Ophthalmology and Therapy最新文献

{"title":"Climate Change and the Impact on Ocular Infectious Diseases: A Narrative Review.","authors":"Yong Le Tong, Carlos Cifuentes-González, Kajal Agrawal, Fatma Shakarchi, Xin Ying Rachel Song, John S Ji, Rupesh Agrawal","doi":"10.1007/s40123-025-01185-0","DOIUrl":"10.1007/s40123-025-01185-0","url":null,"abstract":"<p><p>Climate change and global warming significantly affect the incidence and distribution of infectious ocular diseases. This narrative review explores how climate-related factors-including extreme weather events, precipitation, temperature fluctuations, humidity, wind patterns, ultraviolet radiation, and air pollution-can directly and indirectly influence the burden of ocular infections. By synthesizing evidence from the published literature, we examine how these environmental variables impact disease mechanisms such as pathogen survival, transmission dynamics, and host susceptibility. Increased precipitation has been associated with a higher incidence and recurrence of ocular toxoplasmosis (OT), likely due to the enhanced spread of Toxoplasma gondii oocysts through contaminated water and soil. Rainfall also creates breeding habitats for mosquitoes, facilitating the transmission of vector-borne diseases such as dengue fever and Rift Valley fever. Rising temperatures and humidity have been linked to increased rates of fungal infections, particularly fungal keratitis in tropical regions. Wind has been implicated in the airborne dispersal of pathogens, including fungal spores, T. gondii oocysts, and insect-derived particles such as moth setae, potentially contributing to OT and seasonal hyperacute panuveitis. Air pollution further exacerbates dry eye disease, which influences the vulnerability to microbial keratitis. These climate-related shifts disproportionately affect vulnerable populations-particularly those living in rural, low-income, and tropical areas. This review highlights the urgent need for further research into climate-sensitive mechanisms of ocular infections and the development of targeted adaptation strategies to mitigate their impact on global eye health.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1695-1712"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional and Anatomical Outcomes of Faricimab in Previously Treated Wet Age-Related Macular Degeneration: Systematic Review and Pooled Analysis.","authors":"Ali Khodor, Jonathan T Caranfa, Tavish Nanda, Raul E Ruiz-Lozano, Manuel E Quiroga-Garza, Stephanie Choi, Ali Chehab, Eugenia M Ramos-Dávila, Jeffery S Heier, Chirag P Shah, Andre J Witkin","doi":"10.1007/s40123-025-01181-4","DOIUrl":"10.1007/s40123-025-01181-4","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the outcomes of intravitreal faricimab (IVF; Vabysmo^®) in previously treated patients with wet age-related macular degeneration (wAMD), focusing on best available visual acuity (BAVA), central subfield thickness (CST), injection interval, complications, fluid resolution, and reversion rates to prior therapies.</p><p><strong>Methods: </strong>The PubMed, Embase, and Google Scholar databases were searched for studies reporting outcomes of treatments for previously treated cases of wAMD. Mean differences (MD) with 95% confidence intervals (CI) were used to compute the effect size of the change in outcomes.</p><p><strong>Results: </strong>A total of 29 studies with 2070 patients (1003 women, mean age 78.9 years) and 2128 eyes were included. BAVA and CST were reported in 28 studies, fluid status in 21, injection interval in 14, and reversion rates in 6. Pooled analysis showed significant but modest improvement in BAVA when IVF was given for > 6 months (MD = -0.026 LogMAR, p < 0.05) but not at earlier follow-ups. A similar trend was noted with injection interval extension when IVF was given beyond 6 months (MD = +2.1 weeks, p < 0.05). CST reduction was observed at all time points (overall MD = -37.7 μm, p < 0.05). Complication rates were reported in nine studies, with an overall rate of 1.2%, including retinal pigment epithelium tear, intraocular inflammation, endophthalmitis, and subretinal hemorrhage. Reversion to prior or other anti-vascular endothelial growth factor (anti-VEGF) therapy was reported in six studies, occurring in 23% of eyes.