International Ophthalmology最新文献

{"title":"Impact of external dacryocystorhinostomy on corneal aberrations and optical quality in primary acquired nasolacrimal duct obstruction.","authors":"Titap Yazıcıoglu, Murat Oklar, Dilara Ozkoyuncu Kocabas","doi":"10.1007/s10792-025-03725-w","DOIUrl":"https://doi.org/10.1007/s10792-025-03725-w","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the impact of external dacryocystorhinostomy (EXT-DCR) on optical quality in patients with primary acquired nasolacrimal duct obstruction (PANDO) by evaluating changes in corneal higher-order aberrations (HOAs) and key optical quality parameters, including modulation transfer function (MTF) and point spread function (PSF).</p><p><strong>Methods: </strong>This retrospective study included 26 eyes of 26 patients who underwent unilateral EXT-DCR for PANDO. Preoperative and 6-month postoperative assessments included best-corrected visual acuity (BCVA), manifest refraction spherical equivalent (MRSE), and epiphora severity (Munk score, fluorescein dye disappearance test [FDDT]). HOAs, MTF, and PSF were analyzed at 3 mm and 6 mm pupil diameters using Sirius corneal topography. Paired t-tests, Wilcoxon signed-rank tests, and Spearman correlation analyses were used.</p><p><strong>Results: </strong>Postoperatively, HOA significantly decreased at 3 mm (0.183 ± 0.160 - 0.128 ± 0.058 µm, p = 0.020) and 6 mm (0.744 ± 0.350 - 0.641 ± 0.271 µm, p = 0.039). Spherical aberration at 6 mm also significantly decreased (- 0.237 ± 0.203 - - 0.194 ± 0.247 µm, p = 0.032). MTF and PSF values showed no significant postoperative changes (p > 0.05). Correlation analysis of Δ values (preoperative-postoperative changes) revealed significant associations between reductions in Munk/FDDT scores and improvements in HOA and spherical aberrations (p < 0.05).</p><p><strong>Conclusion: </strong>EXT-DCR may significantly improve optical quality by reducing HOAs and spherical aberrations. The correlation between epiphora resolution and optical quality suggests that stabilizing the tear film plays a key role in reducing optical distortions. While MTF and PSF values did not show significant changes, further studies with larger cohorts and advanced imaging techniques are warranted to explore the broader impact of lacrimal surgery on visual function and contrast sensitivity parameters.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"370"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954334","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":"Pediatric graves' orbitopathy: a case series of 136 Chinese patients.","authors":"Huan Jian, Yanyan Zhu, Weimin He","doi":"10.1007/s10792-025-03583-6","DOIUrl":"https://doi.org/10.1007/s10792-025-03583-6","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the clinical features and treatment methods of pediatric patients with Graves' orbitopathy (GO).</p><p><strong>Methods: </strong>We analyzed 136 GO patients aged 18 or younger at West China Hospital from January 2009 to November 2023, recording symptoms, clinical characteristics, treatments, and prognosis.</p><p><strong>Results: </strong>Patients' ages ranged from 2 to 17 years, with 83.82% being female, mostly at Tanner stage four. Initially, 86.03% had hyperthyroidism. The most common symptom was exophthalmos (90.44%), and the main signs were lid lag (90.46%), eyelid swelling (59.75%), and upper eyelid retraction (53.11%). Females had more exophthalmos and lid lag (p = 0.010, 0.015; t = 2.620, 4.238). Imaging showed 46.97% had no extraocular muscle affected. The most affected muscles were the inferior rectus (44.7%), superior rectus (28.03%), medial rectus (21.21%), and lateral rectus (20.45%). Only six eyes were at the active stage, 65.56% had mild severity, and none were sight-threatening. No treatment was given to 51.87% of patients, while 41.49% received periorbital corticosteroid injections. Two patients had injections plus radiotherapy, and one had injections, radiotherapy, and glucocorticoid pulse therapy. Severity and activity decreased significantly in the treatment group (p < 0.001), while non-treatment group exhibited a significant decrease in severity (p = 0.022).</p><p><strong>Conclusions: </strong>Pediatric GO patients, mainly late-stage pubertal females, had less severe symptoms and better prognoses than adults. Observation is often sufficient, with periorbital corticosteroid injections being effective when necessary.