International Journal of Retina and Vitreous最新文献

{"title":"Accuracy of Retinal Pigment Epithelium (RPE) undulations (Oscillatory sign) as an optical coherence tomography biomarker of acute RPE tears.","authors":"Manoj P Shettigar, Jay Chhablani, Mudit Tyagi, Ritesh Narula, Raja Narayanan","doi":"10.1186/s40942-026-00874-7","DOIUrl":"10.1186/s40942-026-00874-7","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the sensitivity and specificity of Retinal Pigment Epithelium (RPE) undulations (Oscillatory sign) on Optical Coherence Tomography (OCT) and assess its potential role as a predictive OCT biomarker for RPE tears in eyes with neovascular age-related macular degeneration (nAMD).</p><p><strong>Methods: </strong>Retrospective analysis of the patients who had RPE tears following nAMD, which were documented by multimodal imaging. All cases were evaluated for RPE undulations on OCT, and the sensitivity and specificity of the Oscillatory sign in eyes with documented RPE tears were assessed.</p><p><strong>Results: </strong>Seventy-nine eyes out of 936 eyes with nAMD, which were analyzed, were found to have RPE tears, as documented by colour fundus photographs (CFP) and fundus autofluorescence (FAF). OCT images were analyzed for RPE undulations, a sign of oscillatory activity. Thirty-eight eyes of 79 (48.1%) eyes were found to have the oscillatory sign. Oscillatory sign showed a high specificity of 98.95% and sensitivity of 48.10% for an underlying RPE tear. The negative predictive value of the Oscillatory sign was 95.39%, and the positive predictive value of 80.85%.</p><p><strong>Conclusion: </strong>The Oscillatory sign of RPE undulations is not sensitive, but it is a highly specific biomarker and can help facilitate the diagnosis of occult RPE tears.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295028","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":"Choroidal imaging features of KIF11-associated retinopathy: expanding the ocular phenotype.","authors":"Lily C Farrell, Justin C Muste, Atharva Hudlikar, Xin Ying Rachel Song, Pearse A Keane, Rupesh Agrawal, Jose S Pulido","doi":"10.1186/s40942-026-00881-8","DOIUrl":"10.1186/s40942-026-00881-8","url":null,"abstract":"<p><strong>Background: </strong>To characterize foveal architecture and choroidal morphology in KIF11-associated retinopathy using multimodal imaging, and to assess for pachychoroid-like features using quantitative choroidal thickness (CT) and choroidal vascularity index (CVI).</p><p><strong>Methods: </strong>In this retrospective case series, multimodal imaging from two patients (four eyes) with genetically confirmed KIF11-associated retinopathy was analyzed. En-face optical coherence tomography (OCT) images of the macular and inferior peripheral retina were spatially aligned to widefield fundus images to enable fovea-centered spatial mapping. The choroid was segmented and binarized on OCT B-scans to derive quantitative macular CT and CVI measurements, and CT measurements in the mid-peripheral and peripheral retina. Pixel-based measurements were converted to microns using image-scale calibration. Measurements from both eyes were compared with a healthy control.</p><p><strong>Results: </strong>Both KIF11 patients demonstrated bilateral fovea plana, inferior chorioretinal dysplasia, and inferotemporal vascular dragging. Sub-macular CT showed altered spatial patterning relative to a reference control, with lower overall thickness and increased inter-eye variability. In control eyes, CT demonstrated fovea-centered distribution, whereas patient eyes showed disrupted spatial organization, most pronounced in P1 (OD: R² = 0.41; OS: R² = 0.52). Sub-macular CVI ranged from 58 to 65% and demonstrated increased variability in spatial patterning, with reduced quadratic model fit in KIF11 patient eyes (P1 OS: R² = 0.09). Inferior retinal regions showed diffusely increased CT, with focal maximal thickening immediately temporal to chorioretinal dysplasia, forming a sharp, reproducible transition zone. Beyond this, CT progressively decreased with increasing temporal distance from the atrophic border. The ratio of CT at the transition point relative to distal temporal measurements consistently exceeded 1.0.</p><p><strong>Conclusions: </strong>KIF11-associated retinopathy may demonstrate regional pachychoroid-like choroidal phenotype with spatially patterned dysplasia, most pronounced adjacent to areas of chorioretinal atrophy. These preliminary findings may implicate choroidal structural and vascular abnormalities as potential contributors to disease pathogenesis and expand the recognized ocular phenotype of KIF11-related retinal disease. Given the exploratory nature and limited sample size of this study, further studies, on a larger sample size, are warranted to further characterize choroidal morphology in KIF11-associated retinopathy.