International journal of ophthalmology最新文献

{"title":"Endophthalmitis caused by <i>Streptococcus dysgalactiae</i> subsp. <i>dysgalactiae</i> after cataract surgery: an unusual case report.","authors":"Dan-Dan Tian, Le-Han Hao, Chang-Rui Wu, Cheng Pei","doi":"10.18240/ijo.2026.10.24","DOIUrl":"10.18240/ijo.2026.10.24","url":null,"abstract":"","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"19 10","pages":"2083-2086"},"PeriodicalIF":2.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008343","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":"A simplified slipknot technique for pupilloplasty in the treatment of mydriasis.","authors":"Yan-Bo Bao, Yi-Fei Tang, Su-Yu Liu, Zi-Fang He, Ya-Jun Liu, Qing-Hua Yi, Zheng-Gao Xie","doi":"10.18240/ijo.2026.10.15","DOIUrl":"10.18240/ijo.2026.10.15","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the surgical outcomes of a simplified slipknot pupilloplasty technique for repairing mydriasis, with a focus on postoperative visual recovery, pupil morphological stability, knitting efficiency and knot security.</p><p><strong>Methods: </strong>This prospective case series included patients with mydriasis due to trauma, glaucoma attack or iatrogenic damage, who underwent pupilloplasty (with or without intraocular lens implantation) from October 2022 to July 2025. Postoperative follow-ups were performed at 1, 3, 6, and 12mo. All cases had a minimum follow-up period of 3mo (range 3-12mo). Parameters recorded included best-corrected visual acuity (BCVA, logMAR), pupil diameter, and intraocular pressure (IOP).</p><p><strong>Results: </strong>A total of 32 consecutive patients (32 eyes, 21 males) were included. The mean age was 57.9±15.9y (21 to 85y). The simplified slipknot technique resulted in significant visual improvement: the mean preoperative logMAR BCVA was 1.15±0.79 (range, 0.22 to 2.5), which improved to 0.35±0.32 (range, 0 to 1.398) postoperatively. Postoperative pupil diameter remained stable, with a mean of 3.0±0.5 mm (range, 2.5 to 4 mm). The duration of the pupilloplasty was 4.3±0.5min and there was no loosening or shedding of the line knot in any case.</p><p><strong>Conclusion: </strong>The simplified slipknot technique has a similar treatment effect and safety as the traditional technique but requires a shorter time and is easier to perform in pupilloplasty surgery. It causes minimal trauma to intraocular tissues, and is easy to popularize.</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"19 10","pages":"2003-2009"},"PeriodicalIF":2.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008464","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":"Angiogenesis-RNA modification in diabetic retinopathy: biomarkers and targets.","authors":"Xue Wang, Dan-Ping Wu, Wei Du, Rui Li, Wei Lou, Ran-Ran Chen, Yu-Jie Liao, Qian Li, Xiao-Mei Li, Hong-Ping Cui, Jin-Ling Zhang","doi":"10.18240/ijo.2026.10.05","DOIUrl":"10.18240/ijo.2026.10.05","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To identify biomarkers and potential therapeutic targets related to angiogenesis and RNA modification in diabetic retinopathy (DR).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The Gene Expression Omnibus (GEO) datasets GSE12610, GSE87433, and GSE111465, which contain retinal samples from diabetic and normal mice, were analyzed to identify differentially expressed genes (DEGs). The DEGs were then intersected with angiogenesis- and RNA modification-related genes (A&RMRGs) obtained from GeneCards and other databases to identify differentially expressed A&RMRGs in DR. Hub genes were subsequently identified from the protein-protein interaction (PPI) network built on the enrichment results. Their diagnostic value was then estimated by receiver operating characteristic (ROC) analysis, and their expression levels were tested for associations with immune cell infiltration. Regulatory networks of hub genes were constructed using MicroRNA Target Prediction Database (miRDB), ChIPBase, and the Comparative Toxicogenomics Database (CTD). To validate the bioinformatic findings, hub gene transcript levels were quantified with reverse transcription quantitative polymerase chain reaction (RT-qPCR) in high-glucose-treated rat retinal microvascular endothelial cells (rRMECs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Forty-two A&RMRGs showed differential expression in the diabetic retina, with Gene Ontology (GO)/Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment implicating RNA modification and immune-inflammatory regulation, alongside Gene Set Enrichment Analysis (GSEA) evidence of activated RNA-silencing and fatty-acid-transport programs and suppressed neuronal and retinoid-cycle programs. Seven hub