Faculty Bibliography

PURPOSE: We assessed the frequency and predictive factors related to intraocular pressure (IOP) elevation in neovascular age-related macular degeneration (AMD) patients undergoing unilateral intravitreal ranibizumab and/or bevacizumab injections. DESIGN: Retrospective cohort study. PARTICIPANTS: Charts of 207 patients with neovascular AMD who presented to a single physician at a retinal referral practice over a 6-month period were retrospectively reviewed. METHODS: Data recorded included demographic information, clinical findings, total number of bevacizumab and ranibizumab injections received and IOP at each visit. Increases above baseline IOP of >5, >10, or >15 mmHg on >/=2 consecutive visits while under treatment were noted. MAIN OUTCOME MEASURES: The frequency of IOP elevation was compared between treated and untreated eyes. In addition, among treated eyes, frequency and odds ratio of experiencing IOP elevation >5 mmHg above baseline on >/=2 consecutive visits was stratified by number of injections. For the main regression analysis, the outcome variable was IOP elevation >5 mmHg on >/=2 consecutive visits and the main independent variable was total number of injections. RESULTS: On >/=2 consecutive visits, 11.6% of treated versus 5.3% of untreated/control eyes experienced IOP elevation of >5 mmHg. The mean number of injections was higher in those with (24.4; 95% confidence interval [CI], 20.9-28.0; range, 9-39) than without IOP elevation of >5 mmHg (20.4; 95% CI, 18.9-21.8; range, 3-48) on >/=2 consecutive visits. There was an increased odds ratio (5.75; 95% CI, 1.19-27.8; P = 0.03) of experiencing IOP elevation >5 mmHg on >/=2 consecutive visits in patients receiving >/=29 injections compared with 5 mmHg above baseline on >/=2 consecutive visits in treated eyes (P = 0.05). CONCLUSIONS: A greater number of intravitreal anti-vasular endothelial growth factor injections is associated with an increased risk for IOP elevation >5 mmHg on >/=2 consecutive visits in eyes with neovascular AMD receiving intravitreal ranbizumab and/or bevacizumab. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.

PURPOSE:: To report three cases of solitary, focal retinal phlebitis. METHODS:: An observational case series. RESULTS:: Three eyes in three patients were noted to have unilateral decreased vision, macular edema, and a focal retinal phlebitis, which was not at an arteriovenous crossing. All three patients developed a branch retinal vein occlusion at the site of inflammation. These patients had no other evidence of intraocular inflammation, including vitritis, retinitis, retinal vasculitis, or choroiditis, nor was there any systemic disorder associated with inflammation, infection, or coagulation identified. CONCLUSION:: Focal retinal phlebitis appears to be an uncommon and unique entity that produces macular edema and ultimately branch retinal vein occlusion. In our patients, the focal phlebitis and venous occlusion did not occur at an arteriovenous crossing, which is the typical site for branch retinal venous occlusive disease. This suggests that our cases represent a distinct clinical entity, which starts with a focal abnormality in the wall of a retinal venule, resulting in surrounding exudation and, ultimately, ends with branch retinal vein occlusion

PURPOSE: To investigate the prevalence and degree of macular thinning on optical coherence tomography (SDOCT) in African-American female patients with asymptomatic sickle cell disease. DESIGN: Prospective comparative case series. METHODS: Twenty-one sickle cell patients (42 eyes) without other systemic or ocular diseases and 18 healthy control patients (33 eyes) underwent SD-OCT. Images were manually segmented to measure inner retinal thickness (IRT) and outer retinal thickness (ORT). Central macular (central 1 mm), parafoveal (0.5-1.5 mm eccentricity), and perifoveal (1.5-3 mm eccentricity) thickness measurements were obtained in sickle cell patients and age/gender/race-matched healthy control subjects. RESULTS: Central macular total thickness (CMT) in sickle cell patients was 220 +/- 3 mum (mean +/- SEM), which was significantly lower (P < .05) than controls (228 +/- 3 mum). Parafoveal regions had thickness measurements of 314 +/- 5 mum (nasal) and 304 +/- 2 mum (temporal), which were significantly lower than controls (327 +/- 2 mum and 311 +/- 2 mum nasally and temporally, respectively) (P < .03, P < .043). There was also no significant difference in IRT in central macula, parafoveal, and perifoveal regions. Central macular ORT was 175 +/- 2 mum vs 185 +/- 1 mum in controls (P < .0002). ORT in temporal parafoveal and perifoveal regions was 142 +/- 2 mum and 120 +/- 1 mum, respectively, vs 150 +/- 1 mum and 122 +/- 1 mum in controls (P < .001 and P = .16, respectively). CONCLUSIONS: Manual segmentation of SD-OCT images revealed significant total retinal thinning in the central macula and splaying in asymptomatic sickle cell patients. Retinal thinning was predominately in outer retinal layers in central macula and parafoveal regions.

Poly(3-hexylthiophene)-b-poly(gamma-benzyl-L-glutamate) (P3HT-b-PBLG) rod-rod diblock copolymer was synthesized by a ring-opening polymerization of gamma-benzyl-L-glutamate-N-carboxyanhydride using a benzylamine-terminated regioregular P3HT macroinitiator. The opto-electronic properties of the diblock copolymer have been investigated. The P3HT precursor and the P3HT-b-PBLG have similar UV-Vis spectra both in solution and solid state, indicating that the presence of PBLG block does not decrease the effective conjugation length of the semiconducting polythiophene segment. The copolymer displays solvatochromic behavior in THF/water mixtures. The morphology of the diblock copolymer depends upon the solvent used for film casting and annealing results in morphological changes for both films deposited from chloroform and trichlorobenzene.

The authors present the case of an 8-year-old boy with a long-term diagnosis of unilateral optic nerve hypoplasia (ONH) of unknown cause in the right eye. Spectral-domain optical coherence tomography (SD-OCT) of the central macula was consistent with hypoplasia greatest in the inner retinal layers, but also involving the outer retinal layers when compared with the unaffected contralateral eye. Although ONH is commonly associated with hypoplasia of the nerve fiber and ganglion cell layers, it can also be associated with hypoplasia of other layers in the inner and outer retina, including the outer nuclear and photoreceptor inner/outer segment layers, as evidenced by SD-OCT.