Seminars in Ophthalmology最新文献

{"title":"Treat-And-Extend Versus Pro Re Nata Regimen of Intravitreal Conbercept Injection for Neovascular Age-Related Macular Degeneration: Results from COCOA, a Prospective, Open-Label, Multicenter, Randomized Phase IV Clinical Trial.","authors":"Yaoyao Sun, Wenfang Zhang, Bojie Hu, Bin Sun, Tonghe Zhang, Suqin Yu, Gongqiang Yuan, Rongping Dai, Ke Fan, Lifei Wang, Pei Cheng, Gang An, Liangbao An, Fang Wang, Weiqi Chen, Jie Zhang, Xiyuan Zhou, Feng Wang, Jian Ye, Xionggao Huang, Xiaoyan Peng, Jun Li, Miaoqin Wu, Guangming Wan, Jingxiang Zhong, Shaoping Ha, Xiao Ke, Jianhong Liang, Huijun Qi, Hong Yin, Tong Qian, Jinfeng Qu, Xuan Shi, Jing Hou, Heng Miao, Yuou Yao, Enzhong Jin, Xun Deng, Jian Zhang, Xiaoqing Shi, Jun Liu, Jie Ma, Jia Liu, Ye Tao, Bin Liu, Xiaoxin Li, Mingwei Zhao","doi":"10.1080/08820538.2025.2467853","DOIUrl":"https://doi.org/10.1080/08820538.2025.2467853","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate and contrast the effectiveness and safety of two conbercept treatment protocols-a three-dose treat-and-extend (3+T&E) regimen and a three-dose pro re nata (3+PRN) regimen-in Chinese patients diagnosed with neovascular age-related macular degeneration (nAMD).</p><p><strong>Methods: </strong>Eligible patients, who had not undergone anti-VEGF intraocular injections within 3 months prior to enrollment, were randomly assigned to either the 3+T&E or 3+PRN regimen. The 3+T&E group received at least three monthly injections, with subsequent visit intervals extended based on disease activity assessment. The primary endpoint was the mean change in best-corrected visual acuity (BCVA) from baseline to week 48, using a predefined noninferiority threshold.</p><p><strong>Results: </strong>Among 501 participants (249 in 3+T&E, 252 in 3+PRN), approximately half had prior anti-VEGF treatment. At 48 weeks, both regimens showed significant BCVA improvements (+9.9 for 3+PRN, +8.6 for 3+T&E; <i>p</i> = .208), with comparable rates of ≥15-letter gains (32.12% for 3+PRN, 30.77% for 3+T&E; <i>p</i> = .827). The 3+PRN group received fewer injections (mean 6.4 vs. 6.9 in 3+T&E; <i>p</i> = .028) but had shorter intervals between injections (6.93 weeks vs. 7.46 weeks in 3+T&E; <i>p</i> = .010). Drug-related adverse events occurred in 5% of patients, with ocular events evenly distributed and minimal cardiovascular events reported.</p><p><strong>Conclusion: </strong>Both 3+T&E and 3+PRN conbercept regimens effectively improved visual and anatomical outcomes in Chinese nAMD patients. The 3+T&E regimen was noninferior to 3+PRN in improving BCVA from baseline to week 48. The 3+T&E regimen enabled longer injection intervals while 3+PRN regimen with less injections is more cost-effective while maintaining a comparable safety profile. Treatment plan tailored to an individual patient's situation appears necessary.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617116","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 39: Doyens of Dacryology Series - Jeffrey Jay Hurwitz (1944-2022).","authors":"Ahsen Hussain, Mohammad Javed Ali","doi":"10.1080/08820538.2025.2474341","DOIUrl":"https://doi.org/10.1080/08820538.2025.2474341","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568069","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":"Telemedicine in Retinoblastoma: A Review.","authors":"Mattan Arazi, Ido Didi Fabian","doi":"10.1080/08820538.2025.2471989","DOIUrl":"https://doi.org/10.1080/08820538.2025.2471989","url":null,"abstract":"<p><strong>Purpose: </strong>To perform a scoping review of the literature investigating the use of telemedicine in retinoblastoma (RB) care, as well as its integration into broader health-care systems worldwide.</p><p><strong>Methods: </strong>A comprehensive search of academic databases, Medline and Embase, as well as public, web-based sources, was performed. Article references were also screened for inclusion within the review. Only English-language sources that presented evidence of dedicated frameworks incorporating telemedicine-based RB care were included.