International journal of ophthalmology最新文献

{"title":"How retinal artery occlusion reveals moyamoya disease-a case series and descriptive study.","authors":"Zi-Yue Li, Ying Li, Ya-Qi Wang, Ting Chen, Xuan Xiao","doi":"10.18240/ijo.2026.09.12","DOIUrl":"10.18240/ijo.2026.09.12","url":null,"abstract":"<p><strong>Aim: </strong>To systematically characterize the clinical features, correlations, and therapeutic implications of participants with moyamoya disease (MMD)-related retinal artery occlusion (RAO) through a case series and pooled descriptive analysis.</p><p><strong>Methods: </strong>A total of 9 participants with MMD-RAO (2020-2025) and 9 cases retrieved from published literature (1981-2025) were retrospectively reviewed to descriptively explore the association between MMD and RAO. Mean difference (MD) was adopted as the effect size for continuous variables, while odds ratio (OR) was used for categorical variables. Heterogeneity was evaluated using the <i>Q</i> statistic and <i>I</i> ² index. Publication bias was assessed <i>via</i> funnel plots, and sensitivity analysis was performed using the leave-one-out method.</p><p><strong>Results: </strong>Eighteen participants were enrolled in the final analysis, with a male predominance (male:female=1.25:1). Limited improvement in best-corrected visual acuity (BCVA) was observed after treatment (logMAR range: 0.22-3.0). Central retinal artery occlusion (CRAO) was the predominant subtype (83.3%), followed by branch retinal artery occlusion (BRAO, 11.1%) and cilioretinal artery occlusion (CLRAO, 5.6%). Participants in our institutional cohort were significantly older than those reported in literature (52.89±9.53 <i>vs</i> 25.56±12.58y, <i>P</i><0.001). Our cohort presented slightly worse initial BCVA (2.04±0.9 <i>vs</i> 1.90±0.68; MD=0.14, 95%CI: -0.60-0.88, <i>P</i>=0.711, <i>I</i> ²=78.3%) and inferior visual recovery (1.99±0.9 <i>vs</i> 1.22±1.14; MD=0.77, 95%CI: -0.19-1.73, <i>P</i>=0.132, <i>I</i> ²=82.5%), whereas complete visual recovery (logMAR=0.1) was documented in one BRAO case from published reports. The efficacy of intra-arterial thrombolysis (IAT) reached 60% (3/5) in our cohort, and the overall rate of visual improvement was 41.2%. Mild publication bias was detected; however, sensitivity analysis verified the robustness of primary results.</p><p><strong>Conclusion: </strong>Participants with MMD-related RAO exhibit unique clinical characteristics differing from those with isolated RAO or uncomplicated MMD. This study identifies an \"older MMD phenotype\" complicated by RAO, and highlights the necessity of comprehensive vascular screening in elderly participants presenting with RAO to facilitate timely combined ophthalmological and neurological intervention.</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"19 9","pages":"1766-1776"},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FLNA promotes the progression of diabetic retinopathy by increasing M1 macrophages.","authors":"Chun-Hua Li, Mao-Fei Feng, Xue Zhang, Lei Yu","doi":"10.18240/ijo.2026.09.04","DOIUrl":"10.18240/ijo.2026.09.04","url":null,"abstract":"<p><strong>Aim: </strong>To clarify the role of filamin A (FLNA) in promoting diabetic retinopathy (DR) progression and explore its underlying mechanism <i>via</i> modulating M1 macrophage inflammation and adenosine 5'-monophosphate activated protein kinase (AMPK) phosphorylation, as well as its potential as a diagnostic biomarker and therapeutic target.</p><p><strong>Methods: </strong>Gene Expression Omnibus (GEO) dataset and Weighted Gene Co-Expression Network Analysis (WGCNA) were used to identify differentially expressed genes across DR, diabetes mellitus (DM), and control groups. Gene Set Enrichment Analysis (GSEA), Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) were employed to analyze the enrichment of intersecting genes. Machine learning models assessed the predictive performance of these genes, while single-cell sequencing and cell chat examined their expression in M1 macrophages and interactions with other cell types. Quantitative PCR (q-PCR) measured mRNA levels of interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α), and Western blotting assessed protein levels of FLNA, AMPK, and phosphorylated-AMPK (p-AMPK).