Ophthalmology最新文献

{"title":"Bypassed, Not Treated: Dacryocystitis after Custom Gold Jones Tubes.","authors":"Qinghua Wang, Suming Wu, Zhengwei Zhang","doi":"10.1016/j.ophtha.2026.08.033","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.08.033","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of Retinal Detachment in Type 2 Stickler Syndrome.","authors":"Alex Fleet, Kaza Hrishikesh, David Collins, Gregory S Fincham, Howard Martin, Allan J Richards, Ben Clarke, Gavin Fuller, Annie M McNinch, Arabella V Poulson, Philip Alexander, Thomas R W Nixon, Nick Wareham, Martin P Snead","doi":"10.1016/j.ophtha.2026.09.023","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.09.023","url":null,"abstract":"<p><strong>Purpose: </strong>Stickler syndrome is the most common cause of retinal detachment in children. The risk of retinal detachment and blindness in type 1 Stickler syndrome is significantly reduced with prophylactic cryotherapy, but there are no equivalent large studies assessing prophylaxis in type 2 Stickler syndrome. This study evaluates the safety and efficacy of the Cambridge prophylactic cryotherapy protocol in a national cohort of patients with genetically confirmed type 2 Stickler syndrome.</p><p><strong>Design: </strong>Retrospective comparative case series.</p><p><strong>Subjects: </strong>197 patients with genetically confirmed type 2 Stickler syndrome.</p><p><strong>Methods: </strong>Time to retinal detachment was compared in patients receiving a standardized prophylaxis protocol versus controls not receiving prophylaxis. Hazard ratios were calculated with and without patient matching. Analysis was also performed comparing patients who received unilateral prophylaxis (following retinal detachment in their other eye) to a control group.</p><p><strong>Main outcome measure: </strong>Time to retinal detachment.</p><p><strong>Results: </strong>The risk of retinal detachment in the bilateral control group (n=100) was increased 5.7-fold compared to the bilateral prophylaxis group (n=85) (hazard ratio [HR] =5.7, 95% confidence interval [CI], 2.0-16.2; p<0.01). In the matched bilateral control group (n=79), the risk of retinal detachment was increased 3.3-fold compared to the matched bilateral prophylaxis group (n=79) (HR=3.3, 95% CI, 1.0-10.7; p=0.04). The risk of a second eye retinal detachment in the unilateral control group (n=34) was increased 10.1-fold compared to the unilateral prophylaxis group (n=12) (HR=10.1, 95% CI, 1.3-78.1; p=0.03). No patients suffered serious long-term adverse effects from prophylaxis.</p><p><strong>Conclusions: </strong>The Cambridge prophylactic cryotherapy protocol is apparently safe and appears to be effective in reducing the incidence of retinal detachment in patients with Type 2 Stickler syndrome.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Cataract Surgery Accelerate the Progression to Late Age-related Macular Degeneration?","authors":"Emily Y Chew, Gui-Shuang Ying, Susan Vitale","doi":"10.1016/j.ophtha.2026.08.036","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.08.036","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Intraocular Natural Killer/T-Cell Lymphoma.","authors":"Xingyu Xiao, Rongping Dai","doi":"10.1016/j.ophtha.2026.08.002","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.08.002","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External Ophthalmomyiasis after Travel.","authors":"Shaojun Li, Xiuxian Pang","doi":"10.1016/j.ophtha.2026.08.028","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.08.028","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conjunctival Melanocytic Lesions: A Practical Sequential Treatment Approach.","authors":"Elvia Mastrogiuseppe, Rumana N Hussain, Zakariah Ali, Sarah Coupland, Heinrich Heimann","doi":"10.1016/j.ophtha.2026.09.017","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.09.017","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the outcomes of a stepwise multimodal treatment approach for conjunctival melanocytic lesions ranging from low-grade conjunctival melanocytic intraepithelial lesion (LG-CMIL) through high-grade CMIL (HG-CMIL) to invasive conjunctival melanoma (iCoM) and to propose a practical management framework.</p><p><strong>Design: </strong>Retrospective, single-centre cohort study.</p><p><strong>Subjects: </strong>Patients diagnosed with LG-CMIL, HG-CMIL, or iCoM and managed at the Liverpool Ocular Oncology Centre between January 2015 and April 2025 were included.</p><p><strong>Methods: </strong>A sequential stepwise strategy was employed, comprising surgical excision or incisional biopsy, topical chemotherapy (mitomycin C, 5-fluorouracil, or interferon alpha-2b), and adjuvant Ruthenium-106 plaque brachytherapy or proton beam radiotherapy when indicated, selected according to histopathological grade and clinical growth pattern (focal versus diffuse). Kaplan-Meier survival analysis and Cox proportional hazards regression identified prognostic factors for recurrence and metastasis.</p><p><strong>Main outcome measures: </strong>Local recurrence was the primary endpoint; metastatic disease and residual pigmentation after primary therapy were the secondary endpoints.