Publications by authors named "Michael J Venincasa"

16 Publications

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Ophthalmology Residency Match in the Covid-19 Era: Applicant and Program Director Perceptions of the 2020-2021 Application Cycle.

Semin Ophthalmol 2021 Apr 7:1-6. Epub 2021 Apr 7.

Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, CT, USA.

To evaluate the experiences and preferences of ophthalmology residency applicants and program directors (PDs), with emphasis on the effect of COVID-19 as well as recent changes on the application process. Cross-sectional, online surveyParticipants: All applicants to the Bascom Palmer Eye Institute ophthalmology residency program, and all United States ophthalmology residency PDs, during the 2020-2021 application cycle. An online survey was distributed to applicants and program directors of the 2020-2021 ophthalmology residency application cycle.Main Outcome Measures: Applicant demographics, application submissions, interview experiences, financial considerations, match results, and suggestions for improvement of the application process. Responses were obtained from 205 applicants (34.9% response rate) and 37 PDs (30.3%). A successful match into an ophthalmology residency was achieved by 144 (83.7%) applicants. Applicants applied to (mean ± SD) 79.7 ± 22.8 ophthalmology residency programs, received 13.1 ± 8.9 invitations to interview, and attended 11.1 ± 5.8 interviews. Most applicants (N = 126; 71.2%) and PDs (N = 22; 78.6%) expressed a preference for in-person interviews over virtual interviews. If given a choice regarding the future direction for interviews, most applicants were unsure (N = 68; 38.4%) or would prefer to hold interviews virtually (N = 62; 35.0%); PDs felt that interviews should go back to being in-person (39.3%) or were unsure (28.6%). Most PDs (N = 21; 72.4%) reported an increased number of applications received by their respective programs this year compared to previous years. While applicants (N = 108; 61.0%) mostly felt that there should not be a cap on the number of applications, 19 (67.9%) PDs supported a limit on application numbers. Applicants spent an average (SD) of $2320.96 ($1172.86) on the application process this year, which is significantly less than 2018-2019 data. The ophthalmology residency application process was especially complex during the COVID-19 pandemic. Although many applicants and PDs were glad that interviews were held virtually this year, they were less certain regarding future years. The virtual format led to a significantly lower financial burden for applicants and may lead some to prefer this format in the future; if a hybrid model is offered for virtual/in-person interviews, these two interview modes should be compared equally.
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http://dx.doi.org/10.1080/08820538.2021.1906917DOI Listing
April 2021

Elevated preoptic brain activity in zebrafish glial glycine transporter mutants is linked to lethargy-like behaviors and delayed emergence from anesthesia.

Sci Rep 2021 Feb 4;11(1):3148. Epub 2021 Feb 4.

Department of Biology, University of Miami, 1301 Memorial Drive, Coral Gables, FL, 33146, USA.

Delayed emergence from anesthesia was previously reported in a case study of a child with Glycine Encephalopathy. To investigate the neural basis of this delayed emergence, we developed a zebrafish glial glycine transporter (glyt1 - / -) mutant model. We compared locomotor behaviors; dose-response curves for tricaine, ketamine, and 2,6-diisopropylphenol (propofol); time to emergence from these anesthetics; and time to emergence from propofol after craniotomy in glyt1-/- mutants and their siblings. To identify differentially active brain regions in glyt1-/- mutants, we used pERK immunohistochemistry as a proxy for brain-wide neuronal activity. We show that glyt1-/- mutants initiated normal bouts of movement less frequently indicating lethargy-like behaviors. Despite similar anesthesia dose-response curves, glyt1-/- mutants took over twice as long as their siblings to emerge from ketamine or propofol, mimicking findings from the human case study. Reducing glycine levels rescued timely emergence in glyt1-/- mutants, pointing to a causal role for elevated glycine. Brain-wide pERK staining showed elevated activity in hypnotic brain regions in glyt1-/- mutants under baseline conditions and a delay in sensorimotor integration during emergence from anesthesia. Our study links elevated activity in preoptic brain regions and reduced sensorimotor integration to lethargy-like behaviors and delayed emergence from propofol in glyt1-/- mutants.
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http://dx.doi.org/10.1038/s41598-021-82342-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7862283PMC
February 2021

Video-Conference Interviewing for the Ophthalmology Residency Match-Reply.

