Ophthalmology and Therapy最新文献

{"title":"Understanding the Geographic Atrophy Journey: Patient and Physician Perspectives to Inform Better Care.","authors":"Lynn Baker, Firas M Rahhal, Christopher J Gilbert, Theodore Leng","doi":"10.1007/s40123-026-01459-1","DOIUrl":"10.1007/s40123-026-01459-1","url":null,"abstract":"<p><strong>Objectives: </strong>Geographic atrophy (GA) can place substantial physical and emotional burdens on affected individuals, related to both the disease and its treatment. Here, we provide insights into the perspectives of a patient with GA and retina specialists around GA diagnosis, treatment, communication, and needs.</p><p><strong>Methods: </strong>Unstructured qualitative interviews were conducted with a patient author with GA and two retina specialist authors involved in the management of GA. The authors discussed early GA symptoms, its diagnosis and management, treatment experience, support, and education.</p><p><strong>Results: </strong>Several themes emerged. A GA diagnosis can be emotionally distressing and difficult for patients to accept. The reality is that although current treatments delay progression of further visual impairments, these therapies do not restore lost vision. Current GA treatments are associated with frequent clinic visits and intravitreal injections that can lead to discomfort and temporary visual disturbances, which are disruptive to daily life. Physicians also noted a lack of clinical endpoints for guiding optimal dosing. The importance of patient-physician communication in the management of GA was highlighted, focusing on an approach that incorporates the emotional and practical needs of patients. Physicians play a central role in ensuring treatment compliance to minimize further vision loss. Peer support is also invaluable for sharing experiences, treatment expectations, and reassurance. Finally, patient and provider suggestions for improving outcomes for people with GA were discussed, including access to patient-focused educational materials on GA and treatment, development of tangible endpoints in clinical trials, and facilitation of peer support. All authors supported the development of long-acting formulations, systemic medications, or optimally a cure, to reduce treatment burden.</p><p><strong>Conclusions: </strong>GA and its treatment place a substantial burden on patients. Multiple opportunities remain to improve the experiences of people with GA and empower patients to understand their condition and treatment, which ultimately could improve their outcomes. Audio feature available for this article.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3181-3191"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760465","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":"Machine Learning-Based Prediction of Cycloplegic Refraction Using the Eyerobo Vision Screener: Design-A Cross-Sectional Comparative Device Study.","authors":"Mengmeng Xia, Boxue Yao, Yumei Wang, Fengwei Liang, Wuxia Zhao, Li Qin, Shoukuan Liu, Muhammad Usama, Zhihui Zhang, Wu Guo, Emmanuel Eric Pazo, Xinjun Ren","doi":"10.1007/s40123-026-01482-2","DOIUrl":"10.1007/s40123-026-01482-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;A cross-sectional comparative device study to compare the Eyerobo Vision Screener (VS), a portable handheld photorefractor, against a conventional auto-refractor for machine-learning-based prediction of cycloplegic spherical equivalent (SE) and power vector components (J0, J45) in a pediatric myopia cohort, to evaluate whether supplementary IOL Master biometry narrows the performance gap between devices, and to report screening-oriented classification metrics (sensitivity, specificity, positive and negative predictive values, area under the receiver operating characteristic curve [AUC]) at clinically meaningful referral thresholds that quantify the device-model combination's triage performance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data from 1129 eyes of 574 patients aged 6-18 years were collected using three ophthalmic devices before and after pharmacological dilation. All refractive measurements were decomposed into power vectors (SE, J0, J45) following Thibos et al. Twelve clinically motivated feature scenarios were constructed from a symmetric framework comparing the Eyerobo VS and auto-refractor (each under predilation, post-dilation, and combined conditions), with and without IOL Master biometry. TabPFN, a tabular foundation model requiring no hyperparameter