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

{"title":"A cost-minimization analysis of anti-VEGFs for the treatment of neovascular age-related macular degeneration in the Netherlands.","authors":"Sara W Quist, Hidde Nab, Maarten Postma, Sankha Amarakoon, Freekje van Asten, Roel Freriks","doi":"10.1007/s00417-024-06588-6","DOIUrl":"10.1007/s00417-024-06588-6","url":null,"abstract":"<p><strong>Objective: </strong>Age-related macular degeneration (AMD) is the main cause of severe vision loss globally. Neovascular AMD (nAMD) is an advanced stage of AMD treated with anti-vascular endothelial growth factors (anti-VEGFs). Although anti-VEGF treatment is effective, the frequent intravitreal injections place a burden on patients, (in)formal caregivers, and clinics. This study assesses the health-economic impact of anti-VEGF agents with lower injection frequency that have the potential to reduce treatment burden and compares it to the standard of care.</p><p><strong>Methods: </strong>We developed a cost-minimization model to evaluate the direct medical costs associated with first-line unilateral anti-VEGF treatment across a 3-year time horizon in the Netherlands. The analysis compared aflibercept 8 mg, aflibercept 2 mg, bevacizumab, faricimab, and ranibizumab. Our model adopted a treat-and-extend (T&E) regimen for aflibercept 2 mg, bevacizumab, and ranibizumab. For aflibercept 8 mg, a flexible regimen that was extendable up to 24 weeks was applied, while faricimab followed a flexible regimen that was extendable up to 16 weeks. Additionally, since list prices may vary from net prices, we calculated the break-even price for each anti-VEGF in comparison to bevacizumab, which is the recommended first-line treatment due to its low medication price.</p><p><strong>Results: </strong>Based on list prices, aflibercept 8 mg led to the lowest treatment costs (€16,251 per patient over a 3-year time horizon), closely followed by bevacizumab (€17,616 per patient over a 3-year time horizon). Ranibizumab led to the highest per-patient costs (€31,746 over a 3-year time horizon). For bevacizumab, most costs were attributable to administration, while for the other anti-VEGFs, most were attributable to medication. Aflibercept 8 mg is cost-saving compared to bevacizumab at their medication prices at the time of writing. Aflibercept 2 mg, faricimab, and ranibizumab should be priced below €488, €591, and €75, respectively. To be cost-equal to bevacizumab with current list prices, anti-VEGFs should be administered with a maximum of 12.7 to 13.8 injections over a 3-year time horizon.</p><p><strong>Conclusion: </strong>According to the injection frequency observed in clinical trials, aflibercept 8 mg would be the anti-VEGF that generates the lowest per-patient healthcare costs for the treatment of nAMD in the Netherlands after a treatment period of three years. Our study indicates that anti-VEGF drugs with a lower injection frequency might provide a cost-saving solution to the increasing burden of anti-VEGF treatment on the healthcare system.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"327-345"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345148","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":"Negative impact of internal limiting membrane peeling in vitreous hemorrhage secondary to retinal vein occlusion with macular ischemia.","authors":"Akihiko Shiraki, Nobuhiko Shiraki, Kazuichi Maruyama, Taku Wakabayashi, Susumu Sakimoto, Takatoshi Maeno, Kohji Nishida","doi":"10.1007/s00417-024-06645-0","DOIUrl":"10.1007/s00417-024-06645-0","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effect of internal limiting membrane (ILM) peeling on visual outcomes and postoperative epiretinal membrane (ERM) after pars plana vitrectomy (PPV) for vitreous hemorrhage (VH) associated with retinal vein occlusion (RVO) with various degrees of macular ischemia.</p><p><strong>Methods: </strong>We compared the outcomes of eyes that underwent vitrectomy with and without ILM peeling from 2012 to 2021 with a minimum follow-up of 6 months.</p><p><strong>Results: </strong>112 charts were analyzed, and 51 eyes met the inclusion criteria. There were 19 eyes with ILM peeling and 32 eyes with non-ILM peeling. Baseline characteristics did not differ significantly. The mean postoperative visual acuity significantly improved at 6 months compared with the mean preoperative visual acuity (P < 0.001). Visual improvement was significantly greater in the non-ILM peeling group(P < 0.05). Without ischemia within the arcade, there was no significant difference in the visual improvement. In patients with ischemia, the visual improvement in the ILM peeling group was significantly worse than that in the non-ILM peeling group. The incidence of postoperative ERM was significantly higher in the non-ILM peeling; however, there was no significant change in postoperative vision due to the presence of ERM.