Ophthalmology and Therapy最新文献

{"title":"Enhanced Macular Imaging Referral Pathway: Bridging Community Optometrists and Hospital Specialists for Smarter Eye Care.","authors":"Serena Salvatore, Josh Harvey, Amy Hughes, Lisa Gibson, John Hopcroft, Sarah Swift, James Marsterson, Clare Bailey","doi":"10.1007/s40123-026-01477-z","DOIUrl":"10.1007/s40123-026-01477-z","url":null,"abstract":"<p><strong>Introduction: </strong>Hospital eye services in England face sustained demand, with nearly 9 million outpatient appointments in 2023-2024. Teleophthalmology pathways that combine community-acquired imaging with hospital virtual review may reduce unnecessary face-to-face visits. We evaluated an enhanced macular imaging referral pathway linking community optometry optical coherence tomography (OCT) and colour fundus imaging with hospital-led teleophthalmology review.</p><p><strong>Methods: </strong>We performed a retrospective service evaluation of 376 consecutive adult macular referrals received at University Hospitals of Bristol and Weston, between July 2024 and March 2025. Community optometrists submitted bilateral macula-centred 45° colour fundus photographs, bilateral OCT volume scans in digital imaging and communications in medicine (DICOM) format and clinical data via a secure platform. Referrals were reviewed by a consultant ophthalmologist or hospital optometrist within 1 working day. Under the previous pathway, all accepted referrals required an initial face-to-face hospital appointment. Primary outcomes were referral appropriateness, avoided hospital appointments and redirection to other sub-specialties; secondary outcomes were management decision and diagnostic category. Analyses were descriptive.</p><p><strong>Results: </strong>Median age was 74 years (IQR 14); 54.3% were female. Overall, 327/376 referrals (87.0%, 95% CI 83.2-90.0) were appropriate for macular assessment. Of the referrals, 49 (13.0%) were inappropriate because of incomplete imaging (n = 18, 4.7%) or redirection to another sub-specialty (n = 31, 8.2%), most commonly vitreoretinal services (n = 27, 7.2%). Among appropriate referrals, 241/327 (73.7%, 95% CI 68.7-78.2) avoided the mandatory first hospital visit required under the previous pathway. Management outcomes across the cohort were: neovascular age-related macular degeneration (nAMD) pathway, 17.1%; redirection, 6.1%; discharge to community, 10.2%; virtual follow-up, 15.3%; and face-to-face appointment, 51.2%. Mean time to treatment for nAMD was 8.6 days (95% CI 6.0-11.2 days).</p><p><strong>Conclusions: </strong>This teleophthalmology-enabled macular referral pathway achieved high referral appropriateness and substantially reduced mandatory first-visit hospital appointments while supporting timely treatment for sight-threatening macular disease. The model appears scalable and may help National Health Service hospital eye services manage rising demand more efficiently.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3305-3315"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faricimab Improves Choriocapillaris Perfusion in Diabetic Macular Edema.","authors":"Soo Young Lee, Jounghan Kim, Ye Eun Han, Junyeop Lee","doi":"10.1007/s40123-026-01485-z","DOIUrl":"10.1007/s40123-026-01485-z","url":null,"abstract":"<p><strong>Introduction: </strong>This study is a retrospective observational study to evaluate the effects of intravitreal faricimab on choriocapillaris perfusion in diabetic macular edema (DME) using optical coherence tomography angiography (OCTA) and to investigate the relationship between changes in choriocapillaris flow void (CCFV) and visual outcomes.</p><p><strong>Methods: </strong>Eyes with center-involved DME that received four consecutive monthly intravitreal faricimab injections were included. OCTA (Solix FullRange®) was obtained within 1 month before the first injection and 1 month after the fourth injection. The choriocapillaris (CC) slab was segmented per device default, and CCFV was quantified after Phansalkar local thresholding. Additional metrics included central retinal thickness (CRT), subfoveal choroidal thickness (sfChT), and choroidal vascularity index in Sattler's (CVI_S) and Haller's layers (CVI_H). Pre/post differences were tested with paired t-tests, and Pearson correlation analyses were performed to assess the associations of changes in CCFV with changes in structural optical coherence tomography (OCT) parameters and best-corrected visual acuity (BCVA).