Ophthalmologica最新文献

{"title":"The 'Loss of Peak Vision' in Branch Retinal Vein Occlusion: Real-World Implications for Stratified Intervention.","authors":"Hsin-Ho Chuang, Sheng-Chu Chi, Yu-Bai Chou, Chang-Chi Weng, Shih-Jen Chen, Tai-Chi Lin","doi":"10.1159/oph/aeeag001","DOIUrl":"10.1159/oph/aeeag001","url":null,"abstract":"<p><strong>Introduction: </strong>Branch retinal vein occlusion (BRVO) is the second most common retinal vascular disorder. This study evaluated the real-world visual and anatomical outcomes of intravitreal aflibercept in BRVO, addressing the gap between clinical trials and daily practice, and aimed to identify distinct response phenotypes that predict functional decline.</p><p><strong>Methods: </strong>This retrospective analysis included 96 BRVO patients receiving aflibercept monotherapy over 12 months. Patients were stratified into three groups based on anatomical response: Resolved (sustained dry macula), Recurrent (fluid recurrence after initial resolution), and Persistent (incomplete resolution). The primary outcome was change in best-corrected visual acuity (BCVA).</p><p><strong>Results: </strong>At 12 months, eyes were Resolved (52%), Recurrent (27%), or Persistent (21%). The Resolved group achieved the best visual outcomes (-0.29 logMAR; 95% CI: -0.38 to -0.20), whereas the Recurrent group showed the least improvement (-0.05 logMAR; 95% CI: -0.22 to 0.12; p = 0.021 vs. Resolved). Despite achieving complete fluid resolution at month 3, this group experienced significant rebound by month 6. Total injections (p = 0.808) and the distribution of treatment strategies did not differ among groups. Baseline BCVA (β = 0.411, 95% CI: 0.202-0.619; p = 0.001) and treat-and-extend (T&E) regimen (β = 0.244, 95% CI: 0.033-0.454; p = 0.025) significantly predicted visual improvement, whereas baseline central macular thickness and systemic factors were not.</p><p><strong>Conclusion: </strong>In a real-world setting, nearly half of BRVO patients exhibit unstable phenotypes. Despite comparable treatment intensity, cumulative damage from fluid fluctuations causes irreversible visual loss in the Recurrent group. This supports a stratified intervention strategy: evaluating month-3 response to establish strict T&E intervals or early treatment modifications, mitigating preventable vision loss.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689470","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":"Expanded Spectrum of Ectopic Inner Foveal Layer in Stage 3 Epiretinal Membrane.","authors":"Alberto Quarta, Alessandro Avitabile, Ruggero Tartaro, Maria Ludovica Ruggeri, Corina Valentina De Santis Ciacci, Lisa Toto, Rodolfo Mastropasqua","doi":"10.1159/oph/aeeag003","DOIUrl":"10.1159/oph/aeeag003","url":null,"abstract":"<p><strong>Purpose: </strong>To assess Ectopic Inner Foveal Layer (EIFL) spectrum in Stage 3 epiretinal membrane (ERM) and to compare the demographic, anatomical, and functional characteristics among groups.</p><p><strong>Methods: </strong>EIFL was classified into three subtypes based on anatomical OCT features. Patient demographics, BCVA, and structural OCT parameters were collected. Cross-sectional group comparisons, within-subtype correlation analyses, and multinomial logistic regression were performed to assess associations with EIFL subtype classification.</p><p><strong>Results: </strong>Among 114 eyes, three distinct EIFL patterns were identified: nascent EIFL (nEIFL) characterized by minimal EIFL thickness and better BCVA, immature EIFL (iEIFL) showing moderate EIFL thickness with intermediate BCVA, and mature EIFL (mEIFL) demonstrating higher EIFL thickness with poorest BCVA. Large effect sizes were observed between nEIFL and iEIFL (Cohen's d=0.98, p<0.001) and between nEIFL and mEIFL (Cohen's d=0.63, p=0.008) for BCVA. Multinomial Logistic Regression model showed age and EIFL thickness as main predictors of EIFL type (p < 0.001 and p = 0.001 respectively).</p><p><strong>Conclusion: </strong>The proposed EIFL subtypes showed distinct cross-sectional morphological and functional profiles in stage 3 ERM. Less extensive EIFL involvement was associated with better BCVA, whereas greater EIFL thickness and older age were associated with classification into more extensive EIFL subtypes. Longitudinal studies are required to determine whether this anatomical spectrum reflects temporal progression and whether it has prognostic value for postoperative anatomical and functional outcomes.