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"367"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954480","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":"COVID-19 impact on retinal detachment in Germany: seasonal peaks persist and shifts in surgical trends.","authors":"Ahmad Samir Alfaar, Efstathios Vounotrypidis, Armin Wolf","doi":"10.1007/s10792-025-03706-z","DOIUrl":"10.1007/s10792-025-03706-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated how the COVID-19 pandemic coincided with changes in incidence, seasonality, and surgical management of rhegmatogenous retinal detachment (RRD) and tractional retinal detachment (TRD) in Germany.</p><p><strong>Methods: </strong>We performed an observational, retrospective analysis using data from the Diagnosis-Related Group database, covering 116,386 retinal detachment admissions between January 2019 and December 2022. RRD (ICD-10 H33.0) and TRD (ICD-10 H33.4) cases were examined separately. Seasonal decomposition and correlation analyses were applied to identify trends in admission numbers, surgical choices, and reoperations before and after the onset of COVID-19.</p><p><strong>Results: </strong>A total of 96,620 RRD and 19,766 TRD admissions were analyzed. Post-pandemic, RRD decreased by 8.5%, whereas TRD declined by 2.9%. Despite disruptions, established seasonal peaks remained evident, with RRD peaking in July and TRD in March and August. A negative correlation between COVID-19 deaths and RRD cases suggested a temporal association that may reflect barriers to timely care during pandemic peaks. Surgical practice shifted toward more definitive vitrectomy approaches, and reoperation rates for RRD rose slightly from 12.1 to 12.9%.</p><p><strong>Conclusion: </strong>The pandemic correlated with reduced RRD admissions, smaller declines in TRD, and persistent seasonality in Germany. These findings underscore the importance of adaptive healthcare strategies that preserve timely surgical interventions and resource allocation for sight-threatening conditions during public health crises.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"369"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954323","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":"Optimizing the water drinking test: evaluating the reproducibility and validity of a shortened protocol: a randomized prospective trial.","authors":"Tal Yahalomi, Hamza Rayan, Natalya Kovalyuk, Zvika Davidovich, Doron Moscovici, Itai Hacker, Shlomo Nisim, Gal Eidelsztein, Gilad Plopsky, Joseph Pikkel","doi":"10.1007/s10792-025-03736-7","DOIUrl":"https://doi.org/10.1007/s10792-025-03736-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate a a shortened Water drinking test (WDT) protocol and explore potential factors of patient characteristics such as body mass index (BMI) or Body Surface Area (BSA).</p><p><strong>Methods: </strong>This was a prospective, randomized study comparing two validated WDT dosage regimens: 10 mL/kg and a fixed 800 mL intake. Patients were randomly assigned to one of the two groups. The initial 30 min IOP response was compared to the full 60 min test to assess correlation and predictive value. Additionally, the effect of BMI or BSA on IOP dynamics was investigated.</p><p><strong>Results: </strong>Of the 100 enrolled patients, 90 were randomized and the final analysis included 45 patients in the 800 mL group and 35 in the 10 mL/kg group. No significant differences were found between groups in demographic, systemic, or ocular characteristics. The WDT showed strong reproducibility, with high correlations between the 30 min and 60 min tests (r = 0.89, p < 0.001). On the contrary, BMI (r = 0.12, p = 0.26) and BSA (r = 0.16,p = 0.14) had weak correlations with IOP response.</p><p><strong>Conclusion: </strong>The 30 min WDT is a reproducible and reliable method for assessing IOP fluctuations, offering a practical alternative to the full 60 min protocol. BMI and BSA had weak correlations with IOP response, suggesting that adjusting WDT outcomes based on BMI or BSA may be unnecessary.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"368"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954475","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":"Diagnostic efficiency of pan-immune-inflammation value to predict diabetic macular edema and its relationship with OCT-based biomarkers of inflammation.","authors":"Ozlem Candan, Gözde Orman, Nurten Ünlü, Güner Ozkan","doi":"10.1007/s10792-025-03733-w","DOIUrl":"https://doi.org/10.1007/s10792-025-03733-w","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to ascertain the predictive value of pan-immune-inflammation value (PIV) in the diagnosis of diabetic macular oedema (DME) and to analyse the relationship between PIV and inflammatory markers on optical coherence tomography (OCT).