International Ophthalmology最新文献

{"title":"Mortality following glaucoma surgery in octogenarians with primary open angle glaucoma.","authors":"Hussain Aluzri, Vanessa Yeo, Kusy Suleiman, Jay Richardson, Velota C T Sung","doi":"10.1007/s10792-025-03727-8","DOIUrl":"https://doi.org/10.1007/s10792-025-03727-8","url":null,"abstract":"<p><strong>Background: </strong>This study aims to quantify the mortality rate following glaucoma surgery in octogenarian patients with primary open-angle glaucoma (POAG) and identify risk factors associated with mortality in this age group.</p><p><strong>Methods: </strong>A retrospective single centre consecutive case series was conducted involving 115 patients aged 80 and over who underwent glaucoma surgery at the Birmingham Midland Eye Centre between January 2015 and December 2019.</p><p><strong>Results: </strong>The all-cause mortality incidence for patients over 80 undergoing glaucoma surgery is 66.86 deaths per 1000 person-years. On univariable analysis, pre-operative risk factors [hazard ratio [HR], 95% Confidence interval (CI)] for increased mortality include age, [1.099 (1.013, 1.192)], Clinical Frailty Score [1.250 (1.036, 1.507)], chronic obstructive pulmonary disease (COPD) [2.187 (1.252, 3.818)], dementia [2.397 (1.075, 5.343)], myocardial infarction [2.392 (1.208, 4.737)], respiratory system disease [1.974, (1.179, 3.305), and solid tumours [7.344 (2.170, 24.849)]. Visual acuity was the only ophthalmic factor significantly associated [1.745 (1.046, 2.902)] with mortality, while other glaucoma-related parameters, such as intraocular pressure and retinal nerve fibre layer thickness, were non-significant. On multi-variable analysis, Afro-Caribbean became significant [0.469 (0.224, 0.979)], and all univariable risk factors remained significant except for clinical frailty score and dementia. In terms of glaucoma surgery, cyclodiode laser is the only operation that had a significant hazard ratio [2.271 (1.083, 4.762)], likely due to selection bias of ill patients.</p><p><strong>Conclusion: </strong>The overall five-year survival rate post-surgery was 72.01%, with a nine-year survival rate of 43.30%. Clinical frailty scale should be assessed for all elderly patients considered for glaucoma surgery. Assessing systemic health in elderly patients is crucial for optimizing surgical outcomes and improving survival.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"390"},"PeriodicalIF":1.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of bifocal intraocular lenses implantation combined with opposite clear corneal incisions versus bifocal toric intraocular lenses in cataract patients with low corneal astigmatism.","authors":"Qingfen Tian, Xueyan Zhang, Ximing Wang, Xuelian Wu, Bin Li","doi":"10.1007/s10792-025-03755-4","DOIUrl":"https://doi.org/10.1007/s10792-025-03755-4","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate long-term effects of bifocal intraocular lenses (IOLs) implantation combined with opposite clear corneal incisions (OCCIs) and bifocal toric IOL implantation solely in cataract patients with low corneal astigmatism.</p><p><strong>Methods: </strong>The study included 58 patients (60 eyes) with corneal astigmatism of 0.75 to 1.5 diopter (D) who underwent cataract surgery. 30 eyes received bifocal IOLs implantation through steep meridian incisions combined with OCCIs (OCCI group), and 30 eyes received bifocal toric IOLs implantation solely (control group). Uncorrected distance visual acuity (UCDVA), uncorrected near visual acuity (UCNVA), corneal astigmatism, rotational stability of bifocal toric IOLs, corneal higher-order aberrations (HOAs) and spectacle independence were collected postoperatively.</p><p><strong>Results: </strong>No significant difference in UCDVA and UCNVA between the two groups (all P > .05) at 1 week, 1 month, 3, 6 and 12 months postoperatively. Compared with preoperative data, corneal astigmatism in the OCCI group was significantly decreased at 1 month, 3 and 12 months postoperatively (all P < .001), but in the control group, no statistically decreased was detected at 1 month, 3 and 12 months (all P > .05). No obvious rotation of IOLs in the control group postoperatively. No significant difference in corneal HOAs in either group postoperatively compared with preoperative values (all P > .05) or between the two groups (P > .05). The rates of spectacle independence were above 90% in both groups.</p><p><strong>Conclusions: </strong>Both bifocal IOLs implantation through steep meridian incisions combined with OCCIs and bifocal toric IOL implantation solely can significantly reduced corneal astigmatism in cataract patients with low corneal astigmatism, providing good visual quality and stable long-term effects. So bifocal IOLs implantation through steep meridian incisions combined with OCCIs can serve as an alternative to bifocal toric IOL implantation solely.