Seminars in Ophthalmology最新文献

{"title":"Delayed Periocular and Anterior Segment Complications Following Locally Administered Chemotherapy for Vitreous Seeding in Retinoblastoma.","authors":"Linda A Cernichiaro-Espinosa, Benjamin A King, David Taylor Gonzalez, Cigdem Ozturk, Aleksander Kruglov, Rachel C Brennan, Ibrahim Qaddoumi, Carlos Rodriguez-Galindo, Matthew W Wilson, Mary E Hoehn","doi":"10.1080/08820538.2025.2467277","DOIUrl":"https://doi.org/10.1080/08820538.2025.2467277","url":null,"abstract":"<p><strong>Background: </strong>Long-term follow-up is essential for retinoblastoma survivors, as treatment-related sequelae can emerge years after therapy.</p><p><strong>Methods: </strong>This case series reviews 67 eyes treated with periocular and/or intravitreal chemotherapy from 2005 through 2020.</p><p><strong>Results: </strong>Periocular chemotherapy was associated with orbital fibrosis in 79.1% of cases, with risk increasing concomitantly with the number of injections. Cataracts developed in 19.4% of eyes, with 10 out of 13 requiring cataract extraction. Other complications included chronic conjunctivitis and limbal stem cell deficiency (3% each), while strabismus was observed in 29.9% of which 7.5% underwent strabismus surgery. Comparative analyses of periocular and anterior segment complications from other retrospective studies are included to contextualize our findings.</p><p><strong>Conclusions: </strong>Understanding these long-term sequelae is crucial for appropriately following and managing retinoblastoma survivors who were treated during this era. We highlight the importance of vigilant surveillance as treatment protocols continue to evolve.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-9"},"PeriodicalIF":1.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425935","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":"Penetrating Keratoplasty versus Deep Anterior Lamellar Keratoplasty for Keratoconus: A Systematic Review and Meta-Analysis of 27,018 Eyes.","authors":"Abdelaziz A Awad, Abdelrahman M Elettreby, Ahmed A Abo Elnaga, Mohamed A Alsaied, Menna M Aboelkhier, Maab Mohamed Saleh, Dalia Kamal Ewis, Mahmoud Ali, Fatma Mohammed, Mohamed A Aldemerdash, Hashem Abu Serhan","doi":"10.1080/08820538.2025.2457583","DOIUrl":"https://doi.org/10.1080/08820538.2025.2457583","url":null,"abstract":"<p><strong>Purpose: </strong>Keratoconus is a bilateral asymmetrical degeneration in the cornea. It is associated with local thinning in the cornea leading to visual problems such as myopia and astigmatism. Several treatments, such as lenses and keratoplasty surgeries, were utilized to treat this condition. In this study, we aim to compare deep anterior lamellar keratoplasty (DALK) to penetrating keratoplasty (PK).</p><p><strong>Methods: </strong>We registered our study protocol on PROSPERO (CRD42024559427). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched four electronic databases (PubMed, Scopus, Cochrane Library, and Web of Science) to identify eligible studies reported up to June 2024. Using STATA 17, we reported outcomes as risk ratios (RRs) or mean difference (MD) and confidence intervals (CIs). A P-value ≤.05 is considered as statistically significant.</p><p><strong>Results: </strong>The meta-analysis included a total of 47 studies with a total number of 27,018 eyes. There was no significant difference between PK and DALK in terms of best-corrected visual acuity (BCVA) at 1 year (Hedge's g: 0.03 with 95% CI [-0.13, 0.19], <i>p</i> = .71). PK was associated with a lower risk of graft failure than DALK (log RR: -0.41 with 95% CI [-0.74, -0.08], <i>p</i> = .01). PK was associated with a higher risk of graft rejection than DALK (log RR: 0.85 with 95% CI [0.35, 1.35], <i>p</i> < .001). There was no significant difference between PK and DALK in terms of corneal astigmatism at 1 year (Hedge's g: 0.03 with 95% CI [-0.24, 0.31], <i>p</i> = .82).</p><p><strong>Conclusion: </strong>The visual outcomes such as BCVA, astigmatism, and spherical equivalent refraction, of PK and DALK are comparable. However, PK was associated with a higher risk of complications and rejection episodes, but, a lower risk of graft failure.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-18"},"PeriodicalIF":1.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410608","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 37: Doyens of Dacryology Series - Lester Tallmon Jones (1895-1983).","authors":"Roger A Dailey, John L Wobig, Mohammad Javed Ali","doi":"10.1080/08820538.2025.2466276","DOIUrl":"https://doi.org/10.1080/08820538.2025.2466276","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-4"},"PeriodicalIF":1.