Mean BCVA Research Articles

Direct selective laser trabeculoplasty: A retrospective study.

To investigate the effectiveness and safety profiles of Direct Selective Laser Trabeculoplasty (DSLT). Retrospective study of 15 eyes of 10 patients diagnosed with open angle glaucoma (OAG) or ocular hypertension (OHT) who underwent DSLT in June 2023 at University Hospitals of Leicester, UK. We defined success as IOP reduced ≥20% from baseline with no additional medications needed or as a decrease in the number of anti-glaucoma medications while maintaining target IOP. We also considered secondary outcomes such as final BCVA and final number of anti-glaucoma medications. At the fourth month visit, success was reached in 11 eyes (73.3%). We registered 4 failures (26.7%). Mean IOP at baseline was 22.7 ± 4.4 mmHg and was reduced to 18.7 ± 4.2 mmHg (p = 0.008). The absolute mean reduction of IOP in the group of eyes that maintained unchanged the number of medications was 5.4 ± 2.7 mmHg, as baseline IOP was 21.4 ± 4.3 mmHg, and final IOP was 15.9 ± 2.3 mmHg, with a 25.7% reduction (p = 0.003). Mean BCVA remained unchanged (0.1 ± 0.1 logMAR, p = 1.00). No significant adverse events requiring surgical or clinical intervention were observed. DSLT showed profiles of effectiveness and safety comparable with those of SLT in the literature and consistent with the results obtained in previous studies on DSLT itself. DSLT may represent a valid alternative to traditional SLT.

Clinical Features and Treatment Outcomes of Choroidal Osteoma in Asian Indians (80 Patients)

Purpose: To describe the demographic and clinical characteristics, and treatment outcomes of choroidal osteoma in Indian patients. Methods: This cross-sectional hospital-based study included 80 patients (100 eyes) between 2nd October 2012 and 15th May 2024. Results: Forty-nine (61%) participants were female, and 31 (39 %) were male. The most common age group was the second decade (n=27, 34%). Tumor ossification with intact RPE was observed in 37 (44%) eyes and tumor deossification with/without RPE atrophy was observed in 55 (65%). Associated features observed were choroidal neovascularization (CNV) in 40 (40%) eyes, subretinal fluid without CNV in 4 (4%) eyes, and documented tumor growth in 6 (6%) eyes (mean interval, 4 years). At 4 and 8 years, Kaplan–Meier analysis revealed tumor growth in 18% and 38% of eyes, respectively. Of the 83 eyes, OCT showed the presence of choroidal lamellae in ossified zones in 30 eyes (100%), CNV in 40 (48%) eyes, SRF without CNV or growth in 8 (10%) eyes, and RPE atrophy with deossification in 53 (64%) eyes. Treatment included intravitreal anti-VEGF therapy for CNV in 39 eyes, transpupillary thermotherapy in 3, and focal laser photocoagulation in one eye to the perifoveal leaning edge with SRF without CNV. The mean BCVA changed from 0.4 to 0.6 logMAR units (6/15 to 6/24 Snellen’s equivalent) at a mean follow-up of 19 months (3-149 months). Conclusion: Choroidal osteoma is a unilateral condition observed in females. Although benign, the presence of CNV, SRF, or tumor growth requires treatment and periodic surveillance.

Delayed closure of highly myopic macular holes combined with retinoschisis after inverted internal limiting membrane flap.

