Ophthalmology and Therapy最新文献

{"title":"Evaluating the Efficacy of Large Language Models in Guiding Treatment Decisions for Pediatric Refractive Error.","authors":"Daohuan Kang, Hongkang Wu, Lu Yuan, Wenyue Shen, Jia Feng, Jiao Zhan, Andrzej Grzybowski, Wen Sun, Kai Jin","doi":"10.1007/s40123-025-01105-2","DOIUrl":"10.1007/s40123-025-01105-2","url":null,"abstract":"<p><strong>Introduction: </strong>Effective management of pediatric myopia, which includes treatments like corrective lenses and low-dose atropine, requires accurate clinical decisions. However, the complexity of pediatric refractive data, such as variations in visual acuity, axial length, and patient-specific factors, pose challenges to determining optimal treatment. This study aims to evaluate the performance of three large language models in analyzing these refractive data.</p><p><strong>Methods: </strong>A dataset of 100 pediatric refractive records, including parameters like visual acuity and axial length, was analyzed using ChatGPT-3.5, ChatGPT-4o, and Wenxin Yiyan, respectively. Each model was tasked with determining whether intervention was needed and subsequently recommending a treatment (eyeglasses, orthokeratology lens, or low-dose atropine). The recommendations were compared to professional optometrists' consensus, rated on a 1-5 Global Quality Score (GQS) scale, and evaluated for clinical safety utilizing a three-tier accuracy assessment.</p><p><strong>Results: </strong>ChatGPT-4o outperformed both ChatGPT-3.5 and Wenxin Yiyan in determining intervention needs, with an accuracy of 90%, significantly higher than Wenxin Yiyan (p < 0.05). It also achieved the highest GQS of 4.4 ± 0.55, surpassing the other models (p < 0.001), with 85% of responses rated as \"good\" ahead of ChatGPT-3.5 (82%) and Wenxin Yiyan (74%). ChatGPT-4o made only eight errors in recommending interventions, fewer than ChatGPT-3.5 (12) and Wenxin Yiyan (15). Additionally, it performed better with incomplete or abnormal data, maintaining higher quality scores.</p><p><strong>Conclusion: </strong>ChatGPT-4o showed better accuracy and clinical safety, making it a promising tool for decision support in pediatric ophthalmology, although expert oversight is still necessary.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"705-716"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476793","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":"Ocular Manifestations and Pathological Features in Goldenhar Syndrome: A 10-Year Retrospective Study.","authors":"Fei Fang, Tingxi A, Siyi Zhang, Liangbo Chen, Junzhao Chen, Yang Lu, Chunyi Shao, Yao Fu","doi":"10.1007/s40123-025-01100-7","DOIUrl":"10.1007/s40123-025-01100-7","url":null,"abstract":"<p><strong>Introduction: </strong>This study characterized the ocular manifestations and associated pathological features in a large cohort of patients diagnosed with Goldenhar syndrome (GS).</p><p><strong>Methods: </strong>Patients diagnosed with GS at the Department of Ophthalmology at Shanghai Ninth People's Hospital between 2014 and 2023 were retrospectively identified. Each patient underwent a standardized ophthalmological assessment and relevant tests. Epibulbar choristomas and eyelid colobomas were further categorized into different clinical groups, and their incidence rates and associated pathological features were evaluated.</p><p><strong>Results: </strong>A total of 72 patients diagnosed with GS (98 affected eyes) were included. The most prevalent ocular manifestations were epibulbar choristoma (94.44%) and upper eyelid coloboma (50%). Epibulbar choristomas were classified into four groups, with group II epibulbar choristomas being the most common (29.79%). The pathological features of the epibulbar choristomas varied significantly with location (p < 0.001): the choristomas located at the limbus were all dermoids (100%); lipodermoid was the most prevalent type located at the conjunctiva (40%); and dermoid was the predominant type of choristoma involving both the limbus and conjunctiva (50%), followed by lipodermoid (27.27%) and complex choristoma (22.73%). Upper eyelid colobomas were predominantly unilateral, with mild, moderate, and severe defects in 32.5%, 52.5%, and 15% of the cases, respectively. There was a significant coincidence and severity association between upper eyelid colobomas and epibulbar choristomas (p < 0.05).