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

{"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}

{"title":"Assessing the predictability of five intraocular lens calculation methods in eyes with prior myopic keratorefractive lenticule extraction.","authors":"Mª Victoria de Rojas Silva, Adrián Tobío Ruibal, Jorge Suanzes Hernández, Hugo Darriba Folgar","doi":"10.1007/s00417-024-06661-0","DOIUrl":"10.1007/s00417-024-06661-0","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate and compare the predictability of five methods of intraocular lens (IOL) calculation in eyes with prior keratorefractive lenticule extraction (KLEx) for the treatment of myopia.</p><p><strong>Methods: </strong>A retrospective case study included 100 eyes of 52 patients who underwent myopia and myopia with astigmatism treatment with small incision lenticule extraction (SMILE). Preoperative and 3-month postoperative measurements of optical biometry and corneal tomography were obtained. The spherical equivalent of the refractive change induced by surgery was converted to the corneal plane (SMILE-dif). A physically well-defined method was developed in which the same IOL model was implanted before and after SMILE. IOL power was calculated using ray-tracing (RT-Sirius), and several IOL power calculation formulas (Kane, EVO 2.0, Barrett Universal II Formula, Hoffer QST) before surgery. After surgery, IOL power was calculated with RT-Sirius, Kane using Mean Pupil Power at 5.5 mm by ray tracing, EVO 2.0 Post Myopic LASIK/PRK, Barrett True K and Hoffer QST Post Myopic LASIK/PRK after surgery. The difference between the refractive error induced by the IOL before and after SMILE in the corneal plane (IOL-dif) was compared with SMILE-dif. The predicted error (PE) was calculated as the difference between SMILE-dif and IOL-dif.</p><p><strong>Results: </strong>The PE obtained was 0.26 ± 0.55 diopters (D), 0.10 ± 0.45 D, 0.40 ± 0.37 D, -0.03 ± 0.36 D, 0.02 ± 0.51 D, with RT-Sirius, Kane, EVO 2.0, Barrett True K, and Hoffer QST respectively. PE was not statistically significantly different between Barrett True K and Hoffer QST, with differences being more homogeneous with Barrett, (variance σ² = 0,13). The absolute EP obtained with Barrett True K achieved 84% of cases within ± 0.5 D, followed by Kane (72%), Hoffer QST (65%), EVO (61%) and RT-Sirius (59%).</p><p><strong>Conclusions: </strong>Barrett True K formula was the most accurate method for IOL calculation in eyes that had undergone SMILE for the correction of myopia.</p><p><strong>Key messages: </strong>What is known The literature regarding IOL power calculation after SMILE is sparse, and the methods used to estimate corneal power following LASIK/PRK may not be applicable to SMILE procedures. The most common approach to investigating the predictability of IOL calculation formulas involves a theoretical model encompassing the virtual implantation of an IOL. What is new The Hoffer QST formula, Kane formula using Mean Pupil Power at 5.5 mm, EVO 2.0, and Sirius' Ray Tracing software had not been previously evaluated using this approach. The Barrett True K formula was the most accurate method for IOL calculation in eyes that had undergone SMILE for myopia correction, outperforming Ray Tracing.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"873-881"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463304","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 influencing the outcomes of trabeculectomy, conventional canaloplasty, and mitomycin C augmented canaloplasty.","authors":"Julia Prinz, Matthias Fuest, David Kuerten, Peter Walter, Claus Cursiefen, Verena Prokosch","doi":"10.1007/s00417-024-06656-x","DOIUrl":"10.1007/s00417-024-06656-x","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the efficacy, safety, and factors influencing the outcomes of trabeculectomy (TE), conventional canaloplasty (cCP), and mitomycin C augmented canaloplasty (mCP) in glaucoma patients.</p><p><strong>Methods: </strong>Intraocular pressure (IOP), the number of IOP-lowering eye drops, and surgery-related complications were evaluated at baseline and through 18 months postoperatively. Correlations between patients' demographic data, ophthalmic and non-ophthalmic conditions, outcomes and complications were evaluated.</p><p><strong>Results: </strong>171 patients were included. IOP and IOP-lowering eye drops were significantly (p < 0.001) reduced 18 months after TE, cCP, and mCP. At the 18-month follow-up, IOP and IOP-lowering eye drops were significantly lower following TE than cCP (p < 0.001, p = 0.010, respectively) and mCP (p = 0.010, p = 0.014). At the 18-month follow-up, complete success rates were significantly higher after TE compared to cCP and mCP for IOP ≤ 21, 18, and 16 mmHg (p < 0.001). Qualified success rates for IOP ≤ 16 mmHg were higher following TE than cCP and mCP (p = 0.023). In the TE group, clinical hypotony at any postoperative follow-up was positively correlated with previous intravitreal anti-vascular endothelial growth factor (VEGF)-therapy (p < 0.001), leukaemia (p = 0.002), and a spherical equivalent < -3 dioptres (p < 0.001). There were no significant correlations in the cCP and mCP groups.