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Hanson RLW, Airody A, Sivaprasad S, Gale RP. Optical coherence tomography imaging biomarkers associated with neovascular age-related macular degeneration: a systematic review. Eye (Lond) 2023; 37:2438-2453. [PMID: 36526863 PMCID: PMC9871156 DOI: 10.1038/s41433-022-02360-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/13/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
The aim of this systematic literature review is twofold, (1) detail the impact of retinal biomarkers identifiable via optical coherence tomography (OCT) on disease progression and response to treatment in neovascular age-related macular degeneration (nAMD) and (2) establish which biomarkers are currently identifiable by artificial intelligence (AI) models and the utilisation of this technology. Following the PRISMA guidelines, PubMed was searched for peer-reviewed publications dated between January 2016 and January 2022. POPULATION Patients diagnosed with nAMD with OCT imaging. SETTINGS Comparable settings to NHS hospitals. STUDY DESIGNS Randomised controlled trials, prospective/retrospective cohort studies and review articles. From 228 articles, 130 were full-text reviewed, 50 were removed for falling outside the scope of this review with 10 added from the author's inventory, resulting in the inclusion of 90 articles. From 9 biomarkers identified; intraretinal fluid (IRF), subretinal fluid, pigment epithelial detachment, subretinal hyperreflective material (SHRM), retinal pigmental epithelial (RPE) atrophy, drusen, outer retinal tabulation (ORT), hyperreflective foci (HF) and retinal thickness, 5 are considered pertinent to nAMD disease progression; IRF, SHRM, drusen, ORT and HF. A number of these biomarkers can be classified using current AI models. Significant retinal biomarkers pertinent to disease activity and progression in nAMD are identifiable via OCT; IRF being the most important in terms of the significant impact on visual outcome. Incorporating AI into ophthalmology practice is a promising advancement towards automated and reproducible analyses of OCT data with the ability to diagnose disease and predict future disease conversion. SYSTEMATIC REVIEW REGISTRATION This review has been registered with PROSPERO (registration ID: CRD42021233200).
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Affiliation(s)
- Rachel L W Hanson
- Academic Unit of Ophthalmology, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
| | - Archana Airody
- Academic Unit of Ophthalmology, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
| | - Sobha Sivaprasad
- Moorfields National Institute of Health Research, Biomedical Research Centre, London, UK
| | - Richard P Gale
- Academic Unit of Ophthalmology, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK.
- Hull York Medical School, University of York, York, UK.
- York Biomedical Research Institute, University of York, York, UK.
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Kiraly P, Downes SM, Fischer MD. Retinal Angiomatous Proliferation in a Patient with Retinitis Pigmentosa. Genes (Basel) 2023; 14:1438. [PMID: 37510342 PMCID: PMC10379935 DOI: 10.3390/genes14071438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/19/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Retinal angiomatous proliferation (RAP) and other types of choroidal neovascularization (CNV) are very rarely reported in patients with retinitis pigmentosa (RP). We present a case report of a 91-year-old patient with an obvious RP phenotype, who presented with a sudden onset of vision worsening and metamorphopsia in the left eye. Genetic testing on the UK inherited retinal disease panel did not identify a pathogenic variant. Multimodal imaging comprising optical coherence tomography (OCT), OCT angiography, and fluorescein and indocyanine green angiography showed a RAP lesion in the left macula. The patient received three treatments of monthly injections of aflibercept, with excellent morphological and functional outcomes. Taking into account the patient's age at presentation of the RAP lesion, it is not clear whether the RAP was associated or coincidental with RP. This case report highlights the importance of possessing an awareness that RAP lesions can occur in RP. Moreover, due to a good response and potential safety concerns with continuous anti-VEGF injections in RP patients, a pro re nata (PRN) regimen might be the safest option.