</p><p><strong>Conclusions: </strong>We reported the outcomes of utilizing IVF in previously treated cases of wAMD. IVF showed a significant improvement in CST at all time points and in the extension of injection interval. Visual outcomes remained unchanged when followed for less than 6 months but improved significantly but modestly when followed for more than 6 months. Switching to intravitreal faricimab may be a useful treatment option for previously treated patients with wAMD, with a goal of reducing treatment burden and improving treatment efficacy.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1965-1984"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Vitrectomy in Endophthalmitis: Visual Outcomes and Complication Rates.","authors":"Julian W Sromicki, Marc Stahel, Robert A Blum, Katrin A Rudolph, Daniel Barthelmes","doi":"10.1007/s40123-025-01196-x","DOIUrl":"10.1007/s40123-025-01196-x","url":null,"abstract":"<p><strong>Introduction: </strong>This study examined visual outcomes and complication rates after early pars plana vitrectomy (PPV) in eyes with endophthalmitis.</p><p><strong>Methods: </strong>The study was designed as a single-center, retrospective, observational database study. A total of 92 eyes treated with early PPV for endophthalmitis at the University Hospital Zurich between 2006 and 2016 were included. Endophthalmitis cases following cataract surgery (CAT, n = 44), intravitreal injection (IVI, n = 12), trabeculectomy (TRAB, n = 6), and Others (e.g., trauma or endogenous, n = 30) were assessed. Visual acuity (VA) and intraocular pressure (IOP) from prior to endophthalmitis to 12 months after PPV were analyzed. Secondary outcomes included complications following the procedure.</p><p><strong>Results: </strong>CAT and IVI groups showed good visual outcomes. Final VA in CAT and IVI groups was not statistically different to prior to endophthalmitis (CAT p = 0.840, IVI p = 0.933). In the CAT group, 78.9% of eyes with a starting VA of > light perception achieved ≥ 20/40 final VA. The highest rate of patients with at least one complication was observed in TRAB (100%), followed by Others (63.3%), IVI (50.0%), and CAT groups (40.9%).</p><p><strong>Conclusion: </strong>Early PPV may be beneficial in endophthalmitis following cataract surgery and intravitreal injection, regardless of initial VA.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2031-2042"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of a Novel Subtype of Ocular Hypertensive Eyes with the Lowest Risk of Progression Under Treatment.","authors":"Asma Poursoroush, Vida Abedi, Xiaoqin Huang, Jiang Li, Alireza Vafaei Sadr, Amy L de Jongh Curry, Louis R Pasquale, Michael V Boland, Chris A Johnson, Siamak Yousefi","doi":"10.1007/s40123-025-01174-3","DOIUrl":"10.1007/s40123-025-01174-3","url":null,"abstract":"<p><strong>Introduction: </strong>Our aim in this work is to identify a subtype of ocular hypertensive eyes that benefited the most from topical hypertensive medication.</p><p><strong>Methods: </strong>We included 1636 patients (817 patients in the active group and 819 in the observation group) who participated in the Ocular Hypertension Treatment Study (OHTS). We developed principal component analysis (PCA), t-distributed stochastic neighbor embedding (t-SNE), and unsupervised density-based clustering, then applied to the baseline visual fields (VFs) to identify different clusters of eyes. For each cluster, the rate of mean deviation (MD) worsening was calculated based on 7 years of follow-up. To determine which cluster (subtype) of eyes responded better to the ocular hypertensive medications, MD worsening was compared between the active and observation groups within each cluster of eyes separately.</p><p><strong>Results: </strong>We identified 13 clusters based on visual field (VF) tests at baseline visits. Among these, one cluster demonstrated a significantly better response to ocular hypotensive medication compared to the others. Key distinguishing characteristics of this cluster included a lower frequency of family history of glaucoma (p = 0.006) but a higher prevalence of heart disease (p < 0.001) and high blood pressure (p < 0.001). Interestingly, although eyes in this cluster had a worse baseline MD than those in all other clusters (- 2.2 ± 0.1 dB vs. + 0.47 ± 1.2 dB, p < 0.001) and patients were older (64.3 ± 9.5 vs. 54.7 ± 8.94 years, p < 0.001), this was the only cluster where the MD progression rate in the treatment (active) group was significantly lower than in the observation group (+ 0.04 dB/year vs. - 0.09 dB/year, p = 0.03). Furthermore, treated eyes in this cluster had a significantly better MD progression rate than treated eyes in all other clusters (+ 0.04 dB/year vs. - 0.07 dB/year, p < 0.001).