Ophthalmology and Therapy最新文献

{"title":"Real-World Outcomes of Faricimab in Patients with Highly Refractory Neovascular Age-Related Macular Degeneration in Portugal: The REVEAL Study.","authors":"Filipe Mira, Sofia Donato, Fernanda Vaz, Filipa Madeira, Maria Picoto, António Mendes, João Beato, Sónia Torres-Costa, Carolina Pinto, Nuno Oliveira, Susana Feliciano, Miguel Lume, Rita Carreiro, Mariana Couto, Ângela Carneiro","doi":"10.1007/s40123-026-01448-4","DOIUrl":"10.1007/s40123-026-01448-4","url":null,"abstract":"<p><strong>Introduction: </strong>Management of highly refractory exudative neovascular age-related macular degeneration (nAMD) remains challenging when multiple antivascular endothelial growth factor (VEGF) therapies fail to control the disease. Faricimab, through dual inhibition of VEGF-A and angiopoietin-2, may represent a potential therapeutic alternative for this difficult-to-treat population. However, real-world evidence in highly refractory nAMD remains limited and is lacking in the Portuguese population.</p><p><strong>Methods: </strong>This multicenter, retrospective, real-world study included patients with nAMD highly refractory to previous anti-VEGF therapies who were treated with faricimab and followed for at least 6 months. Functional and anatomical outcomes were assessed, including changes in best-corrected visual acuity (BCVA), central subfield thickness (CST), and evolution of intraretinal fluid (IRF) and subretinal fluid (SRF).</p><p><strong>Results: </strong>A total of 46 eyes from 40 patients were included, characterized by a long-standing disease (median [25th percentile (P25); 75th percentile (P75)] duration, 5.0 [3.0; 6.0] years) and a high prior treatment burden (32.0 [24.0; 45.8] anti-VEGF injections and median treatment interval of 4.0 [4.0; 6.0] weeks). After faricimab, functional stability was observed (median change in BCVA of 0.0 [-0.1; 0.1] logMAR). Anatomical outcomes showed improvement, with a median reduction in CST of -12 [-58; 7] µm and complete SRF resolution in 47.8% of eyes. Median treatment intervals of 8.0 [6.0-10.0] weeks were achieved, representing a twofold increase in the median treatment interval.</p><p><strong>Conclusions: </strong>In this real-world study of highly refractory nAMD, faricimab was associated with stabilization of functional outcomes and improvement in anatomical outcomes over short- to mid-term follow-up, alongside a twofold increase in treatment-interval length in routine clinical practice. These findings support the clinical relevance of inhibiting angiopoietin-2 (Ang-2) and represent the first evaluation conducted in routine clinical practice in Portugal, with potential implications for treatment burden and patient adherence.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2953-2969"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448709","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":"180-Degree Nuclear Flip: A Safety and Efficacy Assessment of a Phacoemulsification Technique for Cataract Nuclei of Grade III and Below.","authors":"Ruibo Chen, Tao Xu, Guorong Shi, Chunyan Xi, Mengqing Yin, Kai Hu, Bing Chen","doi":"10.1007/s40123-026-01435-9","DOIUrl":"10.1007/s40123-026-01435-9","url":null,"abstract":"<p><strong>Introduction: </strong>This prospective randomized controlled trial aims to evaluate the effectiveness and safety of a 180° nuclear flip technique in phacoemulsification cataract surgery, comparing it with the traditional endocapsular approach for cataracts of Emery-Little grade III and below.</p><p><strong>Methods: </strong>A total of 142 patients were randomly assigned to either the 180° nuclear flip group (n = 71) or the conventional endocapsular phacoemulsification group (n = 71). The primary outcomes measured were total phacoemulsification time (TPT) and effective phacoemulsification time (EPT). Secondary outcomes were the incidence of postoperative corneal endothelial cell loss (ECL) at 7 and 28 days, as well as intraoperative complications including posterior capsule rupture (PCR).</p><p><strong>Results: </strong>The mean TPT was substantially shorter in the flip group (43.75 ± 17.16 s) compared to the conventional group (58.45 ± 22.27 s) (P < 0.0001). Similarly, the mean EPT was also significantly reduced in the flip group (11.08 ± 5.25 s vs. 14.87 ± 8.54 s, P = 0.0046). There were no PCR cases in the flip group, whereas there was one case (1.4%) in the traditional group. At 28 days postoperatively, the mean ECL rate of the flip group (3.7%) was lower than that of the conventional group (4.9%), although this difference did not reach statistical significance.