JAMA Ophthalmol 2021 02;139(2):249-250

Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.

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http://dx.doi.org/10.1001/jamaophthalmol.2020.5765DOI Listing
February 2021

Analysis of Funding Source and Spin in the Reporting of Studies of Intravitreal Corticosteroid Therapy for Diabetic Macular Edema: A Systematic Review.

Clin Ophthalmol 2020 20;14:2383-2395. Epub 2020 Aug 20.

Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA.

Purpose: This systematic review examined the relationship between industry funding and the presence of spin in high-impact studies evaluating intravitreal corticosteroid therapy for diabetic macular edema.

Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. MEDLINE and Embase were systematically searched from inception through July 16, 2018, for randomized controlled trials and meta-analyses investigating the treatment of patients with diabetic macular edema using intravitreal corticosteroid therapy. Only studies published in English journals with an impact factor greater than 2 as per the Clarivate Analytics 2017 Journal Citation Report were included. The authors independently assessed study quality, funding source and the presence of reporting bias using a standardized datasheet.

Results: Title and abstract screening were completed on 7158 unique hits and full-text review yielded 44 included studies. Overall, there was correspondence between the wording of abstract conclusions and study results in 41/44 (93%) articles. Correspondence between abstract conclusions and significance of main outcome was present in 14/14 (100%) industry-funded and 27/30 (90%) nonindustry-funded studies. The odds ratio of industry funding being associated with noncorrespondence was 0.27 (95% CI: 0.01-5.61, p=0.54). The most common reason for noncorrespondence was the failure to mention rates of steroid-related intraocular pressure elevation.

Conclusion: The results of this systematic review indicate that biased abstract outcome reporting is rare in published randomized controlled trials and meta-analyses of intravitreal corticosteroid therapy for diabetic macular edema. Biased reporting was not associated with the presence of industry funding or a conflict of interest.
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http://dx.doi.org/10.2147/OPTH.S262085DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7445525PMC
August 2020

Pars Plana Vitrectomy Reoperations for Complications of Proliferative Diabetic Retinopathy.

Clin Ophthalmol 2020 10;14:1559-1563. Epub 2020 Jun 10.

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.

Objective: To report visual acuity in patients undergoing pars plana vitrectomy (PPV) reoperations for complications of proliferative diabetic retinopathy (PDR).

Design: Retrospective case series.

Subjects: Diabetic patients undergoing reoperation with PPV between 2015 and 2018 at a university referral center.

Methods: Patient charts were reviewed for indication for initial and repeat PPV, baseline clinical characteristics including gender, age, and lens status, and pre- and post-operative best-corrected visual acuity.

Main Outcome Measures: Best-corrected visual acuity at last follow-up.

Results: Of 538 eyes (409 patients) undergoing a PPV for diabetic retinopathy, 153 (28.4%) eyes had reoperation. Among the 130 eyes (119 patients) that met the inclusion criteria, 55 eyes (50 patients) underwent reoperation for complications of PDR, defined as non-clearing vitreous hemorrhage (NCVH) and/or tractional retinal detachment (TRD). Within this subgroup of 55 eyes, 19 (34.5%) eyes had an indication for the first surgery of NCVH. Fourteen (73.7%) of these NCVH eyes achieved a visual acuity of 20/80 or better. When the indication for the first surgery was TRD (33 eyes, 60%), 8 (24.2%) eyes achieved this same outcome (p=0.0011).

Conclusion: Approximately one of every four eyes treated with PPV for PDR will undergo repeat PPV during follow-up. VA outcomes after the repeat PPV were variable, with NCVH cases achieving better outcomes compared to TRD.
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http://dx.doi.org/10.2147/OPTH.S252285DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293964PMC
June 2020

Educational Impact of Podcasts in the Retina Community.

Ophthalmol Retina 2020 09 5;4(9):958-961. Epub 2020 May 5.

Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida. Electronic address:

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http://dx.doi.org/10.1016/j.oret.2020.04.024DOI Listing
September 2020

Current Applicant Perceptions of the Ophthalmology Residency Match.