To assess functional and anatomical outcomes of internal limiting membrane (ILM) inverted flap in highly myopic macular holes (HMMHs) with outer-retinoschisis (O-RS). Retrospective interventional analysis of 19 eyes with HMMH and O-RS undergoing vitrectomy and ILM inverted flap. At baseline and every follow-up visit (1, 3, 6, 12months and the most recent) we performed best-corrected visual acuity (BCVA, Snellen) and optical coherence tomography (OCT), collecting several parameters: minimum linear diameter (MLD), basal diameter (BD), peri-HMMH nasal and temporal retinal thickness (RTNAS and RTTEM), peri-HMMH nasal and temporal O-RS height (O-RSNAS and O-RSTEM). The ratios O-RSNAS/ RTNAS and O-RSTEM/RTTEM were defined as %O-RSNAS and %O-RSTEM. Postoperatively, we distinguished classic HMMH closure (n = 14) from a newly described "delayed" closure pattern (n = 5). Primary anatomical closure was obtained in 89% of eyes. Mean BCVA improved from 0.23 ± 0.17 to 0.44 ± 0.20 and 0.46 ± 0.25 at 6-months and final follow-up (p = 0.009 and p = 0.001, respectively). At every follow-up, "classic" vs. "delayed closure" did not influence BCVA (all p > 0.05). Baseline O-RSNAS (p = 0.026), O-RSTEM (p = 0.04), %O-RSNAS (p = 0.04) and %O-RSTEM (0.004), were significantly associated with the "flap closure" pattern, differently from MLD and BD. In the "delayed closure" subgroup we reported a 100% closure rate, but 65.8 ± 64.4days after first surgery. Meantime, OCT showed an inverted ILM flap covering an area of persistent tissue loss. O-RSNAS and O-RSTEM progressively reduced until HMMH closure. Inverted flap is useful to close HMMH with O-RS. In case of "delayed closure" pattern, watchful-waiting allows for HMMH self-sealing, without impact on BCVA. What is known Inverted internal limiting membrane (ILM) flap showed favorable anatomic success in cases of highly myopic macular holes (HMMH). What is new HMMHs with outer retinoschisis (class 2c of the staging system) may close following a classic or "delayed closure" pattern. In cases of delayed closure, it took a variable range of 30-179days to seal the HMMH but no further surgery was advisable. Post-operative BCVA improvement was not impacted at any follow-ups when comparing "delayed" and "classic" closure subgroups.

Long-Term Outcomes of Pediatric Pars Planitis: Retrospective Cohort from a Single Tertiary Center in Turkey

ABSTRACT Purpose To retrospectively analyze long-term outcomes of pediatric pars planitis (PP). Methods PP was defined as vitreal inflammation with snowbank or snowball formation in the absence of a related disease. Eighty-five eyes of 44 patients were included in this study. Demographic and clinical characteristics were obtained from medical records. Results Approximately 70% of the patients were males; the mean patient age was 10.4 ± 3.6 years at presentation, and the mean follow-up time was 42.8 ± 27.9 months. At presentation, the mean best corrected visual acuity (BCVA, logMAR) was 0.17 ± 0.27 in the right eyes and 0.27 ± 0.33 in the left eyes. Common symptoms included blurry vision (29 eyes, 65%), redness (17, 38%), pain (8, 18%), and floaters (5, 11%). Sight-threatening complications included optic disc edema/hyperemia (26, 30%), cataracts (16, 18%), macular edema (16, 18%), and glaucoma (15, 17%). All 38 patients who initially required systemic treatment received corticosteroids. During the follow-up, 24 patients were treated with azathioprine, 20 with methotrexate, 11 with cyclosporine, 20 with adalimumab, and 8 with infliximab. At the final examination, the mean BCVA of the right and left eyes improved significantly (0.08 ± 0.23 and 0.06 ± 0.17, p = 0.006 and p < 0.001, respectively). The severities of vitritis, anterior chamber inflammation, snowbank/snowball formation, and endotheliitis decreased (all p < 0.001). Thirty-one patients remained on systemic treatment, with only four patients still receiving corticosteroids. No life-threatening adverse effects were reported. Conclusion Despite pediatric PP’s mild course, severe vision-threatening complications can occur. Immunomodulatory or biologic agents are important for controlling inflammation and tapering corticosteroids. Further research could enhance understanding of optimal treatments.

Minimally Invasive Tube Surgery (MITS)-A Novel Method in Glaucoma Drainage Device Implantation.

Background/Objectives: We introduce a new surgical technique for inserting the eyePlate-300-a glaucoma drainage device (GDD). The flexibility of the eyePlate-300 allows for folding and insertion through a smaller conjunctival incision. The procedure is termed minimally invasive tube surgery (MITS). Methods: We performed a retrospective analysis of thirteen eyes to assess the efficacy of the MITS technique in a large London tertiary teaching eye hospital with 12 months follow-up. The primary outcome was complete success: defined as 'IOP > 5 mmHg, <21 mmHg and off drops'. Secondary outcomes: best corrected visual acuity at 12 months, complications, a reduction in the number of drops and need for further pressure-lowering surgery. Results: Twelve eyes (92%) achieved a lower IOP. The mean pre-operative IOP was 35.69 mmHg (20-53 mmHg); post-operatively, it was reduced to 11.08 mmHg (5-20 mmHg) (p < 0.001). The mean pre-operative drops were 3.462 (3-4), reducing to 0.85 (0-3) at 12 months (p < 0.001). There was no change in the mean BCVA. No intraoperative complications were recorded, and no further IOP lowering surgeries were required. Conclusions: The MITS technique facilitates the implantation of a glaucoma drainage device through a smaller, less traumatic incision. Preliminary one-year data suggest that the procedure may be safe and effective.

