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K Matthew McKay,1,* Filippos Vingopoulos,1,* Jay C Wang,1 Thanos D Papakostas,1,2 Rebecca F Silverman,1 Anna Marmalidou,1 Inês Lains,1 Dean Eliott,1 Demetrios G Vavvas,1 Leo A Kim,1 David M Wu,1 John B Miller1 1Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; 2Retina Service, Weill Cornell Medical College, New York, NY, USA*These authors contributed equally to this workCorrespondence: John B MillerRetina Service, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles St, Boston, MA 02114 Tel +1 (617) 573-3750Fax +1 (617) 573-3698Email john_miller@meei.harvard.eduObjective: To characterize the microvascular retinal changes after repair of macula-off rhegmatogenous retinal detachment (RRD) using optical coherence tomography angiography (OCT-A).Patients and Methods: A retrospective review of patients who underwent repair of macula-off RRD. Fellow unaffected eyes were used as controls. Post-operative OCT-A allowed comparison of vessel density (VD) and foveal avascular zone (FAZ) area in the superficial and deep retinal capillary plexus (DCP) as well as VD in the choriocapillaris layer.Results: Seventeen eyes of 17 RRD patients were included in the final analysis. There was a reduction in VD of the deep retinal capillary plexus in affected eyes compared to fellow eyes (p = 0.046). RRD eyes with reduced VD in DCP compared with their fellow control eyes had worse visual acuity after repair compared to those without (p = 0.032). No significant microvasculature changes were detected in the FAZ area and VD in the superficial capillary plexus and choriocapillaris compared to fellow eyes.Conclusion: In macula-off RRD eyes, significant microvascular changes were detected in the DCP using OCT-A even after successful anatomical repair. Decreased VD in the DCP compared to the fellow healthy eyes was correlated with worse visual acuity.Keywords: microvascular changes, OCT-angiography, macula-off retinal detachment

Este trabajo se enfoca en la temática de las representaciones del espacio local por parte de habitantes de una periferia popular de la Ciudad de México desde sus prácticas de movilidad peatonal. Está basado en la observación de cinco talleres de realización de mapas mentales en­focados en la movilidad peatonal, en los cuales participaron habitantes del “pueblo originario” conurbado de San Gregorio Atlapulco, ubicado en la periferia sur de la Ciudad de México. Los habitantes relatan una imposibilidad de caminar libre y decentemente en San Gregorio, de la cual nace un sentimiento de desterritorialización. El análisis de los talleres usa la movilidad peatonal como enfoque para entender los modos de “apropiación del espacio”, con la idea que cuando el potencial de apropiación del espacio se ve debilitado, los habitantes hacen resaltar ciertos elementos de un “sentido del lugar” que desean preservar.

Abstract Background Docetaxel (D) or secondary hormonal therapy (SHT) each combined with androgen deprivation therapy (ADT) represent possible treatment options in males with metastasized hormone‐sensitive prostate cancer (mHSPC). Real‐world data comparing different protocols are lacking yet. Thus, our objective was to compare the efficacy and safety of abiraterone acetate (AA)+ADT versus D+ADT in mHSPC. Methods In a retrospective multicenter analysis including males with mHSPC treated with either of the aforementioned protocols, overall survival (OS), progression‐free survival 1 (PFS1), and progression‐free survival 2 (PFS2) were assessed for both cohorts. Median time to event was tested by Kaplan–Meier method and log‐rank test. The Cox‐proportional hazards model was used for univariate and multivariate regression analyses. Results Overall, 196 patients were included. The AA+ADT cohort had a longer PFS1 in the log‐rank testing (23 vs. 13 mos., p

