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

{"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":"Pulsed corneal crosslinking in the treatment of Keratoconus: a systematic review and meta-analysis.","authors":"Maria Qureshi, Stephanie L Watson, Himal Kandel","doi":"10.1007/s00417-024-06622-7","DOIUrl":"10.1007/s00417-024-06622-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Corneal crosslinking (CXL) procedures are the treatment of choice in halting progressive corneal ectasia and preserving visual acuity due to keratoconus. Pulsed crosslinking (P-CXL) was developed using intermittent pulsing ultraviolet (UV) light to mitigate the depletion of oxygen levels that occurs with continuous UV exposure in standard crosslinking protocols (C-CXL). This study aimed to explore the use of P-CXL in the treatment of keratoconus and determine whether the availability of oxygen in P-CXL carries superior efficacy outcomes as an alternative to C-CXL modalities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This review was undertaken in accordance with PRISMA guidelines. A search of several databases conducted with two separate reviewers resulted in 29 papers meeting inclusion criteria for the review, 14 selected for meta-analysis. Primary outcomes assessed by the included papers included maximum keratometry (Kmax), corrected and uncorrected distance visual acuity (CDVA, UDVA), and secondary outcomes included central corneal thickness (CCT), endothelial cell count and demarcation line. Statistical analyses were carried out on Review Manager 5.4 and the meta-analysis employed a random-effects model, which estimated the weighted effect size of raw means using inverse variance weights.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;At 12 months P-CXL showed statistically significant reductions in Kmax (-0.75 D; p &lt; 0.001) and improvement in CDVA (-0.10 logMAR; p &lt; 0.001) compared to baseline. The meta-analysis of comparative studies determined that mean differences in Kmax, CDVA, UDVA, Kmean and CCT after 12 months were not statistically significant between pulsed and continuous crosslinking groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Overall, P-CXL is effective in improving visual acuity and keratometry outcomes in keratoconus. The meta-analysis did not show a statistically significant difference in Kmax and CDVA between P-CXL and C-CXL, indicating a non-inferiority of P-CXL. However, findings of the meta-analysis are limited by the fact that different energy levels and exposure times were used for P-CXL in comparison to C-CXL in some studies, making it unsuitable to determine whether the efficacy of CXL is improved by the use of pulsed light.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key messages: &lt;/strong&gt;What is Known • Pulsed crosslinking (P-CXL) uses intermittent UV light to prevent oxygen depletion when using higher energy protocols, unlike continuous UV exposure in standard continuous crosslinking (C-CXL). • This should theoretically enhance the efficacy of the treatment by maintaining higher oxygen levels that are crucial to the cross-linking process. • There are no systematic reviews or meta-analyses directly comparing the efficacy or safety of P-CXL to C-CXL. What is New • Meta-analysis revealed differences in keratometry between P-CXL and C-CXL groups with equivalent fluence (7.2 J/cm&lt;sup&gt;2&lt;/sup&gt;) at 12 months were not statistically significant (Kmax -","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"589-601"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106630","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":"Risk factors of pediatric steroid-induced ocular hypertension.","authors":"Fumio Takano, Kaori Ueda, Yuko Yamada-Nakanishi, Makoto Nakamura","doi":"10.1007/s00417-024-06669-6","DOIUrl":"10.1007/s00417-024-06669-6","url":null,"abstract":"<p><strong>Purpose: </strong>Steroid-induced ocular hypertension (SIOH) is a significant ocular complication of pediatric steroid administration. In this study, we analyzed the risk factors associated with pediatric SIOH.</p><p><strong>Methods: </strong>We retrospectively collected data from 78 children under 20 years of age who received systemic steroids during hospitalization. The data included age, gender, primary disease, intraocular pressure (IOP) before and one month after administration, total monthly steroid dose adjusted for body weight (BW), and one-month changes in red blood cell, white blood cell, and platelet counts. A multivariate analysis was used to identify risk factors related to steroid responsiveness.</p><p><strong>Results: </strong>Thirty patients (38.5%) were classified as steroid responders, and 48 as non-responders. The median IOP during the first month of steroid treatment was 24.0 mmHg (IQR; 23.0-28.3) for responders and 15.0 mmHg (IQR; 12.3-18.0) for non-responders. The Generalized Estimating Equations analysis revealed that younger age, male sex, primary disease, increase the amount of white blood cell (WBC) and total steroid dose per BW in one month were independently associated variables. The receiver operating characteristic analysis also revealed that the cutoff values for age, total monthly steroid dose, the increase amount of WBC were 11.0 years, 40.7 mg/kg and 3.40 × 10²/µl respectively.