Seminars in Ophthalmology最新文献

{"title":"Treat-And-Extend Versus Pro Re Nata Regimen of Intravitreal Conbercept Injection for Neovascular Age-Related Macular Degeneration: Results from COCOA, a Prospective, Open-Label, Multicenter, Randomized Phase IV Clinical Trial.","authors":"Yaoyao Sun, Wenfang Zhang, Bojie Hu, Bin Sun, Tonghe Zhang, Suqin Yu, Gongqiang Yuan, Rongping Dai, Ke Fan, Lifei Wang, Pei Cheng, Gang An, Liangbao An, Fang Wang, Weiqi Chen, Jie Zhang, Xiyuan Zhou, Feng Wang, Jian Ye, Xionggao Huang, Xiaoyan Peng, Jun Li, Miaoqin Wu, Guangming Wan, Jingxiang Zhong, Shaoping Ha, Xiao Ke, Jianhong Liang, Huijun Qi, Hong Yin, Tong Qian, Jinfeng Qu, Xuan Shi, Jing Hou, Heng Miao, Yuou Yao, Enzhong Jin, Xun Deng, Jian Zhang, Xiaoqing Shi, Jun Liu, Jie Ma, Jia Liu, Ye Tao, Bin Liu, Xiaoxin Li, Mingwei Zhao","doi":"10.1080/08820538.2025.2467853","DOIUrl":"10.1080/08820538.2025.2467853","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate and contrast the effectiveness and safety of two conbercept treatment protocols-a three-dose treat-and-extend (3+T&E) regimen and a three-dose pro re nata (3+PRN) regimen-in Chinese patients diagnosed with neovascular age-related macular degeneration (nAMD).</p><p><strong>Methods: </strong>Eligible patients, who had not undergone anti-VEGF intraocular injections within 3 months prior to enrollment, were randomly assigned to either the 3+T&E or 3+PRN regimen. The 3+T&E group received at least three monthly injections, with subsequent visit intervals extended based on disease activity assessment. The primary endpoint was the mean change in best-corrected visual acuity (BCVA) from baseline to week 48, using a predefined noninferiority threshold.</p><p><strong>Results: </strong>Among 501 participants (249 in 3+T&E, 252 in 3+PRN), approximately half had prior anti-VEGF treatment. At 48 weeks, both regimens showed significant BCVA improvements (+9.9 for 3+PRN, +8.6 for 3+T&E; <i>p</i> = .208), with comparable rates of ≥15-letter gains (32.12% for 3+PRN, 30.77% for 3+T&E; <i>p</i> = .827). The 3+PRN group received fewer injections (mean 6.4 vs. 6.9 in 3+T&E; <i>p</i> = .028) but had shorter intervals between injections (6.93 weeks vs. 7.46 weeks in 3+T&E; <i>p</i> = .010). Drug-related adverse events occurred in 5% of patients, with ocular events evenly distributed and minimal cardiovascular events reported.</p><p><strong>Conclusion: </strong>Both 3+T&E and 3+PRN conbercept regimens effectively improved visual and anatomical outcomes in Chinese nAMD patients. The 3+T&E regimen was noninferior to 3+PRN in improving BCVA from baseline to week 48. The 3+T&E regimen enabled longer injection intervals while 3+PRN regimen with less injections is more cost-effective while maintaining a comparable safety profile. Treatment plan tailored to an individual patient's situation appears necessary.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"393-399"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617116","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":"Silicone Oil Tamponade in the Management of Endogenous Endophthalmitis.","authors":"Constance Weber, Zoe Kiy, Katharina Wall, Frank G Holz, Raffael Liegl","doi":"10.1080/08820538.2025.2459312","DOIUrl":"10.1080/08820538.2025.2459312","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate pars plana vitrectomy (ppv) with silicone oil tamponade in the management of patients with endogenous endophthalmitis.</p><p><strong>Methods: </strong>All patients treated with ppv and silicone oil for endogenous endophthalmitis at the University Eye Hospital Bonn between 2015 and 2022 were included. We documented all preoperative data, encompassing BCVA at diagnosis, clinical observations, and presenting symptoms. During each follow-up visit, we evaluated BCVA and monitored for any complications. Statistical analysis was performed using SPSS Statistics.</p><p><strong>Results: </strong>In total, 19 eyes of 19 patients were included in this study. The most common underlying diseases were urosepsis in 5 patients (26.3%), endocarditis and leukemia in 3 patients (15.8%) respectively. The most common bacterial pathogens in the vitreous samples were gram-positive cocci in 3 patients (15.8%) and staphylococcus aureus in 3 patients (15.8%). The most common fungal pathogen was candida albicans in two patients (10.8%). Visual acuity (VA) at diagnosis was 1.93 logMAR (0.4-3.0 logMAR) and increased to 1.39 logMAR (0.2-3.0 logMAR) after six months and 1.21 logMAR (0.2-3.0 logMAR) after one year. 2 patients (10.5%) died during the follow-up because of their underlying disease. 