Ophthalmologica最新文献

{"title":"Limited progression of nuclear sclerosis after lens sparing vitrectomy in proliferative diabetic retinopathy eyes: a real-world investigation with Scheimpflug lens densitometry.","authors":"Luca Mautone, Patrick Fisel, Vasyl Druchkiv, Nefeli Eleni Kounatidou, Philipp Schindler, Martin Stephan Spitzer, Christos Skevas","doi":"10.1159/000546292","DOIUrl":"https://doi.org/10.1159/000546292","url":null,"abstract":"<p><strong>Background: </strong>To objectively investigate the progression of lens nuclear sclerosis after lens spearing pars plana vitrectomy (PPV) in patients with proliferative diabetic retinopathy (PDR).</p><p><strong>Methods: </strong>Comparison of Pentacam HR® Scheimpflug imaging-based lens densitometry of eyes with PDR-associated tractive retinal detachment (Study Group) and nondiabetic eyes with rhegmatogenous retinal detachment (Control Group) after lens-sparing PPV.rp Results: Fifty-nine eyes of 55 subjects treated with gas (GT; 29 eyes in the Study and 30 in the control group; Mean follow-up: 381.41 [±309.17] days) and 42 eyes of 41 subjects treated with silicone oil tamponade (SOT; 10 eyes in the Study and 32 in the control group; mean follow-up: 326.50 [±239.59] days) were included. The prediction model for postoperative lens densitometry progression indicated that the increase in lens densitometry was lower in the study group than in the control group, regardless of the type of tamponade used. A second adjusted prediction model, including only age and baseline lens densitometry-matched eyes, further confirmed that the study group experienced a lower increase in lens densitometry in both SOT and GT cases than the control group.</p><p><strong>Conclusions: </strong>The increase in lens nuclear sclerosis is more pronounced in nondiabetic eyes than in those with PDR after lens-sparing vitrectomy. These findings support the hypothesis that ischemia in PDR may protect against the development of nuclear cataracts following PPV.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-16"},"PeriodicalIF":2.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326477","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":"Safety profile of intravitreal Dexamethasone implant to manage diabetic macular edema: A systematic review of real-world studies.","authors":"Giuseppe Querques, Michele Figus, Maddalena De Bernardo, Mario Damiano Toro, Magda Gharbiya, Valentina Gallinaro, Elena Strina, Vittorio Cacace, Massimo Nicolò","doi":"10.1159/000545987","DOIUrl":"https://doi.org/10.1159/000545987","url":null,"abstract":"<p><strong>Introduction: </strong>With increasing experience using intravitreal dexamethasone implant (DEX-i), it has become a first-line therapy in patients with diabetic macular edema (DME), due mainly to its good efficacy profile. However, this treatment is not devoid of adverse events, which are predominantly transient and should be considered when administering it.</p><p><strong>Methods: </strong>This systematic review without meta-analysis adhered to the guidelines delineated in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Systematic electronic searches were conducted in the PubMed, Medline, Embase, and Google Scholar databases to identify real-world evidence (RWE) studies assessing the safety profile of DEX-i in patients with DME, covering the period from January 1, 2014, to March 1, 2024.</p><p><strong>Results: </strong>This review included Seventy-six RWE that evaluated the safety of DEX-i. Regarding intraocular pressure (IOP)-related adverse events (AEs), these AEs were very heterogeneous and have included different definitions. The incidence of IOP-related AEs varied significantly from study to study, from 2% to almost 60%. In general, the peak IOP increase was typically observed 60 days post-DEX-i injection, followed by a decrease in the subsequent months. In most patients, these IOP-related AEs were successfully and efficiently managed with topical IOP-lowering medication, although some patients required additional treatments (i.e., laser or surgery). Regarding cataract development rates, the results were conflicting, with some studies showing rates ≥40%, %, while others reported rates of 0% or less than 5%. Additionally, current evidence showed the beneficial effects of DEX-i in eyes with DME that underwent cataract surgery. Other serious ocular AEs related to DEX-i were rare, indeed, the reported-incidence-rate of endophthalmitis ranged between 0.07%-0.3%.