Ophthalmology and Therapy最新文献

{"title":"Two-Years Real-World Experience of a Tertiary Center with Intravitreal Brolucizumab Switch for Treatment of Exudative Neovascular Age-Related Macular Degeneration.","authors":"Federico Beretta, Ilaria Zucchiatti, Riccardo Sacconi, Federico Fantaguzzi, Stefano Lingardo, Francesco Bandello, Giuseppe Querques","doi":"10.1007/s40123-025-01141-y","DOIUrl":"10.1007/s40123-025-01141-y","url":null,"abstract":"<p><strong>Introduction: </strong>To analyze visual and anatomical outcomes in patients switched to brolucizumab and previously treated with other intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents for exudative neovascular age-related macular degeneration (nAMD). These outcomes were was assessed in the real-world setting of a tertiary center with a follow-up period of 2 years.</p><p><strong>Methods: </strong>This retrospective longitudinal study included 29 eyes of 24 patients with exudative nAMD previously treated with at least three injections of another intravitreal anti-VEGF molecule. The eyes were then treated with brolucizumab for at least 24 months following the switch. A pro re nata (\"as needed\") therapeutic regimen was followed in our clinic between January 2021 and June 2024, during which time clinical and anatomical parameters were evaluated, and possible adverse events were recorded.</p><p><strong>Results: </strong>After 24 months of treatment with brolucizumab, patients showed a significant reduction in central macular thickness (P = 0.001) and choroidal thickness (P < 0.001). Visual acuity remained stable during the follow-up period. \"Poor responders\" had longer disease duration and had received more injections before the switch than \"good responders.\" Adverse events included one subretinal hemorrhage and one intraocular inflammation across 302 injections.</p><p><strong>Conclusions: </strong>Treatment with brolucizumab is effective in patients previously treated with other therapeutic molecules. The best outcomes were achieved in patients who switched therapy to brolucizumab early in their disease. Treatment with brolucizumab in this population demonstrated an acceptable risk profile, with only one intraocular inflammatory event out of 302 intravitreal injections.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":"14 6","pages":"1325-1335"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985458","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":"Clinical Outcomes of Treatment of Geographic Atrophy: A Narrative Review.","authors":"Anne Helene Køllund Nissen, Thomas Lee Torp, Anna Stage Vergmann","doi":"10.1007/s40123-025-01144-9","DOIUrl":"10.1007/s40123-025-01144-9","url":null,"abstract":"<p><strong>Rationale: </strong>In 2023, the U.S. Food and Drug Administration approved pegcetacoplan (SYFOVRE) as the first therapeutic option for geographic atrophy (GA), a previously untreatable condition associated with age-related macular degeneration. Following this, avacincaptad pegol (Izervay) was also approved for GA treatment, further expanding therapeutic options.</p><p><strong>Objectives: </strong>This article aims to give an overview of the clinical outcomes of GA treatment and to discuss which patient groups may benefit most from these therapies.</p><p><strong>Methods: </strong>A review of the literature was conducted using the databases PubMed, Cochrane Library, and ClinicalTrials.gov. The search yielded six relevant studies.</p><p><strong>Conclusions: </strong>The management of geographic atrophy has advanced with therapies like pegcetacoplan and avacincaptad pegol showing clear benefits in slowing lesion growth. However, safety concerns, such as neovascular complications, persist. Photobiomodulation and dietary supplementation provide alternative options with modest benefits, particularly in the early stages. Larger studies are needed to confirm long-term safety, efficacy, and optimal treatment strategies.