Pneumatic Retinopexy for Rhegmatogenous Retinal Detachment Outcomes: IRIS Registry (Intelligent Research in Sight) Analysis

PurposeTo determine treatment patterns and outcomes of pneumatic retinopexy (PnR) for rhegmatogenous retinal detachments (RRD). DesignRetrospective cohort analysis using IRIS® Registry (Intelligent Research in Sight) database. ParticipantsPatients with RRD treated by PnR from 2013-2022. MethodsCases were identified using International Classification of Diseases, Ninth and Tenth Revisions (ICD-9, ICD-10) diagnostic codes. Surgical procedures were identified using Current Procedural Terminology (CPT) codes for type of RRD repair. Baseline demographic information included age, sex, race and ethnicity, geographic region, smoking status, and health insurance type. Main Outcome MeasuresPrimary outcomes for PnR included single-operation success (SOS) and failure (SOF), change in visual acuity at 9-12 months, rates of complications, rates of secondary procedure following SOF, and outcome by phakic status. Results13,302 unique eyes were analyzed (median age, 64 years, 61.56% male). Overall SOS for primary PnR was 59.82%. The mean BCVA at 9-12 months following PR was LogMAR 0.44 (95% CI: 0.42, 0.46) for SOF eyes, compared to 0.23 (95% CI: 0.22, 0.25) for SOS eyes (P < 0.001). Complications of PR included vitreous hemorrhage (9.1%), ERM (45.17%), proliferative vitreoretinopathy (0.98%), and endophthalmitis (0.14%). Of the 40.18% of eyes with SOF, 81% required either secondary PnR, scleral buckle (SB), vitrectomy (VTX), or complex detachment repair (CDR), whereas the remaining eyes required more than one of these secondary procedures. SOS for phakic eyes was 64.50% versus 53.93% for pseudophakic eyes (P < 0.001). ConclusionsIRIS Registry data reveal real-world outcomes and utilization patterns of PnR for RRD. Overall SOS for primary PnR was 59.82%, which is lower than other cited rates in the literature. Pseudophakic eyes were more likely to fail primary PnR. It is important to counsel patients on risks of the procedure when obtaining informed consent.

Visual recovery following pituitary adenoma surgery: prognostic value of optical coherence tomography and suprasellar tumour volume

ObjectiveThe aim of this study is to investigate the effects of preoperative parameters such as retinal nerve fiber layer (RNFL) thickness, visual acuity (VA), visual field (VF), and tumour volume on postoperative outcomes in patients with pituitary adenoma. DesignRetrospective study. ParticipantsTwo-hundred and seventy-six eyes from 142 patients were included. MethodsAll patients underwent a comprehensive ophthalmological evaluation both before and 12 months after the surgery. RNFL thickness was analyzed using optical coherence tomography. VF testing was carried out using the automated Humphrey Visual Field Analyzer 3. Two primary visual field (VF) parameters, mean deviation (MD), and pattern standard deviation (PSD), were recorded. Patients were categorized into 2 groups based on their visual field outcomes: the MD recovery group and the nonrecovery group. MD recovery was defined as an MD value greater than −2 dB at the 12-month postoperative follow-up visit. ResultsThe mean BCVA was significantly improved postoperatively compared with the preoperative values (P = 0.001). Preoperatively, the upper, temporal, and inferior RNFL values were significantly higher in patients with normal visual fields compared to those with abnormal visual fields (P = 0.001 for upper and temporal, P = 0.008 for inferior). Preoperative suprasellar tumour volume was found to be lower in the MD recovery group (P = 0.001). Multivariate logistic regression analyses revealed that preoperative inferior RNFL thickness were significantly associated with MD recovery (P = 0.023), and preoperative temporal RNFL thickness were significantly associated with VA recovery (P = 0.047). ConclusionRNFL thickness, VF parameters, and suprasellar tumour volume can serve as important prognostic indicators in patients with pituitary adenoma.

A New Ray of Hope in the Treatment of Seasonal Hyperacute Panuveitis: Could Intravitreal Triple Combination Therapy of an Antibiotic with Dual Steroids Play a Pivotal Role?