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631178","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":"Stage of Epiretinal Membrane and Central Bouquet Abnormalities: Key Predictors of Visual Acuity after Vitrectomy.","authors":"Shady Suffo, Alina Bronnikova, Monzer Qassem, Cristian Munteanu, Berthold Seitz, Alaa Din Abdin","doi":"10.1159/oph/aeeag006","DOIUrl":"10.1159/oph/aeeag006","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to investigate the long-term visual outcome after vitrectomy for idiopathic epiretinal membrane (ERM) according to the preoperative stage of the disease, focusing on central bouquet abnormalities (CBAs).</p><p><strong>Methods: </strong>Our retrospective study included 280 eyes of 241 patients with idiopathic ERM who underwent pars plana vitrectomy with membrane peeling and internal limiting membrane peeling between 2016 and 2021. The best corrected visual acuity (BCVA) in logMAR, the CBAs, and the thickness of the ectopic inner foveal layer (EIFL) were documented using spectral-domain optical coherence tomography one day before surgery, 6 weeks, 6 months, and at the last available follow-up after surgery.</p><p><strong>Results: </strong>Mean BCVA improved significantly at each postoperative follow-up compared to baseline (p < 0.001). Patients with stage 2 ERM showed the greatest improvement in BCVA compared to other patients (p < 0.001). The postoperative visual outcome has been negatively affected by higher ERM stage (p < 0.001), preoperative presence of subfoveal detachment (p = 0.033), preoperative presence of vitelliform lesions (p = 0.021), and the presence (p < 0.001) and thickness (p < 0.001) of EIFL.</p><p><strong>Conclusion: </strong>The earlier surgical treatment of ERM at stage 2 may result in better visual outcomes and a greater increase in vision. The preoperative presence of CBAs and a thick EIFL is associated with worse postoperative visual results.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620956","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":"Influence of Structural Optical Coherence Tomography Biomarkers on Functional Outcomes in Eyes with Neovascular Age-Related Macular Degeneration.","authors":"Alaa Din Abdin, Lucy Bedros, Julian Kahlert, Cristian Munteanu, Maziar Mirsalehi, Achim Langenbucher, Shady Suffo, Berthold Seitz","doi":"10.1159/oph/aeeag005","DOIUrl":"10.1159/oph/aeeag005","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to investigate the effect of structural optical coherence tomography (OCT) biomarkers on the functional outcome in eyes with neovascular age-related macular degeneration (nAMD) undergoing anti-vascular endothelial growth factor therapy.</p><p><strong>Methods: </strong>This retrospective study included 305 eyes of 254 patients with primary onset nAMD followed for 2 years. At baseline, several OCT structural biomarkers were assessed. We evaluated the interaction between the presence of all these biomarkers and the best corrected visual acuity (BCVA) in logMAR and the number of intravitreal injections (IVI) administered over 2 years of treatment.</p><p><strong>Results: </strong>The BCVA was 0.44 ± 0.24 before treatment and 0.53 ± 0.20 after 24 months (p = 0.10). BCVA in logMAR after 2 years was significantly positively correlated with baseline presence of intraretinal fluid (IRF) (p< 0.001), vitreomacular traction/adhesion (VMT/A) (p = 0.04), photoreceptor layer damage (PRD) (p < 0.001), and prechoroidal clefts (p = 0.02). A significant positive correlation was found between the number of IVIs administered over 2 years and the presence of IRF (p = 0.02) and subretinal hyperreflective material (SHRM) (p = 0.03) at baseline.</p><p><strong>Conclusion: </strong>The baseline presence of IRF, VMT/A, PRD, and prechoroidal clefts may be limit recovery of BCVA after 2 years of treatment. In addition, the presence of IRF and SHRM may be associated with a higher number of IVIs over 2 years of treatment.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620875","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":"Quantifying Phacoemulsification Handpiece Repulsion as a Function of Tip Design: A Particle Image Velocimetry Study.","authors":"Tommaso Rossi, Giorgio Querzoli, Camilla Pellizzaro, Giulia Rosari, Mariacristina Parravano, Rodolfo Mastropasqua, Luca Placentino, David H Steel, Mario R Romano","doi":"10.1159/oph/aeeag004","DOIUrl":"10.1159/oph/aeeag004","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to compare the fluidics of different phaco tip designs: straight, flared, and balanced, across 2 orthogonal planes centred on the tip aperture, with the aim of inferring lens fragment attraction and repulsion determined by shear fluid motion.