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1. LONG-TERM VISUAL OUTCOMES AND THE TIMING OF SURGICAL REPAIR OF FOVEA-SPLITTING RHEGMATOGENOUS RETINAL DETACHMENTS

Author: Antonio Capone, Christianne A Wa, Jeremy D. Wolfe, Sandeep Randhawa, Ramon Lee, Alan J. Ruby, Cire Nemeth, Tamer H. Mahmoud, George A. Williams, Tarek S Hassan, Kimberly A. Drenser, Bruce R. Garretson, Michael J. Maywood, Ryan A Shields, and Lisa J. Faia
Subjects: Male, Fovea Centralis, medicine.medical_specialty, Visual acuity, genetic structures, Sulfur Hexafluoride, Visual Acuity, Endotamponade, Single Center, Cryosurgery, Time-to-Treatment, chemistry.chemical_compound, Primary outcome, Vitrectomy, Ophthalmology, Humans, Medicine, Aged, Retrospective Studies, Surgical repair, Fluorocarbons, business.industry, Significant difference, Retinal Detachment, Retinal, General Medicine, Middle Aged, eye diseases, Scleral Buckling, chemistry, Cohort, Female, sense organs, medicine.symptom, business, Tomography, Optical Coherence, Follow-Up Studies
Abstract: To evaluate the visual outcomes and the affect of timing of surgical repair of fovea-splitting rhegmatogenous retinal detachments.A retrospective, consecutive cohort from multiple surgeons at a single center. Fovea status (fovea-on, fovea-splitting, or fovea-off) was classified by preoperative optical coherence tomography. The primary outcome measure was the visual acuity at the last follow-up that was further correlated with the timing of surgical repair.One hundred and ninety-five eyes were included with 62 fovea-on, 65 fovea-splitting, and 68 fovea-off detachments. The mean preoperative logarithm of the minimum angle of resolution visual acuity for fovea-on, fovea-splitting, and fovea-off groups was 0.16 ± 0.21, 0.70 ± 0.56, and 1.67 ± 0.87, respectively (P =0.001). Mean postoperative logarithm of the minimum angle of resolution visual acuity for fovea-on, fovea-splitting, and fovea-off groups were 0.07 ± 0.13, 0.10 ± 0.15, and 0.20 ± 0.22, respectively (P =0.001). A statistically significant difference in mean postoperative logMAR visual acuity was found between fovea-off and fovea-on groups (P = 0.003) and between fovea-off and fovea-splitting groups (P = 0.013), however not between fovea-on and fovea-splitting groups (P = 0.827). Visual acuity improved when repair was performed earlier after presentation for fovea-on (R = 0.378, P = 0.002) and fovea-off groups (R = 0.277, P = 0.022), but not for the fovea-splitting group (R = 0.089, P = 0.481).We described the favorable visual outcomes of surgery for fovea-splitting rhegmatogenous retinal detachment and correlated these with the timing of surgical repair, which may help guide the management of this urgent, vision-threatening condition.
Published: 2022
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2. Bilateral Exudative Retinal Detachments, Chemosis, and Impaired Ocular Motility in the Setting of Preeclampsia and HELLP Syndrome

Author: Viren K. Govindaraju, Olivia C. Schimmel, Matthew G. J. Trese, Bruce R. Garretson, and Lisa J. Faia
Subjects: Case Reports
Abstract: Purpose: We present a complication of preeclampsia and hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome including bilateral exudative retinal detachments, bullous chemosis, and impaired ocular motility. Methods: The patient was followed in the inpatient and outpatient setting with clinical examinations, optical coherence tomography, widefield fundus photography, neuroimaging including magnetic resonance imaging of the brain/orbits, as well as carotid artery ultrasonography. Results: Our patient was admitted with bilateral vision changes in the setting of preeclampsia and HELLP syndrome and was found to have bilateral exudative detachments, retinal exudation, severe bullous chemosis, and impaired motility. She was started on intravenous dexamethasone followed by an extended prednisone taper with resolution of her ocular findings and return of her vision to baseline. Conclusions: There is evidence that HELLP syndrome and preeclampsia are proinflammatory syndromes. Aggressive blood pressure control, corticosteroids, and a multidisciplinary approach might accelerate visual and systemic recovery in these complex cases.
Published: 2022

3. Preventing Iatrogenic Retinal Breaks in Cutter-Associated Traction from Chronic Vitreous Hemorrhage (CATCH)

Author: Matthew G J, Trese, Ramon, Lee, Bruce R, Garretson, and Tamer H, Mahmoud
Subjects: Traction, Vitrectomy, Iatrogenic Disease, Retinal Detachment, Humans, Retinal Perforations, Follow-Up Studies, Retrospective Studies, Vitreous Hemorrhage
Abstract: BACKGROUND AND OBJECTIVE: To describe an under-recognized complication in the surgical management of dense, nonclearing vitreous hemorrhage, specifically, the development of iatrogenic retinal breaks as a result of cutter-associated traction. STUDY DESIGN/PATIENTS AND METHODS: Review of surgical cases with cutter-associated traction from chronic vitreous hemorrhage (CATCH). RESULTS: Cutter-associated traction from chronic vitreous hemorrhage is a commonly encountered surgical entity that may result in complications such as iatrogenic retinal breaks, including giant retinal tears. These complications can be minimized or potentially avoided through the use of open sclerotomies or potentially mixed-gauge vitrectomy. CONCLUSION: Careful surgical planning in cases of dense or chronic vitreous hemorrhage is required to prevent cutter-associated tractional retinal breaks. [ Ophthalmic Surg Lasers Imaging Retina 2022;53:584–585.]
Published: 2022
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4. Characterization of Epiretinal Proliferation in Full-Thickness Macular Holes and Effects on Surgical Outcomes

Author: Antonio Capone, Demetrios G. Vavvas, Lisa J. Faia, Yoshihiro Yonekawa, Dean Eliott, George A. Williams, Jay Wang, Jeremy D. Wolfe, Maria A. Woodward, Miin Roh, Adam J. Weiner, Shizuo Mukai, Lucy H. Young, Maxwell S. Stem, Jason Comander, Leo A. Kim, David M. Wu, Bruce R. Garretson, Alan J. Ruby, Kimberly A. Drenser, Ivan J. Lee, Cindy Ung, Esther Lee Kim, Mohammad Dahrouj, Natalie T Huang, Tarek S Hassan, and Ivana K. Kim
Subjects: Adult, Male, Pars plana, medicine.medical_specialty, Visual acuity, Adolescent, genetic structures, medicine.medical_treatment, Visual Acuity, Retinal perforation, Vitrectomy, Endotamponade, Article, 03 medical and health sciences, 0302 clinical medicine, Ophthalmology, medicine, Humans, Aged, Retrospective Studies, 030304 developmental biology, Aged, 80 and over, 0303 health sciences, business.industry, Epiretinal Membrane, Retrospective cohort study, Middle Aged, Retinal Perforations, medicine.disease, eye diseases, medicine.anatomical_structure, Case-Control Studies, 030221 ophthalmology & optometry, Female, Full thickness, sense organs, Tamponade, Epiretinal membrane, medicine.symptom, business, Tomography, Optical Coherence, Follow-Up Studies
Abstract: PURPOSE: Epiretinal proliferation is a distinct clinical entity from epiretinal membrane that is classically associated with lamellar macular holes, but its prevalence and association with full-thickness macular holes (FTMH) have not been well described. We characterize MHEP macular hole associated epiretinal proliferation (MHEP) and its effects on long-term surgical outcomes. DESIGN: Multi-center, interventional, retrospective case control study. SUBJECTS: Consecutive eyes that underwent surgery for FTMH with a minimum of 12-months follow-up. METHODS: All eyes underwent pars plana vitrectomy, removal of any epiretinal membranes, and gas tamponade, with or without internal limiting membrane peeling. Spectral domain optical coherence tomography imaging was obtained pre- and post-operatively. MAIN OUTCOME MEASURES: Improvement in visual acuity and single surgery hole closure rates in eyes with, versus without, MHEP at 12 months. RESULTS: 725 charts were analyzed, and 113 patients met inclusion criteria. Of 113 eyes with FTMH, 30 (26.5%) had MHEP. Patients with FTMH and MHEP were older (P < 0.002), more often male (P = 0.001), and with more advanced macular hole stages than those without MHEP (P = 0.010). A full posterior vitreous detachment was more common in eyes with MHEP (P < 0.004). FTMH with MHEP had significantly less improvement in visual acuity 12-months postoperatively (P = 0.019) with higher rates of ellipsoid and external limiting membrane defects (P < 0.05) and with a higher rate of failure to close with one surgery compared to FTMH without MHEP (26.7% versus 4.8% [P = 0.002]). Peeling the internal limiting membrane was associated with improved rates of hole closure in FTMH with MHEP (P < 0.001). Multivariable testing confirmed that the presence of MHEP was an independent risk factor for less visual improvement (P = 0.031), single-surgery non-closure (P = 0.009), and that ILM peeling improved single-surgery closure rates (P = 0.026). CONCLUSIONS: We found that FTMH with MHEP has poorer anatomic and visual outcomes after vitrectomy compared to FTMH without MHEP. ILM peeling was associated with improved closure rates and should be considered when MHEP is detected preoperatively.
Published: 2019
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5. Natural History of Drusenoid Pigment Epithelial Detachment Associated with Age-Related Macular Degeneration