</p><p><strong>Methods: </strong>A total of 155 patients were included in this observational study: 40 had diabetes without retinopathy, 60 had DME, and 55 were selected as healthy controls. All participants had a complete blood count. The neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and PIV were calculated and compared. Multivariable regression models were used to further investigate the relationship between systemic inflammatory markers and other biomarkers and OCT markers.</p><p><strong>Results: </strong>The DME group had significantly higher WBC (p < 0.001), monocyte (p = 0.003) and neutrophil counts (p = 0.024). PIV showed the highest sensitivity and area under the curve for predicting patients with DME in ROC curve analysis. The optimal PIV cut-off value was > 427.69 to distinguish patients with DME from healthy controls, and > 451.29 from diabetic patients without DR. In the regression analysis, HRF count was associated with PIV (p = 0.036), CMT (p = 0.005), and BCVA (p < 0.001). Additionally, the presence of SRF was associated with WBC (p = 0.043), PIV (p = 0.013), CMT (p = 0.007), and BCVA (p = 0.045).</p><p><strong>Conclusion: </strong>PIV may be a useful marker of systemic neutrophil- and monocyte-mediated inflammation in DME, independent of diabetes duration and HbA1c, though further studies are needed to confirm its clinical utility and define an optimal cut-off value.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"365"},"PeriodicalIF":1.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954320","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":"Pars plana vitrectomy followed by subretinal or intravitreal injection with Conbercept and tissue plasminogen activator for clearance of submacular hemorrhage secondary to idiopathic polypoidal choroidal vasculopathy.","authors":"Fan Yang, Lumei Luo, Yusheng Li, Lingyao Wu, Qi Wan, Wenghan Ji, Zhipeng You","doi":"10.1007/s10792-025-03642-y","DOIUrl":"https://doi.org/10.1007/s10792-025-03642-y","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal treatment approach for submacular hemorrhage (SMH) secondary to idiopathic polypoid choroidal vasculopathy (IPCV) remains uncertain. This study aimed to explore the prognosis and complications of pars plana vitrectomy (PPV) followed by subretinal or intravitreal injection with Conbercept (0.05 ml, 10 mg/ml) and tissue plasminogen activator (t-PA) (0.05 ml ~ 0.1 ml, 0.25 mg/ml) for submacular hemorrhage (SMH) secondary to IPCV.</p><p><strong>Methods: </strong>This retrospective study included patients with SMH secondary to IPCV who received PPV followed by subretinal or intravitreal injection with Conbercept and t-PA at the Affiliated Eye Hospital of Nanchang University between March and November 2023. The rate of SMH clearance, best corrected visual acuity (BCVA), and central macular thickness (CMT), and postoperative complications at 1 week, 1 month, 3 months and 6 months post-treatment were collected.</p><p><strong>Results: </strong>A total of 41 patients were included, with 22 (8 males, 14 left eyes) of who received subretinal injection.Patients who received subretinal injection showed significantly less times of injections (P = 0.008), compared with those received intravitreal injection. Repeated measurement analysis showed that, compared with intravitreal injection, patients who received subretinal injection exhibited significant higher SMH clearance ratio (P < 0.001), while comparable BCVA (P = 0.942) and CMT (0.906). In addition, the occurrence of postoperative complications, including vitreous hemorrhage (P = 0.999) and macular hemorrhage (P = 0.463), between those received subretinal and intravitreal injection were similar.</p><p><strong>Conclusion: </strong>Compared with intravitreal injection, PPV followed by subretinal injection with Conbercept and t-PA might be a more optimal protocol with higher SMH clearance ratio for SMH Secondary to IPCV.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"364"},"PeriodicalIF":1.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954449","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":"Long-term outcomes of vitrectomy for proliferative diabetic retinopathy: a real world study in China.","authors":"Jinghao Mei, Hantao Zhou, Chuying Deng, Shimeng Wang, Binghua Guo, Wei Lin, Zushun Lin, Ke Lin, Ronghan Wu, Zhong Lin","doi":"10.1007/s10792-025-03722-z","DOIUrl":"https://doi.org/10.1007/s10792-025-03722-z","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate long-term outcomes and their predictive factors in Chinese patients with proliferative diabetic retinopathy (PDR) after vitrectomy.</p><p><strong>Study design: </strong>Retrospective and observational.</p><p><strong>Methods: </strong>PDR patients who underwent vitrectomy in a tertiary eye hospital from 2010 to 2020 were enrolled. The cumulative incidences of re-vitrectomy in the primary eye, vitrectomy in the contralateral eye, low vision (< 0.3 Snellen), and postoperative complications were calculated.