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Purpose: To retrospectively analyze clinical outcomes of patients with "treatment‐resistant" neovascular age‐related macular degeneration or diabetic macular edema who were switched to intravitreal faricimab injections (IFIs) using a "real‐world" treat‐and‐extend (TAE) protocol. Methods: Seventy‐one eyes from 62 patients receiving antivascular endothelial growth factor injections were evaluated before and after switching to IFI. Demographic and clinical data were collected. Primary endpoints were treatment interval extension and presence of intraretinal or subretinal fluid on spectral‐domain optical coherence tomography (OCT) after switching to IFI. Secondary endpoints included best‐corrected visual acuity, average OCT central subfield thickness, and presence of a pigment epithelium detachment and pigment epithelium detachment height. Results: The average treatment interval after switching to IFI significantly increased from 37.6 ± 10.8 days to 45.2 ± 16.6 days (p = 0.0016). At the last follow‐up, 35% of eyes were able to achieve a fluid‐free status post‐IFI. A chi‐square test of independence validated this finding by showing a significant difference in the OCT findings trending towards less or no fluid on follow‐up (X2 [3, N = 71] = 13.0705; p = 0.0003). The average central subfield thickness decreased from 327.2 ± 89.1 μm to 294.8 ± 86.5 μm (p = 0.0294). Best‐corrected visual acuity, intraocular pressure, pigment epithelium detachment presence, and height had no significant difference after switching to IFI. Conclusions: In "treatment‐resistant" patients receiving anti‐VEGF therapy for neovascular age‐related macular degeneration or diabetic macular edema, switching to IFI in a "real‐world" TAE protocol led to statistically significant improvements in treatment interval and retinal fluid on spectral domain OCT. [ABSTRACT FROM AUTHOR]

To present a semi-automated method of image alignment to aid in monitoring the progression of inherited retinal degenerations (IRDs). A 22-year-old woman presented with nyctalopia and a family history of retinitis pigmentosa (RP), but with no prior genetic testing. Fundus examination showed a sectoral retinal degeneration involving the inferior and nasal retina with rare, pigmented deposits. Goldmann kinetic perimetry demonstrated corresponding superotemporal visual field defects. The best-corrected visual acuity was 20/20 in both eyes. Multimodal imaging delineated geographically restricted peripheral retinal degeneration extending to the inferior edge of the macula. Central visual function remained intact with normal multifocal electroretinography findings. Optical coherence tomography (OCT) through the leading edge of the retinal degeneration confirmed loss of the photoreceptor layer and associated retinal pigment epithelium. In the region of retinal degeneration, loss of vascular flow density was noted on optical coherence tomography angiography (OCTA). Genetic testing identified a pathologic sequence variant in RHO (c.68C>A, p.Pro23His), confirming autosomal dominant sector retinitis pigmentosa (SRP). Image alignment allowed for precise measurement of the progression of SRP over a period of 18 months. SRP is a rare subtype of RP characterized by focal, typically inferior and nasal, retinal degeneration of the peripheral retina. Although the onset and extent of peripheral retinal degeneration varies, compared with RP, SRP typically progresses more slowly to involve the macula. In this report, we highlight the utility of image registration and alignment to aid in monitoring disease progression in IRDs by means of multimodal imaging. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: To describe the use of capillary blood gas (CBG) sampling to detect and quantify hypoventilation in infants with Robin sequence (RS). Methods: Case series with chart review at two institutions. Infants with RS presenting over a 10‐year period were identified using departmental databases. CBG values obtained during infancy or until airway intervention (AI) were reviewed. Results: From 2008 to 2018, 111 infants with RS were identified as having had been assessed and managed from birth or transfer until discharge home and having CBG data available. In most cases, CBG sampling was obtained every other day until intervention or discharge. A total of 81 (73%) infants required AI: 72 (89%) underwent mandibular distraction osteogenesis, five (6%) underwent tracheotomy, and four (5%) were discharged home with a nasopharyngeal airway. The mean PCO2 at day of life (DOL) 7–30 for the AI group was 52.7 mmHg (95% confidence interval: 51.7–53.7) and for the no AI group was 45.9 mmHg (44.8–47.0; P <.0001). The mean HCO3 at DOL 7–30 for the AI group was 29.8 mEq/L (29.4–30.1) and for the no AI group was 27.0 mEq/L (26.5–27.4; P <.0001). Receiver operating characteristic curves were created for maximum PCO2 and HCO3 values and cutoffs were established by optimizing a balance of sensitivity and specificity. Infants requiring AI surpassed the PCO2 and HCO3 cutoff at a median of DOL 9. Conclusions: Among infants with RS and hypoventilation, objective measures of respiratory acidosis may be apparent by DOL 9. Level of Evidence: 4 Laryngoscope, 131:2789–2794, 2021 [ABSTRACT FROM AUTHOR]