Background/Objective: Age-related macular degeneration (AMD) is a leading cause of irreversible vision loss. Intravitreal anti-vascular endothelial growth factor (VEGF) therapy is the primary treatment for neovascular AMD. This study aimed to assess racial, ethnic, and gender representation in U.S.-based randomized controlled trials (RCTs) of anti-VEGF therapies. Methods: A systematic PubMed search identified 19 eligible RCTs. Titles and abstracts were screened, and demographic data were independently extracted and cross-verified. Chi-squared analysis was used to evaluate disparities in participant representation. Risk of bias was assessed using the ROBIS checklist. Results: Among 8003 participants across 19 trials, 92.3% were Caucasian. Asian, African American, Hispanic/Latino, and American Indian participants collectively comprised just over 5%. This underrepresentation of non-Caucasian groups was statistically significant (p < 0.01, df = 4) and not associated with study sponsorship. Gender analysis showed 59% female and 41% male participation, which was not statistically significant (p = 0.83, df = 1). Conclusions: Non-Caucasian populations remain significantly underrepresented in anti-VEGF RCTs for AMD. This raises concerns about the generalizability of trial findings to diverse populations. Future clinical trials must prioritize inclusive recruitment to ensure equitable, evidence-based care for all patients.

Background: Endophthalmitis is a rare but vision-threatening complication of intravitreal injections. Intravitreal dexamethasone implants and anti–vascular endothelial growth factor (anti-VEGF) agents are widely used, yet comparative real-world endophthalmitis rates remain incompletely defined. This study aimed to compare the incidence of endophthalmitis following intravitreal dexamethasone implant injections with that following anti-VEGF injections administered in outpatient retina practices. Methods: This retrospective cohort study included all intravitreal injections performed between January 2019 and January 2024 at participating practices. Endophthalmitis events consistent with post-injection exogenous endophthalmitis occurring within two weeks of intravitreal injection were identified through clinical records. Chi-square testing was used to compare incidence rates between dexamethasone implant and anti-VEGF injections. Patient characteristics, visual acuity outcomes, and treatment approaches were assessed for confirmed endophthalmitis cases. Results: A total of 330,572 intravitreal injections were analyzed, including 318,618 anti-VEGF injections and 11,954 dexamethasone implant injections. Endophthalmitis occurred more frequently after dexamethasone implant injections (0.125%, 15/11,954; 1.25 per 1,000 injections) than after anti-VEGF injections (0.033%, 106/318,618; 0.33 per 1,000 injections). This difference was statistically significant (χ² = 23.45, p = 2.3 × 10⁻⁷). Among dexamethasone-associated cases, 46.7% recovered to baseline or better visual acuity by six months, while the remaining patients experienced persistent visual deficits. Management commonly included intravitreal antibiotics with or without adjunct corticosteroids. Conclusions: Intravitreal dexamethasone implant injections were associated with a significantly higher incidence of endophthalmitis compared with anti-VEGF injections in this large outpatient cohort. Although nearly half of affected patients regained baseline vision, many had lasting impairment. These findings highlight the need for careful risk–benefit assessment when selecting intravitreal dexamethasone implants and underscore the importance of further study into modifiable risk factors and prevention strategies. A key limitation to consider is that clinically diagnosed endophthalmitis may include sterile intraocular inflammatory reactions following dexamethasone implant injection.

Wildland firefighters play a critical role in protecting communities and natural resources, yet comparatively little research has examined the occupational health risks associated with repeated smoke exposure. This narrative review analyzed documented health effects, contributing exposure determinants, and mitigation strategies across 38 studies meeting pre-specified inclusion criteria. Included studies were predominantly quantitative field investigations evaluating pulmonary, cardiovascular, metabolic, and chemical exposure outcomes. Consistent findings documented decreased lung function, elevated oxidative stress, increased carbon monoxide (CO) exposure, and cumulative cardiovascular risk. Wildland firefighters were associated with polycyclic aromatic hydrocarbon (PAH) levels 2.2–26.7 times higher than controls. Prescribed burns produced CO concentrations 233% higher than off-fire-line days. Cardiovascular disease accounts for approximately 45% of annual line-of-duty fatalities among U.S. firefighters. Contributing factors included career duration, fire type, and operational role. Altogether, these findings underscore the severe, multi-system health risks faced by wildland firefighters and highlight a pressing need for modern mitigation strategies and firefighter-specific protective technologies to safeguard long-term health.