</p><p><strong>Conclusions: </strong>Our study represents the largest reported case series of GS to date and highlights the prevalence of epibulbar choristomas and upper eyelid colobomas. While the predominant pathological type of epibulbar choristomas overall is dermoid, distinct pathological features have been correlated with their anatomic location or clinical group. Upper eyelid colobomas tended to be located on the inner side, often presenting as mild-to-moderate defects and frequently co-occurring with epibulbar choristomas.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"643-657"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399621","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":"Artificial Intelligence-Based Uveitis Diagnosis Through Retinal Vasculature Analysis: A Paradigm Shift in Ocular Tuberculosis.","authors":"Ikhwanuliman Putera, Jose D Vargas Quiros, Saskia M Rombach, Willem A Dik, P Martin van Hagen, Rina La Distia Nora","doi":"10.1007/s40123-025-01103-4","DOIUrl":"10.1007/s40123-025-01103-4","url":null,"abstract":"<p><strong>Introduction: </strong>Diagnosis of uveitis is complex and often requires a series of investigations. Here, we utilize artificial intelligence (AI) for the quantitative analysis of retinal vasculature parameters from fundus photographs to differentiate confirmed ocular tuberculosis (TB) from QuantiFERON (QFT)-positive uveitis without another identifiable cause and ocular toxoplasmosis.</p><p><strong>Methods: </strong>Medical records and stored fundus images of patients with uveitis from a cohort at the Department of Ophthalmology, University of Indonesia, were analyzed. Three groups of patients were included: confirmed ocular TB (group A), QFT-positive uveitis (group B), and ocular toxoplasmosis (group C). Fundus images were processed using the Retinalysis models package for segmentation and quantification of retinal vasculature parameters.</p><p><strong>Results: </strong>The study included nine patients (13 eyes) in group A, 38 patients (48 eyes) in group B, and 26 patients (39 eyes) in group C. Significant differences were found in vein tortuosity parameter, in the eyes within group A showing lower tortuosity score compared to eyes within group B (p = 0.030) and group C (p = 0.013). The area under the curve (AUC) of vein tortuosity for group A compared to group B was 0.749 (95% confidence interval (CI): 0.606-0.892), with a sensitivity of 67.3% and specificity of 76.9%. The AUC of vein tortuosity for group A against group C was 0.803 (95% CI: 0.658-0.948), with a sensitivity of 74.4% and a specificity of 84.6%. In group A, uveitis resolution and vein tortuosity tended to be normalized upon complete antitubercular treatment.</p><p><strong>Conclusions: </strong>AI-based quantification of retinal vasculature parameters, particularly vein tortuosity, can differentiate confirmed ocular TB from QFT-positive uveitis and ocular toxoplasmosis. This approach shows promise for more precise diagnostic and therapeutic accuracy in ocular TB.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"717-732"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483600","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":"Enhancing Precision and Clarity with New Digital Color Assistant in 3D Heads-Up Vitreoretinal Surgery.","authors":"Rodolfo Mastropasqua, Alberto Quarta, Maria Ludovica Ruggeri, Leonardo Mastropasqua","doi":"10.1007/s40123-025-01106-1","DOIUrl":"10.1007/s40123-025-01106-1","url":null,"abstract":"<p><strong>Introduction: </strong>To describe the advantages of the ARTEVO^® 850 digital color assistant (DCA) for enhancing visualization during vitreoretinal surgery.</p><p><strong>Methods: </strong>All surgical procedures were conducted under the expertise of a single surgeon utilizing the ARTEVO^® 850 heads-up microscope from ZEISS. During the surgeries, images were contemporaneously recorded with and without the application of the DCA across key phases: core vitrectomy, peripheral vitrectomy, epiretinal membrane (ERM) peeling, and internal limiting membrane (ILM) peeling. This approach enabled a direct comparison to evaluate the impact of the filter on visualization quality during each specific surgical maneuver.