Vancomycin-Associated Hemorrhagic Occlusive Retinal Vasculitis: A Case Series and Systematic Review.

This study describes three unilateral cases of hemorrhagic occlusive retinal vasculitis (HORV) after cataract surgery and a review of the literature until February 2022, including 21 articles reporting HORV cases. Altogether, 61 eyes (41 patients) were included. Twenty patients had bilateral and 21 patients had unilateral HORV. Prophylactic vancomycin was given to all patients. Additional vancomycin use was associated with the worst outcome. The mean time to HORV was 9 days post-cataract surgery. In bilateral cases, the median time between surgeries was 7 days. Visual acuity was < 20/400 in 48%, with no light perception in 20%. Neovascular glaucoma developed in 43%. Central macular thickening or hyperreflectivity of the inner retinal layers on optical coherence tomography was associated with worse outcomes. Corticosteroid treatment, early panretinal laser photocoagulation, or anti-vascular endothelial growth factor therapy, and prophylaxis alternative to vancomycin is recommended. [Ophthalmic Surg Lasers Imaging Retina 2022;53:702-712.].

Localized Linear IgA Bullous Dermatosis and a Recurrent Cicatricial Ectropion of the Eyelid: A Case Report of a Sixteen-Year Follow-up.

Cicatrizing ectropion of the eyelid is an uncommon condition, possibly resulting in significant ocular morbidity. A potential cause can be a systemic disease, including autoimmune blistering disease (ABD). We herein report a case with a sixteen-year follow-up of a patient with a chronic cicatrizing unilateral ectropion caused by linear IgA bullous dermatosis (LABD). LABD is an ABD, characterized by the accumulation of IgA anti-basement membrane autoantibodies. It has a varied presentation; however, localized or ophthalmic manifestations have been infrequently described. The case demonstrates the benefits of immunohistochemistry in obtaining the correct diagnosis, and difficulties in the medical and surgical management of a recurrent cicatricial ectropion caused by chronic systemic disease.

VISUAL OUTCOMES IN PATIENTS WITH DIABETIC MACULAR EDEMA TREATED WITH DEXAMETHASONE IMPLANT IN ROUTINE CLINICAL PRACTICE.

The aim was to evaluate visual outcomes of the real-life usage of dexamethasone (DEX) implants in diabetic macular edema (DME) patients and evaluate the possible additional visual acuity (VA) gain with combined treatment. We retrospectively reviewed medical records of DME patients treated with DEX implants. The mean best-corrected visual acuity (BCVA) and mean central retinal thickness (CRT) at baseline and one year were compared. BCVA improved from 58.4±14.9 letters at baseline to 62.4±14.5 letters at one-year evaluation (p=0.002). The mean change in BCVA was 5.2±11.1 letters. CRT decreased from 485.7±146.3 µm at baseline to 391.5±129.0 µm at one year (p<0.001). The mean change in CRT was -89.6±143.3 µm. Patients received a mean of 2.0±0.7 DEX implants. Study eyes were also divided into a group receiving DEX implant monotherapy and a group receiving DEX implant and vascular endothelial growth factor inhibitor (anti-VEGF) therapy. Changes in BCVA and CRT and the number of DEX implant injections were compared between the two groups. No difference in VA gain was found between the eyes receiving monotherapy and the eyes receiving combined treatment. In conclusion, DEX implant therapy was effective in gaining vision in DME patients. No additional VA gain was achieved with combined treatment.

Prognostic Factor Analysis of Visual Outcome after Vitrectomy for Rhegmatogenous Retinal Detachment.

Pars plana vitrectomy (PPV) is a surgical approach mainly chosen for complex rhegmatogenous retinal detachment (RRD) repair with highly variable functional results. The aim of this analysis was to evaluate the impact of preoperative factors and postoperative optical coherence tomography (OCT) macular findings on the functional outcome of patients undergoing primary PPV for RRD. A retrospective analysis was performed on 88 eyes of 88 patients with complex RRD managed by PPV. A swept source OCT was used to obtain images at the postoperative visit at least 6 months after PPV. Hierarchical linear regression model was used to evaluate the influence of preoperative factors related to patient, ocular clinical and postoperative OCT macular findings on functional outcomes of PPV for RRD. Duration of symptoms (p = 0.031) and discontinuity of the ellipsoid zone (EZ) on OCT (p = 0.024) showed statistically significant negative correlation, while preoperative best-corrected visual acuity (BCVA; p < 0.001) showed statistically significant positive correlation to postoperative BCVA. Preoperative BCVA and duration of symptoms can be used as prognostic factors for visual outcome in patients undergoing PPV for RRD. Discontinuity of the EZ was the only postoperative OCT variable related to worse postoperative visual outcome.