Eye最新文献

{"title":"Sustainability practices made easy.","authors":"Francesc March de Ribot, Anna March de Ribot, Sjoerd Elferink, Redmer van Leeuwen, David Chang, Oliver Findl","doi":"10.1038/s41433-025-04046-z","DOIUrl":"https://doi.org/10.1038/s41433-025-04046-z","url":null,"abstract":"<p><p>Climate change is a significant challenge worldwide, with implications ranging from extreme weather events to rising sea levels and ecosystem disruptions. Addressing these issues requires a shift towards sustainable practices and global solutions. Healthcare and ophthalmology have a significant responsibility and an opportunity to reduce greenhouse gas emissions and waste, increase efficiency, and maintain safety and quality. Ophthalmology impact is relevant for the high number of patients and procedures, high patient volumes requiring travel to clinics, and extensive use of single-use disposable materials. Eye practices can be more sustainable by optimizing ventilation, using alcohol-based hand rubs, reducing drug waste by reusing medications, and reducing packaging waste. In patient management, we can reduce postoperative visits, evaluate bilateral surgeries, and minimize SF6 gas. The ophthalmology community should critically reassess daily practices to enhance sustainability.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathologic myopia.","authors":"Kyoko Ohno-Matsui","doi":"10.1038/s41433-025-04072-x","DOIUrl":"https://doi.org/10.1038/s41433-025-04072-x","url":null,"abstract":"<p><p>Pathologic myopia (PM) represents a predominant cause of irreversible visual loss worldwide, characterised by progressive axial elongation and profound structural alterations in the posterior segment, notably posterior staphyloma. Posterior staphyloma is a cardinal feature of PM and must be differentiated from physiological myopia, as it indicates localised scleral thinning and ectasia directly impacting the macula and optic nerve. Vision-threatening complications such as myopic traction maculopathy (MTM), frequently driven by vitreoretinal traction on retinal vasculature, and macular atrophy secondary to myopic macular neovascularisation (MNV) are prevalent in PM, often culminating in severe visual impairment. The sclera serves a critical biomechanical role in maintaining ocular structural integrity; hence, targeted interventions aimed at reinforcing the posterior sclera may decelerate disease progression. Although three-dimensional magnetic resonance imaging (3D MRI) has been extensively utilised to visualise the entire shape of the eye, recent advancements such as ultra-widefield optical coherence tomography (UWF-OCT) permit more detailed, practical assessment of posterior segment alterations. Furthermore, polarisation-sensitive OCT (PS-OCT) offers non-invasive in vivo evaluation of scleral collagen fibre orientation and birefringence, deepening our understanding of staphyloma pathogenesis. Early detection of structural changes within the sclera and vitreoretinal interface is paramount for timely intervention to prevent irreversible neuroretinal damage.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel targets beyond vascular endothelial growth factor-A inhibition: improving vision with neovascular age-related macular degeneration treatment.","authors":"Arshad M Khanani, Sophie J Bakri, Carl Regillo, Christina Y Weng, Tien Y Wong, Megan E Baldwin, John J Han, Ian M Leitch","doi":"10.1038/s41433-025-04042-3","DOIUrl":"https://doi.org/10.1038/s41433-025-04042-3","url":null,"abstract":"<p><p>The primary goal in the management of neovascular age-related macular degeneration (nAMD) is to optimise visual acuity outcomes for patients. Landmark clinical trials have demonstrated improved visual outcomes with standard-of-care vascular endothelial growth factor (VEGF) inhibitors, principally targeting a single ligand (VEGF-A). However, in the real-world setting, not all patients attain optimal visual outcomes with these monotherapies. The role of the VEGF-A and VEGF receptor (VEGFR)-2 axis in angiogenesis and vascular permeability is well characterised, but other VEGF family members, including VEGF-C and VEGF-D, which activate VEGFR-2 and VEGFR-3, have also been implicated in nAMD pathogenesis. This may explain the heterogeneous responses observed with current therapies that primarily inhibit VEGF-A signalling, and in patients who continue to lose vision despite treatment, the consequences can be profound. Vision loss affects daily