International Journal of Retina and Vitreous最新文献

{"title":"Biosimilars of anti-VEGF agents in retinal diseases: a narrative review of regulatory, clinical, and pharmacoeconomic aspects.","authors":"Yuan Zong, Qiwei Fan, Lijun Huang","doi":"10.1186/s40942-026-00872-9","DOIUrl":"10.1186/s40942-026-00872-9","url":null,"abstract":"<p><strong>Background: </strong>Anti-vascular endothelial growth factor (anti-VEGF) agents are the cornerstone therapy for retinal vascular diseases including neovascular age-related macular degeneration, diabetic macular edema, and retinal vein occlusion. With patent expirations of ranibizumab and aflibercept, biosimilars have emerged as cost-effective alternatives. However, vitreoretinal specialists require consolidated evidence on regulatory standards, clinical equivalence, and practical implementation strategies to guide evidence-based integration of biosimilars into clinical practice.</p><p><strong>Methods: </strong>We conducted a narrative review of regulatory documents from the FDA, EMA, and NMPA, as well as Phase III clinical trials, real-world studies, and pharmacoeconomic analyses of approved ophthalmic anti-VEGF biosimilars. Literature searches were performed across PubMed, Embase, and regulatory databases from 2015 to 2025. Studies were included if they reported regulatory approval pathways, clinical efficacy and safety data, interchangeability studies, or pharmacoeconomic evaluations of anti-VEGF biosimilars in retinal diseases.</p><p><strong>Results: </strong>Regulatory frameworks demonstrate rigorous biosimilarity assessment through comprehensive analytical characterization, preclinical evaluation, and clinical trials. Pivotal Phase III studies confirm therapeutic equivalence of approved biosimilars (including ranibizumab-nuna and aflibercept-abzv) with comparable visual acuity outcomes, safety profiles, and immunogenicity to originator products. Real-world evidence for ranibizumab biosimilars supports comparable outcomes to originators, while evidence for aflibercept biosimilars remains preliminary and warrants continued pharmacovigilance. Pharmacoeconomic analyses demonstrate 20-40% cost reduction compared to originators, offering substantial healthcare savings and improved patient access. Key implementation considerations include extrapolation principles, switching protocols, and clinic workflow integration.</p><p><strong>Conclusions: </strong>Although real-world data for aflibercept biosimilars are currently limited, emerging evidence for ranibizumab biosimilars supports comparable outcomes. Approved anti-VEGF biosimilars represent safe, effective, and cost-saving alternatives for retinal diseases. With robust analytical and clinical evidence supporting biosimilarity, vitreoretinal specialists can confidently adopt these agents. Successful integration requires understanding of regulatory science, evidence-based switching protocols, and healthcare system collaborations to maximize patient benefits while maintaining treatment standards. Future research should focus on long-term outcomes, broader implementation studies, and pharmacovigilance monitoring.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101556","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":"Preoperative anti-VEGF and the cumulative risk of post-operative vitreous hemorrhage in PDR: a 2-year survival analysis and evaluation of surgical burden.","authors":"Yuxian Lin, Ruibin Wu, Gengjia Li","doi":"10.1186/s40942-026-00871-w","DOIUrl":"10.1186/s40942-026-00871-w","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the long-term risk factors for post-operative vitreous hemorrhage (VH) within 24 months following vitrectomy for proliferative diabetic retinopathy (PDR), evaluate the protective efficacy of preoperative anti-VEGF therapy, and quantify the associated secondary surgical burden.</p><p><strong>Methods: </strong>This retrospective cohort study included 735 eyes from 735 PDR patients. A 24-month survival analysis was employed to categorize patients into VH (n = 179) and non-VH (n = 556) groups. Independent predictors were identified using univariate and multivariate Cox proportional hazards models. A sensitivity analysis was performed on a \"pure hemorrhage model\" (n = 676) by excluding eyes with post-operative tractional retinal detachment (TRD) to isolate the direct vascular-stabilizing effect of anti-VEGF.