Ophthalmology and Therapy最新文献

{"title":"Chronic Ocular Surface Pain: An Optometrist and Ophthalmologist Survey.","authors":"Anat Galor, Kaleb Abbott, Bonnie Henderson, Steve Pflugfelder, Darrell White, Preeya Gupta, Laura Periman, James A Stefater, Tomasz P Stryjewski, Cristos Ifantides, Paul Karpecki","doi":"10.1007/s40123-025-01234-8","DOIUrl":"https://doi.org/10.1007/s40123-025-01234-8","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic ocular surface pain (COSP) is defined as ocular pain that is perceived to originate from the ocular surface and persists for more than 3 months. Clear epidemiological data on COSP prevalence are lacking.</p><p><strong>Methods: </strong>In 2025, a total of 100 eye care providers were surveyed, including 50 optometrists and 50 ophthalmologists. The survey aimed to assess the percentage of their weekly patient volume diagnosed with COSP, the diagnostic methods used, contributing etiologies, and current management strategies. Additionally, practitioners identified key indicators of successful treatment and attributes they believed would have the greatest impact on patient outcomes. Lastly, they rated their satisfaction with current therapeutic options.</p><p><strong>Results: </strong>An estimated 33% of optometrists' patients and 29% of ophthalmologists' patients had COSP. Of those diagnosed with dry eye disease (DED), 63% also had COSP. Providers managed COSP with over-the-counter (OTC) artificial tears (97% of respondents), OTC gels and ointments (90%), hot compresses (86%), and prescription therapies indicated for DED (30-88%), while a minority routinely used amniotic membranes (37%), serum tears (26%), intense pulsed light (18%), and LipiFlow (16%). The proportions of providers who were satisfied or very satisfied with these therapies were as follows: 64% for amniotic membranes and serum tears, 63% for device-based therapies, 40% for prescription medications, and 21% for OTC drops, ointments, and hot compresses.</p><p><strong>Conclusions: </strong>This survey provides initial insight into the prevalence of COSP among patients in US eye care clinics, along with perspectives on managing this condition from both optometrists and ophthalmologists. The most common therapeutic strategies for COSP (OTC artificial tears, gels, and ointments) were associated with the lowest levels of provider satisfaction. COSP and dry eye disease are distinct but closely linked conditions. These results demonstrate an unmet need for new treatment options to address COSP.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001077","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 Experience with Lifitegrast Ophthalmic Solution in Patients with Dry Eye Disease: A Provider Survey in the USA and Canada.","authors":"Cecelia Koetting, Justin Schweitzer, Kelly K Nichols, Marguerite McDonald, Christopher E Starr, Clara C Chan, Mile Brujic, Louis Racine, Francis S Mah, Melissa Barnett, Marjan Farid, Eric D Donnenfeld, Carolina Mercado, Michelle Ratay, Megan Cavet, Robert Ryan, Joel Fain, Lisa K Feulner","doi":"10.1007/s40123-025-01190-3","DOIUrl":"10.1007/s40123-025-01190-3","url":null,"abstract":"<p><strong>Introduction: </strong>Lifitegrast ophthalmic solution 5% is indicated to treat signs and symptoms of dry eye disease (DED). This study assessed eyecare professionals' (ECPs) real-world experiences with lifitegrast in DED.</p><p><strong>Methods: </strong>A total of 12 ECPs (6 ophthalmologists and 6 optometrists) with experience prescribing lifitegrast completed a cross-sectional survey on practice characteristics, lifitegrast utilization, satisfaction, and adverse events (AEs). ECPs rated satisfaction with lifitegrast overall and for specific clinical outcomes versus other prescription eye drops on a 1 (very dissatisfied) to 10 (very satisfied) Likert scale.</p><p><strong>Results: </strong>ECPs reported a mean of 1288 (range, 35-6000) patients with DED treated annually, with 20.9% receiving lifitegrast. Overall, 66.7% of ECPs reported near/complete symptom resolution in patients after 1-3 months of lifitegrast treatment. Mean (range) satisfaction ratings for onset/effectiveness were 6.8 (3-9)/6.6 (3-9). Satisfaction with reduction of DED signs was generally high: increased tear film breakup time, 5.8 (3-9); reduced conjunctival/corneal staining, 6.9 (3-9); increased Schirmer test score, 6.0 (3-9); increased tear meniscus height, 6.0 (3-9); and reduced Ocular Surface Disease Index severity, 7.0 (3-10). Symptom reduction satisfaction ratings were: itching, 5.3 (1-9); dryness, 6.9 (3-9); burning/stinging, 6.3 (1-9); redness, 6.2 (4-9); pain, 6.3 (3-9); light sensitivity, 6.5 (3-9); and blurred/poor vision, 6.8 (4-9). Overall satisfaction (ECPs/patients) was rated 7.1 (3-10)/6.8 (2-9). Predominant uses of lifitegrast included contact lens-induced DED (91.7%) and DED before/after refractive or cataract surgery (83.3% each). AEs reported were consistent with the known AE profile of lifitegrast and included burning/stinging, blurred vision, and dysgeusia.