NVision Eye Centers (United States)

To assess the 12-month outcomes in subjects developing macular neovascularization (MNV) during intravitreal avacincaptad pegol (IVA) treatment for geographic atrophy (GA) secondary to age-related macular degeneration (AMD). This research was conducted as a case-controlled, retrospective study of AMD subjects undergoing IVA treatment for GA from two private practice institutions. Subjects were divided into 1) a Study Group of patients who developed MNV and then underwent anti-vascular endothelial growth factor (VEGF) therapy during the study period, and 2) a Control Group of patients who were complication-free during the study period. Both cohorts had a baseline Snellen visual acuity of ≥ 20/200, a baseline GA total area of ≥ 1 mm2and ≤ 17.5 mm2, and 12 months of follow-up after initiation of IVA for GA. There were 56 patients analyzed. There were no significant differences in baseline features between cohorts. The Study Group had a greater decrease in visual acuity [-0.22 logMAR (-0.27 to -0.17) versus -0.06 logMAR (-0.12 to 0.00); p=<0.0001], and greater GA total lesion growth [1.78 mm2 (1.53-2.03) versus 0.78 mm2 (0.54-1.02); p=<0.0001] during the 12-month study period compared to the Control Group. Patients developing MNV while undergoing IVA treatment for GA secondary to AMD have worse clinical outcomes despite undergoing anti-VEGF therapy compared to patients who were complication-free at 12-months. This highlights the seriousness of MNV in this patient population and may help specialists counsel patients when considering treatment for GA secondary to AMD.

Diffractive trifocal intraocular lenses (IOLs) provide good vision at distance, intermediate, and near, but can also cause positive dysphotopsias. This meta-analysis pooled published evidence on visual disturbances after bilateral implantation of the PanOptix (TFNTXX) IOL for patients undergoing cataract surgery. A systematic literature search was conducted in PubMed and congress presentations from April 2021 to December 2022 to identify studies with patient-reported outcomes on the incidence of visual disturbances (starbursts, halos, glare) post bilateral implantation of PanOptix IOL during cataract surgery. Random-effects meta-analysis was performed to generate pooled proportions for patient-reported visual disturbances with a 95% confidence interval [CI]. Eleven unique studies were included, spanning 580 patients with bilateral implantation of PanOptix IOL from 10 countries with 1 to 12months follow-up. In summary, 33.6% of patients with bilateral PanOptix implantation experienced glare, 43.9% experienced halos, and 30.4% experienced starbursts. Among these patients, small percentages reported severe glare (2.9%), severe halos (5.4%), and severe starbursts (3.4%). Only 0.8%, 1.4%, and 2.6% of patients found glare, halos, and starbursts, respectively, to be very bothersome. Halos are the most frequently reported visual disturbances. However, the likelihood of experiencing severe and/or very bothersome visual disturbances (halos, glare, starbursts) is approximately 5% and 3%, respectively, after bilateral implantation of PanOptix IOL. These findings should inform clinical decision-making and treatment choices when selecting the most appropriate IOL implant for cataract surgery.

The relationship between amyloidosis and vasculature in cognitive impairment and Alzheimer’s disease (AD) pathogenesis is increasingly acknowledged. We conducted a quantitative and topographic assessment of retinal perivascular amyloid plaque (AP) distribution in individuals with both normal and impaired cognition. Using a retrospective dataset of scanning laser ophthalmoscopy fluorescence images from twenty-eight subjects with varying cognitive states, we developed a novel image processing method to examine retinal peri-arteriolar and peri-venular curcumin-positive AP burden. We further correlated retinal perivascular amyloidosis with neuroimaging measures and neurocognitive scores. Our study unveiled that peri-arteriolar AP counts surpassed peri-venular counts throughout the entire cohort (P < 0.0001), irrespective of the primary, secondary, or tertiary vascular branch location, with a notable increase among cognitively impaired individuals. Moreover, secondary branch peri-venular AP count was elevated in the cognitively impaired (P < 0.01). Significantly, peri-venular AP count, particularly in secondary and tertiary venules, exhibited a strong correlation with clinical dementia rating, Montreal cognitive assessment score, hippocampal volume, and white matter hyperintensity count. In conclusion, our exploratory analysis detected greater peri-arteriolar versus peri-venular amyloidosis and a marked elevation of amyloid deposition in secondary branch peri-venular regions among cognitively impaired subjects. These findings underscore the potential feasibility of retinal perivascular amyloid imaging in predicting cognitive decline and AD progression. Larger longitudinal studies encompassing diverse populations and AD-biomarker confirmation are warranted to delineate the temporal-spatial dynamics of retinal perivascular amyloid deposition in cognitive impairment and the AD continuum.

