Ophthalmology and Therapy最新文献

{"title":"The Economic Burden of Anti-Vascular Endothelial Growth Factor on Patients and Caregivers in the UK, Europe, and North America.","authors":"David Tabano, Arjun Watane, Richard Gale, Oliver Cox, Sarah R Hill, Louise Longworth, Yemi Oluboyede, Ayesha Ahmed, Nimesh A Patel","doi":"10.1007/s40123-025-01180-5","DOIUrl":"https://doi.org/10.1007/s40123-025-01180-5","url":null,"abstract":"<p><strong>Introduction: </strong>Intravitreal (IVT) injections of anti-vascular endothelial growth factor (VEGF) agents are the standard of care for neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). While demonstrated to be effective, these treatments potentially place a significant burden on patients owing to their cost and frequency of treatment visits required for administration. The objective of this study was to investigate the economic burden of treatment on patients with nAMD/DME and their informal caregivers in seven countries.</p><p><strong>Methods: </strong>Data were collected from patients and caregivers in the USA, UK, Canada, Italy, Spain, Germany, and France using a survey between September and December 2022. Each survey collected data to facilitate calculating economic burden, combining the total financial costs (i.e., direct costs to receive treatment) and productivity losses associated with attending treatment appointments over a 6-month period. Quality of life data were collected using validated instruments.</p><p><strong>Results: </strong>In total, 194 patients and 194 caregivers reported currently receiving (or caring for someone who receives) anti-VEGF treatment. Across all countries, the modal frequency of anti-VEGF treatment was every 4 weeks, except for patients with DME (every 8 weeks). The largest, mean 6-month economic burden on the pooled population of patients with nAMD/DME was reported in Italy (€1244) and on caregivers it was in the USA (€3069). Economic burden was lower for respondents receiving fewer anti-VEGF injections.</p><p><strong>Conclusions: </strong>More durable therapies for nAMD/DME would reduce treatment burden and have a sizeable impact financially on patients with nAMD/DME and their caregivers.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529133","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":"Multiwavelength Photobiomodulation Improves Multiple Aspects of Visual Function in Early-Stage Dry Age-Related Macular Degeneration.","authors":"Cem Küçükerdönmez, Stephanie E Tedford","doi":"10.1007/s40123-025-01183-2","DOIUrl":"https://doi.org/10.1007/s40123-025-01183-2","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the safety and efficacy of multiwavelength photobiomodulation (PBM) treatment (Tx) in earlier stages of nonexudative (dry) age-related macular degeneration (AMD).</p><p><strong>Methods: </strong>Participants were enrolled with a diagnosis of dry AMD. Participants were treated with a single or repeated series of multiwavelength PBM treatment (LumiThera Valeda^® Light Delivery System; 590, 660, and 850 nm) delivered three times per week over 3-5 weeks every 4 months with follow-up extending out to 16 months. Outcomes analyzed included visual acuity (VA), contrast sensitivity (CS), and electroretinography (ERG).</p><p><strong>Results: </strong>A total of 41 eyes (27 participants) were evaluated after single (1 series of Tx, n = 41 eyes) and repeat (2-4 series of Tx, n = 26 eyes) PBM treatment with up to 16 months of follow-up. Participants were mostly female (n = 22, 81.5%) with a mean time since AMD diagnosis of 5.6 years. Participants enrolled had earlier stage dry AMD with better vision (~ 20/32 Snellen) and a mean baseline VA of 76.5 letters. Single and repeated PBM Tx improved VA, CS, multi-luminance ERG, and fixed luminance ERG parameters. No significant visual decline was noted in any outcome measure or signs of phototoxicity.</p><p><strong>Conclusions: </strong>PBM treatment of patients with earlier stage dry AMD showed improvements on multiple visual outcome measures and no adverse effects. Earlier stage AMD populations may not show robust magnitude effects as their starting vision does not show serious deficits, however; as a result of the degenerative and progressive nature of the disease, repeat treatment and continued monitoring of these outcomes are of interest. These beneficial effects were improved with repeated PBM treatment series.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476226","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":"Clinical Trial Simulation in Geographic Atrophy: Patient, Caregiver, and Trial Site Staff Perspectives.","authors":"Ivana Gunderson, Asma Burale, Bill J Best, Cynthia I Tung, Jochen Huber, Lisa Marsh","doi":"10.1007/s40123-025-01188-x","DOIUrl":"https://doi.org/10.1007/s40123-025-01188-x","url":null,"abstract":"<p><strong>Introduction: </strong>The perspectives of patients with geographic atrophy (GA) should be considered when planning new clinical trials to ensure that real-world patient needs are addressed. The purpose of this study was to explore the perspectives of patients, caregivers, and trial site staff on designing and planning a phase 2 clinical trial in GA.