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

{"title":"Minimum perceptual time (MPT). Repeatability and reproducibility of variables applied to \"sports vision\".","authors":"Antonio Ríder-Vázquez, Margarita Vega-Holm, María Carmen Sánchez-González, Estanislao Gutiérrez-Sánchez","doi":"10.1007/s00417-024-06684-7","DOIUrl":"https://doi.org/10.1007/s00417-024-06684-7","url":null,"abstract":"<p><strong>Purpose: </strong>\"Minimum Perceptual Time\" (MPT) is the ability to take the most visual information in the least time. The purpose of the study was to assess intraobserver and interobserver repeatability of a MPT measurement method by using COI-SV^® software and to analyze the possible influence of age and sex.</p><p><strong>Methods: </strong>MPT was measured in 79 participants by using COI-SV^® software. Visual acuity was 20/80 (2.50 m) and numbers were gradually increasing in quantity and decreasing in exposure time. The most quantity of numbers and the least time was written down. To assess intraobserver and interobserver repeatability, a protocol based on repeating the test 4 times (2 intrasession and 2 intersessions with 2 examinators) was established. Comparison of means and Spearman correlation were performed to evaluate the influence of sex and age. It was investigated inter and intraexaminer variability using repeatability indices, as well as Bland-Altman analysis to define limits of agreement.</p><p><strong>Results: </strong>A total of 79 participants were included (mean age 32.8 ± 11.95 years, range 19-64 years). Regarding sex, there were no significant differences between men and women (p = 0.080), whereas age and MPT had an inverse correlation (p = 0.01). Interexaminer and intraexaminer repeatability proved to be moderate to good in all methods. Bland-Altman showed difference between sessions was 0.259 ± 2.189 (-4.030 and + 4.549) and difference between examiners was - 0.519 ± 2.104 (-4.642 and + 3.604).</p><p><strong>Conclusion: </strong>MPT measurements with COI-SV^® software evidenced moderate to good repeatability and observers` independent result, so it could be included in optometric examinations.</p><p><strong>Key messages: </strong>WHAT IS KNOWN : Sports optometry is a relatively new field, so research is scarce and of poor quality. The scarcity of literature is practically limited to studies in the field of psychology, although they do not provide us with much information since they have not been studied for the mentioned field. The in-depth study of new standardized measurement methods would be of great help for optometrists in their clinical practice.</p><p><strong>What is new: </strong>This study is the first to determine intraobserver and interobserver repeatability and reproducibility for Minimum Perceptual Time (MPT) measurements acquired by the COI-SV® software, exhibiting ICC > 0.7 and establishing limits of agreement by using Bland-Altman analysis. In a significant way, MPT and age would have an inverse correlation, whereas MPT results would be better in men than women. Our results add evidence towards validating the test included in COI-SV® software so that the optometrist can include it in their clinical protocols in order to obtain more complete information on visual examinations.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618754","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":"Delayed closure of highly myopic macular holes combined with retinoschisis after inverted internal limiting membrane flap.","authors":"Matteo Mario Carlà, Carlos Mateo","doi":"10.1007/s00417-024-06678-5","DOIUrl":"https://doi.org/10.1007/s00417-024-06678-5","url":null,"abstract":"<p><strong>Purpose: </strong>To assess functional and anatomical outcomes of internal limiting membrane (ILM) inverted flap in highly myopic macular holes (HMMHs) with outer-retinoschisis (O-RS).</p><p><strong>Methods: </strong>Retrospective interventional analysis of 19 eyes with HMMH and O-RS undergoing vitrectomy and ILM inverted flap. At baseline and every follow-up visit (1, 3, 6, 12 months and the most recent) we performed best-corrected visual acuity (BCVA, Snellen) and optical coherence tomography (OCT), collecting several parameters: minimum linear diameter (MLD), basal diameter (BD), peri-HMMH nasal and temporal retinal thickness (RT_NAS and RT_TEM), peri-HMMH nasal and temporal O-RS height (O-RS_NAS and O-RS_TEM). The ratios O-RS_NAS/ RT_NAS and O-RS_TEM/RT_TEM were defined as %O-RS_NAS and %O-RS_TEM. Postoperatively, we distinguished classic HMMH closure (n = 14) from a newly described \"delayed\" closure pattern (n = 5).</p><p><strong>Results: </strong>Primary anatomical closure was obtained in 89% of eyes. Mean BCVA improved from 0.23 ± 0.17 to 0.44 ± 0.20 and 0.46 ± 0.25 at 6-months and final follow-up (p = 0.009 and p = 0.001, respectively). At every follow-up, \"classic\" vs. \"delayed closure\" did not influence BCVA (all p > 0.05). Baseline O-RS_NAS (p = 0.026), O-RS_TEM (p = 0.04), %O-RS_NAS (p = 0.04) and %O-RS_TEM (0.004), were significantly associated with the \"flap closure\" pattern, differently from MLD and BD. In the \"delayed closure\" subgroup we reported a 100% closure rate, but 65.8 ± 64.4 days after first surgery. Meantime, OCT showed an inverted ILM flap covering an area of persistent tissue loss. O-RS_NAS and O-RS_TEM progressively reduced until HMMH closure.