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

{"title":"One year follow up of descemet stripping only: corneal tomography changes and visual acuity outcomes.","authors":"Alberto Villarrubia Cuadrado, Álvaro Sánchez-Ventosa, Timoteo González-Cruces, Vanessa Díaz-Mesa, Marta Villalva-González, Elisa Palacín Miranda, María Dolores López Pérez, Javier Gersol Pérez-Angulo, José Carlos Díaz-Ramos, Antonio Cano-Ortiz","doi":"10.1007/s00417-025-06747-3","DOIUrl":"https://doi.org/10.1007/s00417-025-06747-3","url":null,"abstract":"<p><strong>Background: </strong>Descemet Stripping Only (DSO) is a minimally invasive procedure for Fuchs' Endothelial Corneal Dystrophy (FECD) that leverages peripheral endothelial regeneration without donor tissue. This study evaluates visual and anatomical outcomes of DSO and the role of guttae distribution in recovery.</p><p><strong>Methods: </strong>A prospective study included 30 eyes of FECD patients undergoing DSO. Patients were classified by guttae distribution: type A (central) or type B (0º-180º meridian). Preoperative and postoperative outcomes, including corrected distance visual acuity (CDVA), central corneal thickness (CCT), and endothelial cell density (ECD), were assessed over 12 months.</p><p><strong>Results: </strong>Of 26 patients completing follow-up, 42.31% achieved a CDVA ≥ 0.22 logMAR by week 4, and 84.62% by month 12. Type B patients recovered faster, reaching CDVA ≥ 0.10 logMAR in 56 days versus 112 days for type A. Mean CCT improved from 606.96 ± 60.97 μm to 550.40 ± 29.67 μm (p = 0.0001). Postoperative ECD averaged 1402.7 ± 130.56 cells/mm². Corneal densitometry improved significantly but remained higher than controls.</p><p><strong>Conclusions: </strong>DSO is an effective treatment for FECD with adequate peripheral endothelial reserve. Guttae distribution affects recovery speed, but final outcomes are similar. If no improvement occurs by the third month, a rescue DMEK is effective. Keratometry remains unchanged, epithelial thickness slightly increases, and corneal densitometry improves postoperatively.</p><p><strong>Key messages: </strong>What is know: DSO is a donor-free surgical option for endothelial dystrophies like Fuchs' dystrophy, utilizing the eye's natural endothelial regenerative capacity in selected patients. Success relies on residual endothelial cell density and biomarkers like preoperative corneal thickness to predict regeneration outcomes.</p><p><strong>What is new: </strong>Pattern of guttae distribution influences recovery timeline in DSO: Patients with type B guttae distribution (0º-180º meridian) achieve a CDVA of 0.1 logMAR faster than those with type A (central guttae), though finalvisual acuity, pachymetry, and endothelial cell density are similar at 12 months. DSO as an effective treatment for fuchs' endothelial corneal dystrophy: Descemet stripping only achieves corneal clearance in most cases within 3-4 months, with significant CDVA and quality of life improvements (NEI VFQ-25 scores), supporting its role as a minimally invasive alternative to donor graft surgeries.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014243","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":"Peripheral retinal and choroidal thickness of eyes with reticular pseudodrusen.","authors":"Je Moon Yoon, Hoon Noh, Seung Wan Nam, Don-Il Ham","doi":"10.1007/s00417-025-06842-5","DOIUrl":"https://doi.org/10.1007/s00417-025-06842-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the peripheral retinal and choroidal thicknesses in eyes with reticular pseudodrusen (RPD).</p><p><strong>Methods: </strong>Imaging data of ultrawide-field swept-source optical coherence tomography taken from 40 patients with age-related macular degeneration (AMD) were analyzed. Thirty-nine eyes of 20 patients had RPD (RPD group) and 39 eyes of 20 patients had no RPD (control group). Eyes with RPD were divided into localized/intermediate and diffuse types according to the fundus distribution. The retinal and choroidal thicknesses were measured at the fovea and six peripheral points in each eye, and the results were statistically analyzed.