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Patients were grouped into three categories: normal BMI (BMI less than 25), overweight BMI (BMI between 25 and 30), and obese BMI (BMI greater than 30). Elevated body mass index (BMI) and increased abdominal girth are associated with vitreous pressure during cataract surgery. Surgeons at our institution do not use the standing phaco-emulsification technique.[3] Patients with a BMI classification of obese undergo cataract surgery at a younger age and are more likely to have diabetic retinopathy. [Extracted from the article]

Some of the newly diagnosed NV-AMD patients could have converted from iAMD to NV-AMD since their last visit with the outside eye care provider. However, 33% of enrollees self-reported eAMD or iAMD but had other ocular pathology, mostly geographic atrophy (GA) or neovascular AMD (NV-AMD). The use of social and digital media to recruit patients with early and intermediate age-related macular degeneration. [Extracted from the article]

To describe the relationship between surgical duration and post-operative outcomes in patients undergoing simple cataract surgery. This was a retrospective cohort study using data from the University of Colorado Department of Ophthalmology Cataract Outcomes Database. We studied eyes which underwent uncomplicated and non-complex cataract extraction via phacoemulsification between January 1, 2014 and December 31, 2018. Surgery duration was defined as "long" when greater than one standard deviation above the mean surgery time for a given surgeon. Post-operative variables were collected and outcomes were compared between the long surgery group and the non-long surgery group in univariate and multivariate analysis. A total of 5839 eyes met criteria, of which 768 (13.2%) were classified as long surgeries. Multivariable analysis showed no association between prolonged postoperative inflammation and long surgeries (odds ratio [OR] 1.10, 95% Confidence Interval [CI] 0.64–1.91, p =.720). Long surgeries were associated with increased need for Nd:YAG capsulotomy (OR 1.42, 95% CI 1.10–1.82, p =.006). Post-operative day 1 visual acuity was poorer in the long surgery group (logMAR difference 0.03, 95% CI 0.01–0.06, p =.018) as was best-corrected visual acuity at post-operative month 1 through 3 (logMAR difference 0.02, 95% CI 0.01–0.04, p =.009). It may be beneficial for patients who have undergone long cataract surgery to be counseled on a slower visual recovery and on the greater likelihood of posterior capsular opacification. However, most outcomes of non-complex, non-complicated surgeries more than one standard deviation above the mean surgery length can be expected to be similar to surgeries of shorter length. [ABSTRACT FROM AUTHOR]

To examine gender differences in visual functioning using the National Eye Institute Visual Functioning Questionnaire-25 (VFQ-25) in a Colorado cohort of patients with age-related macular degeneration (AMD). A retrospective cohort study was conducted using a registry of AMD patients who attended the Sue Anschutz-Rodgers Eye Center (2014 to 2019). Demographic, clinical, and image data were collected, and AMD was categorized as Early/Intermediate AMD, or unilateral/bilateral neovascular (NV) AMD, geographic atrophy (GA), or Both Advanced using the Beckman Classification. Each patient completed the VFQ-25, which evaluates visual functioning, generating a composite score and subscale scores for vision-specific activities. Univariate and multivariable general linear models were used to estimate the associations between gender and VFQ-25 scores with parameter estimates (PE) and standard errors (SE). Among 739 patients with AMD, 294 (39.8%), 115 (15.6%), 168 (22.7%), and 162 (21.9%) were diagnosed with Early/Intermediate AMD, GA, NV AMD, and Both Advanced, respectively. Adjusted for AMD classification, age and habitual visual acuity in the better-seeing and worse-seeing eyes, female gender was not significantly associated with lower composite VFQ-25 scores (PE (SE): −1.2 (0.9), p =.193), and was significantly associated with reportedly worse ocular pain and driving subscale scores (PE (SE): −4.6 (1.0), p <.0001 and −9.1 (2.1), p <.0001, respectively). Gender plays a role in reported driving activities and ocular pain among patients with AMD. This may need to be accounted for in future research related to the use of VFQ-25 for AMD. [ABSTRACT FROM AUTHOR]

