Ophthalmology. Retina最新文献

{"title":"The Next Frontier for Macular Hole Surgery: Estimating Functional Success","authors":"Michael A. Klufas MD","doi":"10.1016/j.oret.2024.12.020","DOIUrl":"10.1016/j.oret.2024.12.020","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 4","pages":"Pages 303-304"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747847","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":"Unilateral Dual Congenital Retinal Macrovessels","authors":"Tarannum Mansoori MS , Satish Gooty Agraharam MS , Swetha Nasani DO","doi":"10.1016/j.oret.2024.08.010","DOIUrl":"10.1016/j.oret.2024.08.010","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 4","pages":"Page e33"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accessory Fovea in Human Eye","authors":"Ryan Zubricky MD, Tamara Vrabec MD","doi":"10.1016/j.oret.2024.08.012","DOIUrl":"10.1016/j.oret.2024.08.012","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 4","pages":"Page e34"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Ranibizumab Biosimilar QL1205 in Neovascular Age-Related Macular Degeneration","authors":"Jan Hamouz MD ,&nbsp;Agnieszka Nowosielska MD ,&nbsp;Anna Święch-Zubilewicz MD ,&nbsp;Santiago Abengoechea MD ,&nbsp;Kristine Baumane MD ,&nbsp;Attila Vajas MD ,&nbsp;Małgorzata Siewierska MD ,&nbsp;Milan Veselovsky MD ,&nbsp;Miroslav Veith MD ,&nbsp;Ágnes Kerényi MD ,&nbsp;Shobhana Mange MD ,&nbsp;Krishnapada Baidya MD ,&nbsp;Guna Laganovska MD ,&nbsp;Ignasi Jürgens MD ,&nbsp;András Papp MD ,&nbsp;Jignesh Gosai MD ,&nbsp;Jana Štefanickova MD ,&nbsp;Mei Han MD ,&nbsp;Piotr Fryczkowski MD ,&nbsp;Dominik Zalewski MD ,&nbsp;Wenbin Wei MD","doi":"10.1016/j.oret.2024.10.001","DOIUrl":"10.1016/j.oret.2024.10.001","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to demonstrate the clinical equivalence of biosimilar QL1205 and reference ranibizumab, Lucentis, in patients with neovascular age-related macular degeneration (nAMD).</div></div><div><h3>Design</h3><div>This was a multicenter, double-masked, randomized, controlled phase III trial.</div></div><div><h3>Participants</h3><div>Treatment-naive patients with active nAMD were randomly assigned to receive QL1205 or reference ranibizumab.</div></div><div><h3>Methods</h3><div>Patients received intravitreal injection of QL1205 or reference ranibizumab at a dose of 0.5 mg in the study eye once every 4 weeks for 48 weeks.</div></div><div><h3>Main Outcome Measures</h3><div>The primary end point was change in best-corrected visual acuity (BCVA) by ETDRS letters at week 8 compared with baseline level. Biosimilarity of QL1205 to reference ranibizumab was assessed with an equivalence range for the difference in BCVA letters between −3.49 and +3.49.</div></div><div><h3>Results</h3><div>Between June 27, 2019 and June 8, 2021, 616 patients were randomized to the QL1205 group (n = 308) and the reference ranibizumab group (n = 308). The mean improvement of BCVA was +6.3 ± 9.13 ETDRS letters in the QL1205 group and +7.3 ± 8.82 ETDRS letters in the reference ranibizumab group at week 8. Both the 90% confidence interval (CI, −2.23 to 0.13) and 95% CI (−2.46 to 0.36) of the difference between the 2 treatment groups (<em>P</em> = 0.1434) were within the predefined equivalence range. Safety profiles were manageable in both groups.</div></div><div><h3>Conclusions</h3><div>QL1205 was biosimilar to reference ranibizumab regarding clinical efficacy, ocular and systemic safety, as well as immunogenicity and pharmacokinetics profiles in the treatment of patients with nAMD.</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 4","pages":"Pages 343-351"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400909","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":"Morphologic Stages of Full-Thickness Macular Hole on Spectral-Domain OCT","authors":"Aurora Pecaku MD ,&nbsp;Isabela Martins Melo MD ,&nbsp;Jessica A. Cao BA ,&nbsp;Shiva Sabour MD ,&nbsp;Sumana C. Naidu MD ,&nbsp;Sueellen Demian MD ,&nbsp;Marko M. Popovic MD, MPH ,&nbsp;Charles C. Wykoff MD, PhD ,&nbsp;Andrea Govetto MD, PhD ,&nbsp;Rajeev H. Muni MD, MSc","doi":"10.1016/j.oret.2024.10.018","DOIUrl":"10.1016/j.oret.2024.10.018","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the sequential morphological changes of the outer retina after full-thickness macular hole (FTMH) formation utilizing a novel, objective staging system based on OCT, and to determine its association with baseline visual acuity, duration of symptoms, and postoperative visual acuity at 3 months.