ABSTRACT Introduction Seasonal Hyperacute Panuveitis (SHAPU) is a blinding disease in Nepal with unknown aetiology. Henceforth, we proposed to study the treatment outcome of a triple intravitreal combination therapy of dual steroids triamcinolone (long-acting steroid) and dexamethasone (short-acting steroid) along with antibiotic moxifloxacin for patients with severe stage of SHAPU. Methods A prospective study was conducted among the SHAPU patients presenting in severe stages during the September to December 2023 outbreak. Intravitreal injection of 4-mg preservative-free triamcinolone acetonide (4 mg/0.1 ml) with intravitreal dexamethasone injection (0.4 mg/0.1 ml) and 0.5 mg/0.1 ml of moxifloxacin was given in the operating theatre. Best corrected visual acuity, intraocular pressure measurements, vitreous haze and fundus evaluation, were assessed to determine the treatment outcome on examination on day 7 and day 30 following intravitreal combination therapy. Result A total of 6 patients (2 female and 4 male) were enrolled. At presentation, the mean BCVA was 2.40 ± 0.30 logMAR, mean intraocular pressure was 12.8 mmHg and vitreous haze was 4+ haze in all cases. The evaluation on the 7th day and 30th after injection showed significant improvement in BCVA (p value = 0.039; p value = 0.040, respectively). The change in the IOP at day 7 (p value = 0.85) was insignificant. However, the IOP change was significant at day 30 (p value = 0.5). Similarly, there was a marked reduction in the vitreous haze with better fundus visibility after treatment. Conclusion This study depicted that steroids prevent the dreaded complication of hypotony due to ciliary shutdown by combating severe inflammation, thus adding new hope to the armamentarium of SHAPU management.

Early real-world experience with intravitreal Faricimab for neovascular AMD: FAN study

PurposeThis study presents real-world experiences and clinical outcomes of patients who switched to faricimab after prior treatment with other anti-vascular endothelial growth factor medication for patients with neovascular age-related macular degeneration (nAMD) in 2022. DesignWe evaluated all consecutive patients that received an intravitreal injection (IVI) with faricimab for nAMD and had complete follow-up visits after at least three IVI. MethodsFunctional and structural parameters including best-corrected visual acuity (BCVA, logMAR), foveal centre point (FCP, µm), central subfield retinal thickness (CSRT, µm) and macular volume (mm3) were evaluated after three (n = 71) and five (n = 57) faricimab injections with complete follow-up visits. ResultsWe included 71 eyes of 63 patients. Mean BCVA at baseline was 0.49 logMAR (0 – 1.6) and did not change significantly after five faricimab injections (p = 0.33). Significant reductions were seen for FCP, CSRT and macular volume after the first five consecutive injections when compared to baseline (p < 0.0001 respectively). FCP was 388.35 µm (173–924 µm) at baseline and decreased to 279.16 µm (97 – 667) at visit 5. CSRT was 370.68 µm (202 – 1074) and decreased to 307.75 µm (168 – 590) at visit 5. Macular volume was reduced from 2.59 mm3 (1.83 – 4.90) to 2.31 mm3 (1.80 – 3.19) at visit 5. Intraocular inflammation was observed in one eye showing anterior chamber cells that resolved with topical corticosteroid treatment. ConclusionsThe results of the FAN (FAricimab for Neovascular AMD) study indicate that faricimab improves structural outcomes in patients with recalcitrant fluid due to nAMD with no major complications observed.

A comprehensive evaluation of efficacy of hyperbaric oxygen therapy in non-arteritic central retinal artery occlusion using enhanced depth imaging optical coherence tomography

This study aimed to assess the efficacy of hyperbaric oxygen therapy (HBOT) in patients with central retinal artery occlusion (CRAO) by analyzing changes in visual acuity (VA) and enhanced depth imaging optical coherence tomography (EDI-OCT) parameters. A comparative retrospective study was conducted by reviewing the medical records of all HBO-treated RAO patients in our department and comparing them with matched RAO patients who did not receive HBO treatment. All patients treated with HBO received treatment within 7 days of the onset of visual symptoms. Baseline characteristics were compared, and VA and OCT parameters were evaluated at baseline and follow-up visits. A total of 50 eyes from 50 patients were included, with 29 eyes in the HBOT group and 21 eyes in the control group. The mean BCVA of the HBOT group at the initial visit was 2.03 logMAR, which improved to 1.55 logMAR at 6 months, with the change being statistically significant (P < 0.01), while the control group's BCVA remained almost unchanged, from 2.1 to 2.11 logMAR (P = 0.762). The central choroidal thickness increased significantly in the HBOT group over the subsequent period. The central fovea, and outer retinal layer thickness in the HBOT group were significantly greater than those in the control group at the 6-month follow-up after treatment. HBOT appears to be effective in improving VA and inducing favorable changes in OCT parameters in patients with CRAO. It helps to preserve retinal layer thickness, especially in the outer retinal layer.

