Ophthalmologica最新文献

{"title":"OCT-Derived Biomarkers in Optic Disc Pit Maculopathy Are Associated with Age, Visual Function, and Natural History.","authors":"Edward Bloch, Blanca C Flores-Sánchez, Odysseas Georgiadis, Conor M Ramsden, Lyndon da Cruz","doi":"10.1159/000545664","DOIUrl":"10.1159/000545664","url":null,"abstract":"<p><strong>Introduction: </strong>Optic disc pit maculopathy (ODP-M) describes the variable intra- (IRF) and/or subretinal fluid (SRF) accumulation complicating a congenital optic disc anomaly that is primarily observed in young adults. This study aimed to explore the morphological variance in ODP-M, in order to measure associations between demographic and functional characteristics and investigate the natural course of the disease.</p><p><strong>Methods: </strong>A single-centre, retrospective, observational study was performed. Subjects with ODP-M were identified through electronic notes review. Demographic characteristics, visual acuity, and anatomical features were analysed with respect to a predefined OCT-based sub-categorisation: type 1a: IRF only; type 1b: IRF + outer lamellar hole (OLH) +/- SRF; type 2: SRF +/- IRF (no OLH).</p><p><strong>Results: </strong>Fifty eyes (50 subjects) were sub-categorised according to fluid distribution into type 1a (34%), type 1b (28%), and type 2 ODP-M (38%). Those with type 2 were found to be significantly younger than those with types 1a/b ODP-M (p < 0.001) and accounted for 93% of cases occurring in subjects ≤20 years old. The presence of OLH (i.e., type 1b) was noted to be independently associated with worse final VA (p = 0.013) and higher likelihood of proceeding to surgery (p = 0.002).</p><p><strong>Conclusion: </strong>There appears to be an age-related variation in ODP-M morphology, indicating the possibility of separate pathoanatomical processes, with distinct clinical courses and potentially different optimal management strategies. Sub-categorisation of ODP-M according to the reported structural features may help guide management of this rare condition.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"185-193"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796128","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":"Anti-Vascular Endothelial Growth Factor Treatment Outcomes in Macular Telangiectasia: A Systematic Review.","authors":"Aswen Sriranganathan, Justin Grad, Andrew Mihalache, Marko M Popovic, Peter J Kertes, Radha Kohly, Rajeev H Muni","doi":"10.1159/000543771","DOIUrl":"10.1159/000543771","url":null,"abstract":"<p><strong>Introduction: </strong>Macular telangiectasia (MacTel) is a rare retinal condition that can cause vision loss, and anti-vascular endothelial growth factor (anti-VEGF) agents have emerged as a potential treatment. This study aimed to evaluate the clinical outcomes of anti-VEGF therapy in patients with MacTel.</p><p><strong>Methods: </strong>A systematic literature search on Ovid MEDLINE, Embase, and Cochrane Library was performed from inception to June 2024 for comparative studies on anti-VEGF agents in MacTel. The primary outcome was the change in best-corrected visual acuity (BCVA). Secondary outcomes were central macular thickness (CMT), central choroidal thickness (CCT), and fluorescein angiography (FA) leakage.</p><p><strong>Results: </strong>Ten studies on 377 eyes of 239 patients followed up over 23.4 ± 8.3 months were included. Mean (SD) BCVA changed from 0.42 (0.39) to 0.35 (0.18) over 23.4 (8.3) months of follow-up in non-proliferative MacTel. Mean BCVA changed from 0.66 (0.43) to 0.52 (0.34) at final follow-up in eyes with choroidal neovascularization (CNV). Five studies reported improved visual acuity, one showed improved FA leakage without visual acuity benefit, and four found no functional benefit. In non-proliferative MacTel, four studies showed no functional improvement, two reported significant functional and morphological improvements, and one suggested potential benefits in improving BCVA. In proliferative MacTel, two studies demonstrated improvement in both anatomical and functional outcomes, while one indicated that anti-VEGF treatment might produce improved results. In non-proliferative MacTel, mean CMT changed from 201 (32) µm to 199 (29) µm. CMT in patients with CNV decreased from an initial value of 328.23 (161.16) µm to 267.44 (118.56) µm at the final follow-up. CCT in proliferative MacTel eyes decreased from 272.37 (52.65) µm and 247.40 (48.80) µm on anti-VEGF therapy. Overall, FA leakage outcomes were improved on ranibizumab therapy. No study documented any significant adverse effects with treatment.