</p><p><strong>Results: </strong>The mean ages were 78.0 ± 6.1 years in the RPD group and 74.4 ± 7.2 years in the control group. The RPD group showed a thinner retina only at the nasal point (p = 0.002) than the control group. The choroid was significantly thinner in the RPD group than in the control group at most peripheral points, except for the far temporal and far inferior points. Diffuse and localized/intermediate types of RPD eyes showed no significant difference in choroidal thickness, except at the nasal point, which was thinner in the diffuse type (p = 0.049).</p><p><strong>Conclusion: </strong>In eyes with RPD, most peripheral retinal thicknesses were not different from those of eyes with AMD without RPD; however, most peripheral choroidal thicknesses were thinner regardless of the fundus distribution status of the RPD. Nasal choroidal thickness may be associated with RPD severity.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985387","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":"Vitrectomy with macular peeling in eyes with vitreomacular interface disorders and nonexudative age-related macular degeneration.","authors":"Marco Pellegrini, Ginevra Giovanna Adamo, Chiara Vivarelli, Laura Sarti, Pietro Maria Talli, Francesco Nasini, Francesco Parmeggiani, Marco Mura","doi":"10.1007/s00417-025-06848-z","DOIUrl":"https://doi.org/10.1007/s00417-025-06848-z","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to assess the outcomes of pars plana vitrectomy and macular peeling for vitreomacular interface disorders in eyes with coexisting nonexudative age-related macular degeneration (AMD), and to compare the rate of AMD progression in operated and fellow eyes.</p><p><strong>Methods: </strong>This retrospective comparative study included patients with bilateral nonexudative AMD and unilateral vitreomacular interface disorder who underwent pars plana vitrectomy with internal limiting membrane peeling. Controlateral unoperated eyes were used as a control group. Cox proportional hazards regression analysis was used to compare the incidence of macular neovascularization, geographic atrophy and progression to late AMD in operated eyes and fellow eyes.</p><p><strong>Results: </strong>142 eyes of 71 patients were included. The mean follow-up duration was 17.5 ± 15.5 months. Best corrected visual acuity significantly improved in operated eyes (from 0.47 ± 0.25 to 0.21 ± 0.18 logMAR; p < 0.001), while no significant difference was observed in fellow eyes (from 0.18 ± 0.22 to 0.33 ± 0.56 logMAR; p = 0.055). Central retinal thickness improved in operated eyes (from 0402.9 ± 79.9 to 296.1 ± 48.4 µm; p < 0.001), while no change in fellow eyes was observed (from 296.1 ± 48.4 to 312.7 ± 110.6 µm; p = 0.205). Vitrectomy was not associated with the risk of developing macular neovascularization (hazard ratio [HR] = 0.30; 95% confidence intervals (CI) = 0.08-1.09; p = 0.068); geographic atrophy (HR = 1.01, 95% CI = 0.32-3.12; p = 0.990) nor progression to late AMD (HR = 0.64, 95% CI = 0.28-1.49; p = 0.307).</p><p><strong>Conclusions: </strong>Pars plana vitrectomy with macular peeling for vitreomacular interface disorders in eyes with coexisting nonexudative AMD is associated with positive visual and functional outcomes, with no shot-term increased risk of AMD progression.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004056","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":"Adaptive optics cone arrangement in hydroxychloroquine users without signs of retinal toxicity based on current screening guidelines: a case-control study.","authors":"João Pedro Romero Braga, Moisés Moura Lucena, Murilo Wendeborn Rodrigues, Arthur Zupelli, Ingrid U Scott, André Messias, Denny Marcos Silva, Rodrigo Jorge","doi":"10.1007/s00417-025-06772-2","DOIUrl":"10.1007/s00417-025-06772-2","url":null,"abstract":"<p><strong>Purpose: </strong>To describe early cone changes detected by adaptive optics (AO) in patients on chronic hydroxychloroquine (HC) treatment with no abnormalities on standard functional or structural retinal tests.