Meta-Analysis Study for the Best Surgical Techniques for Secondary Intraocular Lens Implantation in Complicated Cataract Surgeries

Abstract Background The most appropriate location to implant intraocular lenses (IOL) is the interior of the capsular bag, but in complicated cataract surgeries, procedures of secondary IOL implantation are associated with insufficiency or absence of this anatomic structure. In these cases, the IOL must be fixated at alternative sites of the eye globe, e.g., the iris or the sclera. Aim of the Work to compare different surgical IOL implantation techniques for best correction of aphakia, postoperative visual acuity, acquired astigmatism and least complications as corneal decompensation, glaucoma and angle support. Methodology This systematic review included a discussion of all available studies meeting the eligible criteria including: well conducted descriptive studies, cohort, articles, accepted manuscripts, clinical trials, analytic studies and the literature of reviews, technical notes. An extensive search of electronic literature located 291 studies; 160 duplicates were removed and 131 of which were eliminated after the title and abstract were reviewed. Results This study demonstrated a statistically significant change in the mean BCVA improvement in all techniques when comparing the baseline to one and three month follow up after operation, though with no statistically difference between the three techniques as A final corrected distance visual acuity of 6/12 or better was achieved in (65%) implanted with an AC-IFIOL, in (44.3%) with anRP-IFIOL, and (18.1%) with an SF-PCIOL(two studies only taken in consideration). At six month follow up all groups showed no significant difference in the BCVA compared to the baseline and along the follow up periods. There is no significant loss in mean ECD in all groups. Regarding IOP elevation it was more in scleral fixated and anterior chamber IOL than that in retropupillary IOL, and glaucoma was the second most common complication in secondary IOL implantation after anterior chamber reaction. Conclusion AC-IFIOL, RP-IFIOL, and SF-IFIOL were similar in visual efficacy and mean corneal endothelial cell loss. Although IOP elevation was significantly higher in the SF- PCIOL group than in the other groups, other rates of complications were similar between the groups.

Retrolental cohesive ophthalmic viscoelastic injection for severe subluxated cataracts: a prospective study

BackgroundTo assess anatomical and functional outcomes of retrolental cohesive ophthalmic viscoelastic injection (“Viscolift technique”) in patients with severely subluxated cataracts.MethodsIn the present prospective study, we included patients older than 18 years with severely subluxated cataracts and phacodonesis. Full medical history was obtained at the baseline ophthalmological assessment. A single 25-gauge valved trocar was inserted 4 mm from the limbus and a 27G angled cannula was introduced through the trocar into the retrolental space, while cohesive viscoelastic was progressively injected, in order to center and elevate the cataract to facilitate capsulorhexis. After complete phacoemulsification, a 3-piece intraocular lens (IOL) with a scleral fixated Cionni ring or FIL-SSF scleral fixated IOL was implanted. Patients follow-up interval was 6 months after surgery.ResultsThirteen eyes of 13 patients were enrolled in the study, mean age was 61.5 ± 9.4 years and 53.8% were females. The “Viscolift technique” resulted in centered and more stable cataracts in all cases (100%). After complete phacoemulsification, 61.5% of patients were implanted with a 3-piece IOL with Cionni ring, and 38.5% with a FIL-SSF scleral fixated IOL after complete 25G vitrectomy. Mean BCVA improved from 0.5 ± 0.1 LogMar (20/63 Snellen) to 0.1 ± 0.1 LogMar (20/25 Snellen) (p < 0.001) at the last follow-up. No major complications were noted.ConclusionsThe “Viscolift technique” proved to be a safe and effective surgical approach for recentering and elevating subluxated cataracts, thus allowing the surgeon to perform an easier and better-centered capsulorhexis.

