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

{"title":"Choroidal neovascularization secondary to punctate inner choroidopathy vs myopia: clinical outcomes after 1-year of treatment.","authors":"Leonardo Bottazzi, Eugenio Barlocci, Riccardo Sacconi, Marco Battista, Andrea Servillo, Federico Beretta, Francesco Bandello, Giuseppe Querques","doi":"10.1007/s00417-025-06818-5","DOIUrl":"https://doi.org/10.1007/s00417-025-06818-5","url":null,"abstract":"<p><strong>Background: </strong>One of the most important complications of punctate inner choroidopathy (PIC) is the development of an inflammatory type 2 choroidal neovascularization (iCNV); however, also myopic macular degeneration due to high myopia could be complicated by a type- 2 CNV (mCNV). The aim of this work is to assess similarities and differences in the response to anti-VEGF treatment between mCNV and iCNV during a one-year follow-up, number of intravitreal injections required to control the CNV and the number of recurrences that occurred during a one-year follow-up were evaluated.</p><p><strong>Methods: </strong>Retrospective, longitudinal, case-control study. Patients diagnosed with myopic iCNV secondary to PIC or to simple myopia referring to San Raffaele Hospital were enrolled from January 2021 to December 2022. Choroidal thickness (ChT) and best-corrected visual acuity (BCVA) were measured at the onset of CNV, after resolution of exudation after treatment, and at 1-year follow-up. Primary outcomes included the analysis of the number of intravitreal injections needed and the incidence of recurrences. Secondary outcomes comprised the analysis of ChT.</p><p><strong>Results: </strong>Thirty-seven eyes (37 patients) were enrolled. Sixteen eyes were affected by myopic iCNV secondary to PIC, and 21 eyes by simple mCNV. BCVA significantly improved in both myopic iCNV group (from 0.27 ± 0.12 at the baseline to 0.11 ± 0.08 LogMAR at 12 months follow-up, p < 0.001) and simple mCNV group (from 0.37 ± 0.22 at the baseline to 0.23 ± 0.17 LogMAR at 12 months follow-up, p < 0.001). A significant difference in ChT was found comparing myopic iCNV and simple mCNV groups (mean sub-CNV ChT of 258 ± 116 μm and 89 ± 14 μm, respectively, p < 0.001). Sub-CNV ChT significantly decreases during the follow-up in the PIC group (from 258 ± 116 μm to 192 ± 118 μm, p = 0.002), whereas no differences were disclosed in the myopic group. CNV secondary to PIC needed more anti-VEGF intravitreal injections to achieve resolution of exudation (3.2 ± 1.2 vs 2.1 ± 1.1 intravitreal injections, p = 0.003) and they were characterized by higher number of relapses (44% vs 20%, p < 0.001) in comparison to simple myopic group.</p><p><strong>Conclusions: </strong>PIC group showed a more aggressive pattern of CNV, characterized by higher number of relapses and intravitreal injections needed. Moreover, a higher ChT below the lesion was detected in PIC group in comparison to simple myopic group.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779779","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 avascular retina in retinopathy of prematurity.","authors":"Ting Fang Tan, Su Ann Tay, Swati Agarwal-Sinha, Gavin Siew Wei Tan, Wei-Chi Wu, Andrew S H Tsai","doi":"10.1007/s00417-025-06820-x","DOIUrl":"https://doi.org/10.1007/s00417-025-06820-x","url":null,"abstract":"<p><p>Persistent avascular retina (PAR) has been increasingly reported with the increased use of anti-vascular endothelial growth factor (VEGF) agents in treatment-requiring ROP. However, they have also been observed in ROP eyes that did not meet treatment requirement and spontaneously regressed. PAR is highlighted in the updated nomenclature under the International Classification of Retinopathy of Prematurity, 3rd edition (ICROP3) consensus statement, underscoring the increased emphasis in detecting PAR. PAR has been noted to persist beyond existing ROP screening guidelines, and were found to be associated with complications like retinal tear and detachment, especially in eyes with more posterior PAR. Thus, serial monitoring of retinal vascularization, facilitated by fluorescein angiography and wide-field imaging, for these associated complications have been encouraged. The current lack of consensus in the follow-up and management of PAR prompts further work in this area: understanding the natural course of retinal vascularization in both untreated and treated ROP, the modulation of anti-VEGF on retinal function, and the clinical significance of PAR-associated vascular patterns can help to guide management protocols for PAR in ROP eyes.