To investigate the incidence, contributing factors, management, and long-term outcomes of endophthalmitis following intravitreal injections performed in our clinic. This retrospective study included all patients who received intravitreal bevacizumab, aflibercept, ranibizumab, or dexamethasone injections between 2019 and 2024 at four retina clinics of Ankara Bilkent City Hospital. Demographic characteristics of the patients, visual acuity, intravitreal injection etiology, comorbidities, and treatments applied were recorded. Patients who received antibiotic prophylaxis after intravitreal injections (IVI) were categorized as Group 1, while those who did not receive prophylaxis were classified as Group 2. A total of 4171 patients and 21,339 intravitreal injections were evaluated. Of the participants, 47.2% were female and 52.8% were male, with a mean age of 66.3 ± 10.3 years (range: 40–98). Group 1 included 13,121 injections (61%), while Group 2 had 8,218 injections (39%). Endophthalmitis was observed in 13 patients (3.0 per 1000 patients—8.1 per 10,000 injections). Patients who developed endophthalmitis had an average of 6.1 ± 4.1 prior injections (range: 2–16), and the mean time to presentation after the last injection was 7.6 ± 3.4 days (range: 2–14). Endophthalmitis cases were distributed as 7 in Group 1 (5.3 per 10,000) and 6 in Group 2 (4.4 per 10,000). The endophthalmitis rate in Group 1 was not statistically significantly different from Group 2 (p > 0.05). All patients received vitreous taps and intravitreal vancomycin-ceftazidime injections at initial presentation. Eleven patients (85%) underwent a pars plana vitrectomy within 24 h. The mean follow-up period was 32 ± 20 months, and any case did not require evisceration surgery. Early surgical intervention in cases of endophthalmitis is the most critical approach for preserving the eye and achieving visual rehabilitation. Notably, endophthalmitis was more common in people who got intravitreal bevacizumab or dexamethasone injections, and antibiotic prophylaxis did not appear to reduce the risk of its occurrence.

To evaluate the optical coherence tomography angiography (OCT-A) findings in patients with systemic lupus erythematosus (SLE). Twenty-eight eyes of 28 patients with SLE and 27 eyes of 27 age and sex matched healthy controls were enrolled in this cross-sectional study. The vessel densities in the macula and optic disc were evaluated using the OCT-A (Optovue, Inc., Freemont, CA). Foveal retinal thickness, retinal vascular density in superficial capillary plexus (SCP), deep capillary plexus, and choriocapillaris, foveal avascular zone (FAZ), acircularity index, foveal vessel density (FD), and non-flow area in the superficial retina, the capillary and all-vessels density in the peripapillary area and the inside-disc area were automatically measured using Angiovue software of OCT-A and compared between the groups. The foveal, parafoveal and perifoveal retinal vessel densities in the superficial and deep capillary plexus and choriocapillaris were similar between groups. FAZ area, FAZ perimetry, acirculatory index, FD and non-flow area did not show a statistically significant difference. The vessel density in the inside disc area was significantly lower in patients with SLE (46.3 ± 3.8%) compared to the control group (49.1 ± 4.8%) (P = .02). Our results demonstrate significant decrement in vessel density in the inside-disc area in patients with SLE. The lower vessel density measurement in the inside-disc area might be associated with early neurologic vascular impairment in SLE. Further studies are required to determine the clinical relevance of this finding.

Background: Capsulorhexis is the most important step in intumescent cataract due to the high risk of radial extension of the capsular tear during the cataract surgery. The aim of this study is to present modified the two-stage capsulorhexis technique for intumescent cataract. Materials and methods: The two-stage capsulorhexis technique was used in this study. A small size capsulorhexis approximately 1.5-2 mm diameter was created in the first stage. Liquefied cortex was aspirated with a 25 G cannula to equalize anterior chamber pressure and intracapsular pressure after the small size capsulorhexis. In the second stage, a 5–6 mm capsulorhexis size was performed for a safe phacoemulsification. Results: A total of 73 consecutive patients with intumescent cataract were evaluated in this study. There were 39 male cases and 34 female cases. Mean age was 66 years ± 8 (between 53 and 84 years). A well centered complete continuous curvilinear capsulorhexis approximately 5–6 mm size was achieved in 72 of 73 cases (98.6%). Peripheral extension of capsulorhexis occurred in one eye during the second stage capsulorhexis. In this case, the capsule was cut with Vannas scissors and the capsulorhexis was completed. The rest of surgery was continued with a standard procedure and in-the-bag IOL implantation was done. Conclusions: This technique facilitates the creation of a safe capsulorhexis compared to the one-stage capsulorhexis technique. Surgeons may consider this technique to perform a safe phacoemulsification in the intumescent cataracts.

This study assesses the inflammation levels through the modified systemic inflammation score (mSIS) in patients with nonneovascular and neovascular age-related macular degeneration (AMD). A total of 90 participants were categorized into 3 groups: a control group, individuals with nonneovascular AMD under follow-up, and individuals with neovascular AMD who had not yet started injection treatment. Demographic and clinical parameters, including body mass index, were analyzed. The mSIS, based on serum albumin levels and the lymphocyte-to-monocyte ratio, was used to determine the level of systemic inflammation. There were no significant differences between the groups in terms of age (P = .08) or gender (P = .06). Regarding body mass index, no significant differences were observed between the groups (P = .06). When comparing mSIS scores between the groups, no significant differences were found for mSIS scores 0 and 1 across the groups. However, for mSIS 2, the proportion of participants with an mSIS score of 2 was significantly higher in the neovascular AMD group compared with the control group (P = .01). These findings suggest that mSIS may be a valuable tool for assessing systemic inflammation in AMD. The higher mSIS scores in the neovascular AMD group may indicate that disease severity is associated with increased inflammation. Further large-scale studies are needed to confirm the utility and clinical relevance.

Introduction: Iodine deficiency is a leading cause of preventable physical and mental retardation. Potassium iodate is used for iodine supplementation to prevent iodine deficiency. We herein report a case of toxic retinopathy following intentional ingestion of potassium iodine. Case Presentation: A 41-year-old male presented with a 5-day history of blurred vision in both eyes. His visual acuity (VA) was hand motion and his pupillary reactions were sluggish bilaterally. The fundus examination revealed bilaterally diffuse retinal pigment epithelium atrophy and secondary pigmentary changes at the posterior pole, but his peripheral fundus was relatively spared. Choroidal thinning, punctate hyperreflective dots along the retinal pigment epithelium layer, and outer retinal atrophy were the optical coherence tomography findings, which were consistent with widespread areas of retinal pigment epithelium window defects observed on fundus fluorescein angiography. The visual evoked potential test showed no response in the right eye and revealed a delay in the latency and a decrease in the amplitude of the P100 wave in the left eye. Wave b responses of the photoreceptors could not be observed in the patient’s electroretinogram. After a vitamin supplementation protocol consistent with the literature, at the 4-month follow-up visit his visual acuity had improved to 0.3 in the right eye and counting fingers in the left eye. Conclusion: Potassium iodate toxicity is a cause of serious retinal and choroidal damage and results in severe vision loss. Hydration, hemodialysis, and antioxidants can be helpful to minimize the complications.