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

{"title":"Refractive outcomes for secondary sutureless posterior chamber lens implantation: sutureless scleral fixating lens Carlevale® versus retropupillary iris-claw lens Artisan®.","authors":"Justine Bontemps, Olivier Loria, Lucas Sejournet, Benoit Allignet, Sandra Elbany, Frédéric Matonti, Carole Burillon, Philippe Denis, Laurent Kodjikian, Thibaud Mathis","doi":"10.1007/s00417-024-06683-8","DOIUrl":"https://doi.org/10.1007/s00417-024-06683-8","url":null,"abstract":"<p><strong>Purpose: </strong>To compare refractive outcomes of the foldable intraocular lens sutureless scleral fixated sutureless (Carlevale® FIL-SSF) with the iris-claw lens (Artisan®).</p><p><strong>Methods: </strong>This retrospective study included consecutive patients who underwent a FIL-SSF implantation or an iris-claw implantation between January 2020 and November 2022 in the ophthalmology departments of Hospices Civils de Lyon (France).</p><p><strong>Results: </strong>A total of 271 eyes from 265 patients were included: 96 eyes in the FIL-SSF group and 175 eyes in the iris-claw group. At 6 months, the mean (SD) surgically induced astigmatism (SIA) was significantly lower in the FIL-SSF group with 0.3 (1.8) diopters against 0.8 (2.1) diopters in the iris-claw group (p = 0.01). The mean (SD) refractive error was also lower for the FIL-SSF group with 0.1 (1.2) diopters versus 0.5 (1.6) diopters in the iris-claw group (p < 0.001). The mean best corrected visual acuity at 6 months was not significantly different between FIL-SSF and iris-claw lens with 0.47 (0.58) logMAR and 0.39 (0.55) logMAR, respectively (p = 0.12). However, the mean (SD) operative time was longer for FIL-SSF implantation in comparison to iris-claw implantation (59.8 (21.1) minutes versus 41.9 (24.4) minutes, respectively (p < 0.001)). The rate of postoperative complications was similar between the two techniques.</p><p><strong>Conclusion: </strong>This study shows that FIL-SSF achieves better refractive results than iris-claw lens, with a similar rate of postoperative complications. As a relatively new implantation technique, there is a learning curve required to reduce operating time.</p><p><strong>Key messages: </strong>What is known? Multiple surgical options for correcting aphakia in the absence of capsular support can be used. Currently, foldable intraocular lens sutureless scleral fixated sutureless (FIL-SSF, Carlevale®) and iris-claw (Artisan®) implants are the two preferred options, but there is no consensus on the best technique to adopt. What is new? We showed that FIL-SSF has a significantly lower surgically induced astigmatism compared to the iris-claw implant. Similar rate of postoperative complications was found between these two techniques. Future studies with a longer follow-up period are needed to ascertain its tolerance.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618698","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":"Minimum perceptual time (MPT). Repeatability and reproducibility of variables applied to \"sports vision\".","authors":"Antonio Ríder-Vázquez, Margarita Vega-Holm, María Carmen Sánchez-González, Estanislao Gutiérrez-Sánchez","doi":"10.1007/s00417-024-06684-7","DOIUrl":"https://doi.org/10.1007/s00417-024-06684-7","url":null,"abstract":"<p><strong>Purpose: </strong>\"Minimum Perceptual Time\" (MPT) is the ability to take the most visual information in the least time. The purpose of the study was to assess intraobserver and interobserver repeatability of a MPT measurement method by using COI-SV^® software and to analyze the possible influence of age and sex.</p><p><strong>Methods: </strong>MPT was measured in 79 participants by using COI-SV^® software. Visual acuity was 20/80 (2.50 m) and numbers were gradually increasing in quantity and decreasing in exposure time. The most quantity of numbers and the least time was written down. To assess intraobserver and interobserver repeatability, a protocol based on repeating the test 4 times (2 intrasession and 2 intersessions with 2 examinators) was established. Comparison of means and Spearman correlation were performed to evaluate the influence of sex and age. It was investigated inter and intraexaminer variability using repeatability indices, as well as Bland-Altman analysis to define limits of agreement.</p><p><strong>Results: </strong>A total of 79 participants were included (mean age 32.8 ± 11.95 years, range 19-64 years). Regarding sex, there were no significant differences between men and women (p = 0.080), whereas age and MPT had an inverse correlation (p = 0.01). Interexaminer and intraexaminer repeatability proved to be moderate to good in all methods. Bland-Altman showed difference between sessions was 0.259 ± 2.189 (-4.030 and + 4.549) and difference between examiners was - 0.519 ± 2.104 (-4.642 and + 3.604).