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":"14 6","pages":"1173-1181"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993411","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":"Retinal Ischemic Perivascular Lesions (RIPLs) as Potential Biomarkers for Systemic Vascular Diseases: A Narrative Review of the Literature.","authors":"Celeste Limoli, Hagar Khalid, Siegfried K Wagner, Josef Huemer","doi":"10.1007/s40123-025-01148-5","DOIUrl":"10.1007/s40123-025-01148-5","url":null,"abstract":"<p><p>Retinal ischemic perivascular lesions (RIPLs) are characteristic focal thinning of the inner nuclear layer, with an upward expansion of the outer nuclear layer identified by spectral domain optical coherence tomography (SD-OCT), causing a focal irregular appearance of the middle retina. RIPLs result from retinal hypoperfusion in the deep capillary plexus, as a legacy of paracentral acute middle maculopathy, representing permanent anatomical markers of prior ischemic events. Although frequently found incidentally during routine eye examinations, RIPLs may provide insights into subclinical vascular damage that underpins various cardio- and cerebrovascular diseases. The aim of this narrative review is to summarize the relationships of RIPLs with retinal and systemic vascular diseases, including arterial hypertension, coronary artery disease, carotid artery stenosis, atrial fibrillation, stroke, sickle cell disease, and diabetes mellitus. Cardiovascular and metabolic diseases, which are the leading causes of morbidity and mortality worldwide, often remain asymptomatic for years despite early structural changes until severe adverse events occur. Noninvasive retinal biomarkers such as RIPLs, which are readily and noninvasively detected through SD-OCT scans, could help in the early detection and stratification of patients at risk for cardiovascular diseases, facilitate timely medical interventions and lifestyle changes, and ultimately improve disease prevention in a \"personalized medicine\" approach. While further research is needed to establish the prevalence of RIPLs in the general population and their full clinical significance, advances in ophthalmic imaging technologies combined with rapid progress in artificial intelligence applications in medical research could accelerate the development of RIPLs in retinal imaging-based oculomics.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":"14 6","pages":"1183-1197"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037589","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":"Long-Term Clarity of High-Water-Content Hydrophobic Acrylic Intraocular Lens: A 3-Year Randomized Comparison with a Hydrophobic Lens of Similar Material and Design.","authors":"Akira Miyata, Kazunori Miyata, Keiichiro Minami","doi":"10.1007/s40123-025-01165-4","DOIUrl":"https://doi.org/10.1007/s40123-025-01165-4","url":null,"abstract":"<p><strong>Introduction: </strong>This randomized prospective study aimed to quantitatively evaluate 3-year visual function, glistenings, and surface light scattering following the implantation of high-water-content hydrophobic acrylic intraocular lenses (IOLs).</p><p><strong>Methods: </strong>One-piece high-water-content IOLs (Clareon® SY60WF; group C) and control hydrophobic acrylic IOLs (Vivinex XY1; group V) were randomly implanted in 120 Japanese participants (120 eyes). Subsequently, the corrected distance visual acuity (CDVA), contrast sensitivity, glistening-derived microvacuoles (MVs), and surface light scattering were examined up to 3 years postoperatively. EPCO software was used to confirm the absence of postoperative capsule opacification to ensure that it did not influence the outcomes. MVs within a 15 × 4 mm area were counted using a slit-lamp microscope. Surface light scattering was evaluated using densitometry. Finally, outcomes were compared among the groups.</p><p><strong>Results: </strong>Overall, 116 eyes were compared (58 eyes each in groups C and V). No differences in the CDVA, contrast sensitivity, and MVs were observed between the groups. The mean densitometry value in group C was significantly higher (P = 0.027) than in group V, increasing significantly from the values recorded at 1-4 weeks, although the change was clinically small (0.29%).</p><p><strong>Conclusion: </strong>This randomized comparative study confirmed non-inferiority in visual function of eyes with Clareon IOLs. A 3-year comparison indicated no difference in glistening suppression, CDVA, or contrast sensitivity, whereas a slight increase was observed in surface light scattering.</p><p><strong>Trial registration: </strong>Registered in the Japan Registry for Clinical Trials (identifier jRCTs032190093).