12-month period (January 1, 2011-December 31, 2011) and not used in the final 24-month period (January 1, 2013-December 31, 2014).

Association between anatomical resolution and functional outcomes in the mivi-trust studies using ocriplasmin to treat symptomatic vitreomacular adhesion/vitreomacular traction, including when associated with macular hole.

Purpose: To evaluate visual function in patients with symptomatic vitreomacular adhesion (VMA)/vitreomacular traction including when associated with macular hole after ocriplasmin treatment, and the association between resolution of the underlying condition and improvement in visual function.

Methods: Six hundred and fifty-two patients from 2 Phase 3 trials received a single intravitreal injection of ocriplasmin 125 μg (n = 464) or placebo (n = 188). Mean and categorical changes from baseline in best-corrected visual acuity and 25-item Visual Function Questionnaire scores were used to evaluate visual function.

Microperimetric assessment of retinal sensitivity in eyes with diabetic macular edema from a phase 2 study of intravitreal aflibercept.

Purpose: To evaluate retinal sensitivity in patients with diabetic macular edema who received intravitreal aflibercept injection (IAI) or laser.

Methods: A substudy included 46 patients from DA VINCI (a randomized, double-masked Phase 2 study) receiving either laser, 0.5 mg IAI every 4 weeks, 2 mg IAI every 4 weeks, 2 mg IAI every 8 weeks after 3 monthly doses (2q8), or 2 mg IAI as-needed after 3 monthly doses for 52 weeks.

Efficacy of intravitreal ocriplasmin for treatment of vitreomacular adhesion: subgroup analyses from two randomized trials.

Purpose: To evaluate the efficacy of a single intravitreal injection of ocriplasmin 125 μg across relevant subpopulations of patients with symptomatic vitreomacular adhesion (VMA)/vitreomacular traction (VMT), including when associated with macular hole.

Design: Two multicenter, randomized, placebo-controlled, double-masked, 6-month studies.

Participants: A total of 652 randomized patients (464 receiving ocriplasmin; 188 receiving placebo).

Purtscher-like retinopathy associated with pemphigus vulgaris.

Purpose: To report a case of Purtscher-like retinopathy associated with pemphigus vulgaris.

Method: Case report of a 25-year-old Hispanic male who was referred for sudden and severe reduction of vision from his right eye shortly after an exacerbation of pemphigus vulgaris.

Results: Fundus examination of the right eye revealed severe macular edema, nerve fiber layer infarcts, flame-shaped hemorrhages, and venous dilation.

Enzymatic vitreolysis with ocriplasmin for vitreomacular traction and macular holes.

Background: Vitreomacular adhesion can lead to pathologic traction and macular hole. The standard treatment for severe, symptomatic vitreomacular adhesion is vitrectomy. Ocriplasmin is a recombinant protease with activity against fibronectin and laminin, components of the vitreoretinal interface.

Use of nepafenac (Nevanac) in combination with intravitreal anti-VEGF agents in the treatment of recalcitrant exudative macular degeneration requiring monthly injections.

Purpose: The purpose of this study is to determine the efficacy of combining topical nepafenac with monthly intravitreal injections of ranibizumab or bevacizumab in the treatment of recalcitrant exudative macular degeneration.

Methods: This was a retrospective, consecutive case series of patients with exudative macular degeneration requiring maintenance therapy of antivascular endothelial growth factor ( anti-VEGF) injections at least every 6 weeks, who were started on topical nepafenac. Despite frequent anti-VEGF dosing, all patients included in the study had persistence of any combination of the following: intraretinal cysts, subretinal fluid, and/or pigment epithelial detachment.

Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the "flying saucer" sign).

Purpose: While the long-term incidence of hydroxychloroquine (HCQ) retinopathy is low, there remains no definitive clinical screening test to recognize HCQ toxicity before ophthalmoscopic fundus changes or visual symptoms. Patients receiving HCQ were evaluated with spectral domain optical coherence tomography (SD OCT) to assess the feasibility of identifying HCQ retinopathy at an early stage.

Methods: Twenty-five patients referred for the evaluation of hydroxychloroquine toxicity underwent a comprehensive ocular examination, Humphrey visual field (HVF) perimetry, time domain OCT, and SD OCT.

Lucentis using Visudyne study: determining the threshold-dose fluence of verteporfin photodynamic therapy combined with intravitreal ranibizumab for exudative macular degeneration.

