International Ophthalmology最新文献

{"title":"Contact lens-associated infectious keratitis in physicians: a retrospective observational study.","authors":"Emre Karahan, Ozlem Barut Selver, Mehmet Aykur, Sohret Aydemir, Melis Palamar","doi":"10.1007/s10792-026-04260-y","DOIUrl":"10.1007/s10792-026-04260-y","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the clinical spectrum, contact lens-related behaviors, occupation-related characteristics, and outcomes of physicians with contact lens-associated infectious keratitis.</p><p><strong>Methods: </strong>This retrospective study was conducted at a tertiary referral center (Ege University, Department of Ophthalmology, Izmir, Turkiye) and included physicians diagnosed with contact lens-associated infectious keratitis between November 2012 and March 2026. Medical records were reviewed for demographic, occupational, contact lens-related, ocular surface, and clinical data.</p><p><strong>Results: </strong>Eleven physicians (mean age 44.4 ± 16.3 years [range, 27-72]; 63.6% female) were included. Bacterial keratitis was diagnosed in 7 patients (63.6%), Acanthamoeba keratitis in 3 patients (27.3%), and fungal keratitis in 1 patient (9.1%). Mean BCVA improved from 0.72 ± 0.83 logMAR at presentation to 0.05 ± 0.07 logMAR at final follow-up. All patients used soft contact lenses; overnight wear was reported in 9 patients (81.8%) and water exposure in 5 patients (45.5%). Mean weekly working time was 48.6 ± 10 h (range, 40-70), with 3.6 ± 2.8 (range, 0-8) duties per month. Hospitalization was required in 4 patients (36.4%). Complete resolution was achieved in 8 patients (72.7%), while 2 patients (18.2%) healed with residual scarring, and 1 patient (9.1%) experienced recurrence requiring penetrating keratoplasty.</p><p><strong>Conclusion: </strong>Physicians with contact lens-associated infectious keratitis may exhibit modifiable behavioral risk factors and occupation-related conditions relevant to disease presentation. Although causal relationships cannot be established, these findings underscore the importance of contact lens hygiene, timely lens removal, and attention to ocular surface symptoms in physicians working under demanding schedules.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016775","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":"Unit-based evaluation of retinopathy of prematurity screening practices in Turkiye within the framework of current guidelines.","authors":"Firangiz Nergiz Mehralizada, Ömer Erdeve, Yasemin Ezgi Köstekci, Ferhan Demirtaş, Feyza Çalış Karanfil, Pınar Bingöl Kızıltunç, Emel Okulu, Fatma Begüm Atasay, Huban Atilla, Saadet Arsan","doi":"10.1007/s10792-026-04229-x","DOIUrl":"10.1007/s10792-026-04229-x","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a unit-based experience with expanded retinopathy of prematurity screening criteria for infants born between 32 and 34 weeks' gestation, in relation to current national and international guidelines.</p><p><strong>Methods: </strong>This retrospective study included 425 preterm screened for ROP. Infants were divided into groups based on the presence or absence of ROP and the need for treatment. The population was further categorized by guideline periods (2016 vs. 2021) for a comparative analysis.</p><p><strong>Results: </strong>The mean birth weight of the cohort was 1560 g, and the mean gestational age was 31.3 weeks. Any stage of ROP was diagnosed in 21.2% of infants, with only 2.3% requiring treatment. No treatment-requiring ROP occurred in infants born at ≥30 weeks of gestation. Independent risk factors for ROP were BW < 1500 g (OR:7.29), patent ductus arteriosus (OR:2.17), and the need for invasive mechanical ventilation (OR:3.89). The incidence of ROP decreased significantly over the study period.</p><p><strong>Conclusion: </strong>Our findings support a more targeted screening approach in well-equipped, high-level NICUs, where local data suggests a lower risk of severe ROP in more mature infants. These results highlight the importance of unit-based monitoring and population-specific screening criteria to reduce unnecessary examinations while ensuring comprehensive coverage of high-risk infants.