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410452","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":"Silicone Oil Tamponade in the Management of Endogenous Endophthalmitis.","authors":"Constance Weber, Zoe Kiy, Katharina Wall, Frank G Holz, Raffael Liegl","doi":"10.1080/08820538.2025.2459312","DOIUrl":"https://doi.org/10.1080/08820538.2025.2459312","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate pars plana vitrectomy (ppv) with silicone oil tamponade in the management of patients with endogenous endophthalmitis.</p><p><strong>Methods: </strong>All patients treated with ppv and silicone oil for endogenous endophthalmitis at the University Eye Hospital Bonn between 2015 and 2022 were included. We documented all preoperative data, encompassing BCVA at diagnosis, clinical observations, and presenting symptoms. During each follow-up visit, we evaluated BCVA and monitored for any complications. Statistical analysis was performed using SPSS Statistics.</p><p><strong>Results: </strong>In total, 19 eyes of 19 patients were included in this study. The most common underlying diseases were urosepsis in 5 patients (26.3%), endocarditis and leukemia in 3 patients (15.8%) respectively. The most common bacterial pathogens in the vitreous samples were gram-positive cocci in 3 patients (15.8%) and staphylococcus aureus in 3 patients (15.8%). The most common fungal pathogen was candida albicans in two patients (10.8%). Visual acuity (VA) at diagnosis was 1.93 logMAR (0.4-3.0 logMAR) and increased to 1.39 logMAR (0.2-3.0 logMAR) after six months and 1.21 logMAR (0.2-3.0 logMAR) after one year. 2 patients (10.5%) died during the follow-up because of their underlying disease. 9 eyes (47.4%) developed postoperative complications. One eye with no light perception was enucleated due to pain caused by high intraocular pressure. 2 eyes (10.5%) developed a postoperative retinal detachment needing further surgery.</p><p><strong>Conclusion: </strong>Most patients treated with ppv and silicone oil for endogenous endophthalmitis experienced an improvement in visual acuity; however, due to the severity of the condition, the visual prognosis remains guarded.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391590","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":"Iran Thyroid Eye Disease (IrTED) Registry: Patient Characteristics and Clinical Presentation.","authors":"Shadi Akbarian, Nasser Karimi, Mansoureh Farhangniya, Hossein Ghahvehchian, Samira Chaibakhsh, Mohsen Bahmani Kashkouli","doi":"10.1080/08820538.2025.2463946","DOIUrl":"10.1080/08820538.2025.2463946","url":null,"abstract":"<p><strong>Purpose: </strong>This study explores the geographic distribution and ethnicity of Iranian patients with Thyroid Eye Disease (TED). It also analyzes semiology, the temporal relationship between thyroid dysfunction and TED, and concomitant diseases. An analysis of ocular visual and motility function in Iranian patients with TED at their initial presentation was also conducted.</p><p><strong>Methods: </strong>Data from the Iran TED Registry (IrTED) was extracted and analyzed to examine the demographics, clinical features, severity, and activity of TED. The study included patients who presented to the Rassoul Akram Hospital oculoplastic clinic in Tehran, Iran, between March 2020 and March 2023.</p><p><strong>Results: </strong>The database (https://orc.iums.ac.ir) included 685 patients (66.56% female), with congenital or acquired thyroid dysfunction/disease diagnosed with a mean age of 34.68 years (SD: 13.95, Range 0-78) and TED onset in the mean age of 37.79 years (SD: 14.06, Range: 2-78). Notably, 10.95% of patients developed TED before thyroid dysfunction, while 62.77% were diagnosed with thyroid dysfunction before the onset of TED. Elevated intraocular pressure (≥21 mmHg) in either eye was observed in 49 (7.15%) of participants, with 32 (4.67%) patients bilaterally involved. The distribution of registered patients by province of birth and ethnicity was also graphed. Semiology, coexisting health conditions, and visual and motility functions of patients were presented in a tabular format.</p><p><strong>Conclusion: </strong>The successful implementation of IrTED contributes to a better understanding of TED epidemiology and semiology within the Iranian population.