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

{"title":"Real-world performance of the inflammadry test in dry eye diagnosis: an analysis of 1,515 patients.","authors":"Germán Mejía-Salgado, William Rojas-Carabali, Carlos Cifuentes-González, Laura Zárate-Pinzón, Camilo Andrés Rodríguez-Rodríguez, Guillermo Marroquín-Gómez, Martha Lucía Moreno-Pardo, Juliana Tirado-Ángel, Alejandra de-la-Torre","doi":"10.1007/s00417-025-06760-6","DOIUrl":"https://doi.org/10.1007/s00417-025-06760-6","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the diagnostic performance of the InflammaDry test in diagnosing dry eye disease (DED) using different diagnostic criteria and across varying severities.</p><p><strong>Methods: </strong>A retrospective study was conducted on 1,515 patients. Subjects were categorized into three groups: Group (1) DED based on Dry Eye Workshop-II (DEWS-II): Ocular Surface Disease Index (OSDI) ≥ 13 and at least one abnormal clinical sign (non-invasive tear break-up time [NIBUT] < 10 s, osmolarity > 308 mOsm/L, or corneal/conjunctival staining). Group (2) DED based on criteria used in prior clinical trials: OSDI > 13, Schirmer < 10 mm in 5 min, NIBUT < 10 s, and keratoconjunctival staining. Group (3) Healthy controls: OSDI ≤ 7, NIBUT ≥ 10 s, Schirmer ≥ 10 mm, and no keratoconjunctival staining. DED severity was classified using the ODISSEY European Consensus Group's definitions into severe and non-severe. Sensitivity, specificity, and predictive values were calculated for both criteria.</p><p><strong>Results: </strong>1,363 patients were included in Group 1, 401 in Group 2, and 152 in Group 3. Sensitivity was 81.30% in the population diagnosed using previous clinical trial criteria but decreased to 69.99% when applying the DEWS-II criteria. Specificity was 38.16% in both groups, with 409/467 false negatives respectively.</p><p><strong>Conclusion: </strong>InflammaDry shows good sensitivity in detecting DED in highly symptomatic cases with multiple clinical signs, but its performance decreases when broader criteria like DEWS-II are used. While valuable for detecting inflammation, routine use for DED diagnosis may lead to false negatives, especially in milder cases.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556680","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":"Analysis of prognostic factors in acute retinal necrosis using ultrawide-field fundus imaging.","authors":"Hyun Jee Kim, Tae Gyu Moon, Kyung Chul Yoon, Yong-Sok Ji","doi":"10.1007/s00417-025-06789-7","DOIUrl":"https://doi.org/10.1007/s00417-025-06789-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify prognostic factors for retinal detachment (RD) and final best corrected visual acuity (BCVA) in acute retinal necrosis (ARN) patients using ultrawide-field (UWF) fundus imaging.</p><p><strong>Methods: </strong>This retrospective study included 29 eyes of 25 patients diagnosed with ARN. Clinical data, including symptom duration before presentation, initial and final BCVA, anterior chamber (AC) cell grade, and vitreous opacity grade, were collected. Based on the UWF fundus imaging, the presence of arterial obliteration and the extent of retinal necrosis were analyzed to identify risk factors for RD by categorizing patients into the RD and no RD groups.</p><p><strong>Results: </strong>The mean final BCVA was 0.72 ± 0.77 logarithm of the minimum angle of resolution (logMAR), and RD occurred in 20 eyes (70.0%). Final BCVA showed a significant difference between the RD and no RD groups. AC cell grade was significantly associated with both RD development and final BCVA (p = 0.035, p = 0.015, respectively). Arterial obliteration, fan-shaped necrotic lesions, and greater clock hours of retinitis were significantly related to RD development (p = 0.016, p = 0.001, p = 0.018, respectively). The retinitis zone was significantly correlated with final BCVA (p = 0.007). Additionally, BCVA before and at RD diagnosis showed a significant association with final BCVA.</p><p><strong>Conclusions: </strong>UWF imaging is useful for the prognosis prediction in ARN patients. Identifying characteristic UWF findings, such as arterial obliteration and extent of necrosis, can aid in predicting RD risk and visual outcomes, improving clinical management of ARN.</p><p><strong>Key messages: </strong>WHAT IS KNOWN : Acute retinal necrosis (ARN) is a rapidly progressing inflammatory condition characterized by necrotizing retinitis and vasculitis. Retinal detachment (RD) is a common late complication of ARN, often leading to poor visual prognosis.