</div></div><div><h3>Design</h3><div>Retrospective, observational, multicenter study.</div></div><div><h3>Participants</h3><div>Patients with idiopathic FTMH presenting to St. Michael’s Hospital, Toronto, Canada, and Retina Consultants of Texas, Houston, Texas from 2009 to 2022.</div></div><div><h3>Methods</h3><div>The medical charts of 1000 patients with FTMH were reviewed, and those with ≥2 preoperative spectral-domain OCTs (SD-OCTs) were analyzed. A staging system was developed by assessing outer retinal morphology on successive SD-OCT central foveal scans.</div></div><div><h3>Main Outcome Measures</h3><div>Sequential outer retinal morphological changes with SD-OCT over time and their association with baseline visual acuity, duration of symptoms, and postoperative functional outcomes.</div></div><div><h3>Results</h3><div>Fifty-two eyes of 52 patients with a mean age of 65.4 ± 8.4 years were included. Sequential outer retinal morphologic changes at the FTMH borders occurred in 4 distinct and reproducible stages: stage A, separation of the neurosensory retina from the retinal pigment epithelium with the well-defined external limiting membrane (ELM), ellipsoid zone (EZ), and interdigitation zone (4/52, 7.7%); stage B, thickening of the EZ (27/52, 52.0%); stage C, patchy (moth-eaten) photoreceptor loss (16/52, 30.7%); and stage D, severe or complete loss of inner and outer segments and bare ELM (5/52, 9.6%). When assessing the preoperative OCT scans closest to the time of surgery, over a mean follow-up period of 288.9 ± 350.4 days (range, 5–1841), 28.85% (15/52) of eyes were in stage B, 28.85% (15/52) were in stage C, and 42.3% (22/52) were in stage D. There was a statistically significant association between increasing stage at baseline and longer duration of macular hole symptoms (<em>P</em> = 0.032) and worse visual acuity at baseline (<em>P</em> &lt; 0.001). Additionally, patients presenting with stages B and C at the time point closest to surgery had better visual acuity outcomes 3 months postoperatively than those with stage D (<em>P</em> = 0.04).</div></div><div><h3>Conclusions</h3><div>This SD-OCT staging system describes the sequential in vivo morphologic changes after FTMH formation, providing a novel imaging biomarker.</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 4","pages":"Pages 305-313"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes in nAMD with Aflibercept 8 mg in the Phase 2 CANDELA Study.","authors":"Jordana G Fein, Priya S Vakharia, A Paul Chous, Rutvi Desai, Fabiana Q Silva, Kimberly Reed, Alyson J Berliner, Robert Vitti, Charles C Wykoff","doi":"10.1016/j.oret.2025.03.023","DOIUrl":"https://doi.org/10.1016/j.oret.2025.03.023","url":null,"abstract":"<p><p>In this post hoc analysis of the CANDELA trial, eyes with neovascular age-related macular degeneration treated with aflibercept 8 mg achieved improved anatomic and visual outcomes, suggesting therapeutic benefit compared with aflibercept 2 mg.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780710","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":"Guidelines for the Diagnosis, Management, and Study of Autoimmune Retinopathy from the American Academy of Ophthalmology's Task Force.","authors":"Bobeck S Modjtahedi, Alan G Palestine, Lee M Jampol, David Sarraf, H Nida Sen, Lucia Sobrin, John J Chen, Paul Yang, Grazyna Adamus, Donald S Fong, Cynthia X Qian, Flora Lum","doi":"10.1016/j.oret.2025.03.024","DOIUrl":"https://doi.org/10.1016/j.oret.2025.03.024","url":null,"abstract":"<p><strong>Purpose: </strong>The American Academy of Ophthalmology created a task force to advance the understanding of autoimmune retinopathy (AIR) and provide guidelines on the diagnosis and management of this complex disorder.