Ophthalmology and Therapy最新文献

{"title":"Treat-and-Extend Versus Pro re nata Regimens of Ranibizumab and Aflibercept in Neovascular Age-Related Macular Degeneration: A Comparative Study from Routine Clinical Practice.","authors":"Eloi Debourdeau, Helene Beylerian, Vuong Nguyen, Daniel Barthelmes, Mark Gillies, Pierre Henry Gabrielle, Stela Vujosevic, Louise Otoole, Martin Puzo, Catherine Creuzot-Garcher, Benjamin Wolff, Vincent Daien","doi":"10.1007/s40123-024-00983-2","DOIUrl":"10.1007/s40123-024-00983-2","url":null,"abstract":"<p><strong>Introduction: </strong>Anti-vascular endothelial growth factor (VEGF) is generally given using pro re nata or \"treat-and-extend\" (T&E) regimens for neovascular age-related macular degeneration (nAMD). Randomized clinical trials have reported that T&E is superior to Pro re nata (PRN), but results from clinical trials may not always be replicated in clinical practice. Real-world data comparing T&E and PRN regimens for nAMD are limited. The objective of this work was to report 24-month outcomes of PRN versus T&E regimens for ranibizumab and aflibercept to treat nAMD in routine clinical practice.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of data from a prospectively designed observational outcomes registry, the Fight Retinal Blindness! Project (FRB). Treatment-naïve eyes starting nAMD treatment with at least three injections using a T&E or PRN regimen were tracked by using the FRB. The primary outcome was the mean change in visual acuity (VA) measured by the number of letters read on a logarithm of the minimum angle of resolution chart at 2 years versus baseline. The secondary outcome was the number of injections at 2 years.</p><p><strong>Results: </strong>From January 1, 2015 to January 31, 2019, 3313 eyes from 2948 patients with nAMD were included: 1243 eyes from 1065 patients were classified as PRN and 2070 eyes from 1935 patients started a T&E regimen. At 24 months, patients on the T&E regimen experienced significantly greater mean (95% confidence interval) improvement in VA than those on PRN (+ 4.2 [3.1, 5.2] vs. + 1.3 [0.1, 2.6] letters; p < 0.001), with more injections (14.9 standard deviation(SD) 4.3) vs. 9.8(SD 4.3); p < 0.001).</p><p><strong>Conclusions: </strong>Eyes treated with a T&E regimen had better VA outcomes from VEGF inhibitors than eyes treated PRN. This large real-world data assessment supports previous data from randomized clinical trials that the T&E regimen delivers better outcomes than PRN.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2343-2355"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555307","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 Influence of Corneal Thickness on Surgically Induced Corneal Astigmatism Derived from Total Keratometry Measured by Anterior Segment Swept-Source OCT.","authors":"FangYu Zhao, Yufan Yin, Emmanuel Eric Pazo, Fang Tian, Yuanfeng Jiang, Shaochong Bu","doi":"10.1007/s40123-024-00996-x","DOIUrl":"10.1007/s40123-024-00996-x","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of the study was to explore the possible correlations between the anterior segment parameters derived from anterior segment swept-source optical coherence tomography (AS-SS-OCT) with the surgically induced corneal astigmatism (CSIA) calculated from total keratometry (TK) measured by AS-SS-OCT.</p><p><strong>Methods: </strong>Seventy-one eyes of 67 patients with age-related cataract who underwent phacoemulsification combined with intraocular lens implantation with 2.2-mm incision were included. The CSIA values were calculated from anterior keratometry (CSIA_Kant) and TK (CSIA_TK) measured by AS-SS-OCT, respectively. Hotelling's T² test was used to evaluate the difference. The correlation of CSIA with various parameters derived from AS-SS-OCT was tested with the Spearman correlation coefficient.</p><p><strong>Results: </strong>The centroid of CSIA_Kant and of CSIA_TK were 0.31 ± 0.55 D @ 54° and 0.41 ± 0.59 D @ 51°, with no significant difference (F = 1.283, p = 0.281, Hotelling's T²). The mean absolute CSIA_Kant and CSIA_TK were 0.58 ± 0.24 D and 0.65 ± 0.28 D. Spearman test showed that the magnitude of CSIA_Kant was negatively correlated with preoperative peripheral corneal thickness (PCT, p = 0.045) and the magnitude of anterior keratometry (p = 0.044). The magnitude of CSIA_TK was negatively correlated with preoperative central corneal thickness (CCT, p = 0.003) and preoperative PCT (p = 0.015).