El síndrome metabólico representa una condición clínica de elevada complejidad, cuyos principales mecanismos causantes siguen siendo debatidos inclusive actualmente, lo cual ha provocado que existan múltiples criterios diagnósticos que varían según las distintas autoridades de salud a nivel mundial. Sin embargo, a pesar de dichas discrepancias, se ha observado cómo generalmente las alteraciones en la homeostasis energética, en el aumento de la grasa corporal y en la resistencia a la insulina relacionadas con el mismo afectan directamente eventos fisiológicos en la vida de las mujeres tales como la pubertad, el embarazo y la menopausia. También, a pesar de lo anteriormente descrito, por el momento pocos estudios han evaluado el impacto de este síndrome en la fertilidad de las mujeres que lo presentan; esto si bien en investigaciones relacionadas con este tema se ha descrito que se ha visto relacionado con aumento en las tasas de infertilidad femenina. Respecto a este último punto, han surgido distintos mecanismos que lo explican y que son propuestos actualmente, motivo por el cual se lleva a cabo la presente revisión donde se citan los mismos; así como las perspectivas desde unos puntos de vista clínicos, metabólicos y endocrinológicos relacionados con estos.

Abstract This study presents the global climate model IPSL‐CM6A‐LR developed at Institut Pierre‐Simon Laplace (IPSL) to study natural climate variability and climate response to natural and anthropogenic forcings as part of the sixth phase of the Coupled Model Intercomparison Project (CMIP6). This article describes the different model components, their coupling, and the simulated climate in comparison to previous model versions. We focus here on the representation of the physical climate along with the main characteristics of the global carbon cycle. The model's climatology, as assessed from a range of metrics (related in particular to radiation, temperature, precipitation, and wind), is strongly improved in comparison to previous model versions. Although they are reduced, a number of known biases and shortcomings (e.g., double Intertropical Convergence Zone [ITCZ], frequency of midlatitude wintertime blockings, and El Niño–Southern Oscillation [ENSO] dynamics) persist. The equilibrium climate sensitivity and transient climate response have both increased from the previous climate model IPSL‐CM5A‐LR used in CMIP5. A large ensemble of more than 30 members for the historical period (1850–2018) and a smaller ensemble for a range of emissions scenarios (until 2100 and 2300) are also presented and discussed.

Abstract Background To use a new medium to dynamically visualize serial optical coherence tomography (OCT) scans in order to illustrate and elucidate the pathogenesis of idiopathic macular hole formation, progression, and surgical closure. Case Presentations Two patients at the onset of symptoms with early stage macular holes and one patient following repair were followed with serial OCTs. Images centered at the fovea and at the same orientation were digitally exported and morphed into an Audiovisual Interleaving (avi) movie format. Morphing videos from serial OCTs allowed the OCTs to be viewed dynamically. The videos supported anterior-posterior vitreofoveal traction as the initial event in macular hole formation. Progression of the macular hole occurred with increased cystic thickening of the fovea without evidence of further vitreofoveal traction. During cyst formation, the macular hole enlarged as the edges of the hole became elevated from the retinal pigment epithelium (RPE) with an increase in subretinal fluid. Surgical repair of a macular hole revealed initial closure of the macular hole with subsequent reabsorption of the sub-retinal fluid and restoration of the foveal contour. Conclusions Morphing videos from serial OCTs are a useful tool and helped illustrate and support anterior-posterior vitreofoveal traction with subsequent retinal hydration as the pathogenesis of idiopathic macular holes.

A letter to the editor is presented which discusses a case of a 59-year-old man who showed improvement of diabetic macular oedema following intravitreal injection of bevacizumab.

This paper studies the context of the implementation of sustainable development oriented urban transport and mobility policies, since the 2000s. It aims at bringing new elements in the discussion on how globalization and neoliberalization processes affect cities of the global South. It insists on Amman municipality’s active role and strategy in mobilizing international “best practices” and actor networks. The paper also underlines the plurality of the territorial scales involved in these policy transfers, between the city branding issues at the regional, even international level and the affirmation of the municipality’s territory and competencies at the national level. Finally, it describes the important contestations that are shooking the implementation of these policies, which became a field for power-based territorial conflicts.

