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

{"title":"Exploring the impact of pupil expansion techniques on cataract surgery: unveiling key complications and clinical outcomes: a comparative analysis of 1266 eyes.","authors":"Asaf Achiron, Tal Yahalomi, Michael Ostrovsky, Eliya Levinger, Eyal Cohen, Omar Elhaddad, Derek Tole, Kieren Darcy, Raimo Tuuminen","doi":"10.1007/s00417-025-06748-2","DOIUrl":"https://doi.org/10.1007/s00417-025-06748-2","url":null,"abstract":"<p><strong>Background: </strong>In cataract surgery, inadequate pupil dilation presents a major surgical challenge by narrowing the operation field and restricting visibility and movement. We aim to compare cataract surgery complication rates and clinical outcomes using different pupil expansion methods.</p><p><strong>Methods: </strong>This retrospective cohort study grouped patients according to four techniques of mechanical pupil expansion techniques: sphincterotomy (N = 339), iris stretching (N = 242), iris hooks (N = 391) and expansion rings (N = 294). Incidences and odds ratios for major complications and outcomes were compared between the groups.</p><p><strong>Results: </strong>This single-center study included 1266 adult patients who underwent routine cataract surgery with mechanical pupil dilatation. The mean (± SD) age was 75.5 (± 13.0) years and 727 (57%) patients were male. The risk of pseudophakic cystoid macular edema (PCME) did not differ between the groups. Iris hooks were associated with the highest incidence of posterior capsular rupture (PCR) (3.3%) as compared to sphincterotomy, stretching and expansion rings (0.9%, 0.4% and 1.4%, respectively, P = 0.016). However, this effect was not supported by multivariable analysis. Zonular dialysis tended to be higher among eyes operated with iris hooks and pupil expansion rings, compared with iris stretching and sphincterotomy (2.0% and 1.7%, respectively, P = 0.058) and was found to be independently associated with a specific mechanical pupil expansion method on multivariable analysis (P = 0.050). No differences were observed for other complications, intraocular pressure or best-corrected visual acuity (VA) gain. Surgeon seniority was a significant protective factor from postoperative uveitis on multivariable analysis (P = 0.032).</p><p><strong>Conclusions: </strong>Our large cohort study found no difference between the groups regarding major complications or clinical outcomes, suggesting that all four methods may be equally safe.</p><p><strong>Key messages: </strong>WHAT IS KNOWN : • In cataract surgery, inadequate pupil dilation presents a major surgical challenge by narrowing the operation field and restricting visibility and movement. • Different pupil dilation methods have been used, ranged from topical and intracameral mydriatics and visco-mydriasis to mechanical dilation maneuvers. • Four principal techniques of mechanical pupil expansion, including sphincterotomies, manual iris stretching, iris retracting hooks and pupil expansion rings, are available.</p><p><strong>What is new: </strong>• This single-center study included 1266 adult patients found no difference between the groups regarding major complications or clinical outcomes such as pseudophakic cystoid macular edema (PCME), posterior capsular rupture, zonular dialysis, intraocular pressure, uveitis or best-corrected visual acuity gain. • Surgeon seniority was a significant protective factor from postoperative uveitis.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122584","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":"Preliminary antifibrotic and vasoconstrictor effects of adrenaline in Schlemm's canal and suprachoroidal minimally invasive glaucoma surgery in primary open-angle glaucoma.","authors":"Jinyuan Luo, Julia Fajardo-Sanchez, Mengqi Qin, Brihitejas Patel, Karishma Mahtani, Henrietta Ho, Cynthia Yu-Wai-Man","doi":"10.1007/s00417-024-06642-3","DOIUrl":"10.1007/s00417-024-06642-3","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the antifibrotic and vasoconstrictor effects of adrenaline in Schlemm's canal and suprachoroidal minimally invasive glaucoma surgery (MIGS).</p><p><strong>Methods: </strong>Human trabecular meshwork (TM) cells were treated with different concentrations of adrenaline (0%, 0.0005%, 0.01%), and we measured the effects on contractility, cell viability and the expression of key cell cycle and fibrosis genes. Adrenaline 0.05% was also injected intracamerally in five primary open-angle glaucoma patients undergoing iStent inject or MINIject surgery combined with phacoemulsification. All patients were assessed for ocular and systemic adverse reactions, including the effects on intraoperative pupil size, preoperative and postoperative visual acuity, intraocular pressure, and anterior segment OCT results.