International Journal of Retina and Vitreous最新文献

{"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}

{"title":"Real-world performance of faricimab for neovascular age-related macular degeneration and diabetic macular edema: experience from the BrazilRetNet multicenter study. Report 1.","authors":"Vinicius Kniggendorf, Thiago C Silveira, Vitor D M Costa, Danilo S Soriano, Caio V Regatieri, Renata F Sugai, Arnaldo Bordon, Giovanna S Nutels, Ana L Peixoto, Carlos Augusto Moreira-Neto, Joao Victor C Miranda, Marcio B Nehemy, Francisco M Damico, Leandro C Zacharias, Daniel Lavinsky, Cleide G Machado, Carlos Eduardo D Veloso, Francyne V Cyrino, Wener Cella, Luiz Roisman, Oswaldo F Brasil, Gabriel C Andrade, Francisco Stefanini, Fernando K Malerbi, Fernando M Penha","doi":"10.1186/s40942-026-00860-z","DOIUrl":"10.1186/s40942-026-00860-z","url":null,"abstract":"<p><p>BACKGROUND: To investigate real-world use of faricimab for the treatment of neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). METHODS: In this first analysis of the BrazilRetNet study group, we performed a multicenter, retrospective chart review of patients who completed the first three intravitreal injections of faricimab until October 2025; patients were followed in 15 retinal centers across Brazil. Collected data included clinical and demographic information, treatment strategy and history; main outcome measures were best-corrected visual acuity (BCVA) converted in ETDRS, macular central subfield thickness (CST) measured on optical coherence tomography (OCT), and adverse events. For comparison among baseline and follow-up variables, Wilcoxon test was employed; p values ≦ 0.05 were considered statistically significant. RESULTS: A total of 220 patients’ eyes were included. 145 eyes of 127 nAMD patients (56% women, average 78.6 ± 9.4 years-old, 94.5% caucasian) and 75 eyes of 54 DME patients (63% men, average 66.6 ± 10.9 years old, 83.3% caucasian). Prior intravitreal treatment was reported in 123 eyes (84.8%) with nAMD and 60 eyes (80%) with DME, with a mean of 16.8 and 11.7 previous injections, respectively. Baseline mean BCVA was 57.09 (nAMD) and 63.54 (DME). After three injections, mean BCVA improved to 61.06 for nAMD (p < 0.001; average gain of 3.97 letters) and 70.27 for DME (p < 0.001; average gain of 6.73 ETDRS letters). Baseline mean CST was 320.4 μm (nAMD) and 380.4 μm (DME), decreased to 264.3 μm (nAMD; p < 0.001; − 56.1 μm) and 312.7 μm (DME; p < 0.001; − 67.7 μm). Differences on BCVA and CST remained statistically significant when subgroups of naive or previously treated eyes were analyzed. All reported adverse events occurred in nAMD patients and included submacular hemorrhage (2 eyes), RPE tear (1 eye) and increased intraocular pressure (1 eye). No intraocular inflammation was reported. CONCLUSIONS: Overall, nAMD and DME patients treated with faricimab in this Brazilian cohort, presented BCVA improvement and a decreased CST after three injections. A low incidence of adverse events was reported, mostly associated to the natural history of the disease. Future analyses will provide further information on real-world farcimab treatment for nAMD and DME in Brazil. </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/PMC13251305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771080","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":"Surgical prognosis in epiretinal membrane: 12-month outcomes after membrane peeling in a 5-year cohort with OCT biomarkers.","authors":"Piero Barrera-Arshavin, Álvaro Bofill-Ramirez, Antonia Bayo-Burgos, Eduardo Urrejola-Irarrazabal, Josefina Camelio-Opazo, Juan Ignacio Verdaguer-Diaz, María José Rivas-Figueroa, Luis Filsecker-López, José Manuel López-Astaburuaga, Sergio Zacharías-Santamaría, Jorge Orellana-Rios, Efraín Pérez-Argandoña","doi":"10.1186/s40942-026-00853-y","DOIUrl":"10.1186/s40942-026-00853-y","url":null,"abstract":"<p><strong>Background: </strong>To determine the functional and anatomical outcomes at 12 months after pars plana vitrectomy (PPV) for epiretinal membrane (ERM) and the independent prognostic value of preoperative biomarkers in optical coherence tomography (OCT).</p><p><strong>Methods: </strong>Five-year analytical study of 340 eyes with ERM in stages (Govetto G2-4). Best-corrected visual acuity (BCVA) logMAR and OCT were evaluated at baseline, 1, 3, 6, and 12 months. The primary objective was to determine the change in BCVA at 12 months (ΔlogMAR 12 m - baseline). Univariate tests, ANCOVA, longitudinal mixed linear models, and logistic regression were applied for gain ≥ 0.2 logMAR. The models were adjusted for baseline VA, age, sex, aetiology, surgical technique, and analysis of biomarkers in OCT.