</p><p><strong>Methods: </strong>This cross-sectional study included patients with GA and their caregivers, trial site staff, and investigators from Germany, the UK, and the USA. Participants were asked to spend 30 min reviewing a simulated trial design communicated as a simple video animation with a voiceover. Subsequently, a 90-min web-assisted telephone interview and survey was conducted to identify problems with the design of the simulated trial and explore potential solutions and improvements.</p><p><strong>Results: </strong>Patients (n = 11), caregivers (n = 11), and site staff (n = 16) completed the survey after reviewing the simulated trial design. Survey responses suggested that study recruitment could be facilitated via widespread advertisement and by including a short washout period, i.e., the time period during which patients receive no medication prior to commencing the study drug to ensure that other treatments do not impact the study results. Survey suggestions for reducing the burden of trial participation included minimizing the number and frequency of trial visits, enabling assessments to be completed at home, and making the schedule of trial visits flexible. Appropriate investment in study center facilities was recommended. In addition, survey respondents proposed that providing transport could be highly beneficial, potentially enabling patients and caregivers to attend trial visits more easily.</p><p><strong>Conclusions: </strong>This study provides valuable information on the viewpoints of patients, caregivers, and trial site staff regarding trial design. Accounting for these perspectives when designing future clinical trials may help ensure successful trial completion and promote positive perceptions of clinical research.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476225","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":"Safety Evaluation of Bilateral Same-Day Intravitreal Injection of Faricimab.","authors":"Michael D Karampelas, Irini P Chatziralli, Dimitrios A Karagiannis","doi":"10.1007/s40123-025-01184-1","DOIUrl":"10.1007/s40123-025-01184-1","url":null,"abstract":"<p><strong>Introduction: </strong>Intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents is the most commonly performed ophthalmic procedure. Many retinal specialists routinely perform same-day bilateral intravitreal anti-VEGF injections, in order to reduce the burden to patient and clinic time. There are several reports demonstrating the safety of bilateral same-day treatment with ranibizumab, bevacizumab, and aflibercept, but currently, there are no reports regarding faricimab. The purpose of this study is to report safety outcomes in a cohort of patients who received bilateral same-day faricimab intravitreal injections.</p><p><strong>Methods: </strong>This is a retrospective observational study that included patients who received bilateral same-day faricimab and had a follow-up of at least 6 months. All patients were treated by 4 monthly faricimab injections as a loading dose and subsequently followed up at monthly intervals. All intravitreal injections were done in a sterile room and the second injection was treated as a separate procedure.</p><p><strong>Results: </strong>One hundred eyes from 50 patients were included in the study. The mean follow-up period was 7 months, during which a total of 487 intravitreal injections of faricimab were done. During the follow-up period, five patients (10%) presented with minor ophthalmic issues. There were no cases of endophthalmitis and no patients reported a cerebrovascular, cardiovascular, or thromboembolic event.</p><p><strong>Conclusions: </strong>Our study showed that bilateral same-day intravitreal injection of faricimab appeared to be well tolerated in this limited cohort and is the preferred approach in our practice. Larger studies with longer follow-up will be required in order to support our findings.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369040","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":"The Efficacy and Safety of Trabeculectomy after Failed Primary Glaucoma Drainage Devices.","authors":"Daniel Wang, Zhuangjun Si, Sanjay G Asrani, Joanne C Wen, Divakar Gupta","doi":"10.1007/s40123-025-01189-w","DOIUrl":"10.1007/s40123-025-01189-w","url":null,"abstract":"<p><strong>Introduction: </strong>Trabeculectomy is not usually considered for uncontrolled intraocular pressure (IOP) after glaucoma drainage devices (GDD) because of concern that the conjunctiva has been violated and future trabeculectomy surgery is likely to fail due to fibrosis. We examined the clinical outcomes of patients who underwent a trabeculectomy after failed primary GDD.</p><p><strong>Methods: </strong>This is a cross-sectional study of all patients who had a glaucoma drainage implant that failed or was inadequate in lowering IOP and underwent a trabeculectomy in the same eye from January 2016 to December 2022.