</p><p><strong>Conclusions: </strong>This real-world survey showed that ECPs use lifitegrast to treat one fifth of their patients with DED and reported moderate-to-high personal and patient satisfaction with lifitegrast treatment.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2109-2124"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601144","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 of Intravitreal Brolucizumab Switch in Pachychoroid Neovasculopathy.","authors":"Nicolò Ribarich, Marco Battista, Lisa Checchin, Riccardo Sacconi, Francesco Bandello, Giuseppe Querques","doi":"10.1007/s40123-025-01208-w","DOIUrl":"10.1007/s40123-025-01208-w","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the anatomical and functional outcomes of switching to intravitreally administered brolucizumab (Beovu^®, Novartis) in patients affected by pachychoroid neovasculopathy (PNV) who were considered as non-responders to previous anti-vascular endothelial growth factor (anti-VEGF) therapies, defined as the persistence of intraretinal fluid (IRF), subretinal fluid (SRF), or subretinal hyper-reflective material (SHRM).</p><p><strong>Methods: </strong>Twenty-three eyes of 21 patients with exudative PNV, who were switched to brolucizumab between April 2021 and December 2023, were retrospectively enrolled. All patients had previously received at least one injection of another anti-VEGF agent. Following the switch (baseline), patients received brolucizumab under a pro re nata regimen and were followed for 12 months. Best-corrected visual acuity (BCVA), central macular thickness (CMT), central choroidal thickness (CT), and height of IRF, SRF, SHRM, and pigment epithelial detachment (PED) were assessed at baseline and at the 12-month follow-up.</p><p><strong>Results: </strong>At 12 months after the switch to brolucizumab (mean 5.26 injections), BCVA remained stable (20/50, 0.4 logMAR). However, significant anatomical improvements were observed, including a reduction in SRF (97-18 µm, p = 0.002), SHRM (75-0 µm, p = 0.008), and CT (379-337 µm, p < 0.001). Resolution of IRF was achieved in 70% of eyes and SHRM in 87%. A median of 2 brolucizumab injections were required to achieve fluid control (absence of both IRF and SRF). Notably, the number of injections needed for complete SRF resolution predicted final BCVA.</p><p><strong>Conclusion: </strong>In our cohort of patients with PNV, switching to brolucizumab demonstrated a significant anatomical response, leading to a reduction in exudative features. While BCVA remained stable, the number of brolucizumab injections required to resolve SRF emerged as a predictor of final visual outcome, suggesting that an earlier switch in non-responders might optimize anatomical results. The safety profile of brolucizumab in this study was favourable, with no severe inflammatory adverse events reported.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2155-2164"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659755","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":"Continuous versus Intermittent Use of Tear Substitutes in Patients Treated with Anti-VEGF for Neovascular Age-Related Macular Degeneration: The TREDIA Study.","authors":"Héloïse Torres-Villaros, Audrey Giocanti-Aurégan, Serge Doan, Emilie Agard, Jérémy Billant, Nathalie Arbousoff, Benjamin Matagrin, Inès Fenniri, Corinne Dot","doi":"10.1007/s40123-025-01201-3","DOIUrl":"10.1007/s40123-025-01201-3","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this prospective randomized bicenter study was to compare the effects of continuous versus intermittent use of tear substitutes on the ocular surface and dry eye symptoms in patients receiving repeated and frequent intravitreal injections (IVIs) for neovascular age-related macular degeneration (nAMD).