</p><p><strong>Results: </strong>The overall cumulative incidence of post-operative VH was 18.4% at 12 months and 25.7% at 24 months. Multivariate Cox analysis revealed that preoperative anti-VEGF injection emerged as the strongest protective factor, associated with a 63% reduction in VH hazard (HR 0.37; 95% CI, 0.27-0.51; P < 0.001). This protective effect remained robust in the sensitivity analysis (HR 0.32; P < 0.001), which is consistent with a potential vascular-stabilizing effect independent of anatomical success. Independent risk factors included severe fibrovascular traction (HR 1.93; P = 0.003), younger age, higher HbA1c, and elevated serum creatinine (all P < 0.05). Patients in the VH group had significantly poorer final visual outcomes (1.33 ± 0.75 vs. 0.92 ± 0.60 LogMAR; P < 0.001) and a markedly higher reoperation rate (31.3% vs. 7.2%). Notably, hemorrhage-related indications accounted for 58.4% of the total secondary surgical workload.</p><p><strong>Conclusion: </strong>Post-operative VH is a dominant driver of long-term visual impairment and secondary surgical burden in PDR. Preoperative anti-VEGF supports the hypothesis that preoperative anti-VEGF may contribute to sustained microvascular stabilization. Vitreous hemorrhage-related indications accounted for 58.4% of secondary surgical interventions, suggesting that clinical strategies aimed at reducing recurrent VH could meaningfully decrease the overall reoperation burden in this population.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054443","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":"Longitudinal spatial correlation of retinal sensitivity and structural changes in macular telangiectasia type 2.","authors":"Seungmo Kim, Yoon Jeon Kim, Young Hee Yoon, Junyeop Lee","doi":"10.1186/s40942-026-00873-8","DOIUrl":"10.1186/s40942-026-00873-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the spatial correlation between retinal structure and function in macular telangiectasia type 2 (MacTel) using Compass fundus-tracked microperimetry.</p><p><strong>Methods: </strong>Medical records of 54 eyes from 28 patients were retrospectively reviewed. The relationship between retinal sensitivity and structural parameters including retinal thickness, ellipsoid zone (EZ) integrity, and visual acuity was analyzed. Retinal sensitivity was calculated for nine macular sectors defined by the Early Treatment Diabetic Retinopathy Study (ETDRS) grid, and changes over a 2-year follow-up were evaluated.</p><p><strong>Results: </strong>The mean central retinal thickness was 254.3 ± 103.7 μm, and the mean central retinal sensitivity (mRS) was 28.9 ± 5.4 dB. Microscotomas (< 10 dB) were detected in 18.5% of eyes, predominantly in the temporal macula. Although visual acuity and retinal thickness remained stable during follow-up, the central mRS showed a significant decline (29.51 ± 2.02 dB vs. 28.84 ± 1.38 dB, p = 0.038). The spatial distribution of microscotomas corresponded closely to areas of EZ loss, although pointwise mismatch occasionally occurred.</p><p><strong>Conclusion: </strong>These findings demonstrate that Compass microperimetry can detect subtle longitudinal functional decline despite a lack of significant change in visual acuity and retinal thickness. These results suggest that microperimetry may serve as a complementary functional biomarker for early disease monitoring in MacTel.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054440","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":"Rhegmatogenous and tractional retinal detachment in eyes with retinoblastoma: a retrospective surgical case series from a tertiary eye center.","authors":"Hend AlSafran, Marcos J Rubio Caso, Gorka Sesma, Adhwa Alsadoon, Abdullah M Khan, Saleh AlMesfer","doi":"10.1186/s40942-026-00858-7","DOIUrl":"10.1186/s40942-026-00858-7","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical characteristics, management strategies, and surgical outcomes of tractional and/or rhegmatogenous retinal detachment (TRD/RRD) in eyes with retinoblastoma (RB).</p><p><strong>Methods: </strong>A retrospective surgical case series of patients with treated RB at a tertiary referral center (June 2014-April 2025) who developed non-exudative retinal detachment (RD) was conducted. The data included demographics, tumor activity, RB treatment modalities received, RD features, surgical approach, complications, anatomical reattachment, and final visual acuity.