Ophthalmology and Therapy最新文献

{"title":"A Deep Learning Segmentation Model for Detection of Active Proliferative Diabetic Retinopathy.","authors":"Sebastian Dinesen, Marianne G Schou, Christoffer V Hedegaard, Yousif Subhi, Thiusius R Savarimuthu, Tunde Peto, Jakob K H Andersen, Jakob Grauslund","doi":"10.1007/s40123-025-01127-w","DOIUrl":"https://doi.org/10.1007/s40123-025-01127-w","url":null,"abstract":"<p><strong>Introduction: </strong>Existing deep learning (DL) algorithms lack the capability to accurately identify patients in immediate need of treatment for proliferative diabetic retinopathy (PDR). We aimed to develop a DL segmentation model to detect active PDR in six-field retinal images by the annotation of new retinal vessels and preretinal hemorrhages.</p><p><strong>Methods: </strong>We identified six-field retinal images classified at level 4 of the International Clinical Diabetic Retinopathy Disease Severity Scale collected at the Island of Funen from 2009 to 2019 as part of the Danish screening program for diabetic retinopathy (DR). A certified grader (grader 1) manually dichotomized the images into active or inactive PDR, and the images were then reassessed by two independent certified graders. In cases of disagreement, the final classification decision was made in collaboration between grader 1 and one of the secondary graders. Overall, 637 images were classified as active PDR. We then applied our pre-established DL segmentation model to annotate nine lesion types before training the algorithm. The segmentations of new vessels and preretinal hemorrhages were corrected for any inaccuracies before training the DL algorithm. After the classification and pre-segmentation phases the images were divided into training (70%), validation (10%), and testing (20%) datasets. We added 301 images with inactive PDR to the testing dataset.</p><p><strong>Results: </strong>We included 637 images of active PDR and 301 images of inactive PDR from 199 individuals. The training dataset had 1381 new vessel and preretinal hemorrhage lesions, while the validation dataset had 123 lesions and the testing dataset 374 lesions. The DL system demonstrated a sensitivity of 90% and a specificity of 70% for annotation-assisted classification of active PDR. The negative predictive value was 94%, while the positive predictive value was 57%.</p><p><strong>Conclusions: </strong>Our DL segmentation model achieved excellent sensitivity and acceptable specificity in distinguishing active from inactive PDR.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720785","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":"Optimizing Diagnosis and Management of Dry Eye Disease: A Practical Framework for Hong Kong.","authors":"Douglas Lam, Kelvin Chong, Kendrick Shih, Kelvin H Wan, Arthur Cheng","doi":"10.1007/s40123-025-01129-8","DOIUrl":"https://doi.org/10.1007/s40123-025-01129-8","url":null,"abstract":"<p><p>Dry eye disease (DED) poses a significant and escalating public health challenge. Effective diagnosis is crucial for optimal management. However, current practices are complicated and time-consuming. This paper proposes a revised framework for diagnosing and treating in Hong Kong, explicitly tailored to the local healthcare context and incorporating insights from global consensus guidelines. The framework emphasizes a streamlined assessment strategy and prioritizes direct symptom-based questioning alongside objective tests. It also includes a simplified corneal staining grading scheme to reduce complexity, considering the limited consultation time available in Hong Kong. Furthermore, the framework clearly outlines the appropriate treatment options based on the disease's severity and etiological cause(s) and focuses on the need for long-term management through follow-up or referrals. By addressing the multifaceted nature of DED and considering local healthcare constraints, this framework seeks to enhance patient outcomes through timely diagnosis and accurate assessment and treatment of DED.