International Journal of Retina and Vitreous最新文献

{"title":"Oral belzutifan treatment in von hippel-lindau-associated retinal hemangioblastoma: a promising approach.","authors":"Adnan Kilani, Abdelrahman Assaf, Constantin Jochem, Denise Vogt, Mona Laible, Melih Parlak, Wesam Alkabouni, Armin Wolf","doi":"10.1186/s40942-026-00932-0","DOIUrl":"10.1186/s40942-026-00932-0","url":null,"abstract":"<p><strong>Background: </strong>Von Hippel-Lindau (VHL)-associated retinal hemangioblastomas (RHs) may cause vision-threatening exudation and hemorrhage. Conventional local therapies may be limited in advanced, recurrent, or anatomically high-risk lesions. This study evaluated ocular outcomes and observed tolerability during oral belzutifan treatment in a real-world cohort.</p><p><strong>Methods: </strong>Between January 2023 and June 2025, this retrospective observational study included five consecutive patients with genetically confirmed VHL, contributing seven eyes; each eye had at least one RH that progressed despite prior conventional local therapy. Patients received oral belzutifan 120 mg once daily. Median on-treatment follow-up (FU) was 43 weeks (IQR, 27-50); median documented cumulative belzutifan exposure was 43 weeks (range, 27-50). Data were available through January 2026. Tumor regression was quantified as the relative change in projected pixel area from baseline to last on-treatment FU. The largest baseline lesion per fundus-imaged eye was predefined for the primary analysis; all fundus-imaged lesions were assessed exploratorily. Fourteen fundus-imaged RHs were included in the projected-pixel-area analyses, and one MRI-assessed RH was reported separately. Three retinal specialists independently performed lesion measurements and exploratory overall ocular response (OOR) grading as separate assessments. Readers were masked to one another's assessments; quantitative lesion measurements were additionally masked to patient information, treatment course, and image chronology. Safety was monitored within an interdisciplinary clinical framework.</p><p><strong>Results: </strong>In the predefined primary descriptive analysis of the largest baseline lesion per fundus-imaged eye (six eyes from four patients), all six index lesions regressed (median projected-pixel-area reduction, 58.3%; IQR, 17.2-64.7%). All four lesions in the patient-level sensitivity analysis regressed (median, 59.6%; range, 14.5-64.8%). Across all 14 fundus-imaged lesions, median regression was 57.2% (IQR, 28.5-66.9%), and 11/14 lesions (78.6%) showed > 20% regression. All three readers classified all six evaluable eyes as improved. Exudative retinal detachment resolved in three of four affected eyes. Drug-related adverse events were mostly mild to moderate and manageable.</p><p><strong>Conclusions: </strong>Oral belzutifan was associated with RH regression and improved exudative disease activity in this selected real-world cohort. These findings support systemic HIF-2α inhibition as a potential adjunctive therapeutic option for selected patients with progressive or anatomically high-risk ocular VHL disease. Prospective validation is required.</p><p><strong>Trial registration: </strong>not applicable.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"12 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Misdiagnosis of uveal melanoma and other intraocular malignancies in enucleated eyes: a 28-year national review.","authors":"Hans Witzenhausen, Katerina Stripling, Gustav Stålhammar","doi":"10.1186/s40942-026-00927-x","DOIUrl":"10.1186/s40942-026-00927-x","url":null,"abstract":"<p><strong>Background: </strong>Intraocular tumors are often diagnosed clinically rather than by biopsy, so a benign lesion can be mistaken for malignancy and lead to enucleation. We determined how often uveal melanoma (UM) and other intraocular tumors are clinically misdiagnosed among enucleated eyes at the Swedish national ophthalmic pathology laboratory over 28 years, and the lesions responsible.</p><p><strong>Methods: </strong>In this retrospective, registry-based case series, all enucleation specimens accessioned at the St. Erik Ophthalmic Pathology Laboratory, Stockholm, between 1995 and 2022 under a clinical diagnosis of malignancy were reviewed against pathology reports, referral letters, and clinical records. Predefined criteria identified eyes in which a malignant tumor drove enucleation but was not confirmed histopathologically. In an exploratory analysis, the authors rated the projected visual acuity had enucleation been deferred. The misdiagnosis rate was modeled against calendar year by logistic regression and tested in sensitivity analyses.