Purpose: To determine if intravitreal injection of antibiotics alone versus early pars plana vitrectomy (PPV) plus injection of intravitreal antibiotics predicted better or worse visual outcomes for patients with endophthalmitis after anti-vascular endothelial growth factor (anti-VEGF) injections., Design: Retrospective cohort study PARTICIPANTS: Patients developing endophthalmitis after receiving an intravitreal anti-VEGF injection from the American Academy of Ophthalmology IRIS® Registry between 2016 and 2020., Methods: Inclusion criteria were endophthalmitis diagnosis within 1 to 28 days after anti-VEGF injection and a recorded visual acuity (VA) at baseline, on the day of diagnosis, and post-treatment. Patients in the Injection Only group underwent intravitreal injection of antibiotics alone and in the Early Vitrectomy group received PPV with intravitreal antibiotics or intravitreal injection followed by PPV within 2 days of diagnosis. Patients were excluded if they had cataract surgery during the study, intravitreal steroids before endophthalmitis, or intermediate/posterior uveitis or cystoid macular edema. The study created a 1:1 matched cohort using Mahalanobis Distance Matching, accounting for the differences in VA at baseline and diagnosis., Main Outcome Measures: Post-treatment logMAR VA RESULTS: 1,044 patients diagnosed with post-injection endophthalmitis met the inclusion and exclusion criteria. In the unmatched cohort, there were 935 patients in the Injection Only and 109 in the Early Vitrectomy group. In 1:1 matched cohort 218 patients (109 in each group) were included; the median logMAR VAs were 0.32 [20/40-20/50] at baseline, 0.88 [∼20/150] at diagnosis, and 0.57 [20/70-20/80] post-treatment. There were no statistically significant differences in the visual outcomes between the two matched treatment groups (b = 0.05, p = 0.23); including the subgroup of patients with VA worse than 1.0 logMAR (b = 0.05, p = 0.452)., Conclusions: There was no significant difference in final VA outcomes between patients receiving Injection Only and those treated with Early Vitrectomy for post-injection endophthalmitis. The findings support the use of either treatment strategy., (Copyright © 2024. Published by Elsevier Inc.)

Purpose: To investigate the effects of faricimab, a bispecific antibody targeting VEGF and Ang-2 (thus increasing Tie-2 activity), in patients with CSC based on a recent genetic study that implicated Tie-2 signaling in CSC pathophysiology., Design: A retrospective interventional multicenter case series., Methods: We included patients with chronic CSC (persistent or recurrent SRF for ≥6 months) who received at least one faricimab 6 mg injection between January 1 2022, and April 1 2024,. Study sites included Massachusetts Eye and Ear and University of California San Francisco. Patients with evidence of a choroidal neovascular membrane on color photos, optical coherence tomography (OCT) and/or fluorescein angiography were excluded. 16 eyes (15 patients) met the inclusion criteria. The median central macular thickness at each visit from 52 weeks before to 52 weeks after the first faricimab injection was calculated using automated Heidelberg Spectralis ETDRS subfield measurements., Results: Prior to treatment with faricimab, CSC had been diagnosed a median of 4.1 years (range 0.9-8) earlier and SRF (and intraretinal fluid [IRF] in a subset) had been continuously present for a median of 30 weeks (range 9-257). Decreases in macular thickness were observed in 14/16 eyes after the first faricimab injection and in 14/16 eyes in the full follow-up period compared with prior, 10 of which experienced complete resolution of SRF following the start of the first series of injections at a median of 4 weeks (range 2-25). One eye worsened after the second injection. The median improvement in macular thickness was 40 μm [range -3 to 89.5] (P = .0007). Upon review of OCT images, reductions in macular thickness were consistent with reductions in SRF and/or IRF. Visual acuity improved by 2 lines or more in 6/16 eyes., Conclusions: In a retrospective case series of patients with chronic CSC and longstanding SRF, we observed improvement in macular thickness after intravitreal faricimab. While the small number of patients and variable natural history of CSC preclude definitive conclusions, a randomized controlled trial seems warranted., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: To assess and compare the rate of endophthalmitis and visual outcomes in cases of OGI's without intraocular foreign bodies repaired within and greater than 24 hours from the time of injury., Design: A retrospective review of 2,002 cases of OGI's presenting to a single institution., Subjects, Participants, And/or Controls: Patients with OGI's were admitted and managed according to a standardized protocol., Methods, Intervention, or Testing: The impact of timing of repair was assessed between those undergoing OGI repair within (i) 24 hours, (ii) 25-36 hours, and (iii) greater than 36 hours from the time of injury., Main Outcome and Measure: Rates of endophthalmitis and postoperative visual acuity of logMAR 1.3, logMAR 1.0, and logMAR 0.3 at 180 days and 1 year following open globe repair., Results: 1,382 patients with OGI's were included, of which 75% were male with an average age of 41 years. Maximal zone of injury was zone 1 for 468 patients, zone 2 for 529 patients and zone 3 for 508 patients. 84% of all OGI's underwent repair within 24 hours from the time of injury, 9% from 25-36 hours, and 7% greater than 36 hours. Average preoperative visual acuity was hand motion. Risk factors associated with repair performed greater than 36 hours from the time of injury included female sex (p=0.042). Endophthalmitis was associated with time to repair greater than 36 hours (p=0.049) but not with 25-36 hours or zone of injury (p=0.111). Time to repair had no significant impact on visual acuity outcomes., Conclusions: Although repair of OGI's within 24 hours is the current standard of care, this study found no statistically significant difference in rates of endophthalmitis or visual outcomes in eyes undergoing repair within 24 hours of injury compared to repair extending to 25 to 36 hours . Endophthalmitis rates did increase after 36 hours. We recommend urgent repair of open globe injuries, but in certain circumstances, it may be reasonable to delay repair beyond 24 hours to optimize operating conditions., (Copyright © 2024. Published by Elsevier Inc.)