</p><p><strong>Conclusions: </strong>Overall, the main DEX-i-related AEs were elevation of IOP and cataract. Episodes of ocular hypertension were usually transient and successfully controlled with topical treatment. Additionally, repeated treatment with DEX-i in the same eye was not associated with IOP-related AEs, but it was with cataract-related AEs.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-24"},"PeriodicalIF":2.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286065","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":"The impact of the COVID-19 pandemic on ophthalmology conferences.","authors":"Gabriella Schmuter, Natasha Nayak Kolomeyer, Lisa M Nijm, Jeremiah Tao, Prem S Subramanian, Zaina Al-Mohtaseb, Terry Kim, Aleksandra V Rachitskaya, Janice C Law, Andrea A Tooley","doi":"10.1159/000546635","DOIUrl":"https://doi.org/10.1159/000546635","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic prompted ophthalmology conferences to transition to virtual platforms. The impact of these changes on attendance and research productivity remains underexplored.</p><p><strong>Purpose: </strong>To evaluate the effects of virtual platforms on attendance and research inclusion at ophthalmology conferences during the COVID-19 pandemic.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from five ophthalmology conference organizations conducted from 2019 to 2021. Conference meetings were categorized as in-person, virtual, or hybrid. Data included total attendance, trainee participation, and research submissions, obtained directly from each respective organization.</p><p><strong>Results: </strong>Conference meetings integrating a virtual component experienced a cumulative 7% increase in total attendance and a 28% rise in trainee participation. Research submissions rose by 31%, while research acceptances showed variability, with increases observed in some conferences during the virtual years. These trends highlight the potential for virtual platforms to enhance accessibility and engagement, particularly for trainees.</p><p><strong>Conclusion: </strong>Virtual platforms had an overall positive impact on ophthalmology conference attendance and research engagement during the COVID-19 pandemic. Continued integration of virtual components is recommended to enhance accessibility and inclusivity.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144160743","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":"Indications and outcomes of patients undergoing Immediate Sequential Bilateral Vitreoretinal Surgery (ISBVS): a case series.","authors":"Alasdair I Simpson, Anthony Gigon, Shane Whitlow, Gerard McGowan, Sree Burgula, Conor M Ramsden, Aman Chandra, Johannes Keller, Andrew Davies, Rumana Hussain, David H Steel, Shohista Saidkasimova","doi":"10.1159/000546410","DOIUrl":"10.1159/000546410","url":null,"abstract":"<p><strong>Introduction: </strong>Bilateral vision threatening vitreoretinal disease requiring urgent surgery such as proliferative diabetic retinopathy, vitreous haemorrhage and retinal detachment are not uncommon presentations. Accepted practice has been to address each eye in separate, staged procedures. However, there are specific circumstances in which operating on both eyes in the same anaesthetic sitting may be preferable. Immediate Sequential Bilateral Vitreoretinal Surgery (ISBVS) has been rarely described in the literature. We present a series of cases and discuss the indications, risks and relative merits of this approach.</p><p><strong>Methods: </strong>Multicentre retrospective case series of patients undergoing ISBVS. We circulated a proforma to surgeons across the United Kingdom to collate a series of cases of this rarely performed approach to collate indications, operative approach and post-operative results.</p><p><strong>Results: </strong>Seventeen patients (34 eyes) underwent ISBVS from 8 centres. Twenty eyes had rhematogenous retinal detachments, 12 eye had diabetic vitreous haemorrhage or tractional detachment and 2 had full thickness macular hole. Principal pathology was the same bilaterally in each case. Indications for bilateral surgery included bilateral disease requiring urgent surgical intervention, high risk general anaesthetic, anticipated difficulty with follow-up, convenience in post operative care and patient preference. Visual acuity improved in 22 eyes and worsened in 2. Post operative complications included four eyes with elevated intraocular pressure, three vitreous haemorrhages, one cystoid macular oedema and one with a macular fold. One required re-operation for non-clearing vitreous haemorrhage.