JAMA Ophthalmol 2020 05;138(5):460-466

Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.

Importance: The ophthalmology residency application process is critical for applicants and residency programs, and knowledge about the preferences of applicants would assist both groups in improving the process.

Objective: To evaluate the experiences and preferences of ophthalmology residency applicants.

Design, Setting, And Participants: This cross-sectional, nonvalidated survey was conducted online. All applicants to the Bascom Palmer Eye Institute ophthalmology residency program during the 2018-2019 application cycle were invited to complete the survey. Data collection occurred from April 1, 2019, to April 30, 2019.

Main Outcomes And Measures: Applicant demographics, application submissions, interview experiences, financial considerations, match results, and suggestions for improvement of the application process.

Results: Responses were received from 185 applicants (36.4%), including 77 women (41.6%). A successful match into an ophthalmology residency was achieved by 172 respondents (93.0%). There was a mean (SD) US Medical Licensing Examination Step 1 score of 245.8 (13.3) points. Respondents applied to a mean (SD) of 76.4 (23.5) ophthalmology residency programs, received 14.0 (9.0) invitations to interview, and attended 10.3 (4.4) interviews. Choices regarding applications and interviews were based mostly on program reputation, location, and advisor recommendation. A usual lead time of at least 3 weeks between the invitation and interview was reported by 126 respondents (69.2%), which was reduced to 14 respondents (15.1%) when a wait-list was involved. The ophthalmology residency application process cost a mean (SD) of $5704 ($2831) per applicant. Respondents reported that they were most able to reduce costs through housing choices (hotel stays or similar arrangements) and least able to reduce costs by limiting the number of programs to which they applied or at which they interviewed.

Conclusions And Relevance: The ophthalmology residency application process is complex and poses substantial challenges to applicants and residency programs. These findings suggest that many current applicants have difficulty selecting programs to apply to, and most respondents desired changes to the current system of interview invitations and scheduling.
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http://dx.doi.org/10.1001/jamaophthalmol.2020.0252DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068667PMC
May 2020

Effect of Funding Source on "Spin" in Studies of Ocriplasmin Therapy for Vitreomacular Traction and Macular Hole.

Clin Ophthalmol 2020 13;14:81-88. Epub 2020 Jan 13.

Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA.

Purpose: To examine the relationship between industry funding and "spin" in randomized controlled trials (RCTs) and meta-analyses investigating use of ocriplasmin for patients with vitreomacular traction (VMT) and macular hole (MH).

Methods: In this study, we examined all PubMed and Ovid MEDLINE RCTs and meta-analyses published in journals with impact factor ≥2 investigating effectiveness of ocriplasmin use for VMT and MH. The main outcome measure was correspondence between the studies' main statistical outcome and their abstract conclusion wording. Each article was reviewed by three independent observers and was evaluated for source of funding, industry co-authorship, study methodology, statistical significance of main outcome measure, correspondence between results of main outcome measure and abstract conclusion, and journal impact factor. Funding was determined by public disclosure. Discrepancies were resolved by consensus.

Results: Twelve studies met inclusion criteria, of which 11 were industry funded and 1 was non-industry funded; 11 (91.67%) showed correspondence between outcome and abstract conclusion, without difference between industry-funded and non-industry funded publications or between publications in journals with high impact factor (≥3) versus low impact factor (≥2 and <3).

Conclusion: In RCTs and meta-analyses of ocriplasmin for VMT and MH, our results suggest that neither industry funding nor journal impact factor affected the rate of "spin" in study conclusions. This study helps physicians understand what challenges they face when learning about a newer, less-established drug.
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http://dx.doi.org/10.2147/OPTH.S233816DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6968818PMC
January 2020

ANALYSIS OF THE VITREORETINAL SURGICAL FELLOWSHIP APPLICANT POOL: Publication Misrepresentations and Predictors of Future Academic Output.

Retina 2020 Oct;40(10):2026-2033

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, Florida.

Purpose: To evaluate characteristics associated with misrepresentation of publication record, future career placement, and subsequent academic output among vitreoretinal surgical fellowship applicants.

