International Journal of Retina and Vitreous最新文献

{"title":"Prevalence of macular disorders assessed by OCT in adults 45 years and older from Parintins - the Brazilian Amazon Region Eye Survey (BARES).","authors":"Sung E S Watanabe, Adriana Berezovsky, Arthur G Fernandes, Bruna F Marianelli, João Marcello Furtado, Marcela Cypel, Paulo Henrique Morales, Marcos J Cohen, Cristina C Cunha, Márcia H Mitsuhiro, Galton C Vasconcelos, Mauro Campos, Nívea N Ferraz, Paula Y Sacai, Jacob M Cohen, Sergio Muñoz, Rubens Belfort, Solange R Salomão","doi":"10.1186/s40942-026-00834-1","DOIUrl":"10.1186/s40942-026-00834-1","url":null,"abstract":"<p><strong>Background: </strong>To provide population-level estimates of OCT-detected macular pathology in adults living in the Brazilian Amazon region.</p><p><strong>Methods: </strong>Population-based, cross-sectional study. Eligible participants were residents aged ≥ 45 years identified through cluster sampling (20 clusters: 14 urban and 6 rural) in Parintins City, Amazonas, Brazil. Ophthalmic examinations included visual acuity testing, biomicroscopy, fundoscopy, and subjective refraction. A subset of eligible participants underwent spectral-domain OCT (SD-OCT; iVue-100, Optovue) using macular mapping protocols. OCT images were graded for predefined abnormalities involving the vitreoretinal interface, inner retina, outer retina/retinal pigment epithelium (RPE)/choroid, and ganglion cell complex (GCC). Generalized estimating equations (GEE) were used to evaluate factors associated with any OCT abnormality. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>Of 2,384 eligible individuals, 2,041 (85.7%) were examined and 588 (28.8%) underwent OCT (1,176 eyes), of which 1,069 eyes (90.9%) were gradable. OCT macular abnormalities were detected in at least one eye in 180 participants (30.6%). Overall, outer retinal layer changes were most frequent, followed by GCC thinning and epiretinal membrane. OCT abnormalities were independently associated with older age and lower educational level. Structural abnormalities were identified in 340 (31.8%) eyes; of these, 208 (19.5%) showed changes also detectable on dilated fundus examination, whereas 132 (12.3%) had a clinically normal funduscopic appearance. Clinically notable lesions were detected in 46 (4.3%) eyes, including signs of late AMD in 27 (2.5%) eyes, diabetic maculopathy in 6 (0.6%), lamellar macular hole in 6 (0.6%), full-thickness macular hole in 3 (0.3%), and central serous chorioretinopathy in 4 (0.4%) eyes. Among 774 eyes clinically normal at fundoscopy, OCT revealed subclinical disease in 127 (16.4%).</p><p><strong>Conclusions: </strong>In this underserved Amazonian population, approximately one-third of gradable eyes showed OCT-detected macular abnormalities, many of them subclinical on fundoscopy. Diabetic maculopathy, choroidal neovascular membranes, and late AMD showed very low prevalence and limited epidemiologic weight in this setting. Incorporating OCT into population-based surveys enhances detection and refines burden estimates of subclinical retinal disease and vision-threatening conditions in aging populations.</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/PMC13335215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863937","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":"Parapapillary choroidal dense pigmentation in young healthy eyes: a cross-sectional study.","authors":"Yuki Uto, Takehiro Yamashita, Kazuki Fujiwara, Aiko Iwase, Hiroto Terasaki, Kumiko Nakao, Taiji Sakamoto","doi":"10.1186/s40942-026-00865-8","DOIUrl":"10.1186/s40942-026-00865-8","url":null,"abstract":"<p><strong>Background: </strong>While observing fundus photographs from exploratory research investigating individual differences in the fundus, we discovered a black band around the optic nerve head that had not been reported in previous studies. Such eyes with parapapillary choroidal dense pigmentation (PCP) have a pigmented conus visible on color fundus photography. This study aimed to determine the prevalence of PCP in young healthy eyes and examine its relationships with axial length, optic disc tilt, and conus area.</p><p><strong>Methods: </strong>This prospective, observational, cross-sectional study included the right eyes of 133 participants, who were examined between November 1, 2010 and February 20, 2012. Among them, 117 right eyes of 117 patients were finally analyzed. Participants underwent comprehensive ophthalmologic examinations, including axial length measurement, fundus photography, and optic disc optical coherence tomography (OCT). Based on their color fundus photographs and optic disc cross-sectional OCT images, eyes were categorized into the non-PCP, temporal-PCP, and circum-PCP groups. Optic disc tilt was evaluated using a sine curve based on the retinal nerve fiber layer B-scan images. The conus area in the color fundus images was calculated using ImageJ and corrected using Bennett's formula. The Steel-Dwass test was used to perform multiple comparisons of the axial length, optic disc tilt, and conus area among the three groups.