Seminars in Ophthalmology最新文献

{"title":"Pregnancy-Related Changes in Macular and Ganglion Cell Layer Thickness: A Longitudinal OCT Analysis.","authors":"Andromachi Rapanou, Thomas Chontos, Menelaos Kanakis, Konstantinos Tyrlis, George D Kymionis, Ilias Georgalas","doi":"10.1080/08820538.2026.2706145","DOIUrl":"https://doi.org/10.1080/08820538.2026.2706145","url":null,"abstract":"<p><strong>Introduction: </strong>Pregnancy induces substantial physiological adaptations that affect the eye. Evidence regarding the effect of normal pregnancy on retinal parameters remains limited and inconsistent. This prospective longitudinal study aimed to evaluate ganglion cell layer (GCL) thickness and macular retinal thickness in healthy women during the third trimester of pregnancy and the postpartum period.</p><p><strong>Methods: </strong>91 right eyes of 91 pregnant women were consecutively recruited between November 2017 and June 2024. All participants underwent comprehensive ophthalmic examination and spectral-domain optical coherence tomography (OCT) imaging. Third trimester and postpartum measurements were compared. GCL thickness was assessed in six macular EDTRS sectors, and retinal thickness was assessed in nine macular EDTRS sectors. Paired comparisons were performed using the Wilcoxon signed-rank test, with Benjamini-Hochberg correction applied for multiple testing.</p><p><strong>Results: </strong>Postpartum GCL thickness was significantly greater postpartum in all sectors except the inferonasal sector, which nonetheless showed a similar trend. Retinal thickness was also significantly greater postpartum in several parafoveal sectors. Central and perifoveal sectors showed non-significant increases in the same direction.</p><p><strong>Conclusions: </strong>Normal pregnancy is associated with subtle, region-specific reductions in GCL and macular thickness. These findings support that physiological pregnancy-related changes influence retinal structure even in uncomplicated pregnancies. Larger longitudinal studies are warranted 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":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472460","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":"Treatment Choice in Neovascular Glaucoma: Pars Plana Vitrectomy First, Followed by Ahmed Glaucoma Valve Implantation, or Both Simultaneously?","authors":"Büşra Yılmaz Tuğan, Ecem Önder Tokuç, Damla Demir Çevik, Levent Karabaş, Nurşen Yüksel","doi":"10.1080/08820538.2026.2701240","DOIUrl":"https://doi.org/10.1080/08820538.2026.2701240","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the long-term surgical success rates, clinical outcomes and complications of simultaneous pars plana vitrectomy (PPV) and Ahmed glaucoma valve (AGV) implantation versus AGV implantation performed after PPV in eyes with neovascular glaucoma (NVG) and intractable intraocular pressure (IOP).</p><p><strong>Methods: </strong>This retrospective study evaluated 39 eyes of 39 NVG patients who were divided into two groups: those treated with combined PPV and AGV implantation (Group 1, <i>n</i> = 18) and those treated with AGV implantation after PPV (Group 2, <i>n</i> = 21). Complete success was defined as postoperative IOP of 5-21 mmHg without antiglaucoma medication (AGM); qualified success was defined as postoperative IOP in the same range with or without AGM.</p><p><strong>Results: </strong>Preoperative characteristics were similar between the groups. The median baseline IOP was 37.0 (32.8-45.3) mmHg in Group 1 and 36.0 (29.5-44.0) mmHg in Group 2 (<i>p</i> = .813). Group 1 showed significantly lower median IOP at postoperative day 1 (18.0 vs. 20.0 mmHg, <i>p</i> = .035) and week 2 (11.5 vs. 18.5 mmHg, <i>p</i> = .043) compared with Group 2. At the final visit, IOP levels were comparable (14.0 vs. 15.0 mmHg, <i>p</i> = .944). Hyphema was more frequent in Group 1 (50%) than in Group 2 (14.3%) in the early postoperative period. Long-term surgical success rates for complete success (<i>p</i> = .209) and qualified success (<i>p</i> = .521) did not significantly differ between the groups. At 5 years, qualified success rates were 77.1% for Group 1 and 75.0% for Group 2.</p><p><strong>Conclusion: </strong>Both simultaneous and sequential approaches are safe and effective, offering comparable long-term success for NVG management. The simultaneous approach provides faster initial IOP control and reduces surgical burden. Despite higher early transient inflammation, long-term IOP control or surgical success remains uncompromised.