living and can lead to increased cost of care and susceptibility to falls and injuries. This review will explore the VEGF family of ligands and receptors and their role in nAMD, as well as novel therapeutics in development that target mediators beyond VEGF-A with the potential to provide improved vision benefits to patients. In particular, sozinibercept, an investigational trap biologic inhibitor of VEGF-C and VEGF-D ligands, has shown promising efficacy with superior vision gains when used in combination with ranibizumab dosed monthly (standard-of-care therapy) vs. standard-of-care alone (i.e. monthly ranibizumab). This adds to the increasing evidence that multifaceted approaches that target the VEGF family beyond VEGF-A have the potential to provide better vision outcomes for patients with nAMD.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of ethnicity on the accuracy of fundal reflex referrals.","authors":"Yutao Du, James E Hazelwood, Frederick R Burgess","doi":"10.1038/s41433-025-04070-z","DOIUrl":"https://doi.org/10.1038/s41433-025-04070-z","url":null,"abstract":"","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-related retinal detachment pharmacovigilance signals in the real world: evidence from the FDA Adverse Event Reporting System.","authors":"Xiao-Dong Chen, Kun-Hong Xiao, Shi-Nan Wu, Ming-Yan Wei, Chao-Feng Yu, Ke Feng, Pei-Xin Cai, Yu-Ru Wang, Yan-Liang Miao, Li Li, Bo-Zhao Wang, Shi-Ying Li, Qian Chen","doi":"10.1038/s41433-025-04035-2","DOIUrl":"https://doi.org/10.1038/s41433-025-04035-2","url":null,"abstract":"<p><strong>Objective: </strong>The clinical evidence linking medications to retinal detachment (RD) remains limited. This study utilises real-world data from the U.S. FDA Adverse Event Reporting System (FAERS) to identify drugs associated with RD and characterise their classifications.</p><p><strong>Methods: </strong>A disproportionality analysis was performed on over 17 million FAERS reports. Drugs with statistically significant disproportionate RD reporting were identified and categorised by therapeutic class, signal strength, latency period, subgroup factors (e.g., off-label use, age, gender, subtypes, regions), and sensitivity analysis.</p><p><strong>Results: </strong>Thirty drugs showed significant associations with RD, including ophthalmic agents, anticancer therapies, corticosteroids, and erectile dysfunction medications. Signal strength varied: pilocarpine, encorafenib, and ocriplasmin exhibited the highest signal strength, while prednisolone and bevacizumab showed lower strength. Latency periods differed significantly: erectile dysfunction drugs had the longest median latency (365 days), whereas anticancer drugs had the shortest (14 days). Subgroup analyses revealed elevated RD signal strength with off-label use and distinct susceptibility patterns: younger adults (<65) and males had higher signal strength for specific drug classes (e.g., ophthalmic agents), while older adults (>65) were more susceptible to RD with corticosteroids. Subtype analysis highlighted drug-specific associations with exudative, tractional, and rhegmatogenous RD. Sensitivity analysis restricted to healthcare professional reports further confirmed the robustness of the findings.</p><p><strong>Conclusions: </strong>This study provides a stratified list of medications with disproportionate reporting signals for RD. Further high-quality epidemiological and mechanistic studies are warranted to validate the potential causality associations between these medications and RD. Assessment of drug-related retinal detachment using real-world large-scale data.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conjunctival histopathological changes associated with netarsudil 0.02.","authors":"Michelle T Sun, Chaow Charoenkijkajorn, Jonathan H Lin, Donald S Minckler, Kuldev Singh","doi":"10.1038/s41433-025-04063-y","DOIUrl":"https://doi.org/10.1038/s41433-025-04063-y","url":null,"abstract":"<p><strong>Objective: </strong>To investigate histopathological conjunctival changes associated with topical netarsudil 0.02%.</p><p><strong>Methods: </strong>Observational comparative case series. Histopathological analysis of conjunctival specimens taken from adult patients undergoing glaucoma surgery. Inflammation score was graded by three independent pathologists.