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Rationale: Branch retinal artery occlusion (BRAO) is a rare complication of retinal arterial macroaneurysm (RAM), a low-incidence ocular disease., Patient Concerns: A 75-year-old woman presented with a chief complaint of blurred vision., Diagnoses: The patient for 4 days received a diagnosis of RAM combined with BRAO., Interventions: The patient was treated with two successive intravitreal conbercept injections., Outcomes: The patient's best-corrected visual acuity improved, and the RAM diminished., Lessons: Administration of conbercept injection might be an effective treatment for complex RAM with BRAO., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: To examine rates of acute infectious endophthalmitis after pars plana vitrectomy (PPV) in eyes that received intraoperative subconjunctival antibiotics versus eyes that did not., Methods: A retrospective, nonrandomized, comparative case series of 18,886 consecutive cases of transconjunctival 23-, 25-, and 27-gauge PPV over a 5-year period was performed. The impact of prophylactic intraoperative subconjunctival antibiotics on the development of acute infectious postoperative endophthalmitis was examined., Results: Of 18,886 cases of PPV, 14,068 (74.5%) received intraoperative subconjunctival antibiotics, whereas 4,818 (25.5%) did not. Sixteen cases (0.085%, 1/1,176) of post-PPV endophthalmitis were identified. The incidence of endophthalmitis in eyes that received subconjunctival antibiotics was 0.078% (11/14,068 cases, 1/1,282), whereas the incidence in those that did not receive subconjunctival antibiotics was 0.10% (5/4,818 cases, 1/1,000). No statistically significant difference was identified in the incidence of endophthalmitis between those that received subconjunctival antibiotics and those that did not (P = 0.598). Microbial culture was performed in 11 cases with 6 culture-positive cases (5/8 cases that received subconjunctival antibiotics and 1/3 cases that did not)., Conclusion: Prophylactic subconjunctival antibiotics were not associated with a significantly reduced rate of post-PPV endophthalmitis. With consideration of emerging multidrug-resistant bacteria, routine prophylactic subconjunctival antibiotics may not be justified.

Purpose: To investigate Wnt3a and vascular endothelial growth factor (VEGF) levels in the vitreous fluid of patients with proliferative diabetic retinopathy (PDR) and to examine their correlation with PDR activity., Methods: Vitreous samples from 45 eyes with PDR and 28 eyes with nondiabetic macular disease were collected. Active PDR was present in 24 patients and inactive PDR in 21 patients, according to retinal neovascularization. The Wnt3a and VEGF level of vitreous fluid samples were measured by enzyme-linked immunosorbent assay., Results: Comparison revealed that mean intravitreal levels of Wnt3a increased significantly in PDR eyes compared with control eyes (13.55 ng/mL vs. 1.57 ng/mL, P < 0.001). The mean VEGF concentrations in the vitreous fluid of patients with PDR were also higher than those in nondiabetic controls, with the values being 723.21 pg/mL and 20.81 pg/mL, respectively (P < 0.001). In addition, vitreous concentrations of Wnt3a and VEGF were significantly higher in active PDR than in eyes with inactive PDR (P = 0.016 and P = 0.008, respectively). Furthermore, a significant positive correlation was detected between Wnt3a and VEGF levels in the vitreous., Conclusion: Intravitreous levels of Wnt3a and VEGF in patients with PDR are increased and correlated mutually. Wnt3a may be an important player in the development of diabetic retinopathy and its activity in vitreous fluid can be biomarker of PDR.