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-8"},"PeriodicalIF":3.1,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431129","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":"Comparison of Corneal Endothelial and Anterior Segment Changes After Nd:YAG Laser Capsulotomy in Eyes with and without Pseudoexfoliation Syndrome.","authors":"Osman Özen, Menekşe İnal Özen, Firdevs Örnek","doi":"10.1080/08820538.2026.2699401","DOIUrl":"https://doi.org/10.1080/08820538.2026.2699401","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the changes in corneal endothelium and anterior segment parameters following neodymium:yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy in eyes with and without pseudoexfoliation syndrome (PEX).</p><p><strong>Methods: </strong>Our study included 72 eyes with posterior capsular opacification (PCO). Patients were divided into two groups: PEX and control. All patients underwent detailed examination followed by Nd:YAG laser. Corneal endothelium was evaluated using specular microscopy, and anterior segment parameters were assessed using Sirius corneal topography before laser, at 1 week and 1 month post-laser. Findings were compared between PEX and control groups.</p><p><strong>Results: </strong>Of the 72 eyes, 30 were in the PEX group and 42 in the control group. There was no difference between groups in terms of baseline demographic, clinical data, and laser parameters (<i>p</i> > .05). Although mean pre-laser endothelial cell density (ECD) was lower in the PEX group, the difference was not statistically significant (<i>p</i> = .121). Significant improvement in BCVA was observed in both groups after laser (<i>p</i> < .001), but no significant changes were noted in intraocular pressure (IOP) or anterior segment parameters. Post-laser ECD values decreased significantly in the PEX group (<i>p</i> = .032), while no change was observed in the control group (<i>p</i> = .246). No significant correlation was found between laser energy parameters and clinical variables.</p><p><strong>Conclusion: </strong>A significant decrease in ECD was observed in the PEX group after Nd:YAG laser, whereas this difference was not prominent in the control group. Our results suggest that evaluating ECD before Nd:YAG laser may help minimize potential endothelial damage, especially in patients with PEX.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":3.1,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391639","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":"Longitudinal Structural and Functional Trajectories Following Netarsudil Intensification or Surgical Escalation in Primary Open-Angle Glaucoma.","authors":"Eun Seong Kim, Sang Wook Jin","doi":"10.1080/08820538.2026.2698650","DOIUrl":"https://doi.org/10.1080/08820538.2026.2698650","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize short-term structural and functional progression trajectories in medically uncontrolled primary open-angle glaucoma (POAG) managed with adjunctive netarsudil intensification or immediate surgical escalation.</p><p><strong>Methods: </strong>This retrospective cohort study included 110 eyes with POAG receiving maximally tolerated medical therapy. Thirty-seven eyes underwent netarsudil intensification and 73 eyes underwent trabeculectomy or tube shunt surgery. Stabilized inverse probability weighting was applied to balance baseline covariates. The primary outcome was the 12-month slope of visual field mean deviation (MD). Secondary outcomes included retinal nerve fiber layer (RNFL) thinning rate and intraocular pressure (IOP) reduction.</p><p><strong>Results: </strong>The estimated MD progression rate was -0.61 ± 0.58 dB/year in the netarsudil group and -0.42 ± 0.55 dB/year in the surgical group (between-group difference -0.17 dB/year; 95% CI, -0.38 to 0.04; <i>p</i> = .112). RNFL thinning rates were -1.8 ± 2.1 µm/year and -1.1 ± 1.9 µm/year, respectively (between-group difference -0.7 µm/year; 95% CI, -1.6 to 0.2; <i>p</i> = .138). Surgical management achieved greater IOP reduction (-12.3 ± 3.8 mmHg vs - 5.4 ± 2.3 mmHg; <i>p</i> < .001). During follow-up, 27% of eyes in the netarsudil group required subsequent surgical escalation.</p><p><strong>Conclusions: </strong>Although surgery achieved greater IOP reduction, short-term structural and functional trajectories remained similar after treatment escalation over 12 months.