{"title":"Association between axial length and uveitis.","authors":"Marina Ogawa, Yoshihiko Usui, Kinya Tsubota, Hiroshi Goto","doi":"10.1007/s00417-024-06655-y","DOIUrl":"10.1007/s00417-024-06655-y","url":null,"abstract":"<p><strong>Purpose: </strong>Multiple studies have examined the association between myopia and various ocular diseases, but there is no clinical report of the relationship between myopia and uveitis. This study aimed to elucidate the relationship between myopia and uveitis by comparing axial lengths (AL) of uveitis patients with control individuals.</p><p><strong>Methods: </strong>This study included 1052 eyes (663 patients; 288 males, 375 females; median age 56.0 years) with uveitis referred to Tokyo Medical University Hospital. Controls were 738 eyes with cataract but no other ocular diseases. AL was measured by IOLMaster or conventional A-mode ultrasound system. Uveitis eyes were grouped into various types of non-infectious uveitis, infectious uveitis, and unidentified uveitis. Median AL of each uveitis group was compared with control group using Mann-Whitney U-test, and also compared with adjustment for age and sex using multiple regression analysis. Binary logistic analysis was performed to examine whether AL plays a role in the risk of developing uveitis.</p><p><strong>Results: </strong>Of 1052 eyes, 808 eyes (76.8%) were diagnosed with non-infectious uveitis [sarcoidosis (176 eyes, 16.7%), Vogt-Koyanagi-Harada disease (122 eyes, 11.6%), Behçet's disease (130 eyes, 12.4%), and others (380 eyes, 36.1%)], 146 eyes (13.9%) with infectious uveitis, and 98 eyes (9.3%) with unidentified uveitis. Median AL in all uveitis eyes was significantly shorter than in control eyes (23.73 vs 24.31 mm, p < 0.001 unadjusted), and AL remained significantly shorter in uveitis than in control after age- and sex-adjustment (p < 0.001). Median AL was significantly shorter in non-infectious uveitis (23.72 mm) and in infectious uveitis (23.99 mm) compared to controls (p < 0.001 and < 0.05, respectively), and was significantly shorter in non-infectious uveitis than in infectious uveitis (p < 0.05). Each millimeter decrease in AL was associated with 1.266-fold increase in unadjusted risk [odds ratio (OR), 1.266; 95% confidence interval (CI), 1.196-1.341; p < 0.001) and 1.446-fold in age- and sex-adjusted risk (OR, 1.446; 95% CI, 1.349-1.549; p < 0.001) of developing uveitis.</p><p><strong>Conclusion: </strong>Median AL of uveitis eyes with infectious or non-infectious etiologies was significantly shorter than that in control eyes, suggesting an increased risk of developing uveitis in eyes with shorter AL. This feature should be considered when exploring new pathogenetic mechanisms of uveitis.</p><p><strong>Key messages: </strong>What is known Shorter axial length may be associated with the pathogenesis of central serous chorioretinopathy and increased risk of early age-related macular degeneration. What is new Here we assessed the relationship between myopia and uveitis by comparing axial lengths of uveitis patients. Median axial length in all uveitis eyes was significantly shorter than in control eyes, and axial length remained significantly shorter in uveitis than i","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"837-847"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Justine Bontemps, Olivier Loria, Lucas Sejournet, Benoit Allignet, Sandra Elbany, Frédéric Matonti, Carole Burillon, Philippe Denis, Laurent Kodjikian, Thibaud Mathis
{"title":"Refractive outcomes for secondary sutureless posterior chamber lens implantation: sutureless scleral fixating lens Carlevale® versus retropupillary iris-claw lens Artisan®.","authors":"Justine Bontemps, Olivier Loria, Lucas Sejournet, Benoit Allignet, Sandra Elbany, Frédéric Matonti, Carole Burillon, Philippe Denis, Laurent Kodjikian, Thibaud Mathis","doi":"10.1007/s00417-024-06683-8","DOIUrl":"10.1007/s00417-024-06683-8","url":null,"abstract":"<p><strong>Purpose: </strong>To compare refractive outcomes of the foldable intraocular lens sutureless scleral fixated sutureless (Carlevale® FIL-SSF) with the iris-claw lens (Artisan®).</p><p><strong>Methods: </strong>This retrospective study included consecutive patients who underwent a FIL-SSF implantation or an iris-claw implantation between January 2020 and November 2022 in the ophthalmology departments of Hospices Civils de Lyon (France).