We conducted a systematic review and meta-analysis to evaluate the visual, anatomical, and safety outcomes of the intravitreal faricimab, a novel vascular endothelial growth factor (VEGF)/angiopoietin-2 (Ang-2) bispecific agent, in neovascular age-related macular degeneration (nAMD) patients. The follow-up times in the included studies ranged from a minimum of 36 weeks to a maximum of 52 weeks. EMBASE, Ovid-Medline, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Scopus, the WHO ICTRP, ClinicalTrial.gov, the EU Clinical Trials Register, and Chinese Clinical Trial Registry (ChiCTR) were searched (The last literature search was performed on August 17, 2023) for randomized controlled trials (RCTs) comparing faricimab with control groups for neovascular age-related macular degeneration (nAMD). The risk of bias for eligible RCTs was independently assessed using the Cochrane Risk of Bias Tool by two authors (W.-T.Y. and C.-S.W.). The meta-analysis was conducted using Review Manager 5.4 software. The mean best corrected visual acuity (BCVA), central subfield thickness (CST), total choroidal neovascularization (CNV) area, and total lesion leakage were analyzed as continuous variables and the outcome measurements were reported as the weighted mean difference (WMD) with a 95% confidence interval (CI). The ocular adverse events and ocular serious adverse events were analyzed as dichotomous variables and the outcome measurements were analyzed as the odds ratios (ORs) with a 95% CI. Random-effects model was used in our study for all outcome synthesizing due to different clinical characteristics. Four RCTs with 1,486 patients were eligible for quantitative analysis. There was no statistically significant difference between intravitreal faricimab and anti-VEGF in BCVA [weighted mean difference (WMD) = 0.47; 95% CI: (− 0.17, 1.11)]. The intravitreal faricimab group showed numerically lower CST [WMD = − 5.96; 95% CI = (− 7.11, − 4.82)], total CNV area [WMD = − 0.49; 95% CI = (− 0.68, − 0.30)], and total lesion leakage [WMD = − 0.88; 95% CI = (− 1.08, − 0.69)] after intravitreal therapy compared with the intravitreal anti-VEGF group. There were no statistically significant differences between intravitreal faricimab and anti-VEGF in ocular adverse events (AEs) [pooled odds ratio (OR) = 1.10; 95% CI = (0.81, 1.49)] and serious adverse events (SAEs) [pooled OR = 0.84; 95% CI = (0.37, 1.90)]. The intravitreal bispecific anti-VEGF/angiopoietin 2 (Ang2) antibody faricimab with a extended injection interval was non-inferior to first-line anti-VEGF agents in BCVA. It was safe and had better anatomical recovery. Large, well-designed RCTs are needed to explore the potential benefit of extended faricimab for nAMD. This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022327450).

The aim of this study is to develop an AI model that accurately identifies referable blepharoptosis automatically and to compare the AI model’s performance to a group of non-ophthalmic physicians. In total, 1000 retrospective single-eye images from tertiary oculoplastic clinics were labeled by three oculoplastic surgeons as having either ptosis, including true and pseudoptosis, or a healthy eyelid. A convolutional neural network (CNN) was trained for binary classification. The same dataset was used in testing three non-ophthalmic physicians. The CNN model achieved a sensitivity of 92% and a specificity of 88%, compared with the non-ophthalmic physician group, which achieved a mean sensitivity of 72% and a mean specificity of 82.67%. The AI model showed better performance than the non-ophthalmic physician group in identifying referable blepharoptosis, including true and pseudoptosis, correctly. Therefore, artificial intelligence-aided tools have the potential to assist in the diagnosis and referral of blepharoptosis for general practitioners.

Purpose: The purpose of this study was to investigate the IOP-lowering effects of the ITRI-E-212, a new Rho-associated protein kinase (ROCK) inhibitor. ITRI-E-212 improved fluid outflow through the trabecular meshwork and reduced IOP with transient and mild conjunctival hyperemia. ITRI-E-212 can potentially be developed into new antiglaucoma agents. Methods: ITRI-E-212 was selected from more than 200 amino-isoquinoline structures because of its adequate solubility and drug-loading percentage in eye drops. ITRI-E-212 has less than 50% inhibitory concentration (IC₅₀) against ROCK2. The in vitro kinase inhibition was evaluated using the ADP-Glo kinase assay. A comprehensive analysis of the kinase inhibitor selectivity of ITRI-E-212 was performed using the KINOMEscan methodology. The IOP-lowering effect and tolerability of ITRI-E-212 were investigated in normotensive and ocular hypertensive rabbits. The pharmacokinetics study was performed in vivo in the aqueous humor (AH), and hyperemia was assessed. Results: ITRI-E-212 showed high in vitro inhibitory activity against ROCK2 and high specificity against AGC kinases. The mean IOP-lowering effect of ITRI-E-212 in normotensive and ocular hypertensive models was 24.9% and 28.6%, respectively; 1% ITRI-E-212 produced notable reductions in IOP that were sustained for at least 6 hours after each dose once per day. Only transient, mild hyperemia was observed. The compound extracted from the AH reached 78.4% ROCK2 kinase inhibition at 1 hour after dose administration and was sustained for 4 hours. Conclusions: ITRI-E-212 is a novel and highly specific ROCK2 inhibitor with the ability to lower IOP in animal models. It has favorable pharmacokinetic and ocular tolerability profiles with only minimal conjunctival hyperemia.

Purpose To report the clinical features and treatment outcomes in a cluster of patients with endophthalmitis after cataract surgery caused by nontuberculous mycobacterium. Patients and methods Retrospective chart review and noncomparative, consecutive case series. Nine consecutive cases of endophthalmitis, after cataract surgery in a local clinic, were referred to our hospital. The treatment outcomes and analysis of risk factors for infection are reported. Results The major symptoms at presentation were pain, redness, and decreased vision. Best-corrected visual acuity at presentation ranged from hand motion in two cases (22%), counting fingers at 30 cm in three cases (33%), 20/100 in two cases (20%), 20/63 in one case (11%), to 20/50 in one (11%) case. The mean duration between cataract surgery to presentation at our hospital was 16.7 days. Prompt intravitreal injections (IVI) of amikacin (0.4 mg/0.1 mL) and vancomycin (1 mg/0.1 mL), with topical moxifloxacin were administered initially. Pars plana vitrectomy with amikacin (10 mg/L) and vancomycin (20 mg/L) intravitreal irrigation, and intraocular lens removal were performed for all patients. Systemic antibiotics including amikacin and tigecycline were prescribed for 10 days, and clarithromycin was prescribed for at least 3 months. In all the nine cases, the culture results from either aqueous tapping or vitrectomy sample were positive for nontuberculous Mycobacterium: Mycobacterium abscessus/chelonae, which was compatible with iatrogenic clustered infection. At the last follow-up, three cases (33.3%) had best-corrected visual acuity of counting fingers at 30 cm, while the other six cases had no light perception. Two cases (22%) were enucleated and one case (11%) had phthisis bulbi. Conclusion Nontuberculous mycobacterium endophthalmitis (NTME) often induces chronic recurrent or persistent intraocular inflammation. Very poor outcomes despite aggressive antibiotic treatment and repeated surgical interventions are suggestive of the virulent nature of the organisms. Autoclave sterilization and perioperative disinfection may help in reducing iatrogenic clustered infection.