Seminars in Ophthalmology最新文献

{"title":"Risk Factors for Extraocular Relapse in Retinoblastoma.","authors":"Rosario Aschero, Margarida Simao, Jaume Catala-Mora, Guillermo L Chantada","doi":"10.1080/08820538.2025.2450682","DOIUrl":"10.1080/08820538.2025.2450682","url":null,"abstract":"<p><strong>Background: </strong>Metastatic retinoblastoma remains a significant challenge in pediatric oncology, with stark disparities in survival outcomes between high-income countries (HICs) and low-income countries (LICs). Delayed diagnosis and treatment, driven by socioeconomic factors and limitations in healthcare systems, contribute to poorer outcomes in LICs. Histopathological characteristics, including high-risk pathology factors (HRPFs) and the extent of ocular tumor invasion, are critical for predicting metastatic risk and guiding treatment strategies.</p><p><strong>Methods: </strong>This review examines the role of clinical, histopathological, and molecular characteristics in assessing metastatic risk in retinoblastoma. Literature on HRPFs, tumor invasion, and molecular subtypes was analyzed to understand their impact on risk stratification and therapy optimization, particularly in resource-limited settings.</p><p><strong>Results: </strong>Retinoblastoma is increasingly recognized as a heterogeneous disease with at least two distinct molecular subtypes. High-risk cases frequently exhibit genetic alterations that underscore the need to incorporate molecular profiling into risk assessment. Current adjuvant therapy approaches, however, vary widely, and debates persist regarding their necessity based on tumor characteristics. Integrated strategies that combine clinical, histopathological, and molecular data show promise in improving management and survival outcomes.</p><p><strong>Conclusions: </strong>Addressing the disparities in metastatic retinoblastoma outcomes requires a multifaceted approach. By integrating clinical, histopathological, and molecular insights, management strategies can be optimized to improve survival, particularly in resource-limited settings where challenges are most pronounced.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"474-484"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954503","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":"Readership Awareness Series - Paper 15: How the ICMJE 2025 Recommendations Update Impact the Scientific Community?","authors":"Mohammad Javed Ali, Ali Djalilian","doi":"10.1080/08820538.2025.2454851","DOIUrl":"10.1080/08820538.2025.2454851","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"447-448"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011065","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":"Coats' Disease: A Comprehensive Review of Its Pathophysiology, Diagnosis, and Advances in Treatment.","authors":"Ahmet Yucel Ucgul, Şengül Özdek","doi":"10.1080/08820538.2024.2447965","DOIUrl":"10.1080/08820538.2024.2447965","url":null,"abstract":"<p><strong>Background and purpose: </strong>Coats' disease, first described by George Coats in 1908, is a rare ocular disorder primarily affecting young males, often unilaterally. It is characterized by retinal telangiectasia, aneurysms, and exudation, which, in severe cases, can lead to blindness, painful red eye, or ocular atrophy, particularly with early childhood onset. Over the last century, advancements have been made in understanding its natural history, morphology, incidence, and clinical manifestations, showing a male predominance without significant ethnic disparities. This review aims to provide a comprehensive overview of Coats' disease, focusing on its pathogenesis, clinical presentation, diagnostic methods, and management strategies.</p><p><strong>Methods: </strong>The pathogenesis of Coats' Disease is multifactorial, involving inflammatory, vascular, and potentially genetic components. Early theories suggested inflammation as the primary cause, but modern research highlights the role of vascular endothelial growth factor (VEGF), where ischemic retinal areas elevate VEGF levels, promoting angiogenesis and impairing the blood-retinal barrier. Clinically, the disease is asymptomatic in early stages but progresses to symptoms like reduced visual acuity, strabismus, and leukocoria, typically within the first decade of life. Diagnostic methods include fundus fluorescein angiography, optical coherence tomography (OCT), and OCT angiography (OCTA), with recent studies identifying reduced blood flow density in capillary networks. Management ranges from intravitreal anti-VEGF agents and steroids to surgical options like pars plana vitrectomy and transscleral drainage, with additional techniques such as laser photocoagulation and cryotherapy proving effective in advanced stages.