International Journal of Retina and Vitreous最新文献

{"title":"Modeling pegcetacoplan treatment effect for atrophic age-related macular degeneration with AI-based progression prediction.","authors":"Irmela Mantel, Romina M Lasagni Vitar, Sandro De Zanet","doi":"10.1186/s40942-025-00634-z","DOIUrl":"10.1186/s40942-025-00634-z","url":null,"abstract":"<p><strong>Background: </strong>To illustrate the treatment effect of Pegcetacoplan for atrophy secondary to age-related macular degeneration (AMD), on an individualized topographic progression prediction basis, using a deep learning model.</p><p><strong>Methods: </strong>Patients (N = 99) with atrophy secondary to AMD with longitudinal optical coherence tomography (OCT) data were retrospectively analyzed. We used a previously published deep-learning-based atrophy progression prediction algorithm to predict the 2-year atrophy progression, including the topographic likelihood of future retinal pigment epithelial and outer retinal atrophy (RORA), according to the baseline OCT input. The algorithm output was a step-less individualized topographic modeling of the RORA growth, allowing for illustrating the progression line corresponding to an 80% growth compared to the natural course of 100% growth.</p><p><strong>Results: </strong>The treatment effect of Pegcetacoplan was illustrated as the line when 80% of the growth is reached in this continuous model. Besides the well-known variability of atrophy growth rate, our results showed unequal growth according to the fundus location. It became evident that this difference is of potential functional interest for patient outcomes.</p><p><strong>Conclusions: </strong>This model based on an 80% growth of RORA after two years illustrates the variable effect of treatment with Pegcetacoplan according to the individual situation, supporting personalized medical care.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"14"},"PeriodicalIF":1.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370492","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":"Tear glucose is associated with the presence and severity of diabetic retinopathy.","authors":"Ningyao Cao, Lili Feng, Wei Xu, Fanglin He, Caiwen Xiao, Yan Liu, Weirong Xu, Jingjing Cui, Yuqian Guo, Lianqing Yao, Wenwen Xia, Fei Chen, Yong Li, Chuandi Zhou, Xiaofang Xu","doi":"10.1186/s40942-025-00636-x","DOIUrl":"10.1186/s40942-025-00636-x","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the association between tear glucose (TG) and the presence and severity of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>A cross-sectional study. TG was examined by rapid qualitative test strip in 160 patients. The severity of DR was graded as mild DR and severe DR. The presence and severity of DR were compared between patients with positive and negative TG. The association of TG with the presence and the severity of DR was estimated by multivariable regression analysis and spearman's rank correlation test, respectively. The performance of TG to detect DR was evaluated by the receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>In this study, 160 patients were included, with a median age of 64.0 years, and 88 (55.0%) patients were males. A total of 91 (56.9%) patients had positive TG, and 69 (43.1%) patients had negative TG. In TG-positive group, 41 (45.1%) patients were diagnosed with DR, among them, 8 (19.5%) patients had mild DR, and 33 (80.5%) patients were afflicted with severe DR. Multivariable logistic regression indicated that the presence of DR positively correlated with the presence of positive TG (odds ratio [OR], 3.62; 95% confidence interval [CI], 1.56-8.40; p < 0.01), longer duration of diabetes (OR, 1.11; 95% CI 1.06-1.17; p < 0.01) and higher HbA1c (OR, 1.25; 95% CI 1.01-1.54; p = 0.03). Moreover, Spearman's correlation analysis suggested that the grading of TG increased with the severity of DR (r_s = 0.28, p < 0.01). The area under the curve (AUC) of the model integrating TG, the duration of diabetes and HbA1c was 0.76 (95% CI 0.69-0.84), indicating a fair discriminative ability of DR.</p><p><strong>Conclusion: </strong>TG level was associated with the presence and the severity of DR. TG might be an easy-to-use, non-invasive parameter to the screening and monitoring of DR among patients with diabetes.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"13"},"PeriodicalIF":1.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364765","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":"Predictive value of different baseline optical coherence tomography biomarkers for visual acuity changes in neovascular age-related macular degeneration.","authors":"Hamid Riazi-Esfahani, Hooshang Faghihi, Fatemeh Bazvand, Mohammadreza Mehrabi Bahar, Hassan Khojasteh, Ahmed Husein Ahmed, Shahin Faghihi, Ali Fakhraie, Mohammad Hossein Zamani, Samin Ghasemi, Esmaeil Asadi Khameneh, Elias Khalili Pour","doi":"10.1186/s40942-025-00633-0","DOIUrl":"10.1186/s40942-025-00633-0","url":null,"abstract":"<p><strong>Background: </strong>To evaluate baseline optical coherence tomography (OCT) biomarkers in treatment-naïve patients with neovascular age-related macular degeneration (nAMD) and their correlation with visual acuity changes following intravitreal aflibercept injections.