Ophthalmologica最新文献

{"title":"Diagnostic Accuracy of the EyeArt Artificial Intelligence System for Diabetic Retinopathy: A Systematic Review and Meta-Analysis.","authors":"Isabel Inmaculada Guedes Guedes, Pedro Saavedra Santana, Ángel Ramos de Miguel, Ángel Ramos Macías, Francisco Cabrera López, Ayoze González Hernández","doi":"10.1159/000550443","DOIUrl":"10.1159/000550443","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic retinopathy (DR) persists as a predominant cause of preventable vision loss globally, with its prevalence escalating in conjunction with the diabetes epidemic. Efficient, automated screening is needed to enable earlier detection of DR at scale. Artificial intelligence-driven platforms, such as EyeArt® (Eyenuk Inc.), offer a scalable solution with potential to alleviate the burden on healthcare systems.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA and MOOSE guidelines. This review was prospectively registered in PROSPERO (CRD42024571137). Observational studies published between 2016 and 2024 assessing the diagnostic performance of the EyeArt® system for DR detection were retrieved from PubMed, Scopus, and Embase. Data on sensitivity, specificity, and diagnostic odds ratio (DOR) were extracted, and pooled estimates were calculated using a random-effects model. Study quality was assessed using QUADAS-2 and GRADE frameworks.</p><p><strong>Results: </strong>Seventeen studies, met the inclusion criteria. The pooled log DOR was 3.96 (95% CI: 3.54-4.39), and the area under the summary receiver operating characteristic curve was 0.932 (95% CI: 0.885-0.985), indicating high overall diagnostic accuracy. No significant heterogeneity was observed in the pooled diagnostic OR, although sensitivity and specificity varied across studies.</p><p><strong>Conclusions: </strong>EyeArt® demonstrates high diagnostic accuracy for detecting any-grade and referable DR across diverse clinical and geographical settings. Its integration into DR screening programs could improve early detection, optimize healthcare resource allocation, and expand access to ophthalmic care, particularly in resource-limited environments.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"126-144"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966711","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":"Chorioretinal Atrophy after Voretigene Neparvovec Therapy in <italic>RPE65</italic> Mutation-Associated Inherited Retinal Disease: Longitudinal Characterization in Multimodal Imaging.","authors":"Sandrine H Sassen, Marlene Sassmannshausen, Josua Sassen, Markus N Preising, Johanna P Scholz, Frank G Holz, Birgit Lorenz, Philipp Herrmann","doi":"10.1159/000549548","DOIUrl":"10.1159/000549548","url":null,"abstract":"<p><p><p>Introduction: The detection of chorioretinal atrophy (CRA) following voretigene neparvovec (VN) therapy for RPE65-IRD highlights the need for long-term monitoring to better understand the safety and efficacy of this gene augmentation treatment. This study aimed to longitudinally assess the development of VN-associated CRA, its presentation in multimodal retinal imaging, and potential implications on visual function in patients with RPE65-IRD.</p><p><strong>Methods: </strong>This single-center, prospective cohort study was conducted at the University of Bonn. A total of 21 patients with confirmed RPE65-IRD underwent subretinal VN therapy. Multimodal imaging, including blue-light fundus autofluorescence (BAF), near-infrared imaging (IR), near-infrared fundus autofluorescence (IRAF), and color fundus photography (CFP), assessed atrophy development. The primary outcome measure was the incidence and size of CRA, while secondary outcomes included the relationship between CRA and changes in visual function.</p><p><strong>Results: </strong>The study reported a 50% (16/32 eyes) incidence of CRA, with lesions primarily located in the macula (86.7%), bleb area (86.67%), injection site (80%), and periphery (80%). Lesion detection and size varied between BAF, IR, IRAF, and CFP, with the largest CRA detected in BAF imaging. Initially, the median enlargement rate of CRA was 60.50 mm2/year (131.20). Notably, eyes with CRA development had significantly better baseline low luminance visual acuity.</p><p><strong>Discussion: </strong>This study highlights the crucial role of multimodal imaging in monitoring VN-associated CRA. Differences in lesion detection and size assessment across imaging modalities were observed, with the largest CRA extent detected in BAF imaging. Median visual function remained stable. These findings emphasize the complexity of VN therapy outcomes and the need for close surveillance using combined multimodal imaging to better understand the long-term clinical implications. </p>.