Seminars in Ophthalmology最新文献

{"title":"Lacrimal History - Part 53: Doyens of Dacryology Series - Dinesh Selva (1967-).","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2549200","DOIUrl":"10.1080/08820538.2025.2549200","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"651-654"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967667","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":"Distinguishing Fungal Keratitis from HSV Endothelial Keratitis: A Comparative Clinical and Diagnostic Analysis.","authors":"Poornima Tandra, Bhupesh Bagga","doi":"10.1080/08820538.2025.2601117","DOIUrl":"10.1080/08820538.2025.2601117","url":null,"abstract":"<p><strong>Purpose: </strong>To differentiate the clinical features of fungal keratitis with predominantly deep stromal and endothelial (FSKE) involvement and HSV Endothelial Keratitis (HEK).</p><p><strong>Methods: </strong>Medical records of patients diagnosed with FSKE or HEK between January 2019 and March 2024 were reviewed. We included cases presenting with predominant posterior stromal infiltrates and endothelial exudates that were later confirmed as fungal etiology by microbiology or confocal imaging. These were compared with confirmed HSV endothelial keratitis, diagnosed clinically and/or by PCR (Polymerase Chain Reaction).</p><p><strong>Results: </strong>A total of 77 cases were included in the study, of which 45 were of FSKE and 32 of HEK. Hyphate edges, along with satellite lesions and the presence of hypopyon, are more commonly seen in fungal cases (66.6% (FSKE) vs. 3.1%, (HEK) OR = 62.0, <i>p</i> = .0001). Posterior stromal involvement was also significantly higher in fungal cases (46.6% vs. 8.8%, OR = 9.4, <i>p</i> = .001). Exudates over the endothelial surface (Endo-exudates) were defined as fluffy in cases with Fungal keratitis as opposed to HSV, where they were more of multiple dot-like (OR = 4.1, <i>p</i> = .005). An intact epithelium was more frequently noted in HEK (84.3% vs. 60% in FSKE, OR = 3.5, <i>p</i> = .02), with the presence of corneal oedema (46.8% vs. 13.3%, OR = 5.7, <i>p</i> = .001). Sampling of these endo-exudates revealed the presence of fungal filaments in 88.8% of fungal keratitis.</p><p><strong>Conclusions: </strong>Hyphate edges, satellite lesions, hypopyon, fluffy endothelial exudates, and posterior stromal involvement strongly suggest fungal aetiology, whereas intact epithelium, corneal edema, and dot-like endothelial exudates favour HSV.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"736-743"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744244","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 54: Doyens of Dacryology Series - Jean-Paul Adenis (1947-).","authors":"Mohammad Javed Ali, Bhupendra C K Patel","doi":"10.1080/08820538.2025.2562768","DOIUrl":"10.1080/08820538.2025.2562768","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"678-681"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075920","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 49: Doyens of Dacryology Series - Benjamin Bell (1749-1806), His Conservative Techniques and Experience with Pellier's Gold and Lead Tubes.","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2555123","DOIUrl":"10.1080/08820538.2025.2555123","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"660-666"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967672","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 Pedigree Study of Leber's Hereditary Optic Neuropathy in Korean Population.","authors":"Dong Hee Ha, Ungsoo Samuel Kim","doi":"10.1080/08820538.2025.2588702","DOIUrl":"10.1080/08820538.2025.2588702","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the pedigree-based penetrance analysis in Korean Leber hereditary optic neuropathy (LHON).</p><p><strong>Methods: </strong>The pedigrees of 32 LHON patients' families were thoroughly examined. Index patients were probands diagnosed by mitochondrial DNA (mtDNA) mutation at the position of 11,778 or 11,484, while secondary cases were affected relatives ascertained through index cases. We identified susceptible and at-risk family members of the index patients. We categorized susceptible individuals as unaffected offsprings connected within the matrilineal lineage and at-risk individual as a susceptible individual under the age of 25. The penetrance rates for family members by their relationship with the index patients were analyzed. The differences in penetrance rates by degree of relationship and sex were also investigated.