Ophthalmologica最新文献

{"title":"Eyes on the Text: Assessing Readability of AI & Ophthalmologist Responses to Patient Surgery Queries.","authors":"Sai S Kurapati, Derek J Barnett, Antonio Yaghy, Cameron J Sabet, David N Younessi, Dang Nguyen, John C Lin, Ingrid U Scott","doi":"10.1159/000544917","DOIUrl":"https://doi.org/10.1159/000544917","url":null,"abstract":"<p><strong>Introduction: </strong>Generative artificial intelligence (AI) technologies like GPT-4 can instantaneously provide health information to patients; however, the readability of these outputs compared to ophthalmologist-written responses is unknown. This study aims to evaluate the readability of GPT-4-generated and ophthalmologist-written responses to patient queries about ophthalmic surgery.</p><p><strong>Methods: </strong>This retrospective cross-sectional study used 200 randomly selected patient questions about ophthalmic surgery extracted from the American Academy of Ophthalmology's EyeSmart platform. The questions were inputted into GPT-4, and the generated responses were recorded. Ophthalmologist-written replies to the same questions were compiled for comparison. Readability of GPT-4 and ophthalmologist responses was assessed using six validated metrics: Flesch Kincaid Reading Ease (FK-RE), Flesch Kincaid Grade Level (FK-GL), Gunning Fog Score (GFS), SMOG Index (SI), Coleman Liau Index (CLI), and Automated Readability Index (ARI). Descriptive statistics, one-way ANOVA, Shapiro-Wilk, and Levene's tests (α=0.05) were used to compare readability between the two groups.</p><p><strong>Results: </strong>GPT-4 used a higher percentage of complex words (24.42%) compared to ophthalmologists (17.76%), although mean [SD] word count per sentence was similar (18.43 [2.95] and 18.01 [6.09]). Across all metrics (FK-RE; FK-GL; GFS; SI; CLI; and ARI), GPT-4 responses were at a higher grade level (34.39 [8.51]; 13.19 [2.63]; 16.37 [2.04]; 12.18 [1.43]; 15.72 [1.40]; 12.99 [1.86]) than ophthalmologists' responses (50.61 [15.53]; 10.71 [2.99]; 14.13 [3.55]; 10.07 [2.46]; 12.64 [2.93]; 10.40 [3.61]), with both sources necessitating a 12th-grade education for comprehension. ANOVA tests showed significance (p<0.05) for all comparisons except word count (p=0.438).</p><p><strong>Conclusions: </strong>The National Institutes of Health advises health information to be written at a sixth-seventh grade level. Both GPT-4- and ophthalmologist-written answers exceeded this recommendation, with GPT-4 showing a greater gap. Information accessibility is vital when designing patient resources, particularly with the rise of AI as an educational tool.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-18"},"PeriodicalIF":2.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596909","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":"Infectious causes of retinal vasculitis: Causes, presentation, differentiation and therapy.","authors":"Ariel Schlaen, Juliana Montoya, Milagros Heredia, Sebastián Inchauspe, Emilio M Dodds","doi":"10.1159/000545044","DOIUrl":"https://doi.org/10.1159/000545044","url":null,"abstract":"<p><strong>Background: </strong>Retinal vasculitis is a common manifestation of infections affecting the posterior segment. The purpose of this review is to describe the main characteristics of infectious retinal vasculitis, with an emphasis on its associated specific clinical manifestations.</p><p><strong>Summary: </strong>Retinal vasculitis is usually associated with retinal or choroidal involvement when infectious etiology is present. It may be caused by bacterial, viral, fungal or parasitic infection. Its prevalence and the spectrum of etiologies show geographical variations. Infectious vasculitis tends to exhibit ischemic areas, arterial or venous sheathing or occlusion, while non-infectious retinal vasculitis is predominantly associated with capillary vasculitis.</p><p><strong>Key messages: </strong>Recognizing the features of infectious retinal vasculitis, along with associated ocular and systemic signs, patient habits, and origin, enables the physician to suspect the potential causative etiology of the condition, facilitating more effective management of affected patients.