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"387"},"PeriodicalIF":1.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of medication adherence among elderly ophthalmic patients during transition from hospital to home: a cross-sectional study.","authors":"Lin Lu, Guifang Shi, Yuehong Sun, Yuqian Wu","doi":"10.1007/s10792-025-03759-0","DOIUrl":"10.1007/s10792-025-03759-0","url":null,"abstract":"<p><strong>Background: </strong>Medication adherence is a critical determinant of treatment outcomes and prognosis in patients. This study aims to investigate the current status and influencing factors of medication adherence among elderly ophthalmic patients during the transition from hospital to home, thereby providing evidence-based support for clinical treatment and nursing.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted involving elderly patients who underwent ophthalmic surgery at our hospital between February 2024 and February 2025. To evaluate patients' medication adherence, the Morisky Medication Adherence Scale (MMAS-8) was administered. Pearson correlation analysis was performed to examine the associations between patients' demographic characteristics and their levels of medication adherence. Additionally, univariate and multivariate logistic regression analyses were utilized to identify factors influencing medication adherence among elderly ophthalmic patients.</p><p><strong>Results: </strong>A total of 248 elderly ophthalmic patients were included in the study. The prevalence of poor medication adherence was 45.97% (114/248). Pearson correlation analyses indicated that age (r = 0.587), educational level (r = 0.619), average monthly household income (r = 0.624), number of medications taken (r = 0.596), and total daily medication frequency (r = 0.642) were significantly correlated with poor adherence. Logistic regression analysis revealed that increased age (AOR = 2.751, 95% CI: 2.262-3.425), lower educational level (AOR = 2.406, 95% CI: 1.966-3.414), lower average monthly household income (AOR = 3.031, 95% CI: 2.637-3.742), higher number of medications taken (AOR = 2.925, 95% CI: 2.541-3.326), and greater total daily medication frequency (AOR = 3.446, 95% CI: 2.736-3.808) were independently associated with poorer medication adherence (all p < 0.05).</p><p><strong>Conclusion: </strong>Our study demonstrates that elderly ophthalmic patients often exhibit poorer medication adherence following discharge. These findings highlight the need for healthcare providers to enhance discharge medication counseling and strengthen follow-up efforts to ensure the safe and effective use of medications among elderly patients.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"388"},"PeriodicalIF":1.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148972","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":"Refractive prediction accuracy of new generation IOL calculation formulas in glaucomatous and control eyes after cataract surgery.","authors":"Numan Eraslan, Ayşe Nur Çoban, Ahsen Güleç","doi":"10.1007/s10792-025-03772-3","DOIUrl":"https://doi.org/10.1007/s10792-025-03772-3","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the deviation from the target refraction after cataract surgery between glaucomatous and control eyes using a third-generation formula (SRK/T), a fourth-generation formula (Barrett Universal II), and new-generation formulas (Hill-RBF, Kane, Pearl-DGS, Hoffer QST, EVO, Cooke K6).</p><p><strong>Materials and methods: </strong>This retrospective study included 80 eyes of 80 patients who underwent uncomplicated phacoemulsification between 2017 and 2022. Among them, 22 had primary open-angle glaucoma, 27 had pseudoexfoliative glaucoma (PEG), and 31 served as controls. Biometric measurements were obtained preoperatively, and postoperative refractions were measured with an autorefractometer. The mean follow-up was 2 years.</p><p><strong>Results: </strong>There was no significant difference among the groups in terms of age, gender, intraocular lens (IOL) power, follow-up duration, axial length, anterior chamber depth, lens thickness, central corneal thickness, or intraocular pressure (all p > 0.05). All formulas produced a mean myopic prediction error in all three groups, with the highest deviation observed in the PEG group (mean: - 0.24 D). The smallest mean errors in all groups were with the Barrett Universal II (- 0.03 D, - 0.16 D, and - 0.07 D) and Hoffer QST (- 0.05 D, - 0.20 D, and - 0.08 D) formulas. The refractive prediction error was significantly lower for all formulas in eyes implanted with aspheric IOLs (mean: - 0.07 D) compared to spherical IOLs (mean: - 0.22 D) (p < 0.05).