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Aims/Purpose: To report the changes in diabetic macular oedema (DME) and visual acuity (VA) in a single patient with bilateral DME treated with intravitreal 2 mg aflibercept (AFL) and 6 mg faricimab (FAR) in the context of a randomized clinical trial during 44 weeks. Methods: Interventional case report within a clinical trial. Results: A 57‐year‐old female patient entered a clinical trial to test the efficacy of FAR for DME. DME was present in both eyes. The left eye (LE) was randomized to masked treatment (which resulted to be 6 consecutive intravitreal FAR every 4 weeks followed by FAR every 8 weeks, totalling 8 injections). The RE received open label treatment with monthly AFL at baseline; and then every 4 weeks after Week 16, until Week 44, totalling 8 injections). Baseline best corrected VA was RE 50 letters and LE 64 letters; at Week 24, RE 46 and LE 62; and at Week 44, RE 46 and LE 76. Optical coherence tomography (OCT) revealed a progressive reduction of central macular thickness (CMT) as well as hard exudates and disorganization of retinal layers in both eyes. Angio OCT showed a progression of non‐perfused macular areas in both eyes; the anti‐vascular endothelial growth factor effect of the treatment induced a reduction in the severity of diabetic retinopathy in both eyes demonstrated by fluorescein angiography and colour fundus imaging. Conclusions: Our results show that treatment with AFL and FAR in the eyes of the same patient may cause a similar reduction in CMT, even though a better visual outcome was observed in the eye treaded by FAR. [ABSTRACT FROM AUTHOR]

Aims/Purpose: To report a case of choroidal neovascularization secondary to Best's vitelliform dystrophy in a child managed by intravitreal aflibercept. Methods: Interventional, case report. Results: A 9‐year‐old boy reported decreased visual acuity (VA) with metamorphopsia in his right eye (RE) for the previous month. VA was RE 20/100 and left eye (LE) 20/20. Funduscopy revealed right‐eye macular oedema with deep macular haemorrhage associated to a bilateral orange‐yellowish deposit. Optical coherence tomography (OCT) showed sub‐ and intraretinal fluid in the foveal area along with a hyperreflective subretinal deposit and a localized retinal pigment epithelium (RPE) elevation. Blue autofluorescence (BAF) imaging disclosed a central hyper autofluorescence area as well as a larger defect corresponding to the haemorrhage and the subretinal deposit. The LE was positive for a central deposit located under the RPE with hyper autofluorescence at BAF. Familiar history was unknown for ocular conditions and the clinical history was irrelevant for fever, inflammation, adenopathy, articular, neurological or respiratory conditions. The condition was diagnosed as choroidal neovascularization (CNV) secondary to Best's vitelliform dystrophy and a single intravitreal injection of aflibercept was performed under general anaesthesia. Genetic study revealed a likely pathogenic mutation c.874G>C (p.Glu292Gln) in the BEST1 gene (missense change, not previously published) affecting a functional dominion. The subretinal bleeding and fluid resolved after one single injection of aflibercept and VA improved to 20/20. No recurrences have been observed during the subsequent five years in either eye. Conclusions: We report a case of CNV as first manifestation of a previously not reported mutation of Best's vitelliform dystrophy in a 9‐year‐old boy that was successfully treated with one single intravitreal injection of aflibercept. [ABSTRACT FROM AUTHOR]

Aims/Purpose: The objective of this study has been to evaluate the systemic safety that the use of intracameral adrenaline in cataract surgery has on blood pressure and heart rate. This study aims to demonstrate that this procedure is safe for the patient. Methods: A cohort of 777 patients undergoing cataract surgery was studied. Two differentiated groups were prospectively established. Group I with 394 patients included those in whom only mydriatic eye drops were used to achieve adequate operative mydriasis. Group II with 383 patients in whom operative mydriasis was achieved by using the same mydriatic eye drops as in Group I, reinforced by the use of intracameral adrenaline at the beginning of the intervention. The pre‐anaesthetic evaluation was carried out by the anaesthesiology service. Systolic, diastolic and mean blood pressure was monitored non‐invasively at 5‐min intervals from the start of surgery using an automatically inflating cuff. The heart rate was recorded at the beginning of the intervention and every 5 min until the end of the surgery. Oxygen saturation was monitored by digital pulse oximetry. Results: A total of 496 patients presented cardiovascular pathology, being hypertension the most frequent with 417 patients. 65% of the patients with cardiovascular pathology and 54.3% of the hypertense were dilated with intracameral adrenaline, finding no statistically significant differences between being diagnosed with cardiovascular pathology and receiving or not intracameral adrenaline. In all degrees of anaesthetic risk, the number of patients dilated with adrenaline was similar to those dilated with topical mydriatics. There were not significant differences in the variables recorded during surgery between patients treated with intracameral adrenaline and those who were not. Conclusions: We can conclude that intracameral injection of adrenaline at the beginning of cataract surgery did not statistically increase the risk of side effects on blood pressure or heart rate, when compared to the group of patients who only received pre‐operative topical mydriatics. The use of intracameral adrenaline at the start of phacoemulsification does not imply changes in control actions, drug administration or monitoring by the anaesthesia service. [ABSTRACT FROM AUTHOR]