</p><p><strong>Conclusions: </strong>The increased thickness of the peripheral cornea is correlated with the decrease in the magnitude of the CSIA. The correlation we identified between the corneal thickness and the CSIA indicated that certain preoperative parameters should be considered for the prediction of CSIA for a more precise refractive outcome.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2381-2391"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634079","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":"Stereopsis Following Implantation of Presbyopia-Correcting Intraocular Lenses: A Narrative Review.","authors":"Yongyuan He, Bijun Zhu, Baojiang Li, Haidong Zou, Yingyan Ma","doi":"10.1007/s40123-024-01004-y","DOIUrl":"10.1007/s40123-024-01004-y","url":null,"abstract":"<p><p>Recent advancements in cataract surgery have broadened its scope from mere vision restoration to include correction of refractive errors and presbyopia. This evolution has introduced multifocal and extended depth-of-focus (EDOF) intraocular lenses (IOLs), allowing enhanced vision across multiple distances. However, the influence of these advanced IOLs on stereopsis remains controversial. Factors influencing stereopsis after surgery include visual acuity, interocular differences, residual astigmatism, and the type of IOL, etc. Binocular vision integration and neuroadaptation further affect stereopsis, especially in cases of presbyopia-correcting IOLs. It is widely acknowledged that bilateral implantation of presbyopia-correcting IOLs yield superior stereopsis compared to unilateral implantation. However, there remains no consensus on whether binocular implantation of multifocal or monofocal IOLs provides superior stereopsis. Most studies suggest no significant difference in stereopsis between these two types of implants. Among different types of multifocal IOLs, refractive multifocal IOLs may offer better stereopsis than diffractive multifocal IOLs when implanted bilaterally. Emerging EDOF and hybrid multifocal-EDOF IOLs also demonstrate promising postoperative stereopsis. Additionally, a mix-and-match strategy with different types of IOLs implanted in each eye may result in interocular differences in visual acuity at certain distances, potentially affecting stereopsis. Nevertheless, with appropriate selection, most patients can achieve satisfactory postoperative stereopsis. This review synthesizes current literature on the effects of presbyopia-correcting IOLs on postoperative stereopsis recovery following cataract surgery. Studies on stereopsis outcomes with different IOLs have yielded mixed results, urging further investigation for optimized surgical strategies and patient outcomes.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2331-2341"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879225","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 Role of Widefield Optical Coherence Tomography Angiography in Assessing the Severity of Diabetic Retinopathy.","authors":"Deepika C Parameswarappa, Amelia Janis Langstang, Sanagavarapu Kavya, Ashik Mohamed, Michael W Stewart, Padmaja Kumari Rani","doi":"10.1007/s40123-024-00995-y","DOIUrl":"10.1007/s40123-024-00995-y","url":null,"abstract":"<p><strong>Introduction: </strong>Physicians need an accurate understanding of diabetic retinopathy (DR) severity to optimally manage patients. The aim of this prospective study is to correlate the severity of macular and peripheral retinal vascular abnormalities seen on widefield (WF) optical coherence tomography angiography (OCTA) with DR grading based on WF fundus photography.</p><p><strong>Methods: </strong>The study included 150 eyes from 82 patients with treatment-naïve DR. All patients were imaged with WF fundus photography and swept-source WF OCTA. Quantitative and qualitative analyses of the foveal avascular zone (FAZ) size and shape, and measurement of capillary nonperfusion (CNP) areas, were performed from the OCTA images. The mixed-effects model was used to compare the DR grading from WF photography with the vascular changes seen on WF-OCTA, and Bonferroni correction was applied to the gradings.</p><p><strong>Results: </strong>The mean [± standard deviation (SD)] age of patients was 55.5 (± 9.4) years. The WF-OCTA showed that an increasing size of the FAZ (from 0.442 (± 0.059) µm to 0.933 (± 0.086) µm) correlated with increasing severity of the DR (as determined with WF photography). The deep capillary plexus, FAZ size, and CNP areas in eyes with proliferative diabetic retinopathy (PDR) differed from those with mild nonproliferative diabetic retinopathy (NPDR) (p < 0.001). Most eyes with severe nonproliferative DR were found to have CNP in four quadrants [superficial capillary plexus (SCP) 60%, deep capillary plexus (DCP) 50%]. The WF-OCTA detected subtle neovascularization of the disc (NVD) in 7 eyes (10%) and neovascularization elsewhere (NVE) in 13 eyes (18%) that had been diagnosed with only moderate NPDR on WF photography.