</p><p><strong>Results: </strong>The application of the \"vitrectomy blue\" filter on the ARTEVO^® 850 surgical microscope provided advantages, particularly during core and peripheral vitrectomy. The \"vitrectomy blue\" filter improved visualization of the vitreous, allowing for clearer identification and removal of residual vitreous strands and opacities. In surgeries involving ERM, the \"peeling blue\" filter provided enhanced contrast and clarity in visualizing the membrane, facilitating thorough peeling. Furthermore, when used in conjunction with dye staining techniques, it further amplified the visualization of ERM in high myopic eyes. This combination reduced the need for additional re-staining during surgery, streamlining the procedure and potentially minimizing intraoperative complications related to dye toxicity. In macular hole surgery, the \"peeling blue\" filter contributed to improving the characterization and delineation of the hole edges and surrounding tissues.</p><p><strong>Conclusions: </strong>The ARTEVO^® 850 DCA can potentially enhance tissue visualization during vitreoretinal surgeries, particularly in scenarios with compromised visibility. Our observation underscored the efficacy of the blue filter in improving the clarity and contrast of vitreous, ERM and macular hole visualization. This enhancement was particularly evident when the DCA was used in combination with dye staining techniques, which further improved the visualization of ERM in high myopic eyes.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"805-814"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441639","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":"Efficacy, Safety, and Injection Frequency with Novel Aflibercept 8 mg in Neovascular Age-Related Macular Degeneration: A Comparison with Existing Anti-VEGF Regimens Using a Bayesian Network Meta-Analysis.","authors":"Piotr Wojciechowski, Marlena Wdowiak, Malgorzata Panek, Izabella Lunk, Joao Carrasco, Xin Zhang, Olivia Wu, Jean-François Korobelnik, Paolo Lanzetta","doi":"10.1007/s40123-025-01098-y","DOIUrl":"10.1007/s40123-025-01098-y","url":null,"abstract":"<p><strong>Introduction: </strong>Aflibercept 8 mg administered in extended dosing intervals has shown non-inferior visual gains and comparable safety profile to aflibercept 2 mg in the PULSAR pivotal randomized clinical trial and has the potential to reduce the treatment burden of treating neovascular age-related macular degeneration (nAMD). This study aimed at gathering robust evidence to assess the comparative efficacy, safety, and treatment burden of aflibercept 8 mg against other anti-vascular endothelial growth factor (VEGF) agents as ranibizumab, brolucizumab, faricimab, and bevacizumab in patients with nAMD.</p><p><strong>Methods: </strong>A systematic literature review (SLR) was conducted, targeting clinical trials of anti-VEGF agents in patients with nAMD. The results of the SLR were included in a network meta-analysis (NMA) comparing aflibercept 8 mg to other anti-VEGF treatments in nAMD, considering a 1-year time horizon. Treatment efficacy was assessed based on the change in best-corrected visual acuity (BCVA) from baseline, the proportion of patients gaining or losing 15 Early Treatment Diabetic Retinopathy Study (ETDRS) letters and changes in anatomical outcomes measured as change in central retinal thickness (CRT) or central subfield thickness (CST). Safety was assessed considering the incidence of ocular and non-ocular adverse events. Treatment burden was defined as the mean number of intravitreal injections over the study period.