</p><p><strong>Conclusions: </strong>Vitrectomy either with or without ILM peeling results in visual improvement in patients with VH associated with RVO; however, it should be uniformly avoiding ILM peeling in cases with pre-existing macular ischemia, as it may significantly lead to a deterioration in visual outcomes.</p><p><strong>Key messages: </strong>What is known Pars plana vitrectomy is effective for visual improvement in vitreous hemorrhage associated with retinal vein occlusion. The incidence of postoperative epiretinal membrane is variable depending on the surgical approach. What is new Avoiding ILM peeling in cases of macular ischemia during vitrectomy is crucial for better visual outcomes. Despite higher rates of epiretinal membrane post-surgery in non-ILM peeled eyes, their visual outcomes remain superior to those with ILM peeling.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"369-377"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400034","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":"Immunohistochemical expression of Fibrillin-1 in idiopathic epiretinal membranes.","authors":"Luu Viet Tien, Manabu Yamamoto, Mizuki Tagami, Norihiko Misawa, Shigeru Honda","doi":"10.1007/s00417-024-06667-8","DOIUrl":"10.1007/s00417-024-06667-8","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the expression patterns of Fibrillin-1 in idiopathic epiretinal membranes (iERM) and identify Fibrillin-1-secreting cells.</p><p><strong>Methods: </strong>iERM samples were collected via standard 27-gauge vitrectomy and subsequently subjected to flat-mount immunohistochemistry with double staining for the following markers: Fibrillin-1, glial acidic fibrillary protein (GFAP), cellular retinaldehyde-binding protein (CRALBP), retinoid isomerohydrolase RPE65 (RPE65), and α-smooth muscle actin (α-SMA).</p><p><strong>Results: </strong>Fibrillin-1 was detected throughout the iERM. The colocalization of Fibrillin-1 with α-SMA, CRALBP, and RPE65 suggested that myofibroblasts and retinal pigment epithelial (RPE) cells secreted Fibrillin-1. The lack of colocalization between GFAP and Fibrillin-1 indicated that GFAP-positive glial cells did not secrete Fibrillin-1. The colocalization of CRALBP and RPE65 with α-SMA indicated the transformation of RPE cells into myofibroblasts. This suggested that RPE cells transformed into myofibroblasts and secreted Fibrillin-1. The lack of colocalization between GFAP and α-SMA implied that GFAP-positive glial cells did not express α-SMA.</p><p><strong>Conclusions: </strong>Fibrillin-1 is widely distributed in iERMs, and myofibroblasts were the primary sources of Fibrillin-1 secretion. Additionally, during their transformation into myofibroblasts, RPE cells secreted Fibrillin-1. GFAP-positive glial cells did not express α-SMA nor secrete Fibrillin-1.</p><p><strong>Key messages: </strong>What is known Idiopathic epiretinal membranes are a common cause of visual acuity and quality impairment. The protein and cell components of idiopathic epiretinal membrane exhibit diversity. What is new Fibrillin-1 is present throughout the idiopathic epiretinal membrane. Myofibroblasts are the most important source of Fibrillin-1 secretion. Retinal pigment epithelial cells also secrete Fibrillin-1 when transforming into myofibroblast. Glial cells do not transform to myofibroblast and do not secrete Fibrillin-1.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"415-424"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521743","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":"Preoperative OCT lens evaluation in posterior subcapsular cataract - prevention of complications from phacoemulsification.","authors":"Nina Lutsenko, Oxana Isakova, Olga Rudycheva, Tetyana Kyrylova","doi":"10.1007/s00417-024-06632-5","DOIUrl":"10.1007/s00417-024-06632-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To assess the possibility of anterior segment optical coherence tomography (AS-OCT)-based preoperative evaluation of the lens in order to prevent and predict intraoperative complications of posterior subcapsular cataract (PSC) surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This prospective study included 512 eyes diagnosed with PSC. AS-OCT was performed using Line, Cross Line and 3D Cornea scans to visualize the posterior capsule. The posterior capsule and opacities in the subcortical and cortical lens, their relationship and the state