</p><p><strong>Conclusion: </strong>MPT measurements with COI-SV^® software evidenced moderate to good repeatability and observers` independent result, so it could be included in optometric examinations.</p><p><strong>Key messages: </strong>WHAT IS KNOWN : Sports optometry is a relatively new field, so research is scarce and of poor quality. The scarcity of literature is practically limited to studies in the field of psychology, although they do not provide us with much information since they have not been studied for the mentioned field. The in-depth study of new standardized measurement methods would be of great help for optometrists in their clinical practice.</p><p><strong>What is new: </strong>This study is the first to determine intraobserver and interobserver repeatability and reproducibility for Minimum Perceptual Time (MPT) measurements acquired by the COI-SV® software, exhibiting ICC > 0.7 and establishing limits of agreement by using Bland-Altman analysis. In a significant way, MPT and age would have an inverse correlation, whereas MPT results would be better in men than women. Our results add evidence towards validating the test included in COI-SV® software so that the optometrist can include it in their clinical protocols in order to obtain more complete information on visual examinations.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618754","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":"Delayed closure of highly myopic macular holes combined with retinoschisis after inverted internal limiting membrane flap.","authors":"Matteo Mario Carlà, Carlos Mateo","doi":"10.1007/s00417-024-06678-5","DOIUrl":"https://doi.org/10.1007/s00417-024-06678-5","url":null,"abstract":"<p><strong>Purpose: </strong>To assess functional and anatomical outcomes of internal limiting membrane (ILM) inverted flap in highly myopic macular holes (HMMHs) with outer-retinoschisis (O-RS).</p><p><strong>Methods: </strong>Retrospective interventional analysis of 19 eyes with HMMH and O-RS undergoing vitrectomy and ILM inverted flap. At baseline and every follow-up visit (1, 3, 6, 12 months and the most recent) we performed best-corrected visual acuity (BCVA, Snellen) and optical coherence tomography (OCT), collecting several parameters: minimum linear diameter (MLD), basal diameter (BD), peri-HMMH nasal and temporal retinal thickness (RT_NAS and RT_TEM), peri-HMMH nasal and temporal O-RS height (O-RS_NAS and O-RS_TEM). The ratios O-RS_NAS/ RT_NAS and O-RS_TEM/RT_TEM were defined as %O-RS_NAS and %O-RS_TEM. Postoperatively, we distinguished classic HMMH closure (n = 14) from a newly described \"delayed\" closure pattern (n = 5).</p><p><strong>Results: </strong>Primary anatomical closure was obtained in 89% of eyes. Mean BCVA improved from 0.23 ± 0.17 to 0.44 ± 0.20 and 0.46 ± 0.25 at 6-months and final follow-up (p = 0.009 and p = 0.001, respectively). At every follow-up, \"classic\" vs. \"delayed closure\" did not influence BCVA (all p > 0.05). Baseline O-RS_NAS (p = 0.026), O-RS_TEM (p = 0.04), %O-RS_NAS (p = 0.04) and %O-RS_TEM (0.004), were significantly associated with the \"flap closure\" pattern, differently from MLD and BD. In the \"delayed closure\" subgroup we reported a 100% closure rate, but 65.8 ± 64.4 days after first surgery. Meantime, OCT showed an inverted ILM flap covering an area of persistent tissue loss. O-RS_NAS and O-RS_TEM progressively reduced until HMMH closure.</p><p><strong>Conclusion: </strong>Inverted flap is useful to close HMMH with O-RS. In case of \"delayed closure\" pattern, watchful-waiting allows for HMMH self-sealing, without impact on BCVA.</p><p><strong>Key messages: </strong>What is known Inverted internal limiting membrane (ILM) flap showed favorable anatomic success in cases of highly myopic macular holes (HMMH). What is new HMMHs with outer retinoschisis (class 2c of the staging system) may close following a classic or \"delayed closure\" pattern. In cases of delayed closure, it took a variable range of 30-179 days to seal the HMMH but no further surgery was advisable. Post-operative BCVA improvement was not impacted at any follow-ups when comparing \"delayed\" and \"classic\" closure subgroups.