</p><p><strong>Methods: </strong>Patients with nAMD treated with anti-vascular endothelial growth factor (anti-VEGF) for more than 1 year at 4-8-week intervals were included. The intermittent treatment group received standard 1.5% povidone artificial tears for three days after each IVI, while the continuous treatment group received an ophthalmic lubricant emulsion with 0.18% sodium hyaluronate four times a day throughout the study. The primary endpoint was the mean change in Ocular Surface Disease Index (OSDI) score between baseline and the day of the fourth IVI. Secondary endpoints included the Schirmer test score, tear break-up time (TBUT), and Oxford staining score.</p><p><strong>Results: </strong>Sixty-five patients with mean age of 83.1 ± 6.0 years who had previously received a mean number of 28.5 ± 20.3 IVIs were included. The mean OSDI score change from baseline was -6.6 ± 13.5 points in the continuous treatment group versus +0.6 ± 13.7 points in the intermittent treatment group (p = 0.04). No significant differences in Schirmer test score, TBUT, and Oxford score were found between the groups.</p><p><strong>Conclusions: </strong>Continuous use of tear substitutes in patients with nAMD receiving repeated and frequent IVIs could be beneficial in improving dry eye symptoms, as shown by a significant improvement in OSDI scores in our study, despite no substantial changes in other ocular surface metrics.</p><p><strong>Trial registration number: </strong>NCT06174181.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2231-2241"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682889","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":"Development and Validation of the Relational Tissue Altered (RTA) Index: Applied Artificial Intelligence for the Assessment of Structural Impact from Laser Vision Correction.","authors":"Aydano P Machado, Louise Pellegrino G Esporcatte, Marcella Q Salomão, Bernardo T Lopes, João Marcelo A G Lyra, Renato Ambrósio","doi":"10.1007/s40123-025-01206-y","DOIUrl":"10.1007/s40123-025-01206-y","url":null,"abstract":"<p><strong>Introduction: </strong>A retrospective case-control study was carried out to develop a predictive computational model to objectively and accurately represent the impact of laser vision correction (LVC) on the corneal structure. This study involved data from 3278 eyes (1690 patients) that remained stable after refractive surgery and 105 eyes (66 patients) that developed postoperative ectasia.</p><p><strong>Methods: </strong>An artificial intelligence-based machine learning approach was used to create a predictive model for the impact of corneal refractive surgery. The development process was based on the practice of knowledge discovery in databases (KDD) and addressed each step, including data selection, preprocessing, data transformation, data mining, and model evaluation. To evaluate the predictive model output, we analyzed the receiver operating characteristic (ROC) curves to determine the area under the curve (AUC) and the optimal cutoff points, as well as sensitivity and specificity.</p><p><strong>Results: </strong>The minimal pachymetry was superior to central (apex) pachymetry for all calculations. The Relational Tissue Altered (RTA) showed the highest AUC performance, with area under the curve (AUC) values of 0.913. These AUC values were significantly higher (according to the DeLong test) than those obtained with Residual Stromal Bed (RSB) values of 0.832 and 0.825 (apex), and Percent Tissue Altered (PTA) values of 0.805 (minimum (min)) and 0.800 (apex). RTA demonstrated a sensitivity of 76.0% (95% confidence interval (CI) 68.8-83.2%) and a specificity of 89.2% (95% CI 86.2-92.2%). PTA min showed a sensitivity of 66.0% (95% CI 58.0-74.0%) and a specificity of 85.4% (95% CI 82.0-88.8%).</p><p><strong>Conclusions: </strong>The Relational Tissue Altered (RTA) index provides an objective and data-driven measure of the structural impact induced by laser vision correction (LVC) on the cornea. Compared with traditional parameters such as Residual Stromal Bed (RSB) and Percent Tissue Altered (PTA), which were not originally designed to quantify biomechanical disruption, RTA demonstrated superior performance in characterizing surgical impact. Although not developed as a standalone ectasia predictor, RTA offers unique value when integrated with preoperative assessments of intrinsic corneal susceptibility, including topometric, tomographic, and biomechanical metrics. This synergistic approach holds promise for enhancing risk stratification, refining surgical planning, and advancing the safety and personalization of refractive surgery.