</p><p><strong>Results: </strong>Baseline VA was 0.54 ± 0.44 logMAR (approximate Snellen equivalent: 20/70); distribution according to G2 (n = 166), G3 (n = 146), G4 (n = 28). VA improved significantly at 12 months (Wilcoxon p < 0.001), equivalent to 11-12 ETDRS letters. Secondary ERMs showed greater unadjusted gain than idiopathic ones, but aetiology was not an independent predictor after adjustment. The surgical technique was not independently associated with VA at 12 months (β=+0.031 logMAR; 95% CI; p = 0.408) or with responder status (OR 1.18; 95% CI; p = 0.625). By severity, advanced stages had worse baseline visual acuity (VA) and greater absolute gains (Kruskal-Wallis H = 7.61; p = 0.0223), although with lower final VA compared to lesser stages. Baseline VA was the dominant predictor in all models (β=-0.766; 95% CI; p < 0.001). Among preoperative biomarkers, COST line disruption independently increased the probability of response (OR = 2.08; 95% CI; p = 0.013). DRIL, EZ disruption, and central bouquet alterations did not reach significance after adjustment. Mixed models confirmed early improvement, maintained up to 12 months. Kaplan-Meier showed faster time to response in advanced stages.</p><p><strong>Conclusions: </strong>PPV for ERM achieves significant improvement at 12 months. Baseline VA is the main determinant of prognosis. According to Govetto's classification, the greatest gain occurs in advanced stages, but with lower final VA. The COST line emerges as the only preoperative biomarker with independent prognostic value for achieving ≥ 0.2 logMAR; the others provide limited utility when baseline VA is considered.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13234982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771118","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":"Incidence and risk factors of retinopathy of prematurity in artificial reproductive technology conceived preterm infants in China.","authors":"Shufen Chen, Shuhui Chen, Yuzhen Zhu, Yuxuan Lai, Guihua Xu","doi":"10.1186/s40942-026-00859-6","DOIUrl":"10.1186/s40942-026-00859-6","url":null,"abstract":"<p><p>BACKGROUND: To evaluate the incidence and associated risk factors of retinopathy of prematurity (ROP) in preterm infants conceived through assisted reproductive technology (ART) in China. METHODS: We conducted a retrospective analysis of preterm infants who were hospitalized between August 2019 and December 2024. Infants were divided into two groups based on mode of conception: ART-conceived and naturally conceived. The incidence of ROP was compared between the groups. Clinical data were collected for both the infants and their mothers. RESULTS: A total of 1,019 preterm infants were included, comprising 195 ART-conceived and 824 naturally conceived infants. ROP was diagnosed in 33 ART-conceived (16.9%) and 136 naturally conceived infants (16.5%), with no statistically significant difference between the two groups (P = 0.888). Similarly, no significant difference was observed in ROP staging (P = 0.228). Multivariable logistic regression analysis showed that, in the ART-conceived group, greater gestational age (OR: 0.618) and a history of antenatal corticosteroid use (OR: 0.278) were protective factors, whereas apnea of prematurity (OR: 3.170) increased the risk of ROP. Similarly, in the naturally conceived group, greater gestational age (OR: 0.840) was also a protective factor, while apnea of prematurity (OR: 1.666) increased the risk of ROP. CONCLUSION: The incidence of ROP did not differ significantly between ART-conceived and naturally conceived preterm infants. In ART-conceived infants, higher gestational age and a history of antenatal corticosteroid use were protective factors, whereas apnea of prematurity increased the risk of ROP. </p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716551","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":"Ocular pharmacokinetics of tivozanib eye drops in patients with neovascular age-related macular degeneration: comparison with phase 1 trials of oral tivozanib in solid tumors.","authors":"Shinya Horita, Mayumi Saki, Sotaro Takigawa, Yasumasa Kanai, Kenta Murotani, Fumi Gomi","doi":"10.1186/s40942-026-00848-9","DOIUrl":"10.1186/s40942-026-00848-9","url":null,"abstract":"<p><p>Intravitreal anti-vascular endothelial growth factor (VEGF) therapy is the standard treatment for neovascular age-related macular degeneration (nAMD) but is invasive and burdensome for patients. To overcome these obstacles, tivozanib, a pan-VEGF receptor inhibitor approved for renal cell carcinoma, is in development as eye drops. The phase 1 study of a 3-week administration of tivozanib eye drops showed a preferable safety profile and exploratory efficacy signs in Japanese patients with nAMD. During eye drop