Ophthalmology and Therapy最新文献

{"title":"Dry Eye Disease Management Via Technological Methods: A Systematic Review and Network Meta-analysis.","authors":"Dror Ben Ephraim Noyman, Clara C Chan, Joshua C Teichman, Itamar Arbel, Or Yosefi, Ruth Lapid-Gortzak, Michael Mimouni, Margarita Safir","doi":"10.1007/s40123-025-01187-y","DOIUrl":"10.1007/s40123-025-01187-y","url":null,"abstract":"<p><strong>Introduction: </strong>In recent years, various technological therapeutic modalities have emerged aiming to target the underlying pathophysiology of dry eye disease (DED).</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Scopus, and Embase databases up to July 29, 2023, using predefined search terms related to DED and technological treatments, including intense pulsed light (IPL), LipiFlow, TearCare, iLux, low-level light therapy (LLLT), and acupuncture. Randomized controlled trials (RCTs) evaluating technological interventions for DED with outcome measures for tear secretion, meibomian gland quality, tear break-up time (TBUT), corneal surface health, and symptom scores at 1-2 months post-treatment were included. Data extraction followed PRISMA guidelines. Risk of bias was assessed using Cochrane guidelines. A random-effects frequentist network meta-analysis model was employed, and standardized mean differences (SMDs) were calculated for comparative analyses. P-scores were used to rank treatment efficacy.</p><p><strong>Results: </strong>Ultimately, 45 RCTs involving 3455 patients were included. TearCare combined with meibomian gland expression (MGX) demonstrated the highest efficacy for improving meibomian gland secretion (SMD - 10.08, 95% CI - 13.35 to - 6.82). IPL-based treatments, including IPL combined with diquafosol sodium or LLLT, significantly improved TBUT and symptom scores, with IPL alone ranking highest for symptom relief (P-score 0.811). Acupuncture was the only intervention significantly superior to conservative treatment for increasing Schirmer test values (SMD - 0.69, 95% CI - 1.06 to - 0.32). LipiFlow demonstrated modest improvements but was not significantly superior to other technologies.</p><p><strong>Conclusions: </strong>These findings underscore the potential of advanced technological interventions in the short-term management of DED and support the need for standardized, long-term comparative studies.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1917-1954"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541668","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":"Post-market Surveillance Analysis of Refractive Data in Users of Delivery Tyro^®, a Tyrosine-Releasing Contact Lens.","authors":"Diego Ponzin, Adriano Fasolo, Giancarlo Montani, Daniele Bazzocchi","doi":"10.1007/s40123-025-01195-y","DOIUrl":"10.1007/s40123-025-01195-y","url":null,"abstract":"<p><strong>Introduction: </strong>Myopia is a growing public health concern, particularly among young individuals. Several pharmacological and optical interventions exist to slow its progression, yet each has limitations. In January 2021, Safilens introduced the Delivery Tyro^® daily disposable contact lens, which releases hyaluronic acid, tamarind seed polysaccharide, and tyrosine, a dopamine precursor with antioxidative and cytoprotective properties.</p><p><strong>Methods: </strong>This study analyzed post-market surveillance data collected by 55 optometrists from 241 myopic subjects (mean age, 14.73 years; mean initial spherical equivalent (SE) refraction, - 2.72 diopters [D]) over a 12-month period of bilateral Delivery Tyro^® lens use. The purpose of the analysis was to compare the observed myopia progression in Delivery Tyro^® users with expected rates based on control SE refraction data derived from meta-analyses of similar age and ethnic cohorts.</p><p><strong>Results: </strong>Delivery Tyro^® users experienced slower rates of myopia progression than expected. After 12 months of lens wear, the average change in SE was a - 0.04 D compared with the expected change of - 0.28 D from the reference control group (P < 0.001). Furthermore, 94% of eyes exhibited no significant change in SE (defined as a change of - 0.25 D or less).