</p><p><strong>Results: </strong>Among the 32 families, 29 (90.6%) had the 11,778 mutation, while 3 (9.4%) had the 14,484 mutation. The average penetrance rates were 37.1% for male and 10.2% for female. For Koreans, one previous study reported a ratio of 1.6:1, and in the present study, the ratio was found to be 2.3:1. The total number of individuals at risk was 24 (10 males and 14 females).</p><p><strong>Conclusions: </strong>This study expands previous research by offering new information on the penetrance of LHON in the Korean population through pedigree analysis.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"720-724"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513839","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":"Recurrent Dacryocystitis After Prolonged Lacrimal Stent Intubation: A Case Series and Literature Review.","authors":"Can Yang, Kerui Wang, Xinyue Yu, Ziwei Meng, Cong Hu, Xinyu Zheng, Jiayi Zhang, Rongxin Chen, Xuanwei Liang","doi":"10.1080/08820538.2025.2583073","DOIUrl":"10.1080/08820538.2025.2583073","url":null,"abstract":"<p><strong>Purpose: </strong>To report a case series of recurrent dacryocystitis following long-term lacrimal duct intubation, and to clarify the side effects of long-term lacrimal duct intubation.</p><p><strong>Methods: </strong>This study retrospectively evaluated 24 adults (27 eyes) who presented to our center between September 2019 and December 2024 with recurrent dacryocystitis following probing and subsequent stent intubation. Data collected included patient demographics, clinical presentation, duration of intubation, stent-related complications, computer tomography image, management strategies, and prognosis. Systematically reviewed randomized controlled trial articles on lacrimal duct intubation.</p><p><strong>Results: </strong>Several stent-related complications were identified, including: punctal granuloma (11.1%, 3/27), stent fracture (11.1%, 3/27; all three fractured stents were plastic type, with fragments adherent to granulation tissue.), punctal laceration with recurrent extrusion (3.7%, 1/27; gold stent), soft tissue false passages (47.4%, 9/19), and bony false passages (7.4%, 2/27; cases with traumatic lacrimal obstruction). Among patients undergoing dacryocystorhinostomy, functional success was 81.48% (22/27) and anatomical success was 85.19% (23/27). Denominators vary across outcomes due to incomplete data availability for specific variables in the study cohort.</p><p><strong>Conclusions: </strong>This study emphasizes the importance of standardized operative techniques and appropriate duration of intubation to prevent complications associated with lacrimal stenting.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"682-690"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145445748","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":"Visual, Refractive, and Patient-Reported Outcomes After Unilateral Implantation of a Rotationally Asymmetric Refractive Multifocal IOL.","authors":"Hao Zhang, Alexander L Gonzales, Mario Canto-Cerdán, Ana Belén Plaza-Puche, Antonio Martínez-Abad, Pilar Yébana-Rubio, Kateřina Nouzovská, Mariam Agdgomelashvili, Jorge L Alió, Paolo Piqueras Almario, Jorge L Alió Del Barrio","doi":"10.1080/08820538.2026.2712546","DOIUrl":"https://doi.org/10.1080/08820538.2026.2712546","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate visual, refractive, and quality-of-vision outcomes after unilateral cataract surgery or refractive lens exchange (RLE) with implantation of a rotationally asymmetric refractive multifocal intraocular lens (IOL), including the LENTIS Mplus LS-313 MF30 and LENTIS MplusX.</p><p><strong>Methods: </strong>Thirty-nine patients who underwent unilateral lens extraction (24 for cataract, 15 for RLE) with LENTIS Mplus multifocal IOL implantation were analyzed. Examinations were performed preoperatively and postoperatively at 1, 3, and 6 months, and at the final follow-up. Distance, intermediate, and near visual acuity, refraction, wavefront aberrations, contrast sensitivity, defocus curves, and Quality of Vision questionnaire scores were assessed.