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-46"},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557417","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":"Surgical outcomes of vitrectomy with gas or silicone oil tamponade for giant retinal tears.","authors":"Arielle Benchimol, Paul Denys, Raphaël Lejoyeux, Sébastien Bruneau, Sophie Bonnin, Aude Couturier","doi":"10.1159/000545042","DOIUrl":"https://doi.org/10.1159/000545042","url":null,"abstract":"<p><p>Purpose To assess the long term anatomic and functional outcomes in giant retinal tear associated retinal detachment and identify factors associated with recurrence. Methods This is a retrospective monocentric study, of the patients treated for GRT-RD between 2017 and 2022 at Rothschild Foundation Hospital, Paris, France. Results A total of 65 eyes from 64 patients were analyzed with a mean follow up of 21.5 months. Mean age was 52.7 years and 89.2% of them were men. 69.3 % of eyes were phakic, mean axial length was 25.4 mm and 15 eyes had high myopia. Mean size of the giant retinal tear was 147.7 degrees. Macula was attached in 33 cases. All the patients underwent pars plana vitrectomy. Perfluorocarbon-liquids was used in almost all cases. Retinopexy was then performed. Silicone oil tamponade was used in 47 eyes and gas tamponade was used in 18 eyes (27.7%). Recurrence of RD occurred in 15 eyes. Factors associated with a recurrence of the RD were macula off detachment and presence of another retinal tear. No significant differences were made between silicone oil or gas tamponade in terms of recurrence. No significant difference was shown in postoperative outcomes between the two groups of tamponades. Discussion GRT-RD remains serious with a recurrence rate of 23% in this series. Whereas gas tamponade is less frequently used, its use showed no significant difference compared to silicone oil in terms of postoperative outcomes, and no difference in risk of recurrence of RD in this study. .</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-22"},"PeriodicalIF":2.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542915","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":"Networking of Eye Hospitals on a National Level for Promoting and Advancing Conduct of Clinical Trials.","authors":"Barbara J Wilhelm, Frank G Holz, Katrin Lorenz","doi":"10.1159/000543727","DOIUrl":"10.1159/000543727","url":null,"abstract":"<p><strong>Purpose: </strong>The complexity of clinical trials is increasing for both sponsors and study sites. This impacts planning, preparation, implementation, and conduct of all studies. The exchange of experience and cooperation helps centers to better master the various challenges facing ophthalmological study centers. This serves the efficiency of multicenter studies, including timely patient recruitment.</p><p><strong>Methods: </strong>The DOG (German Society of Ophthalmology) Clinical Study Centers Working Group (WG) was founded in 2011. Since then, regular meetings have been held including the annual during the DOG and meeting. There is also a continuous exchange in between these meetings. Symposia are regularly held at the DOG conferences together with industry and regulatory authorities. A range of courses on the conduct clinical trials has been established, and joint publications and DOG recommendations are regularly generated.</p><p><strong>Results: </strong>Since its foundation, the WG has tremendously gained visibility and popularity. Its members have increased from 40 (2011) to 80 (2024). Study-specific recommendations were produced early on, which were published by the DOG in German and English language. The topics of the publications and symposia range from study design, budget negotiations, special challenges, publication regulations, and legislation to the attractiveness of Germany as a study location. Since 2023, a patient video of the WG has been available to support and foster recruitment of study patients.