Ophthalmologica最新文献

{"title":"The Royal College of Ophthalmologists National Ophthalmology Database Age-related Macular Degeneration (AMD) Audit, Report 2: Baseline characteristics, the care pathway and 12-month visual acuity and safety outcomes for 54,882 eyes starting treatment for neovascular AMD.","authors":"Marta H Gruszka-Goh, Paul H J Donachie, Ramandeep Romi Chhabra, Martin McKibbin","doi":"10.1159/000552289","DOIUrl":"https://doi.org/10.1159/000552289","url":null,"abstract":"<p><strong>Aims: </strong>To report aggregate data from the United Kingdom AMD (age-related macular degeneration) Audit, focussing on baseline characteristics, treatment and one year acuity and safety outcomes for eyes starting treatment for neovascular AMD between April 2021 and March 2023.</p><p><strong>Methods: </strong>Anonymised demographic and clinical data, collected as part of routine clinical care, were extracted from electronic medical records at participating centres providing NHS-funded treatment. Analyses were restricted to eyes with baseline visual acuity recorded at treatment initiation.</p><p><strong>Results: </strong>Analysis included 54,882 eyes of 48,371 patients from 78 participating treatment centres. Just over 60% were female and the median age at the start of treatment was 79.9 years for first treated eyes and 82.2 years for second treated eyes. Median baseline acuity was 60 ETDRS letters (interquartile range (IQR)= 44-70) and 28.1% of eyes had \"good\" acuity, defined as ≥ 70 ETDRS letters. The initial three injections, during the loading phase of monthly treatment, were given within 10 weeks in 64% of eyes and the median number of injections in the first 12 months was 6 (IQR 4-8). The median interval between injections at the end of the first year of treatment was 8 weeks (IQR 6-12 weeks). Trained non-medical healthcare professionals administered at least 72% of injections. Median acuity after 12 months was 65 ETDRS letters (IQR 48-75) and 43.1% had \"good\" visual acuity. The incidence of intra-ocular inflammation and presumed infectious endophthalmitis after each injection were 0.03% (1 in 3,176) and 0.014% (1 in 7,013) respectively. There was no difference in the incidence of either complication by profession of the injector.</p><p><strong>Conclusions: </strong>Aggregate data from the UK AMD Audit provides real-world evidence and a benchmark against which other countries and centres can compare local performance and outcomes. Almost 91% of eyes retained stable acuity and avoided moderate visual loss after 12 months of treatment. The best acuity outcomes were obtained in younger patients and in eyes treated second, with good baseline acuity, prompt completion of the loading phase of treatment and receiving more injections during the first 12 months of treatment.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-16"},"PeriodicalIF":1.9,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777927","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":"Rhegmatogenous retinal detachment associated with giant retinal tears: the effect of tamponade choice on outcome.","authors":"Muhammad Raza Cheema, Alexander Mehta, Jonathan Smith, David Yorston, David H Steel","doi":"10.1159/000552158","DOIUrl":"https://doi.org/10.1159/000552158","url":null,"abstract":"<p><strong>Introduction: </strong>Rhegmatogenous retinal detachment (RRD) associated with giant retinal tears (GRTs) are treated with vitrectomy but choice of intraocular tamponade is difficult, and practice varies amongst vitreoretinal surgeons.We sought to investigate the variables that determine choice of tamponade and how these may affect anatomical and visual outcomes.</p><p><strong>Method: </strong>Cohort study of routinely collected data from the European Society of Retina Specialists and British and Eire Association of Vitreoretinal Surgeons vitreoretinal surgery outcomes database between 2011 and 2024.Consecutive eyes with GRT and primary RRD surgery that had vitrectomy, and either gas or silicone oil (SO),were included. Revision surgery or secondary causes of GRT including trauma and inflammation were excluded.The type of tamponade used was analysed by a range of baseline variables including macular status,GRT extent and the lowest GRT extent.Multivariable logistic and linear regression were used to investigate the association between baseline variables and surgical technique,including tamponade choice,on primary anatomical success and postoperative visual acuity (VA).