Presumed Silicone Oil Droplets After Intravitreal Pegcetacoplan Injections.

Importance: Recently, intravitreal pegcetacoplan became the first drug to gain US Food and Drug Administration approval for the treatment of geographic atrophy associated with nonexudative age-related macular degeneration, but the administration of this medication may be associated with unanticipated posttreatment complications. Objective: To assess the prevalence of presumed silicone oil droplets in the vitreous cavity after intravitreal injection of pegcetacoplan. Design, Setting, and Participants: This case series study involved a retrospective record review of all 55 patients treated with intravitreal pegcetacoplan, 0.1 mL in 150-mg/mL solution, between March 24 and June 5, 2023, at a single specialty retina practice. All injections were done using needles from the kit supplied by Apellis Pharmaceuticals on a 1-mL McKesson Luer lock syringe. Main Outcomes and Measures: The presence or absence of presumed silicone bubbles detected during dilated biomicroscopic fundus examination and/or on color fundus photographs, the presence or absence of symptoms, change in visual acuity, and/or increase in intraocular pressure. Results: A total of 62 intravitreal pegcetacoplan injections were given to 55 patients (mean [SD] age, 83.8 [7.8] years; 33 women [60%]) from March 24 to June 5, 2023. Of the 55 patients, 16 (29%; mean [SD] age, 83.8 [7.4] years; 9 women [56%]) had presumed intravitreal silicone droplets discovered 2 to 4 weeks after treatment, 3 of which were documented on color fundus photographs. Of the 16 patients, 14 (88%) were symptomatic for new floaters that they described as persistent, while 2 (13%) were asymptomatic. There were no signs of inflammation or infection, no increases in intraocular pressure, and no changes in visual acuity for all 16 patients. Conclusions and Relevance: A substantial percentage of patients had symptomatic floaters from presumed intravitreal silicone oil droplets after injections of pegcetacoplan using a McKesson 1-mL Luer lock syringe. These findings support consideration of informing patients of this potential adverse effect, avoiding use of the McKesson syringe, and considering use of silicone-free syringes for pegcetacoplan injections.

Who Is Talking About Adverse Childhood Experiences? Evidence From Twitter to Inform Health Promotion.

BACKGROUND: Growing availability of research about addressing adverse childhood experiences (ACEs) has recently been embraced by the mainstream media and public. Social media, especially Twitter, provides a unique forum and platform for the public to access and share information about this topic. OBJECTIVE: This study aims to better understand how the public is framing, sharing, and using research about ACEs on Twitter and to examine the information being commonly discussed about ACEs. METHOD: We obtained tweets on the topics of ACEs, childhood resilience, and childhood trauma between January 1, 2018, and December 31, 2019. This timeframe was determined based on key related events in the mainstream media. Crimson Hexagon, a social media analytics system using Boolean logic, was used to identify salient topics, influencers, and conduct a content analysis. RESULTS: A total of 195,816 relevant tweets were obtained from our search. The weekly volume was approximately 1,864 tweets. Key topics included general use of the term ACEs (23%), trauma and ACEs (19%), long-term impact of ACEs (12%), preventing ACEs (11%), short-term effects of ACEs (8%), the 1997 ACE Study (5%), and students with ACEs (5%). The top two sentiments were fear and joy. Top conversation influencers included pediatricians, child health advocacy organizations, California's state government, the Centers for Disease Control and Prevention, and National Public Radio. CONCLUSION: This analysis provides insight to the ways the public is conversing about ACEs and related topics. Results indicated that conversations focus on increasing awareness of ACEs by content experts and public health organizations. This presents an opportunity to leverage social media tools to increase public engagement and awareness.