</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":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283438","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":"A two-step approach for suprachoroidal delivery of dexamethasone implant using a custom-made injector.","authors":"Jiyang Tang, Yaoyao Sun, Enzhong Jin, Yuou Yao, Yi Cai, Qiaozhu Zeng, Heng Miao","doi":"10.1186/s40942-026-00883-6","DOIUrl":"10.1186/s40942-026-00883-6","url":null,"abstract":"<p><strong>Background: </strong>Suprachoroidal injection enables targeted posterior segment drug delivery with reduced anterior segment exposure. Off-label use of the dexamethasone implant (Ozurdex) via the suprachoroidal route may benefit patients with macular edema who have contraindications to intravitreal therapy. This article aims to introduce a two-step surgical technique for suprachoroidal Ozurdex injection and reports its feasibility and short-term outcomes in an illustrative case.</p><p><strong>Methods: </strong>A custom‑made injector assembled from a 26‑gauge hypodermic needle and an intravenous catheter. The technique involves: (1) injection of 0.3mL sodium hyaluronate viscoelastic into the suprachoroidal space at 4.0 mm posterior to the limbus; (2) injection of the dexamethasone implant through the same site. The technique was performed in a 37‑year‑old pregnant woman at 24 weeks of gestation with vitreous hemorrhage and macular edema secondary to proliferative diabetic retinopathy in the left eye immediately following pars plana vitrectomy. Main outcomes included feasibility, safety, best‑corrected visual acuity (BCVA), intraocular pressure (IOP) and imaging findings on ultrasound biomicroscopy (UBM) and optical coherence tomography (OCT).</p><p><strong>Results: </strong>The procedure was completed without intraoperative complications. UBM at postoperative week 1 confirmed Ozurdex within an anechoic suprachoroidal space, which resolved by week 12. BCVA improved from decimal 0.2 (Snellen 4/20) at baseline to 0.4 (20/50) at 12 weeks. IOP remained stable (21-23 mmHg), with no cataract progression or significant IOP elevation. OCT showed resolution of intraretinal cysts.</p><p><strong>Conclusions: </strong>This two-step technique for suprachoroidal Ozurdex delivery using a custom‑made injector with viscoelastic pre‑injection is feasible and showed no major safety concerns in this case. It may provide an alternative delivery method for selected patients with non‑infectious macular edema who have relative contraindications to intravitreal anti‑vascular endothelial growth factor (VEGF) or corticosteroid injections. Further studies are needed to establish safety and efficacy.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277336","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":"Physics-informed, phenotype-based endotamponade selection in vitreoretinal surgery: current agents and emerging vitreous substitutes.","authors":"Miguel A Quiroz-Reyes, Erick A Quiroz-Gonzalez, Miguel A Quiroz Gonzalez, Virgilio Lima-Gomez","doi":"10.1186/s40942-026-00878-3","DOIUrl":"10.1186/s40942-026-00878-3","url":null,"abstract":"<p><strong>Background: </strong>Endotamponade selection is best understood as a physics-informed, phenotype-based decision rather than one driven mainly by tamponade duration or material class. This narrative review integrates density, interfacial tension, contact angle, viscosity, and drug-tamponade interactions with phenotype-specific clinical outcomes. The result is a practical framework linking tamponade behavior to retinal geography, disease complexity, and postoperative feasibility.</p><p><strong>Main body: </strong>Lighter-than-water agents (air, expansile gases, and light silicone oils [LSOs]) preferentially support the superior retina, whereas heavy silicone oils (HSOs) and perfluorocarbon liquids (PFCLs) provide stronger inferior support. In uncomplicated rhegmatogenous retinal detachment (RRD) and many idiopathic macular holes (MHs), air or sulfur hexafluoride (SF₆) usually achieves high anatomical success with less early intraocular pressure (IOP) elevation and cataract burden than longer-acting gas or silicone oil when brief postoperative positioning is feasible. LSO remains the principal long-term option for complex, tractional, and traumatic disease because it provides durable, relatively posture-independent support, but at the cost of emulsification, cataract, pressure-related, and corneal complications. HSO and staged short-term PFCL are best viewed as selective strategies for inferior-predominant giant retinal tear (GRT) or posture-limited phenotypes, where the mechanistic rationale is strong but comparative evidence remains largely observational. Hydrogel-based vitreous substitutes are promising but remain investigational.</p><p><strong>Conclusions: </strong>Current evidence supports a physics-informed, phenotype-based approach to endotamponade selection. Future research should prioritize phenotype-stratified comparative studies with standardized anatomical and emulsification endpoints and rigorous evaluation of emerging vitreous substitutes in well-defined clinical settings.