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731026","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":"Comprehensive Analysis of Congenital Aniridia and Differential Diagnoses: Genetic Insights and Clinical Manifestations.","authors":"Jonathan Hall, Marta Corton, Fabian Norbert Fries, Jessica Obst, Clara Grünauer-Kloevekorn, Berthold Seitz, Maria Della Volpe Waizel, Eszter Jávorszky, Kálmán Tory, Erika Maka, Maryam Amini, Shweta Suiwal, Tanja Stachon, Nóra Szentmáry","doi":"10.1007/s40123-025-01122-1","DOIUrl":"https://doi.org/10.1007/s40123-025-01122-1","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital aniridia (CA) is a severe and complex disorder involving the entire eye, primarily characterized by iris anomalies alongside other clinical features that pose significant risks to vision. This study seeks to offer a comprehensive overview of CA by detailing its clinical presentations, genetic underpinnings, associated phenotypes, and differential diagnoses. Additionally, it proposes a diagnostic framework to distinguish CA from other conditions that present with similar iris abnormalities.</p><p><strong>Methods: </strong>We conducted a comprehensive literature review to compile and analyze clinical and genetic data related to CA and its differential diagnoses. We included all studies describing the clinical characteristics, pathogenic variants, and associated syndromes of congenital aniridia.</p><p><strong>Results: </strong>CA presents a wide range of ocular symptoms. Pathogenic variants in the PAX6 gene are the primary genetic cause of CA, though variations in other genes, including FOXC1, PITX2, CYP1B1, FOXD3, PITX3, CPAMD8, ITPR1, TENM3, TRIM44, COL4A1, CRYAA, and PXDN may also be implicated. The differential diagnosis of CA requires careful consideration of conditions with overlapping symptoms, such as WAGR syndrome (which involves deletions affecting the PAX6 and WT1 genes on chromosome 11p13, and potentially BDNF on 11p14.1), Axenfeld-Rieger syndrome (FOXC1/PITX2), ring-chromosome 6 syndrome (which involves FOXC1 microdeletion), COL4A1-related anterior segment dysgenesis, Gillespie syndrome (ITPR1 gene) or Peters anomaly. Accurate diagnosis can be achieved by evaluating specific clinical features-including iris anomalies, aniridia-associated keratopathy, cataracts, glaucoma, foveal hypoplasia, nystagmus, and optic nerve head abnormalities-supplemented by genetic testing.</p><p><strong>Conclusions: </strong>Understanding the diverse clinical presentations and genetic basis of diseases associated with iris abnormalities is essential for accurate diagnosis and effective management. Integrating genetic diagnostics into the evaluation process enables the development of tailored treatment strategies, which can significantly improve patient outcomes.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731004","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":"Evaluation of Visual, Refractive, and Functional Outcomes after Implantation of an Extended Depth of Focus Intraocular Lens in Patients with Stable and Mild Glaucoma.","authors":"Aritz Urcola, Gorka Lauzirika, Igor Illarramendi, Andrea Soto-Velasco, Ronald Sánchez-Avila, Carlota Fuente-García, Aitor Fernández-García","doi":"10.1007/s40123-025-01124-z","DOIUrl":"https://doi.org/10.1007/s40123-025-01124-z","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study is to describe the visual, refractive, functional, and patients' satisfaction outcomes of the AcrySof™ IQ Vivity™ extended depth-of-focus intraocular lens (EDOF IOL) in patients with mild primary open-angle glaucoma (POAG).</p><p><strong>Methods: </strong>This is an ambispective, multicenter, and descriptive study. Patients with mild and stable POAG for at least 6 months, as well as patients who had the AcrySof™ IQ Vivity™ EDOF IOL implanted were included. Humphrey Field Analyzer III (Carl Zeiss Meditec, Dublin, CA, USA) and Triton optical coherence tomography (Topcon, Japan) were used to evaluate the inclusion criteria. In all cases, the formula used to calculate IOL power was Barrett Universal II. Refractive outcomes and visual acuity at distance, intermediate, and near were evaluated from 3 months postoperatively onward. In addition, monocular and binocular defocus curve and contrast sensitivity (CSV-1000, VectorVision, Greenvile, OH, USA) were assessed. Patient satisfaction was assessed through the Intraocular Lens Satisfaction (IOLSAT) and Questionnaire for Visual Disturbances (QUVID) questionnaires .