</p><p><strong>Conclusion: </strong>Anti-VEGF agents may be associated with favorable anatomical and functional outcomes, particularly in proliferative MacTel; however, future large-scale clinical trials are warranted.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"123-136"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440514","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":"Networking of Eye Hospitals on a National Level for Promoting and Advancing Conduct of Clinical Trials.","authors":"Barbara J Wilhelm, Frank G Holz, Katrin Lorenz","doi":"10.1159/000543727","DOIUrl":"10.1159/000543727","url":null,"abstract":"<p><strong>Purpose: </strong>The complexity of clinical trials is increasing for both sponsors and study sites. This impacts planning, preparation, implementation, and conduct of all studies. The exchange of experience and cooperation helps centers to better master the various challenges facing ophthalmological study centers. This serves the efficiency of multicenter studies, including timely patient recruitment.</p><p><strong>Methods: </strong>The DOG (German Society of Ophthalmology) Clinical Study Centers Working Group (WG) was founded in 2011. Since then, regular meetings have been held including the annual during the DOG and meeting. There is also a continuous exchange in between these meetings. Symposia are regularly held at the DOG conferences together with industry and regulatory authorities. A range of courses on the conduct clinical trials has been established, and joint publications and DOG recommendations are regularly generated.</p><p><strong>Results: </strong>Since its foundation, the WG has tremendously gained visibility and popularity. Its members have increased from 40 (2011) to 80 (2024). Study-specific recommendations were produced early on, which were published by the DOG in German and English language. The topics of the publications and symposia range from study design, budget negotiations, special challenges, publication regulations, and legislation to the attractiveness of Germany as a study location. Since 2023, a patient video of the WG has been available to support and foster recruitment of study patients.</p><p><strong>Conclusion: </strong>The DOG Working Group Clinical Study Centers has become a platform for cooperation and representation of the interests of German ophthalmological study centers. It also represents an important link to industry and is engaged in a lively dialogue to promote Germany as a study location in ophthalmology. The group and its activities may serve as a model for other medical societies and countries.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"231-238"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542913","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":"Optical Coherence Tomography Imaging of Perforating Scleral Vessels and Dilated Choroidal Veins as Potential Image Markers in Myopic Choroidal Neovascularization Using Optical Coherence Tomography Angiography.","authors":"Jorge Ruiz-Medrano, Elena Almazán-Alonso, Mariluz Puertas, Ignacio Flores-Moreno, María García-Zamora, Bachar Kudsieh, José M Ruiz-Moreno","doi":"10.1159/000544750","DOIUrl":"10.1159/000544750","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to analyze the role of perforating scleral vessel (PSV) and dilated choroidal veins (DCVs) underneath macular myopic choroidal neovascularization (mCNV).</p><p><strong>Methods: </strong>This retrospective case-control study analyzed 78 eyes from 78 highly myopic patients defined by an axial length (AL) of ≥26 mm, assessed by optical coherence tomography (OCT) and OCT angiography (OCTA) imaging. Patients with clinical diagnosis of mCNV and good-quality OCTA images were selected. Swept source (SS)-OCT and SS-OCTA images (Triton; Topcon Corporation, Tokyo, Japan) were reviewed to detect image markers in the mCNV area. Highly myopic eyes without mCNV, matched by age and AL, were used as control group. The presence of PSV and DCV was recorded. Myopic maculopathy was graded using the atrophic, traction, and neovascularization (ATN) classification.