Ophthalmologica最新文献

{"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}

{"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}

{"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}

{"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}

{"title":"Indications and Outcomes of Patients Undergoing Immediate Sequential Bilateral Vitreoretinal Surgery: A Case Series.","authors":"Alasdair I Simpson, Anthony Gigon, Shane Whitlow, Gerard McGowan, Sree Burgula, Conor M Ramsden, Aman Chandra, Johannes Keller, Andrew Davies, Rumana Hussain, David H Steel, Shohista Saidkasimova","doi":"10.1159/000546410","DOIUrl":"10.1159/000546410","url":null,"abstract":"<p><p><p>Introduction: Bilateral vision threatening vitreoretinal disease requiring urgent surgery such as proliferative diabetic retinopathy, vitreous haemorrhage and retinal detachment are not uncommon presentations. Accepted practice has been to address each eye in separate, staged procedures. However, there are specific circumstances in which operating on both eyes in the same anaesthetic sitting may be preferable. Immediate sequential bilateral vitreoretinal surgery (ISBVS) has rarely been described in the literature. We present a series of cases and discuss the indications, risks and relative merits of this approach.</p><p><strong>Method: </strong>Multicentre retrospective case series of patients undergoing ISBVS. We circulated a proforma to surgeons across the UK to collate a series of cases of this rarely performed approach to collate indications, operative approach and post-operative results.</p><p><strong>Results: </strong>Seventeen patients (34 eyes) underwent ISBVS from 8 centres. Twenty eyes had rhematogenous retinal detachments, 12 eyes had diabetic vitreous haemorrhage or tractional detachment and 2 had full-thickness macular hole. Principal pathology was the same bilaterally in each case. Indications for bilateral surgery included bilateral disease requiring urgent surgical intervention, high-risk general anaesthetic, anticipated difficulty with follow-up, convenience in post-operative care and patient preference. Visual acuity improved in 22 eyes and worsened in 2. Post-operative complications included four eyes with elevated intraocular pressure, three vitreous haemorrhages, one cystoid macular oedema, and one with a macular fold. One required re-operation for non-clearing vitreous haemorrhage.</p><p><strong>Conclusion: </strong>ISBVS is a useful approach which may be underutilised, but further studies are required to validate its safety. </p>.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"326-331"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094490","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":"The Impact of the COVID-19 Pandemic on Ophthalmology Conferences.","authors":"Gabriella Schmuter, Natasha Nayak Kolomeyer, Lisa M Nijm, Jeremiah Tao, Prem S Subramanian, Zaina Al-Mohtaseb, Terry Kim, Aleksandra V Rachitskaya, Janice C Law, Andrea A Tooley","doi":"10.1159/000546635","DOIUrl":"10.1159/000546635","url":null,"abstract":"<p><p><p>Introduction: The COVID-19 pandemic prompted ophthalmology conferences to transition to virtual platforms. The impact of these changes on attendance and research productivity remains underexplored. The objective of this study was to evaluate the effects of virtual platforms on attendance and research inclusion at ophthalmology conferences during the COVID-19 pandemic.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from 5 ophthalmology conference organizations conducted from 2019 to 2021. Conference meetings were categorized as in-person, virtual, or hybrid. Data included total attendance, trainee participation, and research submissions, obtained directly from each respective organization.</p><p><strong>Results: </strong>Conference meetings integrating a virtual component experienced a cumulative 7% increase in total attendance and a 28% rise in trainee participation. Research submissions rose by 31%, while research acceptances showed variability, with increases observed in some conferences during the virtual years. These trends highlight the potential for virtual platforms to enhance accessibility and engagement, particularly for trainees.</p><p><strong>Conclusion: </strong>Virtual platforms had an overall positive impact on ophthalmology conference attendance and research engagement during the COVID-19 pandemic. Continued integration of virtual components is recommended to enhance accessibility and inclusivity. </p>.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"332-336"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12201925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144160743","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":"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":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;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 &lt; 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).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;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 &lt; 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}

{"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}

{"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}

{"title":"Treatment Effects of Panretinal Photocoagulation or Combined Anti-Vascular Endothelial Growth Factor Therapy for Proliferative Diabetic Retinopathy on the Risks of Diabetic Macular Edema and Vitreous Hemorrhage.","authors":"Yi-Ting Hsieh, Hsuan-Chieh Lin, Yong-Chen Huang, Yi-Ting Hsieh, Shu-Hui Chang","doi":"10.1159/000545941","DOIUrl":"10.1159/000545941","url":null,"abstract":"<p><p><p>Introduction: This study evaluated the effect of panretinal photocoagulation (PRP) or combined both anti-VEGF therapy and PRP in proliferative diabetic retinopathy (PDR) on the risk of diabetic macular edema (DME) or vitreous hemorrhage (VH) and compared functional, anatomical outcomes and additional treatments in the two groups.</p><p><strong>Methods: </strong>This retrospective analysis involves patients treated for PDR with either PRP alone or in combination with three consecutive anti-VEGF injections, followed for at least 12 months. Treatment effects and other factors associated with the risk of first DME and VH were assessed.</p><p><strong>Results: </strong>We identified 95 eyes from 69 patients (combined group: 37 eyes from 25 patients; PRP group: 58 eyes from 44 patients). At 1 year, the cumulative incidences of the first DME and VH were 8% and 19% (combined group) and 31% and 19% (PRP group), respectively. Combined treatment reduced the risk of first DME after adjusting for age, HbA1c level, PDR severity, and baseline CRT (csHR: 0.211, 95% CI: 0.064-0.700, p = 0.011). Increased DME risks correlated with poor blood sugar control (HbA1c ≥8.4%), thicker baseline CRT in non-high-risk PDR, and baseline CRT <232 μm in high-risk PDR. The risk of first VH decreased with age (csHR: 0.966, 95% CI: 0.933-0.999, p = 0.045). The combined group exhibited superior best-corrected visual acuity at the third and twelfth months. The combined group were less likely to require additional treatment within 1 year (adjusted OR: 0.254, 95% CI: 0.088-0.739, p = 0.011).</p><p><strong>Conclusion: </strong>Combining anti-VEGF agents with PRP effectively reduced the risk of DME, yielding improved visual outcomes and fewer additional treatments within 1 year. </p>.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"259-269"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047154","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}