Ophthalmologica最新文献

{"title":"Burn and Bury: A Novel Technique to Avoid Conjunctival Peritomy.","authors":"Pietro Maria Talli, Ginevra Giovanna Adamo, Sami Al-Nawaiseh, Antonio Cartabellotta, Laura Sarti, Abdulrahman Badawi, Marco Pellegrini, Marco Mura","doi":"10.1159/000550624","DOIUrl":"10.1159/000550624","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to evaluate the safety and feasibility of a novel surgical technique for subconjunctival burial of 10-0 Prolene sutures without conjunctival peritomy.</p><p><strong>Methods: </strong>A retrospective case series of 12 patients who underwent trans-scleral suture fixation or silicone oil retention suture placement using 10-0 Prolene sutures was conducted between January 2024 and February 2025 at Sant'Anna University Hospital, University of Ferrara, Italy. Inclusion criteria included adults requiring scleral fixation with 10-0 Prolene. Exclusion criteria included prior conjunctival surgery at the site, active ocular surface disease, or inability to complete follow-up. Instead of conjunctival peritomy, a linear high-temperature cautery was applied along the intended suture path to create a fibrotic track. Sutures were passed trans-scleral and left exposed on the cauterized zone, allowing spontaneous re-epithelialization. Follow-up included slit-lamp examination, anterior segment photography, and optical coherence tomography at 1 day, 1 week, and 1, 3, and 6 months.</p><p><strong>Results: </strong>A total of 12 patients (12 eyes) were included. Successful suture burial was achieved in all 12 eyes (100%) without exposure, extrusion, or conjunctival dehiscence during the 6-month follow-up. Re-epithelialization was complete by day 7 in all cases (12/12, 100%). No patient reported foreign body sensation after day 7. There were no infections, granulomas, or surgery revisions.</p><p><strong>Conclusions: </strong>The \"Burn and Bury\" technique is a safe and minimally invasive alternative to conjunctival peritomy for burying trans-scleral Prolene sutures. It preserves conjunctival integrity, reduces surgical trauma, promotes rapid epithelial healing, and enhances patient comfort. This technique may be broadly applicable in anterior segment procedures requiring scleral suture fixation and warrants prospective validation.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"213-218"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227606","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 Concentration Errors in Vitreoretinal Surgery: Insights from a Model of Gas Mass Transfer Dynamics.","authors":"Luke Michaels, Mariantonia Ferrara, Joseph van Batenburg-Sherwood, Mario R Romano, Jean-Yves Guillemaut, Tom H Williamson","doi":"10.1159/000551468","DOIUrl":"10.1159/000551468","url":null,"abstract":"<p><p><p>Introduction: Concentration mix errors of fluorinated gases commonly used in vitreoretinal surgery can lead to catastrophic elevations in intraocular pressure (IOP). The timing and optimal management of this complication is poorly understood. This study aimed to evaluate the impact of controlled venting on IOP elevation following simulated gas mix errors.</p><p><strong>Methods: </strong>A validated mass transfer model of intraocular gas dynamics was used to simulate the properties of \"isovolumetric\" gas concentrations of 20% SF₆, 16% C₂F₆, and 12% C₃F₈, along with the most common concentration mix errors: double concentration, 10/3 (3.33×) concentration, and 100% gas. Simulations were performed on eyes with vitreous cavity volumes of 4.0 mL, 7.2 mL, and 10.0 mL (representing hyperopic to highly myopic eyes). The model calculated gas volume and IOP over time, both before and after controlled venting events to normalise IOP.</p><p><strong>Results: </strong>All gas concentration errors produced complete gas fill and rapid IOP elevations. Only double concentration errors generated IOPs potentially manageable with medical therapy (peak 60 mm Hg for 40% SF₆, 75 mm Hg for 32% C₂F₆, 61 mm Hg for 24% C₃F₈). Simulated 10/3 (3.33×) and 100% concentrations resulted in extreme IOP elevations incompatible with ocular perfusion. Controlled gas venting on day 1 normalised IOP for SF₆ but repeated venting procedures were required for C₂F₆ and C₃F₈ due to continued gas re-expansion. Eyes with larger vitreous cavities experienced prolonged IOP elevation and delayed equilibration after venting.</p><p><strong>Conclusion: </strong>Gas concentration mix errors produce rapid and often unsalvageable IOP rises. While limited SF₆ over-concentrations may be temporarily stabilised with medical therapy and controlled venting, most scenarios, especially involving C₂F₆ or C₃F₈, require urgent surgical complete gas exchange. </p>.