</p><p><strong>Results: </strong>A total of 271 eyes from 265 patients were included: 96 eyes in the FIL-SSF group and 175 eyes in the iris-claw group. At 6 months, the mean (SD) surgically induced astigmatism (SIA) was significantly lower in the FIL-SSF group with 0.3 (1.8) diopters against 0.8 (2.1) diopters in the iris-claw group (p = 0.01). The mean (SD) refractive error was also lower for the FIL-SSF group with 0.1 (1.2) diopters versus 0.5 (1.6) diopters in the iris-claw group (p < 0.001). The mean best corrected visual acuity at 6 months was not significantly different between FIL-SSF and iris-claw lens with 0.47 (0.58) logMAR and 0.39 (0.55) logMAR, respectively (p = 0.12). However, the mean (SD) operative time was longer for FIL-SSF implantation in comparison to iris-claw implantation (59.8 (21.1) minutes versus 41.9 (24.4) minutes, respectively (p < 0.001)). The rate of postoperative complications was similar between the two techniques.</p><p><strong>Conclusion: </strong>This study shows that FIL-SSF achieves better refractive results than iris-claw lens, with a similar rate of postoperative complications. As a relatively new implantation technique, there is a learning curve required to reduce operating time.</p><p><strong>Key messages: </strong>What is known? Multiple surgical options for correcting aphakia in the absence of capsular support can be used. Currently, foldable intraocular lens sutureless scleral fixated sutureless (FIL-SSF, Carlevale®) and iris-claw (Artisan®) implants are the two preferred options, but there is no consensus on the best technique to adopt. What is new? We showed that FIL-SSF has a significantly lower surgically induced astigmatism compared to the iris-claw implant. Similar rate of postoperative complications was found between these two techniques. Future studies with a longer follow-up period are needed to ascertain its tolerance.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"735-743"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of Fresnel prism in small-angle esotropia (≤ 20 prism diopters) with fixation preference.","authors":"Hye Jun Joo, Seong-Joon Kim","doi":"10.1007/s00417-024-06662-z","DOIUrl":"10.1007/s00417-024-06662-z","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to investigate the effects of Fresnel prism treatment for small-angle esotropia (≤ 20 prism diopters [PD]) with fixation preference.</p><p><strong>Methods: </strong>We included 32 patients with remaining esotropia ≤ 20 PD measured using the simultaneous prism and cover test (SPCT) after full refractive error correction. Fresnel prism was applied to make patients orthotropic with glasses. Treatment was discontinued if remaining esotropia ≤ 4 PD was sustained during two consecutive follow-ups (2-month intervals) or if the angle continued to increase with prism adaptation. Patients were divided into treatment success and failure groups. Treatment success was defined by motor and visual acuity (VA) aspects. Criteria for motor success was residual esotropia ≤ 8 PD in patients with initial esotropia > 8 PD and a 30% decrease of esotropia in those with initial esotropia ≤ 8 PD. VA success was improvement of > 0.2 logMAR in the non-dominant eye.</p><p><strong>Results: </strong>The initial esodeviation angle was 6.92 ± 4.66 PD at distance and 10.53 ± 5.58 at near. The logMAR VA was 0.10 ± 0.13 and 0.26 ± 0.20 in the dominant and non-dominant eye, respectively. Among the 32 patients, 14 showed motor success. Among 26 patients whose VA could be measured, 15 showed VA success. Factors influencing motor success were a small amount of maximum prescribed Fresnel prism, less frequent need for Fresnel prism adaptation, and high percentage of achieving orthotropia with Fresnel prism treatment. VA success was influenced by low frequency of anisometropia and the small amount of maximum prescribed Fresnel prism.</p><p><strong>Conclusion: </strong>Fresnel prism could be a non-invasive treatment option for some patients with small-angle esotropia with fixation preference.</p><p><strong>Key messages: </strong>What is known The optimal approach for addressing small-angle esotropia is a topic of debate. Not much research has been conducted on Fresnel prism treatment in patients with small-angle esotropia. What is new Motor success and visual acuity improvement were observed in some patients undergoing Fresnel prism treatment. Factors contributing to motor success were the small maximum angle of esodeviation, the less frequent necessity for Fresnel prism adaptation, and the achievement of orthotropia during Fresnel prism treatment. Visual acuity improvement was hindered by the presence of anisometropia and the large maximum prescribed amount of Fresnel prism. Fresnel prism treatment can be used as a treatment option for some patients with small-angle esotropia with fixation preference.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"857-865"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Edward Kang, Ji-Hye Park, Chungkwon Yoo, Yong Yeon Kim