</p><p><strong>Results: </strong>29 samples were included for analysis. Mean age was 72.4 years and 44.8% were female. Most patients underwent trabeculectomy with mitomycin C (22/29, 76%) while the remainder underwent tube shunt surgery, and one patient underwent insertion of an experimental NT-501 intravitreal implant. All patients were taking ≥2 topical IOP lowering medications, and 12 patients (41.3%) were using topical netarsudil, with mean duration 26.8 months. Compared to those on other glaucoma medications, patients taking netarsudil had significantly thicker conjunctival epithelium (mean 90.1 µm vs 43.2 µm, p = 0.03) and a trend toward higher epithelial cell thickness count (mean 7.7 cells thick vs. 4.9 cells thick, p = 0.07), both of which remained significant and trending respectively when adjusted for confounders (p = 0.02 and p = 0.06). All netarsudil treated samples demonstrated inflammation (graded score ≥0.5) compared to 64.7% of those not on netarsudil (p = 0.03). There were no significant differences in any histopathological parameters in patients who had ceased netarsudil prior to analysis (n = 7) compared to those who had never taken netarsudil (p > 0.05 for all).</p><p><strong>Conclusion: </strong>Conjunctiva treated with netarsudil may be more likely to demonstrate inflammation compared to those treated with other combinations of glaucoma medications. These findings may have surgical implications and additional studies correlating clinical outcomes are required.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to: 'Comment on: 'Incidence and outcomes of post-operative endophthalmitis following elective phacoemulsification cataract surgery, between 2015 and 2022\".","authors":"Magdalene Y L Ting, Giulio Pocobelli, Diana M Butu, Nakul Mandal, Luke Nicholson, Sharmina R Khan","doi":"10.1038/s41433-025-04024-5","DOIUrl":"https://doi.org/10.1038/s41433-025-04024-5","url":null,"abstract":"","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined pathological, microbiological and virological evaluation of vitreous aspirates: a retrospective evaluation of 374 vitrectomy specimens with non-neoplastic disorders.","authors":"Mihaly Sulyok, Kristina Schmauder, Markus Schneider, Jonas Neubauer, Tina Ganzenmueller, Irina Bonzheim, Daniela Süsskind, Karl Ulrich Bartz-Schmidt, Silke Peter, Falko Fend","doi":"10.1038/s41433-025-04047-y","DOIUrl":"https://doi.org/10.1038/s41433-025-04047-y","url":null,"abstract":"<p><strong>Background: </strong>Intraocular infections pose substantial diagnostic challenges due to their varied aetiologies and complex inflammatory responses. The value of combining cytological, microbiological and virological assessments remains underexplored. This extensive retrospective study conducted at a German tertiary care university hospital aims to elucidate the correlation between different inflammatory patterns and detected pathogens in vitreous fluid samples.</p><p><strong>Methods: </strong>A retrospective analysis of 374 non-neoplastic vitreous samples from 353 patients was performed, integrating cytological, microbiological and virological data with final clinical diagnoses.</p><p><strong>Results: </strong>Cytological analysis showed 284 instances of lymphocytic uveitis and 76 of granulocytic endophthalmitis. Pathogens were identified in 46 out of 181 microbiologically tested samples; notable pathogens included Staphylococcus epidermidis, Staphylococcus aureus, Streptococcus pneumoniae, Tropheryma whipplei, Candida albicans and Toxoplasma gondii. Virological tests on 188 samples detected viral DNA in 42 cases, predominantly varicella zoster virus and Epstein-Barr virus, correlating well with clinical suspicions of retinitis. Interestingly, no pathogens were found in 67% of the lymphocytic uveitis cases, and multiple pathogens were detected simultaneously in seven instances, suggesting potential latent infections or reactivations. A significant pattern emerged correlating increased neutrophil counts with pathogen detection, highlighting a notable association (p = 0.03) in a subset analysed for both neutrophil levels and pathogen presence.</p><p><strong>Conclusion: </strong>This study offers critical insights into the epidemiology of intraocular infections in Germany, underscoring the importance of comprehensive pathological assessments. It emphasizes the diagnostic value of the underlying inflammatory patterns for predicting pathogen presence and identifies notable cases of infections, including rare pathogens like Tropheryma whipplei.