</p><p><strong>Conclusion: </strong>Despite advances in IOL calculation formulas, PEG patients showed the highest prediction errors, likely due to zonular weakness. In these cases, selecting Barrett Universal II or Hoffer QST formulas may improve refractive outcomes. Aspheric IOLs also showed better prediction accuracy, though their benefit may vary with pupil size and IOL alignment.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"386"},"PeriodicalIF":1.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative evaluation of visual, refractive, and patient-reported outcomes of four premium intraocular lenses.","authors":"Elinor Megiddo-Barnir, Mario Cantó-Cerdán, Ronald Steven Medalle, Antonio Martinez-Abad, Pilar Yebana-Rubio, Jorge L Alio, Francisco Cavas, Jorge L Alio Del Barrio","doi":"10.1007/s10792-025-03777-y","DOIUrl":"https://doi.org/10.1007/s10792-025-03777-y","url":null,"abstract":"<p><strong>Purpose: </strong>Compare visual, refractive, optical performance, and patient-reported measures in cases implanted with one premium IOL: Precizon Presbyopic NVA, AT Lisa Tri 839, Acrysof IQ Vivity, and TECNIS Eyhance ICB00.</p><p><strong>Methods: </strong>Prospective, comparative clinical study of 100 eyes of 100 patients: Visual acuity, refraction, slitlamp biomicroscopy, defocus curve, ocular aberrations, point spread function, pupil size, contrast sensitivity, and quality of vision were evaluated at 6 months. 79 eyes with Vivity were analyzed for correlations between postoperative near vision and preoperative/postoperative parameters.</p><p><strong>Results: </strong>Postoperative uncorrected distance visual acuity for Precizon, Vivity, AT Lisa, and Eyhance were 0.04, 0.11, 0.02, and 0.07 logMAR, respectively. AT Lisa showed superior aberrometric performance and defocus curve with better near vision. Vivity had better retinal image quality and contrast, exceling in intermediate vision. Precizon excelled in near vision. Vivity had better Quality of vision scores; where 16% achieved uncorrected near vision ≤ 0.1, 72% > 0.1 to < 0.4, and 8% ≥ 0.4 logMAR, with no significant predictors.</p><p><strong>Conclusions: </strong>Our findings suggest that the varied performance of premium IOLs may benefit from personalized selection based on patient goals and expectations. Differences in subjective visual quality highlight the need to manage expectations, particularly with EDOF lenses. However, conclusions should be interpreted with caution due to methodological limitations.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"389"},"PeriodicalIF":1.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of tear film function and ocular surface disease index in patients with unilateral pseudoexfoliation syndrome.","authors":"Seda Karaca Adıyeke, Buket Aras Cırık, Gözde Göknar","doi":"10.1007/s10792-025-03762-5","DOIUrl":"https://doi.org/10.1007/s10792-025-03762-5","url":null,"abstract":"<p><strong>Background: </strong>To evaluate tear film function and ocular surface symptoms in unilateral pseudoexfoliation syndrome (PEX) and explore associations between pseudoexfoliative material, tear instability, and ocular surface disease index (OSDI) scores.</p><p><strong>Methods: </strong>Sixty-seven unilateral PEX patients and 72 matched healthy controls were enrolled. Tear break-up time (TBUT), non-invasive TBUT (NIBUT), basal Schirmer test (BST), and OSDI questionnaire were assessed in PEX-affected eyes (Group 1), fellow eyes (Group 2), and controls (Group 3). Statistical comparisons were performed using paired and independent t-tests or their non-parametric equivalents, and Chi-square analysis for OSDI categories.</p><p><strong>Results: </strong>Mean TBUT was 7.93 ± 2.9 s (G1), 8.93 ± 2.8 s (G2), and 10.04 ± 2.05 s (G3), with G1 and G2 significantly lower than G3 (p < 0.001, p = 0.032). Mean NIBUT was 7.84 ± 2.8 s (G1), 8.15 ± 2.6 s (G2), and 9.42 ± 2.8 s (G3), with G1 and G2 lower than G3 (p < 0.002, p = 0.02). BST was 8.01 ± 3.05 mm (G1), 8.28 ± 3.38 mm (G2), and 9.97 ± 3.5 mm (G3), significantly reduced in G1 and G2 compared with G3 (p = 0.02, p = 0.041). No significant differences were found between G1 and G2 for these tests (p > 0.05). Severe OSDI symptoms occurred in 22.4% of PEX eyes vs. 7.5% of controls, with a significant overall difference in severity distribution (p = 0.049).