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

{"title":"Diabetic Retinopathy (DR) nomogram construction based on optical coherence tomography angiography parameters: a preliminary exploration of DR prediction.","authors":"Zongyi Zhan, Yuqing Lan, Zijing Li","doi":"10.1007/s00417-025-06824-7","DOIUrl":"https://doi.org/10.1007/s00417-025-06824-7","url":null,"abstract":"<p><strong>Aims: </strong>To construct a diabetic retinopathy (DR) prediction nomogram based on optical coherence tomography angiography (OCTA) parameters. Ophthalmologists can then use this nomogram to assess the risk of early-stage DR.</p><p><strong>Methods: </strong>In this retrospective study, patients with type 2 diabetes mellitus who completed DR screening were enrolled and divided into training and validation sets. Fifteen parameters, including OCTA parameters, axial length (AL), age, and sex, were selected via least absolute shrinkage and selection operator (LASSO) in the training set. The chosen parameters were used to construct the model. Model performance was evaluated for both the training and validation sets via receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). A corresponding nomogram was created.</p><p><strong>Results: </strong>A total of 464 eyes from 464 patients were divided into a training set (324, 69.83%) and a validation set (140, 30.17%). The superficial parafoveal capillary density (CD), deep parafoveal CD, foveal CD in the 300 µm-wide area surrounding the foveal avascular zone (FD- 300 area), AL, and patient ages were included in the final model. The area under curve of the model was 0.825 in the training set and 0.831 in the validation set. The calibration curves showed good alignment between the actual and predicted outcomes in both datasets. DCA demonstrated that the nomogram was clinically useful.</p><p><strong>Conclusions: </strong>A model with good performance for predicting DR via OCTA parameters was developed. The superficial parafoveal CD, deep parafoveal CD, and FD- 300 area were important predictive parameters in this model. The corresponding nomogram may serve as a convenient tool for early DR risk prediction and lay the foundation for developing OCTA-based automated diagnostic software for early DR detection.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811180","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 comparison of peripapillary retinal nerve fiber layer thickness and vasculature in non-pathological myopia with anisometropia.","authors":"Yafei Mu, Maierhaba Mijiti, Wei Wei, Reyila Ainiwaer, Bixia Wei, Yanli Qin, Lin Ding, Tao Shen","doi":"10.1007/s00417-025-06826-5","DOIUrl":"https://doi.org/10.1007/s00417-025-06826-5","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the interocular differences in the peripapillary retinal nerve fiber layer (RNFL) thickness and retinal vasculature in non-pathological myopic patients with anisometropia.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 100 eyes from 50 participants aged 11 to 40 with anisometropic myopia. All participants underwent comprehensive ocular examinations, and then the RNFL thickness, ONH parameters, macular vessel density (MVD), optic disc vessel density (OVD), and optic disc perfusion density (OPD) were obtained using the Cirrus spectral domain optical coherence tomography (SD-OCT). The participants were divided into two groups based on the degree of anisometropia: Group 1 had the interocular difference of spherical equivalent (SE) over 1.50 diopters (D), and Group 2 had the interocular difference of SE between 1.00 D and 1.50 D. The interocular differences in retinal parameters were analyzed and compared between the two studied groups.</p><p><strong>Results: </strong>The superior and inferior RNFL were thinner, and the temporal RNFL was thicker in the more myopic eyes. The interocular differences of the temporal RNFL thickness, nasal MVD, temporal and inferior OVD, and temporal OPD were correlated with the interocular differences of SE and AL. The interocular differences of the temporal RNFL thickness, OVD, and OPD in Group 1 were more significant than in Group 2.</p><p><strong>Conclusion: </strong>This study revealed that the temporal peripapillary RNFL was thicker in more myopic eyes, accompanied by higher OVD and OPD. These regional retinal alterations in the temporal peripapillary area may occur before the decrease in RNFL thickness and the onset of myopic pathological changes.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811181","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":"Neuroprotection beyond intraocular pressure: game changer or quiet addiction.","authors":"A Grosso, E Borrelli, M Sacchi, G Calzetti, P Ceruti, G Neri, M Marchetti, A Pinna, V Kostin, M Reibaldi, T Borsello, G Vizzeri","doi":"10.1007/s00417-025-06816-7","DOIUrl":"https://doi.org/10.1007/s00417-025-06816-7","url":null,"abstract":"<p><p>The topic of neuroprotection in glaucoma and age-related macular degeneration (AMD) is well disseminated in the literature. However, the problem is providing ophthalmologists with clear, evidence-based messages to draw on. This review examines the landscape of neuroprotective therapies for glaucoma and AMD. While promising neuroprotective agents, such as citicoline and nicotinamide, have been explored for their potential to mitigate neurodegeneration in glaucoma, robust clinical evidence validating their efficacy remains limited and there is a need for further large-scale, long-term studies to substantiate the neuroprotective effects of these agents. Maintaining low intraocular pressure plays a vital role in preventing neuronal death in glaucoma. AMD has traditionally been considered a disease affecting the outer retinal layers; however, growing evidence suggests that the inner layers are also involved. Neuroprotection is an emerging area of research, with strategies focusing on alleviating oxidative stress, inflammation and apoptosis. A reassessment of clinical endpoints and methodologies in neuroprotection research is critical to better evaluate the efficacy of these therapies in glaucoma and AMD.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788093","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":"Classification of ocular surface diseases: Deep learning for distinguishing ocular surface squamous neoplasia from pterygium.","authors":"Farshid Ramezani, Hossein Azimi, Behrouz Delfanian, Mobina Amanollahi, Jamshid Saeidian, Ahmad Masoumi, Hossein Farrokhpour, Elias Khalili Pour, Mehdi Khodaparast","doi":"10.1007/s00417-025-06804-x","DOIUrl":"https://doi.org/10.1007/s00417-025-06804-x","url":null,"abstract":"<p><strong>Purpose: </strong>Given the significance and potential risks associated with Ocular Surface Squamous Neoplasia (OSSN) and the importance of its differentiation from other conditions, we aimed to develop a Deep Learning (DL) model differentiating OSSN from pterygium (PTG) using slit photographs.</p><p><strong>Methods: </strong>A dataset comprising slit photographs of 162 patients including 77 images of OSSN and 85 images of PTG was assembled. After manual segmentation of the images, a Python-based transfer learning approach utilizing the EfficientNet B7 network was employed for automated image segmentation. GoogleNet, a pre-trained neural network was used to categorize the images into OSSN or PTG. To evaluate the performance of our DL model, K-Fold 10 Cross Validation was implemented, and various performance metrics were measured.</p><p><strong>Results: </strong>There was a statistically significant difference in mean age between the OSSN (63.23 ± 13.74 years) and PTG groups (47.18 ± 11.53) (P-value =.000). Furthermore, 84.41% of patients in the OSSN group and 80.00% of the patients in the PTG group were male. Our classification model, trained on automatically segmented images, demonstrated reliable performance measures in distinguishing OSSN from PTG, with an Area Under Curve (AUC) of 98%, sensitivity, F1 score, and accuracy of 94%, and a Matthews Correlation Coefficient (MCC) of 88%.</p><p><strong>Conclusions: </strong>This study presents a novel DL model that effectively segments and classifies OSSN from PTG images with a relatively high accuracy. In addition to its clinical use, this model can be potentially used as a telemedicine application.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788088","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":"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}