</p><p><strong>Trial registration: </strong>Not applied.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258265","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":"Understanding the effect of educational attainment on the risk of retinal detachment: a Mendelian randomization mediation analysis.","authors":"Andreas Katsimpris, Sebastian-Edgar Baumeister, Hansjörg Baurecht, Andrew Blaikie, Colin Goudie, Andrew J Tatham, Michael Nolde","doi":"10.1186/s40942-026-00869-4","DOIUrl":"10.1186/s40942-026-00869-4","url":null,"abstract":"<p><strong>Purpose: </strong>Higher educational attainment is generally associated with better health outcomes, but paradoxically, some evidence suggests an increased risk of rhegmatogenous retinal detachment (RD) among individuals with higher education, potentially due to myopia. This study aimed to investigate whether the association between education and RD is causal and to what extent it is mediated by refractive error and other modifiable lifestyle factors.</p><p><strong>Methods: </strong>We conducted univariable and multivariable Mendelian randomization (MR) analyses using publicly available genome-wide association study summary statistics from up to 3 million individuals of European ancestry. Genetically predicted educational attainment was examined for its effect on RD risk. MR mediation analysis was employed to estimate the contribution of refractive error, smoking, alcohol consumption, and body mass index (BMI) to the observed association.</p><p><strong>Results: </strong>Each one standard deviation increase in genetically predicted educational attainment was associated with a 1.50-fold higher risk of RD (95% confidence interval [CI]: 1.02-2.21; p = 0.04). MR mediation analysis suggested that the effect of education on RD was largely mediated by refractive error. Adjustments for smoking, alcohol use, and BMI showed limited impact on the association, reinforcing myopia as the principal mediator.</p><p><strong>Conclusions: </strong>Our findings provide evidence consistent with a possible causal effect between higher educational attainment and increased RD risk, driven predominantly by myopia. These results highlight the potential importance of refractive error as a pathway linking educational attainment and RD, which may be relevant for future prevention strategies.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"12 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251621","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":"Combined macular buckle and intraoperative OCT-guided 41-gauge drainage of refractory large bacillary layer detachments in neovascular age-related macular degeneration and diabetic macular edema.","authors":"Ginevra Giovanna Adamo, Antonio Cartabellotta, Pietro Maria Talli, Giuseppe Giannaccare, Chiara Vivarelli, Marco Pellegrini, Francesco Parmeggiani, Marco Mura","doi":"10.1186/s40942-026-00875-6","DOIUrl":"10.1186/s40942-026-00875-6","url":null,"abstract":"<p><strong>Background: </strong>To describe a novel combined surgical technique for the drainage of large bacillary layer detachment (BLD) in patients with advanced neovascular age-related macular degeneration (nAMD) or diabetic macular edema (DME) refractory to intravitreal anti-vascular endothelial growth factor (anti-VEGF) or corticosteroid therapy.</p><p><strong>Methods: </strong>This prospective pilot case series evaluated three eyes of three patients (two nAMD, one DME) with large BLDs runresponsive to intravitreal treatment. The standardized procedure consisted of ab-externo macular buckle placement followed by 23-gauge pars plana vitrectomy (PPV). Intraoperative OCT (iOCT) guided subretinal fluid drainage using a 41-gauge cannula. Primary outcomes were anatomical BLD resolution and changes in best-corrected visual acuity (BCVA) at six-month.</p><p><strong>Results: </strong>Immediate and complete anatomical resolution was achieved in all eyes. BCVA modestly improved from 20/400, 20/400, and 20/800 at baseline to 20/200, 20/200 and 20/400 Snellen at six-month follow-up. No intra- or postoperative complications occurred, and no additional anti-VEGF injections were required during follow-up.</p><p><strong>Conclusions: </strong>Combined intraoperative OCT-guided subretinal drainage with macular buckling achieved immediate anatomical resolution of large, chronic bacillary layer detachments refractory to medical therapy. Functional recovery was limited, likely reflecting irreversible outer retinal and retinal pigment epithelium damage in advanced disease. This approach may represent a salvage option in carefully selected cases of refractory exudative macular disease. Further studies with larger cohorts and longer follow-up are required to define its long-term efficacy, optimal timing, and clinical role.