Seminars in Ophthalmology最新文献

{"title":"Surgical Management of Corneal Sequelae of Vernal Keratoconjunctivitis.","authors":"Supriya Sharma, Prajakta Dandekar, Vaibhav Nagpal, Anahita Kate, Somasheila I Murthy","doi":"10.1080/08820538.2025.2551061","DOIUrl":"https://doi.org/10.1080/08820538.2025.2551061","url":null,"abstract":"<p><strong>Purpose: </strong>Vernal keratoconjunctivitis (VKC) is a chronic, recurrent, allergic ocular surface disorder affecting children and young adults, particularly in tropical climates. Corneal sequelae such as giant papillae (GP), shield ulcers, limbal stem cell deficiency (LSCD), and keratoconus (KC) often necessitate surgical intervention when medical therapy is inadequate. This review summarizes the current surgical strategies for managing VKC-related corneal complications and their outcomes.</p><p><strong>Methods: </strong>comprehensive review of published literature was undertaken using PubMed, Scopus, and Google Scholar up to 2025. Studies focusing on the surgical management of GP, shield ulcers, LSCD, and KC in VKC were analyzed. Emphasis was placed on surgical indications, techniques, outcomes, and adjunctive measures.</p><p><strong>Results: </strong>Surgical excision of refractory GP, combined with adjuvants such as mitomycin-C, amniotic membrane transplantation, or mucous membrane grafting, reduces recurrence and improves ocular surface stability. Shield ulcers benefit from early surgical debridement and amniotic membrane use to prevent scarring and neovascularization. LSCD secondary to VKC can be successfully managed with conjunctival autografts in partial cases, while total LSCD requires allogeneic simple limbal epithelial transplantation with systemic immunosuppression. Keratoconus associated with VKC is often severe and rapidly progressive. Corneal collagen cross-linking is effective when inflammation is controlled, while intrastromal corneal ring segments and keratoplasty (deep anterior lamellar keratoplasty preferred over penetrating keratoplasty) provide visual rehabilitation in advanced cases.</p><p><strong>Conclusion: </strong>Surgical management is pivotal in addressing refractory corneal complications of VKC and in preserving long-term vision. Tailoring surgical intervention to disease severity, ensuring adequate control of ocular surface inflammation, and adopting a multidisciplinary approach integrating medical therapy, surgery, and immunomodulation are essential for optimal outcomes.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-10"},"PeriodicalIF":2.3,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967722","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":"Radiographic Changes of the Nasolacrimal Duct in Silent Sinus Syndrome.","authors":"Lisa Y Lin, Nandini Bothra, Michael K Yoon","doi":"10.1080/08820538.2025.2551064","DOIUrl":"https://doi.org/10.1080/08820538.2025.2551064","url":null,"abstract":"<p><strong>Purpose: </strong>Silent sinus syndrome (SSS), known as chronic maxillary atelectasis, is characterized by inward collapse of the maxillary sinus walls with resultant bowing of the maxillary sinus bones due to negative antral pressures. Functional endoscopic sinus surgery (ESS) is an important first step to normalize pressures. The impact of SSS on nasolacrimal duct (NLD) anatomy remains unclear. The study hypothesized that SSS may distort NLD anatomy, since the duct sits within the maxillary bone, and aimed to compare the radiographic changes on the affected and unaffected sides, as well as pre- and post-ESS.</p><p><strong>Methods: </strong>A retrospective review was conducted on patients with computed tomography (CT) face/orbit with radiographic findings of SSS. A subset who underwent ESS with a post-operative CT was included for secondary analysis. The NLD, sinus, and orbit were measured in a standardized fashion. Primary outcome assessed differences between the affected and unaffected sides, while secondary outcomes evaluated pre- and post-ESS changes. Analysis was performed with a paired-t test.</p><p><strong>Results: </strong>Twenty patients met inclusion criteria, with 12 included in post-ESS analysis. The affected side showed significantly smaller maxillary sinus width and height, and orbit height (<i>p</i> < .001). The distal NLD (lateral) was 0.44 mm larger on the affected side (<i>p</i> = .01), but all other NLD measurements were not significant. No significant changes were observed in NLD, sinus, or orbit measurements after ESS.</p><p><strong>Conclusions: </strong>SSS did not significantly distort NLD anatomy, nor were there anatomical changes post-ESS, aside from a larger distal NLD on the affected side, possibly due to bowing of the inferior turbinate. Future directions could consider 3-D volumetric analysis of the NLD.