Author: Jeannette J. Yu, Elvira Agrón, Traci E. Clemons, Amitha Domalpally, Freekje van Asten, Tiarnan D. Keenan, Catherine Cukras, Emily Y. Chew, Frederick L. Ferris, John Paul SanGiovanni, Traci Clemons, Anne Lindblad, Robert Lindblad, Nilay Shah, Robert Sperduto, Wendy McBee, Gary Gensler, Molly Harrington, Alice Henning, Katrina Jones, Kumar Thotapally, Diana Tull, Valerie Watson, Kayla Williams, Christina Gentry, Francine Kaufman, Chris Morrison, Elizabeth Saverino, Sherrie Schenning, Barbara Blodi, Ronald P. Danis, Matthew Davis, Kathy Glander, Gregory Guilfoil, Larry D. Hubbard, Kristine Johnson, Ronald Klein, Barbara Nardi, Michael Neider, Nancy Robinson, Eileen Rosensteel, Hugh Wabers, Grace Zhang, Alan J. Ruby, Antonio Capone, Bawa Dass, Kimberly Drenser, Bruce R. Garretson, Tarek S. Hassan, Michael Trese, George A. Williams, Jeremy Wolfe, Tina Bell, Mary Zajechowski, Dennis Bezaire, Fran McIver, Anthony Medina, Jackie Pagett, Stephanie Hatch Smith, Lynn Swartz, Tom Treuter, Andrew Antoszyk, Justin Brown, David J. Browning, Walter Holland, Angella Karow, Kelly Stalford, Angela Price, Sarah Ennis, Sherry Fredenberg, Jenna Herby, Uma Balasubramaniam, Loraine Clark, Donna McClain, Michael McOwen, Lynn Watson, Michael Klein, Steven T. Bailey, Thomas J. Hwang, Andreas Lauer, J. Timothy Stout, Patty McCollum, Milt Johnson, Patrick B. Rice, Ivana Kim, John Loewenstein, Joan Miller, Lucia Sobrin, Lucy Young, Jacqueline Sullivan, Patricia Houlihan, Linda Merry, Ann Marie Lane, Ursula Lord Bator, Claudia Evans, Sarah Brett, Charleen Callahan, Marcia Grillo, David Walsh, Kamella Lau Zimmerman, Gary Edd Fish, Rajiv Anand, Lori E. Coors, Dwain G. Fuller, Rand Spencer, Robert C. Wang, Karen Duignan, Sally Arceneaux, Hank Aguado, Nicholas Hesse, Michael Mackens, Brian Swan, Wai T. Wong, Monica Dalal, Naima Jacobs-El, Catherine Meyerle, Benjamin Nicholson, Henry Wiley, Katherine Hall Shimel, Angel Garced, Janice Oparah, Greg Short, Alana Temple, Babilonia Ayukawa, Guy Foster, Darryl Hayes, Dessie Koutsandreas, Roula Nashwinter, John Rowan, Michael Bono, Denise Cunningham, Marilois Palmer, Alicia Zetina, David H. Orth, Kourous Rezaei, Joseph Civantos, Sohail Hasan, Kirk Packo, Celeste Figliulo, Pam Stanberry, Tara Farmer, Kiersten Nelson, Shannya Townsend-Patrick, Philip Rosenfeld, Royce Chen, Rishi Doshi, Sander Dubovy, Brian T. Kim, Matthew Lowrance, Andrew Moshfeghi, Zayna Nahas, Gary Schienbaum, John Vishak, Christina Weng, Zohar Yehoshua, Belen Rodriguez, Jose Rebimbas, Jane Gleichauf, Mike Kicak, Jason Mena, Tim Odem, Elizabeth Sferza-Camp, Alicia Disgdiertt, Jim Oramas, Isabel Rams, Stephanie Thatcher, Susan B. Bressler, Neil M. Bressler, Daniel Finkelstein, Steven H. Sherman, Sharon Solomon, Howard S. Ying, Rita Denbow, Deborah Phillips, Elizabeth Radcliffe, Judy Belt, Dennis Cain, David Emmert, Mark Herring, Jacquelyn McDonald, G. Baker Hubbard, Chris S. Bergstrom, Blaine Cribbs, Andrew Hendrick, Brandon Johnson, Philip Laird, Sonia Mehta, Timothy Olsen, Justin Townsend, Jion Yan, Steven Yeh, Linda Curtis, Judy Brower, Hannah Yi, Jannah Rutter Dobbs, Debbie Jordan, Michael J. Elman, Robert A. Liss, JoAnn Starr, Jennifer Belz, Charlene Putzulo, Teresa Coffey, Ashley Davis, Pamela Singletary, Giorya Shabi Andreani, Theresa Cain, Daniel Ketner, Peter Sotirakos, Suresh Chandra, Barbara A. Blodi, Michael M. Altaweel, Justin L. Gottlieb, Michael Ip, T. Michael Nork, Thomas S. Stevens, Kathryn Burke, Shelly Olson, Kristine Dietzman, Barbara Soderling, Guy Somers, Angie Wealti, Denise Krolnik, John Peterson, Sandra Reed, Thomas Friberg, Andrew Eller, Denise Gallagher, Leanne Labriola, Melissa Pokrifka, Aron Gedansky, Natalie Anthony, Cassandra Grzybowski, Dawn Matthews, Sharon Murajda-Jumba, Jessica Toro, David G. Callanan, Wayne A. Solley, Patrick Williams, Sandy Lash, Bob Boleman, Chris Dock, Michel Shami, Brenda Arrington, Ashaki Meeks, Alan R. Margherio, Paul Raphaelian, Debra Markus, Justin Langdon, Elizabeth Truax, Sandy Lewis, Brad Terry, Amy Noffke, Kean Oh, Ramin Sarrafizadeh, Scott Sneed, Julie Hammersley, Serena Neal, Mary Doran, Nan Jones, Lisa Preston, Heather Jessick, Tanya Tracy Marsh, Michael Tolentino, Adam Berger, Richard Hamilton, David Misch, Suk Jin Moon, Dawn Sutherland, Vera Dilts, Sara Henderson, Esmeralda Medina, Donald Trueman, Laura Holm, Jason Strickland, Darmakusuma Ie, Jeffrey L. Lipkowitz, Kekul B. Shah, Susan Geraghty, Beverly Sannazzaro, Morgan Harper, Krista Bayer, Mary B. Lansing, Lauren B. Fox, Rebecca Lee, Jay B. Stallman, Michael Jacobson, Sean Koh, Scott Lampert, John Miller, Mark Rivellese, Atul Sharma, Robert A. Stoltz, Stephanie Vanderveldt, Leslie Marcus, Starr Hendricks, Ryan Hollman, Grethel Betanzos, Leslie Ellorin, Shelly Fulbright, Debbie McCormick, Paul A. Edwards, Julianne Hall, Mary Monk, Melanie Gutkowski, Melina Mazurek, Janet Murphy, Katherine Gusas, Crystal Moffett, David Burley, Nicole Chesney, Katie Kilgo, Brian Rusinek, Bradley Stern, Tracy Troszak, Rhonda Baker-Levingston, Carl W. Baker, Tracey Caldwell, Tammy Walker, Lynnette F. Lambert, Tracey Martin, Mary Jill Palmer, Tana Williams, Michael A. Novak, Joseph Coney, David G. Miller, Scott Pendergast, Lawrence Singerman, Nicholas Zakov, Hernando Zegarra, Kim DuBois, Susan Rath, Lori Revella, Tammy Brink, Kim Drury, Lisa Hogue, Mary Ilc, Connie Keller, Elizabeth McNamara, Vivian Tanner, Tamara Cunningham, John DuBois, Gregg Greanoff, Trina Nitzsche, Sheila Smith-Brewer, Ricky D. Isernhagen, John W. Kitchens, Thomas W. Stone, William J. Wood, Diana Holcomb, Virginia Therrien, Michelle Buck, Jeanne Van Arsdall, Edward Slade, Todd E. Schneiderman, David J. Spinak, Jackie Gaedke, Heather Davis Brown, Dan Helgren, Jenifer Garrison Pangelinan, Lawrence Halperin, Scott Anagnoste, Mandeep Dhalla, Krista Rosenberg, Barry Taney, W. Scott Thompson, Jaclyn Lopez, Monica Hamlin, Monica Lopez, Jamie Mariano, Evelyn Quinchia, Patricia Aramayo, Rita Veksler, Michael Lee, Richard Dreyer, Irvin Handelman, Colin Ma, Mark Peters, Stephen Hobbs, Amanda Milliron, Marcia Kopfer, Michele Connaughton, A. Christine Hoerner, R. Joseph Logan, Harry J. Wohlsein, David Boyer, Thomas G. Chu, Pouya Dayani, David Liao, Roger L. Novack, Firas M. Rahhal, Richard Roe, Homayoun Tabandeh, Janet Bayramyan, Tammy Gasparyan, Connie Hoang, Janet Kurokouchi, Tammy Eileen Lo, Richard Ngo, Mary Ann Nguyen, Michael Peyton, Charles Yoon, Julio Sierra, Adam Zamboni, Jeff Kessinger, Eric Protacio, Adam Smucker, Pamela Rath, Robert Bergren, Bernard Doft, Judy Liu, Karl Olsen, Lori Merlotti, Willia Ingram, Kellianne Marfisi, Kimberly Yeckel, Heather Schultz Carmelo, Amanda Fec, Keith McBroom, David Steinberg, Marc Levy, Jody Abrams, Melvin Chen, Waldemar Torres, Peggy Jelemensky, Mark Prybylski, Tara Raphael, Diana Appleby, Charlotte Rodman, Mark Sneath, Robert H. Rosa, Vanessa Hoelscher, Adelia Castano, Jocelyn Parker, John Hoskins, Nicholas Anderson, Joseph Googe, Tod A. McMillan, James Miller, Stephen Perkins, Kristina Oliver, Jennifer Beerbower, Bruce Gilliland, Cecile Hunt, Mike Jacobus, Raul Lince, Christopher Morris, Sarah Oelrich, Jerry Whetstone, Clement K. Chan, Steven Lin, Kim Walther, Tiana Gonzales, Lenise Myers, Kenneth Huff, David M. Brown, Eric Chen, Matthew S. Benz, Richard H. Fish, Rosa Y. Kim, James Major, Tien Pei Wong, Charles Wycoff, Cassandra Cone, Debbie Goates Gilaspia, Nubia Landaverde, Robert Smith, Deneva Zamora, Veronica Sneed, Melina Vela, Eric Kegley, Craig Greven, Shree Kurup, Charles Richards, Madison Slusher, Cara Everhart, Joan Fish, Mark Clark, David Miller, Marshall Tyler, J. Michael Jumper, Arthur D. Fu, Robert N. Johnson, Brandon Lujan, H. Richard McDonald, Rosa Rodriguez, Nina Ansari, Jeanifer Joaquin, Silvia Linares, Lizette Lopez, Jessica Sabio, Sean Grout, Chad Indermill, Yesmin Urias, Roberto Zimmerman, Linda Margulies, Sara J. Schmidt, Joy L. Meier, Sherry L. Hadley, William Rosenthal, Barbara Johnson, Lois Swafford, Richard Shields, R. Scott Varner, Richard Rosen, Ronald Gentile, Melissa Rivas, Katy W. Tai, Wanda Carrasquillo-Boyd, Robert Masini, Glenn Stoller, Ken Carnevale, Diane M. LaRosa, Barbara Burger, Tereza Conway, Carla Del Castillo, Julissa Diaz, Susan Jones, Nina Mondoc, Charlene Balfour, C.H. Vitha, Jennifer Lutz, Barbara McGinley, Fadi El Baba, Ann Marie Lavorna, Renee Jones, Jean Lewis, Ruth Tenzler, Mary Salvas-Mladek, Diane Van Kesteren, W. Copley McLean, W. Zachery Bridges, Cameron Stone, Denise Ammons, Mary Lamy, Andrea Menzel, Lea Doll Raymer, Barbara Campbell, Lisa Hawkins, Leslie Rickman, Lorraine Sherlin, Paula Price, Albert Sinyai, Ronald Kingsley, Reagan H. Bradford, Robert E. Leonard, Sonny Icks, Vanessa Bergman, Brittany Ross, Russ Burris, Amanda Butt, Rob Richmond, Alice Lyon, Manjot Gill, Lee Jampol, Rukhsana Mizra, Zuzanna Rozenbajgier, Jeremy Chapman, Lori Kaminski, Andrea Degillio, Evica Simjanoski, Jeffrey Heier, Hyung Cho, Tina Scheufele Cleary, Darin Goldman, Chirag Shah, Trexler Topping, Marissa Weber, Torsten Wiegand, Jeremy Schindelheim, Joy Bankert, Jennifer Stone, Alison Nowak, Sandy Chong, Lindsay Williams, Steven Bennett, Dennis Donovan, Margaret Graham, Cullen Jones, Anne Fung, Jan-Kristine Bayabo, Razelda Bosch, Esperanza Cruz, Ashley Emerson, Alycia Fleming, Denice Barsness, Jorge Rodriguez, Marina Soboleva, Ingrid U. Scott, Esther Bowie, Kimberly A. Neely, David A. Quillen, Laura Walter, Timothy Bennett, James Strong, John Wells, Lloyd Clark, David Johnson, Peggy Miller, Mallie Taylor, Tiffany Swinford, Robbin Spivey, Michael Banach, Lawrence Ho, Richard Lanning, Thomas R. Pheasant, Jay G. Prensky, Steven Truong, Julia Teatsworth, Michelle Dietrich, Ann Wasilus, Ann Miller, Megan Rakes, Teresa Slagle, Michelle Richards, Patricia Schuessler, Lacy Stover, Paul Beer, Naomi S. Falk, Mary Beth Shannon, Jeannie Olmeda, Don Berdeen, Joseph F. Fisher, James Folk, Stephen Russell, Barbara Taylor, Connie Hinz, Jean Walshire, Heather Stockman, Bruce Critser, Stefani Karakas, Cindy Montague, Randy Verdick, Omesh Gupta, Joseph Maguire, Christopher Brady, Francis Char DeCroos, Michael Dollin, Sunir Garg, Adam Gerstenblith, Julia Haller, Allen C. Ho, Jason Hsu, Richard Kaiser, John Pitcher, Carl Regillo, Rajiv Shah, Marc Spirn, William Tasman, James Vander, Noga Senderowitsch, Michele Formoso, Michelle Markun, Cedric George, Christina Centinaro, Lisa Grande, Stefanie Carey, Elaine Liebenbaum, SriniVas Sadda, Mark Humayun, Rachel Sierra, Elizabeth Corona, Margaret Padilla, Moonseok Nu, Sylvia Ramos, Cullen Barnett, Glenn Currie, Cornelia Gottlieb, Richard Garfinkel, Daniel Berinstein, Marcus Colyer, William Deegan, Michael Min-Shyue Lai, Robert Murphy, Michael Osman, Michael Rivers, Reginald Sanders, Manfred A. von Fricken, Debbie Oliver, Jeanne Kirshon, Tanya Alexander Snowden, Thomas Blondo, Alysia Cronise, Vanessa Denny, Kylie Mendez, Janine Newgen, Justin Davis, Mike Flory, Robert Frantz, Bryan Murphy, Steve Rauch, Judy E. Kim, Jane Bachman, Thomas B. Connor, Dennis P. Han, Kimberly Stepian, David V. Weinberg, William J. Wirostko, Krissa Packard, Tracy Kaczanowski, Vesper Williams, Vicki Barwick, Judy Flanders, Dennis Backes, Joe Beringer, Kristy Keller, Kathy Selchert, Paul Bernstein, Michael Teske, Albert Vitale, Susan Allman, Bonnie Carlstrom, Kimberley Wegner, Anne Haroldsen, Deborah Harrison, Cyrie Fry, James Gilman, Glen Jenkins, Paula Morris, Michael Rauser, Joseph Fan, Mukesh Suthar, Gisela Santiago, Kara Rollins Halsey, Christy Quesada, William Kiernan, Jesse Knabb, Richard Alan Lewis, Cindy Dorenbach, Steven Spencer, Dana Barnett, Joseph Morales, Barron C. Fishburne, Jeffrey G. Gross, Michael A. Magee, Amy Flowers, Angie McDowell, Randall Price, Suber Huang, Johnny Tang, Shawn Wilker, Cherie Hornsby, Lisa Ferguson, Kirk Krogstad, Riva Adamovsky, Peggy Allchin, Kathleen Carlton, Claudia Clow, Kelly Sholtis, Stephanie Burke, Mark Harrod, Stacie Hrvatin, Geoffrey Pankhurst, Nelson R. Sabates, Michael Cassell, Komal Desai, Abraham Poulose, Felix Sabates, Yin Chen, Gary Gallimore, Yolanda Konior, Nicola Kim, Sami Uwaydat, Deborah Troillett, Karen Aletter, Robert N. Frank, Gary Abrams, James Puklin, Asheesh Tewari, Cheryl Milanovic, Melanie Bailey, David Griffith, Dena McDonald, Kit Morehead, Zlatan Sadikovic, Lisa Schillace, Elizabeth Silvis, Brian Joondeph, Nancy Christmas, Alan Kimura, Mimi Liu, Stephen Petty, John Zilis, Jenny Benitez, Cassandra Berryman Catlett, Eric Fluegel, Shane Mowry, Hoang Nguyen, David Reflow, Odette M. Houghton, Seema Garg, Maurice B. Landers, Travis Meredith, Sandy Barnhart, Megha Karmalkar, Debra Cantrell, Rona Lyn Esquejo-Leon, Linda Manor, Sue Pope, David Stines, Amelia Stokely, Dean Hainsworth, Dyann Helming, Debbie Eichelberger, Mary Paige Leaton, Chuck Hamm, Edward Chaum, Alessandro Iannaccone, Barbara Jennings, Tracy Murray, Joe Mastellone, Robert Millay, Brian Kim, Theresa Goddard, Liza Jarrett Beaudette, Nina Changelian-Aitken, Fernando Corrada, Jason Dubuque, Raymond Iezzi, Sophie J. Bakri, Jose S. Pulido, Diane Vogen, Rebecca Nielsen, Karin Berg, Jean Burrington, Shannon Howard, Joan Overend, Zbigniew Krason, Denise Lewison, Thomas Link, Kevin J. Blinder, Nicholas E. Engelbrecht, M. Gilbert Grand, Daniel P. Joseph, Gaurav K. Shah, Bradley Smith, Matthew Thomas, Rhonda Weeks, Lynda Boyd, Dana Gabel, Ron Adelman, John Huang, James Kempton, Aaron Parnes, Jennifer Dupont, Elizabeth Perotti, Victoria Donaldson, Kenneth Fong, Pamela Ossorio, Anita Agarwal, Paul Sternberg, Sandy Owings, Tony Adkins, Elaine Lok, Garvin Munn, Buddy Skellie, Neelakshi Bhagat, Monique S. Roy, Marco Zarbin, Catherine Fay, Michael Lazar, Beth Malpica, Tatiana Mikheyav, Lawrence Ulanski, Jennifer Lim, Marcia Niec, Tametha Johnson, Yesenia Ovando, Catherine Nail Carroll, Mark Janowicz, Steven Schwartz, David Cupp, Michael Gorin, Gad Heilweil, Hamid Hosseini, Jean-Pierre Hubschman, Allan Kreiger, Tara Young McCannel, Carolyn Pan, David Sarraf, Irena Tsui, Joshua Udoetek, Vinad Voleti, Logan Hitchcock, Rosaleen Ostrick, Melissa Chun, Jennie Kageyama, Nilo Davila, Kristin Lipka, Christina Shin, Cynthia Owsley, Michael Albert, Richard Feist, John Mason, Martin Thomley, Angelia Johnson, Tracy Emond, Joanna Hamela, Angela Marsh, Karen Searcey, Kia Rookard, Yu-Guang He, Rafael L. Ufret-Vincenty, Mike Molai, William Anderson, John Horna, Alan Letson, Colleen Cebulla, Susie Chang, Fred Davidorf, Jill Salerno, Laura Sladoje, Christina Stetson, Jeri Perry, Scott Savage, Cynthia Toth, Glenn Jaffe, Stefanie Schuman, Neeru Sarin, Jim Crowell, Tiffanie Keaton, Michael Kelly, Brian Lutman, Marriner Skelly, Lauren Welch, Lawrence Morse, Allan Hunter, Susanna Soon-Chun Park, Cynthia Wallace, Ember Dhillon, Marisa Salvador, Barbara Holderreed, Karishma Chandra, Sashi Kaur, Ellen Redenbo, Smiley Hom, Michael Cooney, Irene Barbazetto, James M. Klancnik, John A. Sorenson, Lawrence Yannuzzi, Maria Scolaro, Eugene Agresta, Nancy Gonzalez, Sandeep Grover, K.V. Chalam, Shailesh Gupta, Christopher Lyons, Wenhua Li, Chirag Patel, Jose Carrion, Henry Ferreyra, Amberly Rodriguez, Iliana Molina, Gabriel Balea, Pam Emory, Marlene Rico, Giorgio Siqueiros, Alexander J. Brucker, Joshua Dunaief, Juan Grunwald, Benjamin Kim, Albert M. Maguire, Brian VanderBeek, Sheri Drossner, Joan DuPont, Rebecca Salvo, Jim Berger, Cheryl Devine, Bill Nyberg, Laurel Weeney, David DiLoreto, Mina Chung, Valerie Davis, Peter MacDowell, George O. Gara, Daniel Castillo, Andrea Czubinski, Melissa Keim, Brandi Hardy, Rachel Grunhaus Hollar, Lynn Schueckler, Alice T. Lyon, Aaron Weinberg, Mira Shiloach, Nicole Pelkofer, Qin Zhou, Laura McPoland, Rajendra Apte, P. Kumar Rao, Sam Pistorius, Jamie Kambarian, Eve Adcock, Sarah Gould, Melanie Quinn, Rhonda Curtis, Amy Frost, Charla Meyer, and Greg Rathert
Subjects: 0303 health sciences, medicine.medical_specialty, Visual acuity, genetic structures, business.industry, Eye disease, Hazard ratio, Age-Related Eye Disease Study, Retrospective cohort study, Fundus (eye), Macular degeneration, medicine.disease, eye diseases, 03 medical and health sciences, Ophthalmology, 0302 clinical medicine, 030221 ophthalmology & optometry, medicine, sense organs, medicine.symptom, Prospective cohort study, business, 030304 developmental biology
Abstract: Purpose To investigate the natural history and genetic associations of drusenoid pigment epithelial detachment (DPED) associated with age-related macular degeneration (AMD). Design Retrospective analysis of a prospective cohort study. Participants Of the 4203 Age-Related Eye Disease Study 2 (AREDS2) participants, 391 eyes (325 participants) had DPED without late AMD at the time of DPED detection. Genetic analyses included 120 white AREDS2 participants and 145 Age-Related Eye Disease Study (AREDS) participants with DPED. Methods Baseline and annual stereoscopic fundus photographs were graded centrally to detect DPED, a well-defined yellow elevated mound of confluent drusen ≥433 μm in diameter, and to evaluate progression rates to late AMD: geographic atrophy (GA) and neovascular (NV)-AMD. Five single nucleotide polymorphisms (CFH [rs10611670], C3 [rs2230199], CFI [rs10033900], C2/CFB [rs114254831], ARMS2 [rs10490924]) and genetic risk score (GRS) group were investigated for association with DPED development. Kaplan–Meier analyses and multivariable proportional hazard regressions were performed. Main Outcome Measures Progression rates to late AMD and decrease of ≥3 lines in visual acuity (VA) from the time of DPED detection; association of rate of DPED development with genotype. Results Mean (standard deviation [SD]) follow-up time from DPED detection was 4.7 (0.9) years. DPED was associated with increased risk of progression to late AMD (hazard ratio [HR], 2.36; 95% confidence interval [CI], 1.98–2.82; P Conclusions This study replicates the results of previous natural history studies of eyes with DPED including the high rates of progression to late AMD and vision loss (regardless of progression to late AMD). The genetic associations are consistent with genes associated with AMD progression.
Published: 2019
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6. Vitrectomy for Symptomatic Asteroid Hyalosis