</p><p><strong>Conclusions: </strong>FAZ and CNP areas as measured by WF-OCTA correlate with DR severity. WF-OCTA can also detect subtle NVE and NVD that cannot be seen with fundus photography.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2369-2380"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590973","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":"Safety and Efficacy of Multiple Escalating Doses of RC28-E for Neovascular Age-Related Macular Degeneration: A Phase 1b Trial.","authors":"Yingyi Lu, Xiaobing Yu, Youxin Chen, Chan Wu, Qin Jiang, Shaoping Ha, Dan Zhu, Yanlong Bi, Xiaoling Liu, Han Zhang, Zhuo Li, Wenxiang Wang, Lin Li, He Chen, Yifan Zhang, Hong Dai, Jianmin Fang","doi":"10.1007/s40123-024-00994-z","DOIUrl":"10.1007/s40123-024-00994-z","url":null,"abstract":"<p><strong>Introduction: </strong>To assess the safety and efficacy of repeated intravitreal injections of RC28-E, a novel bispecific antibody that simultaneously binds vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in patients with neovascular age-related macular degeneration (AMD). This was a prospective, multicenter, open-label clinical trial; 37 patients with choroidal neovascularization secondary to AMD and best-corrected visual acuity (BCVA) letter scores between 73 and 34 were enrolled.</p><p><strong>Methods: </strong>Treatment regimens consisted of a 3-month loading phase and a pro re nata (PRN) maintenance phase. This study included three treatment groups: the 0.5, 1.0, and 2.0 mg RC28-E groups, with escalating doses ranging from 0.5 to 2.0 mg. Patients were evaluated monthly for 48 weeks. Safety was assessed based on ocular and systemic adverse events (AEs), pharmacokinetic characteristics, and the presence of anti-RC28-E antibodies. Efficacy was assessed using the mean change in BCVA and central subfield thickness (CST) from baseline to week 48.</p><p><strong>Results: </strong>Most AEs were mild or moderate. The most common AE was a minor injection-related subconjunctival hemorrhage (16.2%). The AEs did not increase with dose or repeated injections. At week 48, mean improvements in BCVA from baseline in the 0.5, 1.0, and 2.0 mg groups were 6.1 ± 8.3, 9.9 ± 10.7, and 7.6 ± 9.38 letters, respectively; mean reductions in CST in the three groups were 112.1 ± 160.5, 175.1 ± 212.4, and 128.7 ± 145.8 μm, respectively. The serum RC28-E concentrations in 95% of the patients were below the quantification limit of the assay. No significant change from baseline was observed in the mean plasma concentrations of VEGF or FGF over the 48 weeks of treatment. Pre-treatment antibodies to RC28-E were detected in 1 of the 37 patients. Antibodies to RC28-E were detected in two patients after dosing with RC28-E for 48 weeks.</p><p><strong>Conclusion: </strong>RC28-E was well tolerated and exhibited an overall favorable safety profile with evidence of improvements in BCVA and anatomical parameters.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2405-2415"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731362","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":"Efficacy and Safety of Preoperative Prophylaxis in Cataract Surgery with Combined Topical Antiseptics: A Microbiological Study.","authors":"Rocco Luigi Modugno, Adriano Fasolo, Davide Camposampiero, Diego Ponzin, Marco Tavolato","doi":"10.1007/s40123-024-01000-2","DOIUrl":"10.1007/s40123-024-01000-2","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the antimicrobial efficacy of an ophthalmic formulation containing hexamidine diisethionate (HD) 0.05%, polyhexamethylene biguanide (PHMB) 0.0001%, and edetate disodium (EDTA) 0.01% (Keratosept^®, Bruschettini, Genova, Italy) on the microbial flora of a healthy ocular surface.</p><p><strong>Methods: </strong>Patients were enrolled consecutively. Each patient applied two drops of Keratosept^® in the eye scheduled for cataract surgery (study eye) three times daily in the 2 days prior to surgery and one time in the morning of surgery. The contralateral eyes were considered as control (control eye). Bilateral conjunctival swabs were collected before the first administration (T0) and the morning of surgery (T1). The swabs were processed within 3 h from sampling for the automated detection of the presence of replicating microorganisms (colony-forming units, CFU/mL) and the provision of real-time growth curves.