administration, two drug delivery pathways affect ocular pharmacokinetics, either directly through the ocular tissues or through systemic circulation. To assess the ocular pharmacokinetics of tivozanib eye drops, we conducted an integrated analysis of systemic adverse event occurrence and systemic exposure in patients with nAMD treated with tivozanib eye drops and in patients with cancer treated with oral tivozanib, using previous phase 1 study results. Systemic exposure was significantly lower with tivozanib eye drops versus oral tivozanib, with no drug-related hypertension due to the systemic pan-VEGF receptor inhibition observed, suggesting systemic VEGF receptors are not fully inhibited by tivozanib. Exploratory efficacy signs in patients with nAMD after short-term use of tivozanib eye drops also suggest tivozanib might reach the retina and inhibit VEGF receptors, although further long-term efficacy studies are warranted. Given the integrated analysis, we hypothesize that tivozanib eye drops could predominantly be delivered to the posterior eye segment through the ocular tissues, with limited contribution by the systemic drug delivery pathway. This hypothesis provides meaningful insights into the ocular pharmacokinetics of tivozanib eye drops.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"12 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13085304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690029","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":"Surgical outcomes of familial exudative vitreoretinopathy-associated retinal detachment: a systematic review and meta-analysis.","authors":"Hashem Abu Serhan, Ahmad Alazzam, Ahmad Barakat, Anas Alamoudi, Raed Alnutaifi, Nagi Ahmed, Taima'a Al-Awaysheh, Mohd Salim Harun Gigani, Ahmed B Sallam","doi":"10.1186/s40942-026-00850-1","DOIUrl":"10.1186/s40942-026-00850-1","url":null,"abstract":"<p><p>BACKGROUND: Familial exudative vitreoretinopathy (FEVR) is a rare hereditary vitreoretinal disorder in children, characterized by abnormal peripheral retinal vascularization leading to retinal detachment (RD) in 21% to 64% of cases. Optimal surgical management remains uncertain owing to disease rarity and heterogeneity of published evidence. PURPOSE: To evaluate anatomical and functional outcomes of surgical repair for FEVR-associated RD. METHODS: This PRISMA-adherent systematic review and meta-analysis was prospectively registered in PROSPERO (CRD420251071825). Eligible designs included retrospective and prospective cohort studies and case series reporting surgical outcomes in FEVR-associated RD with more than five patients. Pre- and postoperative best-corrected visual acuity (BCVA; logMAR) was pooled using random-effects models. Retinal reattachment rates were synthesized as proportions. Subgroup analyses were performed by detachment type (rhegmatogenous (RRD) versus tractional (TRD)) and surgical approach (pars plana vitrectomy (PPV), scleral buckling (SB), combined PPV + SB). Heterogeneity was quantified using I² and 95% prediction intervals. Formal meta-regression was not performed, given insufficient study counts per subgroup. RESULTS: Twenty studies comprising 586 eyes were analyzed. Overall surgery yielded a significant BCVA improvement (MD -0.30 logMAR; 95% CI -0.50 to -0.08; p = .009) with substantial heterogeneity (I² = 86%; prediction interval − 1.03 to 0.45). RRD demonstrated greater functional benefit (MD -0.45 logMAR; 95% CI -0.72 to -0.16) and high anatomical success (88.8%; I² = 0%). TRD showed no significant visual improvement (MD -0.15; p = .38) and lower, more variable reattachment (72.8%; I² = 63.3%). SB achieved the highest reattachment rate (93.2%), combined PPV + SB the most consistent gains (84.0%; I² = 0%), and PPV alone the lowest reattachment (63.0%), reflecting its preferential use in complex TRD. FEVR staging was inconsistently reported, precluding stage-stratified analysis. CONCLUSION: Surgical repair of FEVR-associated RD yields meaningful outcomes, particularly in RRD, while TRD goals are centered on vision preservation. Findings are limited by retrospective designs, substantial heterogeneity, and inconsistent staging data. Prospective multicenter registries with standardized reporting are urgently needed. </p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13217818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662535","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":"Correlation of retinal imaging with presence of inner limiting membrane pores in idiopathic epiretinal gliosis.","authors":"Denise Vogt, Nikolina Durdevic, Azza Dammak, Ricarda G Schumann, Andrea Govetto, Mario R Romano, Efstathios Vounotrypidis, Melih Parlak, Armin