</p><p><strong>Conclusion: </strong>Inverted flap is useful to close HMMH with O-RS. In case of \"delayed closure\" pattern, watchful-waiting allows for HMMH self-sealing, without impact on BCVA.</p><p><strong>Key messages: </strong>What is known Inverted internal limiting membrane (ILM) flap showed favorable anatomic success in cases of highly myopic macular holes (HMMH). What is new HMMHs with outer retinoschisis (class 2c of the staging system) may close following a classic or \"delayed closure\" pattern. In cases of delayed closure, it took a variable range of 30-179 days to seal the HMMH but no further surgery was advisable. Post-operative BCVA improvement was not impacted at any follow-ups when comparing \"delayed\" and \"classic\" closure subgroups.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618750","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":"Continuous intraocular pressure variations following positional transitions in normal subjects and open angle glaucoma patients using a contact lens sensor system.","authors":"Yuning Zhang, Wenxin Yang, Zidong Chen, Xinyi Zhang, Ping Wai Or, Ching Hymn Christopher Lee, Isuru Kaweendra Karunaratne, Yunzhi Xu, Pingping Liu, Iok Tong Chong, Zhen Qin, David C C Lam, Minbin Yu","doi":"10.1007/s00417-024-06680-x","DOIUrl":"https://doi.org/10.1007/s00417-024-06680-x","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy of a novel contact lens sensor system (CLS) in detecting continuous intraocular pressure (IOP) variations following positional transitions, and to explore these IOP variation patterns among normal subjects, untreated glaucoma patients, and untreated ocular hypertension (OHT) subjects.</p><p><strong>Methods: </strong>This prospective comparative study included 20 normal subjects, 14 high tension glaucoma (HTG) patients, 16 normal tension glaucoma (NTG) patients, and 14 OHT subjects. Participants wore the CLS for continuous IOP monitoring while undergoing sequential body position changes: from sitting to supine to a 10° head-down tilt (HDT), with each position maintained for ten minutes. Continuous IOP parameters, including mean, peak, and fluctuation (peak minus valley) in each position, as well as increment (peak minus starting value), interval (time to arrive peak), and velocity (increment divided by interval) after two position transitions, were compared among different positions and groups, respectively.</p><p><strong>Results: </strong>Normal subjects, HTG and NTG patients exhibited higher CLS IOP mean and peak in supine/HDT positions compared to sitting (P < 0.05), but the mean or peak in HDT did not significantly differ from that in supine (P > 0.2). In OHT, all IOP parameters showed no significant difference among various positions (P > 0.1), except for velocity. Comparisons among groups revealed that during the transition from sitting to supine, HTG demonstrated higher IOP increment than other three groups and higher velocity than normal subjects (P < 0.05). NTG patients exhibited no significant differences in IOP increment, interval and velocity, compared to normal subjects (P > 0.05).</p><p><strong>Conclusions: </strong>The CLS proved effective in continuously recording IOP responses following positional changes in normal and glaucomatous eyes. Transitioning from sitting to supine resulted in increased IOP among normal subjects, HTG and NTG patients, but not in OHT. Compared to normal subjects, this IOP increase was more pronounced and rapid in HTG, but comparable in NTG.</p><p><strong>Key messages: </strong>WHAT IS KNOWN : Positional transitions can induce IOP variations, which differ among normal subjects and glaucoma patients, and potentially relate to glaucomatous neuropathy. However, prior findings are constrained by the discontinuity of traditional tonometry.</p><p><strong>What is new: </strong>This study utilized a novel contact lens sensor system (CLS) to continuously monitor IOP during positional transitions in normal subjects and untreated glaucoma/OHT subjects. Continuous IOP outcomes revealed that normal subjects, HTG patients, and NTG patients exhibited an increase in IOP when transitioning from sitting to supine, whereas OHT did not. Compared to normal subjects, this increase in IOP was more pronounced and rapid in HTG patients, but similar in NTG.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618746","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":"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":"https://doi.org/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":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-09","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":"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":"https://doi.org/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":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical changes following corneal crosslinking in keratoconus patients.","authors":"Emilia Felter, Ramin Khoramnia, Maximilian Friedrich, Hyeck-Soo Son, Gerd U Auffarth, Victor A Augustin","doi":"10.1007/s00417-024-06549-z","DOIUrl":"10.1007/s00417-024-06549-z","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the biomechanical and tomographic outcomes of keratoconus patients up to four years after corneal crosslinking (CXL).