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Affiliation(s)
- Peter Kiraly
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford OX3 9DU, UK
| | - Susan M Downes
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford OX3 9DU, UK
| | - M Dominik Fischer
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford OX3 9DU, UK
- Centre for Ophthalmology, University Hospital Tübingen, 72076 Tübingen, Germany
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Rouvas A, Bouratzis N, Georgalas I, Gouliopoulos N. Is there any association between the frequency of wet age-related macular degeneration recurrences and the seasons of the year? Int Ophthalmol 2023:10.1007/s10792-023-02732-z. [PMID: 37162702 DOI: 10.1007/s10792-023-02732-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 04/22/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE To investigate whether a seasonal distribution of the frequency of exudative age-related macular degeneration (wet AMD) recurrences exists. METHODS In total, 129 eyes with 171 recurrences in patients suffering from wet AMD were included in the study. All the patients had been treated with intravitreal anti-VEGF injections according to Pro Re Nata treatment regimen. Recurrence was defined as the re-detection of sub-retinal fluid, intraretinal fluid, and/or sub-macular hemorrhage in optical coherence tomography scans, after at least two consecutive monthly examinations with a "dry" macula. The year was divided in three 4-month periods (zone A: June-September, zone B: October-January, and zone C: February-May) based on the weather conditions prevailing in each period. Mean temperature and hours of sunlight exposure were the main weather markers recorded. RESULTS Eighty-two recurrences (48%) occurred during the period June-September, 50 (29.2%) during the period October-January, and 39 (22.8%) during the period February-May (Chi-square = 17.5, p < 0.001). Among the groups, neither patients' age (78 ± 8 years A, 76 ± 7 years B, and 79 ± 8 years C, p = 0.15) nor gender status (40% men A, 36% men B, and 51% men C, p = 0.35) differed significantly. Mean temperature was 27.6 ± 1.8 °C, 15.1 ± 4.6 °C, and 16.5 ± 4.4 °C in zones A, B, and C, respectively. Hours (h) of sunlight exposure (average hours/month) were 344 ± 34 h, 188 ± 42 h, and 223 ± 57 h in zones A, B, and C. CONCLUSION We demonstrated that the frequency of wet AMD recurrences is significantly elevated during the warmer months, possibly due to the higher levels of UV radiation and mean temperature. Further research is necessary to validate our findings.
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Affiliation(s)
- Alexandros Rouvas
- 2nd Department of Ophthalmology, Medical School of National and Kapodistrian University of Athens, 'Attikon' General Hospital Athens, 1 Rimini Str, 12462, Haidari, Athens, Greece
| | - Nikolaos Bouratzis
- 2nd Department of Ophthalmology, Medical School of National and Kapodistrian University of Athens, 'Attikon' General Hospital Athens, 1 Rimini Str, 12462, Haidari, Athens, Greece
| | - Ilias Georgalas
- 1st Department of Ophthalmology, Medical School of National and Kapodistrian University of Athens, 'G. Gennimatas' General Hospital, Holargos, Athens, Greece
| | - Nikolaos Gouliopoulos
- 2nd Department of Ophthalmology, Medical School of National and Kapodistrian University of Athens, 'Attikon' General Hospital Athens, 1 Rimini Str, 12462, Haidari, Athens, Greece.
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Cho HJ, Jeon YJ, Yoon W, Yoon J, Kim J, Kim JW. Neovascular age-related macular degeneration without exudative recurrence over 24 months after initial remission. Sci Rep 2022; 12:15662. [PMID: 36123375 PMCID: PMC9485132 DOI: 10.1038/s41598-022-19400-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 08/29/2022] [Indexed: 11/09/2022] Open
Abstract
We investigated the characteristics of neovascular age-related macular degeneration (AMD), which rarely recurs after initial remission. This study retrospectively analyzed 392 neovascular AMD patients treated with anti-vascular endothelial growth factor (VEGF). All patients received three monthly loading doses of anti-VEGF injections, followed by a pro re nata (as needed) regimen for 24 months. The baseline characteristics associated with the odds of having no recurrence within 24 months were evaluated using multivariate modeling. After the initial three loading injections over 24 months, 58 (14.8%) eyes showed no exudative recurrence and did not require additional anti-VEGF injections. These patients without exudative recurrence had significantly better best-corrected visual acuity (P = 0.003) and lower central subfoveal thickness (P = 0.035) at 24 months than those with exudative recurrence. Additionally, the incidence of macular atrophy was significantly lower in the former than in the latter (8.6% vs. 21.9%; P = 0.020). Multivariate analysis revealed that younger age (odds ratio [OR], 0.901; P = 0.033), smaller lesion size (OR, 0.589; P = 0.016), and absence of fibrovascular pigment epithelial detachment (PED) (OR, 1.349; P = 0.028) were associated with higher odds of no recurrence during follow-up. Approximately 15% of the neovascular AMD patients showed no exudative recurrence after initial remission during the 24-month follow-up. The infrequent recurrence after initial remission correlated with younger age, smaller lesion size, and absence of fibrovascular PED.
