International Journal of Retina and Vitreous最新文献

{"title":"Stepwise analysis of the scleral encircling learning curve for clinical fellows using surgical video review.","authors":"Minjeong Kim, Yong Hoon Kim, Seok Hyeon Song, Yong Je Choi, Dong Ju Kim, Hyeong Min Kim, Chang Ki Yoon, Eun Kyoung Lee, Kihwang Lee, Un Chul Park, Se Joon Woo, Kyu Hyung Park, Seung Woo Choi","doi":"10.1186/s40942-026-00891-6","DOIUrl":"10.1186/s40942-026-00891-6","url":null,"abstract":"<p><strong>Purpose: </strong>To identify which steps of the 360° scleral encircling (SE) procedure pose the greatest training challenges for retina fellows by analyzing surgical videos and evaluating changes in operative time across a two-year training period.</p><p><strong>Methods: </strong>We retrospectively analyzed videos of SE procedures performed by vitreoretinal fellows at a single academic center (2018-2024). Only cases involving 360° SE without concurrent vitrectomy or gas tamponade were included. For each case, total operative time and the duration of six predefined steps were measured. Cases with damaged videos or performed by fellows with ≤ 5 analyzable cases were excluded. Between-fellow comparisons and learning-curve trends were assessed using analysis of variance and correlation analyses.</p><p><strong>Results: </strong>Fifty-five SE cases performed by six fellows met inclusion criteria. Mean total operative time was 132.27 ± 42.92 min, with significant inter-individual differences (p = 0.0007). Among all steps, binocular indirect ophthalmoscopy showed the greatest inter-individual variability (p < 0.0001), followed by scleral suturing (p = 0.0009) and tire positioning (p = 0.006). Across training, the duration of indirect ophthalmoscopy did not show measurable reduction for any fellow. Five of six fellows demonstrated a significant decrease in total operative time correlated with training progression (p < 0.05 for each), with a marked early decrease within their first five cases, followed by a plateau.</p><p><strong>Conclusion: </strong>Binocular indirect ophthalmoscopy demonstrated the largest variability and the least improvement during SE training. Prioritizing targeted instruction in this technically demanding step may accelerate skill acquisition and improve overall operative efficiency for early-career ophthalmologists.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338571","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 aflibercept 8 mg in patients with neovascular age-related macular degeneration from China: 48-week results from the PULSAR trial.","authors":"Xiaodong Sun, Hong Dai, Youxin Chen, Xufang Sun, Liming Tao, Jun Xiao, Mei Han, Mingwei Zhao, Li Wang, Andrea Schulze, Ursula Maria Schmidt-Ott, Min Zhao, Xin Zhang, Zhaohong Wang, Sergio Leal, Wenbin Wei","doi":"10.1186/s40942-026-00876-5","DOIUrl":"10.1186/s40942-026-00876-5","url":null,"abstract":"<p><strong>Background: </strong>PULSAR (NCT04423718) was a global, phase 3, randomized, double-masked, non-inferiority study of adults with neovascular age-related macular degeneration (nAMD). Patients were randomized 1:1:1 to receive aflibercept 8 mg every 12 (8q12), or 16 weeks (8q16), or aflibercept 2 mg every 8 weeks (2q8), following 3 initial monthly doses. This subgroup analysis investigated the efficacy and safety of aflibercept 8 mg vs. aflibercept 2 mg in patients from China with nAMD from the PULSAR trial.</p><p><strong>Methods: </strong>This exploratory analysis evaluated the change from baseline in best-corrected visual acuity (BCVA), central retinal thickness (CRT), durability, and safety outcomes through week 48 in patients from China. All results were descriptive in nature.</p><p><strong>Results: </strong>Least squares (LS) mean (95% confidence interval [CI]) change from baseline in BCVA at week 48 was + 13.2 (+9.0, +17.4), +9.7 (+5.8, +13.7), and + 10.0 (+6.9, +13.1) letters for patients from China in the 8q12 (n = 31), 8q16 (n = 31), and 2q8 (n = 39) groups, respectively. LS mean (95% CI) change from baseline in CRT (µm) at week 48 was -167 (-183, -151), -166 (-195, -137), and -180 (-195, -165) for patients in the 8q12, 8q16, and 2q8 groups, respectively. Randomized dosing intervals were maintained by 88.5% and 73.1% of patients in the 8q12 and 8q16 groups, respectively. The incidence of ocular treatment-emergent adverse events was similar across treatment groups.</p><p><strong>Conclusions: </strong>In patients with nAMD from China, aflibercept 8 mg administered over extended dosing intervals demonstrated efficacy and a safety profile consistent with that observed with aflibercept 2 mg, in line with the overall PULSAR cohort.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, TRN NCT04423718. Registration date 8 June 2020.