</p><p><strong>Results: </strong>Adrenaline significantly reduced the contractility of TM cells in a dose-dependent manner (87.8%, 80.6%, 7.9% matrix contraction with adrenaline 0%, 0.0005%, 0.01%, respectively). Adrenaline did not exhibit any significant cytotoxicity even at high concentrations (P > 0.05). Adrenaline 0.01% significantly downregulated the expression of key cell cycle genes in the G2 and M phases, and also decreased the expression of MRTFB and ACTA2 genes (P < 0.05). Intracameral injections of adrenaline 0.05% in the five MIGS patients did not result in any ocular or systemic adverse effects.</p><p><strong>Conclusion: </strong>We recommend intracameral injections of adrenaline 0.05% as a cheap and safe drug to be used before MIGS insertion. Adrenaline decreases the risk of bleeding from the trabecular meshwork and also exhibits antifibrotic effects by arresting the cell cycle, thereby increasing the postoperative success rates in MIGS.</p><p><strong>Key message: </strong>What is known Fibrosis is the main cause of surgical failure in minimally invasive glaucoma surgery (MIGS). Mitomycin-C and 5-fluorouracil are too toxic to be used inside the eye. What is new Adrenaline reduced the contractility of trabecular meshwork cells and inhibited the expression of key cell cycle genes and fibrosis genes, without significant cytotoxicity. Intracameral injection of adrenaline 0.05% did not result in any ocular or systemic adverse reactions in MIGS patients.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"489-500"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline characteristics of children in the Early Glasses Study.","authors":"J S Steltman, M Nordmann, D Sanders, W L Asjes-Tydeman, T Dehpoor, I Tissen, R van Ommen, C Wiersma-Hartman, M M van Keulen, D Bakker, S E Loudon, H J Simonsz","doi":"10.1007/s00417-024-06621-8","DOIUrl":"10.1007/s00417-024-06621-8","url":null,"abstract":"<p><strong>Purpose: </strong>The relationship between refractive error at age 1 and the risk of developing amblyopia or accommodative esotropia, and the protection offered by early glasses, is unknown. These are determined in the Early Glasses Study, a prospective, population-based, longitudinal, randomized controlled study. We report baseline findings.</p><p><strong>Methods: </strong>Healthy children aged 12-18 months were recruited at Children's Healthcare Centres (CHCs) and received an entry orthoptic examination followed by cycloplegic retinoscopy. Children with amblyopia, strabismus, ophthalmic disease or very high refractive error were excluded. Those exceeding the AAPOS 2003 Criteria (> + 3.5D spherical equivalent (SE), > 1.5D astigmatism, > 1.5D anisometropia) were randomized into wearing glasses or not, and are followed-up by research orthoptists. Other children are followed-up by regular vision screening at CHCs and visual acuity is measured in all children at age 4.</p><p><strong>Results: </strong>Parents of 865 children were called, 123 were excluded. Of 742 children enrolled, 601 underwent the entry orthoptic examination at age 14.5 ± 1.7 months. Mean SE was + 1.73 ± 1.18D, astigmatism -0.70 ± 0.44D, anisometropia 0.21D (IQR: 0-0.25). Of 62 (10.3%) children exceeding the Criteria, 52 were randomized into wearing glasses or not. Of 539 other children, 522 are followed up at CHCs. In total, 31 were excluded: 2 had strabismus and amblyopia, 7 strabismus, 2 amblyopia suspect, 1 strabismus suspect, 1 squinting during sinusitis, 4 excessive refractive error, 9 myopia, 2 ptosis, 1 oculomotor apraxia, 1 Duane syndrome, 1 congenital nystagmus.</p><p><strong>Conclusion: </strong>Prevalence of strabismus (10/601) was as expected, but prevalence of amblyopia (2/601) was low, suggesting that common amblyopia develops later than generally thought.</p><p><strong>Key messages: </strong>What is known High refractive errors cause amblyopia, but no study has determined the exact relationship between the kind and size of refractive error at age 1 and the risk to develop amblyopia, and assessed the protective effect of glasses in a controlled, population-based, longitudinal study. What is new At baseline, 601 children received a full orthoptic examination followed by retinoscopy in cycloplegia at the age of 14.5 ± 1.7 months; 10.3% had high refractive error exceeding spherical equivalent > + 3.5D, > 1.5D astigmatism, > 1D oblique astigmatism or > 1.5D anisometropia. The prevalence of amblyopia was lower (0.3%) than expected, suggesting that most amblyopia develops after the first year of life. The prevalence of anisometropia, associated with amblyopia in older children, was low (0.8%).