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2215-2229"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668077","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":"Research Progress in Artificial Intelligence for Central Serous Chorioretinopathy: A Systematic Review.","authors":"Ping Zhang, Qing Zhang, Xinya Hu, Wei Chi, Weihua Yang","doi":"10.1007/s40123-025-01209-9","DOIUrl":"10.1007/s40123-025-01209-9","url":null,"abstract":"<p><strong>Introduction: </strong>This review synthesizes advancements in artificial intelligence (AI) applications for central serous chorioretinopathy (CSCR), analyzing challenges and outlining future research directions to guide personalized diagnostic and therapeutic strategies.</p><p><strong>Methods: </strong>A systematic literature search was conducted in the Web of Science database using a comprehensive AI-related keyword set (e.g., \"deep learning,\" \"neural networks,\" \"computer vision\") combined with \"central serous chorioretinopathy.\" The search yielded 698 records, with 73 original research studies selected after excluding reviews and non-empirical work based on predefined criteria.</p><p><strong>Results: </strong>The application of AI in CSCR has progressed from disease classification to dynamic prognostic prediction, leveraging multimodal data fusion (e.g., optical coherence tomography [OCT] and OCT angiography [OCTA] and fundus fluorescein angiography [FFA]) to enhance both qualitative and quantitative diagnostic accuracy. AI models outperform clinical experts in classifying retinal disease subtypes and segmenting lesions. However, clinical translation faces infrastructural barriers (e.g., incompatible PACS systems) and limited physician trust due to \"black box\" decision-making. New approaches, such as explainable AI (XAI), are being integrated to enhance the transparency and clinical applicability of AI models. Key limitations involve single-center data dependency, interobserver annotation variability, and the inability of static frameworks to capture dynamic lesion progression.</p><p><strong>Conclusion: </strong>AI enhances CSCR diagnosis and subtyping efficiency. To optimize clinical translation, future research should focus on multicenter data integration, dynamic visualization frameworks, and standardized guidelines, promoting interdisciplinary collaboration and prospective trials for personalized treatment strategies. Incorporating federated learning for privacy-preserving data sharing and prioritizing explainability will be essential to overcoming barriers to physician adoption and improving trust in AI-driven clinical decision-making. Future efforts should focus on creating dynamic systems that provide real-time insights into lesion progression and integrating them with standardized protocols for wider clinical adoption.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2083-2107"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691173","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":"Risk of Moderate to Severe Ocular Surface Disease Associated with Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Therapy: A Multicenter Cohort Study.","authors":"Yu-Ting Tsao, Eugene Yu-Chuan Kang, Chiao-En Wu, Ning Hung, Hung-Chi Chen, Ching-Hsi Hsiao","doi":"10.1007/s40123-025-01200-4","DOIUrl":"10.1007/s40123-025-01200-4","url":null,"abstract":"<p><strong>Introduction: </strong>Moderate to severe ocular surface disease (OSD) can substantially impair quality of life in patients with lung cancer receiving epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy. Although multiple studies have reported cases of OSD associated with EGFR-TKI therapy, few have investigated major risk factors. In this study, we investigated the key risk factors for moderate to severe OSD in patients with lung cancer receiving EGFR-TKI therapy.</p><p><strong>Methods: </strong>This multicenter retrospective (November 2004-December 2019) cohort study included 31,491 patients with lung cancer. Moderate to severe OSD was defined as severe conjunctivitis, dry eye disease necessitating at least step 2 treatment, keratitis, corneal ulcer, corneal perforation, or OSD necessitating surgery. Risk factors for moderate to severe OSD were investigated using univariate and multivariate Cox proportional hazards models.