</p><p><strong>Conclusion: </strong>The 180° nuclear flip technique is a safe, efficient, and effective method for managing cataracts of grade III hardness and below. It may help reduce the risk of complications, improves intraoperative stability by creating a more spacious operating field, and significantly reduces phacoemulsification time. Video available for this article.</p><p><strong>Trial registration: </strong>chictr.org.cn identifier, ChiCTR2500105241.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2997-3007"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471967","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":"Short-Term Intraocular Pressure Changes After Intravitreal Aflibercept 8 mg via Prefilled Syringe.","authors":"Arianna Peyla, Matteo Bonanata, Martina Pache, Michele Clerici, Moreno Menghini, Gabriela Grimaldi, Giulio Volpe","doi":"10.1007/s40123-026-01460-8","DOIUrl":"10.1007/s40123-026-01460-8","url":null,"abstract":"<p><strong>Introduction: </strong>Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is a standard treatment for neovascular age-related macular degeneration (nAMD) and diabetic macular oedema (DMO). A transient rise in intraocular pressure (IOP) following injection is a well-established short-term effect. Aflibercept 8 mg has recently been introduced in a prefilled syringe (PFS), although data on its short-term effect on IOP are still lacking. The aim of this study was to assess short-term IOP changes after intravitreal aflibercept 8 mg administered via PFS and to compare these results with historical cohorts receiving aflibercept 8 mg via standard syringe and aflibercept 2 mg via PFS.</p><p><strong>Methods: </strong>This single-centre comparative observational cohort study included a prospectively enrolled cohort of patients with nAMD or DMO receiving aflibercept 8 mg via PFS (0.07 mL), while two retrospective historical cohorts receiving aflibercept 8 mg via standard syringe (0.07 mL) or aflibercept 2 mg via PFS (0.05 mL) were used for comparison. IOP was measured with the iCare IC200 rebound tonometer at baseline (T0), 30 s (T1), 5 min (T2), and 15 min (T3) post-injection. Patients with glaucoma or ocular hypertension were excluded. Statistical analysis was performed using Friedman and Kruskal-Wallis tests.</p><p><strong>Results: </strong>Forty-six eyes treated with aflibercept 8 mg PFS were analysed. Baseline IOP was similar across the three groups (p = 0.54). In the aflibercept 8 mg PFS cohort, mean IOP increased from 13.92 ± 4.25 mmHg at baseline to 51.29 ± 15.07 mmHg at 30 s, then fell to 31.32 ± 12.24 mmHg at 5 min and to 20.25 ± 7.08 mmHg at 15 min (p < 0.001). No statistically significant between-group differences were detected at any timepoint (all p ≥ 0.18).</p><p><strong>Conclusion: </strong>Intravitreal aflibercept 8 mg administered via PFS was associated with a transient rise in IOP immediately after injection, which resolved within 15 min and was similar to that observed with aflibercept 2 mg via PFS and aflibercept 8 mg via standard syringe. These findings contribute to the characterization of the short-term IOP response associated with aflibercept 8 mg PFS administration and may help inform routine clinical practice.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3137-3144"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472010","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":"Extended Depth of Field Intraocular Lens for Cataract After Vitrectomy for Retinal Detachment: A Prospective Trial.","authors":"Efstathios Vounotrypidis, Dorian Begaj, Rupert Kamnig, Julie Meyer, Melih Parlak, Christian M Wertheimer, Armin Wolf","doi":"10.1007/s40123-026-01461-7","DOIUrl":"10.1007/s40123-026-01461-7","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate visual outcomes and patient satisfaction following implantation of a non-diffractive extended depth of focus (EDOF) intraocular lens (IOL) in eyes with cataract developing after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).