Ophthalmic Research最新文献

{"title":"Exploring the causal relationship between vitamin D levels and deficiency with the risk of cataract: A Mendelian Randomisation study.","authors":"Munisa Hashimi, Hasnat A Amin, Alexander C Day, Fotios Drenos","doi":"10.1159/000545332","DOIUrl":"https://doi.org/10.1159/000545332","url":null,"abstract":"<p><strong>Background: </strong>Previous observational studies have suggested an association between vitamin D levels and the risk of cataracts. Whilst this correlation has been well reported, there is a lack of causal evidence.</p><p><strong>Methods: </strong>We first conducted an observational study using UK Biobank (UKBB) data to explore the correlation between vitamin D levels and deficiency with incident cataract. To assess causality, we then performed both one-sample and two-sample Mendelian Randomisation (MR) analyses. The one-sample MR used genetic risk scores (GRS) reflecting a genetic predisposition to higher vitamin D levels and vitamin D deficiency, examining its association with incident cataract. The two-sample MR, publicly available summary statistics for vitamin D levels and deficiency were used to investigate their relationship with cataract. Sensitivity analyses using a UKBB meta-analysis for vitamin D in a two-sample MR and a gene-focused analysis using variants in genes with a known role in vitamin D metabolism.</p><p><strong>Results: </strong>The observational analysis showed a statistically significant relationship between both vitamin D levels (OR = 0.998, ln(OR)SE = 3.23x10-4, p = 6.72x10-14) and deficiency (OR = 1.237, ln(OR)SE = 0.022, p = 9.05x10-23) with incident cataract risk. However, there was insufficient evidence to suggest an association between vitamin D supplementation and cataract risk (OR = 0.971, ln(OR)SE = 0.016, p = 0.057). Furthermore, no evidence was found in our one-sample MR analysis to suggest a causal relationship between vitamin D levels (OR = 1.001, ln(OR)SE = 0.002, p = 0.541) or vitamin D deficiency (OR = 1.095, ln(OR)SE = 0.145, p = 0.534) and incident cataract. The inverse variance weighted two-sample MR analysis also showed no evidence to suggest a causal association between vitamin D levels (IVW: OR = 1.122, 95% CI: 0.968-1.301, p = 0.125) or deficiency (IVW: OR= 0.987, 95% CI: 0.959-1.015, p = 0.344) and cataract risk, with consistent results observed using a multi-ethnic cataract cohort. Some evidence was observed between vitamin D levels and increasing cataract risk (Weighted median OR = 1.076, 95% CI: 1.002-1.156, p = 0.045), however, due to sample overlap between the exposure and outcome, datasets should be interpreted with caution.</p><p><strong>Conclusion: </strong>Whilst we identified a correlative association between vitamin D levels and cataract, we found no robust evidence to support a causal relationship between vitamin D levels and deficiency with cataract risk.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":" ","pages":"1-18"},"PeriodicalIF":2.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of localized retinal sensitivities with SD-OCT derived morphologic data in macular subfields in age-related macular degeneration.","authors":"Philipp Anders, Lisa-Marie Anders, Ana Rita Santos, Inês P Marques, Ana C Almeida, Stefan Futterknecht, Maximilian Pfau, Katja Hatz, José Cunha-Vaz, Hendrik P N Scholl, Conceição Lobo, Rufino Silva, Joaquim N Murta","doi":"10.1159/000546990","DOIUrl":"https://doi.org/10.1159/000546990","url":null,"abstract":"<p><p>Introduction This study investigated microperimetry-derived retinal sensitivity and OCT-based macular morphologic data in eyes with early and intermediate age-related macular degeneration. The respective metrics were compared between macular subfields and their associations were determined. Detailed knowledge of functional associations with morphology is an asset to future therapeutic trial design. Methods This is a cross-sectional analysis of microperimetry and SD-OCT baseline data. OCT data were segmented automatically within the HEYEX software (Heidelberg Engineering). Data were assessed for Gaussian normal distribution by the D'Agostino and Pearson test, and appropriate comparison tests were performed for parametric and nonparametric data. The association of retinal sensitivity metrics with OCT morphologic data was tested with mixed-effects models. Results In total, 19 eyes of 19 participants (75±6.4 years) with early and intermediate AMD were included in the analysis. Both in mesopic (p<0.05) and in scotopic red (p<0.001) microperimetry, retinal sensitivities differed significantly between macular subfields in ANOVA. Nasal and temporal subfields showed the highest retinal sensitivities, also compared