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"320-328"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147459345","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":"Intravitreal Fluocinolone Acetonide Implant for Diabetic Macular Edema: 2-Year Results from IDEAL, a Prospective German Observational Study.","authors":"Focke Ziemssen, Hakan Kaymak, Michaela Siebert, Ramin Khoramnia","doi":"10.1159/000551863","DOIUrl":"10.1159/000551863","url":null,"abstract":"<p><p><p>Introduction: The prospective, observational IDEAL study evaluated the effectiveness and safety of the long-acting fluocinolone acetonide (FAc) implant in patients with chronic diabetic macular edema (DME) and examined the influence of various baseline factors on treatment success.</p><p><strong>Methods: </strong>Patients with persistent DME despite prior treatment with available therapies who received FAc implant were included from 35 ophthalmological centers in Germany and monitored for up to 24 months. Demographic and clinical data, including disease duration, previous treatment, best-corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP), and adverse events were recorded at routine visits and analyzed descriptively, also in predefined groups.</p><p><strong>Results: </strong>Overall, 214 eyes from 185 patients (57% male) with a mean (SD) age of 66.2 (9.7) years were followed up for a mean (SD) of 21.53 (6.49) months. Functional and anatomical improvements occurred rapidly within 1 week after FAc injection and were sustained over 24 months in these previously intensively treated eyes (72.9% laser treatment, 79.9% intravitreal therapy with dexamethasone and/or anti-VEGF inhibitors, 28.9% vitrectomy). Mean BCVA increased from 55.8 (18.4) letters at baseline to 60.9 (19.0) letters at 24 months, with comparable results across subgroups defined by baseline characteristics. Eyes with fewer than two prior dexamethasone injections showed a more pronounced CMT reduction. In a subset with early follow-up, greater CMT reduction at week 1 was strongly associated with greater CMT reduction at month 1. Mean IOP in the total cohort increased from 15.3 ± 3.3 mm Hg to 17.4 ± 4.8 mm Hg within 9 months and returned to 16.7 ± 5.0 by month 24. IOP lowering was required in 35.5% of eyes (topical medication), and 4.6% underwent IOP-lowering surgery.</p><p><strong>Conclusion: </strong>The IDEAL observational study demonstrated a rapid onset of effect and reaffirmed the long-term efficacy and safety of the FAc implant in a large cohort of patients with persistent DME despite extensive prior treatment, thus underlining the high medical need of this treatment option for DME patients insufficiently responding to other therapies. </p>.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"352-362"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Outcomes of Epiretinal Membranes with and without Epiretinal Proliferation: A Comparative Study.","authors":"Alberto Quarta, Lisa Toto, Matteo Gironi, Maria Ludovica Ruggeri, Agbeanda Omer Aharrh-Gnama, Annamaria Porreca, Lucio Zeppa, Franco Gabriele, Enrica Greco, Marta Di Nicola, Rodolfo Mastropasqua","doi":"10.1159/000549449","DOIUrl":"10.1159/000549449","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to compare clinical findings, OCT characteristics, and postoperative outcomes in eyes with epiretinal membrane (ERM) with and without associated epiretinal proliferation (EP).</p><p><strong>Methods: </strong>Eyes with ERM with or without associated EP were analyzed for clinical findings and OCT characteristics. The primary outcomes measured were changes in best-corrected visual acuity (BCVA) and OCT features from baseline to the final follow-up visit. Patients with ERM were categorized into two groups based on the presence or absence of EP. Surgical outcomes were also evaluated.</p><p><strong>Results: </strong>Significant changes were reached in each group, particularly for BCVA (p < 0.001 for the ERM group, p = 0.010 for the EP-ERM group). Compared with ERM eyes, EP-ERM had a lower BCVA recovery at 6 months after surgery (p = 0.009). EP-ERM patients demonstrated more frequent microcystic macular edema (MME) (73.3% vs. 37.1%, p = 0.008) and increased central retinal thickness (CRT) (p < 0.001) at 6 months after surgery. No statistically significant differences in terms of external limiting membrane and ellipsoid zone defects were registered at 6 months (p = 0.234, p = 0.446, respectively).</p><p><strong>Conclusion: </strong>EP-ERM showed poorer post-surgical BCVA compared with ERM alone. EP-ERM had a greater chance of MME at 6 months after surgery, with higher CRT. These findings highlight the need for deeper assessment of ERM characteristics to accurately predict surgical outcomes.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"8-16"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458670","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":"Readability of AI and Ophthalmologist Responses to Patient Surgery Queries: Comment.