</p><p><strong>Results: </strong>Seven eyes of seven patients (0.9%) developed TRD or RRD. Four eyes had RRD, two had combined RRD/TRD, and one had TRD. Early RRD during active RB was treated with nondrainage scleral buckling (n = 2), whereas late detachments after complete tumor regression underwent pars plana vitrectomy with silicone oil tamponade (n = 4). Anatomical reattachment at one year was achieved in 83.3% of the operated eyes (five of six eyes undergoing surgery), with no cases of tumor seeding or reactivation observed. One eye was enucleated due to tumor progression. Visual acuity improved to baseline or better in 71.4% of the eyes.</p><p><strong>Conclusions: </strong>In this small series, early RRD during active RB was managed with nonsurgical scleral buckling without evidence of tumor dissemination, and late complex RRD after confirmed tumor quiescence was treated with pars plana vitrectomy and silicone oil tamponade with favorable anatomical outcomes. No tumor seeding or reactivation was observed in any case. However, these findings should be interpreted with caution, given the small sample size, and do not allow definitive conclusions regarding oncologic safety.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054449","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":"Utility of artificial intelligence for the diagnosis, prognosis, and management of central serous chorioretinopathy: a narrative review.","authors":"José Ignacio Fernández-Vigo, Alicia Valverde-Megías, Bárbara Burgos-Blasco, José Joaquim de Moura Ramos, Fernando Ly-Yang","doi":"10.1186/s40942-026-00867-6","DOIUrl":"10.1186/s40942-026-00867-6","url":null,"abstract":"<p><p>Central serous chorioretinopathy (CSC) represents a significant cause of visual impairment, particularly in working-age individuals. Despite advances in multimodal imaging and evidence supporting photodynamic therapy (PDT) as the mainstay of chronic CSC, current clinical workflows are still affected by variability in image interpretation, manual quantification, and individualized treatment selection. This narrative review investigates the utility of Artificial Intelligence (AI) in improving the diagnosis, prognosis, and management of CSC. AI-based image analysis, including Optical Coherence Tomography (OCT), Optical Coherence Tomography Angiography (OCTA), and Fundus Fluorescein Angiography (FFA), has demonstrated high diagnostic accuracy across selected datasets and the ability to identify relevant biomarkers, thereby improving efficiency and consistency. Machine learning models demonstrate promising predictive power for subretinal fluid absorption, visual acuity outcomes, and disease recurrence, and identify critical prognostic factors. While emerging, AI-guided treatment strategies hold promise for personalized therapy, particularly for optimizing PDT, laser-based interventions, and follow-up strategies. The integration of AI into clinical decision-making workflows may elevate diagnostic capabilities, especially for non-specialists, and reduce clinical workload. However, the widespread implementation of AI in CSC faces notable challenges, including dataset bias, limited external validation, insufficient representation of differential diagnoses, regulatory complexities, and ethical considerations pertaining to transparency and equitable access. Future directions emphasize integrating multimodal data, fostering global collaborative efforts, and developing robust, generalizable AI models to fully realize AI's potential to enhance patient care and optimize healthcare delivery for CSC.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13411760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054574","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":"Macular micro vascular changes following macular hole repair: optical coherence tomography angiography study.","authors":"Mohamed Hussein Mohamed Moustafa Hussein, Ahmed Tamer Sayed Seif, Mahrous Hassan Abd El Ghany Shaheen, Islam Abdallah Mohalhal","doi":"10.1186/s40942-026-00863-w","DOIUrl":"10.1186/s40942-026-00863-w","url":null,"abstract":"<p><strong>Background: </strong>To detect changes in the macular vascular profile after macular hole closure using modified classic internal limiting membrane (ILM) peeling and temporal ILM flap techniques and their correlation with the macular microstructure and visual function.