</p><p><strong>Methods: </strong>Case-control study including 36 eyes of 36 female patients. Cases included 18 women on HC for autoimmune disease whose cumulative dose exceeded 1600 g and who demonstrated no evidence of retinal toxicity on visual field (VF), spectral domain optical coherence tomography (SD-OCT), or multifocal electroretinography (mfERG). Controls included 18 women with no known systemic or ocular disease and no history of HC use. For each eye of every study participant, an image was captured using a commercially available flood-illuminated AO retinal camera (rtx1^TM,Imagine Eyes, France), at 2 degrees nasal and 2 degrees temporal to the fovea. The cone density and spacing measurements were automatically detected by the software provided by the RTX1 in a region of interest (ROI).</p><p><strong>Results: </strong>The control group exhibited mean nasal and temporal cone densities of 28,967 ± 1759 and 29,446 ± 1934 cells/mm², respectively, along with mean nasal and temporal spacing of 6.47 ± 0.19 and 6.43 ± 0.21 μm, respectively. The case group showed mean nasal and temporal cone densities of 26,967 ± 1667 and 26,099 ± 2052 cells/mm², respectively, and mean nasal and temporal spacing of 6.72 ± 0.20 and 6.84 ± 0.28 μm, respectively. A significantly (p < 0.01) lower density and larger spacing of cones were observed in the case group compared to the control group.</p><p><strong>Conclusions: </strong>AO may detect retinal changes from HC toxicity before they become apparent on VF, SD-OCT, or mfERG.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1279-1287"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398445","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":"Cataract surgery risk stratification models: a systematic review.","authors":"Chaerim Kang, Angela S Zhu, Olivia Waldman, T Michael Kashner, Paul B Greenberg","doi":"10.1007/s00417-025-06761-5","DOIUrl":"10.1007/s00417-025-06761-5","url":null,"abstract":"<p><strong>Purpose: </strong>Risk stratification models can assist cataract surgeons in clinical decision-making by categorizing patients into distinct groups based on their likelihood of complications. In this systematic review, we assess the characteristics of cataract surgery risk stratification models.</p><p><strong>Methods: </strong>Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we searched six databases (PubMed, OVID, Embase, CINAHL, Cochrane Trials, and Web of Science) in January 2024. We included peer-reviewed, full-text, English-language studies describing models used preoperatively to assess the likelihood of complications in cataract surgery. We excluded letters, editorials, and non-peer-reviewed publications, such as conference abstracts and studies describing predictive models that did not group the patients into distinct risk categories. We constructed a checklist from three frameworks to critically appraise the participants, predictors, and risk of bias in the models.</p><p><strong>Results: </strong>Of 4192 articles, eight met the inclusion criteria. Most models were designed for attending surgeons only and for phacoemulsification to predict zonular complications and posterior capsule rupture. The most common risk factors identified in the models were poor patient positioning, advanced age, small pupils, and pseudoexfoliation syndrome. Methodological limitations included the lack of multivariable modeling, standardized outcome measures, and external validation.</p><p><strong>Conclusion: </strong>Cataract surgeons should understand the limitations of cataract surgery risk stratification models. Existing models can be improved with more robust methods, the use of standardized metrics, and external validation.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1229-1238"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122555","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":"Emerging clinical evidence of a dual role for Ang-2 and VEGF-A blockade with faricimab in retinal diseases.","authors":"Varun Chaudhary, Florie Mar, Manuel J Amador, Andrew Chang, Kara Gibson, Antonia M Joussen, Judy E Kim, Junyeop Lee, Philippe Margaron, Insaf Saffar, David Wong, Charles Wykoff, Srinivas Sadda","doi":"10.1007/s00417-024-06695-4","DOIUrl":"10.1007/s00417-024-06695-4","url":null,"abstract":"<p><p>Anti-vascular endothelial growth factor (VEGF) therapies have transformed the treatment of retinal diseases. However, VEGF signaling is only one component of the complex, multifactorial pathophysiology of retinal diseases, and many patients have residual disease activity despite ongoing anti-VEGF treatment. The