International Ophthalmology最新文献

{"title":"Artificial intelligence in cataract management: current status and future perspectives.","authors":"Zizhuo Zhao, Manlu Huang","doi":"10.1007/s10792-026-04283-5","DOIUrl":"10.1007/s10792-026-04283-5","url":null,"abstract":"<p><strong>Purpose: </strong>To summarize recent advances in artificial intelligence (AI) applications across the entire cataract management pathway and to discuss current challenges and future directions.</p><p><strong>Methods: </strong>We conducted a narrative mini review of studies published since 2021 on AI applications in cataract diagnosis and screening, intraocular lens (IOL) power calculation, intraoperative guidance, and postoperative management, with emphasis on deep learning and emerging technologies.</p><p><strong>Results: </strong>AI models have achieved expert-level performance in automated cataract detection and grading from slit-lamp images, with pooled AUC values approaching 0.99 in meta-analyses. AI-based IOL power calculation formulas have shown superior accuracy compared with traditional formulas, especially in challenging cases such as highly myopic eyes. Intraoperatively, AI systems can recognize surgical phases and track instruments with high accuracy, supporting surgical training and quality assessment. Postoperatively, multimodal AI models integrating imaging and clinical data have improved the prediction of visual outcomes and complications. Emerging technologies, including large language models, portable smartphone-based screening devices, and multimodal prediction models, represent promising new directions, although challenges related to data generalizability, algorithm interpretability, and clinical translation remain to be addressed.</p><p><strong>Conclusion: </strong>AI has the potential to significantly improve the efficiency, accuracy, and accessibility of cataract care, but should serve as an assistive tool rather than a replacement for clinical judgment.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109539","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":"Risk stratification of visual field progression in optic disc drusen with and without glaucoma.","authors":"Rohit Y Reddy, Rongrui Liu, Wesam S Shalaby, Sagar J Shah, Kartik Kumar, Binod Acharya, Qiang Zhang, Joel S Schuman, Jonathan S Myers, Ping Huang","doi":"10.1007/s10792-026-04274-6","DOIUrl":"10.1007/s10792-026-04274-6","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the visual field (VF) progression in patients with optic disc drusen (ODD) with or without glaucoma and identify factors associated with rapid deterioration.</p><p><strong>Methods: </strong>In this single-center retrospective cohort, adult patients with ODD, ≥ 12 months of follow-up, and ≥ 3 reliable standard automated perimetry tests were included. VF progression was quantified as the VF mean deviation (MD) slope (dB/year) using linear mixed-effects modeling. Eyes were categorized as slow progression (MD slope > - 0.5 dB/year) or moderate-fast progression (MD ≤ - 0.5 dB/year). Baseline RNFL thickness and VF MD, Visual acuity, intraocular pressure (IOP), glaucoma diagnosis, and number of IOP-lowering medications (NOM) were extracted from the medical record. Associations with moderate-fast progression were evaluated using logistic regression.</p><p><strong>Results: </strong>A total of 139 eyes from 84 patients were included (mean follow-up 57.4 ± 42.6 months; mean 4.9 perimetry tests/eye). Glaucoma was diagnosed in 83/139 eyes (59.7%). Overall, 91/139 eyes (65.5%) demonstrated VF deterioration (MD slope < 0 dB/year), more frequently in glaucoma-labeled eyes than no-glaucoma eyes (64/83 [77.1%] vs. 27/56 [48.2%]; p < 0.001). Moderate-fast progression occurred in 32/139 eyes (23.0%) and did not differ significantly by glaucoma status (28.9% vs. 14.3%, p = 0.064). In multivariable modeling, higher mean NOM was associated with higher odds of moderate-fast progression (adjusted odds ratio 2.41; 95% CI 1.06-5.45; p = 0.034), whereas glaucoma diagnosis and mean IOP were not independently associated. Severity-stratified analyses showed higher moderate-fast progression with baseline VF MD ≤ -6 dB (34.9% vs. 13.2%, p = 0.004) and RNFL < 80 µm (36.4% vs. 7.0%, p < 0.001).</p><p><strong>Conclusions: </strong>In eyes with ODD, thinner RNFL and worse VF MD at baseline are associated with a higher risk of moderate-fast VF decline, supporting risk-stratified monitoring regardless of glaucoma label or IOP.