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338506","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":"OCTA and microperimetry in Behçet's retinal vasculitis: subgroup analysis, structure-function correlation, and 12-month follow-up evaluation.","authors":"Bruno F A Ferreira, Alex H Higashi, Leandro L Prado, Célio R Gonçalves, Maria A O Haddad, Leandro C Zacharias, Cleide G Machado, Carlos E Hirata, Joyce H Yamamoto","doi":"10.1186/s40942-026-00866-7","DOIUrl":"10.1186/s40942-026-00866-7","url":null,"abstract":"<p><strong>Background: </strong>In Behçet's syndrome (BS)-associated retinal vasculitis, optical coherence tomography (OCT) angiography (OCTA) and microperimetry allow noninvasive assessment of retinal microvascular integrity and macular function, but integrated structure-function analyses across all retinal vascular plexuses during inactive disease remain limited. This study evaluated age- and sex-related differences, structure-function associations, and 12-month changes in inactive retinal vasculitis.</p><p><strong>Methods: </strong>This observational study included 14 patients (23 eyes; mean age 40.6 ± 11.7 years) with inactive BS-associated retinal vasculitis, followed every 4 months for 12 months. Retinal thickness, retinal nerve fiber layer and ganglion cell layer thickness on OCT, foveal avascular zone (FAZ) area and vascular density (VD) on OCTA, and macular sensitivity (MS) on microperimetry were analyzed. Exploratory subgroup analyses were performed according to sex, age, and qualitative OCTA findings. Associations were assessed using generalized estimating equations, and correlations were evaluated using Spearman's coefficient.</p><p><strong>Results: </strong>Male sex, age < 45 years, and qualitative OCTA findings (perifoveal arcade disruption, non-perfusion areas, and microvascular abnormalities in any vascular plexus) were associated with more pronounced quantitative changes on OCT and OCTA (P < 0.05). VD showed strong inverse and direct correlations (r > 0.7) with FAZ area and retinal thickness, respectively, which should be interpreted with caution given the limited sample size. In the superficial vascular plexus (SVP), superior sector VD correlated directly with central MS (r = 0.722; P < 0.001). Structural and functional biomarkers remained stable throughout the 12-month follow-up in patients under clinical remission.</p><p><strong>Conclusions: </strong>Male sex and younger age appeared to be associated with patterns suggestive of greater macular structural and functional involvement in BS-associated retinal vasculitis. Qualitative OCTA findings, particularly involving the SVP and intermediate capillary plexus, were also associated with more pronounced structural and functional alterations. However, given the exploratory nature of the analyses and the limited sample size, these findings should be considered preliminary and warrant further investigation in larger, controlled studies.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338555","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 postoperative positioning on surgical and visual outcomes after pars plana vitrectomy for rhegmatogenous retinal detachment: a systematic review and meta-analysis.","authors":"Yousef Mesaed Al-Shammari, Aljawhara Mesaed Al-Shammari, Mahmoud Alrabiah","doi":"10.1186/s40942-026-00890-7","DOIUrl":"10.1186/s40942-026-00890-7","url":null,"abstract":"<p><strong>Introduction: </strong>Rhegmatogenous retinal detachment (RRD) is a serious ophthalmic pathology managed with pars plana vitrectomy (PPV) with gas tamponade. Even though prone position after surgery is widely used, it has been questioned because of high patient discomfort and contradictory evidence concerning its effects on functional outcomes.</p><p><strong>Objective: </strong>To assess the effect of various positioning options post-surgery on the rate of retinal reattachment and visual outcome after PPV for RRD.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were carried out in accordance with the PRISMA statement. Searches for related papers in PubMed, Scopus, and Web of Science databases were made up to April 2026. Articles describing postoperative positioning after PPV for RRD were considered for inclusion. Primary outcomes were retinal reattachment rate and changes in best corrected visual acuity (BCVA).