MERLIN: Two-Year Results of Brolucizumab in Participants with Neovascular Age-Related Macular Degeneration and Persistent Retinal Fluid

PurposeTo report the safety and efficacy of brolucizumab (Beovu®) 6 mg vs. aflibercept (Eylea®) 2 mg administered every 4 weeks in participants with neovascular age-related macular degeneration (nAMD) and persistent retinal fluid after the Week 52 primary endpoint analysis (from Week 52 up to Week 104, post-study termination). DesignMulticenter, randomized, double-masked Phase 3a study. ParticipantsParticipants with recalcitrant nAMD (persistent residual retinal fluid despite previous frequent anti-vascular endothelial growth factor treatment). MethodsStudy eyes were randomized 2:1 to intravitreal brolucizumab 6 mg or aflibercept 2 mg every 4 weeks for 100 weeks, or until study termination. Main Outcome MeasuresAll available efficacy (analysis of noninferiority in mean best-corrected visual acuity [BCVA], central subfield thickness [CST], fluid-free status [no intraretinal fluid and no subretinal fluid]), and safety data up to study termination, including data up to Week 104 for those participants who completed the study prior to its termination. All P values after Week 52 were nominal and reflect observed data for the efficacy analyses. ResultsBrolucizumab 6 mg every 4 weeks was noninferior to aflibercept 2 mg in mean BCVA change from baseline to Week 104 (least squares mean difference, -0.4 Early Treatment Diabetic Retinopathy Study letters; 95% confidence interval [CI], -3.7 to 3.0; P = 0.0169). The proportion of eyes with ≥15-letter loss was 6.2% for brolucizumab and 4.7% for aflibercept. (P = 0.0014), and a greater proportion of eyes were fluid free at Week 104 (52.5% brolucizumab vs. 28.2% aflibercept; 95% CI, 11.9−37.3; P < 0.001) in eyes treated with brolucizumab vs. aflibercept. Incidence of intraocular inflammation (IOI), including retinal vasculitis and retinal vascular occlusion, was 11.5% (0.8% and 2.2%) for brolucizumab vs 6.1% (0% and 0.6%) for aflibercept, respectively. ConclusionsConsistent with 52-week results, brolucizumab 6 mg every 4 weeks was noninferior in mean BCVA change with anatomic outcomes superior to aflibercept 2 mg every 4 weeks from baseline to Week 104 or study termination. The incidence of IOI, including retinal vasculitis and retinal vascular occlusion, was higher with brolucizumab vs. aflibercept; therefore, brolucizumab should not be used more frequently than every 8 weeks following the loading regimen.

Intraoperative closure of large full thickness macular holes with perfluorocarbon liquid.

To report the role of perfluorocarbon liquid (PFCL) and passive extrusion for management of large full thickness macular holes (FTMHs). A standard pars plana vitrectomy with induction of posterior vitreous detachment was performed for all patients. After internal limiting membrane (ILM) peel, a bubble of perfluorocarbon liquid (PFCL) was injected over the posterior pole and passive extrusion of fluid was performed with a backflush instrument below the PFCL bubble, without touching the FTMH edges, until the FTMH centre was reached. Intraoperative optical coherence tomography (OCT) showed formation of an inner retina roof in all cases and confirmed intraoperative FTMH closure. Complete PFCL removal was performed after fluid-air exchange and gas tamponade was utilised in all cases. Preoperative FTMH mean aperture size was 761um and standard deviation (SD) 100um (range 682-918um). FTMH closure was achieved in all eyes and visualised intraoperatively with OCT. After an average follow-up of 2 months, there was improvement in the mean BCVA and central scotoma. FTMH closure can be achieved intraoperatively with the use of PFCL and passive extrusion. The described surgical technique could be a valid alternative for repair of large FTMHs.

Reconnecting Anisometropic Amblyopic Eyes to the Cortex: VEP-Based Auditory Biofeedback.

