Social media collaboration of retinal physicians: A ‘Young Retina Forum’ survey

Background and objectiveTo describe the impact that social media usage has on a group of retina specialists.Materials and methodsAn anonymous online survey was sent to members of the Young Retina Forum who use the social media platform - Telegram.ResultsOf a total of 178 members, 100 responded (87 men and 13 women), having an average age of 35 years. Of these, 66 respondents were surgical retina attendings in practice for 3 years. In all, 98 respondents found the Young Retina Forum useful for networking and educationally valuable discussions, and 35 respondents had at least one instance when they had used Young Retina Forum to obtain assistance at that moment in the clinic and/or the operating room. At least 58 respondents said Young Retina Forum changed their practice patterns in the clinic and/or operating room.ConclusionIn this study, 58% of Young Retina Forum respondents said their practice patterns have changed due to their experiences using social media. Professional use of social media by ophthalmologists has the potential to improve education, clinical practice, and patient care

Evolving practice patterns of young retinal specialists: A five-year comparison of treatment and surgical preferences

Purpose: To describe trends in demographics and practice patterns of young retina specialists over a five-year follow-up period. Design: A cross-sectional study of young retinal specialists conducted through an online social media platform to evaluate practice patterns for common conditions. Methods: An anonymous survey was performed among U.S.-based young retinal specialists from a variety of practice environments in early stages of practice between August and September 2022. Results were compared to survey results from 2017. Results: In 2022, the survey population included 358 members with 101 respondents compared to 44 respondents in 2017. Most respondents preferred bevacizumab as first-line treatment for foveal-involving diabetic macular edema (DME) (60%), vein occlusions (54%), and macular degeneration (56%). Aflibercept was more popular as first-line for DME patients with poor vision (51%) compared to those with good vision (18%). For proliferative diabetic retinopathy (PDR) without macular edema, respondents prefer panretinal photocoagulation alone (43%) or in combination with anti-VEGF (48%) over anti-VEGF alone (10%). Respondents repaired rhegmatogenous retinal detachments using combined vitrectomy-buckle (20%), primary scleral buckle (10%), and pneumatic retinopexy (PR) (10%). The percentage of respondents who have used PR at least once increased significantly from 2017 to 2022. From 2017 to 2022, more respondents use masks (29.5% to 82.8%) and post-injection antibiotics (2.3% to 16.0%) when performing injections while a smaller minority use topical gel anesthesia (34.1% to 15.5%). Conclusions: Survey results suggest more providers are more likely to observe good visual acuity in diabetic edema and use laser alone in PDR without edema. In addition, longitudinal trends show increased use of PR, masks and post-injection antibiotics, and decreased use of topical gel anesthesia.</p

Discontinuous to continuous therapy for persistent diabetic macular edema leads to reduction in treatment frequency

Objective: To evaluate, in the setting of persistent diabetic macular edema, the impact that continuous fluocinolone acetonide delivery has on treatment burden, visual acuity, central retinal thickness, and intraocular pressure. Materials and methods: A single-center, retrospective, cohort study of patients with persistent diabetic macular edema, previously treated with anti–vascular endothelial growth factor injections, dexamethasone implants, or focal laser, who were subsequently treated with fluocinolone acetonide was conducted. All retinal visits were analyzed prior to fluocinolone acetonide, until the most recent follow-up visit. Primary outcomes were pre– and post–fluocinolone acetonide changes in the best-corrected visual acuity and number of treatments required for diabetic macular edema. Secondary outcomes included changes in the central retinal thickness and intraocular pressure. Results: A total of 19 eyes with persistent diabetic macular edema were included and followed for a mean (SD) of 399.3 (222.9) days. Post–fluocinolone acetonide, the mean best-corrected visual acuity improved by 0.4 ETDRS letters for all eyes ( p = 0.895) and the central retinal thickness decreased by 34.2 µm ( p = 0.077). After fluocinolone acetonide, the number of treatments decreased from an average of one treatment every 2.7 months to one every 6 months ( p = 0.009). Furthermore, post–fluocinolone acetonide, 10/19 eyes (52.6%) did not require additional treatment due to a dry macula, and those who did experienced a non-statistically significant reduction of treatments, from one every 2.6 months pre–fluocinolone acetonide, to one every 2.8 months post–fluocinolone acetonide ( p = 0.622). Conclusions: In the setting of persistent diabetic macular edema, fluocinolone acetonide significantly reduces the therapeutic burden, while maintaining best-corrected visual acuity and improving the central retinal thickness. In patient-centered discussions, judiciously employing fluocinolone acetonide should be performed to mitigate this therapeutic burden for patients. </jats:sec

Anemia and jejunal intussusception: An unusual presentation for a metastatic phyllodes breast tumor

AbstractINTRODUCTIONPhyllodes tumor of the breast is a rare cause of breast cancer, accounting for less than 0.5% of breast cancers. These tumors are classified as benign, borderline, or malignant, with malignant tumors compromising nearly 25% of cases. Metastases occur in 20% of malignant tumors, lungs, bones, liver and brain being the frequent sites of metastases.PRESENTATION OF CASEWe present a case of a metastatic phyllodes tumor to the small bowel causing jejunal intussusception, symptomatic anemia, and small bowel obstruction.DISCUSSIONPatients with phyllodes tumor of the breast can develop disease recurrence even years after initial treatment. Phyllodes tumor metastasizing to the small bowel is extremely rare, with only three known previously described case reports in the literature.CONCLUSIONHigh risk patients, with a past medical history of phyllodes breast cancer, should be monitored closely. Even years after breast cancer treatment, these patients may present with gastrointestinal complaints such as obstruction or bleeding, and therefore metastatic disease to the small bowel should be considered on the differential with subsequent abdominal imaging obtained