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

{"title":"Interocular comparison of peripapillary retinal nerve fiber layer thickness and vasculature in non-pathological myopia with anisometropia.","authors":"Yafei Mu, Maierhaba Mijiti, Wei Wei, Reyila Ainiwaer, Bixia Wei, Yanli Qin, Lin Ding, Tao Shen","doi":"10.1007/s00417-025-06826-5","DOIUrl":"https://doi.org/10.1007/s00417-025-06826-5","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the interocular differences in the peripapillary retinal nerve fiber layer (RNFL) thickness and retinal vasculature in non-pathological myopic patients with anisometropia.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 100 eyes from 50 participants aged 11 to 40 with anisometropic myopia. All participants underwent comprehensive ocular examinations, and then the RNFL thickness, ONH parameters, macular vessel density (MVD), optic disc vessel density (OVD), and optic disc perfusion density (OPD) were obtained using the Cirrus spectral domain optical coherence tomography (SD-OCT). The participants were divided into two groups based on the degree of anisometropia: Group 1 had the interocular difference of spherical equivalent (SE) over 1.50 diopters (D), and Group 2 had the interocular difference of SE between 1.00 D and 1.50 D. The interocular differences in retinal parameters were analyzed and compared between the two studied groups.</p><p><strong>Results: </strong>The superior and inferior RNFL were thinner, and the temporal RNFL was thicker in the more myopic eyes. The interocular differences of the temporal RNFL thickness, nasal MVD, temporal and inferior OVD, and temporal OPD were correlated with the interocular differences of SE and AL. The interocular differences of the temporal RNFL thickness, OVD, and OPD in Group 1 were more significant than in Group 2.</p><p><strong>Conclusion: </strong>This study revealed that the temporal peripapillary RNFL was thicker in more myopic eyes, accompanied by higher OVD and OPD. These regional retinal alterations in the temporal peripapillary area may occur before the decrease in RNFL thickness and the onset of myopic pathological changes.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811181","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":"Neuroprotection beyond intraocular pressure: game changer or quiet addiction.","authors":"A Grosso, E Borrelli, M Sacchi, G Calzetti, P Ceruti, G Neri, M Marchetti, A Pinna, V Kostin, M Reibaldi, T Borsello, G Vizzeri","doi":"10.1007/s00417-025-06816-7","DOIUrl":"https://doi.org/10.1007/s00417-025-06816-7","url":null,"abstract":"<p><p>The topic of neuroprotection in glaucoma and age-related macular degeneration (AMD) is well disseminated in the literature. However, the problem is providing ophthalmologists with clear, evidence-based messages to draw on. This review examines the landscape of neuroprotective therapies for glaucoma and AMD. While promising neuroprotective agents, such as citicoline and nicotinamide, have been explored for their potential to mitigate neurodegeneration in glaucoma, robust clinical evidence validating their efficacy remains limited and there is a need for further large-scale, long-term studies to substantiate the neuroprotective effects of these agents. Maintaining low intraocular pressure plays a vital role in preventing neuronal death in glaucoma. AMD has traditionally been considered a disease affecting the outer retinal layers; however, growing evidence suggests that the inner layers are also involved. Neuroprotection is an emerging area of research, with strategies focusing on alleviating oxidative stress, inflammation and apoptosis. A reassessment of clinical endpoints and methodologies in neuroprotection research is critical to better evaluate the efficacy of these therapies in glaucoma and AMD.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788093","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":"Classification of ocular surface diseases: Deep learning for distinguishing ocular surface squamous neoplasia from pterygium.","authors":"Farshid Ramezani, Hossein Azimi, Behrouz Delfanian, Mobina Amanollahi, Jamshid Saeidian, Ahmad Masoumi, Hossein Farrokhpour, Elias Khalili Pour, Mehdi Khodaparast","doi":"10.1007/s00417-025-06804-x","DOIUrl":"https://doi.org/10.1007/s00417-025-06804-x","url":null,"abstract":"<p><strong>Purpose: </strong>Given the significance and potential risks associated with Ocular Surface Squamous Neoplasia (OSSN) and the importance of its differentiation from other conditions, we aimed to develop a Deep Learning (DL) model differentiating OSSN from pterygium (PTG) using slit photographs.</p><p><strong>Methods: </strong>A dataset comprising slit photographs of 162 patients including 77 images of OSSN and 85 images of PTG was assembled. After manual segmentation of the images, a Python-based transfer learning approach utilizing the EfficientNet B7 network was employed for automated image segmentation. GoogleNet, a pre-trained neural network was used to categorize the images into OSSN or PTG. To evaluate the performance of our DL model, K-Fold 10 Cross Validation was implemented, and various performance metrics were measured.