Epiretinal membrane (ERM) is a common retinal condition characterized by the presence of fibrocellular tissue on the retinal surface, often with visual distortion and loss of visual acuity. We studied European American (EUR), African American (AFR), and Latino (admixed American, AMR) ERM participants in the Million Veteran Program (MVP) for genome-wide association analysis-a total of 38,232 case individuals and 557,988 control individuals. We completed a genome-wide association study (GWAS) in each population separately, and then results were meta-analyzed. Genome-wide significant (GWS) associations were observed in all three populations studied: 31 risk loci in EUR subjects, 3 in AFR, and 2 in AMR, with 48 in trans-ancestry meta-analysis. Many results replicated in the FinnGen sample. Several GWS variants associate to alterations in gene expression in the macula. ERM showed significant genetic correlation to multiple traits. Pathway enrichment analyses implicated collagen and collagen-adjacent mechanisms, among others. This well-powered ERM GWAS identified novel genetic associations that point to biological mechanisms for ERM., Competing Interests: Declaration of interests J.G. is named as an inventor on PCT patent application #15/878,640 entitled “Genotype-guided dosing of opioid agonists,” filed January 24, 2018, and issued on January 26, 2021, as US Patent No. 10900082. J.G. is paid for editorial work for the journal Complex Psychiatry (Karger). D.E. is an ad hoc consultant for Alcon, Dutch Ophthalmic, GelMEDIX, and Genentech; reports research funding from Neurotech and Unity Biotechnology; is a member of the Advisory Board and Stockholder for InGel Therapeutics, Pykus Therapeutics, and RetMap; reports being Advisor, Patents, Royalties, and Stockholder in Aldeyra Therapeutics; and is a member of the Data Safety Monitoring Board for Asclepix. M.B.S. has in the past 3 years received consulting income from Acadia Pharmaceuticals, Aptinyx, atai Life Sciences, BigHealth, Bionomics, BioXcel Therapeutics, Boehringer Ingelheim, Clexio, Eisai, EmpowerPharm, Engrail Therapeutics, Janssen, Jazz Pharmaceuticals, NeuroTrauma Sciences, PureTech Health, Sumitomo Pharma, and Roche/Genentech. M.B.S. has stock options in Oxeia Biopharmaceuticals and EpiVario. He has been paid for his editorial work on Depression and Anxiety (Editor-in-Chief), Biological Psychiatry (Deputy Editor), and UpToDate (Co-Editor-in-Chief for Psychiatry). He is on the scientific advisory board for the Brain and Behavior Research Foundation and the Anxiety and Depression Association of America., (Published by Elsevier Inc.)

