OphthalmologicaPub Date : 2025-01-01Epub Date: 2025-04-01DOI: 10.1159/000545606
Nastasia Foa, Maximilian Pfau, Georg Ansari, Giuseppe Cancian, Gabriela Grimaldi, Samuel Koller, Wolfgang Berger, Pascal Escher, Lucas Janeschitz-Kriegl, Carlo Rivolta, Hendrik P N Scholl, Moreno Menghini
{"title":"Autosomal Dominant RP1 c.2613dupA (p.Arg872Thrfs*2) Variant Retinitis Pigmentosa Shows Linear Loss of the Ellipsoid Zone over Time with Highly Variable Phenotype.","authors":"Nastasia Foa, Maximilian Pfau, Georg Ansari, Giuseppe Cancian, Gabriela Grimaldi, Samuel Koller, Wolfgang Berger, Pascal Escher, Lucas Janeschitz-Kriegl, Carlo Rivolta, Hendrik P N Scholl, Moreno Menghini","doi":"10.1159/000545606","DOIUrl":"10.1159/000545606","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to report the phenotype and progression pattern of RP1 retinitis pigmentosa carrying the variant c.2613dupA (p.Arg872Thrfs*2).</p><p><strong>Methods: </strong>This is a retrospective cohort study from 13 families with confirmed RP1 c.2613dupA (p.Arg872Thrfs*2) variant. Analysis was performed on clinical data including multimodal imaging and visual function tests. Progression rate (PR) was defined as the length of ellipsoid zone (EZ) lost per year and was calculated for all patients. Linear mixed model to predict the diameter of EZ loss as a function of age was applied.</p><p><strong>Results: </strong>Twenty-one patients were included in the study. EZ loss in all patients ranged from 3.8 to 576.0 µm/year (median PR 76.5, IQR 97.6) in right eyes and from 26.6 to 340.7 µm/year (median PR 96.6, IQR 70.3), in left eyes, respectively, with a linear slope of progression for both eyes. The linear mixed model using age as an explanatory variable explained 25% of the variability in PR and showed that male patients had on average a statistically significant smaller EZ diameter at baseline.</p><p><strong>Conclusion: </strong>The rate of progression of RP1 as measured by loss of EZ appears to be linear, independent of the age of onset. Furthermore, it appears that male subjects may present with earlier onset of disease as they showed a statistically significant smaller EZ diameter at baseline. Monitoring of EZ loss could be a valid clinical surrogate marker for clinical trials, but possibly sex differences and high variability of phenotypes need to be considered.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"175-184"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764414","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":"Ultrasound Biomicroscopy in Scleral Fixation Using Gore-Tex Suture of a Subluxated Posterior Chamber Intraocular Lens.","authors":"Alon Tiosano, Ruti Sella, Orly Gal-Or, Rita Zlatkin, Rita Ehrlich, Irit Bahar","doi":"10.1159/000543255","DOIUrl":"10.1159/000543255","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of our study was to assess the outcome of Gore-Tex sutures in minimally invasive scleral fixation of subluxated posterior chamber intraocular lenses (PCIOLs) and to demonstrate a method for validating the lens position.</p><p><strong>Methods: </strong>Retrospective study of patients who underwent lasso in-the-bag scleral fixation of a subluxated PCIOL using the snare technique with Gore-Tex suture from 2019 to 2021 in a single tertiary medical center. Functional outcome was analyzed by clinical assessment, and anatomical outcome, by ultrasound biomicroscopy (UBM).</p><p><strong>Results: </strong>A total of 18 eyes were included. The mean duration of follow-up was 140 days (range 23-659), and the median time from PCIOL implantation to fixation was 8.5 years (IQR 6.25-10.75). All patients had ocular comorbidities, mainly glaucoma (n = 6) and pseudoexfoliation syndrome (n = 5). Best corrected visual acuity improved from a median of 6/30 (0.7 logMAR) to a median of 6/12 (0.35 logMAR) (p = 0.06); postoperative astigmatism measured 0.91 ± 2.19 diopters. UBM demonstrated well-balanced PCIOL fixation with no difference between the horizontal and vertical tilt measurements (p = 0.84; p = 0.94; p = 0.62; p = 0.085). The fixated PCIOL showed <10% decentration with reference to the visual axis. There was a high negative correlation between BCVA improvement and residual lens tilt (r = -0.76, p = 0.037). Postoperative complications included transient ocular hypertension (n = 3), corneal decompensation with subsequent keratoplasty (n = 3), temporary hypotony (n = 2), cystoid macular edema (n = 1), suture exposure (n = 1), and endophthalmitis (n = 1).</p><p><strong>Conclusions: </strong>Subluxated PCIOLs are amenable to treatment with minimally invasive fixation using Gore-Tex suture with good anatomic outcomes. UBM image analysis may serve as a valuable method for assessing PCIOL position following scleral fixation.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"81-88"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882493","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}