</p><p><strong>Results: </strong>At the final visit, 60.72 ± 37.75 months postoperatively, mean uncorrected and corrected distance visual acuity were 0.10 ± 0.23 and 0.01 ± 0.08 logMAR, respectively. Mean uncorrected and corrected near visual acuity were 0.10 ± 0.11 and 0.09 ± 0.17 logMAR, respectively. Mean uncorrected intermediate, corrected distance intermediate, and corrected distance near visual acuity were 0.12 ± 0.14, 0.12 ± 0.07, and 0.12 ± 0.15 logMAR, respectively. Defocus curves demonstrated broad functional vision across distance, intermediate, and near ranges. Contrast sensitivity and quality-of-vision outcomes suggested generally mild visual disturbances.</p><p><strong>Conclusion: </strong>Unilateral implantation was well tolerated, with favorable monocular and binocular performance, high refractive predictability, and minimal optical side effects.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-10"},"PeriodicalIF":3.1,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631546","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":"Teprotumumab for Dysthyroid Optic Neuropathy: A Systematic Review and Single-Arm Meta-Analysis of Visual and Orbital Outcomes.","authors":"Amr Tahoun, Marwan Tahoun, Rana Tahoun","doi":"10.1080/08820538.2026.2708223","DOIUrl":"https://doi.org/10.1080/08820538.2026.2708223","url":null,"abstract":"<p><strong>Importance: </strong>Dysthyroid optic neuropathy (DON) is a sight-threatening complication of thyroid eye disease (TED). The pivotal teprotumumab trials excluded patients with DON, and the only prior treatment meta-analysis addressed intravenous glucocorticoids and orbital decompression, leaving the role of teprotumumab in DON unsynthesised.</p><p><strong>Objective: </strong>To systematically review and, where possible, meta-analyse visual and orbital outcomes following teprotumumab treatment for DON.</p><p><strong>Methods: </strong>PubMed, Ovid (MEDLINE/Embase) and Web of Science were searched from inception to 7 June 2026, following PRISMA 2020 guidelines. Eligible studies enrolled adults with DON treated with teprotumumab. Single-arm random-effects meta-analysis (inverse-variance, REML) pooled the proportion with DON resolution and mean changes in proptosis and best-corrected visual acuity (BCVA); risk of bias was assessed with the ROBINS-I tool.</p><p><strong>Results: </strong>Of 310 unique records, 4 reports met eligibility. Four multi-patient series/cohorts (40 patients) were meta-analyzed. The pooled proportion with DON resolution was 0.77 (95% CI 0.58-0.89; k = 4, I² = 0%). Proptosis fell by a pooled -4.80 mm (95% CI - 6.69 to -2.90; k = 3) but with substantial heterogeneity (I² = 87%), with a two-study BCVA estimate of -0.56 logMAR. Visual fields, color vision and relative afferent pupillary defects improved in the large majority of eyes, often within one to two infusions; DON recurred in approximately 15% at long-term follow-up.</p><p><strong>Conclusion: </strong>The available data on teprotumumab for DON come from only a few small retrospective series without comparator groups, leaving certainty low to very low; even so, treated eyes showed reproducible and frequently early recovery of vision, reversal of optic neuropathy, and reversal of proptosis, and this lack of definitive trial evidence should not be seen as absence of benefit. Because the antibody acts directly on the orbital tissue expansion that compresses the optic nerve, it is a plausible first-line medical option for DON where it is accessible and patients can be monitored closely, provided that eyes failing to improve promptly are escalated without delay to orbital decompression and that emergency surgery remains the response to rapidly worsening sight loss. Adequately designed prospective comparative studies, with longer follow-up of recurrence, safety, and cost, are needed to establish teprotumumab's place in the DON treatment pathway.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-8"},"PeriodicalIF":3.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620892","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":"Comparative Efficacy and Safety of XEN®45 Gel Stent versus Preserflo™ in Glaucoma: A Systematic Review and Meta-Analysis.","authors":"Yousef Mesaed Al-Shammari, Nour Kamal Behbehani, Abdulaziz Mohammed Abdulaziz Almutawaa, Aljawhara Mesaed Al-Shammari, Sayier Salem Alshamari, Hasan Alshawaf","doi":"10.1080/08820538.2026.2706140","DOIUrl":"https://doi.org/10.1080/08820538.2026.2706140","url":null,"abstract":"<p><strong>Background: </strong>Glaucoma is a leading cause of irreversible blindness. Lowering intraocular pressure (IOP) is the only proven way to slow progression. XEN®45 and PRESERFLO™ are minimally invasive bleb-forming devices used in glaucoma surgery. Their comparative performance remains debated.