</p><p><strong>Methods: </strong>Patients who underwent PPV for RRD, with or without macular involvement, and subsequently developed cataract were prospectively enrolled. Cataract surgery was performed with implantation of the Vivity EDOF-IOL (Alcon). Bilateral implantation was performed according to patient preference. Inclusion criteria were attached retina 3-6 months after PPV and corrected distant visual acuity of 0.3-0.7 logMAR. Primary outcomes were monocular and binocular, corrected and uncorrected distance, intermediate, and near visual acuity (CDVA, UDVA, DCIVA, UIVA, DCNVA, UNVA) at 6 months. Secondary outcomes included defocus curve and patient-reported satisfaction.</p><p><strong>Results: </strong>Twenty-seven patients (43 eyes) underwent surgery at 6 ± 3 months after PPV (16 patients bilateral). Thirteen patients had RRD with macular involvement. In the RRD-affected eyes CDVA improved statistically significantly from 0.35 ± 0.16 to 0.03 ± 0.12 and UDVA from 1.01 ± 0.34 to 0.16 ± 0.19 logMAR at 6 months. Mean visual acuities at 6 months for RRD-affected eyes were DCIVA 0.53 ± 0.21, UIVA 0.44 ± 0.15, DCNVA 0.59 ± 0.23, and UNVA 0.47 ± 0.23 logMAR. Binocular UDVA, UIVA, and UNVA for the bilateral cases were - 0.04 ± 0.11, 0.29 ± 0.10, and 0.26 ± 0.13 logMAR, respectively. The defocus curve was comparable between macula-on, macula-off, and fellow eyes. Patient satisfaction was favorable with just two patients reporting halos.</p><p><strong>Conclusion: </strong>Using the Vivity EDOF-IOL in selected patients with cataract after successful PPV for RRD appears to be a safe and effective option, yielding favorable visual outcomes regardless of macular involvement.</p><p><strong>Trial registration number: </strong>DRKS00037029.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3055-3069"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592981","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":"Evaluating Rotational Stability of the Visian V4b TICL in Patients with High Myopic Astigmatism.","authors":"Sanjana Molleti, Hanna Pawlowski, Mina M Sitto, Kayvon A Moin, Phillip C Hoopes, Majid Moshirfar","doi":"10.1007/s40123-026-01445-7","DOIUrl":"10.1007/s40123-026-01445-7","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the rotational stability of the Visian V4b toric implantable collamer lenses (TICLs) over a 12-month follow-up period and to assess refractive outcomes and potential factors associated with lens rotation at one U.S.</p><p><strong>Institution: </strong></p><p><strong>Methods: </strong>This retrospective study included 48 eyes from 26 patients who underwent Visian TICL implantation between 2018 and 2021 at a single U.S. refractive surgical center. Eligible patients were ≥ 18 years old with myopia ranging from - 3.0 to - 20.0 D and astigmatism ranging from - 1.0 to - 4.0 D. Postoperative assessments were conducted at 1 week, 1 month, and 3, 6, and 12 months. Rotational stability was measured using standardized slit lamp photography with image overlay analysis. Visual acuity, refractive outcomes, and vault measurements were recorded at each visit. Vector analysis was performed, and potential factors associated with TICL rotation were analyzed using correlation analyses.</p><p><strong>Results: </strong>Mean (± standard deviation) implanted ICL sphere was - 11.4 ± 1.87 D, and mean implanted ICL cylinder was 2.00 ± 0.81 D. Of the implanted ICL sizes, the majority of eyes received a 13.2-mm ICL (26 eyes, 54.2%) and a 12.6-mm ICL (20 eyes, 41.7%). At 12 months, uncorrected distance visual acuity (UDVA) was 20/20 or better in 83% of eyes, with a safety index of 1.21 and an efficacy index of 1.04. The mean absolute rotation at 12 months was 6.26 ± 6.57°, with no significant change between follow-up visits (all P > 0.05). A significant correlation was found between absolute rotation and ICL sphere, however, no significant correlations were observed between absolute rotation and preoperative sphere, white-to-white distance, anterior chamber angle, postoperative vault, or ICL size. At 1 week postoperatively, clockwise rotation occurred more frequently than counterclockwise rotation (P = 0.004), with no significant difference in rotation direction thereafter.</p><p><strong>Conclusion: </strong>Visian V4b TICLs demonstrate excellent visual and refractive outcomes with acceptable rotational stability over 12 months. Overall, TICLs remain a predictable option for the correction of moderate-to-high myopic astigmatism, with a low risk of clinically significant rotation.