Introduction This study assessed the efficacy, durability, and safety of faricimab in patients with neovascular age-related macular degeneration (nAMD), previously treated with aflibercept or ranibizumab with unsatisfactory results. Methods This was a single-center, prospective cohort study of all consecutive patients with nAMD switched to intravitreally administered faricimab from traditional anti-vascular endothelial growth factor (anti-VEGF) treatments between September 2022 and April 2023 because of unsatisfactory response (maximal fluid-free interval ≤ 8 weeks). Faricimab was administered with a loading dose of four 4-weekly injections, followed by a treat-and-extend regimen. The primary outcome measures were maximum fluid-free interval after the switch and last assigned treatment interval. Secondary outcome measures included best-corrected visual acuity (BCVA) and structural optical coherence tomography parameters. Results Thirty-three eyes of 33 patients were included. Patients were followed for a median of 72 weeks [interquartile range 61, 76]. Median maximum fluid-free treatment interval after switch to faricimab and the last assigned interval were significantly longer than before the switch (7 vs. 4 weeks, p < 0.001 and 8 vs. 5 weeks, p < 0.001, respectively). Significant improvements in central subfield thickness (353 vs. 281 µm), macular volume (2.46 vs. 2.16 mm³), and pigment epithelial detachment height (198 vs. 150 µm) were observed (all p < 0.001). BCVA remained stable at 0.4 versus 0.3 logMAR before switch (p = 0.190). One eye (3%) developed intraocular inflammation and one eye (3%) developed a retinal pigment epithelium tear. Conclusions Faricimab improved anatomical outcomes and allowed longer treatment intervals in patients with nAMD previously treated with other anti-VEGF therapies with unsatisfactory response, reducing treatment burden. A favorable safety profile was observed.

Purpose. To revise the current literature on FIL SSF (Carlevale) intraocular lens, previously known as Carlevale lens, and to compare their outcomes with those from other secondary IOL implants. Methods. We performed a peer review of the literature regarding FIL SSF IOLs until April 2021 and analyzed the results only of articles with a minimum of 25 cases and a follow-up of at least 6 months. The searches yielded 36 citations, 11 of which were abstracts of meeting presentations that were not included in the analysis because of their limited data. The authors reviewed 25 abstracts and selected six articles of possible clinical relevance to review in full text. Of these, four were considered to be sufficiently clinically relevant. Particularly, we extrapolated data regarding the pre- and postoperative best corrected visual acuities (BCVA) and the complications related to the procedure. The complication rates were then compared with those from a recently published Ophthalmic Technology Assessment by the American Academy of Ophthalmology (AAO) on secondary IOL implants. Results. Four studies with a total of 333 cases were included for results analysis. The BCVA improved in all cases after surgery, as expected. Cystoid macular edema (CME) and increased intraocular pressure were the most common complications, with an incidence of up to 7.4% and 16.5%, respectively. Other IOL types from the AAO report included anterior chamber IOLs, iris fixation IOLs, sutured iris fixation IOLs, sutured scleral fixation IOLs, and sutureless scleral fixation IOLs. There was no statistically significant difference in the rates of postoperative CME (p = 0.20), and vitreous hemorrhage (p = 0.89) between other secondary implants and the FIL SSF IOL, whereas the rate of retinal detachment was significantly less with FIL SSF IOLs (p = 0.04). Conclusion. The results of our study suggest the implantation of FIL SSF IOLs is an effective and safe surgical strategy in cases where there is a lack of capsular support. In fact, their outcomes seem to be comparable to those obtained with the other available secondary IOL implants. According to published literature, the FIL SSF (Carlevale) IOL provides favorable functional results with a low rate of postoperative complications.

Recent evidence in basic science is leading to a growing interest in the possible role of curcumin in treating retinal diseases. Curcumin has been demonstrated to be able to modulate gene transcription and reduce ganglion cell apoptosis, downgrade VEGF, modulate glucose levels and decrease vascular dysfunction. So far, the use of curcumin has been limited by poor bioavailability; to overcome this issue, different types of carriers have been used. Multiple recent studies disclosed the efficacy of using curcumin in treating different retinal conditions. The aim of this review is to comprehensively review and discuss the role of curcumin in retinal diseases from bench to bedside.