to the central subfield. Generally, subfields within the 1mm to 2mm diameter ring showed higher retinal sensitivities than subfields within the 2mm to 3mm diameter ring. Superior subfields demonstrated higher retinal sensitivity than inferior subfields in mesopic microperimetry. RPE thickness was mostly negatively associated with retinal sensitivity, which was pronounced in the ETDRS inner ring inferior subfield and for mesopic retinal sensitivity (t-value, P-value: -3.7, <0.01). In the center position inner retinal thickness was negatively associated with mesopic retinal sensitivity (t-value, P-value: -2,2, <0.05). Conclusion Retinal layer thicknesses and their associations with retinal sensitivity show localized differences between macular subfields in early and intermediated AMD. An analysis including more subjects is necessary to confirm these trends. This knowledge is of importance since therapeutic trial design requires detailed morphologic but also functional conception in order to detect therapeutic effects and pass regulatory hurdles.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":" ","pages":"1-18"},"PeriodicalIF":2.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Correlated Color Temperature of OLED Lighting on Near Work-induced Transient Myopia and Accommodation Lag during Reading.","authors":"Weiling Bai, Shifei Wei, Jiahe Gan, Wenzai An, Xintong Liang, Zhining Cai, Yunyun Sun, Shi-Ming Li, Ningli Wang","doi":"10.1159/000546989","DOIUrl":"https://doi.org/10.1159/000546989","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of different correlated color temperatures (CCT) of organic light-emitting diode (OLED) lighting on accommodative lag (LAG) and near work-induced transient myopia (NITM).</p><p><strong>Methods: </strong>The refractions of 31 young adults (11 male) were measured with an open-field autorefractor at 33 cm after 30 and 60 minutes of reading under 4274 K and 1877 K. The initial NITM and LAG were assessed objectively at baseline and every 30 minutes. The use of two CCTs was determined in the order of the random number table.</p><p><strong>Results: </strong>After reading under for 30 minutes, the mean LAG for low-CCT lighting was slightly lower than the high-CCT lighting (-0.97 ± 0.53 D vs -1.21 ± 0.50 D, P = 0.10); after reading for 60 minutes, the difference was significant (-1.09 ± 0.55 D vs -1.36 ± 0.51 D, P = 0.048). When grouped according to the degree of myopia, both mild myopes (-1.11 ± 0.43 vs -1.38 ± 0.60 after 30-minute reading, P = 0.38; -1.34  ± 0.27 vs -1.5  ± 0.54 after 60-minute reading, P = 0.53) and moderate myopes (-0.90 ± 0.57 vs -1.12 ± 0.42 after 30-minute reading, P = 0.16; -0.96  ± 0.61 vs -1.28  ± 0.50 after 60-minute reading, P = 0.05) presented lower LAG magnitude under low-CCT lighting than high-CCT lighting, while the difference was not significant. As for NITM, no significant difference has been found between two CCTs in any group.</p><p><strong>Conclusion: </strong>Reading under low-CCT lighting (1877 K) had a lower LAG magnitude than reading under high-CCT lighting (4274 K), suggesting the potential usefulness of low-CCT lighting for reducing LAG magnitude during near work.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":" ","pages":"1-15"},"PeriodicalIF":2.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Anisometropic Amblyopia Associated with Unilateral High Myopia in Children with Modified Posterior Scleral Reinforcement.","authors":"Minshu Wang, Xuran Dong, Jing Liu, Juan Bu","doi":"10.1159/000546921","DOIUrl":"https://doi.org/10.1159/000546921","url":null,"abstract":"<p><p>Objectives The aim of the study was to investigate the effect of modified posterior scleral reinforcement (PSR) surgery combined with comprehensive amblyopia training in children with high myopia-related anisometropic amblyopia. Methods In this retrospective study, 24 eyes with high myopic amblyopia underwent modified PSR surgery and 20 eyes without surgery were recruited as control group. The best-corrected visual acuity (BCVA), cycloplegic spherical equivalent (SE) and axial length (AL) were evaluated at the beginning of the study before operation and at the three years follow-up. Results The BCVA was significantly improved (P<0.001), whilst the myopic SE elevation (P<0.001) and AL elongation (P<0.001) were significantly attenuated in the PSR group compared to the control group at 3-year follow-up. Regarding the therapeutic effect of amblyopia, the curative ratio in the PSR group was significantly superior (P<0.001). In patients with different degree of amblyopia, BCVA improvement in the PSR group was significantly larger while more significance was recorded in the severe amblyopia group. For both preschoolers (age<6) and schoolchildren (age≥6), AL growth was significantly attenuated in the PSR group (age<6: P<0.01; age≥6: P<0.05). Meanwhile in the PSR group, the improvement in BCVA was significantly higher in younger preschoolers (P<0.05), while more significance was recorded in control group. Conclusion PSR surgery combined with comprehensive amblyopia training may be an effective strategy for the treatment of high myopia-related anisometropic amblyopia.