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Purpose: To elaborate a deep learning (DL) model for automatic prediction of late recurrence (LR) of rhegmatogenous retinal detachment (RRD) using pseudocolor and fundus autofluorescence (AF) ultra‐wide field (UWF) images obtained preoperatively and postoperatively. Materials and Methods: We retrospectively included patients >18 years who underwent either scleral buckling (SB) or pars plana vitrectomy (PPV) for primary or recurrent RRD with a post‐operative follow‐up >2 years. Records of RRD recurrence between 6 weeks and 2 years after surgery served as a ground truth for the training of the deep learning (DL) models. Four separate DL models were trained to predict LR within the 2 postoperative years (binary outputs) using, respectively, UWF preoperative and postoperative pseudocolor images and UWF preoperative and postoperative AF images. Results: A total of 412 eyes were included in the study (332 eyes treated with PPV and 80 eyes with SB). The mean follow‐up was 4.0 ± 2.1 years. The DL models based on preoperative and postoperative pseudocolor UWF imaging predicted recurrence with 85.6% (sensitivity 86.7%, specificity 85.4%) and 90.2% accuracy (sensitivity 87.0%, specificity 90.8%) in PPV‐treated eyes, and 87.0% (sensitivity 86.7%, specificity 87.0%) and 91.1% (sensitivity 88.2%, specificity 91.9%) in SB‐treated eyes, respectively. The DL models using preoperative and postoperative AF‐UWF imaging predicted recurrence with 87.6% (sensitivity 84.0% and specificity 88.3%) and 91.0% (sensitivity 88.9%, specificity 91.5%) accuracy in PPV eyes, and 86.5% (sensitivity 87.5%; specificity 86.2%) and 90.6% (sensitivity 90.0%, specificity 90.7%) in SB eyes, respectively. Among the risk factors detected with visualisation methods, potential novel ones were extensive laser retinopexy and asymmetric staphyloma. Conclusions: DL can accurately predict the LR of RRD based on UWF images (especially postoperative ones), which can help refine follow‐up strategies. Saliency maps might provide further insight into the dynamics of RRD recurrence. [ABSTRACT FROM AUTHOR]

Persistent fetal vasculature (PFV) is a rare malformative ocular disorder resulting from the failure of the hyaloid vasculature to regress. The severity of the visual impairment is depending on the underlying eye defects, ranging from discreet hyaloid remnants to severe ocular anomalies. Although PFV is generally unilateral, sporadic and idiopathic, a genetic cause has been described in some individuals, especially those presenting with a bilateral and/or syndromic form of PFV. The genes occasionally described in PFV are most often responsible for a wide spectrum of ocular phenotypes such as ATOH7 or NDP, a gene also known to be involved in Norrie disease, a X‐linked vitreoretinopathy with extra‐ocular features. We describe here a patient with an ocular phenotype consisting in non‐syndromic bilateral PFV with cataract and microphthalmia, in whom a recurrent heterozygous de novo MIP disease‐causing variant was detected after using a dedicated 119‐ocular genes panel approach. Defects in the MIP gene are classically associated with dominant non‐syndromic congenital cataract without other ocular malformative features. Thus, this case highlights the value of exploring individuals with PFV, even those with non‐syndromic forms. It also broadens the phenotypic spectrum of the MIP gene, adding new insights into the gene networks underlying PFV pathophysiology, that remains unclear. [ABSTRACT FROM AUTHOR]

This article discusses a case of periorbital skin pallor in a preterm infant following the instillation of 2.5% phenylephrine mydriatic eye drops prior to retinopathy of prematurity (ROP) treatment. The infant had a complex medical history, including surgical necrotizing enterocolitis, short bowel syndrome, patent ductus arteriosus, septic shock, and bronchopulmonary dysplasia. The article highlights the potential systemic and local complications associated with phenylephrine eye drops, such as systemic vasoconstriction, hypertension, pulmonary edema, and periocular vasoconstriction. The authors emphasize the importance of monitoring vital signs and reducing the volume and frequency of drops to prevent systemic complications. [Extracted from the article]