Wolf","doi":"10.1186/s40942-026-00849-8","DOIUrl":"10.1186/s40942-026-00849-8","url":null,"abstract":"<p><p>BACKGROUND: To correlate retinal imaging biomarkers in idiopathic epiretinal membranes (iERM) with histopathological findings of internal limiting membrane (ILM) pores. METHODS: We retrospectively included 18 eyes of 18 patients diagnosed with iERM that underwent vitrectomy with membrane peeling between October 2023 and June 2024 at the Department of Ophthalmology, University Hospital Ulm, Germany. The surgically excised tissue was processed as flat mounts for immunocytochemistry. Clinical data and retinal architecture, as assessed by multimodal imaging including optical coherence tomography (OCT), enface OCT, fundus autofluorescence and multicolor imaging, were reviewed pre-and postoperatively. RESULTS: In our study, ILM pores were identified by immunocytochemistry in 15 of 18 specimens (83%). OCT showed ERM stage 2 in 11 eyes (61%), stage 3 in 6 eyes (33%) and stage 4 in 1 eye (6%), with central bouquet abnormalities in 6 of 18 eyes (33%) and ectopic inner foveal layers in 7 of 18 eyes (39%) of eyes. Postoperatively at 12 months, microcystic macular edema (MME) persisted in 3 of 18 eyes (17%) and resolved in one eye. Dissociated optic nerve fiber layer (DONFL) was observed in 15 of 18 eyes (83%). There was no significant correlation between ILM pores and iERM stage, the presence of ellipsoid zone defects, MME or DONFL (Fisher’s exact test: each p > 0.05). CONCLUSION: In iERM, ILM pores are highly frequently seen, but appear to be independent of ERM severity and retinal biomarkers. The presence of ILM pores was not found to be associated with anatomical alterations following ILM removal. </p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13081236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654253","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":"Comparison of the effect of gas and silicone oil tamponades on visual outcomes in the surgical treatment of rhegmatogenous retinal detachment.","authors":"Tural Galbinur, Ayan Mammadkhanova, Hafiz Gahramanov, Ulkar Galbinur, Ayan Galbinur, Gunay Aslanova, Pasha Musayev","doi":"10.1186/s40942-026-00851-0","DOIUrl":"10.1186/s40942-026-00851-0","url":null,"abstract":"<p><p>PURPOSE: The choice of tamponade material for pars plana vitrectomy during rhegmatogenous retinal detachment surgery determines the overall success of the procedure. This study examined how gas and silicone oil tamponades affect visual results, retinal thickness measurements, and treatment-related complications. METHODS: Records of patients who underwent vitrectomy for primary rhegmatogenous retinal detachment in our clinic between January 2020 and December 2025 were retrospectively reviewed. A total of 113 eyes were included in the study, of which 68 were treated with gas and 45 with silicone oil tamponade. Propensity score matching was performed to eliminate baseline differences between groups, with a balance target of standardized mean difference < 0.20 for all covariates, and 40 patients in each group were analyzed. Visual acuity, intraocular pressure, retinal thickness parameters on optical coherence tomography, and complications were evaluated. RESULTS: At six months, the median BCVA was 0.18 (IQR 0.10–0.40) logMAR in the gas group and 0.48 (IQR 0.22–0.90) logMAR in the silicone oil group (p = 0.003; mean: 0.32 ± 0.49 vs. 0.64 ± 0.59 logMAR), with 70% of silicone oil eyes still having oil in situ at this time point. Post-tamponade clearance BCVA remained superior in the gas group (median 0.18 vs. 0.42 logMAR, p = 0.038). Clinically significant visual improvement was achieved in the gas group 70% and silicone oil group 47.5%. A significant decrease in parafoveal retinal thickness, including RNFL, GCL, and GCL + IPL layers, and increase in intraocular pressure were observed in the silicone oil group. Post-tamponade clearance anatomical success rates were similar in both groups (95.0% vs. 87.5%, p = 0.432). In the multivariate analysis, tamponade type was found to be an independent factor affecting visual outcomes. CONCLUSION: Gas tamponade provides better functional outcomes than silicone oil in the treatment of primary rhegmatogenous retinal detachment. In addition to anatomical success, long-term visual prognosis and the potential for inner retinal layer toxicity should also be considered when selecting tamponade. </p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13188595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633412","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":"Intracameral antibiotic prophylaxis and surgical expertise: key determinants in endophthalmitis after cataract surgery.","authors":"Vinicius Campos Bergamo, Luis Filipe Nakayama, Nilva Simeren Bueno de Moraes, Caio