</p><p><strong>Results: </strong>Conjunctival swabs of 32 patients (n = 128) were examined. Six patients were excluded from the efficacy analysis because of microbial load < 50 CFU/mL at T0 in the study eye. No difference between study and control eyes was observed at T0 (p = 0.40). Compared with T0, 20 (76.9%) study eyes and 10 (38.5%) control eyes showed a ≥ 1 log reduction of the microbial load at T1, with a significant difference between groups (p = 0.005). Keratosept^® showed good tolerability, and no adverse events or eye discomfort were recorded.</p><p><strong>Conclusions: </strong>This study showed that the low-dose combination of antiseptic agents in the Keratosept^® ophthalmic solution effectively reduces the bacterial load of healthy flora on the ocular surface.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2417-2423"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752295","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":"A Response to: Letter to the Editor Regarding an Emerging Ophthalmology Challenge: A Narrative Review of TikTok Trends Impacting Eye Health Among Children and Adolescents.","authors":"Sally Al Hassan, Alaa Bou Ghannam, Joanna S Saade","doi":"10.1007/s40123-024-00990-3","DOIUrl":"10.1007/s40123-024-00990-3","url":null,"abstract":"","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2509-2510"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559439","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":"Systematic Literature Reviews Comparing the Long-Term Safety Outcomes for the Port Delivery System with Ranibizumab (PDS) Versus Other Ocular Implants.","authors":"Nancy M Holekamp, Manejeh Yaqub, Shrirang V Ranade, Ronald A Cantrell, Sheena Singh, Gus Gazzard","doi":"10.1007/s40123-024-01001-1","DOIUrl":"10.1007/s40123-024-01001-1","url":null,"abstract":"<p><strong>Objectives: </strong>To determine whether the types and rates of post-surgical complications associated with the Port Delivery System with ranibizumab (PDS) are comparable with those reported for other ocular implants that cross the sclera.</p><p><strong>Methods: </strong>Systematic literature reviews were conducted to determine the long-term (≥ 18-month) safety of ocular implants that cross the sclera in clinical trials and real-world studies. Complication types and rates were compared with those reported for the PDS in phase III clinical trials (Archway, Pagoda, and Pavilion).</p><p><strong>Results: </strong>Sixteen clinical trials (24 publications) and 43 real-world studies were identified reporting 30 complications in eyes with 15 implant types and 8 ocular diseases. Implants were associated with an acceptable, well-characterized safety profile, with most complications resolving spontaneously or with treatment. Device-related complications were reported in 0.7% (0.0-5.0%) of study eyes in clinical trials and 1.3% (0.0-14.5%) of eyes in real-world studies. Rates of conjunctival complications were 2.1% (0.0-22.8%) and 2.2% (0.9-4.6%), respectively. The overall types and rates of adverse events of special interest reported for the PDS in phase III trials (cataract, conjunctival bleb, vitreous hemorrhage, conjunctival erosion, conjunctival retraction, endophthalmitis, implant dislocation, retinal detachment, and hyphema) were within the ranges reported for other ocular implants.</p><p><strong>Conclusions: </strong>The rates of complications reported in phase III clinical trials for the PDS were within the ranges reported for other ocular implants that cross the sclera. This suggests that the long-term safety of the PDS is consistent with other ocular devices established in ophthalmology clinical practice.</p><p><strong>Trial registration: </strong>PROSPERO international prospective register of systematic reviews: CRD5202234129, CRD42022343129.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2303-2329"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875496","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":"Detection of Subclinical Neurotrophic Keratopathy by Noncontact Esthesiometry.","authors":"Marta Villalba, Victor Sabates, Sarp Orgul, Victor L Perez, Swarup S Swaminathan, Alfonso L Sabater","doi":"10.1007/s40123-024-00998-9","DOIUrl":"10.1007/s40123-024-00998-9","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to analyze corneal sensitivity with a new noncontact and handheld esthesiometer (Brill Engines, Spain) in patients with dry eye disease (DED) and patients on hypotensive drops, and to compare it with healthy subjects.