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on treatment-naïve nAMD patients. Baseline OCT biomarkers, including shallow irregular pigment epithelial detachment (SIPED), subretinal hyperreflective material, subretinal fluid, intraretinal fluid (IRF), hyperreflective foci, and subretinal drusenoid deposits, were assessed. Patients received bimonthly aflibercept injections after three loading doses. Visual acuity changes were evaluated at 3 and 12 months. The maximum height and width of the largest pigment epithelial detachment (PED) were also measured.</p><p><strong>Results: </strong>Among 89 eyes with nAMD, mean best-corrected visual acuity (BCVA) improved by 6 Early Treatment Diabetic Retinopathy Study (ETDRS) letters from baseline to month 3, with sustained improvement through month 12. Baseline IRF was associated with poorer visual acuity improvement at month 12, with patients showing a mean improvement of 1.6 ± 18.2 ETDRS letters versus 11.1 ± 10 ETDRS letters in those without IRF (P = 0.002). Multivariable analysis indicated SIPED was linked to lower visual gains at month 3 (P = 0.025). The largest PED width correlated significantly with lower BCVA gains at months 3 (P = 0.021) and 12 (P = 0.043), suggesting its potential as a prognostic factor.</p><p><strong>Conclusion: </strong>Baseline OCT biomarkers, including SIPED, IRF, and PED width, may predict visual acuity changes in nAMD patients treated with aflibercept, highlighting the need for individualized monitoring.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"12"},"PeriodicalIF":1.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255657","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":"Impact of duration of treatments with metformin and sulfonylureas, individually or in combination, on diabetic retinopathy among newly diagnosed type 2 diabetic patients: a pooled cohort's analysis.","authors":"Mansour Bahardoust, Yadollah Mehrabi, Farzad Hadaegh, Davood Khalili, Ali Delpisheh","doi":"10.1186/s40942-025-00637-w","DOIUrl":"10.1186/s40942-025-00637-w","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the effect of metformin and sulfonylurea (SUs) medication time on Diabetic retinopathy (DR) among newly diagnosed patients with type 2 diabetes (T2DM) using a pooled analysis. This study aimed to evaluate the effect of metformin and SUs' medication time on DR among newly diagnosed T2DM using a pooled analysis.</p><p><strong>Methods: </strong>The data of 4,068 newly diagnosed DM individuals(mean age, 60.2 ± 0.85 years) from three prospective cohorts of Tehran Sugar and Lipid Study (TLGS), Multi-Ethnic Study of Atherosclerosis (MESA), and Atherosclerosis Risk in Communities (ARIC) with a mean age of 59.6 ± 08 years were pooled. The cumulative exposure to metformin, SUs, aspirin, statin, and anti-hypertensive medication was also determined using the same approach. The Cox proportional hazards (CPH) model was used to calculate the hazard ratio (HR) (95% CI) for the outcomes while adjusting for confounding factors such as fasting Blood Sugar (FBS), age, statin, aspirin, and anti-hypertensive medications.</p><p><strong>Results: </strong>During follow-up, DR occurred in 519 DM. Metformin alone, SUs alone, and the combination of both reduced the hazard of DR by 10%, 7%, and 11% for each year of use, respectively (p < 0.05). The protective effect of metformin and SUs, individually or in combination, on DR started approximately five years after the initial treatment and continued until approximately 15 years after the initial treatment and then reached a plato.</p><p><strong>Conclusion: </strong>Long-term treatment with metformin and SUs, individually and in combination, was associated with a reduced risk of DR in people with newly diagnosed diabetes for up to a decade compared with no treatment. These findings highlight the protective role of metformin and sulfonylureas as inexpensive and readily available drugs to prevent DR in people with newly diagnosed diabetes.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"9"},"PeriodicalIF":1.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074658","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":"Automated and code-free development of a risk calculator using ChatGPT-4 for predicting diabetic retinopathy and macular edema without retinal imaging.","authors":"Eun Young Choi, Joon Yul Choi, Tae Keun Yoo","doi":"10.1186/s40942-025-00638-9","DOIUrl":"10.1186/s40942-025-00638-9","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) and macular edema (DME) are critical causes of vision loss in patients with diabetes. In many communities, access to ophthalmologists and retinal imaging equipment is limited, making screening for diabetic retinal complications difficult in primary health care centers. We investigated whether ChatGPT-4, an advanced large-language-model chatbot, can develop risk calculators for DR and DME using health check-up tabular data without the need for retinal imaging or coding experience.