9 eyes (47.4%) developed postoperative complications. One eye with no light perception was enucleated due to pain caused by high intraocular pressure. 2 eyes (10.5%) developed a postoperative retinal detachment needing further surgery.</p><p><strong>Conclusion: </strong>Most patients treated with ppv and silicone oil for endogenous endophthalmitis experienced an improvement in visual acuity; however, due to the severity of the condition, the visual prognosis remains guarded.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"405-411"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391590","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":"Lacrimal History - Part 34: Doyens of Dacryology Series - Juan Murube del Castillo (1934-2024).","authors":"Marco Sales-Sanz, Francisco J Muñoz-Negrete, Mohammad Javed Ali","doi":"10.1080/08820538.2025.2463247","DOIUrl":"10.1080/08820538.2025.2463247","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"351-353"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190532","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":"The Association Between Blepharitis and Lower Eyelid Ectropion in a Large Cohort of Patients.","authors":"Lital Smadar, Noa Kapelushnik, Guy J Ben-Simon, Shlomo Segev, Shahar Soudry, Amir Abd-Elkader, Daphna Landau Prat","doi":"10.1080/08820538.2025.2459311","DOIUrl":"10.1080/08820538.2025.2459311","url":null,"abstract":"<p><strong>Purpose: </strong>Blepharitis and lower eyelid ectropion are highly prevalent ocular conditions occurring in 37%-46% and 2-3% of the general adult population, respectively. Blepharitis has multifactorial origins and involves anterior and posterior types of eyelid inflammation. Lower eyelid ectropion results in ocular surface exposure, epiphora and chronic conjunctivitis. This study aims to investigate any possible association between both conditions.</p><p><strong>Methods: </strong>Medical records of 37,692 consecutive patients examined at a single medical screening center between 2001-2020 were retrospectively analyzed.</p><p><strong>Main outcome measures: </strong>The prevalence of lower eyelid ectropion and of blepharitis, a possible association between the two, and the relation of each to age and sex.</p><p><strong>Results: </strong>A total of 35,670 patients were included. Ectropion was diagnosed in 69 patients (0.2%), and blepharitis in 4725 patients (13.2%). Male sex was more prevalent for each pathology (88.4% ectropion, and 85% blepharitis, <i>p</i> < .001). Older age was associated with each diagnosis (77.3 years for ectropion patients vs. 52.2 years for the general screened population and 60.5 years for blepharitis patients vs 52.2 years for the general screened population <i>p</i> < .001). The prevalence of ectropion was significantly higher in patients with coexisting blepharitis compared to those without (0.8% vs. 0.1%, respectively, <i>p</i> < .001).</p><p><strong>Conclusions: </strong>Ectropion was significantly more prevalent in patients with blepharitis. Both conditions were associated with older age and male sex. This coexistence can aid in decision making of early surgical intervention of lower eyelid ectropion as well as the approach to medical treatment of blepharitis.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"400-404"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067794","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":"Low-Level Red Light for the Progression Myopia in Children: A Meta-Analysis.","authors":"Xian Yang, Lin Yao, Gang Sun, Haoyan Zhang, Haolin Yu, Haiqing Bai","doi":"10.1080/08820538.2025.2452885","DOIUrl":"10.1080/08820538.2025.2452885","url":null,"abstract":"<p><strong>Purposes: </strong>This meta-analysis aims to systematically analyze the efficacy of low-level red light (LRL) therapy for myopia control and prevention in children.</p><p><strong>Methods: </strong>All the data were searched from the PubMed, EMBASE, and the Cochrane Library. The Cochrane Handbook was used to evaluate the quality of the included studies. Additionally, this meta-analysis was performed by using the Revman 5.4 software. Inclusion criteria was randomized controlled trials (RCTs), and the patient populations were younger than 18 years.</p><p><strong>Results: </strong>Eight RCTs were included in this study. Compared with control group, LRL treatment could reduce the progression in spherical equivalent refractive (SER) for myopia children (MD, 0.49; 95% CI, 0.27 to 0.71; <i>p</i> < .00001). Also, less change in axial length (AL) and increase in subfoveal choroid thickness (SFCT) was shown in the LRL group for both myopia and premyopia children (MD, -0.24, 28.16; 95% CI, -0.32 to -0.17, 18.78 to 37.55; <i>p</i> < .00001, respectively).