Vinicius Saito Regatieri, Ivan Maynart Tavares, Mauro Silveira de Queiroz Campos, Ana Luisa Hofling-Lima, Maurício Maia","doi":"10.1186/s40942-026-00845-y","DOIUrl":"10.1186/s40942-026-00845-y","url":null,"abstract":"<p><p>BACKGROUND: Postoperative endophthalmitis is a rare but severe complication of cataract surgery. Intracameral moxifloxacin prophylaxis has been widely adopted, but concerns remain regarding bacterial resistance and clinical outcomes. This study aimed to evaluate the impact of intracameral moxifloxacin prophylaxis on endophthalmitis incidence, microbiological patterns, antibiotic resistance, and visual outcomes in a university hospital setting, with comparison to a private hospital cohort. METHODS: This retrospective cohort study analyzed 21,178 cataract surgeries performed at a university hospital (2014–2023). The incidence of endophthalmitis, microbiological profiles, resistance patterns, and visual acuity outcomes (LogMAR) were assessed. Intracameral moxifloxacin prophylaxis was introduced in 2019. A comparative analysis was conducted with 19,360 surgeries from a private hospital. Fisher’s exact test, Mann-Whitney U test, and Joinpoint regression were used for statistical analysis. RESULTS: Endophthalmitis incidence at the university hospital was 0.109% (23/21,178 surgeries), significantly higher than the 0.021% incidence in the private hospital (p = 0.002). Post-prophylaxis, infection rates declined from 0.219% in 2016 to 0.042% in 2023 (p = 0.003). Staphylococcus epidermidis predominated (52.6%), and moxifloxacin resistance remained stable (pre: 45.5%; post: no increase). CONCLUSIONS: Intracameral moxifloxacin significantly reduced endophthalmitis incidence without increasing bacterial resistance. Post-prophylaxis infection rates aligned with national surveillance benchmarks (e.g., SES-SP threshold of 0.07%), reinforcing the efficacy of this preventive strategy in a public university setting. The worsening of final visual acuity post-prophylaxis underscores the need for continued clinical vigilance. Ongoing microbiological surveillance remains essential. </p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13188743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633468","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":"Off-label intravitreal eculizumab for geographic atrophy: report of the first two cases.","authors":"Rodrigo Jorge, Marcelo G B Rego, Arthur S Zupelli, Rodrigo T Calado","doi":"10.1186/s40942-026-00842-1","DOIUrl":"10.1186/s40942-026-00842-1","url":null,"abstract":"<p><p>PURPOSE: To report the feasibility and short-term safety of off-label intravitreal eculizumab as a complement-inhibition strategy for geographic atrophy (GA) secondary to age-related macular degeneration (AMD), based on two clinical cases. CASE REPORTS: Two pseudophakic patients with progressive bilateral visual decline presented with GA and drusen in both eyes. Because this represents a novel, off-label therapeutic approach, intravitreal eculizumab was administered first in the worse-seeing eye in both cases, which also exhibited more advanced atrophic involvement. The treatment was selected as a potentially more accessible alternative to pegcetacoplan or avacincaptad pegol, which remain unavailable in Brazil. At fourmonth follow-up, no ocular toxicity was observed. There was no reduction in visual acuity in the treated eyes; in Case 1, BCVA improved from 20/400 to 20/200, while Case 2 maintained baseline acuity. Full-field electroretinography performed at baseline and at month 1 demonstrated preserved responses without reduction in B-wave amplitude, and multifocal electroretinography showed stable response densities with no amplitude loss.After functional assessment, structural multimodal imaging also showed no evidence of toxicity. Optical coherence tomography (OCT) revealed stable GA-related outer retinal atrophy without inner retinal changes, intra- or subretinal fluid, or any signs of acute retinal injury. Fundus autofluorescence and OCT angiography remained unchanged, with no findings of ocular inflammation, vascular compromise, or early acceleration of GA progression. CONCLUSIONS: Intravitreal eculizumab was feasible and demonstrated short-term safety in these two cases, with preserved visual function and no electrophysiological or structural evidence of toxicity. While biologically plausible as a C5-inhibition strategy, its therapeutic benefit remains unproven. Larger, controlled studies with extended follow-up are required to clarify long-term safety and efficacy in geographic atrophy. </p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"12 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627876","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}