</p><p><strong>Results: </strong>Key findings revealed <i>FLNA</i>, plectin (<i>PLEC</i>), and Tweety family member 3 (<i>TTYH3</i>) as critical genes in DR, with <i>FLNA</i> showing the highest area under the curve (AUC) value and importance, and the random forest model performing best. The AMPK signaling pathway was enriched for FLNA, which was most significantly expressed in M1 macrophages. M1 macrophages promote IL-6, IL-1β, and TNF-α expression. FLNA increases the effect of M1 macrophages on DR progression and AMPK phosphorylation.</p><p><strong>Conclusion: </strong>Our study identifies FLNA as a key regulator in DR progression, primarily by enhancing M1 macrophage-mediated inflammation and AMPK phosphorylation. These findings highlight FLNA's critical role in DR pathogenesis and its potential as a biomarker for early diagnosis and a therapeutic target for intervening in macrophage-driven inflammatory responses.</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"19 9","pages":"1687-1699"},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abnormalities in retinal vascularity and blood perfusion associated with early syphilis revealed by optical coherence tomography angiography.","authors":"Xiao-Liu Wang, Yan-Qiong Zhu, Hui-Yin Zheng, Xin-Yi Luo, Jie-Hui Li, Hou-Jian Zhang, Zu-Guo Liu, Qiu-Ping Liu","doi":"10.18240/ijo.2026.09.13","DOIUrl":"10.18240/ijo.2026.09.13","url":null,"abstract":"<p><strong>Aim: </strong>To explore the feasibility of optical coherence tomography angiography (OCTA) in the early detection of syphilis and syphilitic chorioretinopathy.</p><p><strong>Methods: </strong>Patients with newly diagnosed syphilis were enrolled from September 2022 to November 2023. All the participants underwent serological examinations including rapid plasma reagin (RPR) test and treponema pallidum particle agglutination (TPPA) test, as well as macular OCTA scanning. Quantitative indicators including macular vessel flow density (VFD), vessel length density (VLD), and foveal avascular zone (FAZ) were measured and analyzed.</p><p><strong>Results: </strong>A total of 44 participants were recruited in this study, including 24 patients in the syphilis group (14 males, mean age: 30.83±9.59y) and 20 healthy individuals in the control group (6 males, mean age: 29.6±11.86y). Compared with the control group, the syphilis group presented significantly higher macular VLD and VFD (<i>P</i><0.05), as well as an increased FAZ perimeter. Subgroup analysis was performed based on RPR titers, with patients divided into the low-titer subgroup (1:2-1:4) and high-titer subgroup (1:8-1:128). Both subgroups showed elevated VLD and VFD (excluding inner VFD) relative to controls (all <i>P</i><0.05). Moreover, significant elevation of VFD was only observed in the high-titer subgroup. Receiver operating characteristic analysis identified outer VLD as the optimal indicator for distinguishing syphilis patients from controls, with an area under the curve of 0.802 (95%CI: 0.667-0.937).</p><p><strong>Conclusion: </strong>Syphilis patients with either low or high RPR titers show increased macular VLD and VFD in the absence of obvious visual impairment, indicating the potential of OCTA microvascular parameters for early auxiliary diagnosis of syphilitic ocular lesions.</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"19 9","pages":"1777-1784"},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Desferrioxamine attenuating high glucose-induced ferroptosis and inflammatory responses in Müller glial cells <i>via</i> Nrf2/TXNRD1 pathway.","authors":"Min Luo, Yi Zhang, Na Li, Wen-Fang Zhan","doi":"10.18240/ijo.2026.09.05","DOIUrl":"10.18240/ijo.2026.09.05","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the protective effects of deferoxamine (DFO) on high glucose (HG)-induced ferroptosis and inflammatory responses in retinal Müller glial cells (MGCs) and offer potential therapeutic targets for early intervention in diabetic retinopathy (DR).</p><p><strong>Methods: </strong>Primary MGCs were cultured from C57BL/6J mouse retinas and exposed to normal glucose (NG, 5 mmol/L) or HG (25 mmol/L) conditions for various durations. Ferroptosis-related markers, including intracellular Fe²⁺ levels, glutathione (GSH), reactive oxygen species (ROS), malondialdehyde (MDA), and key proteins glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), ferritin heavy chain 1 (FTH1), were examined using multiple assays such as immunoblotting, enzyme-linked immunosorbent assay (ELISA), immunofluorescence (IF), and fluorometric detection. The role of DFO was evaluated through cell viability assessment and analysis of inflammatory cytokines interleukin-1 beta (IL-1β) and tumor necrosis factor-alpha (TNF-α).