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This article discusses the role of post-operative face-down positioning (FDP) in the surgical management of full-thickness macular hole (FTMH). FDP is believed to improve the closure rate of FTMH by enhancing the contact between the gas bubble and the hole. However, FDP can be challenging for elderly patients and those with comorbidities. The study examined whether FDP improves the anatomical and functional outcomes in FTMH eyes treated with a specific surgical technique. The results showed that FDP did not significantly affect the closure rate or visual acuity in the short term, but after 12 months, the FDP group had better visual acuity and restoration of the ellipsoid zone integrity. Further research is needed to confirm these findings. [Extracted from the article]

Purpose: To investigate the role of complete blood cell count (CBC) measures in retinal artery occlusion (RAO). Methods: This was a case–control study, including 73 newly diagnosed RAO patients and 73 sex‐ and age‐matched subjects without RAO. On the same day of RAO diagnosis, a blood sample was collected and CBC was determined using an automatic blood counter. Dimensional CBC indices, such as mean platelet volume (MPV) and red cell distribution width (RDW), and some CBC‐combined indices, including neutrophil/lymphocyte ratio (NLR), derived NLR [dNLR = neutrophils/(white blood cells ‐ neutrophils)] and platelet/lymphocyte ratio (PLR), were evaluated. Erythrocyte sedimentation rate (ESR) was also measured. Results: Median neutrophils, red cell distribution width (RDW), NLR and dNLR were 4.5x109/L (IQR = 3.8–5.8), 13.4% (IQR = 12.7–14.75), 2.47 (IQR = 1.85–3.13) and 1.70 (IQR = 1.26–2.18) in RAO patients and 4x109/L (IQR = 3.18–4.93), 12.9% (IQR = 12–14), 1.86 (IQR = 1.42–2.44) and 1.32 (IQR = 1.02–1.64) in controls. RAO patients had significantly higher values of neutrophils (p = 0.003), RDW (p = 0.0011), NLR (p = 0.0001) and dNLR (p = 0.0001). There were no significant differences between the values of white blood cells, lymphocytes, platelet count, MPV and PLR. Multivariate logistic regression models revealed a statistically significant correlation between RAO and increased RDW (OR = 1.36, 95% CI = 1.06–1.73, p = 0.015), NLR (OR = 2.02, 95% CI = 1.34–3.06, p = 0.0009) and dNLR (OR = 3.4, 95% CI = 1.71–6.75, p = 0.0005). Conclusion: Results suggest that RDW, NLR and dNLR may be involved in the pathogenesis of RAO and predict its occurrence. However, high‐quality epidemiologic studies, preferably of cohort design, are warranted to confirm whether, or not, an RDW, NLR and dNLR may be considered potential biomarkers of RAO. [ABSTRACT FROM AUTHOR]

Purpose: To assess the in vitro antimicrobial activity of a new commercial ophthalmic solution containing povidone‐iodine 0.6% (IODIM®). Methods: Staphylococcus aureus ATCC 43300, Pseudomonas aeruginosa ATCC 27853, three ocular bacterial isolates (1 S. epidermidis, 1 S. aureus, 1 P. aeruginosa) and five Candida species were used. The bacterial and fungal isolates were cultured on Columbia blood agar base plates and Sabouraud‐dextrose agar plates, respectively and incubated overnight at 37°C. Bacterial and fungal suspensions in sterile saline solution were prepared to an optical density equal to 0.5 McFarland standard (approximately 108CFU/ml). Suspensions of the isolates were made in IODIM® solution to obtain a final concentration of 106CFU/ml. The suspensions were then distributed in conical tubes in a final volume of 1 ml and incubated at 37°C. At different time‐points (1, 5, 10, 15, 20, 25, 30 min and 24 hr), 10 μl of each suspension was removed, seeded on Columbia blood agar base and Sabouraud‐dextrose agar plates and then incubated for 24 hr at 37°C. Positive and negative controls were included in all experiments. Results: After 5‐min incubation, there was no bacterial growth on any plate. Conversely, IODIM® failed to kill the Candida isolates after 30 min' exposure and needed 24 hr to eradicate the organisms. Conclusion: IODIM® ophthalmic solution showed in vitro antimicrobial activity against S. epidermidis, S. aureus, P. aeruginosa and Candida species. Results suggest that it may be a potential candidate for the treatment of ocular surface infections and antimicrobial prophylaxis before intravitreal injections. [ABSTRACT FROM AUTHOR]