{"title":"The association between asymmetric stress distribution on the lamina cribrosa and glaucoma progression.","authors":"Edward Kang, Ji-Hye Park, Chungkwon Yoo, Yong Yeon Kim","doi":"10.1007/s00417-024-06670-z","DOIUrl":"10.1007/s00417-024-06670-z","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess the effect of ocular movements on the progression of glaucoma.</p><p><strong>Methods: </strong>A total of 118 primary open-angle glaucoma patients were enrolled, comprising 71 patients in the progression group and 47 patients in the non-progression group. Utilizing three geometric parameters-axial length, optic disc radius, and optic cup deepening-a personalized virtual optic nerve head (ONH) model was designed. ONH biomechanical changes during ocular movement were simulated using a finite element analysis. Simulation results were analyzed and compared between the progression and non-progression groups.</p><p><strong>Results: </strong>In both progression and non-progression groups, ONH strains significantly increased with increasing rotation angle. When the eye rotated by 10°, the stress on the anterior surface of the lamina cribrosa on the temporal side was significantly higher in the progression group compared to the non-progression group (16.19 ± 0.90 kPa vs. 13.24 ± 3.00 kPa, P < 0.001). The stress ratio, indicating asymmetric stress distribution, was higher in the progression group than in the non-progression group (0.56 ± 0.13 vs. 0.49 ± 0.19, P = 0.018). Stress ratio significantly increased with increasing optic disc radius (standardized β = 0.303, P < 0.001) and optic cup deepening (standardized β = 0.538, P < 0.001).</p><p><strong>Conclusions: </strong>Asymmetric stress distribution with ocular movement was higher in the progression group. This asymmetry was associated with optic disc radius and optic cup deepening. Therefore, ocular movement may contribute to the progression of glaucoma, with ONH geometry playing a role.</p><p><strong>Key messages: </strong>WHAT IS KNOWN : Ocular movement is considered one of the physical stress factors affecting the optic nerve head.</p><p><strong>What is new: </strong>Ocular movement increased the strain on the optic nerve head and resulted in an asymmetric stress distribution on the lamina cribrosa surface. Asymmetric stress distribution on lamina cribrosa with ocular movement was higher in the glaucoma progression group and associated with optic disc radius and optic cup deepening.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"819-828"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Melissa Yuan, Francesco Romano, Xinyi Ding, Mauricio Garcia, Itika Garg, Katherine Millner Overbey, Cade Bennett, Ioanna Ploumi, Isabella Stettler, Ines Lains, Filippos Vingopoulos, Jocelyn Rodriguez, Nimesh A Patel, Leo A Kim, Demetrios G Vavvas, Deeba Husain, Joan W Miller, John B Miller
{"title":"Clinical and imaging characteristics associated with foveal neovascularization in proliferative diabetic retinopathy.","authors":"Melissa Yuan, Francesco Romano, Xinyi Ding, Mauricio Garcia, Itika Garg, Katherine Millner Overbey, Cade Bennett, Ioanna Ploumi, Isabella Stettler, Ines Lains, Filippos Vingopoulos, Jocelyn Rodriguez, Nimesh A Patel, Leo A Kim, Demetrios G Vavvas, Deeba Husain, Joan W Miller, John B Miller","doi":"10.1007/s00417-024-06660-1","DOIUrl":"10.1007/s00417-024-06660-1","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the prevalence of foveal neovascularization (FNV) and its associated clinical features in proliferative diabetic retinopathy (PDR) eyes.</p><p><strong>Methods: </strong>Cross-sectional observational study. Participants underwent ultra-widefield photography, optical coherence tomography (OCT), and swept-source OCT angiography (SS-OCTA). FNV was defined as a hyperreflective lesion breaching the internal limiting membrane and displaying flow signal on OCTA, within 1-mm of foveal avascular zone. Vascular metrics were obtained from the ARI Network portal. Ischemic index (ISI) and inner choroid flow deficit percentage were calculated using FIJI from 12 × 12 and 6 × 6-mm scans, respectively. Logistic regression models were used to compare eyes with and without FNV.</p><p><strong>Results: </strong>We included 249 eyes of 164 patients (age: 58 [50-65] years). FNV was identified in 20 eyes (8%). Univariate logistic regression revealed significant associations between FNV and younger age (p = 0.03), higher maximal HbA1c (p = 0.04), worse visual acuity (VA) (p = 0.01), presence of disorganization of retinal inner layers (DRIL) (p = 0.01), no macular posterior vitreous detachment (PVD) (p = 0.03), neovascularization elsewhere (NVE) and at the disc (NVD) (p = 0.01 and p = 0.001), and greater ISI (p = 0.04). In multivariable analysis, a significant association remained between FNV and worse VA (p = 0.04), NVD (p < 0.001), DRIL (p < 0.001), and absence of macular PVD (p = 0.01). No associations were found with SS-OCTA vascular metrics.