</p><p><strong>Conclusions: </strong>We identified a subtype of ocular hypertensive eyes in the OHTS that showed a better response to topical hypotensive medications, as indicated by the least risk of progression.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1893-1903"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Machine Learning Models for Vault Safety in ICL Implantation: A Comparative Analysis of Regression and Classification Models.","authors":"Qing Zhang, Qi Li, Zhilong Yu, Ruibo Yang, Emmanuel Eric Pazo, Yue Huang, Hui Liu, Chen Zhang, Salissou Moutari, Shaozhen Zhao","doi":"10.1007/s40123-025-01173-4","DOIUrl":"10.1007/s40123-025-01173-4","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate prediction of postoperative vault height following implantable collamer lens (ICL) V4c implantation is critical for minimizing complications and achieving optimal surgical outcomes. This study aims to evaluate the performance of machine learning models in predicting postoperative vault height, focusing on both regression and classification approaches.</p><p><strong>Methods: </strong>This retrospective study analyzed biometric and demographic data, including anterior chamber depth, white-to-white distance, and ICL size, among other variables. Regression and classification models were developed using gradient boosting, random forest, and CatBoost algorithms. Regression models predicted vault height as a continuous variable, while classification models categorized vault heights into binary and multi-class tasks. Model performance was evaluated using metrics including the mean absolute error (MAE) and root mean squared error (RMSE) for regression models, while accuracy, F1-score, and area under the curve (AUC) were used for classification models.</p><p><strong>Results: </strong>Regression models demonstrated moderate predictive performance, with random forest delivering the best performance (MAE: 134.0 µm, RMSE: 171.3 µm, Pearson's correlation coefficient: 0.45). On the other hand, classification models exhibited greater clinical applicability than regression approaches. For the binary classification task (vault < 250 µm vs. ≥ 250 µm), gradient boosting achieved the highest overall performance, with accuracy of 89 ± 12% and an AUC of 0.89. In the task of predicting vault > 750 µm vs. ≤ 750 µm, random forest emerged as the most effective classifier, achieving accuracy of 86 ± 9% and an AUC of 0.88. In multi-class classification, models demonstrated superior performance in predicting intermediate vault heights (250 µm ≤ vault ≤ 750 µm). Random forest achieved the highest accuracy of 94.6% in this category. However, all models faced challenges in accurately classifying extreme vault categories.</p><p><strong>Conclusions: </strong>Classification models, particularly gradient boosting and random forest, demonstrated strong potential for predicting clinically significant vault categories, enabling personalized surgical planning and improved risk management. While regression models offered moderate insights, their limitations suggest that classification approaches are better suited for clinical applications. Future research should focus on enhancing model accuracy for extreme vault prediction and integrating advanced techniques, such as ensemble deep learning, to further refine outcomes.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1789-1812"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Economic Burden of Anti-Vascular Endothelial Growth Factor on Patients and Caregivers in the UK, Europe, and North America.","authors":"David Tabano, Arjun Watane, Richard Gale, Oliver Cox, Sarah R Hill, Louise Longworth, Yemi Oluboyede, Ayesha Ahmed, Nimesh A Patel","doi":"10.1007/s40123-025-01180-5","DOIUrl":"10.1007/s40123-025-01180-5","url":null,"abstract":"<p><strong>Introduction: </strong>Intravitreal (IVT) injections of anti-vascular endothelial growth factor (VEGF) agents are the standard of care for neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). While demonstrated to be effective, these treatments potentially place a significant burden on patients owing to their cost and frequency of treatment visits required for administration. The objective of this study was to investigate the economic burden of treatment on patients with nAMD/DME and their informal caregivers in seven countries.