</p><p><strong>Results: </strong>Seventy-eight eyes from 78 patients (39 with mCNV and 39 without mCNV) were included, out of the total 775 eyes screened. Fifty-nine (75.6%) of them were women. The mean ATN grading of myopic maculopathy was compared between eyes with mCNV and those without mCNV: atrophy scores were 2.71 ± 0.97 versus 2.30 ± 0.89, respectively (p = 0.04); traction scores were 0.64 ± 0.66 versus 0.84 ± 0.98, respectively (p = 0.54); and neovascularization scores were 2.00 ± 0.00 versus 0.33 ± 0.73, respectively (p < 0.001). The presence of OCT imaging markers did not significantly differ between groups; i.e., PSV was found in 34/39 versus 32/39 (p = 0.53) eyes, and DCV was found in 11/39 versus 7/39 eyes, mCNV versus control group, respectively (p = 0.28).</p><p><strong>Conclusions: </strong>PSV and DCV are image markers present in a high number of highly myopic eyes, which are not specific to mCNV.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"160-167"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449597","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":"Prevalence and Risk Factors for Metamorphopsia after Successful Retinal Detachment Surgery.","authors":"Geoffrey Pastor, Julia Salleron, Astrid Zessler, Sarah Stoebener, Karine Angioi-Duprez, Jean-Paul Berrod, Jean-Baptiste Conart","doi":"10.1159/000539430","DOIUrl":"10.1159/000539430","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to determine the prevalence of metamorphopsia following rhegmatogenous retinal detachment (RRD) surgery, as well as associated predictive factors.</p><p><strong>Methods: </strong>A total of 107 eyes successfully operated for RRD underwent metamorphopsia severity assessment using M-CHARTS, and foveal microstructure analysis by spectral domain optical coherence tomography, at 1 and 6 months postoperatively. Univariate and multivariate logistic regression rendered evaluation of preoperative risk factors. The correlation between metamorphopsia score and outer retinal layer (ORL) integrity was investigated and preoperative risk factors evaluated.</p><p><strong>Results: </strong>The prevalence of postoperative metamorphopsia decreased from 51.4 to 29.9% and the median metamorphopsia score significantly improved (0.5, 95% CI: 0.3; 0.9, to 0.2, 95% CI: 0; 0.5, p &lt; 0.001) from 1 to 6 months, respectively. Preoperative macular detachment was the only predictor found (OR 11.0, 95% CI: 3.1; 39.4, p &lt; 0.001). Metamorphopsia severity was significantly associated with outer nuclear layer thickness and the status of the ellipsoid and cone interdigitation zones. One-month M-CHARTS had 81% sensitivity and 87% specificity in predicting full metamorphopsia recovery at 6 months (0.45 cut-off score).</p><p><strong>Conclusion: </strong>The prevalence of metamorphopsia decreased in parallel to ORL restoration, thus demonstrating the etiological role of photoreceptor-level morphological changes. M-CHARTS allowed for monitoring and predicting metamorphopsia recovery after RRD.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1"},"PeriodicalIF":2.1,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311326","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":"An Update on Noninfectious Retinal Vasculitis.","authors":"Nitin Kumar Menia, Yasmine Alcibahy, Francesco Pichi, Piergiorgio Neri, Aniruddha Agarwal","doi":"10.1159/000539608","DOIUrl":"10.1159/000539608","url":null,"abstract":"<p><strong>Background: </strong>Retinal vasculitis (RV) signifies the inflammation of various retinal vessels. Noninfectious RV differs from infectious RV with regard to its pathogenesis and treatment. It can have varied clinical presentations and may be associated with systemic vasculitic diseases.</p><p><strong>Summary: </strong>Noninfectious RV can be caused due to type-III hypersensitivity reactions, increased expression of intracellular adhesion molecules, and genetic susceptibility. Noninfectious RV is primarily classified on the basis of the type of retinal vessels involved. It can be further classified as an occlusive or nonocclusive. RV can be a major association of systemic diseases like Behcet's disease, sarcoidosis and systemic lupus erythematosus. Newer modalities, like ultra-widefield fundus fluorescein angiography, can help in the management of RV. Effective treatment of noninfectious RV requires anti-inflammatory and immunosuppressive therapy. The patients may require treatment with high-dose corticosteroids and biological agents. Anti-vascular endothelial growth factor injections and laser photocoagulation may be indicated to treat the occlusive disease. Prompt treatment may prevent complications like vitreous hemorrhage, neovascular glaucoma, and tractional retinal detachment. The treatment more often requires a multidisciplinary approach.