Postinjection Endophthalmitis in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT)

To describe the incidence and outcomes of endophthalmitis after intravitreal injections of anti-VEGF agents in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT) and to assess the effect of use of prophylactic topical antimicrobials on incidence

Treatment of Postcataract Extraction Endophthalmitis A Summary of the Results From the Endophthalmitis Vitrectomy Study

The articles that follow are part of an ongoing series that aims to review collaborative prospective studies supported by the National Eye Institute. The first article, written by investigators, will remind readers of the rationale, goals, methods, findings, and recommendations. The second article, written by an expert who did not participate in the investigations, will offer a constructive critique and attempt to estimate the impact of the study on the practice of ophthalmology

Endogenous Aspergillus Endophthalmitis in Drug Abusers

• One of two cases of endogenous Aspergillus endophthalmitis in abusers of intravenously administered drugs was treated successfully by subtotal pars plana vitrectomy; amphotericin B administered by intravitreal, periocular, and systemic routes; and flucytosine administered systemically. Aspergillus sp should be considered a possible pathogenic organism in drug abusers with endogenous endophthalmitis. An aggressive diagnostic and therapeutic approach may result in preservation of useful vision

Postinjection Endophthalmitis in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT)

To describe the incidence and outcomes of endophthalmitis after intravitreal injections of anti-VEGF agents in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT) and to assess the effect of use of prophylactic topical antimicrobials on incidence

Subretinal Hyperreflective Material in the Comparison of Age-Related Macular Degeneration Treatments Trials

PurposeTo evaluate the association of subretinal hyperreflective material (SHRM) with visual acuity (VA), geographic atrophy (GA), and scar in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT).DesignProspective cohort study within a randomized clinical trial.ParticipantsThe 1185 CATT participants.MethodsMasked readers graded scar and GA on fundus photography and fluorescein angiography and graded SHRM on time-domain and spectral-domain (SD) optical coherence tomography (OCT) throughout 104 weeks. Measurements of SHRM height and width in the fovea, within the center 1 mm(2), or outside the center 1mm(2) were obtained on SD OCT images at 56 (n = 76) and 104 (n = 66) weeks.Main outcome measuresPresence of SHRM, as well as location and size, and associations with VA, scar, and GA.ResultsAmong CATT participants, the percentage with SHRM at enrollment was 77%, decreasing to 68% at 4 weeks after treatment and to 54% at 104 weeks. At 104 weeks, scar was present more often in eyes with persistent SHRM than in eyes with SHRM that resolved (64% vs. 31%; P < 0.0001). Among eyes with detailed evaluation of SHRM at weeks 56 (n = 76) and 104 (n = 66), mean VA letter score was 73.5 (standard error [SE], 2.8), 73.1 (SE, 3.4), 65.3 (SE, 3.5), and 63.9 (SE, 3.7) when SHRM was absent, present outside the central 1 mm(2), present within the central 1 mm(2) but not the foveal center, or present at the foveal center (P = 0.02), respectively. When SHRM was present, the median maximum height under the fovea, within the central 1 mm(2) including the fovea and anywhere within the scan, was 86 μm, 120 μm, and 122 μm, respectively. Visual acuity was decreased with greater SHRM height and width (P < 0.05).ConclusionsIn eyes with neovascular age-related macular degeneration (AMD), SHRM is common and often persists after anti-vascular endothelial growth factor treatment. At 2 years, eyes with scar were more likely to have SHRM than other eyes. Greater SHRM dimensions were associated with worse VA. In eyes with neovascular AMD, SHRM is an important morphologic biomarker