</p><p><strong>What is new: </strong>Ultrawide-field (UWF) imaging is useful for the prognosis prediction of ARN. UWF image analysis identified arterial obliteration, fan-shaped necrotic lesions, and an increased number of clock hours affected by retinitis as significant risk factors for the development of RD in ARN. Additionally, the zone of necrotic retinitis was strongly associated with the final best corrected visual acuity (BCVA) in ARN patients.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541153","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":"Prediction of short-term anatomic prognosis for central serous chorioretinopathy using a generative adversarial network.","authors":"Ho Ra, Donghyun Jee, Suyeon Han, Seung-Hoon Lee, Jin-Woo Kwon, Yunhea Jung, Jiwon Baek","doi":"10.1007/s00417-025-06786-w","DOIUrl":"https://doi.org/10.1007/s00417-025-06786-w","url":null,"abstract":"<p><strong>Purpose: </strong>To train generative adversarial network (GAN) models to generate predictive optical coherence tomography (OCT) images of central serous chorioretinopathy (CSC) at 3 months after observation using multi-modal OCT images.</p><p><strong>Methods: </strong>Four hundred forty CSC eyes of 440 patients who underwent Cirrus OCT imaging were included. Baseline OCT B-scan images through the foveal center, en face choroid, and en face ellipsoid zone were collected from each patient. The datasets were divided into training and validation (n = 390) and test (n = 50) sets. The input images for each model comprised either baseline B-scan alone or a combination of en face choroid and ellipsoid zones. Predictive post-treatment OCT B-scan images were generated using GAN models and compared with real 3-month images.</p><p><strong>Results: </strong>Of 50 generated OCT images, there were 48, 47, and 48 acceptable images for UNIT, CycleGAN, and RegGAN, respectively. In comparison with real 3-month images, the generated images showed sensitivity, specificity, and positive predictive values (PPV) for residual fluid in the ranges of 0.762-1.000, 0.483-0.724, and 0.583-0.704; for pigment epithelial detachment (PED) of 0.917-1.000, 0.974-1.000, and 0.917-1.000; and for subretinal hyperreflective material (SHRM) of 0.667-0.778, 0.925-0.950 and 0.700-0.750, respectively. RegGAN exhibited the highest values except for sensitivity.</p><p><strong>Conclusions: </strong>GAN models could generate prognostic OCT images with good performance for prediction of residual fluid, PED, and SHRM presence in CSC. Implementation of the models may help predict disease activity in CSC, facilitating the establishment of a proper treatment plan.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541155","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":"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":" ","pages":"647-657"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","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":"Association between axial length and uveitis.","authors":"Marina Ogawa, Yoshihiko Usui, Kinya Tsubota, Hiroshi Goto","doi":"10.1007/s00417-024-06655-y","DOIUrl":"10.1007/s00417-024-06655-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Multiple studies have examined the association between myopia and various ocular diseases, but there is no clinical report of the relationship between myopia and uveitis. This study aimed to elucidate the relationship between myopia and uveitis by comparing axial lengths (AL) of uveitis patients with control individuals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study included 1052 eyes (663 patients; 288 males, 375 females; median age 56.0 years) with uveitis referred to Tokyo Medical University Hospital. Controls were 738 eyes with cataract but no other ocular diseases. AL was measured by IOLMaster or conventional A-mode ultrasound system. Uveitis eyes were grouped into various types of non-infectious uveitis, infectious uveitis, and unidentified uveitis. Median AL of each uveitis group was compared with control group using Mann-Whitney U-test, and also compared with adjustment for age and sex using multiple regression analysis. Binary logistic analysis was performed to examine whether AL plays a role in the risk of developing uveitis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 1052 eyes, 808 eyes (76.8%) were diagnosed with non-infectious uveitis [sarcoidosis (176 eyes, 16.7%), Vogt-Koyanagi-Harada disease (122 eyes, 11.6%), Behçet's disease (130 eyes, 12.4%), and others (380 eyes, 36.1%)], 146 eyes (13.9%) with