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772138","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":"Correlation of iris-ciliary angle with haptic position and vault after implantation of implantable collamer lens.","authors":"Wenxin Xue, Xiaohang Jiao, Weiqun Wang, Yanhui Bai","doi":"10.1007/s00417-025-06806-9","DOIUrl":"https://doi.org/10.1007/s00417-025-06806-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the impact of the iris-ciliary angle (ICA) on the position of the implantable collamer lens (ICL) haptic and vault following ICL implantation.</p><p><strong>Methods: </strong>A prospective, observational study was conducted using data from 135 patients who underwent horizontal ICL implantation. Patients were categorized into three groups by ICA: ICA1 (0-32°), ICA2 (32-64°), and ICA3 (64-96°) to compare parameters. The parameters correlated with the distance from the iris root to the end of the ICL haptic (IRH) and vault was analysed respectively. A multiple linear stepwise regression model was constructed to estimate IRH.</p><p><strong>Results: </strong>The vault decreased sequentially across the three groups (P < 0.001) and was negatively correlated with ICA (P < 0.001). The proportion of ICL haptic insertion under the ciliary body was significantly higher in the ICA3 group compared with the ICA1 and ICA2 groups (P = 0.039). Stepwise regression analysis showed that IRH = -1.174 + 0.005 × ICA + 0.118 × horizontal sulcus-to-sulcus (STS) distance (adjusted R² = 0.334, Durbin-Watson value = 1.908, P < 0.001), with ICA as the primary influencing factor (β = 0.536, P < 0.001), followed by horizontal STS distance (β = 0.348, P < 0.001).</p><p><strong>Conclusions: </strong>When the ICA is excessively large, the ICL haptic is more likely to be inserted under the ciliary body. An increase in ICA is associated with a greater IRH and a lower vault.</p><p><strong>Key messages: </strong>What is known: • More posterior chamber anatomical parameters of eyes are needed to improve the accuracy of predicting the vault. • A negative correlation exists between the iris-ciliary angle (ICA) and vault.</p><p><strong>What is new: </strong>• When the ICA is excessively large, the ICL haptic is more likely to be inserted under the ciliary body. • The ICA is the primary influencing factor when predicting the distance from the iris root to the end of the ICL haptic (IRH).</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752376","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":"Ahmed and baerveldt in glaucoma surgery: what is the safest choice? - a systematic review and meta-analysis.","authors":"Francesco Matarazzo, Maria Laura Passaro, Michele Rinaldi, Gabriele Gallo Afflitto, Francesco Aiello, Fabio Claudio Avolio, Alessandro Aurilia, Diego Strianese, Carlo Nucci, Ciro Costagliola","doi":"10.1007/s00417-025-06794-w","DOIUrl":"https://doi.org/10.1007/s00417-025-06794-w","url":null,"abstract":"<p><strong>Background/aims: </strong>Glaucoma drainage devices (GDDs) are essential in managing complex glaucoma cases. This review focuses on the Ahmed glaucoma valve (AGV) and Baerveldt glaucoma implant (BGI), the most commonly used GDDs. We aim to evaluate complications associated with AGV and BGI, particularly post-operative hypotony.</p><p><strong>Methods: </strong>We systematically reviewed randomized controlled trials (RCTs) and non-randomized studies (NRSs) comparing AGV and BGI. The primary outcome was persistent hypotony (IOP < 5 mmHg). Secondary outcomes included hypotony maculopathy, choroidal effusion, suprachoroidal hemorrhage, vision loss, cystoid macular edema, diplopia, corneal decompensation, endophthalmitis, hyphema, further surgery for IOP control, tube interventions, exposure, and occlusion.</p><p><strong>Results: </strong>Thirteen studies (4 RCTs, 9 NRSs) with 2,513 eyes were analyzed. AGV was associated with a lower incidence of persistent hypotony in RCTs (0.6% vs. 4.4%, p = 0.006), choroidal effusion (4.95% vs. 15.8%, p < 0.0001), vision loss (9% vs. 18.9%, p = 0.01), and cystoid macular edema (2.5% vs. 9.6%, p = 0.009). BGI showed a lower need for further surgery to control IOP in RCTs (14.5% vs. 7.5%, p = 0.01). No significant differences were found for other outcomes, including suprachoroidal hemorrhage, corneal decompensation, and tube-related complications.</p><p><strong>Conclusion: </strong>AGV seems to offers a safer profile with fewer hypotony-related complications compared to BGI. Personalized device selection is crucial for optimizing glaucoma surgery outcomes. Further high-quality, well-designed studies are needed to validate those results.