</p><p><strong>Results: </strong>A total of 1094 patients were included in the analysis. The 1-, 3-, and 5-year cumulative incidences for low vision in both eyes were 18.9%, 34.7%, and 44.4%, respectively. The 1-, 5-, and 10-year cumulative incidences for re-vitrectomy in the primary eye were 7.4%, 9.9%, and 9.9%, respectively, and for vitrectomy in the contralateral eye were 31.0%, 62.7%, and 79.5%, respectively. Vitrectomy in the contralateral eye was associated with younger age (hazard ratio [HR] = 0.99, 95% confidence interval [CI] 0.98-0.99), higher glycated hemoglobin (HR = 1.17, 95% CI 1.08-1.27), no preoperative photocoagulation (HR = 0.55, 95% CI 0.39-0.78), severer diabetic retinopathy level (HR = 2.28, 95% CI 1.56-3.33), and poorer preoperative vision (HR = 1.35, 95% CI 1.14-1.61). The cumulative postoperative incidences of the primary eye at 1, 5, and 10 years were 5.7%, 9.9%, and 9.9% for vitreous hemorrhage, 4.2%, 5.1%, and 5.1% for retinal detachment, and 2.8%, 6.2%, and 8.1% for neovascular glaucoma, respectively.</p><p><strong>Conclusion: </strong>This study reported a comprehensive post-vitrectomy incidence and predictive factors in Chinese PDR patients in a long-term follow up. This would aid in the clinical understanding of this lifelong disease.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"366"},"PeriodicalIF":1.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954424","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":"Exploring the role of oxidative stress in retinal vein occlusion: an updated and comprehensive review on the pathophysiology and treatment perspectives.","authors":"Jiaqi Zhang, Xuejun Xie, Ya Mo","doi":"10.1007/s10792-025-03687-z","DOIUrl":"10.1007/s10792-025-03687-z","url":null,"abstract":"<p><strong>Introduction: </strong>Retinal vein occlusion (RVO) represents a prevalent cause of vision impairment within retinal vascular diseases. Although hypoperfusion and inflammation are recognized pathogenic contributors, emerging evidence highlights oxidative stress as a pivotal mediator operating through ischemia-hypoxia-inflammation cascades.</p><p><strong>Methods: </strong>We conducted a systematic review of preclinical models and clinical studies examining reactive oxygen species (ROS) mechanisms in RVO pathogenesis. We searched PubMed/MEDLINE^™ database for studies published through May 2025, focusing on oxidative stress biomarkers, therapeutic interventions, and neurovascular outcomes.</p><p><strong>Results: </strong>In ischemic retina, ROS accumulation stabilizes hypoxia-inducible factor-1α (HIF-1α) and induces vascular endothelial growth factor (VEGF) expression, promoting vascular hyperpermeability and proinflammatory cytokine release. Bidirectional interactions between ROS signaling and systemic vascular mediators, including hypertension and the renin-angiotensin-aldosterone system (RAAS), disrupt redox homeostasis, increase retinal venous pressure, and impair microvascular perfusion. Oxidative stress-mediated activation of resident microglia and infiltrating macrophages promotes tight-junction protein degradation, resulting in blood-retinal barrier (BRB) breakdown and subsequent neurovascular injury. Patients with elevated systemic oxidative burden frequently present with bilateral, subclinical retinal microvascular impairment. Targeted antioxidant interventions, including nanoparticle-based delivery systems and bioactive phytochemicals, demonstrated efficacy in preclinical models by restoring redox balance, preserving BRB integrity, and reducing neurovascular damage.</p><p><strong>Conclusion: </strong>Oxidative stress represents a critical factor in RVO progression through interconnected vascular, inflammatory, and immune pathways. We propose a comprehensive management framework incorporating multimodal imaging for oxidative biomarker detection, artificial intelligence implementation for risk stratification, and personalized antioxidant therapy guided by validated biomarkers. Future investigations must establish causal relationships and identify specific, noninvasive biomarkers to advance precision prevention and treatment strategies for RVO.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"358"},"PeriodicalIF":1.