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Affiliation(s)
- Han Joo Cho
- Kim's Eye Hospital, Konyang University College of Medicine, 156, 4ga, Yeongdeungpo-dong, Yeongdeungpo-gu, Seoul, South Korea.
| | - Young Joon Jeon
- Kim's Eye Hospital, Konyang University College of Medicine, 156, 4ga, Yeongdeungpo-dong, Yeongdeungpo-gu, Seoul, South Korea
| | - Wontae Yoon
- Kim's Eye Hospital, Konyang University College of Medicine, 156, 4ga, Yeongdeungpo-dong, Yeongdeungpo-gu, Seoul, South Korea
| | - Jihyun Yoon
- Kim's Eye Hospital, Konyang University College of Medicine, 156, 4ga, Yeongdeungpo-dong, Yeongdeungpo-gu, Seoul, South Korea
| | - Jaemin Kim
- Kim's Eye Hospital, Konyang University College of Medicine, 156, 4ga, Yeongdeungpo-dong, Yeongdeungpo-gu, Seoul, South Korea
| | - Jong Woo Kim
- Kim's Eye Hospital, Konyang University College of Medicine, 156, 4ga, Yeongdeungpo-dong, Yeongdeungpo-gu, Seoul, South Korea
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Freund KB, Staurenghi G, Jung JJ, Zweifel SA, Cozzi M, Hill L, Blotner S, Tsuboi M, Gune S. Macular neovascularization lesion type and vision outcomes in neovascular age-related macular degeneration: post hoc analysis of HARBOR. Graefes Arch Clin Exp Ophthalmol 2022; 260:2437-2447. [PMID: 35239009 PMCID: PMC8891431 DOI: 10.1007/s00417-022-05586-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/20/2022] [Accepted: 02/03/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To characterize relationships between Consensus on Neovascular Age-Related Macular Degeneration Nomenclature (CONAN) Study Group classifications of macular neovascularization (MNV) and visual responses to ranibizumab in patients with neovascular age-related macular degeneration (nAMD). METHODS This was a post hoc analysis of the phase 3 HARBOR trial of ranibizumab in nAMD. Analyses included ranibizumab-treated eyes with baseline multimodal imaging data; baseline MNV; subretinal and/or intraretinal fluid at screening, baseline, or week 1; and spectral-domain optical coherence tomography images through month 24 (n = 700). Mean best-corrected visual acuity (BCVA) over time and mean BCVA change at months 12 and 24 were compared between eyes with type 1, type 2/mixed type 1 and 2 (type 2/M), and any type 3 MNV at baseline. RESULTS At baseline, 263 (37.6%), 287 (41.0%), and 150 (21.4%) eyes had type 1, type 2/M, and any type 3 lesions, respectively. Type 1 eyes had the best mean BCVA at baseline (59.0 [95% CI: 57.7-60.3] letters) and month 24 (67.7 [65.8-69.6] letters), whereas type 2/M eyes had the worst (50.0 [48.6-51.4] letters and 60.8 [58.7-62.9] letters, respectively). Mean BCVA gains at month 24 were most pronounced for type 2/M eyes (10.8 [8.9-12.7] letters) and similar for type 1 (8.7 [6.9-10.5] letters) and any type 3 eyes (8.3 [6.3-10.3] letters). CONCLUSION Differences in BCVA outcomes between CONAN lesion type subgroups support the use of an anatomic classification system to characterize MNV and prognosticate visual responses to anti-vascular endothelial growth factor therapy for nAMD. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT00891735. Date of registration: April 29, 2009.
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Affiliation(s)
- K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, NY, USA.
- Department of Ophthalmology, NYU Grossman School of Medicine, New York, NY, USA.
