Ophthalmologica最新文献

{"title":"Peripapillary and Macular OCTA 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":"https://doi.org/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 twelve-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 (CMT) demonstrated significant improvement (p<0.001) within the first month following vitrectomy, which then stabilized from the third month onwards.</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":"1-23"},"PeriodicalIF":2.1,"publicationDate":"2024-11-25","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}

{"title":"Anatomical, functional, and prognostic results of vitrectomy in epiretinal membranes secondary to retinal vein occlusions.","authors":"Yoo-Ri Chung, Adam Mainguy, Irini Chatziralli, Anissa Smaoui, Bahram Bodaghi, Michel Paques, Ramin Tadayoni, Maria Vittoria Cicinelli, Sarah Touhami","doi":"10.1159/000542770","DOIUrl":"https://doi.org/10.1159/000542770","url":null,"abstract":"<p><strong>Introduction: </strong>We investigated the anatomical and functional results of vitrectomy associated with the peeling of secondary epiretinal membranes (ERM) in patients with retinal vein occlusion (RVO) and determined the prognostic factors of surgical outcomes.</p><p><strong>Methods: </strong>This retrospective, multicenter, observational study included 50 patients with RVO who underwent vitrectomy with ERM removal between July 2012 and February 2021. Visual acuity (VA) and central macular thickness (CMT) were investigated up to three years. Univariate analysis identified the predictive factors associated with functional and anatomical outcomes.</p><p><strong>Results: </strong>Fifty eyes from 50 patients (62% with central RVO) were included. The mean VA of 0.9 ± 0.7 logMAR preoperatively improved to 0.5 ± 0.5 logMAR after 24 months (p=0.01). Anatomically, the mean preoperative CMT was 501 ± 168 μm, decreasing to 348 ± 108 μm at month 24 (p=0.008). By 36 months, VA had improved or stabilized in 90% of the eyes, whereas CMT had reduced by at least 20% from baseline in 80% of the eyes. A lower number of intravitreal injections (IVI) was required after vitrectomy. Worse preoperative VA, absence of preoperative pan-retinal photocoagulation, and postoperative use of adjunctive IVI were associated with VA recovery. Higher baseline CMT and the use of preoperative dexamethasone injections were associated with an improvement in CMT.</p><p><strong>Conclusion: </strong>Vitrectomy for ERM secondary to RVO was effective in improving VA and recovering CMT for up to 3 years and reduced the number of IVIs.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-20"},"PeriodicalIF":2.1,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716754","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 Changes in Ocular Biomarkers in Patients with Vogt-Koyanagi-Harada Disease After Pulse Steroid Therapy.","authors":"Tetsuya Muto, Shunsuke Kawaguchi, Shoichiro Kusuda, Keita Misu, Masaaki Sakamoto, Shigeki Machida, Shinichiro Imaizumi, Tetsuju Sekiryu","doi":"10.1159/000542724","DOIUrl":"https://doi.org/10.1159/000542724","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to identify when ocular biomarker changes occur within 1 month and which ocular biomarkers correlate with best-corrected visual acuity (BCVA) at months 1 and 6.</p><p><strong>Methods: </strong>We evaluated 33 patients with Vogt-Koyanagi-Harada (VKH) disease who received pulse steroid therapy. The central anterior-chamber depth (ACD) and peripheral ACD were evaluated. We also analyzed axial length (AL), BCVA, spherical equivalent (SE), choroidal foveal thickness (CFT), and retinal foveal thickness (RFT). Patients were divided into two groups based on BCVA at months 1 and 6, and correlations with ocular biomarkers were investigated.</p><p><strong>Results: </strong>RFT and CFT were significantly reduced as early as day 1 (P < 0.001). AL gradually increased, with a significant increase observed at month 1 (P < 0.05). BCVA improved significantly along with SE reduction, with significant changes observed at week 1 (P < 0.05 and P < 0.01, respectively). Anterior chamber biomarkers gradually increased, with significant increases at week 2 for central ACD (P < 0.05) and at month 1 for peripheral ACD (P < 0.05). The better BCVA group at month 1 significantly correlated with thicker RFT (P < 0.01), better BCVA (P < 0.05), shallower central ACD (P < 0.05), and shallower peripheral ACD (P < 0.05) at the initial visit. No correlation was observed between the better BCVA group at month 6 and ocular biomarkers at the initial visit.</p><p><strong>Conclusion: </strong>Although RFT and CFT changes are the earliest indicators, changes in the anterior-chamber structure appeared to be slow and delayed. Thicker RFT, better BCVA, shallower central ACD, and shallower peripheral ACD at the initial visit correlated with better BCVA at 1 month.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-19"},"PeriodicalIF":2.1,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687995","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":"Dealing with the Verteporfin Shortage: Treatment Options and Outcomes in Patients with Chronic and Non-Resolving Central Serous Chorioretinopathy.","authors":"Femke M van den Tillaart, Franca Hartgers, Carel B Hoyng, Suzanne Yzer","doi":"10.1159/000542224","DOIUrl":"10.1159/000542224","url":null,"abstract":"<p><strong>Introduction: </strong>Half-dose photodynamic therapy (HD-PDT) with verteporfin is the mainstay treatment in central serous chorioretinopathy (CSC). Since 2021, there is a worldwide shortage of verteporfin. This called for adjustments of daily practice. Here, we provide a comprehensive evaluation of the adapted treatment methods and outcomes in patients with non-resolving and chronic CSC.