</p><p><strong>Results: </strong>Thirty eyes were analyzed. Mean CCFV decreased from 53.35 to 48.89%, yielding a mean reduction of 4.46% (95% confidence interval [CI], -6.37 to -2.56; P < 0.001). BCVA improved significantly (mean difference, -0.20 logMAR; 95% CI -0.27 to -0.12; P < 0.001). CRT decreased from 483.43 ± 72.26 to 313.93 ± 58.41 µm (mean difference, -169.50 µm; P < 0.001). sfChT also decreased significantly (mean difference, -35.56 µm; P < 0.001). CVI_H increased significantly (mean difference, 2.71 percentage points; P < 0.001), whereas CVI_S showed a slight but non-significant increase (mean difference, 0.62 percentage points; P = 0.483). No significant correlations were observed between changes in CCFV and those in CRT, sfChT, CVI_S, or CVI_H (all P > 0.05). However, changes in CCFV were positively correlated with changes in BCVA (r = 0.437, 95% CI 0.091-0.689; P = 0.016), with greater reductions in CCFV associated with greater visual acuity improvement.</p><p><strong>Conclusions: </strong>Faricimab was associated with a significant reduction in CCFV, suggesting improved choriocapillaris perfusion accompanied by significant anatomical and functional improvements in DME. The significant association between changes in CCFV and visual acuity improvement suggests that OCTA-derived CCFV may serve as a functional biomarker of treatment response. These findings support the concept that restoration of choriocapillaris perfusion may contribute to visual recovery and highlight the role of the choroid in DME beyond retinal edema resolution.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3529-3545"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857530","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":"Comparative Efficacy of Topical Eye-Drop Regimens for Dry Eye After Cataract Surgery: A Systematic Review and Network Meta-analysis.","authors":"Boyang Song, Yukang Li, Chengfei Liu, Zhaojiang Du","doi":"10.1007/s40123-026-01484-0","DOIUrl":"10.1007/s40123-026-01484-0","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative dry eye can impair visual recovery and patients' perceived benefit after cataract surgery. We compared topical eye-drop regimens across tear-film stability, tear secretion, corneal epithelial damage, and patient-reported symptoms.</p><p><strong>Methods: </strong>A PROSPERO-registered review searched nine databases from inception to January 30, 2026, for randomized trials of ocular-surface treatments after cataract surgery. Frequentist random-effects network meta-analyses assessed 1-month tear-film breakup time, Schirmer test, corneal fluorescein staining, and Ocular Surface Disease Index; safety was summarized descriptively.</p><p><strong>Results: </strong>Forty-seven trials (102 arms; 4920 eyes assessed; 4844 arm-level analyzed observations) were included; 38 trials (81 arms; 3898 analysis units) contributed to network meta-analyses within a 19-node framework. Compared with routine postoperative care, moderate-confidence evidence indicated greater tear-film breakup time with diquafosol plus hyaluronic acid (mean difference 4.17 s, 95% confidence interval 1.99-6.35) and cyclosporine plus carboxymethylcellulose (3.97 s, 1.60-6.34), whereas low-confidence evidence suggested a possible increase with cyclosporine plus deproteinized calf blood extract (4.98 s, 1.93-8.03). Outcome-specific benefits were observed for tear secretion and corneal staining, whereas symptom findings were exploratory. Most top-ranked treatment nodes across the four networks were informed by only one or two trials with few analysis units. Some estimates were affected by high risk of bias or local incoherence. No statistically significant global inconsistency was detected overall.</p><p><strong>Conclusions: </strong>No single topical regimen showed consistently favorable effects across all postoperative ocular-surface outcomes. Outcome-specific signals require confirmation because sparse direct evidence, risk of bias, and limited safety and longer-term data preclude definitive recommendations. Adequately powered head-to-head trials with standardized postoperative care are needed for future clinical guidance.</p><p><strong>Trial registration: </strong>PROSPERO CRD42026138249.