Timothy Hamann

Background/Objectives: To assess the acceptance of, attitudes towards, and concerns regarding allogeneic serum eye drops (Allo-SEDs) among patients treated with autologous serum eye drops (ASEDs). Methods: We conducted this investigator-initiated, cross-sectional, single-center survey at the Department of Ophthalmology, University Hospital Zurich, Switzerland. We consecutively recruited all patients using ASEDs during routine visits, who anonymously completed a 9-item questionnaire comprising eight 11-point Likert-scale items and one open numerical item on the daily application frequency. We assessed perceived ASED effectiveness, willingness to switch to Allo-SEDs under different scenarios, and concerns regarding safety, efficacy, and immunological risks. Results: Of 202 eligible patients, 107 returned the questionnaire (53.0%). The full eligible cohort had a median (IQR) age of 63.5 (49.2–75.0) years and a median ASED treatment duration of 4.0 (1.0–8.0) years. They rated ASEDs as highly effective (median 9, IQR 8.2–10.0) and applied them a median of 7 (5–10.5) times daily. Willingness to switch was low without clinical need (median 3, IQR 0–6; p = 1.0), increased when autologous production was no longer feasible (median 7, IQR 5–9; p < 0.001), and was intermediate for general openness (median 5, IQR 2–8; p = 0.7). Concerns regarding infectious disease transmission, immunological reactions, and therapeutic efficacy correlated with lower willingness to switch (all r = −0.29 to −0.46). Daily application frequency did not correlate with acceptance. Conclusions: Patients were highly satisfied with ASEDs but were reluctant to switch to Allo-SEDs unless autologous production was no longer feasible. Among the domains assessed, concerns regarding infection, immunological reactions, and efficacy were the main barriers to acceptance, supporting targeted patient education.

Background: Fabry disease (FD) is a potentially lethal lysosomal disorder with systemic vascular changes. Previous studies demonstrated retinal vascular involvement using optical coherence tomography angiography (OCTA) in affected patients; Aim: To analyze and quantify the retinal vasculature measuring vessel density (VD), vessel length density (VLD), and the ratio of VD to VLD (VD/VLD) in superficial capillary plexuses (SCP) and deep capillary plexuses (DCP) using OCTA in patients with FD and to show whether they differ from healthy controls (HC); Patients and methods: Single-center, retrospective, consecutive cohort study of patients with genetically proven FD. Patients underwent an ophthalmological examination including OCTA. VD, VLD, foveal avascular zone (FAZ), and the VD/VLD were compared to an HC group using a linear mixed model; Results: A statistically significant difference in the VLD and VD/VLD of DCP was observed between the two groups (p < 0.001). Using ROC curves with AUC and Youden’s Index, a cut-off value for differentiating both groups using VD/VLD in DCP FD with high specificity and high sensitivity was established; Conclusions: FD and HC groups seem to be separable using the VD/VLD ratio in DCP. This new biomarker might differentiate changes in the retinal microvasculature that are not detectable by VD or VLD alone.

Background: During the first COVID-19 pandemic outbreak, a new triage concept had to be implemented for patients with retinal diseases having a scheduled appointment at the medical retina clinic. In this study, we aimed to assess patients’ confidence in this triage concept and patients’ satisfaction regarding the received treatment during the outbreak. Methods: This retrospective study included all patients with a diagnosed retinal disease, triaged into three priority groups based on their condition’s urgency during lockdown. After restrictions were eased, a subset of previously triaged patients was interviewed to assess their confidence in the triage and their satisfaction regarding the received treatment during the pandemic. Results: In total, 743 patients were triaged during the lockdown. Over 80% received an urgent appointment (priority 1). Among all priority 1 patients, over 84% attended their appointment and 77% received an intravitreal injection (IVI), while 7% cancelled their appointment due to COVID-19. In post-lockdown interviews of 254 patients, 90% trusted the emergency regimen and received treatment. Conclusions: Our triage seemed to be useful in optimizing access to treatment for patients with retinal diseases. An excellent rating of patients’ confidence in the triage and satisfaction regarding the received treatment during the first COVID-19 outbreak could be achieved.

Background: To date, there are no studies associating the dried blood spot (DBS) levels of globotrioasylsphingosine (lysoGb3) with quantitative optical coherence tomography angiography (OCTA) parameters in Fabry disease (FD) patients. Here, we aimed to investigate the association between OCTA vessel density (VD), vessel length density (VLD) with DBS lysoGb3. Methods: A retrospective, single center analysis of all consecutive FD patients enrolled at the Department of Ophthalmology of the University Hospital of Zurich from 1 December 2017 to 9 September 2020. An association between VD and VLD detected by OCTA and lysoGb3 was investigated using a linear mixed model. Results: A total of 57 FD patients (23 male, 34 female; 109 eyes) were included. Forty-one patients suffered from the classic phenotype and 16 from the later-onset phenotype. LysoGb3 inversely correlated with VD and VLD in both the superficial (VD: p = 0.034; VLD: p = 0.02) and deep capillary plexus (VD: p = 0.017; VLD: p = 0.018) in the overall FD cohort. Conclusions: Our study shows an association between lysoGb3 and OCTA VD and VLD. This supports the hypothesis that quantitative OCTA parameters might be useful as diagnostic biomarkers for evaluating systemic involvement in FD, and possibly other diseases.