</p><p><strong>Conclusion: </strong>Our meta-analysis shows that LRL therapy could delay the refraction progression of myopia children. It also could reduce progression in axial length and SFCT thinning in both myopia and premoypia children.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"358-363"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011063","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":"Lacrimal History - Part 21: Doyens of Dacryology Series - Baron Guillaume Dupuytren (1777-1835) and His Gold and Silver Lacrimal Cannulas.","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2524935","DOIUrl":"https://doi.org/10.1080/08820538.2025.2524935","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529512","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":"Real-World Engagement with Free Genotyping by Patients with Inherited Retinal Disease in a Single Private Retinal Centre in Australia.","authors":"Lewis E Fry, Alexis Ceecee Britten-Jones, Sena A Gocuk, Lauren N Ayton, Heather G Mack","doi":"10.1080/08820538.2025.2524057","DOIUrl":"https://doi.org/10.1080/08820538.2025.2524057","url":null,"abstract":"<p><strong>Purpose: </strong>Genotyping patients with inherited retinal diseases (IRD) is important for diagnosis, genetic counselling, and future treatments. However, in Australia less than 10% of patients with IRD have undergone genetic testing. Recognised barriers to testing include cost, access, and trust in the treating clinician. We aimed to assess uptake and outcomes to an offer of sponsored (free) genetic testing with home DNA collection, thereby removing typical barriers to genetic testing.</p><p><strong>Methods: </strong>Participation in a sponsored genetic testing program (Invitae Corporation) was offered to adults from a private retinal practice in Australia in July 2022. Email invitations were sent to 233 patients clinically diagnosed with an IRD phenotype by the senior author. Potential participants were ≥18 years old, had no previous diagnostic genetic testing, and had supplied an email address for communication.</p><p><strong>Results: </strong>Emails were successfully delivered to 205 individuals. Response rate to invitation were low, with no reply in the 62% cases (128/205). Of the 58 participants for whom testing was ordered, 47 (47/58, 81%) supplied at-home collected DNA. The solve rate was 34% (16/47), rising to 53% (25/47) when probable solves were included. One of the thirteen families accepted the offer of family studies to clarify the genotype. The most frequent identified IRD-associated gene was PRPH2 (4/16 cases), followed by RHO (2/16 cases).</p><p><strong>Conclusion: </strong>Overall low response, DNA return and acceptance of family testing rates suggest ill-defined human factors affected DNA genetic testing uptake. Improved patient education and follow-up of offers of genetic testing are required to improve patient genotyping.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529513","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":"Symblepharon: A Review of Etiology, Clinical Features, and Management Strategies.","authors":"Supriya Sharma, Sayan Basu, Swapna S Shanbhag","doi":"10.1080/08820538.2025.2519050","DOIUrl":"https://doi.org/10.1080/08820538.2025.2519050","url":null,"abstract":"<p><strong>Background: </strong>A symblepharon is an adhesion between the bulbar and the palpebral conjunctiva and is a manifestation of the loss of conjunctival redundancy. It occurs due to conjunctival scarring, most commonly resulting from trauma or chronic inflammation. Vision can be affected either if the symblepharon is present along with primary keratopathy and limbal stem cell deficiency, or if it is extensive leading to secondary corneal involvement. There is currently no medical treatment for symblepharon, nor can its occurrence be fully prevented. Surgical management is often necessary in cases associated with chronic cicatrizing conjunctivitis.</p><p><strong>Purpose: </strong>This review aims to summarize the etiology, clinical presentation, and management strategies for ocular symblephara. Methods: A comprehensive literature search was conducted using PubMed database, identifying published studies addressing ocular symblephara and their management. Mechanisms of symblephara formation and emerging treatment modalities for prevention of symblephara were also evaluated.