Purpose: To determine the drop volume and total number of dispensed drops using the Nanodropper eyedrop bottle adaptor (Nanodropper, Inc.) compared to drops dispensed from stock bottles to potentially limit ocular toxicity of these eyedrops and prolong bottle use. Patients and Methods: Six topical ocular hypotensive medications (5 solutions, 1 suspension), one steroid (suspension) and two artificial tears emulsions were selected for this study. An analytical balance was used to determine the mass per 10 drops with and without the volume-reducing adaptor and repeated until the bottles were completely emptied. The density of each product was determined using the calculated density. The average drop volume and number of drops per bottle for the nine medications were compared with and without the adaptor with paired t-testing. Results: When all medications were assessed, the drops delivered with the adaptor were 62.1% smaller than eyedrops administered from standard bottles. Compared to stock bottle eyedrops, which had a mean volume of 39.8 ± 2.1 μL, the adaptor resulted in drops with a mean volume of 15.1 ± 1.0 μL, p< 0.0001. The adaptor delivered 2.6x the number of drops dispensed from a standard 2.5 mL bottle (184.1 ± 15.1 drops with adaptor and 69.8 ± 4.9 drops from stock bottle, p< 0.0001). Conclusion: The Nanodropper eyedrop bottle adaptor can significantly reduce drop volume and increase the overall number of drops dispensed compared with stock eyedrop bottles. Further studies are needed to elucidate the clinical impact of utilizing decreased drop volume with direct comparison to current standards of care. [ABSTRACT FROM AUTHOR]

Sparse data exist regarding low vision (LV) services referral patterns. We retrospectively examined our institution's intermediate age-related macular degeneration (iAMD) patients to determine factors influencing referral. We compared visual acuity (VA) and Visual Function Questionnaire (VFQ-25) composite and subscale scores for referred and non-referred iAMD patients. VA was collected at time of referral or most recent visit, and VFQ-25 was taken upon enrollment into the registry. Thirty-six (15.5%) of the 232 iAMD patients were referred to LV. Referred patients were more likely to have older age, worse VA in both eyes, and lower VFQ-25 scores. Univariate analysis of VFQ-25 subscales demonstrated worse scores in general vision, near, distance, mental health, role limitations, dependency, and driving. Multivariable analysis revealed lower scores in general health, general vision, and driving. Forty-eight percent of non-referred patients had VA or VFQ-25 composite scores at least as poor as the median for referred patients. Two-thirds of patients who were not referred had no discernable obstacle to referral. Our institution refers patients with worse objective and functioning vision, but more patients may benefit from referral. Future studies should identify metrics to prompt referral and evaluate this approach. [ABSTRACT FROM AUTHOR]

Age-related macular degeneration (AMD) is a leading cause of vision loss in the elderly. The role of systemic inflammation in AMD remains unclear specifically in patients with intermediate AMD (iAMD). We sought to determine whether systemic inflammation was associated with future iAMD progression. Combinations of 27 circulating inflammatory markers including complement factors, cytokines, chemokines, and high-sensitivity C-reactive protein (hsCRP) were evaluated in iAMD patients recruited into a Colorado AMD registry. Systemic inflammatory markers were combined using principal component analysis. Risk factors for AMD progression were evaluated using Cox regression models. This study included 99 subjects with iAMD, 21 of which progressed to advanced AMD. Two principal components (PCs) were identified that contributed to the risk of progression to advanced AMD, after adjusting for age and bilateral reticular pseudodrusen. The strongest associated PC was explained largely by the pro-inflammatory cytokine TNFα and the anti-inflammatory IL1ra antagonist of IL1. The additional PC was largely explained by IL6, IL8, C3 and factor D in the positive direction and CRP, MCP1, factor B and factor I in the negative direction. When evaluated through multivariate analyses, combinations of biomarkers distinguished patients who did and did not progress to future advanced AMD. Increased risk could result from different combinations of analyte levels indicating a complex relationship rather than a simple increase in a few markers. This suggests that studying systemic inflammation in iAMD can provide insights into early pathologic events and potentially identify patients at highest risk for the development of severe AMD. [ABSTRACT FROM AUTHOR]