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2937-2951"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412553","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":"Nonpenetrating Deep Sclerectomy versus Conventional Surgery in Primary Congenital Glaucoma: a Systematic Review and Meta-analysis.","authors":"Abdullah M Khan, Ibrahim AlJadaan, Abdullah M Al-Omair, Dalal M A Motabagani, Ahmed Mousa, Gorka Sesma","doi":"10.1007/s40123-026-01443-9","DOIUrl":"10.1007/s40123-026-01443-9","url":null,"abstract":"<p><strong>Introduction: </strong>Primary congenital glaucoma (PCG) is a leading cause of irreversible childhood blindness, with elevated prevalence in consanguineous populations of the Middle East and Central Asia. Nonpenetrating deep sclerectomy (NPDS) is theoretically safer than conventional penetrating surgery, yet comparative evidence lacks systematic synthesis.</p><p><strong>Methods: </strong>We systematically searched seven databases through December 2025. Eligible studies compared NPDS with conventional surgery in children with PCG aged under 4 years with ≥ 6 months follow-up. Two reviewers independently screened and extracted data; risk of bias was assessed with ROBINS-I and RoB 2.0. A random-effects meta-analysis [REML with Hartung-Knapp-Sidik-Jonkman (HKSJ) correction] was performed.</p><p><strong>Results: </strong>Five studies [seven arms, 356 eyes; one randomized controlled trial (RCT), four observational] were included. Mean intraocular pressure (IOP) reduction was 10.34 mmHg (HKSJ 95% CI 7.54-13.14; 95% PI: 2.25-18.43 mmHg; I² = 97.2%, indicating substantial between-study variability driven primarily by differences in baseline IOP [β = +0.61 mmHg; P = 0.004], adjuvant use, and surgical technique; P < 0.001). Surgical success was achieved in 77.1% of eyes (95% CI 65.3-85.8%). Visual acuity improved by 0.329 LogMAR (approximately three Snellen lines; 95% CI 0.220-0.438; P = 0.001). The composite complication rate was 13.2% (95% CI 8.7-19.4%), with I² = 0% for hypotony, shallow anterior chamber, and hyphema. NPDS resulted in significantly fewer reinterventions (7.4% versus 14.1%; P = 0.046) and better corneal clarity preservation (92.4% versus 83.4%; P = 0.013) than non-NPDS procedures.</p><p><strong>Conclusions: </strong>Evidence comparing NPDS and conventional surgery in PCG remains limited. Surgery achieved a mean IOP reduction of 10.34 mmHg (HKSJ 95% CI 7.54-13.14), though estimates showed substantial heterogeneity (I² = 97.2%). While NPDS may be associated with lower reintervention rates and improved corneal clarity, no definitive differences in primary efficacy were observed. These findings require confirmation in well-designed prospective studies.</p><p><strong>Trial registration: </strong>PROSPERO registration: CRD420251121650.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2897-2917"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448683","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":"Paediatric Keratoconus: An ERN-EYE Clinical Consensus Statement on Diagnosis, Treatment and Follow-Up Care.","authors":"Luca Buzzonetti, Cosimo Mazzotta, Michele Iester, Mikk Pauklin, Daniel Boehringer, Reda Zemaitiene, Martino Vannucchi, Lidia Cocho, Pavel Studeny, Amélie Gavard, Cristina Monterosso, Dominique Bremond-Gignac, Manca Tekavcic Pompe, Jean-Louis Bourges, Petra Liskova","doi":"10.1007/s40123-026-01463-5","DOIUrl":"10.1007/s40123-026-01463-5","url":null,"abstract":"<p><p>This clinical consensus statement, developed through the European Reference Network for Rare Eye Diseases (ERN-EYE), provides recommendations for the diagnosis, monitoring and management of paediatric keratoconus. Paediatric keratoconus is a corneal ectasia that typically presents during childhood or adolescence, often advancing rapidly and significantly affecting visual development. Despite its impact, standardised paediatric-specific guidelines are lacking. A multidisciplinary panel of experts from across Europe contributed to this statement through a structured Delphi process. The consensus reviews the current understanding of the physiopathology, diagnostic criteria, risk factors and classification systems of paediatric keratoconus. It outlines strategies for early detection and monitoring, emphasises the role of patient and family education and presents current treatment approaches, with specific recommendations for paediatric care. The aim of this document is to guide ophthalmologists, paediatricians and associated professionals in delivering timely and appropriate care, improving outcomes for children with keratoconus across Europe.