Abstract: There is still no agreement on total plasma homocysteine (tHcy) role in age‐related macular degeneration (AMD), the leading cause of new blindness in industrialized countries. We performed a systematic review and meta‐analysis of the published data on the correlation between tHcy and AMD. MEDLINE/PubMed and ISI Web of Sciences searches were performed according to MOOSE guidelines. Case–control studies were eligible for inclusion. Participants and controls were AMD patients and subjects without AMD. The main outcome measure was wet AMD. Homocysteine level was the main exposure variable. Data were pooled using a random‐effects model. Twelve case–control studies were identified: 10 assessed wet AMD, four dry AMD, one early AMD, one late AMD, and one any AMD. As for wet AMD, there was a total of 453 cases and 514 controls. Mean tHcy was on average 1.1 μmol/l (95% confidence interval [CI] = 0.96–1.25) greater in wet AMD cases, but there was evidence of extreme between‐study heterogeneity (p < 0.001, I2 = 91.8%). In a model homogenous for age, including six wet AMD studies (214 cases, 274 controls), mean tHcy was on average 0.58 μmol/l (95% CI = 0.35–0.73) greater in the case group, a not statistically significant result (p = 0.144) associated with moderate heterogeneity (I2 = 39.2%). Our meta‐analysis indicates that there is some weak evidence that increased tHcy might be associated with wet AMD; however, this result should be interpreted cautiously, because of a marked between‐study heterogeneity and the possible effect of publication bias. Future studies, preferably of cohort design, are necessary before any firm conclusions on the putative role of increased tHcy on AMD can be drawn. [ABSTRACT FROM AUTHOR]

Purpose To evaluate a pro re nata administration of Ozurdex® implant versus a single administration for treating diabetic macular oedema ( DME). Methods This exploratory study is designed as a comparative, multicentre, randomized study with a follow-up of 6 months. Patients with DME were assigned to treatment at baseline either with a single Ozurdex® implant during the entire six-month follow-up (fixed group) or Ozurdex® implant followed by retreatment on an individualized basis ( PRN group). Patients were scheduled for monthly evaluation based on assessment of best-corrected visual acuity ( BCVA) and optical coherence tomography. Results Twenty eyes were enrolled to the PRN group, and 22 were included in the fixed group. Following an equally steady, initial gain up to month 1, and maintenance up to month 3, vision started to decline in the fixed regimen group. At 6 months, a difference of 0.11 log MAR in BCVA was observed in favour of the PRN group. Compared to baseline, a significant reduction in retinal thickness was achieved up to month 2, when the fixed regimen group had begun to revert to pretreatment level. At 4 and 5 months, the difference in thickness between the two groups was statistically significant (p < 0.05). Mean number of treatments was 1.6 in the PRN group. Both fixed and PRN administration of Ozurdex showed a good safety profile . Conclusion A personalized treatment with monthly monitoring and retreatment as needed is effective in maintaining functional and anatomical benefits of Ozurdex®. [ABSTRACT FROM AUTHOR]

Internal limiting membrane (ILM) peeling for macular hole (MH) surgery may cause retinal abnormalities, visible on blue-filter fundus photographs as arcuate, slightly dark, extramacular striae along the course of retinal nerve fibres. All subjects underwent extensive ophthalmic examination and retinal imaging, including structural OCT, OCT angiography and colour-coded perfusion maps, before and after surgery. 2 Kishimoto H, Kusuhara S, Matsumiya W, Nagai T & Negi A (2011): Retinal surface imaging provided by Cirrus high-definition optical coherence tomography prominently visualizes a dissociated optic nerve fiber layer appearance after macular hole surgery. [Extracted from the article]

