Seminars in Ophthalmology最新文献

{"title":"Structural Changes in the Lamina Cribrosa Following Cataract Surgery in Primary Angle-Closure and Primary Open-Angle Glaucoma.","authors":"Seray Sahin, Mine Esen Baris, Suzan Guven","doi":"10.1080/08820538.2026.2715498","DOIUrl":"https://doi.org/10.1080/08820538.2026.2715498","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of cataract surgery on selected lamina cribrosa (LC) structural parameters in patients with primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG).</p><p><strong>Methods: </strong>In this prospective comparative study, 50 eyes of 50 patients (25 PACG, 25 POAG) undergoing cataract surgery were consecutively enrolled. Intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness, and LC parameters-including lamina cribrosa thickness (LCT), lamina cribrosa depth (LCD), prelaminar depth (PLD), and prelaminar tissue thickness (PLTT)-were assessed using swept-source optical coherence tomography before and 6 months after surgery. Changes over time and between groups were analyzed using repeated measures analysis or nonparametric equivalents. Analysis of covariance was performed to adjust for postoperative IOP reduction and age.</p><p><strong>Results: </strong>Postoperative IOP decreased significantly in both groups (<i>p</i> = .003 and <i>p</i> = .033), with no significant difference in the magnitude of reduction between groups (<i>p</i> = .174). RNFL thickness did not change significantly in either group. In the PACG group, cataract surgery was associated with a significant increase in LCT (<i>p</i> = .01) and significant decreases in LCD (<i>p</i> = .002) and PLD (<i>p</i> < .001), whereas no significant changes were observed in the POAG group. Significant time ×group interactions were detected for LCT (<i>p</i> = .025), LCD (<i>p</i> = .017), and PLD (<i>p</i> = .001). PLTT did not change significantly in either group, and no significant time ×group interaction was observed (<i>p</i> = .09). These differences remained significant after adjustment for postoperative IOP reduction and age.</p><p><strong>Conclusion: </strong>Cataract surgery was associated with measurable structural changes in the lamina cribrosa in PACG but not in POAG. Although the magnitude of IOP reduction and other ocular factors may have contributed to these findings, the structural response of the lamina cribrosa following IOP-lowering interventions may differ between glaucoma subtypes. Further studies are required to clarify the mechanisms and clinical significance of these changes.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":3.1,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707304","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":"Efficacy and Safety of Aceclidine in Presbyopia, a Systematic Review and Meta -Analysis.","authors":"Taha Ibrahim, Muhammad Burhan, Shaheer Bin Shafiq, Muhammad Junaid Razzak, Ayesha Ahmed Khan, Zain Ul Abideen Shahid, Mudassir Shahnawaz, Saud Ur Rehman, Jawaria Ibrahim, Hashem Abu Serhan","doi":"10.1080/08820538.2026.2716333","DOIUrl":"https://doi.org/10.1080/08820538.2026.2716333","url":null,"abstract":"<p><strong>Background: </strong>Presbyopia is a prevalent age-related visual disorder affecting approximately 1.8 billion individuals worldwide, with many lacking access to effective correction. Topical pharmacologic therapies such as aceclidine have emerged as potential noninvasive treatments, though their efficacy and safety remain incompletely established.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized controlled trials was conducted in accordance with PRISMA guidelines (PROSPERO: CRD420261353653). Databases were searched till March 2026. Adults with presbyopia treated with topical aceclidine, alone or in combination, were included. The primary outcome was ≥ 3-line improvement in distance-corrected near visual acuity (DCNVA). Random-effects models were used to calculate pooled risk ratios (RR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>Five trials involving 883 randomized participants were included. In the primary analysis of parallel-group trials, aceclidine significantly increased the likelihood of achieving a ≥ 3-line improvement in distance-corrected near visual acuity compared with placebo (RR 6.28, 95% CI 4.22-9.35; I² = 2.4%) and compared with aceclidine plus brimonidine (RR 5.05, 95% CI 3.04-8.38; I² = 28.2%). Secondary analyses of crossover trials demonstrated similar superiority over placebo (RR 14.92, 95% CI 6.77-32.86; I² = 0%), whereas no significant difference was observed versus combination therapy (RR 1.11, 95% CI 0.90-1.38; I² = 24.6%). Aceclidine was associated with a higher incidence of treatment-emergent adverse events than placebo (RR 2.23, 95% CI 1.61-3.09). No significant differences were observed in serious adverse events.