</p><p><strong>Results: </strong>There was a statistically significant difference in mean age between the OSSN (63.23 ± 13.74 years) and PTG groups (47.18 ± 11.53) (P-value =.000). Furthermore, 84.41% of patients in the OSSN group and 80.00% of the patients in the PTG group were male. Our classification model, trained on automatically segmented images, demonstrated reliable performance measures in distinguishing OSSN from PTG, with an Area Under Curve (AUC) of 98%, sensitivity, F1 score, and accuracy of 94%, and a Matthews Correlation Coefficient (MCC) of 88%.</p><p><strong>Conclusions: </strong>This study presents a novel DL model that effectively segments and classifies OSSN from PTG images with a relatively high accuracy. In addition to its clinical use, this model can be potentially used as a telemedicine application.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788088","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":"Choroidal neovascularization secondary to punctate inner choroidopathy vs myopia: clinical outcomes after 1-year of treatment.","authors":"Leonardo Bottazzi, Eugenio Barlocci, Riccardo Sacconi, Marco Battista, Andrea Servillo, Federico Beretta, Francesco Bandello, Giuseppe Querques","doi":"10.1007/s00417-025-06818-5","DOIUrl":"https://doi.org/10.1007/s00417-025-06818-5","url":null,"abstract":"<p><strong>Background: </strong>One of the most important complications of punctate inner choroidopathy (PIC) is the development of an inflammatory type 2 choroidal neovascularization (iCNV); however, also myopic macular degeneration due to high myopia could be complicated by a type- 2 CNV (mCNV). The aim of this work is to assess similarities and differences in the response to anti-VEGF treatment between mCNV and iCNV during a one-year follow-up, number of intravitreal injections required to control the CNV and the number of recurrences that occurred during a one-year follow-up were evaluated.</p><p><strong>Methods: </strong>Retrospective, longitudinal, case-control study. Patients diagnosed with myopic iCNV secondary to PIC or to simple myopia referring to San Raffaele Hospital were enrolled from January 2021 to December 2022. Choroidal thickness (ChT) and best-corrected visual acuity (BCVA) were measured at the onset of CNV, after resolution of exudation after treatment, and at 1-year follow-up. Primary outcomes included the analysis of the number of intravitreal injections needed and the incidence of recurrences. Secondary outcomes comprised the analysis of ChT.</p><p><strong>Results: </strong>Thirty-seven eyes (37 patients) were enrolled. Sixteen eyes were affected by myopic iCNV secondary to PIC, and 21 eyes by simple mCNV. BCVA significantly improved in both myopic iCNV group (from 0.27 ± 0.12 at the baseline to 0.11 ± 0.08 LogMAR at 12 months follow-up, p < 0.001) and simple mCNV group (from 0.37 ± 0.22 at the baseline to 0.23 ± 0.17 LogMAR at 12 months follow-up, p < 0.001). A significant difference in ChT was found comparing myopic iCNV and simple mCNV groups (mean sub-CNV ChT of 258 ± 116 μm and 89 ± 14 μm, respectively, p < 0.001). Sub-CNV ChT significantly decreases during the follow-up in the PIC group (from 258 ± 116 μm to 192 ± 118 μm, p = 0.002), whereas no differences were disclosed in the myopic group. CNV secondary to PIC needed more anti-VEGF intravitreal injections to achieve resolution of exudation (3.2 ± 1.2 vs 2.1 ± 1.1 intravitreal injections, p = 0.003) and they were characterized by higher number of relapses (44% vs 20%, p < 0.001) in comparison to simple myopic group.</p><p><strong>Conclusions: </strong>PIC group showed a more aggressive pattern of CNV, characterized by higher number of relapses and intravitreal injections needed. Moreover, a higher ChT below the lesion was detected in PIC group in comparison to simple myopic group.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779779","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":"Persistent avascular retina in retinopathy of prematurity.","authors":"Ting Fang Tan, Su Ann Tay, Swati Agarwal-Sinha, Gavin Siew Wei Tan, Wei-Chi Wu, Andrew S H Tsai","doi":"10.1007/s00417-025-06820-x","DOIUrl":"https://doi.org/10.1007/s00417-025-06820-x","url":null,"abstract":"<p><p>Persistent avascular retina (PAR) has been increasingly reported with the increased use of anti-vascular endothelial growth factor (VEGF) agents in treatment-requiring ROP. However, they have also been observed in ROP eyes that did not meet treatment requirement and spontaneously regressed. PAR is highlighted in the updated nomenclature under the International Classification of Retinopathy of Prematurity, 3rd edition (ICROP3) consensus statement, underscoring the increased emphasis in detecting PAR. PAR has been noted to persist beyond existing ROP screening guidelines, and were found to be associated with complications like retinal tear and detachment, especially in eyes with more posterior PAR. Thus, serial monitoring of retinal vascularization, facilitated by fluorescein angiography and wide-field imaging, for these associated complications have been encouraged. The current lack of consensus in the follow-up and management of PAR prompts further work in this area: understanding the natural course of retinal vascularization in both untreated and treated ROP, the modulation of anti-VEGF on retinal function, and the clinical significance of PAR-associated vascular patterns can help to guide management protocols for PAR in ROP eyes.