</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"555-563"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of intraocular lens power calculation formulae for the Yamane technique of secondary fixation: a systematic review and meta-analysis.","authors":"Aly Hamza Khowaja, Altamash Shahriyar Ghazanfar, Haroon Tayyab","doi":"10.1007/s00417-024-06603-w","DOIUrl":"10.1007/s00417-024-06603-w","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis aims to assess the refractive outcomes of the Yamane technique for intrascleral fixation of intraocular lenses (SF-IOL) and compare the predictive ability of the various intraocular lens power calculation formulae commonly used in conjunction with the technique.</p><p><strong>Methods: </strong>A literature search was conducted in the Medline, Scopus, and Cochrane Library databases for articles published from January 2014 to May 2023. Studies that met the predetermined inclusion criteria were included and subjected to analysis. The primary outcome evaluated was the refractive predictive error, defined as the difference between predicted refraction and post-operative manifest refraction.</p><p><strong>Results: </strong>Eleven studies met the inclusion criteria, with a cumulative sample size of 615 patients (mean age: 66.6 years). Various IOL formulae were used, with SRK/T being the most frequently adopted formula. The overall mean refractive predictive error for all formulae combined was -0.02 D, which was not statistically significant (p = 0.99). Subgroup analysis for individual formulae also showed no significant difference from predicted error for any formula (p > 0.05).</p><p><strong>Conclusion: </strong>The Yamane technique for SF-IOL shows promising refractive outcomes, and the choice of IOL power calculation formula should be tailored based on patient characteristics and surgeon preference. No formula demonstrated superior predictive ability over others. Further research is needed to develop formulae specifically for eyes with secondary aphakia and poor capsular support.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"259-268"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912389","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":"Comparison of visual quality after Q value-guided FS-LASIK and SMILE for correction of myopia with age-related accommodation deficiency.","authors":"Ruiyu Zhang, Yifei Yuan, Yu Zhang, Yueguo Chen","doi":"10.1007/s00417-024-06627-2","DOIUrl":"10.1007/s00417-024-06627-2","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate differences in objective and subjective visual quality 12 months following Q value-guided (Custom-Q) femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) versus small incision lenticule extraction (SMILE) for correction of low-to-moderate myopia and compensate for age-related accommodation deficiency.</p><p><strong>Methods: </strong>Clinical data of 45 patients were analyzed, of whom 23 were treated with FS-LASIK and 22 with SMILE. At the 12-month follow-up, the distance, intermediate, and near visual acuities; objective and subjective refractions; Q factor; corneal higher-order aberrations (HOAs); defocus curve; contrast sensitivity; stereopsis and a subjective visual quality questionnaire were evaluated.</p><p><strong>Results: </strong>At 12 months postoperatively, the two groups had comparable binocular uncorrected distance and intermediate visual acuities (UDVA, UINA). A slightly better uncorrected near visual acuity (UNVA) was observed in the FS-LASIK group (P < 0.05), but patients reported equivalent near vision satisfaction and spectacle independence. Total HOAs and coma increased significantly in all treated eyes (P < 0.05). The Q value and spherical aberration (SA) became more positive, but the shifts were significant only in the SMILE group and the dominant eyes of the FS-LASIK group (P < 0.05). Binocular contrast sensitivity was better in the FS-LASIK group. No significant differences in visual disturbances were found between groups.</p><p><strong>Conclusion: </strong>For myopic patients with mild age-related accommodation deficiency, both FS-LASIK with Custom-Q protocol and SMILE could provide good efficacy, safety, predictability, and high patient satisfaction. The Custom-Q protocol could better preserve the original prolate shape of the cornea and achieve superior visual quality compared to SMILE.