</p><p><strong>Results: </strong>The base-case NMA involving 21 studies did not show significant differences between aflibercept 8 mg and comparators regarding BCVA change from baseline and proportion of patients with a gain or loss of ≥ 15 letters. On the anatomical endpoints, aflibercept 8 mg was associated with statistically significant improvement in CRT/CST change from baseline compared with ranibizumab in fixed and pro re nata regimens. No significant differences were identified versus the other anti-VEGF. The analysis of the safety outcomes did not identify any significant differences between aflibercept 8 mg and any of the comparators. During the first year of treatment, patients treated with aflibercept 8 mg (following 12- or 16-week injection intervals) received on average 5.9 and 5.1 injections, respectively. For the same period, patients treated with faricimab received from 6.2 to 6.7 injections, patients treated with ranibizumab from 7.62 to 12.14 injections, and patients treated with aflibercept 2 mg up to 7.67 injections.</p><p><strong>Conclusion: </strong>Aflibercept 8 mg demonstrates a comparable efficacy and safety to currently available anti-VEGF treatments for nAMD, with the potential added benefit of requiring fewer injections. These results suggest that aflibercept 8 mg could be a favourable treatment option for nAMD, achieving sustained disease control while alleviating the burden of injections on patients, caregivers, and healthcare providers.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"733-753"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493162","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":"Use of an Eyelid Pressure Patch Concomitantly with a Decellularized Dehydrated Amniotic Membrane for Ocular Surface Disease Management.","authors":"Kyle Linsey","doi":"10.1007/s40123-025-01094-2","DOIUrl":"10.1007/s40123-025-01094-2","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent corneal epithelial defects (PCEDs) occur when conditions like dry eye disease (DED), neurotrophic keratitis (NK), and limbal stem cell deficiency impair corneal healing, leading to risks of infection, scarring, or perforation. Decellularized, dehydrated pure amniotic membrane basement membrane (AMBM) supports healing by promoting cell adhesion, growth, and inflammation reduction. Eyelid pressure patching helps stabilize the AMBM, protects the cornea, and enhances its therapeutic effects.</p><p><strong>Methods: </strong>This retrospective study analyzed 144 eyes treated with either a single-layer or three-layer decellularized AMBM combined with a 24-h eyelid pressure patch.</p><p><strong>Results: </strong>Of the patients included, 90% received a single-layer AMBM and 10% a three-layer AMBM. In the single-layer group, 100% of cases showed complete healing and AMBM dissolution. In the three-layer group, 100% showed corneal staining improvement, but 20-30% of the AMBM remained undissolved. No patients reported experiencing pain, discomfort, or infection.</p><p><strong>Conclusions: </strong>Combining eyelid pressure patching with amniotic membrane treatment is a safe and effective approach for healing persistent corneal epithelial defects.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"573-584"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080308","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":"Safety and Efficacy of Lotilaner Ophthalmic Solution (0.25%) in Treating Demodex Blepharitis: Pooled Analysis of Two Pivotal Trials.","authors":"Elizabeth Yeu, James D Paauw, Patrick Vollmer, Gregg J Berdy, William E Whitson, John Meyer, Blake Simmons, Jared D Peterson, Laura M Periman, Blair E Boehmer, Marc R Bloomenstein, Walter O Whitley, Cecelia Koetting, Kavita Dhamdhere, Sesha Neervannan, Joseph B Ciolino","doi":"10.1007/s40123-024-01089-5","DOIUrl":"10.1007/s40123-024-01089-5","url":null,"abstract":"<p><strong>Introduction: </strong>Lotilaner ophthalmic solution (0.25%) is the first United States Food and Drug Administration (US FDA)-approved drug for treating Demodex blepharitis. In pivotal trials, it was found to be well tolerated and demonstrated a significant reduction in collarettes and mite density after a 6-week treatment regimen. This study aimed to report the safety and efficacy profile of lotilaner ophthalmic solution (0.25%) from a pooled analysis of two pivotal trials in patients with Demodex blepharitis.</p><p><strong>Methods: </strong>Pooled data were analyzed from two randomized, double-masked, vehicle-controlled clinical trials [phase 2b/3 Saturn-1 (NCT04475432) and phase 3 Saturn-2 (NCT04784091)] in which patients with Demodex blepharitis were randomly assigned in a 1:1 ratio to receive either lotilaner ophthalmic solution (0.25%) (study group) or the vehicle formulation without lotilaner (control group), twice daily for 6 weeks. The outcome measures were the proportion of patients with 0-2 collarettes (grade 0 collarettes), mite eradication, erythema cure, and the proportion of patients with ≤ 10 collarettes (grade 0 or 1 collarettes) at day 43.