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-5"},"PeriodicalIF":2.3,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967706","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 Passage Obstruction and Cataract Surgery: A Scoping Review and Recommendations for General Ophthalmology Practice.","authors":"Mohammed Almanassra, Rath Suryasnata","doi":"10.1080/08820538.2025.2551857","DOIUrl":"https://doi.org/10.1080/08820538.2025.2551857","url":null,"abstract":"<p><strong>Background: </strong>Lacrimal passage obstruction is common in patients with significant cataract awaiting surgery and may increase the risk of post-perative endophthalmitis.</p><p><strong>Method: </strong>A PubMed-based search was conducted for a scoping review of the published evidence. In total, 17 articles were included.</p><p><strong>Results: </strong>Overall, there is a dearth of scientific evidence on this subject, and the available studies are of poor quality. Nevertheless, some recommendations can be made. Evidence supports the recommendation that a routine lacrimal screening protocol should be performed before cataract surgery to decrease postoperative risk. Both lacrimal irrigation and regurgitation on pressure over the lacrimal sac (ROPLAS), or the micro-reflux test combined with a history of epiphora, have good sensitivity and excellent specificity for diagnosing nasolacrimal duct obstruction. An interval of about four weeks between dacryocystorhinostomy (DCR) and cataract surgery appears adequate for normalization of bacterial flora.</p><p><strong>Conclusion: </strong>Although evidence is limited and of low quality, routine lacrimal screening and appropriate timing after DCR seem advisable in patients planned for cataract surgery.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-5"},"PeriodicalIF":2.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967744","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":"Differential Sex-Based Enrolment into US-Registered Glaucoma Clinical Trials: A Cross-Sectional Study.","authors":"Brendan K Tao, Jim S Xie, Anastasiya Vinokurtseva, John Liu, Hareshan Suntharalingam, Manvis Xia, Nawaaz Nathoo, Matthew Schlenker, Kulbir Gill, Cindy M L Hutnik","doi":"10.1080/08820538.2025.2553697","DOIUrl":"https://doi.org/10.1080/08820538.2025.2553697","url":null,"abstract":"<p><strong>Purpose: </strong>We conducted a cross-sectional study of sex, racial, and ethnic patient enrolment to glaucoma-related randomized controlled trials (RCTs) registered on ClinicalTrials.gov (to January 2023).</p><p><strong>Methods: </strong>Trials were included if they were at least double-masked, completed, and had published results through the registry or a scholarly journal. Sex-based glaucoma disease burden was identified using the Global Burden of Disease database. Pooled population-to-prevalence ratios (PPRs) with 95% confidence intervals (CI) were calculated for female sex, with values between 0.8 and 1.2 constituting sufficient study enrolment.</p><p><strong>Results: </strong>From 1061 records, we identified 177 trials (<i>N</i> = 38.475; 56.2% females) for inclusion in the study. The pooled female PPR was 1.05 [95% CI 1.02, 1.08]. Sub-group analysis revealed equitable female enrolment across study characteristics, although studies published prior to 1997 were indeterminate on whether they under-enrolled female participants.</p><p><strong>Conclusions: </strong>Overall, US-registered, glaucoma-related trials enrolled acceptable proportions of females based on real-world disease burden. Future trial enrolment should strive for equitable demographic representation.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-5"},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967686","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":"Tear Film-Based Diagnostics and Emerging Tissue Engineering Approaches in Personalized Dry Eye Disease Management.","authors":"Vineet Joshi, Sonali Mohapatra, Mahi Al Ahmad Dar, Rohini Sonar, Tejaswini Pingali, Deeksha Prasad, Pragnya Rao Donthineni, Swati Singh, Vivek Singh","doi":"10.1080/08820538.2025.2548865","DOIUrl":"https://doi.org/10.1080/08820538.2025.2548865","url":null,"abstract":"<p><strong>Purpose: </strong>The dry eye disease(DED) is caused by many possible factors, manifesting classical symptoms such as irritation, pain, and visual disturbance, which can severely impact the quality of life.  