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

{"title":"Association between the ARMS2 rs10490924 risk genotype and dry-age related macular degeneration patients with and without reticular pseudodrusen in a Turkish population: findings from a study conducted at a tertiary clinic.","authors":"Onur Furundaoturan, Cumali Degirmenci, Filiz Afrashi, Tahir Atik, Cezmi Akkin, Jale Mentes, Serhad Nalcaci","doi":"10.1007/s00417-024-06699-0","DOIUrl":"https://doi.org/10.1007/s00417-024-06699-0","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the relationship between the presence of reticular pseudodrusen (RPD) and the risk allele of ARMS2 rs10490924 variation in dry-AMD patients by using multimodal imaging. Also, to compare patients with and without RPD and healthy volunteers according to the distribution of the risk allele.</p><p><strong>Methods: </strong>In this cross-sectional study, dry-AMD patients with (Group A, n = 50) and without (Group B, n = 50) RPD and healthy volunteers (Group C, n = 50) were enrolled. After detailed ophthalmologic examination, confocal scanning laser ophthalmoscope (Heidelberg, Germany) was used to acquire near infra-red (NIR) imaging for RPD and the diagnosis was confirmed by Spectral Domain-Optical coherence tomography (Heidelberg, Germany). In silent choroidal neovascularization suspicion, optical coherence tomography angiography (Optovue, Fremont, CA) was performed and those were excluded. For genetic assessment, peripheric blood sampling was performed. Using next-generation sequencing technique (NGS), ARMS2 rs10490924 single nucleotide polymorphism was investigated. Groups were compared according to the distribution of the risky allele.</p><p><strong>Results: </strong>150 eyes of 150 participants were included. In Group A, 42% (21) of patients were heterozygous for the T risk allele, 30% (15) were homozygous, and the risk allele was not detected in 28% (14). In Group B, 44% (22) of patients were heterozygous, 17% (8) were homozygous, and the risk allele was not detected in 39% (20). In Group C, 30% (15) of participants were heterozygous, 4% (2) were homozygous, and variation was not observed in 64% (32). Homozygous participants in Group A were significantly higher than other two groups (Group A-B: OR = 2.67, 95% CI: 0.895, 8.020; Group A-C: OR = 17.14, 95% CI: 3.449, 85.208) while in Group B, homozygous individuals were higher than Group C (respectively, p values 0.0039, 0.0002, 0.013). T risky allele frequencies were 51%, 38%, and 20% in Groups A, B, and C, respectively, which was significantly higher in Group A (p = 0.02).</p><p><strong>Conclusion: </strong>Genetic influence in AMD is inevitable while certain differences according to different ethnicities may apply. Association of genetic variations and imaging findings like RPD is lacking among literature for different populations. By the aspect of this study, the relationship between RPD and ARMS2 rs10490924 polymorphism in dry-AMD patients were highlighted among Turkish population by using multimodal imaging for the first time.</p><p><strong>Key messages: </strong>What is Known? Pathophysiology of age-related macular degeneration is influenced from multiple factors including single nucleotide polymorphisms. The variations of ARMS2 are suspected well in the current literature. Reticular pseudodrusen is related to advanced stages of age related macular degeneration disease. What is New? The ARMS2 rs10490924 risk genotype is associated with the presence of ","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728003","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":"Comments on risk factors for early and late retinal detachment after boston type I keratoprosthesis surgery.","authors":"David Mikhail, Daniel Milad, Mona Harissi-Dagher","doi":"10.1007/s00417-024-06701-9","DOIUrl":"https://doi.org/10.1007/s00417-024-06701-9","url":null,"abstract":"","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739386","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":"Patterns of recurrence in idiopathic orbital myositis.","authors":"Terence Ang, Jessica Y Tong, Sandy Patel, Thomas G Hardy, Alan McNab, Dinesh Selva","doi":"10.1007/s00417-024-06692-7","DOIUrl":"https://doi.org/10.1007/s00417-024-06692-7","url":null,"abstract":"<p><strong>Purpose: </strong>To characterise patterns of disease recurrence in idiopathic orbital myositis (IOM).</p><p><strong>Methods: </strong>Multi-centre retrospective longitudinal study of IOM patients. Serial imaging was also analysed. Patients with incomplete clinical records and specific orbital myositis (e.g. thyroid-associated ophthalmopathy) were excluded.</p><p><strong>Results: </strong>Thirty-three patients (Female: 18, mean age: 40.8 ± 16.8-years-old) presenting between 2001 and 2023. Twelve (36.4%) patients had disease recurrence. There was no difference between age or sex predilection of patients with and without recurrence (P = 0.107 and 0.469, respectively). There was no association between patients presenting with multiple EOM involvement, unilateral disease, anterior tendon sparing or lacrimal gland involvement with recurrence (P = 0.328, 1.0, 0.630 and 0.686, respectively). Recurrence with single EOM involvement occurred in eight (66.7%) patients, and ten (83.3%) patients had recurrence involving different EOM(s) than on initial presentation. Seven (58.3%) patients had metachronous contralateral orbital involvement and one (8.3%) had simultaneous bilateral involvement. There was no association between age, sex, patients presenting initially with single EOM or lacrimal gland involvement with the development of contralateral orbital myositis (i.e. metachronous bilateral disease) (P = 0.777, 0.491, 0.109, and 0.236, respectively). Of the patients with a single acute episode, two (9.5%) patients experienced residual ocular symptoms, compared to four (33.3%) patients with recurrent disease (P = 0.159).