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":" ","pages":"1-15"},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aqueous Humor Cytokine Levels as Prognostic Factors for Ultrasound Cycloplasty Outcomes in Primary Glaucoma Patients.","authors":"Huangyang Shi, Yao Liu, Yanlin Li, Yingjie Li, Ling Jin, Yuan Liu, Ni Guo, Wei Huang, Zhihong Huang, Huishan Lin, Yue Dong, Nachuan Luo, Yuheng Tan, Xin Ma, Jian Ge, Mingkai Lin, Chengguo Zuo","doi":"10.1159/000546980","DOIUrl":"https://doi.org/10.1159/000546980","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the levels of 40 cytokines in the aqueous humor (AH) and their correlation with ultrasound cycloplasty (UCP) outcomes in patients with primary glaucoma.</p><p><strong>Methods: </strong>Aqueous humor samples were collected from 38 primary glaucoma patients after UCP procedure. The cytokines were measured via antibody arrays and evaluated via Cox proportional hazards regression to determine the UCP outcomes. Follow-up visits were performed at 1 day, 1 week, and 1 and 3 months postoperatively. The study subjects were allocated into success and failure groups based on surgical results.</p><p><strong>Results: </strong>Significantly high MCP-1 (P=0.034) and TGF-β1 levels (P=0.041) were observed in the failure group. Both univariate and multivariate analyses indicated that high MCP-1 (P=0.040, P=0.018) and TGF-β1 (P=0.049, P=0.041) levels were significant risk factors for UCP failure. The levels of MCP-1 were positively correlated with intraocular pressure (IOP) at 1 day (r=0.416, P=0.010) and 3 months (r=0.329, P=0.044) postoperatively.</p><p><strong>Conclusions: </strong>In primary glaucoma patients, high postoperative levels of MCP-1 and TGF-β1 were significant risk factors for UCP failure. MCP-1 levels in the AH could be a potential indicator for predicting postoperative IOP.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":" ","pages":"1-23"},"PeriodicalIF":2.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"B7-H3 Exacerbates Laser-induced Choroidal Neovascularization by Promoting Macrophage Recruitment and Polarization via S100A8/A9.","authors":"Xianbin Yuan, Hongya Wu, Hang Ren, Bo Jiang, Weiming Liu, Qingying Yao, Jie Wu, Gaoqin Liu, Peirong Lu","doi":"10.1159/000546556","DOIUrl":"https://doi.org/10.1159/000546556","url":null,"abstract":"<p><p>Background This study investigates the role of the immune costimulatory factor B7-H3 in laser-induced choroidal neovascularization (CNV) and its underlying molecular mechanisms. Methods A CNV model was established in C57BL/6J mice to examine the temporal expression dynamics of B7-H3 in choroidal tissues. B7-H3 knockout (B7-H3-KO) mice were used to assess CNV lesion size compared to wild-type (WT) controls after laser induction. RNA sequencing and xCELL analysis were performed to identify differentially expressed genes and immune cell infiltration patterns. Additionally, in vitro experiments using culture supernatants from murine B7-H3+/- peritoneal macrophages were conducted to evaluate B7-H3's role in angiogenesis using bEnd.3 endothelial cells. Results B7-H3 expression in the CNV model exhibited an initial upregulation followed by a decline. CNV lesions were significantly smaller in B7-H3-KO mice (1.47 × 106 ± 0.21 × 106 µm2, P < 0.001) and in mice receiving intravitreal injections of B7-H3 monoclonal antibody (2.29 × 106 ± 0.21 × 106 µm2, P < 0.05) compared to WT controls (3.46 × 106 ± 0.41 × 106 µm2). Transcriptomic and xCELL analyses revealed reduced M2 macrophage infiltration and downregulation of the S100A8/A9 heterodimer in B7-H3-KO mice. In vitro, B7-H3-KO peritoneal macrophages and RAW264.7 cells treated with S100A8/A9-siRNA exhibited diminished proliferation, migration, and tube formation of bEnd.3 cells. These effects were reversed upon supplementation with exogenous S100A8/A9 heterodimer to B7-H3-KO peritoneal macrophages. Further mechanistic investigation demonstrated that B7-H3 modulates bEnd.3 proliferation and CNV progression via S100A8/A9-mediated activation of the TLR4-NF-κB-VEGFA signaling pathway. Conclusions The immune costimulatory molecule B7-H3 promotes CNV by modulating macrophage-mediated S100A8/A9 signaling, which activates the TLR4-NF-κB-VEGFA axis. These findings highlight B7-H3 as a potential therapeutic target in CNV-associated diseases.