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"30-40"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12788828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743579","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":"Erratum.","authors":"","doi":"10.1159/000550887","DOIUrl":"10.1159/000550887","url":null,"abstract":"<p><p>In the article by Özdek et al. entitled \"Clinical and Demographic Characteristics of Treatment Requiring Retinopathy of Prematurity in Big Premature Infants in Turkiye: Report No. 1 (BIG-ROP Study)\" [Ophthalmologica. 2024;247:293-303; https://doi.org/10.1159/000541053], there is an error in the name of Dr. Özlem Bozkurt, listed as part of the BIG-ROP Study Group, which has incorrectly been published as Dr. Özlem Bozkurt Demiroğlu.The original article has been corrected to reflect this change.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"212"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486573","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":"Clinical Features and Outcomes of Bullous Central Serous Chorioretinopathy: A Multicentric Cohort Study.","authors":"Andrea Montesel, Riccardo Sacconi, Luke Nicholson, Jay Chhablani, Suzanne Yzer, Danial Mohabati, Camiel J F Boon, Giuseppe Querques","doi":"10.1159/000549637","DOIUrl":"10.1159/000549637","url":null,"abstract":"<p><strong>Introduction: </strong>The bullous variant of central serous chorioretinopathy (bvCSC) represents a rare and severe manifestation of CSC. This study aims to evaluate the clinical features, underlying systemic factors, and outcomes of bvCSC through a multicentric study.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients diagnosed with bvCSC across five tertiary eye centers. Demographic data, visual acuity (VA), treatment modalities, and follow-up outcomes were analyzed. A literature review was performed to contextualize the findings.</p><p><strong>Results: </strong>The study included 35 eyes from 25 patients (80% male), with a mean age of 47.7 ± 12.2 years. Systemic comorbidities were identified in 60% of patients. Baseline VA was 1.18 ± 0.89 logMAR. Serous retinal detachment resolved in 63% of eyes, but persistent subretinal fibrosis contributed to limited visual recovery. Treatment varied, with observation (37%) being the most common approach, followed by systemic eplerenone (17%) and focal laser (13%). Available data did not show a clear advantage of any treatment modality.</p><p><strong>Conclusion: </strong>The bvCSC is frequently associated with systemic conditions and has a guarded visual prognosis despite anatomical resolution in most cases. The study underscores the importance of early diagnosis and a tailored treatment to optimize outcomes in this severe CSC variant.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"41-49"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573885","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":"Lost to Follow-Up in Neovascular Age-Related Macular Degeneration: A Systematic Review of Global Trends, Risk Factors, and Clinical Consequences.","authors":"Kimberly Leanne Spooner, Samantha Fraser-Bell, Hemal Mehta, Thomas Hong, Geoffrey Broadhead, James Gilbert Wong, Andrew A Chang","doi":"10.1159/000549177","DOIUrl":"10.1159/000549177","url":null,"abstract":"<p><strong>Introduction: </strong>Loss to follow-up (LTFU) among patients receiving anti-vascular endothelial growth factor therapy for neovascular age-related macular degeneration (nAMD) remains a critical challenge for maintaining visual outcomes. This systematic review and meta-analysis evaluated the prevalence, risk factors, and impact on visual prognosis of LTFU across real-world studies.</p><p><strong>Methods: </strong>A comprehensive literature search of PubMed, Embase, Cochrane, Scopus, and Google Scholar identified studies published between 2015 and 2025. Eligible studies included observational cohorts and registry-based analyses that reported the LTFU rates, risk factors, and visual outcomes following treatment discontinuation. Random-effects meta-analysis (DerSimonian-Laird) estimated pooled odds ratios (ORs) and 95% confidence intervals (CIs); heterogeneity was assessed via I2 and Cochran's Q. Continuous predictors were analysed using regression-based ORs or standardized mean differences (SMDs), where appropriate.