</p><p><strong>Conclusions: </strong>Tear film stability and quantity are reduced in unilateral PEX, affecting even clinically unaffected eyes. The higher prevalence of severe ocular surface symptoms underscores the need for routine ocular surface assessment and early intervention in this population.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"384"},"PeriodicalIF":1.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal ischemic perivascular lesion \"a subclinical ischemic sign\" in the fellow eye of patients with retinal vein occlusion.","authors":"Ayna Sariyeva Ismayilov, Mahmut Oğuz Ulusoy, Burcu Kahkeci, Ahmet Metin Karğın","doi":"10.1007/s10792-025-03756-3","DOIUrl":"10.1007/s10792-025-03756-3","url":null,"abstract":"<p><strong>Background: </strong>To examine the prevalence of retinal ischemic perivascular lesions (RIPLs) in the fellow eye of patients with retinal vein occlusion (RVO) and investigate their relationship with systemic vascular diseases.</p><p><strong>Methods: </strong>In this retrospective case-control observational study, 91 fellow eyes of RVO patients (91 eyes) and the eyes of 63 age-matched healthy (63 eyes) volunteers were evaluated. RIPLs were assessed by examining cross-sectional scans from 6 × 6 mm optical coherence tomography angiography (OCTA). Quadrantal superficial capillary plexus (SCP) and deep capillary plexus (DCP) were quantitatively analyzed in the RIPL areas. The relationship between vascular diseases (hypertension, diabetes, coronary artery disease, carotid stenosis, atrial fibrillation, stroke, myocardial infarction) in participants and RIPL was also investigated.</p><p><strong>Results: </strong>RIPLs were found in 25 eyes (27.4%) of RVO patients and five eyes (7.9%) in the control group (p = 0.018). There were statistically significant differences in DCP VD (%) in the superior (p = 0.024) and inferior (p = 0.044) temporal quadrants, where RIPLs were more common. RVO in the fellow eye was associated with a 5-fold increase in the possibility of the presence of RIPL compared with controls (OR = 5.00, 95% CI = 1.01- 15.11). Presence of RIPLs was associated with 5.13-fold higher odds of carotid artery stenosis (OR = 5.13, 95% CI = 1.02- 28.25) and 4.94-fold higher odds of a history of myocardial infarction (OR = 4.94, 95% CI = 1.24- 58.25).</p><p><strong>Conclusion: </strong>RIPL, a subclinical retinal ischemic lesion, was found at rates almost 3.5 times higher in the fellow eye of RVO patients. These lesions are significantly associated with carotid artery stenosis and a history of myocardial infarction. RIPL may be an ophthalmological indicator that can be used for systemic macrovascular disease.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"383"},"PeriodicalIF":1.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence-free time after pterygium surgery with sutureless conjunctival-limbal vs. conjunctival graft: is there still a role for conjunctival graft alone?","authors":"Stefano Lucentini, Cecilia Acuti Martellucci, Luca Rossi, Matteo Sacchi, Paolo Nucci, Saverio V Luccarelli","doi":"10.1007/s10792-025-03770-5","DOIUrl":"https://doi.org/10.1007/s10792-025-03770-5","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the risk of recurrence and disease-free time after conjunctival-limbal autograft (CLAG) or conjunctival autograft (CAG) with sutureless (fibrin glue) fixation for pterygium excision.</p><p><strong>Methods: </strong>This is a retrospective cohort study. We reviewed the charts of 312 patients who underwent CLAG and CAG sutureless techniques between 2010 and 2019. Follow-up visits were scheduled on day 1, at weeks 1 and 4, and at 3, 6, 9, and 12 months post-surgery, with subsequent visits every two years thereafter. The primary outcomes were the overall recurrence rate and average time to recurrence. The secondary outcomes were the rates of postoperative complications and the operation duration. Multivariate logistic regression was performed to verify the potential independent predictors of the study outcomes.</p><p><strong>Results: </strong>265 patients were included, with a mean follow-up time of 31.5 months (maximum 8 years). The pterygium recurrence rate was significantly lower in the CLAG group at 12 months (3.9 vs. 17.4%, p < 0.001) and at the end of the follow-up (4.6 vs. 18.2%, p < 0.001). Patients with CLAG also had a longer time to recurrence (8.8 vs. 4.8 months, p = 0.012). The complications rate was lower for CLAG (0.8 vs. 10.9%, p < 0.001), while no clinically relevant differences were found in the surgery duration (23.4 min for CLAG vs. 25.2 min for CAG). Multivariate analysis confirmed these bivariate results.