tuning, was evaluated alongside seven conventional machine-learning algorithms using patient-level five-fold grouped cross-validation repeated over three random seeds. Agreement was assessed using Bland-Altman analysis, Pearson correlation, and clinical threshold analysis. In addition to regression metrics, a screening-classification analysis was performed at three prespecified clinical thresholds (cycloplegic SE &lt;math&gt;&lt;mrow&gt;&lt;mo&gt;≤&lt;/mo&gt; &lt;mo&gt;-&lt;/mo&gt; &lt;mn&gt;0.50&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt;  D, &lt;math&gt;&lt;mrow&gt;&lt;mo&gt;≤&lt;/mo&gt; &lt;mo&gt;-&lt;/mo&gt; &lt;mn&gt;3.00&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt;  D, and &lt;math&gt;&lt;mrow&gt;&lt;mo&gt;≤&lt;/mo&gt; &lt;mo&gt;-&lt;/mo&gt; &lt;mn&gt;6.00&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt;  D), reporting sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and AUC with 95% paired bootstrap confidence intervals. Formal paired statistical comparison between TabPFN and the next-best algorithm and a one-eye-per-patient sensitivity analysis are also reported.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;TabPFN achieved the lowest mean absolute error (MAE) on all Eyerobo scenarios and was competitive with Ridge on auto-refractor scenarios; on the headline Eyerobo Pre + IOL scenario, the per-eye paired difference in MAE between TabPFN (0.425 D) and the next-best gradient-boosting learner (XGBoost, 0.542 D) was 0.117 D in favour of TabPFN, with paired Wilcoxon signed-rank &lt;math&gt;&lt;mrow&gt;&lt;mi&gt;p&lt;/mi&gt; &lt;mo&gt;&lt;&lt;/mo&gt; &lt;mn&gt;0.001&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt; . For predilation SE prediction, the auto-refractor achieved an MAE of 0.295 D (87.4% within ± 0.50 D), compared with 0.657 D (61.6%) for the Eyerobo VS. Adding IOL Master biometry to the Eyerobo reduced this gap by 64%, yielding an MAE of 0.425 D (72.0%). For astigmatic power vector compon","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3469-3498"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819292","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":"Selective Photocoagulation of Large Retinal Capillary Aneurysm (LRCA) by Navigated Focal Laser.","authors":"Francesca Amoroso, Victoria Maréchal, Salomon Yves Cohen, Dmitrii Maltsev, Alexandre Pedinielli, Benedicte Dupas, Alexandra Miere, Eric H Souied","doi":"10.1007/s40123-026-01486-y","DOIUrl":"10.1007/s40123-026-01486-y","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the anatomical and functional outcome of selective photocoagulation of large retinal capillary aneurysm (LRCA) including telangiectatic capillaries (TelCaps) and perifoveal vascular anomalous complex (PVAC) by navigated focal laser (Navilas®, OD-OS GmBH, Teltwo, Germany).</p><p><strong>Methods: </strong>Consecutive patients with telangiectatic lesions greater than 150 µm in diameter were included in this analysis. All patients were treated with navigated focal laser, planned on multimodal imaging.</p><p><strong>Results: </strong>Fifty-one eyes of 50 patients were retrospectively analyzed. Navigated laser photocoagulation of LRCA successfully occluded 100% of the lesions, inducing significant improvement in best-corrected visual acuity (BCVA) at 3 (p = 0.002) and 6 months (p = 0.001). There was a significant decrease in central macular thickness (CMT) from 369 ± 97 µm at baseline to 298 ± 77.5 µm at 3 months (p = 0.0004) and to 281±87 µm at 6 months (p = 0.0004). No scar was detected in the macular region after the laser treatment.</p><p><strong>Conclusion: </strong>LRCA arising from retinal capillaries are an ideal candidate for navigated laser treatment. Navigated focal treatment was shown to be effective and safe in occluding these kinds of lesions, with resolution of secondary edema and no side effects.</p><p><strong>Trial registration: </strong>Not applicable. This was a retrospective observational study and was not registered as a clinical trial.