Ophthalmologica最新文献

{"title":"Intravitreal Tamponade Agents in Vitreoretinal Surgery: Current Advances and Future Directions.","authors":"Marco R Pastore, Alberto Grotto, Marco Celega, Cosmin Sava, Alessandra Martina, Olimpia Colombo, Eric H Souied, Daniele Tognetto","doi":"10.1159/000550824","DOIUrl":"10.1159/000550824","url":null,"abstract":"<p><strong>Background: </strong>Intravitreal tamponades are essential tools in vitreoretinal surgery, widely used for the treatment of posterior segment pathologies. Conventional tamponade agents - such as intraocular gases and silicone oils - have significantly improved surgical outcomes but are associated with limitations including the need for specific postoperative positioning, intraocular pressure fluctuations, and in some cases, secondary removal procedures.</p><p><strong>Summary: </strong>This review provides a comprehensive overview of currently available intravitreal tamponade agents, highlighting their indications, physical properties, clinical applications, and complications. Special attention is given to heavy tamponades, perfluorocarbon liquids, and recent developments in tamponade strategies. The article also explores future directions, including drug-eluting tamponades and the development of synthetic vitreous substitutes that aim to mimic the native vitreous body and reduce the need for postoperative interventions.</p><p><strong>Key message: </strong>While current tamponade agents remain indispensable in vitreoretinal surgery, ongoing research into smarter, safer, and more physiologically compatible materials holds great promise. Future tamponades may not only offer mechanical support but also actively contribute to retinal healing and pharmacologic delivery, potentially transforming the standard of care in retinal surgery.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"249-264"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146181753","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":"Consensus Recommendations on the Use of Per- and Polyfluoroalkyl Substances-Containing Ocular Endotamponades.","authors":"Mario R Romano, Mariantonia Ferrara, Martin Zinkernagel, David H Steel, Salvador Pastor-Idoate, Antonio Boccardi, Aude Couturier, Jana D'Amato Tothova, Vivek Pravin Dave, Belma Dikme, Martina Dunkel, Nicole Eter, Jens Folke Kiilgaard, Francesc March de Ribot, Helge Menz, Siegfried Priglinger, Peter Szurman, Tom H Williamson, Anat Loewenstein, Alistair Laidlaw","doi":"10.1159/000550950","DOIUrl":"10.1159/000550950","url":null,"abstract":"<p><p>We conducted an expert-led consensus to develop recommendations on the use of per- and polyfluoroalkyl substances (PFAS)-containing ocular endotamponades (OEs) in vitreoretinal surgery, aiming to promote a more sustainable surgical practice. We used a modified Delphi methodology with panel consisting of fourteen vitreoretinal surgeons and five representatives of companies involved in OEs production and marketing. Based on a literature review and the latest updates on European Union's PFAS restriction proposal, the facilitator prepared a list of statements on PFAS-containing OEs currently used. Each statement was graded individually using a nine-point scale (from 1 \"absolutely disagree\" to 9 \"absolutely agree\") and the consensus was defined as a score between 7 and 9 from ≥80% of members. After two rounds, and related discussion, the recommendations highlighted the crucial role of PFAS-containing OEs in surgical practice and the potential negative impact of their ban on patients' outcomes. There was a strong agreement on the need of perfluorocarbon liquids as intraoperative tool, although it was also pointed out that their use should be avoided if possible. Fluorinated gases were deemed essential with no agreement on the possibility to replace SF6 and/or C2F6 with C3F8 at different concentrations. Conversely, semifluorinated alkanes as rinsing solution as well as F6H8 were considered extraneous. No consensus was reached about the current role of heavy silicone oils. Finally, the use of air as alternative and environment-friendly OE was judged not supported by sufficient evidence but worth of further investigation.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"275-287"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258907","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":"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":"Gas Tamponade-Free Vitrectomy with Suprachoroidal Buckling for the Treatment of Rhegmatogenous Retinal Detachment: Long-Term Results of a Case Series.","authors":"Shohista Saidkasimova, Jared Ching, Aadil Hussain, Timothy L Jackson","doi":"10.1159/000551698","DOIUrl":"10.1159/000551698","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical treatment of rhegmatogenous retinal detachment is evolving. The purpose of this paper is to describe the clinical results of retrospective consecutive case series of suprachoroidal viscobuckling, without gas tamponade, for the treatment of rhegmatogenous retinal detachment. Nine patients with retinal detachment due to a single retinal break or few breaks within 1 clock hour were included.</p><p><strong>Methods: </strong>Patients were treated with pars plana vitrectomy, trans-scleral suprachoroidal injection of sodium hyaluronate under the break to create a temporary indent, laser retinopexy, and no gas tamponade, under local anaesthesia. The main outcome measure was retinal reattachment at 12 weeks and adverse events.