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954332","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":"Morphologic changes of the double-layer sign during anti-vascular endothelial growth factor therapy in eyes with neovascular age-related macular degeneration.","authors":"Taiichi Hikichi, Haruka Kurabe, Amane Notoya, Yuuna Oguro, Misaki Hirano, Yumeka Doi","doi":"10.1007/s10792-025-03732-x","DOIUrl":"https://doi.org/10.1007/s10792-025-03732-x","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate longitudinal morphologic changes of the double-layer sign (DLS) on optical coherence tomography (OCT) in eyes with neovascular age-related macular degeneration (nAMD) presenting with exudative macular neovascularization (eMNV) undergoing anti-vascular endothelial growth factor (VEGF) therapy.</p><p><strong>Methods: </strong>This retrospective study included 207 consecutive treatment-naïve eyes (207 patients) with nAMD presenting with eMNV and a DLS treated with intravitreal anti-VEGF injections and were followed for ≥ 12 months. All eyes received 3 monthly loading injections followed by either treat-and-extend (TAE) or pro re nata (PRN) retreatment, per predefined criteria. DLS area, length, and height were measured at baseline, after loading, and 12 months.</p><p><strong>Results: </strong>All 207 eyes demonstrated significant reductions in mean (± standard deviation) DLS area, length, and height 1 month after the third monthly injection (165 ± 188 µm², 1446 ± 639 µm, and 202 ± 109 µm, respectively) compared with baseline (302 ± 264 µm², 1801 ± 573 µm, and 282 ± 150 µm, respectively) (P = 0.001, P = 0.001, and P = 0.024, respectively). At 12 months the mean change in DLS area was - 141 µm² [95% confidence interval (CI) - 185 to - 98], and median (95% CI) injection number was 8.1 (7.9 to 8.4). Eyes with subretinal and/or intraretinal fluid (SRF/IRF) at 12 months showed re-enlargement of DLS parameters, whereas eyes without SRF/IRF maintained the post-treatment decrease.</p><p><strong>Conclusion: </strong>DLS morphology regresses after anti-VEGF therapy, and persistent or recurrent fluid is associated with less durable regression. The DLS regresses in response to anti-VEGF therapy, and its behaviour correlates with the clinical course of exudative MNV associated with a DLS. DLS monitoring may complement-but not replace-multimodal imaging when assessing MNV activity.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"363"},"PeriodicalIF":1.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954464","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":"Corneal collagen cross-linking combined with lamellar keratoplasty in the treatment of Acanthamoeba keratitis.","authors":"Tingting Lin, Can Zhao, Lijuan Feng, Hua Gao, Suxia Li, Man Du, Jijun Sun, Xiaowei Zhong, Xiuhai Lu, Vanissa W S Chow, Weiyun Shi, Ting Wang","doi":"10.1007/s10792-025-03615-1","DOIUrl":"https://doi.org/10.1007/s10792-025-03615-1","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the outcomes of corneal collagen cross-linking combined with lamellar keratoplasty (CXL-LK) versus LK alone in treating medically unresponsive acanthamoeba keratitis (AK).</p><p><strong>Methods: </strong>This retrospective, non-randomized controlled clinical study included 11 eyes (CXL-LK group) and 16 eyes (LK group) at a tertiary ophthalmology center. Corneal infiltration, density of acanthamoeba cysts (AC) and pathological changes following CXL in AK patients were assessed. One-year post-operation, refractive outcomes, graft survival, corneal endothelial loss rates and AK recurrence were evaluated.</p><p><strong>Results: </strong>The area and depth of the infiltrates were reduced following CXL in AK patients, and the density of the AC decreased. Histopathological results indicated a reduction in AC volume after CXL, with the contents appearing wrinkled and degraded. At one year postoperatively, the corneal endothelial loss rate was 10.12% in the CXL-LK group, significantly lower than the 27.43% observed in the LK group (p = 0.031). None of the patients in the CXL-LK group experienced AK recurrence, with an average duration of anti-amoebic treatment of 62.20 ± 50.33 days, while a significant higher proportion of patients (31.25%) in the LK group experienced recurrence, with a significantly longer treatment duration of 182.75 ± 106.77 days (p = 0.009). The graft survival rate demonstrated statistically significant differences between the two groups one year after surgery (90.9% in the CXL-LK group vs. 68.75% in the LK group, P < 0.05).</p><p><strong>Conclusion: </strong>CXL reduced AK infiltration, promoted AC degradation and effectively halted disease progression. CXL-LK significantly shortened the duration of anti-amoebic treatment, decreased AK recurrence and improved graft outcomes after LK.</p><p><strong>Trial registration: </strong>ChiCTR1900026147 (2019-09-23).</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"361"},"PeriodicalIF":1.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954343","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}