angiopoietin/tyrosine kinase with immunoglobulin and epidermal growth factor receptor-2 (Ang/Tie2) signaling pathway is critical to endothelial cell homeostasis, survival, integrity, and vascular stability. Ang-2 can interfere with Ang-1/Tie2 signaling and is increased in several retinal diseases. Lack of Tie2 signaling due to elevated Ang-2 levels drives vascular instability through pericyte dropout, neovascularization, vascular leakage, inflammation, and fibrosis. Although Ang-2 and VEGF can synergistically promote vascular instability and neovascularization, Ang-2 may also mediate vascular instability independently of VEGF. Faricimab is a bispecific antibody designed for intraocular use that inhibits two distinct pathways via Ang-2 and VEGF-A blockade. Clinical biomarkers of vascular instability are important for evaluating disease control and subsequent treatment decisions. These biomarkers include measurement/evaluation with optical coherence tomography (OCT) of intraretinal fluid, subretinal fluid, central subfield thickness, and pigment epithelial detachments (PEDs), and fluorescein angiography imaging of macular leakage and PEDs. Hyperreflective foci (HRF), thought to be representative of activated microglia, indicating an inflammatory microenvironment, and epiretinal membranes (ERMs), a marker for retinal fibrotic proliferation in diabetic macular edema (DME), are both also identified using OCT. Here we summarize data (secondary endpoint and prespecified exploratory analyses as well as post hoc analyses) from six Phase III trials suggest that dual therapy Ang-2/VEGF-A inhibition with faricimab (6 mg) has a greater effect on reducing/resolving biomarkers of vascular instability than aflibercept (2 mg), by both controlling neovascularization and vascular leakage (with resultant resolution of exudation associated with DME, neovascular age-related macular degeneration, and retinal vein occlusion), as well as by targeting inflammation (reduction of HRF in DME) and retinal fibrotic proliferation (reducing the risk of ERMs in eyes with DME). Modulation of both the Ang-2 and VEGF-A pathways with faricimab may therefore provide greater disease control than anti-VEGF monotherapy, potentially leading to extended treatment durability and improved long-term outcomes.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1239-1247"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871864","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":"Angiographic features of pediatric stage 4 familial exudative vitreoretinopathy with radial retinal folds.","authors":"Wenting Zhang, Xuerui Zhang, Haodong Xiao, Huanyu Liu, Yuan Yang, Jie Peng, Peiquan Zhao","doi":"10.1007/s00417-024-06668-7","DOIUrl":"10.1007/s00417-024-06668-7","url":null,"abstract":"<p><strong>Purpose: </strong>To describe vascular anomalies and nonperfusion areas (NPAs) of stage 4 familial exudative vitreoretinopathy (FEVR) with radial retinal folds (RFs) and analyze their potential clinical significance.</p><p><strong>Methods: </strong>Retinal detachment (RD) could exceed the RFs due to exudative, rhegmatogenous, or tractional factors, which we could call secondary RD. Fluorescein fundus angiography (FFA) and risk factors for progression to secondary RD of pediatric stage 4 FEVR patients with radial RFs were respectively explored.</p><p><strong>Results: </strong>Fifty-eight eyes with RFs from 49 stage 4 pediatric FEVR patients were studied. Various angiographic changes were noted, including peripheral NPAs (93.1%), thinning retinal arteries (48.3%), straightened retinal vessels (34.5%), supernumerary vascular branching (32.8%), arteriovenous shunt (20.7%), aberrant circumferential vessels (13.8%), bulbous vascular endings (10.3%) and peripheral vascular dilation (6.9%). Nineteen (35.2%), 21(38.2%), and 14 (25.9%) of 58 eyes showed severe, moderate, and mild peripheral NPAs, respectively. The rate of secondary RDwas higher in eyes with severe peripheral NPAs (p = 0.004). The severity of the nonperfusion area (p = 0.040) was higher in eyes with exudation. Eight eyes (42.1%) with exudation and 12 eyes (30.8%) without exudation on color fundus pictures exhibited fluorescein leakage (p = 0.394). The rate of secondary RD was 26.3% in eyes with exudation, and 2.6% in eyes without exudation (p = 0.012).