</p><p><strong>Results: </strong>Of 24,242 specimens, 1,661 were enucleations, and after predefined exclusions, 1,419 eyes had been enucleated for a presumed tumor. Thirty-nine (2.7%) were misdiagnoses: 21 diagnosed as UM, 11 with another suspected neoplasm, and 7 with a suspected unspecified malignancy. Intraocular hemorrhage was the lesion most often mistaken for UM. Among the 21 μm eyes, the projected visual impact of enucleation was nil in 13 that had no useful vision at enucleation, a loss of useful vision in 1 (decimal acuity 0.25, a benign leiomyoma), and not estimable in 7. The misdiagnosis rate did not change appreciably (odds ratio 0.97 per year, 95% CI 0.94 to 1.01, P = 0.16), remained between 2.3% and 4.2% in sensitivity analyses, and did not differ between 1995 and 2010 (2.8%) and 2011-2022 (1.8%; P = 0.25). Misdiagnosed eyes were almost always blind, painful, or had opaque media, where clinical and imaging assessment is least reliable.</p><p><strong>Conclusions: </strong>Clinical misdiagnosis preceded 2.7% of tumor-related enucleations over 28 years, at a stable rate, and intraocular hemorrhage was the most frequent mimic of UM. In an exploratory projection based on incomplete records, misdiagnosis seldom appeared to sacrifice useful vision. The findings reinforce the value of multimodal imaging, ocular-oncology consultation, and consideration of biopsy before enucleation when the diagnosis is uncertain.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"12 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early intraocular pressure kinetics after intravitreal aflibercept 8 mg (0.07 mL) versus aflibercept 2 mg (0.05 mL) in nonglaucomatous eyes: a prospective comparative study.","authors":"Annika Licht, Astrid Schneider, V Romanou, Alireza Mirshahi","doi":"10.1186/s40942-026-00906-2","DOIUrl":"https://doi.org/10.1186/s40942-026-00906-2","url":null,"abstract":"<p><strong>Background: </strong>Transient intraocular pressure (IOP) spikes after intravitreal injection (IVI) are expected. The higher-volume aflibercept 8 mg (0.07 mL) formulation has recently entered clinical use, yet its early IOP kinetics-particularly the immediate post-injection trajectory in eyes without known glaucoma or ocular hypertension-remain incompletely characterised.</p><p><strong>Methods: </strong>In this prospective, non-randomised, single-centre comparative study, 48 eyes of 48 patients received intravitreal aflibercept 8 mg/0.07 mL (n = 25) or aflibercept 2 mg/0.05 mL (n = 23). Eyes with any history of glaucoma or ocular hypertension were excluded. IOP was measured at baseline and at 3, 10, and 30 min after injection using iCare IC200 tonometry. The primary objective was to assess within-group IOP changes from baseline in the 0.07-mL group. A hierarchical fixed-sequence procedure was applied using paired Wilcoxon signed-rank tests with Hodges-Lehmann (HL) estimates and 95% confidence intervals (CIs). Between-group differences were explored using a linear mixed-effects model adjusted for baseline IOP, age, sex, and lens status.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups. In the 0.07-mL group, HL pseudo-median IOP changes from baseline were + 25.5 mmHg (95% CI 18.5 to 32.0; p < 0.001) at 3 min, + 11.0 mmHg (95% CI 8.0 to 15.0; p < 0.001) at 10 min, and + 3.5 mmHg (95% CI 1.5 to 5.5; p = 0.002) at 30 min. Adjusted between-group differences (0.07 mL minus 0.05 mL) were + 5.8 mmHg (95% CI 0.3 to 11.3; p = 0.038) at 3 min, + 2.8 mmHg (95% CI - 2.7 to 8.3; p = 0.31) at 10 min, and + 0.2 mmHg (95% CI - 5.3 to 5.7; p = 0.94) at 30 min. Two eyes in the 0.07-mL group received topical IOP-lowering medication after the 30-minute assessment; no paracentesis was performed.</p><p><strong>Conclusions: </strong>In eyes without known outflow disease, intravitreal aflibercept 8 mg (0.07 mL) was associated with a higher early IOP spike than aflibercept 2 mg (0.05 mL). However, the pressure increase was transient, and exploratory between-group analyses suggested convergence of IOP levels by 30 min. By defining the early IOP trajectory in eyes with intact outflow, these data provide a physiological reference for the short-term ocular safety of higher-volume anti-VEGF therapy and a benchmark against which exaggerated or delayed responses in at-risk eyes can be interpreted.</p><p><strong>Trial registration: </strong>Not applicable (observational study).