This study aimed to evaluate the effectiveness of a visual rehabilitation method for anisometropic amblyopia that uses visual evoked potential (VEP) parameters and sound biofeedback to increase objectiveness. an observational, case-controlled trial. Ophthalmology Clinic, Emergency County Hospital, Cluj-Napoca, Romania. Sixteen subjects with amblyopic anisometropia, aged 15-57, and sixteen controls, aged 24-33, were included. Subjects were divided into two groups. The control group, composed of normal-vision subjects, and the amblyopic group received 10 training sessions. The rehabilitation program lasted 10 min, took place twice a week, and ran over five consecutive weeks. During each session, the subjects were asked to fixate on a target on the computer screen and were instructed to keep the fixation and maintain the sound of the biofeedback at high frequency. The study assessed the main visual parameters at baseline, after 10 sessions, and 1, 3, 6, and 12 months after treatment. Performance was evaluated by measuring visual acuity, contrast sensitivity, and reading velocity (words/minute). In the experimental group, mean BCVA improved with two rows, which means an improvement in the LogMARLogMAR scale with an average of nine letters. These values tended to be maintained over time. Both groups showed better reading velocities after training, but this parameter has undergone large variability during follow-ups. Contrast sensitivity was also improved and stable. Visual rehabilitation with the Retimax Vision Trainer can improve visual performance in patients with amblyopia after the critical period, an improvement that is maintained in most cases for at least one year after treatment.

Evaluating the Safety and Efficacy of a Novel Glaucoma Drainage Device in High-Risk Adult Glaucoma Patients: A One-Year Pilot Study.

Background: We report on the 12-month safety and efficacy outcomes of a new non-valved glaucoma drainage device, the eyePlate-300 (Rheon Medical, Lausanne, Switzerland), in managing refractory glaucoma. Methods: A retrospective review was conducted on consecutive patients over 18 who underwent glaucoma drainage device (GDD) surgery with the eyePlate-300 after a single glaucoma consultation between February 2020 and April 2021, with at least 12 months of documented post-op follow-up. Results: A total of 16 eyes from 15 patients were included. Complete success was observed in 47% of patients and overall success in 83%. The mean IOP decreased from 31.5 mm Hg to 10.7 mm Hg (67% reduction from baseline), and the number of IOP-lowering drops was reduced from 3.1 to 0.7 at one year. The mean BCVA remained stable. No additional IOP-lowering surgeries were required, and no severe sight-threatening complications were noted. Conclusions: The initial one-year results suggest that the eyePlate could be a safe and effective device for reducing IOP in an ethnically diverse refractory glaucoma population. Further follow-up is necessary to determine the long-term safety and efficacy.

Outcomes of Photorefractive Keratectomy in Patients Who Underwent Keratoplasty

&amp;lt;i&amp;gt;Purpose&amp;lt;/i&amp;gt;: To assess the efficacy of photorefractive keratectomy (PRK) in patients who underwent corneal transplantation, and to determine the influencing factors. &amp;lt;i&amp;gt;Methods&amp;lt;/i&amp;gt;: The present study was a retrospective chart review research that was conducted at Dhahran Eye Specialist Hospital between 2014 and 2017. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: Seventy-nine eyes were included in the study. The mean BCVA showed an improvement of two lines post-PRK as compared to that before PRK (0.73 ± 0.1 and 0.54 ± 0.2, respectively). There was a statistically significant decrease in the cylindrical value postoperatively as compared to that preoperatively (−2.15 ± 1.4 and−3.25 ± 1.8, respectively; p &amp;lt; 0.001). However, there was no statistically significant difference in spherical equivalent and sphere. Three eyes (4%) developed postoperative complications. There was a medium positive correlation between residual stroma and achieved spherical equivalent (SE) (r = 0.305, p = 0.006), as well as between optical zone and postoperative uncorrected visual acuity (r = 0.350, p = 0.001), in addition to post SE (r = 0.307, p = 0.006). However, the depth of ablation showed a medium negative correlation with achieved SE (r = −0.375, p = 0.001). &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: PRK may be an option for correcting refractive errors in patients who underwent keratoplasty. The optical zone and residual stromal thickness have a positive correlation with the effects of the outcomes, whereas the depth of ablation has a negative correlation with the outcomes.

Pro Re Nata brolucizumab for early onset and treatment-naïve diabetic macular edema: A prospective study.

