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

{"title":"Foveal hyper-reflective vertical lines detected by optical coherence tomography: Imaging features, literature review and differential diagnoses.","authors":"Adi Porat Rein, Hashem Totah, Koby Brosh, David Zadok, Joel Hanhart","doi":"10.1007/s00417-024-06616-5","DOIUrl":"10.1007/s00417-024-06616-5","url":null,"abstract":"<p><strong>Purpose: </strong>To describe foveal hyper-reflective vertical lines (FVL) as a specific morphological finding on structural spectral-domain optical coherence tomography (SD-OCT) and discuss its differential diagnosis.</p><p><strong>Methods: </strong>Observational case series. Ten patients (10 eyes) with FVL were meticulously examined at the Ophthalmology Department, Shaare Zedek Medical Center, Jerusalem, Israel. Detailed analysis of SD-OCT findings, clinical records, and retinal imaging was conducted to establish correlations between FVL and various underlying conditions.</p><p><strong>Results: </strong>We established the following list of settings, supported by the clinical context and ancillary investigations, in which SD-OCT displayed FVL: inflammation (1 eye), mechanical (1 eye), resorption of fluids of various origins (4 eyes), macular telangiectasia (1 eye), age-related macular degeneration (1 eye), diabetic retinopathy (1 eye) and scar (1 eye).</p><p><strong>Conclusions: </strong>FVL can be observed in various underlying conditions. Recognition of this pattern and formulation of an appropriate differential diagnosis is of interest for correctly diagnosing and treating patients whose structural OCT harbors this yet overlooked finding.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"849-855"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463308","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":"Development and preliminary evaluation of a novel preoperative index for quantitative analysis of photoreceptor loss in full-thickness macular holes.","authors":"Alberto Quarta, Andrea Govetto, Annamaria Porreca, Lisa Toto, Marta Di Nicola, Maria Ludovica Ruggeri, Matteo Gironi, Mario Nubile, Luca Agnifili, Mario R Romano, Rodolfo Mastropasqua","doi":"10.1007/s00417-024-06654-z","DOIUrl":"10.1007/s00417-024-06654-z","url":null,"abstract":"<p><strong>Purpose: </strong>To identify novel quantitative parameters for evaluating photoreceptor loss in full-thickness macular holes (FTMH), exploring their potential clinical impact on postoperative functional and anatomical recovery.</p><p><strong>Methods: </strong>This pilot study enrolled 38 eyes from 38 patients diagnosed with FTMH. Preoperatively, eyes underwent analysis and were subsequently followed for six months post-surgery. Best-corrected visual acuity (BCVA) was recorded, and cross-sectional images of FTMH were obtained using B-scan optical coherence tomography (OCT) and en-face OCT. Quantitative assessment of ellipsoid zone (EZ) and external limiting membrane (ELM) integrity changes was conducted and correlated with postoperative anatomical and functional recovery. The photoreceptor Integrity Index (PIIN), calculated as the ratio of photoreceptor area to lumen hole area measured at customized segmentation, was correlated with the minimum and base diameters of the hole, positive change in BCVA, preoperative EZ defect (EZd), preoperative ELM defect (ELMd), and changes in EZ and ELM over the six-month follow-up period (∆-EZ and ∆-ELM). The main outcome measures focused on evaluating the effectiveness of PIIN in predicting postoperative anatomical and functional changes.</p><p><strong>Results: </strong>A higher PIIN correlated with a greater BCVA change over six months (p < 0.001). Univariate regression analysis using the PIIN as a predictor for positive change in BCVA (|∆-BCVA| [logMAR]) over time yielded significant results (p < 0.001). Additionally, the PIIN significantly correlated with EZd at baseline, ELM at baseline, and ELMd change over the six-month follow-up period.</p><p><strong>Conclusion: </strong>The PIIN shows promise as a tool for evaluating photoreceptor loss in macular holes and estimating postoperative functional and anatomical recovery.</p><p><strong>Key messages: </strong>What is known Previous studies have extensively used optical coherence tomography (OCT) to investigate various biomarkers for assessing patients with full-thickness macular hole (FTMH), without considering detailed MH ultrastructural features Existing indexes used to predict surgical outcomes for FTMH primarily depend on geometrical parameters and do not integrate detailed ultrastructural characteristics, such as cellular components.  What is new A novel concept introduces the quantitative measurement of residual photoreceptors located at the edge of FTMH. The Photoreceptor Integrity Index (PIIN) integrates different ultrastructural components of macular holes, aiming to become a valuable clinical tool to predict both anatomical and functional recovery outcomes following surgical intervention for FTMH.