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772138","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":"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":"1089-1103"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","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":"Enhancing diabetic retinopathy and macular edema detection through multi scale feature fusion using deep learning model.","authors":"Gowri L, Haris R, Sumathi M, S P Raja","doi":"10.1007/s00417-024-06687-4","DOIUrl":"10.1007/s00417-024-06687-4","url":null,"abstract":"<p><strong>Background: </strong>This work tackles the growing problem of early identification of diabetic retinopathy and diabetic macular edema. The deep neural network design utilizes multi-scale feature fusion to improve automated diagnostic accuracy. Methods This approach uses convolutional neural networks (CNN) and is designed to combine higher-level semantic inputs with low-level textural characteristics. The contextual and localized abstract representations that complement each other are combined via a unique fusion technique.</p><p><strong>Results: </strong>Use the MESSIDOR dataset, which comprises retinal images labeled with pathological annotations, for model training and validation to ensure robust algorithm development. The suggested model shows a 98% general precision and good performance in diabetic retinopathy. This model achieves an impressive nearly 100% exactness for diabetic macular edema, with particularly high accuracy (0.99).</p><p><strong>Conclusion: </strong>Consistent performance increases the likelihood that the vision will be upheld through public screening and extensive clinical integration.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"935-956"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828334","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":"Assessment of insulin-degrading enzyme inhibitor for the treatment of corneal erosion in a rat model.","authors":"Levy Issac, Dollberg Dolev, Bahar Irit, Dotan Assaf, Issac Levy","doi":"10.1007/s00417-024-06717-1","DOIUrl":"10.1007/s00417-024-06717-1","url":null,"abstract":"<p><strong>Background: </strong>Diabetes poses a risk to diabetic keratopathy in up to two-thirds of patients. Insulin-degrading enzyme (IDE) is a protease that can break down insulin and several growth factors and may impair wound healing. Increased IDE levels have been found in fluid from diabetic skin ulcers. This study sought to determine the effect of IDE inhibitor on corneal wound healing in a rat model.</p><p><strong>Methods: </strong>Thirty-four male Wistar rats were divided into two groups: no diabetes and streptozocin-induced diabetes. Six weeks later, a 4-mm central corneal erosion was created under anesthesia in the right eye of all rats. In each group, half the rats were treated with ADT21 drops (IDE inhibitor) and half with NaCl 0.9% (sham) drops, four times daily. Image J analysis was performed to evaluate the area of erosion and healing rate.</p><p><strong>Results: </strong>There was a trend for more rapid healing in rats treated with IDEI than NaCl drops, regardless of the diabetic condition. Comparison of erosion closure over time revealed that the wounds closed significantly more quickly in the non-diabetic rats treated with IDEI than in the non-diabetic rats treated with NaCl (p = 0.045), overall mean closure time 56.00 h, 95% CI [50.54, 61.46]. No such difference was seen in the diabetic group.</p><p><strong>Conclusions: </strong>To our knowledge, this is the first study to test ADT21 drops as a novel treatment for corneal wound repair. Our results suggest a potential benefit of IDE inhibitor for treating corneal injury.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1015-1021"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876771","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":"Analysis of choroidal markers of activity in pachychoroid disease spectrum.","authors":"Raphaela M Fuganti, Fernando Campiolo, Ahmad Mansour, Luiz H Lima, Mauricio Maia, Antonio Marcelo Casella","doi":"10.1007/s00417-025-06740-w","DOIUrl":"10.1007/s00417-025-06740-w","url":null,"abstract":"<p><strong>Purpose: </strong>To detect choroidal markers of disease activity in eyes with chronic active unilateral pachychoroid disease spectrum (PDS) compared to the non-active contralateral eyes, based on multimodal imaging and particularly indocyanine green angiography (ICGA).