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-8"},"PeriodicalIF":3.1,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376773","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":"Unravelling Stevens-Johnson Syndrome: Clinicopathological Insights and Therapeutic Advances.","authors":"Ranjan Kumar Behera, Parul Chawla Gupta, Manu Saini, Anu Malik, Pankaj Gupta","doi":"10.1080/08820538.2025.2565502","DOIUrl":"10.1080/08820538.2025.2565502","url":null,"abstract":"<p><strong>Introduction: </strong>Stevens-Johnson syndrome and Toxic Epidermal Necrolysis are a group of immunologically driven, multisystemic and dermatological blistering diseases. Certain classes of drugs and occasional viral infections are usually the inciting factors. The clinical presentation is generally nonspecific and can progress to severe ocular and vision-threatening complications, with prognosis depending upon several factors. Several grading systems exist to assess the impact of the disease, both in the acute and chronic phases. Diagnosis can be made based on clinical history, examination, and a questionnaire-based approach involving different bodily systems.</p><p><strong>Methods: </strong>A literature search was conducted using various relevant keywords across different electronic databases. A total of 83 articles were included in the study.</p><p><strong>Results: </strong>This comprehensive review highlights the various aspects of Stevens-Johnson syndrome, including disease burden, etiopathogenesis, clinical presentation, disease grading, diagnosis, and management of both the acute and chronic phases.</p><p><strong>Discussion: </strong>Timely management by a multidisciplinary team is required to prevent long-term complications. Amniotic membrane transplantation is beneficial in the acute phase, in conjunction with medications, and in the chronic phase for surgical interventions such as eyelid malposition, persistent corneal epithelial defects, and lid margin keratinisation. For end-stage disease, procedures such as eyelid surgeries, amniotic membrane transplantation, mucous membrane grafting, and keratoprosthesis can help in ocular salvage.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"579-593"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308994","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 Application of Artificial Intelligence in Epiretinal Membrane from Detection to Prognosis Prediction.","authors":"Muxin Xu, Jianwei Lin, Shirong Chen, Yuqiang Huang","doi":"10.1080/08820538.2025.2583072","DOIUrl":"10.1080/08820538.2025.2583072","url":null,"abstract":"<p><strong>Introduction: </strong>Epiretinal membrane (ERM) is a prevalent vitreoretinal interface disorder characterized by fibro-cellular proliferation on the inner retinal surface. The prevalence increases markedly with age, and progressive membrane contraction distorts retinal architecture, producing metamorphopsia and irreversible visual impairment thereby significantly impairing patients' quality of life. This highlights the need for more accurate and efficient diagnostic and therapeutic strategies. Artificial intelligence (AI) has emerged as a promising tool to address such challenges. This review summarizes and evaluates recent studies on the applications of AI in ERM management, identifying current limitations and future research directions.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed, Web of Science, Embase, and Cochrane Library databases, focusing on studies related to AI and ERM published over the past decade.</p><p><strong>Results: </strong>The findings indicate that while research on treatment and prognosis prediction remains limited, and new technologies are expected in image processing, current AI models demonstrate substantial potential in the ERM management, especially in detection and diagnosis.</p><p><strong>Discussions: </strong>Nonetheless, current evidence is constrained by challenges such as single-center design, limited external validation across devices or ethnicities, insufficient multimodal imaging, and lack of health-economic or workflow integration data. Future multicenter prospective studies, federated learning platforms, publicly annotated imaging dataset and cost-effectiveness analyses are warranted to develop robust, generalizable models that can be seamlessly integrated into clinical workflows, substantially optimizing ERM management and delivering tangible benefits to both patients and clinical practice.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"594-603"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482838","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 42: Doyens of Dacryology Series - François Codère (1952-) Jane Madeleine Olver (1954-), and David Irving Silbert (1962-).","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2535094","DOIUrl":"10.1080/08820538.2025.2535094","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"563-567"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660107","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":"Dual Margins on Autofluorescence in Tubercular Serpiginous-Like Choroiditis: A Biomarker for Increased Risk of Paradoxical Worsening and the Need for Immunosuppression.","authors":"Navya Cherukuri, Avinash Pathengay, Mudit Tyagi, Sai Bhakti Mishra, Soumyava Basu, Rajeev R Pappuru","doi":"10.1080/08820538.2025.2588206","DOIUrl":"10.1080/08820538.2025.2588206","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the prognostic role of dual margins on fundus autofluorescence (AF) in predicting treatment outcomes in tubercular serpiginous-like choroiditis (TB SLC).