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"637-645"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499149","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":"Ocular involvement of oak processionary caterpillar hairs: Clinical outcome up to one year.","authors":"Martin Dominik Leclaire, Friederike Elisabeth Vietmeier, Maximilian Treder, Nicole Eter, Lamis Baydoun","doi":"10.1007/s00417-024-06648-x","DOIUrl":"10.1007/s00417-024-06648-x","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate a consecutive series of patients that presented with ocular findings after contact with the oak processionary caterpillar (OPC) during an epidemic reproduction of the OPC in Germany in 2019 and to assess the 1-year outcome of those eyes with persisting OPC hairs in the cornea.</p><p><strong>Methods: </strong>Retrospective analysis of 11 eyes (11 patients) that presented in June/July 2019 with acute ocular symptoms after outdoor activity or caterpillar nest removal. Evaluation of patients charts and slit-lamp images up to one year. Assessment of the incidence of patients with OPC-associated ocular complaints in the subsequent years (2020-2023).</p><p><strong>Results: </strong>All patients had conjunctival injection, foreign body sensation, pain, itching and/or burning sensation. In 9/11 eyes, multiple caterpillar hairs could be detected in the superficial and deeper cornea. Hair removal was attempted in 8/9 eyes; in one eye hair removal was impossible due to its deep stromal location (lost-to-follow-up). Entire hair removal was successful in 2/9 eyes, hence, six eyes with persisting hairs within the cornea were followed. Stromal haze developed adjacent to the hairs in all eyes and individual hairs disappeared (n = 4) and/or showed migration within the cornea (n = 3). Until 2023, the number of patients with OPC-associated ocular complaints decreased continuously.</p><p><strong>Conclusions: </strong>Ophthalmologists should be aware of the possibility of caterpillar hairs in patients with acute eye symptoms after outdoor acitivities, especially in early summer; the incidence may fluctuate, though. Hair removal is recommended to avoid possible intraocular migration, still residing hairs did not cause any serious long-term complications in our cohort.</p><p><strong>Key messages: </strong>What is known Within the late spring and early summer season, mass reproduction of the oak processionary carterpillar (OPC) can lead to an increased number of patients with OPC-related eye complaints (pain, itching and burning sensation) caused by OPC hairs within a very short period of time. Within that season, people should be (more) actively sensitized to avoid trees with OPC hairs, take precautions and avoid eye rubing when having complaints What is new Complete surgical removal of the hairs can be difficult and is often unsuccessful due to their tiny size and often stromal location most possibly resulting from eye rubbing In the longer-term, residing hairs have shown to develop haze adjacent to the hair, migrate within the cornea or disappear/resolve. Since this may go along with an inflammatory reaction, long-term follow-up and topical steroids may be useful.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"771-779"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618756","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":"Ahmed's sub-flap mattress suture deep sclerectomy assessment with Ultrasound Biomicroscopy.","authors":"Mina Maged Habib, Gihan Mohamed Hilmy, Ahmed Mostafa AbdelRahman, Mohamed Sabry Kotb","doi":"10.1007/s00417-024-06598-4","DOIUrl":"10.1007/s00417-024-06598-4","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the efficacy of adding Ahmed's sub-flap mattress suture to deep sclerectomy (DS).</p><p><strong>Methods: </strong>Forty eyes with open angle glaucoma were assigned randomly into two groups: Group A: underwent DS with Ahmed's sub-flap mattress suture. Group B: underwent conventional DS. Patients were followed up closely for 6 months with serial IOP measurements and ultrasound biomicroscopy (UBM) was used to assess the surgical site functionally and anatomically at the first and sixth month.</p><p><strong>Results: </strong>Adding Ahmed's sub-flap mattress suture improved the IOP lowering effect of DS significantly from 43% in group B to 53% in group A at 6-month (p = 0.027). IOP in group A was at 1 week, 1 month and 6-month visits (7.9 ± 1.3, 11.7 ± 2.2 and 13.3 ± 1.9 mmHg respectively) compared to group B (10.1 ± 4.6, 14.1 ± 5.2 and 16.8 ± 4.1 mmHg respectively) (p = 0.025, 0.041 and 0.001 respectively). UBM parameters were significantly larger in group A at 1 and 6 months. Strong statistically significant negative correlations were established between IOP and all the UBM parameters apart from intrascleral lake height at the first and sixth month (p < 0.01 in all of them). Finally, significant correlations were found between IOP at 6 months and whole bleb anteroposterior length and height at 1 month (p = 0.001).