Author: Elizabeth Marlow, Bruce R. Garretson, Kimberly A. Drenser, Lisa J. Faia, and Tarek S Hassan
Subjects: Pars plana, medicine.medical_specialty, Asteroid hyalosis, genetic structures, business.industry, medicine.medical_treatment, Vitrectomy, medicine.disease, Posterior vitreous detachment, eye diseases, 03 medical and health sciences, 0302 clinical medicine, Acute vision loss, medicine.anatomical_structure, Ophthalmology, 030221 ophthalmology & optometry, Medicine, Case Series, Vitreous separation, business, 030217 neurology & neurosurgery
Abstract: Purpose: Acute vision loss may accompany complete or partial posterior vitreous separation in asteroid hyalosis (AH), and pars plana vitrectomy may resolve these symptoms. Methods: Six individuals with AH and acute vision loss associated with diagnosed posterior vitreous separation were treated with pars plana vitrectomy, and visual acuity (VA) recovery was monitored for 3 months. Results: The study patients’ preoperative VA ranged from 20/25 to 20/2500 (mean, 20/150; logMAR, 0.88). The average decrease in VA with anterior progression of the hyaloid was logMAR 0.70. Following surgical clearance of the asteroid bodies, VA returned to baseline within 1 month following vitrectomy in 2 eyes, and within 3 months in all eyes. Final VA was 20/20 to 20/200 (mean, 20/35; logMAR, 0.24). Conclusions: Patients with AH may present with acute onset of severe vision loss in association with posterior vitreous separation. Vitrectomy may be curative and restore vision.
Published: 2021

7. Clinical Outcomes And Treatment Course of Eyes with Neovascular Age-Related Macular Degeneration Following the Development of Endophthalmitis

Author: Kimberly A. Drenser, Scott R. Sneed, Nicole Koulisis, Amir H. Guerami, Stavros N. Moysidis, Paul V. Raphaelian, Anne Merrylees Dersch, Christian J. Sanfilippo, George A. Williams, Jeremy D. Wolfe, Sunita Yedavally, Viren K. Govindaraju, Sandeep Randhawa, Lisa J. Faia, Hajir Dadgostar, William R. Rhoades, Michael T. Trese, Kean T. Oh, Bruce R. Garretson, Robert E. Engstrom, Alan J. Ruby, A. Bawa Dass, Thomas A. Hanscom, Alan R. Margherio, Tamer H. Mahmoud, Douglas J. Covert, Tarek S Hassan, and Antonio Capone
Subjects: Male, Vascular Endothelial Growth Factor A, 0301 basic medicine, Pars plana, medicine.medical_specialty, Visual acuity, Bevacizumab, medicine.medical_treatment, Visual Acuity, Angiogenesis Inhibitors, Vitrectomy, Risk Assessment, Disease course, 03 medical and health sciences, 0302 clinical medicine, Endophthalmitis, Risk Factors, Ophthalmology, medicine, Humans, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Incidence, Incidence (epidemiology), General Medicine, Middle Aged, Macular degeneration, medicine.disease, United States, 030104 developmental biology, medicine.anatomical_structure, Intravitreal Injections, Wet Macular Degeneration, 030221 ophthalmology & optometry, Female, medicine.symptom, business, Tomography, Optical Coherence, medicine.drug
Abstract: To evaluate the clinical course of patients with neovascular age-related macular degeneration (nAMD) after developing endophthalmitis during their treatment with intravitreal injections.Multicenter, retrospective series.From April 2013 to October 2018, 196,598 intravitreal anti-vascular endothelial growth factor (VEGF) injections were performed, with 75 cases of endophthalmitis (incidence 0.0381%). There was no association between intravitreal anti-VEGF drug (P = 0.29), anesthetic method (P = 0.26), povidone concentration (P = 0.22), or any intraprocedure variable and endophthalmitis incidence. Seventy-two patients (96%) were treated with intravitreal tap and inject , while 3 underwent immediate pars plana vitrectomy. After endophthalmitis resolution, 17 patients (22.7%) were not re-treated for nAMD (in 10 cases due to inactive disease; follow-up, 115 ± 8.4 weeks). Patients required less frequent anti-VEGF injections after infection (7.4 ± 0.61 weeks vs. 11.5 ± 1.8 weeks; P = 0.004). Preinfection logarithm of the minimum angle of resolution visual acuity was 0.585 ± 0.053 (∼20/77). It worsened with endophthalmitis (1.67 ± 0.08, ∼20/935; P0.001) and again on postendophthalmitis treatment day 1 (1.94 ± 0.064; count fingers; P0.001), but improved after reinitiating nAMD therapy (1.02 ± 0.11; ∼20/209; P0.001). Better visual acuity on postendophthalmitis week 1 (P = 0.002) and reinitiation of nAMD treatment (P = 0.008) were associated with better final visual acuity, and streptococcal culture with worse visual acuity (P = 0.028). The postendophthalmitis treatment interval was associated with the anti-VEGF drug used (aflibercept = ranibizumabbevacizumab; P0.001).Patients with nAMD required fewer injections after endophthalmitis, suggesting a biological change in disease activity. Neovascular age-related macular degeneration became quiescent in 13.3% of eyes. Most achieved better outcomes with anti-VEGF reinitiation.
Published: 2020
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8. PERIPHERAL RETINAL ANGIOGRAPHIC FINDINGS IN MACULAR TELANGIECTASIS TYPE 2

Author: Stavros N. Moysidis, Michael T. Trese, Prethy Rao, Nicole Koulisis, Bruce R. Garretson, Antonio Capone, Kimberly A. Drenser, Viren K. Govindaraju, Tarek S Hassan, George A. Williams, Jeremy D. Wolfe, Lisa J. Faia, Tamer H. Mahmoud, Alan J. Ruby, Sandeep Randhawa, and Samuel Gamsky
Subjects: Male, medicine.medical_specialty, 03 medical and health sciences, chemistry.chemical_compound, Venous tortuosity, 0302 clinical medicine, Ophthalmology, Medicine, Humans, In patient, Arterial Tortuosity, Macula Lutea, 030212 general & internal medicine, Fluorescein Angiography, Aged, Retrospective Studies, medicine.diagnostic_test, business.industry, Incidence (epidemiology), Retinal Vessels, Retinal, General Medicine, Fluorescein angiography, Peripheral, Capillaries, chemistry, 030221 ophthalmology & optometry, Retinal Telangiectasis, Female, business, Tomography, Optical Coherence
Abstract: Purpose To evaluate the retinal periphery in patients with idiopathic juxtafoveal telangiectasis or macular telangiectasis type 2 (MacTel2), using widefield fluorescein angiography (WFA). Methods Single-center, retrospective, observational case series of 50 eyes of 50 patients with MacTel2 and 50 eyes of 50 age-matched controls. Results Thirty-seven eyes in the MacTel2 group (74%) showed peripheral capillary nonperfusion or dropout, compared to 37 eyes in the control group (74%, p=1.0). Morphologically, the MacTel2 group trended towards having a higher proportion of pruning-type capillary dropout (44%) compared to controls (28%), but this was not statistically significant (p=0.12). Patients with MacTel2 had a higher incidence of microaneurysms compared to controls (MacTel2 56%; Controls 42%; p=0.048), independent of age or systemic risk factors. There was no difference in the incidence of venous-venous shunts (MacTel2 10%; Controls 10%; p=1.0), arteriovenous shunts (MacTel2 14%; Controls 18%; p=0.60), venous tortuosity (MacTel2 60%; Controls 66%; p=0.58), or arterial tortuosity (MacTel2 54%; Controls 68%; p=0.20), which was mild in the majority of cases. Conclusions We note a high incidence of peripheral vascular and retinal findings in both patients with MacTel2 and age-matched controls, using WFA. Patients with MacTel2 had significantly more microaneurysms, independent of age or other systemic risk factors.Summary SUMMARY:: We note a high incidence of peripheral retinal vascular findings in both patients with macular telangiectasis type 2 and age-matched controls. Patients with MacTel2 had significantly more microaneurysms compared to controls, independent of age or other systemic risk factors.
Published: 2020

9. Predictors of Endophthalmitis after Intravitreal Injection

Author: Alan R. Margherio, Douglas Covert, Scott Sneed, Ivan J. Lee, Maria A. Woodward, Alan J. Ruby, A. Bawa Dass, Maxwell S. Stem, Michael T. Trese, Sunita Yedavally, Paul V. Raephaelian, Antonio Capone, Bruce R. Garretson, Tarek S Hassan, Sandeep Randhawa, Kean T. Oh, Kimberly A. Drenser, George A. Williams, Lisa J. Faia, Jeremy D. Wolfe, and Prethy Rao
Subjects: 0303 health sciences, medicine.medical_specialty, business.industry, Incidence (epidemiology), Retrospective cohort study, Odds ratio, Eye infection, medicine.disease, Surgery, 03 medical and health sciences, Ophthalmology, 0302 clinical medicine, Endophthalmitis, 030221 ophthalmology & optometry, medicine, Current Procedural Terminology, Ranibizumab, business, 030304 developmental biology, Cohort study, medicine.drug
Abstract: Purpose To determine the incidence of endophthalmitis after anti–vascular endothelial growth factor (VEGF) therapy at our institution and to identify potential risk factors for endophthalmitis occurring after injection. Design Retrospective, single-center cohort study. Participants All patients who received an intravitreal injection of an anti-VEGF medication between January 1, 2014, and March 31, 2017. Methods Current Procedural Terminology and International Classification of Diseases billing codes were used to identify instances of anti-VEGF administration and cases of endophthalmitis. Medical records and injection technique were reviewed carefully in each case. Multivariable logistic regression analysis was performed in a stepwise fashion to determine independent predictors of endophthalmitis based on injection protocol. Main Outcome Measures Incidence of endophthalmitis after injection and odds of endophthalmitis by injection technique with 95% confidence intervals (CIs). Results A total of 154 198 anti-VEGF injections were performed during the period of interest, resulting in 58 cases of endophthalmitis (0.038% [1:2659]). After adjustment for confounders, both 2% lidocaine jelly (odds ratio [OR], 11.28; 95% CI, 3.39–37.46; P Conclusions The incidence of endophthalmitis after anti-VEGF injections is low. Use of lidocaine jelly or Tetravisc may increase the risk of endophthalmitis after injection.
Published: 2019
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10. Progression of Geographic Atrophy in Age-related Macular Degeneration