</p><p><strong>Methods: </strong>Phaco handpiece of Virtuoso (BVI) longitudinally drove straight and flared tips, while Centurion (Alcon) drove balanced tip in longitudinal, torsional, and combined modes. Tests were run into a Plexiglas chamber filled with balanced salt solution with neutrally buoyant particles, and particle image velocimetry analysis was performed at 6,250 frames per second.</p><p><strong>Results: </strong>BSS velocity increased with stroke length and was significantly higher for the balanced tip longitudinal stroke (p < 0.01). At 90% ultrasound power, the balanced tip generated significantly higher BSS velocities than the straight and flared tips, both in longitudinal, purely torsional, and combined motion (p < 0.05). Aspiration significantly altered BSS velocities in all tested tips (p < 0.05 for all), increasing attraction. Straight tips showed the lowest BSS velocity at all stroke lengths (p < 0.01); balanced tip in torsional mode had the second highest BSS velocity (after the same tip in longitudinal mode) across the vertical plane.</p><p><strong>Conclusion: </strong>Straight tips in longitudinal mode determine significantly lower fluid velocity in a test chamber than flared and balanced tips operating in longitudinal, torsional, and combined modes.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620931","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":"Delayed Spontaneous Closure of Macular Holes after Failed Surgery: A Scoping Review of Clinical Outcomes and Predictors.","authors":"Alberto Quarta, Maria Ludovica Ruggeri, Ruggero Tartaro, Lisa Toto, Rodolfo Mastropasqua","doi":"10.1159/oph/aeeag002","DOIUrl":"10.1159/oph/aeeag002","url":null,"abstract":"<p><strong>Background: </strong>Review the phenomenon of delayed and spontaneous closure of full-thickness macular holes (FTMHs) following apparent primary surgical failure and to synthesize reported timelines, visual outcomes, and proposed mechanisms.</p><p><strong>Summary: </strong>A scoping review was conducted using PubMed and Embase (January 1990-June 2024). Case reports, case series, and observational studies were eligible if they described MH that remained open after surgery but subsequently closed spontaneously. Data on baseline characteristics, surgical technique, postoperative features, time to closure, and visual outcomes were extracted. Fifteen studies met inclusion criteria, of which 13 provided patient-level data. Across all cases, the mean time to closure was 536 days (median 150, IQR 90-480, range 27-2555), although this distribution was skewed by rare very late closures up to 7 years. Excluding cases closing beyond 1 year, the mean time to closure was 124 days (median 120, IQR 70-150, range 27-270), indicating that most delayed closures occur within 3-6 months. Visual acuity (VA) showed a mean improvement of -0.32 logMAR (median -0.35, IQR -0.50 to -0.15, range -1.10 to +0.80). Restricting to cases closing within 1 year yielded a mean improvement of -0.35 logMAR (median -0.50, IQR -0.65 to -0.20), corresponding to approximately three to four lines of VA gain.</p><p><strong>Key messages: </strong>Delayed spontaneous closure of FTMHs after apparent primary surgical failure is uncommon but clinically relevant. It has most often been observed within the first 6-12 months and is frequently accompanied by some VA improvement, although outcomes vary widely.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148606028","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 Risk of Retinal Vascular Events in Patients Using Semaglutide: A Scoping Review.","authors":"Salma Choujaa Goudira, Kurt Højlund, Jakob Grauslund","doi":"10.1159/000553235","DOIUrl":"10.1159/000553235","url":null,"abstract":"<p><strong>Background: </strong>This scoping review aimed to explore existing clinical trials on the association between semaglutide use and the occurrence of retinal vascular events to detect any potential safety concern.</p><p><strong>Summary: </strong>The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines. A search was performed across PubMed, Embase via Ovid, <ext-link ext-link-type=\"uri\" xlink:href=\"http://ClinicalTrials.gov\" xmlns:xlink=\"http://www.w3.org/1999/xlink\">ClinicalTrials.gov</ext-link>, and Google Scholar on April 16, 2025, and March 5, 2026. We aimed to detect clinical trials reporting retinal vascular events while investigating the effect of semaglutide in patients with type 2 diabetes or obesity. Reports on optic ischemic neuropathy were included as a reference outcome to evaluate whether the method used in the review might be capable of detecting rare ophthalmic vascular adverse events and thereby a potential safety signal.