</p><p><strong>Key messages: </strong>What is known Both femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) and small-incision lenticule extraction (SMILE) have been widely applied in young myopic patients, with comparable efficacy and safety. Studies evaluating the clinical outcomes of FS-LASIK and SMILE in treating myopia with age-related accommodation insufficiency are lacking. What is new For myopic patients with mild age-related accommodation deficiency, both FS-LASIK with Custom-Q protocol and SMILE could provide good efficacy, safety, predictability, and high patient satisfaction. The Custom-Q protocol could better preserve the original prolate shape of the cornea and achieve superior visual quality compared to SMILE.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"571-580"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284407","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":"Association of contrast sensitivity with vessel density and functional parameters in different stages of glaucoma.","authors":"I-Wen Lai, Tsing-Hong Wang, Jehn-Yu Huang, Chien-Chia Su","doi":"10.1007/s00417-024-06626-3","DOIUrl":"10.1007/s00417-024-06626-3","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the association between contrast sensitivity (CS), vessel density (VD), and functional parameters in patients with glaucoma of varying severity.</p><p><strong>Methods: </strong>Ninety-four eyes of 94 patients (57 men and 37 women, aged 56.52 ± 11.28 years) were divided into mild and moderate to advanced glaucoma groups. The mild glaucoma group was further subdivided based on the presence of central visual field defect (CVFD). Pearson's correlations were used to evaluate the associations between area under the log CS function (AULCSF), best-corrected visual acuity (BCVA), 10 - 2 visual field (VF), and structural parameters, including VD. The area under the receiver operating characteristic (AUROC) curve was calculated to detect abnormal CS (AULCSF < 1.2).</p><p><strong>Results: </strong>In mild glaucoma without CVFD, AULCSF was associated with radial peripapillary capillary VD (γ = 0.597, P = 0.001), with an AUROC of 0.840 (P = 0.006) for detecting abnormal CS. In mild glaucoma with CVFD, AULCSF worsened and was associated with superficial parafoveal VD (γ = 0.569, P = 0.017) and macular whole image VD (γ = 0.632, P = 0.007), with AUROCs of 0.833 (P = 0.021) and 0.792 (P = 0.043), respectively. In moderate to advanced glaucoma, the relationship between AULCSF and the mean deviation of 10 - 2 VF and BCVA was more robust than that observed in structural measures.</p><p><strong>Conclusions: </strong>Decreased VD is linked to early CS impairment. Radial peripapillary capillary and macular VD can serve as indicators of CS function in the early stages of glaucoma. KEY  MESSAGES: What is known Contrast sensitivity loss has been reported in glaucoma patients but its relationship with glaucoma-related structural and functional changes in different glaucoma severity and central visual field defect (CVFD) remains elusive. What is new Decline in RPC peripapillary vessel density was associated with early impairment of contrast sensitivity in mild glaucoma without CVFD. Decline in macular vessel density and central 16 points of 10-2 visual field damage were associated with contrast sensitivity reduction in mild glaucoma with CVFD. Microvasculature change can serve as an indicator for abnormal contrast sensitivity.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"477-487"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132543","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 Control Technology: New Horizons in Maculopathy and Presbyopia.","authors":"Abel Szeps, Juan Manuel Suarez, Rodrigo Torres, Rafael Iribarren","doi":"10.1007/s00417-024-06633-4","DOIUrl":"10.1007/s00417-024-06633-4","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate changes in choroidal thickness in presbyopes, when reading with regular glasses versus choroidal control glasses, in patients with or without Age-Related Macular Degeneration (AMD).</p><p><strong>Methods: </strong>This was a pilot study on short-term axial length (AL) in 33 eyes of 24 presbyopic patients aged 60 to 80 years, assigned to two age-matched groups, with or without AMD. About them, changes in choroidal thickness were evaluated with ocular biometry through indirect measurements of axial length at baseline, after 20' of reading with conventional lenses, and after another 20' of reading with peripheral hyperopic defocus glasses. The differences in axial length between the three different times were analyzed.</p><p><strong>Results: </strong>In presbyopes without AMD there was a significant axial length shortening of -13.44 microns in the first conventional reading period, which was reversed by 90% with hyperopic defocus lenses, recovering + 12.11 microns by axial lengthening (choroidal thinning, p = 0.03). In patients with AMD, axial shortening was significantly greater than controls, -23.86 microns with conventional lenses (p < 0.001) and they, also increased their axial length with defocus, although this response was smaller in proportion (+ 15.52 microns).