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069072","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 neovascularization detection from fundus images using deformable attention ResNet and swarm-hiking optimization.","authors":"Karpagavadivu Karuppusamy, Baranidharan Thangavel, Kavitha Mettupalayam Subramanian, Sumathi Thangavel","doi":"10.1007/s10792-026-04143-2","DOIUrl":"10.1007/s10792-026-04143-2","url":null,"abstract":"<p><strong>Background: </strong>In the detection of retinal neovascularization (RNV) from fundus images, defining anatomically consistent perivascular regions is challenging due to asymmetric retinal tissue deformation caused by abnormal vessel proliferation in RNV, leading to inaccurate extraction of pathological features. Moreover, early pathological changes in perivascular zones are minute and blend with normal tissue variability, while existing models focused on global retinal features tend to miss these localized abnormalities, resulting in reduced detection accuracy.</p><p><strong>Methods: </strong>A novel deep learning (DL) framework, Deformable Attention Pyramid ResNet with Perivascular Swarm-Hiking Optimization (DAPR-PSHO) is proposed for precise RNV detection. In this, a Deformable Attention Pyramid Scene Parsing-ResNet (DAPSP-ResNet) is employed, which adaptively adjusts its receptive fields using deformable convolutions to accurately capture irregular vessel structures, and enriches feature extraction by integrating local vessel details with global retinal context. Then, a PeriV-Transformer driven Particle Swarm-Hiking Optimization is introduced, to focus attention on minute perivascular changes while maintaining global retinal context, and fine-tunes transformer parameters, thereby effectively capturing early-stage RNV and enhancing anatomical fidelity indetection.</p><p><strong>Result: </strong>The proposed RNV detection model attains a high accuracy of 0.98, precision of 0.985, and recall of 0.986 comparedto the existing models.</p><p><strong>Conclusion: </strong>The DAPR-PSHO framework successfully addresses the limitations of global-feature-focused models by eff ectively isolating localized, early-stage abnormalities in perivascular zones, significantly improving RNV detection accuracy and anatomical fidelity.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074812","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":"Glaucoma management across 13 countries in Central, Eastern and Southeastern Europe: an exploratory survey.","authors":"Natalia Palarie, Fidan Aghayeva, Ewa Kosior-Jarecka, Nino Kobakhidze, Maryana Kovalska, Makedonka Atanasovska-Velkovska, Karolína Skorkovská, Lidija Kelava, Ilir Osmani, Lala Ćeklić, Adriana Chicu, Neda Sergeeva, Qëndresë Daka","doi":"10.1007/s10792-026-04284-4","DOIUrl":"10.1007/s10792-026-04284-4","url":null,"abstract":"<p><strong>Purpose: </strong>To describe glaucoma management practices, access and reimbursement across 13 countries in Central, Eastern and Southeastern Europe (CESE).</p><p><strong>Methods: </strong>A structured questionnaire adapted from the 2015 European Glaucoma Society (EGS) survey was completed by one ophthalmologist with knowledge of prevailing practice and regulation in each participating country. The survey covered areas such as patient organization availability, national guidelines, residency training, access to diagnostic tools, treatment protocols, surgical techniques, laser treatments, minimally invasive glaucoma surgery (MIGS) and moderately invasive bleb-forming shunts (MIBS), and healthcare coverage. Responses were summarized descriptively.</p><p><strong>Results: </strong>Ophthalmology residency programs varied in duration with limited surgical training access and no subspecialty glaucoma fellowships. Diagnostic protocols were relatively standardized but showed variability in tool availability and usage. Insurance coverage ranged from full coverage to none. Medical monotherapy was usually the initial treatment. Laser treatments were variably accessible, with frequent use reported in some countries and limited availability in others. The availability of MIGS and MIBS was reported as limited in most countries, with their use generally being rare or occasional.</p><p><strong>Conclusion: </strong>This exploratory key-informant survey identified shared approaches alongside marked differences in training, reimbursement, diagnostic access and surgical availability. Findings represent reported practices and should not be interpreted as nationally representative estimates.