Ophthalmologica最新文献

{"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":2.3,"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}

{"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":2.3,"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":"Early Retinal Changes Detected Using Optical Coherence Tomography Angiography in Youth with Type 1 Diabetes Mellitus: A Case-Control Study.","authors":"I-Hsin Ma, Wei-Lun Huang, Yao-Lin Liu, Yi-Ching Tung, Tzu-Hsun Tsai","doi":"10.1159/000552020","DOIUrl":"10.1159/000552020","url":null,"abstract":"<p><p><p>Introduction: Despite contemporary management, the incidence of diabetic retinopathy in adolescents during the first 2-5 years of type 1 diabetes mellitus (T1DM) remains unchanged, underscoring the need to better understand early retinal changes. In this study, we investigated early retinal changes in children with T1DM using optical coherence tomography angiography (OCTA). Incorporating a literature review of retinal changes in other age groups, we propose a model sequence of retinal changes in patients with T1DM.</p><p><strong>Methods: </strong>In this prospective case-control study, conducted at National Taiwan University Hospital from 2021 to 2023, we prospectively recruited children with T1DM from a pediatric endocrinology clinic and control children undergoing routine eye examinations at the Department of Ophthalmology. All patients and controls underwent comprehensive ophthalmological examinations and OCTA.</p><p><strong>Results: </strong>In the T1DM group, the average age at diagnosis was 7.39 ± 4.29 years, average diabetes duration was 5.0 ± 3.19 years, and average glycosylated hemoglobin level was 7.41 ± 0.92%. In the control group, the mean age was 10.8 ± 4.31 years, ranging from 5 to 20 years old, and that of diabetes mellitus (DM) group was 12.27 ± 4.32 years (p = 0.08). The T1DM group showed significant decreases in macular vessel density, particularly in the superficial and deep vascular plexuses. Full retinal thickness was greater in the perifoveal annulus in the T1DM group. Prepubertal onset of T1DM negatively impacted the superficial capillary plexus in both the parafoveal and perifoveal areas. Other DM factors did not significantly correlate with vascular parameters.</p><p><strong>Conclusion: </strong>Using OCTA, we detected early, clinically inapparent microvascular reductions in vessel density in children with T1DM, while retinal layer thickness remained preserved. These findings, along with previous literature, are consistent with a hypothetical sequence in which microvascular alterations detectable by OCTA, structural changes on OCT may occur sequentially and prior to clinically visible structural changes. </p>.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"363-373"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691342","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 and Microperimetry Outcomes of an Extended Macular Vision Intraocular Lens in Macular Atrophy.","authors":"Martin Bedersdorfer, Gregor von Ehrlich-Treuenstätt, Tristan Früh, Karl T Boden, Peter Szurman, Boris V Stanzel","doi":"10.1159/000552124","DOIUrl":"10.1159/000552124","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate visual acuity and microperimetry correlated with anatomical changes in eyes with macular diseases implanted with the EyeMax Mono intraocular lens (IOL) (SharpView Ophthalmology).</p><p><strong>Methods: </strong>A single-center retrospective, real-world case series was set in Knappschaft Eye Hospital, Sulzbach, Germany. Patients with macular disease who underwent EyeMax Mono IOL implantation were included. The outcome measures were corrected distance visual acuity (CDVA) and microperimetry indices: fixation stability and bivariate contour ellipse areas (BCEAs) at 63% and 95%. The geographic atrophy (GA) monitor (RetInSight) was used to analyze changes in retinal integrity.