</p><p><strong>Design: </strong>A search on PubMed and Google Scholar of English-language studies was conducted without date restrictions. The Task Force reviewed the current literature and formulated an expert consensus on the management of AIR as well as recommendations for future efforts to improve our understanding of this condition.</p><p><strong>Results: </strong>Key clinical and imaging features are discussed, and a new diagnostic framework is proposed based on likelihood of AIR (probable AIR, possible AIR, and unlikely AIR) to provide a more standardized approach for categorizing disease. Patients who possess all the following features can be categorized as having probable AIR: (1) signs of disease progression based on subjective symptoms and objective testing within six months, (2) examination with less than 1+ anterior chamber or vitreous cell/haze, (3) optical coherence tomography (OCT) with outer retinal disruption and loss of the external limiting membrane/outer retinal bands/ellipsoid zone often relatively sparing the fovea, (4) characteristic fundus autofluorescence (FAF) abnormalities, (5) full field ERG with reduction of both rod and cone responses, and (6) positive anti-retinal antibodies. Those with some but not all of these features, or with otherwise atypical presentations, can be classified as possible AIR. Features that would make AIR unlikely and should elicit strong suspicion for alternative diagnoses are: (1) slowly progressive symptoms or changes on testing taking place over years, (2) retinal examination with bone spicules, retinal vascular sheathing, or retinal hemorrhages, (3) examination with more than 1+ anterior chamber or vitreous cell/haze, (4) OCT changes predominantly at the level of the RPE or areas of focal/sharply delineated outer retinal/RPE atrophy, (5) fluorescein angiography with diffuse retinal vasculitis or large areas of non-perfusion, or (6) a normal full-field electroretinogram (even with an abnormal multifocal electroretinogram).</p><p><strong>Conclusions: </strong>These criteria will allow for better classification of patients reported in the literature and improve communication between clinicians. Further study is necessary to optimize the approach for managing AIR and will require collaborative multi-center efforts.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780711","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":"Abnormal Opacified Vitreous Humor Associated with Optic Disc Pit","authors":"Utsab Pan MS, FVRS,&nbsp;Romana Fazal DNB, FVRS,&nbsp;Abdul Mannan Mondal D.Optom","doi":"10.1016/j.oret.2024.09.001","DOIUrl":"10.1016/j.oret.2024.09.001","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 4","pages":"Page e38"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381390","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":"Detection of Macular Neovascularization in Eyes Presenting with Macular Edema using OCT Angiography and a Deep Learning Model","authors":"Nida Wongchaisuwat MD ,&nbsp;Jie Wang PhD ,&nbsp;Elizabeth S. White MS ,&nbsp;Thomas S. Hwang MD ,&nbsp;Yali Jia PhD ,&nbsp;Steven T. Bailey MD","doi":"10.1016/j.oret.2024.10.017","DOIUrl":"10.1016/j.oret.2024.10.017","url":null,"abstract":"<div><h3>Purpose</h3><div>To test the diagnostic performance of an artificial intelligence algorithm for detecting and segmenting macular neovascularization (MNV) with OCT and OCT angiography (OCTA) in eyes with macular edema from various diagnoses.</div></div><div><h3>Design</h3><div>Prospective cross-sectional study.</div></div><div><h3>Participants</h3><div>Study participants with macular edema due to either treatment-naïve exudative age-related macular degeneration (AMD), diabetic macular edema (DME), or retinal vein occlusion (RVO).</div></div><div><h3>Methods</h3><div>Study participants were imaged with macular 3 × 3–mm and 6 × 6–mm spectral-domain OCTA. Eyes with exudative AMD were required to have MNV in the central 3 × 3–mm area. A previously developed hybrid multitask convolutional neural network for MNV detection (aiMNV), and segmentation was applied to all images, regardless of image quality.