</p><p><strong>Results: </strong>The mean age and axial length of the participants were 25.8 years and 25.5 mm, respectively. Of the 117 eyes, 49, 17, and 51 had non-PCP, temporal-PCP, and circum-PCP, respectively. The axial length (p = 0.011) and conus area (p = 0.047) were significantly shorter and smaller, respectively, for the circum-PCP group than for the non-PCP group. No significant differences were observed in the other intergroup comparisons.</p><p><strong>Conclusions: </strong>OCT findings revealed that PCP appears black due to choroidal pigment. The eyes with circumferential PCP had shorter axial lengths and smaller conus areas than that of those without, suggesting that it may occur more likely in eyes with less axial elongation.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856296","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":"Optical coherence tomography angiography as non-invasive tool for detection of characteristics patterns in circumscribed choroidal hemangioma.","authors":"T Kurdiani, M Lever, K Al-Ghazzawi, N E Bechrakis, T Kiefer","doi":"10.1186/s40942-026-00864-9","DOIUrl":"10.1186/s40942-026-00864-9","url":null,"abstract":"<p><strong>Introduction: </strong>Circumscribed choroidal hemangioma (CH) is a benign vascular intraocular tumor, most commonly diagnosed in adulthood. Clinical symptoms include visual disturbances caused by subretinal fluid and degenerative retinal changes involving the macula. Diagnosis is based on clinical examination; however, multimodal imaging techniques such as optical coherence tomography (OCT), fluorescein angiography (FA), indocyanine green angiography (ICGA), and ultrasound (US) are essential in differentiating from other intraocular tumor entities. While FA and ICGA are dye-related invasive methods with possible side effects, OCT Angiography (OCTA) is a non-invasive diagnostic method for visualizing retinal and choroidal vasculature. We aimed to explore OCTA as a noninvasive diagnostic modality for CH focusing on characteristical patterns.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 26 patients with untreated CH who underwent OCTA, as well as conventional FA and ICGA. OCTA images were evaluated for specific irregular vascular patterns within the choroidal vasculature, such as 'bag of worms', spaghetti-like/giant vessels, club-like appearance vessels with terminal bulbs, and avascular zones.</p><p><strong>Results: </strong>Of the 26 Patients analysed, 85% (22 eyes) exhibited irregular vascular patterns in the choroidal vasculature, as described above, and were labelled OCTA pattern present. Four eyes showed no such patterns and were labelled as OCTA pattern non-present. Compared to the second group, the OCTA pattern present group had significantly smaller tumor thickness (1.87 vs. 3.53 mm; p = 0.0001).</p><p><strong>Conclusion: </strong>These findings suggest that OCTA can effectively detect characteristic changes in CH, particularly in lesions with tumor prominence below 3 mm. OCTA has the potential to become a valuable non-invasive tool for CH diagnosis; however, larger studies are needed to further validate its clinical utility.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13157661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837658","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":"Removal of scleral buckle: indications, long-term outcomes and comparison with the literature.","authors":"Eunice Linh You, Sihame Doukkali, Mélanie Hébert, Mohammadhossein Ghasempourabadi, Kelvin You, David Jin, Serge Bourgault, Mathieu Caissie, Éric Tourville, Ali Dirani","doi":"10.1186/s40942-026-00839-w","DOIUrl":"10.1186/s40942-026-00839-w","url":null,"abstract":"<p><strong>Objective: </strong>To assess the clinical indications for scleral buckle removal (SBR) and evaluate the functional and anatomic outcomes, including the risk of recurrent retinal detachment (RD) following SBR.</p><p><strong>Design: </strong>Retrospective chart review.</p><p><strong>Methods: </strong>A single-center analysis of patients operated for SBR was conducted at the Centre hospitalier universitaire de Québec - Université Laval in Quebec, Canada between 2008 and 2023 with a minimum of 1 year follow-up. Data were gathered on preoperative characteristics, indication for SBR, time to SBR, surgical techniques used and postoperative outcomes including final best-corrected visual acuity (BCVA). The primary outcome was the incidence of recurrent RD after SBR.