</p><p><strong>Conclusions: </strong>ISBVS is a useful approach which may be underutilised, but further studies are required to validate its safety.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-13"},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094490","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":"Association between Ectopic Inner Foveal Layer on Optical Coherence Tomography and Postoperative Quantitative Metamorphopsia in Patients Undergoing Epiretinal Membrane Surgery.","authors":"Micol Alkabes, Andrea Muraca, Lamberto La Franca, Alessandro Rabiolo, Paolo Fogagnolo, Stefano Ranno, Filippo Frerio, Mattia Marchetti, Davide Wild, Valentina Gatti, Stefano De Cillà","doi":"10.1159/000546248","DOIUrl":"10.1159/000546248","url":null,"abstract":"<p><strong>Introduction: </strong>Epiretinal membrane (ERM) is a condition that can lead to visual impairment and metamorphopsia. This study aimed to examine the correlation between metamorphopsia and foveal microstructure before and after macular surgery in a cohort of patients with advanced ERM.</p><p><strong>Methods: </strong>The severity of metamorphopsia was quantified using M-CHARTS, and foveal microstructure was evaluated via two optical coherence tomography (OCT) measures: central foveal thickness and ectopic inner foveal layer (EIFL). Assessments were performed pre- and post-surgery with an average follow-up of 1 year. Correlations between morphological and functional parameters pre- and post-surgery were explored by means of regression analysis.</p><p><strong>Results: </strong>Sixty eyes of 57 patients diagnosed with advanced ERM and surgically treated were included in the study. Our findings showed a significant correlation between postoperative metamorphopsia and both pre- (R2 = 0.431) and postoperative (R2 = 0.300) EIFL thickness. Disparities were observed in metamorphopsia scores between patients with ERM stages 3 and 4, both pre- (0.46 ± 0.31 and 0.84 ± 0.32, respectively, p < 0.01) and post-surgery (0.18 ± 0.21 and 0.46 ± 0.28, respectively, p < 0.01). Postoperative EIFL thickness was the only variable significantly associated with postoperative metamorphopsia scores according to multiple regression analysis.</p><p><strong>Conclusion: </strong>EIFL thickness emerges as a critical determinant of postoperative metamorphopsia severity, underscoring its importance in predicting functional outcomes after ERM surgery. Although surgery improved metamorphopsia across stages, patients with more advanced ERM experienced less favorable outcomes, stressing the importance of a timely surgical intervention.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-10"},"PeriodicalIF":2.1,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018080","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":"Response to \"Readability of AI & Ophthalmologist Responses to Patient Surgery Queries: Comment\" by Daungsupawong and Wiwanitkit.","authors":"Sai S Kurapati, Antonio Yaghy, Derek J Barnett, Ingrid U Scott","doi":"10.1159/000546049","DOIUrl":"https://doi.org/10.1159/000546049","url":null,"abstract":"","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-4"},"PeriodicalIF":2.1,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022118","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":"The Seven Sins of Automated Diabetic Retinopathy Screening: Barriers for Clinical Implementation of Artificial Intelligence-Based Devices in National Screening Programs.","authors":"Jakob Grauslund, Andrzej Grzybowski","doi":"10.1159/000545969","DOIUrl":"10.1159/000545969","url":null,"abstract":"","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-4"},"PeriodicalIF":2.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022119","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":"Treatment Effects of Panretinal Photocoagulation or Combined Anti-Vascular Endothelial Growth Factor Therapy for Proliferative Diabetic Retinopathy on the Risks of Diabetic Macular Edema and Vitreous Hemorrhage.","authors":"Hsuan-Chieh Lin, Yong-Chen Huang, Yi-Ting Hsieh, Shu-Hui Chang","doi":"10.1159/000545941","DOIUrl":"10.1159/000545941","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated the effect of panretinal photocoagulation (PRP) or combined both anti-VEGF therapy and PRP in proliferative diabetic retinopathy (PDR) on the risk of diabetic macular edema (DME) or vitreous hemorrhage (VH) and compared functional, anatomical outcomes and additional treatments in the two groups.