of the retrolenticular space were assessed. The study sample was divided into three groups while taking into account the revealed morphological changes in the lens. Groups 1, 2, and 3 comprised 312, 185 and 15 eyes, respectively, with each group characterized by a specific type (1, 2 or 3) of morphological AS-OCT changes in the PSC. Surgery consisted of ultrasound phacoemulsification with intraocular lens implantation. Well-known measures related to cataract surgery stages were performed, if required, to preserve the integrity of the posterior capsule, while taking into account the type of PSC changes. We preoperatively determined the eyes at risk for intraoperative posterior capsular rupture (PCR) and detection of posterior capsular plaque (PCP), and compared this data with the postoperative data on the state of the posterior capsule.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The PSC cases with an expected rate of intraoperative complications of 0 to 10% were classified as those with a low risk, whereas the rest, with a high risk of complications. Only eyes with type 2 or type 3 PSC changes were expected to have a high risk of intraoperative PCP, and only eyes with type 3 PSC changes, a high risk of PCR. In groups 1, 2 and 3, the rates of intraoperative PCP were 0%, 100% and 46.7%, respectively, and the rates of intraoperative PCR, 0%, 0% and 53.3%, respectively. There was a significant positive correlation between preoperative OCT-based morphology of the lens and intraoperative complications (r = 0.88, p ≤0.001). Sensitivity and specificity for the method of AS-OCT-based evaluation of risks of intraoperative complications in PSC surgery were 98.8% and 96.5%, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;AS-OCT allows evaluating preoperatively posterior lens opacification morphology and posterior capsular changes, determining the risks of complications, and performing surgical planning for PSC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key messages: &lt;/strong&gt;What is Known? Complications (posterior capsule (PC) rupture with or without vitreous loss and residual PC plaque) are common in, and affect the expected outcome of, posterior subcapsular cataract (PSC) surgery. What is new? PC plaque is most likely in eyes with preoperative type 2 changes in the PSC, whereas eyes with preoperative type 3 changes are likely to show PC rupture or residual PC plaque. AS-OCT enables an experienced surgeon to predict the risks of intraoperati","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"443-450"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145554","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":"Outcomes of amniotic membrane transplant for refractory macular hole - an optical coherence tomography and autofluorescence long-term study.","authors":"Helena Proença, Marília Antunes, Joana Tavares Ferreira, Paula Magro, Mun Faria, Carlos Marques-Neves","doi":"10.1007/s00417-024-06609-4","DOIUrl":"10.1007/s00417-024-06609-4","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze anatomical and functional outcomes of cryopreserved human amniotic membrane (hAM) transplant in refractory macular hole (MH) surgery, present retinal layers structure after MH closure, identify visual acuity improvement determinants and complication rate.</p><p><strong>Methods: </strong>Prospective and interventional case series including seventeen patients: 13 refractory and 4 chronic (8, 15, 18 and 30-years) MH. All patients underwent vitrectomy, hAM subretinal transplant, tamponade and positioning. Complete ophthalmological examination, axial length, best-corrected visual acuity, retinography, optical coherence tomography (OCT) and autofluorescence were recorded.</p><p><strong>Results: </strong>Mean follow-up was 31 months (range 6-53). Mean LogMAR visual acuity (1.71 ± 0.42) improved significantly (1.13 ± 0.41) (P < 0.001). Patients with better baseline BCVA ended up with better final BCVA (P = 0.018). Mean MH minimum linear diameter was 831 ± 252 μm and base diameter was 1409 ± 358 μm. MH closed in all patients. Transitory ocular hypertension in one patient and transient vitreous cavity haemorrhage in another were the only postoperative complications. OCT matched scans showed plug integration and inner retinal layers rearrangement. MH size did not correlate with final BCVA. Autofluorescence showed no developing atrophy signs during long-term follow-up.</p><p><strong>Conclusion: </strong>Cryopreserved human amniotic membrane transplant may be a valuable approach to achieve macular hole closure and visual acuity improvement in refractory MH.