</p><p><strong>Methods: </strong>In this retrospective cohort study, we compared patients referred in the year before the verteporfin shortage (group 1), with patients referred in the first year of verteporfin shortage (group 2). Treatment strategies, subretinal fluid (SRF) resolution, and visual acuity (VA) were evaluated during a follow-up period of at least 4 months.</p><p><strong>Results: </strong>Eighty-five eyes of 79 patients were analyzed, 36 eyes in group 1 and 49 in group 2. The treatment strategy at the first visit shifted from HD-PDT as the most performed treatment in group 1 to a more patient-tailored approach in group 2, with a wait-and-see policy in most cases. During follow-up, HD-PDT was performed significantly less in group 2 (89% vs. 45%; p < 0.001). At a mean follow-up time of 6.2 months, SRF resolved in 61% of the eyes in group 1 and in 55% in group 2 (p = 0.821). No difference in VA was observed between the groups at follow-up (p = 0.637).</p><p><strong>Conclusion: </strong>During the shortage of verteporfin, a different treatment strategy was applied, with HD-PDT being performed less frequently. By implementing a more patient-tailored approach, the VA and the resolution rate of SRF remained similar to the year before the shortage.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-11"},"PeriodicalIF":2.1,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505193","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":"Advancing the Frontiers of Retinal Vasculitis: Insights, Challenges, and Future Directions.","authors":"Marion R Munk, Emmett T Cunningham","doi":"10.1159/000541813","DOIUrl":"10.1159/000541813","url":null,"abstract":"","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-3"},"PeriodicalIF":2.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400876","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":"Efficacy and Safety of Intravitreal Faricimab in Neovascular Age-Related Macular Degeneration, Diabetic Macular Edema, and Retinal Vein Occlusion: A Meta-Analysis.","authors":"Prem A H Nichani, Marko M Popovic, Andrew Mihalache, Ananya Pathak, Rajeev H Muni, David T W Wong, Peter J Kertes","doi":"10.1159/000541662","DOIUrl":"10.1159/000541662","url":null,"abstract":"<p><strong>Introduction: </strong>Intravitreal anti-vascular endothelial growth factor (VEGF) therapy has become the mainstay of treatment in many retinal diseases. The comparative efficacy and safety of newer bispecific anti-VEGF/angiopoietin 2 (Ang2) agents in the treatment paradigm versus widely used monospecific anti-VEGF agents remains unclear.</p><p><strong>Methods: </strong>A systematic literature search of MEDLINE, Embase, and Cochrane Library was conducted to identify comparative observational studies and randomized controlled trials published from 2015 to Jul 2024. With assessment by three independent reviewers, original English peer-reviewed full-text articles evaluating faricimab versus monospecific anti-VEGF agent(s) in FDA-indicated retinal disease with data on at least one set of efficacy and/or safety outcomes for each treatment arm and a minimum 3-month follow-up period were included. Data were appraised using the Cochrane RoB2 and ROBINS-I tools, PRISMA, and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) guidelines. All outcomes were collected at the last follow-up. Random effects meta-analyses with 95% confidence intervals were conducted to calculate weighted mean differences and risk ratios. Change in best-corrected visual acuity (BCVA, ETDRS letters), change in central subfield thickness (CSFT, μm), and presence of retinal fluid were primary endpoints; ocular adverse events were secondary endpoints.</p><p><strong>Results: </strong>Across 13 studies, in the context of neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), and retinal vein occlusion (RVO), 2,226 eyes received anti-VEGF monotherapy and 3,022 received faricimab. Final and change in BCVA were similar between treatment groups. Faricimab was associated with a significantly higher reduction in CSFT in DME and RVO eyes but not in nAMD eyes. The incidence of ocular adverse events was similar between groups.</p><p><strong>Conclusion: </strong>There was no difference in BCVA between faricimab and anti-VEGF monotherapy in nAMD, DME, and RVO. While faricimab offered superior improvement in CSFT at the final follow-up for DME and RVO eyes, this effect was not seen in nAMD eyes. Future studies are needed to establish the long-term safety and efficacy of faricimab for retinal vascular disease.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-18"},"PeriodicalIF":2.1,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372465","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":"Baseline Features in Polypoidal Choroidal Vasculopathy in Caucasian Patients.","authors":"Maria Ludovica Ruggeri, Lisa Toto, Rossella D'Aloisio, Anna Romano, Alberto Quarta, Matteo Gironi, Federico Formenti, Raffaella Aloia, Annamaria Porreca, Marta Di Nicola, Rodolfo Mastropasqua","doi":"10.1159/000540911","DOIUrl":"10.1159/000540911","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to investigate demographic, anatomical, angiographic, and functional parameters in patients suffering from polypoidal choroidal vasculopathy (PCV).