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1159/000545970","DOIUrl":"10.1159/000545970","url":null,"abstract":"","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"103-104"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976254","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":"Predictive Value of Optical Coherence Tomography Biomarkers on Visual Outcomes in Patients with Retinal Vein Occlusion.","authors":"Rachid Bouchikh-El Jarroudi, Pablo Enrique Díaz-Aljaro, Jordi Castellví-Manent, Nevena Romanic Bubalo, Rubén Dario Fernandez-Torrón, Antonio Sabala Llopart, Judit Ruiz-Mata, Susana Castillo-Acedo, María Larrousse Morellón, Cristina Tural Llacher, Susana Ruiz-Bilbao","doi":"10.1159/000550350","DOIUrl":"10.1159/000550350","url":null,"abstract":"<p><strong>Introduction: </strong>This article aimed to evaluate the prognostic significance of different optical coherence tomography (OCT) imaging biomarkers in predicting visual outcomes in patients with retinal vein occlusion (RVO).</p><p><strong>Methods: </strong>This was a retrospective study conducted on consecutive patients diagnosed with RVO, who were referred to or treated at a third-level university hospital. The primary endpoints were the mean change in best corrected visual acuity (BCVA) from baseline to the month 6, month 12, and month 18 follow-up visits, and the influence of OCT imaging biomarkers, including ellipsoid zone (EZ) alterations, disorganization of the retinal inner layers (DRILs), hyperreflective foci, neurosensorial detachment, and fibrosis on functional outcomes, defined as a BCVA improvement of ≥5 ETDRS letters.</p><p><strong>Results: </strong>One hundred and sixty-three eyes were included. In the overall study sample, mean (standard error) BCVA increased significantly from 49.6 (1.8) letters at diagnosis to 54.6 (1.8) letters at month 6 (p = 0.0069), 54.3 (1.9) letters at month 12 (p = 0.0071), and 53.6 (1.9) letters at month 18 (p = 0.0313). In multivariate analysis, the presence of EZ alterations at diagnosis (OR: 0.19; p = 0.0008) and their persistence to month 12 (OR: 0.34; p = 0.0043) were associated with a reduced probability of achieving a BCVA improvement of ≥5 ETDRS letters at month 12. By month 18, significant predictors of visual outcomes included EZ alterations at diagnosis (OR: 0.19; p = 0.0008), sustained EZ alterations through 18 months (OR: 0.34; p = 0.0043), and DRIL at month 18 (OR: 0.38; p = 0.0321).</p><p><strong>Conclusions: </strong>The presence of EZ alterations at diagnosis and their persistence at 12 and 18 months, along with DRIL at 18 months, were adverse prognostic markers for BCVA outcomes in patients with RVO.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"145-157"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912666","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":"MAGIC: Study Design and Rationale for the Phase 2 Clinical Trial of Faricimab for Non-Proliferative Diabetic Retinopathy.","authors":"Avery W Zhou, Ryan A Sahraravand, Liisa M Baumann, Gail Megan Teagle, Jeremiah Brown, Dante Pieramici, Sarah E Holy, Michael J Borne, Robert W Wong, Matthew A Cunningham, William A Pearce, Effie Z Rahman, Margaret Chang, Abdhish R Bhavsar, David M Brown, Daniel Virgil Alfaro, Kenneth C Fan, Lasse Jørgensen Cehofski, Michael Ip, Srinivas R Sadda, Luis A Lesmes, Justis P Ehlers, Varun Chaudhary, Hasenin Al-Khersan, Charles C Wykoff","doi":"10.1159/000550491","DOIUrl":"10.1159/000550491","url":null,"abstract":"<p><p><p>Purpose: Describe the design and rationale of the MAGIC (<ext-link ext-link-type=\"uri\" xlink:href=\"http://ClinicalTrials.gov\" xmlns:xlink=\"http://www.w3.org/1999/xlink\">ClinicalTrials.gov</ext-link> identifier, NCT05681884) trial assessing change in retinal nonperfusion (RNP) among eyes with non-proliferative diabetic retinopathy (NPDR) in sham and treated patients.</p><p><strong>Design: </strong>Phase 2 prospective, randomized, multicenter, open-label, clinical trial.</p><p><strong>Participants: </strong>Adults with NPDR and substantial RNP (>5 disc areas) on ultra-widefield fluorescein angiography images.</p><p><strong>Methods: </strong>Patients will be randomized (1:1) into 1 of 2 arms: group 1 receiving intravitreal faricimab 6 mg every 4 weeks (Q4W) and group 2 being observed Q16W. At 48 weeks, group 1 will receive faricimab Q16W and group 2 will initiate faricimab Q4W through the final trial endpoint at year 2. The primary endpoint is change in RNP area through week 48. Secondary endpoints include change in RNP area through week 96; percentage of neovascularization, vitreous hemorrhage, DME, and/or PDR development; change in best-corrected visual acuity; change in central subfield thickness; contrast sensitivity (CS) measured using the quantitative contrast sensitivity function (qCSF); detection of apoptosing retinal cells (DARC) analysis; and proportion of subjects with ≥ 2-step improvement in Diabetic Retinopathy Severity Score (DRSS). Safety outcomes include incidence and severity of adverse events.