Purpose: Combination verteporfin photodynamic therapy (vPDT) and antivascular endothelial growth factor (anti-VEGF) therapy may decrease the need for injections while maintaining visual acuity in exudative age-related macular degeneration. This pilot study was designed to determine the threshold fluence dose of vPDT (the dose required to demonstrate an effect on choroidal perfusion) combined with ranibizumab.

Methods: Seven patients were randomized to sham vPDT (two patients), 20% fluence vPDT (two patients), or 40% fluence vPDT (three patients) in combination with three-monthly intravitreal 0.

A placebo-controlled trial of microplasmin intravitreous injection to facilitate posterior vitreous detachment before vitrectomy.

Purpose: To evaluate the safety and efficacy of a preoperative intravitreous injection of microplasmin in patients scheduled for vitreous surgery.

Design: Phase 2, multicenter, placebo-controlled, double-masked, parallel-group, dose-ranging clinical trial.

Participants: One hundred twenty-five patients scheduled for pars plana vitrectomy (PPV), primarily for treatment of either vitreomacular traction or macular hole.

Selected clinical comparisons of spectral domain and time domain optical coherence tomography.

The authors report four cases where spectral domain optical coherence tomography (SD-OCT) imaged pathology not captured by time domain optical coherence tomography (TD-OCT). These cases include one of angioid streaks, two of juxtafoveal telangiectasia, and one of age-related macular degeneration. In each case, the improved images provided by SD-OCT changed either the management of the patient or the counseling of their disease process.

Retinal pigment epithelium tears following ranibizumab for exudative age-related macular degeneration.

Purpose: To report two cases of retinal pigment epithelium (RPE) tears following intravitreous ranibizumab injection for age-related macular degeneration (AMD)-associated serous pigment epithelium detachment (PED).

Design: Noncomparative case series.

Methods: The charts of two patients who received intravitreous ranibizumab for AMD-associated PED and developed RPE tears were reviewed.

Full-thickness eccentric macular hole following vitrectomy with internal limiting membrane peeling.

A 65-year-old man presented after macular hole surgery with trypan blue-assisted internal limiting membrane peeling in his left eye. Although the patient had no visual complaints in the left eye, on clinical examination an eccentric full-thickness macular hole was noted just inside the superior vascular arcade and documented by optical coherence tomography. The patient was observed and continued to remain asymptomatic.

Intravitreal clearance of moxifloxacin.

Purpose: To study the clearance of a single dose of intravitreally injected moxifloxacin in rabbits.

Methods: Intravitreal injections of 200 microg/0.1 mL of moxifloxacin were performed in rabbits.

Short-term course of intraocular pressure after intravitreal injection of triamcinolone acetonide.

Objective: To describe the natural history of intraocular pressure (IOP) within the first 30 minutes after intravitreal injection of triamcinolone acetonide (TA).

Design: Prospective, interventional, consecutive case series.

Participants: Thirty-eight consecutive patients who met inclusion and exclusion criteria and underwent intravitreal injection of 0.

Optical coherence tomography of idiopathic juxtafoveolar telangiectasia.

Background And Objective: To document optical coherence tomography (OCT) findings in a series of eyes with group 2A idiopathic juxtafoveal telangiectasia.

Patients And Methods: This study is a retrospective review of patient charts, OCT, fundus photography, and fluorescein angiography involving 23 eyes (12 patients). Mean retinal thickness in 9 macular areas was calculated and compared to previously published measurements from normal eyes.

Clearance of intravitreal moxifloxacin.

Purpose: To study the clearance of moxifloxacin after intravitreal injection in rabbits.

Methods: Intravitreal injections of 200 microg/0.1 mL of moxifloxacin were administered to rabbits.

Acute endophthalmitis incidence: intravitreal triamcinolone.

Objective: To report the incidence of acute postinjection endophthalmitis following intravitreal injection of triamcinolone acetonide (IVTA) as an office procedure.

Methods: Retrospective, noncomparative, consecutive, interventional case series of all patients who had received IVTA at 2 clinical centers between January 1, 2000, and January 30, 2004.

Results: A total of 1006 eyes received IVTA.

Anterior chamber and sutured posterior chamber intraocular lenses in eyes with poor capsular support.

Purpose: To compare the clinical outcomes and complications of patients who had surgical placement of anterior chamber (AC IOLs) and sutured posterior chamber intraocular lenses (PC IOLs) after cataract surgery resulting in poor capsular support.

Setting: Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida.

Methods: A retrospective interventional comparative case series of 181 eyes of 181 patients that had implantation of an intraocular lens with inadequate capsular support was conducted.