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016830","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":"Short-term adjunctive use of a liposomal tear substitute after repeated intravitreal therapy: a randomized pilot study.","authors":"Carlo Cagini, Marco Messina, Tito Fiore, Maria Luisa Chiruzzi, Martina Frenguelli, Luigi Crescenzi, Maria Poddi","doi":"10.1007/s10792-026-04249-7","DOIUrl":"10.1007/s10792-026-04249-7","url":null,"abstract":"<p><strong>Purpose: </strong>This pilot study investigates the efficacy of a liposomal ophthalmic solution containing cross-linked hyaluronic acid, trehalose, and stearylamine in reducing the occurrence of dry eye-like signs and symptoms in patients undergoing repeated intravitreal treatment.</p><p><strong>Methods: </strong>Participants aged over 50 years old were randomly assigned to receive either standard therapy alone (Group 1) or standard therapy with additional eye drops (Group 2). Examinations included TBUT, Schirmer's test, fluorescein staining, the Ocular Surface Disease Index (OSDI), and the 5-item Dry Eye Questionnaire (DEQ-5) at baseline and day 15, with a 30-day telephone follow-up for OSDI reassessment.</p><p><strong>Results: </strong>Ninety patients with age-related macular degeneration or other retinal diseases requiring anti-VEGF (vascular endothelial growth factor) treatment were enrolled in the study. In Group 1, which comprised 20 males and 25 females, DEQ-5 scores did not exhibit any significant change between V0 and V1 (10.89 ± 2.71 to 10.57 ± 2.60, p = 0.173), while Group 2, composed of 18 males and 27 females, demonstrated a considerable reduction in DEQ-5 values (9.28 ± 3.24 to 8.00 ± 3.64, p < 0.0001). OSDI scores in Group 1 showed no relevant change between V0 and V1 (p = 0.497), whereas in Group 2 they improved significantly (p < 0.0001). Additionally, Group 2 had notable enhancements in TBUT and Schirmer tests (p < 0.0001), while Group 1 experienced a significant decrease in TBUT values alone (p = 0.026).</p><p><strong>Conclusion: </strong>Chronic intravitreal therapy contributes to significant ocular surface impairment, which can be effectively mitigated by the administration of a tear substitute alongside the standard treatment.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982675","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 journal, a journey, a home: reflections on more than two decades with international ophthalmology.","authors":"Piergiorgio Neri","doi":"10.1007/s10792-026-04250-0","DOIUrl":"https://doi.org/10.1007/s10792-026-04250-0","url":null,"abstract":"","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963295","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":"Associatıon of systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) with graft survival in regraft cases after penetrating keratoplasty.","authors":"Erel Icel, Bora Yuksel, Tarik Guzel, Tuncay Kusbeci, Ipek Cikmazkara","doi":"10.1007/s10792-026-04264-8","DOIUrl":"10.1007/s10792-026-04264-8","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether preoperative systemic immune-inflammatory indices are associated with subsequent regraft requirement due to late endothelial failure following penetrating keratoplasty (PK).</p><p><strong>Methods: </strong>This retrospective study reviewed 1,738 PK cases performed in a tertiary eye center. Eyes that later underwent regraft due to late endothelial failure (n=51) were compared with PK recipients maintaining long-term graft clarity (n=50). Preoperative complete blood counts obtained prior to the primary PK were used to calculate neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation Index (SII) and Systemic Inflammation Response Index (SIRI). Donor characteristics, preservation intervals, surgical parameters, and glaucoma-related variables were recorded. Multivariable logistic regression and receiver operating characteristic (ROC) analyses were performed to identify factors associated with regraft risk.