</p><p><strong>Patients and methods: </strong>Prospective comparative study that included 50 eyes with primary full-thickness macular hole (FTMH). Group A (n = 25) was treated using the modified classic ILM peeling technique, whereas group B (n = 25) was treated using the temporal ILM flap technique. The main outcome measures were macular hole closure, macular vascular and structural repair, and visual recovery rates. We performed OCT and OCTA using spectral-domain OCT (SD-OCT). The chi-square test was used to compare qualitative data, and the independent t-test was used to compare quantitative data. Analysis of variance test (ANOVA) was used to compare paired groups, and Spearman's correlation coefficients were used to assess the correlations between quantitative parameters. P-value < 0.05.</p><p><strong>Results: </strong>Anatomical closure was comparable between groups A (80%) and B (88%) (p = 0.44). Both groups showed significant improvement in BCVA (p < 0.001), with no intergroup differences. The reduction in the FAZ area in the DCP was significant in both groups (p < 0.001). Only Group A showed a significant reduction in the FAZ in the SCP (p < 0.001). Preoperative hole dimensions correlated negatively with baseline BCVA and positively with FAZ in the SCP. Central macular thickness was inversely correlated with FAZ in both plexuses postoperatively. The magnitude of change in the FAZ in the DCP correlated negatively with the BCVA in groups A and B (p = 0.034 and p = 0.043, respectively).</p><p><strong>Conclusion: </strong>Free ILM peeling and temporal ILM flap techniques achieved comparable anatomical closure rates and sustained visual improvement. Preoperative hole dimensions are major determinants of structural remodeling and functional recovery, while OCTA reveals substantial microvascular rearrangement, especially within the DCP, which correlates with visual recovery.</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":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13217651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148030563","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":"Artificial intelligence and neurodegeneration: state of the art and explainability.","authors":"Emanuele Crincoli, Maria Cristina Savastano, Alfonso Savastano, Matteo Mario Carlà, Federico Giannuzzi, Fiammetta Catania, Raphael Kilian, Clara Rizzo, Stanislao Rizzo","doi":"10.1186/s40942-026-00807-4","DOIUrl":"10.1186/s40942-026-00807-4","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer disease (AD) and Parkinson disease (PD) are an increasing healthcare concern and growing cause of disability in our century. The advent of the artificial intelligence (AI) era and the early changes in retina and optic nerve morphology detected in neurodegenerative diseases by recent literature opened the way to the perspective of a AI-based diagnosis for both conditions.</p><p><strong>Main body: </strong>In AD a generalized decrease in macular Ganglion Cells-Inner Plexiform Layer (GC-IPL) and retinal nerve fiber layer (RNFL) and peripapillary RNFL thickness has been documented. Moreover, clinical AD is characterized by a lower choroidal thickness and higher choroidal vascularity index. AI can be predicted with around 80% accuracy based on small fundus vessels characteristics. Similarly, AI based on Optical Coherence Tomography (OCT) images showed very good performance in detecting AD, especially based on total macular volume (TVM) and GCL thickness. A combination of OCT and color fundus photographs (CFP) imaging reached 85% accuracy in detecting MCI. In PD typical retinal anomalies include a generalized thinning of the peripapillary RNFL with a degeneration pattern similar to the one of mitochondrial optic neuropathies, foveal pit widening, generalized retinal and retinal pigmented epithelium thinning and outer plexiform layer thickening. AI CFP-based detection of PD showed only 65% accuracy due to a low specificity, while multimodal imaging-based AI was the best approach, reaching a 100% sensitivity and 85% specificity.