</p><p><strong>Design: </strong>Retrospective interventional study.</p><p><strong>Methods: </strong>Patients with active TB SLC demonstrating dual hyperautofluorescent margins with an intervening hypoautofluorescent zone on baseline AF, positive laboratory evidence of tuberculosis, radiological evidence of active or healed TB, and ≥3 months follow-up were included. Each case was matched with three controls without dual margins. All patients received oral corticosteroids (prednisolone 1 mg/kg, tapered over 1-2 months) with concurrent antitubercular therapy. Primary outcomes were paradoxical worsening (PW), recurrence, and need for additional immunosuppression. Logistic regression was used to analyze risk factors for PW.</p><p><strong>Results: </strong>Three hundred and sixty-six patients of active SLC were screened and twenty-one cases and 63 controls were evaluated. PW occurred significantly more often in the dual-margin group (47.6% vs. 14.3%, <i>p</i> = .002). Recurrence rates were comparable (9% vs. 6%, <i>p</i> = .63). Escalation of immunosuppression, including increased corticosteroid use or additional immunomodulatory therapy, was required more frequently in cases (47.6% vs. 20.6%, <i>p</i> = .01).</p><p><strong>Conclusion: </strong>Dual AF margins may serve as an imaging biomarker of aggressive TB SLC and may predict higher risk of PW and greater immunosuppressive requirements. Early recognition may facilitate closer follow-up and timely therapeutic escalation.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"644-650"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513786","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 47: Doyens of Dacryology Series - Sir William Blizard (1743-1835) and His Lacrimal Irrigation with Quicksilver.","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2541504","DOIUrl":"10.1080/08820538.2025.2541504","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"568-573"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144744884","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":"Beyond the Label: Inconsistencies in AREDS2 Eye Supplements and a Call for Standardisation.","authors":"David Beckers, David Lockington, Florian Kretz, Lena Beckers","doi":"10.1080/08820538.2025.2577391","DOIUrl":"10.1080/08820538.2025.2577391","url":null,"abstract":"<p><strong>Purpose: </strong>Age-related macular degeneration (AMD) remains a major cause of vision impairment among older adults globally. While treatment exists for the more aggressive, exudative form, options for managing nonexudative AMD are limited. One of the few interventions with scientific backing is the AREDS2 micronutrient formula, which has demonstrated an ability to slow disease progression in patients with intermediate AMD.This investigation set out to systematically assess over-the-counter supplements in the UK that are promoted for macular support, measuring how closely their contents align with the evidence-based AREDS2 formulation.</p><p><strong>Methods: </strong>Products marketed as beneficial for AMD were collected and analyzed. Their labeled ingredients and dosages were directly compared with the standardized nutrient profile outlined in the AREDS2 clinical trials.</p><p><strong>Results: </strong>The analysis revealed that most commercially available supplements deviated markedly from the AREDS2 formula. On average, vitamin C levels were 52.3% lower than recommended, vitamin E levels were 61.2% lower, and zinc content was reduced by 40.1%. Only a small subset of products fully matched both the composition and dosage of the reference formulation.</p><p><strong>Conclusion: </strong>These findings highlight a significant gap between marketed claims and clinical evidence. Most supplements do not meet the established AREDS2 standards, potentially limiting their efficacy. Some were promoted specifically for AMD, while others used general \"macular health\" claims, adding to patient confusion. This inconsistency underscores the need for regulatory measures to enforce standardized labeling and formulation requirements to ensure informed clinical recommendations.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"627-630"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313504","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}