Eye最新文献

Myopic traction maculopathy (MTM) affects around 30% of patients with pathologic myopia and is responsible for a high proportion of legal blindness cases in myopic population. The main surgical solutions to MTM are macular buckling (MB) ab-externo surgery and pars plana vitrectomy (PPV) ab-interno surgery. The recently proposed MTM staging system (MSS) provides a new classification of the condition based on evolutive changes occurring in the natural course of the disease. Based on MSS staging, a customised surgical approach has been proposed according to different stages of MTM. The aim of this systematic review is to describe literature from 2017 to the present date to assess concordance of recent literature to the results proposed from the authors of the MSS.

Background/objectives: To compare sub-Tenon's ("dropless") and topical steroid regimens for inflammation prophylaxis following cataract surgery.

Subjects/methods: This retrospective cohort study was conducted using the electronic health record (EHR) of a single academic medical centre in Philadelphia, Pennsylvania, USA. All patients who underwent phacoemulsification cataract surgeries from January 1, 2023, to August 31, 2024 were analysed. Eyes in the dropless group received an intraoperative sub-Tenon's triamcinolone acetonide (TA) injection. Eyes in the topical group followed a routine postoperative topical steroid taper (prednisolone acetate 1% drops). Baseline characteristics included age, race, and relevant comorbidities. Key outcomes assessed were incidence of intraocular pressure (IOP) spikes greater than 35 mmHg, cystoid macular oedema (CMO), and rebound iritis. Differences were analysed with Fisher's exact tests and linear regressions.

Results: A total of 3307 eyes were included (291 treated with the dropless protocol and 3016 with topical drops). Baseline patient characteristics were similar between groups in terms of age, sex, and comorbidities, with the exception that the dropless cohort had a higher proportion of Black patients (46.0% vs 34.4%, p < 0.01) and diabetic patients (40.5% vs. 30.9%, p < 0.01). There were no significant differences between dropless and topical groups in the incidence of IOP spikes >35 mmHg, CMO, or rebound iritis (all p > 0.05).

Conclusions: Sub-Tenon's TA was noninferior to topical steroids in terms of incidence of IOP spikes, CMO, and rebound iritis following cataract surgery. However, further research is needed to identify risk factors for adverse outcomes and determine ideal use cases for a dropless protocol.

Background/aims: To evaluate the association between blood glucose levels and the development of endophthalmitis in patients receiving anti-vascular endothelial growth factor (VEGF) injections.

Methods: Retrospective analysis of electronic medical records of patients who received anti-VEGF injections at four centres within a single ophthalmic institution. Pre-injection, random, fasting, and post-prandial blood glucose levels were analysed with respect to the development of endophthalmitis. The association between blood glucose levels, and the presence and duration of diabetes mellitus (DM), and the development of post-injection endophthalmitis was determined.

Results: This study included 60,707 injections administered to 25,751 patients, 48.73% of whom had DM. Sixteen patients developed post-injection endophthalmitis; incidence rate was 6 per 10,000 patients (0.06%) and 2 per 10,000 injections (0.03%). A higher proportion of patients with endophthalmitis had DM (68.75%), compared to those without endophthalmitis (48.72%). The presence of diabetes had a significant association with post-injection endophthalmitis (OR 5.05, 95% CI 1.82-16.27, P-0.00). Regarding duration of diabetes, there was no statistically significant difference between patients with and without endophthalmitis (OR 3.33, P = 0.281). Compared to patients without endophthalmitis, those with endophthalmitis had similar random blood glucose levels (150.89 ± 63.75 mg/dL vs. 141 ± 64 mg/dL), similar fasting blood glucose levels (135.86 ± 32.73 mg/dL vs. 132 ± 53 mg/dL), and higher post-prandial levels (208.2 ± 69.12 mg/dL vs. 188 ± 56 mg/dL), but it was not statistically significant.

Conclusion: We found a significant association between presence of diabetes and post-injection endophthalmitis. Immediate pre-injection blood glucose levels were not associated with post-injection endophthalmitis but the duration of diabetes was longer in patients developing endophthalmitis.

Background/objectives: To assess the association between preeclampsia in pregnancy and the development of ophthalmic complications.

Subjects/methods: This retrospective cohort study included pregnant patients aged ≥18 years with preeclampsia (139,959) and without (1,935,751) in the TriNetX US Collaborative Network. We matched both cohorts using a propensity score (1:1) for demographics, comorbidities, and laboratory values. Our primary outcomes were the hazards of retinal vascular pathology, papilledema, and cortical visual impairment using Cox proportional hazard and Kaplan-Meier methods.

Results: Preeclampsia was associated with an increased lifetime risk of hypertensive retinopathy (aHR: 1.925; 95% CI: 1.349, 2.747), vascular occlusions (aHR: 1.926; 95% CI: 1.249, 2.970), papilledema (aHR: 1.637; 95% CI: 1.425, 1.881), and cortical visual impairment (aHR: 4.036; 95% CI: 2.427, 6.713). In preeclampsia patients ≥35 years, the risk of developing cortical visual impairment was further amplified, aHR: 6.817 (95% CI: 3.066, 15.154).

Conclusions: Preeclampsia was significantly associated with significant ophthalmic changes, emphasising the importance of close monitoring during pregnancy.