</p><p><strong>Key messages: </strong>Thirteen randomized clinical trials (predominantly double-blind and placebo-controlled) were included, comparing 17,478 individuals treated with semaglutide and 17,334 placebos. A total of 15 retinal vascular events were reported in the semaglutide groups compared with four events in placebo arms. In large, long-term trials (SELECT, SOUL, FLOW), incidence rates were consistently low but numerically higher in semaglutide-treated patients, ranging from 0 to 0.33 events per 1,000 person-years versus 0-0.05 in placebo groups. In trials with active comparators, rates ranged from 0 to 5.99 events per 1,000 person-years in semaglutide groups and 0-3.52 in comparator groups. For ischemic optic neuropathies, six events were reported among 11,757 semaglutide-treated patients versus one event among 11,105 placebo-treated individuals; in trials with active comparators, two versus one event were reported. In conclusion, retinal vascular events, especially retinal arterial occlusions, showed a higher pattern of reporting in the semaglutide arm across clinical trials, the majority of which were randomized placebo-controlled trials. Optic ischemic neuropathies were also found to be higher on the semaglutide arm. These findings support the need for further investigation through large-scale registry studies.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-13"},"PeriodicalIF":2.3,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148331835","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":"Interpreting Relative Afferent Pupillary Defect in Leber Hereditary Optic Neuropathy Using Interocular Visual Acuity Difference.","authors":"Yasuyuki Takai, Akiko Yamagami, Kenji Inoue, Ryoma Yasumoto, Hitoshi Ishikawa","doi":"10.1159/000553194","DOIUrl":"10.1159/000553194","url":null,"abstract":"<p><strong>Introduction: </strong>The aims of this study were to clarify how relative afferent pupillary defect (RAPD) relates to interocular visual acuity asymmetry in Leber hereditary optic neuropathy (LHON), and to derive clinically interpretable thresholds of absolute interocular best-corrected visual acuity difference (|ΔBCVA|) for RAPD interpretation.</p><p><strong>Methods: </strong>This retrospective study included patients with genetically confirmed LHON (one of the three primary mitochondrial DNA mutations: m.11778G>A, m.14484T>C, or m.3460G>A) who presented within 6 months of symptom onset and underwent RAPD assessment at the initial visit. The absolute |ΔBCVA| (logarithm of the minimum angle of resolution [logMAR]) was analyzed using multivariable logistic regression. Discrimination was assessed by receiver operating characteristic (ROC) analysis. In unilateral-onset cases, time to fellow-eye involvement was compared by the Kaplan-Meier analysis.</p><p><strong>Results: </strong>Ninety-two patients were included; 23 (25%) were RAPD-positive. In multivariable logistic regression, |ΔBCVA| was independently associated with RAPD (adjusted odds ratio 1.20 per 0.1 logMAR, 95% confidence interval [CI] 1.08-1.35; p < 0.001). ROC analysis showed good discrimination (area under the curve 0.791, 95% CI 0.672-0.910). The Youden-optimal cutoff was 0.88 logMAR (sensitivity 56.5%, specificity 92.8%); additional thresholds were 0.47 logMAR for higher sensitivity (87.0%, 58.0%) and 1.14 logMAR for higher specificity (52.2%, 97.1%). In the Kaplan-Meier analysis, fellow-eye involvement occurred earlier in RAPD-negative than RAPD-positive cases (log-rank p = 0.020), with an estimated median time to involvement of 2 months and 4 months, respectively.</p><p><strong>Conclusion: </strong>In LHON, RAPD is largely driven by interocular acuity asymmetry. Quantitative |ΔBCVA| thresholds can support interpretation of RAPD without prematurely excluding LHON and may help plan diagnostic work-up and follow-up while confirmatory testing is pending.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-9"},"PeriodicalIF":2.3,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308384","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":"One-Month versus 3-Month Heavy Silicone Oil Tamponade in Complex Rhegmatogenous Retinal Redetachment.","authors":"Giancarlo Sborgia, Giacomo Boscia, Alfredo Niro, Camilla Di Pardo, Alessandra Sborgia, Pasquale Viggiano, Pierluigi Grenga, Marco Coassin, Alfonso Savastano, Francesco Boscia","doi":"10.1159/000549883","DOIUrl":"10.1159/000549883","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to compare functional and anatomical results after 1- vs. 3-month heavy silicone oil (HSO) tamponade to repair complex inferior recurrent rhegmatogenous retinal detachment (Re-RRD).