</p><p><strong>Conclusion: </strong>Surgical approaches to symblephara management involve excision of the fibrotic tissue and placement of mechanical barriers or biological tissue substitutes such as amniotic membranes, conjunctival autografts, and oral mucous membrane grafts. Surgical intervention is recommended for symblepharon in cases where cosmesis is a concern, the visual axis is affected, or in extensive cases before procedures such as cataract surgery, limbal stem cell transplantation, or keratoprosthesis surgery, as well as to facilitate scleral contact lens fitting. Management also involves addressing the underlying disease that led to symblepharon formation. The recurrence rate of symblepharon following surgical treatment is higher in eyes with Stevens-Johnson syndrome or mucous membrane pemphigoid compared to those with ocular chemical burns. Further research is needed to explore preventive strategies such as anti-fibrotic agents and potential medical treatment for symblepharon.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-23"},"PeriodicalIF":1.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485779","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":"Impact of a Focussed Workshop on Ocular Surface Disorders on the Knowledge and Practice of Attendees Over a Decade.","authors":"Jayesh Vazirani, Vikas Mittal","doi":"10.1080/08820538.2025.2523500","DOIUrl":"https://doi.org/10.1080/08820538.2025.2523500","url":null,"abstract":"<p><strong>Purpose: </strong>The Ocular Surface Workshop (OSW) is a sub-specialty meeting focussed on the management of complex ocular surface disorders. This survey aimed to assess the impact of the workshop on the knowledge and practice of attendees over a decade.</p><p><strong>Methods: </strong>An online survey was circulated to attendees of past editions of the OSW in February 2025. Survey results were compiled and presented using descriptive statistics, charts and tables.</p><p><strong>Results: </strong>Sixty-seven responses were received within the survey period. Respondents had a median age of 42 years, and included a significant proportion of trainees and young clinicians. Most respondents (64%) attended the workshop multiple times. Attendees improved their knowledge about various complex ocular surface conditions, which positively impacted their practice. Respondents also reported improvements in the availability of good quality care for ocular surface disorders in their practice location.</p><p><strong>Conclusions: </strong>Attendees of the OSW reported significant improvements in their knowledge and impact on their practice after attending the workshop. The workshop serves as a model than can be emulated by other sub-specialty meetings to enhance clinician knowledge and improve access to high quality care for patients.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-6"},"PeriodicalIF":1.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485778","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":"Immunological Impact of Sex Hormones at Ocular Surface: A Narrative Review.","authors":"Alessandro Ferraro, Mariateresa Laborante, Francesco Cutrupi, Andrea Salerno, Marco Coassin, Antonio Di Zazzo","doi":"10.1080/08820538.2025.2522716","DOIUrl":"https://doi.org/10.1080/08820538.2025.2522716","url":null,"abstract":"<p><p>Relationship between sex hormones and ocular surface immunity is controversial. Estrogens, androgens, and progesterone, play pivotal roles in modulating immune responses on the ocular surface. Estrogens exhibit dual roles, acting as both pro-inflammatory and anti-inflammatory agents depending on their concentration and receptor interaction, while androgens generally demonstrate immunosuppressive effects. Progesterone, though less studied, may have immunomodulatory properties. Despite numerous studies, the exact molecular pathways through which sex hormones regulate ocular immunity are not fully understood, and findings often appear inconsistent. To address these gaps, a comprehensive literature search was conducted across PubMed, Scopus, and Web of Science, focusing on keywords related to sex hormones, immunity, and ocular surface health. The aim is to summarize hormone receptor mechanisms, their influence on immune cell function and production of inflammatory mediators at the ocular surface. Overall, this review highlights the intricate interplay between sex hormones and ocular surface immunity, emphasizing that hormonal balance is essential for maintaining ocular health. A deeper understanding of these mechanisms could drive the development of novel, hormone-based therapeutic strategies for inflammatory ocular disorders, such dry eye disease, meeting an urgent clinical need.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476651","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}