David M. Wu

Purpose: To highlight the clinical utility of ultra-widefield swept-source optical coherence tomography angiography (SS-OCTA) in evaluating diabetic retinopathy (DR), particularly focusing on its ability to detect peripheral ischemia and neovascularization. Methods : Eyes of 5 participants with varying severity of DR were imaged with expanded-field 12 × 12-mm SS-OCTA scans and ultra-widefield SS-OCTA montages. Montages were created by stitching five 21 × 26-mm scans, offering up to a 200° field of view. Cases were assessed for areas of nonperfusion, intraretinal microvascular abnormalities, and neovascularization extending beyond the posterior pole. Results : Ultra-widefield SS-OCTA imaging demonstrated progressive mid-peripheral and peripheral nonperfusion, intraretinal microvascular abnormalities, and neovascularization in association with increasing DR severity. Peripheral nonperfusion and neovascular changes were detected beyond the scope of standard 12 × 12-mm scan areas. Conclusions : Ultra-widefield SS-OCTA is effective in noninvasively detecting peripheral retinal lesions such as ischemia and neovascularization. This technology offers potential to refine DR staging, improve risk stratification, and guide earlier clinical interventions.

Purpose: To evaluate B-scan echographic features of endophthalmitis for their correlation with disease characteristics and long-term vision outcomes. Methods: Patients diagnosed with endophthalmitis at Massachusetts Eye and Ear between 2011 and 2021 were recruited (N = 209). Data included demographics, infection source, initial therapy, and findings from culture isolates, best-corrected visual acuity (BCVA), slit lamp, and B-scan ultrasonography. Results: More patients with positive microbial cultures, vs those with negative cultures, had dense vitreous debris on initial B-scan ( P = .008). Patients whose initial slit lamp examination provided difficult/no view into the anterior chamber had more frequent findings of retinal detachment (RD) and T-sign ( P < .001 and P = .016, respectively) and worse final mean BCVA ( P < .001) vs patients with adequate views. Patients with dense vitreous opacities on initial B-scan had significantly worse initial mean BCVA vs patients with mild or moderate vitreous opacities ( P < .001 and P = .013, respectively) and had significantly worse final mean BCVA vs patients with mild vitreous opacities ( P < .001). Final mean BCVA was significantly worse in patients with choroidal detachment, RD, or T-sign than in patients without these features (each P < .001). Reductions in vitreous opacities and vitreous membranes were observed at 1 month postpresentation, whereas choroidal detachment was significantly more common at 1 week and RD more common at 1 month postpresentation. Conclusions: Positive cultures, specific microbial species, and B-scan findings (dense vitreous opacities, choroidal detachment, RD, and T-sign) are independent predictors of worse vision outcomes in patients with endophthalmitis.

Background: Best-corrected visual acuity (BCVA) is the current gold standard of retinal function measurement but is not affected in early and intermediate forms of age-related macular degeneration (AMD). Increasing evidence suggests that microperimetry is a sensitive measure of visual function. This study sought to analyze the associations between plasma and urine metabolites and microperimetry in AMD. Methods: We included data on 363 eyes (95 controls, 268 AMD). Microperimetry was performed in patients with or without AMD using the Macular Integrity Assessment (MAIA) microperimetry system, employing a 37-point full-threshold protocol. Plasma and urine samples were analyzed via ultra-high-performance liquid chromatography–mass spectrometry. Multilevel mixed-effects linear models were used to assess associations between the metabolites and retinal sensitivity. Statistical significance was determined by considering the number of independent tests that accounted for 80% of the variance (ENT80). Results: We identified two plasma and seven urine metabolites, which were significantly associated with mean retinal sensitivity in AMD, and the key results include metabolites in the lysine metabolism pathway. Conclusions: To our knowledge, we present the first assessment of the associations between plasma and urinary metabolites and retinal microperimetry sensitivity in AMD. This work can reveal more insight into the pathogenesis of AMD.

Purpose: To describe a case of a drusenoid pigment epithelial detachment that resolved after retinal detachment (RD) repair using multimodal imaging. Methods: A single case was evaluated. Results: An 83-year-old woman with intermediate age-related macular degeneration had repair of a rhegmatogenous RD with subsequent resolution of macular drusen and improved visual acuity and metamorphopsia. Conclusions: RD repair may be associated with resolution of drusen, leading to improved functional outcomes.

Medication samples of anti-VEGF agents can represent a good option for retina specialists to provide timely treatment for newly converted neovascular age-related macular degeneration (nvAMD) while ...

This article describes two cases of delayed-onset Cutibacterium acnes (C acnes) endophthalmitis 1 month after cataract surgery manifesting with unusual epiretinal deposits. Both patients were referred for persistent inflammation after cataract surgery. After failing to respond to a vitreous tap with injection of antibiotics, the patients underwent pars plana vitrectomy and in one of the cases partial posterior capsulectomy for a posterior capsular plaque. Intraoperatively, both cases were found to have unusual multifocal epiretinal deposits. The clinical presentations described here represent a highly unique manifestation of C acnes endophthalmitis distinct from the classic anterior segment findings. [Ophthalmic Surg Lasers Imaging Retina. 2022;53:164–167.]