Graefe’s Archive for Clinical and Experimental Ophthalmology最新文献

{"title":"Topical insulin as a novel treatment for persistent epithelial defects and other ocular surface disorders: a systematic review.","authors":"Raluca Bievel Radulescu, Stefano Ferrari, Horia T Stanca, Diego Ponzin","doi":"10.1007/s00417-025-06840-7","DOIUrl":"https://doi.org/10.1007/s00417-025-06840-7","url":null,"abstract":"<p><strong>Purpose: </strong>Through this systematic review, we evaluated the therapeutic potential of topical eye insulin in different concentrations to treat several surface ocular pathologies, including: persistent epithelial defects, diabetic keratopathy after a vitrectomy, neutrophic keratopathy and dry eye syndrome. We have consolidated through the data, what are the doses used, the methods of preparation for insulin, whether there are adverse effects and what would be the effectiveness of the eye drops with insulin.</p><p><strong>Methods: </strong>We carried out an extensive search including Pubmed, Cochrane Library, Scopus and Web Of Science. We found 43 relevant studies, after which we excluded duplicates, animal studies, case reports, we ended up with 13 studies to include in the article. Through the Newcastle-Ottawa scale for observational studies and the Jadad scale for randomized controlled trials, we investigated the methodological quality of these articles.</p><p><strong>Results: </strong>Within the review we included a significant number of 268 patients who used eye drops with insulin in concentrations from 0.5 to 2 U/ml administered typically four times per day, having an ocular benefit in corneal healing rates without adverse effects. The quality analysis of the included studies showed a NOS score of moderate-high quality, whereas the Jadad scale showed a high quality.</p><p><strong>Conclusions: </strong>Our systematic review demonstrates that topical insulin is a promising therapeutic option for persistent epithelial defects, diabetic keratopathy following vitrectomy, neurotrophic keratopathy, and dry eye syndrome, significantly enhancing corneal healing rates with a favorable safety profile. Given its accessibility, cost-effectiveness, and potential superiority over conventional treatments, topical insulin could serve as an alternative or adjunct to therapies such as autologous serum and amniotic membrane transplantation.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086070","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":"Bezafibrate was unsuccessful to treat leber hereditary optic neuropathy.","authors":"Christophe Orssaud","doi":"10.1007/s00417-025-06835-4","DOIUrl":"https://doi.org/10.1007/s00417-025-06835-4","url":null,"abstract":"","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077680","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":"How early can we detect diabetic retinopathy? A narrative review of imaging tools for structural assessment of the retina.","authors":"Megan Vaughan, Philip Denmead, Nicole Tay, Ranjan Rajendram, Michel Michaelides, Emily Patterson","doi":"10.1007/s00417-025-06828-3","DOIUrl":"https://doi.org/10.1007/s00417-025-06828-3","url":null,"abstract":"<p><p>Despite current screening models, enhanced imaging modalities, and treatment regimens, diabetic retinopathy (DR) remains one of the leading causes of vision loss in working age adults. DR can result in irreversible structural and functional retinal damage, leading to visual impairment and reduced quality of life. Given potentially irreversible photoreceptor damage, diagnosis and treatment at the earliest stages will provide the best opportunity to avoid visual disturbances or retinopathy progression. We will review herein the current structural imaging methods used for DR assessment and their capability of detecting DR in the first stages of disease. Imaging tools, such as fundus photography, optical coherence tomography, fundus fluorescein angiography, optical coherence tomography angiography and adaptive optics-assisted imaging will be reviewed. Finally, we describe the future of DR screening programmes and the introduction of artificial intelligence as an innovative approach to detecting subtle changes in the diabetic retina. CLINICAL TRIAL REGISTRATION NUMBER: N/A.