</p><p><strong>Conclusions: </strong>These findings support the hypothesis that Delivery Tyro^® may reduce myopia progression, likely attributable to the release of tyrosine during lens wear, either due to its antioxidative properties or its role as a precursor of dopamine, a key neurotransmitter in the retina involved in visual signaling, and refractive development. Given the convenience of daily disposable lenses, Delivery Tyro^® may offer a practical solution for myopia management, particularly for young patients at elevated risk of rapid myopia progression due to genetic and environmental factors. Further confirmation of the efficacy of Delivery Tyro^® through controlled, randomized clinical trials is warranted.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2071-2081"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554090","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":"Correlating 10-2 Visual Field Loss with Structural and Angiographic Parameters in Advanced Glaucoma.","authors":"Kübra Atay Dinçer, Metehan Karaatlı, Onur Özalp, Tülay Şimşek, Monisha Esther Nongpiur, Eray Atalay","doi":"10.1007/s40123-025-01192-1","DOIUrl":"10.1007/s40123-025-01192-1","url":null,"abstract":"<p><strong>Introduction: </strong>We investigated the relationship between optical coherence tomography (OCT) angiography (OCTA)-derived vascular parameters, central visual field (10-2 VF), ganglion cell complex (GCC), and retinal nerve fiber layer (RNFL) thickness in patients with advanced glaucoma.</p><p><strong>Methods: </strong>This retrospective, cross-sectional study included 28 eyes of 23 patients with advanced glaucoma (VF mean deviation [MD] worse than - 12 dB on 24-2 testing). All participants underwent comprehensive ophthalmic examinations, OCT, OCTA, and 10-2 VF tests. Pearson's correlation was used to assess relationships between structural, functional, and vascular parameters.</p><p><strong>Results: </strong>Statistically significant positive correlations were found between GCC thickness and 10-2 VF MD (r = 0.529, p = 0.005), and between parafoveal superficial capillary plexus vessel density (SCP-VD) and 10-2 VF MD (r = 0.549, p = 0.002). Macular SCP vessel area density showed a positive correlation with RNFL thickness (r = 0.429, p = 0.036). Mean vessel length in the optic nerve head layer exhibited a negative correlation with 10-2 VF MD (r = - 0.528, p = 0.003). Quadrant-wise analysis revealed positive associations between SCP-VD and both GCC (r = 0.409, p = 0.038) and RNFL thickness (r = 0.410, p = 0.047) in the superior hemifield, and between deep capillary plexus vessel density and RNFL thickness (r = 0.533, p = 0.007) in the inferior hemifield.</p><p><strong>Conclusion: </strong>Parafoveal SCP-VD and GCC thickness, due to their significant correlations with 10-2 VF MD, may serve as surrogate markers for monitoring central visual function and disease progression in advanced glaucoma, particularly when reliable VF testing is not feasible.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1955-1964"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554088","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 Anatomical and Functional Outcomes of Faricimab in Recalcitrant Neovascular Age-Related Macular Degeneration: A Retrospective Real-World Study in an East-Asian Population.","authors":"Yen-An Lai, Mei-Chi Tsui, Shuo-Fang Cheng, Yi-Ting Hsieh, Tso-Ting Lai, Yun Hsia, Shih-Wen Wang, I-Hsin Ma, Kuo-Chi Hung, Chang-Pin Lin, Chang-Hao Yang, Chung-May Yang, Tzyy-Chang Ho","doi":"10.1007/s40123-025-01163-6","DOIUrl":"10.1007/s40123-025-01163-6","url":null,"abstract":"<p><strong>Introduction: </strong>Neovascular age-related macular degeneration (nAMD) is a leading cause of vision loss, with some eyes showing recalcitrant disease despite standard anti-vascular endothelial growth factor (anti-VEGF) therapy. While clinical trials have demonstrated promising efficacy and safety of faricimab in treatment-naïve patients, only 9% of participants were Asian, and real-world data on its effectiveness in pretreated Asian populations remain limited. This study aims to evaluate the efficacy and longitudinal response of intravitreal faricimab in patients with recalcitrant nAMD in Taiwan by analyzing visual acuity, anatomical outcomes, and treatment interval extension over a 6-month period.