</p><p><strong>Methods: </strong>Sixty eyes of 60 patients with a definite diagnosis of treatment-naïve exudative unilateral PCV were evaluated in this retrospective study. Fellow eyes and age-matched healthy subjects were enrolled as comparison. All subjects underwent complete ophthalmic evaluation with multimodal imaging assessment, including spectral-domain optical coherence tomography (OCT) and OCT angiography. Main outcome measures in the comparison analysis were central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and choroidal vascularity index (CVI), whereas outcome measures for correlation analyses were best corrected visual acuity (BCVA), intraretinal fluid and subretinal fluid (SRF) presence, SRF thickness, vascularized pigmented epithelial detachment height, and PCV outer retina to choriocapillaris flow area.</p><p><strong>Results: </strong>CVI was significantly higher in affected and fellow eyes if compared with the healthy ones (p = 0.049; p = 0.003). Subfoveal choroid resulted to be thicker in the diseased eyes when compared with healthy ones (p = 0.002). A negative correlation was assessed between age and SFCT, CMT, and BCVA. In addition, a significant association between male gender and anatomical and functional parameters has been found with male prevalence at baseline in cases. No association between systemic conditions and PCV features was found.</p><p><strong>Conclusions: </strong>Patients with unilateral PCV show choroidal changes in terms of higher values of CVI, also in fellow eyes, that were negatively related with age. In our cohort of patients, males showed the poorest diagnosis with a baseline lower BCVA and higher CMT when compared with females. PCV was not associated with any systemic condition.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366071","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":"Changes of Optical Coherence Tomography Biomarkers after Peeling of Epiretinal Membranes.","authors":"Christoph Leisser, Andreas Schlatter, Manuel Ruiss, Caroline Pilwachs, Oliver Findl","doi":"10.1159/000541425","DOIUrl":"10.1159/000541425","url":null,"abstract":"<p><strong>Introduction: </strong>Several optical coherence tomography (OCT) biomarkers for postsurgical success among patients with idiopathic epiretinal membranes (iERMs) undergoing pars plana vitrectomy and membrane peeling have been described in the past. The aim of this study was to examine the remission of OCT biomarkers in patients with iERM after pars plana vitrectomy with membrane peeling 3 months and 1 year after surgery.</p><p><strong>Methods: </strong>This prospective study included patients scheduled for pars plana vitrectomy with membrane peeling for iERM. The postoperative remission of presurgical OCT biomarkers was analyzed from OCTs at predefined time points (3 months, 1 year) after surgery and correlated with visual acuity.</p><p><strong>Results: </strong>Among 75 patients included, remission of pre-surgically present OCT biomarkers was observed in 87.5% of eyes with disorganization of retinal inner layers, in 82.4% with cotton ball sign, in 70.4% with intraretinal cystoid changes, in 57.1% with hyperreflective foci, in 51.2% with ectopic inner foveal layer (EIFL), and in all eyes with defects of the ellipsoid zone. Central macular thickness (CMT) showed a significant reduction after surgery (p < 0.001 and p = 0.019) and was the only significant predictor for development of distance-corrected visual acuity (DCVA) 1 year after surgery (p < 0.001).</p><p><strong>Conclusion: </strong>CMT was the only significant predictor for development of DCVA 1 year after surgery. Remission rates of most of the other OCT biomarkers were high, but did not significantly influence postsurgical DCVA.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-10"},"PeriodicalIF":2.1,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351336","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":"New Approaches in the Management of Submacular Hemorrhages.","authors":"Matias Iglicki, Dinah Zur","doi":"10.1159/000541451","DOIUrl":"10.1159/000541451","url":null,"abstract":"","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-2"},"PeriodicalIF":2.1,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292798","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":"Diagnostic work-up of retinal vasculitis: An algorithmic approach.","authors":"Atul Arora, Manisha Agarwal, Nicholas Chieh Loh, Hind Amin, Nitin Kumar Menia, Rupesh Agrawal, Vishali Gupta","doi":"10.1159/000541149","DOIUrl":"https://doi.org/10.1159/000541149","url":null,"abstract":"<p><p>Retinal vasculitis has heterogenous etiologies encompassing infections, autoimmune, masquerades and idiopathic. The heterogeneity in the underlying clinical features and aetiologies of retinal vasculitis makes its diagnosis challenging for clinicians and the work up thus becomes quite extensive and many a times several unwarranted investigations are done to look for a possible etiology. Timely and accurate diagnosis is crucial for effective management and vision preservation. The algorithmic approach needs understanding of the phenotype, clinical as well as imaging biomarkers so that only customized investigations are done in order to make the timely diagnosis and initiate specific therapy wherever required. In this review article, we shall present an algorithmic approach that combines clinical assessment, ophthalmic imaging, laboratory investigations, and targeted ancillary tests.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-18"},"PeriodicalIF":2.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140718","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}