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3245-3272"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866171","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 Prospective Evaluation of the 2-Year Efficacy and Safety of INTERCIL: A Novel Uveal Spacer for Open-Angle Glaucoma.","authors":"Lilit Voskanyan, Vahan Papoyan, Hayk Babayan, Hovsep Miroyan, Christophe Baudouin","doi":"10.1007/s40123-026-01469-z","DOIUrl":"10.1007/s40123-026-01469-z","url":null,"abstract":"<p><strong>Introduction: </strong>Intraocular pressure (IOP) reduction is the most commonly therapeutically modifiable risk factor in glaucoma. Minimally invasive glaucoma surgeries are generally considered safe but ineffective, constrained by physiological pressure. Invasive bleb-forming filtration surgeries are effective, but associated with high risk and high rates of failure. Technologies utilizing uveoscleral rely on creation of a cyclodialysis cleft. This study evaluated a novel supraciliary uveal spacer (INTERCIL^®) designed to enhance uveoscleral outflow, avoiding anterior and posterior chamber entry or bleb formation.</p><p><strong>Methods: </strong>SAFARI 3, a prospective, single-center, single-arm study included adults with mild-to-moderate glaucoma (Shaffer grade 1-4), uncontrolled on 1-4 medications (baseline IOP 21-35 mmHg). Patients underwent standalone ab externo implantation of INTERCIL^®. The primary endpoint was mean change in medicated IOP at 24 months. Secondary outcomes included medication reduction, success rates (IOP ≤ 18 mmHg with ≥ 20% reduction), safety, and quality of life.</p><p><strong>Results: </strong>Twenty-nine patients with primary open-angle glaucoma (POAG) were analyzed (mean age 65.9 years; baseline IOP 23.4 ± 1.9 mmHg; medications 1.9 ± 0.9). At 24 months (n = 19), mean IOP decreased to 14.4 ± 3.1 mmHg (39% reduction); medication use decreased to 0.4 ± 0.8 (83% reduction), with 73.7% medication-free. Complete and qualified success rates were 74% and 95%, respectively. All patients achieved ≥ 20% IOP reduction by 12 and 24 months; 94.7% had IOP between 6 and 18 mmHg at 24 months. Adverse events were mild to moderate in severity. One event of inadvertent anterior chamber entry with migration affected one patient. Six cases of cataract, not deemed device- or procedure-related, were reported; causality cannot be excluded, but cataract development is not uncommon after glaucoma surgery. Device position remained stable overall, and visual function parameters showed no clinically significant changes.</p><p><strong>Conclusions: </strong>INTERCIL^® provided sustained IOP and medication reduction by potentially harnessing uveoscleral outflow, without surgical risks associated with bleb- or cleft- dependent procedures, suggesting a potential new concept for patients with open-angle glaucoma requiring durable disease control.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, NCT05236439.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3379-3399"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796396","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":"Wnt Pathway Agonism as a Therapeutic Strategy for Retinal Vascular Diseases: A Narrative Review of Evidence to Date.","authors":"Stephane Angers, Charles C Wykoff, David A Antonetti, Harald J Junge, Eric Nudleman, Aaron Nagiel, Patricio G Schlottmann, Donald J D'Amico, Jonathan Prenner, David R Guyer, Charles G Miller, Keith Baker, Paul Stephens, Erin Henry, Hans Rekers, Anthony P Adamis, Yin Shan Eric Ng","doi":"10.1007/s40123-026-01476-0","DOIUrl":"10.1007/s40123-026-01476-0","url":null,"abstract":"<p><p>Breakdown of the blood-retinal barrier (BRB) is implicated in many blinding retinal diseases, including diabetic macular edema, neovascular age-related macular degeneration, and retinal vein occlusion. Anti-vascular endothelial growth factor (anti-VEGF) therapies or laser photocoagulation are currently the standard of care for retinal diseases that are characterized by breakdown of the vascular barrier function and vascular hyperpermeability. However, inadequate response to anti-VEGF therapy is seen in a substantial proportion of patients and laser photocoagulation does not restore vision loss and can lead to collateral damage of the retina. Thus, new therapeutic targets are needed. The β-catenin-dependent wingless-related integration site (Wnt) signaling pathway plays a critical role in inner BRB development and maintenance. There are several potential therapeutics for retinal vascular diseases targeting the Wnt/β-catenin pathway under investigation, including several in preclinical development and one (MK-3000; also known as Restoret and formerly EYE103) with early clinical trial results advancing to late-stage clinical development. In this narrative review we examine the role of Wnt/β-catenin signaling in inner BRB maintenance and in retinal vascular diseases, as well as the potential for Wnt pathway agonism as a therapeutic approach.