</p><p><strong>Conclusion: </strong>Adding Ahmed's sub-flap mattress suture to routine DS is an effective economical addition that will enhance the IOP lowering effect of DS. Also, assessment of the bleb by UBM is useful in predicting the success of deep sclerectomy surgery.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"797-806"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463303","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":"Progression to complete retinal pigment epithelium and outer retinal atrophy (cRORA): post hoc analysis of the GATHER1 trial.","authors":"Giulia Corradetti, Ayesha Karamat, Sowmya Srinivas, Sophiana Lindenberg, Swetha B Velaga, Federico Corvi, Yamini Attiku, Muneeswar Gupta Nittala, Dhaval Desai, Liansheng Zhu, Dina Abulon, SriniVas R Sadda","doi":"10.1007/s00417-024-06676-7","DOIUrl":"10.1007/s00417-024-06676-7","url":null,"abstract":"<p><strong>Purpose: </strong>Determine rates of progression of incomplete retinal pigment epithelium and outer retinal atrophy (iRORA) to complete retinal pigment epithelium and outer retinal atrophy (cRORA) and rates of progression of drusen to iRORA/cRORA in eyes with geographic atrophy (GA) treated with avacincaptad pegol (ACP).</p><p><strong>Methods: </strong>Post hoc analysis of the GATHER1 prospective, randomized, double-masked Phase II/III study that evaluated ACP 2 mg vs. sham. Optical coherence tomography (OCT) data from GATHER1 were transferred to the Doheny Image Reading and Research Lab for masked analysis by readers experienced with Classification of Atrophy Meeting (CAM) grading features. Regions of OCT volume scans more than 500 µm from the border of GA lesions were evaluated at baseline and at months 6, 12, and 18. Participants with iRORA and/or drusen (≥ 40 µm height on OCT) at baseline were included in the analysis.</p><p><strong>Results: </strong>The proportion of eyes progressing from iRORA to cRORA in the ACP 2 mg group was 5.0%, 15.0%, and 20.0% at months 6, 12, and 18 respectively, as compared with 11.8%, 30.2%, and 41.8% of eyes in the sham group. The proportion of ACP 2 mg-treated eyes progressing from drusen to iRORA or cRORA was 3.8%, 7.6%, and 7.6% at months 6, 12, and 18 compared with 15.9%, 18.1%, and 27.2% of sham-treated eyes.</p><p><strong>Conclusions: </strong>Rates of progression from iRORA to cRORA and drusen to iRORA/cRORA were reduced in eyes treated with ACP 2 mg vs. sham, with increasing separation between groups over time, suggesting early intervention may slow disease progression.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT02686658. Date of registration: February 16, 2016.</p><p><strong>Key messages: </strong>What is known Geographic atrophy is an advanced form of age-related macular degeneration (AMD) that leads to irreversible vision loss, presenting a significant public health unmet need. The Classification of Atrophy Meeting (CAM) group recommended a new nomenclature for advanced AMD lesions, based on the affected anatomical layers on optical coherence tomography. Accordingly, the terms incomplete retinal pigment epithelium and outer retinal atrophy (iRORA) and complete retinal pigment epithelium and outer retinal atrophy (cRORA) were introduced (Guymer et al., Ophthalmology 127:394-409, 2020; Sadda et al., Ophthalmology 125:537-548, 2018). What is new GATHER1 post hoc analysis shows that treatment with avacincaptad pegol (ACP) 2 mg decreases the proportion of eyes that progress from iRORA to cRORA, and from drusen to iRORA or cRORA, compared with sham, over 6, 12, and 18 months. These findings suggest a potential role for ACP in delaying the progression of existing pre-atrophic AMD lesions.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"669-677"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618758","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":"Impact of EnChroma glasses on red-green color vision deficiency: a prospective study.","authors":"Maxime Mouffokes, Stéphanie Baillif","doi":"10.1007/s00417-024-06574-y","DOIUrl":"10.1007/s00417-024-06574-y","url":null,"abstract":"","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"883-884"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365057","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":"Three-dimensional choroidal characteristics in different subtypes of central serous chorioretinopathy using swept-source optical coherence tomography angiography.","authors":"Yue Zhang, Jianing Wang, Jing Liu, Xiaoya Gu, Shuang Song, Xiaobing Yu","doi":"10.1007/s00417-024-06691-8","DOIUrl":"10.1007/s00417-024-06691-8","url":null,"abstract":"<p><strong>Purpose: </strong>To assess choroid vascular characteristics in four subtypes of central serous chorioretinopathy (CSC) eyes under the new classification system.