</p><p><strong>Methods: </strong>In this longitudinal retrospective-prospective single-center case series, the preoperative tomographic and biomechanical results from 200 keratoconus eyes of 161 patients undergoing CXL were compared to follow-up examinations at three-months, six-months, one-year, two-years, three-years, and four-years after CXL. Primary outcomes included the Corvis Biomechanical Factor (CBiF) and five biomechanical response parameters obtained from the Corvis ST. Tomographically, the Belin-Ambrósio deviation index (BAD-D) and the maximal keratometry (K_max) measured by the Pentacam were analyzed. Additionally, Corvis E-staging, the thinnest corneal thickness (TCT), and the best-corrected visual acuity (BCVA) were obtained. Primary outcomes were compared using a paired t-test.</p><p><strong>Results: </strong>The CBiF decreased significantly at the six-month (p < 0.001) and one-year (p < 0.001) follow-ups when compared to preoperative values. E-staging behaved accordingly to the CBiF. Within the two- to four-year follow-ups, the biomechanical outcomes showed no significant differences when compared to preoperative. Tomographically, the BAD-D increased significantly during the first year after CXL with a maximum at six-months (p < 0.001), while K_max decreased significantly (p < 0.001) and continuously up to four years after CXL. The TCT was lower at all postoperative follow-up visits compared to preoperative, and the BCVA improved.</p><p><strong>Conclusion: </strong>In the first year after CXL, there was a temporary progression in both the biomechanical CBiF and E-staging, as well as in the tomographic analysis. CXL contributes to the stabilization of both the tomographic and biomechanical properties of the cornea up to four years postoperatively.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"3635-3642"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330774","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":"The impact of interrupted corneal collagen crosslinking (CXL) treatment.","authors":"Marit Tholvsen, Karim Makdoumi","doi":"10.1007/s00417-024-06505-x","DOIUrl":"10.1007/s00417-024-06505-x","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate progression of keratoconus in patients where CXL treatment was interrupted due to insufficient swelling of the cornea.</p><p><strong>Methods: </strong>A retrospective review was conducted of all patients with keratoconus diagnosis who underwent CXL at the Department of Ophthalmology, Örebro University Hospital (USÖ) during the years 2010-2017. In total 377 eyes of 280 patients were screened for inclusion. In 17 eyes (15 patients), the treatment was interrupted due to insufficient swelling of the cornea. Patient journals were reviewed and keratometry examinations were analysed for long-term progression.</p><p><strong>Results: </strong>Eleven eyes (nine patients) were included in the study. Five eyes showed no signs of progression after the interrupted CXL treatment. In one eye progression continued, however, first after a period of a number of years, indicating a delayed course of clinical progression.</p><p><strong>Conclusion: </strong>This study indicates that debridement of the corneal epithelium and riboflavin administration without intense UVA radiation may slow or arrest the progression of keratoconus, likely due to photosensitisation from ambient light.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"3643-3648"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418579","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":"Retinal artery occlusion in young patients without typical cardiovascular risk factors: etiologies, prognosis, and suggested work-up.","authors":"Alejandra M Maiz, Sadhana Murali, Jason M L Miller","doi":"10.1007/s00417-024-06527-5","DOIUrl":"10.1007/s00417-024-06527-5","url":null,"abstract":"<p><strong>Purpose: </strong>To understand the etiology, work-up, and secondary systemic and ocular events of retinal artery occlusion (RAO) in young patients (≤ 45 years old) without typical cardiovascular risk factors.</p><p><strong>Methods: </strong>Retrospective longitudinal case series of 18 young patients with RAO and without typical cardiovascular risk factors evaluated at the University of Michigan Medicine Health System between the year 2000 and 2022. Laboratory and imaging studies performed at the time of RAO diagnosis, along with systemic and ocular events during follow-up, were recorded. These data were combined with data from a literature review of 74 similar patients experiencing a RAO.</p><p><strong>Results: </strong>Fifteen (83%) of patients were female and 10 (56%) suffered a branch retinal artery occlusion (BRAO). 