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752373","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":"Spontaneous epiretinal membrane resolution: mechanisms, outcomes, and implications for clinical management.","authors":"Alberto Quarta, Maria Ludovica Ruggeri, Ruggero Tartaro, Lisa Toto, Rodolfo Mastropasqua","doi":"10.1007/s00417-025-06815-8","DOIUrl":"https://doi.org/10.1007/s00417-025-06815-8","url":null,"abstract":"<p><strong>Purpose: </strong>To review the phenomenon of spontaneous epiretinal membrane (ERM) resolution focusing on the clinical settings, mechanisms of resolution, and implications for management.</p><p><strong>Methods: </strong>A comprehensive review of case reports and studies describing spontaneous ERM resolution was conducted. Data were extracted regarding ERM type, patient demographics, visual outcomes, and suspected mechanisms. Findings were analyzed to identify trends and to compare cases of spontaneous resolution across different ERM types.</p><p><strong>Results: </strong>Spontaneous ERM resolution was more frequently observed in younger patients or cases associated with posterior vitreous detachment (PVD). In idiopathic ERMs, spontaneous separation often involved PVD and extracellular matrix remodeling. Inflammatory ERMs demonstrated resolution due to reduced inflammation and traction, while secondary ERMs linked to vascular or traumatic events benefited from mechanisms such as photocoagulation-induced PVD or gliotic contraction. Visual outcomes varied, with improvements in best-corrected visual acuity (BCVA) and metamorphopsia in most cases, though persistent structural changes occasionally limited functional recovery.</p><p><strong>Conclusion: </strong>Spontaneous ERM resolution is a rare but clinically significant event influenced by vitreoretinal interface dynamics and patient-specific factors. Younger age, the presence of PVD, and underlying inflammatory or vascular conditions may contribute to natural resolution. Recognizing these cases allows for tailored management strategies supporting observation in selected patients while minimizing unnecessary surgical interventions. These insights may guide future research into therapeutic approaches that mimic natural resolution mechanisms.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752379","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 different eyelid speculums compared to manual eyelid opening on intraocular pressure in children under general anesthesia.","authors":"Oren Iny, Achia Nemet, Erez Tsumi, Asim Ali, Chiya Robert Barrett, Ahed Imtirat","doi":"10.1007/s00417-025-06808-7","DOIUrl":"https://doi.org/10.1007/s00417-025-06808-7","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of 4 commonly used eyelid speculums on intraocular pressure (IOP) among children undergoing examination under anesthesia.</p><p><strong>Methods: </strong>In this comparative cross-sectional study, IOP of children undergoing EUA at Soroka Medical Center was measured by manually opening the eyelids and the result was compared to measurements taken with 4 commonly-used speculums. Barraquer and Alfonso speculums were used in patients of all ages, whereas V- and U-shaped speculums were used in patients older than 6 months of age only. All measurements were taken using a Tono-Pen tonometer.</p><p><strong>Results: </strong>Data were collected from 41 eyes of 21 patients (8 eyes ≤ 6 months of age). Mean age was 3.6 years (range 10 days-14 years), and 52% were male. Mean IOP without an eyelid speculum was 14.3 ± 4.7 mmHg. In comparison to manual eyelid opening, the mean IOP measurement with the Barraquer speculum did not differ significantly (14.7 vs. 14.3 mmHg, respectively, p = 0.139). However, all other types of speculums significantly increased IOP measurements (14.3 vs. 18.9 mmHg, p < 0.001) for Alfonso speculum, (15.0 vs. 19.0 mmHg, p < 0.001) for V-shape speculum, and (15.0 vs. 18.8 mmHg, p < 0.001) for the U-shape speculum. The results were the same when the data from each eye were analyzed separately.</p><p><strong>Conclusions: </strong>The Barraquer speculum did not affect IOP measurements under general anesthesia among children up to age 14 years. IOP measurements obtained with other types of speculums are expected to be overestimated.</p><p><strong>Key messages: </strong>What is known: • Obtaining accurate IOP measurements in children with glaucoma is important to assess disease progression and guide treatment decisions.</p><p><strong>What is new: </strong>• The Barraquer speculum did not affect IOP measurements under general anesthesia among children up to 14 years. • IOP measurements obtained with other types of speculums are usually overestimated.