</p><p><strong>Conclusion: </strong>The prognosis of Coats' Disease heavily depends on the stage of disease at presentation. Early detection and intervention can preserve vision, but advanced stages often result in poor outcomes. Factors such as younger age at presentation, advanced stage, and severe manifestations are associated with more aggressive progression and poorer prognosis. This review highlights the importance of early diagnosis and a multifaceted management approach, emphasizing the need for further research into its pathophysiology and innovative treatment strategies to improve patient outcomes.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"458-473"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650657","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":"Readership Awareness Series - Paper 14: The Submission Dilemma - How to Choose a Journal?","authors":"Mohammad Javed Ali, Ali Djalilian","doi":"10.1080/08820538.2024.2424079","DOIUrl":"10.1080/08820538.2024.2424079","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"445-446"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558722","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 37: Doyens of Dacryology Series - Lester Tallmon Jones (1895-1983).","authors":"Roger A Dailey, John L Wobig, Mohammad Javed Ali","doi":"10.1080/08820538.2025.2466276","DOIUrl":"10.1080/08820538.2025.2466276","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"451-454"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410452","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":"Diagnostic Yield of Routine Metastatic Work-Up in Patients with Conjunctival Melanoma.","authors":"Tracy J Lu, Zhouxuan Li, Krish Manisundaram, Stella Kim, Jing Ning, Bita Esmaeli","doi":"10.1080/08820538.2025.2468382","DOIUrl":"10.1080/08820538.2025.2468382","url":null,"abstract":"<p><strong>Background: </strong>Conjunctival melanoma (CM) is a rare and potentially aggressive malignancy of the ocular surface with high rates of local recurrence and metastasis. The objective of this report was to evaluate the yield of diagnostic staging tests in patients with conjunctival melanoma.</p><p><strong>Methods: </strong>81 consecutive patients with invasive conjunctival melanoma treated by the senior author over the course of 23 years were included. All imaging studies at baseline and during the follow up were reviewed. We also reviewed the yield of sentinel lymph node biopsy (SLNB) in patients who had this procedure as part of their baseline staging.</p><p><strong>Results: </strong>We found an overall nodal metastatic rate of 16% and distant metastatic rate of 26%. The SLNB positivity rate was 23.1% (6 out of 26 patients).Eight out of 81 (10%) patients with CM had brain metastasis as identified on routine brain magnetic resonance imaging.</p><p><strong>Conclusions: </strong>More than a third of patients with nodal metastasis and most patients with distant metastasis, including 100% of patients with brain metastasis, were detected to have metastatic disease during the follow-up period, highlighting the importance of continued surveillance imaging. Twelve of 20 patients with distant metastasis (57%) never had nodal metastasis, highlighting the importance of continued surveillance for distant metastasis even with a negative SLNB result.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"538-545"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468942","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":"Ciliary Body Medulloepithelioma: Clinical and Pathologic Challenges with a Focus on Molecular Genetics.","authors":"Ari H August, Linda A Cernichiaro-Espinosa, Mariana Moctezuma-Davila, Turner D Wibbelsman, Matthew W Wilson, Patricia Chévez-Barrios, Carol L Shields, Sara E Lally, Charles G Eberhart, Brent A Orr, Edward Simpson, Ralph C Eagle, Tatyana Milman","doi":"10.1080/08820538.2025.2457066","DOIUrl":"10.1080/08820538.2025.2457066","url":null,"abstract":"<p><strong>Objective: </strong>Ciliary body medulloepithelioma (CBME), a pediatric intraocular tumor with potential for locally aggressive behavior and metastasis, may present with a diverse spectrum of clinical and histopathologic features leading to diagnostic and management challenges. Examination of unusual CBME cases highlights challenges and modern diagnostic techniques which facilitate accurate diagnosis and guide management.