</p><p><strong>Methods: </strong>Data were collected from patients and caregivers in the USA, UK, Canada, Italy, Spain, Germany, and France using a survey between September and December 2022. Each survey collected data to facilitate calculating economic burden, combining the total financial costs (i.e., direct costs to receive treatment) and productivity losses associated with attending treatment appointments over a 6-month period. Quality of life data were collected using validated instruments.</p><p><strong>Results: </strong>In total, 194 patients and 194 caregivers reported currently receiving (or caring for someone who receives) anti-VEGF treatment. Across all countries, the modal frequency of anti-VEGF treatment was every 4 weeks, except for patients with DME (every 8 weeks). The largest, mean 6-month economic burden on the pooled population of patients with nAMD/DME was reported in Italy (€1244) and on caregivers it was in the USA (€3069). Economic burden was lower for respondents receiving fewer anti-VEGF injections.</p><p><strong>Conclusions: </strong>More durable therapies for nAMD/DME would reduce treatment burden and have a sizeable impact financially on patients with nAMD/DME and their caregivers.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1869-1892"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World 5-Year Outcomes of Age-Related Macular Degeneration with Bevacizumab as First-Line Anti-VEGF.","authors":"H Mhmud, J P Vermeulen, O A M Tigchelaar-Besling, F D Verbraak, D Barthelmes, M Gillies, T L Ponsioen, Caroline C W Klaver","doi":"10.1007/s40123-025-01178-z","DOIUrl":"10.1007/s40123-025-01178-z","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate long-term outcomes of anti-VEGF therapy for neovascular age-related macular degeneration (nAMD) in the Netherlands (NL), where bevacizumab is the mandated first-line drug, compared to high-income countries using ranibizumab or aflibercept as initial treatments.</p><p><strong>Methods: </strong>Five-year data from the Fight Retinal Blindness! (FRB) registry, a real-world prospective registry, were analyzed. Outcomes from 1473 Dutch eyes (1229 patients) treated with bevacizumab were compared with 7144 eyes (5884 patients) in a reference group (RG) from 13 socioeconomically similar countries. The primary outcome was mean visual acuity (VA) at yearly intervals; secondary outcomes included injection frequency and switching rates to alternative anti-VEGF agents.</p><p><strong>Results: </strong>Throughout the 60 months, mean VA was consistently higher in Dutch eyes (baseline: NL 60.2 vs. RG 59.2; 60 months: NL 64.9 vs. RG 62.6). The Dutch group cumulatively received 14.5 more injections over 5 years and had a higher rate of switching (70.9% vs. 50.9%) with a shorter median time to switching (11.9 months vs. 17.7 months).</p><p><strong>Conclusions: </strong>Patients treated in Dutch FRB! clinics have good long-term outcomes with a 2.3-letter higher mean VA at the 60-month timepoint compared to FRB! clinics in the RG. The Dutch patients, who began treatment with bevacizumab, received 14.5 more injections over 5 years and had a 40% higher rate of switching to an alternative drug, with switching occurring 5.8 months earlier. This study highlights the benefits of early and more intensive management to optimize visual outcomes, which appear more important than the choice and price of the first-line drug.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1813-1826"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiwavelength Photobiomodulation Improves Multiple Aspects of Visual Function in Early-Stage Dry Age-Related Macular Degeneration.","authors":"Cem Küçükerdönmez, Stephanie E Tedford","doi":"10.1007/s40123-025-01183-2","DOIUrl":"10.1007/s40123-025-01183-2","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the safety and efficacy of multiwavelength photobiomodulation (PBM) treatment (Tx) in earlier stages of nonexudative (dry) age-related macular degeneration (AMD).</p><p><strong>Methods: </strong>Participants were enrolled with a diagnosis of dry AMD. Participants were treated with a single or repeated series of multiwavelength PBM treatment (LumiThera Valeda^® Light Delivery System; 590, 660, and 850 nm) delivered three times per week over 3-5 weeks every 4 months with follow-up extending out to 16 months. Outcomes analyzed included visual acuity (VA), contrast sensitivity (CS), and electroretinography (ERG).