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PurposeMethodsResultsConclusionThis multicenter study aimed to evaluate visual outcomes and analyze the specific viral pathogens and other factors associated with severe visual impairment (SVI), and retinal detachment (RD) in patients with acute retinal necrosis (ARN)A retrospective multicenter cohort study included ARN patients who underwent aqueous or vitreous PCR testing. Multivariable mixed-effects Poisson regression was used to identify factors associated with viral pathogens and SVI. A mixed-effects parametric survival-time model was applied to evaluate RD risk factors.A total of 56 patients (65 eyes) diagnosed with ARN were included. 31 patients (47.7%) had a final visual acuity of 20/200 or worse. SVI was associated with zone 1 involvement (aRR 4.2), immunocompromised status (aRR 2.8), and RD (aRR 4.8). RD occurred in 23 patients (35.4%) after an average of 4.26 months from the onset of ARN. The incidence rate of RD was 1.4 per 1,000 eye-days (95% CI: 0.9–2.1. It increased in VZV-ARN cases by 4.02 times (log-rank p = 0.008), patients with retinitis affecting 2–3 quadrants, and in immunocompetent status.Zone 1 involvement, immunocompromised status, and RD were key risk factors for SVI in ARN. RD occurred in approximately one-third of cases. Early and aggressive intervention is essential in VZV-ARN cases, particularly in cases where retinitis involves 2–3 quadrants of the retina and in immunocompetent individuals, to mitigate the risk of RD. [ABSTRACT FROM AUTHOR]

Background: Proliferative diabetic retinopathy (PDR) often leads to tractional retinal detachment and vitreous hemorrhage, requiring vitrectomy. Poor visual outcomes are commonly caused by macular edema and proliferative vitreous retinopathy after vitrectomy. Intravitreal dexamethasone implant has shown promise in improving visual function after vitrectomy for diabetic macular edema, but its role in vitrectomy for PDR treatment remains unexplored. This study aims to assess the effectiveness of vitrectomy combined with an intravitreal dexamethasone implant for PDR patients. Methods: We will design a single-mask, randomized controlled trial with 100 participants diagnosed with PDR requiring vitrectomy. Participants will be randomly assigned to either the Ozurdex (0.7 mg dexamethasone intravitreal implant) group or the control group. The dexamethasone implant group will undergo vitrectomy combined with 0.7 mg dexamethasone intravitreal implant, while the control group will undergo vitrectomy alone. A single surgeon will perform all the vitrectomy surgeries, and the choice of intravitreal dexamethasone implant treatment will be disclosed before the closure of scleral wounds. Primary and secondary outcomes will be assessed at baseline and at 4, 8, 12, and 24 weeks post-vitrectomy. Statistical analysis: Statistical analysis will be conducted using R software. A p value 0.05 will be considered statistically significant. The analysis methods will include the following: visual acuity and OCT measurements will be analyzed using repeated measures analysis of variance (ANOVA) with two-tailed tests; rates of visual improvement, visual decline, postoperative vitreous hemorrhage, elevated intraocular pressure, and postoperative retinal detachment will be analyzed using chi-square tests with two-tailed tests. Logistic regression analysis will be used to analyze risk factors for poor visual prognosis, neovascular glaucoma development, and postoperative vitreous hemorrhage occurrence. Discussion: This protocol aims to enhance our understanding of the effects of combining an intravitreal Ozurdex 0.7 mg dexamethasone implant with vitrectomy on visual outcomes and macular morphology changes in treating late complications of PDR. Trial registration: The trial was registered at the Chinese Clinical Trial Registry on May 11, 2022, with registration number ChiCTR2200059760. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionThis study aimed to evaluate pars plana vitrectomy (ppv) with silicone oil tamponade in the management of patients with endogenous endophthalmitis.All patients treated with ppv and silicone oil for endogenous endophthalmitis at the University Eye Hospital Bonn between 2015 and 2022 were included. We documented all preoperative data, encompassing BCVA at diagnosis, clinical observations, and presenting symptoms. During each follow-up visit, we evaluated BCVA and monitored for any complications. Statistical analysis was performed using SPSS Statistics.In total, 19 eyes of 19 patients were included in this study. The most common underlying diseases were urosepsis in 5 patients (26.3%), endocarditis and leukemia in 3 patients (15.8%) respectively. The most common bacterial pathogens in the vitreous samples were gram-positive cocci in 3 patients (15.8%) and staphylococcus aureus in 3 patients (15.8%). The most common fungal pathogen was candida albicans in two patients (10.8%). Visual acuity (VA) at diagnosis was 1.93 logMAR (0.4–3.0 logMAR) and increased to 1.39 logMAR (0.2–3.0 logMAR) after six months and 1.21 logMAR (0.2–3.0 logMAR) after one year. 2 patients (10.5%) died during the follow-up because of their underlying disease. 9 eyes (47.4%) developed postoperative complications. One eye with no light perception was enucleated due to pain caused by high intraocular pressure. 2 eyes (10.5%) developed a postoperative retinal detachment needing further surgery.Most patients treated with ppv and silicone oil for endogenous endophthalmitis experienced an improvement in visual acuity; however, due to the severity of the condition, the visual prognosis remains guarded. [ABSTRACT FROM AUTHOR]

Subretinal injections provide direct access to photoreceptors and RPE, which is crucial for the delivery of gene therapy and neuroprotective approaches. To access the subretinal space, transvitreal (TV) and transscleral (TS) subretinal injections have been widely used in humans and animal models. In this work, we investigated recent trends and outcomes of utilizing TV and TS subretinal models of retinal detachment (RD). A literature review revealed an increasing utilization of both models over the past two decades, with TS emerging as the predominant model since 2012. Subretinal injection in CX3CR1 + /GFP CCR2 + /RFP mice revealed early inflammatory responses, with TS injections inducing higher infiltration of CD11b + CCR2 + cells compared to TV. Further leukocyte immunophenotyping indicated divergent infiltration patterns, with the TS approach exhibiting higher proportions of neutrophils and macrophages/microglia-like cells, while the TV injections had higher CD45hi CD11b + Ly6G- Ly6C + infiltration. Notably, late-stage analysis demonstrates higher photoreceptor cell death in the TS approach, paralleled by increased subretinal infiltration of CD11b + cells. Both models showed significant reactive gliosis, suggesting comparable late-stage wound healing responses. These findings underscore the utility of these approaches for subretinal delivery, offering insights into their distinctive leukocyte infiltration and late-stage tissue responses. [ABSTRACT FROM AUTHOR]

Background/Objectives: Central serous chorioretinopathy (CSCR) is a common retinopathy that can present with other concurrent diseases; thus, further research into the prevalence of other ocular comorbidities in eyes with CSCR is required. Methods: This retrospective, multicentric, cross-sectional observational study reviewed the charts of 9157 patients. Of them, 579 (6.32%) patients and 766 eyes had an additional ocular comorbidity, in addition to CSCR, in at least one subject eye. Results: The baseline best-corrected visual acuity (BCVA) of the subjects eyes was 0.49 ± 0.36 logMAR. The average BCVA of subject eyes with coexisting macular diseases was 0.50 logMAR, while the corresponding BCVA of subject eyes with coexisting peripheral disease was 0.55 logMAR. The most prevalent coexisting macular diseases were non-proliferative diabetic retinopathy (26.8%), non-exudative age-related macular degeneration (AMD) (7.6%) and hypertensive retinopathy (3.0%). The most prevalent coexisting non-macular diseases were lattice degeneration (8.9%), optic atrophy (5.1%), rhegmatogenous retinal detachment (1.70%) and optic disc pit (1.7%). The odds of having a comorbid disease in the same eye as CSCR were statistically significant for branch retinal vein occlusion (OR 11.56, p-value = 0.02) and non-exudative AMD (OR 2.06; p-value = 0.01); additionally, there was a trend towards significance for idiopathic polypoidal choroidal vasculopathy (OR 4.43; p-value = 0.05) when compared to the eyes without CSCR. Conclusions: Certain diseases are more likely to coexist in eyes with CSCR. Additionally, eyes with CSCR may have statistically significant odds of certain diseases when compared to eyes without CSCR. [ABSTRACT FROM AUTHOR]