genes (&lt;i&gt;Wdr3&lt;/i&gt;, &lt;i&gt;Crebbp&lt;/i&gt;, &lt;i&gt;Sdad1&lt;/i&gt;, &lt;i&gt;Stat3&lt;/i&gt;, &lt;i&gt;Gnl2&lt;/i&gt;, &lt;i&gt;Nhp2&lt;/i&gt;, and &lt;i&gt;Hsp90aa1&lt;/i&gt;) were selected, all of them were upregulated in DR. The DR retina showed higher levels of central memory CD8&lt;sup&gt;+&lt;/sup&gt; T cells and lower levels of monocytes, Tregs, and CD56&lt;sup&gt;bright&lt;/sup&gt; natural killer (NK) cells. Monocyte infiltration was inversely associated with &lt;i&gt;Stat3&lt;/i&gt; expression (&lt;i&gt;r&lt;/i&gt;=-0.604, &lt;i&gt;P&lt;/i&gt;&lt;0.001), and central memory CD8&lt;sup&gt;+&lt;/sup&gt; T cell levels were positively associated with &lt;i&gt;Nhp2&lt;/i&gt; expression (&lt;i&gt;r&lt;/i&gt;=0.539, &lt;i&gt;P&lt;/i&gt;=0.003). A total of 60 miRNAs, 43 transcription factors (TFs), and 47 drugs may regulate RNA modification of angiogenesis-associated genes in DR. &lt;i&gt;Gnl2&lt;/i&gt; [area under the ROC curve (AUC)=0.914, 95% confidence interval (CI): 0.810-1.000) and &lt;i&gt;Stat3&lt;/i&gt; (AUC=0.964, 95%CI: 0.892-1.000) showed high diagnostic value. Exposure of rRMECs to high glucose led to a marked rise in &lt;i&gt;Stat3&lt;/i&gt; expression and a fall in &lt;i&gt;Sdad1&lt;/i&gt;, leaving the transcript levels of the remaining five hub genes unchanged.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;These findings identify &lt;i&gt;Stat3&lt;/i&gt; as a point of convergence between RNA modification, immune dysregulation, and angiogenesis, nominating the hub genes as candidate biomar","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"19 10","pages":"1914-1928"},"PeriodicalIF":2.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008413","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":"Comment on: \"Conjunctival microbiota variations in a subset of middle-aged and elderly individuals from Beijing, China\".","authors":"Omer Faruk Yilmaz, Abdurrahman Sarmis, Muhammed Ali Mutlu, Serap Karaca","doi":"10.18240/ijo.2026.10.26","DOIUrl":"10.18240/ijo.2026.10.26","url":null,"abstract":"","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"19 10","pages":"2091-2092"},"PeriodicalIF":2.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008553","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":"One-year structural and functional outcomes of accelerated epithelium-off corneal cross-linking in keratoconus.","authors":"Iva Ćubela, Daliborka Miletić, Biljana Kuzmanović Elabjer, Senad Ramić, Ivan Pavlović, Dean Šarić, Mladen Bušić","doi":"10.18240/ijo.2026.10.10","DOIUrl":"10.18240/ijo.2026.10.10","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the structural and functional outcomes of accelerated epithelium-off corneal collagen cross-linking (CXL) in patients with keratoconus (KC) 1y after treatment.</p><p><strong>Methods: </strong>This retrospective study included patients who underwent an accelerated epi-off CXL for progressive KC at the Department of Ophthalmology, Sveti Duh University Hospital, Zagreb, Croatia, between January and December 2023. The protocol consisted of epithelial removal, riboflavin 0.1% instillation for 3min, and ultraviolet-A (UVA) irradiation at 9 mW/cm² for 10min. Pentacam HR was used to assess keratometric parameters (Kmax, Kmean), curvature-based indices [index of surface variance, index of vertical asymmetry, keratoconus index, central keratoconus index, index of height asymmetry (IHA), index of height decentration, minimum sagittal curvature (Rmin)], pachymetry-based indices [central corneal thickness (CCT), average pachymetric progression index, maximum Ambrósio relational thickness], Belin/Ambrósio deviation, and the ABCD progression system preoperatively and at 12mo.</p><p><strong>Results: </strong>A total of 45 eyes from 45 patients (mean age: 29.1±6.2y) were included in the study. One year after CXL treatment, only Kmax front (55.20 to 55.00 D) showed a statistically significant decrease among the keratometric parameters. A statistically significant reduction was observed in all curvature-based indices, except for IHA, which did not reach statistical significance, whereas Rmin (6.11 to 6.14 mm) showed a statistically significant increase. Additionally, CCT, anterior radius of curvature (ARC), and best-corrected distance visual acuity (BCVA) also demonstrated statistically significant increase.</p><p><strong>Conclusion: </strong>Accelerated epi-off CXL results in significant structural and functional improvements in KC at the 1-year follow-up. Decreased Kmax and curvature indices, increased Rmin, CCT, and ARC, and improved BCVA indicate better corneal regularity, biomechanical stability, and functional vision, with ABCD analysis confirming disease stabilization.