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Retinal detachment (RD) is a vision-threatening ocular emergency that necessitates rapid diagnosis and intervention. This review examines the evolving role of optical coherence tomography (OCT) in RD by synthesizing the literature on preoperative biomarkers and advanced image modalities that inform diagnosis, prognosis, and surgical planning. We evaluated studies employing spectral-domain OCT, swept-source OCT, OCT angiography, adaptive optics OCT, and en face OCT to assess photoreceptor integrity, retinal detachment height, intraretinal cystic cavities, outer retinal corrugations and undulation, and macular involvement. The incorporation of OCT assessment into clinical practice may facilitate more precise surgical timing, technique selection, and postoperative monitoring. Further research is needed to standardize imaging protocols and validate specific prognostic biomarkers for optimal surgical outcomes. Key aspects include uniform imaging protocols, validating OCT-derived biomarkers such as ellipsoid zone integrity, and correlating OCT metrics with functional outcomes.

A 41-year-old man presented with progressive loss of vision in both eyes. He also had elongated digits and pectus excavatum. Evaluation revealed ectopia lentis, which is consistent with Marfan’s syndrome.

The prevalence of wet age-related macular degeneration (AMD) in the US is expected to increase to 82 million by 2050. Addressing the specialized needs for this population will become increasingly challenging as prevalence rises. Frequent anti-vascular endothelial growth factor (anti-VEGF) injections have been the recourse for this population; however, the burden wet AMD places on patients underscores the critical need for durable therapeutic approaches. Gene therapy is a bioengineered treatment that has transformed the management of previously untreatable disorders. Ongoing advancements and refinements in its biomechanism could lead to more sustainable treatment options for wet AMD. In this article, we provide recent updates on gene therapy trials for wet AMD.

Neovascular age-related macular degeneration (nAMD) treatment has been revolutionized by the introduction of vascular endothelial growth factor antagonists (anti-VEGF), but the need for frequent intravitreal injections poses a heavy burden to patients and physicians. Evolving anti-VEGF therapies include longer duration agents, approaches that target multiple pathways, topical anti-VEGF agents, sustained-release, and genetic therapies. Abicipar pegol, a designed ankyrin repeat protein (DARPin), demonstrated the ability to maintain stable visual acuity with 12-week dosing, but was not approved by the FDA due to higher than usual rates of intraocular inflammation. Conbercept, a recombinant anti-VEGF fusion protein, has been approved in China, and is in Phase 3 trials globally. KSI-301 is an anti-VEGF antibody biopolymer conjugate that allowed 66% of nAMD patients to maintain at least a 6-month treatment-free interval in Phase 1b studies. OPT-302, an inhibitor of VEGF-C/D, will be tested in phase 3 studies that compare anti-VEGF-A monotherapy against combination therapy with OPT-302. Faricimab is a bispecific anti-VEGF/Ang-2 antibody that upregulates the Tie-2 signaling pathway and promotes vascular stability; it is undergoing phase 3 trials with potential for 12- or 16-week dosing. PAN-90806 is a topical anti-VEGF agent that showed the ability to reduce injection frequency by 79% compared to ranibizumab monotherapy in a phase 1/2a trial. Sustained-release anti-VEGF therapies include the ranibizumab Port Delivery System (in phase 3 studies), GB-102 (Phase 2b), OTX-TKI (phase 1), and Durasert (preclinical). Suprachoroidal delivery of the tyrosine kinase inhibitor, axitinib, is in preclinical studies. Genetic therapies in phase 1 studies include RGX-314 and ADVM-022, which introduce a viral vector that modifes the retina's cellular apparatus to create an anti-VEGF biofactory, potentially serving as a one-time treatment. Further investigation is warranted for drugs and delivery systems that hope to advance visual outcomes and reduce treatment burden of nAMD. Keywords: ADVM-022, age-related macular degeneration, abicipar pegol, CLS-AX, conbercept, faricimab, GB-102, KSI-301, PAN-90806, OTX-TKI, ranibizumab port delivery system, RGX-314, VEGF

To assess public awareness, interest, and concerns regarding Vuity (1.25% pilocarpine hydrochloride ophthalmic solution), an eye drop for the treatment of presbyopia, based on Google Trends. We used Google Trends that provides a relative search volume for queried terms, to evaluate searches for Vuity from June 30, 2021, to June 30, 2022, in the United States. The data for this study were downloaded on June 30, 2022. Main outcome measures were changes in relative search volumes for the terms \"Vuity,\" \"Eye drops for reading,\" \"Eye drops for near vision,\" \"Presbyopia,\" \"Pilocarpine,\" and related popular search terms, such as \"Vuity side effects,\" and \"Vuity retinal detachment\". Since the approval of Vuity on October 29, 2021, notable increases in the relative search volumes occurred for Vuity in October 2021, December 2021, and from March to April 2022, which coincided with its approval, availability, and subsequent direct-to-consumer advertising based on positive results of clinical trials. The direct-to-consumer advertising had the greatest impact on the search volume for Vuity. Specific interests included Vuity cost, where to buy it, and its side effects. Retinal detachment was the most highly searched Vuity side effect. Geographic variation was evident, with the relative search volumes highest for \"Vuity\" in Wyoming, followed by North Dakota. Google Trends is a useful tool for monitoring increases in public interest in Vuity for presbyopia. Public concerns regarding side effects warrant further real-world investigations of the causal relationship between Vuity and retinal detachment.