OphthalmologicaPub Date : 2025-01-01Epub Date: 2025-03-03DOI: 10.1159/000545042
Arielle Benchimol, Paul Denys, Raphaël Lejoyeux, Sébastien Bruneau, Sophie Bonnin, Aude Couturier
{"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":"10.1159/000545042","url":null,"abstract":"<p><strong>Introduction: </strong>The aims of the study were to assess the long-term anatomic and functional outcomes in giant retinal tear (GRT)-associated retinal detachment (GRT-RD) and identify factors associated with recurrence.</p><p><strong>Methods: </strong>This is a retrospective monocentric study of the patients treated for GRT-RD between 2017 and 2022 at Rothschild Foundation Hospital, Paris, France.</p><p><strong>Results: </strong>A total of 65 eyes from 64 patients were analyzed with a mean follow-up of 21.5 months. The mean age was 52.7 years and 89.2% of them were men. 69.3% of eyes were phakic, the mean axial length was 25.4 mm, and 15 eyes had high myopia. The mean size of the GRT was 147.7°. Macula was attached in 33 cases. All the patients underwent pars plana vitrectomy. Perfluorocarbon liquids were 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 the 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.</p><p><strong>Conclusion: </strong>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":"141-148"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","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}
OphthalmologicaPub Date : 2025-01-01Epub Date: 2025-03-10DOI: 10.1159/000544917
Sai S Kurapati, Derek J Barnett, Antonio Yaghy, Cameron J Sabet, David N Younessi, Dang Nguyen, John C Lin, Ingrid U Scott
{"title":"Eyes on the Text: Assessing Readability of Artificial Intelligence and 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":"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 aimed 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 (standard deviation) 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>Conclusion: </strong>The National Institutes of Health advises health information to be written at a 6th- to 7th-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":"149-159"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","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}
OphthalmologicaPub Date : 2025-01-01Epub Date: 2025-04-08DOI: 10.1159/000544958
Daniele De Geronimo, Mariacristina Parravano, Riccardo Sacconi, Eliana Costanzo, Monica Varano, Giuseppe Querques
{"title":"Geographic Atrophy and Peripheral Atrophy: Quantitative Analysis with Ultra-Widefield Autofluorescence.","authors":"Daniele De Geronimo, Mariacristina Parravano, Riccardo Sacconi, Eliana Costanzo, Monica Varano, Giuseppe Querques","doi":"10.1159/000544958","DOIUrl":"10.1159/000544958","url":null,"abstract":"<p><strong>Introduction: </strong>To analyze and correlate the topographic distribution of atrophic areas at the posterior pole and peripheral retina in subjects with geographic atrophy (GA) using ultra-widefield fundus autofluorescence (FAF) imaging.</p><p><strong>Methods: </strong>This multicenter observational study included 15 patients (9 males, 19 eyes) with coexisting GA and peripheral atrophy. All eyes were imaged with Ultra-widefield Optos California (Optos, PLC, Dunfermline, Scotland) to acquire ultra-widefield (200°) color and FAF images centered on the fovea, superior, inferior, nasal, and temporal sectors. The extent of GA in the central FAF image and the peripheral atrophic areas in the peripheral FAF images were measured by manually defining the boundaries of the atrophic regions using the \"ROI free\" function integrated into the device software. The values obtained were then analyzed and correlated.</p><p><strong>Results: </strong>The mean ± standard deviation (SD) GA size was 13.9 ± 15.0 mm2 (range: 1.8-71.3 mm2) and the total peripheral atrophy was 51.0 ± 68.3 mm2 (range: 1.4-292.1 mm2). The topographic analysis showed that the mean ± SD of superior peripheral atrophy was 9.0 ± 20.6 mm2, temporal atrophy was 30.5 ± 55.9 mm2, inferior atrophy was 9.3 ± 16.3 mm2, and nasal atrophy was 1.8 ± 3.9 mm2. GA size was significantly correlated with total peripheral atrophy (Rho = 0.463, p = 0.046) and temporal peripheral atrophy (Rho = 0.474, p = 0.040), whereas no correlations were found with peripheral atrophy in the remaining sectors.</p><p><strong>Conclusion: </strong>Ultra-widefield autofluorescence is a valuable technique for visualizing and assessing the extent of macular and peripheral atrophy. Macular atrophy correlates significantly with total and temporal peripheral atrophy but demonstrates no significant correlation with atrophy in the remaining sectors.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"168-174"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811865","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}
