Baltaj S. Sandhur

Purpose: The objective of this study was to report the clinical features, microbiologic profile, treatments, and outcomes of culture-proven endophthalmitis following penetrating keratoplasty (PKP) in a contemporary cohort. Methods: A retrospective chart review of all patients with culture-proven endophthalmitis following PKP between January 2017 and July 2025 was conducted. Patients with endophthalmitis from endothelial keratoplasty, trauma, or other surgery were excluded. Results: Ten eyes of 10 patients met inclusion criteria. The mean age was 74 ± 3 years, and 70% were female. Indications for PKP were diverse, including 5 optical grafts for Fuchs dystrophy, keratoconus, and corneal edema and 4 therapeutic grafts. Initial visual acuity was hand motion on average. Hypopyon was present in 60%, vitritis in 80%, and suture abscesses in 30%. Initial management was intravitreal aspiration, with intravitreal injection of antimicrobials in 90% and primary pars plana vitrectomy in 10% of eyes. A pars plana vitrectomy for endophthalmitis was performed 1 to 5 days later in an additional 5 of 10 eyes (50%): 3 of 5 for debulking of the vitreous and 2 of 5 because of retinal detachments. Vitreous cultures were positive in all cases, with Candida in 40% isolates, Streptococcus sp. in 20%, Staphylococcus aureus in 10%, Staphylococcus epidermidis in 10%, Enterococcus in 10%, and Pseudomonas in 10%. Despite prompt treatment, visual acuity at the last follow-up was poor at <5/200; however, no eyes were eviscerated or enucleated. Conclusions: Endophthalmitis after PKP is an uncommon but devastating complication. In this series, fungal pathogens accounted for a substantial proportion of cases. Management was individualized, but outcomes were generally poor.

Purpose: To evaluate the efficacy and safety of adjunctive intravitreal anti-vascular endothelial growth factor (VEGF) therapy combined with standard ablative treatment in Coats disease. Methods: A search of PubMed, Embase, and SCOPUS was conducted to identify studies comparing ablative therapy alone versus ablative therapy with anti-VEGF for Coats disease. Five studies (136 eyes treated with ablation alone and 82 with combination therapy) were included. Data on treatment sessions, quiescence, visual acuity (VA) and tractional retinal detachment (TRD) were extracted. Results: Adjunctive anti-VEGF significantly reduced the treatment sessions required to achieve quiescence (Mean difference [MD] 0.47 sessions, 95% confidence interval [CI] 0.10-0.85, p = 0.01). No significant difference was found in anatomic outcomes with both groups having a similar number of eyes which resulted in phthisis. No significant difference was found in the BCVA at final follow up (MD = 0.20, 95% CI -0.20 to 0.59, p = 0.33) without significant heterogeneity (I ² =23%, p = 0.28). Eyes with adjunctive anti-VEGF were not found to be associated with a significantly higher risk of TRD (RR 2.64, 95% CI 0.34-20.30, p = 0.35). Due to the retrospective design of the included studies, the overall grade of evidence was deemed low. Conclusions: Adjunctive anti-VEGF therapy may reduce the total treatment burden while achieving similar anatomical and functional outcomes. In addition, there appears to be no significant increase in the risk of TRD. Judicious use of anti-VEGF may be a useful therapy to consider in patients with Coats disease requiring ablative therapy.

Individual differences in smoking reinforcement and cue-specific cigarette craving are theorized to influence smoking cessation and relapse. However, there has been little laboratory research that prospectively evaluates these relationships. The present study evaluated whether lab-based indices of pretreatment smoking reinforcement and cue-specific craving predicted subsequent bio-verified abstinence. Participants were 253 adults (aged 28-70, 54% female, 78% White, 3% Hispanic) who reported smoking more than five cigarettes per day when enrolled in a randomized, double-blind, placebo-controlled smoking cessation trial (NCT03262662). During a lab visit ∼1 week before treatment began, participants completed the Choice Behavior under Cued Conditions task. On each of the 36 Choice Behavior under Cued Conditions trials, participants spent between $0.01 and $0.25 for a chance (5%-95%) to sample a cigarette or a cup of water. All participants received varenicline, either during Weeks 1-15 or 4-15 of the study, along with counseling at each visit, and attempted to quit smoking at the end of Week 4. Cotinine-bio-verified (< 15 ng/mL) 7-day point-prevalence abstinence was assessed at Weeks 6, 8, 15, and 28. The predictive validity of pretreatment smoking reinforcement and cue-specific craving on abstinence were examined in logistic regressions. As predicted, greater pretreatment smoking reinforcement predicted lower odds of abstinence, an effect that did not vary significantly across time, treatment groups, or biological sex. Pretreatment cue-specific craving was not predictive of abstinence. This study highlights the theoretical importance of smoking reinforcement and the predictive utility of Choice Behavior under Cued Conditions in identifying those at risk for relapse. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Slow-coagulation continuous wave cyclophotocoagulation (SC-CWCPC) is a promising treatment option for refractory glaucoma. However, its efficacy following a failed MicroPulse transscleral cyclophotocoagulation (MP-TSCPC) procedure remains unexplored. This study evaluates the efficacy of SC-CWCPC in patients with uncontrolled intraocular pressure (IOP) after undergoing MP-TSCPC. A retrospective case series of patients with uncontrolled glaucoma who underwent SC-CWCPC following MP-TSCPC failure was conducted. All procedures were performed by a single glaucoma surgeon between January 2022 And October 2024. Patients with < 3 months follow-up were excluded. SC-CWCPC was performed using 1250-milliwatt power and 4-second applications. Surgical success was defined as IOP between 6 and 21 mmHg with a ≥ 20% reduction from baseline on topical medication, no incisional reoperation for glaucoma, and no loss of light perception vision. Eight patients (10 eyes) with a mean age of 43.75 ± 24.59 years were included. 90% (9/10) had prior Tube/Trabeculectomy procedures. Mean preoperative IOP was 26.10 ± 15.80 mmHg on 3.1 ± 1.20 antiglaucoma medications (AGM). At a mean follow up time of 10.97 ± 3.42 months, IOP decreased to 15.80 ± 5.31 mmHg ( p = 0.002) with 2.30 ± 1.49 AGM ( p = 0.070) with an overall success rate of 80%. One eye required Ahmed Glaucoma Valve implantation one year postoperatively while another had prolonged inflammation that resolved medically. No cases of persistent hypotony or significant visual acuity loss occurred. SC-CWCPC is an effective and safe surgical intervention in patients with refractory glaucoma following failed MP-TSCPC. The results of our study are helpful in expanding the role of the SC-CWCPC technique in the management of glaucomatous patients.

In light of the potential effects of spaceflight on the anterior segment of the eye, there is a pressing need for anterior segment imaging to be available and accessible to monitor astronauts’ ocular health, including alterations to the cornea and lens. We aim to highlight the clinical basis and need for anterior segment imaging for astronauts. We explore the impacts of spaceflight-associated hazards, including microgravity and radiation, on astronauts’ risk of developing anterior segment pathology including risk of ocular trauma, infection, dry eye symptoms, cataracts, and possibly additional pathologies from increased radiation exposure. Such risks highlight the potential value that longitudinal assessment of anterior ocular structures would offer in future spaceflight missions. Specifically, anterior segment imaging would enable evaluations of corneal morphology, including longitudinal monitoring for microgravity-induced changes, and evaluation of interventions that aim to preserve anterior segment health during spaceflight. Lastly, non-invasive anterior segment imaging allows for unique insights into astronaut ocular health and can be performed routinely through modalities such as anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM). We discuss these modalities and their implications for astronaut health during future spaceflight.