Purpose: Continuous‐wave cyclophotocoagulation (CW‐CPC) is often preferred to medical and surgical treatments for managing refractory glaucoma. This review summarizes diode CW‐CPC indications, history, histopathology, methods, efficacy and safety. It also provides an overview of the latest data available on micropulse transscleral laser treatment (MP‐TLT) that uses repetitive micropulses of diode laser energy in an off‐and‐on cyclical fashion. Methods: A literature review was conducted on transscleral CW‐CPC (CW‐TSCPC), endoscopic CPC (ECP) and MP‐TLT. Relevant series of adult and paediatric patients were included for assessing the procedures. Results: Regarding CW‐TCPC, highly variable success rates are reported in the literature, depending on the definition of success, type of underlying glaucoma, energy settings, follow‐up duration and retreatment rates. CW‐CPC often needs to be repeated, especially in paediatric patients. CW‐CPC exposes to risks of inflammation and chronic ocular hypotony or phthisis with irreversible visual loss. CW‐TSCPC has mainly been used in very severe forms of glaucoma, in painful eyes with limited visual potential or after filtering surgery failure. Published data on ECP are more limited but overall good success rates have been reported. Through the direct visualization of the targeted ciliary body in anatomically abnormal eyes, ECP is the preferred surgical procedure in paediatric refractory glaucoma. Complication rates are relatively low after ECP; however, large studies with long‐term follow‐up are needed. ECP may be used in difficult, refractory cases, but it is often used earlier when combined with cataract surgery. Despite limited data on the exact mechanism of action of MP‐TLT and a lack of standardization of laser settings, the first data from heterogeneous case series shows that it has a similar efficacy and a better safety profile compared to CW‐TSCPC in the medium term. Conclusion: Although they may lead to sight‐threatening complications, both CW‐TSCPC and ECP seem effective. ECP appears to be superior to CW‐TSCPC in paediatric refractory glaucoma. Unlike ECP combined with cataract surgery, evidence supporting a wider use of CW‐TSCPC and MP‐TLT in earlier stages of neuropathy is lacking. While it now appears that the safety profile of MP‐TLT is superior to that of CW‐CPC, robust prospective comparative studies including homogeneous and well‐defined cohorts of patients are still needed to confirm an at least comparable efficacy in the long term. [ABSTRACT FROM AUTHOR]

This study aims to assess the prevalence and characteristics of preterm infants with retinopathy of prematurity (ROP) treated outside the recommended guidelines. In this retrospective monocentric cohort, we included all premature children treated in our department for ROP by laser photoablation or anti-VEGF intravitreal injection. The main outcome was treatment of both eyes for ROP less severe than pre-threshold type 1, treated outside ETROP guidelines. A total of 114 children received treatment for ROP in our department, among whom 32 (28.1%) children received treatment for indications outside the ETROP guidelines for both eyes. The indications outside the guidelines were persistent stage 2 or 3 ROP that showed no evidence of regression after 41 weeks of corrected gestational age (11 children; 34.4%), pre-plus stage (11; 34.4%), difficulties in disease staging (7; 21.9%), type 2 ROP with plus disease (2; 6.2%), and treatment due to logistical difficulties (1; 3.1%; hospitalized in neonatal units hundreds of miles away from our department, with no fundus examination possible in the neonatal unit). To resume, in our cohort, 28.1% of children received treatment for ROP less severe than pre-threshold type 1 both eyes. The main indications for off-label treatment were the persistence of active ROP during follow-up and the presence of pre-plus-stage disease. Our data suggest the need to update ROP treatment criteria to reflect real-life practices. Additional studies are required in order to evaluate the long-term benefits and side effects of treatments outside the recommended indications, and to establish revised treatment guidelines. [ABSTRACT FROM AUTHOR]