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741861","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":"Optimizing pain management and pupil dilation in cataract surgery: a systematic review and meta-analysis of phenylephrine/ketorolac (OMIDRIA®).","authors":"Mohamed Abo Zeid, Amr Elrosasy, Kareem Khalefa, Mohamed Elhadary, Shrouk F Mohamed, Amr Elkelany, Hashem Abu Serhan","doi":"10.1007/s00417-025-06811-y","DOIUrl":"https://doi.org/10.1007/s00417-025-06811-y","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review and meta-analysis aims to evaluate the efficacy and safety of the combination of phenylephrine 1% and ketorolac 0.3% (OMIDRIA®) for optimizing pain management and maintaining pupil dilation during cataract surgery. Comparisons were made against placebo/vehicle, phenylephrine alone, and epinephrine.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Cochrane CENTRAL, Embase, Scopus, and Web of Science was conducted. Eligible studies were randomized clinical trials and observational studies assessing intracameral phenylephrine/ketorolac against control groups. Key outcomes included pain management, pupil diameter, and adverse events. Data were synthesized using meta-analysis with fixed and random-effects models, and heterogeneity was assessed using the I² statistic.</p><p><strong>Results: </strong>Ten studies, including 220,061 patients, were analyzed. The combination of phenylephrine/ketorolac significantly reduced postoperative pain (RR = 0.72, 95% CI: 0.60-0.86) and opioid use (RR = 0.45, 95% CI: 0.23-0.89) compared to vehicle and epinephrine. PE/K also maintained a larger pupil diameter (MD = 0.54 mm, 95% CI: 0.32-0.75) with minimal heterogeneity (I² = 0%) and reduced the incidence of severe pain (RR = 0.41, 95% CI: 0.27-0.63). No significant differences in adverse events such as elevated intraocular pressure, inflammation, or headaches were observed.</p><p><strong>Conclusion: </strong>Phenylephrine/ketorolac (OMIDRIA®) demonstrates superior efficacy in maintaining intraoperative mydriasis, reducing postoperative pain, and minimizing opioid use without increasing adverse events. This combination offers a preferable alternative to traditional agents, potentially setting a new standard for pain management and pupil dilation in cataract surgery.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742790","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":"Nocturnal diastolic hypotension is associated with central visual field defect in early and moderate normal tension glaucoma.","authors":"Sung Il Im, Changmin Cha, Sangjoon Lee, Seunguk Lee","doi":"10.1007/s00417-025-06813-w","DOIUrl":"https://doi.org/10.1007/s00417-025-06813-w","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the association between systemic blood pressure-related hemodynamic indices and central-most visual field defect (CMVFD) in patients with early and moderate normal tension glaucoma (NTG).</p><p><strong>Methods: </strong>This cross-sectional study examined 36 eyes of 36 early and moderate NTG patients with CMVFD from 295 consecutive NTG patients who underwent 24-h ambulatory blood pressure monitoring (ABPM). Hemodynamic variables and ocular examination results were compared between two groups. CMVFD was defined as a glaucomatous defect with at least one abnormal point at P < 1% within the central 5 degrees on two consecutive 24-2 or 30-2 visual field tests.</p><p><strong>Results: </strong>There were no significant differences in baseline demographics except for body weight (P = .009). The cup-to-disc ratio, pattern standard deviation in visual field test, and inferotemporal segmental thickness of retinal nerve fiber layer in OCT showed significant differences in the ophthalmic examinations. Univariate logistic regression analysis revealed significant association between CMVFD and 24-h average diastolic blood pressure, nighttime average systolic blood pressure, nighttime average diastolic blood pressure, and body weight. In multivariate logistic regression analysis, only the nighttime average diastolic blood pressure (odds ratio [OR] 0.877; P = .037) was independently associated with CMVFD in early and moderate NTG.</p><p><strong>Conclusion: </strong>Central-most visual field defects were identified in some patients with early and moderate NTG. Particularly, low nocturnal diastolic blood pressure (nocturnal diastolic hypotension) was independently related to CMVFD, and should be considered when managing systemic care for NTG patients.</p><p><strong>Key messages: </strong>What is known: • The visual field defects are at greater risk in glaucoma patients with nocturnal hypotension.