</p><p><strong>Conclusions: </strong>The majority of stage 4 FEVR eyes with RFs have severe peripheral NPAs. Exudation is related to more severe peripheral NPAs. Exudation and NPAs are predictive factors for secondary RD.</p><p><strong>Key messages: </strong>What is known • Radial retinal folds are a typical clinical sign of FEVR, observed in 50.9% of FEVR patients, but little is known about the angiographic characteristics of these individuals. What is new • The severity of the nonperfusion area was graded into 3 levels. The severity of the nonperfusion area and hard exudation are risk factors for progression to total retinal detachment.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1469-1477"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784674","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":"Cushing's syndrome related to higher rates and earlier onset of cataract: A nationwide retrospective cohort study.","authors":"Yael Sharon, Tzipora Shochat, Yaron Rudman, Shiri Kushnir, Alon Zahavi, Ilan Shimon, Maria Fleseriu, Amit Akirov","doi":"10.1007/s00417-025-06752-6","DOIUrl":"10.1007/s00417-025-06752-6","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the risk of cataract in patients with Cushing's syndrome (CS) and evaluate whether disease onset occurs at an earlier age compared to general population.</p><p><strong>Methods: </strong>A nationwide retrospective matched-cohort study including individuals diagnosed with endogenous CS from 2000 to 2023. Patients with CS were matched in a 1:5 ratio with a control group individually matched for age, sex, socioeconomic status, and body mass index. The primary outcome was the incidence of cataract and cataract surgery. The Cox proportional hazards model, accounting for death without cataract as a competing risk, was employed to estimate hazard ratio.</p><p><strong>Results: </strong>The study cohort included 609 patients with CS, 65% women and 35% men, and 3018 controls. The average age at CS diagnosis was 48.1 ± 17 years. Follow-up duration was 14.6 years (IQR 9.8-20.2). The source of hypercortisolism was Cushing's disease (CD) in 259 (42.6%) and adrenal CS (aCS) in 206 patients (33.8%). After CS diagnosis, cataract was observed in 171 patients (28.1%), and 771 controls (25.5%). Patients with CS had a 34% higher risk of developing cataract compared to their matched controls (HR = 1.34, 95% CI 1.03-1.75, p = 0.03). Cataract developed earlier in patients with CS compared to controls, with a mean age of onset at 64.7 ± 9.7 versus 67.6 ± 8.4 years, respectively (p = 0.01). A total of 49 (8.05%) patients had undergone cataract surgery after a diagnosis of CS compared to 177 (5.86%) in the control group (p = 0.07).</p><p><strong>Conclusion: </strong>Patients with endogenous CS have an increased likelihood of developing cataracts and they experienced onset at a younger age. Guidelines should include annual cataract monitoring for CS patients, beginning 3-5 years earlier than the current general recommendations.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1345-1353"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023236","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":"Age-stratified anatomical differences of orbital floor and medial orbital wall blowout fractures.","authors":"Jose Miguel Ambat, Yasuhiro Takahashi","doi":"10.1007/s00417-024-06734-0","DOIUrl":"10.1007/s00417-024-06734-0","url":null,"abstract":"<p><strong>Purpose: </strong>To define the anatomical variance between orbital floor and medial orbital wall blowout fractures, and its change with age.</p><p><strong>Methods: </strong>This was a retrospective, observational study analyzing data from 557 patients with isolated blowout fractures of the orbital floor or medial orbital wall. Axial and quasi-sagittal CT images were analyzed to compare radiologic data on orbital wall morphology between fracture site groups and among age groups. Patient ages were classified as: 0-9 (childhood), 10-18 (adolescence), 19-44 (early adulthood), 45-64 (middle adulthood), and ≥ 65 years (late adulthood).