</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Neuropathy Symptoms and Ocular Surface Lesions in Patients with Type 2 Diabetes Mellitus and Dry Eye: A Clinical Correlational Study.","authors":"Yanling Liu, Dapeng Sun, Qianqian Kong, Dongfang Li, Rui Wang, Jia Yin, Lixin Xie, Yanling Dong, Yangyang Zhang","doi":"10.1007/s40123-025-01150-x","DOIUrl":"https://doi.org/10.1007/s40123-025-01150-x","url":null,"abstract":"<p><strong>Introduction: </strong>Reduced corneal sensation in individuals with type 2 diabetes mellitus (T2DM) leads to a dissociation between dry eye disease (DED) signs and symptoms, thereby affecting diagnostic accuracy. This study aimed to investigate the correlation between ocular surface signs and diabetic peripheral neuropathy (DPN) symptoms in patients with T2DM-associated DED.</p><p><strong>Methods: </strong>The Michigan Neuropathy Screening Instrument Questionnaire (MNSIQ) was used to categorize patients with T2DM into MNSIQ-DPN and non-DPN groups. Ocular irritation symptoms were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. Ocular surface lesions were assessed via Cochet-Bonnet esthesiometry, corneal fluorescein staining (CFS), the Schirmer I tear test (SIT), tear meniscus height (TMH), noninvasive keratography break-up time (NIKf-BUT), and the meibomian gland loss (MGL) grade detected by OCULUS. Corneal nerve fiber parameters were evaluated using in vivo confocal microscopy (IVCM).</p><p><strong>Results: </strong>A total of 116 patients with T2DM, comprising 76 non-DPN patients and 40 MNSIQ-DPN patients, along with 51 age-matched participants without diabetes, were enrolled. Although OSDI scores were equivalent between MNSIQ-DPN patients and non-DPN patients, MNSIQ-DPN patients presented significantly more severe CFS (p < 0.001), meibomian gland dysfunction (MGD) (p < 0.001), corneal nerve fiber loss (p < 0.001), sensory dysfunction (p = 0.02), and corneal microneuromas (p < 0.001). The MNSIQ score was significantly positively correlated with CFS (p < 0.001); MGD (p < 0.01); corneal nerve fiber loss, including corneal nerve fiber density and length and branch density, in the paracentral (all p < 0.001) and inferior-whorl areas (p < 0.01, p < 0.05 and p < 0.01, respectively); and corneal microneuromas, characterized by increased microneuroma numbers (p < 0.001) and areas (p < 0.001) in these regions.</p><p><strong>Conclusion: </strong>MNSIQ scores were significantly and robustly correlated with the presence of corneal epithelial defects, MGD, and nerve fiber loss in patients with T2DM. These findings suggest that DPN is a critical factor in diabetic ocular surface complications, highlighting the importance of the MNSIQ for assessing these conditions.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Narrative Review of Amniotic Membrane Transplantation in Ocular Surface Repair: Unveiling the Immunoregulatory Pathways for Timely Intervention.","authors":"Andrew Hopkinson, Francisco C Figueiredo","doi":"10.1007/s40123-025-01143-w","DOIUrl":"https://doi.org/10.1007/s40123-025-01143-w","url":null,"abstract":"<p><p>This narrative review explores the pathophysiology of ocular surface inflammation and highlights the therapeutic potential of patch amniotic membrane transplantation (patch-AMT) in ocular surface repair. Disruptions in ocular surface homeostasis caused by trauma, disease, or immune dysregulation trigger an inflammatory cascade that, if unresolved, can impair epithelial healing, lead to fibrosis, corneal haze, and vision loss. Patch-AMT provides a biological intervention with epitheliotropic, anti-inflammatory, anti-fibrotic, anti-angiogenic, and neuroprotective effects that support wound healing, regulate inflammation, and reduce pain. The review examines patch-AMT's role in acute conditions (chemical burns, Stevens-Johnson Syndrome) and chronic disease (persistent epithelial defects, dry eye disease), focusing on its ability to entrap immune cells, regulate cytokine signaling, and prevent fibrotic remodeling while releasing trophic proteins. Additionally, this review explores how preservation methods, application orientation, and intervention timing influences patch-AMT's efficacy. Recent advancements in non-surgical application methods have expanded accessibility, enabling earlier intervention and outpatient use. However, variability in clinical protocols emphasize the need for standardized guidelines. The review concludes by highlighting the need for further research to refine treatment timing, optimize repeat application strategies, and evaluate cost-effectiveness. While patch-AMT remains underutilized, growing evidence underscores its potential to improve clinical outcomes, particularly when applied early in disease progression.