Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a public health threat in December 2019 in Hubei, a province in China, and rapidly spreads all over the world, causing an endured pandemic. 1 Growing evidence suggests that human-to-human transmission of SARS-CoV-2 occurs through droplets, contacts, and fomites. 2,3 This virus was also detected in the ocular surface of COVID-19 patients with conjunctivitis, 4,5 especially in the prodromal stages of the disease until complete recovery. In Italy, many cases were registered, putting the national health care system under a lot of pressure, especially due to the limited number of intensive care units. Ophthalmologists are the high-risk category to become infected or asymptomatic carriers during routine visits because they come in close faceto-face contact with patients during slit-lamp examination, ophthalmoscopy, and other ophthalmologic imaging processes, and the virus load is especially high in the nasal cavity. In Italy, the government ordered the suspension of all deferral outpatient and surgical activities for at least 2 months. Therefore, in these unprecedented circumstances, we proceeded to reorganize the clinical management of the patients, paying attention to those who suffered from ocular pathologies that could lead to blindness. In particular, we evaluated how to guarantee continuity in intravitreal injection (IVI) therapy with anti-vascular endothelial growth factor (anti-VEGF) to patients affected by neovascular age-related macular degeneration (AMD), retinal venous occlusion (RVO), myopic choroidal neovascularization (CNV), proliferative diabetic retinopathy (PDR), and diabetic macular edema (DME) without Visit SAGE journals online journals.sagepub.com/ home/oed SAGE journals
The aim of this retrospective study was to describe the vascular features in eyes with Coats disease, using optical coherence tomography angiography (OCTA), at baseline and after 3 monthly intravitreal injections of ranibizumab. Fifteen eyes of 15 consecutive patients affected by Coats' disease were recruited in this study. All patients underwent the best-corrected visual acuity (BCVA) evaluation, fundus examination, fluorescein angiography (FA), indocyanine green angiography (ICGA), multicolor imaging, structural Spectral Domain (SD)-OCT and OCTA at baseline and 1 month after the third monthly ranibizumab injection (loading phase). Fifteen patients completed the study, of whom nine were males and six females. Mean age was 20.4 ± 2 years. BCVA was 0.46 ± 0.11 logMar and 0.47 ± 0.12 logMar at baseline and after treatment, respectively (p = 0.164). SD-OCT revealed no significant decrease in central macular thickness (486.33 μm ± 93.37 at baseline vs. 483.4 μm ± 80.97 after treatment; p = 0.915). The subretinal exudates persisted in macular region after intravitreal injections. OCTA showed a general vascular rarefaction in superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillary (CC) that did not change after loading phase. This study showed no functional and vascular improvement following 3 monthly ranibizumab injections. OCTA, non-invasive technique, could be useful during follow up of these patients and provide a better understand of pathogenesis of this disorder.
Objectives: To evaluate the outcomes of strabismus surgery in patients with thyroid eye disease (TED) and to assess the influence of preceding treatments such as steroid administration, orbital decompression and radiotherapy. Methods: Retrospective study on a cohort of patients with TED undergoing strabismus surgery. Data collection included clinical features, smoking status, preceding steroid therapy, orbital radiation therapy and orbital decompression. Qualitative evaluation, assessing diplopia and quality of life and quantitative evaluation, assessing the eye misalignment were analysed 1 year after the last squint surgical procedure. Results: Seventy-nine patients were identified. Ninety-five surgical procedures were performed on 92 eyes. A significant overall improvement of ocular motility was registered ( p < 0.001, paired t-test). Forty-five (57%) patients had excellent outcomes, twenty-three (29%) had good outcomes and eleven (14%) had poor outcomes. The average number of muscles operated was significantly greater in patients who underwent orbital bone decompression (1.58 ± 0.63; p = 0.0082; 95% CI 1.413–10.214). Quantitative and qualitative outcomes were not associated with the preceding therapy: steroid ( p = 0.75), radiotherapy ( p = 0.95) or orbital bone decompression ( p = 0.25). The success rate was no different between adjustable and fixed sutures ( p = 0.8). Conclusion: Strabismus surgery in TED patients resulted in a high success rate in reducing diplopia and improving ocular motility. The success rate was not negatively associated with previous therapies. Indeed, resolution of diplopia required more squint procedures in patients who have previously undergone to orbital decompression.
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