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085990","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":"Time to improvement following teprotumumab treatment of thyroid eye disease: real world experience.","authors":"Yael Lustig-Barzelay, Daniel Yagoda, Eran Zunz, Shirin Hamed-Azzam, Inbal Avisar, Shay Kehat-Ophir, Zvi Gur, Tali Cukierman-Yaffe, Nancy Agmon-Levin, Daphna Landau-Prat, Guy J Ben-Simon","doi":"10.1007/s00417-025-06855-0","DOIUrl":"https://doi.org/10.1007/s00417-025-06855-0","url":null,"abstract":"<p><strong>Background: </strong>Teprotumumab is the only FDA-approved medication for thyroid eye disease (TED), showing benefits in reducing proptosis, diplopia, clinical activity score (CAS), and improving quality of life. This study describes the clinical outcomes of TED patients treated with Teprotumumab across 5 medical centers in Israel and evaluates time-to-improvement.</p><p><strong>Methods: </strong>A retrospective cohort study of electronic medical records for Israeli patients treated with Teprotumumab between 2021 and 2024 in five medical centers. The main outcome included changes in proptosis and diplopia.</p><p><strong>Results: </strong>Thirty-two TED patients (mean age 53.3, 19 females) received partial or complete treatment with Teprotumumab. All had previously failed IV glucocorticoids, and some also failed other biologics. Four patients had decompression surgery prior; 3 with optic neuropathy and 1 with proptosis improved after 1-7 doses. Proptosis decreased by 2.4mm (right) and 2.0mm (left) (p < 0.001, p = 0.002, paired sample t-test), with significant reductions in primary gaze diplopia (p = 0.015, chi-square test). Four patients (12.5%) had symptom recurrence 8-12 months post-treatment; one improved with additional treatment. Thirteen patients (40.6%) had significant improvement within 3 infusions. Adverse events included myalgia (n = 4), hyperglycemia (n = 3), diarrhea (n = 3), and hearing issues (n = 4). One patient developed encephalopathy, successfully treated with plasmapheresis.</p><p><strong>Conclusions: </strong>Teprotumumab was effective in reducing diplopia and proptosis among Israeli TED patients, with rapid improvement in nearly half of the cases. Further studies are warranted to confirm these findings in real-world settings.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998037","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":"Interocular distribution differences of parafoveal cone photoreceptors between dominant and non-dominant eyes assessed using an adaptive optics scanning laser ophthalmoscope.","authors":"Ying Chen, Huiling Ma, Huiyan Li, Xinyun Wang, Menghui Zhang, Sisi Liu, Xiawei Wang, Hongguang Cui","doi":"10.1007/s00417-025-06852-3","DOIUrl":"https://doi.org/10.1007/s00417-025-06852-3","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate distribution differences of parafoveal cone photoreceptors between dominant and non-dominant eyes using the adaptive optics scanning laser ophthalmoscope (AO-SLO) system.</p><p><strong>Methods: </strong>This retrospective study included 156 eyes from 78 healthy subjects, all of whom had best-corrected visual acuity of 20/20 or better in both eyes and underwent ophthalmological examinations. The dominant eye was determined using the hole-in-the-card test. Retinal cone photoreceptor observations were performed at an eccentricity of 3.0° from the foveal center using the AO-SLO system. Quantitative distribution parameters, including cone density, spacing, regularity, and dispersion of both dominant and non-dominant eyes, were analyzed and compared.</p><p><strong>Results: </strong>Dominant eyes exhibited higher cone photoreceptors density at a 3.0° horizontal eccentricity from the fovea [22,896 (20,954, 25,179) cells/mm²] than non-dominant eyes [22,621 (20,147, 24,253) cells/mm²] (p = 0.03). Correspondingly, the spacing of cone photoreceptors in dominant eyes [5.41 (5.09, 5.68) µm] was smaller than that in non-dominant eyes [5.47 (5.23, 5.72) µm] (p = 0.041). The interocular difference in cone regularity between dominant [96.53 (95.07, 97.46)%] and non-dominant [96.68 (95.49, 97.57)%] eyes was statistically significant (p = 0.04). However, there was no significant interocular difference in cone dispersion, which could reflect distribution uniformity (p = 0.795).</p><p><strong>Conclusion: </strong>Our findings reveal that the dominant eye exhibits higher cone density in the parafoveal region with narrower spacing but a less regular arrangement than the non-dominant eye. These cytological features provide new evidence linking cone photoreceptor distribution to ocular dominance, which may account for the electrophysiological asymmetry observed between the two eyes.