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383253","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":"Immune Checkpoint Inhibitors in the Treatment of Ocular Surface Cancers: A Review.","authors":"Wendy J Li, Wisam Najdawi, Omar Badla, Anat Galor, Carol L Karp","doi":"10.1080/08820538.2025.2458658","DOIUrl":"https://doi.org/10.1080/08820538.2025.2458658","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) have transformed cancer therapy by targeting key immune pathways such as PD-1, PD-L1, CTLA-4, and LAG-3 to enhance the immune system's ability to combat malignancies. Their use in treating ocular surface tumors is an emerging area of interest, particularly in conjunctival melanoma (CM) and ocular surface squamous neoplasia (OSSN). Some studies have indicated the potential of ICI's in sebaceous gland carcinoma (SeC), conjunctival lymphoma, and Kaposi sarcoma.</p><p><strong>Purpose: </strong>This review aims to evaluate the role of ICIs in treating ocular surface tumors, focusing on their mechanisms of action, clinical outcomes, and therapeutic potential.</p><p><strong>Methods: </strong>A literature review was conducted by searching Pubmed for studies published between January 2014 and October 2024. Studies included were original research, clinical trials, case reports and series, and reviews.</p><p><strong>Results: </strong>ICIs, including pembrolizumab and nivolumab, have shown promising results in CM, achieving tumor regression and disease stabilization in advanced and metastatic cases. ICIs have also demonstrated efficacy in OSSN, particularly in lesions with high tumor mutational burden, with responses ranging from partial to complete resolution. Although clinical data for SeC and conjunctival lymphoma remain limited to isolated reports, these studies suggest a role for ICIs in managing refractory or advanced disease.</p><p><strong>Conclusion: </strong>ICIs hold transformative potential in improving outcomes for ocular surface malignancies, particularly in cases where conventional treatments fail or pose significant morbidity. Despite their promise, challenges persist, including variable response rates, immune-related adverse events, and the need for reliable predictive biomarkers. Comprehensive prospective studies are necessary to refine the application of ICIs, optimize treatment strategies, and expand therapeutic options for these challenging cancers.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383250","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":"Evaluation of the Efficacy and Safety of Preoperative Intravitreal Triamcinolone Acetonide Combined with Internal Limiting Membrane Peeling for the Treatment of Idiopathic Macular Epiretinal Membrane.","authors":"Jie Wang, Yuyan Liu, Yanhua Chu, Guoge Han, Quanhong Han","doi":"10.1080/08820538.2025.2463999","DOIUrl":"https://doi.org/10.1080/08820538.2025.2463999","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the efficacy and safety of preoperative intravitreal triamcinolone acetonide (IVTA) combined with internal limiting membrane (ILM) peeling for idiopathic epiretinal membrane (IMEM).</p><p><strong>Methods: </strong>This was a retrospective study. Thirty-six phakic eyes of 35 patients were included in this study. IVTA was administered to 18 patients (18 eyes, Group IVTA) 7 days before vitrectomy, while the other 17 patients (18 eyes, Group no-IVTA) only underwent vitrectomy and ILM peeling. Patients were followed up for at least 6 months. Data on best-corrected visual acuity (BCVA), intraocular pressure (IOP), central macular thickness (CMT), inner retinal thickness (IRT), vascular parameters (measured by optical coherence tomography angiography, OCTA), mean macular sensitivity (MMS), 63% bivariate contour ellipse area (BCEA) and P1 (measured by macular integrity assessment, MAIA) were collected.</p><p><strong>Results: </strong>There were significant differences in BCVA and IRT between the IVTA group and the no-IVTA group at 6 months after surgery (<i>p</i> = .000 and <i>p</i> = .010). The CMT and MMS of the two groups significantly changed from the preoperative values; however, there were no differences between the 2 groups during the entire study period (<i>p</i> = .242 and <i>p</i> = .849). The changes in vascular parameters, including foveal avascular zone (FAZ) area and vessel densities of superficial and deep capillary plexus (SCP VD and DCP VD), in the two groups were not statistically significant. There were no statistically significant differences in 63% BCEA and P1 either.</p><p><strong>Conclusion: </strong>Macular morphology and macular integrity improved after vitrectomy combined with ILM peeling surgery. Compared with the no-IVTA group, preoperative intravitreal triamcinolone acetonide can improve best corrected visual acuity and accelerate the absorption of intraretinal fluid in terms of a significant reduction in IRT.