</p><p><strong>Results: </strong>Overall, 833 participants were randomized to receive either the study drug (N = 415) or vehicle (N = 418). On day 43, 49.8% of patients in the study group vs. 9.9% in the control group (p < 0.0001) had collarette grade 0 (0-2 collarettes). A reduction to ≤ 10 collarettes (grade 0 or 1 collarettes) was achieved in 85.1% of patients in study group vs. 28.0% in control group (p < 0.0001). The proportion of patients achieving mite eradication (60.2% vs. 16.1%, p < 0.0001) and erythema cure (24.9% vs. 7.9%, p < 0.0001) were also statistically significantly higher in the study group compared to the control group. The rates of adverse events were low in both studies, with no serious drug-related ocular adverse events reported. As many as 92% of patients rated the study drop as neutral to very comfortable.</p><p><strong>Conclusions: </strong>Twice-daily treatment with lotilaner ophthalmic solution (0.25%) for 6 weeks demonstrated statistical significance for all outcome measures compared to the vehicle control, with low rates of adverse events and a high rate of drop comfort.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"555-571"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053090","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":"Treatment Interval Progression and Adherence to Observe-and-Plan Regimen for Neovascular Age-Related Macular Degeneration Treated with Aflibercept 2 mg.","authors":"Leyla Turan, Andreas Arnold-Vangsted, Morten la Cour, Delila Hodzic-Hadzibegovic, Javad N Hajari, Oliver N Klefter, Miklos Schneider, Yousif Subhi","doi":"10.1007/s40123-025-01095-1","DOIUrl":"10.1007/s40123-025-01095-1","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment burden of anti-vascular endothelial growth factor (VEGF) therapy for neovascular age-related macular degeneration (AMD) can be reduced with the Observe-and-Plan (O&P) regimen, which allows for an individualized treatment while reducing the number of injections and assessment visits. In this study, we evaluate detailed characteristics of treatment interval adjustment through individual follow-ups and evaluate adherence to the O&P regimen in a real-world setting in one of the largest centers in Europe.</p><p><strong>Methods: </strong>This was a retrospective cohort study of treatment-naïve eyes with neovascular AMD that were treated with intravitreal aflibercept 2 mg in an O&P regimen who had persisting exudation after completion of loading dose. We evaluated decisions on adjustment of treatment intervals and adherence to the O&P regimen from a total of 5 follow-up visits. Data from visits and decision on treatment intervals were extracted from a treatment database.</p><p><strong>Results: </strong>A total of 561 eyes were eligible for this study. Treatment intervals gradually increased from a 4-weeks interval (loading dose) to a wide distribution of intervals from 4-weeks to 12-weeks, and at the 5th follow-up 24.9% were followed without any treatment. In total, 209 eyes (49.5%) at the 5th follow-up (of 422 eyes present at the 5th follow-up) adhered to the treatment algorithm.</p><p><strong>Conclusion: </strong>Aflibercept 2 mg in an O&P treatment regimen leads to a variety of treatment intervals, and some eyes may be overtreated. An important proportion of eyes deviate from the intended O&P treatment regimen. Our study contributes to understanding real-world implications of personalized treatment regimens.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"585-597"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080307","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":"Third-Generation Trabecular Micro-Bypass Implantation with Phacoemulsification for Glaucoma.","authors":"Zachary Vest, Nadia Alinaghizadeh, Connor Prendergast","doi":"10.1007/s40123-024-01087-7","DOIUrl":"10.1007/s40123-024-01087-7","url":null,"abstract":"<p><strong>Introduction: </strong>This retrospective, consecutive, real-world case series assessed the efficacy and safety of third-generation trabecular micro-bypass stent implantation (iStent infinite) with phacoemulsification in patients with mild-to-moderate primary open-angle glaucoma (POAG).