</p><p><strong>Methods: </strong>Data-driven prediction models were developed using medical history and laboratory blood test data from diabetic patients in the Korea National Health and Nutrition Examination Surveys (KNHANES). The dataset was divided into training (KNHANES 2017-2020) and validation (KNHANES 2021) datasets. ChatGPT-4 was used to build prediction formulas for DR and DME and developed a web-based risk calculator tool. Logistic regression analysis was performed by ChatGPT-4 to predict DR and DME, followed by the automatic generation of Hypertext Markup Language (HTML) code for the web-based tool. The performance of the models was evaluated using areas under the curves of receiver operating characteristic curve (ROC-AUCs).</p><p><strong>Results: </strong>ChatGPT-4 successfully developed a risk calculator for DR and DME, operational on a web browser without any coding experience. The validation set showed ROC-AUCs of 0.786 and 0.835 for predicting DR and DME, respectively. The performance of the ChatGPT-4 developed models was comparable to those created using various machine-learning tools.</p><p><strong>Conclusion: </strong>By utilizing ChatGPT-4 with code-free prompts, we overcame the technical barriers associated with using coding skills for developing prediction models, making it feasible to build a risk calculator for DR and DME prediction. Our approach offers an easily accessible tool for the risk prediction of DM and DME in diabetic patients during health check-ups, without the need for retinal imaging. Based on this automatically developed risk calculator using ChatGPT-4, health care workers will be able to effectively screen patients who require retinal examinations using only medical history and laboratory data. Future research should focus on validating this approach in diverse populations and exploring the integration of more comprehensive clinical data to enhance predictive performance.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"11"},"PeriodicalIF":1.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074655","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":"The role of optical coherence tomography angiography in assessing diabetic choroidopathy: a systematic review.","authors":"M Hossein Nowroozzadeh, Mansoureh Bagheri","doi":"10.1186/s40942-024-00618-5","DOIUrl":"10.1186/s40942-024-00618-5","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) is a leading cause of vision impairment worldwide, affecting both retinal and choroidal vasculature. While advances in imaging technology, particularly optical coherence tomography angiography (OCTA), provide new opportunities to assess choroidal changes in diabetic patients, the role of OCTA in early diagnosis and monitoring of diabetic choroidopathy remains unclear.</p><p><strong>Objective: </strong>This review aims to evaluate the potential role of OCTA in diagnosing and monitoring diabetic choroidopathy.</p><p><strong>Methods: </strong>A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Databases including PubMed, Embase, Cochrane Library, Google Scholar, ISI, and Scopus were searched for studies on diabetic choroidopathy assessed by OCTA. Studies included were peer-reviewed, published in English, and excluded case reports, conference proceedings, and studies on treated DR patients. Two independent reviewers screened articles for eligibility based on predefined criteria.</p><p><strong>Results: </strong>OCTA allows for non-invasive, high-resolution visualization of retinal and choroidal microvasculature, providing both qualitative and quantitative data. The majority of studies indicate a significant decrease in choroidal perfusion parameters in diabetic patients without DR compared to healthy controls. Conflicting evidence exists regarding the correlation between choriocapillaris flow reduction and DR severity. OCTA may also predict changes in visual function related to choroidal perfusion, though it cannot fully replace clinical examinations.</p><p><strong>Conclusions: </strong>OCTA is a valuable tool for early detection and monitoring of diabetic choroidopathy. However, its role is limited by variability in findings and its inability to detect certain features of diabetic microangiopathy. Further studies are needed to clarify its clinical utility and standardize assessment methods.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"10"},"PeriodicalIF":1.