infectious uveitis, and 98 eyes (9.3%) with unidentified uveitis. Median AL in all uveitis eyes was significantly shorter than in control eyes (23.73 vs 24.31 mm, p &lt; 0.001 unadjusted), and AL remained significantly shorter in uveitis than in control after age- and sex-adjustment (p &lt; 0.001). Median AL was significantly shorter in non-infectious uveitis (23.72 mm) and in infectious uveitis (23.99 mm) compared to controls (p &lt; 0.001 and &lt; 0.05, respectively), and was significantly shorter in non-infectious uveitis than in infectious uveitis (p &lt; 0.05). Each millimeter decrease in AL was associated with 1.266-fold increase in unadjusted risk [odds ratio (OR), 1.266; 95% confidence interval (CI), 1.196-1.341; p &lt; 0.001) and 1.446-fold in age- and sex-adjusted risk (OR, 1.446; 95% CI, 1.349-1.549; p &lt; 0.001) of developing uveitis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Median AL of uveitis eyes with infectious or non-infectious etiologies was significantly shorter than that in control eyes, suggesting an increased risk of developing uveitis in eyes with shorter AL. This feature should be considered when exploring new pathogenetic mechanisms of uveitis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key messages: &lt;/strong&gt;What is known Shorter axial length may be associated with the pathogenesis of central serous chorioretinopathy and increased risk of early age-related macular degeneration. What is new Here we assessed the relationship between myopia and uveitis by comparing axial lengths of uveitis patients. Median axial length in all uveitis eyes was significantly shorter than in control eyes, and axial length remained significantly shorter in uveitis than i","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"837-847"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463305","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":"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":"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":" ","pages":"735-743"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953155/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between asymmetric stress distribution on the lamina cribrosa and glaucoma progression.","authors":"Edward Kang, Ji-Hye Park, Chungkwon Yoo, Yong Yeon Kim","doi":"10.1007/s00417-024-06670-z","DOIUrl":"10.1007/s00417-024-06670-z","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess the effect of ocular movements on the progression of glaucoma.</p><p><strong>Methods: </strong>A total of 118 primary open-angle glaucoma patients were enrolled, comprising 71 patients in the progression group and 47 patients in the non-progression group. Utilizing three geometric parameters-axial length, optic disc radius, and optic cup deepening-a personalized virtual optic nerve head (ONH) model was designed. ONH biomechanical changes during ocular movement were simulated using a finite element analysis. Simulation results were analyzed and compared between the progression and non-progression groups.</p><p><strong>Results: </strong>In both progression and non-progression groups, ONH strains significantly increased with increasing rotation angle. When the eye rotated by 10°, the stress on the anterior surface of the lamina cribrosa on the temporal side was significantly higher in the progression group compared to the non-progression group (16.19 ± 0.90 kPa vs. 13.24 ± 3.00 kPa, P < 0.001). The stress ratio, indicating asymmetric stress distribution, was higher in the progression group than in the non-progression group (0.56 ± 0.13 vs. 0.49 ± 0.19, P = 0.018). Stress ratio significantly increased with increasing optic disc radius (standardized β = 0.303, P < 0.001) and optic cup deepening (standardized β = 0.538, P < 0.001).</p><p><strong>Conclusions: </strong>Asymmetric stress distribution with ocular movement was higher in the progression group. This asymmetry was associated with optic disc radius and optic cup deepening. Therefore, ocular movement may contribute to the progression of glaucoma, with ONH geometry playing a role.</p><p><strong>Key messages: </strong>WHAT IS KNOWN : Ocular movement is considered one of the physical stress factors affecting the optic nerve head.</p><p><strong>What is new: </strong>Ocular movement increased the strain on the optic nerve head and resulted in an asymmetric stress distribution on the lamina cribrosa surface. Asymmetric stress distribution on lamina cribrosa with ocular movement was higher in the glaucoma progression group and associated with optic disc radius and optic cup deepening.