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Purpose: The main purpose of the study was to report the estimated incidence, cumulative rate, risk factors and outcomes of submacular haemorrhage (SMH) with loss of vision in neovascular age‐related macular degeneration (nAMD) receiving intravitreal injections (IVT) of vascular endothelial growth factor (VEGF) inhibitor in routine clinical practice. Methods: Retrospective analysis of treatment‐naïve eyes receiving IVTs of VEGF inhibitors (ranibizumab, aflibercept or bevacizumab) for nAMD from 1 January 2010 to 31 December 2020 that were tracked the Fight Retinal Blindness! registry. Estimated incidence, cumulative rate and hazard ratios (HR) of SMH with loss of vision during treatment were measured using the Poisson regression, Kaplan–Meier survival curves and Cox proportional hazard models. Results: We identified 7642 eyes (6425 patients) with a total of 135 095 IVT over a 10‐year period. One hundred five eyes developed SMH with loss of vision with a rate of 1 per 1283 injections (0.08% 95% confidence interval [95% CI] [0.06; 0.09]). The estimated incidence [95% CI] was 4.6 [3.8; 5.7] SMH with loss of vision per year per 1000 treated patients during the study. The cumulative [95% CI] rate of SMH per patient did not increase significantly with each successive injection (p = 0.947). SMH cases had a mean VA drop of around 6 lines at diagnosis, which then improved moderately to a 4‐line loss at 1 year. Conclusions: Submacular haemorrhage (SMH) with loss of vision is an uncommon complication that can occur at any time in eyes treated for nAMD in routine clinical practice, with only limited recovery of vision 1 year later. [ABSTRACT FROM AUTHOR]

Background: Clinical ophthalmological guidelines encourage the assessment of potential benefits and harms when deciding whether to perform elective ophthalmology procedures during the COVID‐19 pandemic, in order to minimize the risk of disease transmission. Method: We performed probability calculations to estimate COVID‐19 infection status and likelihood of disease transmission among neovascular age‐related macular degeneration patients and health‐care workers during anti‐VEGF procedures, at various community prevalence levels of COVID‐19. We then applied the expected burden of COVID‐19 illness and death expressed through health‐adjusted life‐years (HALYs) lost. We compared these results to the expected disease burden of severe visual impairment if sight protecting anti‐VEGF injections were not performed. Results: Our calculations suggest a wide range of contexts where the benefits of treatment to prevent progression to severe visual impairment or blindness are greater than the expected harms to the patient and immediate health care team due to COVID‐19. For example, with appropriate protective equipment the benefits of treatment outweigh harms when the chance of progression to severe visual impairment is >0.044% for all scenarios where COVID‐19 prevalence was 1/1000, even when the attack rate in the clinical setting is very high (5‐43%). Conclusion: Unless COVID‐19 prevalence is very high, the reduced disease burden from avoiding visual impairment outweighs the expected HALYs lost from COVID‐19 transmission. This finding is driven by the fact that HALYs lost when someone suffers severe visual impairment for 5 years are equivalent to nearly 400 moderate cases of infectious disease lasting 2 weeks each. [ABSTRACT FROM AUTHOR]

A bstract Background: The study compares the change in best-corrected visual acuity with the change in central retinal sensitivity before treatment and 6 months after treatment with photodynamic therapy in patients with symptomatic central serous chorio retinopathy. Design: Prospective, single-centre, interventional case series. Participants: Eleven consecutive patients with previously untreated central serous chorio retinopathy. Methods: Patients had microperimetry and best-corrected visual acuity recorded before and 6 months after treatment with photodynamic therapy. Refracted best-corrected visual acuity was assessed at 2 m and adjusted to give the number of letters read at 1 m. Threshold microperimetry was performed by presenting a Goldman III stimulus to 29 points over the central 12° around fixation. Significant visual improvement at 6 months was defined as a best-corrected visual acuity ≥10 letters or, microperimetry change in mean retinal sensitivity ≥2 decibels (dB). Main Outcome Measures: Improvement in best-corrected visual acuity compared with microperimetry following photodynamic therapy treatment in patients with central serous chorio retinopathy. Results: All patients reported a subjective improvement in vision and had complete resolution of subretinal fluid at 6 months. Two patients had a significant improvement in best-corrected visual acuity (mean ± SD +4.2 ± 5.8 letters), compared with all 11 patients who recorded a significant improvement in mean retinal sensitivity (mean ± SD 4.6 ± 1.9 dB) ( P < 0.001). Conclusions: These data suggest that compared with microperimetry, best-corrected visual acuity is underestimating the effectiveness of photodynamic therapy in the treatment of central serous chorio retinopathy. [ABSTRACT FROM AUTHOR]