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

{"title":"Longitudinal changes in the position and thickness of the peak peripapillary retinal nerve fiber layer in school children.","authors":"Takehiro Yamashita, Hiroto Terasaki, Ryo Asaoka, Naoya Yoshihara, Naoko Kakiuchi, Taiji Sakamoto","doi":"10.1007/s00417-025-06810-z","DOIUrl":"https://doi.org/10.1007/s00417-025-06810-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the relationship between changes in the position and thickness of the peak circumpapillary retinal nerve fiber layer (cpRNFL) and axial elongation in schoolchildren.</p><p><strong>Methods: </strong>This prospective cohort study involved the right eyes of 75 elementary school students examined over a period of six years (from the age of 8-9 years to 14-15 years). During the first and final years, all participants underwent optical axial length measurements, color fundus photography, and cpRNFL thickness measurements using optical coherence tomography. The supratemporal (ST) and infratemporal (IT) peak angles (ST and IT angle) were defined as those formed by the ST/IT peak position of the cpRNFL curve, the center of the optic disc, and the fovea. The RNFL thickness at the peaks (ST and IT thicknesses) was also determined. The Wilcoxon signed-rank test was used to compare the cpRNFL parameters and axial lengths in the first and final years.</p><p><strong>Results: </strong>The mean axial length was significantly longer in the final year (24.82 mm) than in the first year (23.34 mm). The mean ST and IT angles were significantly lower in the final year (67.6° and 58.2°) than in the first year (74.2° and 64.0°). The mean IT thickness was significantly greater in the final year (195.1 μm) than in the first year (185.0 μm); however, no significant changes in ST thickness were observed.</p><p><strong>Conclusion: </strong>The ST and IT peaks shifted toward the line connecting the fovea and the center of the optic disc between ages 8-9 and 14-15 years, and IT thickness increased. These changes indicate that nerve fibers are concentrated on the temporal side of the optic disc, especially in the IT area.</p><p><strong>Key messages: </strong>WHAT IS KNOWN : The circumpapillary retinal nerve fiber layer (cpRNFL) in normal eyes exhibits a double-hump pattern, with individual variability in the position of the peaks. Additionally, the mechanisms underlying these differences remain unclear.</p><p><strong>What is new: </strong>Eyes with greater axial elongation tended to have narrower supratemporal (ST) and infratemporal (IT) angles and increased IT thickness. Greater axial elongation during childhood growth caused a significant shift of the cpRNFL peaks toward the fovea and increased IT thickness. Based on the plate hypothesis, the shift and compression of nerve fibers during growth may serve as a potential predictor of normal-tension glaucoma onset in the future.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709619","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 pilot study of deep learning for automatic contouring of sulcus-to-sulcus diameter in ultrasound biomicroscopy.","authors":"Xiaohong Zheng, Xiaokang Li, Ke Hu, Jingji Long, Xingtao Zhou, Yuanyuan Wang, Yi Guo, Ke Zheng","doi":"10.1007/s00417-025-06764-2","DOIUrl":"https://doi.org/10.1007/s00417-025-06764-2","url":null,"abstract":"<p><strong>Purpose: </strong>To construct a deep learning (DL) algorithm for automatic prediction of sulcus-to-sulcus diameter (STS) and distance between STS plane and anterior crystalline lens surface (STSL) from ultrasound biomicroscopy (UBM) images based on YOLOv8 and verify its accuracy and reliability.</p><p><strong>Methods: </strong>This study used data from 100 eyes of 100 myopic patients treated with ICL from March 2023 to August 2024. UBM was used for the measurements of the STS and STSL (4 images for each eye). The data set (400 images) was randomly split at the patient level into a train, validation and test sets at the ratio of 8:1:1. The ciliary sulci on both sides and the anterior capsule of the lens in the UBM images were located with the YOLOv8 algorithm, and then the distances were calculated and compared with the manual labeled values and compared against an external expert with ANOVA, the YOLOv8 algorithm was tested in 26 eyes (104 images ) independent UBM data sets. Bland-Altman tests and intergroup correlation coefficients (ICCs) were used to assess the agreement between the labeled and YOLOv8 predicted values.</p><p><strong>Results: </strong>The deep learning-predicted STS and STSL demonstrated a high level of accuracy and reduced contouring time (by savings of 98.80% of work time) when compared with manual labeling contours in the testing set and showed a good accuracy when compared with external ophthalmologist manual labeling contours and in the external evaluation. The prediction error of the STS being 3.27 ± 2.01% and STSL being 67.95 ± 140.09% for the YOLOv8 algorithm at testing set, 4.10 ± 3.00 (%), and 49.66 ± 42.73 (%) in the external test set. The ICC was 0.312 between the predicted and labeled STS (P = 0.01) and 0.086 between the predicted and labeled STSL (P > 0.05).