Purpose: To report a patient with severe hemophilia A who received intravitreal antivascular endothelial growth factor (anti-VEGF) for exudative age-related macular degeneration (AMD). Methods: A case and its findings were analyzed. A systematic literature was performed. Results: A patient with severe hemophilia A received intravitreal anti-VEGF for exudative AMD, after which he developed a severe subconjunctival hemorrhage requiring hemostatic intervention. The effects of anti-VEGF in patients with preexisting blood-clotting disorders, such as classic hemophilia, have not been widely reported in the current literature. Conclusions: This case illustrates that precautions must be taken when performing ocular procedures on patients with serious hemostasis disorders.
Purpose: To determine whether AI significantly affects the performance of diabetic retinopathy (DR) grading by ophthalmology residents. Secondary objectives included evaluation of AI's effects on intergrader variability, self-reported confidence, and decision making. Methods: Four ophthalmology residents at a single academic medical center across all years of training (PGY-2 to PGY-4) analyzed 265 retinal fundus photographs for diabetic retinopathy from a publicly available dataset without and with the assistance of an AI algorithm, separated by a 3-week washout period Results: Overall, there was no significant difference without versus with AI in five-class grading, as measured by QWK, with differences ranging from +0.010-0.017, p=0.09-0.32. No significant difference without and with AI was observed for binary classification of referable DR, except for the specificity of the PGY-3 resident (71.8% to 80%, p=0.019). Intergrader agreement among residents significantly increased with AI (FK +0.072, p=0.0003). Self-reported confidence also significantly increased for 3 out of 4 residents. Conclusion: The use of an AI algorithm did not significantly affect the DR grading performance of ophthalmology residents but did increase intergrader agreement and self-reported confidence. Introducing AI into the ophthalmology residency curriculum may be beneficial as the technology becomes more prevalent.
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