</p><p><strong>Results: </strong>Neutrophil counts, NLR, SII and SIRI were significantly higher in the regraft cohort, whereas lymphocyte, monocyte, platelet counts, and PLR did not differ between groups. SII and SIRI demonstrated modest discriminative ability for regraft (AUC 0.649 and 0.642 respectively). In multivariable analyses both SII (OR 1.002 per unit increase, p=0.037) and SIRI (OR 2.657 per unit increase, p=0.023) remained independently associated with regraft after adjustment for donor age, preservation intervals, graft size, and glaucoma-related factors. Donor age and the number of antiglaucoma medications were also independently associated with regraft risk. Notably, shorter preservation intervals in the regraft cohort did not translate into improved outcomes.</p><p><strong>Conclusions: </strong>Elevated preoperative SII and SIRI values were associated with subsequent regraft requirement due to late endothelial failure after PK. Although their discriminative performance was modest, these findings suggest that systemic immune-inflammatory status may contribute to long-term graft outcomes and may provide supportive information within a multifactorial preoperative risk assessment framework.Hemogram-derived indices may provide supportive information as adjunctive markers within preoperative risk assessment frameworks in corneal transplantation.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930089","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":"Agreement between Sirius Scheimpflug-Placido tomography and Anterion swept-source OCT in keratoconic eyes stratified by prior corneal cross-linking: a retrospective cross-sectional agreement study.","authors":"Kubra Erdogan, Metin Unlu, Furkan Ozer","doi":"10.1007/s10792-026-04227-z","DOIUrl":"10.1007/s10792-026-04227-z","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to assess the agreement between the Scheimpflug-Placido tomographer (Sirius) and the anterior-segment swept-source optical coherence tomography (Anterion) in evaluating anterior segment parameters separately in keratoconus (KC) patients with and without corneal cross-linking (CXL).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 108 eyes of patients with keratoconus (KC), divided into two groups according to previous corneal collagen cross-linking (CXL) status: eyes with prior CXL (wCXL group, n = 72) and eyes without CXL (woCXL group, n = 36). Evaluated parameters included anterior and posterior keratometric measurements, pachymetric measurements, anterior chamber parameters, corneal astigmatism, and corneal shape/elevation-related indices. Measurements from both devices were compared using Bland-Altman analysis, assessing fixed and proportional biases. Agreement between devices was interpreted based on the combination of absence of significant fixed bias, absence of proportional bias, and the width of the 95% limits of agreement (LoA).</p><p><strong>Results: </strong>In the wCXL group, anterior astigmatism (ant-Ast) and anterior best-fit toric ellipsoid (ant-BFT) demonstrated the most favorable bias characteristics. In the woCXL group, ant-Ast, ACD, posterior K1, and posterior Kmean showed favorable bias characteristics.</p><p><strong>Conclusions: </strong>Although ant-Ast and ant-BFT in the wCXL group and ACD, ant-Ast, posterior K1, and posterior Kmean in the woCXL group demonstrated no statistically significant fixed or proportional bias, the relatively wide LoA do not support interchangeable use of Sirius and Anterion for these measurements.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944822","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":"Construct validity of five phacoemulsification modules on the EyeSi surgical simulator: a cross-sectional study across three levels of surgical expertise.","authors":"Ismail Laamoud, Hassan Moutei, Fouad Chraibi, Meriem Abdellaoui, Idriss Benatiya Andaloussi","doi":"10.1007/s10792-026-04251-z","DOIUrl":"10.1007/s10792-026-04251-z","url":null,"abstract":"<p><strong>Purpose: </strong>Virtual reality simulators are increasingly integrated into cataract surgery training to facilitate skill acquisition outside the operating room. However, their educational value depends on the validity of simulated tasks. This study aimed to evaluate the construct validity of five procedural phacoemulsification modules on the EyeSi simulator (version 3.10.67) across three levels of surgical expertise.