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618750","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":"Continuous intraocular pressure variations following positional transitions in normal subjects and open angle glaucoma patients using a contact lens sensor system.","authors":"Yuning Zhang, Wenxin Yang, Zidong Chen, Xinyi Zhang, Ping Wai Or, Ching Hymn Christopher Lee, Isuru Kaweendra Karunaratne, Yunzhi Xu, Pingping Liu, Iok Tong Chong, Zhen Qin, David C C Lam, Minbin Yu","doi":"10.1007/s00417-024-06680-x","DOIUrl":"https://doi.org/10.1007/s00417-024-06680-x","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy of a novel contact lens sensor system (CLS) in detecting continuous intraocular pressure (IOP) variations following positional transitions, and to explore these IOP variation patterns among normal subjects, untreated glaucoma patients, and untreated ocular hypertension (OHT) subjects.</p><p><strong>Methods: </strong>This prospective comparative study included 20 normal subjects, 14 high tension glaucoma (HTG) patients, 16 normal tension glaucoma (NTG) patients, and 14 OHT subjects. Participants wore the CLS for continuous IOP monitoring while undergoing sequential body position changes: from sitting to supine to a 10° head-down tilt (HDT), with each position maintained for ten minutes. Continuous IOP parameters, including mean, peak, and fluctuation (peak minus valley) in each position, as well as increment (peak minus starting value), interval (time to arrive peak), and velocity (increment divided by interval) after two position transitions, were compared among different positions and groups, respectively.</p><p><strong>Results: </strong>Normal subjects, HTG and NTG patients exhibited higher CLS IOP mean and peak in supine/HDT positions compared to sitting (P < 0.05), but the mean or peak in HDT did not significantly differ from that in supine (P > 0.2). In OHT, all IOP parameters showed no significant difference among various positions (P > 0.1), except for velocity. Comparisons among groups revealed that during the transition from sitting to supine, HTG demonstrated higher IOP increment than other three groups and higher velocity than normal subjects (P < 0.05). NTG patients exhibited no significant differences in IOP increment, interval and velocity, compared to normal subjects (P > 0.05).</p><p><strong>Conclusions: </strong>The CLS proved effective in continuously recording IOP responses following positional changes in normal and glaucomatous eyes. Transitioning from sitting to supine resulted in increased IOP among normal subjects, HTG and NTG patients, but not in OHT. Compared to normal subjects, this IOP increase was more pronounced and rapid in HTG, but comparable in NTG.</p><p><strong>Key messages: </strong>WHAT IS KNOWN : Positional transitions can induce IOP variations, which differ among normal subjects and glaucoma patients, and potentially relate to glaucomatous neuropathy. However, prior findings are constrained by the discontinuity of traditional tonometry.</p><p><strong>What is new: </strong>This study utilized a novel contact lens sensor system (CLS) to continuously monitor IOP during positional transitions in normal subjects and untreated glaucoma/OHT subjects. Continuous IOP outcomes revealed that normal subjects, HTG patients, and NTG patients exhibited an increase in IOP when transitioning from sitting to supine, whereas OHT did not. Compared to normal subjects, this increase in IOP was more pronounced and rapid in HTG patients, but similar in NTG.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618746","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":"Proton beam irradiation with anti-VEGF therapy for polypoidal choroidal vasculopathy: results of a 24-month, phase II randomized study.","authors":"Wenyi Tang, Xianxin Qiu, Jingli Guo, Gezhi Xu, Lin Kong, Wei Liu","doi":"10.1007/s00417-024-06681-w","DOIUrl":"https://doi.org/10.1007/s00417-024-06681-w","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the efficacy and safety of proton beam irradiation (PBI) and anti-vascular endothelial growth factor (anti-VEGF) therapy for polypoidal choroidal vasculopathy (PCV)/ aneurysmal type 1 macular neovascularization (AT1).</p><p><strong>Methods: </strong>The randomized clinical trial consisted of newly diagnosed active PCV/AT1 patients who were randomized 1:1 to treatment with three initial monthly intravitreal anti-VEGF agent (conbercept) injections with or without single 14 GyE radiation. Subsequent anti-VEGF therapy was given pro re nata. The primary outcome measures were number of anti-VEGF injections, best-corrected visual acuity (BCVA), and central retinal thickness (CRT) at 24 months. Secondary outcome measures included the polypoidal lesion regression rate, changes in the areas of polypoidal lesions and branching vascular network (BVN), and radiotherapy-related adverse events at 24 months.