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3441-3453"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818563","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 Mixed-Methods Investigation of Myopia Management Practices Among Eye Care Practitioners in China.","authors":"Jong Mei Khew, Mohd Zaki Awg Isa, Monica Jong, Fan Lu, Jun Jiang, Philip Morgan, Kah Ooi Tan","doi":"10.1007/s40123-026-01471-5","DOIUrl":"10.1007/s40123-026-01471-5","url":null,"abstract":"<p><strong>Introduction: </strong>Myopia management in China has expanded rapidly, largely driven by government initiatives to address the escalating myopia burden. Despite the availability of multiple interventions, practitioners face challenges in practicing myopia management due to the heterogeneity in practitioner training, practice settings, and geographical locations. A systematic, standardized, evidence-based practice would enhance myopia management practice. This study explored the perceptions of myopia management practices among practitioners in diverse practice settings and geographical locations within China. It compared the perspectives of optometrists and ophthalmologists on myopia management and how the identified barriers can be addressed.</p><p><strong>Methods: </strong>Mixed-method research combining qualitative and quantitative approaches was employed in this study. Stage 1 qualitative study involved face-to-face semistructured interviews with 37 practitioners (27 optometrists and 10 ophthalmologists). Stage 2 involved a quantitative survey of 500 practitioners (401 optometrists, 99 ophthalmologists). Logistic regression models were used to explore possible differences between the perceived barriers.</p><p><strong>Results: </strong>The stage 1 analysis identified common barriers, including limited public awareness, treatment costs, poor compliance, and unpredictable clinical outcomes. Stage 2 validated these themes, emphasizing low public awareness, high treatment costs, lack of compliance, unpredictable outcomes, and excessive product availability. Significant geographical and practice-setting differences were evident, particularly in clinical guidance, commercialization, and instrument costs. Myopia control spectacles were most preferred and considered as the most effective treatment option.</p><p><strong>Conclusions: </strong>This study concluded that effective myopia management practice in China necessitates improvements in public education, addressing treatment costs, enhancing patient compliance, managing unpredictable clinical outcomes, promoting a patient-centered approach, and expanding continuing education. Addressing these issues is crucial in delivering effective, accessible, and standardized myopia management care in different geographical locations and practice settings.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3273-3292"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721364","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 Graft Survival Following Penetrating Keratoplasty in Eyes with Preoperative Corneal Neovascularization.","authors":"Matteo Menean, Andrea Servillo, Pasquale Viggiano, Cecilia Mularoni, Giulio Ferrari, Paolo Rama, Giorgio Paganoni, Francesco Bandello, Karl Anders Knutsson","doi":"10.1007/s40123-026-01487-x","DOIUrl":"10.1007/s40123-026-01487-x","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to evaluate long-term graft survival following penetrating keratoplasty (PKP) in eyes with preoperative corneal neovascularization (CorNV), and to assess the impact of the extent of CorNV on graft outcomes.</p><p><strong>Methods: </strong>This was a retrospective longitudinal study. Patients with preoperative CorNV who underwent PKP between 2003 and 2024 were included. Demographics, underlying pathology, and CorNV stage (clock-hour extent) and depth were recorded at baseline before PKP. Visual acuity and endothelial cell density (ECD) were assessed during follow-up. Kaplan-Meier survival analysis and Cox proportional hazards models were used to identify risk factors for graft failure. Graft failure was set as primary outcome.</p><p><strong>Results: </strong>A total of 80 eyes were included (mean age 55 ± 16 years; 42 male, 53%; 38 female, 47%). Moderate to severe CorNV (> 3 clock-hours) showed no significant association with increased graft failure risk (HR 1.51; p = 0.31). Survival was mainly influenced by etiology: patients with Acanthamoeba keratitis had significantly better outcomes than those with burns (HR 11.02; p = 0.032). One-year visual acuity improved notably. CorNV depth was not linked to graft survival.</p><p><strong>Conclusions: </strong>In this cohort, preoperative CorNV extent was not significantly associated with graft failure after PKP; outcomes depend largely on the underlying etiology. Thorough assessment of CorNV features and etiology is advised to refine risk stratification. Standardized imaging and multicenter studies are needed to clarify additional prognostic factors and further improve management.