Seminars in Ophthalmology最新文献

{"title":"Lacrimal History - Part 36: Doyens of Dacryology Series - Michael McDonogh.","authors":"Mohammad Javed Ali, Peter John Wormald","doi":"10.1080/08820538.2025.2452088","DOIUrl":"10.1080/08820538.2025.2452088","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"449-450"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024437","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":"Adjuvant Brachytherapy Using Iodine-125 Plaques for Conjunctival Melanoma with Scleral Invasion.","authors":"Alyssa C Bonnell, Laura D Selby, Minh T Nguyen, Jonathan Chen, Alexei V Chvetsov, Andrew W Stacey","doi":"10.1080/08820538.2025.2479781","DOIUrl":"10.1080/08820538.2025.2479781","url":null,"abstract":"<p><strong>Purpose: </strong>To report a series of patients with unresectable conjunctival melanoma treated with surgical excision followed by adjuvant iodine-125 plaque brachytherapy.</p><p><strong>Methods: </strong>A retrospective review of a consecutive series of patients at one institution who were found to have scleral-invasive conjunctival melanoma and who were treated with adjuvant plaque brachytherapy. Pre-operative, radiation, and post-operative data were collected for each patient. Patients were evaluated for intraocular pressure, visual acuity (VA), radiation complications, local recurrence, and presence of metastatic disease.</p><p><strong>Results: </strong>A total of 9 patients met inclusion criteria. After surgical excision, all 9 patients were treated with iodine-125 plaque brachytherapy with a dose of 85 Gy to a depth of 3 mm from the plaque face for a prescribed dwell time of 2-3 days. Patients were followed for a median of 45 months (range: 3-66). There have been no local recurrences to this point. Following surgery, 4 of the 9 patients maintained a VA of 20/50 or better. Overall mean visual acuity declined from Snellen 20/59 preoperatively to 20/209 postoperatively. Limbal stem cell deficiency occurred in 3 patients (33%) but may be explained by additional treatments provided in each of these patients (mitomycin C eyedrops in two and proton beam radiation in one). One patient with a second, high-risk forniceal conjunctival melanoma developed metastatic disease.</p><p><strong>Conclusions: </strong>Plaque brachytherapy with iodine-125, delivering a dose of 85 Gy to a depth of 3 mm over a short period of time (3 days) provides safe and promising results for vision and tumor control in patients with scleral-invasive conjunctival melanoma.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"546-550"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658542","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":"Tumor Location of Uveal Melanoma and Impact on Metastasis-Free Survival in 1001 Cases.","authors":"Carol L Shields, Madison Woods, Randy Calotti, Haley Evans, Robert Medina, Shady Mina, Jose E Pena, Ayra Khan, Henry Nguyen, Rolika Bansal, Hidayet Sener, Sara E Lally, Jerry A Shields","doi":"10.1080/08820538.2025.2507750","DOIUrl":"10.1080/08820538.2025.2507750","url":null,"abstract":"<p><strong>Background: </strong>There is limited literature on tumor location of uveal melanoma (UM) and the relative impact on metastasis-free survival (MFS).</p><p><strong>Methods: </strong>A review of 1001 consecutive eyes with UM was performed and precise tumor location was identified according to quadrant (5 zones), clock hour (13 zones), anteroposterior (5 zones), and a combination of clock hour and anteroposterior regions (49 zones). Heat maps were constructed for frequency in each zone and Kaplan-Meier estimates for 5- and 10-year MFS was calculated.</p><p><strong>Results: </strong>The UM quadrant regions included central (macula and juxtapapillary) (18%), superior (19%), nasal (18%), inferior (18%), and temporal (27%). The central region demonstrated smaller UM thickness (<i>p</i> < .01) and diameter (<i>p</i> < .01). The MFS (5- and 10-years) for central region (90%, 86%) was more favorable than other quadrants (<i>p</i> < .01).The UM clock hour regions included central (18%), 1:00 (6%), 2:00 (6%), 3:00 (10%), 4:00 (6%), 5:00 (7%), 6:00 (7%), 7:00 (5%), 8:00 (7%), 9:00 (9%), 10:00 (6%), 11:00 (5%), and 12:00 (8%). The central region demonstrated smaller UM thickness (<i>p</i> < .01) and diameter (<i>p</i> < .01). The MFS (5- and 10-years) for central region (90%, 86%) was more favorable than any clock hour region (<i>p</i> = .03).The UM anteroposterior regions included central (18%), post-equatorial (28%), equatorial (26%), peripheral (13%), and ciliary body (15%). Increasing UM thickness (<i>p</i> < .01) and diameter (<i>p</i> < .01) stepwise were noted with increasing anterior location. The MFS (5- and 10-years) for central region (90%, 86%) was more favorable than other anteroposterior regions (<i>p</i> < .01).A combination of clock hour and anteroposterior regions (49 zones) revealed random distribution with no preferential location. Multivariate regression analysis adjusted for tumor thickness/diameter and proximity to foveola/optic disc showed no benefit of any location.</p><p><strong>Conclusions: </strong>Across all fundus regions, UM occurred most often in the central region. Uveal melanoma in the central region was smaller in thickness and base and demonstrated more favorable MFS compared to other quadrants, clock hours, and anteroposterior zones. Analysis of the 49 zones showed no benefit of tumor location alone after adjusting for tumor size and proximity to foveola and optic disc.