</p><p><strong>Conclusions: </strong>The deep learning-predicted STS and STSL demonstrated high accuracy and reduced measurement time, which could have a positive impact on the clinical setting.</p><p><strong>Key messages: </strong>What is known: ICL implantation remains challenging because of difficulties in determining the appropriate lens size. There is a wide variation in the values of ciliary sulcus-to-sulcus (STS) diameter measurements.</p><p><strong>What is new: </strong>This is the first study to automatically measure the STS-related distance based on YOLOv8 and assess the accuracy compared to the conventional manual labeling. The YOLOv8 algorithm proposed advantages in high accuracy, automatic prediction of posterior chamber STS-related parameters from ultrasound biomicroscope images.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691731","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":"Long-term visual function and refractive changes after vitrectomy for stage 4 retinopathy of prematurity.","authors":"Kuniko Tachibana, Chiharu Iwahashi, Kazuki Kuniyoshi, Shunji Kusaka","doi":"10.1007/s00417-025-06801-0","DOIUrl":"https://doi.org/10.1007/s00417-025-06801-0","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate longitudinal changes in best-corrected visual acuity (BCVA) and refraction in patients following vitrectomy for stage 4 retinopathy of prematurity (ROP).</p><p><strong>Methods: </strong>We conducted a retrospective review of 42 eyes from 25 patients (35 eyes with stage 4A, 7 eyes with stage 4B) who had successful vitrectomy for stage 4 ROP and were followed for at least 8 years. Postoperative BCVAs and refractive errors between ages 5 and 8 years were compared. Factors related to BCVA at ages 5 and 8, as well as their differences, were analyzed.</p><p><strong>Results: </strong>In stage 4A ROP eyes, the mean logMAR BCVA improved significantly from 0.83 (20/135) to 0.63 (20/85) (p < 0.001) and a myopic shift of 1 D or more occurred in 21 eyes (61.8%) between ages 5 and 8. In the poor BCVA group at age 5 in the stage 4A eyes, dominant eyes showed a trend of BCVA improvement by ages 5-8 (p = 0.06). Multiple regression analysis of the patients with stage 4A ROP showed that phakic and dominant eyes at age 5 were independently associated with better BCVA at ages 5 and 8 (p = 0.006 and 0.016 for age 5; p = 0.009 and 0.002 for age 8). No significant BCVA improvement was noted in stage 4B ROP eyes during the same period.</p><p><strong>Conclusion: </strong>This study indicated the possibility of continued visual improvement beyond age 5 in patients who underwent vitrectomy for stage 4A ROP, although a myopic shift occurred concurrently.</p><p><strong>Key messages: </strong>What is known Previous studies have reported long-term visual prognosis and refractive errors at specific time points after vitrectomy for ROP in small case series, but there has been limited research on serial changes. What is new This study demonstrates the potential for ongoing visual improvement beyond age 5 and highlights longitudinal myopic changes between ages 5 and 8 in patients who underwent vitrectomy for stage 4A ROP. In patients with poor visual acuity at age 5, being the dominant eye was significantly associated with improved visual acuity by age 8. The findings indicate that postoperative visual acuity in ROP patients gradually improves, even as myopia progresses, underscoring the need for long-term follow-up.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691789","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":"Intravitreal Dexamethasone Implant in Vitreoretinal Surgery: An Overview of the Literature.","authors":"Giacomo Boscia, Alessandro Feo, Alfonso Savastano, Pasquale Viggiano, Luca Landini, Arcangelo Clemente, Giacomo Scotti, Maria Oliva Grassi, Guglielmo Parisi, Ermete Giancipoli, Giovanni Alessio, Francesco Boscia, Rodolfo Mastropasqua, Michele Reibaldi, Mario R Romano, Enrico Borrelli","doi":"10.1007/s00417-025-06797-7","DOIUrl":"https://doi.org/10.1007/s00417-025-06797-7","url":null,"abstract":"<p><strong>Background: </strong>The sustained-release intravitreal 0.7 mg dexamethasone implant (DEX implant) (Ozurdex®, Allergan®, an AbbVie Company, North Chicago, Illinois, USA) is widely used to treat various inflammatory retinal disorders. Notably, its application is expanding in the field of vitreoretinal surgery.