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069094","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":"Chronological age was not an independent predictor of visual recovery following cataract surgery in adults aged ≥ 75 years: a retrospective tertiary referral centre audit.","authors":"Hidayah Embong, Iqbal Tajunisah","doi":"10.1007/s10792-026-04276-4","DOIUrl":"10.1007/s10792-026-04276-4","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether chronological age independently influences surgical success, intraoperative challenges, complications and visual outcomes following cataract surgery in patients aged ≥ 75 years.</p><p><strong>Methods: </strong>This retrospective clinical audit included 189 eyes from 183 consecutive patients aged ≥ 75 years who underwent cataract surgery at a tertiary referral centre. Demographic data, ocular and systemic comorbidities, intraoperative challenges, complications and postoperative visual outcomes were analysed. The primary outcome was best-corrected visual acuity (BCVA) ≥ 6/12 at six weeks. Multivariable logistic regression identified independent predictors of visual success.</p><p><strong>Results: </strong>The mean patient age was 80.98 ± 4.28 years. Systemic multimorbidity was present in 97.8% of patients and ocular comorbidities were identified in 49.2% of eyes. Phacoemulsification was performed in 92.6% of eyes, while 7.4% underwent planned or conversion to extracapsular cataract extraction (ECCE). Intraoperative challenges included small pupils (52.9%), hazy corneas (20.6%), floppy iris syndrome (14.7%) and patient restlessness (11.8%). Intraoperative complications occurred in 18.5% of eyes. At six weeks, 76.7% achieved BCVA ≥ 6/12 and 89.9% showed visual improvement. Independent predictors of failure to achieve BCVA ≥ 6/12 were severe preoperative visual impairment ( adjusted odds ratio [aOR] 0.13, p < 0.001), ocular comorbidities (aOR = 0.35, p = 0.015) and intraoperative complications (aOR = 0.31, p = 0.012). Chronological age was not independently associated with visual outcome.</p><p><strong>Conclusion: </strong>Patients aged ≥ 75 years can achieve favourable visual outcomes after cataract surgery despite having multiple comorbidities and increased surgical complexity. Postoperative visual recovery is primarily determined by ocular status and intraoperative complications rather than age factor alone. Advanced age should not be a deterrent for cataract surgery if required.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069079","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 serum myelin basic protein in POAG patients at a tertiary institution in Lagos, Nigeria.","authors":"Judith Ogechi Anikwenwa, Adetunji Olusesan Adenekan, Adegboyega Sunday Alabi, Oluwatobi Olalekan Idowu, Ademola Ayoda Sule, Olufisayo Temitayo Aribaba, Solomon Oladapo Rotimi, Adeola Olukorede Onakoya","doi":"10.1007/s10792-026-04275-5","DOIUrl":"10.1007/s10792-026-04275-5","url":null,"abstract":"<p><strong>Purpose: </strong>Glaucoma, a neurodegenerative disorder, causes retinal ganglion cell damage and loss of neurons in the visual system up to the visual cortex. The loss of myelin sheath leads to the release of myelin sheath components, including the myelin basic protein (MBP), into the bloodstream. While MBP has shown promise as a biomarker for glaucoma in some Asian populations, data among individuals of African descent remain limited. This study evaluated the serum levels of MBP in primary open-angle glaucoma (POAG) patients compared to non-glaucoma controls, with the aim of reporting its usefulness as a biomarker for glaucoma detection in an African population.</p><p><strong>Methods: </strong>This cross-sectional study compared serum MBP levels in treatment-naive primary open-angle glaucoma (POAG) patients and non-glaucoma controls. Blood samples were collected from 83 treatment-naive POAG participants and 83 age and sex matched non-glaucoma participants and analyzed using enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>The mean age of POAG participants was 50.78 ± 17.3 years, with a male predilection. The mean intraocular pressure (IOP) was significantly higher in POAG patients (18.22 ± 6.8 mmHg) than in controls (13.89 ± 2.5 mmHg). Serum MBP levels were significantly elevated in POAG patients (1128.75 ng/L) compared to controls (963.75 ng/L; p < 0.001). There was no significant correlation between MBP levels and disease severity. MBP levels were higher in high-tension glaucoma and females; however, the difference was not statistically significant.</p><p><strong>Conclusion: </strong>Findings supported the neurodegenerative state of POAG and the use of serum MBP levels as a potential biomarker for early POAG detection.