</p><p><strong>Results: </strong>In total, 72 AcrySof™ IQ Vivity™ lenses from 36 patients were enrolled, of which 28 were women. The mean age was 71.61 ± 7.68 years, the mean thickness of the retinal nerve fiber layer (RNFL) was 79.24 ± 14.96 µm, the mean intraocular pressure (IOP) was 16.88 ± 3.09 mmHg, and the mean number of topical anti-glaucoma medication was 0.89 ± 0.95. Binocular corrected distance visual acuity (CDVA), binocular corrected intermediate visual acuity (CIVA), and binocular corrected near visual acuity (CNVA) were 0.00 ± 0.12, 0.16 ± 0.14, and 0.24 ± 0.11 LogMAR, respectively. Spherical equivalent was -0.27 ± 0.33 diopters (D). In addition, 86.11% of eyes were within ± 0.5 D and 95.83% were within ± 1.0 D. The binocular defocus curve shows a peak of maximum visual acuity (VA) at 0 D (0.00 ± 0.11 LogMAR) and smooth curve at intermediate (66 cm/-1.5 D) 0.11 ± 0.09 LogMAR and near distance (40 cm/-2.5 D) 0.36 ± 0.18 LogMAR. Binocular contrast sensitivity showed a decrease in high spatial frequencies compared with low spatial frequencies. The IOLSAT revealed that in bright light conditions, 88.89%, 91.67%, and 63.89% of patients \"never\" or \"rarely\" need glasses at far, arm's length, and near distances, respectively. In addition, according to the QUVID, 97.06% of patients \"never\" report shadow areas.</p><p><strong>Conclusions: </strong>The new AcrySof™ IQ Vivity™ EDOF IOL seems to provide good visual outcomes at distance, intermediate, and near vision, with an adequate contrast sensitivity, defocus curve, a low rate of visual disturbances and high visual satisfaction in patients with mild and stable POAG.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700878","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":"Six-Month Outcomes from a Prospective, Randomized Study of iStent infinite Versus Hydrus in Open-Angle Glaucoma: The INTEGRITY Study.","authors":"Iqbal Ike K Ahmed, John P Berdahl, Arkadiy Yadgarov, George R Reiss, Steven R Sarkisian, Sébastien Gagné, Marco Robles, Lilit A Voskanyan, Omar Sadruddin, Dari Parizadeh, Jane Ellen Giamporcaro, Angela C Kothe, L Jay Katz, Tomas Navratil","doi":"10.1007/s40123-025-01126-x","DOIUrl":"https://doi.org/10.1007/s40123-025-01126-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;This was a prospective, randomized, double-masked, multicenter, 24-month study to compare effectiveness and safety outcomes following standalone implantation of two types of current generation trabecular stents in adults with open-angle glaucoma (OAG). An interim analysis was performed at month 6.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Eyes with OAG, mean IOP ≤ 24 mmHg on zero to three intraocular pressure (IOP)-lowering medications at screening, and with baseline mean diurnal IOP (MDIOP) 21-36 mmHg after medication washout were randomized to standalone implantation of the current generation of three trabecular micro-bypass stents (iStent infinite) or one trabecular bypass stent (Hydrus). Eyes on medication were to undergo a medication washout prior to the month 6 visit. Analyses included a comparison of the proportion of iStent infinite versus Hydrus eyes achieving MDIOP reduction of 20% or greater from baseline at month 6. Reduction from baseline in MDIOP and number of medications were also assessed. Safety parameters included intraoperative/postoperative complications, corrected visual acuity, slit-lamp biomicroscopy, ophthalmoscopy, gonioscopy, perimetry, and adverse events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Eyes with primarily mild-to-moderate disease severity were randomized: 91 iStent infinite eyes had screening mean (± standard deviation [SD]) IOP of 17.0 ± 3.2 mmHg on 1.6 ± 0.9 medications and baseline unmedicated MDIOP of 23.7 ± 2.9 mmHg; 89 Hydrus eyes had screening mean (± SD) IOP of 17.1 ± 3.3 mmHg on 1.5 ± 0.9 medications and baseline unmedicated MDIOP of 23.5 ± 2.7 mmHg. At month 6, a similar proportion of iStent infinite eyes (82.7%) versus Hydrus eyes (78.9%) achieved MDIOP reduction ≥ 20% from baseline regardless of IOP medication use or surgical complications. The difference was statistically significantly different (78.2% iStent infinite versus 65.0% Hydrus) for unmedicated MDIOP reduction ≥ 20% from baseline in eyes with no surgical complications (difference 13.2%; 95% confidence interval (CI) 3.0%, 23.3%). Mean MDIOP change from baseline, regardless of IOP medication use or surgical complications, was similar between groups (- 7.4 ± 2.9 mmHg iStent infinite and - 7.2 ± 2.9 mmHg Hydrus), whereas unmedicated MDIOP change from baseline without surgical complications was statistically significantly superior in iStent infinite eyes (- 6.8 ± 4.1 mmHg) versus Hydrus eyes (- 5.7 ± 4.1 mmHg) (difference - 1.1 mmHg; 95% CI - 2.0 mmHg, - 0.2 mmHg). Improper stent placement was reported in one iStent infinite and seven Hydrus eyes (1.1% versus 7.9%). One iStent infinite versus four Hydrus eyes experienced peripheral anterior synechiae &gt; 1 mm (1.1% versus 4.5%). Overall, there were significantly fewer surgical complications in the iStent infinite eyes (3.3%) compared to Hydrus eyes (16.9%; difference of - 13.6%, 95% CI - 23.8%, - 3.4%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this study of standalone implantation ","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700954","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":"Correction: A Preservative-Free Combination of Sodium Hyaluronate and Trehalose Improves Dry Eye Signs and Symptoms and Increases Patient Satisfaction in Real-Life Settings: The TEARS Study.","authors":"Antonio J Mateo-Orobia, Sarah Farrant, Eduardo Del-Prado-Sanz, Alejandro Blasco-Martínez, Miriam Idoipe-Corta, Noelia Lafuente-Ojeda, Luis E Pablo-Júlvez","doi":"10.1007/s40123-025-01110-5","DOIUrl":"https://doi.org/10.1007/s40123-025-01110-5","url":null,"abstract":"","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710666","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":"Deep-Learning-Assisted Analysis of Early Biomarker Changes in Treatment-Naïve Patients with Neovascular AMD Under Intravitreal Faricimab.","authors":"Michael Hafner, Ben Asani, Franziska Eckardt, Jakob Siedlecki, Benedikt Schworm, Siegfried G Priglinger, Johannes Schiefelbein","doi":"10.1007/s40123-025-01125-y","DOIUrl":"https://doi.org/10.1007/s40123-025-01125-y","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI)-driven biomarker segmentation offers an objective approach to assessing neovascular age-related macular degeneration (nAMD). In addition, faricimab, a bispecific VEGF and Ang-2 inhibitor, presents new potential in disease management. This study applies an AI-based segmentation algorithm to quantify key optical coherence tomography (OCT) biomarkers and assess the short-term efficacy of intravitreal faricimab in treatment-naïve patients.</p><p><strong>Methods: </strong>This retrospective analysis includes 40 eyes from 38 treatment-naïve patients with nAMD treated with faricimab at LMU University Hospital Munich between January 2023 and September 2024. Patients received 4-monthly intravitreal injections. Biomarkers of disease activity, including central retinal thickness (CRT), intraretinal fluid (IRF), subretinal fluid (SRF), subretinal hyperreflective material (SHRM) and fibrovascular pigment epithelium detachment (fvPED), were quantified using a deep learning-based semantic segmentation algorithm. Best-corrected visual acuity (BCVA) and OCT imaging data were analyzed at baseline (mo0) and after 1 (mo1), 2 (mo2) and 3 months (mo3).</p><p><strong>Results: </strong>AI-driven analysis revealed significant reductions in key biomarkers. CRT decreased from 433.6 (IQR: 306.6) µm at mo0 to 241.5 (IQR: 130.8) µm at mo3 (p < 0.0001). IRF and SRF volumes were reduced by > 99% from mo0 to mo3 (both p < 0.0001). BCVA improved from 0.60 (IQR: 0.30) logMAR at mo0 to 0.40 (IQR: 0.33) logMAR at mo3 (p < 0.0001). Correlation analysis identified IRF and SHRM reductions as the strongest predictors of visual improvement.