</p><p><strong>Results: </strong>215 eyes with GRT associated RRD were analysed.The mean age was 53 years,80% were male,7% had PVR Grade C.58% of the cases were macula on.Overall,50% of the eyes received SO tamponade and 50% gas.Silicone oil was used in more of the macula off cases and in eyes with larger GRTs.Overall,187 of the 215 (87%) eyes achieved primary anatomical success,with 88% of gas tamponade cases achieving primary success versus 86% of the oil cases.Data on visual outcomes were available on 196 eyes of the 215 eyes.Overall, 57% of these eyes achieved 0.3 logMAR postoperative VA or better,with higher percentages in the gas compared to the oil group (78% versus 36%).Multivariable analysis found that tamponade type was not associated with anatomical outcome.The only factor associated with a reduced anatomical success rate was PVR C (Odds Ratio 0.29(95% confidence interval (CI) 0.09-0.90) p=0.03) Multivariable analysis found that postoperative VA was significantly better with gas compared to SO with oil.Overall, the odds of achieving a VA of 0.3 logMAR or better were at least 2 times higher with gas as compared to oil (Odds ratio 4.65 (95% CI: 2.41, 8.99), p<0.001),rising to at least 5 times higher in the subgroup of patients with a VA of 0.3 logMAR or better at baseline, (OR 17.56 (95% CI 5.15, 59.89), p<0.001).</p><p><strong>Conclusion: </strong>Our results show that gas tamponade has a similar anatomical success rate to SO,but better visual outcomes in the repair of GRT associated RRD.Further studies are needed to confirm these findings and inform tamponade choice.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-20"},"PeriodicalIF":1.9,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777938","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":"Towards a Customized Vitreous Substitute: Swelling Behavior, Enzymatic Degradation, and Cellular Adhesion of a Hyaluronic Acid-Based Hydrogel.","authors":"Michelle Mueller, Dalya Yapar, Katja Lemmer, Rudolph Tobias Linn, Peter Szurman","doi":"10.1159/000551941","DOIUrl":"https://doi.org/10.1159/000551941","url":null,"abstract":"<p><strong>Purpose: </strong>Hyaluronic acid (HA)-based hydrogels are promising vitreous substitutes, but clinical translation requires more than biocompatibility alone. Key determinants such as intraocular swelling, enzymatic stability, and cellular interactions must be precisely controlled. This study investigated strategies to further refine an advanced HA-hydrogel towards these requirements.</p><p><strong>Methods: </strong>UV-crosslinked HA hydrogels were tested as chunks and injectable extrudates under varying osmolarities. Swelling behavior was analyzed in physiological media, including a dehydration-rehydration protocol. Enzymatic degradation assays with hyaluronidase, trypsin, and collagenase were performed, and fibroblast adhesion/proliferation was evaluated in the context of proliferative vitreoretinopathy (PVR).</p><p><strong>Results: </strong>Swelling was formulation- and format-dependent, with pre-dehydrated extrudates reaching up to 1.8-fold baseline weight. Only hyaluronidase induced degradation, while proteases had no effect. Fibroblasts showed reduced proliferation on the hydrogel surface.</p><p><strong>Conclusion: </strong>Systematic tuning of swelling, enzymatic stability, and antifibrotic properties advances HA-hydrogels towards clinical application as customizable vitreous substitutes.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-20"},"PeriodicalIF":1.9,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729633","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":"Visual and Microperimetry Outcomes of an Extended Macular Vision Intraocular Lens in Macular Atrophy.","authors":"Martin Bedersdorfer, Gregor von Ehrlich-Treuenstätt, Tristan Früh, Karl T Boden, Peter Szurman, Boris V Stanzel","doi":"10.1159/000552124","DOIUrl":"https://doi.org/10.1159/000552124","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate visual acuity and microperimetry correlated with anatomical changes in eyes with macular diseases implanted with the EyeMax Mono intraocular lens (IOL) (SharpView Ophthalmology).</p><p><strong>Methods: </strong>A single-center retrospective, real-world case series set in Knappschaft Eye Hospital, Sulzbach, Germany. Patients with macular disease who underwent EyeMax Mono IOL implantation were included. The outcome measures were corrected distance visual acuity (CDVA) and microperimetry indices: fixation stability and bivariate contour ellipse areas (BCEAs) at 63% and 95%. The geographic atrophy (GA) monitor (RetInSight) was used to analyze changes in retinal integrity.</p><p><strong>Results: </strong>Twenty-one eyes (11 patients; mean age 72.8±8.3 years, mean follow-up 7.4±4.0 months) were included. Preoperative GA measured 4.7±4.0 mm2 (n=14) and EZ loss on SD-OCT was 2433.1±1009.5 µm (n=17). The CDVA improved by 0.2 logMAR (p=0.007, n=21), with 12 eyes gaining ≥1 line and seven eyes gaining ≥3 lines. Fixation stability improved in two eyes, stabilized in nine eyes, and worsened in four eyes. The changes in BCEA were not statistically significant. Higher preoperative BCEA correlated with greater postoperative improvement (p<0.001). In the foveal fixation group (n=4), 75% and 50% of patients showed improved BCEA and CDVA, respectively. In extrafoveal fixation (n=11), BCEA improved in 50% of patients, while 64% showed CDVA improvement. The GA monitor showed worsening in 9/15 eyes, and 4 eyes showed worsening on microperimetry without a CDVA decline. Anatomical changes stabilized in six eyes; of these, two exhibited a decline in microperimetry without a CDVA decline.