Background: Ocular emergencies are commonly evaluated in general emergency departments (ED) where ophthalmologists are rarely available. Nonmydriatic ocular imaging combining color fundus photographs and optical coherence tomography (NMFP-OCT) can help with rapid remote triage by ophthalmologists. We evaluated the rate at which retinal detachments (RDs) can be diagnosed with NMFP-OCT in the ED. Methods: Quality improvement project with prospective collection of data on RD patients who had NMFP-OCT obtained by ED staff over 1 year. Photographs were interpreted remotely by ophthalmologists and all patients underwent an in-person ophthalmologic examination in the ED to confirm the presence of a RD. Results: A total of 63 eyes (58 patients) had a RD, among which 53 (84.1%) had strong suggestion of RD on ocular imaging (34 [54%] were seen on both color and OCT nerve/macula; 11 [17.5%] were seen on color but missed on OCT; 8 [12.7%] were missed on color but seen on OCT). Ten RDs (15.9%) were missed on both color and OCT because of peripheral location of the RD (4, 40%), vitreous hemorrhage (4, 40%), or poor image quality (2, 20%). A total of 40 out of 58 patients were not seen by an eye care provider prior to reaching our ED and 10 had an inappropriate stroke workup for acute vision loss of presumed vascular origin. Conclusion: NMFP-OCT of the posterior pole obtained by ED staff revealed the RD in 84.1% of eyes, allowing for rapid remote triage of patients with visual symptoms and avoiding unnecessary testing when the diagnosis of RD is confirmed. [ABSTRACT FROM AUTHOR]

Purpose: To characterize the dynamic changes of fundus in Vogt-Koyanagi-Harada (VKH) disease through enhanced spectral-domain optical coherence tomography (EDI-OCT) and explore the predictors of visual prognosis. Methods: In this retrospective cohort study, a total of 2152 VKH patients referred to our uveitis center from January 2013 to April 2022 were screened; 151 new-onset VKH patients (299 eyes) and 82 healthy controls (164 eyes) were included. The manifestations of fundus at baseline, 1 month, 3 months, and 12 months after treatment were analysed and their relevance to visual prognosis were evaluated. Results: After retinal detachment (RD) (97.3%) and optic disc swelling (100%) presented at baseline, retinal reattachment (81.6%) and the granular hyperreflective depositions at the retinal pigment epithelium (RPE) (61.5%) were observed at month 1. The RPE and ellipsoid zone rearrangement accompanying interdigitation zone attenuation (57.9%) was noted finally. Choroidal thickness of patients was higher than that in the controls at baseline and month 1 (both P < 0.001). Best-corrected visual acuity (BCVA) (logarithm of the minimum angle of resolution [logMAR]) (P < 0.001; OR, 4.01), subretinal fibrinoid exudate (P < 0.001; OR, 3.9) and RPE folds (p = 0.001; OR, 2.39) at baseline, and the RD at month 1 (P < 0.001; OR, 3.42) were associated with visual prognosis. Conclusions: New-onset VKH patients after treatment exhibited dynamic changes in the fundus especially the outer retina during a 12-month period. The BCVA, subretinal fibrinoid exudate, and RPE folds at baseline, and RD at month May 1, serve as predictors of visual prognosis. [ABSTRACT FROM AUTHOR]

