AIM: To determine whether the prevalence of treated hypertension is higher among males or females with early/intermediate (e/i) age-related macular degeneration (AMD) with and without bilateral reticular pseudodrusen (RPD). METHODS: Retrospective review of the records of patients with e/iAMD who were recruited into the University of Colorado AMD registry between July 2014 and November 2019. Images were classified using the Beckman Initiative criteria and presence/absence of RPD. Patients were categorized into three groups: 1) e/iAMD with RPD; 2) e/iAMD without RPD; 3) control patients who did not have AMD. Multinomial logistic regression analysis was used for adjusted analysis with odds ratios (OR) and confidence intervals (CI). RESULTS: There were 260 patients with e/iAMD of which 101 had bilateral RPD and 159 had no RPD, and 221 controls. Overall, 62% of patients were female and the three groups did not differ by gender. When stratified by gender, the female e/iAMD/RPD group had a higher prevalence of hypertension, 64.1% vs 45.2% for controls, OR=2.2 (95%CI: 1.2-4.0). The frequency of hypertension in the e/iAMD/no RPD group was 54.1% and did not significantly differ from the control group. Among males, prevalence rates of treated hypertension did not differ. There is a significant interaction of hypertension and gender for the e/iAMD/RPD group such that women with e/iAMD who had RPD were significantly more likely to have hypertension (P=0.042). This relationship was not significant in the e/iAMD/no RPD group (P=0.269). CONCLUSION: Among females treated hypertension is significantly higher among e/iAMD/RPD patients, whereas for males there is no significant association.

Background Glaucoma drainage implants have been used with increasing frequency for the management of glaucoma. Patients who are candidates for glaucoma drainage devices often have more severe disease and are at risk of vision loss with post-operative elevations in intraocular pressure (IOP). One post-operative complication that can result in IOP elevation after glaucoma drainage device implantation is occlusion of the tube lumen. Case presentation Here, we present a novel case of tube occlusion by the anterior capsule in a patient who underwent combined phacoemulsification and Ahmed glaucoma valve implantation. The tube occlusion was successfully managed with Nd:YAG capsulotomy with immediate IOP lowering. Conclusions While there have been previous reports of occlusion of the tube lumen by vitreous, iris, blood and fibrin, to our knowledge this is the first report of tube occlusion by the anterior lens capsule and the first report to describe its successful management.

Purpose: To evaluate sublingual/oral midazolam in phacoemulsification patients with no intravenous line. Design: prospective, consecutive case series as part of a quality assurance program. Methods:Two surgeons' data from 193 consecutive procedures receiving sublingual plus oral midazolam were analyzed for total midazolam dose, need for additional medications, nausea/vomiting, respiratory depression, and total monitoring time. Low health-risk (American Society of Anesthesiologist 2 (ASA2) and higher health-risk (American Society of Anesthesiologist 3(ASA3)) groups were compared.Results: There were no statistical differences between groups, except ASA2 cases required more midazolam syrup than ASA3 cases (5.94 ± 0.18 vs. 5.08 ± 0.08 mg, p < 0.001). Fewer than 3% of all cases needed additional medication or experienced nausea. Average time monitored was under 80 minutes. One patient had mild (successfully treated) respiratory depression. Only 3 cases required additional syrup, and only 3 intravenous lines were started. There were no intraoperative events. Conclusion:Sublingual/oral midazolam without intravenous line is a safe, efficient complement to topical anaesthesia for phacoemulsification with IOL. PrecisSublingual/oral midazolam without intravenous line is a safe, efficient means of achieving monitored anaesthesia care for phacoemulsification with IOL that offers advantages to both patient and surgeon.