</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"12 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of cilioretinal artery perfusion length with central visual acuity and vascular circulation in central retinal artery occlusion.","authors":"Ke Wu, Tao Lei, Runsheng Wang, Bo Zhang, Weiwei Wang, Xiaotang Wang, Teng Ma","doi":"10.1186/s40942-026-00921-3","DOIUrl":"10.1186/s40942-026-00921-3","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the effects of varying lengths of cilioretinal artery perfusion on central visual acuity and fundus angiography circulation time in patients with central retinal artery occlusion (CRAO).</p><p><strong>Methods: </strong>A retrospective analysis included 582 CRAO patients, including 87 patients with cilioretinal arteries. Cilioretinal arteries were classified by direction into nasal and temporal groups, with the temporal group further subdivided into four subtypes based on the optic disc-macula distance (DMD): 1/4, 2/4, 3/4, and 4/4 DMD. Differences in basic information, visual acuity, and circulation time among the groups were analyzed.</p><p><strong>Results: </strong>Patients in the 4/4 DMD group were the oldest among the temporal subgroups (P < 0.05). The 4/4 DMD group demonstrated the best BCVA, while the Nasal-1/4DMD group had the worst (P < 0.05); notably, 13.33% of patients in the 4/4 DMD group had no light perception. There was no statistically significant difference in the circulation time of four groups (both arm-retinal circulation time and retinal trunk-to-branch filling time, P > 0.05).</p><p><strong>Conclusion: </strong>CRAO patients with cilioretinal artery supply less than 1/4 DMD have poor outcomes. 4/4DMD group was associated with better visual outcomes, but extensive macular perfusion by the cilioretinal artery did not invariably prevent severe visual loss during the acute phase.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"12 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microaneurysm segmentation in early diabetic retinopathy: a localized patch-based U-Net approach to overcome microscopic lesion oversight.","authors":"Likhitha D Atada, Madhura Prakash Manjunath, Deepthi K Prasad, Venkatakrishnan Srinivasan","doi":"10.1186/s40942-026-00919-x","DOIUrl":"10.1186/s40942-026-00919-x","url":null,"abstract":"<p><strong>Background: </strong>Diabetic Retinopathy (DR) is a leading cause of vision impairment and a major long-term microvascular complication of diabetes. Early detection and prevention of diabetes-related complications through advanced imaging and software-assisted patient management remain important clinical priorities. Microaneurysms (MAs) are the earliest and most subtle indicators of DR, but their small size and low contrast often lead to missed detection during manual fundus examination, delaying intervention. Automated MA segmentation is therefore essential for large-scale DR screening.</p><p><strong>Methods: </strong>We conducted a controlled empirical evaluation of localized patch-based training for microaneurysm (MA) segmentation, benchmarking a compact, imbalance-aware U-Net model including learnable transposed-convolution up-sampling against a full-image U-Net trained on identical data. Fundus images and corresponding MA masks were divided into non-overlapping 256 × 256 patches, increasing MA pixel density per training sample by approximately 60-fold relative to full-image input thereby directly targeting the extreme class imbalance that causes full-image models to collapse to all-background predictions. The model was trained and evaluated on the publicly available IDRiD [Indian Diabetic Retinopathy Image Dataset] and DDR [Dataset for Diabetic Retinopathy] datasets. Performance was assessed using Intersection over Union (IoU), Dice coefficient, accuracy, recall, and precision.</p><p><strong>Results: </strong>Performance was evaluated on a representative held-out subset of 100 images selected from an independent pool of 514 MA-annotated test images spanning the IDRiD and DDR datasets. The patch-based model achieved an overall pixel-level accuracy of 99.89%, a Dice coefficient of 76.9%, IoU of 63.2%, recall (sensitivity) of 69.1% and precision of 88.7%, while the full-image U-Net trained on the same data failed to recover any MA pixels (IoU = 0, Dice = 0) despite comparable pixel accuracy thereby demonstrating that overlap-based metrics, not accuracy, are the decisive criterion for this task. Per-image lesion-coverage analysis showed a mean match rate of approximately 60% of annotated MA contours, providing a clinically interpretable read-out beyond pixel overlap.</p><p><strong>Conclusion: </strong>This controlled empirical evaluation demonstrates that localized patch-based training is an effective and computationally efficient strategy for overcoming the extreme class imbalance that causes conventional full-image U-Nets to systematically miss microaneurysms. The proposed patch-based U-Net showed promising microaneurysm segmentation performance on a held-out subset of IDRiD and DDR images; further evaluation on the additional datasets and independent external cohorts can aid in the clinical screening utility.