</p><p><strong>Conclusions: </strong>EyeMax Mono IOL improved CDVA, although no significant changes were observed in the microperimetry indices. Better microperimetry outcomes were observed in extrafoveal fixation cases. While the optical design of the IOL likely contributes to visual improvement, the small sample size limited the statistical power to detect significant microperimetry changes.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-15"},"PeriodicalIF":1.9,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729567","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":"Early retinal changes detected using optical coherence tomography angiography in youth with type 1 diabetes mellitus: A case-control study.","authors":"I-Hsin Ma, Wei-Lun Huang, Yao-Lin Liu, Yi-Ching Tung, Tzu-Hsun Tsai","doi":"10.1159/000552020","DOIUrl":"https://doi.org/10.1159/000552020","url":null,"abstract":"<p><strong>Background: </strong>Despite contemporary management, the incidence of diabetic retinopathy in adolescents during the first 2-5 years of T1DM remains unchanged, underscoring the need to better understand early retinal changes. In this study, we investigated early retinal changes in children with T1DM using optical coherence tomography angiography (OCTA). Incorporating a literature review of retinal changes in other age groups, we propose a model sequence of retinal changes in patients with T1DM.</p><p><strong>Methods: </strong>In this prospective case-control study, conducted at National Taiwan University Hospital (NTUH) from 2021 to 2023, we prospectively recruited children with T1DM from a paediatric endocrinology clinic and control children undergoing routine eye examinations at the Department of Ophthalmology. All patients and controls underwent comprehensive ophthalmological examinations and OCTA.</p><p><strong>Results: </strong>In the T1DM group, the average age at diagnosis was 7.39 ± 4.29 years, average diabetes duration was 5.0 ± 3.19 years, and average glycosylated haemoglobin level was 7.41 ± 0.92%. In the control group, the mean age was10.8 ± 4.31 years, ranging from 5 to 20 years old, and that of DM group was 12.27 ± 4.32 years (p=0.08). The T1DM group showed significant decreases in macular vessel density, particularly in the superficial and deep vascular plexuses. Full retinal thickness was greater in the perifoveal annulus in the T1DM group. Prepubertal onset of T1DM negatively impacted the superficial capillary plexus in both the parafoveal and perifoveal areas. Other DM factors did not significantly correlate with vascular parameters.</p><p><strong>Conclusions: </strong>Using OCTA, we detected early, clinically inapparent microvascular reductions in vessel density in children with T1DM, while retinal layer thickness remained preserved. These findings, along with previous literature, infer that microvascular alterations detectable by OCTA, structural changes on OCT may occur sequentially and prior to clinically visible structural changes.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-17"},"PeriodicalIF":1.9,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691342","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":"Densiron 68 Tamponade Duration and Redetachment Risk after Removal in Inferior PVR-associated Retinal Detachment.","authors":"Adriano Carnevali, Domenico Chisari, Alessandra Mancini, Massimiliano Borselli, Giovanni Scalia, Giovanna Carnovale Scalzo, Andrea Lucisano, Vincenzo Scorcia","doi":"10.1159/000551398","DOIUrl":"https://doi.org/10.1159/000551398","url":null,"abstract":"<p><strong>Introduction: </strong>Inferior retinal detachment (I-RD) complicated by proliferative vitreoretinopathy (PVR) is challenging to treat and prone to recurrence (RDR). Heavy silicone oil (HSO) tamponades such as Densiron 68 have improved inferior tamponade and are widely used in this setting. It was evaluated whether prolonged Densiron-68 tamponade (≥3 months) protects against RDR after oil removal, overall and in patients with previous failed retinal detachment (RD) surgery.</p><p><strong>Methods: </strong>We retrospectively reviewed 112 consecutive eyes with rhegmatogenous I-RD and grade-C PVR treated with PPV and Densiron 68. Mean follow-up after oil removal was ~12 months. Multivariate logistic regression was performed including laterality, sex, age, tamponade duration, previous failed RD surgery, previous SO tamponade, lens status, and 360° laser retinopexy. Patients were then stratified by history of failed RD surgery (History-/History+) and by tamponade duration (Short <3 months vs Long ≥3 months).