</p><p><strong>Conclusion: </strong>In consideration of the overall very good performance, AD and PD are likely to benefit from the support of retinal-imaging based AI for early diagnosis. To optimize the performance, especially in terms of specificity, the use of multimodal imaging and possible integration with meta-data has been demonstrated to be the best technique, especially for PD diagnosis. However, training and testing on a larger sample size and longitudinal evaluation of the chosen models will be needed before application on general population. So far, explainability of the proposed models seems robust and coherent with the corresponding central nervous system damage.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13366837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microaneurysm segmentation under out-of-domain generalization: from diabetic retinopathy to leukemic retinopathy.","authors":"Edgar Platas-Campero, Raquel Díaz-Hernández, Anabel Sánchez-Sánchez, Saúl Zapotecas-Martínez, Nohemi Sánchez-Medel, Sashwanthi Mohan, Jamyl Habib-Castillo, Leopoldo Altamirano-Robles","doi":"10.1186/s40942-026-00844-z","DOIUrl":"10.1186/s40942-026-00844-z","url":null,"abstract":"<p><strong>Purpose: </strong>To propose inter-disease out-of-domain generalization (OODG) across retinal diseases for microaneurysm (MA) segmentation using a deep-learning model trained and validated on diabetic retinopathy (DR) and qualitatively evaluated on leukemic retinopathy (LR).</p><p><strong>Methods: </strong>A U-Net based segmentation model was trained using the IDRiD dataset, which comprises 81 DR images, using only MA annotations. The images were split into patches, and a statistical filtering step was applied to retain only structurally homogeneous patches. The study was organized in two phases: in Phase I, the U-Net was trained and evaluated using DR patches; in Phase II, the model was tested directly, without retraining, on LR images. Finally, MA segmentations were subjected to qualitative assessment by clinical specialists.</p><p><strong>Results: </strong>The proposed U-Net achieved an IoU of 0.842, a Dice score of 0.914, an accuracy of 0.998, and a validation loss of 0.120.</p><p><strong>Conclusion: </strong>The results suggest that knowledge learned from DR can generalize effectively to a related clinical context such as LR, opening the possibility of reusing models in diseases with similar structures and lesion patterns.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13361911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959781","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":"Longitudinal polarization diversity optical coherence tomography before and after photodynamic therapy in chronic central serous chorioretinopathy: a prospective clinical study.","authors":"Parsa Khatami, Mohammad Shahidul Islam, Thomas J van Rijssen, Matheus Rizzo, Iago Rocha Bastos, Giulianna Mendes Recchia, Ali Tavakoli, Farhad Tafreshi, Myeong Jin Ju, Eduardo Vitor Navajas","doi":"10.1186/s40942-026-00857-8","DOIUrl":"10.1186/s40942-026-00857-8","url":null,"abstract":"<p><strong>Background: </strong>Central serous chorioretinopathy (CSC) is the fourth most common retinopathy globally. Chronic central serous chorioretinopathy (cCSC) is a subtype of CSC characterized by persistent or recurrent subretinal fluid (SRF) for more than 3 months. CSC's pathophysiology is described by choriocapillaries (CC) hyperpermeability and vascular congestion. Photodynamic therapy (PDT) is the current treatment of choice for cCSC. PDT causes vascular remodelling by inducing reactive oxygen species (ROS). Melanin in the retinal pigment epithelium (RPE) is a major target of ROS and can be observed non-invasively using polarization-diversity OCT (PD-OCT). Fourier-domain mode-locked (FDML) OCT is an imaging modality that can be used for high-resolution imaging of choriocapillaries.Our study aimed to evaluate melanin-related depolarization and CC changes longitudinally before and after PDT in patients with cCSC.</p><p><strong>Methods: </strong>This prospective clinical pilot study was conducted in accordance with the Declaration of Helsinki and approved by the institutional review board (REB H15-02914). 