</p><p><strong>Results: </strong>Twenty-one eyes (11 patients; mean age 72.8 ± 8.3 years, mean follow-up 7.4 ± 4.0 months) were included. Preoperative GA measured 4.7 ± 4.0 mm2 (n = 14), and EZ loss on SD-OCT was 2,433.1 ± 1,009.5 µm (n = 17). The CDVA improved by 0.2 logMAR (p = 0.007, n = 21), with 12 eyes gaining ≥1 line and seven eyes gaining ≥3 lines. Fixation stability improved in two eyes, stabilized in nine eyes, and worsened in four eyes. The changes in BCEA were not statistically significant. Higher preoperative BCEA correlated with greater postoperative improvement (p < 0.001). In the foveal fixation group (n = 4), 75% and 50% of patients showed improved BCEA and CDVA, respectively. In extrafoveal fixation (n = 11), BCEA improved in 50% of patients, while 64% showed CDVA improvement. The GA monitor showed worsening in 9/15 eyes, and 4 eyes showed worsening on microperimetry without a CDVA decline. Anatomical changes stabilized in six eyes; of these, two exhibited a decline in microperimetry without a CDVA decline.</p><p><strong>Conclusions: </strong>EyeMax Mono IOL improved CDVA, although no significant changes were observed in the microperimetry indices. Better microperimetry outcomes were observed in extrafoveal fixation cases. While the optical design of the IOL likely contributes to visual improvement, the small sample size limited the statistical power to detect significant microperimetry changes.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"386-394"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729567","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":"Comparative Evaluation of High- versus Low-Viscosity Silicone Oil in Macula-Off Retinal Detachment: Emulsification, Inflammation, and AI-Assisted Biomarker Detection.","authors":"Cesare Mariotti, Silvia Iorio, Giulia Gregori, Enrico Nacciarriti, Lorenzo Mangoni, Clara Rizzo, Marco Lupidi","doi":"10.1159/000551074","DOIUrl":"10.1159/000551074","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to compare the emulsification rates, intraocular pressure (IOP) changes, and retinal hyperreflective foci (HRF) between low-viscosity (1,000 cS) and high-viscosity (5,000 cS) silicone oils (SOs) used as tamponade agents following 25-gauge pars plana vitrectomy (PPV) in cases of naïve macula-off rhegmatogenous retinal detachment using an artificial intelligence (AI)-based quantification approach.</p><p><strong>Methods: </strong>This retrospective study was conducted in eyes treated with PPV and SO tamponade. The clinical parameters that were assessed included best-corrected visual acuity (BCVA), IOP, the presence of emulsification in the iridocorneal angle - in the anterior or posterior chambers, and structural retinal biomarkers such as intraretinal fluid, subretinal fluid, and HRF detected and quantified through an AI-based analysis of spectral-domain optical coherence tomography (OCT) images.</p><p><strong>Results: </strong>Twenty-five eyes were enrolled (12 with 1,000-cS SO and 13 with 5,000-cS SO endotamponades) for this study. No statistically significant differences in BCVA or anatomical outcomes between the two groups were found. However, SO emulsification occurred more often in the 1,000-cS group (66%) compared to the 5,000-cS group (7%) (p = 0.0036). Elevated IOP was more frequent in the 1,000-cS group (8 vs. 4 cases; p = 0.03), and HRF count was significantly higher in eyes with 1,000-cS oil (p = 0.04).</p><p><strong>Conclusion: </strong>High-viscosity SO demonstrated a lower emulsification rate and reduced inflammatory response compared to low-viscosity SO, with no compromise in visual outcomes. AI-assisted OCT analysis enabled an accurate, automated detection of HRF, supporting its utility in monitoring SO-related complications.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"230-237"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147308677","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":"Optimal Timing for Idiopathic Epiretinal Membrane Peeling Surgery Based on a Preoperative Visual Acuity Threshold.","authors":"Jules Fricker, Lucas Sejournet, Benoît Allignet, Yasmine Serrar, Ilyès Barkat, Jacques Chumbi-Flores, Mariam Ghazaryan, Marieta Rushanyan, François Devin, Ariane Malcles, Thibaud Mathis, Laurent Kodjikian","doi":"10.1159/000550589","DOIUrl":"10.1159/000550589","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to evaluate the efficacy and safety of vitrectomy-peeling for idiopathic epiretinal membrane (iERM) in patients with preserved preoperative best-corrected visual acuity (BCVA) compared to those with reduced BCVA and determine the optimal preoperative VA threshold for intervention.