</p><p><strong>Conclusion: </strong>This study summarises the patterns of recurrence in IOM. Recurrence was not associated with age, sex, multiple EOM involvement, bilateral disease, tendon-sparing or lacrimal gland involvement. Recurrence was observed in a heterogenous sample of patients and may frequently develop contralateral disease or involve different EOMs (i.e. 'migratory' disease).</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716078","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":"Retromode Infrared Scanning Laser Ophthalmoscopy in Vogt-Koyanagi-Harada Disease.","authors":"Shintaro Yasuda, Takeshi Yoshida, Yudai Suzuki, Yuiko Sugahara, Junfuku Lee, Koju Kamoi, Shintaro Horie, Hiroshi Takase, Kyoko Ohno-Matsui","doi":"10.1007/s00417-024-06693-6","DOIUrl":"https://doi.org/10.1007/s00417-024-06693-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined six patients with Vogt-Koyanagi-Harada (VKH) disease using retromode infrared scanning laser ophthalmoscopy (RMI-SLO).</p><p><strong>Methods: </strong>We conducted a single-center retrospective review of the medical records of six patients diagnosed with VKH disease. The RMI-SLO images were compared to those obtained using color fundus photography, optical coherence tomography (OCT), and dye-based retinal angiography.</p><p><strong>Results: </strong>In the acute phase of VKH disease, RMI-SLO revealed pseudo-three-dimensional (3D) regions and wavy patterns. These observations corresponded to the areas of serous retinal detachment (sRD) and choroidal folds identified on OCT. Notably, the detection of pseudo-3D regions by RMI-SLO proved to be more effective than color fundus photography in identifying sRDs. Hyper-reflective lines inside the sRDs were observed in the RMI-SLO images and were consistent with the fibrinous membranes observed in the OCT images. The hyper-reflective choroidal vasculature in RMI-SLO images was notably absent, a finding like the fuzzy pattern of large stromal choroidal vessels observed in indocyanine green angiography images. Following steroid treatment, these abnormal findings reverted to normal.</p><p><strong>Conclusions: </strong>RMI-SLO imaging could serve as an alternative option for both pre- and post-treatment assessments in VKH disease. Moreover, it has the potential to reduce the need for retinal angiography.</p><p><strong>Key messages: </strong>What is known Optical coherence tomography (OCT) and indocyanine green angiography (ICGA) are essential for the diagnosis of Vogt-Koyanagi-Harada (VKH) disease. However, it is difficult to visualize a wide area of the fundus with OCT, and ICGA carries risks of allergic reactions or shock. What is new Retromode infrared scanning laser ophthalmoscopy (RMI-SLO) can demonstrate pseudo-three-dimensional regions and wavy patterns corresponding to serous retinal detachment and choroidal folds in the acute stage of VKH disease. Hyper-reflective choroidal vasculature was absent in the acute stage of VKH disease on RMI-SLO and may correlate with choroidal thickening. RMI-SLO could be an alternative option for the assessment of VKH disease and has the potential to reduce the need for dye-based retinal angiography.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709949","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":"Long-term outcomes of sural nerve vertical cross-face graft for lacrimal gland neurotization in neurodeprivative dry eye.","authors":"Alfonso Strianese, Federico Bolognesi, Giuseppe Giannaccare, Valentino de Ruvo, Fabiana Allevi, Filippo Tarabbia, Luca Mario Rossetti, Federico Biglioli, Paolo Fogagnolo","doi":"10.1007/s00417-024-06697-2","DOIUrl":"https://doi.org/10.1007/s00417-024-06697-2","url":null,"abstract":"<p><strong>Purpose: </strong>We recently described a novel surgical procedure to reinnervate the lacrimal gland in neurodeprivative dry eye disease and reported the 1-year outcomes of patients treated accordingly. The purpose of this paper is to describe the long-term outcomes of this innovative surgical technique.</p><p><strong>Methods: </strong>Monocentric cross-sectional study including consecutive patients affected by facial palsy with an absolute deficiency of tear secretion (Schirmer test 0 mm/5 min) who underwent lacrimal gland neurotization, as previously described. Before surgery (T0) and at the last follow-up visit (T1), the following parameters were evaluated: tear film break-up time (TBUT), corneal fluorescein staining (Oxford score), Schirmer test type I, usage of tear substitutes (daily number of instillation). At T1, subjective satisfaction with surgery was collected and tear film osmolarity (TFO) was measured in both operated and contralateral eye. Corneal sensitivity was performed at T0 and T1 in patients who underwent neurotization of both lacrimal gland and cornea due to the concomitant presence of neurotrophic keratopathy (trigeminal nerve palsy).