</p><p><strong>Conclusion: </strong>Reading with positive lenses produces myopic defocus and choroidal thickening in presbyopes with and without AMD but was significantly greater in the latter. Glasses with Choroidal Control Technology reduced thickening during reading.</p><p><strong>Key messages: </strong>What is known • Presbyopia spectacles for near produce myopic defocus and choroidal thickening. What is new • There are differences in choroidal thickening during reading between normal subjects and those with age related macular degeneration. • Spectacles with Defocus Choroidal Control Technology reduce choroidal thickening during reading in presbyopes.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"581-588"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145552","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":"Retinal oxygen metabolic function in choroideremia and retinitis pigmentosa.","authors":"Dominique Prétot, Maria Della Volpe Waizel, Karolina Kaminska, Philippe Valmaggia, Giorgio Placidi, Benedetto Falsini, Fabian N Fries, Nóra Szentmáry, Carlo Rivolta, Hendrik P N Scholl, Giacomo Calzetti","doi":"10.1007/s00417-024-06659-8","DOIUrl":"10.1007/s00417-024-06659-8","url":null,"abstract":"<p><strong>Purpose: </strong>To measure the retinal oxygen metabolic function with retinal oximetry (RO) in patients with choroideremia (CHM) and compare these findings with retinitis pigmentosa (RP) patients and controls.</p><p><strong>Methods: </strong>Prospective observational study including 18 eyes of 9 molecularly confirmed CHM patients (9♂; 40.2 ± 21.2 years (mean ± SD), 77 eyes from 39 patients with RP (15♀ 24♂; 45.6 ± 14.7 years) and 100 eyes from 53 controls (31♀ 22♂; 40.2 ± 13.4 years). Main outcome parameters were the mean arterial (A-SO₂; %), venular (V-SO₂; %) oxygen saturation, and their difference (A-V SO₂; %) recorded with the oxygen saturation tool of the Retinal Vessel Analyzer (IMEDOS Systems UG, Germany). Statistical analyses were performed with linear mixed-effects models.</p><p><strong>Results: </strong>Eyes suffering from CHM differed significantly from both RP and control eyes, when the retinal oxygen metabolic parameters were taken into account. While RP showed significantly higher A-SO₂ and V-SO₂ values when compared to controls, CHM showed opposite findings with significantly lower values when compared to both RP and controls (P < 0.001). The A-V SO₂, which represents the retinal oxygen metabolic consumption, showed significantly lower values in CHM compared to controls.</p><p><strong>Conclusion: </strong>The retina in CHM is a relatively hypoxic environment. The decrease in oxygen levels may be due to the profound choroidal degeneration, leading to decreased oxygen flux to the retina. RO measurements may help understand the pathogenesis of CHM and RP. These findings may provide useful details to inform the planning of clinical trials of emerging therapies for CHM.</p><p><strong>Key messages: </strong>What was known before? Retinal oxygen metabolic function measured with retinal oximetry (RO) shows significant alterations in patients with retinitis pigmentosa.</p><p><strong>What this study adds: </strong>RO function in choroideremia is significantly altered when compared to controls. Furthermore, RO in choroideremia shows opposing findings within different oxygen metabolic parameters to those that were so far known for retinitis pigmentosa. By providing insights into the retinal oxygen metabolic mechanisms, RO can help understand the underlying pathophysiology in choroideremia.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"379-385"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunohistochemical expression of Fibrillin-1 in idiopathic epiretinal membranes.","authors":"Luu Viet Tien, Manabu Yamamoto, Mizuki Tagami, Norihiko Misawa, Shigeru Honda","doi":"10.1007/s00417-024-06667-8","DOIUrl":"10.1007/s00417-024-06667-8","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the expression patterns of Fibrillin-1 in idiopathic epiretinal membranes (iERM) and identify Fibrillin-1-secreting cells.</p><p><strong>Methods: </strong>iERM samples were collected via standard 27-gauge vitrectomy and subsequently subjected to flat-mount immunohistochemistry with double staining for the following markers: Fibrillin-1, glial acidic fibrillary protein (GFAP), cellular retinaldehyde-binding protein (CRALBP), retinoid isomerohydrolase RPE65 (RPE65), and α-smooth muscle actin (α-SMA).