Causative Pathogens of Endophthalmitis after Intravitreal Anti-VEGF Injection: An International Multicenter Study

Purpose: The main objective of this study was to investigate the microbiological spectrum of endophthalmitis after anti- VEGF injections and to compare streptococcal with nonstreptococcus- associated cases with regard to baseline characteristics and injection procedure. Methods: Retrospective,international multicenter study of patients with culture-positive endophthalmitis after intravitreal anti-VEGF injection at 17 different retina referral centers. Results: Eighty-three cases with 87 identified pathogens were included. Coagulasenegative staphylococci (59%) and viridans streptococci (15%) were the most frequent pathogens found. The use of postoperative antibiotics and performance of injections in an operating room setting significantly reduced the rate of streptococcus-induced endophthalmitis cases (p = 0.01 for both). Conclusion: We found a statistically significant lower rate of postinjectional local antibiotic therapy and operating room-based procedures among the streptococcus-induced cases compared to cases caused by other organisms

The Classification of Common Macular Diseases Using Deep Learning on Optical Coherence Tomography Images with and without Prior Automated Segmentation

We compared the performance of deep learning (DL) in the classification of optical coherence tomography (OCT) images of macular diseases between automated classification alone and in combination with automated segmentation. OCT images were collected from patients with neovascular age-related macular degeneration, polypoidal choroidal vasculopathy, diabetic macular edema, retinal vein occlusion, cystoid macular edema in Irvine-Gass syndrome, and other macular diseases, along with the normal fellow eyes. A total of 14,327 OCT images were used to train DL models. Three experiments were conducted: classification alone (CA), use of automated segmentation of the OCT images by RelayNet, and the graph-cut technique before the classification (combination method 1 (CM1) and 2 (CM2), respectively). For validation of classification of the macular diseases, the sensitivity, specificity, and accuracy of CA were found at 62.55%, 95.16%, and 93.14%, respectively, whereas the sensitivity, specificity, and accuracy of CM1 were found at 72.90%, 96.20%, and 93.92%, respectively, and of CM2 at 71.36%, 96.42%, and 94.80%, respectively. The accuracy of CM2 was statistically higher than that of CA (p = 0.05878). All three methods achieved AUC at 97%. Applying DL for segmentation of OCT images prior to classification of the images by another DL model may improve the performance of the classification

Causative Pathogens of Endophthalmitis after Intravitreal Anti-VEGF Injection: An International Multicenter Study

Purpose: The main objective of this study was to investigate the microbiological spectrum of endophthalmitis after anti- VEGF injections and to compare streptococcal with nonstreptococcus- associated cases with regard to baseline characteristics and injection procedure. Methods: Retrospective,international multicenter study of patients with culture-positive endophthalmitis after intravitreal anti-VEGF injection at 17 different retina referral centers. Results: Eighty-three cases with 87 identified pathogens were included. Coagulasenegative staphylococci (59%) and viridans streptococci (15%) were the most frequent pathogens found. The use of postoperative antibiotics and performance of injections in an operating room setting significantly reduced the rate of streptococcus-induced endophthalmitis cases (p = 0.01 for both). Conclusion: We found a statistically significant lower rate of postinjectional local antibiotic therapy and operating room-based procedures among the streptococcus-induced cases compared to cases caused by other organisms

Causative Pathogens of Endophthalmitis after Intravitreal Anti-VEGF Injection: An International Multicenter Study

Purpose: The main objective of this study was to investigate the microbiological spectrum of endophthalmitis after anti- VEGF injections and to compare streptococcal with nonstreptococcus- associated cases with regard to baseline characteristics and injection procedure. Methods: Retrospective,international multicenter study of patients with culture-positive endophthalmitis after intravitreal anti-VEGF injection at 17 different retina referral centers. Results: Eighty-three cases with 87 identified pathogens were included. Coagulasenegative staphylococci (59%) and viridans streptococci (15%) were the most frequent pathogens found. The use of postoperative antibiotics and performance of injections in an operating room setting significantly reduced the rate of streptococcus-induced endophthalmitis cases (p = 0.01 for both). Conclusion: We found a statistically significant lower rate of postinjectional local antibiotic therapy and operating room-based procedures among the streptococcus-induced cases compared to cases caused by other organisms

Subclinical subretinal fluid detectable only by optical coherence tomography in choroidal naevi-the SON study

Background Subretinal fluid is a risk factor for growth and malignant transformation of choroidal naevi, however it is unclear if this applies to subclinical fluid that is only detectable by optical coherence tomography (OCT). The objective of this study was to determine the prevalence and associations of subclinical but OCT-detectable subretinal fluid over choroidal naevi. Methods Cross-sectional study of 309 consecutive cases of choroidal naevi imaged by OCT between July 2017 to January 2019. Multicentre international study involving ten retinal specialist centres. All patients presenting to retinal specialists had routine clinical examination and OCT imaging. The prevalence of subclinical OCT-detectable subretinal fluid over choroidal naevi and its associations with other features known to predict growth and malignant transformation were noted and analysed. Results Of 309 identified consecutive cases, the mean patient age was 65 years, 89.3% of patients were Caucasian and 3.9% were Asian. The prevalence of subclinical but OCT-detectable subretinal fluid associated with choroidal naevi was 11.7% (36/309). Naevi with fluid were associated with larger basal diameters, greater thickness, presence of a halo, orange pigmentation, hyperautofluorescence, and hypodensity on B-scan ultrasonography. Conclusion and relevance Of choroidal naevi where subretinal fluid is not visible on clinical examination, 11.7% demonstrate subretinal fluid on OCT scans. These naevi more commonly exhibit features known to be associated with growth and transformation to melanoma. The presence of subclinical OCT-detectable fluid over choroidal naevi may assist in their risk stratification