Indian Journal of Ophthalmology最新文献

{"title":"Retinal vein occlusion-related macular edema: An updated review of current evidence and future directions.","authors":"Shreyas Temkar, Goutham Rajasekar, Aahan D Shah, Nawazish Shaikh, Amit K Deb, Kalyan Basa","doi":"10.4103/IJO.IJO_3361_25","DOIUrl":"https://doi.org/10.4103/IJO.IJO_3361_25","url":null,"abstract":"<p><p>Macular edema is the leading cause of visual impairment in retinal vein occlusion (RVO). Management has evolved significantly with advances in retinal imaging and the recognition of vascular endothelial growth factor (VEGF) as a key pathogenic mediator. Anti-VEGF agents are now the mainstay of treatment, supported by robust evidence from randomized clinical trials and real-world studies. Intravitreal corticosteroids play a selective role in patients with suboptimal anti-VEGF responses or contraindications to anti-VEGFs, while the role of laser photocoagulation has become limited. Optical coherence tomography remains central to diagnosis, monitoring, and prognostication. Fluorescein angiography and optical coherence tomography have a role in assessing retinal perfusion, including the macula. Emerging therapies, including biosimilars and long-acting delivery systems, aim to increase accessibility and durability of treatment in RVO-related macular edema (RVO-ME). This review summarizes current evidence and future directions in the management of RVO-ME.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"74 5","pages":"715-723"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-VEGF therapy for posterior segment disorders: The story so far….","authors":"Rohan Chawla","doi":"10.4103/IJO.IJO_151_26","DOIUrl":"https://doi.org/10.4103/IJO.IJO_151_26","url":null,"abstract":"","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"74 5","pages":"625-626"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual and optical outcomes of pupilloplasty in glued intrascleral intraocular lens eyes with irregular mydriatic pupils.","authors":"Vipin Rana, Amit N Tripathi, Santosh Kumar, Ranjit Goenka, Vijay K Sharma, Jaya Kaushik, Vinod K Patra","doi":"10.4103/IJO.IJO_3102_25","DOIUrl":"https://doi.org/10.4103/IJO.IJO_3102_25","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this paper is to evaluate the impact of pupilloplasty on visual outcomes and optical quality in eyes with irregular, persistently dilated pupils following glued intrascleral posterior chamber intraocular lens (IOL) implantation.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>Fourteen eyes of fourteen patients presenting with persistent mydriasis and visual symptoms after glued intrascleral IOL fixation were analyzed. Single-pass four-throw pupilloplasty was performed in all cases except one, which required trifold pupilloplasty. Preoperative and 1-week postoperative evaluations included best-corrected visual acuity (BCVA), mesopic pupil diameter, and corneal wavefront parameters-optical path difference root mean square (OPD RMS), higher-order RMS (HO RMS), astigmatism RMS, coma, spherical aberration, and point spread function (PSF) Strehl ratio-measured using the Sirius Scheimpflug-Placido system. Subjective visual satisfaction was also assessed. Outcomes were assessed at 1 week postoperatively, representing early anatomical and optical stabilization following pupillary reconstruction.</p><p><strong>Results: </strong>Mean BCVA improved significantly from 0.62 ± 0.31 to 0.23 ± 0.10 logMAR ( P < 0.001). Mesopic pupil size reduced from 6.18 ± 0.88 to 2.59 ± 0.21 mm ( P < 0.001). Significant postoperative reductions were observed in OPD RMS, HO RMS, astigmatism RMS, coma, and spherical aberration (all P ≤ 0.03). The PSF Strehl ratio increased more than threefold ( P < 0.001). All patients reported symptomatic improvement, with 85.7% rating postoperative vision as very good or excellent. No intraoperative or postoperative complications were noted.</p><p><strong>Conclusion: </strong>Pupilloplasty effectively reconstructs a near-physiologic pupil and leads to marked early improvement in visual acuity and optical quality in eyes with irregular mydriasis after glued intrascleral IOL implantation; however, longer follow-up studies are required to confirm long-term stability.