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Outcomes of Retropupillary Iris-Claw Intraocular Lens Implantation for Various Indications.","authors":"Hyo Song Park, Sung Chul Park, Jin Ha Kim, Young Hoon Ohn, Tae Kwann Park, Jung Woo Han","doi":"10.1007/s40123-025-01153-8","DOIUrl":"https://doi.org/10.1007/s40123-025-01153-8","url":null,"abstract":"<p><strong>Introduction: </strong>The retropupillary iris-claw intraocular lens (RP-IOL) offers a sutureless solution to complications like aphakia, intraocular lens (IOL) dislocation, and opacification post-cataract surgery. Unlike time-consuming, complication-prone traditional methods, RP-IOL potentially reduces surgical time and complications. This study evaluates RP-IOL's clinical outcomes to assess its efficacy and safety.</p><p><strong>Methods: </strong>This single-center retrospective case series reviewed medical records of 68 eyes from 68 patients who underwent RP-IOL implantation between January 2017 and May 2023. Preoperative and postoperative data, including visual acuity (VA), intraocular pressure (IOP), and spherical equivalent (SE), were analyzed.</p><p><strong>Results: </strong>The mean uncorrected VA improved significantly from 1.25 ± 0.73 (logarithm of the minimum angle of resolution) preoperatively to 0.42 ± 0.47 at 1 month postoperatively (P < 0.001). The mean IOP decreased significantly from 17.69 ± 5.01 mmHg preoperatively to 16.09 ± 4.23 mmHg 1 month postoperatively (P = 0.041). Postoperative complications occurred in 35.3% of cases, with the most common being IOP elevation (13.2%), cystoid macular edema (11.8%), and disenclavation of IOL (7.4%). Most complications were successfully managed. The study also included a subanalysis of seven patients with IOL opacification, showing improved VA postoperatively, although without statistical significance due to the small sample size.</p><p><strong>Conclusions: </strong>RP-IOL implantation is an effective and safe option for secondary IOL implantation or exchange in cases of aphakia, IOL dislocation, and IOL opacification. The procedure offers significant improvements in visual acuity and a reduction in intraocular pressure, with manageable postoperative complications. While the study supports the use of RP-IOL as a viable option, further research with larger sample sizes and prospective designs is recommended to establish its long-term efficacy and safety compared to traditional methods.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Data on Morphological and Functional Responses After Switching to Faricimab in Recalcitrant, Chronic Diabetic Macular Edema.","authors":"Viktoria Deiters, Anna Lorger, Franziska Eckardt, Jakob Siedlecki, Benedikt Schworm, Siegfried G Priglinger, Tina R Herold","doi":"10.1007/s40123-025-01162-7","DOIUrl":"https://doi.org/10.1007/s40123-025-01162-7","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to assess the morphological and functional effects of faricimab in patients with chronic diabetic macular edema (DME) who had an insufficient response to previous treatments.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective study including eyes with pretreated chronic DME that were switched to faricimab and received at least three injections. The main outcome measures were central subfield thickness (CST) and best-corrected visual acuity (BCVA) changes before and after switching to faricimab.</p><p><strong>Results: </strong>Twenty-two eyes from 18 patients were analyzed, with a mean pretreatment period of 5.7 years. Most eyes had been treated with two or more intravitreal agents. Before switching to faricimab, the mean CST was 468.5 ± 163.6 µm, which decreased to 383.1 ± 125.3 µm, 362.8 ± 93.4 µm (p = 0.207), and 339.5 ± 94.3 µm (p < 0.001) after the first, second, and third injections, respectively. BCVA showed improvement from 0.48 to 0.37 logMAR after the third injection, though the change was only statistically significant after the first injection (p = 0.022).</p><p><strong>Conclusions: </strong>The study demonstrated significant CST reduction in patients with chronic DME in a real-world setting, even after prolonged treatment, suggesting that faricimab can lead to morphological and functional benefits in these cases. Further data are needed to explore the real-world, long-term effects and durability of faricimab in chronic DME.