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"564-574"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094716","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":"Nodulo-Ulcerative Ocular Surface Squamous Neoplasia in 27 Patients: Clinical Presentation, Management and Outcomes.","authors":"Vijitha S Vempuluru, Anshika Luthra, Prerna Sinha, Suneetha Gavara, Swathi Kaliki","doi":"10.1080/08820538.2024.2432908","DOIUrl":"10.1080/08820538.2024.2432908","url":null,"abstract":"<p><strong>Purpose: </strong>To report the clinical presentation, management, and outcomes of nodulo-ulcerative ocular surface squamous neoplasia (nuOSSN).</p><p><strong>Methods: </strong>Retrospective interventional clinical cohort study of 27 patients from a quaternary ocular oncology center.</p><p><strong>Results: </strong>Twenty-seven patients were diagnosed with nuOSSN during the six-year study period. The mean age at presentation was 53 years (median, 51 years; range, 25 to 81 years). Misdiagnosis was noted in 7 (26%) patients, and the mean lag time from symptom onset to presentation at our center was 14 months (median, 6 months; range, 1 to 96 months). The bulbar conjunctiva was the commonest epicenter (<i>n</i> = 19, 70%), and the temporal quadrant was most commonly involved (<i>n</i> = 13, 48%). The mean tumor diameter and thickness were 18 mm (median, 16 mm; range, 8 to 60 mm) and 3 mm (median, 2 mm; range, 1 to 5 mm), respectively. Corneal, limbal, and scleral thinning were seen in 15 (56%), 18 (67%), and 10 (37%) patients, respectively. Peripheral corneal opacification was seen in 18 (67%), and thickening around the area of scleral thinning was seen in 12 (44%) patients. Tumors belonged to the American Joint Committee for Cancer classification T2 (<i>n</i> = 2, 7%), T3 (<i>n</i> = 19, 70%), and T4 (<i>n</i> = 6, 22%) categories. Primary treatment (<i>n</i> = 19) included topical 1% 5-fluorouracil (5FU) eye drops (<i>n</i> = 1, 4%), excisional biopsy (<i>n</i> = 4, 14%), extended enucleation (<i>n</i> = 11, 41%), and orbital exenteration (<i>n</i> = 3, 11%). At a mean follow-up of 9 months (median, 3 months; range 1 to 46 months) in 19 patients who received treatment, the outcomes included local tumor recurrence in 2 patients (11%), tumor control in 16 (84%), globe salvage in 3 (16%), and lymph node metastasis in 2 patients (11%).</p><p><strong>Conclusion: </strong>nuOSSN is an aggressive form of the disease that is frequently misdiagnosed due to the presence of corneoscleral thinning. Globe salvage rates are poor owing to the advanced stage of presentation.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"501-507"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751602","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":"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":"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":"529-537"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","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":"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":"10.1080/08820538.2025.2469975","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"455-457"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","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":"Onset and Resolution of Ocular Motor Cranial Nerve Palsies Following the Use of Intra-Arterial Chemotherapy for Retinoblastoma.","authors":"Ali Al-Gilgawi, Zishan Naeem, Catriona Duncan, Fergus Robertson, Mandeep S Sagoo, M Ashwin Reddy","doi":"10.1080/08820538.2025.2501796","DOIUrl":"10.1080/08820538.2025.2501796","url":null,"abstract":"<p><strong>Introduction: </strong>Intra-arterial chemotherapy (IAC) has revolutionised the treatment of retinoblastoma with respect to eye salvage. We present a case series assessing the onset and resolution of cranial nerve palsies following IAC in the treatment of retinoblastoma.</p><p><strong>Materials and methods: </strong>A retrospective case series examining children treated with IAC between 2014 and 2020 for refractory retinoblastoma. The initial approach to catheterisation was the same in all cases. All patients were assessed by an orthoptist and those with nerve palsies were followed up for resolution.</p><p><strong>Results: </strong>There were 41 patients treated with IAC in this time period with a median age of 15 months (5-125). Of these, 7 (17%) developed cranial nerve palsies (NP). These were either 3^rd (3 of 7), 6^th (1 of 7) or mixed 3^rd and 6^th (3 of 7) palsies. Onset was at a median of 5 days after the injection. Five resolved and resolution was at a median of 3 months (0.75-26) from onset. Two children still had extra-ocular muscle involvement due to NPs that did not resolve and the cumulative doses of Melphalan were 47.5 mg and 37.5 mg.  All children who had cranial nerve palsies that resolved had a cumulative dose of less than 20 mg of Melphalan.</p><p><strong>Conclusion: </strong>Cranial nerve palsy is an infrequent occurrence after IAC but families need to be aware of this as a complication. It is reassuring that the majority resolve. In our experience, a high cumulative dose of melphalan due to the refractory nature of the tumour increases the risk of this complication long term.