Simple Bimanual Technique of Internal Limiting Membrane Retrieval.

PURPOSE: To describe a novel technique of internal limiting membrane retrieval. METHODS: A 25-gauge vitrectomy was performed in all patients. After internal limiting membrane (ILM) peeling (after brilliant blue dye staining), the ILM was held with the forceps in the midvitreous cavity and a 25-gauge cannula mounted on a 2 mL of balanced salt solution-filled syringe was introduced. When the tip of the cannula made contact with the ILM, mild suction was applied, and the ILM was retrieved in the syringe. RESULTS: Internal limiting membrane retrieval was successful in the all the patients attempted. CONCLUSION: To conclude, bimanual technique of membranous tissue removal using a soft tip cannula under direct visualization is a safe and efficient technique that makes membrane retrieval a predictable process.

Clinical Challenge: Unusual Presentation of a Macular Hemorrhage Extending From the Internal Limiting Membrane to the Subretinal Space on Optical Coherence Tomography (OCT) in a Patient With Branch Retinal Vein Occlusion (BRVO).

Branch retinal vein occlusion (BRVO) is a common retinal vascular disorder typically characterized by distinct findings on fundus examination and optical coherence tomography (OCT). An unusual and challenging presentation involves a full-thickness macular hemorrhage extending from the internal limiting membrane (ILM) to the subretinal space. Here, we present the case of a 52-year-old male with type 2 diabetes mellitus who experienced sudden vision loss in the right eye and progressive vision decline in the left eye. Fundus examination revealed superotemporal BRVO in the right eye and old inferotemporal BRVO with extensive neovascularization in the left eye. OCT of the right eye showed a full-thickness hemorrhage from the ILM to the subretinal space, impacting the foveola and surrounding nasal perifoveal region. Fundus fluorescein angiography confirmed ischemic areas corresponding to BRVO. This rare presentation of macular hemorrhage complicates the management of BRVO and highlights the need for further research into the underlying pathological mechanisms and management strategies.

Title evaluation of FluSight influenza forecasting in the 2021-22 and 2022-23 seasons with a new target laboratory-confirmed influenza hospitalizations.

Accurate forecasts can enable more effective public health responses during seasonal influenza epidemics. For the 2021-22 and 2022-23 influenza seasons, 26 forecasting teams provided national and jurisdiction-specific probabilistic predictions of weekly confirmed influenza hospital admissions for one-to-four weeks ahead. Forecast skill is evaluated using the Weighted Interval Score (WIS), relative WIS, and coverage. Six out of 23 models outperform the baseline model across forecast weeks and locations in 2021-22 and 12 out of 18 models in 2022-23. Averaging across all forecast targets, the FluSight ensemble is the 2nd most accurate model measured by WIS in 2021-22 and the 5th most accurate in the 2022-23 season. Forecast skill and 95% coverage for the FluSight ensemble and most component models degrade over longer forecast horizons. In this work we demonstrate that while the FluSight ensemble was a robust predictor, even ensembles face challenges during periods of rapid change.

Evaluation of FluSight influenza forecasting in the 2021-22 and 2022-23 seasons with a new target laboratory-confirmed influenza hospitalizations.

Accurate forecasts can enable more effective public health responses during seasonal influenza epidemics. Forecasting teams were asked to provide national and jurisdiction-specific probabilistic predictions of weekly confirmed influenza hospital admissions for one through four weeks ahead for the 2021-22 and 2022-23 influenza seasons. Across both seasons, 26 teams submitted forecasts, with the submitting teams varying between seasons. Forecast skill was evaluated using the Weighted Interval Score (WIS), relative WIS, and coverage. Six out of 23 models outperformed the baseline model across forecast weeks and locations in 2021-22 and 12 out of 18 models in 2022-23. Averaging across all forecast targets, the FluSight ensemble was the 2nd most accurate model measured by WIS in 2021-22 and the 5th most accurate in the 2022-23 season. Forecast skill and 95% coverage for the FluSight ensemble and most component models degraded over longer forecast horizons and during periods of rapid change. Current influenza forecasting efforts help inform situational awareness, but research is needed to address limitations, including decreased performance during periods of changing epidemic dynamics.

Focal choroidal excavation: review of literature.

Focal choroidal excavation (FCE) is defined as an area of concavity in choroid detected on optical coherence tomography. These are mostly present in macular region without evidence of accompanying scleral ectasia or posterior staphyloma. Though initially considered to be congenital, increasing number of cases have been identified in association with other choroidal pathologies such as central serous choroidopathy, choroidal neovascularisation, polypoidal choroidal vasculopathy, choroiditis, choroidal tumours. In this review article, we aim to elaborate on the morphology, pathogenesis and differential diagnosis of FCE and specifically discuss the spectrum of diseases with known association along with the impact of their treatment on FCE.

Retinal neovascularization in a patient with chronic central serous chorioretinopathy.

A 45-year-old male presented with diminution of vision in both eyes since the last 2 years. The best-corrected visual acuity was 20/200 in his right eye and 20/600 in left eye. BE fundi had changes of chronic CSCR with PED and NSD in the RE and subretinal fibrosis in the left eye. Both eyes had peripheral pigmentary changes. Multimodal imaging showed peripheral avascular retina in both eyes with neovascularization at disc in the right eye which promptly resolved with a single injection of anti-VEGF. Retinal neovascularization is an unusual finding in the setting of CSCR and has not been reported in the literature.

Acute macular neuroretinopathy in a patient with acute coronary syndrome.

A young man presented with bilateral diminution of vision after acute coronary syndrome. Fundus showed dark wedge-shaped perifoveal lesions in both eyes. Fundus fluorescein angiography and indocyanine angiography were normal. Optical coherence tomography showed characteristic findings of outer nuclear layer thinning and disruption of ellipsoid zone. Optical coherence tomography angiography showed flow voids in deep capillary plexus. A diagnosis of acute macular neuroretinopathy was made. The multimodal imaging findings and pathophysiology of such a scenario are presented.

Posterior lenticonus with persistent fetal vasculature.

A 10 year old girl present with both eyes central cataract with posterior lenticonus. Intraoperative, she was noted to have both eyes persistent fetal vasculature (PFV). To the best of our knowledge, association of bilateral posterior lenticonus and PFV has not been reported before. This supports the hypothesis that PFV has a role in pathogenesis of posterior lenticonus.

Unilateral giant peripapillary drusen and retinal drusenoid deposits in a case of X-linked retinoschisis.

A 25-year-old man with X-linked retinoschisis presented with multiple giant optic nerve head drusen and multiple retinal drusenoid deposits in one eye. There was an area of coarse pigmentation in the lower half of the retina, with convex upper borders extending on either side of the optic disc, suggestive of a spontaneously resolved retinal detachment. The possible aetiopathogenesis of such occurrence is discussed.