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Ocular Safety Profile Assessment: A Novel Grading Scale for Ocular Adverse Reactions Associated with Bemarituzumab.","authors":"Asim V Farooq, Savreet Kaur, Pradeep Hundal, Maureen Burke, Rosilin Sulaiman, Anita Zahlten-Kümeli, Sumera Raoof, Zhezhen Li, Telma Murias Dos Santos, Xiaojun Jacqueline Huang, Kathryn Colby","doi":"10.1007/s40123-025-01139-6","DOIUrl":"https://doi.org/10.1007/s40123-025-01139-6","url":null,"abstract":"<p><p>Targeted cancer therapies have transformed the landscape of cancer treatments but are often associated with off-target adverse drug reactions due to overlapping molecular pathways in healthy tissues, including those in the eye. Fibroblast growth factor receptors (FGFRs), expressed across various parts of the eye, can become unintended targets of FGFR inhibitors such as erdafitinib, infigratinib, and pemigatinib, leading to ocular adverse events (AEs) affecting the ocular surface and retina. AEs across clinical trials are graded using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE), which may not completely capture the ocular sequelae resulting from the use of emerging therapies. As CTCAE grading is mainly through the description of symptoms and their impact on visual acuity, it is imperative to use a tool that relies more on objective findings from ophthalmologic evaluations. The novel ocular adverse reaction severity grading scale developed by Amgen in collaboration with expert ophthalmologists, accounts for the anatomical regions impacted by ocular adverse reactions and anchors each severity grade to objective observable criteria from ophthalmologic evaluations. This grading scale is being used across the clinical development program for bemarituzumab to precisely characterize the ocular safety profile, enabling cross-specialty collaboration between oncologists and eye care providers to implement appropriate management strategies. This commentary article highlights the efforts led by Amgen in collaboration with regulatory, medical, and academic fields to develop tools that facilitate early recognition of adverse reactions and appropriate interventions for patient care.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathologic Genetic Mutations May Correlate with Poor Visual Outcome in Patients with Hydroxychloroquine Retinopathy.","authors":"Hsun-I Chiu, Hui-Chen Cheng, Chih-Chiau Wu, Shih-Jen Chen, De-Kuang Hwang, Yi-Ming Huang, Yu-Bai Chou, Po-Kang Lin, Tai-Chi Lin, Ko-Hua Chen, Pei-Yu Lin, Yu-Fan Chang, An-Guor Wang","doi":"10.1007/s40123-025-01151-w","DOIUrl":"https://doi.org/10.1007/s40123-025-01151-w","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the progression rate and identify potential genetic risk factors for poor visual outcome in chloroquine/hydroxychloroquine (CQ/HCQ) retinopathy.</p><p><strong>Methods: </strong>Ocular variables, including best-corrected visual acuity (BCVA), hypoautofluorescent area in fundus autofluorescence (FAF) and others were analyzed in patients with a diagnosis of CQ/HCQ retinopathy based on comprehensive ocular and demographic examinations. Whole exome sequencing (WES) was used to investigate the candidate genes associated with inherited retinal diseases. Multivariate analysis was used to analyze the correlation between pathogenic genetic mutation and visual outcome, with poor vision defined as BCVA < 6/12.</p><p><strong>Results: </strong>Forty-one patients with an average age of 61.1 ± 13.6 years, daily dose of 8.2 ± 3.6 mg/kg, and treatment period of 12.4 ± 5.6 years were recruited with a mean follow-up of 3.3 ± 2.8 years. Longitudinal observation revealed that eyes continued to have visual acuity decline with a mean progression rate of 0.065 ± 0.164 (ΔLogMAR/year) and structural change with a mean progression rate of 2.16 ± 4.32 (Δhypoautofluorescent area-to-disc-area ratio per year) despite drug cessation. Pathogenic genetic mutations were found in nine of 29 patients (31%) and were associated with poor visual acuity (odds ratio, OR = 17.402, p = 0.024). Elevated HCQ dose and renal disease were related to increased hypoautofluorescent area in FAF (OR = 17.659, p < 0.001, and OR = 7.285, p = 0.007, respectively).</p><p><strong>Conclusions: </strong>The study highlights the importance of identifying genetic mutations and monitoring hypoautofluorescent areas in FAF for predicting and managing visual outcomes in patients with CQ/HCQ retinopathy.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}