To determine the efficacy and safety of brolucizumab therapy administered on a pro re nata (PRN) basis without loading dose in treatment naïve patients with diabetic macular edema (DME) for 1 year follow-up. Patients with recent DME (<6 months) received a mandatory brolucizumab injection at inclusion and other injections could be given on a PRN basis with an 8-week interval (between injections) at minimum. Rescue therapy with other anti-VEGF was possible in case of incomplete DME resolution after the second brolucizumab with a minimum of 1-month treatment free interval between 2 injections. The primary outcome measure was the change in (BCVA) at 12 months. Secondary outcome measures included the change in central subfield thickness (CST), the change in hard exudate surface area and microaneurysms at 1 year. A total of 53 patients were included. At 12 months, the mean (SD) number of injections was 2.6 (0.8) in addition to the first mandatory injection. The mean (SD) interval between 2 consecutive injections was 3.2 (1.4) months. The mean (SD) BCVA improved from 0.62 (0.1) logMAR to 0.40 (0.16) logMAR (p = 0.012). The mean CST reduced from 397.0 (47.2) µm to 224.5 (28.1) µm (p = 0.013). The hard exudate surface area decreased significantly (p = 0.012) as did microaneurysms (p = 0.02). Seven patients required at least 1 rescue therapy. No patients experienced intra-ocular inflammatory adverse events. Brolucizumab therapy for DME is a safe and effective modality for the treatment of recent DME and has the potential to reduce the number of injections.

Efficacy and Safety of Efdamrofusp Alfa versus Aflibercept in Participants with Neovascular Age-Related Macular Degeneration: A Randomized, Double-Masked, Active-Controlled, Noninferiority, Phase II Trial

PurposeTo evaluate efficacy and safety of efdamrofusp alfa compared with aflibercept in neovascular age-related macular degeneration (nAMD). DesignRandomized, double-masked, multicenter, active-controlled, non-inferiority phase 2 study ParticipantsA total of 231 treatment-naïve and previously treated participants with active choroidal neovascularization secondary to nAMD were enrolled. MethodsEligible participants were randomized (1:1:1) to 2 mg efdamrofusp alfa, 4 mg efdamrofusp alfa or 2 mg aflibercept groups. Participants in all groups received three initial monthly loading doses, followed by treatment every 8 weeks with assessment every 4 weeks up to week 52. Main outcome measuresThe primary endpoint was the mean BCVA change from baseline to week 36. The pre-specified noninferiority margin was set as –5 letters (80% CI). ResultsEach treatment group included 77 participants. The mean BCVA changes from baseline to week 36 for 2 mg efdamrofusp alfa, 4 mg efdamrofusp alfa and aflibercept groups were +10.6, +11.4, +12.0 letters, respectively; Least Squares (LS) mean difference were –1.4 (80% CI: –3.5 to 0.7) between 2 mg efdamrofusp alfa and aflibercept, and –0.6 (80% CI: –2.7 to 1.6) between 4 mg efdamrofusp alfa and aflibercept. Mean central retinal thickness changes were consistent across groups. Adverse event rate was comparable among the groups. ConclusionsEfdamrofusp alfa demonstrated noninferiority to aflibercept in BCVA improvement, accompanied by a similar safety profile.

Effect of baseline fluid localization on visual acuity and prognosis in type 1 macular neovascularization treated with anti-VEGF

PurposeTo assess the prognostic value of subretinal (SRF) and intraretinal fluid (IRF) localizations in type 1 macular neovascularization (MNV) due to age-related macular degeneration (AMD).SubjectsEyes were prospectively treated with anti-vascular epithelial growth factor (anti-VEGF) intravitreal injections (IVT) according to a Pro-Re-Nata (PRN) or Treat and Extend (TAE) regimen during 24 months. A total of 211 eyes with treatment-naïve type 1 MNV secondary to AMD were consecutively included. Eyes were divided between 2 groups according to the fluid localization: presence of SRF alone (SRF group), or presence of IRF associated or not with SRF (IRF ± SRF group).ResultsAt baseline the mean BCVA was 66.2 letters. SRF was present in 94.8% of eyes, IRF in 30.8%, and both in 25.6%. Data were available for 201 eyes at 12 months, and 157 eyes at 24 months. The presence of IRF at baseline was associated with lower baseline BCVA and significantly lower BCVA at 12 months (p < 0.001) and 24 months (p < 0.001). Eyes with SRF alone displayed better visual outcomes (BCVA at month 12, SRF = 74.3 letters, IRF ± SRF = 56.9 letters). In the presence of baseline IRF, fibrosis (p = 0.03) and atrophy (p < 0.001) were more frequently found at 24 months. In a multivariate model, the presence of baseline IRF was significantly associated with lower BCVA at month 12 but not at month 24.ConclusionIn type 1 MNV, the presence of baseline IRF was associated with worse visual outcomes compared to SRF alone, and more frequent atrophy and fibrosis.