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"74 Suppl 1","pages":"S97-S102"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-month outcomes of PresbyEDOF: A retrospective case study evaluating a laser-based corneal solution for presbyopia correction.","authors":"David Beckers, Lena Beckers, Florian T A Kretz, Mücella Kirca, Amr Saad, Hakan Kaymak, Karsten Klabe, Detlev Breyer","doi":"10.4103/IJO.IJO_1169_25","DOIUrl":"https://doi.org/10.4103/IJO.IJO_1169_25","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety, efficacy, and refractive predictability of PresbyEDOF, an individualized corneal laser technique for presbyopia correction.</p><p><strong>Methods: </strong>In this retrospective, single-center case series, 114 eyes of 57 patients (mean age 54 ± 4.7 years) were treated with PresbyEDOF using the SCHWIND AMARIS 1050RS. The treatment induced approximately 1.5 D of extended depth of focus in both the near-dominant and far-dominant eye, with a planned anisometropia of 1.5 D. Primary outcomes at 3 months included binocular uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), refractive predictability, change in corrected distance visual acuity (CDVA), residual astigmatism, retreatment rate, and visual disturbances.</p><p><strong>Results: </strong>Binocular UDVA of 0.0 logMAR was achieved in 92% of patients. UNVA of ≥0.0 logMAR was achieved in 40% and ≥0.2 logMAR in 93% of patients. CDVA remained unchanged in 38% of eyes, decreased by one line in 27%, and improved by one line in 35%. Residual astigmatism >0.5 D occurred in 4% of eyes. Retreatment was required in three patients (5.3%), including two cases retargeted for improved intermediate vision. No intraoperative complications, ectasia, or infections were observed. All patients reported improved visual quality, with photic phenomena described as rare and transient.</p><p><strong>Conclusions: </strong>PresbyEDOF demonstrated favorable distance and near visual outcomes, high visual quality, and low residual astigmatism at 3 months. The technique appears to be a safe and effective corneal approach for presbyopia correction, warranting further prospective studies with longer follow-up.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"74 Suppl 1","pages":"S131-S133"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fight retinoblastoma India: A decade of collective action, collaboration, and patient-centered care.","authors":"Poonam Bagai, Santosh G Honavar, Amita Mahajan, Sima Das, Haresh Gupta","doi":"10.4103/IJO.IJO_1020_26","DOIUrl":"https://doi.org/10.4103/IJO.IJO_1020_26","url":null,"abstract":"","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"74 Suppl 1","pages":"S1-S3"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing the invisible costs of anti-VEGF: The road to regularity.","authors":"Surbhi Agrawal","doi":"10.4103/IJO.IJO_36_26","DOIUrl":"10.4103/IJO.IJO_36_26","url":null,"abstract":"<p><p>Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy has transformed outcomes in retinal disease, but its benefits depend on early initiation and sustained regular treatment. In India, poor adherence is often attributed to drug cost alone; however, the invisible indirect costs of care may be equally important. These include repeated hospital visits, transport expenses, loss of wages, caregiver burden, domestic responsibilities, administrative delays, and medico-legal practices that increase pre-procedure testing and paperwork. This perspective highlights \"visit burden\" as an under-recognized barrier to regularity and argues that improving compliance requires redesigning care around the patient's real-life circumstances. Practical strategies include insurance approval of treatment plans rather than individual injections, rationalizing pre-procedure investigations, enabling same-day injections, avoiding unnecessary post-injection antibiotics, adopting protocols that reduce visit frequency such as treat-and-extend, and scheduling follow-up visits precisely with reminders. Post-injection reviews should be purposeful and evidence-based rather than routine. Real-world anti-VEGF outcomes will improve not only by choosing the right drug, but by delivering treatment in a way that patients can realistically continue.