Purpose: The protein concentrations of apoptosis inducing factor (AIF), macrophage migration inhibitory factor (MIF), interleukin-1β (IL-1β), poly ADP ribose polymerase-1 (PARP-1), poly (ADP-ribose) (PAR), α-synuclein (α-SYN), monocyte chemotactic protein‑1 (MCP-1) and tumor necrosis factor-α (TNF-α) in the vitreous of eyes with rhegmatogenous retinal detachment associated with choroidal detachment (RRDCD) were observed and analyzed. Methods: A total of 57 patients' samples were included. 30 patients with RRD were set as the control group, 27 patients with RRDCD were set as the experimental group (16 patients with preoperative glucocorticosteroid (GC+) and 11 patients without preoperative glucocorticosteroid (GC−)). The levels of AIF, MIF, IL-1β, PARP-1, PAR, α-SYN, MCP-1 and TNF-α in vitreous of patients in the control and experimental groups were detected by enzyme-linked immunosorbent assay (ELISA). Results: The concentration of AIF in the vitreous was higher in the RRD group (9.96 ± 2.78 ng/ml) than in the RRDCD (GC+) group (7.65 ± 2.13 ng/ml, p = 0.006),the RRDCD (GC+) group was lower than the RRDCD (GC−) group (10.28 ± 2.81 ng/ml) (p = 0.013). The concentration of MIF in vitreous fluid was lower in the RRDCD (GC+) group (61.21 ± 17.56 ng/ml) than in the RRDCD (GC−) group (74.30 ± 9.66 ng/ml, p = 0.039). In the experimental group, the protein concentration of MCP-1 in the RRDCD (GC+) group was higher in the preoperative PVR grading C (284.93 ± 54.96 ng/ml) grade than in the D grade (225.94 ± 24.05 ng/ml) (p = 0.050); The protein concentration of MIF was lower in the RRDCD (GC+) group of patients with an ocular axis of <26 mm (56.19 ± 6.99 ng/ml) than in those with an ocular axis of ≥26 mm (76.26 ± 26.60 ng/ml, p = 0.043). Conclusion: Low expression of Parthanatos-related proteins is present in the vitreous of patients with RRDCD (GC+), and preoperative treatment with glucocorticoids may reduce the expression of Parthanatos-related proteins. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether the intraocular lens (IOL) calculation of the fellow eye (FE) can be used in eyes undergoing combined phacovitrectomy. Methods: In this retrospective, consecutive case series, we enrolled patients who underwent combined phacovitrectomy with silicone oil removal and IOL implantation at the Goethe‐University. Preoperative examinations included biometry (IOLMaster 700; Carl Zeiss). We used the IOL calculation of the FE (FE group) to calculate the prediction error compared with the IOL calculation using only the axial length (AL) of the FE (AL‐FE group), as well as using the AL of the operated eye (OE group) in addition to the measurable biometric parameters. IOL calculation was performed using the Barrett Universal II formula. We compared the mean (MAE) and median absolute prediction error (MedAE) with each other. Furthermore, the number of eyes with ±0.50, ±1.00 and ±2.00 dioptres (D) deviation from the target refraction was compared. Results: In total, 79 eyes of 79 patients were included. MedAE was lowest in the OE group (0.41 D), followed by FE group (1.00 D) and AL‐FE group (1.02 D). Comparison between the AL‐FE and FE groups showed no statistically significant difference (p = 0.712). Comparing eyes within ±0.50 D of the target refraction, the OE group (63.3%) performed best, followed by the AL‐FE group (27.8%) and the FE group (26.6%). Conclusion: Our results indicate no clinically relevant difference between using the IOL calculation of the FE versus using only the AL of the FE in addition to the measurable parameters for the IOL calculation. A two‐step procedure should always be strived for. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to investigate the quantitative differences between severe stage 3 and stage 4A retinopathy of prematurity (ROP) by evaluating the pre-treatment fundus photographs. Methods: Thirty-three eyes with clinical diagnosed as severe stage 3 were classified as severe stage 3 group. Twenty-two eyes with retinal detachment without foveal involvement were classified as stage 4A group. Quantitative measurements were performed on pre-treatment 130 degree fundus photographs. Results: In the severe Stage 3 group, dense fibrous membranes, vertical tractional bands, and dragging were detected in 18 eyes (55%), in 5 eyes (15%), and in none of the eyes, respectively. In the stage 4A group, dense fibrous membranes, vertical tractional bands, and dragging were detected in 21 eyes (96%), in 22(100%) eyes, and in 17 eyes (77%), respectively. Dragging and vertical tractional bands were higher in the Stage 4A group than in the severe stage 3 group (p = 0.000). Disc-to-fovea distance, the width of the fibrous membranes, the total area of the fibrous membranes, total retinoschisis, and detachment areas were significantly higher in the stage 4A group than in the severe stage 3 group (respectively, p = 0.000,p = 0.006, p = 0.024,p = 0.000). Conclusions: Fibrous membranes and tractional bands can be detected in severe stage 3 ROP, but the width and the total area of the fibrous membranes and total retinoschisis-detachment area were found to be higher in stage 4A eyes. The dragging of the posterior pole can be an important diagnostic indicator for the diagnosis of stage 4A. Therefore this finding may be a simple auxiliary finding for diagnosis and prognosis of stage 4A ROP. [ABSTRACT FROM AUTHOR]

Purpose: Proliferative vitreoretinopathy (PVR) is a complication of retinal detachment which requires multiple vitreoretinal surgical interventions and frequent use of oil endotamponade. In this study, we conducted an in-depth analysis of complications associated with the use of heavy silicone oil in the management of inferior PVR. Methods: A retrospective cohort study of 20 eyes that underwent vitrectomy for inferior PVR with use of heavy silicone oil (Densiron 68) between March 2021 and October 2022 at Oxford Eye Hospital. Complications were classified into major categories relating to intraocular pressure, inflammation, lens, and oil emulsification/migration. Visual outcomes and surgical success rate were also evaluated. Results: Fill-induced pressure spikes (> 30 mmHg) within 14 days post-surgery were common after Densiron tamponade, especially in patients previously on glaucoma drops. The number of glaucoma drugs were increased in 45% of patients during Densiron tamponade. In 20% of cases, an increased medication was continued long-term after Densiron removal. Significant cataract progression occurred in all phakic patients. In 25% of pseudophakic cases, posterior capsule opacification was noted. Inflammatory complications, such as anterior uveitis, were rare and any cystoid macular oedema was transient. No unexplained acute loss of vision following Densiron removal was encountered. The anatomical success rate at 30 days after Densiron removal was 70%. The mean (± SD) best-corrected visual acuities were 1.04 (± 0.79), 0.85 (± 0.62) and 0.50 (± 0.51) logMAR prior, during and after Densiron tamponade, respectively. Conclusion: The outcomes in this cohort treated with Densiron 68 were comparable to previously reported anatomical and functional results in cases with inferior PVR. IOP and lens-related complications require additional treatment during or after Densiron tamponade. Inflammatory complications rarely occurred over tamponade durations of around three months. Trial registration: Analyses were conducted as an internal quality improvement audit and as such did not require external IRB review. [ABSTRACT FROM AUTHOR]

Introduction and Primary ObjectiveConclusionsPediatric rhegmatogenous retinal detachment (RRD) presents unique challenges in diagnosis and management. A thorough evaluation of family, medical, and ocular history is helpful, as systemic and genetic conditions can predispose children to RRD. Trauma, high myopia, and history of prematurity are also common risk factors. Examining young children in the outpatient setting may have limitations, but the yield can be maximized by modifying examination techniques and utilizing imaging technologies. In this manscript, the considerations for diagnosis and management of pediatric rhegmatogenous retinal detachment are outlined.Primary scleral buckling is the treatment of choice for the vast majority of pediatric RRDs, as it offers a higher single surgery success rate in these young eyes with firmly adherent posterior hyaloid. Primary vitrectomy is not recommended due to this reason. Scleral buckling is the mainstay of pediatric RRD surgery, even in cases that may typically undergo vitrectomy in adults. Prophylactic treatment of the fellow eye may also be warranted in certain clinical scenarios. Understanding the unique challenges these patients face is important for early diagnosis, timely intervention, and tailored surgical strategies to optimize visual outcomes in this vulnerable patient population. [ABSTRACT FROM AUTHOR]