</p><p><strong>Conclusions: </strong>Aceclidine provides significant short-term improvement in near vision with an acceptable safety profile. Monotherapy may offer slight efficacy benefits over combination regimens. However, limited study numbers and short follow-up necessitate further large-scale, long-term trials.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-11"},"PeriodicalIF":3.1,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707193","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":"Corneal Epithelial Thickness Alterations in Multiple Myeloma Patients Treated with Belantamab Mafodotin.","authors":"Tae Yeon Kim, Alison Hong, Mary Ann Stepp, Hun Lee","doi":"10.1080/08820538.2026.2711727","DOIUrl":"https://doi.org/10.1080/08820538.2026.2711727","url":null,"abstract":"<p><p>To quantify sectoral corneal epithelial thickness (CET) changes in patients with multiple myeloma treated with belantamab mafodotin using anterior segment optical coherence tomography (AS-OCT), and compare CET measurements with those of normal eyes. This retrospective observational study analyzed eight eyes from four patients with multiple myeloma who received belantamab mafodotin and subsequently discontinued therapy because of keratopathy. Clinical parameters-including best-corrected visual acuity (BCVA), mean keratometry, spherical equivalent, and Keratopathy Visual Acuity (KVA) scale-were assessed at baseline and at treatment discontinuation. CET at discontinuation was measured with using swept-source AS-OCT with a 25-sector mapping protocol: a central zone (0-2 mm) and three concentric annuli-inner (2-5 mm), middle (5-7 mm), and outer (7-10 mm)-each subdivided into eight sectors (S, SN, N, IN, I, IT, T, ST). CET values from the patient group were compared with those from 14 normal eyes of 11 controls. Therapy was discontinued after a mean of 5.5 cycles, approximately 4 months after the first infusion. From baseline to discontinuation, BCVA worsened from logMAR 0.04 to 0.20 (<i>p</i> = .027), and the KVA scale increased from 0.25 to 2.88 (<i>p</i> = .008). Compared with normal eyes, eyes exposed to belantamab mafodotin exhibited significantly thinner epithelium across all 25 sectors-including the central and all annular sectors (all <i>p</i> < .05). Within-patient sectoral analysis revealed greater thinning in the inferior than in the superior sectors of the middle ring (5-7 mm; <i>p</i> = .039). No significant nasal-temporal asymmetry was observed. Patients who discontinued belantamab mafodotin therapy due to keratopathy exhibited diffuse epithelial thinning relative to normal eyes, with disproportionate thinning in inferior mid-peripheral sectors. Sectoral AS-OCT mapping of the corneal epithelium may serve as an objective biomarker for quantifying belantamab mafodotin-associated ocular surface toxicity.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-9"},"PeriodicalIF":3.1,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707260","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 Cicatricial Pemphigoid and Solid Tumors: Review with Case Series.","authors":"Jeonghyun Esther Kwon, Amirhossein Moghtader, Christie Kang, Zahra Bibak Bejandi, Sumaiya Shahjahan, Ahmad Alzein, Sandeep Jain, Mohammad Soleimani, Ali R Djalilian","doi":"10.1080/08820538.2025.2588663","DOIUrl":"10.1080/08820538.2025.2588663","url":null,"abstract":"<p><strong>Introduction: </strong>Ocular cicatricial pemphigoid (OCP) is a chronic autoimmune condition characterized by recurrent conjunctival inflammation and progressive cicatrization, affecting nearly 70% of mucous membrane pemphigoid patients and potentially leading to blindness. Literature suggests an association between OCP and malignancy.