A 43-year-old man presented with sudden painless loss of vision in his left eye. Funduscopic examination revealed hyperemia and swelling of the optic nerve, macular edema, diffuse intraretinal hemorrhages, and dilated and tortuous retinal veins. A 43-year-old man with hypertension presented with sudden painless loss of vision in his left eye. Visual acuity was measurable only by ability to count fingers at a distance of 3 feet. A relative afferent pupillary defect was also noted. Intraocular pressure was at the upper limit of the normal range, at 20 mm Hg bilaterally. Funduscopic examination was remarkable for optic-nerve cupping of the right eye (Panel A, arrow) and hyperemia and swelling of the optic nerve (Panel B, arrow), macular edema, diffuse intraretinal hemorrhages, and dilated and tortuous retinal veins (Panel B, arrowhead) in the left eye. A . . .

BACKGROUND AND OBJECTIVE: To describe a simulation technique for laser barrier retinopexy as an option for ophthalmologists in training to practice slit lamp and laser indirect ophthalmoscopy (LIO) retinopexy. MATERIALS AND METHODS: A commercially available fundus model and laser printer labels were used to simulate laser retinopexy of horseshoe tears (HST). At two time points, seven first-year residents and seven second-year residents were asked to complete three rows of laser burns around HSTs and the times were recorded. RESULTS: Second-year residents completed simulated retinopexies in less time than first-year residents on both the slit lamp (P = .001) and with LIO (P = .001). Second-year residents were also statistically more efficient when retested at the second time point (P = .003 and P = .005, slit lamp and LIO, respectively). CONCLUSION: This novel educational model is able to capture differences in training level and increased experience among ophthalmology trainees, and may be beneficial as part of a structured teaching program. [Ophthalmic Surg Lasers Imaging Retina 2022;53:606–609.]

Objective To evaluate the quality and readability of online health content regarding the ocular health effects of blue light. Methods Five commercial and five non-commercial websites with content regarding the ocular effect of blue light were examined. Quality evaluations were conducted using a 14-question assessment composed by the authors and the 16-question DISCERN instrument. Website accountability was evaluated via the Journal of the American Medical Association (JAMA) benchmarks. Readability was determined using an online tool (Readable). Correlational and comparative analyses were conducted where appropriate. Results The average questionnaire score was 84 (standard deviation [SD] ± 17.89, 95% confidence interval [CI] 77.32-90.68) out of 136 points (61.8%). Significant differences in quality were identified between websites (p = 0.02), with Healthline achieving the highest score. Compared to commercial websites, non-commercial websites trended toward having significantly higher median questionnaire scores (p = 0.06). Zero websites achieved all four JAMA benchmarks. The average reading grade level of content was 10.43 (SD ± 1.15, 95% CI 9.60 - 11.25), with differences between websites trending toward significance (p = 0.09). There was no correlation between resource readability and quality (ρ = 0.28; p = 0.43) or accountability (ρ = 0.47; p = 0.17). Conclusions There remain substantial deficiencies in the quality, accountability, and readability of online content concerning the effect of blue light on ocular health. Clinicians and patients must recognize such issues when recommending and consuming these resources.

A 59-year-old patient with bilateral worsening diabetic macular edema received intravitreal injection of aflibercept (Eylea; Regeneron, Tarrytown, NY) to the left eye only. On 1-month follow-up, there was noted bilateral improvement of visual acuity and diabetic macular edema on spectral-domain optical coherence tomography imaging, reflecting bilateral effect of unilateral treatment with aflibercept. [ Ophthalmic Surg Lasers Imaging Retina. 2016;47:474–476.]

The taxanes are chemotherapeutic agents that may, in rare cases, cause cystoid macular edema without leakage on fluorescein angiography. Two patients with evidence of taxane-related macular edema presented and were evaluated using novel en face optical coherence tomography (OCT) and OCT angiography (OCTA) imaging modalities. Although OCTA revealed no flow abnormalities in either patient, en face OCT revealed a striking bilateral symmetric cystic tessellation pattern. [[ Ophthalmic Surg Lasers Imaging Retina . 2016;47:176–179.]