Methods: A retrospective review of 337 vitreoretinal surgical applicants between 2015 and 2018 was conducted. Publications reported in the applications were verified using PubMed, Google, and Google Scholar. Applications were considered misrepresented if there was no record of the publication or if there was an inconsistency in authorship. Applicants were followed after graduation and their employment position and postgraduation publications were recorded. The main outcome measures were the number of unverifiable publications, postfellowship job placement, and postgraduate peer-reviewed publications.

Results: Of the 377 applicants, 309 (82.0%) listed peer-reviewed publications. Of those with a publication, 32 (10.4%) had misrepresentations. A reported desire to pursue an academic career was associated with a future career in academic medicine, whereas Alpha Omega Alpha status was correlated with a future career in private practice. Alpha Omega Alpha status, a reported desire to pursue an academic career, and the number of peer-reviewed publications before fellowship were positively correlated with higher numbers of peer-reviewed publications after fellowship.

Conclusion: Unverifiable authorship among vitreoretinal surgical fellowship applicants is significant, affecting nearly one in 10 applicants with peer-reviewed publications. A reported desire to pursue academic medicine as listed on the fellowship application is a useful indicator for a future career in academics, and for increased number of peer-reviewed publications after fellowship.
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http://dx.doi.org/10.1097/IAE.0000000000002698DOI Listing
October 2020

Pregabalin Failed to Prevent Dry Eye Symptoms after Laser-Assisted in Situ Keratomileusis (LASIK) in a Randomized Pilot Study.

J Clin Med 2019 Sep 1;8(9). Epub 2019 Sep 1.

Department of Physical Medicine and Rehabilitation, University of Miami, Miami, FL 33136, USA.

Purpose: Perioperative pregabalin administration has been found to reduce the risk of persistent pain after a variety of surgical procedures. However, this approach has not been tested in relation to eye surgery. As such, the purpose of this study was to evaluate whether perioperative pregabalin can reduce the presence of dry eye (DE) symptoms, including eye pain, six months after laser-assisted in situ keratomileusis (LASIK).

Methods: Prospective, masked, randomized single-center pilot study. Patients were treated with either pregabalin (oral solution of pregabalin 150 mg twice daily, first dose prior to surgery, continued for a total of 28 doses over 14 days) or placebo solution. The primary outcome was dry eye symptoms as measured by the Dry Eye Questionnaire 5 (DEQ-5). Secondary outcome measures included pain-related eye symptoms.

Results: In total, 43 individuals were enrolled in the study and randomized to pregabalin ( = 21) or placebo ( = 22). Of those, 42 individuals completed the final visit after six months of follow-up. Some differences were noted between the two groups at baseline, including a higher frequency of females in the pregabalin group. At 6-months, there were no significant differences in the percentage of patients with DE symptoms (DEQ5 ≥ 6, 57% vs. 33%, = 0.14), DE symptom severity (DEQ5, 6.6 ± 5.0 vs. 4.5 ± 4.2, = 0.14), ocular pain intensity (numerical rating scale, 1.10 ± 1.48 vs. 0.38 ± 0.97, = 0.08), or neuropathic pain complaints (Neuropathic Pain Symptom Inventory-Eye, 2.81 ± 4.07 vs. 3.14 ± 5.85, = 0.83) between the pregabalin and control groups. Ocular signs were likewise similar between the groups, and of note, did not correlate with DE symptoms. The strongest predictor of DE symptoms six months post-surgery was the presence of DE symptoms prior to surgery.

Conclusions: Perioperative pregabalin did not reduce the frequency or severity of DE symptoms at a six month follow-up after LASIK in this small pilot study.
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http://dx.doi.org/10.3390/jcm8091355DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780750PMC
September 2019

Perceptions of Vitreoretinal Surgical Fellowship Training in the United States.

Ophthalmol Retina 2019 09 10;3(9):802-804. Epub 2019 May 10.

Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida. Electronic address:

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http://dx.doi.org/10.1016/j.oret.2019.05.006DOI Listing
September 2019

Inadvertent Subconjunctival Injection of a Fluocinolone Acetonide Implant.

JAMA Ophthalmol 2019 Mar 14;137(3):e184149. Epub 2019 Mar 14.

Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida.