</p><p><strong>Results: </strong>Ten studies with 1262 eyes were included. Pooled analysis showed no statistically significant difference in retinal reattachment rate between prone/face-down positioning and support-the-break/adjustable positioning (RR = 0.96, 95% CI 0.84 to 1.11, p = 0.231), with moderate heterogeneity. The evidence for reattachment rate outcome was of low certainty. Two studies with 90 eyes showed a very small borderline difference in logMAR BCVA change in favour of prone positioning versus supine positioning (MD = -0.07, 95% CI -0.14 to 0.00, p = 0.049). However, the certainty of evidence for this comparison was very low. The clinical relevance of this small difference is uncertain. Descriptive single-arm analyses demonstrated postoperative improvement in BCVA for both the prone and supine positioning arms, nonetheless, there was significant heterogeneity in these analyses.</p><p><strong>Conclusion: </strong>In the pooled analysis, there was no statistically significant difference in the rate of retinal reattachment between prone positioning and support-the-break positioning after PPV for RRD, and the certainty of evidence for this outcome was low. For BCVA, the pooled analysis showed a small borderline difference in logMAR BCVA in favour of prone positioning versus supine positioning. However, the certainty of evidence for this comparison was very low and the clinical importance of this finding is unclear. Thus, the current evidence does not allow a strong conclusion of clinically meaningful functional superiority of prone positioning. Postoperative positioning should be determined by the location of the retinal break, the tamponade agent, surgical factors, patient tolerance, and the judgment of the clinician.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329799","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":"Genotype-phenotype correlations in retinitis pigmentosa: structural and vascular insights using OCT and OCTA.","authors":"Melike Balikoglu-Yilmaz, Aydan Kocar, Aslı Subasioglu, Roya Gasimli, Ferhan Elmali","doi":"10.1186/s40942-026-00882-7","DOIUrl":"10.1186/s40942-026-00882-7","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to identify disease-related genetic variants in 41 patients with retinitis pigmentosa (RP) and to evaluate their phenotypic effects on the retina and choroid.</p><p><strong>Methods: </strong>Patients diagnosed with RP underwent targeted next-generation sequencing of RP-related genes and mitochondrial DNA analysis, with genetic counseling. Variants were classified according to ACMG guidelines. Central macular thickness (CMT), retinal nerve fiber layer thickness (RNFLT), subfoveal choroidal thickness (SfCT), foveal avascular zone area (FAZa), ellipsoid zone (EZ) integrity, and vascular density (VD) in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) were assessed using OCT and OCTA.</p><p><strong>Results: </strong>Patients were classified into three groups: Group 1 (USH2A; n = 11), Group 2 (other single-gene variants; n = 21), and Group 3 (multiple-gene variants; n = 9). There were no significant differences in age, sex, consanguinity, symptom onset, disease duration, best-corrected visual acuity, intraocular pressure, RNFLT, or EZ integrity. Pairwise comparisons showed a higher preserved EZ rate in Group 2 (66.7%) than in Group 3 (4.8%, p = 0.020). Mean SfCT was lower in Group 3 (147.9 ± 107.7 μm) than in Group 2 (243.9 ± 26.3 μm, p = 0.046). SCP and DCP FAZa and VD did not differ significantly; inferior-quadrant CC VD was lower in Group 3 than in Groups 1 and 2 (p ≤ 0.01).</p><p><strong>Conclusion: </strong>RP patients harboring more than one variant showed reduced preserved EZ, SfCT, and inferior-quadrant CC VD compared to patients with a single variant. These findings require further investigation in larger cohorts, together with functional studies, to clarify their clinical and biological significance.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317164","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":"First-in-human application of decellularized human amniotic membrane hydrogel as an injectable intraocular scaffold for large idiopathic full-thickness macular hole closure: four-month clinical outcomes.","authors":"Jakkrit Juhong, Hathaichanok Impheng, Mukdawan Sukhang, Auemphon Mordmuang","doi":"10.1186/s40942-026-00893-4","DOIUrl":"10.1186/s40942-026-00893-4","url":null,"abstract":"<p><strong>Background: </strong>Large idiopathic full-thickness macular holes (FTMH) with minimum diameter > 400 μm carry surgical success rates of approximately 60% with standard vitrectomy and gas tamponade. Novel biologic scaffolds have improved closure rates but are limited by intraoperative handling challenges. We describe a surgical technique using thermosensitive injectable decellularized human amniotic membrane (dAM) hydrogel as an intraocular scaffold for large FTMH, and illustrate its feasibility and safety in a first-in-human application with four-month anatomical, functional, and electrophysiological outcomes.