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217677","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":"Code-free automated machine learning for OCT-based classification of vitreoretinal interface diseases.","authors":"Lorenzo Ferro Desideri, Enrico Bernardi, Carla Troyas, Yousif Subhi, Mehmet Cem Sabaner, Martin Zinkernagel, Rodrigo Anguita","doi":"10.1186/s40942-026-00880-9","DOIUrl":"10.1186/s40942-026-00880-9","url":null,"abstract":"<p><strong>Background: </strong>Differentiation of vitreoretinal interface disorders on optical coherence tomography (OCT) relies on expert interpretation and can be challenging in borderline cases. Automated machine learning (AutoML) platforms may enable clinician-driven artificial intelligence development without coding expertise. This study evaluated the performance of a code-free AutoML approach for OCT-based classification.</p><p><strong>Methods: </strong>In this cross-sectional image classification study, 434 OCT B-scans from publicly available datasets were manually labeled into four categories: epiretinal membrane (ERM), lamellar macular hole (LMH), full-thickness macular hole (MH), and normal retina. Images were uploaded to a cloud-based AutoML platform (Google Cloud Vertex AI), which automatically performed data splitting (80% training, 10% validation, 10% test), model training, and optimization. Performance was assessed using precision, recall, average precision, and confusion matrix analysis.</p><p><strong>Results: </strong>The model achieved an overall average precision of 0.988, with precision and recall of 97.6%. MH and normal retina were classified with perfect precision and recall (100%). ERM showed high precision (100%) with slightly reduced recall (92.9%), while LMH demonstrated complete recall (100%) with lower precision (83.3%). Misclassifications were limited to anatomically related entities.</p><p><strong>Conclusions: </strong>Code-free AutoML enables accurate OCT-based classification of vitreoretinal interface disorders using a clinician-driven workflow. This approach may facilitate broader adoption of artificial intelligence in ophthalmology and support rapid clinical research prototyping.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204848","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":"Evaluation of OCT image quality in gas-filled eyes using four OCT devices.","authors":"Mitsuru Otsubo, Tomoko Ro-Mase, Shun Konno, Ami Konno, Harumasa Yokota, Taiji Nagaoka","doi":"10.1186/s40942-026-00879-2","DOIUrl":"10.1186/s40942-026-00879-2","url":null,"abstract":"<p><strong>Purpose: </strong>To compare optical coherence tomography (OCT) image quality obtained on postoperative day 1 under intraocular gas tamponade using four OCT devices, including two swept-source OCT (SS-OCT) and two spectral-domain OCT (SD-OCT) systems.</p><p><strong>Methods: </strong>This retrospective study included 30 consecutive eyes of 30 patients who underwent pars plana vitrectomy with gas tamponade between June 2025 and February 2026. On postoperative day 1, OCT imaging was performed using four devices: two SS-OCT systems (DRI OCT Triton and PLEX Elite 9000) and two SD-OCT systems (RTVue XR Avanti and SPECTRALIS OCT). OCT image quality was graded using a 5-point scale by two masked graders, and the mean score was used for analysis. The primary analysis compared image quality scores among devices in 25 eyes with macular hole using the Friedman test with Bonferroni correction.</p><p><strong>Results: </strong>The mean patient age was 70.0 ± 8.7 years, and 13 patients (43.3%) were male. The median (interquartile range) image quality scores in macular hole cases (n = 25) were 5.0 (4.0-5.0) for Triton, 5.0 (4.0-5.0) for Plex Elite, 4.0 (4.0-5.0) for Avanti, and 2.0 (1.0-3.0) for Spectralis. Image quality scores differed significantly among the four devices (Friedman test, p < 0.001).</p><p><strong>Conclusions: </strong>Under intraocular gas tamponade, the SD-OCT device Avanti demonstrated relatively preserved image quality. These findings suggest that device-specific acquisition characteristics, beyond wavelength differences, substantially influence OCT image quality in gas-filled eyes. These findings may assist clinicians in selecting appropriate OCT devices for reliable postoperative assessment under gas tamponade.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175921","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":"Determinants of retinal and choriocapillaris microvascular alterations in pediatric β-thalassemia: an OCTA study.","authors":"Mohamed Rateb Amin, Maha Mohamed Youssef, Amina Abdelsalam Ali, Lameece Moustafa Hassan","doi":"10.1186/s40942-026-00852-z","DOIUrl":"10.1186/s40942-026-00852-z","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate retinal and choriocapillaris microvascular changes observed using optical coherence tomography angiography (OCTA) in pediatric patients with β-thalassemia and to identify hematologic and clinical predictors of these changes.