OphthalmologicaPub Date : 2025-01-01Epub Date: 2024-10-24DOI: 10.1159/000542224
Femke M van den Tillaart, Franca Hartgers, Carel B Hoyng, Suzanne Yzer
{"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><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 w","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"11-21"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11901414/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OphthalmologicaPub Date : 2025-01-01Epub Date: 2024-11-27DOI: 10.1159/000541057
Elsa Toumi, Damien Guindolet, Sophie Bonnin, Sébastien Bruneau, Marie Leflot, Amélie Duvillier, Raphaël Lejoyeux, Ramin Tadayoni
{"title":"Visual Outcomes after Spontaneous and Surgical Closure of Small Idiopathic Macular Holes: A Comparative Study.","authors":"Elsa Toumi, Damien Guindolet, Sophie Bonnin, Sébastien Bruneau, Marie Leflot, Amélie Duvillier, Raphaël Lejoyeux, Ramin Tadayoni","doi":"10.1159/000541057","DOIUrl":"10.1159/000541057","url":null,"abstract":"<p><strong>Introduction: </strong>Small full-thickness macular holes (FTMHs) are classically treated surgically but can also occasionally close spontaneously. Long-term visual outcomes of spontaneously closed FTMHs are not well described. We compared best-corrected visual acuity (BCVA) after surgical and spontaneous closure of idiopathic FTMH (IMHs) and assessed the effect of IMH size on BCVA.</p><p><strong>Methods: </strong>This retrospective study was performed at Rothschild Foundation Hospital, Paris, France, from January 2015 to June 2021. The study included patients with small IMH, i.e., ≤250 μm, divided into spontaneously closed IMH (SIMH) and surgically closed IMH. Both groups were divided into 3 subgroups according to IMH diameter: <100 μm, 100-150 μm, or 151-200 μm.</p><p><strong>Results: </strong>A total of 109 patients had surgical IMH closure and 18 spontaneous IMH closure. Among all the patients of the study, we observed 17% of spontaneous closure. All SIMHs were <250 μm. The groups did not differ in final BCVA or BCVA gain. BCVA significantly improved after surgery whatever the IMH size. In the SIMH group, final BCVA did not differ by IMH size. In the 100-150 μm subgroups, BCVA gain was significantly greater for the surgical closure compared to the SIMH groups (-0.35 ± 0.2 vs. -0.16 ± 0.2 logMAR; p = 0.01).</p><p><strong>Conclusion: </strong>Vision results are similar between spontaneously closed and surgically closed macular holes. Spontaneous closure of macular holes can occur; it is therefore reasonable to consider observation before macular hole surgery.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"22-28"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740188","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}
OphthalmologicaPub Date : 2025-01-01Epub Date: 2025-04-23DOI: 10.1159/000545969
Jakob Grauslund, Andrzej Grzybowski
{"title":"The Seven Sins of Automated Diabetic Retinopathy Screening: Barriers for Clinical Implementation of Artificial Intelligence-Based Devices in National Screening Programs.","authors":"Jakob Grauslund, Andrzej Grzybowski","doi":"10.1159/000545969","DOIUrl":"10.1159/000545969","url":null,"abstract":"","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"137-140"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OphthalmologicaPub Date : 2025-01-01Epub Date: 2025-02-26DOI: 10.1159/000543749
Francesco Pignatelli, Alfredo Niro, Pasquale Viggiano, Giacomo Boscia, Gianluca Besozzi, Cristiana Iaculli, Giuseppe Addabbo, Francesco Boscia, Ermete Giancipoli
{"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":"112-122"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","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":"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":"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 was 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 noninfectious 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":"202-230"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","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}