</p><p><strong>Methods: </strong>An observational retrospective case-control study. The study evaluated individuals diagnosed with chronic active unilateral PDS (group 1) by comparing the eyes with the non-active fellow eyes (group 2). Imaging was performed using fundus photographs, ICGA, and spectral-domain optical coherence tomography (SD-OCT). Choroidal thickness, choroidal vascular density, choroidal vasodilation, choroidal vascular leakage, and choroidal meridian breakdown were evaluated.</p><p><strong>Results: </strong>Of the 90 patients with chronic PDS with ICGA at our database, 27 Caucasians (mean age: 55.9 years) were identified with active unilateral PDS. Group 1 showed a higher prevalence of the following parameters compared to Group 2: choroidal meridian breakdown (81.5% vs. 25.9%; p < 0.001), choroidal vasodilation (88.9% vs. 48.1%; p < 0.001), greater subfoveal choroidal thickness (420 ± 79.8 μm vs. 346 ± 78.5 μm; p = 0.002), ICGA choroidal vascular leakage (96.3% vs. 29.6%; p < 0.001), and choroidal hyperpermeability (100% vs. 29.6%; p < 0.001), with a nonsignificant increase in choroidal vascular density (55.4%±13.4 vs. 49.3%±13.5 in the contralateral eye; p = 0.167).</p><p><strong>Conclusion: </strong>Choroidal meridian breakdown, thicker choroid, choroidal vasodilation, and ICGA choroidal vascular leakage are potential posterior choroidal markers of disease activity in PDS.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"973-984"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028637","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":"Clinical features of midzonal iris pigment epithelial cysts: surprising findings revealed by ultrasound biomicroscopy.","authors":"Jonathan T Regenold, Zélia M Corrêa, James J Augsburger","doi":"10.1007/s00417-024-06653-0","DOIUrl":"10.1007/s00417-024-06653-0","url":null,"abstract":"<p><strong>Purpose: </strong>Midzonal iris pigment epithelial (IPE) cysts are typically asymptomatic but can pose a differential diagnostic challenge by mimicking ciliary body melanoma. We conducted a case series study of the clinical characteristics of these iris cysts, particularly their shapes and sizes and associated lesions revealed by ultrasound biomicroscopy (UBM).</p><p><strong>Methods: </strong>Charts of patients with midzonal IPE cysts encountered by one or more of the authors were reviewed retrospectively. Pertinent demographic information and clinical data about these patients and their cysts were abstracted.</p><p><strong>Results: </strong>69 patients were identified. At initial diagnosis, patients ranged in age from 14.8 to 89.5 years (median: 66.0 years). Only one patient was < 30 years old at diagnosis. 38 patients (55.1%) were female. 74 eyes (39 right, 35 left) contained one or more clinically identified midzonal IPE cysts. The cysts involved the right eye alone in 34 (49.3%), the left eye alone in 30 (43.5%), and both eyes in 5 (7.2%) patients. The midzonal IPE cysts were located most often inferotemporally (51.4%) and second most often temporally (23.0%). UBM imaging had been performed on 44 of the 74 affected eyes. The median largest basal diameter of the midzonal IPE cysts evaluated by UBM was 4.5 mm (extremes: 1.5 to 13 mm), and the median height of these cysts was 1.5 mm (extremes: 0.6 to 6 mm). The largest lesion was a complete ring cyst. All 3 UBM-evaluated eyes that appeared by slit lamp biomicroscopy to have two or more distinct midzonal IPE cysts were shown by UBM to have a single sausage or kidney-bean shaped partial ring cyst with radial folds between the lobules and not separate multiple cysts. UBM imaging also identified peripheral IPE cysts in 32 of 44 evaluated eyes (72.7%).</p><p><strong>Conclusions: </strong>Our case series confirmed previously reported findings regarding age at diagnosis and most common locations of midzonal IPE cysts. However, our UBM images revealed that at least some IPE cysts identified by slit lamp biomicroscopy as multifocal are partial ring cysts with radial folds in the cyst wall between lobules and not true independent multiple cysts.</p><p><strong>Key messages: </strong>What is known Midzonal IPE cysts occur most often unilaterally and inferotemporally. Midzonal IPE cysts are frequently associated with peripheral IPE cysts. What is new UBM imaging of eyes with two-clinically detected IPE cysts showed that they were confluent as opposed to separate cysts. The median largest basal diameter of midzonal IPE cysts evaluated by UBM was 4.5 mm (extremes: 1.5 and 13 mm). The median height of midzonal IPE cysts evaluated by UBM was 1.5 mm (extremes: 0.6 and 6 mm).</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1125-1134"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638646","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}