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and prevalence of mucous membrane pemphigoid with ocular involvement: a retrospective analysis using the TriNetX database.","authors":"Camellia Edalat, Matthew Spangler, Jennifer Thorne, Paulina Liberman, Meghan Berkenstock","doi":"10.1038/s41433-025-04040-5","DOIUrl":"https://doi.org/10.1038/s41433-025-04040-5","url":null,"abstract":"<p><strong>Background: </strong>Mucous membrane pemphigoid with ocular involvement (oMMP) is an autoimmune disease that results in chronic conjunctivitis, conjunctival scarring, and if left untreated, permanent vision loss. oMMP is quite rare with incidence rates between one in 12,000 to one in 60,000, but there is a lack of large population-based studies that focus solely on oMMP. Thus, we sought to examine the cumulative and annual incidence and prevalence of oMMP in the TriNetX database and compared these findings to the US population for greater generalizability.</p><p><strong>Methods: </strong>This was a retrospective study utilised International Classification of Disease, 10th edition (ICD-10) codes to determine the yearly and cumulative incidence and prevalence, demographics, ocular complications, and immunosuppressant treatments prescribed for oMMP from 2013 to 2023. TriNetX software was used to analyze the data.</p><p><strong>Results: </strong>A total of 4052 patients were diagnosed with oMMP with a mean age of 73 years (SD = 14; range 18-90). The majority of patients were female (n = 2604 64.26%) and non-Hispanic, white (n = 3098, 76.46%). Prednisone was the most common systemic medication prescribed to 40% of patients. The most used immunosuppressive drug was mycophenolate mofetil (21%). Glaucoma was the most common ocular complication (n = 375, 9.25%). Between 2013 and 2023, there was a continuous rise in the cumulative incidence and prevalence rates. The 11-year cumulative incidence and prevalence were 1.41per 100,000 persons and 6.72 per 100,000 persons, respectively.</p><p><strong>Conclusions: </strong>Compared to current literature, the TriNetX population with oMMP had similar demographics and immunosuppressant use, but showed a higher incidence and an overall increasing prevalence.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent disparities in diabetic retinopathy outcomes among socially deprived individuals despite treatment adherence.","authors":"Alexander T Hong, Jason S Chwa, Lucas Humayun, Hossein Ameri","doi":"10.1038/s41433-025-04071-y","DOIUrl":"https://doi.org/10.1038/s41433-025-04071-y","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the long-term impact of social determinants of health on diabetic retinopathy (DR) incidence, complications, and management in patients with type 2 diabetes mellitus (T2DM), with emphasis on disparities among treatment-adherent individuals and demographic subgroups.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using TriNetX, a national electronic health records network spanning 70 U.S. healthcare organisations. Adults diagnosed with T2DM were categorised into socially deprived and non-deprived cohorts based on ICD-10 codes related to housing instability, food insecurity, and financial hardship. Propensity score matching balanced cohorts on demographics, comorbidities, laboratory values, medications, and ophthalmic care utilisation. Outcomes included incident DR, sight-threatening complications, ophthalmic treatment and diagnostics, and documented treatment nonadherence. Cox proportional hazards models estimated hazard ratios (HRs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Matched cohorts included 62,786 socially deprived and 62,786 non-deprived patients (mean age, 54 years; 42% female; 49% White, 27% Black, 14% Hispanic). Over a 10-year follow-up, social deprivation was associated with increased risk of DR (HR 1.40, 95% CI 1.34-1.47) and sight-threatening complications, including blindness. Documented nonadherence was significantly increased in the socially deprived cohort (HR 3.57, 95% CI 3.47-3.68). Among patients without documented nonadherence, social deprivation was associated with increased DR risk (HR 1.44, 95% CI 1.35-1.54) and treatment utilisation. Disparities were most pronounced in males, Hispanic individuals, and adults aged 18-39.</p><p><strong>Conclusions: </strong>Social deprivation, regardless of documented treatment adherence, increased DR incidence and complications. Targeted interventions are needed to address persistent disparities and reduce DR burden.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}