</p><p><strong>Surgical technique: </strong>A 62-year-old man with a Gass stage 4 idiopathic FTMH (minimum diameter 572 μm) and preoperative BCVA of 20/200 underwent combined phacoemulsification and 25-gauge pars plana vitrectomy (PPV) with ILM peeling. Following fluid-air exchange, dAM hydrogel (10 mg/mL, thermosensitive, prepared by detergent decellularization and pepsin solubilization) was injected via a 25-gauge soft-tip cannula, followed by SF6 gas tamponade. Pre-clinical biocompatibility was confirmed by CCK-8 assay and transwell invasion assay prior to clinical use.</p><p><strong>Outcomes: </strong>At one month, SD-OCT confirmed complete Type 1 anatomical closure and BCVA improved to 20/80. At four months (day 121), BCVA further improved to 20/40 + 1 (logMAR 0.30), with no metamorphopsia, IOP 12.7 mmHg, and sustained Type 1 closure with progressive ellipsoid zone (EZ) reconstitution on OCT. Multifocal ERG (103 segments) confirmed measurable foveal P1 responses (Ring 1: 34.19 nV/deg²) with normal central N1 implicit time (40.2 ms; normal range 36.8-46.4 ms). No intraocular adverse events occurred at any time point.</p><p><strong>Conclusions: </strong>This injectable dAM hydrogel scaffold technique is a feasible, instrument-sparing method for large FTMH repair, achieving stable Type 1 closure with progressive visual and electrophysiological recovery over four months. mfERG evidence of preserved foveal photoreceptor function supports its safety. Prospective comparative evaluation is ongoing (ClinicalTrials.gov: NCT06433284).</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov NCT06433284 (MACROHOLE trial). Registered April 2024.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317129","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":"Diagnostic value of congenital hypertrophy of the retinal pigment epithelium in familial adenomatous polyposis: a systematic review.","authors":"Esmaeil Asadi Khameneh, Romina Dadkhah, Moein Zangiabadian, Amirreza Mafi, Amirhossein Hashemi, Mohamad Sanei, Ahmad Mirshahi, Zahra Mahdizad, Fatemeh Bazvand","doi":"10.1186/s40942-026-00886-3","DOIUrl":"10.1186/s40942-026-00886-3","url":null,"abstract":"<p><strong>Background: </strong>Congenital hypertrophy of the retinal pigment epithelium (CHRPE) has been proposed as a phenotypic marker of familial adenomatous polyposis (FAP). This systematic review aimed to evaluate the evidence regarding the association between CHRPE and FAP and to determine the potential clinical utility of CHRPE for the early identification of individuals with adenomatous polyposis coli (APC) mutations.</p><p><strong>Methods: </strong>A systematic search of PubMed/MEDLINE, Embase, and Web of Science from inception to August 2025 in accordance with PRISMA guideline and a PROSPERO-registered protocol was done. Studies reporting CHRPE in individuals with confirmed or suspected FAP or at-risk first-degree relatives were identified. Data extraction and quality assessment using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool were performed independently by two reviewers. Due to substantial heterogeneity in CHRPE definitions, diagnostic criteria, population characteristics, and APC mutation testing methods, quantitative pooling was not considered appropriate and findings were synthesized qualitatively.</p><p><strong>Results: </strong>Forty-three studies were included. CHRPE demonstrated consistently high specificity for FAP and APC mutation carriage across most studies. Sensitivity ranged from 40% to 100% in affected individuals and from 57% to 100% in at-risk relatives, while specificity ranged from 58% to 100%, depending on diagnostic criteria. Stricter definitions incorporating lesion multiplicity and bilaterality improved specificity at the expense of sensitivity.</p><p><strong>Conclusion: </strong>CHRPE is associated with FAP but demonstrates variable diagnostic performance across studies. Its clinical utility as a standalone screening marker is limited by heterogeneous diagnostic definitions. Standardized diagnostic criteria and prospective studies using contemporary genetic testing are needed.