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3547-3558"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866240","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":"Intravitreal Dexamethasone Implant in Punctate Inner Choroidopathy: Clinical Indications and Outcomes in a Real-World Case Series.","authors":"Matteo Capobianco, Federico Rissotto, Costanza Marzano, Andrea Trinco, Sebastiano Del Fabbro, Francesco Bandello, Alessandro Invernizzi, Elisabetta Miserocchi, Maria Vittoria Cicinelli","doi":"10.1007/s40123-026-01480-4","DOIUrl":"10.1007/s40123-026-01480-4","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study is to characterize the clinical indications, treatment patterns, and outcomes associated with intravitreal dexamethasone implant (DEX implant) in eyes with punctate inner choroidopathy (PIC).</p><p><strong>Methods: </strong>This retrospective observational case series included eyes with PIC treated with at least one DEX implant. Eyes were categorized according to the indication for treatment as (1) bridging therapy while initiating systemic immunomodulatory therapy (IMT), (2) adjunctive treatment for recurrent inflammatory activity despite ongoing IMT, or (3) local therapy in patients not receiving systemic IMT. Main outcome measures included best-corrected visual acuity (BCVA), inflammatory control, inflammatory recurrence, retreatment requirements, and safety.</p><p><strong>Results: </strong>Twenty-five eyes from 22 patients were included. Mean age at index injection was 56.5 ± 11.1 years, and 18/22 patients (82%) were female. DEX implant was used as bridging therapy in 5 eyes (20%), adjunctive therapy during ongoing IMT in 6 eyes (24%), and local therapy without IMT in 14 eyes (56%). A total of 33 DEX implants were administered during follow-up. Complete resolution of inflammatory activity was achieved in all eyes within 6 months of the first DEX implant. Mean BCVA remained stable, from 0.33 logarithm of the minimum angle of resolution (logMAR) at baseline to 0.34 logMAR at month 6. Inflammatory recurrence occurred in 7/25 eyes (28%) after a mean of 6.0 ± 3.5 months, with no recurrences observed among eyes receiving DEX implant during ongoing IMT. Intraocular pressure elevation occurred in 12/25 eyes (48%) and was successfully controlled with topical therapy. Other ocular adverse events were infrequent and included retinal detachment, peripheral retinal hole, hypotony, and posterior vitreous detachment, each occurring once in a different eye (4% each).</p><p><strong>Conclusions: </strong>Intravitreal DEX implant provides effective short-term control of inflammatory activity in PIC and serves multiple complementary roles in clinical practice, including bridging during IMT initiation, adjunctive treatment for breakthrough inflammation, and stand-alone local therapy in selected patients. The absence of recurrences among eyes receiving concomitant IMT and the higher recurrence rate in those cases managed without systemic immunomodulation suggest that DEX implant is most effectively integrated into a broader long-term immunomodulatory strategy for patients with relapsing disease.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3349-3361"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796419","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":"Outcomes of One Dioptre Toric IOL Correction in Low Corneal Astigmatism: A Comparison with Non-toric IOLs.","authors":"Ben Connell, Jack Kane","doi":"10.1007/s40123-026-01483-1","DOIUrl":"10.1007/s40123-026-01483-1","url":null,"abstract":"<p><strong>Introduction: </strong>Toric intraocular lenses (IOLs) effectively correct astigmatism, but their benefit at low levels of corneal astigmatism remains uncertain. We compared visual and refractive outcomes between non-toric and toric IOLs in patients with low corneal astigmatism.</p><p><strong>Methods: </strong>This was a real-world comparative cohort study. We analysed 804 eyes undergoing cataract surgery for which the Barrett Toric Calculator recommended an IOL with 1 dioptre (D) of toricity. Postoperative uncorrected distance visual acuity (UDVA), refractive astigmatism and corrected distance visual acuity (CDVA) were compared between non-toric and toric IOL groups, with pre-specified subgroup analyses by astigmatism magnitude and axis.