</p><p><strong>Results: </strong>A total of 23 eyes in 22 patients met our criteria. Average IOP [± standard deviation (SD)] prior to trabeculectomy was 21.7 ± 9.3 on 3.2 ± 1.3 medications. The length of follow-up was between 0.3 and 5.0 years with an average follow-up time of 2.2 years. At 1 year (n = 16), IOP was 11 ± 1.9 mm Hg on 1.8 ± 1.5 medications. At 2 years, the average IOP was 11.8 ± 4.6 on 1.9 ± 1.4 medications. At all follow-up points, the decrease in IOP and medication was statistically significant compared with baseline (paired t-tests; p < 0.05). Most postoperative complications self-resolved with medical management (three early wound leaks, two late wound leaks, two instances of hypotony maculopathy, and one instance of cystoid macular edema). One early wound leak required surgical repair. One eye underwent an additional GDD surgery, and three eyes underwent bleb needling. In all, 20 (87%) eyes at final visit were within two lines of their baseline vision prior to trabeculectomy. No eyes progressed to having no light perception visual acuity or had an ocular infection.</p><p><strong>Conclusions: </strong>This study suggests that trabeculectomy after a GDD is an effective and safe option for IOP control and glaucoma medication reduction. In this small sample of surgical cases, complication and reoperation rates were comparable to published rates.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369041","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":"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":"https://doi.org/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":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World 5-Year Outcomes of Age-Related Macular Degeneration with Bevacizumab as First-Line Anti-VEGF.","authors":"H Mhmud, J P Vermeulen, O A M Tigchelaar-Besling, F D Verbraak, D Barthelmes, M Gillies, T L Ponsioen, Caroline C W Klaver","doi":"10.1007/s40123-025-01178-z","DOIUrl":"https://doi.org/10.1007/s40123-025-01178-z","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate long-term outcomes of anti-VEGF therapy for neovascular age-related macular degeneration (nAMD) in the Netherlands (NL), where bevacizumab is the mandated first-line drug, compared to high-income countries using ranibizumab or aflibercept as initial treatments.</p><p><strong>Methods: </strong>Five-year data from the Fight Retinal Blindness! (FRB) registry, a real-world prospective registry, were analyzed. Outcomes from 1473 Dutch eyes (1229 patients) treated with bevacizumab were compared with 7144 eyes (5884 patients) in a reference group (RG) from 13 socioeconomically similar countries. The primary outcome was mean visual acuity (VA) at yearly intervals; secondary outcomes included injection frequency and switching rates to alternative anti-VEGF agents.</p><p><strong>Results: </strong>Throughout the 60 months, mean VA was consistently higher in Dutch eyes (baseline: NL 60.2 vs. RG 59.2; 60 months: NL 64.9 vs. RG 62.6). The Dutch group cumulatively received 14.5 more injections over 5 years and had a higher rate of switching (70.9% vs. 50.9%) with a shorter median time to switching (11.9 months vs. 17.7 months).</p><p><strong>Conclusions: </strong>Patients treated in Dutch FRB! clinics have good long-term outcomes with a 2.3-letter higher mean VA at the 60-month timepoint compared to FRB! clinics in the RG. The Dutch patients, who began treatment with bevacizumab, received 14.5 more injections over 5 years and had a 40% higher rate of switching to an alternative drug, with switching occurring 5.8 months earlier. This study highlights the benefits of early and more intensive management to optimize visual outcomes, which appear more important than the choice and price of the first-line drug.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302642","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":"Exploring Machine Learning Models for Vault Safety in ICL Implantation: A Comparative Analysis of Regression and Classification Models.","authors":"Qing Zhang, Qi Li, Zhilong Yu, Ruibo Yang, Emmanuel Eric Pazo, Yue Huang, Hui Liu, Chen Zhang, Salissou Moutari, Shaozhen Zhao","doi":"10.1007/s40123-025-01173-4","DOIUrl":"https://doi.org/10.1007/s40123-025-01173-4","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate prediction of postoperative vault height following implantable collamer lens (ICL) V4c implantation is critical for minimizing complications and achieving optimal surgical outcomes. This study aims to evaluate the performance of machine learning models in predicting postoperative vault height, focusing on both regression and classification approaches.