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3225-3243"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761971","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":"Combined Orbital Decompression and Rectus Muscle Myectomy for Large-Angle Strabismus in Thyroid-Associated Orbitopathy.","authors":"Meng-Wei Hsieh, Lung-Chi Lee, Chia-Chen Hsu, Hsu-Chieh Chang, Yi-Hao Chen, Ke-Hung Chien","doi":"10.1007/s40123-026-01479-x","DOIUrl":"10.1007/s40123-026-01479-x","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid-associated orbitopathy (TAO) often causes restrictive strabismus and diplopia. Large-angle deviations pose particular challenges owing to extraocular muscle fibrosis and unpredictable surgical dose-response. Although combined orbital decompression and strabismus correction has been proposed to reduce the number of procedures, its effectiveness in large-angle TAO remains uncertain. This study aimed to evaluate the outcomes of combined orbital decompression and rectus muscle myectomy in this population.</p><p><strong>Methods: </strong>In this retrospective cohort study, 88 patients with TAO-associated strabismus > 25 prism diopters (PD) underwent either staged (step) surgery (n = 42) or combined surgery (n = 46) at a tertiary center between 2018 and 2022. All had stable thyroid function for ≥ 6 months before surgery. The combined procedure involved simultaneous orbital decompression and rectus myectomy. Outcomes included deviation angles, Hertel exophthalmometry, and the field of binocular single vision (BSV).</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups. Postoperatively, the combined-surgery group had smaller residual horizontal and vertical deviations-median 0 (0-3) and 2 (0-3) PD-than the step group, 5 (4-5) and 3 (3-5) PD (all p < 0.001). The BSV field was wider after combined surgery [410 (396-426)° versus 360 (328-386)°, p < 0.001]. Overall success rates (≤ 5 PD deviation in primary and reading positions) were similar (84.8% versus 81.0%, p = 0.633). Transient lower lid retraction occurred in a few patients and was successfully corrected.</p><p><strong>Conclusions: </strong>Combined orbital decompression with rectus myectomy achieved effective alignment and superior binocular function compared with staged surgery, offering a practical and safe option for TAO-related large-angle strabismus.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3515-3528"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851285","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":"Stereopsis and Outer Retinal Structure After Reduced-Fluence Photodynamic Therapy for Central Serous Chorioretinopathy: A 12-Month Study.","authors":"Maya Kishimoto-Kishi, Akiko Miki, Amiko Matsuyama, Toshiki Oka, Eisuke Ikeuchi, Makoto Nakamura","doi":"10.1007/s40123-026-01511-0","DOIUrl":"https://doi.org/10.1007/s40123-026-01511-0","url":null,"abstract":"<p><strong>Introduction: </strong>Changes in binocular function after anatomical resolution of central serous chorioretinopathy (CSC) following reduced-fluence photodynamic therapy (RFPDT) remain unclear. We characterized 12-month stereopsis outcomes and the associated clinical and optical coherence tomography (OCT) factors.</p><p><strong>Methods: </strong>This retrospective single-center study included 51 eyes of 51 patients with unilateral CSC treated with RFPDT. Best-corrected visual acuity (BCVA), Titmus Stereo Test (TST), TNO stereotest (TNO), and central retinal thickness (CRT) were assessed at baseline and at 3, 6, and 12 months. Stereopsis (TST and TNO) was the primary longitudinal outcome; BCVA and CRT were secondary. Change over time was assessed with linear mixed-effects models. Associations of baseline and concurrent clinical and OCT factors with stereopsis were examined using Spearman correlation and multivariable linear regression.