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061298","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":"Immune inflammatory targets and anti-inflammatory therapy in dry eye disease.","authors":"Zongcan Zhu, Wenjing Zhang, Qibing Mei","doi":"10.1007/s10792-026-04278-2","DOIUrl":"10.1007/s10792-026-04278-2","url":null,"abstract":"<p><strong>Background: </strong>Dry eye disease (DED) is a common category of ocular surface disease caused by insufficient tear secretion or reduced tear film quality, which leads to damage to ocular surface epithelial cells and initiates an inflammatory response, ultimately forming a vicious cycle dominated by chronic inflammation. The signaling pathways involved in DED are complex and need to be further explored.</p><p><strong>Methods: </strong>A literature search of PubMed was conducted to identify studies on DED published between 2013 and 2026.The search strategy adopted a combination of keywords as follows: \"dry eye disease\", \"neuroimmune and inflammation\", \"inflammatory signaling pathway\", \"ocular surface microenvironment. Inclusion Criteria\": 1.Original human clinical trials, in vitro cellular experiments, and animal model studies related to DED;2. Systematic reviews focusing on immunity and inflammation in DED.</p><p><strong>Exclusion criteria: </strong>1. Studies solely addressing other ocular surface diseases such as conjunctivitis, keratitis, and uveitis; 2. Studies lacking experimental data supporting anti-inflammatory therapeutic effects.</p><p><strong>Results: </strong>Previous studies have shown that anti-inflammatory therapies hold great promise for the treatment of moderate to severe DED. Inhibiting T cell activation or the release of inflammatory cytokines can help break the vicious cycle of inflammation. The NF-κB pathway plays a central role in the pathogenesis of DED.</p><p><strong>Conclusions: </strong>Chronic inflammation can continuously damage epithelial cells, exacerbating the severity of DED and significantly impacting the patient's quality of life. Therefore, understanding the underlying inflammatory mechanisms is crucial for the development of effective therapeutic strategies for DED.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061272","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":"Post-traumatic ınfectious keratitis: clinical, microbiological, and visual outcomes.","authors":"Emine Doğan, Alik Salamatov, Burçin Çakır, Sibel Alişan Alimoğlu, Gürsoy Alagöz","doi":"10.1007/s10792-026-04280-8","DOIUrl":"10.1007/s10792-026-04280-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the demographic, etiological, clinical and microbiological characteristics of patients diagnosed with post-traumatic infectious keratitis and to assess treatment outcomes.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 30 patients diagnosed with post-traumatic infectious keratitis between 2016 and 2024 at a tertiary ophthalmology clinic. Data on demographics, mechanisms of injury, timing of presentation, clinical findings, microbiological results, treatment modalities and visual outcomes were reviewed.</p><p><strong>Results: </strong>The mean age was 54.45 ± 18.06 years, with a distinct seasonal peak during the harvest period (July-September). Agricultural injuries (plant material, soil, and metal) were the primary causes. Corneal scraping cultures were positive in 8 patients (26.7%). Despite the relatively low culture positivity rate, likely due to prior antimicrobial therapy (33.3%), favorable visual outcomes (final visual acuity ≥ 0.5) were achieved in 66.7% of patients following prompt empirical antimicrobial therapy, with a mean final visual acuity of 0.71 ± 0.24.</p><p><strong>Conclusion: </strong>Post-traumatic infectious keratitis is a significant occupational hazard, particularly during harvest seasons. Our study suggests that even when microbiological yield is low, prompt initiation of empirical fortified antibiotic therapy may result in favorable visual outcomes.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061330","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":"The impact of overlooked Fuchs' Endothelial Corneal Dystrophy: postoperative results following intraocular interventions.","authors":"Gozde Sahin Vural, Ferhat Avci","doi":"10.1007/s10792-026-04277-3","DOIUrl":"10.1007/s10792-026-04277-3","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate postoperative outcomes in patients with previously unrecognized Fuchs endothelial corneal dystrophy (FECD) following intraocular surgery and to identify clinical, endothelial, and tomographic features associated with delayed diagnosis and corneal decompensation.