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"74 5","pages":"639-642"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neovascular age-related macular degeneration management - Beyond anti-VEGF.","authors":"Apoorva Ayachit, Shailesh Rao, Shadma Eqbal, Giriraj Vibhute, Farhat Fatima, Shrinivas Joshi, Guruprasad Ayachit, Jay Chhablani","doi":"10.4103/IJO.IJO_3274_25","DOIUrl":"https://doi.org/10.4103/IJO.IJO_3274_25","url":null,"abstract":"<p><p>Intravitreal anti-vascular endothelial growth factor (VEGF) therapy has transformed neovascular age-related macular degeneration (nAMD) into a chronic, treatable condition. However, real-world outcomes remain limited by treatment burden, limited durability, variable response, and progression of atrophy or fibrosis, highlighting the need for strategies beyond VEGF-A suppression. This narrative review summarizes emerging therapeutic approaches aimed at addressing these unmet needs. Adjunctive pharmacologic targets, including angiopoietin/Tie2 signaling, VEGF-C/D, integrins, hypoxia-inducible pathways, and intracellular tyrosine kinase inhibition, are discussed. Gene-based therapies offering the potential for prolonged intraocular VEGF suppression are discussed, though challenges related to inflammation, irreversibility, and patient selection persist. Finally, surgical and regenerative strategies such as retinal pigment epithelium monolayer transplantation are reviewed as investigational options for highly selected patients. Collectively, these developments signal a shift toward individualized, multipronged nAMD management, with anti-VEGF therapy remaining foundational, while biomarkers, intraocular biochemical milieu, and patient adherence may guide future care.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"74 5","pages":"653-660"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility and applications of high-resolution anterior segment optical coherence tomography in unraveling the diagnosis of isolated bilateral corneal haze in children.","authors":"Sunita Chaurasia, Muralidhar Ramappa","doi":"10.4103/IJO.IJO_241_26","DOIUrl":"https://doi.org/10.4103/IJO.IJO_241_26","url":null,"abstract":"","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"74 Suppl 1","pages":"S152-S155"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating predictive accuracy of intraocular lens power calculation formulas in high axial myopia: A comparative analysis.","authors":"Teck Chee Cheng, Thayaletchumy Gopala Krishnan, Jemaima Che Hamzah","doi":"10.4103/IJO.IJO_2193_25","DOIUrl":"https://doi.org/10.4103/IJO.IJO_2193_25","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the precision of six intraocular lens (IOL) power calculation formulas-Barrett Universal II, SRK/T, Haigis, Holladay I, Holladay II, and Hoffer Q-among myopic patients undergoing cataract surgery.</p><p><strong>Methods: </strong>This retrospective study included 164 eyes from 131 patients with an axial length (AL) greater than 26.0 mm who underwent uncomplicated cataract surgery with monofocal IOL implantation at a tertiary referral center between 2018 and 2021 Several biometric data points were recorded using the IOLMaster 700. Additionally, refractive prediction error was observed and defined as the difference between predicted and postoperative spherical equivalents. Formula performance was assessed using mean absolute error (MAE), mean numerical error, median absolute error, and proportion of eyes achieving predefined refractive accuracy (±0.25 D, ±0.50 D, ±1.00 D, and ± 2.00 D).</p><p><strong>Results: </strong>Barrett Universal II showed the lowest calculation of MAE (0.54 ± 0.71 D), followed by SRK/T (0.57 ± 0.75 D) and Haigis (0.61 ± 0.69 D). Barrett Universal II demonstrated significant predictive accuracy compared with Holladay I, Holladay II, and Hoffer Q ( P < 0.05), while no statistically significant differences were observed when compared to SRK/T and Haigis. Besides, it resulted in the highest proportions of eyes within ± 0.25 D (36.6%), ±0.50 D (59.1%), ±1.00 D (88.4%), and ± 2.00 D (98.8%). The absolute prediction error increased with AL ( P < 0.05), whereas there was no significant correlation with keratometry.</p><p><strong>Conclusion: </strong>In highly myopic eyes, Barrett Universal II showed numerically lower refractive prediction errors, with overall accuracy comparable to SRK/T and Haigis. No formula demonstrated consistent statistical superiority, indicating broadly equivalent performance among the leading formulas in this population.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"74 Suppl 1","pages":"S66-S73"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is cycloplegic refraction necessary in adults? Insights from a comparative refraction study.","authors":"Rohan Arora, Anisha Agrawal, Mithila Joshi, Purva Kavishwar, Bina John","doi":"10.4103/IJO.IJO_2997_25","DOIUrl":"https://doi.org/10.4103/IJO.IJO_2997_25","url":null,"abstract":"","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"74 Suppl 1","pages":"S160-S163"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}