</p><p><strong>Methods: </strong>There were 83 subjects in total for analysis including 16 individuals with acute CSC, 13 with non-resolving CSC, 12 with recurrent CSC, 16 with chronic CSC, and 26 healthy control eyes. We utilized the integrated software of SS-OCTA to acquire measurements of the central choroidal thickness (CT), the choriocapillaris perfusion area (CCPA), three-dimensional choroidal vascularity index (CVI) and three-dimensional choroidal vessel volume (CVV). The SNK-q test was conducted for pairwise comparisons among four subgroups of CSC and healthy control eyes. A multiple linear regression model was employed to investigate the relationship between CVI, CCPA and other factors.</p><p><strong>Results: </strong>CT, CVI, and CCPA of the chronic CSC subgroup were significantly lower than the other three CSC subgroups. Lower CVI was significantly correlated with the subgroup of chronic CSC (β = -0.140, P = 0.016), lower CT (β = 0.0014, P < 0.01), and higher CCPA (β = -0.141, P < 0.01). Lower CCPA was significantly correlated with the subgroup of chronic CSC (β = -0.937, P < 0.01), diabetes (β = -0.118, P = 0.015), higher CVV (β = -0.414, P = 0.014), and higher CVI (β = -0.764, P < 0.01).</p><p><strong>Conclusions: </strong>This is the first study to evaluate the choroidal characteristics of four subtypes of CSC under the new classification system in detail. It seems that chronic CSC displays distinct pathophysiological alterations in choroidal characteristics.</p><p><strong>Registration number: </strong>NCT05687422.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"689-697"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting the duration of air tamponade following vitreoretinal surgery.","authors":"Fatih Bilgehan Kaplan, Cihan Kerekli, Onat Yakalı, Banu Açıkalın","doi":"10.1007/s00417-024-06696-3","DOIUrl":"10.1007/s00417-024-06696-3","url":null,"abstract":"<p><strong>Purpose: </strong>Air as a tamponade in pars plana vitrectomy (PPV) is increasingly preferred due to its quick rehabilitation time. We aim to examine the factors affecting the absorption time of air tamponade.</p><p><strong>Method: </strong>The study included 82 eyes from 78 patients who underwent PPV with air used as the tamponade. All patients underwent detailed ophthalmic examinations preoperatively and on the first and third postoperative days. The study evaluated demographic and clinical characteristics, surgical indications, and whether concurrent phacoemulsification surgery was performed. A single surgeon conducted all surgeries and examinations. The intraocular air percentage and volume in milliliters were determined. Patients were divided into two groups based on whether the intraocular air volume was reduced by more or less than 1.5 ml from the first to the third day.</p><p><strong>Results: </strong>Concurrent cataract surgery was performed in 35.4% of the eyes. All 82 eyes were pseudophakic at the end of the surgery. The mean air percentage in the eyes was 68.90% on the first day and 47.29% on the third day. Only the concurrent cataract surgery significantly shortened the air elimination time (p = 0.005). Other factors, such as diabetic retinopathy, glaucoma, and concurrent anti-VEGF therapy, did not show a significant impact.</p><p><strong>Conclusion: </strong>The study concluded that concurrent cataract surgery notably reduces air tamponade duration after PPV. We think these findings are crucial for patient selection and surgical planning, especially in cases where maintaining a longer tamponade duration is critical, such as in retinal detachment or macular hole surgeries.</p><p><strong>Key messages: </strong>What is known The use of air as tamponade is becoming increasingly widespread in vitreoretinal surgery. What is new Compared to performing the surgeries separately, air tamponade shows faster absorption in concurrent cataract and vitreoretinal surgery. Factors such as diabetic retinopathy, glaucoma, and concurrent anti-VEGF therapy do not significantly affect the absorption time of intraocular air after vitreoretinal surgery.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"727-733"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709947","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":"Asymmetric choroidal vascular pattern in tilted disc syndrome.","authors":"Kyosuke Nonaka, Ichiro Maruko, Mizuha Kakehashi, Moeko Kawai, Taiji Hasegawa, Tomohiro Iida","doi":"10.1007/s00417-024-06686-5","DOIUrl":"10.1007/s00417-024-06686-5","url":null,"abstract":"<p><strong>Purpose: </strong>To observe the choroidal vasculature in patients with tilted disc syndrome (TDS) using en face optical coherence tomography (OCT) and to evaluate the symmetry of the choroidal vascular pattern in the macular area.</p><p><strong>Methods: </strong>En face OCT was performed using a Plex Elite 9000 (Zeiss) with a 12 × 12 mm image of the macula, which was flattened with retinal pigment epithelium and segmented into choroidal layers. The middle/large choroidal vessels were evaluated for vertical symmetry qualitatively by the retina specialist coauthors and quantitatively by binarization analysis of choroidal vessel density and mean vessel diameter.