</p><p><strong>Methods: </strong>A retrospective clinicopathologic analysis of 6 patients with unusual clinical or pathologic features of CBME was performed.</p><p><strong>Results: </strong>The mean duration of delay in accurate diagnosis was 5.7 years (SD: 8.2, median: 3, range: 0-22). All patients developed cataract, 4 (67%) were diagnosed with glaucoma, and 4 (67%) underwent surgery prior to accurate diagnosis. At initial presentation, only one patient with a known history of genetically confirmed DICER1 syndrome underwent appropriate imaging leading to a timely identification of a ciliary body mass and no delay in diagnosis. Following identification of intraocular mass, 4 (67%) patients underwent enucleation. Two patients (33%) underwent exenteration for extraocular extension of CBME. Initial histopathologic differential diagnosis included CBME, melanoma, adenoma or adenocarcinoma of the pigmented ciliary body epithelium, retinoblastoma, sarcoma, and malignant teratoma. Immunohistochemistry and genetic testing assisted in the diagnosis of CBME. Two patients (33%) had a germline DICER1 variant; this was known prior to CBME diagnosis in one patient and discovered after CBME diagnosis in the second patient.</p><p><strong>Conclusion: </strong>This series highlights the unusual clinical and histopathologic features of CBME that contribute to delays in diagnosis. Modern aids including genetic testing, ancillary imaging studies, and immunohistochemistry facilitate a timely accurate diagnosis of CBME and guide management.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"518-528"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047675","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":"Lag Time Between Onset of First Symptom and Treatment of Retinoblastoma: Outcomes at Three Years from Recruitment.","authors":"Swathi Kaliki, Vijitha S Vempuluru, Akruti Desai, Xunda Ji, Yihua Zou, Riffat Rashid, Sadia Sultana, Sadik Taju Sherief, Nathalie Cassoux, Rosdali Y Diaz Coronado, Juan Luis Garcia Leon, Arturo Manuel Zapata López, Vladimir G Polyakov, Tatiana L Ushakova, Andrey A Yarovoy, Soma Rani Roy, Alia Ahmad, Lamis Al Harby, M Ashwin Reddy, Mandeep S Sagoo, Jesse L Berry, Jonathan Kim, Ashley Polski, Nicholas J Astbury, Covadonga Bascaran, Sharon Blum, Nir Gomel, Richard Bowman, Matthew J Burton, Allen Foster, Andrew W Stacey, David M Steinberg, David Refaeli, Marcia Zondervan, Ido Didi Fabian","doi":"10.1080/08820538.2025.2491004","DOIUrl":"10.1080/08820538.2025.2491004","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of lag time between diagnosis of retinoblastoma (RB) and treatment in patients from 10 countries.</p><p><strong>Methods: </strong>Prospective study of 692 treatment-naïve RB patients from 10 countries followed up for 3 years from recruitment.</p><p><strong>Results: </strong>The mean lag time from the onset of the first symptom to visit to the RB treatment center was 150 days. The mean follow-up duration was 26 months (median, 32 months; range, <1-51 months). A higher socioeconomic status of the country was associated with a lower risk of enucleation: Lower-middle-income countries vs. low-income countries (<i>p</i><.001), Upper-middle-income vs. low-income countries (<i>p</i> = .009), and high-income countries vs. low-income countries (<i>p</i> = .014). A greater AJCC stage was associated with a greater risk of enucleation: T2 vs. T1 (<i>p</i><.001) and T3 vs. T1 (<i>p</i><.001). Increased lag time (<i>p</i><.001) and AJCC T4 stage (T4 vs. T2; <i>p</i><.001) were associated with increased risk of death. By Kaplan-Meier analysis, the cumulative incidence of enucleation at 3 months, 1 year, and 3 years was 49%, 55%, and 61%, respectively; and survival at 1, 2, and 3 years was 92%, 88%, and 87%, respectively. Three-year Kaplan-Meier survival estimates were 95% with a lag time of <3 months vs. 83% with a lag time of 3-12 months vs. 62% with a lag time of >12 months.</p><p><strong>Conclusion: </strong>A lower socioeconomic status and greater AJCC stage were associated with an increased risk of enucleation. Increased lag time from the onset of the first symptom to visit the RB treatment center and AJCC T4 stage were associated with an increased risk of death from RB.