</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"19 10","pages":"1964-1970"},"PeriodicalIF":2.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008354","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":"How much vitrectomy is enough? A narrative review.","authors":"Fatih Ali Ceylan","doi":"10.18240/ijo.2026.10.20","DOIUrl":"10.18240/ijo.2026.10.20","url":null,"abstract":"<p><p>The optimal extent of vitreous removal in modern vitreoretinal surgery remains controversial. While extensive vitrectomy has traditionally been performed to minimize traction and reduce postoperative complications, emerging evidence challenges its routine use across all indications. This narrative review critically evaluates whether extensive vitreous removal provides superior outcomes compared to limited, vitreous-sparing approaches. Current data do not demonstrate a consistent or clinically meaningful advantage of extensive vitrectomy. Although broader vitreous removal may reduce residual traction, it is associated with increased intraoperative manipulation and a higher risk of iatrogenic retinal injury, particularly during peripheral vitreous shaving. In contrast, limited vitrectomy appears sufficient in macular surgery and selected cases of rhegmatogenous retinal detachment, especially with advances in microincisional techniques, high-speed cutters and improved visualization systems. In complex tractional diseases, however, more extensive dissection may still be required. Overall, the available evidence supports a selective, pathology-driven approach rather than routine extensive vitreous removal, reflecting a shift toward more precise and minimally invasive vitreoretinal surgery.</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"19 10","pages":"2041-2046"},"PeriodicalIF":2.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008359","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":"Clinical characteristics of delayed reversible loss of light perception following vitreoretinal surgery and risk factors influencing time to recovery.","authors":"Mei-Qi Liu, Jia-Yi Wei, Ren-Wan Liu, Sai-Fei Zhang, Jun-Yi Chen, Zong-Duan Zhang, Qin-Tuo Pan","doi":"10.18240/ijo.2026.10.13","DOIUrl":"10.18240/ijo.2026.10.13","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the incidence and clinical features of delayed reversible loss of light perception (D-RLLP) following vitreoretinal surgery, including vitrectomy or silicone oil (SO) removal, and to identify risk factors influencing its recovery time.</p><p><strong>Methods: </strong>This study retrospectively reviewed 19 029 cases (19 029 eyes) of vitreoretinal surgery performed between October 2016 and March 2024. Based on strict temporal criteria, postoperative loss of light perception was classified as immediate postoperative loss of light perception (IP-LLP), D-RLLP, and delayed permanent loss of light perception (D-PLLP). The incidence of reversible loss of light perception (RLLP) and its clinical features were evaluated. A multiple linear regression model was constructed to identify the independent predictors of the recovery time of D-RLLP.</p><p><strong>Results: </strong>Among 19 029 vitreoretinal surgeries, 113 eyes (0.59%) experienced postoperative loss of light perception (LLP), including 32 eyes (28.32%) with IP-LLP, 78 eyes (69.03%) with D-RLLP, and 3 eyes (2.65%) with D-PLLP. The overall incidence of D-RLLP was 0.41% (78/19 029). D-RLLP incidence was significantly higher following SO removal (0.89%, 33/3703) than general vitrectomy (0.29%, 45/15 326; <i>P</i><0.001). In 78 D-RLLP cases, the median recovery time was 47min (interquartile range: 28-71min), with 25.64% recovering in ≤30min, 64.10% in 30-60min, and 10.26% requiring >60min. Multivariate regression identified a history of hypertension (<i>B</i>=18.63, <i>P</i>=0.046) and intraocular pressure difference (<i>B</i>=1.77/min per mm Hg, <i>P</i>=0.011) as independent predictors of prolonged recovery time.</p><p><strong>Conclusion: </strong>D-RLLP is a rare clinical event following vitreoretinal surgery, with a median recovery time of 47min, and the vast majority of affected eyes recovered within 1h. SO removal displayed a significantly higher RLLP incidence than vitrectomy. Importantly, a history of hypertension and greater intraocular pressure difference correlated significantly with an extended recovery time.</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"19 10","pages":"1985-1993"},"PeriodicalIF":2.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008520","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":"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":"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}