</p><p><strong>Methods: </strong>We conducted a comprehensive literature search across the Web of Science, PubMed, EMBASE, and ScienceDirect databases for articles related to Ozurdex and its applications in vitreoretinal disorders. Additionally, relevant studies were identified from the reference lists of retrieved articles. Our search was limited to studies written in English or those in other languages that provided an English abstract with sufficient information.</p><p><strong>Results: </strong>Multiple studies have demonstrated the efficacy and safety of the DEX implant across a broad spectrum of vitreoretinal and post-surgical conditions. Notably, the implant's unique pharmacokinetics remain largely unaffected by the vitrectomized status of the eye, ensuring consistent effectiveness in vitreoretinal surgery. Our research highlights the primary off-label applications of the DEX implant, which include epiretinal membrane (ERM), rhegmatogenous retinal detachment (RRD), post-surgical cystoid macular edema (PSCME), and refractory diabetic macular edema (DME).</p><p><strong>Conclusion: </strong>This review highlights the increasing role of the DEX implant in vitreoretinal surgery, emphasizing its effectiveness and safety in various surgical and post-surgical settings, while also addressing associated complications.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662522","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":"Long-term visual outcomes of patients with neovascular age-related macular degeneration treated with anti-VEGF therapy lost to follow-up.","authors":"Ki Tae Nam, Cheolmin Yun","doi":"10.1007/s00417-025-06798-6","DOIUrl":"https://doi.org/10.1007/s00417-025-06798-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the long-term visual outcomes of patients with neovascular age-related macular degeneration (AMD) who were lost to follow-up (LTFU) during treatment compared with those with continuous follow-up (CFU).</p><p><strong>Methods: </strong>A retrospective study was conducted on patients diagnosed with neovascular AMD who received anti-VEGF therapy from 2010 to 2022. The patients were classified into the long-term LTFU group (LTFU for more than 6 months), the short-term LTFU group (LTFU for 2 months to less than 6 months), and the CFU group. We conducted a comparative analysis of baseline characteristics, factors related to visual prognosis, and differences in the occurrence of severe vision loss.</p><p><strong>Results: </strong>A total of 169 patients were classified into 43 in the long-term LTFU group, 57 in the short-term LTFU group, and 69 in the CFU group. The mean follow-up duration was 57.12 ± 31.68 months. There was no significant difference in baseline visual acuity (logMAR) among the long-term LTFU, short-term LTFU, and CFU groups (0.76 ± 0.54, 0.68 ± 0.51, and 0.72 ± 0.54, respectively; P = 0.734). The final visual acuity was significantly lower in the long-term LTFU group (1.12 ± 0.79) compared with the short-term LTFU group (0.65 ± 0.62) and the CFU group (0.65 ± 0.56) (P < 0.001), and the change in visual acuity was significantly greater in the long-term LTFU group (0.36 ± 0.69) compared with the short-term LTFU group (-0.03 ± 0.64) and the CFU group (-0.07 ± 0.58) (P = 0.001). Long-term LTFU was significantly associated with changes in visual acuity from the baseline to the final visit (P = 0.002) and severe vision loss (P = 0.002).</p><p><strong>Conclusion: </strong>In patients with neovascular AMD, those LTFU for more than six months during treatment had worse long-term visual outcomes compared to those with regular follow-up or shorter LTFU durations.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669685","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":"Illuminating eye care: the promise and future of red light therapy in ophthalmology.","authors":"Fei Xue, Yating Zhou","doi":"10.1007/s00417-025-06800-1","DOIUrl":"https://doi.org/10.1007/s00417-025-06800-1","url":null,"abstract":"<p><p>With the rapid global rise of myopia, glaucoma, AMD, and dry eye disease, red light therapy (RLT) is quickly emerging as a non-invasive, breakthrough approach with extraordinary potential to transform eye health management. Originally applied for wound healing and pain relief, RLT has shown remarkable, multi-faceted effects in ophthalmology: slowing myopia progression, protecting retinal cells in glaucoma, reducing inflammation in AMD, and relieving symptoms of dry eye disease. However, alongside the surge in research interest, questions regarding optimal dosing, safety, and standardization remain pressing. This review summarizes the latest advances of RLT in eye health, explores its mechanisms of action, analyzes safety concerns in clinical applications, and discusses its synergistic potential with existing treatment methods as well as the integration of RLT with artificial intelligence and wearable technologies. In the future, RLT is expected to play a significant role in the management of chronic ocular diseases, but its long-term effects and safety need careful evaluation, with challenges also remaining in regulatory policies and clinical standardization.