</p><p><strong>Conclusion: </strong>The DOG Working Group Clinical Study Centers has become a platform for cooperation and representation of the interests of German ophthalmological study centers. It also represents an important link to industry and is engaged in a lively dialogue to promote Germany as a study location in ophthalmology. The group and its activities may serve as a model for other medical societies and countries.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-7"},"PeriodicalIF":2.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542913","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":"Recalcitrant Macular Edema after Pseudophakic Rhegmatogenous Retinal Detachment Repair: Risk Factors and Response to Intravitreal Dexamethasone Implant.","authors":"Francesco Pignatelli, Alfredo Niro, Pasquale Viggiano, Giacomo Boscia, Gianluca Besozzi, Cristiana Iaculli, Giuseppe Addabbo, Francesco Boscia, Ermete Giancipoli","doi":"10.1159/000543749","DOIUrl":"10.1159/000543749","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to evaluate risk factors for recalcitrance to topical therapy of post-surgical macular edema (PSME) after rhegmatogenous retinal detachment (RRD) repair and its response to intravitreal dexamethasone implant (DEX-I).</p><p><strong>Methods: </strong>This two-center retrospective study reviewed the charts of pseudophakic patients who had undergone vitrectomy for RRD and experienced PSME within 6 months of surgery. A regression model analyzed the relationship between the recalcitrance of PSME to topical therapy and independent variables, including clinical data, surgical steps, and OCT parameters recorded at 1 month after surgery. The best-corrected visual acuity (BCVA) and central macular thickness (CMT) of eyes with responsive and recalcitrant PSME to topical therapy, the latest treated with DEX-I, were compared over follow-up.</p><p><strong>Results: </strong>Of the 361 eyes screened, 42 (11.7%) experienced PSME. Among those, all the eyes with recalcitrant PSME (21/42) received at least one DEX-I (1.38 ± 0.49 implant). The mean follow-up was 11.9 ± 0.3 months. Disrupted retinal outer layers (p = 0.02) and hyperreflective foci (HRF) (p = 0.01) were linked to recalcitrant PSME. An increased risk for recalcitrance was observed in the presence of HRF (OR: 7.69; IC: 1.31-44.9; p = 0.02). Over follow-up, BCVA and CMT were significantly (p < 0.01) worse in implanted eyes that experienced the more significant fluctuation of CMT (189.2 ± 104.7 µm (range: 58-409 µm); p < 0.01) with a reimplant rate of 42.8%. No one of the implanted eyes experienced ocular hypertension requiring intervention or other complications.</p><p><strong>Conclusion: </strong>HRF were found to be a risk factor for recalcitrance to topical therapy of PSME. Limited response to DEX-I was observed in such cases.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-11"},"PeriodicalIF":2.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516361","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":"Optical Coherence Tomography imaging of perforating scleral vessels and dilated choroidal veins as potential image markers in myopic choroidal neovascularization using optical coherence tomography angiography.","authors":"Jorge Ruiz-Medrano, Elena Almazán-Alonso, Mariluz Puertas, Ignacio Flores-Moreno, María García-Zamora, Bachar Kudsieh, José M Ruiz-Moreno","doi":"10.1159/000544750","DOIUrl":"https://doi.org/10.1159/000544750","url":null,"abstract":"<p><strong>Introduction: </strong>To analyze the role of perforating scleral vessel (PSV) and dilated choroidal veins (DCV) underneath macular myopic choroidal neovascularization (mCNV).</p><p><strong>Methods: </strong>This retrospective case-control study analyzed 78 eyes from 78 highly myopic patients defined by an axial length (AL) of ≥26 mm, assessed by optical coherence tomography (OCT) and OCT-angiography (OCTA) imaging. Patients with clinical diagnosis of mCNV and good-quality OCTA images were selected. Swept source (SS)-OCT and SS-OCTA images (TRITON; Topcon Corporation, Tokyo, Japan) were reviewed to detect image markers in the mCNV area. Highly myopic eyes without mCNV, matched by age and AL, were used as control group. The presence of PSV and DCV were recorded. Myopic maculopathy was graded using the ATN (Atrophic, Traction and Neovacularization) classification.