Background: In this study, we evaluated the incidence of cystoid macular edema (CME) after pars plana vitrectomy (PPV) for different retinal pathologies and assessed the role of optical coherence tomography (OCT) biomarkers in guiding treatment decisions in post-surgical CME patients who were refractory to medical therapy over a follow-up period of 12 months. Methods: Medical records of consecutive pseudophakic patients, who underwent PPV for different retinal pathologies, were retrospectively evaluated in this single-center, uncontrolled study. The incidence of post-PPV CME was assessed. Eyes with post-PPV CME in the first 2 months after surgery, with available clinical and OCT data for 12 months after surgery, were included in the evaluation. The mean best-corrected visual acuity (BCVA; logMAR), mean central macular thickness (CMT; μm) change, and response to different treatments [medical therapy and intravitreal dexamethasone (DEX) implant] were evaluated 1, 3, 6, 9, and 12 months after PPV. The impact of OCT biomarkers on the exposure to DEX implants was assessed. Adverse events, potentially related to the treatment, were investigated as well. Results: Of the 346 pseudophakic patients (352 eyes) who participated in this study, 54 (54 eyes) developed CME within the first 2 months after PPV (incidence of 15.3%). Among them, 48 patients were deemed eligible for the 12-month analysis. Preoperative mean BCVA (1.44 ± 0.99 logMAR) significantly improved to 0.32 ± 0.37 logMAR after 12 months (p < 0.001). The mean baseline CMT of 347 (±123.5) μm significantly decreased to 290 μm (±80.4; p = 0.003) by the end of the follow-up. Twenty-five eyes (52%) required one or more DEX implants for CME, due to being refractory to topical therapy. Significant correlations were found between the mean CMT values at various time points. Additionally, patients who required DEX implants at months 3 and 9 were more likely to present intraretinal fluid (IRF), disorganization of inner retinal layers (DRIL), disorganization of outer retinal layers (DROL), and hyper-reflective foci (HRF) at 1-month OCT. Five patients experienced a slight increase in intraocular pressure (IOP), which was successfully managed with topical medication. Conclusions: Topical therapy alone can be a valuable option for post-PPV CME in approximately 50% of patients. Significant visual recovery and macular thickness reduction at 12 months demonstrated that DEX implants can be a safe and effective second-line treatment for pseudophakic patients with post-PPV CME and who are refractory to medical therapy. Early post-surgical OCT biomarkers may indicate a more severe CME that might benefit from the steroid implant. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionsTo describe a case series of presumed Sympathetic Ophthalmia (SO) triggered by diode laser cyclophotocoagulation (CPC) for the treatment of neovascular glaucoma.Patients developing bilateral granulomatous uveitis after CPC between 2014 and 2024. Cases with prior ocular trauma or penetrating ocular surgery were excluded. Treatment consisted of systemic steroids acutely and subsequently steroid-sparing drugs for long-term control.Three patients were included. The cause of neovascular glaucoma in the inciting eyes was a central retinal vein occlusion. The ocular inflammation was characterised by vitritis, serous retinal detachment, and choroidal thickening. The follow-up for each case was 2, 6 and 10 years, respectively. During this period, all patients remained under constant immunosuppression due to recurrence of inflammation while attempting tapering of systemic therapy after a period of clinical stability. The final best-corrected visual acuity of the sympathising eyes was ≥6/9 Snellen and there was no perception of light in the inciting eyes. The blind eyes were comfortable and did not require surgical removal.Patients responded well to prompt immunosuppression and preserved vision in the sympathising eye. Steroid-sparing medication could not be stopped due to inflammation flare-ups and risk of visual loss. There could be a potential link between breakdown of the blood-retina barrier prior to the development of SO and sustained inflammatory reaction. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionTo examine propranolol efficacy in treating diffuse (DCH) and circumscribed choroidal hemangiomas (CCH) and controlling intraocular pressure (IOP) in patients with Sturge-Weber syndrome (SWS).A SWS patient case treated with propranolol for DCH is presented. Following PRISMA guidelines, we also performed a systematic review using PubMed/Web of Science, analyzing 14 studies detailing propranolol treatment outcomes for DCH, CCH, and IOP control in SWS. Demographic, clinical, treatment, and outcome data were extracted and statistically analyzed. Fisher’s exact test was used to compare findings such as retinal detachment rates.We reviewed patients treated with propranolol, including 8 DCH, 18 CCH, and 16 SWS cases of IOP control. Retinal detachment rates were significantly higher in DCH compared to CCH cases. Post-propranolol, 73% of DCH and CCH cases showed subretinal fluid improvement, and in SWS patients, 94% had IOP reduction.This study underscores the potential utility of propranolol beyond its traditional use in cutaneous hemangioma for treatment of CCH/DCH and IOP control. [ABSTRACT FROM AUTHOR]

To investigate the impact of the COVID-19 pandemic on the incidence and clinical characteristics of rhegmatogenous retinal detachment (RRD) patients referred to a high-volume center, Farabi Eye Hospital, Iran. In a retrospective study, all new RRD patients referred to Farabi Eye Hospital between March 2019 and March 2020 (pre-pandemic, Group 1) and March 2020 and March 2021 (post-pandemic, Group 2) were analyzed. The groups were compared based on demographic and clinical data. A total of 375 patients were included (131 pre-pandemic, 244 post-pandemic, and 34 during lockdowns). The during-pandemic group had a shorter referral time (44.97 vs. 76.76 days, p = 0.031) and surgical wait time (4.64 vs. 8.63 days, p < 0.001). No significant differences were found in pre-operative features (etiology, proliferative vitreoretinopathy, break type), surgical procedures, or initial treatment failure rates between the groups. General anesthesia use was significantly higher in the during-pandemic group (81.6% vs. 71.8%, p = 0.029). The COVID-19 pandemic did not significantly alter the demographic, clinical characteristics, or initial surgical outcomes of RRD patients. However, patients were referred and treated more expeditiously during the pandemic. The increased use of general anesthesia requires further investigation. [ABSTRACT FROM AUTHOR]

Background: Retinal pigment epithelium (RPE) tear is a well-known complication of RPE detachment and is typically associated with significant visual acuity decline. However, in this case, despite the occurrence of an RPE tear there was an unexpected improvement in visual acuity. Case presentation: A 68-year-old male presented with blurred vision in his right eye of a month's duration. Pachychoroid neovasculopathy was diagnosed. After monthly anti-vascular endothelial growth factor injections over a three months period. the choroidal neovascular membrane gradually diminished. While the pigment epithelial detachment expanded and the subretinal fluid increased. This was accompanied by deterioration in the visual acuity of the patient. The anti-VEGF treatment was discontinued, expectant management was adopted. Three months later, a retinal pigment epithelium tear was observed near the fovea, unexpectedly accompanied by complete resolution of the subretinal fluid, partial reattachment of the RPE detachment, and a significant improvement in visual acuity. Conclusions: This case presents a rare instance of significant improvement in visual acuity and anatomical reconstruction of macular structure following the development of a retinal pigment epithelial (RPE) tear in a patient with pachychoroid neovasculopathy. We suggest that the fovea-sparing nature of the RPE tear in our case and the resulting "incision and drainage" effect may explain this unexpected outcome. [ABSTRACT FROM AUTHOR]