</p><p><strong>Key messages: </strong>What is known Human amniotic membrane transplantation is a recent surgical technique for refractory, chronic or extra-large macular holes. This surgical procedure has a shallow learning curve, high macular hole closure rate, does not require silicone oil tamponade and has very low complication rate. What is new Subretinal amniotic membrane transplant technique was successful at closing all patients' macular holes and improving visual acuity. Concerning final visual acuity predictors neither preoperative characteristics, namely the macular hole size or duration, etiology, lens status or axial length, nor surgical procedure modifications such as flap shape or tamponade lead to different outcomes. Our series included patients with refractory macular holes due to failed extended ILM peeling, failed inverted flap technique, failed autologous retinal transplant and failed epiretinal amniotic membrane transplant suggesting the technique's effectiveness in challenging refractory cases.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"315-326"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284419","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":"Quintessence of currently approved and upcoming treatments for dry eye disease.","authors":"Sunanda Patil, Gayatri Sawale, Santosh Ghuge, Sadhana Sathaye","doi":"10.1007/s00417-024-06587-7","DOIUrl":"10.1007/s00417-024-06587-7","url":null,"abstract":"<p><p>Dry eye disease (DED), also known as dry eye syndrome, is a multifactorial ocular surface disease. The aim of this review is to present the details of currently approved and upcoming treatment options for DED in a nutshell. We conducted a thorough literature search using PubMed and searched US FDA website, clinicaltrials.gov, and data available in public domain for currently approved and upcoming treatment options for DED. Currently, the US Food and Drug Administration (FDA)-approved medical treatments for treatment of DED include cyclosporine formulations (RESTASIS^® [cyclosporine 0.05% ophthalmic emulsion], VEVYE^® [cyclosporine 0.1% ophthalmic solution], and CEQUA™ [cyclosporine 0.09% ophthalmic solution]), XIIDRA^® (lifitegrast), a leukocyte function-associated antigen-1 (LFA-1)/intracellular adhesion molecule-1(ICAM-1) inhibitor, EYSUVIS™ (loteprednol etabonate ophthalmic suspension 0.25%), a corticosteroid, and MIEBO™ (perfluorohexyloctane ophthalmic solution), a semifluorinated alkane. TYRVAYA™ (varenicline solution nasal spray), a cholinergic agonist, is another formulation approved for the treatment of the signs and symptoms of DED. The medical devices approved for treating DED due to meibomian glands dysfunction (MGD) include Lumenis OptiLight™ (intense pulsed light [IPL] device), TearCare^® system, and TearScience™ LipiFlow™ thermal pulsation system. Punctal plugs are another treatment option approved for management of DED. There are hundreds of clinical studies evaluating newer treatments for managing the signs and symptoms. Cyclosporine formulations TJO-087 (cyclosporine A nanoemulsion 0.08%), SCAI-001 eye drops (cyclosporine 0.01%, 0.02%) are being evaluated against RESTASIS^® and other approved treatments. The potential treatments being assessed include IC 265, OK-101, PL9643, SYL1001 (tivanisiran), SHJ002, OXERVATE^® (cenegermin-bkbj ophthalmic solution 0.002%), HBM9036 (tanfanercept ophthalmic solution), OCS-02 (licaminlimab), MIM-D3 (tavilermide ophthalmic solution 5%), AR-15,512, BRM421, reproxalap, and AZR-MD-001 (selenium sulphide ointment 0.5%). The pathophysiology of DED is complex and multifactorial; there is a need to understand it even deeper. The new treatments and different delivery systems seem promising and provide a hope of effective treatment for DED.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"269-278"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106631","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":"Expression of matrix metalloproteinases and their inhibitors in corneal stromal fibroblasts and keratocytes from healthy and keratoconus corneas.","authors":"Tim Berger, Elias Flockerzi, Maximilian Berger, Ning Chai, Tanja Stachon, Nóra Szentmáry, Berthold Seitz","doi":"10.1007/s00417-024-06601-y","DOIUrl":"10.1007/s00417-024-06601-y","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the in-vitro expression of matrix metalloproteinases (MMP) and tissue inhibitors of metalloproteinases (TIMP) in corneal stromal cells by distinguishing between fibroblasts and keratocytes of healthy and keratoconus (KC) corneas.