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"551-557"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045142","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":"Ocular Surface Squamous Neoplasia: A Cohort Study and Updates in the Pathogenesis, Diagnosis, and Medical Management.","authors":"Nefeli Eleni Kounatidou, Chara Tzavara, Athanasiadou Aikaterini, Sotiria Palioura","doi":"10.1080/08820538.2025.2536229","DOIUrl":"https://doi.org/10.1080/08820538.2025.2536229","url":null,"abstract":"<p><strong>Purpose: </strong>To review the current literature on the pathogenesis, diagnosis, and management of ocular surface squamous neoplasia (OSSN), and to evaluate the efficacy and safety of topical therapies-interferon alpha-2b (IFNα-2b), mitomycin-C (MMC), and 5-fluorouracil (5-FU)-in a retrospective cohort of patients with OSSN.</p><p><strong>Method: </strong>A comprehensive literature review was conducted alongside a retrospective cohort study involving 43 patients diagnosed with OSSN. Treatment outcomes, recurrence rates, and toxicity profiles associated with IFNα-2b, MMC, and 5-FU were analyzed. Data on treatment duration, number of cycles required for tumor resolution, and associations with patient demographics were assessed.</p><p><strong>Results: </strong>A mean of 2.56 treatment cycles was required for complete tumor resolution across the cohort. IFNα-2b led to tumor resolution in a shorter time frame compared to 5-FU. No significant correlation was identified between patient demographics and treatment response. However, a history of cancer was associated with larger tumor size and greater limbal involvement at presentation.</p><p><strong>Conclusions: </strong>Topical agents are effective and well-tolerated treatments for OSSN, with IFNα-2b demonstrating faster response times in this cohort. The literature highlights a lack of prospective randomized trials comparing these therapies. Furthermore, limited understanding of the molecular mechanisms underlying OSSN pathogenesis continues to hinder individualized treatment strategies and risk stratification.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708561","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":"Chemical Injuries Classification and Management - Current Perspectives.","authors":"Mugundhan Rajarajan, Varsha Bhambhani Chavda, Vanathi Murugesan, Shweta Agarwal","doi":"10.1080/08820538.2025.2535588","DOIUrl":"https://doi.org/10.1080/08820538.2025.2535588","url":null,"abstract":"<p><strong>Background: </strong>Chemical injuries to the eye are a significant cause of vision impairment worldwide. These injuries demand immediate and appropriate intervention due to their potential for causing visual morbidity and long-term sequelae. The severity and managmenet is influenced by factors such as the chemical type, concentration, duration of exposure, and the extent of ocular surface involvement. Chemical injuries to the eye are a significant cause of vision impairment worldwide. These injuries demand immediate and appropriate intervention due to their potential for causing visual morbidity and long-term sequelae. The severity and managmenet is influenced by factors such as the chemical type, concentration, duration of exposure, and the extent of ocular surface involvement.</p><p><strong>Purpose: </strong>To provide a comprehensive overview of current perspectives in the classification and management of ocular chemical injuries, with emphasis on recent advances in treatment protocols during both the acute and chronic phases.</p><p><strong>Methods: </strong>After thorough literature search in PubMed and MEDLINE 72 studies with maximum relevance that were published as systematic reviews, as well as randomized and non-randomized comparative studies (cohort or case series) on the topic of chemical injuries classification and management were finally selected for this article.</p><p><strong>Results: </strong>Early management is centered on immediate irrigation, neutralization of the chemical agent, and prevention of further tissue damage through clinical assessment and medical therapy. In severe cases, surgical intervention may be necessary to restore ocular integrity. In the chronic phase, once the ocular surface is stabilized, visual rehabilitation becomes the focus, involving a multifactorial decision-making approach tailored to individual patient needs.</p><p><strong>Conclusion: </strong>Effective management of ocular chemical injuries requires a dynamic, phased approach, integrating timely acute intervention with personalized long-term rehabilitation strategies. Recent advancements in therapeutic techniques have improved outcomes, but ongoing research and clinical vigilance remain essential for optimizing care.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-15"},"PeriodicalIF":1.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708558","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}