Purpose: This study aimed to evaluate the efficacy of multiple injections of intravitreal bevacizumab for treatment-naïve subfoveal occult choroidal neovascularization (CNV) in age-related macular degeneration (AMD). Methods: Twelve eyes of 12 patients (mean age 76 ± 6 years) with mean best corrected visual acuity (BCVA) of 20/100 and occult subfoveal CNV at fluorescein angiography (FA), indocyanine-green (ICG) angiography and optical coherence tomography (OCT), showing intra- or subretinal fluid with or without retinal pigment epithelial detachment (PED), underwent multiple intravitreal injections (mean 2.4 ± 0.7) of 1.25 mg (0.05 ml) bevacizumab. Visual acuity and OCT findings were assessed at the end of follow-up. Results: After a mean follow-up of 5.7 ± 2 months, BCVA improved from 20/100 (range 20/50–20/303) to 20/60 (range 20/28–20/200) (p = 0.038). Five eyes (42%) increased BCVA by ≥ 3 lines, six eyes (50%) increased BCVA by < 3 lines and one eye (8%) remained stable. Macular thickness decreased from 298 ± 71 μm to 223 ± 72 μm (p = 0.017). No ocular or systemic side-effects were observed. Conclusions: Short-term results suggest that multiple intravitreal injections of 1.25 mg bevacizumab are well tolerated and associated with significant improvements in BCVA and decreased retinal thickness by OCT in most patients with treatment-naïve occult CNV. Further evaluation of intravitreal bevacizumab for the treatment of occult CNV is warranted. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the role of some blood count‐derived inflammation biomarkers in non‐arteritic anterior ischemic optic neuropathy (NAION). Methods: 37 newly diagnosed NAION patients and 37 sex‐ and age‐matched subjects without NAION were recruited between January 2017 and December 2018. A blood sample was taken and complete blood cell count was performed. The following blood cell count‐derived indexes were evaluated: neutrophil/lymphocyte ratio (NLR), derived NLR [dNLR = neutrophils/(white blood cells‐neutrophils)], platelet/lymphocyte ratio (PLR). Results: NAION patients had significantly higher median values of mean platelet volume (MPV; p = 0.01), red cell distribution width (RDW; p = 0.015), NLR (p = 0.03), and dNLR (p = 0.01). There were no significant differences in white blood cells, lymphocytes, neutrophils, and PLR. Conclusion: Results suggest that MPV, RDW, NLR and dNLR may be disease biomarkers in NAION. Larger scale studies are necessary to confirm these findings. [ABSTRACT FROM AUTHOR]

Purpose: To assess the in vitro antimicrobial activity of a new commercial ophthalmic solution containing povidone‐iodine 0.6% (IODIM®). Methods: Staphylococcus aureus ATCC 43300, Pseudomonas aeruginosa ATCC 27853, three ocular bacterial isolates (1 S. epidermidis, 1 S. aureus, 1 P. aeruginosa) and five Candida species were used. The bacterial and fungal isolates were cultured on Columbia blood agar base plates and Sabouraud‐dextrose agar plates, respectively and incubated overnight at 37°C. Bacterial and fungal suspensions in sterile saline solution were prepared to an optical density equal to 0.5 McFarland standard (approximately 108CFU/ml). Suspensions of the isolates were made in IODIM® solution to obtain a final concentration of 106CFU/ml. The suspensions were then distributed in conical tubes in a final volume of 1 ml and incubated at 37°C. At different time‐points (1, 5, 10, 15, 20, 25, 30 min and 24 hr), 10 μl of each suspension was removed, seeded on Columbia blood agar base and Sabouraud‐dextrose agar plates and then incubated for 24 hr at 37°C. Positive and negative controls were included in all experiments. Results: After 5‐min incubation, there was no bacterial growth on any plate. Conversely, IODIM® failed to kill the Candida isolates after 30 min' exposure and needed 24 hr to eradicate the organisms. Conclusion: IODIM® ophthalmic solution showed in vitro antimicrobial activity against S. epidermidis, S. aureus, P. aeruginosa and Candida species. Results suggest that it may be a potential candidate for the treatment of ocular surface infections and antimicrobial prophylaxis before intravitreal injections. [ABSTRACT FROM AUTHOR]