This review aims to critically evaluate currently available point‑of‑care (POC) diagnostic kits for DED, focusing on osmolarity‑based and biomarker‑based assays, while exploring emerging technologies that promise better precision and personalized management.</p><p><strong>Methods: </strong>A comprehensive literature survey (2010-2025) was undertaken using PubMed, Scopus, and Google Scholar to identify studies assessing DED pathophysiology, tear film biomarkers, and commercially available diagnostic systems. Particular emphasis was placed on kits measuring tear osmolarity (TearLab, I-PEN, ScoutPro) and inflammatory or protective biomarkers (MMP‑9, lactoferrin, IL‑6).</p><p><strong>Results: </strong>Osmolarity‑based kits provide rapid, reproducible insights into tear hyperosmolarity, a recognized hallmark of DED, but also has limitations due to environmental variability, reflex tearing, and cost. Biomarker‑based kits, particularly MMP‑9 (InflammaDry) and lactoferrin assays, enhance diagnostic specificity by targeting ocular surface inflammation and lacrimal gland dysfunction, respectively. Emerging multiplex immunoassays, nanobiosensors, and paper‑based microfluidic platforms offer quick, low‑volume demand, and multi‑analyte detection with precise disease stratification potential.</p><p><strong>Conclusion: </strong>Current diagnostic kits have improved early detection and management of DED but are still limited by single parameter constraints, moderate reproducibility, and high costs. The combination of multiplex biomarker panels, biosensor technologies, and patient-specific organ-on-chip models is a promising deal toward precision diagnostics.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-14"},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967708","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":"https://doi.org/10.1080/08820538.2025.2553461","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-5"},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","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":"Ocular Complications in stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Comprehensive Review.","authors":"Kiana Hassanpour, Hassan Asadigandomani, Sahel Soltani Shahgoli, Amirmohammad Amoozadehsamakoosh, Mohammad Soleimani","doi":"10.1080/08820538.2025.2548869","DOIUrl":"https://doi.org/10.1080/08820538.2025.2548869","url":null,"abstract":"<p><strong>Background: </strong>Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis are rare but life-threatening mucocutaneous disorders, primarily triggered by adverse drug reactions. Although systemic manifestations have been extensively studied, ocular involvement remains a major cause of morbidity, often resulting in severe visual impairment or blindness.</p><p><strong>Methods: </strong>This narrative review synthesizes current evidence regarding the clinical presentation, pathophysiology, and management strategies for ocular complications in SJS/TEN. A comprehensive literature search was conducted to highlight both acute and chronic ophthalmic manifestations and therapeutic interventions.</p><p><strong>Results: </strong>Ocular involvement is reported in up to 75% of SJS/TEN patients during the acute phase, manifesting as conjunctivitis, pseudomembrane formation, corneal erosions, and eyelid abnormalities. Early interventions such as lubrication, topical corticosteroids, and amniotic membrane transplantation (AMT) have shown efficacy in mitigating long-term damage. Nonetheless, a substantial number of patients develop chronic complications including symblepharon, limbal stem cell deficiency, and severe dry eye syndrome. Long-term management involves scleral lenses and surgical procedures such as limbal stem cell transplantation, mucous membrane grafting (MMG), and keratoprosthesis. Innovations like ProKera® have improved epithelial healing, yet irreversible damage from the acute phase remains a persistent challenge.</p><p><strong>Conclusion: </strong>Ocular complications of SJS/TEN are multifaceted and necessitate early and sustained multidisciplinary management. Timely ophthalmologic intervention is crucial in the acute phase, while chronic care aims to restore ocular surface stability and preserve vision. Further research is needed to develop standardized treatment protocols and explore emerging therapies that may enhance long-term outcomes and quality of life.