</p><p><strong>Results: </strong>HG exposure significantly increased intracellular Fe²⁺ content, decreased GSH levels, elevated ROS and MDA concentrations, and altered expression profiles of ferroptosis regulators GPX4 and SLC7A11. Immunoblot and IF analyses confirmed downregulation of GPX4 and SLC7A11 alongside accumulation of FTH1 under prolonged HG treatment. DFO administration markedly attenuated these ferroptotic changes while reducing inflammatory cytokine secretion, demonstrating its protective effect against HG-induced damage in MGCs by modulating the nuclear factor erythroid 2-related factor 2 (Nrf2)/thioredoxin reductase 1 (TXNRD1) pathway.</p><p><strong>Conclusion: </strong>Low-dose DFO effectively mitigates HG-induced ferroptosis and inflammatory responses in MGCs through the Nrf2/TXNRD1 signaling axis, providing a theoretical framework for developing novel therapeutic strategies in DR management.</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"19 9","pages":"1700-1710"},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucocorticoid-induced RPE injury in ARPE-19 cells: association with excessive autophagy and AMPK/mTOR signaling.","authors":"Wen-Xue Guan, Yue Guo, Si-Tong Chen, Zhi-Ming Liu, Yao-Yao Sun, Ming-Wei Zhao","doi":"10.18240/ijo.2026.09.01","DOIUrl":"10.18240/ijo.2026.09.01","url":null,"abstract":"<p><strong>Aim: </strong>To investigate whether excessive glucocorticoid (GC) exposure disrupts retinal pigment epithelial (RPE) homeostasis through glucocorticoid receptor (GR)-dependent autophagy hyperactivation.</p><p><strong>Methods: </strong>Human retinal pigment epithelial cell line (ARPE-19 cells) were exposed to GC (0-100 µmol/L, 48h). GR subcellular localization was analyzed <i>via</i> mitochondrial fractionation and immunofluorescence. Functional assessments included barrier integrity [zonula occludens-1 (ZO-1) immunostaining], phagocytic capacity (FluoSpheres™-labeled photoreceptor outer segment uptake), and ultrastructural analysis (transmission electron microscopy, TEM). Autophagic flux was quantified using mCherry-green fluorescent protein-microtubule-associated protein 1A/1B-light chain 3 (LC3) B reporters. Molecular mechanisms were probed through AMP-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR) pathway activity and autophagic flux assessed by LC3-II levels. GR dependency was confirmed using the antagonist RU486, and cell-type specificity was assessed using mouse photoreceptor (661W) cells.</p><p><strong>Results: </strong>GC induced GR upregulation and mitochondrial translocation in a dose- and time-dependent manner, correlating with pathological autophagy activation. Key findings included: 1) tight junction disruption, evidenced by ZO-1 fragmentation, 2) reduction in phagocytic uptake efficiency, 3) mitochondrial shrinkage and autolysosome accumulation (TEM), 4) altered AMPK/mTOR signaling (p-AMPK up, p-mTOR down) associated with autophagosome formation, 5) elevated LC3-II levels confirming excessive autophagic flux. Critically, all GC-induced effects, including GR upregulation, signaling changes, and increased autophagy, were abolished by GR antagonism with RU486.</p><p><strong>Conclusion: </strong>This study shows that GR-dependent GC exposure induces autophagic flux with ultrastructural evidence suggestive of mitochondria-targeted autophagy and alters AMPK/mTOR signaling, correlating with RPE barrier collapse and phagocytic failure, a possible link to steroid-associated central serous chorioretinopathy (CSC).