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"12 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Air versus long-acting gas tamponade for idiopathic macular hole surgery with 24-hour face-down positioning: a bicentric retrospective study.","authors":"Benjamin Jacob, Eric Parrat, Umberto Lorenzi","doi":"10.1186/s40942-026-00908-0","DOIUrl":"10.1186/s40942-026-00908-0","url":null,"abstract":"<p><p>We compared air and gas tamponade for idiopathic full-thickness macular hole (FTMH) surgery with a 24-hour face-down protocol, in a bicentric, retrospective real-world series of 36 air- and 19 gas-treated eyes. Allocation was non-random (gas predominated earlier, air later). Preoperative symptom duration was short in both groups (median 1 [1-2] months); median hole diameter was 456 [312-611] µm (air) and 497 [364-776] µm (gas; p = 0.40). FTMH closure at 1 month was 100% (36/36) with air and 94.7% (18/19) with gas (p = 0.35), reaching 100% in both groups at 3 and 6 months. Best-corrected visual acuity improved significantly within each group, with no significant between-group difference at any timepoint. No complications occurred with air, whereas peripheral retinal breaks occurred only in the gas group. The air group was younger than the gas group (66.1 vs. 74.4 years; p = 0.018). Air was associated with anatomical and functional outcomes comparable to gas in this cohort; however, the non-random allocation, small sample, absence of a pre-specified margin and limited statistical power preclude any formal non-inferiority conclusion. Air with short positioning appears a practical alternative to gas in sub-acute holes across the size spectrum, warranting prospective confirmation.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"12 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-year real-world effectiveness of faricimab after treatment switch in neovascular age-related macular degeneration.","authors":"Jorge Ruiz-Medrano, Margarita Zamorano, Carlota Moreno de Alboran, José M Ruiz-Moreno","doi":"10.1186/s40942-026-00916-0","DOIUrl":"10.1186/s40942-026-00916-0","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the 2-year real-world outcomes of switching to intravitreal faricimab in patients with neovascular age-related macular degeneration (nAMD) previously treated with anti-VEGF agents and unable to extend treatment intervals (TI) beyond 12 weeks.</p><p><strong>Methods: </strong>Prospective cohort study including patients with nAMD managed under a treat-and-extend regimen who required frequent anti-VEGF injections (< 12-week intervals) to maintain retinal dryness. Patients were switched to faricimab without a loading phase and followed for a minimum of 2 years. TI were extended in 4-week increments based on anatomical response. The primary outcome was change in TIl; secondary outcomes included change in best-corrected visual acuity (BCVA) and identification of predictors of response. \"Optimal responders\" were defined as eyes achieving ≥ 8-week interval extension.</p><p><strong>Results: </strong>A total of 110 eyes from 97 patients were included (mean age 78.7 ± 9.8 years). Prior to switching, the mean TI was 6.18 ± 2.05 weeks, which increased significantly to 13.61 ± 5.62 weeks at the last follow-up visit (p < 0.001). BCVA remained stable over 2 years (0.42 ± 0.24 vs. 0.43 ± 0.25; p = 0.0117). At final follow-up, 68.2% of eyes achieved intervals ≥ 12 weeks, 20.0% ≥16 weeks, and 24.6% reached ≥ 20-week intervals. Overall, 89.1% of eyes experienced interval extension. Optimal responders accounted for 47.3% of eyes and were significantly younger and had received fewer prior injections (p < 0.05).</p><p><strong>Conclusions: </strong>Switching to faricimab in previous treated nAMD patients enabled meaningful extension of TI over 2 years while maintaining stable visual acuity. These findings support faricimab as an effective strategy to reduce treatment burden in patients who are difficult to extend with prior anti-VEGF therapies.