</p><p><strong>Key messages: </strong>This review provides a comprehensive update on the various causes of noninfectious RV, including both systemic and isolated ocular conditions. It also details various complications and management strategies for this condition.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-14"},"PeriodicalIF":2.1,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238507","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":"Epiretinal Membrane Formation following Rhegmatogenous Retinal Detachment Repair: A Retrospective Cohort Study.","authors":"Marko M Popovic, Jenna M Berinstein, Jovany Franco, Henry W Zhou, Sohat Sharma, Frances Wu, Rajeev Muni, Leo Kim","doi":"10.1159/000537814","DOIUrl":"10.1159/000537814","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the incidence of and risk factors for epiretinal membrane (ERM) formation following primary rhegmatogenous retinal detachment (RRD) repair.</p><p><strong>Methods: </strong>This comparative, retrospective, single-center cohort study included eyes with primary RRD treated between 2011 and 2023 at Massachusetts Eye and Ear, Boston, Massachusetts, with pars plana vitrectomy (PPV), scleral buckle (SB), PPV+SB, or pneumatic retinopexy (PnR). Demographic, clinical, and surgical parameters were collected from medical records. The primary outcome was the risk of ERM formation, while the secondary outcome was the risk of ERM requiring surgery. Univariable and multivariable Cox regression were performed, and a hazard ratio (HR) and 95% confidence interval (95% CI) were reported.</p><p><strong>Results: </strong>Overall, 394 eyes were included. The mean age was 58.49 ± 12.8 years, and most patients were male. There was a significantly lower risk of ERM formation following SB compared to PPV in the univariable analysis (HR = 0.2, 95% CI = 0.08-0.60, p = 0.003); however, there was no significant association between treatment modality and ERM formation on multivariable Cox regression controlling for confounding factors (p = 0.24). ERM formation was found more commonly in patients who were older (HR = 1.0 per 1 year increase in age, 95% CI = 1.01-1.04, p = 0.001), those with worse baseline visual acuity (HR = 1.3, 95% CI = 1.09-1.71, p = 0.008), and those with macula-off RRDs (HR = 2.1, 95% CI = 1.41-3.32, p &lt; 0.001).</p><p><strong>Conclusion: </strong>Surgical modality does not have a significant impact on the risk of ERM following retinal detachment repair. However, age, baseline visual acuity, and macular status are important predictors of ERM formation after RRD repair.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-9"},"PeriodicalIF":2.6,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140896925","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":"Quantitative Autofluorescence at AMD's Beginnings Highlights Retinal Topography and Grading System Differences: ALSTAR2 Baseline.","authors":"Andreas Berlin, Nathan A Fischer, Mark E Clark, Deepayan Kar, Thomas A Swain, Richard M Martindale, Gerald McGwin, Jason N Crosson, Kenneth R Sloan, Cynthia Owsley, Christine A Curcio","doi":"10.1159/000538696","DOIUrl":"10.1159/000538696","url":null,"abstract":"<p><strong>Introduction: </strong>The aims of the study were to describe baseline quantitative (short-wavelength) autofluorescence (qAF) findings in a large pseudophakic cohort at age-related macular degeneration (AMD)'s beginnings and to assess qAF8 as an outcome measure and evaluate Age-Related Eye Disease Study (AREDS) and Beckman grading systems.</p><p><strong>Methods: </strong>In the ALSTAR2 baseline cohort (NCT04112667), 346 pseudophakic eyes of 188 persons (74.0 ± 5.5 years) were classified as normal (N = 160 by AREDS, 158 by Beckman), early AMD (eAMD) (N = 104, 66), and intermediate AMD (iAMD) (N = 82, 122). Groups were compared via mean qAF intensities in a 6°-8° annulus (qAF8) and maps of differences between observations and the overall mean, divided by standard deviation (Z-score).</p><p><strong>Results: </strong>qAF8 did not differ significantly among diagnostic groups by either stratification (p = 0.0869 AREDS; p = 0.0569 by Beckman). Notably, 45 eyes considered eAMD by AREDS became iAMD by Beckman. For AREDS-stratified eyes, Z-score maps showed higher centrally located qAF for normal, near the mean in eAMD, and lower values for iAMD. Maps deviated from this pattern for Beckman-stratified eyes.