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374605","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":"Syncope in the Ophthalmology Outpatient Department.","authors":"James Pietris, Stephen Bacchi, Arthas Flabouris, WengOnn Chan","doi":"10.1080/08820538.2025.2464003","DOIUrl":"https://doi.org/10.1080/08820538.2025.2464003","url":null,"abstract":"<p><strong>Introduction: </strong>Syncope is a clinical symptom that occurs commonly in all medical facilities, including the ophthalmology outpatient department. A broad differential diagnosis exists for syncope, of which vasovagal syncope is the most common.</p><p><strong>Results: </strong>Efficient recognition and management of syncope in the ophthalmology department is essential to minimise its economic and time cost to patients, staff and the healthcare system.</p><p><strong>Conclusions: </strong>We propose a three-step approach to managing syncope for ophthalmology staff consisting of risk factor identification, preventative strategies and appropriate initial management to triage patients effectively and efficiently with minimal disruption to workflow in this inherently busy environment.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-4"},"PeriodicalIF":1.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365861","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 34: Doyens of Dacryology Series - Juan Murube del Castillo (1934-2024).","authors":"Marco Sales-Sanz, Francisco J Muñoz-Negrete, Mohammad Javed Ali","doi":"10.1080/08820538.2025.2463247","DOIUrl":"https://doi.org/10.1080/08820538.2025.2463247","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190532","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":"Phacofragmentation of Posteriorly Dislocated Lens Fragments: Limbal versus Pars Plana Approach.","authors":"Muhammad M Shamim, Sam Karimaghaei, Riley Sanders, Sami H Uwaydat, Ahmed B Sallam","doi":"10.1080/08820538.2024.2376630","DOIUrl":"10.1080/08820538.2024.2376630","url":null,"abstract":"<p><strong>Purpose: </strong>To assess intra-operative complications and feasibility of removing crystalline lens fragments from the vitreous cavity through a limbal incision compared to a pars plana approach.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Subjects: </strong>16 eyes underwent phacofragmentation via a limbal approach (Group A) and 9 eyes through a pars plana approach (Group B) at an academic center over a 10-year period.</p><p><strong>Methods: </strong>We collected pre-operative, intra-operative, and post-operative data. We compared rates of intraoperative complications, including corneal wound burn, iris or capsular damage, retinal tears, and hemorrhage, and recorded post-operative BCVA and IOP measurements at the one-month post-operative appointment. We also compared rates of post-operative complications, including corneal edema, choroidal detachment, or retinal detachment.</p><p><strong>Main outcome measures: </strong>Primary outcomes of the study were the rates of intraoperative complications and the feasibility of crystalline lens removal with the limbal approach. We defined the latter outcome as the ability to complete lens removal without switching to the pars plana route.</p><p><strong>Results: </strong>Mean BCVA for group A was 1.6, and for group B was 2.0 (<i>p</i> = .19). There was no significant difference between the two groups in the incidence of intraoperative complications, including corneal wound burn, iris damage, anterior capsular tear, iatrogenic retinal tear, or suprachoroidal hemorrhage (<i>p</i> > .99). There was no significant difference in the incidence of intra-operative vitreous hemorrhage (<i>p</i> = .36). Additionally, there was no significant difference in post-operative corneal edema (<i>p</i> = .27), choroidal detachment (<i>p</i> = .52), or retinal detachment (<i>p</i> > .99). The mean post-operative BCVA was 1.0 in group A and 1.0 in group B (<i>p</i> = .75). We completed all cases in group A using the limbal approach without switching to the pars plana route.</p><p><strong>Conclusion: </strong>Phacofragmentation through a limbal incision provides a feasible option for dropped nuclear fragment removal and is not associated with a higher risk of complications than the pars plana route.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"115-119"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564256","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}