</p><p><strong>Results: </strong>78 eyes from 78 patients (39 with mCNV and 39 without mCNV) were included, out of the total 775 eyes screened. Fifty-nine (75.6%) of them were women. The mean ATN grading of myopic-maculopathy was compared between eyes with mCNV and those without mCNV: Atrophy scores were 2.71±0.97 vs. 2.30±0.89, respectively (p=0.04); Traction scores were 0.64±0.66 vs. 0.84±0.98, respectively (p=0.54); and Neovascularization scores were 2.00±0.00 vs. 0.33±0.73, respectively (p<0.001). The presence of OCT-imaging markers did not significantly differ between groups; i.e., PSV was found in 34/39 vs. 32/39 (p=0.53) eyes and DCV was found in 11/39 vs. 7/39 eyes, mCNV vs. control group respectively (p=0.28).</p><p><strong>Conclusions: </strong>PSV and DCV are image markers present in a high number of highly myopic eyes, which are not specific to mCNV.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-18"},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449597","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":"Anti-Vascular Endothelial Growth Factor Treatment Outcomes in Macular Telangiectasia: A Systematic Review.","authors":"Aswen Sriranganathan, Justin Grad, Andrew Mihalache, Marko M Popovic, Peter J Kertes, Radha Kohly, Rajeev H Muni","doi":"10.1159/000543771","DOIUrl":"10.1159/000543771","url":null,"abstract":"<p><strong>Introduction: </strong>Macular telangiectasia (MacTel) is a rare retinal condition that can cause vision loss, and anti-vascular endothelial growth factor (anti-VEGF) agents have emerged as a potential treatment. This study aimed to evaluate the clinical outcomes of anti-VEGF therapy in patients with MacTel.</p><p><strong>Methods: </strong>A systematic literature search on Ovid MEDLINE, Embase, and Cochrane Library was performed from inception to June 2024 for comparative studies on anti-VEGF agents in MacTel. The primary outcome was the change in best-corrected visual acuity (BCVA). Secondary outcomes were central macular thickness (CMT), central choroidal thickness (CCT), and fluorescein angiography (FA) leakage.</p><p><strong>Results: </strong>Ten studies on 377 eyes of 239 patients followed up over 23.4 ± 8.3 months were included. Mean (SD) BCVA changed from 0.42 (0.39) to 0.35 (0.18) over 23.4 (8.3) months of follow-up in non-proliferative MacTel. Mean BCVA changed from 0.66 (0.43) to 0.52 (0.34) at final follow-up in eyes with choroidal neovascularization (CNV). Five studies reported improved visual acuity, one showed improved FA leakage without visual acuity benefit, and four found no functional benefit. In non-proliferative MacTel, four studies showed no functional improvement, two reported significant functional and morphological improvements, and one suggested potential benefits in improving BCVA. In proliferative MacTel, two studies demonstrated improvement in both anatomical and functional outcomes, while one indicated that anti-VEGF treatment might produce improved results. In non-proliferative MacTel, mean CMT changed from 201 (32) µm to 199 (29) µm. CMT in patients with CNV decreased from an initial value of 328.23 (161.16) µm to 267.44 (118.56) µm at the final follow-up. CCT in proliferative MacTel eyes decreased from 272.37 (52.65) µm and 247.40 (48.80) µm on anti-VEGF therapy. Overall, FA leakage outcomes were improved on ranibizumab therapy. No study documented any significant adverse effects with treatment.</p><p><strong>Conclusion: </strong>Anti-VEGF agents may be associated with favorable anatomical and functional outcomes, particularly in proliferative MacTel; however, future large-scale clinical trials are warranted.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-14"},"PeriodicalIF":2.