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

{"title":"Analysis of asymmetry in macular structure and function associated with ocular dominance.","authors":"Li Bao, Yutong Song, Xiaoyue Wang, Xi Huang","doi":"10.1007/s00417-025-06782-0","DOIUrl":"https://doi.org/10.1007/s00417-025-06782-0","url":null,"abstract":"<p><strong>Purpose: </strong>Research on the correlation between ocular dominance and macular structure and function is inconsistent. This clinical observational study explored the effect of ocular dominance on retinal structure and the correlation between binocular structural asymmetry and ocular dominance.</p><p><strong>Methods: </strong>Forty healthy young adults (aged 20-29 years) were enrolled. Ocular dominance, refractive error, pattern visual evoked potential (PVEP), multifocal electroretinography (mfERG), swept-source optical coherence tomography (SS-OCT), and optical coherence tomography angiography (OCTA)tests were performed.</p><p><strong>Results: </strong>Among the 40 subjects, 24 (60%) were right-eye dominant. The dominant eye had a larger amplitude density of Ring 1 in the mfERG (198.52 ± 51.43 vs. 175.92 ± 50.17, p = 0.003), larger density of the superficial capillary plexus of the macula within the 4-12 mm diameter range (dominant eyes vs. nondominant eyes: 4-6 mm: 80.89 (78.24,83.58) vs. 78.93 (74.85,81.77), p < 0.001; 7-9 mm: 73.01 (69.22,75.90) vs. 71.75 (69.43,74.37), p = 0.009; 10-12 mm: 55.79 ± 5.40 vs. 54.46 ± 7.03, p = 0.033), and a thicker choroidal layer (dominant eyes vs. nondominant eyes: 7-9 mm: 289.70 ± 58.85 vs. 279.86 ± 59.16, p = 0.045; 10-12 m: 270.05 ± 44.87 vs. 259.64 ± 43.50, p = 0.014). The right eye had a higher choroidal vascular density (right eyes vs. left eyes: 0-1 mm: 95.45 (84.56,98.67) vs. 91.04 (79.79,97.04), p = 0.018) and lower superficial retinal vascular density (right eyes vs. left eyes: 10-12 mm: 54.29 ± 5.98 vs. 55.82 ± 6.34, p = 0.027) and choroidal vascular density (right eyes vs. left eyes: 7-9 mm: 90.98 ± 2.89 vs. 92.18 ± 2.61, p = 0.041).</p><p><strong>Conclusion: </strong>Ocular dominance influenced macular foveal function, parafoveal vessel density and choroidal thickness. The functional and morphological differences in ocular dominance and laterality are inconsistent.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614651","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":"Assessment of intraorbital hydroxyapatite implant exposure beyond 10 years of implantation.","authors":"Xia Ding, Dai Su, Yuan Cao, Xiaowei Zhu, Yue Xing, Ming Lin, Jin Li","doi":"10.1007/s00417-025-06785-x","DOIUrl":"https://doi.org/10.1007/s00417-025-06785-x","url":null,"abstract":"<p><strong>Background: </strong>To analyze intraorbital Hydroxyapatite(HA) implant exposure occurring beyond ten years of implantation and suggest potential contributing factors.</p><p><strong>Design: </strong>A retrospective cohort study based in the Shanghai Ninth People's Hospital.</p><p><strong>Methods: </strong>One hundred and one Chinese patients with HA implant exposure were identified, from which 38 patients with implants exposure after ten years of insertion were selected and analyzed for demographic and medical records, clinical manifestations, surgery type, implant size, exposure area, follow-up duration, complications, details regarding prosthesis care, and treatment methods. All of the removed implants were sent for an HE pathologic examination.</p><p><strong>Results: </strong>The 38 cases experienced exposure 10 to 19 years after implantation and presented to the clinic with increased secretions, proliferation of granulation tissue, visible suture exposure, and difficulty in wearing the external prosthesis. Other complications included implant forward position in 3 patients, eyelid retraction in 4 patients, and all the patients presented with post-enucleation socket syndrome. Reviewing the medical history, HA implant sizes ranged from 18 to 22 mm. Fourteen patients underwent implant repair surgery, of which 2 experienced recurrence, and ultimately, 26 implants were removed. Of the 26 removed implants, histologic examination showed that 17 exhibited chronic infection, and 12 had limited fibrovascular ingrowth. The questionnaires indicated that 26 patients did not renew the external prosthesis regularly.</p><p><strong>Conclusion: </strong>This study identified late complications and potential risk factors for implant exposure beyond ten years of implantation, including chronic infection, non-absorbable sutures, and low and delayed vascularization.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604686","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":"Modified double-flanged technique in the management of dislocated posterior intraocular lenses.","authors":"Mehmet Icoz, Sevde Akcay Usta","doi":"10.1007/s00417-025-06795-9","DOIUrl":"https://doi.org/10.1007/s00417-025-06795-9","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the modified double-flanged technique in cases of subluxated foldable single-piece intraocular lenses (IOLs).