Waddellsehested4543
To describe our managing strategy for COVID-19 emergency, to evaluate the adherence to intravitreal treatment (AtT) rate during the outbreak in a referral hospital in Milan and to correlate it with patients clinical features.
AtT rate of patients with scheduled intravitreal injections (IVT) during the COVID-19 outbreak from 23/02/20 to 31/03/20 was compared to the previous trimester and with March 2019. The impact of age, sex, visual function and diagnosis on the AtT rate during unlocked/locked weeks (from March 8) was evaluated.
Of 650 consecutive patients with scheduled IVT, AtT rate during the COVID-19 outbreak was 0.37. This was significantly lower compared to AtT registered in the previous trimester (0.92) and in the same weeks in 2019 (0.90) (both p <0.001). Patients adherent to treatment were significantly younger (p<0.001) and had a lower best-corrected visual acuity in the fellow eye (p=0.046). During the lockdown weeks AtT rate was significantly lower than in the two unlocked weeks (0.19 vs 0.73, p<0.001). In addition, the AtT rate in patients classified as "Emergent" during the lockdown weeks was 0.60.
These preliminary results can help the retina specialist community to foresee this unique scenario and to develop successful management strategies.
These preliminary results can help the retina specialist community to foresee this unique scenario and to develop successful management strategies.
To assess the safety and efficacy of less dense pan-retinal photocoagulation (PRP) after intravitreal bevacizumab in aggressive posterior retinopathy of prematurity (APROP) infants.
Retrospective consecutive case series of premature infants diagnosed with APROP between August 2012 and November 2015 who received intravitreal bevacizumab with subsequent modified indirect diode laser PRP for reactivation or incomplete vascularization. Main outcome measures included post-procedural reactivation, retinal detachments, or anterior segment ischemia.
61 eyes of 31 premature infants were identified. The average gestational age was 24 +/- 2.2 weeks (range 22-27) and average birth weight was 661.5 +/- 167.1 g (range 340.0 - 930.5 g). Average follow-up was 3.9 +/- 1.3 years (range, 1.3 - 5.4 yrs). At last follow-up, no patient had experienced post-laser reactivation, retinal detachments (RD), anterior segment ischemia, or other laser complications.
This study suggests that nonconfluent PRP for APROP infants who have received intravitreal bevacizumab may be safe and effective. This study's strengths include a sizeable sample size, long-term follow-up of nearly 4 years, and consistency in treatment among patients by a single, experienced ROP specialist.
This study suggests that nonconfluent PRP for APROP infants who have received intravitreal bevacizumab may be safe and effective. This study's strengths include a sizeable sample size, long-term follow-up of nearly 4 years, and consistency in treatment among patients by a single, experienced ROP specialist.
A prior study revealed discrepancies in self-reported surgical numbers between male and female ophthalmology residents. This study further investigates the gender differences in self-reported procedural volume amongst vitreoretinal surgery fellows and examines the differences for surgical, medical, and total self-reported procedural volume between male and female vitreoretinal fellows.
A retrospective review of case logs submitted to the American Society of Retina Specialists by first and second year vitreoretinal fellows from 7/1/2018 to 6/30/2019 was performed. Fellows that reported fewer than 100 pars plana vitrectomies were excluded. A total of 133 fellows were included.
37 of 57 (65%) first year fellows and 59 of 76 (78%) second year fellows were male. An average of 1120 procedures were self-reported amongst all vitreoretinal fellows. In the group of second year fellows at the completion of fellowship, men reported more total procedures (1171 [864-1600] vs. 1005 [719-1257], p=0.072). Women reportedl barriers facing female vitreoretinal surgeons in training.
To evaluate microstructural changes in cystoid macular edema (CME) in retinitis pigmentosa (RP) after intravitreal dexamethasone implant injection.
In an extended cohort of a randomized trial of intravitreal dexamethasone implant for the management of RP-CME, microstructural changes during six months after treatment were evaluated using spectral domain optical coherence tomography.
Forty-two eyes were included, and all had cystoid space in the inner nuclear layer (INL) at baseline. No eyes showed subretinal fluid, and 28.6% showed hyperreflective foci. Among 38 eyes with cystoid space both in the INL and outer nuclear layer/Henle's layer (ONL/HL), 13 (34.2%) showed complete resolution and 12 (31.6%) showed cystoid space only in the INL at 2 months after injection, while others showed persistent cystoid space in both layers. After complete resolution, cystoid space recurrence was earlier in the INL than in the ONL/HL. Tacrolimus manufacturer Multivariable analysis showed that greater cystoid space area in the INL and ONL/HL, presence of macular leakage, and longer intact external limiting membrane at baseline were associated with greater cystoid space area decrease after treatment.
Resolution and recurrence pattern of RP-CME after dexamethasone treatment showed that the INL is the primary layer of cystic change, and this suggests its pathogenesis is most likely due to Müller cell dysfunction.
Resolution and recurrence pattern of RP-CME after dexamethasone treatment showed that the INL is the primary layer of cystic change, and this suggests its pathogenesis is most likely due to Müller cell dysfunction.On November 22, 1963, John F. Kennedy, the 35th president of the United States, was assassinated in Dallas, Texas. John B. Connally, the Governor of Texas, simultaneously was injured in the shooting. Both Kennedy and Connally were transported to and cared for at the Parkland Memorial Hospital. Within 3 hours, the accused assassin, Lee Harvey Oswald, was arrested and taken to the Dallas City Jail in the Downtown Municipal Building. When the authorities were transferring Oswald from the City to the County Jail at midday on November 24, Jack Ruby shot him as the event was televised and broadcast live to the nation. Oswald was rushed to Parkland Memorial Hospital where he was operated on by the same surgeons who had attended Kennedy and Connally 2 days previously. This article reviews the operative treatment that Oswald received before discussing the state of abdominal vascular trauma in the 1960s.