</p><p><strong>Methods: </strong>This was a retrospective observational study at National Taiwan University Hospital. Patients switched to intravitreal faricimab (6 mg/0.05 mL; Vabysmo™) from July 2023 to May 2024 with 6 months follow-up identified via electronic medical records. Injections were administered without a loading phase. Retreatment was guided by the presence of retinal fluid on optical coherence tomography (OCT), with or without visual decline.</p><p><strong>Results: </strong>A total of 33 eyes from 28 patients were analyzed. Visual acuity remained stable over 6 months (p = 0.147). Central retinal thickness significantly improved from 267 to 235 μm at 3 months (p = 0.002) and remained stable at 6 months (p = 0.003). Subretinal fluid resolved in 36.4% of eyes at 3 months (p < 0.001) and 48.5% at 6 months (p = 0.002), while changes in intraretinal fluid (IRF) and pigment epithelial detachment (PED) height were not significant. Treatment intervals were extended in 52% of eyes, with 56% reaching ≥ 16 weeks (Q16W) intervals. No serious ocular or systemic adverse events were reported.</p><p><strong>Conclusions: </strong>Intravitreal faricimab demonstrated improved anatomical outcomes with stable visual acuity and extended treatment intervals in patients with recalcitrant nAMD in Taiwan, addressing a key evidence gap. Future studies with longer follow-ups are needed to validate these findings.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1723-1737"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216502","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":"Advanced Characterization of Vitreous Hyperreflective Dots via OCT-Derived Metrics: A Cross-Sectional Study.","authors":"William Rojas-Carabali, Jinghan Lin, Paola Saboya-Galindo, Eunice Jin Hui Goh, Joewee Boon, Carlos Cifuentes-González, Rupesh Agrawal","doi":"10.1007/s40123-025-01182-3","DOIUrl":"10.1007/s40123-025-01182-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The use of optical coherence tomography (OCT) as a potential tool for the measurement of vitreous inflammation has been previously described as a more objective and reproducible method when compared to historically known subjective scales. In this study, our objective is to evaluate OCT's ability to characterize vitreous hyperreflective dots (VHDs) across eyes with varying conditions, including healthy controls, vitreous degenerations, intraocular inflammation, and others.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We utilized a purpose built semiautomated software comprising an image binarization tool to segment OCT scans of 61 eyes, comprising 15 eyes with vitreous degenerations, 20 uveitic eyes, 17 healthy controls, and 9 with other eye conditions. The vitreous dot index (VDI) was computed by determining the number of dots (VDI-N) and the dot area (VDI-A). VHDs were identified as the hyperreflective shadows observed in OCT images within segmented areas of the vitreous, stratified as zones I, II, and III. We compared the difference between groups using analysis of variance (ANOVA). Intergrader reliability was evaluated by comparing results obtained by two trained independent graders, employing intraclass correlation coefficient (ICC) analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;When the medians of VDI-N and VDI-A were compared in healthy controls, patients with uveitis, patients with vitreous degeneration, and others, patients with vitreous degeneration had the highest VDI-N median (2.61 ± 2.76 mm&lt;sup&gt;3&lt;/sup&gt; p &lt; 0.001) followed by healthy controls (0.48 ± 0.87 mm&lt;sup&gt;3&lt;/sup&gt; p &lt; 0.001) in zone l. As for VDI-A in the same zone, healthy controls had the greatest median (0.71 ± 0.96, p &lt; 0.001) among the different groups. In zone II, uveitis and the healthy control group had similar medians for VDI-N (0.03 ± 0.36 and 0.03 ± 0.29, p &lt; 0.001 respectably) and VDI-A was greater in the vitreous degeneration group (0.40 ± 0.50 p &lt; 0.001). Zone III had lower VDI-N and VDI-A; patients with uveitis and patients with vitreous degeneration had equal VDI-N (0.00 ± 0.03 p &lt; 0.001) and patients with uveitis had the higher VDI-A among the rest of the groups (0.00 ± 0.65 p &lt; 0.001). For the total vitreous (TV), the highest VDI-N was found in patients with vitreous degeneration (2.92 ± 2.85 p &lt; 0.001) while the highest VDI-A was in the uveitis group patients (0.66 ± 1.31) p &lt; 0.001. The average vitreous dot density index and the average vitreous dot reflectivity index (VDRI) in the TV were greater in patients with vitreous degeneration (2.15 × 10&lt;sup&gt;-5&lt;/sup&gt; ± 1.52 × 10&lt;sup&gt;-5&lt;/sup&gt;) and patients with uveitis (0.13 ± 0.08), respectively. When comparing VDI markers using a Kruskal-Wallis nonparametric one-way ANOVA test, we found that only the average vitreous dot reflectivity index in zone I and VDI-A in TV were statistically significant. However, only the reflectivity index was significant when comparing patients with vitreous degeneration a","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1827-1841"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302628","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":"Revisiting the Role of Intravitreal Triamcinolone in Diabetic Macular Edema: 12-Month Outcomes after Bevacizumab Failure.","authors":"Sukhum Silpa-Archa, Variya Nganthavee, Peranut Chotcomwongse, Pawas Lalitwongsa, Paisan Ruamviboonsuk","doi":"10.1007/s40123-025-01172-5","DOIUrl":"10.1007/s40123-025-01172-5","url":null,"abstract":"<p><strong>Introduction: </strong>Refractory diabetic macular edema (DME) is challenging in resource-limited settings, where costly alternatives such as non-bevacizumab anti-vascular endothelial growth factors (VEGFs) and corticosteroid implants are inaccessible. In Thailand, budget constraints exclude these drugs from healthcare schemes covering 92% of the population, a common issue in developing Asian countries. Therefore, this study aimed to evaluate the treatment outcome of repeated intravitreal triamcinolone acetonide (IVTA) dosages for DME refractory to intravitreal bevacizumab over a 12-month period using a decision algorithm.</p><p><strong>Methods: </strong>This was a comparative retrospective study. The included patients were randomly divided into two groups that received either 2 mg or 4 mg IVTA, following a decision algorithm. The primary outcome was the difference in central macular thickness (CMT) between the 2 mg IVTA and 4 mg IVTA groups at 6-month and 12-month follow-up visits.</p><p><strong>Results: </strong>Overall, 81 eyes (62 patients) with DME refractory to bevacizumab were enrolled. The study involved 53 eyes (37 cases) divided into two groups: group 1 (2 mg IVTA) of 14 eyes, and group 2 (4 mg IVTA) of 39 eyes. The 4 mg IVTA group had a higher initial CMT than their 2 mg IVTA counterparts (P = 0.02). This difference disappeared after 6 and 12 months. The improvement in CMT in both groups was maintained across the 6- and 12-month follow-up periods compared with baseline. Univariate logistic regression analysis revealed that patients with thinner CMT before IVTA treatment had a greater probability of being DME-free over long-term follow-up.</p><p><strong>Conclusions: </strong>Repeated IVTA treatments for DME refractory to bevacizumab over a 12-month period demonstrated efficacy and appeared to have a comparable safety profile. Patients with thinner CMT before IVTA treatment had a greater probability of remaining DME-free after IVTA treatment.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1755-1772"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249044","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 Trial Simulation in Diabetic Retinopathy: Insights from Patients and Site Staff.","authors":"Stela Vujosevic, Ivana Gunderson, Asma Burale, Ben Moody, Rebecca C Stacy, Martin Gliem","doi":"10.1007/s40123-025-01164-5","DOIUrl":"10.1007/s40123-025-01164-5","url":null,"abstract":"<p><strong>Introduction: </strong>High patient burdens from diabetic retinopathy (DR)-associated vision loss and intravitreal therapy (IVT) support patient experience inclusion in DR trial designs. This trial simulation characterized patient and site staff opinions to improve future nonproliferative DR (NPDR) trial designs.