</p><p><strong>Conclusions: </strong>Compared with CAG, CLAG reduced the risk and time to pterygium recurrence. Owing to the comparable surgical time and better safety profile, the CLAG technique can be considered a clinically and potentially cost-effective approach for pterygium management.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"385"},"PeriodicalIF":1.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New trends in the treatment of open-angle glaucoma: a critical review.","authors":"Aigean Bilal, Farah Constantin, Sergiu Chirila, Tony Hangan","doi":"10.1007/s10792-025-03773-2","DOIUrl":"10.1007/s10792-025-03773-2","url":null,"abstract":"<p><strong>Purpose: </strong>This critical review explores current and emerging strategies for the management of open-angle glaucoma (OAG), highlighting pharmacological, laser-based, and surgical innovations. It aims to synthesize recent evidence, assess real-world applicability, and evaluate future directions in personalized glaucoma care.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Cochrane Library databases for English-language publications between January 2000 and May 2025. Studies on first-line therapies, combination treatments, microinvasive glaucoma surgery (MIGS), laser modalities, and novel drug delivery systems were included. The review presents an overview of significant advancements and future directions in glaucoma treatment.</p><p><strong>Results: </strong>Prostaglandin analogs remain the cornerstone of medical therapy, while fixed combinations and sustained-release implants improve adherence. Selective laser trabeculoplasty (SLT) has gained traction as a first-line treatment in mild OAG, though its effectiveness in advanced stages is limited. MIGS procedures are increasingly used as safer alternatives to traditional surgery, especially when combined with cataract extraction. Affordable goniotomy techniques and suprachoroidal approaches offer promising solutions in resource-constrained settings. Neuroprotection, vascular modulation, and caspase inhibition represent future adjunctive strategies. In Romania, glaucoma remains a major public health challenge, with limited treatment coverage and delayed diagnoses due to systemic gaps in education and screening.</p><p><strong>Conclusions: </strong>Management of OAG is shifting toward patient-centered interventions that balance efficacy, safety, and accessibility. Continued integration of novel therapies, surgical innovation, and real-world cost-effectiveness data is essential for optimizing treatment algorithms, particularly in under-resourced health systems.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"381"},"PeriodicalIF":1.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130874","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":"Evaluation of structural and microvascular retinal and choroidal changes using optical coherence tomography angiography in rheumatoid arthritis.","authors":"Zeynep Kunt, Oğuzhan Oruz, Astan İbayev, Müge Aydın Tufan, Aysel Pelit, Caner İncekaş","doi":"10.1007/s10792-025-03775-0","DOIUrl":"https://doi.org/10.1007/s10792-025-03775-0","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate choroidal and retinal ultrastructural and microvascular changes in patients with rheumatoid arthritis (RA) and their association with RA disease activity.</p><p><strong>Method: </strong>This case-control study included 32 people with RA and 34 healthy people who were matched in terms of age and sex. Participants underwent retinal and choroidal imaging with swept source optical coherence tomography (SS-OCT) and swept source optical coherence tomography angiography (SS-OCTA). Choroidal thickness (CT), choroidal vascularity index (CVI), foveal avascular zone (FAZ) and vessel density (VD) were calculated and compared between patient and control groups.</p><p><strong>Results: </strong>Subfoveal choroidal thickness (SFCT) and temporal parafoveal choroidal thickness were significantly thicker in patients than controls (p = 0.028, p = 0.045, p = 0.028, p = 0.010). CVI was significantly lower in patients than controls (p = 0.010). FAZ and VD were not different between control and patient groups (p > 0.05 for all).</p><p><strong>Conclusion: </strong>Our study showed increased SFCT and temporal CT, and decreased CVI in RA patients. While no statistically significant difference was found in FAZ and VD values, a trend toward lower VD values was observed in RA patients compared to the control group. Longitudinal evaluation using OCT and OCTA could contribute to elucidating the progression of retinal and choroidal alterations in RA and their potential effect on visual function.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"382"},"PeriodicalIF":1.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}