</p><p><strong>Key messages: </strong>What is known? • The adaptive optics scanning laser ophthalmoscope can correct aberrations caused by irregularities in the eye's optics, allowing for the direct and noninvasive observation of retinal microstructures in vivo. What is new? • Our study reveals that parafoveal cone photoreceptors in dominant eyes exhibit significantly higher density, narrower spacing, and a less regular arrangement compared to those in non-dominant eyes in vivo. • The cytological asymmetry between photoreceptor cells in dominant and non-dominant eyes may serve as a potential basis for the electrophysiological differences observed between the two.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998895","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":"Identifying potential tear biomarkers in premature infants with retinopathy of prematurity based on proteome and transcriptome analysis.","authors":"Dongting Wu, Zixin Fan, Yarou Hu, Yi Chen, Ruyin Tian, Cui Wang, Honghui He, Yuhang Yang, Guoming Zhang","doi":"10.1007/s00417-025-06838-1","DOIUrl":"https://doi.org/10.1007/s00417-025-06838-1","url":null,"abstract":"<p><strong>Aim: </strong>To identify the potential tear fluid biomarkers in premature infants with and without retinopathy of prematurity (ROP) based on proteomic and transcriptomic analysis.</p><p><strong>Methods: </strong>Tears were collected from the 46 eyes of the 23 enrolled premature infants, with and without ROP. Data-independent acquisition (DIA) mass spectrometry was utilized for the quantitative proteomic analysis of the two groups. Two published transcriptome datasets involving mouse oxygen-induced retinopathy (OIR) model data were selected from the Gene Expression Omnibus (GEO) database. iDEP (integrated Differential Expression and Pathway analysis) were used for differential expression analysis. Gene Ontology (GO)-based functional and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed.</p><p><strong>Results: </strong>In this study, a total of 1742 proteins were quantified from the two groups. 55 differentially expressed proteins closely related to immune and angiogenesis processes were identified, including 33 highly expressed as well as 22 lowly expressed in the ROP group. Combined with RNA-seq data from OIR model, we screened two particularly critical proteins, LYN and filamin A (FLNA), which were both expressed at significantly elevated levels.</p><p><strong>Conclusions: </strong>According to the findings of the tear proteomics data, we hypothesized two particularly critical proteins, LYN and FLNA, may serve as pivotal regulators of immune and angiogenesis processes in ROP. These results will assist in the provision of new potential targets for the diagnosis of ROP.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014239","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":"Management practices and surgical techniques for ab externo less invasive glaucoma surgery: a literature review and expert recommendations.","authors":"Kin Sheng Lim, Julián García-Feijóo, Karsten Klabe","doi":"10.1007/s00417-025-06843-4","DOIUrl":"https://doi.org/10.1007/s00417-025-06843-4","url":null,"abstract":"<p><strong>Purpose: </strong>Subconjunctival bleb-forming devices (SBD) can provide greater intraocular pressure reductions than minimally invasive glaucoma surgery (MIGS) whilst remaining less invasive than traditional surgical techniques. However, variations in management practices and surgical techniques indicate the need for concise and clear guidance on these procedures in diverse patient populations. Here we describe current recommendations on the use of PRESERFLO MicroShunt, an ab externo SBD, according to a review of current literature and the opinions of 20 international glaucoma experts.</p><p><strong>Methods: </strong>A literature search was performed to return all publications relating to the PRESERFLO MicroShunt, which were then reviewed to extract information or guidance on patient selection, pre-operative patient preparation, peri-operative practices and techniques, and post-operative management. Alongside the literature search findings, participants in an expert panel meeting discussed their current practices relating to these same four aspects of PRESERFLO MicroShunt use.