</p><p><strong>Methods: </strong>Between March 27 and May 31, 2023, survey data were collected from trial simulation participants. After a preread and trial design animation, study features were simulated followed by a 75-90-min web-assisted telephone interview. Patients with NPDR and trial site staff from the United States, United Kingdom, and Germany were included. The likelihood of patient participation and the challenges faced by site staff in conducting the simulated clinical trial at their study site were assessed using a 1-7 scale. Outcomes were evaluated via thematic analysis and descriptive statistics.</p><p><strong>Results: </strong>Twenty-two patients aged 36-55 years and mostly female (59.1%), and 16 site staff were interviewed. Mean NPDR duration was 9.3 years; most patients (81.8%) had never participated in a clinical trial. Although eligibility criteria resembled other trials, site staff indicated that restrictive exclusion criteria of the trial simulation could limit recruitment and that endpoints did not match patients' goals, which mainly focused on saving vision. The proposed 4-5-h on-site visits and 72-week trial length were considered \"too long\" by 45.5% and 50.0% of patients, respectively. For the 1:2 sham or active treatment allocation ratio, responses were 40.9% neutral, 36.4% positive, and 22.7% negative. Some patients misunderstood that sham injections imitate actual injections, expressing concerns about adverse events. Patients reported IVT-related anxieties, particularly IVT-inexperienced patients. Mean patient trial participation interest score was 4.9/7; 62.5% of site staff were interested in conducting the trial. Some proposed adaptations were implemented in the trial protocol (e.g., offering patient/caregiver transportation).</p><p><strong>Conclusions: </strong>Insights gained from respondent feedback in this simulation may inform future DR clinical trial design, potentially enhancing recruitment rates and patient experience.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1773-1787"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584469","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":"Lissamine Green in Ophthalmology: A Comprehensive Review of Diagnostic and Clinical Applications.","authors":"Stefano Barabino, Pasquale Aragona, Stefano Bonini, Emilia Cantera, Antonio Di Zazzo, Giuseppe Giannaccare, Andrea Leonardi, Giancarlo Montani, Alessandro Mularoni, Vincenzo Orfeo, Edoardo Villani, Fabrizio Zeri, Maurizio Rolando","doi":"10.1007/s40123-025-01168-1","DOIUrl":"10.1007/s40123-025-01168-1","url":null,"abstract":"<p><p>Lissamine green (LG), a diagnostic dye that stains devitalized or damaged epithelial cells, is widely used to assess ocular surface integrity, enabling the detection of inflammation, epithelial defects, and conjunctival irregularities. To explore the diagnostic and clinical applications of LG in ophthalmology, focusing on its use for ocular surface diseases, a group of experts in ophthalmology and optometry participated in an advisory board to share their clinical practice experience with the use of LG. Building on the advisory board contents, this narrative review was based on a combination of expert opinions from the roundtable discussion and a comprehensive review of the current literature. This review highlights the clinical relevance of LG as a diagnostic tool in ocular surface disease and underscores the potential of newer formulations to enhance diagnostic accuracy. In particular, the review highlights the historical development of LG use in ophthalmology and its advantages over other dyes, especially in terms of patient comfort and safety, as well as specific clinical protocols for using LG in assessing dry eye disease severity and inflammatory responses. Additionally, the review examines recent advancements in LG formulations, which enhance their utility in clinical practice, and addresses safety considerations. Potential areas for future research are also discussed, particularly in developing standardized evaluation procedures using artificial intelligence.