Despite e-scooters' increasing popularity on college campuses, there is a paucity of data on scooter-related injuries among collegiate student-athletes. Investigate e-scooter usage, scooter-associated injury incidence, and motivating factors for e-scooter utilization by student-athletes. 186 collegiate athletes at a single NCAA Division 1 university. All participants completed a cross-sectional survey investigating attitudes surrounding e-scooters and related injuries. Descriptive and inferential statistical analyses were employed, including Fisher's exact testing and logistic regression. Of the surveyed athletes, 132 (71.0%) reported current/prior scooter use with 24 (12.9%) reporting riding injuries. Incidence Proportion of scooter-related injuries totaled 18.2%. Injuries were not associated with surface type (p = 0.25), riding frequency (p = 0.15), or riding duration (p = 0.15). E-scooters have a substantial usage footprint amongst college athletes and pose unique health risks on campuses. Understanding dynamics of student-athletes regarding e-scooters is vital to enhance safety and prevent avoidable injuries.

Central retinal artery occlusion (CRAO) is a vision-threatening ophthalmic emergency requiring rapid recognition and evaluation. Although embolic etiologies predominate, low-flow ischemia related to hemodynamic instability represents an underrecognized mechanism. We report the case of a 66-year-old woman with end-stage renal disease (ESRD) on hemodialysis who experienced recurrent transient right-eye visual symptoms near the end of dialysis sessions. She had chronic intradialytic hypotension, with systolic blood pressures ranging from 90 to 100 mmHg and post-dialysis pressures averaging 90/50 mmHg. Ophthalmologic examination demonstrated markedly reduced visual acuity in the right eye, normal intraocular pressures, full extraocular movements, and full confrontation visual fields bilaterally. Dilated fundus examination showed diffuse retinal pallor with a characteristic cherry-red spot, consistent with CRAO. Comprehensive evaluation, including carotid Doppler ultrasound, CT angiography of the head and neck, brain magnetic resonance imaging, and transthoracic echocardiography, revealed no embolic or large-vessel source. The event was attributed to recurrent intradialytic systemic hypoperfusion superimposed on impaired microvascular autoregulation from diabetes and cardiovascular disease. Management included antiplatelet therapy and optimization of intradialytic blood pressure, after which no further visual ischemic episodes were reported. This case highlights intradialytic hypotension as a potential nonembolic cause of CRAO in patients undergoing hemodialysis and underscores the importance of early recognition and hemodynamic optimization in this high-risk population.

Background Endophthalmitis is a rare but vision-threatening complication of intravitreal injections. Intravitreal dexamethasone implants and anti–vascular endothelial growth factor (anti-VEGF) agents are widely used, yet comparative real-world endophthalmitis rates remain incompletely defined. This study aimed to compare the incidence of endophthalmitis following intravitreal dexamethasone implant injections with that following anti-VEGF injections administered in outpatient retina practices. Methods This retrospective cohort study included all intravitreal injections performed between January 2019 and January 2024 at participating practices. Endophthalmitis events occurring within two weeks of injection were identified through clinical records. Chi-square testing was used to compare incidence rates between dexamethasone implant and anti-VEGF injections. Patient characteristics, visual acuity outcomes, and treatment approaches were assessed for confirmed endophthalmitis cases. Results A total of 330,572 intravitreal injections were analyzed, including 318,618 anti-VEGF injections and 11,954 dexamethasone implant injections. Endophthalmitis occurred more frequently after dexamethasone implant injections (0.125%, 15/11,954; 1.25 per 1,000 injections) than after anti-VEGF injections (0.033%, 106/318,618; 0.33 per 1,000 injections). This difference was statistically significant (χ² = 23.45, p = 2.3 × 10⁻⁷). Among dexamethasone-associated cases, 46.7% recovered to baseline or better visual acuity by six months, while the remaining patients experienced persistent visual deficits. Management commonly included intravitreal antibiotics with or without adjunct corticosteroids. Conclusions Intravitreal dexamethasone implant injections were associated with a significantly higher incidence of endophthalmitis compared with anti-VEGF injections in this large outpatient cohort. Although nearly half of affected patients regained baseline vision, many had lasting impairment. These findings highlight the need for careful risk–benefit assessment when selecting intravitreal dexamethasone implants and underscore the importance of further study into modifiable risk factors and prevention strategies.