</p><p><strong>Conclusion: </strong>This study demonstrates the potential of AI-assisted biomarker analysis for precise disease monitoring in nAMD. Faricimab significantly reduced disease activity biomarkers and improved visual acuity in treatment-naïve patients, reinforcing its efficacy in early disease control. Future studies should explore long-term outcomes and further integrate AI-driven biomarker evaluation in clinical practice.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710679","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":"Aqueous Humor Concentrations of Travoprost Free Acid and Residual Drug in Explanted Implants from Patients Administered a Travoprost Intracameral Implant.","authors":"Gabriella Szekely, Lilit A Voskanyan, Kerry G Stephens, Long V Doan, Jennifer R Seal, Mohammed K ElMallah, Todd Fjield, David Applegate, Dale W Usner, L Jay Katz, Angela C Kothe, Tomas Navratil","doi":"10.1007/s40123-025-01130-1","DOIUrl":"https://doi.org/10.1007/s40123-025-01130-1","url":null,"abstract":"<p><strong>Introduction: </strong>To determine the aqueous humor (AH) exposure to travoprost free acid (TFA) and the in vivo elution rate of travoprost over a 24-month period in subjects with open-angle glaucoma administered a travoprost intracameral implant, 75 µg.</p><p><strong>Methods: </strong>In this prospective, single-center, open-label study, 210 subjects (7 cohorts of 30 subjects each) were administered a travoprost intracameral implant and followed for 3-24 months. At pre-determined timepoints (3, 6, 12, 15, 18, 21, and 24 months), AH was collected, a new implant was administered, and the prior implant removed. AH samples were assayed for TFA concentrations using a validated liquid chromatography-tandem mass spectrometry method. Explants were analyzed for remaining travoprost using a validated high-performance liquid chromatography method.</p><p><strong>Results: </strong>Mean AH concentrations of TFA were 5.0, 3.7, 5.6, 2.0, 2.2, 3.8, and 3.3 ng/mL at 3, 6, 12, 15, 18, 21, and 24 months, respectively, post-administration. Mean percent travoprost remaining in explants was approximately 79%, 70%, 50%, 39%, 35%, 28%, and 16% at 3, 6, 12, 15, 18, 21 and 24 months, respectively, post-administration.</p><p><strong>Conclusions: </strong>Concentrations of TFA in AH through month 24 were above the established efficacious concentration of 0.1 ng/mL for intracameral implants, indicating that adequate TFA levels were achieved to elicit maximal intraocular pressure (IOP)-lowering efficacy, and supported by low levels of IOP in subjects through 24 months. The remaining dose of travoprost in explants at 24 months (i.e., 16%) indicates the potential for efficacious drug delivery beyond 2 years.</p><p><strong>Trial registration number: </strong>Clinical Trials.gov Identifier: NCT06582732 (31 August 2024: retrospectively registered).</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700947","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":"Is Multiwavelength Photobiomodulation Effective and Safe for Age-Related Macular Degeneration? A Systematic Review and Meta-Analysis.","authors":"Kai-Yang Chen, Hung Kuan Lee, Hoi-Chun Chan, Chi-Ming Chan","doi":"10.1007/s40123-025-01119-w","DOIUrl":"https://doi.org/10.1007/s40123-025-01119-w","url":null,"abstract":"<p><strong>Introduction: </strong>This systematic review and meta-analysis compares the complications and effects of photobiomodulation (PBM) therapy with sham treatment in patients with age-related macular degeneration (AMD). AMD is a leading cause of visual impairment in older adults, with current treatments primarily focusing on symptom management. PBM therapy is emerging as a potential intervention to improve clinical and anatomical outcomes in patients with AMD, necessitating a comparative analysis with sham treatment to determine its efficacy and safety.</p><p><strong>Methods: </strong>A systematic search was conducted across PubMed/Medline, Google Scholar and the Cochrane Library from inception to January 13, 2025. Randomised controlled trials (RCTs) meeting predefined inclusion criteria were selected. Meta-analysis employed random-effects models. The risk of bias in the included studies was assessed using Cochrane tools.