Clinical, molecular, and immunologic mechanisms of CMV retinitis: Evolving understanding in HIV and non-HIV immunosuppressed patients.

Introduction: Rates of CMV retinitis (CMVR) resulting from HIV have declined following the advent of highly active antiretroviral therapy (HAART); however, other immunosuppressed populations are becoming increasingly affected by CMVR. More research is required to identify and target differences found in these patients, as they may represent a promising avenue for targeted treatment therapy.

Areas Covered: This review includes information from studies on the prevalence, pathophysiology, and clinical manifestations of CMV and CMVR.

Favorable Outcome After Pegcetacoplan (Syfovre)-Associated Occlusive Retinal Vasculitis.

An 86-year-old woman with advanced dry age-related macular degeneration developed occlusive retinal vasculitis 11 days after her first pegcetacoplan injection. Vision decreased from 20/30 to counting fingers. Vision improved to 20/200 with periocular and systemic steroids.

Inflammation and Occlusive Retinal Vasculitis Post Faricimab.

Importance: Randomized clinical trials have shown the safety and efficacy of faricimab as a novel vascular endothelial growth factor and angiopoietin-2 inhibitor in the treatment of neovascular age-related macular degeneration (nAMD) and macular edema of various etiologies. However, more rare adverse events may not be considered in clinical trials.

Objective: To describe 3 eyes that developed irreversible vision loss following initial mild intraocular inflammation (IOI) to faricimab.

Presumed bilateral acute idiopathic maculopathy in a pediatric patient.

Purpose: To describe a rare case of presumed bilateral acute idiopathic maculopathy (AIM) in a pediatric patient.

Observation: An 11-year-old male was evaluated for a "fuzzy Dorito-shaped" spot in the central vision of his right eye (OD) that started 3 days before presenting to our clinic. On examination, best-corrected visual acuity (BCVA) was counting fingers at 5 feet OD, and 20/25 in the left eye (OS).

Case Reports: Chemokine and Cytokine Profiling in Patients with Herpetic Uveitis.

Purpose: To report cytokine/chemokine profiles of ocular fluid in two patients with herpetic uveitis.

Methods: Cytokine and chemokine profiling of ocular fluid was performed in two patients with herpetic uveitis. Ocular fluid findings were correlated with disease manifestations and the patients' clinical course.

Corneal and conjunctival abnormalities in a cohort of survivors from the Western African Ebola virus disease outbreak.

Purpose: To characterize corneal and conjunctival abnormalities (CCAs) and their impact on visual acuity in a cohort of survivors from the Western African Ebola virus disease (EVD) outbreak.

Design: A post hoc analysis of 121 patients, who had previously undergone screening for the Ebola Virus Persistence in Ocular Tissues and Fluids study, was performed.

Methods: Patients underwent a comprehensive ophthalmic exam at the Lowell and Ruth Gess Eye Hospital in Freetown, Sierra Leone.

Macular Edema Ranibizumab versus Intravitreal Anti-inflammatory Therapy Trial: 24-Week Outcomes of Uveitic Macular Edema Re-treatment.

Purpose: Evaluation of longer-term effectiveness of 3 intravitreal therapies (methotrexate, ranibizumab, or dexamethasone implant) for participants enrolled in the randomized comparative effectiveness trial the Macular Edema Ranibizumab versus Intravitreal Anti-inflammatory Therapy (MERIT) Trial followed up for 24 weeks.

Design: Multicenter randomized controlled clinical trial with masked evaluation of retinal thickness and visual acuity.

Participants: Patients with persistent or recurrent uveitic macular edema.

Long-term visual outcomes and histopathologic findings after cataract surgery in Ebola virus disease survivors in the Ebola virus RNA persistence in ocular tissues and fluids (EVICT) study.

Background/objectives: Ebola virus disease (EVD) survivors develop post-acute ophthalmic sequelae, including a high prevalence of uveitis that may be complicated by vision-threatening cataract. After the non-detection of Ebola virus (EBOV) RNA in sampled ocular fluid, vision impairment due to cataract can be treated safely and effectively via manual small incision cataract surgery (MSICS). However, the long-term ocular visual outcomes and assessment of ocular tissues, including for genomic RNA, have been infrequently or not reported in Western African survivors.

Global Health Security in Vision Care: Health Systems Strengthening During Ebola Virus Disease Outbreak Responses.

During the last decade, global health security has been threatened by major Ebola virus disease outbreaks in Western Africa (2014 to 2016) and in eastern Democratic Republic of the Congo (2018 to 2020). Particularly in Western Africa, the outbreak initially overwhelmed health care capacity in already fragile health systems. Thousands of survivors were at risk of newly recognized postacute ocular complications, and their need for urgent ophthalmic care challenged national vision health systems with scarce eye care services.

Establishing Vitreoretinal Surgery Capacity in Sierra Leone: Challenges and Opportunities to Address Retinal Health Disparities in Resource-limited Settings.