</p><p><strong>Methods: </strong>This case series reports on 10 clinically diagnosed OCP patients with solid malignancies seen at the Illinois Eye and Ear Infirmary between January 2019 and January 2025. In addition, a review of current literature on the association between OCP and cancer was conducted using MEDLINE and Google Scholar databases.</p><p><strong>Results: </strong>Six patients had an OCP diagnosis before their cancer diagnosis, three had a cancer diagnosis prior to OCP diagnosis, and one had both simultaneously. Patients diagnosed with cancer after OCP experienced clinically worsening OCP, while those with prior cancer diagnosis had stable OCP.</p><p><strong>Discussions: </strong>Given the potential association with malignancy, patients with OCP or cicatricial conjunctivitis should undergo thorough systemic histories, age-appropriate cancer screenings, and patient education within a multidisciplinary care model to optimize early screening and improve the ocular and overall health outcomes.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"691-702"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669674","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 61: Doyens of Dacryology Series - Robert William Haxall (1802-1872), and His Prize Essay on Fistula Lachrymalis.","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2560178","DOIUrl":"10.1080/08820538.2025.2560178","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"667-671"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034175","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 55: Doyens of Dacryology Series - Georg Joseph Beer (1763-1821), and His Concepts of the Hernia and Hydrops of the Lacrimal Sac.","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2560180","DOIUrl":"10.1080/08820538.2025.2560180","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"672-677"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055654","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":"Intraocular Tuberculosis: Current Insights and Emerging Therapeutic Paradigms.","authors":"Mohini Agrawal, K Shyamsundar, Keerthana Raghu, Rajiv Raman, L Dhanurekha, Radha Annamalai, Avinash Mishra, Jyotirmay Biswas","doi":"10.1080/08820538.2025.2596385","DOIUrl":"10.1080/08820538.2025.2596385","url":null,"abstract":"<p><strong>Background: </strong>Intraocular tuberculosis (OTb) is a sight-threatening manifestation of Mycobaterium tuberculosis infection. It is characterized by a wide spectrum of clinical phenotypes, including anterior uveitis, posterior uveitis, retinal vasculitis, and choroiditis. Diagnosis remains challenging due to its diverse clinical presentations and the absence of standardized criteria. This review summarizes current knowledge on the clinical spectrum, diagnostic modalities, and emerging management strategies for OTb.</p><p><strong>Methods: </strong>A comprehensive systemic literature search was conducted on Medline and PubMed to identify relevant studies on ocular tuberculosis.</p><p><strong>Results: </strong>Key diagnostic tools include optical coherence tomography (OCT), fluorescein angiography (FA), interferon-gamma release assays (IGRA), polymerase chain reaction (PCR), and high-resolution computerized tomography (HRCT). Management typically involves a combination of anti-tuberculosis therapy (ATT) and corticosteroids, although optimal treatment regimens remain a topic of ongoing debate. Emerging challenges in treatment include paradoxical worsening, drug resistance, and corticosteroid dependency. Recent advancements, such as intravitreal anti-VEGF agents, moxifloxacin, and immunomodulatory therapy, have shown promise in refractory cases.</p><p><strong>Conclusion: </strong>A multidisciplinary approach is essential for the timely diagnosis, individualized treatment, and improved visual outcomes in patients with  intraocular tuberculosis.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"703-719"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145638691","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":"Six-Month Versus Nine-Month Anti-Tubercular Therapy for Tubercular Posterior Uveitis: A Multicenter, Randomized Controlled Trial.","authors":"Talluri Ronnie Abhishek, Md Hasnat Ali, May Zun Aung Win, Somsiri Sukavatcharin, Anup Kelgaonkar, Soumyava Basu","doi":"10.1080/08820538.2025.2599224","DOIUrl":"10.1080/08820538.2025.2599224","url":null,"abstract":"<p><strong>Purpose: </strong>The benefits of anti-tubercular therapy (ATT) in treating ocular tuberculosis (TB) are well documented. However, the optimal duration of ATT remains uncertain. We assessed the efficacy of 6-month ATT compared to 9-month therapy in preventing recurrent intraocular inflammation.