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1649-1660"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226121","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":"Systemic Effects of Intravitreal Anti-VEGF Therapy: A Review of Safety across Organ Systems.","authors":"Mousumi Banerjee, Sikshya Moharana, Srikanta Kumar Padhy","doi":"10.1007/s40123-025-01157-4","DOIUrl":"10.1007/s40123-025-01157-4","url":null,"abstract":"<p><p>Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapies have transformed the management of retinal diseases such as diabetic macular edema and neovascular age-related macular degeneration. However, concerns about their systemic absorption and potential adverse effects on overall health remain. In this review, we systematically aggregate existing literature on the systemic impact of anti-VEGF therapy, with a detailed analysis of the pharmacodynamics and pharmacokinetics of individual drugs. By examining their metabolism, clearance, and systemic exposure, we aim to clarify the extent of their effects beyond the eye. We further explore their influence on renal and cardiovascular health, with evidence suggesting a generally safe profile in the short term but potential risks in high-risk patients, particularly those with preexisting kidney or heart conditions. Additionally, this review addresses the critical concerns surrounding anti-VEGF use in special populations, including pregnant and lactating women and neonates with retinopathy of prematurity (ROP). We discuss the potential risks, the safest options available, and precautionary measures that should be taken when administering these therapies in these groups. While anti-VEGFs remain an essential tool in ophthalmology, careful patient selection, monitoring, and individualized treatment approaches are necessary to mitigate potential systemic risks. Further research is needed to refine our understanding of long-term safety.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1661-1684"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234727","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":"Changes in Ocular Biometry After Pharmacologic Cycloplegia and Mydriasis in Primary Angle Closure Disease.","authors":"Yao Ma, Jia Liu, Zhiqiao Liang, Kangyi Yang, Kun Lv, Wenbo Liu, Huijuan Wu","doi":"10.1007/s40123-025-01176-1","DOIUrl":"10.1007/s40123-025-01176-1","url":null,"abstract":"<p><strong>Introduction: </strong>The mechanism of primary angle closure disease (PACD) has been extensively investigated, while some cases remain unexplained. Hypothesizing that chronic primary ciliary block (CB) may play a role in PACD pathogenesis and the contribution could be revealed by pharmacologic cycloplegia and mydriasis, this study analyzed changes in anterior segment biometric parameters following cycloplegic intervention.</p><p><strong>Methods: </strong>A total of 170 eyes of 170 Chinese subjects aged between 50 and 80 years were included: 90 in the primary angle closure suspect (PACS) group, 33 in the primary angle closure (PAC)/PAC glaucoma (PACG) group, and 47 in the normal control group. All participants underwent a comprehensive ophthalmic examination, and ultrasound biomicroscopy (UBM) was conducted in patients with PACD at the baseline. Compound tropicamide (Mydrin P, Santen, Osaka, Japan) was administered to patients for pupillary dilation. Intraocular pressure (IOP) measurement and IOLMaster were performed before and 45 min after mydriasis.</p><p><strong>Results: </strong>Following dilation, PACS and PAC/PACG eyes demonstrated less significant changes in the anterior section compared to normal eyes based on △ACD-△LT (the difference in the changes of anterior chamber depth and lens thickness) (P < 0.01). Nine PACD eyes had a △ACD-△LT greater than 0.10 mm (1 PAC/PACG and 8 PACS eyes). About 8.94% of PACD eyes exhibited an elevated post-IOP. In PACS eyes, significantly higher pre-IOP (P < 0.05), shallower anterior chamber (AC, P < 0.01), more anterior lens position (P < 0.01), and narrower anterior chamber width (ACW, P < 0.05) were observed.</p><p><strong>Conclusions: </strong>A minority of PACD eyes displayed obvious movement of the ciliary-lens diaphragm, suggesting that primary CB may be an infrequent occurrence in PACD eyes. Additionally, higher IOP, shallower AC, more anteriorly placed lens, and smaller ACW may facilitate the identification of IOP spikes following dilation in clinical practice.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"1985-1997"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554087","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}