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2825-2861"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649125","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":"The Science and Clinical Evolution of Corneal Cross-Linking: Mechanism of Action, Ultra-Structural Changes, Clinical Indications, and Emerging Treatment Strategies.","authors":"Cosimo Mazzotta, Marco Lombardo, Alessandro Avitabile, Giovanni Alessio, Davide Borroni, Francesco D'Oria","doi":"10.1007/s40123-026-01450-w","DOIUrl":"10.1007/s40123-026-01450-w","url":null,"abstract":"<p><p>Keratoconus is the most common corneal ectatic disorder worldwide. Typically manifesting in adolescence, it imposes a substantial burden on quality of life and, if untreated, may progress to advanced stages requiring corneal transplantation. Riboflavin/UV-A corneal cross-linking (CXL) has become the cornerstone therapy for stabilizing corneal biomechanics and halting disease progression. CXL acts through UV-A photo-activated riboflavin-driven photochemistry that induces covalent cross-links within stromal proteins. Extensive theoretical, experimental, and clinical evidence has clarified its mechanism of action, demonstrating ultrastructural stromal reorganization, resulting in biomechanical stiffening and a sustained long-term effect. Over time, riboflavin ophthalmic formulations for CXL, delivery strategies, and treatment protocols have progressed and expanded beyond the epithelium-off approach to include safer and comparably effective transepithelial techniques. In addition, novel chemical cross-linkers are being investigated as non-light-based alternatives for corneal stabilization. Beyond corneal ectatic disorders, CXL is increasingly being explored for additional clinical indications, including infectious keratitis, bullous keratopathy, and inflammatory dry eye. This systematic review describes the most recent advances in understanding the mechanism of action of CXL and associated ultrastructural changes and synthesizes current evidence on the evolution of treatment protocols and their expanding clinical indications. By critically appraising available data, we aim to guide clinical decision-making and identify priorities toward safer, more effective, and individualized CXL therapies.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2863-2895"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148423005","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":"Prevalence and Visual Acuity Characteristics of Patients with Macular Telangiectasia.","authors":"Danah A Younis, Daniel X Chen, Siyan Chen, AnMarie Nguyen, Bobeck S Modjtahedi","doi":"10.1007/s40123-026-01452-8","DOIUrl":"10.1007/s40123-026-01452-8","url":null,"abstract":"<p><strong>Introduction: </strong>Macular telangiectasia (MacTel) is a neurodegenerative retinal disease with progressive visual decline. Contemporary prevalence estimates based on diverse patient populations are required to better understand this condition.</p><p><strong>Methods: </strong>This was a retrospective cross-sectional study conducted at Kaiser Permanente Southern California that included patients over 18 years of age who underwent ophthalmology or optometry evaluations between January 1, 2020 and September 1, 2025. The primary outcome was prevalence of macular telangiectasia (MacTel) based on clinician diagnoses. Secondary outcomes included mean visual acuity and distribution of visual acuity (≥ 20/25, ≥ 20/40, ≥ 20/80, ≥ 20/200, and < 20/200) analyzed separately for all eyes as well as better- and worse-seeing eyes. Logistic regressions were performed to compare prevalence between different demographic groups with calculation of adjusted prevalence rates and adjusted odds ratios (aOR).