</p><p><strong>Results: </strong>Among 2375 eyes that had placement of scleral buckle for RD, 35 (1.5%) required SBR. Infection (34%) and pain (31%) were the most common reasons for SBR. The median time from buckle placement to removal was significantly shorter for infectious cases (2.4 months) compared to non-infectious cases (12.6 months) (p = 0.006). Four patients (11%) experienced recurrent RD, with 3/4 of those cases occurring when buckle explantation was performed within the first month. Postoperative BCVA at final follow-up improved from logMAR 0.70 to logMAR 0.30 (Snellen equivalent of 20/100 to 20/40). A multivariate logistic regression analysis demonstrated no statistically significant predictors of recurrent RD.</p><p><strong>Conclusion: </strong>Infection and pain are the leading indications for SBR, with infections requiring earlier removal. Recurrent RD occurred in 11% of cases, especially with early removal, with all recurrences occurring within 3 months of SBR. Despite these risks, visual outcomes post-SBR are generally favorable. Close monitoring during the early postoperative period is therefore recommended.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837672","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":"Pars plana vitrectomy for tractional and combined tractional rhegmatogenous retinal detachment in type 1 diabetes mellitus: outcomes, prognostic factors, and a proposed staging system.","authors":"Mohammed S Alshehri, Adhwa Alsadoon, Alanaud Albazei, Turki Algethami, Marco Mura, Sulaiman M Alsulaiman, Faisal S Alqahtani","doi":"10.1186/s40942-026-00835-0","DOIUrl":"10.1186/s40942-026-00835-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pars plana vitrectomy (PPV) in young type 1 diabetes mellitus (T1DM) patients presents greater surgical challenges than in type 2 (T2DM) cases. Despite advances in vitreoretinal surgery, there is no universally accepted classification system for tractional retinal detachment (TRD), and limited data exist on the comparative effectiveness of endotamponade agents and the prognostic significance of outer retinal biomarkers in T1DM cohorts. This study evaluates PPV outcomes for TRD and combined tractional rhegmatogenous retinal detachment (TRRD) in T1DM, introduces a proposed staging system for TRD, assesses the impact of tamponade selection on outcomes, and investigates the role of outer retinal structural biomarkers in predicting visual success.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective cohort study was conducted at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, on T1DM patients treated with PPV for TRD and combined TRRD between June 2014 and December 2022. A novel TRD staging system was proposed based on the extent of the tractional membrane, posterior hyaloid attachment status, and the presence of retinal breaks, classifying cases into simple TRD (stages 1, 2, 3a), complex TRD (stages 3b, 4, 5), and combined TRRD (acute and chronic). Anatomical success was defined as retinal reattachment, and visual success was defined as improvement in visual acuity of more than two Snellen lines. Postoperative optical coherence tomography (OCT) at 1 year assessed external limiting membrane (ELM) and ellipsoid zone (EZ) integrity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 339 eyes (255 patients), complex TRD was the most common presentation (41.6%). Iatrogenic retinal breaks occurred in 39.2%, and tamponade was used in 74.0% of cases. Anatomical success was achieved in 73.2% after a single surgery and 91.2% overall. Visual success was achieved in 55.2% of eyes, with vision improvement observed in 69.2%. Eyes without tamponade achieved the highest visual success rate (80.8%), followed by gas tamponade (84.3% for C3F8/SF6) compared to silicone oil (51.9%) (p &lt; 0.001). Combined TRRD had significantly lower visual success compared to complex TRD (47.3% vs. 64.5%, p = 0.018). Multivariate analysis identified preoperative LogMAR visual acuity (RR 9.88, 95% CI: 4.68-20.83, p &lt; 0.001), intact ellipsoid zone status (RR 20.4, 95% CI: 3.8-109.41, p &lt; 0.001), combined TRRD stage (RR 0.08, 95% CI: 0.01-0.5, p = 0.007), and absence of subretinal fluid (RR 3.49, 95% CI: 1.12-10.87, p = 0.031) as significant independent predictors of visual success.