56% of patients had one risk factor associated with cryptogenic stroke, most commonly a migraine history (33%). The most frequent etiology of RAO was vasculitis (28%), followed by idiopathic (22%) and patent foramen ovale (PFO, 17%). Three out of four patients with idiopathic RAOs developed new migraines around the time of RAO diagnosis, whereas none of the patients with a clear etiology had new onset migraines (n = 14). No patients suffered a stroke or myocardial infarction (MI) in the follow-up period (average 3.6 years ± 3.2 years). Two patients (11%) suffered a repeat RAO, both of whom were diagnosed with a vasculitis. Patients with isolated retinal vasculitis required repeat fluorescein angiograms for up to 2 years after the initial event to definitively identify the vasculitic etiology of the RAO. When our data are pooled with similarly healthy patients from previously published RAO series, structural/functional cardiac abnormalities and vasculitides are the most common identifiable etiologies for RAOs in this group.</p><p><strong>Conclusion: </strong>The most common identifiable etiologies of RAO in young patients with low cardiovascular risk are structural/functional cardiac abnormalities and vasculitides, with a small range of additional causes/associations accounting for remaining cases. We suggest a focused work-up algorithm to rapidly identify etiologies in this group while minimizing unnecessary testing. The long-term risk of systemic or ocular secondary events in these patients is low regardless of the etiology of their RAO.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"3577-3587"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283522","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":"Response to letter to the editor Re: comment on \"Comparison of functional and morphologic changes between brolucizumab and faricimab in neovascular age-related macular degeneration\".","authors":"Maiko Maruyama-Inoue, Jacob Yuhang Chin, Kazuaki Kadonosono","doi":"10.1007/s00417-024-06516-8","DOIUrl":"10.1007/s00417-024-06516-8","url":null,"abstract":"","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"3735-3736"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912094","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":"Title - Long term outcomes of vitrectomy and ERM peel: Can pre-operative metamorphopsia measured using the D-Chart help improve surgical candidate selection?","authors":"James E Hazelwood, Kim Ah-See, Su Ling Young, Harry G B Bennett, Ashraf Khan, Colin R Goudie","doi":"10.1007/s00417-024-06514-w","DOIUrl":"10.1007/s00417-024-06514-w","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the predictive value of pre-operative metamorphopsia, measured using the D-Chart, in patients undergoing epiretinal membrane (ERM) surgery and how this relates to improvement in quality of life after surgery.</p><p><strong>Methods: </strong>17 patients from vitreo-retinal surgery clinics at a tertiary ophthalmology centre were recruited when listed for pars plana vitrectomy (PPV) with ERM peel between September 2019 - February 2020. Pre-operatively patients underwent visual acuity (VA), Visual-Function Index 14 (VF-14) and metamorphopsia (D-Chart-Thomson Software Solutions) assessment and answered a questionnaire regarding cardinal ERM symptoms. Post-operatively patients were re-assessed in the same domains.</p><p><strong>Results: </strong>13 patients completed the protocol (inclusion rate 76%) with a mean follow-up of 32.1 (± 3.1) months. Mean pre-operative VA of the affected eye was 0.42 logMAR (± 0.25). Mean pre-operative VF-14 score was 81.51 (± 12.8) and mean M-Score of the affected eye was 14.6 (± 12.7). Post-operatively, mean VA of the operated eye was 0.11 logMAR (± 0.11), mean VF-14 score was 97.4 (± 3.8) and mean M-Score was 1.31 (± 2.8). Mean improvement in VA was 0.31 logMAR (p < 0.001), in VF-14 15.9 (p = 0.002), and M-Score -13.3 (p = 0.003). There was a significant association between pre-operative D-Chart score and improvement in VA (r = -0.570, p = 0.042), visual functioning (r = 0.606 p = 0.028) and metamorphopsia (r = 0.916 p < 0.001), with those demonstrating poorer D-Chart scores showing greater improvements.</p><p><strong>Conclusion: </strong>Pre- and post-operative visual distortion measured using the D-Chart, correlates with vision related quality of life in patients undergoing epiretinal membrane surgery. Patients with worse pre-operative distortion scores noticed the greatest improvements in distortion and vision related quality of life following surgery. With a mean follow-up time of 32.1 months, this long-term follow-up data further reinforces the efficacy of vitrectomy and ERM peel by demonstrating significant and sustained improvement in visual acuity, metamorphopsia and visual functioning. The authors suggest there is a role for D-Chart assessment pre-operatively to improve selection of patients in ERM surgery.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"3475-3481"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140956277","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}