</p><p><strong>Design: </strong>Multi-center, open-label, non-inferiority, randomized controlled trial across three centers in India, Myanmar, and Thailand.</p><p><strong>Methods: </strong>Patients aged <math><mo>≥</mo></math> 18 years with tubercular posterior uveitis (retinal vasculitis, serpiginous-like choroiditis [SLC] or multifocal choroiditis) were randomized to receive either 6- or 9-month ATT. Systemic corticosteroids were mandatory for SLC and, at the treating physician's discretion, for other phenotypes. The primary outcome measure was the non-recurrence of inflammation 1 year after ATT.</p><p><strong>Results: </strong>Sixty-four patients (64.1% males, median age 38 years [22-70], 43.8% bilateral) were randomized across the three sites during the study period. Thirty patients were assigned to the 6-month arm and 34 to the 9-month arm. Both treatments demonstrated a high non-recurrence rate on intention-to-treat (ITT) analysis (0.94 [0.79-0.99] for 9-month [<i>n</i> = 32] and 0.85 [0.65-0.96] for 6-month treatment [<i>n</i> = 26]). The difference in proportion remained below the non-inferiority margin (0.16) for both the ITT (0.09 [84% CI -0.02 - 0.2]) and per-protocol (0.13 [84% CI 0.01 - 0.25]) analyses. In subgroup analysis, retinal vasculitis appeared to favor 6-month ATT, and SLC 9-months, with the confidence intervals not deviating on bootstrap resampling. No discontinuation due to drug toxicity was reported in either group.</p><p><strong>Conclusion: </strong>Six-month ATT is non-inferior to 9-month ATT for treating tubercular posterior uveitis, though it may vary between the different clinical phenotypes.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"729-735"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709261","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 48: Doyens of Dacryology Series - James Vose Solomon (1817-1899) and His Methods of Lacrimal Duct Dilatation.","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2553461","DOIUrl":"10.1080/08820538.2025.2553461","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"655-659"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967659","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":"Evaluating the Endoscopic Jones Primary Dye Test in Lacrimal Dysfunction.","authors":"Carmelo Z Macri, Jessica Y Tong, Abdullah I Almater, Dinesh Selva","doi":"10.1080/08820538.2025.2588716","DOIUrl":"10.1080/08820538.2025.2588716","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the diagnostic performance of the endoscopic Jones (eJones) I and II tests in patients presenting with epiphora.</p><p><strong>Methods: </strong>A retrospective review was conducted of patients assessed for epiphora in a tertiary oculoplastic unit. All patients underwent rigid nasal endoscopy, dacryocystography (DCG), and dacryoscintigraphy (DSG). Lacrimal drainage status was categorized as nasolacrimal duct obstruction (NLDO), nasolacrimal duct stenosis (NLDS), or functional epiphora based on imaging findings. eJones I and II test outcomes were compared across diagnostic groups.</p><p><strong>Results: </strong>Thirty-five symptomatic eyes were included. Functional epiphora was identified in 17 eyes, NLDO in 13 eyes, NLDS in one eye, and four eyes demonstrated normal lacrimal systems. All eyes with NLDO or NLDS had negative eJones I results, while all symptomatic eyes with normal imaging findings had positive eJones I results. Eyes with functional epiphora showed mixed eJones I outcomes.</p><p><strong>Conclusions: </strong>The eJones I test reliably confirmed anatomical obstruction but yielded variable results in cases of functional epiphora, highlighting the multifactorial mechanisms underlying this condition. Further studies are warranted to validate and refine the diagnostic utility of eJones testing.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"725-728"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145542347","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}