</p><p><strong>Results: </strong>A total of 45 eyes (86.5%) completed the 24-month follow-up. At 24 months, the combination therapy group required fewer anti-VEGF injections compared with the monotherapy group (5.9 ± 4.1 vs. 8.8 ± 5.3; P = 0.04). The mean gains in BCVA and the mean decrease in CRT were not significantly different between the two groups (P = 0.85 and P = 0.17, respectively). Combination therapy was superior to monotherapy for complete polypoidal lesion regression (80.0% vs. 48%, P = 0.03) and change in BVN area (- 1.03 ± 1.24 mm² vs. 0.36 ± 0.77 mm², P < 0.01). The radiation-related microvascular abnormalities were observed in 55.0% of eyes following combination therapy at 15.7 ± 2.5 months.</p><p><strong>Conclusion: </strong>PBI (14 GyE) combined with anti-VEGF therapy could decrease the need for additional anti-VEGF injections for PCV/AT1. Longer follow-up is needed to fully evaluate the long-term safety of PBI.</p><p><strong>Key messages: </strong>What is known The current main methods for treating PCV/AT1 include anti-VEGF drugs as monotherapy or in combination with photodynamic therapy. However, some cases can be challenging with multiple repeated injections due to the relatively low regression rate of polyps and high recurrence rate. What is new Proton beam irradiation therapy with anti-VEGF drugs can synergistically promote the regression of polyps and the shrinkage of branching vascular network, and reduce the anti-VEGF treatment burden for patients with PCV/AT1. Radiation retinopathy was mild and did not appear to be visually significant at the 24-month follow-up. Proton beam irradiation can be a new strategy for the treatment of PCV/AT1.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618696","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":"Subclinical corneal inflammation and subbasal nerve alterations in keratoconus detected by in vivo confocal microscopy: a cross-sectional study.","authors":"Chareenun Chirapapaisan, Methawee Sawarot, Sathiya Kengpunpanich","doi":"10.1007/s00417-024-06664-x","DOIUrl":"https://doi.org/10.1007/s00417-024-06664-x","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the intracorneal inflammation and subbasal nerve alterations in keratoconus.</p><p><strong>Methods: </strong>This prospective cross-sectional study recruited patients with keratoconus, who were diagnosed and graded the severity based on clinical examination and Schiempflug tomography. Laser in vivo confocal microscopy (IVCM) was performed on the corneal subbasal layer centrally to explore the inflammatory cells (ICs), subbasal nerve density (SND), and nerve tortuosity. Keratoconus severity and related factors including ocular allergy, systemic atopy, eye rubbing, floppy eyelids, and contact lens use were recorded. Association between the factors, IC density, SND and keratoconus severity were analyzed.</p><p><strong>Results: </strong>Thirty-four keratoconus eyes were enrolled, and their IVCM findings were compared with those of 20 age-matched normal eyes. Keratoconus showed a significant increase in ICs (44.25 ± 7.01 vs. 13.06 ± 7.51 cells/mm², p < 0.001) and a significant decrease in SND (16.54 ± 0.79 vs. 20.62 ± 0.72 mm/mm², p < 0.001) when compared to controls. The alterations were pronounced in severe keratoconus as the IC density was significantly higher (p < 0.001), whereas SND was lower (p = 0.001) in high-graded keratoconus than in low-graded keratoconus. However, there was no significant correlation between the number of IC and SND in keratoconus eyes (p = 0.835). Corneal sensitivity and nerve tortuosity were not different between keratoconus and the controls. No keratoconus-related factors were associated with IC density except the severity of keratoconus (p < 0.001, 95% CI [0.70, 0.95]).</p><p><strong>Conclusion: </strong>Keratoconus, a clinically noninflammatory corneal disease, demonstrates subclinical corneal inflammation and subbasal nerve decline as shown by IVCM. These alterations correlate considerably with the severity of keratoconus.</p><p><strong>Key messages: </strong>What is known Traditionally, Keratoconus is a clinically noninflammatory corneal disease. What is new Our study suspected keratoconus may be subclinical corneal inflammatory disease. In our research, A Keratoconus patient was discovered to have corneal inflammation and a reduction in sub-basal nerve density through the use of In Vivo Confocal Microscopy. Increase in corneal inflammation is considerably correlated with the severity of keratoconus.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618710","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}