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":" ","pages":"1-19"},"PeriodicalIF":2.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cataract Surgery in Eyes with Microphthalmos and/or Uveal Coloboma.","authors":"Leyi Wang, Bozhao Wang, Ying Wang, Xin Wang, Hongling Yang, Ran Wu, Yan Cui","doi":"10.1159/000544002","DOIUrl":"10.1159/000544002","url":null,"abstract":"<p><strong>Introduction: </strong>Cataract may cause severe visual impairment in eyes with microphthalmos (MO) and uveal coloboma (UC). Despite their similarities, distinguishing between these conditions is crucial for cataract surgery. We aimed to compare complications, nucleus hardness, surgical strategies, and outcomes of cataract surgery between MO and UC.</p><p><strong>Methods: </strong>This retrospective comparative study included 19 eyes with MO and 20 with UC. Preoperative, intraoperative, and postoperative data of eyes that underwent cataract surgery were analysed.</p><p><strong>Results: </strong>MO eyes had lower high-hardness nucleus rates (p = 0.002) than UC. The most common preoperative complications in the MO and UC groups were glaucoma (37.5%) and retinal detachment (15.4%), respectively. No significant differences in the phacoemulsification (p = 0.45) or intraocular lens implantation (p > 0.99) rates between the two groups. Extracapsular cataract extraction was performed in five eyes (25%), and posterior capsular rupture was the most common surgical complication (15%) in the UC group. Combined surgery was mainly used to deal with high or unstable intraocular pressure (IOP; 77%) in the MO group versus posterior pars plana vitrectomy (85.71%) in the UC group to treat vitreoretinal pathologies. Corrected distance visual acuity was significantly improved in both MO (p = 0.0005) and UC (p < 0.001) groups, while IOP was decreased (p = 0.03) in the MO group.</p><p><strong>Conclusion: </strong>Eyes with MO and UC exhibited distinct cataract grades and complications, necessitating varied surgical strategies; while cataract surgery has proven to be effective in improving the visual acuity in both groups. Our findings hold significant value for guiding clinical treatment decision-making.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":" ","pages":"147-155"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Biometric Factors Associated with Prediction Errors Related to Lens Position in Vitrectomized Patients.","authors":"Eloi Debourdeau, Pierre Pineau, Chloe Chamard, Julien Plat, Didier Hoa, Frederico Manna, Sandrine Akouete, Thibault Mura, Max Villain, Nicolas Molinari, Vincent Daien","doi":"10.1159/000542358","DOIUrl":"10.1159/000542358","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to evaluate clinical and biometric factors leading to a prediction error related to lens position in pars plana vitrectomy.</p><p><strong>Methods: </strong>This study was conducted as a consecutive retrospective case series at the Department of Ophthalmology, Montpellier University Hospital. All medical files and PCI biometrical reports from a single surgeon were reviewed from 2017 to 2019. Patients who had phacoemulsification with the ASPHINA 509 MP® intraocular lens were selected and stratified into 3 groups: phacoemulsification alone (group 1), phacoemulsification and vitrectomy with gas tamponade (group 2), and phacoemulsification and vitrectomy without tamponade (group 3). Clinical factors and biometry factors from initial and final biometry were collected. Refractive error, actual lens position, C constant, axial length delta, and pre-operative and post-operative anterior and posterior segment variation parameters were calculated.</p><p><strong>Results: </strong>A total of 140 eyes were analyzed, 90 in group 1, and 25 in group 2 and 3. The mean prediction error was 0.10 ± 0.55 D (group 1); -0.36 ± 0.74 D (group 2); and -0.12 ± 0.54 D (group 3) with p < 0.05 for group 1 vs. group 2. The mean actual lens position was 5.25 ± 0.29 mm; 5.66 ± 0.60 mm; and 5.50 ± 0.43 mm for the 3 groups, respectively (p < 0.001). Axial length delta was -0.10 ± 0.13 mm in group 1, -0.062 ± 0.20 mm in group 2, and -0.022 ± 0.17 mm in group 3 (p = 0.015). Multilinear regression analysis found a significant and independent influence of vitrectomy and gas tamponade on prediction error.</p><p><strong>Conclusion: </strong>Myopic shift in the case of vitrectomy is multifactorial, effective lens position is modified by vitrectomy and vitreous refractive index is changing. The integration of these data in formulas may improve refractive outcome after cataract and vitrectomy surgery.