Purpose . To assess real‐life anatomical and functional outcomes of switch to bevacizumab in patients undergoing aflibercept intravitreal injections for nAMD. Methods . Retrospective chart review of all patients diagnosed with nAMD and undergoing intravitreal injections of aflibercept who switched to bevacizumab after the resolution XI/1986 of Lombardy Region. Results . Among 128 patients undergoing intravitreal injections, a total of 29 eyes of 29 patients met all inclusion criteria and were included in the statistical analysis. Best corrected visual acuity and central macular thickness did not change significantly ( p > 0.05) between baseline, after the loading phase, and at the last follow‐up. Conclusion . Switching to bevacizumab has been safe and efficacious in patients responding to the loading phase. According to our results, the restrictions imposed by Lombardy Region did not cause any harm to patients undergoing intravitreal anti‐VEGF injections.

Purpose: The CBI-LVC is a biomechanical index to detect ectasia in post-refractive surgery patients (PRK, LASIK, SMILE). This study aims to evaluate the distribution of the CBI-LVC in stable patients who underwent Phototherapeutic Keratectomy (PTK) compared to PRK patients. Methods: Patients who underwent PRK and PTK performed between 2000 and 2018in Humanitas Research Hospital, Rozzano, Milan, Italy and remained stable for at least four years post-surgery were included. All eyes were examined with the Corvis ST (Oculus, Germany), whose output allows the calculation of the CBI-LVC. The distribution and specificity of the CBI-LVC in the two populations were estimated using a Wilcoxon Mann-Whitney test and compared. Results: 175 eyes of 148 patients were included (85 eyes of 50 PTK patients and 90 eyes of 90 PRK patients). The distribution of CBI-LVC in the two groups showed a minor difference, with a median value in PRK patients of 0.000 (95% CI 0.000; 0.002) and 0.008 (95% CI 0.000; 0.037) in PTK patients (Mann-Whitney U test p = 0.023). The statistical analysis showed that the CBI-LVC provided a specificity of 92.22% in the PRK group, while in the PTK group it was 82.35%. Nevertheless, this difference was not statistically significant (Chi-squared test with Yates, p = 0.080). Conclusion: CBI-LVC provided similar specificity in stable PTK patients compared to those who underwent PRK. These results suggest that the CBI-LVC could be a useful tool to aid corneal surgeons in managing PTK patients.

Purpose: To determine the test-retest reliability of visual function parameters in patients with genetically confirmed Pseudoxanthoma elasticum (PXE), as a necessary step toward evaluating their suitability as outcome measures in future therapeutic trials. Methods: In this prospective natural history study (PROPXE, ClinicalTrials.gov ID: NCT05662085 ), patients with PXE underwent comprehensive visual function evaluation in one study eye at baseline and at a month 2 retest visit. Functional testing included light- and dark-adapted steady state microperimetry and dark-adaptometry at 8°, 15° 30°, and 46° eccentricity. Test-retest reliability was evaluated using Bland-Altman statistics. Results: Twenty-six patients (14 female, 12 male; median [IQR] age 55 years [43; 59]) with genetically confirmed PXE were included in the study. Overall, the steady-state microperimetry limits of agreement (LoA) were ±2 dB for mean sensitivity and ±6.8 dB for pointwise sensitivity in both scotopic (cyan and red) and mesopic conditions. The LoAs of rod intercept time as a measure of dark adaptometry were ± 12 min at the inner measurement points (8° and 15°) and ± 18 min at the outer measurement points (30° and 46°). Conclusions: Scotopic and mesopic microperimetry LoAs are similar to earlier published test-retest analyses in other retinal diseases. Dark-adaptometry curve parameters were markedly more variable compared to previous data in healthy volunteers. This is likely attributable to the severe dark adaptation abnormalities in PXE, leading to long test durations. Translational Relevance: The evaluation of functional biomarkers is critical for designing future clinical trials aimed at slowing PXE progression.