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440514","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 Spectrum of Functional, Structural, and Patient-Reported Outcomes in Intermediate Age-Related Macular Degeneration: A MACUSTAR Study Report.","authors":"Jan Henrik Terheyden, Frank G Holz, Charlotte Behning, Hannah M P Dunbar, Steffen Schmitz-Valckenberg, Adnan Tufail, Matthias Schmid, David P Crabb, Marlene Saßmannshausen, Alison Binns, Carel B Hoyng, Nadia Zakaria, Stephen Poor, Klaus-Peter Moll, Deborah Cosette, Cecília Martinho, Joana Batuca, José Cunha-Vaz, Ulrich F O Luhmann, Sergio Leal, Robert P Finger","doi":"10.1159/000543231","DOIUrl":"10.1159/000543231","url":null,"abstract":"<p><strong>Introduction: </strong>There is an unmet medical need for therapies in intermediate age-related macular degeneration (iAMD). The prospective European multicenter cohort study MACUSTAR validates structural, functional, and patient-reported iAMD endpoints for use in future trials. The multiplicity of assessments allows characterizing iAMD in more dimensions than previously available. We describe the heterogeneity of assessments in the iAMD baseline cohort of the MACUSTAR study.</p><p><strong>Methods: </strong>A wide range of assessments was administered across 20 European study sites in accordance with established guidelines. These assessments encompassed multiple structural evaluations, such as color fundus photography, fundus autofluorescence, and optical coherence tomography. Additionally, functional tests were conducted, including assessments of best-corrected and low-luminance visual acuity (VA), Moorfields acuity, contrast sensitivity, reading speed, mesopic and scotopic microperimetry, and dark adaptometry. Moreover, patient-reported outcome assessments, specifically the Vision Impairment in Low Luminance questionnaire, were also incorporated into the evaluation process. Associations between variables were investigated using Phi coefficients, Pearson correlation coefficients and age-corrected regression models.</p><p><strong>Results: </strong>Five-hundred eighty-five individuals with iAMD (66% women; mean (standard deviation) age: 72 ± 7 years) were included in the MACUSTAR study. Forty-nine percent had pigmentary abnormalities, 27% had reticular pseudodrusen; 10% and 9% had incomplete and complete retinal pigment epithelium and outer retinal atrophy at baseline, respectively. Mean best-corrected VA, low-luminance VA and mesopic average threshold on microperimetry at baseline were 0.03 ± 0.11 logMAR, 0.24 ± 0.16 logMAR, and 23.3 ± 3.7 dB. Mean Vision Impairment in Low Luminance (VILL) subscale scores at baseline were 2 ± 2 to 2 ± 3 logits. Phi coefficients between structural assessments ranged between 0.17 and 0.22 (median 0.21); correlation coefficients between function tests ranged between 0.07 and 0.69 (median 0.34) and between VILL scores ranged between 0.21 and 0.68 (median 0.23).</p><p><strong>Conclusion: </strong>The findings from this broad and comprehensive spectrum of assessments of structure, function, and patient-reported outcomes in iAMD suggest that the disease spectrum is diverse and heterogeneous and that further efforts are necessary to fully understand and characterize iAMD in all its complexities. A further in-depth characterization will enable novel enrichment strategies for clinical trials in iAMD.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-11"},"PeriodicalIF":2.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123309","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":"Clinical Outcomes of the PAUL® Glaucoma Implant for Secondary Glaucoma after Vitreoretinal Surgery.","authors":"Constance Weber, Pascal Schipper, Wolfgang Walz, Kristin Raming, Sandrine Künzel, Frank G Holz, Raffael Liegl, Karl Mercieca","doi":"10.1159/000543748","DOIUrl":"10.1159/000543748","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to report clinical outcomes from a single-center cohort undergoing PAUL® glaucoma implant (PGI) surgery for secondary glaucoma after vitreoretinal surgery (VR).</p><p><strong>Methods: </strong>Retrospective review of patients undergoing PGI surgery at the University Eye Hospital Bonn, Germany, from April/2021 to May/2023 was conducted.