</p><p><strong>Conclusion: </strong>TE, cCP, and mCP led to a significant reduction in IOP and IOP-lowering eye drops during 18 months of follow-up. At 18 months of follow-up, IOP and IOP-lowering eye drops were significantly lower following TE compared to cCP and mCP. Anti-VEGF-therapy, cystostatic therapy in leukaemia, and a spherical equivalent < -3 dioptres were significantly correlated with postoperative hypotony, macular folds, and choroidal detachment in the TE group.</p><p><strong>Key messages: </strong>What is known • Trabeculectomy (TE) is considered the gold standard in the surgical management of glaucoma. However, TE involves extensive postoperative management and might be associated with severe surgery-related complications. What is new • In this study, intraocular pressure (IOP) and IOP-lowering eye drops were significantly lower following TE compared to conventional canaloplasty (cCP) and mitomycin C augmented canaloplasty (mCP) at a follow-up of 18 months. • In patients undergoing TE, anti-VEGF-therapy, cystostatic therapy in leukaemia, and a spherical equivalent < -3 dioptres were significantly correlated with postoperative hypotony, macular folds, and choroidal detachment.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"807-817"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499150","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":"Proton beam irradiation with anti-VEGF therapy for polypoidal choroidal vasculopathy: results of a 24-month, phase II randomized study.","authors":"Wenyi Tang, Xianxin Qiu, Jingli Guo, Gezhi Xu, Lin Kong, Wei Liu","doi":"10.1007/s00417-024-06681-w","DOIUrl":"10.1007/s00417-024-06681-w","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the efficacy and safety of proton beam irradiation (PBI) and anti-vascular endothelial growth factor (anti-VEGF) therapy for polypoidal choroidal vasculopathy (PCV)/ aneurysmal type 1 macular neovascularization (AT1).</p><p><strong>Methods: </strong>The randomized clinical trial consisted of newly diagnosed active PCV/AT1 patients who were randomized 1:1 to treatment with three initial monthly intravitreal anti-VEGF agent (conbercept) injections with or without single 14 GyE radiation. Subsequent anti-VEGF therapy was given pro re nata. The primary outcome measures were number of anti-VEGF injections, best-corrected visual acuity (BCVA), and central retinal thickness (CRT) at 24 months. Secondary outcome measures included the polypoidal lesion regression rate, changes in the areas of polypoidal lesions and branching vascular network (BVN), and radiotherapy-related adverse events at 24 months.</p><p><strong>Results: </strong>A total of 45 eyes (86.5%) completed the 24-month follow-up. At 24 months, the combination therapy group required fewer anti-VEGF injections compared with the monotherapy group (5.9 ± 4.1 vs. 8.8 ± 5.3; P = 0.04). The mean gains in BCVA and the mean decrease in CRT were not significantly different between the two groups (P = 0.85 and P = 0.17, respectively). Combination therapy was superior to monotherapy for complete polypoidal lesion regression (80.0% vs. 48%, P = 0.03) and change in BVN area (- 1.03 ± 1.24 mm² vs. 0.36 ± 0.77 mm², P < 0.01). The radiation-related microvascular abnormalities were observed in 55.0% of eyes following combination therapy at 15.7 ± 2.5 months.</p><p><strong>Conclusion: </strong>PBI (14 GyE) combined with anti-VEGF therapy could decrease the need for additional anti-VEGF injections for PCV/AT1. Longer follow-up is needed to fully evaluate the long-term safety of PBI.</p><p><strong>Key messages: </strong>What is known The current main methods for treating PCV/AT1 include anti-VEGF drugs as monotherapy or in combination with photodynamic therapy. However, some cases can be challenging with multiple repeated injections due to the relatively low regression rate of polyps and high recurrence rate. What is new Proton beam irradiation therapy with anti-VEGF drugs can synergistically promote the regression of polyps and the shrinkage of branching vascular network, and reduce the anti-VEGF treatment burden for patients with PCV/AT1. Radiation retinopathy was mild and did not appear to be visually significant at the 24-month follow-up. Proton beam irradiation can be a new strategy for the treatment of PCV/AT1.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"659-668"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618696","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}