</p><p><strong>What is new: </strong>• The nocturnal diastolic hypotension is independently related to the presence of central-most visual field defect (CMVFD) in patients with early and moderate normal tension glaucoma. • If average nocturnal diastolic blood pressure is found to be low, it should be considered a modifiable risk factor for CMVFD.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735779","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":"Outcomes of localized corneal collagen crosslinking with a conventional device in progressive keratoconus.","authors":"Ofri Vorobichik Berar, Rachel Shemesh, Nir Gomel, Yoav Berger, Irina S Barequet","doi":"10.1007/s00417-025-06803-y","DOIUrl":"https://doi.org/10.1007/s00417-025-06803-y","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the outcomes of localized crosslinking (L-CXL) for progressive keratoconus utilizing a standard CXL device.</p><p><strong>Design: </strong>This retrospective cohort study.</p><p><strong>Methods: </strong>included patients diagnosed with progressive keratoconus and treated with a localized cone-centered CXL (based on corneal topography) using the accelerated CXL protocol with a standard CXL device.</p><p><strong>Results: </strong>We Identified 24consecutive eyes. The average BDVA before CXL was 0.282 ± 0.35 LogMar, remained overall stable at 12-month post-surgery at 0.204 ± 0.173 LogMar (P = 0.395). Ten eyes (of eight patients) (42%) demonstrated an improvement in BDVA at 12 months of 1-4 lines and none of the other eyes lost BDVA. These eyes had significantly lower pre-operative BDVA than the stable eyes (P = 0.034). Ten eyes (of eight patients) (42%) demonstrated an improvement in K-max at 12 months post-operatively, of at least 1D; six of these eyes had improvement in both BDVA and Kmax. None of the eyes developed an increase in Kmax throughout the follow-up.</p><p><strong>Conclusion: </strong>In this series, cone-centered L-CXL, using a conventional CXL device resulted in significant stabilization and even improvements in BDVA and Kmax in almost half of the eyes, without significant adverse events. Addressing the CXL application onto the affected area results in beneficial results.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718775","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":"Asymmetric stress distribution on lamina cribrosa in glaucoma patients with high myopia.","authors":"Edward Kang, Ji-Hye Park, Chungkwon Yoo, Yong Yeon Kim","doi":"10.1007/s00417-025-06809-6","DOIUrl":"https://doi.org/10.1007/s00417-025-06809-6","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the impact of biomechanical changes in the optic nerve head on glaucoma progression during ocular rotation in highly myopic eyes with primary open-angle glaucoma.</p><p><strong>Methods: </strong>This study retrospectively enrolled 147 patients with primary open-angle glaucoma, including 57 with high myopia and 90 with non-high myopia. Personalized optic nerve head models were designed, and simulations were performed using finite element analysis to evaluate the effect of ocular rotation on the optic nerve head. Biomechanical changes in the optic nerve head were analyzed and compared between the groups.</p><p><strong>Results: </strong>The mean strain on the lamina cribrosa was significantly higher in the high myopia group compared to the non-high myopia group during ocular rotation. The stress ratio, indicating asymmetric stress distribution, was higher in the high myopia group than in the non-high myopia group. The stress ratio increased significantly as axial length increased. Both stress ratio and mean lamina cribrosa strain were correlated with rate of retinal nerve fiber layer thickness reduction (stress ratio: partial coefficient = -0.171, P = 0.040; mean lamina cribrosa strain: partial coefficient = -0.196, P = 0.018).</p><p><strong>Conclusion: </strong>High myopia leads to increased lamina cribrosa strain and asymmetric stress distribution during ocular rotation. These findings underscore the importance of considering optic nerve head biomechanics in patients with high myopia. Additionally, the stress ratio may serve as a novel indicator for predicting glaucoma progression.</p><p><strong>Key messages: </strong>What is known Biomechanical changes in the optic nerve head differ between patients with high myopia and those with non-high myopia. What is new Asymmetric stress distribution on the lamina cribrosa during ocular movement was higher in the high myopia group and was associated with structural progression of glaucoma. A longer axial length increased the asymmetric stress on the lamina cribrosa during ocular movement.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718774","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}