</p><p><strong>Results: </strong>Among 6677 eligible patients who received EGFR-TKI therapy, 220 (3.3%) developed moderate to severe OSD. Multivariate analysis revealed the following independent risk factors: female sex (hazard ratio [HR]: 1.43; 95% CI: 1.08-1.90), prior ocular surgery (HR: 4.15; 95% CI: 1.54-11.21), older age (HR: 1.16; 95% CI: 1.03-1.31), autoimmune disease (HR: 3.38; 95% CI: 1.38-8.25), peptic ulcer (HR: 1.90; 95% CI: 1.35-2.68), thyroid disease (HR: 2.34; 95% CI: 1.03-5.28), and systemic steroid use (HR: 1.50; 95% CI: 1.13-1.97). The following were specific risk factors for severe OSD: distant metastasis (HR: 3.29; 95% CI: 1.16-9.28), prior radiotherapy (HR: 2.29; 95% CI: 1.13-4.65), thyroid disease (HR: 3.78; 95% CI: 1.15-12.40), and high Charlson Comorbidity Index scores (HR: 1.11; 95% CI: 1.01-1.23).</p><p><strong>Conclusion: </strong>Patients with the identified risk factors are at an elevated risk of moderate to severe OSD during EGFR-TKI therapy. Early recognition and timely intervention by ophthalmologists and oncologists in high-risk individuals may mitigate disease progression and improve quality of life.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2179-2196"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659757","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":"Faricimab in the Treatment of Exudative Neovascular Age-Related Macular Degeneration and Diabetic Macular Edema in Italy: The FARIT Real World Study.","authors":"Marco Lupidi, Cristiana Iaculli, Luisa Marco, Settimio Rossi, Emilia Sicari, Giulia Villa, Vittorio Pirani","doi":"10.1007/s40123-025-01204-0","DOIUrl":"10.1007/s40123-025-01204-0","url":null,"abstract":"<p><strong>Introduction: </strong>Faricimab is a bispecific antibody that enables greater disease control and extended durability compared with vascular endothelial growth factor (VEGF) inhibition alone in neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). This study aimed to evaluate its effectiveness, durability, and economic and social burden in Italian clinical practice.</p><p><strong>Methods: </strong>FARIT was a retrospective, observational, multicenter cohort study across four Italian sites. Adult patients with nAMD or DME who initiated faricimab from February 2023 and had ≥ 6 months of follow-up were included. Clinical outcomes, treatment patterns, and patient-reported data were collected through chart review and electronic surveys.</p><p><strong>Results: </strong>A total of 87 eyes (68 with nAMD, 19 with DME) were followed for a median of 14 months. Among them, 33 eyes (24 with nAMD, 9 with DME) were anti-VEGF naïve. At 1 year, 95.4% and 100% of naïve eyes with nAMD and DME, respectively, reached a dosing interval of every 12 weeks (Q12W) or longer; 63.6% and 100% received the treatment every 16 weeks (Q16W). Among switch eyes, 92.4% (nAMD) and 71.5% (DME) reached ≥ Q12W, with 35.9% and 42.9%, respectively, on Q16W dosing. After a full loading phase, the median number of injections administered during the post-loading follow-up period (12 months for nAMD, 10 months for DME) was three for nAMD and two for DME. The interval extensions were driven by visual acuity stabilization/improvement and fluid resolution. Patients and caregivers reported high satisfaction and reduced burden, with fewer injections and better visual outcomes contributing most to improved quality of life. Economic analysis showed a 12-month direct cost (excluding the drug cost) of 1223.8 €/patient from the healthcare system perspective.</p><p><strong>Conclusions: </strong>Faricimab provided effective disease control and extended treatment intervals in treatment-naïve and previously treated eyes with nAMD and DME, showing a fast anatomical response and reduced injection burden.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2197-2214"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668078","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":"Assessment of Relationship between Neovascularization Type Using Wide Field Optical Coherence Tomography Angiography in Eyes with Proliferative Diabetic Retinopathy.","authors":"Akshita Aggarwal, Dibya Prabha, Brijesh Takkar, Sobha Sivaprasad, Padmaja Kumari Rani","doi":"10.1007/s40123-025-01213-z","DOIUrl":"10.1007/s40123-025-01213-z","url":null,"abstract":"<p><strong>Introduction: </strong>Retinal neovascularization in proliferative diabetic retinopathy (PDR) presents with varying morphology and clinical implications. This study aims to classify retinal neovascularization into subtypes and assess their correlation with ischemic index using widefield optical coherence tomography (OCT) angiography.