Background: The aim of this study was to analyze demographically stratified incidence rates of patients with diabetic macular edema (DME) commenced in anti-VEGF therapy, to study temporal trends, to report the proportion of patients in active therapy over time, and to develop a model to forecast the future number of patients in active treatment. Methods: This was a retrospective registry-based study of all patients with DME who received at least one intravitreal anti-VEGF treatment from 1 January 2007 to 30 June 2022. Population data were extracted from Statistics Denmark. Results: This study included 2220 patients with DME who were commenced in anti-VEGF therapy. Demographic analyses revealed higher incidence rates among males than females and among those aged 60–80 years. The number of patients in active treatment followed an exponential decay curve; hence, this was used to mathematically model the number of patients in active therapy. The number of patients in active treatment is expected to stay relatively stable with a minimal increase until the year 2023. Conclusions: This study provides insight into the practical aspects of the anti-VEGF treatment of DME that allow the planning of adequate health services.

Purpose: To investigate whether phacoemulsification (PE) experience impacts and transfers to the skill acquisition of novices in manual small-incision cataract surgery (MSICS) within a simulation environment. Setting: Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark. Design: Prospective controlled experimental study. Methods: The study included 29 residents or specialist in ophthalmology with no prior MSICS experience. Participants were required to have either (1) proficiency on the EyeSi surgical simulator (PE group [PG]) or (2) no prior extensive exposure to the EyeSi simulator or any PE surgery experience as a primary surgeon (control group [CG]). Possible skill transfer was assessed using a test on the HelpMeSee virtual-reality simulator, including 9 modules and 30 steps (points). A pass/fail score was determined at 20 points (of 30 points). Performance scores were analyzed using independent samples t tests, pass rates using the Fisher exact test, and individual modules using Fisher-Freeman-Halton analysis. Results: The PG performed significantly better in overall performance score (mean ± SD, PG; 21.8 points ± 2.3 vs CG; 18.9 points ± 2.2, P = .002, t-value = −3.39) and pass rates (PG; 72% vs CG; 22%, P = .018). The subanalysis for individual modules demonstrated significant differences exclusively in the capsulorhexis and cortex removal modules. Conclusions: The results suggest a positive interprocedural transfer of skills between PE and MSICS. Pretraining and experience in PE demonstrated a significant effect on the performance of MSICS within a simulation environment. These findings suggest that PE experience provides an advantage before MSICS training in surgical residency programs.

Objectives: This study investigates the feasibility of implementing telescreening for retinopathy of prematurity (ROP) using the ICON GO^® widefield camera operated by a non-physician healthcare professional (NPHP). We hypothesized that images captured by an NPHP are adequate to evaluate ROP changes without further examinations. Secondly, the level of agreement between independent ROP graders were evaluated based on the fundus photographs. Methods: National ROP screening criteria were gestational age (GA) < 32 weeks or birthweight (BW) < 1500 g. Exclusion criteria were children hospitalized and born outside the Capital Region and examinations not performed by an NPHP. The screenings were performed using the ICON GO^®. The NPHP selected the best images for evaluation by an on-site ophthalmologist, regarding whether re-examination was necessary and if so, whether the re-examination was beneficial. Lastly, the images were re-evaluated by an independent off-site ophthalmologist. Results: A total of 415 screening sessions on 165 patients performed by an NPHP were included. Re-examination was necessary in three screening sessions and beneficial in two. The level of agreement between the on-site and off-site ophthalmologists regarding ROP screening outcome was k = 0.82, ROP stage k = 0.69, plus disease k = 0.69, and lastly ROP zone k = 0.37. Of the screened children, ninety-seven (58.8%) had no ROP at any time points, sixty-two (37.6%) had some stage of ROP not requiring treatment, and six (3.6%) received ROP treatment. Conclusions: Telemedicine screening for ROP with the ICON GO^® camera performed by an NPHP was feasible with an almost-perfect agreement and negligible need for re-examinations. The approach effectively identified children needing treatment, supporting the use of telescreening in ROP management.

Advances in genomics have the potential to revolutionize clinical diagnostics. Here, we examine the microbiome of vitreous (intraocular body fluid) from patients who developed endophthalmitis following cataract surgery or intravitreal injection. Endophthalmitis is an inflammation of the intraocular cavity and can lead to a permanent loss of vision. As controls, we included vitreous from endophthalmitis-negative patients, balanced salt solution used during vitrectomy, and DNA extraction blanks. We compared two DNA isolation procedures and found that an ultraclean production of reagents appeared to reduce background DNA in these low microbial biomass samples. We created a curated microbial genome database (>5700 genomes) and designed a metagenomics workflow with filtering steps to reduce DNA sequences originating from: i) human hosts, ii) ambiguousness/contaminants in public microbial reference genomes, and iii) the environment. Our metagenomic read classification revealed in nearly all cases the same microorganism than was determined in cultivation‐ and mass spectrometry-based analyses. For some patients, we identified the sequence type of the microorganism and antibiotic resistance genes through analyses of whole genome sequence (WGS) assemblies of isolates and metagenomic assemblies. Together, we conclude that genomics-based analyses of human ocular body fluid specimens can provide actionable information relevant to infectious disease management.