</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"19 9","pages":"1657-1666"},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why aren't we using AI in eye clinics? A systematic review of barriers and solutions in AI-based fundus image diagnostics for ocular diseases.","authors":"Tehmina Shehryar, Zoha Zahid Fazal, Anum Abdul Salam, Santhoshi Varada, Fakhar Jabran, Muhammad Usman Akram","doi":"10.18240/ijo.2026.09.17","DOIUrl":"10.18240/ijo.2026.09.17","url":null,"abstract":"<p><p>Artificial intelligence (AI) has shown remarkable accuracy in the diagnosis of common ocular diseases such as diabetic retinopathy (DR), glaucoma, retinopathy of prematurity (ROP), and age-related macular degeneration (AMD), often matching or even outperforming expert clinicians. Despite these advancements, AI adoption in clinical settings remains limited due to key barriers. This systematic review evaluates 34 studies (2018-2025) highlighting AI's diagnostic performance (often >90% accuracy) while pointing out significant gaps in real-world deployment. We identify these persistent challenges through comprehensive analysis of current literature and propose actionable pathways to bridge the \"last-mile gap\" between research and clinical practice. This review pointed out three significant gaps in real-world deployment. These include 1) disjointed integration into clinical workflows, 2) lack of transparency in AI decision-making, and 3) poor generalizability across diverse populations. Our findings provide a framework for advancing AI implementation in ocular diagnostics to achieve equitable, scalable, and trustworthy solutions for global vision care.</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"19 9","pages":"1809-1825"},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting ferroptosis in ocular diseases: mechanisms, clinical implications, and therapeutic horizons.","authors":"Nai-Yuan Zhang, Hui-Qian Kong, Yu-Qiao Liao, Yi-Ji Pan, Wei Sun, Lei Xi, Hong-Hua Yu, Yun-Hong Shi","doi":"10.18240/ijo.2026.09.21","DOIUrl":"10.18240/ijo.2026.09.21","url":null,"abstract":"<p><p>Ferroptosis, an iron-dependent form of regulated cell death driven by lipid peroxidation, has been increasingly implicated in selected ocular diseases, although its causal relevance varies across disease entities. The retina and retinal pigment epithelium are biologically susceptible to ferroptosis-related injury because of their high oxygen demand, abundant polyunsaturated lipids, mitochondrial activity, light exposure, and tightly regulated iron handling. This review summarizes core mechanisms of ocular ferroptosis, including iron uptake and export, glutathione-glutathione peroxidase 4 (GPX4)-dependent antioxidant defense, lipid peroxidation, mitochondrial dysfunction, neuroinflammation, and blood-retina barrier disruption. We discuss evidence from major degenerative, vascular, ischemic, hereditary, infectious, and immune-mediated retinal diseases, with particular attention to glaucoma, age-related macular degeneration, diabetic retinopathy, ocular toxoplasmosis, uveitis, retinal vasculitis, and inflammatory chorioretinopathy. We also evaluate ferroptosis-targeted therapeutic strategies, proposed operational criteria for defining ferroptosis in retinal disease, and candidate structural, functional, biochemical, and imaging endpoints for future translational studies. Current evidence supports ferroptosis as a context-dependent contributor to retinal injury rather than a uniform pathogenic mechanism. Future studies should integrate cell-type-resolved biomarkers, lipidomic and imaging readouts, functional rescue experiments, and clinically meaningful visual outcomes to clarify when ferroptosis modulation may support vision preservation.</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"19 9","pages":"1858-1877"},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orbital compartment syndrome following the use of sinonasal oxidized cellulose and gelatin sponge hemostat: report of two cases and literature review.","authors":"Hossein Ghahvehchian, Mohsen Bahmani Kashkouli, Nasser Karimi, Mansooreh Jamshidian Tehrani, Gholamhoseyn Aghai, Amir Manavishad","doi":"10.18240/ijo.2026.09.24","DOIUrl":"10.18240/ijo.2026.09.24","url":null,"abstract":"","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"19 9","pages":"1886-1890"},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between retinal nerve fibre thickness, suprasellar extension and post-operative visual outcome in pituitary macroadenoma.","authors":"Teck Chee Cheng, Mae-Lynn Catherine Bastion, Norshamsiah Md Din, Jegan Thanabalan, Kah Lay Oh, Seng Fai Tang, Diana Lim, Amalina Saiful Anwar, Safinaz Mohd Khialdin","doi":"10.18240/ijo.2026.09.11","DOIUrl":"10.18240/ijo.2026.09.11","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the relationship between retinal nerve fibre layer (RNFL) thickness, suprasellar extension (SSE), tumour volume (TV) and visual outcome after pituitary adenoma surgery.