Background and Objective: Our objective was to evaluate retinal microvascular changes and visual outcomes following rhegmatogenous retinal detachment (RRD) repair using wide-field swept-source optical coherence tomography angiography (WF SS-OCTA)., Patients and Methods: The study included 116 eyes of 111 patients with macula-off ( n = 68) or macula-on ( n = 48) RRD treated with a single successful procedure, 79 fellow eyes, and 183 eyes of control patients imaged with WF SS-OCTA (3 ×3, 6 ×6, and 12 ×12 mm images). Mixed-effects multiple linear regression models were used for statistical analysis., Results: Vessel density (VD) and vessel skeletonized density (VSD) of the superficial capillary plexus (3 ×3 mm scans) and full-thickness retina (12 ×12 mm) were significantly reduced in RRD eyes compared to fellow and control eyes. Decreased VSD and VD in all layers (3 ×3 mm and 6 ×6 mm) were significantly associated with greater preoperative extent of retinal detachment ( P < 0.05) and poorer postoperative best-corrected visual acuity (BCVA) in RRD eyes ( P < 0.05). Macula-off status was associated with increased foveal avascular zone irregularity (12 ×12 mm, P = 0.02)., Conclusions: Decreased VD on WF SS-OCTA is associated with poorer postoperative BCVA following RRD repair. [ Ophthalmic Surg Lasers Imaging Retina 2024;55:310-317.] .

Introduction: To report a case of macular hole (MH)-associated retinal detachment (RD) with Straatsma syndrome. Methods: A clinical case was retrospectively reviewed. Results: A 39-year-old woman with Straatsma syndrome was treated for an MH-associated RD. The MH was closed with vitrectomy and internal limiting membrane peeling, during which an unusually strong vitreoretinal adhesion was encountered in the area of myelinated nerve fibers. One day postoperatively, the patient developed serous choroidal effusions and a serous RD, which resolved by postoperative week 1. The patient's vision ultimately returned to baseline. Conclusions: The presence of an unusually strong vitreoretinal adhesion in the area of myelinated nerve fibers and the development of a postoperative serous RD suggest that myelination may contribute to vitreoretinal adhesion and the development of MHs in Straatsma syndrome., Competing Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Eliott: consultant to Alcon, Aldeyra Therapeutics, Apellis, Dutch Ophthalmic, Genentech, Neurotech, Pykus Therapeutics, RetMap; DSMB for Asclepix, Aviceda, Clearside Biomedical, EyeBio; research grants for Neurotech, Unity Biotechnology. Isaac. (None are relevant to this article). Neither of the other authors declared potential conflicts of interest., (© The Author(s) 2024.)

Competing Interests: The authors declare that they have no conflicts of interest to disclose.

Competing Interests: The authors declare that they have no conflicts of interest to disclose.

Competing Interests: Mary C. Boulanger and Marisa G. Tieger declare no conflict of interest. Dean Eliott reports consulting for Alcon, Allergan, Dutch Ophthalmic, and Genentech, research funding from Neurotech and Unity Biotechnology, and stock and royalties from Aldeyra Therapeutics. Andrew J. Yee reports consulting for AbbVie, Adaptive Biotechnologies, Amgen, BMS, Celgene, GSK, Janssen, Karyopharm, Oncopeptides, Pfizer, Prothena, Regeneron, Sanofi, Sebia, and Takeda.

The standard of care for open globe injuries is prompt surgical closure, as delay in repair is a reported risk factor for post-traumatic endophthalmitis and is associated with worse visual outcomes. This article serves as a review of the current management and outcomes of open globe injuries repaired greater than 24 hours from the time of injury, specifically evaluating the rates of endophthalmitis in cases with and without intraocular foreign bodies, visual outcomes and rates of primary enucleation or evisceration.

We report the case of a 28-year-old man with X-linked retinoschisis (XLRS) and type I diabetes mellitus. The patient had bilateral foveoschisis with a tractional retinal fold in the right eye. Optical coherence tomography (OCT) revealed hyperreflective material within the inner nuclear and outer plexiform layers, photoreceptor atrophy, and retinal pigment epithelium irregularities in both eyes. Fluorescein angiography showed hyperfluorescent foveal spots corresponding to the hyperreflective material observed on OCT. This is a unique presentation of XLRS, with concurrent foveoschisis and photoreceptor atrophy in both eyes. The hyperreflective material on OCT serves as a distinctive feature of XLRS. [ Ophthalmic Surg Lasers Imaging Retina 2023;54:603-606.] .