</p><p><strong>Results: </strong>Thirty-three eyes of 33 patients were included. Mean number of preoperative VR surgeries was 2 (1-4), the majority following retinal detachment (23 eyes, 69.7%). 18 eyes had previous silicone oil tamponade (54.4%). Complete (without drops) and qualified (with or without drops) success rates (95% CI) after 1 year were 69.7% (54.5-84.8) and 97% (90.9-100) for criterion A (IOP ≤21 mm Hg), 66.7% (51.5-81.8) and 87.9% (51.5-81.8) for criterion B (IOP ≤18 mm Hg), 54.5% (39.4-72.7) and 72.7% (54.5-87.9%) for criterion C (IOP ≤15 mm Hg), and 24.2% (9.1-39.4) and 30.3% (15.2-48.4) for criterion D (IOP ≤12 mm Hg), respectively. Mean IOP decreased from 25.64 mm Hg (14-49 mm Hg) to 13.59 mm Hg (8-20 mm Hg) (reduction of 41.1%) after 12 months with a reduction of IOP-lowering agents from 3.21 (1-5) to 0.38 (0-3). Seven eyes (21.2%) developed postoperative complications, most of which eventually resolved. Two eyes had a tube flushing because of high postoperative IOP with silicone oil obstruction. Postoperative non-glaucoma-related procedures were performed in 10 eyes (24.4%). None of these led to high IOP or further complications in the postoperative phase.</p><p><strong>Conclusion: </strong>PGI surgery is an effective procedure for reducing both IOP and topical therapy in patients with uncontrolled secondary glaucoma following vitreoretinal surgery. Non-glaucoma-related procedures can be safely performed after PGI implantation with good IOP control.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-12"},"PeriodicalIF":2.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047448","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":"Peripapillary and Macular Optical Coherence Tomography Angiography Predictors of Visual Improvement in Patients Treated with Vitrectomy for Idiopathic Epiretinal Membrane.","authors":"Elvia Mastrogiuseppe, Giacomo Visioli, Giuseppe Maria Albanese, Ludovico Iannetti, Enrico Romano, Antonio Guillot, Luca Lucchino, Magda Gharbiya","doi":"10.1159/000542214","DOIUrl":"10.1159/000542214","url":null,"abstract":"<p><strong>Introduction: </strong>We investigated the changes of peripapillary and macular microvasculature in idiopathic macular epiretinal membrane (iERM) eyes before and after pars plana vitrectomy (PPV), aiming to identify potential optical coherence tomography angiography (OCTA) predictors of visual acuity improvement.</p><p><strong>Methods: </strong>Fifty-seven eyes diagnosed with iERM were enrolled and underwent PPV with ERM and internal limiting membrane (ILM) peeling. Data were collected before surgery and during the 12-month postoperative period. OCTA analysis focused on radial peripapillary capillary (RPC) vessel density (VD), superficial and deep capillary plexus (SCP and DCP, respectively). Functional and OCT structural outcomes, including best-corrected visual acuity (BCVA) and macular thickness, were also recorded.</p><p><strong>Results: </strong>Multivariate linear regression analysis revealed that higher preoperative RPC VD, lower SCP VD, and lower BCVA were predictors of postoperative BCVA improvement (p < 0.001, p = 0.047, and p < 0.001, respectively). Throughout the follow-up period, there was an observed increase in intradisc RPC VD, whole-disc VD, and parafoveal DCP VD (all p < 0.001). BCVA and central macular thickness demonstrated significant improvement (p < 0.001) within the first month following vitrectomy, which then stabilized from the third month onward.</p><p><strong>Conclusions: </strong>Preoperative microvascular measurements in iERM patients can forecast postoperative BCVA. OCTA findings reveal that both increased RPC density and reduced SCP density at baseline could serve as predictors of better visual outcomes after surgery. Enhanced RPC density may reflect a healthier optic nerve with greater potential for visual recovery, while a less dense SCP could indicate less iERM contraction, both contributing to more favorable postoperative visual results.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"54-66"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716757","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}