</p><p><strong>Methods: </strong>This single-center retrospective cohort study analyzed 415 eyes from 368 patients who underwent iERM surgery between January 2019 and July 2023. Epidemiological, surgical, and spectral domain-optical coherence tomography data were collected preoperatively and at each follow-up visit. Patients were divided into three groups based on preoperative BCVA: poor (≤60 Early Treatment Diabetic Retinopathy Study [ETDRS] letters), moderate (61-76 ETDRS), and good (≥77 ETDRS). The primary outcome was final BCVA at the last visit, while secondary outcomes included analyzing surgical complications and preoperative predictive factors to develop a predictive model of postoperative BCVA.</p><p><strong>Results: </strong>Median preoperative BCVA was 75 ETDRS letters (IQR 70-80), improving significantly postoperatively to 80 ETDRS (IQR 75-85) (p < 0.001). BCVA improved across all groups: from 60 to 67.5 (IQR 60-77) in the poor group (p < 0.001), from 70 to 80 (IQR 75-83.5) in the moderate group (p < 0.001), and from 80 to 82 (IQR 80-85) in the good group (p < 0.001). The optimal preoperative BCVA threshold was 75 letters, through an iterative process increasing in 5 ETDRS letter increments, with no significant differences in complications between groups (p = 0.81).</p><p><strong>Conclusion: </strong>Patients with good preoperative BCVA achieved better final BCVA. Performing vitrectomy-peeling for idiopathic ERM at BCVA >75 ETDRS letters leads to optimal visual outcomes without increasing complications.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"182-196"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093573","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":"Aflibercept 2 mg for Neovascular Age-Related Macular Degeneration: XTEND at 3 Years.","authors":"Jean-François Korobelnik, Varun Chaudhary, Paul Mitchell, Se Woong Kang, Helmut Allmeier, JinKyung Lee, Xin Zhang, Tobias Machewitz, Clare Bailey","doi":"10.1159/000549663","DOIUrl":"10.1159/000549663","url":null,"abstract":"<p><p><p>Introduction: Long-term, global data evaluating intravitreal aflibercept (IVT-AFL) 2 mg for treatment of neovascular age-related macular degeneration (nAMD) in real-world practice are needed. This study investigated the long-term, real-world effectiveness and safety of IVT-AFL 2 mg in patients with nAMD.</p><p><strong>Methods: </strong>XTEND was a multicenter, observational, prospective study. Enrollment was conducted between May 2019 and May 2020; the patient follow-up period was 36 months. Treatment-naïve patients were treated with IVT-AFL 2 mg (fixed dosing or treat-and-extend [T&E]) according to the local label; for the T&E regimen, treatment intervals could be extended according to the national label (either European Medicines Agency [EMA]-aligned or non-EMA-aligned).</p><p><strong>Results: </strong>Overall, 1,483 patients across 17 countries were treated with IVT-AFL 2 mg; mean ± standard deviation (SD) age was 78.8 ± 8.5 years; 60.4% were female. Overall, 62.6% of patients completed the 36-month follow-up visit. The mean (95% confidence interval [CI]) changes in best-corrected visual acuity from baseline were +4.6 (3.7, 5.4), +2.3 (1.3, 3.3), and +0.9 (-0.2, 1.9) at months 12, 24, and 36, respectively. The mean (95% CI) changes in central subfield thickness from baseline were -106 (-114, -99) μm, -109 (-117, -102) μm, and -110 (-118, -103) μm at months 12, 24, and 36, respectively. The mean ± SD numbers of injections from baseline to months 12, 24, and 36 were 7.7 ± 2.7, 11.3 ± 5.3, and 13.7 ± 7.5, respectively. No new safety concerns were identified.</p><p><strong>Conclusion: </strong>This study demonstrates that improvements with IVT-AFL 2 mg were maintained through month 36, suggesting that long-term durability of vision is achievable in patients with treatment-naïve nAMD in real-world practice. </p>.