</p><p><strong>Results: </strong>We included 52 studies. Short-term LTFU was defined as 6-12 months without treatment; long-term LTFU as ≥12 months. LTFU rates ranged from <5% to >75% over up to 10 years. Older age was moderately associated with LTFU (SMD = 0.47, 95% CI: 0.37-0.57; ≈6-7 years older). Greater travel distance increased LTFU risk (OR = 1.35 per 10-km increase, 95% CI: 1.14-1.60). Male sex (OR = 1.20, 95% CI: 1.05-1.37) and caregiver/transport dependence (OR = 2.00, 95% CI: 1.45-2.75) were also associated with a higher likelihood of LTFU. Treat-and-extend (T&E) regimens showed lower LTFU than pro re nata. Patients who were LTFU had worse visual outcomes even after resuming care.</p><p><strong>Conclusion: </strong>LTFU in nAMD treatment is common and driven by demographic (age, sex, and race), socioeconomic (income and insurance), and access (distance and caregiver need) factors. Continuous treatment, early response, and structured regimens (e.g., T&E) mitigate dropout risk. Interventions to improve access and personalize support are essential to reduce LTFU and preserve visual outcomes.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"79-102"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145506248","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":"Two-Year Treatment Outcomes of Simultaneous Intravitreal Dexamethasone and Aflibercept on Diabetic Macular Edema.","authors":"Tai-Chi Lin, Hsin-Wei Huang, Yu-Chien Chung, Tsui-Kang Hsu, Yi-Ming Huang, Sheng-Chu Chi, Chen-Yu Chao, Po-Chen Tseng","doi":"10.1159/000550320","DOIUrl":"10.1159/000550320","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to report 2-year follow-up data on patients with diabetic macular edema (DME) treated with simultaneous intravitreal dexamethasone (DEX) and aflibercept.</p><p><strong>Methods: </strong>Multicenter, retrospective analysis of eyes with DME treated with simultaneous DEX implant and aflibercept injection. Main outcome measures were changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) from baseline to 24 months. The secondary endpoint was the interval of retreatment.</p><p><strong>Results: </strong>Two-year data were available for 52 of the 76 initially included eyes. Compared to baseline, significant improvements in mean BCVA and CRT were observed at 6, 12, 18, and 24 months. An average of 3.26 ± 1.70 intravitreal treatments was required, with a mean retreatment interval of 10.21 ± 6.35 months throughout the study period.</p><p><strong>Conclusion: </strong>Simultaneous intravitreal DEX and aflibercept treatment resulted in sustained improvements in both visual and anatomical outcomes over a 24-month period. This combination therapy represents a valid treatment strategy and demonstrates synergistic efficacy in the management of DME.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"70-78"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906383","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":"Response to \"Readability of AI and Ophthalmologist Responses to Patient Surgery Queries: Comment\" by Daungsupawong and Wiwanitkit.","authors":"Sai S Kurapati, Antonio Yaghy, Derek J Barnett, Ingrid U Scott","doi":"10.1159/000546049","DOIUrl":"10.1159/000546049","url":null,"abstract":"","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"105-106"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022118","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":"Silicone Oil Removal Related Vision Loss: Questioning Different Outcomes.","authors":"Maria Ludovica Ruggeri, Alberto Quarta, Tommaso Verdina, Daniela Bacherini, Ruggero Tartaro, Corina Valentina De Santis Ciacci, Lisa Toto, Rodolfo Mastropasqua","doi":"10.1159/000550106","DOIUrl":"10.1159/000550106","url":null,"abstract":"<p><strong>Introduction: </strong>Silicone oil removal-related vision loss (SORVL) is a rare, sight-threatening condition occurring in patients who previously underwent silicone oil removal (ROSO) surgery. Today, few cases have been reported in the literature, predominantly described as unrecoverable, and the disease spectrum and its pathophysiology are mostly unknown.</p><p><strong>Methods: </strong>We retrospectively report 6 different cases of SORVL, analyzing the different clinical outcomes. Patients clinical characteristics at presentation and throughout follow-ups are reported, including cases of significant improvement and a rare case of complete recovery.