Purpose: To report clinical outcomes of two different timings of intravitreal dexamethasone (DEX) implant administration for prevention of diabetic macular oedema (DME) worsening following cataract surgery., Methods: This multicentre, retrospective study included patients with DME who received an intravitreal DEX implant 1 month before cataract surgery, 'precataract DEX' group, or at the time of cataract surgery, 'concomitant treatments' group. Inclusion criteria were a follow-up ≥3 months and ophthalmological examination with optical coherence tomography (OCT) imaging at baseline (cataract surgery) and throughout follow-up. Anatomical improvement was considered to be a decrease in OCT central subfield (CSF) thickness ≥20% compared to baseline. The primary outcomes were anatomical and functional results at 3 months., Results: Two hundred twenty-one patients were included: 136 in the 'precataract DEX' group and 85 in the 'concomitant treatments' group. At 3 months, a reduction of CSF thickness ≥ 20% was found in 7.3% of eyes in the 'precataract DEX group' and in 83.7% of eyes in the 'concomitant treatments' group (p < 0.001), with mean CSF thickness lower in the latter group (371 ± 52 µm versus 325 ± 57 µm, p < 0.001). At 3 months, mean best-corrected visual acuity had improved from baseline in both groups (p < 0.001), with no difference between groups (p = 0. 20). No serious systemic adverse events were reported., Conclusion: Both approaches prevented a worsening of DME, showing a comparable visual outcome. Dexamethasone (DEX) implant given at the same time as cataract surgery provided a better anatomical outcome., (© 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Purpose: To assess the in vitro antimicrobial activity of a new commercial ophthalmic solution containing povidone-iodine 0.6% (IODIM ® )., Methods: Staphylococcus aureus ATCC 43300, Pseudomonas aeruginosa ATCC 27853, three ocular bacterial isolates (1 S. epidermidis, 1 S. aureus, 1 P. aeruginosa) and five Candida species were used. The bacterial and fungal isolates were cultured on Columbia blood agar base plates and Sabouraud-dextrose agar plates, respectively and incubated overnight at 37°C. Bacterial and fungal suspensions in sterile saline solution were prepared to an optical density equal to 0.5 McFarland standard (approximately 10 8 CFU/ml). Suspensions of the isolates were made in IODIM ® solution to obtain a final concentration of 10 6 CFU/ml. The suspensions were then distributed in conical tubes in a final volume of 1 ml and incubated at 37°C. At different time-points (1, 5, 10, 15, 20, 25, 30 min and 24 hr), 10 μl of each suspension was removed, seeded on Columbia blood agar base and Sabouraud-dextrose agar plates and then incubated for 24 hr at 37°C. Positive and negative controls were included in all experiments., Results: After 5-min incubation, there was no bacterial growth on any plate. Conversely, IODIM ® failed to kill the Candida isolates after 30 min' exposure and needed 24 hr to eradicate the organisms., Conclusion: IODIM ® ophthalmic solution showed in vitro antimicrobial activity against S. epidermidis, S. aureus, P. aeruginosa and Candida species. Results suggest that it may be a potential candidate for the treatment of ocular surface infections and antimicrobial prophylaxis before intravitreal injections., (© 2019 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

There is still no agreement on total plasma homocysteine (tHcy) role in age-related macular degeneration (AMD), the leading cause of new blindness in industrialized countries. We performed a systematic review and meta-analysis of the published data on the correlation between tHcy and AMD. MEDLINE/PubMed and ISI Web of Sciences searches were performed according to MOOSE guidelines. Case-control studies were eligible for inclusion. Participants and controls were AMD patients and subjects without AMD. The main outcome measure was wet AMD. Homocysteine level was the main exposure variable. Data were pooled using a random-effects model. Twelve case-control studies were identified: 10 assessed wet AMD, four dry AMD, one early AMD, one late AMD, and one any AMD. As for wet AMD, there was a total of 453 cases and 514 controls. Mean tHcy was on average 1.1 μmol/l (95% confidence interval [CI] = 0.96-1.25) greater in wet AMD cases, but there was evidence of extreme between-study heterogeneity (p < 0.001, I 2  = 91.8%). In a model homogenous for age, including six wet AMD studies (214 cases, 274 controls), mean tHcy was on average 0.58 μmol/l (95% CI = 0.35-0.73) greater in the case group, a not statistically significant result (p = 0.144) associated with moderate heterogeneity (I 2  = 39.2%). Our meta-analysis indicates that there is some weak evidence that increased tHcy might be associated with wet AMD; however, this result should be interpreted cautiously, because of a marked between-study heterogeneity and the possible effect of publication bias. Future studies, preferably of cohort design, are necessary before any firm conclusions on the putative role of increased tHcy on AMD can be drawn., (© 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)