Ophthalmology. Retina最新文献

{"title":"Visualizing a Microaneurysm with Adaptive Optics Scanning Laser Ophthalmoscopy.","authors":"Ke-Yu Liu, Yan-Lai Zhang, Wen-Li Deng","doi":"10.1016/j.oret.2025.09.007","DOIUrl":"https://doi.org/10.1016/j.oret.2025.09.007","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Judge Failure: Defining Treatment Resistance to Anti-VEGF Therapy in Exudative Maculopathies - A Systematic Scoping Review.","authors":"Geoffrey K Broadhead, Long Phan, Tiarnán D L Keenan, Jennifer Chin, Thomas Hong, Emily Y Chew, Andrew A Chang","doi":"10.1016/j.oret.2025.10.006","DOIUrl":"https://doi.org/10.1016/j.oret.2025.10.006","url":null,"abstract":"<p><strong>Topic: </strong>To evaluate the currently used definitions of treatment resistance in common retinal vascular diseases (neovascular age-related macular degeneration (nAMD), diabetic macula edema (DME) and retinal vein occlusion (RVO)) through a systematic scoping review of published studies.</p><p><strong>Clinical relevance: </strong>A notable proportion of patients receiving therapy for retinal vascular diseases exhibit suboptimal responses to anti-vascular endothelial growth factor (anti-VEGF) therapy, however currently there are no well-recognized definitions of resistance to treatment in these conditions. Clear definitions of treatment-resistance would aid in developing treatment strategies and guiding research studies for these patients.</p><p><strong>Methods: </strong>The online databases Pubmed, Embase and the Cochrane Database of Systemic Reviews were searched on January 5^thand August 16^th 2025 for articles relating to treatment resistance in all three conditions.</p><p><strong>Results: </strong>402 publications were identified, of which 88 met the eligibility criteria: 30 relating to nAMD (Table 1), 48 relating to DME (Table 2) and 10 relating to RVO (Table 3). Wide heterogeneity exists in the definition of treatment resistance for each condition. Persistent intraretinal fluid and/or subretinal fluid on optical coherence tomography (OCT) is the most commonly used criterion in each condition. Duration of prior treatment for defining resistance is commonly longest for nAMD, however treatment frequency of approximately ≤6-weekly injections for defining resistance was generally similar across all 3 conditions.</p><p><strong>Conclusions: </strong>There is wide variability in the definitions used, however persistent intraretinal and/or subretinal fluid on OCT despite regular anti-VEGF therapy of approximately ≤6-weekly intervals are the most common criteria across all three conditions. Adoption of these definitions for future studies would help ensure consistency and may potentially improve patient outcomes by improving the validity of future studies and allowing for the development of treatment paradigms to manage this patient subgroup.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lack of long-term benefit from anti-VEGF combined therapy in cT2b retinoblastoma.","authors":"Hanhan Shi, Yunhan Zhu, Jie Yang, Mingpeng Xu, Lu Chen, Yanping Han, Min Zhou, Minglei Han, Jia Tan, Renbing Jia, Peiwei Chai, Xuyang Wen, Jiayan Fan","doi":"10.1016/j.oret.2025.10.007","DOIUrl":"https://doi.org/10.1016/j.oret.2025.10.007","url":null,"abstract":"<p><p>This prospective clinical trial showed that vincristine-etoposide-carboplatin (VEC) plus intravitreal anti-VEGF therapy offers limited long-term benefits for patients with unilateral advanced retinoblastoma.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Fellow Eye Posterior Vitreous Detachment and Complications Using a Large Database of Retina Specialists.","authors":"John Brown, Curtis Heisel, Nick Boucher, Nitika Aggarwal, Rusirini Fernando, Nikoo Hamzeh, Palak Patel, Mathew MacCumber, Manjot K Gill","doi":"10.1016/j.oret.2025.09.015","DOIUrl":"https://doi.org/10.1016/j.oret.2025.09.015","url":null,"abstract":"<p><strong>Purpose: </strong>To identify risk factors in diagnosis of second eye PVD after first eye PVD and subsequent complications.</p><p><strong>Methods: </strong>This multicenter, retrospective, observational study analyzed 22,525 patients with first eye PVD (2015-2024) from the CorEvitas Vestrum Health Database.