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663360","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":"Factors associated with satisfaction with oral sedation during ophthalmic surgeries.","authors":"Konstantina Sampani, Ahsan Hussain, Nayan Sanjiv, Samaneh Davoudi, Sreevardhan Alluri, Hyunjoo J Lee, Steven Ness, Susannah Rowe, Manju L Subramanian","doi":"10.1007/s00417-025-06781-1","DOIUrl":"https://doi.org/10.1007/s00417-025-06781-1","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate patient and surgical characteristics associated with higher patient, surgeon, or anesthesia provider satisfaction with oral sedation in ophthalmic procedures.</p><p><strong>Design: </strong>This was a secondary analysis of a prospective, randomized, double-masked, non-inferiority clinical trial measuring patient satisfaction comparing oral versus intravenous (IV) sedation for ophthalmic surgeries.</p><p><strong>Methods: </strong>Data was collected from a validated 6-point satisfaction survey from patients, surgeons, and anesthesia providers. We focused on the oral sedation arm and used multivariate regression analysis to investigate the relationship between satisfaction scores and patients' characteristics, surgery duration, and need for additional anesthesia during the ophthalmic procedure.</p><p><strong>Results: </strong>In total, 142 patients receiving initial oral triazolam with IV placebo were included in this study. Non-White (p = 0.02) and non-English speaker patients (p = 0.003) had higher satisfaction scores with oral sedation. Shorter surgery duration was associated with higher satisfaction scores for both patients (p = 0.01) and surgeons (p = 0.03) but not for anesthesia providers (p = 0.21). The need for supplemental IV sedation intraoperatively was significantly associated with lower satisfaction scores among patients (p < 0.001), surgeons (p < 0.001), and anesthesia providers (p < 0.001).</p><p><strong>Conclusions: </strong>Shorter length of surgery was positively associated with higher patient and surgeon satisfaction with oral sedation. Other factors including non-White race and non-English primary language were associated with higher patient satisfaction. Additional IV sedation needed during surgery was associated with worse patient, surgeon, and anesthesia provider satisfaction. Tailoring oral sedation to procedures that are shorter in duration may help maximize the success of oral sedation as an alternative to intravenous sedation.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656980","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":"Peripapillary hyperreflective ovoid mass-like structure (PHOMS) and optic disc drusen in pediatric pseudo-papilledema.","authors":"Aliénor Vienne-Jumeau, Pierre Lebranchu, Inji Akhenak, Dominique Bremond-Gignac, Matthieu P Robert","doi":"10.1007/s00417-025-06799-5","DOIUrl":"https://doi.org/10.1007/s00417-025-06799-5","url":null,"abstract":"<p><strong>Purpose: </strong>Diagnosing pseudo-papilloedema (PPO) in children presents challenges and may lead to invasive investigations, with optic disc drusen (ODD) being the most common etiology. Other specific causes include tilted disc, optic neuritis, tumoral infiltration, vitreo-papillary traction, and Leber hereditary optic neuropathy. Peripapillary hyperreflective ovoid mass-like structures (PHOMS) are frequently observed in these cases, yet their pathophysiology remains unexplained, particularly their relation to ODD, which is still debated. Here, we explored whether patients with PPO associated with ODD, or seemingly isolated cases, could exhibit PHOMS without ODD or ODD without PHOMS, and how this might affect retinal nerve fiber layer (RNFL) thickness.</p><p><strong>Methods: </strong>In this two-centre retrospective observational study, we included patients under 20 years old presenting with PPO without specific causes, with a subgroup followed for at least one year. Enhanced depth imaging optical coherence tomography was used to assess the presence and evolution of PHOMS and ODD, as well as RNFL thickness.</p><p><strong>Results: </strong>We included twenty-seven patients, with thirteen followed for at least one year. In all eyes, we observed concomitant PHOMS and either deep or superficial ODD. RNFL thickness was increased in patients with deep ODD and decreased in those with superficial ODD, which was observed during follow-up.</p><p><strong>Conclusions: </strong>ODD and PHOMS are concomitant features present in patients with PPO. PHOMS sometimes serve as indicators, as buried ODD are challenging to identify in young children. However, ODD tend to become more superficial over time, while RNFL thickness decreases.