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"12 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjunctive dexamethasone implant during vitrectomy with silicone oil for diabetic tractional retinal detachment: a systematic review and exploratory meta-analysis.","authors":"Ahmar Jan Qureshi, Ali Shan Hafeez, Hamna Hassan Siddiqui, Ahsab Zaka, Muhammad Riyyan Tariq Tagga, Tooba Munir, Eashel Farooq, Muhammad Bilal, Atiqullah Sadaqat","doi":"10.1186/s40942-026-00903-5","DOIUrl":"10.1186/s40942-026-00903-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Diabetic tractional retinal detachment (TRD) secondary to proliferative diabetic retinopathy is a vision-threatening complication that may require pars plana vitrectomy in selected cases, particularly when the macula is threatened or detached. Silicone oil tamponade is commonly used in complex cases, although tamponade choice varies according to surgical findings and surgeon preference.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate surgical outcomes associated with adjunctive dexamethasone implant during pars plana vitrectomy with silicone oil or heavy silicone oil tamponade for diabetic tractional retinal detachment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive literature search of PubMed, Scopus, Web of Science, and ClinicalTrials.gov was performed from inception through 2025. Randomized and non-randomized comparative studies assessing PPV with silicone oil with or without adjunctive dexamethasone implant were considered. Definitions of postoperative PVR and retinal redetachment were accepted as reported by the original studies; no individual-level imaging or independent photographic regrading was available. The anatomical outcome was an exploratory composite of study-reported postoperative proliferative vitreoretinopathy (PVR) and/or retinal redetachment outcomes. Because definitions and follow-up time points differed across studies, this outcome was not treated as a uniformly graded PVR endpoint. Randomized and non-randomized comparative studies were identified; randomized trials were prioritized for the main analysis, while the non-randomized study was considered separately because of serious risk of bias. Secondary outcomes included best-corrected visual acuity (BCVA), central subfield thickness (CST), ocular hypertension, and postoperative complications. The protocol was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD420261283105) prior to the commencement of the review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Four studies involving 305 eyes were included. In the main randomized-trial analysis, two studies comprising 123 eyes contributed to the exploratory study-reported postoperative proliferative/redetachment composite. The pooled estimate was highly imprecise (RR 0.20, 95% CI 0.00 to 16.06; I² = 0%) and did not provide conclusive evidence of benefit. In an exploratory sensitivity analysis including the non-randomized study, the estimate favored dexamethasone implant, but this analysis was subject to serious risk of bias. BCVA and CST findings were limited by small sample sizes, heterogeneity, and inconsistent reporting. Intraocular-pressure outcomes were not pooled because definitions and assessment time points differed across studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Current evidence is insufficient to support routine adjunctive dexamethasone implant use during vitrectomy with silicone oil for diabetic tractional retinal detachment. The available stud","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal sensitivity assessed by microperimetry and its topographic correlation with macular structure by optical coherence tomography following macular hole surgery: a cross-sectional study.","authors":"Rodrigo Schwartz Pegado, Gabriel Castilho Sandoval Barbosa, Luciana Virgínia Ferreira Costa-Cunha, Leandro Cabral Zacharias, Rony Carlos Preti, Mário Luiz Ribeiro Monteiro, Leonardo Provetti Cunha","doi":"10.1186/s40942-026-00904-4","DOIUrl":"10.1186/s40942-026-00904-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;To evaluate retinal sensitivity (RS) assessed by microperimetry in the macular region of patients undergoing surgical repair of idiopathic macular hole (MH), and to investigate the topographic correlation between RS and both total macular thickness (TMT) and ganglion cell complex (GCC) thickness obtained by optical coherence tomography (OCT), establishing point-by-point anatomic correspondence between sensitivity measurements and their structurally matched retinal areas, six months after successful MH surgery with internal limiting membrane (ILM) peeling.