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"819-828"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545111","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":"Effect of Fresnel prism in small-angle esotropia (≤ 20 prism diopters) with fixation preference.","authors":"Hye Jun Joo, Seong-Joon Kim","doi":"10.1007/s00417-024-06662-z","DOIUrl":"10.1007/s00417-024-06662-z","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to investigate the effects of Fresnel prism treatment for small-angle esotropia (≤ 20 prism diopters [PD]) with fixation preference.</p><p><strong>Methods: </strong>We included 32 patients with remaining esotropia ≤ 20 PD measured using the simultaneous prism and cover test (SPCT) after full refractive error correction. Fresnel prism was applied to make patients orthotropic with glasses. Treatment was discontinued if remaining esotropia ≤ 4 PD was sustained during two consecutive follow-ups (2-month intervals) or if the angle continued to increase with prism adaptation. Patients were divided into treatment success and failure groups. Treatment success was defined by motor and visual acuity (VA) aspects. Criteria for motor success was residual esotropia ≤ 8 PD in patients with initial esotropia > 8 PD and a 30% decrease of esotropia in those with initial esotropia ≤ 8 PD. VA success was improvement of > 0.2 logMAR in the non-dominant eye.</p><p><strong>Results: </strong>The initial esodeviation angle was 6.92 ± 4.66 PD at distance and 10.53 ± 5.58 at near. The logMAR VA was 0.10 ± 0.13 and 0.26 ± 0.20 in the dominant and non-dominant eye, respectively. Among the 32 patients, 14 showed motor success. Among 26 patients whose VA could be measured, 15 showed VA success. Factors influencing motor success were a small amount of maximum prescribed Fresnel prism, less frequent need for Fresnel prism adaptation, and high percentage of achieving orthotropia with Fresnel prism treatment. VA success was influenced by low frequency of anisometropia and the small amount of maximum prescribed Fresnel prism.</p><p><strong>Conclusion: </strong>Fresnel prism could be a non-invasive treatment option for some patients with small-angle esotropia with fixation preference.</p><p><strong>Key messages: </strong>What is known The optimal approach for addressing small-angle esotropia is a topic of debate. Not much research has been conducted on Fresnel prism treatment in patients with small-angle esotropia. What is new Motor success and visual acuity improvement were observed in some patients undergoing Fresnel prism treatment. Factors contributing to motor success were the small maximum angle of esodeviation, the less frequent necessity for Fresnel prism adaptation, and the achievement of orthotropia during Fresnel prism treatment. Visual acuity improvement was hindered by the presence of anisometropia and the large maximum prescribed amount of Fresnel prism. Fresnel prism treatment can be used as a treatment option for some patients with small-angle esotropia with fixation preference.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"857-865"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463307","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":"Clinical and imaging characteristics associated with foveal neovascularization in proliferative diabetic retinopathy.","authors":"Melissa Yuan, Francesco Romano, Xinyi Ding, Mauricio Garcia, Itika Garg, Katherine Millner Overbey, Cade Bennett, Ioanna Ploumi, Isabella Stettler, Ines Lains, Filippos Vingopoulos, Jocelyn Rodriguez, Nimesh A Patel, Leo A Kim, Demetrios G Vavvas, Deeba Husain, Joan W Miller, John B Miller","doi":"10.1007/s00417-024-06660-1","DOIUrl":"10.1007/s00417-024-06660-1","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the prevalence of foveal neovascularization (FNV) and its associated clinical features in proliferative diabetic retinopathy (PDR) eyes.</p><p><strong>Methods: </strong>Cross-sectional observational study. Participants underwent ultra-widefield photography, optical coherence tomography (OCT), and swept-source OCT angiography (SS-OCTA). FNV was defined as a hyperreflective lesion breaching the internal limiting membrane and displaying flow signal on OCTA, within 1-mm of foveal avascular zone. Vascular metrics were obtained from the ARI Network portal. Ischemic index (ISI) and inner choroid flow deficit percentage were calculated using FIJI from 12 × 12 and 6 × 6-mm scans, respectively. Logistic regression models were used to compare eyes with and without FNV.