Glaucoma is one of the main causes of irreversible visual field loss and blindness worldwide. Vision loss in this multifactorial neurodegenerative disease results from progressive degeneration of retinal ganglion cells (RGCs) and their axons. Identifying molecular markers that can be measured objectively and quantitatively may provide essential insights into glaucoma diagnosis and enhance pathophysiology understanding. The chronic, progressive DBA/2J glaucomatous mouse model of glaucoma and C57BL6/J optic nerve crush (ONC) mouse model were used in this study. Changes in PVALB expression with RGC and optic nerve degeneration were assessed via gene expression microarray analysis, quantitative real-time polymerase chain reaction (qRT-PCR), Western blot and immunohistochemistry. Microarray analysis of the retinal gene expression in the DBA/2J mice at different ages showed that the expression of PVALB was downregulated as the mice aged and developed glaucoma with retinal ganglion cell loss. Analysis of qRT-PCR results demonstrated PVALB at the mRNA level was reduced in the retinas and optic nerves of old DBA/2J mice and in those after ONC compared to baseline young DBA2/J mice. PVALB protein expression measured by Western blot was also significantly reduced signal in the retinas and optic nerves of old DBA/2J mice and those eyes with crushed nerves. Immunohistochemical staining results demonstrated that there were fewer PVALB-positive cells in the ganglion cell layer (GCL) of the retina and staining pattern changed in the optic nerve from old DBA/2J mice as well as in mice eyes following ONC. PVALB is abundantly expressed both by RGCs' soma in the retinas and RGCs' axons in the optic nerves of C57BL/6J. Furthermore, the expression level of PVALB decreases with RGC degeneration in the glaucomatous DBA/2J mice and after ONC injury of C57BL6/6J, indicating that PVALB is a reliable RGC molecular marker that can be used to study retinal and optic nerve degeneration.

ABSTRACTTikTok has recently emerged as a rapidly growing global phenomenon that is becoming popular among medical professionals and patients alike. The use of other social media platforms such as Instagram and Twitter by ophthalmologists is well-documented, but the prevalence of ophthalmologists on TikTok is not well understood. We sought to analyze the scope of popular ophthalmology content on TikTok.

The purpose of this study was to report an isolated case of 2 siblings who developed central toxic keratopathy (CTK) after undergoing laser-assisted keratomileusis (LASIK) on the same day. This was a case report and literature review. Two sisters with no significant medical history underwent uncomplicated LASIK on the same day. Postoperative day 1 slitlamp examination findings were unremarkable. One week later, both patients returned for routine examination and were found to have a reduction in visual acuity, hyperopic shift, bilateral central opacification at the interface, and characteristic posterior stromal "mud cracks" or macrostriae most consistent with the entity CTK. The patients reported only mild ocular discomfort with minimal signs of inflammation. None of the other LASIK patients from the same surgery day nor any previous or following days thereafter developed any complications. The siblings were closely followed and treated with a short course of prophylactic topical antibiotics and rapid steroid taper, along with aggressive lubrication and long-term systemic treatment including oral doxycycline, vitamin C, and coenzyme Q10. Three months later, both patients had resolution of CTK with an uncorrected visual acuity of 20/20 or better in both eyes. CTK is a rare, noninflammatory but potentially sight-threatening entity most commonly associated with excimer laser ablation procedures. Its pathophysiology is poorly understood but likely multifactorial. Its isolated presentation in this case of 2 siblings suggests a possible underlying genetic predisposition, which has not been previously described. With careful monitoring and early supportive treatment, patients can have a complete and rapid resolution.

To evaluate the benefits of internal limiting membrane peeling in proliferative diabetic retinopathy subjects undergoing pars plana vitrectomy for the treatment of vitreous hemorrhage. Two hundred and fifty-eight proliferative diabetic retinopathy subjects undergoing pars plana vitrectomy for vitreous hemorrhage were enrolled into the trial. Patients were randomized into one of two cohorts: Group A patients underwent internal limiting membrane peeling, whereas Group B patients did not undergo internal limiting membrane peeling. The main outcome was best-corrected visual acuity at 6 months. Secondary outcomes were optical coherence tomography central macular thickness at 6 months, incidence of diabetic macular edema treatment during the postoperative trial period, and incidence of epiretinal membrane at 6 months. Two hundred and seven patients were randomized and completed 6 months follow-up. Group A had better best-corrected visual acuity at 6 months than Group B (P < 0.01). Group A had a lower incidence of diabetic macular edema treatment during the postoperative trial period and a lower incidence of epiretinal membrane at 6 months than Group B (P = 0.02 and P < 0.001, respectively). There was a trend toward lower central macular thickness on optical coherence tomography in Group A than Group B (P = 0.09). There were no significant differences in baseline details or complications intraoperatively or postoperatively between cohorts. This trial demonstrated better vision, fewer postoperative diabetic macular edema treatments, and a lower incidence of epiretinal membrane at 6 months when internal limiting membrane peeling was performed. Internal limiting membrane peeling may be considered a vital maneuver to perform in proliferative diabetic retinopathy subjects undergoing pars plana vitrectomy for vitreous hemorrhage.