</p><p><strong>Methods: </strong>Patients underwent phacoemulsification combined with implantation of iStent infinite (containing three stents) by a single U.S. glaucoma surgeon. Outcomes through 12 months included mean intraocular pressure (IOP) and medications; proportions of eyes with IOP ≤ 18 mmHg, ≤ 15 mmHg, or ≤ 12 mmHg; proportions of eyes on 0, 1, 2, or ≥ 3 topical glaucoma medications; adverse events; and secondary glaucoma procedures. Data are presented for the observed cohort of all available eyes at each time point and the consistent cohort of eyes with data at 12 months postoperative.</p><p><strong>Results: </strong>A total of 121 eyes with mild (66.1%) or moderate (33.9%) POAG underwent iStent infinite implantation between February 2023 and June 2024. In eyes with 12-month follow-up data (n = 32), mean IOP reduced from 18.1 ± 3.3 mmHg preoperatively to 13.8 ± 3.4 mmHg at 12 months (23.8% reduction, p < 0.001), while mean number of medications reduced from 1.38 ± 0.91 to 1.06 ± 1.13 medications (23.2% reduction, p = 0.023). The proportions of eyes achieving IOP ≤ 18/15/12 mmHg increased from 53.1%/21.9%/3.1% preoperatively to 87.5%/75.0%/43.8% at 12 months, respectively (all p < 0.01). Adverse events were largely mild and transient; three eyes (< 3%) had secondary laser or micro-invasive glaucoma interventions due to IOP and/or medications above goal.</p><p><strong>Conclusions: </strong>iStent infinite implantation with cataract surgery resulted in clinically and statistically significant IOP and medication reductions through 12 months postoperative, with favorable safety. This cohort constitutes one of the first and largest published datasets for this device in combination with cataract surgery in real-world usage.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"529-539"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984425","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":"Surgical Parameters and Prognostic Factors in Persistent Fetal Vasculature: Insights from a Retrospective Cohort Study.","authors":"Fatima AlGhazal, Valmore A Semidey, Marcos J Rubio-Caso, Sulaiman M AlSulaiman, Gorka Sesma","doi":"10.1007/s40123-024-01088-6","DOIUrl":"10.1007/s40123-024-01088-6","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent fetal vasculature (PFV) is a congenital anomaly associated with significant surgical challenges, including a high risk of postoperative retinal detachment (RD). This study aimed to evaluate the impact of surgical approach and axial length (AL) on RD risk and visual outcomes in pediatric PFV management.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted involving 76 eyes of 74 patients who underwent cataract surgery for PFV between 2014 and 2022. Patients were categorized by RD status postoperatively (14 with RD, 62 without RD). Key predictors, including surgical approach (corneal vs. pars plicata), AL, and age at surgery, were analyzed. The primary outcomes were RD incidence and final best-corrected visual acuity (BCVA).</p><p><strong>Results: </strong>Compared to the pars plicata approach, the corneal approach was associated with a significantly lower risk of RD, as indicated by a multivariate odds ratio of 0.08 (95% CI 0.01-0.6, P = 0.011). A shorter AL increased the risk of RD (median 17 vs. 20 mm, P = 0.002). The RD group showed poorer visual outcomes (P < 0.001), with a 71% loss of light perception. Surgery before 3 months improved outcomes, regardless of RD. Visible ciliary processes were strongly correlated with RD (P < 0.001).</p><p><strong>Conclusions: </strong>Corneal surgical approach and longer AL are associated with a lower RD risk in PFV cataract surgery. Early intervention and thorough preoperative assessment of the AL and ciliary processes are crucial for optimal outcomes.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"515-528"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984419","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}