</p><p><strong>Results: </strong>All patients had closure of the causative break, but in 1 patient there was a small area of peripheral retinal detachment due to a missed break. This was walled off with laser barrage and was non-progressive. Eight cases had successful primary reattachment, and all had final reattachment. There was 1 case of raised intraocular pressure that responded to topical therapy but no clinically significant complications.</p><p><strong>Conclusions: </strong>Vitrectomy and viscobuckle for simple retinal detachment appears to be safe and effective. This has the potential to reduce the burden of recovery and complications associated with gas tamponade and permanent buckling. Further study appears warranted.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"313-319"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581844","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":"Elevated Anxiety Levels in Central Serous Chorioretinopathy: Evidence from a Prospective Case-Control Study.","authors":"Saloni Joshi, Manavi D Sindal, Maithili Umate, Jay Chhablani","doi":"10.1159/000550428","DOIUrl":"10.1159/000550428","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to compare association of anxiety disorder in patients with CSCR and age-gender-matched healthy controls in a prospective study.</p><p><strong>Methods: </strong>This prospective cross-sectional case-control questionnaire-based survey included participants in the age group of 18-55 years, presenting with treatment naïve CSCR, as group A. Age and gender matched normal controls were included as group B. For assessment of anxiety, the Hamilton Anxiety Rating Scale (HAM-A) was administered to both groups by a trained study coordinator. The anxiety scores were graded as follows: no/minimal anxiety <7, mild 8-14, moderate 15-23, severe >24. The scoring was assessed using chi-square/Fischer's exact test.</p><p><strong>Results: </strong>The study recruited a total of 100 participants in each arm. There was a male preponderance in both groups, with a mean age of 39.61 + 6.07 years in group A and 40.07 + 8.74 years in group B. Among those with CSCR, 16% had mild anxiety, 46% moderate, 36% had severe, and 2% did not have any anxiety, while in the control population, 13% had moderate anxiety, and 1 had severe anxiety. The odds of those with CSCR having anxiety were 5 times more than the controls (OR 5.71 [4.20-7.22], p < 0.0001).</p><p><strong>Conclusion: </strong>This study highlights the strong association of anxiety with CSCR compared to healthy controls. Anxiety alters the internal hormonal milieu, leading to excess endogenous steroid secretion that contributes to the occurrence of CSCR. Addressing anxiety and encouraging lifestyle modifications in patients with CSCR can be a potential avenue to manage these cases.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"167-174"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030303","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":"Clinical Guidelines for the Diagnosis and Management of Retinal Artery Occlusions by the Spanish Society of Retina and Vitreous.","authors":"Pablo Carnota-Méndez, Lidia Remolí-Sargues, Sergio Copete, Álvaro Fernández-Vega-Gonzálezd, Javier Montero-Hernández, Javier Zarranz-Ventura, Maria Socorro Alforja-Castiella, Arturo Renú-Jornet, Antonio Doncel-Moriano, Francisco Gómez-Ulla, Susana Ruiz-Bilbao, José Viéitez-Vázquez, Carlos Méndez-Vázquez, Cristina Blanco-Marchite, Almudena Moreno-Martínez, Nicolás Sánchez-Maluf, Nuria Olivier-Pascual","doi":"10.1159/000551309","DOIUrl":"10.1159/000551309","url":null,"abstract":"<p><p>Retinal artery occlusions (RAOs) constitute a rare but serious ophthalmological emergency with a poor prognosis for visual recovery, for which there is currently no adequate therapeutic strategy. However, there is substantial evidence highlighting the importance of systemic (non-ophthalmological) management of patients with RAO. Since RAOs are the ocular analogous of a cerebral stroke, they require a similar urgent, multidisciplinary approach involving laboratory tests and imaging studies that go beyond the typical scope of ophthalmologists. This calls for cooperation and understanding from all stakeholders, including neurologists, radiologists, interventional neuroradiologists, emergency and primary care physicians, as well as patients and the wider community. Therefore, while there are presently no proven therapies to restore vision following RAOs, the ophthalmologist's primary responsibility lies in prompt systemic referral. It is imperative to exclude underlying vascular pathology to rule out concurrent cerebrovascular disease and to minimize the risk of subsequent cerebrovascular and cardiovascular events. These guidelines have been developed by a panel of retina specialists in Spain, representing the Spanish Retina and Vitreous Society (SERV). The recommendations provided are derived from an evidence-based expert consensus methodology and not from a formal systematic review. The aim was to inform ophthalmologists and other healthcare professionals who care for these patients about the significance and seriousness of the condition, support decision-making regarding appropriate ophthalmological and systemic management, and provide a foundation for creating protocols.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"288-312"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444502","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}