</p><p><strong>Methods: </strong>Stromal cells were isolated from healthy and KC corneas (n = 8). A normal-glucose, serum-containing cell culture medium (NGSC-medium) was used for cultivation of healthy human corneal fibroblasts (HCFs) and KC human corneal fibroblasts (KC-HCFs). In order to obtain a keratocyte phenotype, the initial cultivation with NGSC-medium was changed to a low-glucose, serum-free cell culture medium for healthy (Keratocytes) and KC cells (KC-Keratocytes). Gene and protein expression of MMP-1, -2, -3, -7, -9 and TIMP-1, -2, -3 were measured by quantitative PCR and Enzyme-Linked Immunosorbent Assay (ELISA) from the cell culture supernatant.</p><p><strong>Results: </strong>KC-HCFs demonstrated a lower mRNA gene expression for MMP-2 compared to HCFs. In contrast to their respective fibroblast groups (either HCFs or KC-HCFs), Keratocytes showed a higher mRNA gene expression of TIMP-3, whereas TIMP-1 mRNA gene expression was lower in Keratocytes and KC-Keratocytes. Protein analysis of the cell culture supernatant revealed lower concentrations of MMP-1 in KC-HCFs compared to HCFs. Compared to Keratocytes, TIMP-1 concentrations was lower in the cell culture supernatant of KC-Keratocytes. In HCFs and KC-HCFs, protein levels of MMP-1 and TIMP-1 were higher and MMP-2 was lower compared to Keratocytes and KC-Keratocytes, respectively.</p><p><strong>Conclusion: </strong>This study indicates an imbalance in MMP and TIMP expression between healthy and diseased cells. Furthermore, differences in the expression of MMPs and TIMPs exist between corneal fibroblasts and keratocytes, which could influence the specific proteolytic metabolism in-vivo and contribute to the progression of KC.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"467-475"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035650","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":"Reassessment of arterial versus venous perfusion of diabetic retinal neovascularization using ultrawide-field fluorescein angiography.","authors":"Benjamin R Lin, Piero Carletti, Jonathan Yi, Philip J Rosenfeld, Jonathan F Russell","doi":"10.1007/s00417-024-06650-3","DOIUrl":"10.1007/s00417-024-06650-3","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess whether diabetic NV is perfused by the arterial or the venous circulation.</p><p><strong>Methods: </strong>This is a retrospective, consecutive case series evaluating patients with proliferative diabetic retinopathy (PDR) imaged with ultrawide-field (UWF) fluorescein angiography (FA). Areas of neovascularization elsewhere (NVE) and neovascularization of the disc (NVD) were assessed. Perfusion was defined as arterial, arteriovenous, or venous if the area of diabetic neovascularization (NV) began to hyperfluoresce either prior, during, or after laminar venous flow, respectively.</p><p><strong>Results: </strong>A total of 180 eyes from 176 patients with 928 NV were identified (830 NVE, 98 NVD). Of those, 5.1% of NVE were classified as arterial and 58.2% of NVD were classified as arterial. The remaining NV were classified as arteriovenous except for a small subset (6.1%) which were indeterminate. None of the NV were classified as venous. Noteworthy examples demonstrated NV that nearly fully perfused prior to any detectable fluorescence within nearby veins as well as clear shunting of blood from a feeding artery to a draining vein.</p><p><strong>Conclusions: </strong>UWF FA images suggest that some NV is perfused by retinal arteries. This may be useful in devising strategies for early detection and treatment of NV precursors.</p><p><strong>Key messages: </strong>What is known • Diabetic retinal neovascularization has long been thought to be perfused by the retinal venous circulation. • Vascular endothelial growth factor has been shown to play key roles in both angiogenesis and arteriogenesis. What is new • Ultrawide-field fluorescein angiography demonstrates that at least some diabetic neovascularization is perfused by the retinal arterial circulation. • This supports the hypothesis that diabetic neovascularization may arise from arterially-perfused intraretinal microvascular abnormalities in the capillary bed.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"361-368"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravitreal methotrexate as an adjuvant in vitrectomy in cases of retinal detachment with proliferative vitreoretinopathy.","authors":"Renu P Rajan, K Naresh Babu, Karthik Kumar Arumugam, Sabareesh Muraleedharan, Obuli Ramachandran, Soumya Jena, Sakshi Kumar, Anubhav Upadhyay","doi":"10.1007/s00417-024-06665-w","DOIUrl":"10.1007/s00417-024-06665-w","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the rate of re-detachment in patients with rhegmatogenous retinal detachment and Grade-C PVR following vitreoretinal surgery, with and without serial intravitreal injections of methotrexate.