Author: Tiarnan D. Keenan, Elvira Agrón, Amitha Domalpally, Traci E. Clemons, Freekje van Asten, Wai T. Wong, Ronald G. Danis, SriniVas Sadda, Philip J. Rosenfeld, Michael L. Klein, Rinki Ratnapriya, Anand Swaroop, Frederick L. Ferris, Emily Y. Chew, John Paul SanGiovanni, Traci Clemons, Anne Lindblad, Robert Lindblad, Nilay Shah, Robert Sperduto, Wendy McBee, Gary Gensler, Molly Harrington, Alice Henning, Katrina Jones, Kumar Thotapally, Diana Tull, Valerie Watson, Kayla Williams, Christina Gentry, Francine Kaufman, Chris Morrison, Elizabeth Saverino, Sherrie Schenning, Barbara Blodi, Ronald P. Danis, Matthew Davis, Kathy Glander, Gregory Guilfoil, Larry D. Hubbard, Kristine Johnson, Ronald Klein, Barbara Nardi, Michael Neider, Nancy Robinson, Eileen Rosensteel, Hugh Wabers, Grace Zhang, Alan J. Ruby, Antonio Capone, Bawa Dass, Kimberly Drenser, Bruce R. Garretson, Tarek S. Hassan, Michael Trese, George A. Williams, Jeremy Wolfe, Tina Bell, Mary Zajechowski, Dennis Bezaire, Fran McIver, Anthony Medina, Jackie Pagett, Stephanie Hatch Smith, Lynn Swartz, Tom Treuter, Andrew Antoszyk, Justin Brown, David J. Browning, Walter Holland, Angella Karow, Kelly Stalford, Angela Price, Sarah Ennis, Sherry Fredenberg, Jenna Herby, Uma Balasubramaniam, Loraine Clark, Donna McClain, Michael McOwen, Lynn Watson, Michael Klein, Steven T. Bailey, Thomas J. Hwang, Andreas Lauer, J. Timothy Stout, Patty McCollum, Milt Johnson, Patrick B. Rice, Ivana Kim, John Loewenstein, Joan Miller, Lucia Sobrin, Lucy Young, Jacqueline Sullivan, Patricia Houlihan, Linda Merry, Ann Marie Lane, Ursula Lord Bator, Claudia Evans, Sarah Brett, Charleen Callahan, Marcia Grillo, David Walsh, Kamella Lau Zimmerman, Gary Edd Fish, Rajiv Anand, Lori E. Coors, Dwain G. Fuller, Rand Spencer, Robert C. Wang, Karen Duignan, Sally Arceneaux, Hank Aguado, Nicholas Hesse, Michael Mackens, Brian Swan, Catherine Cukras, Monica Dalal, Naima Jacobs-El, Catherine Meyerle, Benjamin Nicholson, Henry Wiley, Katherine Hall Shimel, Angel Garced, Janice Oparah, Greg Short, Alana Temple, Babilonia Ayukawa, Guy Foster, Darryl Hayes, Dessie Koutsandreas, Roula Nashwinter, John Rowan, Michael Bono, Denise Cunningham, Marilois Palmer, Alicia Zetina, David H. Orth, Kourous Rezaei, Joseph Civantos, Sohail Hasan, Kirk Packo, Celeste Figliulo, Pam Stanberry, Tara Farmer, Kiersten Nelson, Shannya Townsend-Patrick, Philip Rosenfeld, Royce Chen, Rishi Doshi, Sander Dubovy, Brian T. Kim, Matthew Lowrance, Andrew Moshfeghi, Zayna Nahas, Gary Schienbaum, John Vishak, Christina Weng, Zohar Yehoshua, Belen Rodriguez, Jose Rebimbas, Jane Gleichauf, Mike Kicak, Jason Mena, Tim Odem, Elizabeth Sferza-Camp, Alicia Disgdiertt, Jim Oramas, Isabel Rams, Stephanie Thatcher, Susan B. Bressler, Neil M. Bressler, Daniel Finkelstein, Steven H. Sherman, Sharon Solomon, Howard S. Ying, Rita Denbow, Deborah Phillips, Elizabeth Radcliffe, Judy Belt, Dennis Cain, David Emmert, Mark Herring, Jacquelyn McDonald, G. Baker Hubbard, Chris S. Bergstrom, Blaine Cribbs, Andrew Hendrick, Brandon Johnson, Philip Laird, Sonia Mehta, Timothy Olsen, Justin Townsend, Jion Yan, Steven Yeh, Linda Curtis, Judy Brower, Hannah Yi, Jannah Rutter Dobbs, Debbie Jordan, Michael J. Elman, Robert A. Liss, JoAnn Starr, Jennifer Belz, Charlene Putzulo, Teresa Coffey, Ashley Davis, Pamela Singletary, Giorya Shabi Andreani, Theresa Cain, Daniel Ketner, Peter Sotirakos, Suresh Chandra, Barbara A. Blodi, Michael M. Altaweel, Justin L. Gottlieb, Michael Ip, T. Michael Nork, Thomas S. Stevens, Kathryn Burke, Shelly Olson, Kristine Dietzman, Barbara Soderling, Guy Somers, Angie Wealti, Denise Krolnik, John Peterson, Sandra Reed, Thomas Friberg, Andrew Eller, Denise Gallagher, Leanne Labriola, Melissa Pokrifka, Aron Gedansky, Natalie Anthony, Cassandra Grzybowski, Dawn Matthews, Sharon Murajda-Jumba, Jessica Toro, David G. Callanan, Wayne A. Solley, Patrick Williams, Sandy Lash, Bob Boleman, Chris Dock, Michel Shami, Brenda Arrington, Ashaki Meeks, Alan R. Margherio, Paul Raphaelian, Debra Markus, Justin Langdon, Elizabeth Truax, Sandy Lewis, Brad Terry, Amy Noffke, Kean Oh, Ramin Sarrafizadeh, Scott Sneed, Julie Hammersley, Serena Neal, Mary Doran, Nan Jones, Lisa Preston, Heather Jessick, Tanya Tracy Marsh, Michael Tolentino, Adam Berger, Richard Hamilton, David Misch, Suk Jin Moon, Dawn Sutherland, Vera Dilts, Sara Henderson, Esmeralda Medina, Donald Trueman, Laura Holm, Jason Strickland, Darmakusuma Ie, Jeffrey L. Lipkowitz, Kekul B. Shah, Susan Geraghty, Beverly Sannazzaro, Morgan Harper, Krista Bayer, Mary B. Lansing, Lauren B. Fox, Rebecca Lee, Jay B. Stallman, Michael Jacobson, Sean Koh, Scott Lampert, John Miller, Mark Rivellese, Atul Sharma, Robert A. Stoltz, Stephanie Vanderveldt, Leslie Marcus, Starr Hendricks, Ryan Hollman, Grethel Betanzos, Leslie Ellorin, Shelly Fulbright, Debbie McCormick, Paul A. Edwards, Julianne Hall, Mary Monk, Melanie Gutkowski, Melina Mazurek, Janet Murphy, Katherine Gusas, Crystal Moffett, David Burley, Nicole Chesney, Katie Kilgo, Brian Rusinek, Bradley Stern, Tracy Troszak, Rhonda Baker-Levingston, Carl W. Baker, Tracey Caldwell, Tammy Walker, Lynnette F. Lambert, Tracey Martin, Mary Jill Palmer, Tana Williams, Michael A. Novak, Joseph Coney, David G. Miller, Scott Pendergast, Lawrence Singerman, Nicholas Zakov, Hernando Zegarra, Kim DuBois, Susan Rath, Lori Revella, Tammy Brink, Kim Drury, Lisa Hogue, Mary Ilc, Connie Keller, Elizabeth McNamara, Vivian Tanner, Tamara Cunningham, John DuBois, Gregg Greanoff, Trina Nitzsche, Sheila Smith-Brewer, Ricky D. Isernhagen, John W. Kitchens, Thomas W. Stone, William J. Wood, Diana Holcomb, Virginia Therrien, Michelle Buck, Jeanne Van Arsdall, Edward Slade, Todd E. Schneiderman, David J. Spinak, Jackie Gaedke, Heather Davis Brown, Dan Helgren, Jenifer Garrison Pangelinan, Lawrence Halperin, Scott Anagnoste, Mandeep Dhalla, Krista Rosenberg, Barry Taney, W. Scott Thompson, Jaclyn Lopez, Monica Hamlin, Monica Lopez, Jamie Mariano, Evelyn Quinchia, Patricia Aramayo, Rita Veksler, Michael Lee, Richard Dreyer, Irvin Handelman, Colin Ma, Mark Peters, Stephen Hobbs, Amanda Milliron, Marcia Kopfer, Michele Connaughton, A. Christine Hoerner, R. Joseph Logan, Harry J. Wohlsein, David Boyer, Thomas G. Chu, Pouya Dayani, David Liao, Roger L. Novack, Firas M. Rahhal, Richard Roe, Homayoun Tabandeh, Janet Bayramyan, Tammy Gasparyan, Connie Hoang, Janet Kurokouchi, Tammy Eileen Lo, Richard Ngo, Mary Ann Nguyen, Michael Peyton, Charles Yoon, Julio Sierra, Adam Zamboni, Jeff Kessinger, Eric Protacio, Adam Smucker, Pamela Rath, Robert Bergren, Bernard Doft, Judy Liu, Karl Olsen, Lori Merlotti, Willia Ingram, Kellianne Marfisi, Kimberly Yeckel, Heather Schultz Carmelo, Amanda Fec, Keith McBroom, David Steinberg, Marc Levy, Jody Abrams, Melvin Chen, Waldemar Torres, Peggy Jelemensky, Mark Prybylski, Tara Raphael, Diana Appleby, Charlotte Rodman, Mark Sneath, Robert H. Rosa, Vanessa Hoelscher, Adelia Castano, Jocelyn Parker, John Hoskins, Nicholas Anderson, Joseph Googe, Tod A. McMillan, James Miller, Stephen Perkins, Kristina Oliver, Jennifer Beerbower, Bruce Gilliland, Cecile Hunt, Mike Jacobus, Raul Lince, Christopher Morris, Sarah Oelrich, Jerry Whetstone, Clement K. Chan, Steven Lin, Kim Walther, Tiana Gonzales, Lenise Myers, Kenneth Huff, David M. Brown, Eric Chen, Matthew S. Benz, Richard H. Fish, Rosa Y. Kim, James Major, Tien Pei Wong, Charles Wycoff, Cassandra Cone, Debbie Goates Gilaspia, Nubia Landaverde, Robert Smith, Deneva Zamora, Veronica Sneed, Melina Vela, Eric Kegley, Craig Greven, Shree Kurup, Charles Richards, Madison Slusher, Cara Everhart, Joan Fish, Mark Clark, David Miller, Marshall Tyler, J. Michael Jumper, Arthur D. Fu, Robert N. Johnson, Brandon Lujan, H. Richard McDonald, Rosa Rodriguez, Nina Ansari, Jeanifer Joaquin, Silvia Linares, Lizette Lopez, Jessica Sabio, Sean Grout, Chad Indermill, Yesmin Urias, Roberto Zimmerman, Linda Margulies, Sara J. Schmidt, Joy L. Meier, Sherry L. Hadley, William Rosenthal, Barbara Johnson, Lois Swafford, Richard Shields, R. Scott Varner, Richard Rosen, Ronald Gentile, Melissa Rivas, Katy W. Tai, Wanda Carrasquillo-Boyd, Robert Masini, Glenn Stoller, Ken Carnevale, Diane M. LaRosa, Barbara Burger, Tereza Conway, Carla Del Castillo, Julissa Diaz, Susan Jones, Nina Mondoc, Charlene Balfour, C.H. Vitha, Jennifer Lutz, Barbara McGinley, Fadi El Baba, Ann Marie Lavorna, Renee Jones, Jean Lewis, Ruth Tenzler, Mary Salvas-Mladek, Diane Van Kesteren, W. Copley McLean, W. Zachery Bridges, Cameron Stone, Denise Ammons, Mary Lamy, Andrea Menzel, Lea Doll Raymer, Barbara Campbell, Lisa Hawkins, Leslie Rickman, Lorraine Sherlin, Paula Price, Albert Sinyai, Ronald Kingsley, Reagan H. Bradford, Robert E. Leonard, Sonny Icks, Vanessa Bergman, Brittany Ross, Russ Burris, Amanda Butt, Rob Richmond, Alice Lyon, Manjot Gill, Lee Jampol, Rukhsana Mizra, Zuzanna Rozenbajgier, Jeremy Chapman, Lori Kaminski, Andrea Degillio, Evica Simjanoski, Jeffrey Heier, Hyung Cho, Tina Scheufele Cleary, Darin Goldman, Chirag Shah, Trexler Topping, Marissa Weber, Torsten Wiegand, Jeremy Schindelheim, Joy Bankert, Jennifer Stone, Alison Nowak, Sandy Chong, Lindsay Williams, Steven Bennett, Dennis Donovan, Margaret Graham, Cullen Jones, Anne Fung, Jan-Kristine Bayabo, Razelda Bosch, Esperanza Cruz, Ashley Emerson, Alycia Fleming, Denice Barsness, Jorge Rodriguez, Marina Soboleva, Ingrid U. Scott, Esther Bowie, Kimberly A. Neely, David A. Quillen, Laura Walter, Timothy Bennett, James Strong, John Wells, Lloyd Clark, David Johnson, Peggy Miller, Mallie Taylor, Tiffany Swinford, Robbin Spivey, Michael Banach, Lawrence Ho, Richard Lanning, Thomas R. Pheasant, Jay G. Prensky, Steven Truong, Julia Teatsworth, Michelle Dietrich, Ann Wasilus, Ann Miller, Megan Rakes, Teresa Slagle, Michelle Richards, Patricia Schuessler, Lacy Stover, Paul Beer, Naomi S. Falk, Mary Beth Shannon, Jeannie Olmeda, Don Berdeen, Joseph F. Fisher, James Folk, Stephen Russell, Barbara Taylor, Connie Hinz, Jean Walshire, Heather Stockman, Bruce Critser, Stefani Karakas, Cindy Montague, Randy Verdick, Omesh Gupta, Joseph Maguire, Christopher Brady, Francis Char DeCroos, Michael Dollin, Sunir Garg, Adam Gerstenblith, Julia Haller, Allen C. Ho, Jason Hsu, Richard Kaiser, John Pitcher, Carl Regillo, Rajiv Shah, Marc Spirn, William Tasman, James Vander, Noga Senderowitsch, Michele Formoso, Michelle Markun, Cedric George, Christina Centinaro, Lisa Grande, Stefanie Carey, Elaine Liebenbaum, Mark Humayun, Rachel Sierra, Elizabeth Corona, Margaret Padilla, Moonseok Nu, Sylvia Ramos, Cullen Barnett, Glenn Currie, Cornelia Gottlieb, Richard Garfinkel, Daniel Berinstein, Marcus Colyer, William Deegan, Michael Min-Shyue Lai, Robert Murphy, Michael Osman, Michael Rivers, Reginald Sanders, Manfred A. von Fricken, Debbie Oliver, Jeanne Kirshon, Tanya Alexander Snowden, Thomas Blondo, Alysia Cronise, Vanessa Denny, Kylie Mendez, Janine Newgen, Justin Davis, Mike Flory, Robert Frantz, Bryan Murphy, Steve Rauch, Judy E. Kim, Jane Bachman, Thomas B. Connor, Dennis P. Han, Kimberly Stepian, David V. Weinberg, William J. Wirostko, Krissa Packard, Tracy Kaczanowski, Vesper Williams, Vicki Barwick, Judy Flanders, Dennis Backes, Joe Beringer, Kristy Keller, Kathy Selchert, Paul Bernstein, Michael Teske, Albert Vitale, Susan Allman, Bonnie Carlstrom, Kimberley Wegner, Anne Haroldsen, Deborah Harrison, Cyrie Fry, James Gilman, Glen Jenkins, Paula Morris, Michael Rauser, Joseph Fan, Mukesh Suthar, Gisela Santiago, Kara Rollins Halsey, Christy Quesada, William Kiernan, Jesse Knabb, Richard Alan Lewis, Cindy Dorenbach, Steven Spencer, Dana Barnett, Joseph Morales, Barron C. Fishburne, Jeffrey G. Gross, Michael A. Magee, Amy Flowers, Angie McDowell, Randall Price, Suber Huang, Johnny Tang, Shawn Wilker, Cherie Hornsby, Lisa Ferguson, Kirk Krogstad, Riva Adamovsky, Peggy Allchin, Kathleen Carlton, Claudia Clow, Kelly Sholtis, Stephanie Burke, Mark Harrod, Stacie Hrvatin, Geoffrey Pankhurst, Nelson R. Sabates, Michael Cassell, Komal Desai, Abraham Poulose, Felix Sabates, Yin Chen, Gary Gallimore, Yolanda Konior, Nicola Kim, Sami Uwaydat, Deborah Troillett, Karen Aletter, Robert N. Frank, Gary Abrams, James Puklin, Asheesh Tewari, Cheryl Milanovic, Melanie Bailey, David Griffith, Dena McDonald, Kit Morehead, Zlatan Sadikovic, Lisa Schillace, Elizabeth Silvis, Brian Joondeph, Nancy Christmas, Alan Kimura, Mimi Liu, Stephen Petty, John Zilis, Jenny Benitez, Cassandra Berryman Catlett, Eric Fluegel, Shane Mowry, Hoang Nguyen, David Reflow, Odette M. Houghton, Seema Garg, Maurice B. Landers, Travis Meredith, Sandy Barnhart, Megha Karmalkar, Debra Cantrell, Rona Lyn Esquejo-Leon, Linda Manor, Sue Pope, David Stines, Amelia Stokely, Dean Hainsworth, Dyann Helming, Debbie Eichelberger, Mary Paige Leaton, Chuck Hamm, Edward Chaum, Alessandro Iannaccone, Barbara Jennings, Tracy Murray, Joe Mastellone, Robert Millay, Brian Kim, Theresa Goddard, Liza Jarrett Beaudette, Nina Changelian-Aitken, Fernando Corrada, Jason Dubuque, Raymond Iezzi, Sophie J. Bakri, Jose S. Pulido, Diane Vogen, Rebecca Nielsen, Karin Berg, Jean Burrington, Shannon Howard, Joan Overend, Zbigniew Krason, Denise Lewison, Thomas Link, Kevin J. Blinder, Nicholas E. Engelbrecht, M. Gilbert Grand, Daniel P. Joseph, Gaurav K. Shah, Bradley Smith, Matthew Thomas, Rhonda Weeks, Lynda Boyd, Dana Gabel, Ron Adelman, John Huang, James Kempton, Aaron Parnes, Jennifer Dupont, Elizabeth Perotti, Victoria Donaldson, Kenneth Fong, Pamela Ossorio, Anita Agarwal, Paul Sternberg, Sandy Owings, Tony Adkins, Elaine Lok, Garvin Munn, Buddy Skellie, Neelakshi Bhagat, Monique S. Roy, Marco Zarbin, Catherine Fay, Michael Lazar, Beth Malpica, Tatiana Mikheyav, Lawrence Ulanski, Jennifer Lim, Marcia Niec, Tametha Johnson, Yesenia Ovando, Catherine Nail Carroll, Mark Janowicz, Steven Schwartz, David Cupp, Michael Gorin, Gad Heilweil, Hamid Hosseini, Jean-Pierre Hubschman, Allan Kreiger, Tara Young McCannel, Carolyn Pan, David Sarraf, Irena Tsui, Joshua Udoetek, Vinad Voleti, Logan Hitchcock, Rosaleen Ostrick, Melissa Chun, Jennie Kageyama, Nilo Davila, Kristin Lipka, Christina Shin, Cynthia Owsley, Michael Albert, Richard Feist, John Mason, Martin Thomley, Angelia Johnson, Tracy Emond, Joanna Hamela, Angela Marsh, Karen Searcey, Kia Rookard, Yu-Guang He, Rafael L. Ufret-Vincenty, Mike Molai, William Anderson, John Horna, Alan Letson, Colleen Cebulla, Susie Chang, Fred Davidorf, Jill Salerno, Laura Sladoje, Christina Stetson, Jeri Perry, Scott Savage, Cynthia Toth, Glenn Jaffe, Stefanie Schuman, Neeru Sarin, Jim Crowell, Tiffanie Keaton, Michael Kelly, Brian Lutman, Marriner Skelly, Lauren Welch, Lawrence Morse, Allan Hunter, Susanna Soon-Chun Park, Cynthia Wallace, Ember Dhillon, Marisa Salvador, Barbara Holderreed, Karishma Chandra, Sashi Kaur, Ellen Redenbo, Smiley Hom, Michael Cooney, Irene Barbazetto, James M. Klancnik, John A. Sorenson, Lawrence Yannuzzi, Maria Scolaro, Eugene Agresta, Nancy Gonzalez, Sandeep Grover, K.V. Chalam, Shailesh Gupta, Christopher Lyons, Wenhua Li, Chirag Patel, Jose Carrion, Henry Ferreyra, Amberly Rodriguez, Iliana Molina, Gabriel Balea, Pam Emory, Marlene Rico, Giorgio Siqueiros, Alexander J. Brucker, Joshua Dunaief, Juan Grunwald, Benjamin Kim, Albert M. Maguire, Brian VanderBeek, Sheri Drossner, Joan DuPont, Rebecca Salvo, Jim Berger, Cheryl Devine, Bill Nyberg, Laurel Weeney, David DiLoreto, Mina Chung, Valerie Davis, Peter MacDowell, George O. Gara, Daniel Castillo, Andrea Czubinski, Melissa Keim, Brandi Hardy, Rachel Grunhaus Hollar, Lynn Schueckler, Alice T. Lyon, Aaron Weinberg, Mira Shiloach, Nicole Pelkofer, Qin Zhou, Laura McPoland, Rajendra Apte, P. Kumar Rao, Sam Pistorius, Jamie Kambarian, Eve Adcock, Sarah Gould, Melanie Quinn, Rhonda Curtis, Amy Frost, Charla Meyer, and Greg Rathert
Subjects: 0301 basic medicine, medicine.medical_specialty, genetic structures, business.industry, Eye disease, Incidence (epidemiology), Fundus (eye), Macular degeneration, medicine.disease, eye diseases, Confidence interval, Geographic atrophy, 03 medical and health sciences, Ophthalmology, 030104 developmental biology, 0302 clinical medicine, Age related, 030221 ophthalmology & optometry, medicine, sense organs, Prospective cohort study, business
Abstract: Purpose To analyze the prevalence, incidence, and clinical characteristics of eyes with geographic atrophy (GA) in age-related macular degeneration (AMD), including clinical and genetic factors affecting enlargement. Design Prospective cohort study within a controlled clinical trial. Participants Age-Related Eye Disease Study 2 (AREDS2) participants, aged 50–85 years. Methods Baseline and annual stereoscopic color fundus photographs were evaluated for GA presence and area. Analyses included GA prevalence and incidence rates, Kaplan-Meier rates, mixed-model regression, and multivariable analysis of the square root of GA, area adjusted for covariates, including clinical/imaging characteristics and genotype. Main Outcome Measures (1) Presence or development of GA; (2) change in the square root of GA area over time. Results At baseline, 517 eyes (6.2%) of 411 participants (9.8%) had pre-existing GA (without neovascular AMD), with the following characteristics: 33% central, 67% noncentral; and the following configurations: 36% small, 26% solid/unifocal, 24% multifocal, 9% horseshoe/ring, and 6% indeterminate. Of the remaining 6530 eyes at risk, 1099 eyes (17.3%) of 883 participants developed incident GA without prior neovascular disease during mean follow-up of 4.4 years. The Kaplan-Meier rate of incident GA was 19% of eyes at 5 years. In eyes with incident GA, 4-year risk of subsequent neovascular AMD was 29%. In eyes with incident noncentral GA, 4-year risk of central involvement was 57%. GA enlargement rate (following square root transformation) was similar in eyes with pre-existing GA (0.29 mm/year; 95% confidence interval 0.27–0.30) and incident GA (0.28 mm/year; 0.27–0.30). In the combined group, GA enlargement was significantly faster with noncentrality, multifocality, intermediate baseline size, and bilateral GA (P Conclusions Analyses of AREDS2 data on natural history of GA provide representative data on GA evolution and enlargement. GA enlargement, which was influenced by lesion features, was relentless, resulting in rapid central vision loss. The genetic variants associated with faster enlargement were partially distinct from those associated with risk of incident GA. These findings are relevant to further investigations of GA pathogenesis and clinical trial planning.
Published: 2018
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11. Anatomic and Visual Outcomes Following Surgical Repair of Retinoschisis-Related Retinal Detachments