</p><p><strong>Results: </strong>After Densiron-68 removal, 24 eyes (29.3%) developed RDR. Anatomical success was 63.0% with one operation and no tamponade, 82.6% after additional procedures, and 92.4% including eyes stable with silicone oil in situ. In multivariate analysis, no covariate was significantly associated with RDR; prolonged tamponade was not protective overall (OR 1.02; p=0.867). Previous failed RD surgery showed the strongest association with higher recurrence risk (OR 1.15; p=0.070). Stratified analysis revealed that eyes with previous failed RD surgery had significantly higher odds of RDR (OR 4.44; p=0.0028). Within this group, prolonged tamponade was associated with lower recurrence compared with short tamponade (OR 3.96; p=0.025). In eyes without prior surgery, tamponade duration had no effect (p=0.979). Most recurrences (84,85%) occurred within three months from surgery.</p><p><strong>Conclusion: </strong>Prolonged Densiron-68 tamponade did not reduce RDR risk in the overall cohort but conferred protection in eyes with previous failed RD surgery. Extending tamponade may therefore be justified in specific high-risk group of patients, while routine prolongation in lower-risk cases appears unnecessary. Prospective validation is needed to refine timing of HSO removal and optimize outcomes.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-21"},"PeriodicalIF":1.9,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691402","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":"Intravitreal fluocinolone acetonide implant for diabetic macular edema - 2-year results from IDEAL, a prospective German observational study.","authors":"Focke Ziemssen, Hakan Kaymak, Michaela Siebert, Ramin Khoramnia","doi":"10.1159/000551863","DOIUrl":"https://doi.org/10.1159/000551863","url":null,"abstract":"<p><strong>Introduction: </strong>The prospective, observational IDEAL study evaluated the effectiveness and safety of the long-acting fluocinolone acetonide (FAc) implant in patients with chronic diabetic macular edema (DME) and examined the influence of various baseline factors on treatment success.</p><p><strong>Methods: </strong>Patients with persistent DME despite prior treatment with available therapies who received a FAc implant were included from 35 ophthalmological centers in Germany and monitored for up to 24 months. Demographic and clinical data, including disease duration, previous treatment, best-corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP) and adverse events were recorded at routine visits and analysed descriptively, also in predefined groups.</p><p><strong>Results: </strong>Overall, 214 eyes from 185 patients (57% male) with a mean (SD) age of 66.2 (9.7) years were followed up for a mean (SD) of 21.53 (6.49) months. Functional and anatomical improvements occurred rapidly within one week after FAc injection and were sustained over 24-months in these previously intensively treated eyes (72.9% laser treatment, 79.9% intravitreal therapy with dexamethasone and/or anti-VEGF inhibitors, 28.9% vitrectomy). Mean BCVA increased from 55.8 (18.4) letters at baseline to 60.9 (19.0) letters at 24 months, with comparable results across subgroups defined by baseline characteristics. Eyes with fewer than two prior dexamethasone injections showed a more pronounced CMT reduction. In a subset with early follow-up, greater CMT reduction at week 1 was strongly associated with greater CMT reduction at month 1. Mean IOP in the total cohort increased from 15.3 ± 3.3 mmHg to 17.4 ± 4.8 mmHg within 9 months and returned to 16.7 ± 5.0 by month 24. IOP-lowering was required in 35.5% of eyes (topical medication), and 4.6% underwent IOP-lowering surgery.</p><p><strong>Conclusion: </strong>The IDEAL observational study demonstrated a rapid onset of effect and reaffirmed the long-term efficacy and safety of the FAC implant in a large cohort of patients with persistent DME despite extensive prior treatment, thus underlining the high medical need of this treatment option for DME patients insufficiently responding to other therapies.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-22"},"PeriodicalIF":1.9,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691364","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":"Gas tamponade-free vitrectomy with suprachoroidal buckling for the treatment of rhegmatogenous retinal detachment. Long term results of a case series.","authors":"Shohista Saidkasimova, Jared Ching, Aadil Hussain, Timothy L Jackson","doi":"10.1159/000551698","DOIUrl":"https://doi.org/10.1159/000551698","url":null,"abstract":"<p><p>Purpose To describe the clinical results of suprachoroidal viscobuckling, without gas tamponade, for the treatment of rhegmatogenous retinal detachment.</p><p><strong>Design: </strong>Retrospective consecutive single centre case series.</p><p><strong>Participants: </strong>Nine patients with retinal detachment due to a single retinal break or few breaks within one clock hour. Methods Patients were treated with pars plana vitrectomy, trans-scleral suprachoroidal injection of sodium hyaluronate under the break to create a temporary indent, laser retinopexy and no gas tamponade, under local anaesthetic.</p><p><strong>Main outcome measures: </strong>Retinal reattachment at 12 weeks and adverse events.