</p><p><strong>Results: </strong>Of 1,927,300 patients who had seen an eye care provider during the study period, 1224 were diagnosed with MacTel (prevalence 0.06%). The mean age of patients with MacTel was 65.5 years (SD 11.2). Compared to those between the ages of 18-39 (adjusted prevalence 0.01%), MacTel was more common in the 40-59 (adjusted prevalence 0.05%, OR 9.61 95% CI 6.39-14.45, p < 0.01) and ≥ 60 age groups (adjusted prevalence 0.10%, OR 20.36 95% CI 13.66-30.34, p < 0.001). MacTel was more common in women (adjusted prevalence 0.04%, OR 1.31 95% CI 1.17-1.47) and less common in non-white patients, with all comparisons except with Hispanic patients reaching statistical significance (white adjusted prevalence 0.05%, reference group; Asian adjusted prevalence 0.03%, OR 0.69, 95% CI 0.57-0.84, p < 0.001; Black adjusted prevalence 0.02%, OR 0.55 95% CI 0.43-0.71, p < 0.001; Hispanic adjusted prevalence 0.04%, OR 0.93, 95% CI 0.81-1.06, p = 0.27; other/unknown adjusted prevalence 0.03%, OR 0.74, 95% CI 0.58-0.95, p = 0.02). Mean visual acuity was 0.38 logMAR (~ 20/50) for all eyes, 0.23 logMAR (~ 20/40) in the better-seeing eye, and 0.53 logMAR (~ 20/70) in the worse-seeing eye. Among all eyes, 26.8% had VA ≥ 20/25, 58.3% ≥ 20/40, 85.0% ≥ 20/80, 94.6% ≥ 20/200, and 5.4% < 20/200.</p><p><strong>Conclusion: </strong>MacTel was identified in 0.06% of adults in this large diverse USA-based cohort. Visual acuity was symmetric between eyes, with an average of 20/40 in better-seeing eyes. These findings provide contemporary real-world data to inform clinical understanding and research. Demographic differences in disease prevalence highlight the need to ensure diverse patient representation in future studies and clinical outreach.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2971-2978"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437653","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":"Impact of an Ophthalmic Cooling Device on Corneal Immune and Sensory Nerve Features in Chronic Ocular Surface Pain: A Prospective, Feasibility Study.","authors":"Jeremy Chung Bo Chiang, Mengliang Wu, Ji-Hyun Lee, Alyssa Curkpatrick, Cristos Ifantides, Thanh Nguyen, Anat Galor, Helen Wu, Richard Lindstrom, Vance Thompson, Laura E Downie","doi":"10.1007/s40123-026-01454-6","DOIUrl":"10.1007/s40123-026-01454-6","url":null,"abstract":"<p><strong>Introduction: </strong>A safe and effective treatment for chronic ocular surface pain (COSP) remains an unmet need. This prospective feasibility study investigated the impact of an ophthalmic cooling device (ETX-4143) on ocular pain, as well as corneal nerve and immune cell features, in individuals with COSP.</p><p><strong>Methods: </strong>For this clinical trial (Clinicaltrials.gov:NCT07059754), the more symptomatic (study) eye was treated with the ETX-4143 device, involving two metallic probes, internally cooled by a -20 °C fluid, applied to the bulbar conjunctiva posterior to the limbus at 3 and 9 o'clock for 4 min, with a fellow (untreated) eye control. Ocular pain, best-corrected visual acuity (BCVA), tear osmolarity, corneal sensitivity, slit lamp biomicroscopy, ocular surface staining, and static and functional in vivo confocal microscopy (Fun-IVCM) were conducted at baseline and 2-, 6-, and 12-weeks posttreatment. Corneal nerve and immune cell parameters were quantified.</p><p><strong>Results: </strong>Five eligible participants were enrolled and completed the study (mean age 66.4 ± 9.9 years, 60% female/40% male). Relative to baseline, ocular pain, measured with the Chronic Ocular Pain Questionnaire (COP-Q) Eye Pain Severity Module, was significantly lower at 2 weeks (mean change -4.4 units, 95% CI -7.4 to -1.4, P = 0.02), 6 weeks (-5.0 units, 95% CI -7.0 to -3.0, P = 0.002), and 12 weeks posttreatment (-5.8 units, 95% CI -7.8 to -3.8, P = 0.001); benefit progressed with time. Clinical ocular surface signs, BCVA, and corneal nerve morphology remained stable. In the study eye, corneal Fun-IVCM showed an increase in putative intraepithelial T-cell motility up to 6 weeks posttreatment (P < 0.001), followed by a reduction at 12 weeks (P = 0.03) that was accompanied by reduced probing of putative dendritic cells (P = 0.049), relative to baseline.</p><p><strong>Conclusions: </strong>The ETX-4143 device showed a favorable safety profile, including preserved corneal nerve morphology, while improving pain outcomes and modulating corneal immune dynamics up to 12 weeks posttreatment, acknowledging these findings are exploratory. Randomized controlled trials are warranted to evaluate treatment efficacy and mechanisms.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, NCT07059754.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2979-2996"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448667","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}