Wills Eye Hospital

To assess factors associated with retinal detachment (RD) in eyes presenting with endogenous endophthalmitis (EE). Multicenter retrospective study of individuals with an EE diagnosis from seven tertiary care centers. Demographics, medical history, ocular examination findings, microbial cultures (blood or intraocular), and management strategies were assessed relative to subsequent RD occurring within 6 months of EE diagnosis. Of note, this study did not distinguish between intraocular cultures without growth and eyes that were not sampled for an intraocular organism. A total of 201 eyes from 171 patients presented with EE. Of these, 22.4% (45/201) had a subsequent RD. Eyes that experienced a subsequent RD had worse presenting visual acuity ( P = 0.006) and lower intraocular pressure at presentation (RD: 13.7 ± 5.4 mmHg vs. No RD: 15.7 ± 6.5 mmHg, P = 0.04). Compared with other forms of bacteremia, S. aureus bacteremia was associated with increased odds of subsequent RD (OR: 6.10, CI: 1.82-20.41, P = 0.003). Eyes with a subsequent RD did not have significantly greater rates of therapeutic pars plana vitrectomy (RD: 11/48, 22.9% vs. No RD: 36/153, 23.5%). Eyes presenting with visual acuity ≤ light perception or S. aureus bacteremia had a higher risk of subsequent RD and may warrant closer surveillance. Although no therapeutic strategies were associated with reduced odds of subsequent RD, a pars plana vitrectomy was not associated with an increased risk of RD, suggesting that it may aid in eyes with lackluster responses to systemic and intravitreal pharmacotherapy.

Anti-vascular endothelial growth factor (anti-VEGF) treatment protocols for neovascular age-related macular degeneration (nAMD) have evolved from fixed, monthly, or bimonthly dosing to individualized, extended dosing regimens. Although a PRN (as-needed) injection protocol may reduce the number of injections, it confers a similar treatment burden by requiring regimented follow-up visits, and disease activity may resurface between visits. Various personalized treatment intervals have been implemented in more recent randomized controlled clinical trials (RCTs), reflecting a shifting focus toward individualized, variable, extended treatment intervals rather than the frequent, fixed regimens used in older RCTs. Newer agents, such as faricimab and aflibercept 8.0 mg, have been evaluated in phase 3 RCTs and potentially offer extended durability of dosing in intervals of up to 12-16 weeks or longer. Recently introduced anti-VEGF agents were tested in pivotal trials using individualized, variable, extended treatment intervals, with results showing adequate nAMD control compared to older, fixed dosing regimens, but additional studies are needed to determine the real-world durability of these agents compared to older anti-VEGF agents.

Fiber bundle imaging systems suffer from sampling artifacts such as honeycomb patterns due to their discrete and non-uniform fiber layout, fundamentally limiting image resolution. Conventional reconstruction methods rely on precise calibration of the fiber layout or learning from paired datasets, both of which have limited generalization across imaging setups and require sample-specific preparation. We present an unsupervised method for reconstructing high-resolution images using a burst of misaligned frames that does not require known fiber layout, paired training data, or per-sample calibration. Our approach jointly solves motion estimation and image reconstruction through test-time training. We model each burst frame as a deformed observation of a single canonical view, parameterizing the underlying motion with a coordinate-based network. A second coordinate-based network learns a joint super-resolved scene representation shared across aligned frames. Both networks are trained jointly end-to-end without paired ground truth or external supervision. Simulation and experimental results demonstrate that our method robustly removes fiber bundle artifacts and generalizes to various sample types. We also released a benchmark dataset for optical fiber bundle imaging to facilitate future research.

Optical coherence tomography (OCT) has transformed clinical eye care by providing high-resolution volumetric imaging of the retina. Recently, ultrawide-field-of-view (FOV) OCT played an increasingly significant clinical role; however, most clinical OCT systems offer only a rather limited FOV. We increased the FOV of clinical OCT by volumetrically montaging multiple OCT datasets in three dimensions (3D). We performed volumetric montaging by representing the internal limiting membrane (ILM) and retinal pigment epithelium (RPE) in each volume as point clouds and using these point clouds to compute transformations that map each volume to a common reference frame. We validated our methodology using datasets from three institutions with different OCT hardware and data-acquisition procedures. Using the mean surface distance between point clouds, we found the error in montaging was less than the lateral pixel size. Our method enabled existing clinical OCT to achieve ultrawide FOV imaging without any hardware modification.