</p><p><strong>Results: </strong>All patients had closure of the causative break, but in one patient there was a small area of peripheral retinal detachment due to missed break. This was walled off with laser barrage and was non progressive. Eight cases had successful primary reattachment, and all had final reattachment. There was one case of raised intraocular pressure that responded to topical therapy, but no clinically significant complications.</p><p><strong>Conclusions: </strong>Vitrectomy and viscobuckle for simple retinal detachment appear to be safe and effective. This has the potential to reduce the burden of recovery and complications associated with gas tamponade and permanent buckling. Further study appears warranted.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-9"},"PeriodicalIF":1.9,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581844","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":"Three-year follow-up after fluocinolone acetonide implant injected one month after dexamethasone implant for treating diabetic macular edema: the ILUVI1MOIS Study.","authors":"Lisa Delperier, Nicolas Rousseau, Thomas Charles Victor Goronflot, Alexy Henry, Olivier Lebreton, Hélène Massé, Yann Maucourant, Valentin Pipelart, Manon Clément, Marie-Laure Le Lez, Raoul Kanav Khanna, Adam Mainguy, Michel Weber, Alexandra Poinas, Jean-Baptiste Ducloyer","doi":"10.1159/000551760","DOIUrl":"https://doi.org/10.1159/000551760","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this multicenter study was to assess the efficacy and safety of injecting a fluocinolone acetonide implant (FACi) one month after the last dexamethasone implant (DEXi) intravitreal injection (IVI) in chronic diabetic macular edema (DME) patients, as a Methods: This retrospective study evaluated a standardised care protocol implemented across five centres. Inclusion criteria were: pseudophakic, chronic DME treated with DEXi every <6 months, FACi injected one month after the last DEXi. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) and additional treatment were assessed on the day of FACi injection (M0), 1 (M1) and 3 months (M3) later and then every 3 months until month 36 (M36).</p><p><strong>Results: </strong>Thirty-seven eyes (30 patients) were included: the median age was 73 [IQR: 66, 78] years and the median DME duration was 72 [59, 84] months. The mean BCVA was 62.8 ±17.7 letters at M0 and remained stable throughout the follow-up. The cumulative incidence of additional IVI was 35.1% [95%CI: 20.2; 50.5] at M12 and 70.1% [51.3; 82.8] at M36. Among the 25 eyes with additional IVI, the median reinjection interval increased by a factor of 4.3 [2.2; 8.4]. The mean IOP was 15.8 ±4.1 mmHg at M0 and remained stable during the follow-up. The cumulative incidence of the \"IOP >30 mmHg\" event was 2.7% [0.0; 12.2] at M12 and 18.8% [7.2; 34.4] at M36. One patient underwent incisional surgery (Xen Stent implantation).</p><p><strong>Conclusion: </strong>Injecting FACi one month after the last DEXi in patients requiring DEXi IVI every <6 months allowed maintaining the BCVA while spacing out or even discontinuing IVI with limited IOP concerns.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-17"},"PeriodicalIF":1.9,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147531607","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":"Time Effect on Silicone Oil Emulsion Formed in a Model of the Eye Vitreous Chamber.","authors":"Michela Elena Pedretti, Eva Santini, Francesca Ravera, Mariantonia Ferrara, Libero Liggieri, Irene Nepita, Mario R Romano, Rodolfo Repetto","doi":"10.1159/000550198","DOIUrl":"10.1159/000550198","url":null,"abstract":"<p><strong>Introduction: </strong>Silicone oil (SO) is widely used as a long-term intraocular tamponade following pars plana vitrectomy (PPV) for complex retinal conditions. However, its emulsification is associated with serious complications, including intraocular inflammation and glaucoma. While various factors influencing this process have been explored, the role of time in SO emulsification remains unclear. This study investigates the movement time effect on SO emulsification using a physiologically realistic model, with a focus on changes in droplet size distribution and emulsion density.</p><p><strong>Methods: </strong>A 3D-printed, anatomically accurate model of the human vitreous chamber was filled with SO and an albumin-containing aqueous phase, maintained at 35°C. Experiments were conducted with varying albumin concentrations and saccadic eye movements of different amplitudes. Emulsions were sampled and analyzed after 6 h, 12 h, 24 h, and 6 days.</p><p><strong>Results: </strong>Emulsification was observed under all conditions. Over time, the number of smaller droplets increased, and emulsion density rose sharply within the first 12 h, followed by a slower progression. Higher albumin levels and larger saccadic amplitudes promoted more extensive emulsification.</p><p><strong>Conclusion: </strong>These findings identify the early postoperative period, particularly the first 12 h, as critical for SO emulsification.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474408","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}