</p><p><strong>Methods: </strong>This cross-sectional observational study included 120 eyes of 120 children (< 18 years): 40 with thalassemia major, 40 with thalassemia intermedia, and 40 age-matched controls. All participants received a thorough ophthalmic examination and OCTA imaging (6 × 6 mm scans) to assess vessel density (VD) in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC), as well as foveal avascular zone (FAZ) parameters. Clinical data included hemoglobin level, serum ferritin, transfusion history, hydroxyurea use, and splenomegaly. Correlation and regression analyses were conducted to determine predictive factors of the associated OCTA changes.</p><p><strong>Results: </strong>In both thalassemia major and intermedia, the area and perimeter of the FAZ was significantly greater as compared with controls (p < 0.01). SCP whole VD was significantly lower in thalassemia intermedia compared with controls (p = 0.023), while DCP whole VD was significantly lower in both thalassemia groups (p < 0.001). Choriocapillaris flow was also significantly reduced in thalassemia patients (p < 0.001). Serum ferritin levels and blood transfusion rate showed limited and inconsistent correlations with OCTA parameters. In contrast, hemoglobin level demonstrated significant positive correlations with VD across multiple SCP and DCP regions. Multivariable regression analysis indicated that hemoglobin was the only independent predictor of superficial and deep whole VD (p = 0.015 and p = 0.002, respectively).</p><p><strong>Conclusions: </strong>Children with β-thalassemia exhibit significant subclinical retinal and choriocapillaris microvascular alterations detectable by OCTA. Hemoglobin level, rather than iron indices, is the strongest determinant of retinal vascular density, suggesting that chronic anemia-related hypoxia plays a central role in retinal microvascular compromise in pediatric β-thalassemia.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13238000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149735","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":"Public interest in retinal detachment in the United States: a Google Trends analysis.","authors":"Thanaphat Seeboonruang, Muhammad Z Chauhan, Qais A Dihan, Ahmed F Shakarchi, Jamie L Surgent-Nahay, Ahmed B Sallam","doi":"10.1186/s40942-026-00870-x","DOIUrl":"10.1186/s40942-026-00870-x","url":null,"abstract":"<p><strong>Background: </strong>Rhegmatogenous retinal detachment (RD) is a vision-threatening condition requiring timely diagnosis and treatment, yet population-level public interest and information-seeking behavior is difficult to assess using traditional utilization data alone. This study evaluated temporal and geographic patterns of public interest in retinal detachment in the United States and contextualized this interest relative to retina specialist availability.</p><p><strong>Methods: </strong>In this retrospective observational study, we queried Google Trends for RD-related search terms in the United States from 2008 to 2025. Google Trends reports relative search volume (RSV) on a normalized scale from 0 to 100. We extracted annual and state-level values using a composite of diagnostic and surgical RD terms. We obtained state-level counts of vitreoretinal surgeons from the American Society of Retina Specialists database and calculated retina surgeon density per 100,000 population using 2025 U.S. Census estimates. We also calculated the Search-to-Surgeon Index as an exploratory ratio of state-level relative search volume to retina surgeon density. We evaluated associations between RSV, Search-to-Surgeon Index, population age structure, and time using the using the Mann-Kendall trend test with Sen's slope estimator and the Spearman correlation test.</p><p><strong>Results: </strong>From 2008 to 2025, retinal detachment-related relative search volume increased by 178%, with a significant temporal increasing trend (τ = 0.745, P < 0.001). Relative search volume declined sharply in April 2020. In 2025, state-level relative search volume ranged from 61 to 100 (median, 84). States with a higher proportion of residents aged 50 years and older demonstrated higher relative search volume (ρ = 0.56, P < 0.001). Retina surgeon density varied more than tenfold across states, ranging from 0.17 to 2.09 per 100,000 residents. Search-to-Surgeon index values ranged from 40 to 406 (median, 155), with the highest values observed in states with limited retina surgeon availability. Population age distribution was not significantly associated with Search-to-Surgeon index (ρ = -0.06, P > 0.10).</p><p><strong>Conclusions: </strong>Public interest in retinal detachment has increased substantially over time and varies widely across U.S. states. Integrating Google Trends data with retina surgeon distribution highlights geographic mismatches between public interest and specialist availability. This exploratory framework may help identify regions with disproportionate public concern relative to local workforce capacity.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13445831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143360","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}