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074660","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":"Semaglutide, type 2 diabetes, and the risk of nonarteritic anterior ischemic optic neuropathy.","authors":"Fernando K Malerbi, Marcello C Bertoluci","doi":"10.1186/s40942-024-00622-9","DOIUrl":"10.1186/s40942-024-00622-9","url":null,"abstract":"<p><p>In the last months, conflicting evidence on a possible association between the use of semaglutide and incident nonarteritic anterior ischemic optic neuropathy (NAION) has emerged. A recently published study, which evaluated all patients with type 2 diabetes in Denmark, has shown with robustness that once-weekly semaglutide doubles the five-year risk of NAION. In this comment, the new evidence is discussed, along with practical implications for type 2 diabetes patients. The possibility of ophthalmological evaluation regarding optic disc morphology is suggested, before initiation of semaglutide treatment or, for those patients already under treatment, during a follow-up ophthalmological visit. If a disc-at-risk pattern is detected, such information could be brought to the attention of the attending clinician involved with diabetes control and discussed with patients for a shared decision-making approach. A new risk-benefit discussion weighing the undoubted benefits of semaglutide in reducing cardiovascular mortality and cardiovascular events, heart failure hospitalization, and renal protection must be started and carefully balanced against a rare but devastating condition such as NAION.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"8"},"PeriodicalIF":1.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023339","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":"Intravitreal dexamethasone implant (Ozurdex®) findings over time: ultrasound and ultra-widefield fundus photography.","authors":"Gabriela Assumpção Brito Pereira Pellegrini, Arnaldo Furman Bordon, Norma Allemann","doi":"10.1186/s40942-024-00625-6","DOIUrl":"10.1186/s40942-024-00625-6","url":null,"abstract":"<p><strong>Background: </strong>Ozurdex® (Allergan®, AbbVie Company, North Chicago, Illinois, EUA), is composed of 0.7 mg of dexamethasone, fused in a solid biodegradable PLGA polymer, whose degradation occurs naturally in the vitreous cavity, usually in six months after its application.</p><p><strong>Methods: </strong>In this study, we included patients aged ≥ 18 years with one or two eyes who had an indication for Ozurdex^® implants. Eyes submitted to Ozurdex^® application were evaluated in the first hour after the injection via transpalpebral contact B-scan ocular ultrasonography (Aviso® or Compact Touch^®, Quantel^®) and non-mydriatic ultra-widefield fundus photography (California^®, Optos^®) performed sequentially. The exams were executed using similar parameters and techniques, by the same ophthalmologist, after every 45 days, until the end of 180 days. The programed visits were the initial (tagged D0) and sequential (D45, D90, D135, and D180) visits, with a possible variance of seven days, before or after. The ultrasonographic Ozurdex^® findings evaluated were: non-quantitative: structure, height, reflectivity, artifact production, location, and movement; and quantitative: length and thickness. Ultra-widefield fundus photography parameters were: Ozurdex^® visualization, location, and structure.</p><p><strong>Results: </strong>The B-scan showed the implant initially, at the D0 visit, as a well-delimited and homogeneously highly reflective linear and continuous structure. On D45, Ozurdex^® implants presented with low internal reflectivity and irregularity in the limits. On D90, D135, and D180, reductions in the length and thickness progressively lessened, leading to the final appearance of a small highly reflective clust. Over time, all the implants presented reductions in length and thickness. The mean length at D0 was 7.42 ± 0.39 mm and at the final visit (D180) it was 1.50 ± 0.47 mm. The mean thickness at D0 was 0.77 ± 0.13 mm and at the final visit (D180) it was 0.44 ± 0.18 mm.</p><p><strong>Conclusions: </strong>Considering implant dimensions, the change in length over time was more evident than the change in thickness. In all the cases where visualization was possible, positive correlations with B-scan findings were found despite changes in patient position. These alterations evidenced in the Ozurdex® implant over time may be related to the degradation of the glucose polymer structure.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"7"},"PeriodicalIF":1.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005278","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":"Supervised machine learning statistical models for visual outcome prediction in macular hole surgery: a single-surgeon, standardized surgery study.","authors":"Kanika Godani, Vishma Prabhu, Priyanka Gandhi, Ayushi Choudhary, Shubham Darade, Rupal Kathare, Prathiba Hande, Ramesh Venkatesh","doi":"10.1186/s40942-025-00630-3","DOIUrl":"10.1186/s40942-025-00630-3","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the predictive accuracy of various machine learning (ML) statistical models in forecasting postoperative visual acuity (VA) outcomes following macular hole (MH) surgery using preoperative optical coherence tomography (OCT) parameters.