</div></div><div><h3>Main Outcome Measures</h3><div>Sensitivity, specificity, positive predictive value, and negative predictive value of detecting MNV and intersection over union (IoU) score and F1 score for segmentation.</div></div><div><h3>Results</h3><div>Of 114 eyes from 112 study participants, 56 eyes had MNV due to exudative AMD and 58 eyes with macular edema due to either DME or RVO. The 3 × 3–mm OCTA scans with aiMNV detected MNV with 96.4% sensitivity, 98.3% specificity, 98.2% positive predictive value, and 96.6% negative predictive value. For segmentation, the average IoU score was 0.947, and the F1 score was 0.973. The 6 × 6–mm scans performed well; however, sensitivity for MNV detection was lower than 3 × 3–mm scans due to lower scan sampling density.</div></div><div><h3>Conclusions</h3><div>This novel aiMNV algorithm can accurately detect and segment MNV in eyes with exudative AMD from a control group of eyes that present with macular edema from either DME or RVO. Higher scan sampling density improved the aiMNV sensitivity for MNV detection.</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 4","pages":"Pages 378-385"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal Fluid and Thickness Fluctuations in Archway Trial for Port Delivery System with Ranibizumab versus Monthly Ranibizumab Injections","authors":"Veeral S. Sheth MD ,&nbsp;Nancy M. Holekamp MD ,&nbsp;Arshad M. Khanani MD, FASRS ,&nbsp;Aleksandra Rachitskaya MD, FASRS ,&nbsp;Steven Blotner MS ,&nbsp;Shamika Gune MD ,&nbsp;Dominic Heinrich MD ,&nbsp;Katie F. Maass PhD ,&nbsp;Usha Chakravarthy MD, PhD","doi":"10.1016/j.oret.2024.10.015","DOIUrl":"10.1016/j.oret.2024.10.015","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine proportion of eyes with neovascular age-related macular degeneration (nAMD) with retinal fluid and central subfield thickness (CST) fluctuations and evaluate their impact on best-corrected visual acuity (BCVA) in eyes treated with the Port Delivery System with ranibizumab (PDS) versus monthly intravitreal ranibizumab injections.</div></div><div><h3>Design</h3><div>Post hoc analyses of phase 3 Archway trial (NCT03677934).</div></div><div><h3>Participants</h3><div>Adults with nAMD responsive to anti-VEGF therapy.</div></div><div><h3>Intervention</h3><div>Four hundred eighteen patients randomized 3:2 to the PDS (100 mg/mL) with refill-exchanges every 24 weeks (Q24W) or monthly intravitreal ranibizumab (0.5 mg) for 96 weeks.</div></div><div><h3>Outcomes</h3><div>Proportion of eyes in each treatment arm with subretinal and/or intraretinal fluid (SRF/IRF) overall and in central 1 mm; BCVA changes from baseline by treatment arm and fluid presence/location; proportion of eyes with CST fluctuations from baseline to week 48, week 48 to 96, and baseline to week 96; effects of CST fluctuations on BCVA.</div></div><div><h3>Results</h3><div>Four hundred fifteen eyes were assessed. In the PDS versus monthly ranibizumab arm, proportion of eyes with SRF/IRF, central SRF, and central IRF were 47.6% versus 50.9%, 29.0% versus 19.2%, and 11.7% versus 12.6% at baseline, and 57.8% versus 56.1%, 21.6% versus 14.8%, and 7.0% versus 8.4% at week 96, respectively. BCVA changes from baseline to week 96 were −1.1 letters with the PDS versus −1.4 with monthly ranibizumab in eyes with SRF/IRF, and −1.9 versus −1.8 in eyes with central SRF. In eyes with central IRF, BCVA changes from baseline to week 96 were −2.1 with the PDS versus −6.9 with monthly ranibizumab, respectively (mean BCVA at 96 weeks 68.9 [20/40] vs. 64.6 [20/50]). CST fluctuations occurred in 32.1% and 29.7% of PDS versus monthly ranibizumab eyes; corresponding BCVA changes from baseline to week 96 were −2.5 versus −2.6 (mean BCVA at 96 weeks 72.7 [20/35] vs. 71.5 [20/38]).</div></div><div><h3>Conclusions</h3><div>Port Delivery System with ranibizumab Q24W maintained BCVA to 96 weeks regardless of SRF/IRF, central SRF, central IRF, or CST fluctuations, comparable with monthly ranibizumab, thus supporting the use of the PDS in stabilizing retinal anatomy without the need for monthly treatment in patients with nAMD.</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 4","pages":"Pages 330-342"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}