</p><p><strong>Methods: </strong>A retrospective, comparative, cohort study was conducted involving 46 eyes from 46 patients who were affected by complex inferior Re-RRD and had previously undergone tamponade with either gas or silicone oil. All the eyes were treated using HSO (Densiron® 68), which was removed after 1 (group A) or 3 months (group B). The outcomes included the attachment rate, best-corrected visual acuity (BCVA), and intraocular pressure (IOP), comparing these results at 3, 6, and 12 months after HSO removal.</p><p><strong>Results: </strong>Out of 46 eyes that experienced a complex inferior Re-RRD after initial surgery and received HSO, 24 were in group A and 22 in group B, with HSO removal after 1 and 3 months, respectively. The reattachment rates were similar: 91.6% for group A and 81.8% for group B (p = 0.4). In group A, a significant visual gain occurred during all follow-up (p < 0.001); in group B, the significant improvement (p ≤ 0.03) was lost at 12 months. Mean BCVA was better in group A than B at 6 and 12 months (p ≤ 0.02). Group B exhibited a significant increase in mean IOP after 3 months (p < 0.001), consistently exceeding the values observed in group A throughout the follow-up (p ≤ 0.002). Macular edema occurred in 7 eyes, with no notable differences between the groups.</p><p><strong>Conclusion: </strong>A 1-month HSO endotamponade has a similar reattachment rate but provides better visual recovery and controlled IOP than a 3-month endotamponade in complex Re-RRD with inferior involvement.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-9"},"PeriodicalIF":2.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258789","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":"Visual Loss after Silicone Oil Removal: Analysis of a German Cohort.","authors":"Jonathan Meinke, Constance Liegl, Benjamin Aretz, Frank G Holz, Raffael Liegl","doi":"10.1159/000552793","DOIUrl":"10.1159/000552793","url":null,"abstract":"<p><strong>Introduction: </strong>Silicone oil (SO) has been used in ophthalmic surgery for many years as a long-acting endotamponade. However, its use remains a subject of ongoing debate due to potential complications, including emulsification and retinal toxicity. A further concern described by surgeons is the unexplained functional deterioration associated with SO removal. Recent analyses suggest that this SO-associated impairment in visual acuity is an underrecognized problem and may have been insufficiently investigated to date. The present study aims to evaluate visual outcomes after SO removal in eyes that had previously undergone SO tamponade for rhegmatogenous retinal detachment and to identify factors associated with postoperative visual deterioration.</p><p><strong>Methods: </strong>This was a retrospective single-center longitudinal study conducted at the Department of Ophthalmology, University of Bonn, Germany. Patients who underwent SO (Siluron®; Fluoron, Ulm, Germany) removal in our department within a period of 1.5 years (July 2022-December 2023) with a follow-up of at least 6 months were included. Demographic data, clinical course, and visual acuity development of these patients were analyzed. In addition, intraocular pressure (IOP), type of SO, optical coherence tomography, and surgical parameters including duration of the SO tamponade were recorded. The analysis was conducted using a logistic regression model with a binomial link function to estimate the risk of visual loss after SO removal, complemented by predictive modeling and visualization of key predictors' effects on outcome probabilities.</p><p><strong>Results: </strong>A total of 255 SO removals were performed during the review period. The most common reason for SO removal was retinal detachment surgery, accounting for 160 cases (62.7%). Of these, 88 eyes met the inclusion criteria and were included in the analysis, and 63 (71.59%) patients were male. The median age at SO removal was 64 years (20-91 years). Macular involvement was present in 40 (45.5%) patients of retinal detachments. Logistic regression analysis indicated that a greater macular volume of the foveal area >0.23 mm3 during SO endotamponade was significantly associated with a lower risk of visual loss. Furthermore, a higher IOP reduction following surgery was also a significant factor associated with a lower risk of visual deterioration.</p><p><strong>Conclusion: </strong>Visual loss following SO removal remains an underrecognized and insufficiently studied complication. In this cohort, lower foveal macular volume during SO tamponade and a smaller postoperative decrease in IOP were the only variables significantly associated with visual deterioration after SO removal.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-10"},"PeriodicalIF":2.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150478","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}