Background: This study evaluates the efficacy of intravitreal Faricimab in reducing pigment epithelium detachment (PED) and fluid volumes in both treatment-naïve eyes and eyes unresponsive to anti-VEGF mono-therapies, all diagnosed with type 1 macular neovascularization (T1 MNV) over a period of 12-month. Methods: A retrospective, single-center cohort study was conducted at the Jules Gonin Eye Hospital, Lausanne, Switzerland. Clinical records of treatment-naïve and non-responder switch patients presenting T1 MNV secondary to neovascular age-related macular degeneration (nAMD) from September 2022 to March 2023 were reviewed. Patients received a loading dose of three monthly Faricimab injections followed by a treat-and-extend (T&E) regimen. Multimodal imaging, including structural OCT and AI-assisted analysis, was used to quantify PED volumes and related fluid biomarkers at baseline, 3-month, 6-month, and 12-month follow-up. Statistical analyses included linear mixed models to evaluate differences and trends in intraretinal (IRF), subretinal fluid (SRF) and PED volumes. Results: 65 eyes of 65 patients were enrolled (female: 70.7%; mean age = 80.7yrs, SD = 6.9yrs). 80% had received anti-VEGF treatment (Switch group) and 20% were treatment-Naïve at baseline. At 12 months, intravitreal treatments were more frequent in the Switch group (mean number = 8.3 vs. 6.0; p = 0.009). BCVA improved at the 12-month follow-up in Naïve eyes (+ 6.9 ETDRS letters from baseline, p = 0.053) and was maintained in Switch eyes. No cases of intraocular inflammation were observed. Significant reduction in SRF and IRF volumes were noted in both groups. A significant reduction in PED volume was observed over the follow-up period in both groups (mean slope = -206 nL, 95%CL = -273/-138; p-value < 0.001). Conclusions: Intravitreal Faricimab significantly reduced PED volumes in both treatment-Naïve and non-responder Switch patients over 12 months. The study highlights Faricimab's potential as an effective treatment option for T1 MNV in nAMD, offering significant improvements in PED volume and related fluid biomarkers. [ABSTRACT FROM AUTHOR]

Introduction: Various surgical techniques, including 360° buckling surgery with a retinal cerclage, have been employed to achieve retinal reattachment. Although retinal cerclage is generally effective, long-term complications can arise. Peripheral retinal ischemia and secondary neovascular glaucoma are rare, but serious complications can occur even years after successful retinal reattachment. Case Presentation: We report a rare case of a 79-year-old woman who underwent 360° buckling surgery with cerclage for retinal detachment 10 years ago. Although the initial surgery successfully reattached the retina, she later developed a complication characterized by peripheral retinal ischemia and secondary neovascular glaucoma. Conclusion: Early detection and prompt management of such complications are crucial to prevent irreversible visual impairment. [ABSTRACT FROM AUTHOR]

Introduction: Proliferative vitreoretinopathy (PVR) is a condition in which proliferation forms after rhegmatogenous retinal detachment (RRD) surgery or old RRD, and sometimes, PVR can occur under silicone oil (SO). Here, we report 2 cases of PVR in which we evaluated preoperative B-scan images of proliferation under SO using ultra-widefield swept-source OCT (UWF-SS-OCT). Case Presentation: The first case was a 61-year-old male who presented with PVR under SO tamponade after multiple pars plana vitrectomies (PPVs) at the previous hospital, and the second case was a 23-year-old man patient who was diagnosed with Coats disease in childhood and presented with PVR under SO after PPV for total RRD at our hospital. B-scan images of UWF-SS-OCT provided findings of epiretinal two-layered proliferation or emulsified SO in the peripheral area. Conclusion: UWF-SS-OCT is useful for preoperative assessment of the proliferation of PVR before SO removal. In addition, peculiar proliferation may occur in the eye under SO. [ABSTRACT FROM AUTHOR]