</p><p><strong>Results: </strong>Among enrolled patients, 83% were males who underwent ROSO for a previous rhegmatogenous retinal detachment surgery with pars plana vitrectomy. Two (33.3%) cases presented significant improvement over time, with one of them (16.6%) experiencing complete recovery. Clinical presentation, diagnosis and course of the disease outline both similarities and differences that may help in the hypothesis-generating process on possible underlying mechanisms.</p><p><strong>Conclusion: </strong>Although sharing connections in the onset of symptoms and clinical spectrum, this case series evidences differences in outcome in SORVL cases and highlights the heterogeneity of SORVL. Future studies should be aimed at investigating the pathophysiology of SORVL and factors influencing the course of this condition.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"61-69"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual Outcomes after Primary Vitrectomy in Open Globe Trauma.","authors":"Sara Margarita Pérez-Pérez, Gabriela Escobar Zuluaga, Valentina Cárdenas Arias, Daniela Jaramillo-Ramirez, Jacobo Cruz Bravo, Laura Quintero Arciniegas, Camilo Eduardo Martínez, Nathalie Tamayo Martínez","doi":"10.1159/000550369","DOIUrl":"10.1159/000550369","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to assess the impact of early vitrectomy on visual outcomes 1 month after surgery in patients with open ocular trauma.</p><p><strong>Methods: </strong>A historical cohort study analyzed 180 eyes from patients who underwent primary vitrectomy between 2017 and 2023. Data collected included the Birmingham Eye Trauma Terminology for injury assessment, the Ocular Trauma Score (OTS) for clinical findings, and visual acuity measured on the logMAR scale. Visual outcomes were compared between early surgery (within 4 days) and delayed surgery (after 4 days) using a linear mixed-effects model with a random effect for the surgeries performed.</p><p><strong>Results: </strong>Most cases had an OTS of 1 and underwent pars plana vitrectomy (PPV) and phacoemulsification (PHACO). OTS 2 cases underwent PPV with PHACO and air tamponade, while OTS 3-4 cases involved additional tamponades. One month after surgery, OTS 2 eyes with early surgery showed significantly better visual outcomes (p = 0.003). There were no statistically significant differences in complications regarding the time of surgery.</p><p><strong>Conclusion: </strong>Early vitrectomy, particularly within 4 days of injury, seems to improve both functional and anatomical outcomes in patients with severe open ocular trauma, especially for OTS 2.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"158-166"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to Resolution of Outer Retinal Folds following Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment Using En Face Optical Coherence Tomography.","authors":"Alban Comet, Frédéric Matonti, John Conrath, Thierry David, François Devin, Christophe Morel, Pierre Gascon, Prithvi Ramtohul","doi":"10.1159/000550319","DOIUrl":"10.1159/000550319","url":null,"abstract":"<p><strong>Introduction: </strong>Rhegmatogenous retinal detachment (rRD) can cause irreversible damage to the outer retina, leading to loss of visual acuity despite successful surgery. Postoperative complications, such as retinal folds, particularly macular outer retinal folds (mORFs), can affect vision with distortions and visual field defects when the macula is involved.</p><p><strong>Methods: </strong>Our study was conducted to assess the time to resolution of mORFs after rRD repair through pars plana vitrectomy. ORFs are characterized as vertical hyperreflective lesions on SD-OCT, whereas on en face SD-OCT they appear as single or multiple linear or curvilinear hyperreflective bands surrounded by a hyporeflective halo. The study included 26 non-consecutive patients with mORFs observed via SD-OCT after surgery.</p><p><strong>Results: </strong>The mean time for mORFs resolution was 3.7 months, with all mORFs fully absorbed within 6 months. Factors such as mORFs length influenced resorption speed, but no significant association with other variables (e.g., tamponade agent or retinotomy) was found.</p><p><strong>Conclusion: </strong>The study concludes that mORFs after rRD surgery generally resolve without requiring additional interventions and that precise monitoring using SD-OCT is essential for tracking their resolution.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"107-115"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934526","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}