</p><p><strong>Methods: </strong>A prospective observational study was conducted in a tertiary teaching hospital which included patients with pituitary macroadenoma who required surgical resection between December 2015 to February 2020. Agreeable subjects underwent complete ocular examination, Humphrey visual field (HVF) and RNFL measurement using spectral domain optical coherence tomography preoperatively and 3-month postoperatively. Post-operative visual outcome was evaluated using both best-corrected visual acuity (BCVA, logMAR) and HVF mean deviation (MD). TV was estimated by multiplying the transverse, anteroposterior, and craniocaudal maximum diameter; and SSE by measuring tumour extension beyond the supraclinoid internal carotid artery from magnetic resonance imaging.</p><p><strong>Results: </strong>Thirty-eight patients (18 males) were recruited. The mean age was 47.6±14.8y. The median and interquartile range (IQR) was 10.78 (6.45-16.94) cm³ and 14.05 (4.99-22.90) mm for TV and SSE, respectively. While postoperative RNFL significantly reduced in all sectors, significant improvement was seen in median BCVA in logMAR (from 0.301 to 0.176, <i>P</i><0.001) and MD of HVF (from -10.04 to -3.91, <i>P</i><0.001). Pre-operative global RNFL was significantly correlated with post-operative logMAR (<i>r</i>=-0.303, <i>P</i>=0.015) and MD (<i>r</i>=0.510, <i>P</i><0.001). Only SSE showed significant negative correlations with all RNFL sectors. Each 10 µm thicker pre-operative global RNFL was associated with 0.13 lower (better) postoperative logMAR (<i>β</i>=-0.013, <i>P</i><0.001) and 0.83 dB higher (better) MD (<i>β</i>=0.083, <i>P</i>=0.008). Patients with normal RNFL had better post-operative MD [median (IQR)=-2.35 (-1.45, -5.94)] than with thinned RNFL [median (IQR)=-6.63 (-2.80, -8.77), <i>P</i>=0.009].</p><p><strong>Conclusion: </strong>SSE shows stronger association with RNFL thinning than TV, and thicker pre-operative RNFL predicted better post-operative visual outcomes.</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"19 9","pages":"1757-1765"},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual and accommodative outcomes after femtosecond LASIK with and without monovision in patients over 40 years.","authors":"Yuan-Yuan Qi, Qi Li, Gui-Li Wang, Hui-Yu Wang, Wan-Ting Li, Shao-Zhen Zhao","doi":"10.18240/ijo.2026.09.09","DOIUrl":"10.18240/ijo.2026.09.09","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate changes in visual acuity and accommodation function following femtosecond laser-assisted <i>in situ</i> keratomileusis (FS-LASIK) combined with monovision in patients aged over 40y.</p><p><strong>Methods: </strong>This prospective, non-randomized cohort study included patients who were divided into an FS-LASIK binocular group (full correction) and an FS-LASIK monovision group. The binocular group consisted of Group 1 (15 patients) with simple myopia and Group 2 (12 patients) with myopia and presbyopia. The monovision group (Group 3) included 13 patients with myopia and presbyopia. Parameters assessed included the uncorrected distance visual acuity (UCVA), the uncorrected near visual acuity (UNVA), contrast sensitivity (CS), binocular cross-cylinder (BCC), accommodative amplitude (AMP), positive relative accommodation (PRA), negative relative accommodation (NRA), and accommodative facility (AF). Patient satisfaction was evaluated at 3mo postoperatively.</p><p><strong>Results: </strong>A total of 40 patients (80 eyes) were enrolled (mean age 43.63±3.666y; 12 males). At 3mo after FS-LASIK, UCVA improved significantly in all patients (<i>P</i><0.001), while UNVA remained comparable to preoperative levels (<i>P</i>>0.05). BCC in Group 3 decreased by 0.30±0.43 compared to preoperative levels, showing a statistically significant difference (<i>P</i>=0.037). The AMP in Group 3 showed an increasing trend with greater improvement in the nondominant eye than in the dominant eye (<i>P</i>>0.05). Patient satisfaction was high in all groups.</p><p><strong>Conclusion: </strong>FS-LASIK combined with monovision is an effective treatment for patients aged over 40y with myopia and presbyopia, which not only improves visual acuity but also achieves high patient satisfaction and improves postoperative BCC.</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"19 9","pages":"1739-1748"},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}