</p><p><strong>Results: </strong>Baseline corneal astigmatism was lower in the non-toric group than in the toric group (median 0.4 versus 0.7 D; P < 0.001), reflecting surgeon selection within the Barrett-recommended 1 D toric population. Postoperative refractive astigmatism was lower in the toric group (mean 0.31 versus 0.36 D; P = 0.022), a difference smaller than the 0.25 D increment in which subjective refraction was recorded, but UDVA was comparable overall (median 79 versus 78 letters; P = 0.122) as was CDVA (median 85 versus 85 letters; P = 0.235). In the with-the-rule (WTR) astigmatism subgroup, UDVA was better with non-toric IOLs (median 80 versus 77 letters; P = 0.002); against-the-rule and oblique subgroups showed no UDVA differences.</p><p><strong>Conclusions: </strong>In eyes with low corneal astigmatism, 1 D toric IOLs reduced postoperative refractive astigmatism, particularly in eyes with against-the-rule (ATR) astigmatism and at higher levels of baseline corneal astigmatism, but did not improve uncorrected or corrected visual acuity overall. In eyes with WTR astigmatism, non-toric IOLs achieved better uncorrected vision. These findings suggest a statistically significant refractive benefit of low-power toric IOLs that is most evident in ATR eyes, while the functional visual benefit in this population remains uncertain and axis-dependent.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3455-3468"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Experience with Enhanced Monofocal Intraocular Lenses Following Cataract Surgery: A Multicenter Retrospective Case Series.","authors":"Eric Donnenfeld, Ravi Patel, Michael Patterson, Inder Paul Singh, Farrell Tyson, P Dee Stephenson","doi":"10.1007/s40123-026-01473-3","DOIUrl":"10.1007/s40123-026-01473-3","url":null,"abstract":"<p><strong>Introduction: </strong>The enVista Aspire (EA) and enVista Aspire Toric (ETA) lenses are monofocal intraocular lenses (IOLs) with intermediate-optimized optics designed to broaden depth of focus. This study describes outcomes with these IOLs in real-world clinical practice.</p><p><strong>Methods: </strong>This multicenter, retrospective, real-world case series study included six cataract surgeons in the USA. Surgeons provided a convenience sample of ≥ 5 study IOL implantation cases and completed a retrospective experience survey. Outcomes included visual acuity (corrected and uncorrected distance visual acuity [CDVA, UDVA] and uncorrected intermediate visual acuity [UIVA]), refractive outcomes, and safety (adverse events and visual changes). The surgeon survey captured IOL utilization patterns and surgeon experience as supplementary descriptive findings.</p><p><strong>Results: </strong>The analysis included 141 eyes (88 EA and 53 ETA) from 84 patients. Patients were aged 62-84 years, with postoperative follow-up ranging from approximately Days 1-6 to 4 months. At the last available postoperative visit, monocular CDVA of 20/25 or better was achieved by 97.2% of EA and 94.9% of ETA eyes; monocular UDVA of 20/25 or better by 71.3% and 84.9%, respectively; and monocular UIVA of 20/32 or better by 76.6% and 93.0%, respectively. A binocular UIVA of 20/32 or better was achieved by 100% of patients. Mean ± SD SEQ outcome was -0.06 ± 0.30 D (EA) and 0.00 ± 0.32 D (ETA). No serious adverse events were documented in the available records. Findings from the surgeon survey indicated positive surgeon experience with the qualities and outcomes of the study IOLs.</p><p><strong>Conclusions: </strong>In this descriptive real-world analysis, a high proportion of eyes implanted with the study IOLs achieved good distance and functional intermediate vision.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3499-3513"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840949","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":"Low-Concentration Atropine for Myopia Management: Recent Evidence and Clinical Implications.","authors":"Imran Jawaid, Carla Lanca","doi":"10.1007/s40123-026-01466-2","DOIUrl":"10.1007/s40123-026-01466-2","url":null,"abstract":"<p><p>We conducted a narrative review of peer-reviewed randomized controlled trials (RCTs) investigating low-concentration atropine for myopia management. Studies were identified using the terms \"myopia\" AND \"atropine\" and supplemented through reference searches. Key data on spherical equivalent refraction (SER), axial length (AL) progression, participant demographics, and ethnicity were extracted and qualitatively compared across trials. In addition, observed AL progression was contextualized against expected age-matched myopic axial elongation