Combination Therapy for Diabetic Macular Edema

Diabetic macular edema is a main reason for visual loss in diabetic patients. Until recent years, macular laser photocoagulation was the only available therapy. The awareness that inflammation is an important factor in the pathogenetic process of DME gave reason for intravitreal treatment with corticosteroids. The introduction of anti-VEGF drugs brought a revolutionary change in the treatment of DME. This paper will review the important clinical trials with an emphasis on combination therapies

A Review of Innovations in Rhegmatogenous Retinal Detachment Surgical Techniques.

Rhegmatogenous retinal detachment (RRD) requires surgical intervention for its repair. There are variable techniques used for this purpose, and they are all being continuously refined. In this review, we detail the recent innovations in surgical management of RRD and proliferative vitreoretinopathy (PVR)

Macular Hole following Intravitreal Bevacizumab Injection in Choroidal Neovascularization Caused by Age-Related Macular Degeneration

This report describes formation of a full-thickness macular hole subsequent to an injection of bevacizumab for the treatment of neovascular AMD. This complication may be caused by focal tractional forces on the retinal surface due to either vitreous incarceration at the injection site or contraction of the choroidal neovascularization membrane. Alternatively, it may be due to a toxic effect of bevacizumab on a previously compromised retina

Macular Hole Surgery with Internal Limiting Membrane Peeling Facilitated by Membrane-Blue® versus Membrane-Blue-Dual®: A Retrospective Comparative Study

Background. This study aims to compare the outcome of macular hole (MH) surgery with internal limiting membrane (ILM) peeling facilitated by two different vital dyes. Methods. This was a retrospective chart review. The group designated “group-MB” underwent pars plana vitrectomy with ILM peeling facilitated by Membrane-Blue (MB), whereas in “group-MBD,” the vital dye used was Membrane-Blue-Dual (MBD). Results. Seventy-four eyes comprised the study population: 53 in group-MB and 21 in group-MBD. There was no difference in the rate of macular hole closure in group-MB or group-MBD: 71.2% closed MHs compared to 66.7%, respectively (p=0.7). Postoperative visual improvement was of a higher magnitude in the MBD group compared to the MB group: −0.34±0.81 logMAR versus 0.01±0.06 logMAR, respectively (p=0.003). Conclusions. In this study, MBD led to better visual results that may be related to better staining characteristics or lesser toxicity compared to MB

The ideal intravitreal injection setting: office, ambulatory surgery room or operating theatre? A narrative review and international survey

PurposeThis study reviews evidence and provides recommendations for the ideal setting of intravitreal injection (IVI) administration of vascular endothelial growth factor (VEGF) inhibitors.MethodsA multi-step approach was employed, including content analysis of regulations and guidelines, a systematic literature review, and an international survey assessing perioperative complications and endophthalmitis incidence in relation to injection settings. The literature review searched PubMed and Cochrane databases from 2006 to 2022, focusing on studies reporting correlations between complications and treatment settings. The survey utilized a web-based questionnaire distributed to clinical sites and the international ophthalmic community, with data managed using electronic capture tools.ResultsWe reviewed regulations and guidelines from 23 countries across five continents, finding significant variation in IVI administration settings. In most countries, IVI is primarily administered in outpatient clean rooms (96%) or offices (39%), while in others, it is restricted to ambulatory surgery rooms or hospital-based operating theatres (4%). The literature review found that endophthalmitis risk after IVI is generally low (0.01% to 0.26% per procedure), with no significant difference between office-based and operating room settings. The international survey (20 centers, 96,624 anti-VEGF injections) found low overall incidences of severe perioperative systemic adverse events and endophthalmitis, independent of injection settings.ConclusionNo significant differences in perioperative complications were observed among various settings, including operating theatres, ambulatory surgery rooms, offices, hospitals, or extra-hospital environments. Choosing the appropriate clinical setting can optimize patient management, potentially increasing effectiveness, quality, productivity, and capacity

Effect of Baseline Subretinal Fluid on Treatment Outcomes in VIVID-DME and VISTA-DME Studies

Purpose To evaluate the effect of baseline subretinal fluid (SRF) on treatment outcomes with intravitreal aflibercept injection (IAI) versus laser treatment in patients with diabetic macular edema (DME) in the VIVID and VISTA studies. Design Post hoc analysis of 2 randomized controlled trials. Participants Eight hundred seventy-two patients with DME. Methods We randomized patients to receive IAI 2 mg every 4 weeks (2q4), IAI 2 mg every 8 weeks after 5 monthly doses (2q8), or laser. Main Outcome Measures Effect of presence or absence of baseline SRF on visual outcomes in the integrated dataset at weeks 52 and 100. Results Mean best-corrected visual acuity (BCVA) gains in the 2q4, 2q8, and laser arms at week 52 were +14.5, +11.0, and –2.3 letters, respectively, (those with baseline SRF) and +10.3, +10.6, and +2.5 letters, respectively, (those without). At week 100, mean gains were +13.5, +10.9, and −2.3 letters (those with baseline SRF) and +10.6, +10.0, and +2.7 letters (those without). The treatment effect for IAI versus laser from baseline to week 52 of 100 was greater for patients with baseline SRF versus those without (nominal P Conclusions This post hoc analysis demonstrated the visual outcome benefits of IAI over laser, regardless of baseline SRF status. A greater treatment effect of IAI was observed in patients with baseline SRF versus those without; however, no meaningful impact of baseline SRF status on treatment outcomes with IAI was demonstrated, indicating that the differential effects of laser might have been the driving force behind the different treatment outcomes in both groups

Terms non-exudative and non-neovascular: awaiting entry at the doors of AMD reclassification

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Artistic Practices: social interactions and cultural dynamics

This is the final version of the article. Available from the publisher via the link in this record.Book Review of: Zembylas, T. (Ed.). (2014). Artistic Practices: social interactions and cultural dynamics. Routledg