</p><p><strong>Results: </strong>Of 22,525 patients, 38.3% were diagnosed with complications after first eye PVD within one year (24.3% vitreous hemorrhage [VH], 24.1% retinal break [RB], 5.2% retinal detachment [RD]). Second eye PVD occurred in 21.2% of the 22,525 patients. The median time to diagnosis of second eye PVD was 37 months, with 74.5% of patients diagnosed with a second eye PVD having it within 72 months. Increased risk of second eye PVD was associated with first eye VH (HR 1.08, p = 0.027), first eye RB (HR 1.13, p < 0.001), lattice degeneration in either eye (HR 1.09, p = 0.037), and pseudophakia in the second eye (HR 1.21, p < 0.001). Age > 65 (HR 0.79, p < 0.001) and male gender (HR 0.93, p = 0.022) reduced risk. 33.2% of eyes that experienced a second eye PVD had associated complications, of which 21.1% were detected within 12 months. Risk factors included male gender (HR 1.46, p < 0.001), lattice degeneration in either eye (HR 1.38, p < 0.001), and first eye VH (HR 2.09, p < 0.001), RB (HR 1.78, p < 0.001), or RD (HR 1.35, p = 0.004). Any complication in the first eye PVD (HR 3.66, p < 0.001) greatly increased risk. Age > 65 reduced complication risk (HR 0.77, p < 0.001).</p><p><strong>Conclusions: </strong>Following first eye PVD, second eye PVD may occur after several years, necessitating the need for continuous follow-up especially in higher risk groups such as younger patients, patients with first eye VH and RB, those with pseudophakia in the second eye, and those with lattice degeneration in either eye. Following onset of second eye PVD, high risk groups such as male patients, those with lattice degeneration in either eye, or any history of complications in the first eye PVD warrant closer and longer follow-up due to greater risk for complications after second eye PVD.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Litigation Involving Intravitreal Injections in Ophthalmology: A Review of Legal Claims and Outcomes.","authors":"Maria A Bantounou, Matthew R Starr","doi":"10.1016/j.oret.2025.09.014","DOIUrl":"https://doi.org/10.1016/j.oret.2025.09.014","url":null,"abstract":"<p><strong>Purpose: </strong>Intravitreal (IVT) injections are among the most commonly performed procedures in ophthalmology. Although generally safe, they do carry some risk. This study aimed to characterize lawsuits related IVT injections and identify trends and actionable insights relevant to clinical practice and patient safety.</p><p><strong>Design: </strong>Retrospective medico-legal case review.</p><p><strong>Subjects: </strong>Sixty IVT injection-related lawsuits.</p><p><strong>Methods: </strong>The WestLaw database was queried for lawsuits involving IVT injections from 2000 to 2025 using key search terms. Trial court documents, trial court orders, cases, verdicts and settlements were reviewed. As all data were publicly available, institutional review board review was not required.</p><p><strong>Main outcome measures: </strong>Case characteristics and litigation outcomes cited in lawsuits.</p><p><strong>Results: </strong>Sixty IVT-related lawsuits were identified. Louisiana (32%) and California (20%) were the most commonly involved states. The most frequently cited agents were triamcinolone (33.3%), brolucizumab (13.3%), and bevacizumab (13.3%). Male patients comprised the most common plaintiff group (43%). Lawsuits against physicians accounted for 13% (n=8) of cases, often involving male attendings (75%), VA settings (63%), and residents (38%). Common allegations included injection-related injuries and delayed treatment. Outcomes were primarily in favor of the defendant (50%), followed by settlements (undisclosed) in two cases (25%), one in favor of the plaintiff with an award of $1,607,683 (12.5%), and one with an unknown outcome (12.5%). Lawsuits (n=37) against manufacturers commonly cited product liability (97%) and failure to warn (94%) as the legal claims, and often involved contaminated injections (57%). Twenty-nine cases (78.4%) were settled, including 18 patient claims against manufacturers (median settlement: $193,563; IQR: $109,118-$258,161), 7 cases (18.9%) were decided for the defendant, and 1 (2.7%) for the plaintiff. Fifteen cases involved fraud claims, primarily Medicare fraud (n=8) and improper billing (n=4); among these, 4 were settled, 4 decided for the plaintiff, 4 for the defendant, and 3 remain ongoing. Eight fraud cases included financial awards (median: $2,335,919; IQR: $366,169-$34,999,361).</p><p><strong>Conclusion: </strong>Three key areas of vulnerability emerged: procedural lapses, inadequate informed consent, and regulatory failures. Addressing these issues may reduce litigation risk and enhance patient safety surrounding IVT injections.