</p><p><strong>Results: </strong>The review identified 57 peer-reviewed studies, of which 19 were found potentially eligible for inclusion. Following exclusion criteria and a web-based search, 11 sources referencing 10 telemedicine frameworks, comprising four peer-reviewed articles, and seven publicly available initiatives, were included. Major themes leveraging telemedicine in RB care included knowledge exchange and capacity building, the establishment of direct partnerships incorporating teleconsultation, and the development of care coordination networks. Many telehealth platforms were effectively integrated into health-care systems; however, challenges included the absence of RB specific initiatives, the need for publicly available, measurable peer-reviewed outcomes and the complexities of multidimensional RB care.</p><p><strong>Conclusion: </strong>Tele-efforts have the potential to enhance delivery of RB care to remote, resource-limited communities. Future research should explore improved integration of policy-driven telemedicine within health-care systems, assess the economic feasibility of providing such care, and facilitate empirical evaluations, ultimately leading to increased sustainability, funding and investment of these models.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-6"},"PeriodicalIF":1.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711150","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":"Global Research Trends in Endoscopic and External Dacryocystorhinostomy: A Bibliometric Analysis.","authors":"Ahmet Ufuk Kılıçtaş, Furkan Ozer","doi":"10.1080/08820538.2025.2474032","DOIUrl":"https://doi.org/10.1080/08820538.2025.2474032","url":null,"abstract":"<p><strong>Aim: </strong>To carry out an exhaustive bibliometric analysis of the existing literature on endoscopic dacryocystorhinostomy (DCR), with a view to comparing this with the trend in external DCR.</p><p><strong>Methods: </strong>A total of 1,230 publications on endoscopic DCR and 1,036 on external DCR were retrieved from the Web of Science databases and analyzed. Data on publication types, indexing categories, journal and publisher contributions, temporal trends, authorship networks, frequently used keywords, and country-level contributions were evaluated. Co-authorship and keyword co-occurrence networks were visualized to identify collaboration patterns and thematic focuses. Citation metrics, including the top 100 most-cited publications, were also assessed.</p><p><strong>Results: </strong>Original articles accounted for over 85% of the publications in both endoscopic and external DCR literature. The research is predominantly concentrated in ophthalmology (44.4%) and otorhinolaryngology (32.1%) for endoscopic DCR, with most publications indexed in the Science Citation Index Expanded (77.3%). The number of endoscopic DCR publications peaked in 2020, while external DCR peaked in 2015. Ali Mohammad Javed emerged as the most prolific author with 78 publications, and the co-authorship network revealed strong interdisciplinary collaborations. India led the publication output for both endoscopic (16.9%) and external (15.7%) DCR, followed by the United States and Turkey. Frequently used keywords such as \"dacryocystorhinostomy\" and \"epiphora\" highlighted the primary clinical focus.</p><p><strong>Conclusion: </strong>The bibliometric analysis highlights the increasing trend in publications over the last decade, indicating an escalating interest in minimally invasive methods, with endoscopic DCR being a prominent approach for the management of nasolacrimal duct obstruction. Key contributors, impactful journals, and strong collaborations drive innovation in the field. However, research gaps remain in patient-reported metrics, and contributions from underrepresented regions. Addressing these areas through international and multidisciplinary efforts will advance the field further.