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Josh Wallsh,1 Charlotte Luths,2 Haily Kil,2 Ron Gallemore2 1Albany Medical Center, Department of Ophthalmology, Albany, NY, USA; 2Retina Macula Institute and Research Center, Torrance, CA, USACorrespondence: Ron GallemoreRetina Macula Institute and Research Center, 4201 Torrance Blvd Suite 220, Torrance, CA 90503, USAEmail rongallemoremd@gmail.comPurpose: To evaluate the initial ten years of results from the intravitreal dexamethasone implant (DEX) in patients treated for retinal vein occlusion (RVO), diabetic macular edema (DME) or uveitis.Methods: Retrospective chart review of patients receiving DEX since its FDA approval. Best-corrected visual acuity (BCVA), central macular thickness (CMT) on optical coherence tomography, intraocular pressure and cataract status were collected. Baseline data were collected from the initial DEX and post-treatment data at the visit at least four weeks after the last DEX.Results: In total, 315 eyes received 1216 DEX over 63.9± 4.6 weeks. In the branch RVO (n=90), central RVO (n=59) and DME (n=62) cohorts, BCVA improved significantly (p< 0.05). The uveitis (n=154) cohort did not have a significant change in BCVA, 0.62± 0.04 to 0.61± 0.04 logMAR (p=0.34). Younger patients, vitrectomized eyes, and eyes without a history of glaucoma were associated with significantly better BCVA outcomes in the uveitis cohort (p< 0.05). Overall, CMT decreased significantly from 376.6± 6.8 to 322.7± 5.0 μm (p< 0.05). Intraocular pressure increased significantly (p< 0.001) and the percentage of patients requiring anti-glaucoma medications increased from 33.0% to 67.6%. Of phakic eyes, 58.8% (n=63) had cataract progression or underwent surgery with those who underwent surgery experiencing a significant improvement in BCVA (p< 0.05).Conclusion: Repeated DEX over extended follow-up offers significant anatomic benefits to all cohorts. Visual benefits are only seen in RVO, DME and select uveitis demographics.Keywords: uveitis, branch retinal vein occlusion, central retinal vein occlusion, diabetic macular edema, dexamethasone implant

Jea H Yu,1 Jaycob Avaylon,1 Hyein Kil,1 Jisoo K Kim,1 Ron P Gallemore1,21Department of Clinical Research, Retina Macula Institute, Torrance, CA, USA; 2Department of Ophthalmology, University of California, Los Angeles, CA, USAPurpose: To report a case of endophthalmitis associated with Legionella Pneumophila.Case Report: A 46-year-old, highly myopic male with a complex history of recurrent retinal detachments, macular hole, cataract surgery and an infected scleral buckle in the left eye, presented with pain, redness, hypopyon and vision loss in the left eye, 14 days following blunt head trauma. Empirical treatment for endophthalmitis with intravitreal injections of Vancomycin and Ceftazidime afforded minimal improvement. He developed recurrent hypopyon and underwent vitrectomy surgery with intravitreal antibiotic injections at the time of surgery and had improvement. Intraoperative culture was positive for Legionella Pneumophila. He had continued episodes of recurrent inflammation which were quelled by intravitreal moxifloxacin injections performed every 3–10 days. He developed a recurrent RD with proliferative vitreoretinopathy (PVR) and underwent vitrectomy with silicone oil. The retina was reattached but had no light perception vision in the affected eye.Conclusion: When endophthalmitis is contracted in a work-place setting, a culture for L. pneumophila should be considered. A combination of intravitreal moxifloxacin and oral azithromycin may be effective.Keywords: endophthalmitis, Legionella Pneumophila, Legionnaire’s disease

Marine protected area (MPAs) networks can buffer marine ecosystems from the impacts of climate change by allowing species to redistribute as conditions change and by reducing other stressors. There are, however, few examples where climate change has been considered in MPA network design. In this paper, we assess how climate change considerations were integrated into the design of a newly released MPA network in the Northern Shelf Bioregion in British Columbia, Canada, and then evaluate the resulting network against projected physical and biogeochemical changes and biological responses. We found that representation, replication, and size and spacing recommendations integrated into the design phase were met in most cases. Furthermore, despite varying degrees of projected changes in temperature, dissolved oxygen, and aragonite saturation across the MPA network, suitable habitat for demersal fish species is projected to remain in the network despite some redistribution among sites. We also found that mid-depth MPAs are particularly important for persistence, as fish are projected to move deeper to avoid warming in shallower areas. Our results highlight that a representative MPA network with adequate replication, that incorporates areas of varying climate change trajectory, should buffer against the impacts of climate change.

Objectives: To compare the effectiveness of bivalent and monovalent COVID-19 vaccines throughout the 2022-2023 winter season based on real-world data. Methods: This retrospective observational matched cohort study used the national vaccination program and a surveillance dataset from the Republic of Korea, and included adults aged >18 years who received bivalent or monovalent COVID-19 vaccines between October 11, 2022, and December 17, 2022. Cox proportional hazard models were used to estimate the hazard ratio for COVID-19 infection between the groups. Results: We included 29,245 matched individuals in the bivalent and monovalent vaccine groups, respectively. The bivalent vaccine recipients showed 12.2% (95% confidence interval [CI] 6.5-17.7%) additional protection against COVID-19 infection compared with the monovalent vaccine recipients. The additional protection provided by bivalent vaccines was significantly higher among residents of long-term care facilities (39.4%, 95% CI 21.6-53.1%). Maximum additional protection was observed 3 to 4 months after completing the vaccination (17.6%, 95% CI 6.6-27.3%). Conclusion: Bivalent COVID-19 vaccines showed significantly better protection against infection than monovalent vaccines among adults during the 2022-2023 winter season. Our results highlight that immunization programs with bivalent vaccines comprising recent variants can be an effective measure to prepare for seasonal COVID-19 circulation.

This paper considers generalized consistent sampling and reconstruction processes in an abstract separable Hilbert space. Using an operator-theoretical approach, quasi-consistent and consistent approximations with optimal properties, such as possessing the minimum norm or being closest to the original vector, are derived. The results are illustrated with several examples.