</p><p><strong>Results: </strong>We included 249 eyes of 164 patients (age: 58 [50-65] years). FNV was identified in 20 eyes (8%). Univariate logistic regression revealed significant associations between FNV and younger age (p = 0.03), higher maximal HbA1c (p = 0.04), worse visual acuity (VA) (p = 0.01), presence of disorganization of retinal inner layers (DRIL) (p = 0.01), no macular posterior vitreous detachment (PVD) (p = 0.03), neovascularization elsewhere (NVE) and at the disc (NVD) (p = 0.01 and p = 0.001), and greater ISI (p = 0.04). In multivariable analysis, a significant association remained between FNV and worse VA (p = 0.04), NVD (p < 0.001), DRIL (p < 0.001), and absence of macular PVD (p = 0.01). No associations were found with SS-OCTA vascular metrics.</p><p><strong>Conclusions: </strong>This study provides a comprehensive characterization of FNV in PDR. FNV was identified in 8% of our cohort, being more prevalent in younger patients with severe PDR, as evidenced by NVD and DRIL presence. The absence of macular PVD may explain its association with younger age.</p><p><strong>Key messages: </strong>What is known • Neovascularization at the fovea occurs rarely in proliferative diabetic retinopathy. • OCT and OCT-angiography can be used to evaluate foveal neovascularization, which may be associated with choroidal vascular abnormalities. What is new • Foveal neovascularization was seen in 8% of eyes with proliferative diabetic retinopathy in this cohort. • Risk factors for foveal neovascularization included younger age, absence of macular posterior vitreous detachment, presence of neovascularization of the disc, and presence of disorganization of retinal inner layers. • We did not identify an association between foveal neovascularization and choroidal perfusion abnormalities in this study.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"679-687"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618738","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":"Real-world therapy and persistence of patients with neovascular age-related macular degeneration and diabetic retinopathy or diabetic macular edema: a German claims data analysis.","authors":"Julia Krieger, Oliver Cox, Jan-Paul Flacke, Lena Beilschmidt, Sabrina Mueller, Ulf Maywald, Michael Janusz Koss","doi":"10.1007/s00417-024-06690-9","DOIUrl":"10.1007/s00417-024-06690-9","url":null,"abstract":"<p><strong>Purpose: </strong>Vascular endothelial growth factor (VEGF) inhibition is the current and high-volume standard-of-care for patients with neovascular age-related macular degeneration (nAMD) and diabetic retinopathy (DR) with diabetic macular edema (DME). This study assessed the impact of non-persistence in anti-VEGF treatment using claims data from two German states.</p><p><strong>Methods: </strong>This study identified adults with nAMD or DR/DME and incident anti-VEGF treatment (= index) in January 2015-June 2019 using the German AOK PLUS claims database (January 2014-June 2021, ~ 3.5 million insured). Baseline characteristics were observed within 12 months before index. Patient follow-up lasted ≥ 24 months or until death. Non-persistence (gap of ≥ 180 days) was calculated using Kaplan-Meier estimation. Cox regression identified variables linked to non- persistence. The study analysed reimbursed anti-VEGF treatments, thus excluding off-label use of bevacizumab.</p><p><strong>Results: </strong>5,498 patients diagnosed with nAMD (mean age, 80.09 years; male, 37.50%; mean Charlson Comorbidity Index [CCI] score, 3.07) and 484 patients with DR/DME (mean age, 67.14; male, 58.88%; mean CCI score, 4.54) were identified. Non-persistence to anti-VEGF treatment within 12 months after index occurred in 51.38% of nAMD patients and 62.60% of DR/DME patients, with mean times to first gap of 11.28 and 8.98 months, respectively. Cox regression revealed factors associated with non-persistence, including higher age, female gender, higher care needs, longer AMD history, and the use of ranibizumab.</p><p><strong>Conclusion: </strong>Epidemiologic and ophthalmologic factors associated with anti-VEGF non-persistence were successfully identified in the first year of therapy. The analyzed dataset can potentially be enriched with additional health insurance database sets under the used criteria to gain more understanding of anti-VEGF non-persistence.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"713-725"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716081","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}