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-13"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531720","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":"<i>In Vitro</i> Efficacy of Miltefosine Against Clinical Isolates of <i>Acanthamoeba</i> spp. from Patients with Keratitis.","authors":"Lakshminarayanan Gowtham, Savitri Sharma, Bhupesh Bagga","doi":"10.1080/08820538.2025.2467272","DOIUrl":"https://doi.org/10.1080/08820538.2025.2467272","url":null,"abstract":"<p><strong>Purpose: </strong>The US Food and Drug Administration (USFDA) granted the miltefosine orphan drug designation in 2016 for treating <i>Acanthamoeba</i> keratitis. This study evaluates miltefosine's <i>in vitro</i> efficacy against clinical isolates of <i>Acanthamoeba</i> from patients with keratitis and its safety profile in human corneal epithelial cell line to rationalize its localized ocular application.</p><p><strong>Methods: </strong><i>Acanthamoeba</i> spp. isolated from corneal scrapings of keratitis patients (<i>n</i> = 17) were cultured axenically, genotyped, and tested for miltefosine's minimal cysticidal and trophozoicidal concentrations (MCC and MTC) by microbroth dilution method. Safer concentrations of miltefosine were determined using human corneal epithelial (HCE) cells at four incubation points. Trophozoites and cysts of one of the isolates, <i>A. castellanii</i>, were challenged on confluent monolayers of HCE in the presence and absence of miltefosine for 24 h. Cytopathic effects were evaluated using microscopic analysis.</p><p><strong>Results: </strong>The majority of <i>Acanthamoeba</i> isolates tested were T4 genotypes (94.11%). MTC₉₀ and MCC₉₀ of miltefosine were 0.125 and 4 mg/mL, respectively. Miltefosine was found safe on HCE at 0.0625 and 0.125 mg/mL for 4 and 0.25 h, respectively. Microscopical findings showed that <i>A. castellanii</i> trophozoites destroyed the cellular structures of HCE within 24 h without miltefosine. Drug pre-treatment prevented the initiation of infection at both the tested concentrations (0.0625 and 0.125 mg/mL) upto 24 h.</p><p><strong>Conclusion: </strong>Miltefosine was effective against <i>Acanthamoeba</i> trophozoites and cysts <i>in vitro</i> with >30-fold higher cidal concentration for cysts compared to trophozoites. An effective trophozoicidal concentration of miltefosine (0.125 mg/mL), found to be safe for HCEs, suggests its potential utility as an adjunct treatment for <i>Acanthamoeba</i> keratitis.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503857","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":"Incidence and Management of Retinopathy and Uveitis in Patients Receiving BRAF/MEK Inhibitor Therapy.","authors":"Isana Nakajima, Koji Yoshino, Hideki Tsuji","doi":"10.1080/08820538.2025.2468381","DOIUrl":"10.1080/08820538.2025.2468381","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the clinical features of ocular adverse events in patients receiving BRAF/MEK inhibitor therapy.</p><p><strong>Methods: </strong>In this retrospective study, 65 patients were treated with BRAF/MEK inhibitors (dabrafenib/trametinib or encorafenib/binimetinib).</p><p><strong>Results: </strong>Of the 65 patients, 28 had malignant melanoma and 37 had non-melanoma malignancies. Bilateral MEK-associated retinopathy was observed in nine cases; none experienced vision loss due to MEK-associated retinopathy. Uveitis was diagnosed in four patients (6.1%), three of whom presented with Vogt-Koyanagi-Harada (VKH)-like uveitis. All VKH-like uveitis cases were observed in patients with melanoma and their incidences were significantly higher in these patients than in those without melanoma (<i>p</i> = .04). Treatment with corticosteroids resulted in either resolution or control of symptoms in all cases of VKH-like uveitis, enabling continuation of BRAF/MEK inhibitor therapy.</p><p><strong>Conclusion: </strong>VKH-like uveitis was found to be significantly more frequent in patients with melanoma than in those with other malignancies.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483911","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":"Persistent Corneal Epithelial Defect Following Pars Plana Vitrectomy: A Narrative Review.","authors":"Makan Ziafati, Reza Mirshahi, Maria Vittoria Cicinelli, Rezvaneh Nazari","doi":"10.1080/08820538.2025.2470253","DOIUrl":"https://doi.org/10.1080/08820538.2025.2470253","url":null,"abstract":"<p><strong>Purpose: </strong>Persistent corneal epithelial defects (PCEDs) following pars plana vitrectomy (PPV) represent a significant clinical challenge, potentially leading to corneal scarring, vision loss, and other severe complications. This review aims to summarize the prevalence, associated risk factors, and management strategies for PCEDs in the context of PPV, providing evidence-based guidance for clinicians.