</p><p><strong>Results: </strong>A total of six studies, comprising 360 patients and 477 eyes, focused on PBM for dry AMD. Five studies were eligible for meta-analysis. Best-corrected visual acuity (BCVA) showed no significant improvement with PBM (SMD - 0.30, 95% CI - 0.85 to 0.26, p = 0.30), with high heterogeneity (I² = 83%). Macular drusen volume also showed no significant change (SMD - 0.08, 95% CI - 0.52 to 0.37, p = 0.74), with moderate heterogeneity (I² = 48%). A single study reported no significant effect on geographic atrophy (SMD - 0.28, 95% CI - 1.26 to 0.71, p = 0.58). Central subfield thickness (SMD 0.11, 95% CI - 0.25 to 0.47, p = 0.58) and microperimetry (SMD - 0.02, 95% CI - 0.48 to 0.44, p = 0.94) also showed no significant changes. The adverse events analysis indicated a statistically significant increase in adverse events in the sham group within 6 months (RR 0.48, 95% CI 0.29-0.82, p = 0.007), while the overall effect on adverse events was non-significant (RR 1.04, 95% CI 0.51-2.12, p = 0.91, I² = 78%). Qualitative analysis suggested that PBM might enhance quality of life and clinical and anatomical outcomes compared to sham treatment.</p><p><strong>Conclusion: </strong>This meta-analysis suggests that, to date, there are no significant clinical benefits of PBM therapy for patients with AMD. Further long-term studies are needed to establish its clinical relevance and safety profile.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639735","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":"Varenicline Nasal Spray for the Treatment of Dry Eye Disease Following Corneal Collagen Crosslinking.","authors":"Tanner J Ferguson, David Durgan, Travis Whitt, Russell J Swan","doi":"10.1007/s40123-025-01118-x","DOIUrl":"https://doi.org/10.1007/s40123-025-01118-x","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the safety and effectiveness of a varenicline solution nasal spray 0.03 mg (VNS) in reducing signs and symptoms of dry eye disease following corneal collagen cross-linking (CXL).</p><p><strong>Methods: </strong>Subjects undergoing CXL were randomized to VNS (study) or vehicle (control) twice daily and initiated treatment with VNS 28 days prior to the procedure with continued use for 28 days following the procedure. After starting treatment, subjects were seen on the day of surgery and postoperatively at days 2, 3, 4, 7 and 28. The primary outcome measure was the change in the National Eye Institute Visual Function Questionnaire (NEI-VFQ)-25, a dry eye questionnaire, from baseline to day 28. The second primary outcome measure was the mean area change of corneal epithelial healing following the CXL procedure. The secondary outcome measures for this study were the eye dryness score (EDS), degree of fluorescein staining and supplemental artificial tear usage.</p><p><strong>Results: </strong>Twelve subjects were enrolled in the study group and eight in the control group. At day 28, the NEI-VFQ-25 questionnaire demonstrated an improvement from baseline in the study group and a reduction in the control group, but the between-group comparison was not statistically significant (p > 0.05). There was a directional trend toward faster mean change of epithelial healing in the study group, but the difference was not statistically significant at any time point. There were four total adverse events, all of which were mild in nature and resolved without sequelae.</p><p><strong>Conclusions: </strong>VNS is an attractive treatment option for patients following CXL. Patients hoping to avoid punctal occlusion or additional use of topical medications following a procedure such as CXL may be well suited for a neurostimulator treatment option like VNS that spares the ocular surface.</p><p><strong>Trial registration: </strong>Registered with clinicaltrials.gov (NCT05136924).</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634331","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}