Week in review: Endophthalmitis outbreak, hypoglycemia worsens diabetic retinopathy, pediatric ophthalmologist shortage

A weekly roundup of ophthalmic news from around the web.

Outbreak of fungal endophthalmitis due to contaminated viscoelastic reported in South Korea. In October 2020, South Korean ophthalmologists first reported a cluster of fungal endophthalmitis cases in patients who had undergone cataract surgery. By June 2021, 381 cases throughout the country had been officially reported. The outbreak was traced to sodium hyaluronate, used as a viscoelastic, that had been contaminated with Fusarium species. After treatment with antifungals and/or vitrectomies (with or without IOL removal), 94% of patients achieved disease remission after 6 months. JAMA Ophthalmology

Researchers begin to uncover the mechanisms behind diabetic eye disease. Using data from lab-grown murine and human eye cells, a team of investigators at Johns Hopkins Medicine found that low glucose levels start a chain of events that can cause worsening of diabetic retinopathy. During episodes of hypoglycemia, levels of hypoxia-inducible factor-1 (HIF-1α) increase, causing greater expression of the glucose transporter Glut1 and other cell proteins in the retina and eventually an overgrowth of blood vessels. The Johns Hopkins researchers plan to use these findings to study the effects of low glucose levels on other organs of patients with diabetes. Johns Hopkins University; Cell Reports

Looking for a pediatric ophthalmologist? It may be a long search. Only 10% of US counties have more than one pediatric ophthalmologist and 45% of counties have just one, according to a recent cross-sectional study. Four states have the most pediatric ophthalmologists: California, New York, Florida, and Texas, reflecting larger populations in these states. Fewer clinicians were available in more rural areas and in counties with lower family income and less access to Internet service. The authors note that lack of access to specific pediatric ophthalmology care has a negative impact on how soon serious ophthalmologic conditions are diagnosed, treated, and managed. JAMA Ophthalmology