</p><p><strong>Methods: </strong>This retrospective observational study included 50 treatment-naïve patients (84 eyes) with PDR who underwent baseline widefield fundus photography (CLARUS 500™) and widefield optical coherence tomography angiography (WF-OCTA; Plex Elite 9000) between January 2022 and June 2024. Quantitative analysis of WF-OCTA images assessed capillary nonperfusion (CNP), ischemic index (ISI), and three neovascularization (NV) subtypes: type 1 NV (flat, intraretinal or subinternal limiting membrane growth), type 2 NV (preretinal proliferation extending into the vitreous), and type 3 NV (a combination of types 1 and 2 features, showing both flat and protruding components). Two clinicians manually delineated capillary nonperfusion (CNP) using ImageJ software. Neovascularization (NV) was classified by subtype and location (posterior versus mid-periphery). Ischemic index (ISI), nonperfusion area, best corrected visual acuity (BCVA), and the need for adjunctive interventions (additional laser or vitreoretinal surgery) were correlated with treatment response to panretinal photocoagulation (PRP).</p><p><strong>Results: </strong>Type 1 neovascularization was most frequent (42.1%), with a mean ischemic index (ISI) of 0.19 ± 0.17. Type 3 neovascularization showed the highest ISI (0.27 ± 0.07) and largest nonperfusion area (36.66 mm² ± 10.24). Best corrected visual acuity (BCVA) improved in 58% of patients after panretinal photocoagulation, with type 3 showing the greatest improvement. Adjunct laser therapy was required more frequently for type 2 (13 cases) following standard panretinal photocoagulation. However, type 3 required the least supplemental laser.</p><p><strong>Conclusions: </strong>WF-OCTA proves valuable in the assessment of disease severity and its extent, along with possible implications on planning the intervention for PDR.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2243-2251"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699194","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":"Morphological and Functional Outcomes in the Long-Term Natural Course of Peripapillary Pachychoroid Syndrome.","authors":"Christina Karakosta, Peter Kiraly, Anastasios Bisoukis, Konstantinos I Bougioukas, M Dominik Fischer","doi":"10.1007/s40123-025-01226-8","DOIUrl":"https://doi.org/10.1007/s40123-025-01226-8","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigated the long-term natural history of peripapillary pachychoroid syndrome (PPS), analyzing both morphological and functional outcomes.</p><p><strong>Methods: </strong>This retrospective study included 24 eyes from 14 participants diagnosed with PPS. No interventions were administered. Baseline and follow-up assessments comprised best-corrected visual acuity (BCVA), measured on the LogMAR scale, inner nasal (IN) and outer nasal (ON) macular thickness measured using the ETDRS (Early Treatment Diabetic Retinopathy Study) subfields. To account for repeated measures and the hierarchical structure of eyes nested within participants, and to appropriately handle incomplete longitudinal data, linear mixed-effects models were utilized for all statistical analyses.</p><p><strong>Results: </strong>The mean age was 74 ± 7 years, and 71% of patients had bilateral PPS. All patients had peripapillary atrophy at baseline. The mean baseline BCVA was 0.05 and showed only small variations over time. ON macular thickness showed a significant decrease at 2 years (Δ = - 36.9 µm, p = 0.034), whereas IN macular thickness decreased significantly at both 2 years (Δ = - 40.75 µm, p = 0.023) and 3 years (Δ = - 39.97 µm, p = 0.042). One-quarter of participants developed a serous pigment epithelium detachment with subretinal fluid, suggesting an overlapping PPS/CSC (central serous chorioretinopathy) phenotype.</p><p><strong>Conclusions: </strong>Peripapillary atrophy appears to be an important anatomical predisposition for PPS. Waxing and waning of intraretinal fluid were observed during the natural course of PPS, with a significant reduction at 2 years. Most patients remained asymptomatic and maintained stable BCVA throughout long-term follow-up, indicating a generally favorable prognosis in the absence of intervention.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963806","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}