</p><p><strong>Results: </strong>PRESERFLO MicroShunt can be considered for the majority of patients with medically uncontrolled open-angle glaucoma, as well as in patients with uveitic glaucoma, advanced glaucoma and high myopia, adults with congenital glaucoma, and in some cases normal tension glaucoma patients. Prior to surgery, steroid drops may be given for 2-4 weeks if feasible, and acetazolamide may also be useful in patients with advanced glaucoma and high IOP. During surgery, a deep (8 mm) and wide sub-Tenon pocket is essential to surgical success. Mitomycin C is generally used at a concentration of 0.4 mg/mL for a minimum of 2-3 min. Intracameral bevacizumab and/or dexamethasone may be considered to increase the chance of surgical success. Post-operatively, antibiotics should be given for 7 days and steroid drops for 3-6 months. Monitoring visits may be less frequent than in patients undergoing trabeculectomy.</p><p><strong>Conclusion: </strong>Management practices and surgical techniques for ab externo SBD vary, and surgeons must use their best clinical judgement based on the requirements of the individual patient. However, here we provide some recommendations for patient selection and pre-, peri- and post-surgical management based on the opinions of experts in the use of PRESERFLO MicroShunt, which we hope will prove useful in optimizing surgical outcomes.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988836","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":"One-year functional and structural results of faricimab for treatment-naïve neovascular age related macular degeneration: An OCT angiography study.","authors":"Alessandra Scampoli, Matteo Mario Carlà, Giulia Grieco, Lorenzo Governatori, Roberta Catalani, Stanislao Rizzo, Tomaso Caporossi","doi":"10.1007/s00417-025-06849-y","DOIUrl":"https://doi.org/10.1007/s00417-025-06849-y","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the 1-year functional and anatomic outcomes of treatment-naïve neovascular age-related macular degeneration (nAMD) eyes undergoing a treat and extend (TAE) regimen with faricimab, METHODS: Prospective interventional study on 33 eyes with treatment-naïve nAMD undergoing a loading phase of 4 monthly faricimab followed by a TAE regimen. Participants underwent functional assessment and retinal imaging with optical coherence tomography and angiography (OCT/OCTA), at baseline and follow-up visits (V0-V5). Primary outcomes were safety, changes in best-corrected visual acuity (BCVA) and central subfield thickness (CST). Secondary outcomes included changes in OCT biomarkers (intraretinal and subretinal fluid [IRF and SRF], maximum pigment epithelium detachment [PED] height) and vascular densities (VD) in the superficial (SCP) and deep capillary plexuses (DCP).</p><p><strong>Results: </strong>Mean follow-up was 14.1 ± 2.7 months. At the final visit, 36.4% eyes were on a q16w regimen, and 36.4% on q12w. Results showed significant reductions in CST (V0: 334 ± 102 μm, V5: 227 ± 47 μm, p < 0.001), presence of IRF/SRF and PED height. BCVA improved significantly from 0.51 ± 0.23 to 0.36 ± 0.26 LogMAR (p = 0.03). A dry macula after the loading phase was achieved in 63.7% of cases and correlated with longer inter-injections intervals during TAE. SCP's VD showed a transient decrease in V1-V3 but returned to baseline values at V5, while no significant changes were observed in DCP VD. No cases of intraocular inflammation or adverse events were observed.</p><p><strong>Conclusion: </strong>Faricimab showed favorable results in treatment-naive nAMD, leading to structural and functional improvements and allowing for extended treatment intervals even in real-world setting.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013596","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":"Identification of markers predicting clinical course in patients with Behcet disease by combination of machine learning and unbiased clustering analysis.","authors":"Kinya Tsubota, Yoshihiko Usui, Hiroyuki Shimizu, Hiroshi Goto","doi":"10.1007/s00417-025-06850-5","DOIUrl":"https://doi.org/10.1007/s00417-025-06850-5","url":null,"abstract":"<p><strong>Purpose: </strong>Behçet's disease (BD) is a multisystem inflammatory disorder with diverse clinical manifestations. Identifying biomarkers predictive of clinical outcomes, such as tumor necrosis factor (TNF) inhibitor initiation and ocular inflammatory attack frequency, is critical for improving management. This study aimed to identify biomarkers predicting the clinical course of BD using peripheral blood test data and unbiased clustering combined with machine learning.</p><p><strong>Methods: </strong>A retrospective cohort study of 238 BD patients diagnosed at Tokyo Medical University Hospital (2004-2020) was conducted. Unsupervised hierarchical clustering was applied to peripheral blood data, dividing patients into distinct groups. Machine learning techniques were used to explore biomarkers predicting the clinical course.