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;PPV for TRD in T1DM achieves excellent overall anatomical outcomes. The proposed TRD staging system demonstrated prognostic value, with combined TRRD carrying a worse visual prognosis. Preoperative visual acuity, TRD stage, outer retinal integrity (ELM/EZ) on postoperative OCT, and tamponade type were significant determinants of functional outcomes. The ","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837698","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":"Retinal organoids: current status of development and new avenues for application in disease modeling, drug discovery and therapeutics.","authors":"Renu Agarwal, Igor Iezhitsa, Jose R Hombrebueno, Puneet Agarwal","doi":"10.1186/s40942-026-00846-x","DOIUrl":"10.1186/s40942-026-00846-x","url":null,"abstract":"<p><p>Visual impairment affects over 2.2 billion people worldwide and the major causes include age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy. For research in these areas, although animal models offer a more physiologically complex system than in vitro approaches, their use raises ethical considerations, and species-specific differences such as variations in protein sequences and signaling pathways. This can limit the direct translatability of the outcomes. Traditional 2-D cell cultures, in contrast, lack the multicellular organization and dynamic microenvironment necessary to replicate human retinal complexity. Retinal organoids (ROs), three-dimensional tissue constructs derived from pluripotent stem cells, have emerged as a promising model due to their human origin and complex cellular interactions that cannot be achieved in conventional 2-D/3-D co-culture models. In this review, we provide a brief overview of the evolution from 2-D to 3-D retinal models, highlight the structural and functional features of ROs including the presence of layered retinal architecture, photoreceptor outer segment formation, and light-responsive electrophysiological activity and summarize their applications in disease modeling, drug discovery, and gene and cell therapy. ROs represent a significant advancement over traditional models by enabling the recapitulation of human-specific retinal development, facilitating the study of patient-derived disease phenotypes, and providing a platform for personalized therapeutic screening. Their development has deepened understanding of pathological mechanisms in conditions such as retinitis pigmentosa and AMD, while enabling preclinical testing of targeted interventions like CRISPR-based gene editing and photoreceptor cell replacement. Nonetheless, challenges remain in fully replicating retinal vascularization, long-term functional maturation, and synaptic connectivity, underscoring the need for continued refinement and integration with complementary model systems.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13289485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815410","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":"Exploratory study on a novel automatic quantification software by artificial intelligence for geographic atrophy associated to age-related macular degeneration.","authors":"Jorge Ruiz-Medrano, Aiwen Su, Zaixing Mao, Masahiro Akiba, José M Ruiz-Moreno","doi":"10.1186/s40942-026-00862-x","DOIUrl":"10.1186/s40942-026-00862-x","url":null,"abstract":"<p><p>OBJECTIVES: To determine the accuracy and repeatability of novel artificial intelligence (AI)–based software for automated quantification of geographic atrophy (GA) associated with age-related macular degeneration (AMD) using swept-source optical coherence tomography (SS-OCT) images. METHODS: This cross-sectional observational study included 33 eyes from 33 patients with GA secondary to AMD and one healthy control eye, all without a history of choroidal neovascularization. Each eye underwent three consecutive 7 × 7 mm2 SS-OCT scans (Topcon Corporation, Tokyo, Japan). Two independent observers manually delineated GA areas on en face OCT images in a masked fashion at two time points separated by 15 days. Individual and mean manual measurements were compared with automated AI-derived GA measurements, yielding a total of 165 measurements. Lesions were categorized according to morphology (regular vs. irregular) and number (single vs. multiple). Agreement between manual and AI measurements was assessed using Lin’s concordance correlation coefficient (CCC). Software repeatability was evaluated using the intraclass correlation coefficient (ICC) based on a two-way mixed-effects model. RESULTS: The mean patient age was 73.4 ± 11.7 years. Twelve eyes exhibited regular lesion morphology, and 11 eyes had single GA lesions. Intra-observer repeatability was excellent, with ICCs of 0.999 (95% CI, 0.997–0.999) for Observer X and 0.999 (95% CI, 0.999–0.999) for Observer Y. Agreement between the mean manual measurements of both observers was also high (ICC = 0.997; 95% CI, 0.989–0.999). Agreement between AI-based measurements and the mean of the four manual annotations was strong for the overall cohort (CCC = 0.992; 95% CI, 0.981–0.998). Stratified analyses showed CCCs of 0.989 (95% CI, 0.816–0.997) for regular lesions and 0.988 (95% CI, 0.944–0.998) for irregular lesions, and 0.999 (95% CI, 0.998–1.000) for single lesions and 0.984 (95% CI, 0.963–0.995) for multiple