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-15"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967717","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 Disorders in Children\": A Comprehensive Review of Pathogenesis, Diagnosis, and Management.","authors":"Venugopal Anitha, Anita Rhagavan, Srinivas K Rao, Bhasker Srinivasan, Rakhi Kusumesh, Nambi Nallasamy, Meenakshi Ravindran","doi":"10.1080/08820538.2025.2536228","DOIUrl":"https://doi.org/10.1080/08820538.2025.2536228","url":null,"abstract":"<p><strong>Purpose: </strong>To provide a comprehensive overview of Pediatric ocular surface disorders (OSD), encompassing their epidemiology, pathogenesis, clinical manifestations, diagnostic modalities, and evolving management strategies.</p><p><strong>Methods: </strong>A narrative review of current literature was conducted, synthesizing data from clinical studies, case series, and expert consensus on the diagnosis and treatment of Pediatric OSD. Emphasis was placed on recent therapeutic advancements and multidisciplinary approaches to care.</p><p><strong>Results: </strong>Pediatric OSD comprises a heterogeneous group of infectious, inflammatory, allergic, and traumatic conditions. Management varies by severity, ranging from conservative approaches such as lubricants and antihistamines to advanced therapies including immunomodulators, amniotic membrane transplantation, and keratoprosthesis. Novel treatments such as cytokine-targeted biologics, stem cell-based therapies, and scleral contact lenses are expanding therapeutic options. Early and accurate diagnosis, alongside individualized care plans, are critical for preserving ocular surface integrity and preventing long-term complications.</p><p><strong>Conclusions: </strong>Management of Pediatric OSD requires a multidisciplinary and personalized approach. Growing awareness among clinicians, along with the integration of novel therapeutics, holds promise for improved patient outcomes. Standardized management protocols and continued research into emerging therapies are essential to optimize ocular health and quality of life in children affected by OSD.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-17"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967599","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 53: Doyens of Dacryology Series - Dinesh Selva (1967-).","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2549200","DOIUrl":"https://doi.org/10.1080/08820538.2025.2549200","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-4"},"PeriodicalIF":2.3,"publicationDate":"2025-08-21","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":"Challenges in Managing the Ocular Complications of Stevens-Johnson Syndrome in Patients with Co-Existent Auto-Immune Disease.","authors":"Sujaya Singh, Lim Yi Wen, Cheau Wei Chin, Raveendran Ramachandran, Jasmin Raja","doi":"10.1080/08820538.2025.2540815","DOIUrl":"https://doi.org/10.1080/08820538.2025.2540815","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the clinical course and management challenges of chronic ocular complications in Stevens-Johnson syndrome (SJS) patients with co-existing autoimmune diseases, emphasizing the role of systemic immunomodulatory therapy (IMT) in controlling inflammation and preventing disease progression.</p><p><strong>Method: </strong>Two cases of chronic ocular SJS with underlying autoimmune diseases are described. Both patients experienced recurrent ocular inflammation, conjunctival scarring, and progressive limbal stem cell deficiency. They were managed with systemic IMT, including corticosteroids, mycophenolate mofetil (MMF), azathioprine, intravenous immunoglobulin (IVIG), cyclophosphamide, and rituximab. Disease progression, treatment response, and outcomes were assessed over a year follow-up.</p><p><strong>Result: </strong>Both patients had recurrent ocular inflammation despite initial management with corticosteroids and conventional immunosuppressives. The introduction of MMF combined with rituximab successfully stabilized inflammation and ocular surface integrity in both cases. Long-term IMT was necessary to maintain ocular stability and prevent progressive ocular surface failure.</p><p><strong>Conclusion: </strong>Chronic ocular complications of SJS require tailored immunosuppressive strategies, particularly in patients with preexisting autoimmune diseases. Early identification of disease patterns and co-management with rheumatologists are crucial. Rituximab and MMF may provide long-term disease control, but discontinuation of IMT should be approached cautiously to prevent recurrence. Further research is needed to optimize treatment protocols and determine the ideal duration of systemic therapy in chronic ocular SJS.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-8"},"PeriodicalIF":2.3,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967549","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}