</p><p><strong>Conclusions: </strong>In a large sample of pseudophakic eyes, qAF8 does not differ overall from normal aging to iAMD but also does not capture the earliest AMD activity in the macula lutea. AREDS classification gives results more consistent with a slow decline in histologic autofluorescence than Beckman classification.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-13"},"PeriodicalIF":2.1,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140849708","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":"Prediction of chronic central serous chorioretinopathy through combined manual annotation and AI-assisted volume measurement of flat irregular pigment epithelium.","authors":"Lorenzo Ferro Desideri, Davide Scandella, Lieselotte Berger, Raphael Sznitman, Martin Zinkernagel, Rodrigo Anguita","doi":"10.1159/000538543","DOIUrl":"https://doi.org/10.1159/000538543","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study is to investigate the role of an artificial intelligence (AI)-developed OCT program to predict the clinical course of central serous chorioretinopathy (CSC ) based on baseline pigment epithelium detachment (PED) features.</p><p><strong>Methods: </strong>Single-center, observational study with a retrospective design. Treatment-naïve patients with acute CSC and chronic CSC were recruited and OCTs were analyzed by an AI-developed platform (Discovery OCT Fluid and Biomarker Detector, RetinAI AG, Switzerland), providing automatic detection and volumetric quantification of PEDs. Flat irregular PED presence was annotated manually and afterwards measured by the AI program automatically.</p><p><strong>Results: </strong>115 eyes of 101 patients with CSC were included, of which 70 were diagnosed with chronic CSC and 45 with acute CSC. It was found that patients with baseline presence of foveal flat PEDs and multiple flat foveal and extrafoveal PEDs had a higher chance of developing chronic form. AI-based volumetric analysis revealed no significant differences between the groups.</p><p><strong>Conclusions: </strong>While more evidence is needed to confirm the effectiveness of AI-based PED quantitative analysis, this study highlights the significance of identifying flat irregular PEDs at the earliest stage possible in patients with CSC, to optimize patient management and long-term visual outcomes.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140331949","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":"Submacular hemorrhage during neovascular age-related macular degeneration: a meta-analysis and meta-regression on the use of tPA and anti-VEGFs.","authors":"Daniele Veritti, Valentina Sarao, Deborah Martinuzzi, Sara Menzio, Paolo Lanzetta","doi":"10.1159/000537939","DOIUrl":"10.1159/000537939","url":null,"abstract":"<p><strong>Background: </strong>Submacular hemorrhage (SMH) associated with neovascular age-related macular degeneration (nAMD) precipitates rapid visual decline and impacts quality of life. Treatments vary, but combined recombinant tissue plasminogen activator (tPA) and anti-vascular endothelial growth factor (anti-VEGF) therapy has gained prominence as a viable treatment option.</p><p><strong>Objectives: </strong>This study aims to evaluate the efficacy of the combination of tPA and anti-VEGF.</p><p><strong>Methods: </strong>We conducted a systematic review meta-analysis following PRISMA guidelines, focusing on studies examining tPA and anti-VEGF therapy in SMH secondary to nAMD. Outcomes measured were change in best-corrected visual acuity (BCVA) and success rate of SMH displacement. Meta-regression assessed the relative efficacy of intravitreal and subretinal delivery.</p><p><strong>Results: </strong>Out of 257 initial reports, 22 studies involving 29 patient populations met inclusion criteria. Our analysis showed significant improvement in BCVA and a high rate of successful SMH displacement with combined tPA and anti-VEGF therapy. No significant differences were found between subretinal and intravitreal tPA administration. Furthermore, when evaluating the effects of subretinal versus intravitreal anti-VEGF administration in patients treated with subretinal tPA, the results indicated similar efficacy.</p><p><strong>Conclusions: </strong>Combined tPA and anti-VEGF therapy is effective in managing SMH in nAMD patients, significantly improving visual acuity and SMH displacement. The location of tPA and anti-VEGF delivery did not significantly impact outcomes.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11326526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140331950","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}