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epstein–Barr Virus Lymphoproliferative Disorder in a Patient with Acute Lymphoblastic Leukemia","authors":"Lydia Zhong BA,&nbsp;Michael Ip MD,&nbsp;Kirk K. Hou MD, PhD","doi":"10.1016/j.oret.2025.02.026","DOIUrl":"10.1016/j.oret.2025.02.026","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 10","pages":"Page e100"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subhyaloid Air Bubble Post Intravitreal Injection","authors":"Mariana Vaz MD ,&nbsp;Ana Mafalda Pereira MD ,&nbsp;Diogo Cabral MD","doi":"10.1016/j.oret.2025.02.014","DOIUrl":"10.1016/j.oret.2025.02.014","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 10","pages":"Page e96"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-Induced Vasculitis and Choroiditis after Brolucizumab","authors":"Andrea Servillo MD ,&nbsp;Maria Vittoria Cicinelli MD ,&nbsp;Cecilia Mularoni MD ,&nbsp;Carlo La Spina MD ,&nbsp;Francesco Bandello MD ,&nbsp;Elisabetta Miserocchi PhD, MD","doi":"10.1016/j.oret.2025.05.020","DOIUrl":"10.1016/j.oret.2025.05.020","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 10","pages":"Pages 1023-1025"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinitis Pigmentosa with Preserved Para-arteriolar Retinal Pigment Epithelium","authors":"Zehao Liu MD,&nbsp;Xinyu Liu MD,&nbsp;Ying Lin MD, PhD","doi":"10.1016/j.oret.2025.02.019","DOIUrl":"10.1016/j.oret.2025.02.019","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 10","pages":"Page e97"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endophthalmitis Incidence after Intravitreal Injection of Anti-VEGF Agents with Povidone-Iodine versus Aqueous Chlorhexidine Antisepsis","authors":"Brandon Bates MD,&nbsp;John Fitzpatrick MD,&nbsp;Caroline Rosanky BA,&nbsp;Jared Moon MD,&nbsp;Edward Wood MD,&nbsp;Philip Storey MD, MPH","doi":"10.1016/j.oret.2025.03.022","DOIUrl":"10.1016/j.oret.2025.03.022","url":null,"abstract":"<div><h3>Purpose</h3><div><span>To evaluate the incidence of postinjection endophthalmitis (PIE) after </span>intravitreal injection<span> (IVI) of anti-VEGF agents in eyes prepared with topical 5% povidone-iodine (PI) or 0.05% aqueous chlorhexidine (AqCHX) as antisepsis.</span></div></div><div><h3>Design</h3><div>Retrospective, single-center, comparative cohort study.</div></div><div><h3>Participants</h3><div>Individuals who received ≥1 intravitreal anti-VEGF injection with use of PI or AqCHX as antisepsis.</div></div><div><h3>Methods</h3><div>For all patients receiving intravitreal anti-VEGF injections at Austin Retina Associates between March 1, 2015 and November 1, 2023, all injections and cases of suspected PIE were identified with billing codes and confirmed with review of electronic medical record data. Eyes that presented after injection with pain or decreased vision warranting treatment with intravitreal antibiotics were considered suspected PIE cases. Eyes were grouped based on preparation with PI or AqCHX.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes were incidence of suspected and culture-positive PIE and visual acuity (VA) at 3 months postendophthalmitis.</div></div><div><h3>Results</h3><div>A total of 302 474 IVIs were administered during the study period. Within the PI group, 59 cases of suspected PIE occurred after 267 190 injections (0.022%; 1 in 4529 injections) compared with 5 cases after 35 284 injections (0.014%; 1 in 7057 injections) in the AqCHX group (<em>P</em> = 0.34). For the PI group, there were 10 culture-positive PIE cases (0.0037%, 1 in 26 719 injections) compared with 0 cases in the AqCHX group (<em>P</em> = 0.25). At 3 months postinfection, average VA in the PI group was 0.97 (∼20/200) and 1.4 (∼20/500) in the AqCHX group (<em>P</em> = 0.41). When controlling for prefilled syringe status, there was no difference in rates of PIE between antisepsis groups (<em>P</em> = 0.23).</div></div><div><h3>Conclusions</h3><div>The incidence of endophthalmitis after IVI is low, with no difference in the rates of infection with eyes prepared with topical PI compared with AqCHX. Topical AqCHX has similar efficacy to PI for the prevention of endophthalmitis after IVI.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 10","pages":"Pages 928-933"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}