5 eyes with cCSC were imaged at baseline and within one hour, one week, and one month after half-dose PDT. Eligible patients had cCSC with active disease on multimodal imaging and no other major ocular comorbidities. Imaging included custom-built swept-source OCT angiography (OCTA) and polarization-diversity OCT (PD-OCT) and commercial SSOCT. PD-OCT depolarization was qualitatively assessed using degree of polarization uniformity (DOPU). PD-OCT volumes were manually segmented into: (1) the RPE layer (Inner RPE to outer Bruch's membrane), the full choroidal slab (Outer RPE to Choroidoscleral interface).</p><p><strong>Results: </strong>PD-OCT revealed a decrease in DOPU after PDT across all patients. Manual segmentation of PD-OCT images showed that this effect was most prominent within the RPE-Bruch's Complex. The full choroidal slab demonstrated less depolarization post-PDT. FDML OCTA demonstrated transient flow alterations in the choriocapillaris within the same 4,000-µm PDT treatment zone. Immediately after PDT, FDML revealed irregular flow deficits and heterogeneous darkening across the choriocapillaris.</p><p><strong>Conclusion: </strong>DOPU provides a novel, non-invasive marker for assessing RPE melanin integrity and may serve as a complementary tool for DOPU related changed following PDT in CSC. Our findings suggest a novel mechanism and transient effect of PDT action on RPE melanin.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13335328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874156","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 cross sectional study of optical coherence tomography angiography biomarkers and best corrected visual acuity in epiretinal membrane eyes.","authors":"Shing Chuen Chow, Nicholas Siu Kay Fung, Jeffrey Man Yeung Lo, Kendrick Co Shih, Allie Lee, Angie Hon Chi Fong, Phoebe Cheuk Lam Lam, Lai Yu Ng, Rachel Ya Yuan Leung, Christopher Kai Shun Leung","doi":"10.1186/s40942-026-00855-w","DOIUrl":"10.1186/s40942-026-00855-w","url":null,"abstract":"<p><strong>Background: </strong>To compare Optical Coherence Tomography Angiography (OCTA) biomarkers in epiretinal membrane (ERM) eyes and normal eyes, to investigate the association of each biomarker with best corrected visual acuity (BCVA), and to identify their optimal cut-off values for various best correct visual acuity in ERM eyes.</p><p><strong>Methods: </strong>A cross-sectional observational population study of the right eye of 6011 participants aged above 50 was performed. Central subfield thickness (CST_A), foveal avascular zone (FAZ_A), mean vessel density (mVD_full) and mean capillary perfusion density(mCPD_full) were measured by OCTA. Welch's T-test was used to compare different mean values of parameters between normal eye and epiretinal membrane eyes. Multivariable linear regression test was used to assess the correlation between BCVA LogMAR and OCTA parameters. The cut-off values of biomarkers for best corrected visual acuity (BCVA LogMAR ≥ 0.18 / 0.3) in epiretinal membrane eyes were determined using receiver operating characteristic (ROC) and Area under curve (AUC) analysis.</p><p><strong>Results: </strong>ERM eyes had a significantly higher CST_A than normal eyes (Normal: 249.437 (95% CI 248.845 to 250.029) vs. ERM: 308.202 (95% CI 299.915 to 316.489) P < 0.001) A smaller FAZ_A was found in ERM eyes than normal eyes (Normal: 0.269 (95%CI 0.266 to 0.273) vs. ERM: 0.225 (95%CI 0.202 to 0.248) P < 0.001). Both mVD_full and mCPD_full were lower in ERM eyes when compared with normal eyes (mVD_full Normal: 16.397 (95% CI 16.343 to 16.451) vs. ERM 15.610 (95% CI 15.372 to 16.048) (P < 0.001)) (mCPD Normal: 0.399 (95% CI 0.397 to 0.400) ERM: 0.381 (95% CI 0.373 to 0.390) (P < 0.001)). Among CST_A, FAZ_A, mVD_full and mCPD_full, only CST_A was found to be significantly associated with best corrected visual acuity (BCVA). Better visual outcome is associated with smaller CST_A (beta* =0.265). CST_A was found to have an acceptable AUC value for BCVA LogMar ≥ 0.3 in epiretinal membrane eyes (AUC value = 0.708). The AUROC values of other biomarkers were less than 0.7 in predicting BCVA in epiretinal membrane eyes.</p><p><strong>Conclusion: </strong>CST_A was found to be thicker in ERM eyes while mVD_full, mCPD_full and FAZ_A were lower in ERM eyes than normal eyes. CST_A was found to be significantly associated with BCVA in ERM eyes. The cut off value of CST_A was found to be 345.5, with an acceptable AUC value for discriminating BCVA LogMAR ≥ 0.3 in epiretinal membrane eyes.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863997","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}