Author: Kimberly A. Drenser, Alan J. Ruby, Jade M. Price, Adam J. Weiner, George A. Williams, Jeremy D. Wolfe, Bozho Todorich, Bruce R. Garretson, Tarek S Hassan, Lisa J. Faia, Maxwell S. Stem, Antonio Capone, and Sandeep Randhawa
Subjects: Surgical repair, medicine.medical_specialty, business.industry, Retinoschisis, Retinal detachment, Retinal, medicine.disease, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, chemistry, Ophthalmology, 030221 ophthalmology & optometry, medicine, business, 030217 neurology & neurosurgery
Abstract: Purpose: The purpose of this article is to report the characteristics of patients with retinoschisis-related retinal detachments and to summarize their clinical outcomes after surgical repair. Methods: A single-center interventional case series of 37 eyes from 35 patients who underwent surgery to repair a retinoschisis-related retinal detachment between January 1, 2009 and January 1, 2017 was conducted. Results: The mean ± SD age at the time of the first retinal detachment repair was 63 ± 13 years. As the initial surgery, scleral buckle was performed in 14 eyes, scleral buckle + vitrectomy in 14 eyes, and vitrectomy in 9 eyes. The single-operation success rate for the entire cohort was 65% (24/37), and the final anatomic success rate was 97% (36/37). Among eyes requiring more than 1 surgery, 46% (6/13) developed proliferative vitreoretinopathy. Best-corrected visual acuity improved or remained stable after 1 year of follow-up in the majority (n = 27, 73%) of eyes. The mean (SD) number of surgeries required to achieve the final anatomic and visual result was 1.8 (1.2) for all eyes (range, 1-5 surgeries). Conclusion: The single-surgery success rate for retinoschisis-related retinal detachments was lower than that reported for typical rhegmatogenous retinal detachments, and the incidence of proliferative vitreoretinopathy was higher. When counseling patients with retinoschisis-related retinal detachments, it is important to caution them that they may require more than 1 surgery to achieve anatomic success.
Published: 2018
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12. Progressive Massive Choroidal Neovascularization

Author: Yoshihiro Yonekawa, Aparna A. Shah, Tarek S Hassan, Prethy Rao, Bruce R. Garretson, Antonio Capone, Benjamin J. Thomas, and Albert Y. Cheung
Subjects: medicine.medical_specialty, genetic structures, business.industry, Macular degeneration, medicine.disease, eye diseases, 03 medical and health sciences, 0302 clinical medicine, Choroidal neovascularization, Refractory, Severe phenotype, Ophthalmology, Age related, Choroidal neovascular membrane, 030221 ophthalmology & optometry, medicine, sense organs, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract: Purpose: A small subset of patients with neovascular age-related macular degeneration (AMD) can have relentless progression of choroidal neovascularization (CNV) and subsequent disciform scarring (DS) with extension beyond the vascular arcades to the equator. We present the clinical courses of this severe phenotype of progressive massive CNV (PM-CNV). Methods: Retrospective case series of 14 eyes of 8 patients who presented with (1) massive DS encompassing the posterior pole and extending to the equator and (2) progressive DS expansion despite treatment between 2004 and 2015 at a tertiary referral center. Demographics, clinical and ocular characteristics, fluorescein angiographic findings, and treatment regimens were reviewed. Results: Baseline characteristics included a mean age of 73.0 years (range, 65.- 86.9 years) with 7 (87.5%) women. Six (75%) patients had bilateral PM-CNV. Mean follow-up was 10.5 years (range, 0.5-18.2 years). Ten (71.4%) eyes underwent intravitreal anti-vascular endothelial growth factor therapy, 3 (21.4%) intravitreal corticosteroid injections, and 3 photodynamic therapy. Most eyes (92.9%) demonstrated subretinal hemorrhage at the edge of the DS prior to DS expansion during treatment. Of the 6 patients with bilateral PM-CNV, 5 developed DS in 1 eye earlier than the subsequent eye (mean time, 63.6 months). Final visual acuity was ≤20/400 in all eyes (20/400 [n = 1]), count fingers (n = 5), hand motions (n = 5), and no light perception (n = 3). Conclusion: Progressive massive CNV is a profound reactivation of DS in some AMD eyes and is associated with severe, often bilateral, vision loss.
Published: 2017
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13. STUDY OF INTRAOCULAR PRESSURE AFTER 23-GAUGE AND 25-GAUGE PARS PLANA VITRECTOMY RANDOMIZED TO FLUID VERSUS AIR FILL

Author: Tushar M. Ranchod, Kimberly A. Drenser, Mamtha Balasubramaniam, Alan J. Ruby, George A. Williams, Antonio Capone, Bruce R. Garretson, Tarek S Hassan, and Lawrence Y Ho
Subjects: Male, Pars plana, Microsurgery, Intraocular pressure, medicine.medical_specialty, genetic structures, medicine.medical_treatment, Visual Acuity, Ocular Hypotension, Vitrectomy, Suture closure, Tonometry, Ocular, Double-Blind Method, Retinal Diseases, Ophthalmology, medicine, Humans, Prospective Studies, Intraocular Pressure, Aged, business.industry, Air, Suture Techniques, General Medicine, Lens Subluxation, Middle Aged, eye diseases, Surgery, medicine.anatomical_structure, Sclerostomy, Female, sense organs, business
Abstract: Purpose To determine if a difference in intraocular pressure (IOP) exists after small-gauge pars plana vitrectomy randomized to fluid versus 80% sterile air fill. Methods Ninety-two eyes undergoing 23-gauge and 25-gauge transconjunctival pars plana vitrectomy were randomized to fluid versus air fill, and IOP was measured at 5 different time points. Results There is no difference in the mean IOP for eyes undergoing small-gauge pars plana vitrectomy randomized to fluid versus air fill after vitrectomy. Using 23-gauge instrumentation, the mean immediate and 2-hour postoperative IOPs were statistically lower than the mean preoperative IOP. The mean Postoperative Day 1 and Week 1 IOPs were statistically higher than the mean immediate postoperative IOP. Using 25-gauge instrumentation, the mean IOP was not statistically different at any time points in the 2 groups. When comparing 23-gauge with 25-gauge instrumentation, the immediate postoperative IOP was statistically lower and the rate of suture closure for sclerotomies was higher for 23-gauge vitrectomy. Conclusion When performing 23-gauge or 25-gauge pars plana vitrectomy, there was no difference in mean IOP for fluid- versus air-filled eyes. However, the mean IOP in the immediate postoperative period was statistically lower, and there was a higher rate of suture closure for 23-gauge compared with 25-gauge instrumentation.
Published: 2011
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14. ENDOGENOUS METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS ENDOPHTHALMITIS

Author: Kimberly A. Drenser, Lawrence Y Ho, Bruce R. Garretson, Tushar M. Ranchod, George A. Williams, and Vincent T. Ho
Subjects: Adult, Male, Methicillin-Resistant Staphylococcus aureus, medicine.medical_specialty, Visual acuity, Adolescent, genetic structures, Enucleation, Visual Acuity, medicine.disease_cause, Eye Infections, Bacterial, Endophthalmitis, Ophthalmology, medicine, Humans, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Retinal detachment, Retrospective cohort study, General Medicine, Consecutive case series, Middle Aged, Staphylococcal Infections, Eye infection, medicine.disease, Methicillin-resistant Staphylococcus aureus, Anti-Bacterial Agents, Female, medicine.symptom, business
Abstract: Purpose: To report on the presentation, treatment, and outcomes of the largest series to date for patients with endogenous methicillin-resistant Staphylococcus aureus endophthalmitis at a single institution and compare the results from previously published reports of this disease entity. Methods: Retrospective, noncomparative, consecutive case series of patients who were treated for endogenous methicillin-resistant S. aureus endophthalmitis from a single tertiary referral institution were reviewed. Results: Eight eyes of seven consecutive patients, with a mean age of 58.1 years, were diagnosed with culture-proven endogenous methicillin-resistant S. aureus endophthalmitis. Five patients were male, and six patients had a unilateral presentation. Five of eight eyes were treated with initial vitreous tap and injection of antibiotics, and six eyes showed a retinal detachment during the course of treatment. Final visual acuity ranged from 20/40 to no light perception, and 5 of 8 eyes showed improvement in visual acuity from initial presentation. Only one eye became blind and painful and required enucleation. Conclusion: This series represents the largest single-institution report on endogenous methicillin-resistant S. aureus endophthalmitis and associated outcomes. Although previously reported cases cited poor visual outcomes and high enucleation rates, the authors' current series shows that retinal detachments are common and enucleation rates are low.
Published: 2011
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15. Repair of Primary Rhegmatogenous Retinal Detachment Using 25-Gauge Transconjunctival Sutureless Vitrectomy

Author: Kimberly A. Drenser, Kate E. Urban, Bruce R. Garretson, M. M. Lai, Alan J. Ruby, Tarek S Hassan, and Ramin Sarrafizadeh
Subjects: Adult, Male, Microsurgery, Sutureless vitrectomy, medicine.medical_specialty, genetic structures, Sulfur Hexafluoride, Visual Acuity, Postoperative Complications, Vitrectomy, Ophthalmology, Humans, Medicine, Intraoperative Complications, Aged, Retrospective Studies, Aged, 80 and over, Fluorocarbons, business.industry, Suture Techniques, Retinal Detachment, Retinal detachment, General Medicine, Middle Aged, medicine.disease, eye diseases, Treatment Outcome, Female, business, Conjunctiva
Abstract: To evaluate the anatomical and visual outcomes of primary rhegmatogenous retinal detachment repairs performed using 25-gauge transconjunctival sutureless vitrectomy.: A retrospective, noncomparative interventional case series including 53 consecutive eyes of 52 patients who underwent 25-gauge transconjunctival sutureless vitrectomy to repair primary rhegmatogenous retinal detachment was performed. Variables collected for the study were patient demographics, lens status, preoperative visual acuity, and macular status. Outcome measures included single-operation anatomical success rate, final anatomical success rate, postoperative visual acuity, and surgical complications.: The retina was reattached with a single operation in 39 (74%) of 53 eyes. The final anatomical success rate was 100%. The mean time to redetachment was 72 days (range, 13-334 days). Proliferative vitreoretinopathy (64%) and development of new retinal breaks (43%) were the most common reasons associated with redetachment. Mean visual acuity improved from 20/100 to 20/60 (P = 0.001); 55% of eyes had final vision of 20/40 or better. Three eyes (6%) developed postoperative choroidal hemorrhage. Three eyes (6%) developed visually significant macular pucker that required surgery. No postoperative hypotony or endophthalmitis was observed.: Repair of primary rhegmatogenous retinal detachments using 25-gauge transconjunctival sutureless vitrectomy resulted in excellent final anatomical success rate and postoperative visual outcomes. However, redetachments due to new tears and/or proliferative vitreoretinopathy resulted in a lower single-operation success rate than those reported with 20-gauge systems.
Published: 2008
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16. No-Touch Removal of Anterior Segment-Migrated Dexamethasone Implant

Author: John D. Pitcher, Ashkan M. Abbey, Ehsan Rahimy, Bruce R. Garretson, and Julia A. Haller
Subjects: Male, medicine.medical_specialty, Ophthalmologic Surgical Procedures, Dexamethasone, Macular Edema, Device removal, Foreign-Body Migration, Anterior Eye Segment, Ophthalmology, Retinal Vein Occlusion, medicine, Humans, Macular edema, Glucocorticoids, Device Removal, Aged, Aged, 80 and over, Drug Implants, EYE FOREIGN BODY, business.industry, General Medicine, Middle Aged, medicine.disease, Eye Foreign Bodies, Intravitreal Injections, Female, Implant, business, Ophthalmologic Surgical Procedure, medicine.drug
Published: 2015

17. Retinal neovascularization after internal carotid artery occlusion

Author: Tushar M. Ranchod, Bruce R. Garretson, and Kimberley A Drenser
Subjects: medicine.medical_specialty, genetic structures, business.industry, medicine.medical_treatment, Fistula, Vitrectomy, Retinal, Cryotherapy, General Medicine, medicine.disease, eye diseases, Surgery, Ophthalmology, chemistry.chemical_compound, chemistry, medicine.artery, Vitreous hemorrhage, medicine, sense organs, Embolization, Internal carotid artery, Ligation, business
Abstract: PURPOSE: To report a case of retinal neovascularization after surgical ligation of the internal carotid artery for treatment of direct carotid-cavernous fistula. METHODS: Case report. RESULT: A 44-year-old Asian woman presented with unilateral retinal neovascularization and vitreous hemorrhage. Surgical ligation of the ipsilateral internal carotid artery had been performed 14 years earlier as a treatment for carotid-cavernous fistula after failed attempts at fistula embolization. Vitrectomy was performed for removal of nonclearing vitreous hemorrhage, with intraoperative peripheral retinal ablation and cryotherapy of the lesion. CONCLUSION: We report a case of retinal neovascularization associated with total occlusion of the ipsilateral internal carotid artery 14 years earlier.
Published: 2014

18. The age-related eye disease study (AREDS) system for classifying cataracts from photographs: AREDS report no. 4∗∗Members of the Age-Related Eye Disease Study Research Group are listed at the end of the article