</p><p><strong>Methods: </strong>This cross-sectional comparative study was conducted at a tertiary referral hospital and a university simulation center in Morocco. Twenty-five participants were stratified into novices (n = 17), advanced residents (n = 4), and expert surgeons (n = 4). Participants completed five EyeSi phacoemulsification modules, and performance metrics were compared across groups.</p><p><strong>Results: </strong>Overall simulator performance improved with increasing surgical experience. Total scores differed significantly between groups (p = 0.005), with median values of 311, 365, and 473 for novices, advanced residents, and experts, respectively. Total completion time also differed significantly (p = 0.047). At the module level, construct validity was demonstrated for capsulorhexis (p = 0.030), divide and conquer (p = 0.009), and intraocular lens (IOL) insertion (p = 0.002), whereas hydrodissection and irrigation/aspiration did not reach statistical significance (p = 0.084 and p = 0.053, respectively).</p><p><strong>Conclusions: </strong>In a recent EyeSi software version, construct validity was confirmed for three of the five evaluated procedural modules across three levels of surgical expertise. Complementary analyses further supported an association between simulator performance and surgical experience across all modules. These findings reinforce the educational value of the EyeSi simulator while highlighting the need for the continuous evaluation and refinement of individual procedural modules and their scoring algorithms.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944794","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":"Conjunctival biopsy findings associated with fibrosis and sequelae in ocular Mucous membrane pemphigoid.","authors":"Ariana Ringer, Andrea Smichowski, Carlos Nuncio Siegrist, German Daniel Grossi, Ramiro Adrian Gómez, Jorge Oscar Zarate, Javier Eduardo Rosa, Maria Lorena Brance, Ana Rosa Pérez, Ignacio Javier Gandino","doi":"10.1007/s10792-026-04273-7","DOIUrl":"10.1007/s10792-026-04273-7","url":null,"abstract":"<p><strong>Purpose: </strong>Ocular mucous membrane pemphigoid (OcMMP) leads to fibrosis of the conjunctiva with potential sequelae. Our objective was to describe biopsies from patients with OcMMP and identify biopsy characteristics associated with fibrosis and sequelae.</p><p><strong>Methods: </strong>Patients with histologically confirmed OcMMP were selected. Fibrosis grades were defined according to Foster's stages. The subjects were divided into two groups: early stages (0 and 1) versus later stages (2, 3, and 4). A Cox multivariate analysis was performed to determine whether immunofluorescence deposits were associated with sequelae.</p><p><strong>Results: </strong>Fifty-seven patients were included. The mean age at diagnosis was 62.7 (SD 13.2) years, and 41 (71.9%) were women. The follow-up time was 1.5 years (IQR 0.3-3). Patients with early Foster were 50.9%. The presence of mast cells was associated with early stages, whereas eosinophils were associated with later stages at the time of diagnosis. In the multivariate Cox regression analysis, the presence of IgA deposits was associated with developing sequelae (HR 10.8; IC 95% 1.3-92.9; p 0.03).</p><p><strong>Conclusion: </strong>Eosinophils were more frequently observed in patients with advanced Foster stages, and IgA was associated with the sequelae.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944797","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":"Anterior segment OCT-based assessment of efficacy of topical cyclosporine in edematous punctal stenosis.","authors":"Hilal Nalcı Baytaroğlu, Kubra Ozdemir Yalcinsoy","doi":"10.1007/s10792-026-04253-x","DOIUrl":"10.1007/s10792-026-04253-x","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of topical cyclosporine-A treatment on edematous punctal stenosis (PS) using anterior segment optical coherence tomography (AS-OCT).