</p><p><strong>Methods: </strong>A total of 31 patients (57 eyes) with DED, 23 patients (46 eyes) with glaucoma, and 21 healthy patients (33 eyes) were recruited. In all patients, corneal sensitivity was measured. Subsequently, a keratography test (Keratograph 5M, Oculus) was carried out to measure tear meniscus height (TMH), non-invasive breakup time (NIBUT), bulbar redness (Jenvis scale), and corneal staining (CS, Oxford scale). Both corneal sensitivity and ocular surface parameters were compared between DED, glaucoma, and healthy subjects. Linear mixed models were constructed to utilize data from both eyes of patients. An alpha level of 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The mean age was 56.1 ± 16.1 years in the DED group, 69.5 ± 11.7 years in the glaucoma group, and 37.190 ± 11.677 years in the control group. After adjustment for age and sex, corneal sensitivity was significantly reduced in DED and glaucoma vs control group (P = 0.02 and P = 0.009, respectively). NIBUT was lower in DED and glaucoma groups (P < 0.001 and P = 0.001, respectively). Redness and CS values were higher in the DED group (P = 0.04 and P = 0.001, respectively). TMH was lower in the glaucoma group (P = 0.03).</p><p><strong>Conclusions: </strong>Corneal sensitivity measured with a novel noncontact esthesiometer was reduced in DED and glaucoma groups compared to controls. In clinical practice, this esthesiometer could be an easy-to-use device to screen for patients with subclinical neurotrophic keratopathy.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2393-2404"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724115","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":"Platelet-rich Fibrin Membrane Transplantation for the Treatment of Highly Myopic Macular Hole Retinal Detachment.","authors":"Guojing Lu, Siyu Zeng, Rong Huang, Lei Du","doi":"10.1007/s40123-024-00997-w","DOIUrl":"10.1007/s40123-024-00997-w","url":null,"abstract":"<p><strong>Introduction: </strong>Highly myopic macular hole retinal detachment (MHRD) is often associated with a poor prognosis, and there is currently no optimal treatment. Platelet-rich fibrin (PRF), an autologous blood product, has been shown to promote tissue regeneration. This prospective, randomized, controlled study investigated the efficacy of conventional internal limiting membrane (ILM) peeling versus PRF membrane transplantation in highly myopic MHRD.</p><p><strong>Methods: </strong>Eyes with highly myopic MHRD were randomly assigned to either a conventional ILM peeling group (IP group, n = 19) or a PRF membrane transplantation group (PMT group, n = 21). The study followed participants for a period of 6 months. The primary outcome measure was macular hole (MH) closure assessed using optical coherence tomography. Secondary outcomes included best-corrected visual acuity (BCVA), central retinal thickness (CRT), superficial vascular density (SVD), deep vascular density (DVD), rate of retinal reattachment, and any complications encountered.</p><p><strong>Results: </strong>MH closure was achieved in a significantly greater proportion of eyes in the PMT group (21/21, 100.00%) compared to the IP group (15/19, 78.95%) (P = 0.042). Retinal reattachment was accomplished in all patients (100.00%) within both groups. Except for an insignificant difference in BCVA observed at 1 week post-surgery in the IP group, significant improvements in BCVA and CRT were documented in both groups across all other post-operative time points. Final BCVA (P = 0.040), CRT (P = 0.002), SVD (P = 0.002), and DVD (P = 0.013) were all significantly higher in the PMT group compared to the IP group. No serious complications were identified in either group.</p><p><strong>Conclusions: </strong>This study demonstrated the superiority of PRF membrane transplantation compared to conventional ILM peeling in promoting MH closure and enhancing retinal vascular density in patients with highly myopic MHRD. Additionally, PRF membrane transplantation effectively restores retinal reattachment, improves visual function, and increases retinal thickness without introducing additional complications.</p><p><strong>Trial registration number: </strong>www.</p><p><strong>Clinicaltrials: </strong>gov , NCT06200727.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2425-2443"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767006","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}