</p><p><strong>Main outcome measures: </strong>Study design rationale.</p><p><strong>Results: </strong>Recruitment commenced in May 2023 and was completed in May 2024. Group 1 will be dosed Q4W to maximize detection of an impact on RNP progression compared to the untreated group 2. During year 2, group 1 will be dosed Q16W to assess for maintenance of any changes in RNP trajectory achieved during year 1. Group 2 will assess the natural history of RNP progression through year 1, then transition to maximal dosing to evaluate for a potential change in trajectory of RNP progression. Additional assessments, including CS and DARC, will address the unmet need for a better understanding of visual dysfunction among patients with NPDR and investigate the potential role of apoptosis in RNP, respectively.</p><p><strong>Conclusion: </strong>MAGIC is a randomized clinical trial that assesses RNP progression among eyes with NPDR, including its natural history and the impact of faricimab. Its innovative study design also explores the utility of novel assessments of retinal physiology and function. </p>.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"265-274"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Dietary Patterns with Age-Related Macular Degeneration in a Multiethnic Older Singaporean Population.","authors":"Yijia Zhang, Preeti Gupta, Eva Fenwick, Ryan Man, Chiew Meng Johnny Wong, Anna Cheng Sim Tan, Chui Ming Gemmy Cheung, Marjorelee T Colega, Mary Foong-Fong Chong, Jun S Lai, Ecosse Luc Lamoureux","doi":"10.1159/000550522","DOIUrl":"10.1159/000550522","url":null,"abstract":"<p><p><p>Introduction: The associations of dietary patterns and age-related macular degeneration (AMD) have been reported using mostly Western and Japanese populations and evidence in multiethnic Asian populations, with potentially different dietary patterns, is lacking. In this study, we aimed to identify dietary patterns in a multiethnic older Singaporean population and examine their associations with AMD.</p><p><strong>Methods: </strong>This was a cross-sectional analysis of the Population Health and Eye Disease Profile in Elderly Singaporeans (PIONEER) study. Dietary intake was assessed using a 110-item interviewer-administered food frequency questionnaire validated in a Singaporean population. Presence and stage of AMD were categorized using fundus photographs and an established AMD classification. Dietary patterns were generated by applying exploratory factor analysis, and their associations with presence of AMD and stage of AMD were evaluated using adjusted logistic regression models and adjusted multinomial logistic regression models, respectively.</p><p><strong>Results: </strong>Of 1,480 Chinese, Malay, and Indian individuals aged ≥60 years (mean 71.3 ± 7.7), age-standardized prevalence of any, early, and late AMD were 7.1%, 4.8%, and 2.2%. Three dietary patterns were generated: \"snacks, fried foods, and refined carbohydrates\"; \"poultry, meat, and Fish\"; and \"wholemeal bread, legumes, and nuts.\" After adjusting for covariates, higher \"snacks, fried foods, and refined carbohydrates\" pattern scores were associated with higher odds of any AMD (OR = 1.41, 95% CI: 1.02-1.96) and early AMD (OR = 1.63, 95% CI: 1.12-2.37). \"Snacks, fried foods, and refined carbohydrates\" pattern scores in the highest quartile were associated with higher odds of any AMD (OR = 2.18, 95% CI: 1.01-4.72), compared to the lowest quartile.</p><p><strong>Conclusion: </strong>Only the \"snacks, fried foods, and refined carbohydrates\" pattern was associated with AMD in this multiethnic older Singaporean population. These findings may inform the development of dietary guidelines in Singapore for more targeted AMD management, although prospective, longitudinal data are needed. </p>.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"116-125"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994541","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":"Quality of Life in Patients with Retinal Vein Occlusion: A Review of the Literature.","authors":"Dimitrios Kazantzis, Genovefa Machairoudia, Panagiotis Theodossiadis, Irini Chatziralli","doi":"10.1159/000551378","DOIUrl":"10.1159/000551378","url":null,"abstract":"<p><strong>Background: </strong>Retinal vein occlusion (RVO) is the second most common retinal vascular disorder after diabetic retinopathy and represents a significant cause of visual loss worldwide. Beyond visual impairment, RVO can profoundly affect patients' wellbeing and overall vision-related quality of life (QoL). Increasing evidence indicates that vision-related disability contributes to increased levels of anxiety and social limitations in affected individuals. This narrative review synthesizes current evidence on QoL outcomes in patients with RVO, highlights factors influencing psychological outcomes, and explores the role of treatment interventions in modifying patient-reported wellbeing.