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http://dx.doi.org/10.1001/jamaophthalmol.2018.4149DOI Listing
March 2019

Effect of funding source on reporting bias in studies of intravitreal anti-vascular endothelial growth factor therapy for retinal vein occlusion.

Acta Ophthalmol 2019 Mar 19;97(2):e296-e302. Epub 2018 Sep 19.

Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA.

Purpose: To examine the relationship between industry funding and outcome reporting bias in high-quality studies investigating the use of intravitreal anti-vascular endothelial growth factor (VEGF) agents for patients with macular oedema secondary to branch or central retinal vein occlusion (RVO).

Methods: This systematic review in PubMed and Ovid MEDLINE examined all randomized clinical trials and meta-analyses published in journals with impact factor of ≥2 that investigated effectiveness of intravitreal anti-VEGF therapy in patients with RVO. The main outcome measure was correspondence between statistical outcome and abstract conclusion wording.

Results: Forty-five studies met inclusion criteria; 38 (84%) showed correspondence between outcome and abstract conclusion without difference between industry-funded and nonindustry-funded publications (p = 0.39) or between publications in journals with impact factor ≥3 versus <3 (p = 0.96).

Conclusion: In high-quality studies of intravitreal anti-VEGF therapy for RVO, neither industry funding nor journal impact factor affected the rate of outcome reporting bias.
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http://dx.doi.org/10.1111/aos.13917DOI Listing
March 2019

Combination of anterior segment optical coherence tomography modalities to improve accuracy of rectus muscle insertion location.

J AAPOS 2017 Jun 17;21(3):243-246. Epub 2017 May 17.

Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida. Electronic address:

Anterior segment optical coherence tomography (AS-OCT) is useful for locating the extraocular muscle insertion prior to strabismus surgery; however, its accuracy decreases in reoperations. This masked retrospective study investigated whether a combination of AS-OCT modalities improves accuracy. The distance between the corneoscleral limbus and extraocular muscle insertion was measured with AS-OCT, first using the standard grayscale modality alone and then refined with the color modality. The AS-OCT measurement was considered accurate when within 1.00 mm of the intraoperative caliper measurement. A total of 139 AS-OCT images were analyzed from 74 patients (mean age, 52 years), including 60 medial rectus (19 reoperations), 61 lateral rectus (11 reoperations), 10 superior rectus, and 8 inferior rectus muscles. Compared to grayscale alone, the combination grayscale/color modalities improved AS-OCT accuracy from 77% to 87% (P = 0.03), reflecting an increase from 83% to 94% (P = 0.01) in primary surgeries and from 53% to 60% (P = 0.60) in reoperations.
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http://dx.doi.org/10.1016/j.jaapos.2017.05.005DOI Listing
June 2017

Long-term effects of cataract surgery on tear film parameters.

ScientificWorldJournal 2013 20;2013:643764. Epub 2013 Jan 20.

Department of Ophthalmology, Miami Veterans Affairs Medical Center, 1201 NW 16th Street, Miami, FL 33125, USA.

Purpose: To examine the differences in tear film parameters more than 3 months postsurgery in eyes with cataract surgery (surgical eyes) versus eyes without cataract surgery (nonsurgical eyes).

Methods: 29 patients were seen at the Miami Veterans Affairs Medical Center (VAMC) who had cataract surgery by phacoemulsification in one eye more than 3 months prior to the study date and had no history of surgical intervention in their fellow eye. Tear film parameters were measured in both eyes and compared using McNemar tests for dichotomous variables and paired and single sample t-tests for continuous variables.

Results: Mean patient age was 73 (standard deviation (SD): 11); 26 patients (90%) identified themselves as White and 7 (24%) as Hispanic. The mean number of days between surgery and this study was 952 (SD: 1109). There were no statistical differences between the surgical eye and the nonsurgical eye with respect to any of the measured tear film parameters. Confidence intervals around these differences were narrow enough to exclude a substantial effect of cataract surgery. The elapsed time between cataract surgery and measurement of the tear parameters did not appear to affect the difference in parameters between the two eyes.

Conclusion: We found that eyes that had cataract surgery more than 3 months prior to testing had no differences in their tear film parameters compared to eyes without a history of surgery.
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http://dx.doi.org/10.1155/2013/643764DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3563207PMC
August 2013