and physiological emmetropic eye growth derived from previously published normative models. Evidence from pivotal trials such as ATOM and LAMP, mainly conducted in Asian populations, demonstrated dose-dependent efficacy of atropine, with 0.05% showing superior outcomes compared with 0.01%. However, more recent studies in non-Asian populations, including STAR, MOSAIC, WA-ATOM, and MTS, have reported more modest treatment effects with 0.01% atropine. Differences in efficacy appear influenced by factors including age, ethnicity, baseline progression rates, environmental exposures, and placebo-group axial elongation rates. The coronavirus disease 2019 (COVID-19) pandemic also impacted outcomes in several trials, highlighting environmental influences on myopia progression. In addition, off-protocol use of myopia-control interventions in studies such as CHAMP further complicates interpretation of atropine efficacy. While low-concentration atropine remains a promising option for myopia management, rebound progression after cessation remains a concern. Emerging evidence suggests that future research should look at higher atropine concentrations, individualized treatment strategies, and comparisons against normative ocular growth trajectories rather than placebo alone. Licensed atropine formulations, particularly within Europe, are anticipated to improve treatment standardization, support regulatory oversight, and help refine future clinical guidelines for myopia management.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3203-3219"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707184","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 Individualized Office-Based Vision Therapy for Intermittent Exotropia: A Retrospective Cohort Study.","authors":"Xinyuan Pan, Ziang Yin, Huina Zhang, Wesley T Beaulieu, Jinyou Zou, Zhikuan Yang, Susan A Cotter, Xiaoning Li","doi":"10.1007/s40123-026-01455-5","DOIUrl":"10.1007/s40123-026-01455-5","url":null,"abstract":"<p><strong>Introduction: </strong>Vision therapy (VT) has been proposed as a nonsurgical treatment option for intermittent exotropia (IXT), although evidence regarding the optimal treatment dosage remains limited. This study aims to investigate the relationships between VT dosage and baseline demographic and clinical characteristics of treatment outcomes in IXT.</p><p><strong>Methods: </strong>Patients with IXT who underwent office-based VT between July 2020 and March 2024 at Changsha Aier Eye Hospital were included. Treatment outcome was classified as functional recovery (yes/no), defined by prespecified thresholds for fusion on the Worth Dot test (33 cm, 1 m, and 3 m), stereoacuity (distance and near), and convergence amplitudes. Binary logistic regression was used to evaluate associations between baseline characteristics and VT dosage on treatment outcomes. The Benjamini-Hochberg procedure was used to adjust P values and maintain the false discovery rate at 5%.</p><p><strong>Results: </strong>Among 636 patients, 296 (46.5%) achieved functional recovery (38.5% in the ten-session group, 46.5% in the 20-session group, and 52.9% in the ≥ 30-session group). After adjustment for baseline fusion status, stereoacuity, and convergence amplitudes, each additional ten VT sessions was associated with a 5% increase in the odds of functional recovery (odds ratio, OR = 1.05, 95% CI 1.02-1.07; P = 0.003). Patients with better baseline Worth Dot fusion at 3 m were more likely to meet recovery criteria (OR = 1.28 per 1-point increase, 95% CI 1.12-1.48; P < 0.001). Moreover, worse baseline stereoacuity at near (OR = 0.43 per 1-log10 arcsec increase, 95% CI 0.30-0.62; P < 0.001) and far (OR = 0.12 per 1-log10 arcsec increase, 95% CI 0.06-0.23; P < 0.001) were associated with a reduced likelihood of functional recovery. Age, gender, treatment frequency, baseline Worth Dot at 33 cm or 1 m, and baseline convergence amplitudes were not associated with outcomes. Significant improvements were observed for nearly all measured clinical parameters.</p><p><strong>Conclusions: </strong>Office-based VT was associated with functional recovery in patients with IXT, with greater gains in those who received more therapy sessions and had better baseline binocular function. Prospective, randomized trials are needed to confirm these findings.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3363-3377"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796351","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}