Author: Don Doherty, I. Kivitz, V. Regan, R. Swords, C. Ma, R. G. Chenoweth, P. Lopez, David H. Orth, Aaron Kassoff, P. F. Ciatto, P. Streasick, A. Randall, Mary Zajechowski, S. Kieval, Tarek S Hassan, D. Armiger, Thomas R. Friberg, D. A. Bryant, Karl G. Csaky, Andrew W. Eller, John DuBois, S. A. McCarthy, C. Beardsley, P. Manatrey, Raymond R. Margherio, C. Callahan, F. McIver, Claudia Evans, Linda Curtis, S. Sandoval, Johanna M. Seddon, A. La-Reau, John Zilis, B. Lewis, J. C. Werner, B. Stribling, Roula Nashwinter, V. D. Crouse, J. Buehler, Donald Martin, A Jr Capone, G. Smith, G. Babilonia-Ayukawa, David I. Walsh, Y. J. Kim, E. Kuehl, Frederick L. Ferris, Kirk H. Packo, M. Haughey, Andrew P. Schachat, James Gilman, Richard F. Dreyer, Shannon Howard, B. Mack, M. S. Cox, George A. Williams, S. deBustros, N. Davis, R. Falk, Stuart G Parker, Daniel F. Martin, M. K. Paine, C. MacLeod, C. Bridges, L. M. Ayres, D. A. Jones-Devonish, L. Goodman, B. Myles, E. Y. Chew, Pauline T. Merrill, Chris Morrison, K. Cumming, Michael L. Klein, N. J. Rosenberg, I. Burton, D. Saperstein, F. Kaufman, P Jr Sternberg, Joseph E. Robertson, K. Hall Dabas, C. Stanley, Richard Mercer, Bruce R. Garretson, H. Crider, Dessie Koutsandreas, J. Civantos, M. Mehu, David J. Wilson, Judith Alexander, Alan J. Ruby, Michael B. Gorin, T. P. Flood, M. K. Pinnolis, L. Szydlowski, Michael T. Trese, J. Kassoff, K. K. Snow, M. Eglow, and P. Patel
Subjects: Ophthalmology, medicine.medical_specialty, Cataracts, business.industry, medicine, Age-Related Eye Disease Study, medicine.disease, business
Published: 2001
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19. The Endophthalmitis Vitrectomy Study

Author: Mark W. Johnson, Bernard H. Doft, Sheryl F. Kelsey, Michael Barza, Louis A. Wilson, Charles C. Barr, Stephen R. Wisniewski, Andrew K. Vine, Barbara A. Blodi, Susan G. Elner, Laurie M. Jessup, Sharad Khanderia, Carl L. Pierson, Julie Willis, Frances McIver, Sally Stanley, Scott R. Sneed, Antonio Capone, Thomas M. Aaberg, Jennifer I. Lim, Paul Sternberg, Diana S. Coffman, Cameile N. Moore, Susanne K. Gardner, Frederick S. Nolte, Ann Fremstad, Deborah Gibbs, James Gilman, Ray Swords, H.Edith Aguilar, Travis A. Meredith, Vinod Lakhanpal, Faith D. Christian, A. Hood, Richard S. Schwalbe, Emery E. Billings, William Buie, James J. Mallonee, Mary Ann Millar, Sharon Verbeek, Peter A. Campochiaro, Carol B. Palardy, Lois Reynolds, James D. Dick, Dennis Cain, Donald J. D'Amico, Albert R. Frederick, Michael G. Morley, Richard D. Pesavento, Carmen A. Puliafito, Trexler M. Topping, Susan M. Finn, Laura A. Raymond, Ann Sullivan Baker, Barbara Paton, Claudia Evans, Jeffrey Napoli, Christine Kierman, Kathryn Makris, Tom McInnes, Wini T. Reidy, Ruth White, Richard A. Garfinkel, A.Raymond Pilkerton, Robert A. Frantz, Gill B. Abernathy, Jay G. Barbaccia, H.Russell Ensey, Carol A. Ormes, Choong H. Park, Joel Caplan, Kathryn Russell, Robert Toma, Kirk H. Packo, Serge de Bustros, Timothy P. Flood, Louis Glazer, Maggie DeAlba, Evangeline Evanich, Michael A. Montwill, Jeri J. Rothman, Gail Ruderman, Melodie Beard, William Landau, Min H. Shen, Martha Gordon, Sharon Graff, Kathy Kwiatkowski, Loreen Pappas, Douglas Bryant, Don Doherty, Frank Morini, Linda Arredondo, Bruce R. Garretson, Carlos Gerena, Maureen Hunt, Sharon M. Kinnaird, Toni Neri, Thomas A. Rice, Michael A. Novak, Pamela S. Rowe, Scott Jamieson, Deborah Newberry, Glenn R. Rech, Michael J. Dul, Livia Kinser, Krystyna Strozewski, Susan Clark-Rath, Marty DeLisio, David L. Dempsey, Donna Kukula, Anne Pinter-Smith, Sheila Smith-Brewer, Tracey Ludwig, Robert B. Chambers, Frederick H. Davidorf, Cindy S. Taylor, Karen N. Hale, William J. Buesching, Chhanda Chaudhuri, Nanci J. Cover, Gail R. Shortlidge, Michael J. Keating, Scott J. Savage, Paula Andrzejewska, Susan Cometet, Jill D. Milliron, Rob Richmond, Lori Schneider, Debra Weisenberger, Herbert L. Cantrill, Robert C. Ramsay, Amy B. Brallier, Timothy P. Johnson, Edith E. Rossing, Kathleen A. Knauth, Martha M. Monahan, Neal W. Oestreich, Kenneth F. Clark, Anita M. Glennen, David L. Yarian, Stuart N. Green, Steven R. Leff, Leo Masciulli, Margaret M. Lucido, Edward J. Ludwig, Charlotte L. Marano, Linda Peters, Kim Joho, Doris C. Volkert, Finn Andersen, Donna Coffey, Alex Schlosser, Ann Honeywell, Robert N. Mames, William T. Driebe, George A. Stern, Amye Francis, Z.Suzanne Zam, Rhonda Cooper, Darla Gaskins, Diana J. Shamis, Melinda Willingham, Kay Barker, Harry Rosa, Scott M. Friedman, Thomas W. Gardner, George W. Blankenship, Carole J. Coyle, Christopher J. Bero, Cindy Halas, Suzanne Schick, Jean Walker, Denise Cunningham, H.Michael Lambert, Pamela S. Clogston, Pamela M. Frady, S.Neal Gardner, Michael S. Osato, Louise Carr, James Shigley, Pedro F. Lopez, Lawrence P. Chong, Donald A. Frambach, Lupe CisnerosMargaret^Padilla, Edmond Ming Yee, Tamako Nakamura, A.Frances Walonker, Ronald Morales, Tracy Nichols, Maria E. Huete, Peter E. Liggett, Richard R. Ober, Beth Quillen-Thomas, Mark Williams, Steven M. Bloom, Pamela J. Greene, Greg K. Whittington, Mark E. Martin, Glen Watson, Betty Jenkins-Curry, Leigh A. Gilkey, Steven Huelsman, Dennis P. Han, Thomas C. Burton, William F. Mieler, Jose S. Pulido, Frederick H. Reeser, Janet L. Newman, Kathy A. Werner, Paul J. Pisarzewicz, Nina A. Reinerio, Mary Lee K. Walloch, Zuzana Wilmer, Jan Laabs, Ruth Picchiottino, Jim Phillips, Walter Wipplinger, Gary W. Abrams, Dale T. Jurkiewicz, Margaret L. Leet, Paul Mandel, Kim Metzger, Lori Suchla, Denise Zarling, Mark W. Balles, Edwin H. Ryan, William H. Knobloch, Sally M. Cook, Darlette G. Luke, Patricia Ferrieri, Norynne M. Schiminsky, Anne Genia, David A. Philiph, Elizabeth K. Stinson, Linda M. Wright, William C. McMichael, Sandy J. Mielke, Lisa J. Ponwith, Peter Reed Pavan, Scott E. Pautler, Marion L. Coats, Nancy M. Kirk, Sharon M. Millard, Frank C. Castellano, Charlotte R. Edwards, Angela Marquardt, Amy J. McCormack, Michael T. McCormick, Bernard Renshaw, Angela Restuccia, Monica Campbell, Nell Christopher, L.Scott Garrett, Demetrios G. Halkias, Kim Hothersall, Karen Mickler, Thomas S. Minnick, Cheryl Burr, Wyatt Saxon, Miguel A. Arcacha, Steve Carlton, Sonya K. Edison, Marc J. Mallis, Tamre L. Sayers, Thomas W. Sudds, Robert J. Tiberia, Sherry Wolabaugh, Reagan H. Bradford, David W. Parke, Thomas C. Wolf, Janie M. Shofner, Lee E. Tobey, Harold G. Jensen, Dinah Sanchez, Janie Shofner, Russell Burris, Kellie K. Drake, Kay R. Grissom, J.James Rowsey, Charles P. Wilkinson, Gary C. Brown, William E. Benson, Jay L. Federman, Alfred C. Lucier, Joseph I. Maguire, Lov K. Sarin, Eric P. Shakin, Arunan Sivalingam, William Tasman, James F. Vander, Nancy Ward, Clement A. Weisbecker, Caroline L. Agnew, Richard Lambert, Terrance Torner, Kathy Carlson, Gerrie Franchine, Michelle S. Serfass, Robert L. Bergren, Louis A. Lobes, Karl R. Olsen, Jeffrey S. Rinkoff, Donna J. Metz, Margaret N. Leonard, Lisa M. Karenchak, Regis P. Kowalski, Lynn A. Wellman, Linda A. Wilcox, Alan F. Campbell, David R. Steinberg, Gary L. Vagstad, Kimberly A. Flook, Mary M. Good, Beverly J. Keenen, Kim A. Mellinger, Raymond R. Margherio, Morton S. Cox, Patrick L. Murphy, Michael T. Trese, Jane C. Werner, George A. Williams, Patricia E. Manatrey, Janet L. Prote, Richard Lucarotti, Susan Martin, Jeff Band, Grace Bostic, Kristi Gumming, Beth Mitchell, Virginia S. Regan, Craig Bridges, Sam Cox, Gary Houston, John Johnson, Pat Streasik, Betty Wood, Mark S. Blumenkranz, Lisa Cayo, Virginia Kaye, Carmen Luz Valenzuela, Ira K. Orgel, Lon S. Poliner, Paul E. Tornambe, Sarah V. Cannon, Janet L. Nielsen, Anne Carlson, Pauline Chan, Lynne Drake, Martha Grim, Corky Peterson, Lynn A. Borg, Joann Gillyatt, Conny Beyer, Mark E. Hammer, W.Sanderson Grizzard, Theresa L. Shannon, Janet R. Traynom, Melinda J. Collado, Dennis W. McManus, Daniel E. Sweeney, Donald H. Adams, Thomas T. Watson, Michael V. Antworth, Johanna Glacy Araos, Mark A. Greenwald, Mohsen Habib, Sandra K. Myers, Karen M. Ockers, Judy-Ann Thibodeau, Brett Watkins, Philip T. Nelsen, J.Gregory Rosenthal, Fay V. Mintz, Michael Biedenbach, Nicholas J. Leonardy, Sue M. Lawniczak, Chuck Bork, George Hageage, Evelyn B. Hunter, MarLynn J. Marshall, Patricia Roman, Rick Hill, Thomas Hofbauer, Jack Lemanowicz, Howard P. Cupples, Gladys I. Guzman, Richard J. Brodeur, Donald Yee, Edward C. Delaha, Stanley L. Geyer, Stacey Slovis, William J. Shields, Susan Lauber, Karl Michelitsch, Aaron Kassoff, Sharon Watling, JoAnne C. Buehler, Jeffrey McVay, Gale K. Podobinski, Robert L. Sillett, Shirley Groer, Brian Avery, Steven H. Belle, James Boles, Linda Henry, Sarah J. Shema, Linda Titus-Emstoff, Matthew Davis, Yvonne L. Magli, Larry Hubbard, Suzanne Thomas, Donald F. Everett, Richard Mowery, Donald Everett, Kathryn Davis, Stanley Azen, Preston Covey, Brooks McCuen, Andrew Packer, and Jeffrey Robin
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, Eye disease, Vitrectomy, Intraocular lens, Eye infection, medicine.disease, Surgery, law.invention, Clinical trial, Ophthalmology, Endophthalmitis, Randomized controlled trial, law, medicine, Complication, business
Abstract: Purpose: The authors determine if specific features of the clinical presentation of acute postoperative endophthalmitis correlate with the microbiologic culture results. Methods: A total of 420 patients who had clinical evidence of endophthalmitis within 6 weeks after cataract surgery or secondary intraocular lens implantation were evaluated as part of a randomized clinical trial. Results of cultures performed on aqueous and vitreous specimens obtained at presentation were categorized as follows: gram-positive coagulase-negative micrococci, "other" gram-positive, gram-negative, and equivocal/no growth. Results: Eleven features of the initial clinical presentation were associated with significant differences in the microbiologic spectrum ( P Conclusions: The presenting characteristics of acute endophthalmitis after cataract surgery may be helpful in predicting the most likely culture results. Such predictions do not appear sufficiently strong to guide the initial empiric choice of intravitreal antibiotics.
Published: 1997
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20. Sustained delivery fluocinolone acetonide vitreous inserts provide benefit for at least 3 years in patients with diabetic macular edema

Author: Kane Frances Elizabeth, Elias Reichel, Ken Green, David M. Brown, Sanford Chen, José M. Ruiz-Moreno, David S. Boyer, Peter A. Campochiaro, Clare Bailey, Andrew Pearson, Bruce R. Garretson, Kathleen Billman, Seenu M. Hariprasad, Gisèle Soubrane, Barry Kapik, and Amod Gupta
Subjects: medicine.medical_specialty, genetic structures, medicine.medical_treatment, Visual Acuity, Trabeculectomy, Cataract, Macular Edema, law.invention, Fluocinolone acetonide, Randomized controlled trial, Double-Blind Method, law, Glaucoma surgery, Medicine, Humans, Fluorescein Angiography, Glucocorticoids, Antihypertensive Agents, Drug Implants, Diabetic Retinopathy, Phacoemulsification, business.industry, Glaucoma, Diabetic retinopathy, medicine.disease, eye diseases, Surgery, Clinical trial, Vitreous Body, Ophthalmology, Treatment Outcome, Fluocinolone Acetonide, business, Tomography, Optical Coherence, medicine.drug, Retinopathy, Follow-Up Studies
Abstract: Objective To assess long-term efficacy and safety of intravitreal inserts releasing 0.2 μg/d (low dose) or 0.5 μg/d (high dose) fluocinolone acetonide (FAc) in patients with diabetic macular edema (DME). Design Two randomized, sham injection-controlled, double-masked, multicenter clinical trials. Participants Subjects with persistent DME despite ≥1 macular laser treatment were randomized 1:2:2 to sham injection (n = 185), low-dose insert (n = 375), or high-dose insert (n = 393). Methods Subjects received study drug or sham injection and after 6 weeks were eligible for rescue laser. Based on retreatment criteria, additional study drug or sham injections could be given after 1 year. Main Outcome Measures Percentage of patients with improvement of ≥15 letters from baseline. Secondary outcomes included other parameters of visual function and foveal thickness. Results At month 36, the percentage of patients who gained ≥15 in letter score using the last observation carried forward method was 28.7% (low dose) and 27.8% (high dose) in the FAc insert groups compared with 18.9% ( P = 0.018) in the sham group, and considering only those patients still in the trial at month 36, it was 33.0% (low dose) and 31.9% (high dose) compared with 21.4% in the sham group ( P = 0.030). Preplanned subgroup analysis demonstrated a doubling of benefit compared with sham injections in patients who reported duration of DME ≥3 years at baseline; the percentage who gained ≥15 in letter score at month 36 was 34.0% (low dose; P P = 0.002) compared with 13.4% (sham). An improvement ≥2 steps in the Early Treatment Diabetic Retinopathy Study retinopathy scale occurred in 13.7% (low dose) and 10.1% (high dose) compared with 8.9% in the sham group. Almost all phakic patients in the FAc insert groups developed cataract, but their visual benefit after cataract surgery was similar to that in pseudophakic patients. The incidence of incisional glaucoma surgery at month 36 was 4.8% in the low-dose group and 8.1% in the high-dose insert group. Conclusions In patients with DME FAc inserts provide substantial visual benefit for up to 3 years and would provide a valuable addition to the options available for patients with DME. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references.
Published: 2012