</p><p><strong>Results: </strong>The orbital floor fracture group demonstrated significantly steeper orbital floors (p < 0.001), while the medial wall fracture group exhibited a tendency for more convex medial orbital walls (p = 0.066). Among age groups, medial wall fracture was predominant in the late adulthood group only (p < 0.001). Patients in the childhood and late adulthood groups had significantly flatter orbital floors (p < 0.001). Patients in the childhood group presented with a concave medial orbital wall (p < 0.001). The anteroposterior length of the medial orbital wall and the number of ethmoid air cells were not different between fracture groups (p = 0.603 and 0.753, respectively) and among age groups (p = 0.306 and 0.456, respectively).</p><p><strong>Conclusion: </strong>Patients with orbital floor and medial orbital wall fractures had anatomically steeper orbital floors and convex medial orbital walls, respectively. Age-related differences in the shape of the orbital walls may influence variation in orbital blowout fracture sites by age.</p><p><strong>Key messages: </strong>WHAT IS KNOWN : Fracture sites of the orbital walls differ according to age groups. The floor is more commonly fractured in children, with a shift to the medial wall in the elderly.</p><p><strong>What is new: </strong>Orbital floor and medial orbital wall fractures present with anatomically higher floor and medial walls, respectively, compared to each other.  This indicates steeper convexities of the walls which predispose them to fracturing. Children's medial orbital walls are initially concave, then shift to convex structures with facial bone and sinus maturation. This explains why there is a change in blowout fracture site between age groups, as it has been documented that concave structures are more resistant to deformation.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1443-1449"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947774","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":"Reexamine the link between retinal layer thickness and cognitive function after correction of axial length: the Beijing Eye Study 2011.","authors":"Zhe Pan, Zihan Li, Hui Xie, Yu Huang, Can Can Xue, Xiaodong Wu, Tien Yin Wong, Chun Zhang, Jost B Jonas, Ya Xing Wang","doi":"10.1007/s00417-025-06777-x","DOIUrl":"10.1007/s00417-025-06777-x","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the relationship between retinal layer thickness and cognitive function in elderly Chinese, accounting for the influence of axial length.</p><p><strong>Methods: </strong>The participants of the Beijing Eye Study 2011 which is a population-based cross-sectional study without any retinal or optic nerve disease underwent a series of ocular examinations including spectral-domain optical coherence tomography (OCT) of the retina. Using a multiple-surface OCT segmentation algorithm, the retina was automatically segmented into 9 layers. Cognitive function was evaluated applying the Mini Mental Statement Examination (MMSE). Cognitive impairment was defined as an MMSE score < 26.</p><p><strong>Results: </strong>The study included 2067 participants (56.7% women) (2067 eyes) with a mean age of 61.4 ± 8.4 years. After adjusting for age, gender and axial length, a lower cognitive function was related with a thinning of the ganglion cell layer (GCL) (P = 0.029, B = 0.04) and photoreceptor outer segment layer (POS) (P = 0.042, B = 0.04), while the retinal nerve fiber layer (RNFL) thickness (P = 0.144) was not significantly associated with the cognitive function score. For every unit decrease in MMSE score, the GCL and POS thickness separately decreased by 0.06 µm (95%CI: 0.01 µm, 0.12 µm), and 0.05 µm (95%CI: 0.002 µm, 0.10 µm). As compared with cognitively normal participants, those with cognitive impairment had a significantly thinner GCL (P = 0.019, OR = 1.04), and POS (P = 0.022, OR = 1.04) in multivariate logistic regression.</p><p><strong>Conclusion: </strong>After adding axial length as dependence in multivariate analysis, cognitive impairment was not significantly associated with the thickness of RNFL, while the association between a lower cognitive function score and thinner GCL and POS was statistically associated in current study.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1297-1305"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500632","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}