</p><p><strong>Key messages: </strong>WHAT IS KNOWN : Diagnosing the cause of pseudo-papilledema (PPO) in children is challenging and often requires invasive investigations. The relationship between optic disc drusen (ODD) and peripapillary hyperreflective ovoid mass-like structures (PHOMS) in the context of PPO remains poorly understood.</p><p><strong>What is new: </strong>PHOMS and ODD seem to consistently co-occur in pediatric PPO cases where no other specific causes are identified. Retinal nerve fiber layer (RNFL) thickness increases in the presence of deep ODD and decreases as ODD become more superficial with age. RNFL thinning progresses in correlation with the patient's age.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656983","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":"Machine learning-based progress prediction in accelerated cross-linking for Keratoconus.","authors":"Qi Wan, Qiong Wang, Ran Wei, Jing Tang, Hongbo Yin, Ying-Ping Deng, Ke Ma","doi":"10.1007/s00417-025-06792-y","DOIUrl":"https://doi.org/10.1007/s00417-025-06792-y","url":null,"abstract":"<p><strong>Background: </strong>To analyze corneal topographic and biomechanical parameters in keratoconus patients before undergoing accelerated corneal collagen cross-linking (A-CXL) surgery and use machine learning models to identify prognostic factors for disease progression after treatment.</p><p><strong>Methods: </strong>This was a retrospective, single-center study on 95 eyes from 69 keratoconus patients (mean age 21.46 ± 7.07 years) undergoing A-CXL, with 3-22 months follow-up. Corneal tomography (Pentacam) and biomechanical measurements (Corvis ST) were performed at baseline and follow-up visits. Changes in the E-stage were used to define progression. LASSO, XGBoost, and random forest machine learning models were applied to identify prognostic factors. A nomogram was developed to predict progression probabilities.</p><p><strong>Results: </strong>42.1% of eyes showed progression based on E-stage change. Maximal keratometry (Kmax) and index of surface variance (ISV) were significantly higher in the progression group. The nomogram incorporating Kmax and ISV predicted progression better than individual parameters. The progression rate was 51.4% in high-risk eyes versus 16% in low-risk eyes stratified by the nomogram.</p><p><strong>Conclusions: </strong>Kmax and ISV are important prognostic factors for keratoconus progression after A-CXL. The nomogram can improve prediction accuracy compared to single parameters. It enables personalized risk assessment to guide treatment decisions.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648297","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":"Insights into scleral violaceous hue in anterior scleritis: anterior segment optical coherence tomography evaluation.","authors":"Plern Sutra, Thananop Pothikamjorn, Sarah Lopez, Jaskirat Takhar, Mathinee Chongchareon, Jeremy Keenan, John A Gonzales","doi":"10.1007/s00417-025-06788-8","DOIUrl":"https://doi.org/10.1007/s00417-025-06788-8","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the scleral thickness of inactive scleritis characterized by a violaceous hue (violaceous sclera) using anterior segment optical coherence tomography (AS-OCT).</p><p><strong>Methods: </strong>Retrospective observational case series of patients with inactive unilateral anterior scleritis featuring a violaceous hue. Mean scleral thickness was measured by AS-OCT in violaceous areas and compared with the same region in the contralateral unaffected eye. Measurements were performed by two masked graders.</p><p><strong>Results: </strong>Nine patients with median age of 52 ± 12.8 years were assessed. Eight patients were female. Rheumatoid arthritis and history of treated latent tuberculosis (33.3%) were the most common causes of anterior scleritis. Mean scleral thickness was 582.93 ± 124.03 µm and 648.59 ± 103.61 µm for violaceous sclera and the corresponding unaffected areas of the contralateral eye, respectively (mean difference = -65.65 µm, 95% CI: -143.73 to 12.42, p = 0.0885). The mean image contrast percentage of scleral hyperreflectivity as assessed by image conversion in an area of violaceous hue was 65.07 µm ± 6.49 µm compared to 42.70 µm ± 5.46 µm of unaffected areas (mean difference = 22.37 µm, 95% CI: 14.72 µm to 30.03 µm, p = 0.0001).</p><p><strong>Conclusion: </strong>Using AS-OCT, the thicknesses of violaceous sclerae were not significantly thinner than the contralateral unaffected areas, despite a mean difference of approximately 65 microns. The increased scleral hyperreflectivity observed in the violaceous sclera may suggest collagen remodeling in these areas. Such remodeling could play a role in the sclera reflecting violaceous hues while still preventing direct visualization of the underlying choroid.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648279","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}