</p><p><strong>Methods: </strong>It was a randomized control trial. Patients aged more than 18 years undergoing pars plana vitrectomy for rhegmatogenous retinal detachment with PVR grade C or more were included in the study. Patients treated with intravitreal injection of methotrexate were grouped as cases and those not injected served as controls. The cases received 3 intravitreal injections of methotrexate at monthly intervals. Patients were evaluated on Day 1, 1st month, 2nd month, 3rd month and 6th month in terms of BCVA, rate of re-attachment and grade of PVR.</p><p><strong>Results: </strong>The case group had 23 patients and the control group had 20 patients. 2 patients in the case group were lost to follow-up after the first follow-up, so they were excluded. So 21 patients in case group and 20 patients in control group were followed up. Six months after surgery, 15 'cases' had completely attached retina whereas 6 patients had partial detachment with macula on. There was no patient amongst the cases with macula-off retinal re-detachment. Out of 20 patients in the control group, 9 had a complete retinal attachment, 4 had partial detachment with macula-on and 7 had partial detachment with macula-off. There was statistically significant difference in macula off retinal detachment rates (p-value- 0.003).</p><p><strong>Conclusion: </strong>Serial intravitreal methotrexate injections reduce the incidence of re-detachment in patients undergoing PPV for RRD with PVR-C. Further investigation into this promising therapeutic approach is warranted.</p><p><strong>Key messages: </strong>What is known Methotrexate is an anti-inflammatory agent which is safe for intravitreal use There are case series retrospective and prospective studies suggesting potential benefit of intravitreal methotrexate in preventing re-detachment due to PVR What is new First randomized control trial studying the efficacy of intravitreal methotrexate in preventing re-detachment due to PVR Our study showed statistically significant difference in macula off retinal detachment between the 2 groups at 6 months of follow up.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"387-391"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463309","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":"Temperature control during pars plana vitrectomy.","authors":"Mario R Romano, Laura Barachetti, Mariantonia Ferrara, Alessandro Mauro, Lorenzo Crepaldi, Valerio Bronzo, Giovanni Franzo, Giuliano Ravasio, Chiara Giudice","doi":"10.1007/s00417-024-06631-6","DOIUrl":"10.1007/s00417-024-06631-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of temperature-controlled pars plana vitrectomy (PPV) on structural and functional outcomes in a rabbit eye model in vivo.</p><p><strong>Methods: </strong>Ten healthy New Zealand White rabbits underwent temperature-controlled PPV in the right eye (group A), using a device specifically designed to heat the infusion fluid/air and integrated into the vitrectomy machine, and conventional PPV in the left eye (group B). Both eyes received ophthalmic examination and electroretinography (ERG) before and 1 week postoperatively. After 1-week ERG, rabbits were enucleated and then sacrificed. Histological and immunohistochemical examinations were performed on enucleated eyes and expression of glial fibrillary acidic protein (GFAP) and vimentin investigated.</p><p><strong>Results: </strong>Postoperatively, only group B showed significantly decreased amplitude and increased latency of a-wave at 3 cd·s/m² (p = 0.001 and 0.005, respectively). Significant increase of b-wave latency at 0.01 cd·s/m² was detected in both groups (p = 0.019 and 0.023, respectively). Postoperatively, amplitude of oscillatory potentials (OPs) increased significantly in group A (p = 0.023) and decreased in group B. In both groups, OPs latency significantly increased at 1-week test (P < 0.05). A greater number of eyes without structural retinal alterations was detected in group A compared to group B (6 vs 5, respectively). GFAP expression was higher in group B than group A, even if the difference was not statistically significant.</p><p><strong>Conclusion: </strong>Temperature-controlled PPV resulted in more favorable functional and structural outcomes in rabbit eyes compared with conventional PPV, supporting the potential beneficial role of the intraoperative management of intraocular temperature in vitreoretinal surgery.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"425-435"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153696","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}