</p><p><strong>Results: </strong>Improvements in TST, TNO, and BCVA were evident by 3 months (all P < 0.001), with no significant further change thereafter except a small BCVA gain by 12 months (P = 0.006). At 12 months, abnormal stereopsis remained in 35% (TST) and 57% (TNO) of eyes. Larger baseline serous retinal detachment (SRD) area was independently associated with worse concurrent TST and TNO, but not with 12-month stereopsis. Greater 12-month outer retinal layer thickness (ORLT) was associated with better concurrent TNO in an adjusted model (P = 0.029). In eyes with good baseline acuity, longer baseline photoreceptor outer segment (POS) length was the only independent predictor of better 12-month TST.</p><p><strong>Conclusion: </strong>Stereopsis improved during the 12 months following RFPDT but often remained abnormal, even in eyes with good BCVA. Different structural parameters were associated with stereopsis by disease stage-subretinal fluid extent during active disease and residual outer retinal structure after resolution-and in these good-acuity eyes, pre-treatment outer retinal structure predicted 12-month stereopsis. Together, these findings suggest that stereopsis may capture residual visual dysfunction that is not fully reflected by BCVA.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075641","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":"Effect of Reproxalap Treatment on Dry Eye Disease Symptoms: Analysis of Pooled Data From Two Randomized, Vehicle-Controlled, 12-Week Clinical Trials.","authors":"John D Sheppard, Kelly Nichols, Christopher E Starr, Amber Lewis, Desiree Owen, Cathy Zhao, Mei Li, Bill Cavanagh, Todd C Brady","doi":"10.1007/s40123-026-01503-0","DOIUrl":"https://doi.org/10.1007/s40123-026-01503-0","url":null,"abstract":"<p><strong>Introduction: </strong>Reproxalap is a novel reactive aldehyde species inhibitor. Pooled data from two clinical trials were used to evaluate effects on symptoms and safety of reproxalap treatment versus vehicle in participants with dry eye disease (DED).</p><p><strong>Methods: </strong>Data were pooled from identically designed arms of two 12-week, randomized, vehicle-controlled, double-masked, parallel-group clinical trials comparing topical ophthalmic reproxalap 0.25% with vehicle, each dosed four times daily for 4 weeks then twice daily for 8 weeks, in participants with DED. Symptoms of ocular dryness and ocular discomfort were assessed using a visual analog scale (0-100) in the intent-to-treat ocular dryness (ITTOD) population (prespecified for the symptom primary endpoint analysis in each trial) of participants with a baseline ocular dryness score of ≥ 3 on the Ora Calibra^® Ocular Discomfort & 4-Symptom Questionnaire. Safety parameters were evaluated in all treated participants.</p><p><strong>Results: </strong>A total of 417 participants received study treatment (207 reproxalap, 210 vehicle), and 335 participants were included in the ITTOD population (167 reproxalap, 168 vehicle). The mean improvement from baseline in both ocular dryness and ocular discomfort scores was greater with reproxalap than vehicle at each timepoint (nominal p < 0.05). The least-squares mean difference (reproxalap - vehicle) in overall change from baseline from week 1 to week 12 was -8.5 (95% CI -12.6 to -4.5, p < 0.001) for ocular dryness score and -7.7 (95% CI -11.8 to -3.5, p < 0.001) for ocular discomfort score. The most common adverse event was mild instillation site irritation. There were no serious treatment-related adverse events.</p><p><strong>Conclusions: </strong>Reproxalap reduced ocular dryness and discomfort symptoms compared with vehicle as soon as week 1, the first post-baseline assessment, and there were no safety concerns. Reproxalap may represent an innovative, rapidly acting therapeutic option for patients with DED.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov NCT03916042 and NCT03879863.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075605","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":"Adjunctive 0.05% Atropine for Children with Continued Rapid Myopia Progression During Defocus Incorporated Multiple Segments Spectacle Lens Treatment: A Retrospective Matched Cohort Study.","authors":"QingLin Xu, Minsong Xue, Hong Liu, WenYu Gao, Haiying Zhu, Yuwen Ran, Hong Zhong, Longbo Wen, Zhikuan Yang","doi":"10.1007/s40123-026-01492-0","DOIUrl":"https://doi.org/10.1007/s40123-026-01492-0","url":null,"abstract":"<p><strong>Introduction: </strong>Defocus Incorporated Multiple Segments (DIMS) lenses slow myopia progression, but some children continue to experience rapid axial elongation despite treatment. This study evaluated whether adjunctive 0.05% atropine was associated with additional myopia control in children with an insufficient response to DIMS monotherapy.