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"17-29"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12782608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573877","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":"Densiron 68 Tamponade Duration and Redetachment Risk after Removal in Inferior Proliferative Vitreoretinopathy-Associated Retinal Detachment.","authors":"Adriano Carnevali, Domenico Chisari, Alessandra Mancini, Massimiliano Borselli, Giovanni Scalia, Giovanna Carnovale Scalzo, Andrea Lucisano, Vincenzo Scorcia","doi":"10.1159/000551398","DOIUrl":"10.1159/000551398","url":null,"abstract":"<p><strong>Introduction: </strong>Inferior retinal detachment (I-RD) complicated by proliferative vitreoretinopathy (PVR) is challenging to treat and prone to recurrence (retinal detachment recurrence [RDR]). Heavy silicone oil (HSO) tamponades such as Densiron 68 have improved inferior tamponade and are widely used in this setting. It was evaluated whether prolonged Densiron 68 tamponade (>3 months) protects against RDR after oil removal, overall and in patients with previous failed retinal detachment (RD) surgery.</p><p><strong>Methods: </strong>We retrospectively reviewed 112 consecutive eyes with rhegmatogenous I-RD and grade-C PVR treated with pars plana vitrectomy and Densiron 68. Mean follow-up after oil removal was ∼12 months. Multivariate logistic regression was performed including laterality, sex, age, tamponade duration, previous failed RD surgery, previous silicone oil tamponade, lens status, and 360° laser retinopexy. Patients were then stratified by history of failed RD surgery (History-/History+) and by tamponade duration (short ≤3 months vs. long >3 months).</p><p><strong>Results: </strong>After Densiron 68 removal, 24 eyes (29.3%) developed RDR. Anatomical success was 63.0% with one operation and no tamponade, 82.6% after additional procedures, and 92.4% including eyes stable with silicone oil in situ. In multivariate analysis, no covariate was significantly associated with RDR; prolonged tamponade was not protective overall (OR = 1.02; p = 0.867). Previous failed RD surgery showed the strongest association with higher recurrence risk (OR = 1.15; p = 0.070). Stratified analysis revealed that eyes with previous failed RD surgery had significantly higher odds of RDR (OR = 4.44; p = 0.0028). Within this group, prolonged tamponade was associated with lower recurrence compared with short tamponade (OR = 3.96; p = 0.025). In eyes without prior surgery, tamponade duration had no effect (p = 0.979). Most recurrences (84.85%) occurred within 3 months from surgery.</p><p><strong>Conclusion: </strong>Prolonged Densiron 68 tamponade did not reduce RDR risk in the overall cohort but conferred protection in eyes with previous failed RD surgery. Extending tamponade may therefore be justified in specific high-risk group of patients, while routine prolongation in lower-risk cases appears unnecessary. Prospective validation is needed to refine timing of HSO removal and optimize outcomes.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"329-339"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691402","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":"Comparative Real-World Efficacy of Anti-Vascular Endothelial Growth Factor Agents in Neovascular Age-Related Macular Degeneration: A Multicenter Retrospective Study.","authors":"Efraim Berco, Yuval Kozlov, Michael Ostrovsky, Raman Tuli, Thomas Kin Man Lee, Ksenia Samocha, Eilon Shcolnik, Shalhevet Goldfeather Ben Zaken, Nir Shoham-Hazon","doi":"10.1159/000550160","DOIUrl":"10.1159/000550160","url":null,"abstract":"<p><p><p>Introduction: This study directly compared the real-world effectiveness of bevacizumab, aflibercept 2 mg, and ranibizumab as first-line treatments for neovascular age-related macular degeneration (nvAMD).</p><p><strong>Methods: </strong>A multicenter retrospective cohort of treatment-naïve nvAMD eyes managed with a treat-and-extend regimen in Israel and Canada. Primary outcomes were changes in visual acuity (VA) and central retinal thickness (CRT). Secondary outcomes included treatment burden (total injections and final maintained interval), non-response (persistent/worsening exudation or functional decline despite adequate treatment), non-extension (final interval of 4 weeks), and absence of active exudation.