| | - Giovanni Staurenghi
- Department of Biomedical and Clinical Science Luigi Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Jesse J Jung
- East Bay Retina Consultants, Inc., Oakland, CA, USA
- Department of Ophthalmology, University of California, San Francisco, CA, USA
| | - Sandrine A Zweifel
- Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Mariano Cozzi
- Department of Biomedical and Clinical Science Luigi Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Lauren Hill
- Genentech, Inc., South San Francisco, CA, USA
| | | | - Min Tsuboi
- Genentech, Inc., South San Francisco, CA, USA
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Chaudhary V, Matonti F, Zarranz-Ventura J, Stewart MW. IMPACT OF FLUID COMPARTMENTS ON FUNCTIONAL OUTCOMES FOR PATIENTS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: A Systematic Literature Review. Retina 2022; 42:589-606. [PMID: 34393212 PMCID: PMC8946587 DOI: 10.1097/iae.0000000000003283] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Understanding the impact of fluid in different retinal compartments is critical to developing treatment paradigms that optimize visual acuity and reduce treatment burden in neovascular age-related macular degeneration. This systematic review aimed to determine the impact of persistent/new subretinal fluid, intraretinal fluid, and subretinal pigment epithelial fluid on visual acuity over 1 year of treatment. METHODS Publication eligibility and data extraction were conducted according to Cochrane methods: 27 of the 1,797 screened records were eligible. RESULTS Intraretinal fluid negatively affected visual acuity at baseline and throughout treatment, with foveal intraretinal fluid associated with lower visual acuity than extrafoveal intraretinal fluid. Some studies found that subretinal fluid (particularly subfoveal) was associated with higher visual acuity at Year 1 and longer term, and others suggested subretinal fluid did not affect visual acuity at Years 1 and 2. Data on the effects of subretinal pigment epithelial fluid were scarce, and consensus was not reached. Few studies reported numbers of injections associated with fluid status. CONCLUSION To optimally manage neovascular age-related macular degeneration, clinicians should understand the impact of fluid compartments on visual acuity. After initial treatment, antivascular endothelial growth factor regimens that tolerate stable subretinal fluid (if visual acuity is stable/improved) but not intraretinal fluid may enable patients to achieve their best possible visual acuity. Confirmatory studies are required to validate these findings.
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Affiliation(s)
- Varun Chaudhary
- Hamilton Regional Eye Institute, St Joseph's Healthcare Hamilton, Department of Health Research Methods, Evidence and Impact, McMaster University, Division of Ophthalmology, Department of Surgery, McMaster University, Canada;
| | - Frédéric Matonti
- Centre Monticelli Paradis, 433 bis rue Paradis, Marseille, France and Aix Marseille University, CNRS, INT, Inst Neurosci Timone, Marseille, France and Clinique Juge, Groupe Almaviva Santé, Marseille, France;
| | - Javier Zarranz-Ventura
- Institut Clínic d'Oftalmologia, Hospital Clínic de Barcelona, and Institut de Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; and
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A Delphi study on the clinical management of age-related macular degeneration. Int Ophthalmol 2022; 42:1799-1809. [PMID: 35149923 DOI: 10.1007/s10792-021-02177-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 12/18/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Age-related macular degeneration (AMD) is one of the main causes of blindness and visual impairment worldwide. As achieving a dry macula is one of the main objectives in AMD management, the purpose of this work was to reach a consensus on the relevance of retinal fluid in function, disease activity control and treatment patterns. METHODS Forty-seven Portuguese ophthalmologists specialized in AMD participated in a DELPHI panel. Two rounds of presential meetings were conducted and a cut-off of 80% or more of votes was defined to consider answers consensual. RESULTS Consensus was reached for 11 out of 18 questions. These questions focused on the impact of anatomical results on visual acuity, standards exams and parameters to assess disease activity, frequency and factors which influence disease activity assessment, criteria to use non-fixed treatment regimens, usefulness of individualized regimens and conditions for treatment interruption. No consensus was obtained for relevance of the different fluid types in AMD prognosis, frequency of fluid presence assessment, factors commonly associated with progression to geographic atrophy, ideal conditions for a fixed treatment regimen, date of first disease activity assessment and parameters to monitor disease activity. CONCLUSIONS Consensus was achieved for over half of the questions assessed through this Delphi study. The questions for which no consensus was reached concerned either subjects that need further investigation or monitoring times which are influenced by resource availability. Raising awareness for these issues will allow the improvement of AMD management and treatment.