</p><p><strong>Conclusions: </strong>This study provides a comprehensive characterization of FNV in PDR. FNV was identified in 8% of our cohort, being more prevalent in younger patients with severe PDR, as evidenced by NVD and DRIL presence. The absence of macular PVD may explain its association with younger age.</p><p><strong>Key messages: </strong>What is known • Neovascularization at the fovea occurs rarely in proliferative diabetic retinopathy. • OCT and OCT-angiography can be used to evaluate foveal neovascularization, which may be associated with choroidal vascular abnormalities. What is new • Foveal neovascularization was seen in 8% of eyes with proliferative diabetic retinopathy in this cohort. • Risk factors for foveal neovascularization included younger age, absence of macular posterior vitreous detachment, presence of neovascularization of the disc, and presence of disorganization of retinal inner layers. • We did not identify an association between foveal neovascularization and choroidal perfusion abnormalities in this study.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"679-687"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julia Krieger, Oliver Cox, Jan-Paul Flacke, Lena Beilschmidt, Sabrina Mueller, Ulf Maywald, Michael Janusz Koss
{"title":"Real-world therapy and persistence of patients with neovascular age-related macular degeneration and diabetic retinopathy or diabetic macular edema: a German claims data analysis.","authors":"Julia Krieger, Oliver Cox, Jan-Paul Flacke, Lena Beilschmidt, Sabrina Mueller, Ulf Maywald, Michael Janusz Koss","doi":"10.1007/s00417-024-06690-9","DOIUrl":"10.1007/s00417-024-06690-9","url":null,"abstract":"<p><strong>Purpose: </strong>Vascular endothelial growth factor (VEGF) inhibition is the current and high-volume standard-of-care for patients with neovascular age-related macular degeneration (nAMD) and diabetic retinopathy (DR) with diabetic macular edema (DME). This study assessed the impact of non-persistence in anti-VEGF treatment using claims data from two German states.</p><p><strong>Methods: </strong>This study identified adults with nAMD or DR/DME and incident anti-VEGF treatment (= index) in January 2015-June 2019 using the German AOK PLUS claims database (January 2014-June 2021, ~ 3.5 million insured). Baseline characteristics were observed within 12 months before index. Patient follow-up lasted ≥ 24 months or until death. Non-persistence (gap of ≥ 180 days) was calculated using Kaplan-Meier estimation. Cox regression identified variables linked to non- persistence. The study analysed reimbursed anti-VEGF treatments, thus excluding off-label use of bevacizumab.</p><p><strong>Results: </strong>5,498 patients diagnosed with nAMD (mean age, 80.09 years; male, 37.50%; mean Charlson Comorbidity Index [CCI] score, 3.07) and 484 patients with DR/DME (mean age, 67.14; male, 58.88%; mean CCI score, 4.54) were identified. Non-persistence to anti-VEGF treatment within 12 months after index occurred in 51.38% of nAMD patients and 62.60% of DR/DME patients, with mean times to first gap of 11.28 and 8.98 months, respectively. Cox regression revealed factors associated with non-persistence, including higher age, female gender, higher care needs, longer AMD history, and the use of ranibizumab.</p><p><strong>Conclusion: </strong>Epidemiologic and ophthalmologic factors associated with anti-VEGF non-persistence were successfully identified in the first year of therapy. The analyzed dataset can potentially be enriched with additional health insurance database sets under the used criteria to gain more understanding of anti-VEGF non-persistence.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"713-725"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adi Porat Rein, Hashem Totah, Koby Brosh, David Zadok, Joel Hanhart
{"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}
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
{"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}
Martin Dominik Leclaire, Friederike Elisabeth Vietmeier, Maximilian Treder, Nicole Eter, Lamis Baydoun
{"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}
Mina Maged Habib, Gihan Mohamed Hilmy, Ahmed Mostafa AbdelRahman, Mohamed Sabry Kotb
{"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}