21. Vitrectomy for Prevention of Macular Holes

Author: Gregg T. Kokame, Howard Schatz, Paul Sternberg, Cheryl Enger, Bruce R. Garretson, R. Joseph Olk, Ronald G. Michels, Thomas A. Rice, Patrick J. Murphy, Thomas M. Aaberg, Maureen G. Maguire, Rick D. Isernhagen, Jack O. Sipperley, David R. Williams, Brooks W. Mc Cuen, Howard D. Gilbert, Brian B. Berger, M. Gilbert Grand, Serge de Bustros, William J. Wood, Robert N. Johnson, H. Richard McDonald, Bert M. Glaser, Kirk H. Packo, William D. Freeman, and Andrew P. Schachat
Subjects: medicine.medical_specialty, Visual acuity, genetic structures, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Eye disease, Vitrectomy, Fundus (eye), Fluorescein angiography, medicine.disease, eye diseases, Surgery, law.invention, Ophthalmology, Randomized controlled trial, law, medicine, sense organs, medicine.symptom, business, Macular hole, Retinopathy
Abstract: Purpose: The purpose of this study is to assess the benefit of vitreous surgery in preventing full-thickness macular holes in patients with impending (stage 1) macular holes. Methods: A prospective randomized multicenter clinical trial was conducted on patients with full-thickness macular holes in their first eye (stage 3 or 4) and signs and symptoms of stage 1 macular holes in their fellow eye (study eye). The study eye was randomized to vitreous surgery or observation. Outcome was assessed by standardized measurement of visual acuity, detailed clinical examination, fundus photographs, and fluorescein angiography. Results: A full-thickness macular hole developed in 10 (37%) of 27 patients in the vitrectomy group compared with 14 (40%) of 35 patients randomized to observation ( P = 0.81). This difference of 3% has a 95% confidence interval of (-21%,27%). Conclusion: The study was terminated because of low recruitment. The authors were unable to prove (or disprove) the benefit of vitreous surgery in patients with stage 1 macular holes. The authors can state, however, that should a beneficial effect from vitrectomy exist, it would probably be minimal. Considering the cost and morbidity of vitreous surgery, a conservative approach for stage 1 macular hole might be appropriate.
Published: 1994
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22. Vitrectomy for a symptomatic lamellar macular hole

Author: John S. Pollack, Kimberly A. Drenser, Bruce R. Garretson, Alan J. Ruby, George A. Williams, and Ramin Sarrafizadeh
Subjects: Male, medicine.medical_specialty, Visual acuity, genetic structures, medicine.medical_treatment, Eye disease, Sulfur Hexafluoride, Vision Disorders, Visual Acuity, Vitrectomy, Basement Membrane, Optical coherence tomography, Ophthalmology, medicine, Prone Position, Humans, Macular hole, Aged, Retrospective Studies, Aged, 80 and over, Fluorocarbons, medicine.diagnostic_test, business.industry, Middle Aged, medicine.disease, Retinal Perforations, eye diseases, Surgery, Treatment Outcome, Central visual loss, Maculopathy, Female, sense organs, medicine.symptom, business, Tomography, Optical Coherence, Retinopathy
Abstract: Purpose To investigate the surgical findings and outcomes after vitrectomy for a lamellar macular hole (LMH). Design Retrospective, consecutive, interventional case series. Participants Twenty-seven patients (27 eyes) with a lamellar macular hole and central vision loss. Intervention All patients underwent 3-port vitrectomy with internal limiting membrane (ILM) stripping by one of the authors. Best-corrected visual acuity (BCVA) and appearance by optical coherence tomography (OCT) were obtained preoperatively and postoperatively. Main Outcome Measures Preoperative and postoperative BCVA and OCT imaging. Results Visual acuity improved postoperatively in 25 of 27 eyes (93%), with a mean improvement of 3.2 Snellen lines. Preoperative and postoperative OCT images were obtained in 24 of 27 eyes (89%) and were judged to have improved or normalized in 22 of 24 (92%) of these patients. Conclusion In patients with central visual loss from a lamellar macular hole, vitrectomy with ILM stripping appears to be a beneficial treatment.
Published: 2007

23. Intravitreal triamcinolone for the treatment of idiopathic juxtafoveal telangiectasis

Author: Clarion D Alldredge and Bruce R. Garretson
Subjects: medicine.medical_specialty, Fovea Centralis, Triamcinolone acetonide, Visual acuity, Visual Acuity, Triamcinolone Acetonide, Injections, Retinal Diseases, Ophthalmology, Medicine, Humans, Telangiectasis, Fluorescein Angiography, Glucocorticoids, Intravitreal triamcinolone, medicine.diagnostic_test, business.industry, Fovea centralis, Retinal Vessels, General Medicine, Middle Aged, Fluorescein angiography, Vitreous Body, medicine.anatomical_structure, Female, medicine.symptom, business, medicine.drug
Published: 2003

24. The effect of duration of macular detachment on results after the scleral buckle repair of primary, macula-off retinal detachments

Author: George A. Williams, Barbara Kuczynski, Bruce R. Garretson, Tarek S Hassan, Alan J. Ruby, and Ramin Sarrafizadeh
Subjects: Adult, Male, Proliferative vitreoretinopathy, medicine.medical_specialty, Visual acuity, Time Factors, genetic structures, Adolescent, Eye disease, medicine.medical_treatment, Visual Acuity, Scleral buckle, chemistry.chemical_compound, Postoperative Complications, Ophthalmology, medicine, Humans, Macula Lutea, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Retinal Detachment, Retinal detachment, Retinal, Middle Aged, medicine.disease, eye diseases, Surgery, Scleral Buckling, Treatment Outcome, chemistry, Maculopathy, Female, sense organs, medicine.symptom, business, Retinopathy
Abstract: Purpose To present a current series that determined the effect of duration of macular detachment (DMD) and patient age on postscleral buckle (SB) visual acuity (VA) and anatomic results. Design Retrospective, noncomparative, observational case series. Participants Ninety-four consecutive patients (94 eyes) with primary, uncomplicated, macula-off retinal detachments, a preoperative VA of 20/200 or worse, and a precise history of when macular function was lost. Intervention Standard explant scleral buckle technique performed by multiple surgeons. Main outcome measures Visual acuity, anatomic reattachment, and proliferative vitreoretinopathy. Results Visual acuity after SB of 20/40 or better was seen in 71% of eyes with a DMD of 10 days or fewer, 27% of eyes with a DMD of 11 days to 6 weeks, and 14% of eyes with a DMD of more than 6 weeks. Eyes achieved a mean VA after SB of 20/41 after a DMD of 10 days or fewer, 20/121 after a DMD of 11 days to 6 weeks, and 20/178 after a DMD of more than 6 weeks. No decrease in VA was seen within the 1- to 10-day period or the 11 days to 6 week period of DMD. Patients 60 years of age or less achieved a mean VA after SB of 20/47 compared with 20/81 for patients between 61 to 75 years of age and 20 of 96 in patients more than 76 years of age. Duration of macular detachment and patient age had no statistically significant effect on final anatomic reattachment after SB, reoperation rate, or proliferative vitreoretinopathy. Conclusions Eyes with primary, uncomplicated, macula-off retinal detachment repaired with SB achieve excellent postoperative VA if repaired within the first 10 days of macular detachment. These results are better than the VA in eyes repaired after 11 days to 6 weeks and more than 6 weeks of macular detachment. Patients 60 years of age and younger obtained better postoperative VA than older patients. Duration of macular detachment and patient age did not significantly effect anatomic outcomes.
Published: 2002

25. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E and beta carotene for age-related cataract and vision loss: AREDS report no. 9

Author: J. A. Cohen, C. Callahan, C. Neubert, T. Drefcinski, J. C. Werner, A Jr Capone, T M Sr Aaberg, Stuart G Parker, S. Kieval, J. I. Lim, Chris Morrison, P. Wallace, Linda Curtis, N. Davis, D. Saperstein, K. K. Snow, R. Swords, F. Kaufman, J. Buehler, Michael T. Trese, David R. Jones, T. P. Flood, Joseph E. Robertson, Claudia Evans, M. Lambert, M. K. Pinnolis, T M Jr Aaberg, C. Bridges, M. McVicker, S. De Bustros, M. Johnson, C. Ma, H. Daniel, Richard F. Dreyer, C. Stanley, Don Doherty, Patrick B. Rice, D. A. Jones-Devonish, Pauline T. Merrill, S. Strittman, J. Kassoff, L. Szydlowski, M. Eglow, Daniel F. Martin, Mary Zajechowski, Alan J. Ruby, V. Regan, B. Stribling, K. Cumming, B. Ju, David I. Walsh, H. Anderson, P. Siedlak, Celeste Figliulo, V. D. Crouse, Shannon Howard, J. Locatelli, C. Breadsley, B. Lewis, John Zilis, Tim Stout, James Gilman, R. Falk, M. Mairs, Bruce R. Garretson, David H. Orth, J. Civantos, P. Streasick, K. Sherman, Tarek S Hassan, D. A. Bryant, Travis A. Meredith, D. Armiger, A. Kassoff, P Jr Sternberg, R. R. Margherio, T. Taitsel, J. M. Seddon, B. Myles, Michael L. Klein, F. McIver, Kirk H. Packo, G. Smith, H. Yi, M. S. Cox, A. O'Malley, R. G. Chenoweth, Andreas K. Lauer, J. Dubois-Moran, H. Crider, B. Graig, M. Mehu, A. Quattrocchi, David J. Wilson, P. Manatrey, George A. Williams, Christina Gentry, and I. Burton
Subjects: Male, medicine.medical_specialty, Aging, Vision Disorders, Visual Acuity, Ascorbic Acid, Placebo, Gastroenterology, Antioxidants, Cataract, Article, Double-Blind Method, beta-Carotene, Risk Factors, Internal medicine, Lens, Crystalline, Odds Ratio, Photography, Medicine, Humans, Vitamin E, Prospective Studies, Aged, Aged, 80 and over, business.industry, Age-Related Eye Disease Study, Middle Aged, beta Carotene, Clinical trial, Ophthalmology, Dietary Supplements, Disease Progression, Female, business, Age-related cataract
Abstract: Experimental and observational data suggest that micronutrients with antioxidant capabilities may retard the development of age-related cataract.To evaluate the effect of a high-dose antioxidant formulation on the development and progression of age-related lens opacities and visual acuity loss.The 11-center Age-Related Eye Disease Study (AREDS) was a double-masked clinical trial. Participants were randomly assigned to receive daily oral tablets containing either antioxidants (vitamin C, 500 mg; vitamin E, 400 IU; and beta carotene, 15 mg) or no antioxidants. Participants with more than a few small drusen were also randomly assigned to receive tablets with or without zinc (80 mg of zinc as zinc oxide) and copper (2 mg of copper as cupric oxide) as part of the age-related macular degeneration trial. Baseline and annual (starting at year 2) lens photographs were graded at a reading center for the severity of lens opacities using the AREDS cataract grading scale.Primary outcomes were (1) an increase from baseline in nuclear, cortical, or posterior subcapsular opacity grades or cataract surgery, and (2) at least moderate visual acuity loss from baseline (/=15 letters). Primary analyses used repeated-measures logistic regression with a statistical significance level of P =.01. Serum level measurements, medical histories, and mortality rates were used for safety monitoring.Of 4757 participants enrolled, 4629 who were aged from 55 to 80 years had at least 1 natural lens present and were followed up for an average of 6.3 years. No statistically significant effect of the antioxidant formulation was seen on the development or progression of age-related lens opacities (odds ratio = 0.97, P =.55). There was also no statistically significant effect of treatment in reducing the risk of progression for any of the 3 lens opacity types or for cataract surgery. For the 1117 participants with no age-related macular degeneration at baseline, no statistically significant difference was noted between treatment groups for at least moderate visual acuity loss. No statistically significant serious adverse effect was associated with treatment.Use of a high-dose formulation of vitamin C, vitamin E, and beta carotene in a relatively well-nourished older adult cohort had no apparent effect on the 7-year risk of development or progression of age-related lens opacities or visual acuity loss.
Published: 2001

26. Vitrectomy for diffuse diabetic macular edema associated with a taut premacular posterior hyaloid

Author: Bruce R. Garretson, Michael T. Trese, Raymond R. Margherio, Philip J. Ferrone, George A. Williams, Scott D. Pendergast, Tarek S Hassan, and Morton S. Cox
Subjects: Adult, Male, medicine.medical_specialty, Visual acuity, genetic structures, medicine.medical_treatment, Visual Acuity, Vitrectomy, Fundus (eye), Basement Membrane, Macular Edema, medicine, Humans, Fluorescein Angiography, Macular edema, Aged, Retrospective Studies, Aged, 80 and over, Diabetic Retinopathy, Laser Coagulation, medicine.diagnostic_test, business.industry, Diabetic retinopathy, Middle Aged, medicine.disease, Fluorescein angiography, eye diseases, Surgery, Contact lens, Vitreous Body, Ophthalmology, Treatment Outcome, Female, sense organs, medicine.symptom, business, Laser coagulation
Abstract: PURPOSE: To evaluate the role of vitrectomy in eyes with diffuse diabetic macular edema associated with a taut posterior hyaloid. METHODS: Records of 55 eyes of 50 patients with diabetic retinopathy and diffuse clinically significant diabetic macular edema who underwent vitrectomy with stripping of the premacular posterior hyaloid were reviewed. In all 55 eyes, diffuse diabetic macular edema was present on contact lens examination and confirmed with fluorescein angiography. On fundus examination, the premacular posterior hyaloid was attached and appeared taut. RESULTS: The mean preoperative best-corrected visual acuity was 20/160, and the mean final best-corrected visual acuity was 20/80 (P < .0001, Wilcoxon signed rank test), with 27 (49.1%) of the 55 eyes demonstrating improvement in best-corrected visual acuity of 2 or more lines. Fifty-two (94.5%) of the 55 vitrectomized eyes showed improvement in clinically significant macular edema and in 45 eyes (81.8%) the macular edema resolved completely during a mean period of 4.5 months (range, 1 to 13 months). Eyes with macular ischemia and preoperative best-corrected visual acuity of 20/200 or less tended to respond less favorably to vitrectomy than eyes lacking these characteristics. All eyes had at least 6 months of follow-up after surgery, with a mean follow-up of 23.2 months. CONCLUSION: In eyes with persistent diffuse diabetic macular edema with a taut premacular posterior hyaloid face unresponsive to laser therapy, vitrectomy with removal of the posterior hyaloid appears to be beneficial in some cases. Careful selection of eyes with favorable preoperative clinical characteristics may improve surgical outcomes.
Published: 2000

27. VITREORETINAL DEGENERATION COMPLICATED BY RETINAL DETACHMENT IN ALPORT SYNDROME

Author: Bruce R. Garretson, Saad Shaikh, and George A. Williams
Subjects: Adult, Male, medicine.medical_specialty, Eye Diseases, business.industry, Vitreoretinal degeneration, Retinal Degeneration, Retinal Detachment, Visual Acuity, Retinal detachment, Nephritis, Hereditary, General Medicine, medicine.disease, Vitreous Body, Ophthalmology, medicine, Humans, Alport syndrome, business
Published: 2003
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28. Surgery for full-thickness macular Holes: author reply

Author: Tarek S Hassan, Bruce R. Garretson, George A. Williams, Daniel M Berinstein, and Alan J. Ruby
Subjects: Ophthalmology, medicine.medical_specialty, business.industry, medicine, Full thickness, business, Surgery
Published: 2001
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29. Suction elevation of epiretinal membranes

Author: Kirk H. Packo, Bruce R. Garretson, and Serge de Bustros
Subjects: Suction (medicine), medicine.medical_specialty, business.industry, medicine.medical_treatment, Forceps, Posterior pole, Vitrectomy, Suction, medicine.disease, Cannula, Surgery, Retinal Tear, Ophthalmology, Membrane, Retinal Diseases, Medicine, Humans, Macula Lutea, Epiretinal membrane, business
Abstract: To the Editor. —The surgical treatment of patients with macular pucker from epiretinal membrane formation has become increasingly common with the advent of new vitreoretinal techniques. Typically, after vitrectomy is performed, an edge of the epiretinal tissue is elevated with a bent needle or membrane pick, enabling the membrane to be grasped and removed with forceps. It is often difficult to identify an accessible membrane edge, particularly in patients with idiopathic epiretinal membranes, and intraoperative complications, such as bleeding and/or creation of retinal tears, can occur. We recently used an alternative technique to facilitate the elevation and removal of epiretinal tissue in our patients with idiopathic epiretinal membranes. Surgical Technique. —A standard three-port vitrectomy setup is used. Deep vitrectomy is performed, with the complete removal of all formed vitreous over the posterior pole. A 20-gauge soft-tipped extrusion cannula (Model 149.52, Grieshaber, Schaffhausen, Switzerland) is introduced just over the surface of
Published: 1992