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Kodjikian L, Parravano M, Clemens A, Dolz-Marco R, Holz FG, Munk MR, Nicolò M, Ricci F, Silva R, Talks SJ, Verma RK, Zarranz-Ventura J, Zweifel SA. Fluid as a critical biomarker in neovascular age-related macular degeneration management: literature review and consensus recommendations. Eye (Lond) 2021; 35:2119-2135. [PMID: 33795837 PMCID: PMC8302650 DOI: 10.1038/s41433-021-01487-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/11/2021] [Accepted: 02/22/2021] [Indexed: 12/23/2022] Open
Abstract
Current guidelines on the management of patients with neovascular age-related macular degeneration (nAMD) lack clear recommendations on the interpretation of fluid as seen on optical coherence tomography (OCT) imaging and the incorporation of this information into an ongoing disease treatment strategy. Our objective was to review current guidelines and scientific evidence on the role of fluid as a biomarker in the management of nAMD, and develop a clinically oriented, practical algorithm for diagnosis and management based on a consensus of expert European retinal specialists. PubMed was searched for articles published since 2006 relating to the role of fluid in nAMD. A total of 654 publications were screened for relevance and 66 publications were included for review. Of these, 14 were treatment guidelines, consensus statements and systematic reviews or meta-analyses, in which OCT was consistently recommended as an important tool in the initial diagnosis and ongoing management of nAMD. However, few guidelines distinguished between types of fluid when providing recommendations. A total of 52 publications reported primary evidence from clinical trials, studies, and chart reviews. Observations from these were sometimes inconsistent, but trends were observed with regard to features reported as being predictive of visual outcomes. Based on these findings, diagnostic recommendations and a treatment algorithm based on a treat-and-extend (T&E) regimen were developed. These provide guidance on the diagnosis of nAMD as well as a simple treatment pathway based on the T&E regimen, with treatment decisions made according to the observations of fluid as a critical biomarker for disease activity.
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Affiliation(s)
- Laurent Kodjikian
- Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.,UMR-CNRS 5510 Matéis, Villeurbanne, INSA de Lyon, Université Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | | | - Andreas Clemens
- Novartis Pharma AG, Basel, Switzerland.,Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | | | - Frank G Holz
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Marion R Munk
- Department of Ophthalmology, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Massimo Nicolò
- University Eye Clinic of Genoa DINOGMI, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy
| | - Federico Ricci
- Department of Experimental Medicine, University Tor Vergata, Rome, Italy
| | - Rufino Silva
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra (ICBR-FMUC), Coimbra, Portugal.,Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Association of Innovation and Biomedical Research in Light and Image (AIBILI), Coimbra, Portugal
| | - S James Talks
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Javier Zarranz-Ventura
- Hospital Clínic de Barcelona, Barcelona, Spain.,Institut de Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Sandrine A Zweifel
- Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland. .,University of Zurich, Zurich, Switzerland.
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Robbins CB, Feng HL, Fekrat S. Quiescent Neovascular Age-Related Macular Degeneration After Endophthalmitis. JOURNAL OF VITREORETINAL DISEASES 2020; 4:300-305. [PMID: 37009179 PMCID: PMC9976098 DOI: 10.1177/2474126420914282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Purpose:This article describes eyes that achieved extended remission of neovascular age-related macular degeneration (NVAMD) following acute endophthalmitis.Methods:Adults who presented to the Duke Eye Center with acute endophthalmitis over a 9-year period and had at least 3 months of follow-up were identified. A retrospective review of medical records was performed to collect clinical data including demographic information, examination findings, etiology, treatment, and outcomes.Results:A total of 133 eyes of 130 patients with endophthalmitis were identified. Of these, 15 eyes of 14 patients (11.3%) were receiving intravitreal antivascular endothelial growth factor (anti-VEGF) injections for NVAMD. Six of these 15 eyes (40%) did not require an anti-VEGF injection after endophthalmitis for a mean of 36.2 months. Endophthalmitis was injection-related in 5 of 6 eyes (83%) and Baerveldt glaucoma drainage device–related in 1 of 6 eyes (17%). Two of the 6 (33%) had culture-proven infectious endophthalmitis, whereas 4 of 6 (67%) had culture-negative endophthalmitis. Five of 6 eyes have required no anti-VEGF therapy to date; the remaining eye restarted intravitreal aflibercept therapy 9.3 months after endophthalmitis.Conclusions:Acute endophthalmitis may be associated with reduced activity of choroidal neovascularization in a subset of eyes with NVAMD.
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Affiliation(s)
- Cason B. Robbins
- Duke Eye Center, Duke University School of Medicine, Durham, NC, USA
| | - Henry L. Feng
- Duke Eye Center, Duke University School of Medicine, Durham, NC, USA
| | - Sharon Fekrat
- Duke Eye Center, Duke University School of Medicine, Durham, NC, USA
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