</p><p><strong>Summary: </strong>Across the included studies, patients with RVO reported significantly reduced vision-related QoL compared with healthy controls, as assessed by the NEI VFQ-25. Anti-vascular endothelial growth factor (VEGF) therapies, including ranibizumab, aflibercept, and bevacizumab, consistently improved QoL scores, with gains evident as early as 1 month and sustained up to 12 months. Improvements were most pronounced in visual function and daily activity subscales, although near vision, mental health, and social functioning frequently remained below normal levels. Predictors of better QoL outcomes included stereopsis, fellow eye vision, and central macular thickness reduction, while systemic comorbidities such as hypertension and diabetes were associated with poorer outcomes.</p><p><strong>Key messages: </strong>While anti-VEGF therapy improves QoL in patients with RVO, long-term management should extend beyond vision restoration. A multidisciplinary approach - integrating ophthalmology, primary care, and psychological support - is essential to address systemic risk factors, reduce treatment burden, and improve overall wellbeing. Future studies should explore long-term QoL outcomes and evaluate strategies that support holistic, patient-centered care.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"407-418"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356044","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":"Biocompatibility and Inflammatory Pathways of Silicone Oil in Complex Retinal Detachment: An in vitro and Clinical Study.","authors":"Tomás Rechi-Sierra, Rosa Lomelino-Pinheiro, Elisa Julião-Campos, Carlos Marques Neves, Pablo Redruello-Guerrero, Tatsiana Stalmashka, Eva María Sobas Abad, Nadia Galindo Cabello, Francisco Javier Valentin Bravo, Reinaldo Vallejo, Ricardo Usategui-Martín, Cristina Andrés Iglesias, Salvador Pastor-Idoate","doi":"10.1159/000550687","DOIUrl":"10.1159/000550687","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to characterize the inflammatory cytokine profile within silicone oil-associated fluid (SOAF) from eyes with complex rhegmatogenous retinal detachment (RRD) treated with silicone oil (SO) tamponade, comparing groups according to tamponade duration. Additionally, we aimed to assess in vitro the emulsification stability of SO in the presence of biological surfactant agents.</p><p><strong>Methods: </strong>This prospective multicenter study included 65 patients with complex RRD who underwent pars plana vitrectomy (PPV) with SO tamponade, divided into two groups according to tamponade duration (<6 months vs ≥6 months), and 30 control eyes that underwent PPV for epiretinal membrane or full-thickness macular hole without SO. SOAF and undiluted vitreous samples were collected and analyzed for cytokine levels (IL-1α, IL-4, IL-6, IL-8, IL-10, IL-12, IL-17, IP-10/CXCL10, IFNγ, TNFα, TGFβ1-3, and MCP-1) using multiplex bead-based immunoassays and ELISA. In vitro emulsification assays were performed using SOs of different viscosities and various biological surfactants.</p><p><strong>Results: </strong>The inflammatory composite score (mean z-score of log10-transformed IL-6, IL-8, and MCP-1) was significantly higher in RRD eyes than in controls (0.78 [0.35-1.16] vs. -0.52 [-0.88 to 0.01]; p < 0.0001), with no significant differences between tamponade duration groups (0.82 [0.41-1.24] vs. 0.76 [0.33-1.13]; p = 0.62). In SOAF, IL-6, IL-8, MCP-1, and TGF-β isoforms were elevated compared with vitreous controls. In vitro assays showed that stable emulsions were formed in the presence of proteins (albumin or cell-culture supernatants), whereas lipidic or vitaminic surfactants produced unstable emulsions.</p><p><strong>Conclusion: </strong>Eyes with complex RRD exhibit a sustained pro-inflammatory and pro-fibrotic microenvironment within the perisilicone compartment, independent of tamponade duration. Proteins, particularly albumin, appear to act as key biological surfactants linking inflammation to SO emulsification. These findings highlight the need for targeted anti-inflammatory and anti-fibrotic strategies, as well as standardized tools for detecting subclinical emulsification.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"197-211"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146086343","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}