</p><p><strong>Methods: </strong>Patients with edematous PS who suffered from epiphora for at least 3 months were prospectively evaluated. Those with a history of acute/subacute infection, use of preservative-containing eyedrops or anti-glaucoma drops within 1 month, pathologies of other parts of the nasolacrimal drainage system were excluded. All cases were treated with a two-week course of steroid drops and long-term preservative-free cyclosporine A drops. Munk score, outer punctal diameter (OPD), vertical canalicular length (VCL), inner punctal diameter (IPD) at 100 and 500µ, tear well diameter (TWD), tear well depth (TWDp), and punctal reserve (PR) on punctum-OCT were measured. Evaluations were performed at baseline, 1 month and 3 months post-treatment.</p><p><strong>Results: </strong>Forty-four eyes of 22 patients were evaluated. Mean duration of symptoms was 7.4±6.5 (3-24) months. Median Munk score was 4 (range 2-5) at the baseline, 0 (range, 0-5) at 1 month, and 1 (range, 0-3) at 3 months. Mean OPD at the 3rd month was significantly higher than the baseline (430.0 ± 115.5µ vs 491.4 ± 110.0µ, ANOVA p=0.021). Other AS-OCT parameters did not show any significant change. One patient with no improvement in symptoms and findings with clinical treatment and underwent perforated punctal plug insertion.</p><p><strong>Conclusion: </strong>The anti-inflammatory effect of topical Cyclosporine-A may be effective in managing long-lasting edematous PS by increasing the diameter of the punctal opening and decreasing hyperlacrimation.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930070","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":"Alpinia Oxyphylla-Shenqi Siwu Decoction protects against high glucose-induced retinal pigment epithelial cell injury involving the PI3K/AKT/mTOR pathway.","authors":"Weiling Zhang, Chunying Jing","doi":"10.1007/s10792-026-04272-8","DOIUrl":"10.1007/s10792-026-04272-8","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) is a leading cause of vision loss in working-age adults, and current treatments (anti-VEGF drugs, steroids, laser photocoagulation) mainly target late-stage microvascular complications while offering little for the neurodegeneration and neurovascular unit dysfunction that characterize early DR. Multi-component, multi-target traditional Chinese medicine compound decoctions are attractive candidates for early intervention. Here we investigated the protective effect and molecular mechanism of Alpinia Oxyphylla-Shenqi Siwu Decoction (AOSWSD) in a high glucose-induced ARPE-19 injury model of early DR.</p><p><strong>Methods: </strong>ARPE-19 cells were exposed to 30 mmol/L glucose and treated with drug-containing rat serum obtained from rats gavaged with AOSWSD at low, middle and high doses (4.6, 9.2 and 18.4 g/kg/day of crude drug), with a matched normal-rat-serum control. Cell viability, migration, apoptosis, intracellular ROS, cytokine secretion, VEGFR2 immunofluorescence, p-AKT/AKT and p-mTOR/mTOR ratios, and mRNA levels of VEGFA, VEGFR2, HIF-1α, PIK3CA, AKT1, mTOR, Caspase-3, Bcl-2 and Bax were quantified by CCK-8 assay, scratch assay, flow cytometry, DCFH-DA staining, ELISA, immunofluorescence and RT-qPCR, respectively.</p><p><strong>Results: </strong>Under high-glucose exposure, AOSWSD-containing serum dose-dependently improved cell viability, restored migration, suppressed apoptosis, reduced intracellular ROS, and lowered the secretion of VEGFA, TNF-α and IL-6. Mechanistically, AOSWSD acted along a coordinated VEGFA/VEGFR2-PI3K/AKT/mTOR axis: it reduced secreted VEGFA and VEGFR2 protein at the upstream end, and lowered PIK3CA, AKT1 and mTOR transcripts together with the p-AKT/AKT and p-mTOR/mTOR ratios at the downstream end. Bcl-2, Bax and Caspase-3 expression and the Bax/Bcl-2 ratio were likewise restored towards control values.</p><p><strong>Conclusion: </strong>AOSWSD protects ARPE-19 cells from high glucose-induced injury through simultaneous, dose-dependent modulation of oxidative stress, inflammation, apoptosis and angiogenic signaling, with the VEGFA/VEGFR2-PI3K/AKT/mTOR cascade acting as a principal molecular substrate. These results support AOSWSD as a candidate multi-target intervention for early-stage DR and provide a basis for further mechanistic, chemical and translational studies.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919841","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}