</p><p><strong>Conclusion: </strong>High-dose steroid administration, especially in male, younger patients, necessitates careful monitoring for IOP changes during treatment. WBC count also needs to be monitored during IOP follow-ups.</p><p><strong>Key messages: </strong>What is known Steroid-induced ocular hypertension (SIOH) is one of the essential complications during steroid administration, but only limited analyses have been performed in children. What is new A comprehensive analysis of multiple factors was performed that are predicted to be associated with pediatric SIOH from previous literature. Younger age, male sex, primary disease, increase the amount of WBC, and higher total monthly steroid dose were extracted as risk factors of SIOH. This study can contribute to the prediction of cases in which ophthalmologic examinations are particularly important during systemic steroid administration in children.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"867-872"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499151","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}

{"title":"Predictive risk scores for visual prognosis after photodynamic therapy for central serous chorioretinopathy.","authors":"Ryoh Funatsu, Hiroto Terasaki, Naohisa Mihara, Hideki Shiihara, Shozo Sonoda, Taiji Sakamoto","doi":"10.1007/s00417-024-06698-1","DOIUrl":"10.1007/s00417-024-06698-1","url":null,"abstract":"<p><strong>Purpose: </strong>To comprehensively evaluate baseline characteristics of patients with central serous chorioretinopathy (CSC) and develop predictive risk scores to identify visual prognosis.</p><p><strong>Methods: </strong>This single-institute, retrospective cohort study included 144 eyes of 144 patients with CSC who underwent photodynamic therapy and achieved serous retinal detachment resolution. We developed and assessed the performance of several risk scores for best-corrected visual acuity (BCVA) outcomes six months post-treatment: i) BCVA improvement (≤-1.0 logMAR), and ii) BCVA deterioration (≥+ 1.0 logMAR).</p><p><strong>Results: </strong>The BCVA improvement models used photoreceptor outer segment thickness, loss of photoreceptor outer segment, and neurosensory retinal thickness (NSRT), while the BCVA deterioration models included outer nuclear layer thickness and NSRT. The BCVA improvement models demonstrated a corrected area under the curve (AUC) of 0.786 (95% confidence interval [CI]: 0.699-0.864), with 80.4% sensitivity, and 71.2% specificity. The BCVA deterioration models achieved a corrected AUC of 0.864 (95% CI: 0.742-0.958), with 85.7% sensitivity, and 83.5% specificity.</p><p><strong>Conclusion: </strong>The predictive models for CSC exhibited favorable performance in predicting individual visual prognoses. A thinner outer nuclear layer may be associated with BCVA deterioration, whereas preservation of the photoreceptor outer segment may be correlated with BCVA improvement.</p><p><strong>Key messages: </strong>WHAT IS KNOWN : Pre-treatment best-corrected visual acuity, thickness of each sensory retinal layer, time from onset to treatment, and macular atrophy were each found to be associated with visual prognosis for patients with central serous chorioretinopathy (CSC).</p><p><strong>What is new: </strong>The current study comprehensively assessed potential prognostic factors and precisely identified individual likelihood of visual prognosis. The study found that different regions of the sensory retina were associated with either worsening or improving visual acuity. Accurately predicting visual outcomes after photodynamic therapy for CSC would help healthcare providers create personalized treatment plans and enable patients to make informed decisions about their treatment based on their expected visual results.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"705-711"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686827","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":"Subclinical corneal inflammation and subbasal nerve alterations in keratoconus detected by in vivo confocal microscopy: a cross-sectional study.","authors":"Chareenun Chirapapaisan, Methawee Sawarot, Sathiya Kengpunpanich","doi":"10.1007/s00417-024-06664-x","DOIUrl":"10.1007/s00417-024-06664-x","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the intracorneal inflammation and subbasal nerve alterations in keratoconus.</p><p><strong>Methods: </strong>This prospective cross-sectional study recruited patients with keratoconus, who were diagnosed and graded the severity based on clinical examination and Schiempflug tomography. Laser in vivo confocal microscopy (IVCM) was performed on the corneal subbasal layer centrally to explore the inflammatory cells (ICs), subbasal nerve density (SND), and nerve tortuosity. Keratoconus severity and related factors including ocular allergy, systemic atopy, eye rubbing, floppy eyelids, and contact lens use were recorded. Association between the factors, IC density, SND and keratoconus severity were analyzed.