</p><p><strong>Results: </strong>Fibrillin-1 was detected throughout the iERM. The colocalization of Fibrillin-1 with α-SMA, CRALBP, and RPE65 suggested that myofibroblasts and retinal pigment epithelial (RPE) cells secreted Fibrillin-1. The lack of colocalization between GFAP and Fibrillin-1 indicated that GFAP-positive glial cells did not secrete Fibrillin-1. The colocalization of CRALBP and RPE65 with α-SMA indicated the transformation of RPE cells into myofibroblasts. This suggested that RPE cells transformed into myofibroblasts and secreted Fibrillin-1. The lack of colocalization between GFAP and α-SMA implied that GFAP-positive glial cells did not express α-SMA.</p><p><strong>Conclusions: </strong>Fibrillin-1 is widely distributed in iERMs, and myofibroblasts were the primary sources of Fibrillin-1 secretion. Additionally, during their transformation into myofibroblasts, RPE cells secreted Fibrillin-1. GFAP-positive glial cells did not express α-SMA nor secrete Fibrillin-1.</p><p><strong>Key messages: </strong>What is known Idiopathic epiretinal membranes are a common cause of visual acuity and quality impairment. The protein and cell components of idiopathic epiretinal membrane exhibit diversity. What is new Fibrillin-1 is present throughout the idiopathic epiretinal membrane. Myofibroblasts are the most important source of Fibrillin-1 secretion. Retinal pigment epithelial cells also secrete Fibrillin-1 when transforming into myofibroblast. Glial cells do not transform to myofibroblast and do not secrete Fibrillin-1.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"415-424"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521743","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":"A cost-minimization analysis of anti-VEGFs for the treatment of neovascular age-related macular degeneration in the Netherlands.","authors":"Sara W Quist, Hidde Nab, Maarten Postma, Sankha Amarakoon, Freekje van Asten, Roel Freriks","doi":"10.1007/s00417-024-06588-6","DOIUrl":"10.1007/s00417-024-06588-6","url":null,"abstract":"<p><strong>Objective: </strong>Age-related macular degeneration (AMD) is the main cause of severe vision loss globally. Neovascular AMD (nAMD) is an advanced stage of AMD treated with anti-vascular endothelial growth factors (anti-VEGFs). Although anti-VEGF treatment is effective, the frequent intravitreal injections place a burden on patients, (in)formal caregivers, and clinics. This study assesses the health-economic impact of anti-VEGF agents with lower injection frequency that have the potential to reduce treatment burden and compares it to the standard of care.</p><p><strong>Methods: </strong>We developed a cost-minimization model to evaluate the direct medical costs associated with first-line unilateral anti-VEGF treatment across a 3-year time horizon in the Netherlands. The analysis compared aflibercept 8 mg, aflibercept 2 mg, bevacizumab, faricimab, and ranibizumab. Our model adopted a treat-and-extend (T&E) regimen for aflibercept 2 mg, bevacizumab, and ranibizumab. For aflibercept 8 mg, a flexible regimen that was extendable up to 24 weeks was applied, while faricimab followed a flexible regimen that was extendable up to 16 weeks. Additionally, since list prices may vary from net prices, we calculated the break-even price for each anti-VEGF in comparison to bevacizumab, which is the recommended first-line treatment due to its low medication price.</p><p><strong>Results: </strong>Based on list prices, aflibercept 8 mg led to the lowest treatment costs (€16,251 per patient over a 3-year time horizon), closely followed by bevacizumab (€17,616 per patient over a 3-year time horizon). Ranibizumab led to the highest per-patient costs (€31,746 over a 3-year time horizon). For bevacizumab, most costs were attributable to administration, while for the other anti-VEGFs, most were attributable to medication. Aflibercept 8 mg is cost-saving compared to bevacizumab at their medication prices at the time of writing. Aflibercept 2 mg, faricimab, and ranibizumab should be priced below €488, €591, and €75, respectively. To be cost-equal to bevacizumab with current list prices, anti-VEGFs should be administered with a maximum of 12.7 to 13.8 injections over a 3-year time horizon.</p><p><strong>Conclusion: </strong>According to the injection frequency observed in clinical trials, aflibercept 8 mg would be the anti-VEGF that generates the lowest per-patient healthcare costs for the treatment of nAMD in the Netherlands after a treatment period of three years. Our study indicates that anti-VEGF drugs with a lower injection frequency might provide a cost-saving solution to the increasing burden of anti-VEGF treatment on the healthcare system.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"327-345"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}