</p><p><strong>Results: </strong>Cluster analysis identified four groups: Group A (low C-reactive protein), Group B (high angiotensin-converting enzyme), Group C (high anti-streptolysin O), and Group D (low neutrophil count). Group C had a higher rate of TNF inhibitor initiation (47%, p = 0.04), while Group D had fewer ocular inflammation attacks per year (1.4, p = 0.04). Logistic regression analysis identified red blood cell count (p < 0.01) and monocyte percentage (p = 0.02) as predictive biomarkers for TNF inhibitor initiation. Machine learning further confirmed mean corpuscular hemoglobin concentration (MCHC) as a significant predictor of TNF inhibitor initiation. Additionally, multiple regression analysis identified the neutrophil/lymphocyte ratio as a predictor of the number of inflammatory attacks per year (p = 0.02).</p><p><strong>Conclusions: </strong>Unsupervised clustering of blood test data identified distinct BD clinical phenotypes. Monocyte percentage may predict TNF inhibitor initiation, while neutrophil/lymphocyte ratio may predict ocular inflammation frequency, highlighting pathophysiologic heterogeneity in BD.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994105","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":"Efficacy of vitrectomy combined with and without cataract surgery for diabetic macular edema: one-year follow-up multi-center study in Japan.","authors":"Yutaka Yamada, Yoshihiro Takamura, Kazuma Saito, Akira Minamoto, Gaku Ishigooka, Takashi Koto, Yuki Nakano, Eiko Tsuiki, Hiroto Terasaki, Miho Shimizu, Masayo Kimura, Yoshinori Mitamura, Reio Sekine, Yutaro Mizusawa, Takao Hirano, Tomoyuki Oyama, Takeshi Iwase, Fumiaki Higashijima, Hisashi Matsubara, Masaru Inatani","doi":"10.1007/s00417-025-06845-2","DOIUrl":"https://doi.org/10.1007/s00417-025-06845-2","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy of vitrectomy, with and without cataract surgery, for diabetic macular edema (DME) in Japan.</p><p><strong>Method: </strong>This retrospective study was conducted at 22 sites in Japan and enrolled patients who underwent vitrectomy either without (VIT group) or with (VIT + CS group) cataract surgery. Central retinal thickness (CRT) and best-corrected visual acuity (BCVA) were measured before surgery and at 1, 3, 6, and 12 months after surgery.</p><p><strong>Results: </strong>A total of 722 patients with DME (482 in the VIT + CS group and 240 in the VIT group) were enrolled. CRT significantly decreased after 1 month and continued thereafter in both groups. BCVA significantly improved at 1 month in the VIT + CS group and at 6 months in the VIT group. In both groups, regardless of epiretinal membrane removal, CRT and BCVA significantly improved, with no additional benefit from concomitant internal limiting membrane peeling. The change in BCVA was significantly correlated with the change in CRT during 6 months postoperatively in all patients and in the VIT group. Patients with worse preoperative visual acuity had a higher likelihood of improved BCVA at 6 and 12 months after surgery. No significant difference in BCVA was observed before and after surgery in patients with a preoperative visual acuity of 20/40 or better. However, in patients with a visual acuity of 20/50 or worse, BCVA significantly improved 1 month after surgery.</p><p><strong>Conclusion: </strong>Vitrectomy is anatomically and functionally effective for DME, and combined cataract surgery is beneficial in DME cases with cataracts. Patients with poor preoperative BCVA improved, while those with good vision maintained it. However, better preoperative vision increased the risk of postoperative deterioration, underscoring the need for careful evaluation of surgical indications.</p><p><strong>Key messages: </strong>What is known In vitrectomy for diabetic macular edema (DME), DRCR.net showed that 13-31% of patients experience decreased vision despite reduced edema, leaving the efficacy of vitrectomy uncertain. What is new Our multicenter study demonstrated that vitrectomy with and without cataract surgery was effective in improving central retinal thickness and visual acuity in the patients with DME. Better preoperative visual acuity increased the risk of postoperative decline, and thus the need for careful evaluation of surgical indications.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984001","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}