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Observational, analytical, cross-sectional study including 40 consecutive patients who underwent 25-gauge pars plana vitrectomy with ILM peeling for idiopathic MH at a single center (Juiz de Fora Eye Hospital, Brazil) between 2022 and 2024, with a minimum postoperative follow-up of six months. An age- and sex-matched control group of 43 healthy subjects was recruited for comparison. All patients were pseudophakic at the time of assessment. Retinal sensitivity was assessed using the MP-3 microperimeter (Nidek Technologies, Italy) with a 44-point stimulus grid (Goldmann size III, 4 - 2 staircase strategy) distributed across the central 20°, designed to match the nine-sector ETDRS grid. Macular structure was evaluated by swept-source OCT (DRI OCT Triton; Topcon, Japan). TMT and GCC thickness (µm) were measured in all nine ETDRS sectors. Spearman correlation coefficients were used to assess topographic structure-function relationships. Multivariate linear regression was performed to identify independent predictors of postoperative foveal RS and mean RS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All 40 MH eyes achieved anatomic closure. Best-corrected visual acuity (BCVA) improved significantly postoperatively (0.94 ± 0.22 to 0.54 ± 0.26 logMAR; p &lt; 0.001) but remained inferior to controls (0.12 ± 0.09 logMAR; p &lt; 0.001). Mean RS was significantly lower in patients than in controls (24.78 ± 2.73 vs. 26.46 ± 1.77 dB; p = 0.002; AUC = 0.721), with significant reductions observed at the fovea and in six of eight parafoveal/perifoveal sectors. The temporal outer sector showed the highest discriminative capacity (AUC = 0.774). Mean GCC thickness (µm) was significantly reduced postoperatively compared to both preoperative values (107.55 ± 11.80 vs. 95.97 ± 13.31 μm; p &lt; 0.001) and controls (104.26 ± 7.95 μm; p = 0.001). Significant positive topographic correlations were found between RS and TMT at the fovea (ρ = 0.542; p &lt; 0.001) and in all four outer ETDRS sectors (ρ ranging from 0.546 to 0.645; all p &lt; 0.001), as well as between RS and GCC thickness in multiple sectors (ρ ranging from 0.240 to 0.391; p &lt; 0.05). In the multivariate model, specific regional GCC and TMT sector thicknesses were independent predictors of postoperative foveal RS, while preoperative BCVA and MH morphometric parameters showed limited independent predictive value.&lt;/p&gt;&lt;p&gt;&lt;stron","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world functional and anatomical outcomes of intravitreal aflibercept 8 mg in treatment-naïve neovascular age-related macular degeneration: a phenotype-based analysis by pachychoroid and polypoidal lesion status.","authors":"Amiko Matsuyama, Akiko Miki, Toshiki Oka, Eisuke Ikeuchi, Maya Kishimoto-Kishi, Katsuaki Miki, Hisanori Imai, Makoto Nakamura","doi":"10.1186/s40942-026-00901-7","DOIUrl":"10.1186/s40942-026-00901-7","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the short-term functional and anatomical outcomes of intravitreal aflibercept 8 mg in treatment-naïve neovascular age-related macular degeneration (nAMD), and to explore whether the early treatment response varied according to pachychoroid and polypoidal lesion status.</p><p><strong>Methods: </strong>This retrospective, multicenter observational study evaluated 45 treatment-naïve eyes of 45 patients with nAMD who received three monthly loading injections of aflibercept 8 mg. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), central choroidal thickness (CCT), and exudative findings (subretinal fluid [SRF], intraretinal fluid [IRF], and subretinal hyperreflective material [SHRM]) were assessed at baseline and at 1, 2, and 4 months. Pachychoroid and polypoidal lesion status was determined using multimodal imaging. Longitudinal changes were analyzed using linear mixed-effects models, with subgroup analyses by pachychoroid and polypoidal lesion status.</p><p><strong>Results: </strong>At 4 months, mean BCVA improved from 0.27 ± 0.33 to 0.20 ± 0.31 logMAR (P = 0.005), CRT decreased from 382.1 ± 189.7 to 231.3 ± 109.1 μm, and CCT from 263.0 ± 146.5 to 231.0 ± 127.2 μm (both P < 0.001). The dry macula rate (absence of both SRF and IRF) increased from 17.8% to 75.6% (P < 0.001). Functional and retinal anatomical responses were broadly consistent across phenotypes, with no significant time-by-phenotype interactions for BCVA or CRT. Pachychoroid eyes showed a greater CCT reduction (interaction P < 0.001), but this was no longer significant after adjusting for baseline CCT. As exploratory observations, the time-by-polypoidal-lesion interaction for BCVA was not significant (P = 0.052), and residual SHRM at 4 months was present in 0% of polypoidal-lesion eyes versus 22.2% of those without (P = 0.067).</p><p><strong>Conclusions: </strong>Intravitreal aflibercept 8 mg led to significant short-term improvements in BCVA, CRT, CCT, and exudative findings in treatment-naïve nAMD, with benefit observed irrespective of pachychoroid or polypoidal lesion status.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}