</p><p><strong>Methods: </strong>This retrospective study analyzed biometric and demographic data, including anterior chamber depth, white-to-white distance, and ICL size, among other variables. Regression and classification models were developed using gradient boosting, random forest, and CatBoost algorithms. Regression models predicted vault height as a continuous variable, while classification models categorized vault heights into binary and multi-class tasks. Model performance was evaluated using metrics including the mean absolute error (MAE) and root mean squared error (RMSE) for regression models, while accuracy, F1-score, and area under the curve (AUC) were used for classification models.</p><p><strong>Results: </strong>Regression models demonstrated moderate predictive performance, with random forest delivering the best performance (MAE: 134.0 µm, RMSE: 171.3 µm, Pearson's correlation coefficient: 0.45). On the other hand, classification models exhibited greater clinical applicability than regression approaches. For the binary classification task (vault < 250 µm vs. ≥ 250 µm), gradient boosting achieved the highest overall performance, with accuracy of 89 ± 12% and an AUC of 0.89. In the task of predicting vault > 750 µm vs. ≤ 750 µm, random forest emerged as the most effective classifier, achieving accuracy of 86 ± 9% and an AUC of 0.88. In multi-class classification, models demonstrated superior performance in predicting intermediate vault heights (250 µm ≤ vault ≤ 750 µm). Random forest achieved the highest accuracy of 94.6% in this category. However, all models faced challenges in accurately classifying extreme vault categories.</p><p><strong>Conclusions: </strong>Classification models, particularly gradient boosting and random forest, demonstrated strong potential for predicting clinically significant vault categories, enabling personalized surgical planning and improved risk management. While regression models offered moderate insights, their limitations suggest that classification approaches are better suited for clinical applications. Future research should focus on enhancing model accuracy for extreme vault prediction and integrating advanced techniques, such as ensemble deep learning, to further refine outcomes.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258663","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":"The Use of a Viscous Cysteamine Eyedrop in a Belgian Cohort: Early 3-Year Results.","authors":"Emiel Matthys, Heleen Delbeke, Karel Van Keer, Ingele Casteels","doi":"10.1007/s40123-025-01170-7","DOIUrl":"https://doi.org/10.1007/s40123-025-01170-7","url":null,"abstract":"<p><strong>Introduction: </strong>With the life expectancy of patients with cystinosis increasing (ORPHA213), the corneal burden and the objective assessment of corneal crystal deposition have become increasingly important. Previous research highlights the disadvantages of hospital-prepared cysteamine solutions (HPCS), including limited efficacy, which can lead to visual decline. Cystadrops^® is a viscous topical treatment in cystinosis care that counteracts these disadvantages.</p><p><strong>Methods: </strong>A total of 14 patients with cystinosis and corneal involvement are being followed in the multidisciplinary cystinosis clinic of the University Hospital of Leuven. Data retrieved between September 2014 and March 2023 were analyzed. All patients were initially treated with HPCS before switching to Cystadrops^®. Patients were assessed yearly according to the standard clinical ophthalmological examination for patients with cystinosis developed by Pinxten et al. Photophobia, corneal crystal deposition, and corneal crystal deposition depth were measured by the Liang cystinosis photophobia score, Gahl score, and anterior segment optical coherence tomography (OCT) respectively. Corneal densitometry was assessed with Scheimpflug imaging.</p><p><strong>Results: </strong>OCT mean crystal depth was 83% of total corneal thickness. The mean corneal density was 28.9 grayscale units. We found a positive trend (F = 0.20, p = 0.65) in corneal densitometry despite the use of HPCS, with a decreasing trend (F = 3.30, p = 0.08) after switching to Cystadrops^®. Photophobia scores significantly reduced after switching treatments (p = 0.008). In total, seven patients developed anterior segment complications while using HPCS. No new anterior segment complications developed while using Cystadrops^®.</p><p><strong>Conclusions: </strong>This study underscores previous research, demonstrating HPCS' limited effectiveness in reducing corneal crystal deposition due to unachievable dosing frequencies and poor stability. Our data highlights the effectiveness of Cystadrops^® in treating the ocular symptoms of cystinosis. The data demonstrates the difficulty of reversing high levels of corneal crystal deposition and anterior segment complications. Starting Cystadrops^® early in the disease course may prevent high rates of crystal deposition, thus reducing complications and their impact on vision and quality of life.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249046","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":"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":"https://doi.org/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":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}