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis according to PRISMA guidelines. PubMed, Scopus, and Web of Science were searched through November 2025. Studies directly comparing XEN®45 and PRESERFLO™ were included. The primary outcomes were postoperative IOP and surgical success (Criteria A: IOP < 21 mmHg with ≥20% reduction and no repeat surgery). Secondary outcomes included number of glaucoma medications and postoperative revisions. Random-effects models were used.</p><p><strong>Results: </strong>Six studies including 840 eyes were analyzed. XEN®45 was associated with higher postoperative IOP compared with PRESERFLO™ (MD = 1.63 mmHg, <i>p</i> < .0001, I² = 0.0%). XEN®45 also showed lower surgical success (RR = 0.72, <i>p</i> < .0001, I² ≈ 0%). No significant difference was found in medication reduction or revision rates in the primary analysis. Sensitivity analyses confirmed the robustness of the main findings.</p><p><strong>Conclusions: </strong>Both devices are effective. However, PRESERFLO™ achieved lower IOP and higher surgical success under strict criteria. The differences were small but consistent. PRESERFLO™ may offer a modest advantage in patients requiring low target IOP.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-9"},"PeriodicalIF":3.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562983","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":"Artificial Intelligence in Inherited Retinal Diseases: Imaging-Based Applications and Emerging Trends.","authors":"Eirini Maliagkani, Anna Gkoritsa, Konstantinos Tyrlis, Stylianos Kandarakis, Ilias Georgalas","doi":"10.1080/08820538.2026.2707227","DOIUrl":"https://doi.org/10.1080/08820538.2026.2707227","url":null,"abstract":"<p><strong>Introduction: </strong>Inherited retinal diseases (IRDs) represent a heterogeneous group of progressive disorders that lead to visual impairment and blindness while posing significant diagnostic and management challenges. Advances in retinal imaging have improved clinical assessment; however, early diagnosis, disease monitoring, and prognostic evaluation remain difficult, particularly given the genetic and phenotypic complexity of IRDs. Artificial intelligence (AI), especially deep learning (DL), has emerged as a promising tool for addressing these challenges in ophthalmology.</p><p><strong>Methods: </strong>This narrative review summarizes recent peer-reviewed studies investigating the application of AI to retinal imaging modalities in IRDs. We focused on AI-based approaches for disease detection, segmentation, classification, and prognostic assessment using imaging techniques such as optical coherence tomography (OCT), fundus autofluorescence (FAF), and color fundus photography. Peer-reviewed studies published between 2019 and 2025 were reviewed.</p><p><strong>Results: </strong>The reviewed literature demonstrates that AI models can achieve high performance in automated image analysis tasks, particularly in retinitis pigmentosa (RP) and Stargardt disease (STGD). DL-based methods showed strong results in retinal layer and lesion segmentation, disease classification, and structure-function analysis. Emerging applications include prognostic modeling and identification of retinal regions with preserved functional or therapeutic potential, although these remain less well explored. Key limitations across studies include small datasets, limited external validation, lack of longitudinal analyses, and minimal integration of explainable AI techniques.</p><p><strong>Discussions: </strong>AI has substantial potential to support imaging-based diagnosis and management of IRDs, particularly through automated image analysis and quantitative assessment of retinal biomarkers. However, current evidence remains limited by small datasets, scarce external validation, lack of longitudinal analysis, and variability in imaging protocols across studies. Future research should emphasize collaborative multicenter efforts, integration of multimodal imaging data, longitudinal monitoring, independent external validation, and the development of interpretable AI systems to improve robustness and support broader clinical adoption.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-12"},"PeriodicalIF":3.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550331","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}