</p><p><strong>Results: </strong>Data from 9 patients (4 M, 5 F; mean age 47.1 ± 17.1 years) who underwent lacrimal gland neurotization and were followed up for an average time of 87 months (± 15) (range 60-108) were analyzed. The study procedure was combined in all cases with facial reanimation, while corneal neurotization was performed in 4 cases. At T1, the mean value of Schirmer test was significantly higher compared to T0 (5.8 ± 2.0 vs 0 ± 0 mm/5 min; p < 0.0001). TBUT and corneal fluorescein staining were significantly better compared to baseline (respectively, 2.4 ± 1.8 vs 1.2 ± 0.6 s, p = 0.04 and 1.7 ± 0.8 vs 3.1 ± 0.6, p = 0.0004). TFO was not significantly different between operated eye and contralateral one (306.7 ± 9.5 mOsm/L vs 308.9 ± 11.3 mOsm/L, p = 0.67). The mean daily number of tear substitute instillations was lower at T1 compared to T0 (12 ± 7 vs 21.8 ± 4.3; p = 0.011). Overall, all patients were satisfied with surgery at T1 (very satisfied: n = 3 and satisfied: n = 6). No major postoperative complications were recorded throughout the entire follow-up.</p><p><strong>Conclusion: </strong>Lacrimal gland neurotization through the sural nerve is a safe and effective procedure with stable favorable outcomes in the long term.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716075","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":"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":"https://doi.org/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":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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":"https://doi.org/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":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-25","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":"A comparison of cycloplegic effect of cyclopentolate 0.5% versus 1.0% eye drops with five different refraction measurement modalities in young adults.","authors":"Klemens Paul Kaiser, Christoph Lwowski, Faisal Nazir, Thomas Kohnen, Yaroslava Wenner","doi":"10.1007/s00417-024-06658-9","DOIUrl":"https://doi.org/10.1007/s00417-024-06658-9","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the refraction before and after cycloplegia with 0.5% and 1.0% cyclopentolate eye drops using five different measurement modalities.</p><p><strong>Methods: </strong>This prospective, clinical comparative study enrolled 96 eyes of 48 healthy patients with a mean age of 26.6 ± 4.21 years (range: 19-34). Subjective refraction, retinoscopy, and objective refraction were measured using three autorefractometers: Topcon KR-800 (TC), Retinomax K-plus 3 (RM + 3), and Retinomax K-plus Screeen (RM + S) under noncycloplegic and cycloplegic conditions. Cycloplegia was performed in the right eye using 0.5% and in the left eye with 1.0% cyclopentolate eye drops. Differences in refraction in noncycloplegia and cycloplegia, between cycloplegia with 0.5% and 1.0% cyclopentolate, and between the devices were investigated.</p><p><strong>Results: </strong>Cycloplegic mean spherical equivalent was -1.77 ± 2.34 diopters (D) (-9.75 to + 1.625). All approaches showed a statistically significant hyperopic shift (p < 0.001, each) after induction of cycloplegia using both regimes. Lowest median (interquartile range) hyperopic shift was shown by TC (0.25 D (0.38)) and retinoscopy (0.25D (0.75)), and the highest by RM + 3 (0.75 (1.31)). No statistically significant differences between cycloplegia using 0.5% and 1.0% regimens were shown in all modalities (p > 0.05, each). In noncycloplegia, there were greater differences compared to cycloplegia. No influence of iris color on the refraction was found.</p><p><strong>Conclusion: </strong>After induction of cycloplegia all devices showed a hyperopic shift and good comparability to retinoscopy. In all measurement modalities, no significant refraction differences between 0.5% and 1.0% cyclopentolate eye drops were seen. Therefore, 0.5% cyclopentolate was proven to have a sufficient effect with presumably better tolerability.</p><p><strong>Key messages: </strong>What is known Cycloplegic refraction is a key test in the evaluation of any patient with active accommodation. The most frequently used clinical tests to determine the exact refraction are retinoscopy, subjective refraction, and objective refraction using autorefractometry. What is new No significant differences in the refraction between cycloplegia using 0.5% and 1.0% cyclopentolate eye drops were found. In noncycloplegia, hand-held autorefractometers tend to measure higher myopia. The evaluation of cycloplegic refraction showed good comparability between retinoscopy and subjective refraction as well as three different autorefractometers.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692894","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":"https://doi.org/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":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-22","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":"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":"https://doi.org/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":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}