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Purpose To evaluate the effect of one full year of the coronavirus disease 2019 (COVID-19) pandemic on clinical presentation of acute, primary rhegmatogenous retinal detachment (RRD). Design Single-center, retrospective observational cohort study. Methods Patients were divided into two cohorts; consecutive patients treated for primary RRD during the COVID-19 pandemic (March 9, 2020 to March 7, 2021; pandemic cohort) and patients treated during the corresponding time in previous year (March 11, 2019 to March 8, 2020; control cohort). Main outcome measures Proportion of patients presenting with macula-involving (mac-off) or macula-sparring (mac-on) RRD. Results 952 patients in the pandemic cohort and 872 patients in the control cohort were included. Demographic factors were similar. Compared to the control cohort, significantly greater number of pandemic cohort patients presented with mac-off RRDs ([60.92%] pandemic, [48.17%] control, P = 0.0001) and primary proliferative vitreoretinopathy (PVR; [15.53%] pandemic, [6.9%] control, P = 0.0001). Pandemic cohort patients (10.81%) had significantly higher rates of lost to follow-up compared to control cohort (4.43%; P = 0.0001). Patients new to our clinic demonstrated significant increase in mac-off RRDs in the pandemic cohort (65.35%) compared to control cohort (50.40%; P = 0.0001). Pandemic cohort patients showed worse median final best-corrected visual acuity (BCVA; 0.30 logarithm of the minimum angle of resolution [logMAR]) compared to control cohort (0.18 logMAR; P = 0.0001). Conclusions Patients with primary RRD during the first year of the COVID-19 pandemic were more likely to have mac-off disease, present with primary PVR, be lost to follow-up, and have worse final BCVA outcomes.

Evaluate factors associated with coronavirus 2019 (COVID-19) vaccine hesitancy and clinical trends in primary rhegmatogenous retinal detachments (RRDs) during the first year of vaccine availability.Single-center, clinical cohort study.Consecutive patients from December 14, 2020, to December 12, 2021, presenting vaccinated (Prior-), subsequently vaccinated (Later-), or remaining unvaccinated (Never-Vax). Primary outcome was proportion with macula-off (mac-off) RRD. Secondary outcomes included logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA), primary proliferative vitreoretinopathy (PVR), proportion lost to follow-up, and distance traveled.1047 patients were divided into 391 Prior-, 252 Later-, and 404 Never-Vax cohorts. Significantly greater proportions of Later- and Never-Vax cohorts presented with mac-off RRDs (Prior-Vax = 44.5%; Later-Vax = 54%, P.0001; Never-Vax = 57.9%, P.0001) and primary PVR (Prior-Vax = 4.3%; Later-Vax = 13.6%, P.0001; Never-Vax = 17.1%, P.0001) compared to Prior-Vax cohort. Significantly greater proportion of Never-Vax cohort (7.7%, P.0001) were lost to follow-up compared to Prior- (2.3%) and Later-Vax (2.2%) cohorts. Never-Vax cohort (median = 35 miles) traveled farther compared to Prior- (median = 22.3 miles; P.0001) and Later-Vax cohorts (25.45 miles; P = .0038). Prior-Vax cohort had significantly better (P.05) initial (median = 0.30 logMAR) and final (0.18 logMAR) BCVA compared to Later- (Initial: 0.54 logMAR; Final: 0.30 logMAR) and Never-Vax (Initial: 0.70 logMAR; Final: 0.40 logMAR) cohorts.COVID-19 vaccine hesitancy is associated with worse clinical presentation and outcomes for primary RRD.

To evaluate potential accumulation of fluid in the outer choroid in eyes with central serous chorioretinopathy.Retrospective observational case series.Patients in 2 community-based retinal practices were evaluated for hyporeflective areas in the outer choroid consistent with collections of fluid using enhanced depth imaging optical coherence tomography. Eligible patients were examined over the preceding 2 years, had a history of central serous chorioretinopathy, and did not have a history of choroidal neovascularization or photodynamic therapy.In the New York group there were 131 eyes of 70 patients who had a mean age of 56.3 (± 12.5) years, and 88 (67.2%) had hyporeflective regions consistent with posterior loculation of fluid in the macular region. In the Minnesota data set there were 91 eyes of 48 patients who had a mean age of 47.9 (± 9.9) years and hyporeflective regions consistent with posterior loculation of fluid was present in 59 (64.8%). In the entire group the mean subfoveal choroidal thickness of those without loculated fluid was 344 μm, as compared with 498 μm with loculated fluid (P.001). The areas of loculated fluid were hyporeflective, were larger topographically than the large choroidal vessels, had an angular inner border, and did not have a bounding vascular wall.Posterior loculation of fluid is a common finding in central serous chorioretinopathy, but it has a different pattern and distribution than do collections of fluid in the outer choroid and suprachoroidal space as seen in other forms of choroidal effusion.

Purpose To review outcomes of vitrectomy plus or minus scleral buckling for retinal detachment (RD) attributable to peripheral break(s) with noncausal macular hole, plus or minus internal limiting membrane (ILM) peeling. Design Retrospective chart review. Methods Forty-nine consecutive patients from March 1, 1998 to March 31, 2009 with RD attributable to peripheral break and macular hole were treated by vitrectomy. Five had no scleral buckle placed. Forty-three underwent ILM peeling. Results The main outcome measures were retinal reattachment, macular hole status, and vision. Final retinal reattachment rate was 95.9% (47/49) with 1 and 100% with 2 operations. Final macular hole closure rate was 39/43 with ILM peeling (90.7%), and 2/6 without (33.3%, P value=.0041). Mean final acuity was 20/120, and 20/100 if the macular hole was closed. Conclusion Vitrectomy, plus or minus scleral buckle, with ILM peeling is effective for repair of RD with macular hole. ILM peeling can increase the rate of macular hole closure.

Purpose To report molluscum contagiosum as a cause of severe posttraumatic intraocular inflammation. Methods A 9-year-old girl developed severe intraocular inflammation in the right eye after a corneoscleral laceration. She underwent vitrectomy, and bacterial and fungal cultures of intraocular fluids were negative. A pedunculated white-tan mass removed from her right optic nerve head was sent for histologic evaluation. Result Histologic examination of the tissue showed stratified keratinizing squamous epithelium with intracytoplasmic inclusions consistent with molluscum contagiosum. Conclusions It is likely that infected epithelial cells were implanted at the time of injury. Vitrectomy as debridement was curative.

We studied the use of Q-switched Nd:YAG laser pulses to soften sclerotic lens nuclei before phacoemulsification. We obtained 105 lens nuclei from extracapsular cataract extractions, graded them for degree of sclerosis, and randomized them into laser treatment (53 lenses) or control groups (52 lenses). The treated lenses received laser pulses until confluent pits and clefts were visible. All lenses were phacoemulsified and the times recorded. Nd:YAG laser pretreatment decreased phacoemulsification time in all grades. In moderately sclerotic nuclei, average phacoemulsification time was reduced from 40.1 to 23.9 seconds (40.4%). The nuclei of ten lenses obtained from intracapsular cataract extractions were treated intracapsularly, and the posterior capsule was inadvertently ruptured in five.