</p><p><strong>Methods: </strong>This retrospective study was conducted on 14 eyes of 14 patients.The following steps were performed in the surgical technique, respectively;the dislocated foldable single-piece IOL was repositioned into the anterior chamber, and the haptic was extracted through the corneal main incision.A 27-gauge needle was passed through the widest part of the haptic, close to the haptic-optic junction.A 6.0 polypropylene suture was passed through the needle. For the same process on the other haptic, the IOL was rotated 180 degrees.The polypropylene part of the created haptic-polypropylene complex was extracted through the scleral tunnel using a 26-gauge needle as a guide. The 1.5 mm tips of the polypropylene were cauterized to form flanges, which were then embedded into the sclera. The preoperative and postoperative first and sixth month ophthalmological findings were evaluated.</p><p><strong>Results: </strong>Both uncorrected visual acuity and best-corrected visual acuity were significantly higher at the postoperative sixth-month follow-up(p < 0.001).Possible causes of IOL subluxation; were pseudoexfoliation in five patients (36%),complicated cataract surgery in three patients (21%),trauma in two patients (14%) and no cause was found in four patients (29%). Of the 28 flanges, 24 (86%) were located intrasclerally, while four (14%) were in the subtenon space.Elevated intraocular pressure was detected in one case (7%) in the early postoperative period, and cystoid macular edema was noted in two cases (14%).</p><p><strong>Conclusion: </strong>This study demonstrated that the modified double-flanged technique could be effectively and safely applied in cases of subluxated foldable single-piece IOL.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604687","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":"Imaging biomarkers and artificial intelligence for diagnosis, prediction, and therapy of macular fibrosis in age-related macular degeneration: Narrative review and future directions.","authors":"Rishikesh Gandhewar, Thales Guimaraes, Sagnik Sen, Nikolas Pontikos, Ismail Moghul, Theodoros Empeslidis, Michel Michaelides, Konstantinos Balaskas","doi":"10.1007/s00417-025-06790-0","DOIUrl":"https://doi.org/10.1007/s00417-025-06790-0","url":null,"abstract":"<p><p>Macular fibrosis is an end-stage complication of neovascular Age-related Macular Degeneration (nAMD) with a complex and multifactorial pathophysiology that can lead to significant visual impairment. Despite the success of anti-vascular endothelium growth factors (anti-VEGF) over the last decade that revolutionised the management and visual prognosis of nAMD, macular fibrosis develops in a significant proportion of patients and, along with macular atrophy (MA), is a main driver of long-term vision deterioration. There remains an unmet need to better understand macular fibrosis and develop anti-fibrotic therapies. The use of imaging biomarkers in combination with novel Artificial Intelligence (AI) algorithms holds significant potential for improving the accuracy of diagnosis, disease monitoring, and therapeutic discovery for macular fibrosis. In this review, we aim to provide a comprehensive overview of the current state of knowledge regarding the various imaging modalities and biomarkers for macular fibrosis alongside outlining potential avenues for AI applications. We discuss manifestations of macular fibrosis and its precursors with diagnostic and prognostic significance on various imaging modalities, including Optical Coherence Tomography (OCT), Colour Fundus Photography (CFP), Fluorescein Angiography (FA), OCT-Angiography (OCTA) and collate data from prospective and retrospective research on known biomarkers. The predominant role of OCT for biomarker identification is highlighted. The review coincides with a resurgence of intense research interest in academia and industry for therapeutic discovery and clinical testing of anti-fibrotic molecules.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585526","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":"Comparable choroidal thickness between treated eyes and untreated fellow-eyes in patients with unilateral neovascular AMD: a paired-eyes comparative study.","authors":"Francesco Cinque, Femke M van den Tillaert, Suzanne Yzer, Anita de Breuk, Tom J Heesterbeek, Carel B Hoyng, Yara Te Lechanteur","doi":"10.1007/s00417-025-06751-7","DOIUrl":"10.1007/s00417-025-06751-7","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the potential effect of anti-VEGF treatment on choroidal thickness (CT) in unilateral neovascular age-related macular degeneration (AMD) patients.