</p><p><strong>Results: </strong>Thirty-four keratoconus eyes were enrolled, and their IVCM findings were compared with those of 20 age-matched normal eyes. Keratoconus showed a significant increase in ICs (44.25 ± 7.01 vs. 13.06 ± 7.51 cells/mm², p < 0.001) and a significant decrease in SND (16.54 ± 0.79 vs. 20.62 ± 0.72 mm/mm², p < 0.001) when compared to controls. The alterations were pronounced in severe keratoconus as the IC density was significantly higher (p < 0.001), whereas SND was lower (p = 0.001) in high-graded keratoconus than in low-graded keratoconus. However, there was no significant correlation between the number of IC and SND in keratoconus eyes (p = 0.835). Corneal sensitivity and nerve tortuosity were not different between keratoconus and the controls. No keratoconus-related factors were associated with IC density except the severity of keratoconus (p < 0.001, 95% CI [0.70, 0.95]).</p><p><strong>Conclusion: </strong>Keratoconus, a clinically noninflammatory corneal disease, demonstrates subclinical corneal inflammation and subbasal nerve decline as shown by IVCM. These alterations correlate considerably with the severity of keratoconus.</p><p><strong>Key messages: </strong>What is known Traditionally, Keratoconus is a clinically noninflammatory corneal disease. What is new Our study suspected keratoconus may be subclinical corneal inflammatory disease. In our research, A Keratoconus patient was discovered to have corneal inflammation and a reduction in sub-basal nerve density through the use of In Vivo Confocal Microscopy. Increase in corneal inflammation is considerably correlated with the severity of keratoconus.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"761-769"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618710","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":"Factors Associated with Retinal Microvasculature Dropout Induced by Elevation of Intraocular Pressure in Primary Open-Angle Glaucoma.","authors":"Alex T Vasconcelos, Lucas A Rosa, Lígia I De Fendi, Vítor J B Fontes, Denny M Garcia, George C Cardoso, Carlos Gustavo De Moraes, Jayter S Paula","doi":"10.1007/s00417-024-06652-1","DOIUrl":"10.1007/s00417-024-06652-1","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the risk factors related to decrease in vessel density (VD) observed in primary open-angle glaucoma (POAG), due to acute increase in intraocular pressure (IOP) by an ophthalmodynamometer (OPD).</p><p><strong>Methods: </strong>This cross-sectional study involved 42 eyes of participants (22 Controls and 20 POAG patients) that underwent optical coherence tomography angiography (OCT-A) to assess VD in the peripapillary region in three examination sets: primary gaze position (1), 25-degree adduction (2) and 25-degree adduction with OPD compression (3). Individual relationships between IOP levels and changes in the superficial complex VD were evaluated after image processing and exclusion of large retinal vessels. Multivariable regression analysis was used to verify factors associated with differences in VD induced by IOP elevation.</p><p><strong>Results: </strong>A significant increase in IOP was induced by OPD compression during adduction (mean ± SD, Control: + 13.8 ± 2.8; POAG: + 13.4 ± 2.1 mmHg). Only during IOP elevation (set 3), a significant VD decrease was observed both in POAG eyes (p = 0.008) and controls (p = 0.022). Baseline IOP (p = 0.022), maximum IOP (p = 0.003), and scleral rigidity (p = 0.029) were significantly associated with VD decreases in eyes with POAG. No changes were observed in VD during adduction gaze exclusively.</p><p><strong>Conclusion: </strong>Acute IOP elevation induced with OPD, but not adduction gaze, decreased peripapillary VD measured with OCT-A imaging. IOP levels and scleral rigidity significantly affected VD reduction in POAG patients. Thus, high scleral rigidity may decrease the ability of the globe to dampen the well-known effects of IOP fluctuation on glaucoma onset and progression.</p><p><strong>Key messages: </strong>What is known Decrease vascular density in the peripapillary retina was associated with POAG, but factors related to the vascular response to elevated IOP are unexplored. What is new OCT-A quantification shows decreases in vascular density of the superficial layers of the peripapillary retina during an acute elevation in IOP. High IOP levels and scleral rigidity significantly affected vascular density reduction in POAG patients.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"787-796"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389920","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":"Cystoid macular edema after low-energy femtosecond-assisted cataract surgery.","authors":"Catharina Latz, Annika Licht, Peyman Bayati, Kazem Taya, Alireza Mirshahi","doi":"10.1007/s00417-024-06663-y","DOIUrl":"10.1007/s00417-024-06663-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the occurrence of pseudophakic cystoid macular edema (PCME) post low-energy femtosecond laser-assisted cataract surgery (FLACS) in a high-volume surgical setting.