</p><p><strong>Methods: </strong>This retrospective matched cohort study included 54 children with rapid myopia progression during initial DIMS lens wear. We matched 27 children receiving adjunctive 0.05% atropine with 27 children who continued DIMS monotherapy by age, sex, axial length, and spherical equivalent refraction (SER). A pre-intervention observation period of approximately 6 months was used to identify children with rapid axial elongation during initial DIMS monotherapy, followed by an approximately 12-month intervention period to compare progression outcomes between groups. Statistical analyses included t tests, chi-square tests, analysis of covariance, and multivariable linear regression.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups. During the pre-intervention phase, the time-normalized axial elongation rate was similar between the monotherapy and combination groups (0.47 ± 0.03 vs. 0.54 ± 0.03 mm/year, P = 0.170), whereas the combination group showed greater myopic SER progression than the monotherapy group (- 0.98 ± 0.10 vs. - 0.61 ± 0.11 D/year, P = 0.016). During the intervention phase, after adjustment for the corresponding pre-intervention progression rate, the adjusted axial elongation rate was lower in the combination group than in the monotherapy group (0.12 ± 0.04 vs. 0.31 ± 0.04 mm/year, P = 0.001), as was SER progression (- 0.19 ± 0.08 vs. - 0.55 ± 0.08 D/year, P = 0.001).</p><p><strong>Conclusions: </strong>In children with rapid myopia progression during DIMS lens treatment, adjunctive 0.05% atropine was associated with a lower axial elongation rate and slower SER progression than continued DIMS monotherapy. These findings support further prospective evaluation of this treatment strategy.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149063482","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":"Effect of Residual Astigmatism on Visual Acuity Following Bifocal, Trifocal, and Extended Depth-of-Focus Intraocular Lens Implantation: A Retrospective Cohort Study.","authors":"Qi Chen, Tingting Peng, Huafang Guo, Yong Wang","doi":"10.1007/s40123-026-01502-1","DOIUrl":"https://doi.org/10.1007/s40123-026-01502-1","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the effects of residual astigmatism magnitude and axis on visual outcomes after simultaneous vision intraocular lens (SVIOL) implantation.</p><p><strong>Methods: </strong>This retrospective cohort study reviewed medical records of cataract patients who underwent implantation of bifocal, trifocal, or extended depth-of-focus (EDOF) IOLs. Patients were stratified by residual astigmatism magnitude (mild [0-0.50 D], moderate [0.75-1.00 D], high [1.25-1.50 D]) and axis (with-the-rule [WTR], against-the-rule [ATR], oblique). Uncorrected distance, intermediate, and near visual acuities (UDVA, UIVA, UNVA) and corrected distance visual acuity (CDVA) recorded at the 1-month postoperative visit were extracted for analysis.</p><p><strong>Results: </strong>A total of 879 eyes from 879 patients were analyzed (bifocal: 497 [56.5%]; trifocal: 166 [18.9%]; EDOF: 216 [24.6%]). In the bifocal group, UDVA, UIVA, and UNVA worsened with increasing astigmatism (all P < 0.05), whereas CDVA declined only in the high-astigmatism subgroup (P < 0.05). In the trifocal group, mild astigmatism yielded better UDVA, UIVA, and UNVA than moderate or high astigmatism (all P < 0.05) and better CDVA than the high-astigmatism subgroup (P < 0.05). In the EDOF group, mild astigmatism outperformed moderate and high astigmatism in UDVA and UIVA (both P < 0.05) and high astigmatism in UNVA and CDVA (both P < 0.05). Trifocal IOLs with mild or moderate astigmatism achieved better intermediate and near vision than other IOL types, whereas EDOF IOLs outperformed bifocal IOLs in the high-astigmatism subgroup (all P < 0.05). Astigmatic axis did not independently predict visual acuity in stratified multiple linear regression (all P > 0.05).</p><p><strong>Conclusions: </strong>Mild-to-moderate astigmatism primarily impairs intermediate and near vision, with trifocal IOLs exhibiting greater tolerance, whereas high astigmatism degrades vision at all distances, a setting in which EDOF IOLs perform better. Astigmatic axis appears to exert little influence.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149063463","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}