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308204","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":"From white dot syndromes to primary inflammatory choriocapillaropathies (PICCPs): updating and expanding the spectrum through multimodal imaging.","authors":"Raul N G Vianna, Remo T Moraes, Heloisa Nascimento, André Messias, Juliana Oréfice, Marcia Brazuna, Luciana F Peixoto, Rodrigo Meirelles, Antônio Marcelo B Casella","doi":"10.1186/s40942-026-00885-4","DOIUrl":"10.1186/s40942-026-00885-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The term \"white dot syndromes\" (WDS) has historically been used as a descriptive label to encompass a heterogeneous group of inflammatory chorioretinal disorders characterized by multifocal whitish fundus lesions. Although clinically convenient, this classification relied predominantly on ophthalmoscopic appearance and fluorescein angiography findings and failed to identify the primary anatomical site of inflammation or the underlying pathogenic mechanisms. Consequently, profoundly disparate entities-such as acute posterior multifocal placoid pigment epitheliopathy (APMPPE), diffuse unilateral subacute neuroretinitis (DUSN), and HLA-A29 birdshot retinochoroiditis, among others-were inappropriately grouped together despite fundamentally different immunological substrates and target tissues.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This narrative review revisits the historical evolution of the WDS concept and synthesizes evidence derived from multimodal retinal and choroidal imaging, including fundus autofluorescence, indocyanine green angiography, optical coherence tomography, and optical coherence tomography angiography, to identify shared pathogenic mechanisms and clinically relevant distinctions among them.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Advances in multimodal imaging over the past two decades have substantially reshaped the understanding of these disorders, demonstrating that a subset of conditions previously classified as WDS share a common pathogenic mechanism characterized by primary inflammatory ischemia of the choriocapillaris, with secondary involvement of the outer retina and retinal pigment epithelium. These findings support grouping these disorders under the concept of primary inflammatory choriocapillaropathies (PICCPs). Conventionally, this group includes APMPPE, idiopathic multifocal chorioretinitis, relentless placoid chorioretinitis, and serpiginous choroiditis (SC). Multiple evanescent white dot syndrome (MEWDS) is likewise included, although its pathophysiology remains debated, particularly regarding whether the primary target is the choriocapillaris or the photoreceptors. MEWDS is included in this review given the clinical and imaging overlap with classical PICCPs. Another rare entity that shares overlapping clinical and imaging features with SC-known as persistent placoid maculopathy (PPM)-may also be considered within this spectrum.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This paper revisits the concept of PICCPs, which more accurately reflects the underlying pathophysiology of this group of disorders than the outdated WDS classification. Emphasis is placed on the role of multimodal imaging in refining disease classification, assessing disease activity and reversibility of ischemic injury, and guiding therapeutic decision-making. We also propose extending the PICCPs spectrum to include PPM. Adoption of a mechanism-based framework has important clinical implications for diagnosis, management, and prognosis.","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308128","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 outcomes after switching to faricimab in previously treated neovascular age-related macular degeneration: longitudinal outcomes up to 24 months.","authors":"Daniel Egger, Florian Amesbauer, Hamza Mohamed, Konstantin E Thiel, Reinhard Angermann, Sebastian M Waldstein","doi":"10.1186/s40942-026-00889-0","DOIUrl":"10.1186/s40942-026-00889-0","url":null,"abstract":"<p><strong>Background: </strong>In neovascular age-related macular degeneration (nAMD), persistent disease activity despite anti-VEGF therapy is common. Switching to faricimab may improve outcomes and extend treatment intervals in treatment-resistant patients, but long-term real-world data remain limited.</p><p><strong>Methods: </strong>In this retrospective, single-centre study, 43 eyes of 38 patients with treatment-resistant nAMD were switched to faricimab and followed for up to 24 months. Insufficient disease control was defined as inability to extend treatment intervals beyond 8 weeks under a treat-and-extend regimen. Outcomes included best-corrected visual acuity (BCVA), central subfield thickness (CST), pigment epithelial detachment (PED) height, fluid status, and treatment intervals. Longitudinal changes were analysed using mixed-effects models. Exploratory analyses of baseline and early response predictors were performed.