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"558-563"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013454","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":"Risk Factors for Extraocular Relapse in Retinoblastoma.","authors":"Rosario Aschero, Margarida Simao, Jaume Catala-Mora, Guillermo L Chantada","doi":"10.1080/08820538.2025.2450682","DOIUrl":"10.1080/08820538.2025.2450682","url":null,"abstract":"<p><strong>Background: </strong>Metastatic retinoblastoma remains a significant challenge in pediatric oncology, with stark disparities in survival outcomes between high-income countries (HICs) and low-income countries (LICs). Delayed diagnosis and treatment, driven by socioeconomic factors and limitations in healthcare systems, contribute to poorer outcomes in LICs. Histopathological characteristics, including high-risk pathology factors (HRPFs) and the extent of ocular tumor invasion, are critical for predicting metastatic risk and guiding treatment strategies.</p><p><strong>Methods: </strong>This review examines the role of clinical, histopathological, and molecular characteristics in assessing metastatic risk in retinoblastoma. Literature on HRPFs, tumor invasion, and molecular subtypes was analyzed to understand their impact on risk stratification and therapy optimization, particularly in resource-limited settings.</p><p><strong>Results: </strong>Retinoblastoma is increasingly recognized as a heterogeneous disease with at least two distinct molecular subtypes. High-risk cases frequently exhibit genetic alterations that underscore the need to incorporate molecular profiling into risk assessment. Current adjuvant therapy approaches, however, vary widely, and debates persist regarding their necessity based on tumor characteristics. Integrated strategies that combine clinical, histopathological, and molecular data show promise in improving management and survival outcomes.</p><p><strong>Conclusions: </strong>Addressing the disparities in metastatic retinoblastoma outcomes requires a multifaceted approach. By integrating clinical, histopathological, and molecular insights, management strategies can be optimized to improve survival, particularly in resource-limited settings where challenges are most pronounced.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"474-484"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954503","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":"Readership Awareness Series - Paper 15: How the ICMJE 2025 Recommendations Update Impact the Scientific Community?","authors":"Mohammad Javed Ali, Ali Djalilian","doi":"10.1080/08820538.2025.2454851","DOIUrl":"10.1080/08820538.2025.2454851","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"447-448"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011065","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":"Coats' Disease: A Comprehensive Review of Its Pathophysiology, Diagnosis, and Advances in Treatment.","authors":"Ahmet Yucel Ucgul, Şengül Özdek","doi":"10.1080/08820538.2024.2447965","DOIUrl":"10.1080/08820538.2024.2447965","url":null,"abstract":"<p><strong>Background and purpose: </strong>Coats' disease, first described by George Coats in 1908, is a rare ocular disorder primarily affecting young males, often unilaterally. It is characterized by retinal telangiectasia, aneurysms, and exudation, which, in severe cases, can lead to blindness, painful red eye, or ocular atrophy, particularly with early childhood onset. Over the last century, advancements have been made in understanding its natural history, morphology, incidence, and clinical manifestations, showing a male predominance without significant ethnic disparities. This review aims to provide a comprehensive overview of Coats' disease, focusing on its pathogenesis, clinical presentation, diagnostic methods, and management strategies.</p><p><strong>Methods: </strong>The pathogenesis of Coats' Disease is multifactorial, involving inflammatory, vascular, and potentially genetic components. Early theories suggested inflammation as the primary cause, but modern research highlights the role of vascular endothelial growth factor (VEGF), where ischemic retinal areas elevate VEGF levels, promoting angiogenesis and impairing the blood-retinal barrier. Clinically, the disease is asymptomatic in early stages but progresses to symptoms like reduced visual acuity, strabismus, and leukocoria, typically within the first decade of life. Diagnostic methods include fundus fluorescein angiography, optical coherence tomography (OCT), and OCT angiography (OCTA), with recent studies identifying reduced blood flow density in capillary networks. Management ranges from intravitreal anti-VEGF agents and steroids to surgical options like pars plana vitrectomy and transscleral drainage, with additional techniques such as laser photocoagulation and cryotherapy proving effective in advanced stages.</p><p><strong>Conclusion: </strong>The prognosis of Coats' Disease heavily depends on the stage of disease at presentation. Early detection and intervention can preserve vision, but advanced stages often result in poor outcomes. Factors such as younger age at presentation, advanced stage, and severe manifestations are associated with more aggressive progression and poorer prognosis. This review highlights the importance of early diagnosis and a multifaceted management approach, emphasizing the need for further research into its pathophysiology and innovative treatment strategies to improve patient outcomes.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"458-473"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650657","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}