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":" ","pages":"52-60"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early versus Late Switch to an Intravitreal Dexamethasone Implant after Failed Anti-VEGF Therapy for Diabetic Macular Edema: A Systematic Review and Meta-Analysis.","authors":"Chanyuan Cao, Guoxiao Yu, Zhen Deng","doi":"10.1159/000546682","DOIUrl":"10.1159/000546682","url":null,"abstract":"<p><strong>Introduction: </strong>Monthly anti-vascular endothelial growth factors (VEGFs) are the primary line of management of diabetic macular edema (DME). However, a large number of patients do not respond to anti-VEGF and require dexamethasone implants (DEXIs) as a second line of therapy. There remains a clinical conundrum on the optimal timing of the switch to DEXI. We systematically reviewed the literature to assess outcomes after an early versus late switch to DEXI after failed anti-VEGF therapy in DME.</p><p><strong>Methods: </strong>Relevant studies were identified by searching PubMed, CENTRAL, Scopus, Web of Science, and Embase till 25th December 2024. We assessed changes in central retinal thickness (CRT), best-corrected visual acuity (BCVA), and risk of ocular hypertension between early versus late switch groups.</p><p><strong>Results: </strong>Six studies were included. Pooled analysis of all six studies showed that there was a tendency of improved CRT (MD: 19.01; 95% CI: -27.29, 65.31; I2 = 85%) and BCVA (MD: 0.05; 95% CI: -0.04, 0.14; I2 = 72%) with early switch as compared to late switch group but without statistical significance. Removing one outlier study showed statistically significant improvement in CRT (MD: 36.84; 95% CI: 7.54, 66.14; I2 = 48%) and BCVA with early switch (MD: 0.09; 95% CI: 0.08, 0.11; I2 = 0%). Subgroup analysis based on the definition of late switch indicated better outcomes with an early switch when the late switch was defined as after >6 anti-VEGF injections. No difference was noted in the risk of ocular hypertension between the two groups (OR: 0.81; 95% CI: 0.38, 1.73; I2 = 30%).</p><p><strong>Conclusions: </strong>An early switch to DEXI may tend toward better outcomes as compared to a late switch in treatment-resistant DME patients. High heterogeneity of the meta-analysis and outlier studies are important limitations of present evidence, which can only be resolved with high-quality randomized controlled trials.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":" ","pages":"360-371"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Factors behind Patient Nonadherence to Intravitreal Anti-Vascular Endothelial Growth Factor Injections in Macular Diseases.","authors":"Efrat Naaman, Noa Yanir-Prat, Diana Shair-Nakhleh, Nitai Bar, Beata Miller, Anna Fishman, Shiri Zayit-Soudry","doi":"10.1159/000543352","DOIUrl":"10.1159/000543352","url":null,"abstract":"<p><strong>Introduction: </strong>In recent years, intravitreal injections (IVTs) of vascular endothelial growth factor (VEGF) inhibitors have become the standard of care for several macular disorders. Frequently, the therapeutic course requires numerous injections, posing a burden on patients. Nonadherence to treatment may result in reduced visual outcomes, therefore understanding and addressing the underlying causes is imperative.</p><p><strong>Methods: </strong>A cross-sectional study of patients who missed their scheduled appointment for anti-VEGF IVT as part of the routine management of their macular disease at a single tertiary center between November 2020 and February 2021. A telephone survey was conducted and patient medical charts were reviewed for ophthalmological data.</p><p><strong>Results: </strong>A total of 100/556 (18%) patients who failed to attend their scheduled anti-VEGF IVT appointments were documented. Among these subjects, the average age was 66 (SD ± 14) years with a nearly equal gender distribution of 49:51 F:M ratio. Reported no-show reasons included concurrent illness (39%), administrative issues such as missing financial coverage forms or scheduling problems (28%), and lack of motivation (11%). Additionally, 73% of patients who missed appointments expressed a need for accompaniment, and 74% resided outside the hospital city.</p><p><strong>Conclusions: </strong>Study results highlight modifiable factors contributing to no-shows to anti-VEGF IVT, such as poor transportation access, complicated administrative processes, and difficulty rescheduling missed appointments. Understanding potential obstacles to anti-VEGF IVT therapy, particularly those that are preventable, can enhance adherence and potentially improve the clinical outcome.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":" ","pages":"221-227"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}