</p><p><strong>Method: </strong>This is a cross-sectional study where patients were included as part of an ongoing prospective study which included patients with unilateral neovascular (n) AMD. The fellow-eye served as control. All patients had spectral-domain optical coherence tomography (SD-OCT) with enhanced depth imaging (EDI) done at every visit. CT was measured independently by two graders at five locations: subfoveal, 1500 micron temporal and nasal, 3000 micron temporal and nasal. The average of the measurements was used after statistical verification of their accuracy. CT differences were initially analysed via a paired T-test and later via multiple linear regression. Variables such as number of injections were studied and presence of geographic atrophy (GA) in fellow-eyes was evaluated via SD-OCT.</p><p><strong>Results: </strong>A total of 112 patients met the inclusion criteria (Female 67%). The median (IQR) years of treatment was 2.6 (4.1). The subfoveal choroidal thickness (SFCT) in the neovascular (NV) eye appeared thinner in the NNV eye initially (-11.0 μm difference between NV and NNV SFCT (CI -23.4 to 1.3). However, after age-adjustment this trend disappeared (CI -29.8 to 4.6). In fact, apart from age (CI -6.2 to -0.1)), no other variable including number of anti-VEGF injections (CI -1.5 to 1.4) predicted SFCT. Presence of GA in fellow eyes did not influence the SFCT compared to non-GA fellow eyes, difference (CI -59.7 to 46.6).</p><p><strong>Conclusions: </strong>This study shows no statistically significant CT difference in NV versus NNV eyes. There was no relationship between number of injections and CT.</p><p><strong>Key messages: </strong>What is known Intravitreal injection with anti-vascular endothelial growth factors (anti-VEGF) is the mainstay treatment for exudation secondary to neovascular AMD. One quarter of anti-VEGF treated neovascular AMD patients will develop signs of macular atrophy within 2 years, possibly related to anti-VEGF treatment. What this study adds A hypothesized mechanism for atrophy induction is the effect of anti-VEGF on choroidal thickness. In this cross-sectional study, we found a non-significant 11 micron difference between anti-VEGF treated eyes and non-treated eyes in long-term follow-up neovascular AMD patients. A relationship between choroidal thinning and the number of anti-VEGF injections was furthermore not shown. How this study might affect research, practice or policy There is no significant choroidal thickness difference between anti-VEGF treated and non-treated long-term follow-up neovascular AMD. We therefore suggest that atrophy induction through choroidal thinning secondary to anti-VEGF injections is of limited concern.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582278","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":"Impact of the COVID-19 pandemic on glaucoma surgery in German hospitals.","authors":"Philip Keye, Charlotte Evers, Timothy Gläser, Philip Braun, Patrick Thelen, Daniel Böhringer, Stefan Johann Lang, Thomas Reinhard, Jan Lübke","doi":"10.1007/s00417-025-06787-9","DOIUrl":"https://doi.org/10.1007/s00417-025-06787-9","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the quantitative changes in surgical glaucoma care in German hospitals between 2019 and 2022 with special focus on the impact of the COVID-19 pandemic on overall volume and trends within glaucoma surgery.</p><p><strong>Methods: </strong>The quality reports of The Federal Joint Committee (G-BA), containing information on the quantity of surgical glaucoma procedures of 296 German hospitals were obtained in machine-readable form for the years 2019, 2020, 2021 and 2022. We analyzed the annual numbers and proportions of different glaucoma surgery types as categorized by German OPS codes, with special focus on 2020, the first year of the COVID-19 pandemic in Germany.</p><p><strong>Results: </strong>The total number of surgical glaucoma procedures in German hospitals in 2020 decreased by 8.5% compared to 2019 and recovered to pre-pandemic levels in 2021. Within filtration surgery, the number of classic trabeculectomy steadily declined while bleb-forming filtration devices were used more frequently. In all four years, cyclodestructive procedures were the most frequently performed interventions overall.</p><p><strong>Conclusion: </strong>The impact of the COVID-19 pandemic on overall surgical volume, especially in 2020, was substantial but overall moderate and transient. The trend towards minimally invasive procedures and bleb-forming filtration devices accelerated after 2020, resulting in a pronounced decline of classic filtration surgery, such as trabeculectomy.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572793","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 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}