</p><p><strong>Methods: </strong>This retrospective study included 158 eyes (151 patients) with full-thickness MHs treated between 2017 and 2023 by the same surgeon and using the same intraoperative surgical technique. Data from electronic medical records and OCT scans were extracted, with OCT-derived qualitative and quantitative MH characteristics recorded. Six supervised ML models-ANCOVA, Random Forest (RF) regression, K-Nearest Neighbor, Support Vector Machine, Extreme Gradient Boosting, and Lasso regression-were trained using an 80:20 training-to-testing split. Model performance was evaluated on an independent testing dataset using the XLSTAT software. In total, the ML statistical models were trained and tested on 14,652 OCT data points from 1332 OCT images.</p><p><strong>Results: </strong>Overall, 91% achieved MH closure post-surgery, with a median VA gain of -0.3 logMAR units. The RF regression model outperformed other ML models, achieving the lowest mean square error (MSE = 0.038) on internal validation. The most significant predictors of VA were postoperative MH closure status (variable importance = 43.078) and MH area index (21.328). The model accurately predicted the post-operative VA within 0.1, 0.2 and 0.3 logMAR units in 61%, 78%, and 87% of OCT images, respectively.</p><p><strong>Conclusion: </strong>The RF regression model demonstrated superior predictive accuracy for forecasting postoperative VA, suggesting ML-driven approaches may improve surgical planning and patient counselling by providing reliable insights into expected visual outcomes based on pre-operative OCT features.</p><p><strong>Clinical trial registration number: </strong>Not applicable.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"5"},"PeriodicalIF":1.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978442","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":"Efficacy & safety of brolucizumab 6.0 mg versus 3.6 mg in diabetic macular edema.","authors":"Sanjay Kumar Mishra, Pradeep Kumar, Amrita Joshi, Aman Saraf, Abhijeet Awasthi, Supriya Dhar, Khaleel M, Atul Kumar, Vipin Rana, Ravi D","doi":"10.1186/s40942-025-00628-x","DOIUrl":"10.1186/s40942-025-00628-x","url":null,"abstract":"<p><strong>Background: </strong>Management of Diabetic Macular edema (DME) requires repeated injections. Therefore newer Anti-VEGFs like Brolucizumab with longer durability have been introduced. We compared two different dosages of Brolucizumab, 6.0 mg and 3.6 mg, for their safety & efficacy in treatment of DME, in treatment naïve patients over 52 weeks.</p><p><strong>Method: </strong>A prospective, pilot randomised controlled, single centre, double blinded, two arm comparative study was conducted between Dec 2022 to Apr 2024. The study recruited 82 patients of DME who were randomised into two groups of 41 patients each, one group to be treated with Brolucizumab 6.0 mg in 50 μL and the other to receive 3.6 mg in 30 μL. All patients received the first dose of Brolucizumab at 0 week and were then followed up at every 4 weeks for detailed ophthalmic and OCT macula examination. Those who met the pre-defined re-treatment criteria were re-injected with Brolucizumab, the dose being fixed for each group throughout the study. All patient receiving an injection were further followed up on Day 1, Day 7 and Day 28 to look for any adverse reactions. The efficacy parameters included change in best corrected visusal acuity (BCVA), contrast and central macular thickness (CMT) on Optical Coherence Tomography. The average number of injections recd in each group were also calculated.</p><p><strong>Results: </strong>The change in BCVA from baseline in 6.0 mg group was 0.54 LogMAR units and 3.6 mg group was 0.59 LogMAR units, which was not statistically significant. The reduction in CMT from baseline in 6.0 mg group was 133.2 µm (μ) and 3.6 mg group was 110.6 μ, which was not statistically significant. The improvement in contrast from baseline in 6.0 mg group was 0.74 and 3.6 mg group was 0.95, with p value of 0.0002. The re-injection interval was 14.21 weeks in 6.0 mg group and 15.56 weeks for 3.6 mg subgroup. The total number of adverse events in both groups were similar at 70 in 6.0 mg group and 47 in 3.6 mg group with only one grade 4 adverse event occurring in each group.</p><p><strong>Conclusion: </strong>The results of present study show that the safety and efficacy of both doses of Brolucizumab, i.e. 6.0 mg and 3.6 mg, for treating diabetic macular edema is similar. Trial registration Study was registered with Clinical trials registry of India (CTRI ref no. CTRI/2023/06/054105), registered on 14 Nov 2022.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"6"},"PeriodicalIF":1.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978439","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}