</p><p><strong>Results: </strong>The 2 cases and 4 eyes (19.0%) that were difficult to segment due to the severe slope of the macular area were excluded. Of the 17 eyes in the remaining 13 cases, asymmetric middle/large choroidal vessels were observed in all eyes. Vessel density (P = 0.01) and mean vessel diameter (P < 0.01) of the choroidal middle/large vessels were significantly higher in the superior than in the inferior choroidal segmentation. Serous retinal detachment was observed in 4 eyes, all asymmetric cases.</p><p><strong>Conclusion: </strong>Vertical asymmetry of the middle and large choroidal vessels is observed in most TDS patients. Circulatory imbalance due to choroidal vascular abnormalities in TDS may be one of the causes of serous retinal detachment.</p><p><strong>Key messages: </strong>What is known: Tilted disc syndrome is the congenital disease with ocular morphologic abnormalities associated with incomplete closure of the embryonic fissure of the eye at the inferior optic nerve head  Vertical cross-sectional optical coherence tomography images revealed that the choroid above the macula in tilted disc syndrome is relatively thickened, whereas the choroid within the inferior staphyloma is thinning.</p><p><strong>What is new: </strong>  Evaluation of choroidal vascularity in tilted disc syndrome by en face optical coherence tomography revealed qualitatively and quantitatively highly dense choroidal vessels in the superior region, with larger diameter choroidal vessels than in the inferior region, and vertical asymmetry with an upward predominance.  Choroidal circulatory imbalance due to vertical asymmetry of the choroidal vessels may be one of the causes of serous retinal detachment in tilted disc syndrome.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"699-704"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686812","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":"Risk factors for hyphema following goniotomy or trabecular bypass stent placement combined with phacoemulsification.","authors":"George Holmes, Shayma Jawad, Stephen Chen, Ruifeng Cui, Jamie Dietze, Joel Palko","doi":"10.1007/s00417-024-06647-y","DOIUrl":"10.1007/s00417-024-06647-y","url":null,"abstract":"<p><strong>Purpose: </strong>To report the rates and risk factors for layered hyphemas after goniotomy (PG) and trabecular bypass stent (PTBS) surgery combined with phacoemulsification.</p><p><strong>Methods: </strong>Patient data was obtained using a retrospective chart review from adult patients (18 years of age or older) undergoing either PG or PTBS at the West Virginia University Eye Institute between 2013 and 2023. Generalized estimating equations were used to identify significant predictors of layered hyphema on post-operative day one. Predictors evaluated included age, race, glaucoma severity, glaucoma type, surgical time, complex cataract extraction, pre-operative intraocular pressure, post-operative day one intraocular pressure, peri-operative anti-thrombotic therapy (ATT) use, body mass index, and surgery type (i.e., PG or PTBS).</p><p><strong>Results: </strong>Of the 405 eyes from 279 patients included in the study, the overall layered hyphema rate was 10.1% in the whole sample. In multivariate generalized estimating equation model controlling for glaucoma stage and preoperative IOP, only surgery type (PG vs PTBS) predicted post-operative day one hyphema (β = 2.47, SE = 1.01, p = 0.02). The hyphema rates in the PG group and PTBS groups were 40/316 (12.7%) and 1/89 (1.1%), respectively. Eyes of patients on ATT had a hyphema rate of 16/189 (8.5%) compared to 25/216 (11.6%) in eyes of patients not on ATT.</p><p><strong>Conclusions: </strong>Performing PG over PTBS was a significant predictor of a post-operative day one layered hyphema. No other systemic or ocular features, including the use of ATT, showed a statistically significant relationship with post-operative hyphemas.</p><p><strong>Key messages: </strong>What is Known. • The prevalence of minimally invasive glaucoma surgery has significantly increased in recent years. • Hyphema is a common postoperative complication of minimally invasive glaucoma surgery, however risk factors for hyphema in this setting have not been thoroughly evaluated.</p><p><strong>What is new: </strong>• The use of perioperative antithrombotic therapy did not significantly increase the risk for postoperative hyphema following angle based minimally invasive glaucoma surgery. • Hyphema risk was significantly higher in patients undergoing goniotomy combined with phacoemulsification compared to trabecular bypass stent surgery with phacoemulsification.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"781-786"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375386","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}