</p><p><strong>Methods: </strong>This retrospective analysis involves patients treated for PDR with either PRP alone or in combination with three consecutive anti-VEGF injections, followed for at least 12 months. Treatment effects and other factors associated with the risk of first DME and VH were assessed.</p><p><strong>Results: </strong>We identified 95 eyes from 69 patients (combined group: 37 eyes from 25 patients; PRP group: 58 eyes from 44 patients). At 1 year, the cumulative incidences of the first DME and VH were 8% and 19% (combined group) and 31% and 19% (PRP group), respectively. Combined treatment reduced the risk of first DME after adjusting for age, HbA1c level, PDR severity, and baseline CRT (csHR: 0.211, 95% CI: 0.064-0.700, p = 0.011). Increased DME risks correlated with poor blood sugar control (HbA1c ≥8.4%), thicker baseline CRT in non-high-risk PDR, and baseline CRT <232 μm in high-risk PDR. The risk of first VH decreased with age (csHR: 0.966, 95% CI: 0.933-0.999, p = 0.045). The combined group exhibited superior best-corrected visual acuity at the third and twelfth months. The combined group were less likely to require additional treatment within 1 year (adjusted OR: 0.254, 95% CI: 0.088-0.739, p = 0.011).</p><p><strong>Conclusion: </strong>Combining anti-VEGF agents with PRP effectively reduced the risk of DME, yielding improved visual outcomes and fewer additional treatments within 1 year.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-11"},"PeriodicalIF":2.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047154","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":"Readability of AI and Ophthalmologist Responses to Patient Surgery Queries: Comment.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1159/000545970","DOIUrl":"10.1159/000545970","url":null,"abstract":"","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-2"},"PeriodicalIF":2.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976254","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":"Impact of Anatomically Defined Retinal Zones on Ultrawide-Field Fluorescein Angiography Nonperfusion Measurements in Diabetic Retinopathy.","authors":"Mohamed Ashraf, Abdulrahman Rageh, Michael J Gilbert, Paolo S Silva","doi":"10.1159/000545754","DOIUrl":"10.1159/000545754","url":null,"abstract":"<p><strong>Introduction: </strong>The aims of the study were to determine the effect of retinal zone placement on nonperfusion index (NPI) measurements using ultrawide-field fluorescein angiography (FA) in eyes with diabetic retinopathy (DR) and assess its association with disease progression.</p><p><strong>Methods: </strong>The study analyzed retinal periphery zones based on FA findings in 18 eyes without DR to standardize anatomical boundaries. NPI measurements were then conducted on a separate set of 285 eyes with DR. Eyes were grouped by NPI levels, and Cox regression was used to examine the association between nonperfusion in the mid-peripheral and far peripheral retina and progression to proliferative diabetic retinopathy (PDR).</p><p><strong>Results: </strong>The retinal zones defined by FA (FA-defined zones) were similar in size to a standard 15-mm radius circle centered on the optic disk (14.98 ± 1.40 mm). However, when compared to circles centered on the fovea, the fovea-centered circles were displaced temporally by an average of 3.94 mm, leading to a significant overestimation of the anatomic nasal far periphery (79.10 ± 13.60 mm2 vs. 36.91 ± 10.52 mm2, p < 0.001). Among the eyes with at least 1 year of follow-up (N = 121, 42.5%), those with medium and high mid-peripheral NPI had a significantly higher risk of progression to PDR (HR, 3.44; 95% CI, 1.36-8.70; p = 0.009) when using FA-defined zones. No significant association was found when using fovea-centered zones (HR, 1.39; 95% CI, 0.56-3.46; p = 0.476).</p><p><strong>Conclusion: </strong>While the diameter of the retinal measurement zones did not differ significantly, the location of the zone center had a substantial impact on NPI measurements. Using FA-defined zones centered on the optic disk led to lower mid-peripheral and higher far peripheral NPI measurements, providing a more accurate prediction of progression to PDR compared to fovea-centered zone.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-8"},"PeriodicalIF":2.1,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034296","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}