</p><p><strong>Results: </strong>Among 165 eyes, including 39 LG-CMIL, 39 HG-CMIL, and 87 iCoM cases, HG-CMIL demonstrated the highest recurrence rate (24.3%; 9 eyes) and the earliest recurrence events (median 8.2 months), whereas LG-CMIL showed the lowest recurrence risk (11.1%; 4 eyes). Metastatic disease occurred exclusively in iCoM (11.4%; 8 eyes), accounting for 16.7% of deaths in the cohort. Non-bulbar involvement (HR 2.76, p=0.014) and residual pigmentation (HR 2.77, p=0.024) independently predicted local recurrence, while ulcerative features (HR 15.08, p=0.001), non-bulbar involvement (HR 7.28, p=0.015) and increased tumour thickness (HR 2.15, p=0.030) were associated with metastatic spread.</p><p><strong>Conclusions: </strong>A tailored sequential multimodal approach achieved satisfactory local disease control, with local recurrence being primarily driven by non-bulbar involvement and residual pigmentation after primary therapy, while metastatic spread was strongly associated with ulcerative features, followed by non-bulbar involvement and tumour thickness.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Centralized Multidisciplinary Retinoblastoma Care Closes the Outcome Gap: Survival and Globe Salvage for 1000 Eyes from 601 Patients.","authors":"Yacoub A Yousef, Hadeel Halalsheh, Mona Mohammad, Jakub Khzouz, Dima Abu Laban, Reem Al Jabari, Hazem Haboob, Munir Shawagfeh, Imad Jaradat, Iyad Sultan, Maysa Al-Hussaini, Mustafa Mehyar, Ibrahim Al-Nawaiseh","doi":"10.1016/j.ophtha.2026.09.015","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.09.015","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Retinoblastoma (RB) outcomes in low- and middle-income countries remain inferior to those achieved in high-income countries, largely due to delayed diagnosis, limited access to specialized care, and fragmented treatment systems. The aim of this study is to evaluate the long-term impact of a two-decade strategy based on centralized multidisciplinary care, structured capacity building, and a telemedicine-supported international twinning partnership in reducing disparities in retinoblastoma (RB) outcomes in a resource-limited setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Retrospective, single-center cohort study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Subjects: &lt;/strong&gt;601 children with RB (1000 affected eyes) treated at King Hussein Cancer Center (KHCC) between March 2003 and December 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Demographic characteristics, tumor classification, treatment modalities, globe salvage, metastasis, secondary malignancies, and survival outcomes were reviewed. Overall survival was estimated using the Kaplan-Meier method.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;Globe salvage rate, rates of metastasis and secondary malignancy, and 5-year overall survival.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 601 children, 314 (52%) were male, 399 (66%) had bilateral disease, and 346 (58%) were non-Jordanian, referred from 15 countries. Of 1000 affected eyes, 120 (12%) were enucleated before referral; among the remaining eyes, 7 (0.7%) had extraocular disease, and by International Classification, 52 (5.2%) were Group A, 134 (13%) Group B, 204 (20%) Group C, 391 (39%) Group D, and 92 (9.2%) Group E. Of 880 eyes treated at KHCC, primary enucleation was performed in 157 (18%), and conservative eye-salvage therapy was attempted in 723 (82%). Among the 723 eyes that underwent eye-salvaging treatment, systemic chemotherapy was administered in 713 (99%), transpupillary thermo therapy (TTT) in all 723 (100%), cryotherapy in 248 (34%), intra-arterial chemotherapy in 34 (4.7%; 11 primary and 23 secondary), intravitreal chemotherapy in 43 (5.9%), subtenon chemotherapy in 24 (3.3%), and iodine-125 plaque brachytherapy in 23 (3.2%). Ten Group A eyes in 10 patients were treated with TTT and/or cryotherapy alone without systemic chemotherapy. Overall eye salvage rate was 61% (538/880); among conservatively treated eyes, salvage rate was 74.4% (538/723), ranging from 98% (Group A) to 17% (Group E). At median follow-up of 120 months, metastasis occurred in 26 patients (4.3%) and secondary malignancy in 7 (1.2%). Estimated 5-year overall survival was 96% (95% CI, 94%-98%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A centralized multidisciplinary RB program integrating telemedicine, international collaboration, and advanced globe-salvage therapies achieved survival and eye-preservation outcomes comparable to high-income settings despite resource constraints. Over two decades, KHCC evolved into a major regional referral center, offering a scalable model for reducing glob","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Cui et al.: Current indications and outcomes of penetrating keratoplasty in the United States: an IRIS® Registry Study (Ophthalmology. 2026;133:709-719).","authors":"Dalia Abdulhussein","doi":"10.1016/j.ophtha.2026.08.021","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.08.021","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and Ethnic Disparities in Retinal Care Access and Experience.","authors":"Ahmed B Sallam, Muhammad Z Chauhan, Ahmed F Shakarchi, Carina T Sanvicente, Paul H Phillips","doi":"10.1016/j.ophtha.2026.08.034","DOIUrl":"10.1016/j.ophtha.2026.08.034","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"REPLY.","authors":"David Cui, Priya M Mathews, Esen K Akpek","doi":"10.1016/j.ophtha.2026.08.022","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.08.022","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}