</p><p><strong>Methods: </strong>A comprehensive systematic review was conducted using PubMed and Embase databases, identifying English-language studies addressing PCEDs after PPV.</p><p><strong>Results: </strong>The prevalence of PCEDs post-PPV varied widely, from 0% to 78.37%, influenced by intrinsic factors such as diabetes mellitus, which impairs corneal nerve function and healing, and extrinsic factors like intraoperative tamponade with C3F8. Management strategies ranged from conservative options like bandage contact lenses to advanced treatments like topical insulin.</p><p><strong>Conclusion: </strong>PCEDs after PPV are multifactorial and demand individualized management. Advanced therapies, particularly serum-based treatments, and topical insulin, show promising outcomes. Further prospective research is warranted to refine these treatments.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-13"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483916","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":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2025-02-21","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":"Lacrimal History - Part 38: Doyens of Dacryology Series - Rona Zel Silkiss (1957-) and Jennifer Anne Sivak-Callcott (1970-).","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2469975","DOIUrl":"https://doi.org/10.1080/08820538.2025.2469975","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468968","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":"CT-Based Machine Learning Radiomics Analysis to Diagnose Dysthyroid Optic Neuropathy.","authors":"Lan Ma, Xue Jiang, Xuan Yang, Minghui Wang, Zhijia Hou, Ju Zhang, Dongmei Li","doi":"10.1080/08820538.2025.2463948","DOIUrl":"https://doi.org/10.1080/08820538.2025.2463948","url":null,"abstract":"<p><strong>Purpose: </strong>To develop CT-based machine learning radiomics models used for the diagnosis of dysthyroid optic neuropathy (DON).</p><p><strong>Materials and methods: </strong>This is a retrospective study included 57 patients (114 orbits) diagnosed with thyroid-associated ophthalmopathy (TAO) at the Beijing Tongren Hospital between December 2019 and June 2023. CT scans, medical history, examination results, and clinical data of the participants were collected. DON was diagnosed based on clinical manifestations and examinations. The DON orbits and non-DON orbits were then divided into a training set and a test set at a ratio of approximately 7:3. The 3D slicer software was used to identify the volumes of interest (VOI). Radiomics features were extracted using the Pyradiomics and selected by t-test and least absolute shrinkage and selection operator (LASSO) regression algorithm with 10-fold cross-validation. Machine-learning models, including random forest (RF) model, support vector machine (SVM) model, and logistic regression (LR) model were built and validated by receiver operating characteristic (ROC) curves, area under the curves (AUC) and confusion matrix-related data. The net benefit of the models is shown by the decision curve analysis (DCA).</p><p><strong>Results: </strong>We extracted 107 features from the imaging data, representing various image information of the optic nerve and surrounding orbital tissues. Using the LASSO method, we identified the five most informative features. The AUC ranged from 0.77 to 0.80 in the training set and the AUC of the RF, SVM and LR models based on the features were 0.86, 0.80 and 0.83 in the test set, respectively. The DeLong test showed there was no significant difference between the three models (RF model vs SVM model: <i>p</i> = .92; RF model vs LR model: <i>p</i> = .94; SVM model vs LR model: <i>p</i> = .98) and the models showed optimal clinical efficacy in DCA.</p><p><strong>Conclusions: </strong>The CT-based machine learning radiomics analysis exhibited excellent ability to diagnose DON and may enhance diagnostic convenience.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450097","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}