Purpose: To report a case of proliferative vitreoretinopathy (PVR) in a man with recurrent retinal detachment successfully managed without surgical intervention following the initiation of intravitreal methotrexate injections to arrest progression of PVR., Methods: Report of a case., Results: A 60-year-old man presented to the retina clinic 4 weeks after undergoing vitrectomy for rhegmatogenous retinal detachment and was found to have an inferior recurrent retinal detachment. He underwent repeat vitrectomy and scleral buckling with successful reattachment of the retina in the immediate postoperative period. At postoperative Week 2, preretinal membranes were noted inferiorly with stretching of the causative retinal break and localized subretinal fluid, consistent with early PVR. The patient underwent immediate laser barricade, and a course of intravitreal methotrexate injections was started. At the final follow-up 7 months later, the retina was fully attached without progression of PVR., Conclusion: Intravitreal methotrexate may play a role in arresting progression of early postoperative PVR and obviating the need for surgical intervention.

Purpose: The purpose of this study was to present a case of indolent endogenous endophthalmitis in a young, seemingly healthy woman., Methods: This study is a retrospective case report., Results: A 25-year-old woman with no significant medical history presented with vision loss in the left eye over the course of 1 month. Examination showed vitritis and a white-yellow lesion overlying the macula and optic nerve in the left eye. Initial laboratory testing for infectious and inflammatory causes was unrevealing. A diagnostic vitrectomy was performed, and the patient was found to have presumed endogenous endophthalmitis due to Streptococcus anginosus, an extremely uncommon bacterium. Subsequent workup did not reveal evidence of bacteremia, endocarditis, or orbital infection. This case is unique because, unlike the three previously reported cases of S. anginosus endophthalmitis, this patient was seemingly healthy, never had an elevated white blood cell count, never had documented bacteremia, had a normal echocardiogram, and had normal orbital findings on magnetic resonance imaging and computed tomography scans. Further questioning revealed a remote history of facial cellulitis and possible sinusitis treated with oral antibiotics, which are the presumed etiology., Conclusion: Streptococcus anginosus endophthalmitis can occur in young, seemingly healthy patients. Endogenous endophthalmitis should be considered in the differential diagnosis even without systemic comorbidities or other risk factors. Detailed questioning about medical history and thorough review of systems, including nonocular symptoms, are essential.

Purpose: To investigate the prevalence and clinical characteristics of diabetic patients with retinal venous loops (RVLs) and to assess the association with retinal ischemia using widefield swept-source optical coherence tomography angiography (WF SS-OCTA)., Methods: In this retrospective, cross-sectional study, a total of 195 eyes of 132 diabetic patients (31 eyes with no diabetic retinopathy (DR), 76 eyes with nonproliferative DR (NPDR), and 88 eyes with proliferative DR (PDR)) were imaged with WF SS-OCTA using Angio 6 × 6 mm and Montage 15 × 15 mm scans. Quantitative ischemia-related parameters, including ischemia index (ratio of nonperfusion area to total retinal area), foveal avascular zone (FAZ), and neovascularization features, were evaluated. RVLs were classified as type I or type II according to the branching level of the feeder vessel. A multivariate generalized estimating equations (GEE) logistic regression model was used to analyze the association of systemic parameters and ischemia-related metrics with RVLs in PDR eyes., Results: Forty-eight RVLs were identified in 22 eyes (11.28%). The prevalence of RVLs was higher in PDR compared to NPDR eyes (21.59% vs. 3.95%, P < 0.05). Type II RVLs accounted for a higher proportion than type I (89.58% vs. 10.42%, P < 0.001). RVLs were more likely to originate from superior (vs. inferior) and temporal (vs. nasal) veins (P < 0.05). The GEE model showed that neovascularization (NV) flow area and diastolic blood pressure were associated with RVLs in the PDR group (P < 0.05)., Conclusion: WF SS-OCTA is useful for the identification of RVLs in patients with DR. NV flow area and diastolic blood pressure were associated with the presence of RVLs in eyes with PDR. Ischemia index, FAZ, and other WF SS-OCTA parameters were not associated with RVLs. Further longitudinal studies are needed to identify the role of RVLs in DR progression., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)