Retina-The Journal of Retinal and Vitreous Diseases最新文献

Purpose: To investigate the potential utility of intravitreal antivascular endothelial growth factor (anti-VEGF) therapy for stages 3 and 4 proliferative sickle cell retinopathy (PSR).

Methods: Retrospective review of anatomical and visual acuity outcomes after intravitreal anti-VEGF therapy for stages 3 and 4 PSR eyes.

Results: There were 45 PSR eyes (17 stage 3 and 28 stage 4) treated with anti-VEGF agents (bevacizumab (37 eyes), aflibercept (6 eyes), ranibizumab (3 eyes), one eye received both bevacizumab and aflibercept). Follow-up ranged from 1 to 120 months (mean = 21 months). Within 1 month after anti-VEGF treatment, VA improved ≥2 lines in 18/45 eyes, remained stable in 26/45 eyes, and worsened in 1/45 eyes. The median visual acuity remained 20/20 for stage 3 and improved from 20/200 to 20/30 for stage 4 PSR eyes. More stage 4 PSR eyes had VA improvement posttreatment than stage 3 PSR eyes ( P = 0.003). There were no cases of endophthalmitis. Visual acuity outcomes were similar for anti-VEGF with and without laser treatment. Control of PSR was achieved in 42/45 (93%) of eyes without the need for pars plana vitrectomy.

Conclusion: Within one month of treatment, administration of anti-VEGF therapy of PSR eyes resulted in seafan regression, clearing of vitreous hemorrhage, and stable or improved vision in most eyes.

Purpose: To explore the relationship between atopic dermatitis (AD) and the risk of developing age-related macular degeneration (AMD).

Methods: This retrospective cohort study used data from two large databases: the US-based TriNetX Research Network (46,018 patients with AD aged ≥50 years, spanning 2005-2021) and Taiwan's National Health Insurance Research Database (9,513 patients with AD aged ≥50 years, spanning 2003-2017). The main outcome was the incidence of AMD. The Cox regression analysis was used to calculate hazard ratios (HRs) for AMD. Additional analyses examined the risk of dry and wet AMD, with stratified assessments based on age, sex, ethnicity, race, and AD activity.

Results: Adults with AD exhibited a significantly elevated risk of developing AMD in both the TriNetX cohort (HR 1.97; 95% CI: 1.78-2.19) and the National Health Insurance Research Database cohort (HR 1.25; 95% CI: 1.11-1.41). Individual outcome analyses confirmed a heightened risk for both dry and wet AMD associated with AD. This increased risk was consistent across various groups stratified by demographic factors and AD activity.

Conclusion: AD in adulthood is linked to a greater likelihood of developing AMD. These findings underscore the importance of regular funduscopic evaluations and proactive management of AMD in patients with AD.

Purpose: To identify clinical and surgical risk factors associated with recurrent rhegmatogenous retinal detachment (RRD) in the index eye and RRD in the fellow eye.

Methods: Retrospective observational study of adult patients who underwent RRD repair at two tertiary care centers over six years.

Results: Among 794 patients with primary RRD, recurrence occurred in 20.5%, and RRD in the fellow eye was observed in 5.2%. Postoperative visual acuity significantly improved at one year (95% CI -0.44 to 0.30; P < 0.001). Higher recurrence rates were found in patients with prolonged symptom duration ( P = 0.005), preoperative proliferative vitreoretinopathy ( P = 0.006), and worse initial visual acuity ( P < 0.001). Recurrences were most frequent within the first 90 days postoperatively, while fellow eye RRD primarily occurred after 1 year. Pneumatic retinopexy (SE 0.37; 95% CI 1.07-4.64, P = 0.03) and the extent of detachment (SE 0.04; 95% CI 1.0-1.2; P = 0.005) were significant predictors of recurrence in multivariate analyses. Age (SE 0.01; 95% CI 1.01-1.05; P = 0.01) and male sex (SE 0.38; 95% CI 1.66-7.47; P = 0.001) were significant predictors for fellow eye RRD.

Conclusion: The study highlights pneumatic retinopexy and detachment extent as significant predictors of RRD recurrence. It also identifies older age and male sex as risk factors for RRD in the fellow eye. Our findings emphasize the importance of risk stratification and recommend close monitoring during the first 90 days and beyond the one-year postoperative period.

Purpose: To describe a novel Optical Coherence Tomography (OCT) finding called "scolex sign" in cases of central serous chorioretinopathy(CSCR).

Methods: This retrospective multicenter study included CSCR patients with serous pigment epithelial detachments(PED) greater than 100µm, with or without subretinal fluid(SRF). Eyes showing a distinct hyperreflective focus on the PED wall(scolex sign) were analyzed. An equal number of age-matched controls with PEDs but without the scolex sign were included. Multimodal imaging data were reviewed. A subgroup analysis based on SRF status was also performed.

Results: Of 291 eyes with large serous PEDs, 52 eyes exhibited the "scolex sign" and were compared to 52 age-matched controls. Baseline characteristics including gender, systemic comorbidities, best recorded visual acuity(BRVA) and OCT parameters were similar in both the groups. However eyes with "scolex" sign exhibited more number of central PEDs and shorter distance from foveal centre. On follow-up, eyes with "scolex" sign showed a higher rate of PED flattening and SRF resolution trended to be higher compared to controls.

Conclusion: The "scolex" sign represents a novel, benign OCT feature seen in a subset of CSCR cases. While not associated with poorer outcomes or adverse sequalae, it may reflect ongoing reparative changes, indicating a resolving stage of the disease.

Purpose: To compare anatomical and functional outcomes as well as postoperative complication rates between cryotherapy and illuminated endolaser retinopexy in chandelier-assisted scleral buckling (CASB) for rhegmatogenous retinal detachment (RRD).

Methods: This retrospective study included 63 eyes from 63 patients treated with CASB between January 2021 and January 2024. Group 1 (n=31) underwent retinopexy with cryotherapy, while Group 2 (n=32) received illuminated endolaser through the same cannula as the chandelier light. All surgeries were performed using a noncontact wide-angle viewing system (WAVS) by a single experienced vitreoretinal surgeon. Outcome measures included best-corrected visual acuity (BCVA), intraocular pressure (IOP), swept-source OCT, and postoperative complications.

Results: Mean BCVA improved significantly in both groups. In Group 1, BCVA improved from 1.39 ± 0.74 logMAR (approx. Snellen 20/490) to 1.01 ± 0.63 (20/204), p<0.001. In Group 2, BCVA improved from 1.50 ± 0.67 (20/632) to 1.14 ± 0.66 (20/276), p<0.001. Final BCVA (p=0.21) and retinal reattachment rates (p=0.67) were similar. However, cystoid macular edema occurred significantly more in Group 1 (19.3%) than in Group 2 (3.1%) (p=0.04). Rates of epiretinal membrane, cataract, and IOP elevation did not differ significantly (p>0.05). No buckle exposure or infection was observed.

Conclusion: Both techniques are effective for CASB. Endolaser provides a lower risk of CME and enhanced surgical precision, suggesting it may be a favorable option in selected cases.