</p><p><strong>Results: </strong>A total of 41 eyes (27 participants) were evaluated after single (1 series of Tx, n = 41 eyes) and repeat (2-4 series of Tx, n = 26 eyes) PBM treatment with up to 16 months of follow-up. Participants were mostly female (n = 22, 81.5%) with a mean time since AMD diagnosis of 5.6 years. Participants enrolled had earlier stage dry AMD with better vision (~ 20/32 Snellen) and a mean baseline VA of 76.5 letters. Single and repeated PBM Tx improved VA, CS, multi-luminance ERG, and fixed luminance ERG parameters. No significant visual decline was noted in any outcome measure or signs of phototoxicity.</p><p><strong>Conclusions: </strong>PBM treatment of patients with earlier stage dry AMD showed improvements on multiple visual outcome measures and no adverse effects. Earlier stage AMD populations may not show robust magnitude effects as their starting vision does not show serious deficits, however; as a result of the degenerative and progressive nature of the disease, repeat treatment and continued monitoring of these outcomes are of interest. These beneficial effects were improved with repeated PBM treatment series.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1843-1853"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selecting the Right AI Algorithm for the Job: A Guide for Navigating the AI Jungle in Ophthalmology.","authors":"Louis Arnould, Atif Anwer, Andrzej Grzybowski, Fabrice Meriaudeau","doi":"10.1007/s40123-025-01191-2","DOIUrl":"10.1007/s40123-025-01191-2","url":null,"abstract":"","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1637-1647"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microaneurysm Counting as a Biomarker for the Hyperperfusion Stage of Nonproliferative Diabetic Retinopathy.","authors":"Luís Mendes, Ana Rocha, Marta Lopes, Ana Almeida, Nicole Duarte, Débora Reste-Ferreira, António Martinho, Pedro Pereira, Inês Marques, Conceição Lobo, José Cunha-Vaz","doi":"10.1007/s40123-025-01179-y","DOIUrl":"10.1007/s40123-025-01179-y","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the utility of microaneurysm (MA) counting as a tool for characterizing the hyperperfusion stage of nonproliferative diabetic retinopathy (NPDR) and to examine the hypothesis that MAs can serve as a surrogate biomarker for the presence of intraretinal microvascular abnormalities (IRMAs).</p><p><strong>Methods: </strong>Forty-nine (n = 49) eyes with type 2 diabetes mellitus with NPDR were included in this analysis: 12 with Early Treatment Diabetic Retinopathy Study (ETDRS) levels 43 and 37 with levels 47-53. Automated MA detection was performed using the RetmarkerDR software (Retmarker SA, Meteda Group, Italy), alongside manual detection, both done in the central retina (field 2). Based on MA counts, microaneurysm turnover (MAT) was computed. IRMAs were manually counted based on swept-source optical coherence tomography (SS-OCT) angiography on PLEX® Elite 9000 (ZEISS, Dublin, CA, USA). The statistically significant differences between ETDRS groups were studied by comparing Mann-Whitney U test p values (significance value < 0.05). The correlation between the presence of MAs and IRMAs and MAT and IRMAs was examined using Spearman correlation analysis.</p><p><strong>Results: </strong>There was an observed increase in the number of IRMAs, MAs, and MAT values as NPDR progressed, independently of the counting method used. Specifically, this increase was noted when transitioning from ETDRS groups characterized by the predominance of the hypoperfusion stage (ETDRS 43) to those associated with the hyperperfusion stage (ETDRS 47-53). When MAs were counted manually, a moderate correlation was identified between the number of MAs and the presence of IRMAs (ρ = 0.40; p value = 0.005). Additionally, a similar correlation was found between MAT and the presence of IRMAs (ρ = 0.43; p value = 0.002).</p><p><strong>Conclusions: </strong>This study underscores the potential relevance of MAs as a pivotal indicator of the hyperperfusion stage of NPDR and supports their role as surrogate biomarkers for IRMAs. These results suggest a role for MA counting in the assessment and management of diabetic eye disease.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1905-1915"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}