</p><p><strong>Results: </strong>Mean BCVA remained stable throughout follow-up, with no significant change from baseline at any time point (p > 0.05). CST decreased significantly at all visits, ranging from - 45.8 μm (95% CI - 65.3 μm to - 26.3 μm) at 1 month to - 52.3 μm (95% CI - 73.7 μm to - 30.8 μm) at 24 months (p < 0.001). PED height decreased at 1 month (- 19.0 μm; 95% CI - 33.6 μm to - 4.4 μm, p = 0.011) and remained reduced from 12 to 24 months, ranging from - 25.9 μm (95% CI - 39.7 μm to - 12.1 μm, p < 0.001) to - 49.1 μm (95% CI - 65.1 μm to - 33.0 μm, p < 0.001). Presence of subretinal fluid decreased significantly at all time points, with odds ratios (OR) ranging from 0.064 (95% CI 0.01 to 0.41, p = 0.004) at 1 month to 0.012 (95% CI 0.01 to 0.10, p < 0.001) at 24 months, whereas intraretinal fluid showed a variable response, with a significant reduction observed at 3 months only (OR 0.204, 95% CI 0.05 to 0.79, p = 0.021). The proportion of eyes with a dry macula increased from 0% at baseline to 23.1% at 12 months and 24.0% at 24 months. Treatment intervals extended from 5.9 ± 1.2 weeks before switch to 8.7 ± 2.6 weeks at 12 months (p < 0.001) and 10.6 ± 3.0 weeks at 24 months (p < 0.001). No adverse events were observed.</p><p><strong>Conclusion: </strong>Switching to faricimab was associated with improved anatomical outcomes and extended treatment intervals while maintaining stable visual acuity, suggesting benefits primarily related to anatomical control and reduced treatment burden.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308183","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":"Postoperative cystoid macular edema after pars plana vitrectomy for epiretinal membrane: incidence, anatomical and functional outcomes, and response to intravitreal dexamethasone implant.","authors":"Leonardo Provetti Cunha, Manuela Ferreira Guimarães, Leandro Cabral Zacharias, Rony Carlos Preti, Luciana Virgínia Ferreira Costa-Cunha, Mário Luiz Ribeiro Monteiro","doi":"10.1186/s40942-026-00888-1","DOIUrl":"10.1186/s40942-026-00888-1","url":null,"abstract":"<p><strong>Background: </strong>To determine the incidence of postoperative cystoid macular edema (CME) following pars plana vitrectomy (PPV) with epiretinal membrane (ERM) peeling, and to evaluate the anatomical and functional response to intravitreal dexamethasone implant (Ozurdex; AbbVie) in affected eyes.</p><p><strong>Methods: </strong>This retrospective, single-center cohort study included 92 consecutive eyes with idiopathic ERM that underwent PPV with ERM peeling by a single surgeon. Eyes were allocated to a control group (n = 84), comprising eyes without postoperative CME, or to a CME group (n = 8), comprising eyes that developed postoperative CME confirmed on swept-source optical coherence tomography (SS-OCT) and subsequently received intravitreal dexamethasone implant (DEX). Best-corrected visual acuity (BCVA, logMAR), central macular thickness (CMT, µm), and intraocular pressure (IOP, mmHg) were assessed preoperatively and postoperatively in both groups, and before and after DEX implantation in the CME group.</p><p><strong>Results: </strong>The incidence of postoperative CME requiring treatment was 8.7%. Most baseline characteristics were comparable between groups, although preoperative IOP was significantly lower in the CME group. CMT decreased significantly after surgery in both the control group (335.1 ± 37.3 to 289.5 ± 22.9 μm; p < 0.001) and the CME group (382.9 ± 74.6 to 310.9 ± 22.9 μm; p = 0.033); however, postoperative CMT remained significantly higher in the CME group than in controls (p = 0.034). DEX implantation produced an additional significant CMT reduction (379.9 ± 67.1 to 302.7 ± 35.3 μm; p = 0.003), reducing the between-group difference to a non-significant level (p = 0.332). BCVA improved significantly after surgery in the control group (0.32 ± 0.26 to 0.04 ± 0.10 logMAR; p < 0.001) but not in the CME group (p = 0.582). Following DEX implantation, BCVA improved significantly in the CME group (0.47 ± 0.35 to 0.22 ± 0.25 logMAR; p = 0.002), approaching values observed in the control group (p = 0.078). IOP remained stable in controls (p = 0.576). A transient but significant IOP increase was observed in the CME group after surgery (11.5 ± 2.7 to 15.3 ± 3.7 mmHg; p = 0.019), with no further change after DEX implantation (p = 0.747).</p><p><strong>Conclusions: </strong>Postoperative CME requiring treatment occurred in approximately 1 in 11 eyes following PPV with ERM peeling and was associated with significant anatomical and functional impairment. The present findings suggest that intravitreal dexamethasone implant was associated with improvement in selected cases of postoperative CME without additional impact on IOP; however, larger prospective studies are required to confirm these results.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308191","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}