lesions. Agreement by lesion size was lower for small lesions (< 3.7 mm2; n = 12; CCC = 0.903; 95% CI, 0.742–0.974) and higher for medium (3.7–9.4 mm2; n = 13; CCC = 0.978; 95% CI, 0.940–0.994) and large lesions (> 9.4 mm2; n = 8; CCC = 0.956; 95% CI, 0.676–0.998). CONCLUSIONS: This AI-based software demonstrates high accuracy and excellent repeatability for automated GA area quantification across different lesion morphologies, numbers, and sizes, with minimal processing time. These findings could support its potential utility in routine clinical practice and research applications. CLINICAL TRIAL NUMBER: Not applicable. </p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815388","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":"Correlations between SS-OCT and OCT angiography biomarkers in treatment-naïve neovascular AMD during aflibercept therapy: a prospective study.","authors":"Marcussi Palata Rezende, Fernanda Atoui Faria, Daniel Prado Beraldo, Julia Polido, Rubens Belfort, Thiago Cabral","doi":"10.1186/s40942-026-00854-x","DOIUrl":"10.1186/s40942-026-00854-x","url":null,"abstract":"&lt;p&gt;&lt;p&gt;BACKGROUND: Swept-source OCT (SS-OCT) and OCT angiography (SS-OCTA) enable high-resolution assessment of retinal and choroidal biomarkers in neovascular AMD (nAMD). However, prospective analyses and how these biomarkers correlate before and after therapy are limited. The aim of this study was to prospectively evaluate biomarker correlations following a loading dose of aflibercept using state-of-the-art, high-resolution imaging with SS-OCT and SS-OCTA over the course of a 4-month follow-up in treatment-naïve nAMD. METHODS: This prospective interventional case series study included 21 eyes from 21 treatment-naïve patients with nAMD. All eyes received three monthly intravitreal aflibercept injections. Patients were evaluated at baseline and one month after the loading phase (4-month visit). The biomarkers included the best-corrected visual acuity (BCVA), central macular thickness (CMT), central choroidal thickness (CCT), macular neovascularization area (MNVA), vessel density (VD), and avascular area of the superficial plexus (AASP) and deep plexus (AADP). Pre (baseline) and posttreatment values were compared, and correlations were analyzed using Pearson’s or Spearman’s methods. RESULTS: Significant functional, structural, and vascular improvements in all the evaluated biomarkers except intraocular pressure were observed after treatment. The mean BCVA improved from 1.11 ± 0.47 to 0.56 ± 0.20 logMAR (p &lt; 0.001). SS-OCT (CMT and CCT), and SS-OCTA (MNVA, AASP and AADP) metrics were significantly lower following treatment. Correlation analysis revealed multiple statistically significant associations among structural, functional, and vascular biomarkers. The baseline CMT showed a moderate positive correlation with the CMT posttreatment (r = 0.53; p = 0.013) and a very high negative correlation with CMT reduction (r = − 0.95; p &lt; 0.001). The baseline CCT was highly correlated with CCT posttreatment (r = 0.87; p = 0.002). The BCVA correlated significantly with CMT at baseline and posttreatment. Notably, the baseline MNVA was moderately negatively correlated with the posttreatment CCT (r = − 0.51; p = 0.019). Significant correlations were also identified between the AADP and both the baseline CMT and CMT reduction, as well as between changes in AASP and CCT. These findings highlight complex and interdependent relationships among retinal thickness, choroidal structure, visual function, and OCTA-derived microvascular biomarkers following aflibercept therapy. CONCLUSIONS: In treatment-naïve eyes with nAMD, aflibercept loading therapy induces significant and coordinated functional, structural, and microvascular changes. The observed correlations demonstrate that baseline SS-OCT and SS-OCTA biomarkers not only reflect initial disease burden but are also closely associated with the magnitude and direction of anatomical and vascular remodeling after treatment. These findings support the value of integrated multimodal biomarker assessment for improving prognos","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13267608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771083","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":"Fluocinolone acetonide implant in diabetic macular edema: sustained benefits and effects of following prior therapy.","authors":"Philipp Necpal, Klemens P Kaiser, Ron C Kroener, Pankaj Singh","doi":"10.1186/s40942-026-00861-y","DOIUrl":"10.1186/s40942-026-00861-y","url":null,"abstract":"<p><p>PURPOSE: To (1) evaluate long-term real-world anatomical and functional outcomes after implantation of a sustained-release fluocinolone acetonide (FAc) implant in eyes with diabetic macular edema (DME) and (2) to assess the influence of prior anti–vascular endothelial growth factor (anti-VEGF) and corticosteroid exposure on treatment response and durability. METHODS: This retrospective, single-center study included 74 eyes from 47 DME patients treated with intravitreal FAc implant. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), intraocular pressure (IOP), prior treatment burden, and need for additional intravitreal therapy were evaluated over a median follow-up of 40 months. Baseline changes were analysed using paired statistical testing. Spearman correlations assessed associations between prior treatment exposure and clinical outcomes. RESULTS: FAc implantation significantly reduced CRT (median −75.5 µm; p<0.001). Eyes receiving fewer than six prior anti-VEGF injections demonstrated greater CRT reduction (−93 µm; p<0.001) than eyes receiving six or more injections (−65 µm; p=0.015). BCVA improved modestly overall (+3.95 ETDRS letters; p=0.037), with greater gains in less pretreated eyes (+7.53 letters; p=0.002) compared to eyes with ≥6 prior injections (+0.0 letters; p=0.492). Higher prior anti-VEGF burden correlated with shorter treatment durability (ρ = −0.35; p<0.003) and increased need for supplemental therapy (ρ = 0.30; p<0.001). CONCLUSIONS: FAc implantation provides sustained anatomical improvement and modest functional benefit in DME, particularly when introduced earlier in the treatment course. Earlier integration of long-acting corticosteroid therapy may enhance durability and reduce cumulative anti-VEGF burden. </p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"12 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771115","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":"Prevention of postoperative proliferative vitreoretinopathy in complex retinal detachments with serial intravitreal methotrexate injections.","authors":"Lucas Valadão de Brito Soares, Tiago Nelson de Oliveira Rassi, Wener Passarinho Cella, Mauricio Maia","doi":"10.1186/s40942-026-00856-9","DOIUrl":"10.1186/s40942-026-00856-9","url":null,"abstract":"<p><p>BACKGROUND: Proliferative vitreoretinopathy (PVR) remains the leading cause of surgical failure after rhegmatogenous retinal detachment (RRD) repair. Intravitreal methotrexate (MTX) has emerged as a potential antiproliferative adjunct; however, the available evidence remains inconclusive. This study evaluated the safety and clinical outcomes associated with a standardized protocol of serial intravitreal MTX injections administered throughout the critical postoperative period in eyes with complex RRD. METHODS: This retrospective observational analysis included 49 eyes of 49 patients selected from 50 consecutively screened patients undergoing pars plana vitrectomy (PPV) for complex RRD, defined as PVR grade C, recurrent retinal detachment due to PVR, or retinal detachment associated with penetrating ocular trauma. All included eyes were treated according to a standardized institutional protocol consisting of an intraoperative intravitreal MTX injection (400 µg/0.1 mL), followed by biweekly injections through postoperative week 12. The primary outcome was single-surgery anatomic success (SSAS), defined as retinal reattachment without fibrotic membrane formation at 12 weeks. Secondary outcomes included final retinal reattachment over total follow-up, changes in best-corrected visual acuity (BCVA), and safety outcomes. RESULTS: Forty-nine of 50 screened patients met the inclusion criteria and were included in the final analysis. SSAS at 12 weeks was achieved in 42 of 49 eyes (85.7%). Seven eyes required reoperation during follow-up, yielding a final retinal reattachment rate of 93.8% over the total follow-up period. Mean BCVA improved significantly from 2.52 ± 0.58 logMAR preoperatively to 1.23 ± 0.84 logMAR at 3 months (p < 0.001). Mean follow-up was 14.7 ± 10.8 months. The most frequent adverse event among analyzed eyes was conjunctival hyperemia, which resolved after completion of the MTX protocol. No severe ocular or systemic MTX-related adverse events were observed. CONCLUSIONS: Serial intravitreal MTX administered during the early postoperative period showed a favorable safety profile and was associated with encouraging anatomic and visual outcomes in this cohort of complex RRD. However, given the retrospective design, lack of a control group, cohort heterogeneity, potential selection bias, and the influence of adjunctive surgical procedures, these findings should be interpreted cautiously and as hypothesis-generating. Prospective controlled studies are required to better define the role of MTX in preventing postoperative PVR. </p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13251097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771075","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}