30. Paclitaxel Maculopathy

Author: Mandar M, Joshi and Bruce R, Garretson
Subjects: Paclitaxel, Brain Neoplasms, Antibodies, Monoclonal, Breast Neoplasms, Middle Aged, Trastuzumab, Antibodies, Monoclonal, Humanized, Antineoplastic Agents, Phytogenic, Macular Edema, Ophthalmology, Humans, Drug Therapy, Combination, Female, Fluorescein Angiography, Tomography, Optical Coherence
Published: 2007
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31. A Randomized, Placebo-Controlled, Clinical Trial of High-Dose Supplementation With Vitamins C and E, Beta Carotene, and Zinc for Age-Related Macular Degeneration and Vision Loss

Author: T M Sr Aaberg, S. Kieval, David R. Jones, A. Kassoff, P. Manatrey, R. G. Chenoweth, Don Doherty, T. Taitsel, J. M. Seddon, C. Bridges, Linda Curtis, Christina Gentry, M. McVicker, H. Daniel, S. deBustros, C. Stanley, B. Stribling, B. Myles, Richard F. Dreyer, I. Burton, L. Szydlowski, A. O'Malley, G. Smith, Patrick B. Rice, D. A. Jones-Devonish, J. A. Cohen, P Jr Sternberg, David I. Walsh, Pauline T. Merrill, Bruce R. Garretson, A Jr Capon, H. Crider, C. Callahan, Travis A. Meredith, B. Graig, R. Swords, H. Yi, R. Falk, A. Quattrocchi, George A. Williams, John Zilis, J. C. Werner, Shannon Howard, J. Civantos, M. S. Cox, F. McIver, D. Saperstein, Michael L. Klein, Alan J. Ruby, P. Wallace, J. Kassoff, F. Kaufman, M. Mehu, David J. Wilson, N. Davis, Daniel F. Martin, Claudia Evans, T. P. Flood, Joseph E. Robertson, Kirk H. Packo, M. Lambert, M. K. Pinnolis, K. K. Snow, James Gilman, J. Buehler, T M Jr Aaberg, J. Locatelli, M. Johnson, M. Mairs, David H. Orth, T. Drefcinski, P. Streasick, Stuart G Parker, Tarek S Hassan, Chris Morrison, D. A. Bryant, C. Ma, K. Cumming, Andreas K. Lauer, J. Dubois-Moran, V. Regan, A Jr Capone, B. Ju, B. Lewis, J. T. Stout, H. Anderson, P. Siedlak, Celeste Figliulo, V. D. Crouse, Mary Zajechowski, K. Sherman, D. Armiger, C. Beardsley, R. R. Margherio, C. Neubert, J. I. Lim, S. Strittman, M. Eglow, and Michael T. Trese
Subjects: Male, medicine.medical_specialty, Vision Disorders, Visual Acuity, chemistry.chemical_element, Ascorbic Acid, Zinc, Placebo, Gastroenterology, Antioxidants, Article, Macular Degeneration, Double-Blind Method, Risk Factors, beta-Carotene, Internal medicine, medicine, Humans, Vitamin E, Prospective Studies, Aged, Aged, 80 and over, business.industry, Age-Related Eye Disease Study, Middle Aged, Macular degeneration, beta Carotene, medicine.disease, Clinical trial, Age-related maculopathy, Ophthalmology, chemistry, Dietary Supplements, Disease Progression, Drug Evaluation, Drug Therapy, Combination, Female, Meso-zeaxanthin, business, Follow-Up Studies
Abstract: Observational and experimental data suggest that antioxidant and/or zinc supplements may delay progression of age-related macular degeneration (AMD) and vision loss.To evaluate the effect of high-dose vitamins C and E, beta carotene, and zinc supplements on AMD progression and visual acuity.The Age-Related Eye Disease Study, an 11-center double-masked clinical trial, enrolled participants in an AMD trial if they had extensive small drusen, intermediate drusen, large drusen, noncentral geographic atrophy, or pigment abnormalities in 1 or both eyes, or advanced AMD or vision loss due to AMD in 1 eye. At least 1 eye had best-corrected visual acuity of 20/32 or better. Participants were randomly assigned to receive daily oral tablets containing: (1) antioxidants (vitamin C, 500 mg; vitamin E, 400 IU; and beta carotene, 15 mg); (2) zinc, 80 mg, as zinc oxide and copper, 2 mg, as cupric oxide; (3) antioxidants plus zinc; or (4) placebo.(1) Photographic assessment of progression to or treatment for advanced AMD and (2) at least moderate visual acuity loss from baseline (or =15 letters). Primary analyses used repeated-measures logistic regression with a significance level of.01, unadjusted for covariates. Serum level measurements, medical histories, and mortality rates were used for safety monitoring.Average follow-up of the 3640 enrolled study participants, aged 55-80 years, was 6.3 years, with 2.4% lost to follow-up. Comparison with placebo demonstrated a statistically significant odds reduction for the development of advanced AMD with antioxidants plus zinc (odds ratio [OR], 0.72; 99% confidence interval [CI], 0.52-0.98). The ORs for zinc alone and antioxidants alone are 0.75 (99% CI, 0.55-1.03) and 0.80 (99% CI, 0.59-1.09), respectively. Participants with extensive small drusen, nonextensive intermediate size drusen, or pigment abnormalities had only a 1.3% 5-year probability of progression to advanced AMD. Odds reduction estimates increased when these 1063 participants were excluded (antioxidants plus zinc: OR, 0.66; 99% CI, 0.47-0.91; zinc: OR, 0.71; 99% CI, 0.52-0.99; antioxidants: OR, 0.76; 99% CI, 0.55-1.05). Both zinc and antioxidants plus zinc significantly reduced the odds of developing advanced AMD in this higher-risk group. The only statistically significant reduction in rates of at least moderate visual acuity loss occurred in persons assigned to receive antioxidants plus zinc (OR, 0.73; 99% CI, 0.54-0.99). No statistically significant serious adverse effect was associated with any of the formulations.Persons older than 55 years should have dilated eye examinations to determine their risk of developing advanced AMD. Those with extensive intermediate size drusen, at least 1 large druse, noncentral geographic atrophy in 1 or both eyes, or advanced AMD or vision loss due to AMD in 1 eye, and without contraindications such as smoking, should consider taking a supplement of antioxidants plus zinc such as that used in this study.
Published: 2001
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32. EXTERNAL VERSUS INTERNAL APPROACH TO THE REMOVAL OF METALLIC INTRAOCULAR FOREIGN BODIES

Author: Bruce R. Garretson, Raymond R. Margherio, Michael T. Trese, Philip J. Ferrone, Tarek S Hassan, David R. Chow, Barbara Kuczynski, Morton S. Cox, and George A. Williams
Subjects: Adult, Male, medicine.medical_specialty, Visual acuity, Adolescent, medicine.medical_treatment, Forceps, Visual Acuity, Vitrectomy, Internal approach, Retina, Eye injuries, Magnetics, Lens, Crystalline, medicine, Humans, Child, Foreign Bodies, Aged, Retrospective Studies, business.industry, Significant difference, Retrospective cohort study, General Medicine, Middle Aged, Prognosis, medicine.disease, Eye Injuries, Penetrating, Surgery, Ophthalmology, Eye Foreign Bodies, Metals, Child, Preschool, Female, medicine.symptom, business, Corneal Injuries
Abstract: OBJECTIVE To review the management of metallic intraocular foreign bodies (IOFB) at a single institution and to compare the use of internal and external approaches for their removal. SUBJECTS AND METHODS A retrospective review was conducted on 70 eyes from 70 patients who underwent surgical removal of a metallic IOFB with either an internal (vitrectomy followed by forceps or internal magnet use) or external approach (large electromagnet) by seven vitreoretinal surgeons at a single institution between 1973 and 1996. Visual acuity and complications occurring with the two approaches were the main outcome measures studied. RESULTS Overall, patients showed significant improvement in visual acuity following surgical intervention (P < 0.001) despite widely varying surgical techniques. When the authors compared patients treated with an external versus an internal approach they found no statistically significant difference with regard to visual outcome and a trend toward a higher rate of postoperative endophthalmitis in the external approach group. CONCLUSION Surgical removal of metallic IOFB results in significant visual improvement. The external approach to the removal of magnetic metallic IOFB remains a viable treatment option in select cases.
Published: 2000
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33. Assessment of Intraocular Pressure in Vitrectomized Gas-Containing Eyes

Author: Jennifer I. Lim, William E. Shaw, Eve J. Higginbotham, Norman P. Blair, Bruce R. Garretson, and Marilyn D. Farber
Subjects: Applanation tonometry, medicine.medical_specialty, Intraocular pressure, genetic structures, Anterior Chamber, Eye disease, medicine.medical_treatment, Vitrectomy, Tono pen, Corneal Diseases, Clinical study, Tonometry, Ocular, Ophthalmology, Indwelling catheter, Humans, Medicine, Fluorocarbons, business.industry, Air, Eye bank, medicine.disease, eye diseases, Evaluation Studies as Topic, Gases, sense organs, business
Abstract: • Elevation of intraocular pressure (IOP) in gas-containing eyes occurs not infrequently, and applanation tonometry in eyes with epithelial irregularities is not accurate. The pneumotonometer and Tono-Pen (Oculab, La Jolla, Calif) are alternative tonometers for use in these eyes, yet the accuracy of determining IOP with the Tono-Pen has not been determined manometrically. We performed a clinical and manometric study comparing the Tono-Pen with the pneumotonometer in gas-filled vitrectomized eyes. In our clinical study, we measured IOP in 50 eyes of 50 patients with corneal irregularities following vitrectomy and air/gas-fluid exchange. Tono-Pen measurements were highly correlated with those of the pneumotonometer. However, there was a mean difference of 1.4 mm Hg between Tono-Pen and pneumotonometer IOP readings. A larger percentage of Tono-Pen readings were lower than those of the pneumotonometer as IOP levels increased. To assess the accuracy of these tonometers, we compared manometric readings via an indwelling catheter with Tono-Pen and pneumotonometer IOP readings in 11 eye bank eyes following a lensectomy, vitrectomy, and air-fluid exchange. Overall, Tono-Pen and pneumotonometer readings were highly correlated with those of the manometer. However, both machines showed a significant underestimation of IOP at pressures greater than or equal to 30 mm Hg; pneumotonometer and Tono-Pen readings averaged 10.2 and 12.1 mm Hg lower, respectively, than those of the manometer. We conclude that both the pneumotonometer and the Tono-Pen underestimate IOP at pressures greater than or equal to 30 mm Hg. Use of the equations derived to calculate the true IOP from the tonometer reading will help guide intervention for avoiding damage due to elevated IOP in these gas-containing eyes.
Published: 1990
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34. External beam irradiation for retinoblastoma: Patterns of failure and dose-response analysis

Author: Paula J. Schomberg, John D. Earle, Steven J. Buskirk, Bruce R. Garretson, Robert L. Foote, and Dennis M. Robertson
Subjects: Male, Cancer Research, genetic structures, medicine.medical_treatment, Posterior pole, Cryotherapy, Radiotherapy, High-Energy, External beam irradiation, Cataracts, medicine, Humans, Radiology, Nuclear Medicine and imaging, Patterns of failure, Retina, Radiation, Retinoblastoma, business.industry, Eye Neoplasms, Infant, Newborn, Infant, Dose-Response Relationship, Radiation, medicine.disease, eye diseases, Radiation therapy, medicine.anatomical_structure, Oncology, Child, Preschool, Female, sense organs, business, Nuclear medicine
Abstract: Eighteen children with retinoblastoma (25 eyes) were treated with external beam radiation at the Mayo Clinic between January 1977 and January 1987; 15 eyes were in groups I to III and 10 were in groups IV and V (ReeseEllsworth classification). The median number of tumors per eye was 3. Radiation therapy consisted of 4- or 6-MV photons. Doses varied from 39 to 51 Gy in 1.8- to 3.0-Gy fractions. Fourteen eyes were treated through lateral fields by anterior segment-sparing techniques, and 11 eyes were treated by an anterior approach with no attempt at anterior segment sparing. All patients survived (median follow-up, 31.5 months). Cataracts developed in five eyes at a median of 23 months, four in eyes treated with anterior segment-sparing techniques. Of the 15 group I to III eyes, 6 required additional treatment; 4 were salvaged with cryotherapy or photocoagulation and 2 were enucleated. Of the 10 group IV and V eyes, 8 required additional treatment; 4 were salvaged with cryotherapy or photocoagulation, 1 with persistent disease is being followed closely, and 3 were enucleated. Ten (71%) of the 14 eyes treated with anterior segment-sparing techniques required additional treatment (9 of the 10 for tumors anterior to the equator). Four (36%) of the 11 eyes treated with an anterior approach required additional treatment (3 of the 4 for tumors in the posterior pole of group IV or V eyes). Ninety percent of the tumors 10 disc diameters or smaller (1 disc diameter = 1.6 mm) were controlled independently of dose and fractionation used when they were not in the low-dose area of the anterior retina of an eye treated with an anterior segment-sparing technique. We find that use of lateral, anterior segment-sparing techniques has a high risk of anterior retinal tumor development and cataract formation and should be abandoned in favor of techniques that treat the entire retina. A dose of 45 Gy in 1.8-Gy fractions appears to be adequate for local control of tumors smaller than 10 disc diameters. Larger tumors may require additional treatment.
Published: 1989
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35. Choroidal melanoma treatment with iodine 125 brachytherapy

Author: Bruce R. Garretson, John D. Earle, and Dennis M. Robertson
Subjects: Adult, Male, medicine.medical_specialty, Visual acuity, genetic structures, Eye disease, medicine.medical_treatment, Enucleation, Brachytherapy, Iodine Radioisotopes, Cataracts, Ophthalmology, medicine, Humans, Neoplasm Metastasis, Melanoma, Vision, Ocular, Aged, Ultrasonography, Retina, business.industry, Choroid Neoplasms, Middle Aged, medicine.disease, eye diseases, Surgery, medicine.anatomical_structure, Optic nerve, Female, sense organs, Choroid, medicine.symptom, business
Abstract: • Twenty-six patients were treated for malignant melanoma of the choroid with iodine 125 episcleral plaques. Patients were followed up for at least two years, with a mean follow-up of 45 months. Tumor shrinkage was documented by A-scan ultrasonography in all but one patient. The average reduction in tumor thickness was 46%. Visual acuity remained within two Snellen lines of pre-operative levels in 14 (54%) of the 26 patients. Of the 12 patients who lost more than two lines of central visual acuity, eight developed radiation changes affecting either the optic nerve or retina, and three developed cataracts; enucleation accounted for the loss of vision in the final patient. Enucleation was necessary in one other patient in this series because of tumor growth. The mean duration between treatment with iodine 125 and the development of radiation changes affecting the optic nerve or retina was 32 months.
Published: 1987

36. Rhodococcus equi Endophthalmitis

Author: Richard G. Fiscella, Bruce R. Garretson, and David S. Hillman
Subjects: Intraocular foreign body, medicine.medical_specialty, Visual acuity, genetic structures, biology, business.industry, Fulminant, Eye disease, Corneal laceration, Aerobic bacillus, biology.organism_classification, medicine.disease, eye diseases, Surgery, Ophthalmology, Endophthalmitis, medicine, sense organs, Rhodococcus equi, medicine.symptom, business
Abstract: To the Editor. — Rhodococcus (Corynebacterium) equi is a gram-positive, aerobic bacillus that is a common pathogen in animals. Until a few years ago, to our knowledge, no cases of human infection had been reported. Recently, human infestation has been seen in immunocompromised patients, presenting primarily with pulmonary manifestations. We wish to report the first case of ocular involvement in a patient who developed a fulminant endophthalmitis after penetrating injury with an intraocular foreign body. Report of a Case. —A healthy 29-year-old man was striking a valve on his car with a metal hammer when he felt something strike his left eye. He presented to his local emergency room where ophthalmologic examination revealed a visual acuity of 20/20 OD and 20/100 OS. The remainder of the examination of the right eye yielded normal results. The left eye had a 1-mm full-thickness corneal laceration at the 3-o'clock position near the limbus.
Published: 1989
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