</p><p><strong>Results: </strong>A total of 322 eyes received bevacizumab (n = 174), aflibercept (n = 110), or ranibizumab (n = 38) over a mean follow-up of 16.75 ± 12.66 months. Mean VA improved from 0.77 ± 0.47-0.60 ± 0.45 logarithm of the minimum angle of resolution following an average of 10.5 ± 6.3 injections. Aflibercept produced greater CRT reduction (-51.94 μm; p < 0.001), fewer injections (-2.35; p = 0.001), longer final intervals (+2.14 weeks; p < 0.001), and lower odds of non-response (adjusted odds ratio [aOR] 0.016; p < 0.001) and non-extension (aOR 0.128, p < 0.001) versus bevacizumab. It showed the largest mean VA gain, just short of significance on multivariable analysis (p = 0.059). Ranibizumab showed greater CRT reduction (-44.53 μm; p = 0.012) and lower non-extension odds (aOR 0.079; p = 0.001) than bevacizumab but did not significantly reduce treatment burden or improve VA.</p><p><strong>Conclusion: </strong>In this first real-world, head-to-head comparison, aflibercept and ranibizumab outperformed bevacizumab in key anatomic and treatment-efficiency outcomes, with aflibercept showing the most consistent advantages. These findings highlight clinically relevant differences among anti-vascular endothelial growth factor agents and underscore the importance of real-world data to guide nvAMD management. </p>.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"50-60"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12845526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794446","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":"Three-Year Follow-Up after Fluocinolone Acetonide Implant Injected 1 Month after Dexamethasone Implant for Treating Diabetic Macular Edema: The ILUVI1MOIS Study.","authors":"Lisa Delperier, Nicolas Rousseau, Thomas Charles Victor Goronflot, Alexy Henry, Olivier Lebreton, Hélène Massé, Yann Maucourant, Valentin Pipelart, Manon Clément, Marie-Laure Le Lez, Raoul Kanav Khanna, Adam Mainguy, Michel Weber, Alexandra Poinas, Jean-Baptiste Ducloyer","doi":"10.1159/000551760","DOIUrl":"10.1159/000551760","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this multicenter study was to assess the efficacy and safety of injecting a fluocinolone acetonide implant (FACi) 1 month after the last dexamethasone implant (DEXi) intravitreal injection (IVI) in chronic diabetic macular edema (DME) patients.</p><p><strong>Methods: </strong>This retrospective study evaluated a standardized care protocol implemented across 5 centers. Inclusion criteria were as follows: pseudophakic, chronic DME treated with DEXi every <6 months, FACi injected 1 month after the last DEXi. Best corrected visual acuity (BCVA), intraocular pressure (IOP), and additional treatment were assessed on the day of FACi injection (M0), 1 (M1), and 3 months (M3) later and then every 3 months until month 36 (M36).</p><p><strong>Results: </strong>Thirty-seven eyes (30 patients) were included: the median age was 73 (interquartile range [IQR]: 66, 78) years and the median DME duration was 72 [59, 84] months. The mean BCVA was 62.8 ± 17.7 letters at M0 and remained stable throughout the follow-up. The cumulative incidence of additional IVI was 35.1% [95% CI: 20.2; 50.5] at M12 and 70.1% [51.3; 82.8] at M36. Among the 25 eyes with additional IVI, the median reinjection interval increased by a factor of 4.3 [2.2; 8.4]. The mean IOP was 15.8 ± 4.1 mm Hg at M0 and remained stable during the follow-up. The cumulative incidence of the \"IOP >30 mm Hg\" event was 2.7% [0.0; 12.2] at M12 and 18.8% [7.2; 34.4] at M36. One patient underwent incisional surgery (Xen stent implantation).</p><p><strong>Conclusion: </strong>Injecting FACi 1 month after the last DEXi in patients requiring DEXi IVI every <6 months allowed maintaining the BCVA while spacing out or even discontinuing IVI with limited IOP concerns.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"340-351"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147531607","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}