</p><p><strong>Methods: </strong>This retrospective observational study included patients who underwent intraocular surgery without a preoperative diagnosis of FECD and were subsequently referred for persistent postoperative corneal edema. Demographic data, surgical history, best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were recorded. Endothelial cell parameters were assessed using non-contact specular microscopy, and corneal morphology was evaluated with Scheimpflug-based tomography, including pachymetric distribution, posterior corneal elevation, and higher-order aberrations.</p><p><strong>Results: </strong>Forty-five eyes of 39 patients (mean age 69.8 ± 10.5 years; 86% female) were analyzed. Phacoemulsification was the most common prior procedure (91.1%), and the mean interval between surgery and FECD diagnosis was 33.4 ± 24.1 months. Mean BCVA showed a numerical but statistically non-significant increase from 0.18 ± 0.07 at presentation/FECD diagnosis to 0.36 ± 0.19 at the last follow-up visit (p = 0.090). Mean IOP was 16.0 ± 4.3 mmHg at presentation/FECD diagnosis and 14.8 ± 4.4 mmHg at the last follow-up visit, with no statistically significant change (p = 0.087). Specular microscopy demonstrated reduced endothelial cell density (1146.7 ± 467.7 cells/mm²), increased polymegathism (CV: 33.8 ± 14.9%), and decreased hexagonality (17.5 ± 29.9%). Mean central corneal thickness was 588.0 ± 83.6 µm by specular microscopy and 636.0 ± 105.5 µm by tomography. Tomography revealed loss of regular isopach contours (90%), posterior corneal elevation (66.7%), and thinnest point displacement (46.7%). Posterior corneal higher-order aberrations were increased (3.93 ± 4.01 µm RMS). Endothelial keratoplasty was indicated in 38 eyes (84.4%).</p><p><strong>Conclusions: </strong>Previously unrecognized FECD may predispose patients to postoperative corneal decompensation after intraocular surgery, and comprehensive endothelial and tomographic assessment may facilitate earlier diagnosis, improved risk stratification, and reduced postoperative corneal morbidity.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038543","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":"Ocular surface dryness and disease activity in rheumatoid arthritis patients attending rheumatology clinic at Alexandria Main University Hospital.","authors":"Mohamed Sobhy Hassan, Btoul Khaldon Bitmani, Nermen Magdy Abdelmegeid, Tamer Hamdy Massoud","doi":"10.1007/s10792-026-04247-9","DOIUrl":"10.1007/s10792-026-04247-9","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate ocular surface dryness in patients with rheumatoid arthritis and to investigate its association with disease activity parameters.</p><p><strong>Methods: </strong>This cross-sectional study included adult RA patients attending the Rheumatology Outpatient Clinic at Alexandria Main University Hospital. All participants underwent rheumatologic evaluation including Disease Activity Score-28, laboratory assessment of rheumatoid factor, anti-cyclic citrullinated peptide antibodies, and C-reactive protein, as well as comprehensive ophthalmologic examination. Dry eye assessment included the validated Arabic Ocular Surface Disease Index, Schirmer tear test I with and without anesthesia, and fluorescein staining graded using the Oxford scale.</p><p><strong>Results: </strong>Thirty-one female RA patients were included, with a mean age of 45.32 ± 10.26 years. Most patients exhibited moderate disease activity (64.5%), followed by high (19.4%) and low activity (16.1%). Severe dry eye symptoms were reported by 87.1% of participants based on OSDI scores. Objective testing revealed reduced tear production in a substantial proportion of eyes, with severe aqueous deficiency detected in 11.3% without anesthesia and 21.0% after anesthesia. Fluorescein staining demonstrated predominantly minimal to mild epithelial changes. Correlation analysis showed no statistically significant associations between disease activity, inflammatory markers, serological status (RF and anti-CCP), disease duration, and any subjective or objective dry eye parameters.</p><p><strong>Conclusion: </strong>Ocular surface dryness is highly prevalent among patients with rheumatoid arthritis, with severe symptoms frequently observed despite generally mild to moderate objective findings. The absence of significant correlations with disease activity, inflammatory markers, or disease duration suggests that dry eye in RA may occur independently of systemic disease status. Routine ophthalmologic screening should therefore be considered for all RA patients regardless of disease activity.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038635","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}