A range of challenges exists regarding vitreoretinal (VR) surgical services in resource-limited settings, including Sierra Leone. As a result, retinal pathologies may contribute to vision loss and blindness. In the wake of the 2013 to 2016 outbreak of Ebola virus disease in West Africa, gaps in ophthalmic care were underscored as survivors were experiencing a constellation of sequelae, including uveitis and VR disease.

Ocular Complications of Mpox: Evolving Understanding and Future Directions.

Mpox (formerly known as monkeypox), an infectious disease caused by the monkeypox virus (MPXV), has been endemic in regions of Central and Western Africa. In 2022, the global spread of the clade IIb MPXV led to a multinational outbreak, primarily affecting sexual transmission networks among men who have sex with men. Despite interventions, new cases have continued to emerge.

Dietary Supplementation for Retinitis Pigmentosa: A Report by the American Academy of Ophthalmology.

Purpose: To review the evidence on the effectiveness of dietary supplementation for retinitis pigmentosa (RP).

Methods: A literature search of the PubMed database was last conducted in January 2024 to identify published English-language original research on dietary supplementation for RP. Eligible compounds included products ingested orally containing nutrients intended to supplement the diet.

Therapies for Central Serous Chorioretinopathy: A Report by the American Academy of Ophthalmology.

Purpose: To assess the safety and efficacy of the multiple therapeutic modalities for the treatment of central serous chorioretinopathy (CSCR).

Methods: A literature search of English-language studies in the PubMed database with no date restrictions was last conducted in May 2024. The combined searches yielded 612 citations, 31 of which were selected for full-text review and for inclusion in this assessment.

Advances in the management of intraocular foreign bodies.

Intraocular foreign bodies (IOFBs) remain a severe complication of ocular trauma commonly encountered worldwide. This literature review aimed to discuss current practice patterns, areas of controversy, and advances in the management of IOFBs. Injuries involving IOFBs carry significant ocular morbidity and management can be extremely challenging.

Suprachoroidal Drug Delivery for Macular Edema Associated With Noninfectious Uveitis.

To evaluate clinical trials in the literature that focus on suprachoroidal drug delivery for the treatment of noninfectious uveitis and other posterior segment diseases. A synthesis of the literature was performed. In 2021, suprachoroidal space triamcinolone acetonide, a corticosteroid delivery system used for the treatment of uveitic macular edema (ME), was approved by the US Food and Drug Administration.

Deep sequencing as a diagnostic tool in patients with suspected primary vitreoretinal lymphoma.

Purpose: To compare the diagnostic utility of metagenomic deep sequencing (MDS) to cytology, flow cytometry and gene rearrangement by PCR in ocular samples of patients with suspected vitreoretinal lymphoma (VRL).

Methods: Patients with suspected VRL underwent ocular sampling of one or both eyes at the Emory Eye Center from September 2017 to June 2022. Ocular samples were evaluated with MDS and conventional diagnostics.

Common Practice Patterns in the Diagnosis and Management of Acute Retinal Necrosis: A Survey Study of Uveitis Specialists.

Purpose: Due to lack of large randomized clinical trials to determine best practices in treating acute retinal necrosis (ARN), there is not a clear consensus amongst ophthalmologists on how to best manage this potentially blinding condition. The aim of this study is to survey common practice patterns and analyze the factors that affect ophthalmologists' management of ARN.

Methods: An anonymous survey was distributed to uveitis and retina specialists who are members of the American Uveitis Society (AUS) via email to query practice patterns regarding ARN.

Case report: CMV retinitis following local and systemic immunosuppression.

We report the case of a 71-year-old man who presented 2 years following renal transplantation with diffuse, unilateral cytomegalovirus retinitis five weeks after receiving an intravitreal dexamethasone implant device for the management of central retinal vein occlusion. Examination of the left eye showed diffuse retinal hemorrhages, attenuated and tortuous retinal vessels, and superior retinal whitening. The patient was successfully treated with serial intravitreal foscarnet injections and oral valganciclovir with disease regression observed by 12 weeks after presentation.

Clinical characteristics and aetiology of uveitis in a viral haemorrhagic fever zone.

Background/objectives: Studies on uveitis in Sierra Leone were conducted prior to the Ebola Virus Disease epidemic of 2013-16, which was associated with uveitis in 20% of survivors. They did not include imaging or investigation of tuberculosis and used laboratory services outside the country. We performed a cross-sectional study on patients presenting with uveitis to establish their clinical characteristics and identify the impact of in-country laboratory diagnoses.

Treatment of Noninfectious Uveitic Macular Edema with Periocular and Intraocular Corticosteroid Therapies: A Report by the American Academy of Ophthalmology.

Purpose: To review the evidence on the effectiveness and complications of periocular and intraocular corticosteroid therapies for noninfectious uveitic macular edema.

Methods: A literature search of the PubMed database was conducted last in December 2021 and a post-assessment search was conducted in March 2023. The searches were limited to articles published in English and no date restrictions were imposed.