</p><p><strong>Methods: </strong>The medical records of 242 FLACS patients were retrospectively reviewed. The central subfield macular thickness (CSMT) was measured via optical coherence tomography (OCT) before and 4-6 weeks after surgery, and the results were compared for PCME detection. Macular edema was defined as a 10% increase in CSMT, a new onset of intraretinal fluid, or a decrease in visual acuity (VA). VA development in PCME patients was reviewed at 2-3 months and 6 months.</p><p><strong>Results: </strong>The median patient age was 72 years (49-92 years). Among 242 eyes, seven eyes (2.89%) developed PCME. The median preoperative CSMT in these eyes was 255 μm (minimum 231 μm, maximum 326 μm), whereas the median CSMT at 4-6 weeks after surgery was 317 μm (minimum 255 μm, maximum 463 μm). 4- to 6-week postoperative visual acuity decreased in comparison with 1-week postoperative values in three eyes of two patients, remained stable in two patients, and improved in one patient, whereas one patient did not return for his 1-week appointment but improved from 0.4 to 0.2 logMAR 2.5 months postoperatively. By 3-6 months, all eyes with PCME had gained visual acuity in comparison with their preoperative values. None of the PCME patients had diabetes or used prostaglandin analogues. Three patients were receiving anticoagulation medication.</p><p><strong>Conclusion: </strong>A 2.89% incidence of PCME after low-energy FLACS matched published standard phacoemulsification rates. In our series of uncomplicated cases, PCME caused only a transient postoperative decrease in visual acuity.</p><p><strong>Key messages: </strong>What is known Increased prostaglandin levels have been detected in the aqueous humour of cataract patients after femtosecond laser application. Prostaglandins are mediators of inflammation. Femtosecond lasers come in low energy and high energy variants. There is contrasting evidence of increased incidence of PCME after femtosecond laser assisted cataract surgery (FLACS) What is new The incidence of PCME after low-energy FLACS in our high volume surgical setting is 2.89% Low-energy FLACS does not seem to have a causative effect on PCME.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"829-835"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463306","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":"Association of tear osmolarity and corneal nerves structure in dry eye disease: an in vivo study.","authors":"Moumi Maity, Manindra Bikram Allay, Mohammed Hasnat Ali, Rashmi Deshmukh, Sayan Basu, Swati Singh","doi":"10.1007/s00417-024-06657-w","DOIUrl":"10.1007/s00417-024-06657-w","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the structural changes in corneal sub-basal nerves of dry eye disease (DED) patients with tear hyperosmolarity versus normosmolar tears.</p><p><strong>Methods: </strong>A prospective evaluation of the tear film (keratograph 5 M), tear osmolarity, and sub-basal corneal nerves (laser scanning in-vivo confocal microscopy) was performed in a cohort of 53 DED patients (106 eyes) diagnosed as per DEWS II criteria. Patients with tear hyperosmolarity (Group 1, n = 48 eyes) were compared with DED patients without tear hyperosmolarity (Group 2, n = 58 eyes).</p><p><strong>Results: </strong>Of 53 patients (27 females), 28 had Sjogren's syndrome, and the rest had meibomian gland dysfunction. There were more SS patients (21 vs 7) and females in Group 1. The two groups were similar in age, TMH, NIBUT, meibomian gland loss, bulbar redness, and corneal staining, except for Schirmer I (p < 0.001), and tear osmolarity (p < 0.001; worse in group 1). The groups did not differ in dendritic cell density, whether immature (53.8 vs. 38) or mature (2.7 vs. 0). The significantly different corneal nerve parameters were nerve fiber length (p = 0.005), density (p = 0.01), and branching density (p = 0.04), with lower values observed in group 1. Only tear osmolarity had a weak negative correlation with corneal nerve fiber length (r, -0.38), density (r, -0.32), and branching (r, -0.28). SS patients with hyperosmolar tears had reduced nerve fiber length and branching compared to SS patients with normosmolar tears.</p><p><strong>Conclusion: </strong>Tear hyperosmolarity is associated with reduced nerve branching, fiber density, and fiber length despite similar levels of conjunctival congestion, tear film stability, and meibomian gland loss in DED patients.</p><p><strong>Key messages: </strong>What is known • Corneal nerves are reduced in density and length in dry eye disease patients. • Laboratory studies have shown fragmentation of corneal nerves on exposure to hyperosmolar solutions. What is new • Tear hyperosmolarity is associated with reduced nerve branching, fiber density, and fiber length in dry eyes compared to normosmolar tears. • The effect is independent of dendritic cell density.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"753-760"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400023","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}