Survey of ophthalmology最新文献

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The evaluation and management of dry anophthalmic socket syndrome. 干性眼窝综合征的评价与治疗。
IF 5.9 2区 医学
Survey of ophthalmology Pub Date : 2025-10-09 DOI: 10.1016/j.survophthal.2025.10.001
Duoduo Wu, Blanche Xiaohong Lim, Gangadhara Sundar, Swati Singh, Mohammad Javed Ali, Sachin Gupta, Jean-Louis deSousa, Louis Tong, Fiona Stapleton, Chris Hong Long Lim
{"title":"The evaluation and management of dry anophthalmic socket syndrome.","authors":"Duoduo Wu, Blanche Xiaohong Lim, Gangadhara Sundar, Swati Singh, Mohammad Javed Ali, Sachin Gupta, Jean-Louis deSousa, Louis Tong, Fiona Stapleton, Chris Hong Long Lim","doi":"10.1016/j.survophthal.2025.10.001","DOIUrl":"10.1016/j.survophthal.2025.10.001","url":null,"abstract":"<p><p>Dry anophthalmic socket syndrome (DASS) is a complex and multifaceted condition that commonly affects patients who have undergone enucleation or evisceration and wear an ocular prothesis. The diagnosis and management of DASS poses significant challenges due to the absence of a standardized diagnostic criteria and evidence-based treatment protocol. Though DASS symptoms can be disproportionate to observable clinical signs, patient-reported outcomes and scoring systems remain the cornerstone of its diagnostic framework. While a dearth of literature exists, parallels can be drawn from other ocular surface conditions, including dry eye disease and contact lens-associated dry eye, regarding inflammatory pathways and surface interactions. DASS is postulated to be related to disruptions to tear film homeostasis, lid margin disease, and chronic inflammation driven by mechanical friction between the prosthesis and socket tissues. We provide a comprehensive review of the pathophysiological processes underlying DASS, discussing current and evolving diagnostic approaches, including use of symptom questionnaires and objective biomarkers such as tear film osmolarity and matrix metalloproteinase-9. Emerging concepts, such as detailed mechanisms of chronic inflammation and the precise nature of mechanical interactions will also be evaluated, alongside future directions for research aimed at optimising guidelines to improve patients' quality of life.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fibrogliosis in neovascular age-related macular degeneration: A new mechanistic perspective. 新生血管性年龄相关性黄斑变性中的纤维胶质瘤:一个新的机制视角。
IF 5.9 2区 医学
Survey of ophthalmology Pub Date : 2025-10-06 DOI: 10.1016/j.survophthal.2025.09.019
David A Merle, Federico Beretta, Riccardo Sacconi, Giuseppe Querques
{"title":"Fibrogliosis in neovascular age-related macular degeneration: A new mechanistic perspective.","authors":"David A Merle, Federico Beretta, Riccardo Sacconi, Giuseppe Querques","doi":"10.1016/j.survophthal.2025.09.019","DOIUrl":"10.1016/j.survophthal.2025.09.019","url":null,"abstract":"<p><p>Age-related macular degeneration (AMD) remains among the leading causes of blindness in industrialized nations, with fibrosis secondary to macular neovascularization (MNV) significantly contributing to visual decline despite treatment with anti-vascular endothelial growth factor therapy. Although traditionally viewed as detrimental, fibrosis may reflect a delicate balance between beneficial vessel stabilization and harmful scarring. We critically evaluate the pathophysiology of fibrosis in AMD and introduces the novel hypothetical concept of \"fibrogliosis\", which emphasizes the central role of Müller glia and retinal microglia activation following disruption of the outer blood-retinal barrier. According to this concept, fibrogliosis manifests differently among MNV subtypes, influenced largely by their impact on outer blood-retinal barrier integrity. Recognizing this variability underscores the importance of further investigation into the hypothetical concept of fibrogliosis, which in theory could guide future therapeutic strategies to balance vascular stabilization with the modulation of neovascularization and fibrosis.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Additional observations on ROCK inhibitors: Reticular corneal epithelial edema. ROCK抑制剂的其他观察结果:网状角膜上皮水肿。
IF 5.9 2区 医学
Survey of ophthalmology Pub Date : 2025-10-03 DOI: 10.1016/j.survophthal.2025.09.020
Omar Nusair, Mohammad Soleimani
{"title":"Additional observations on ROCK inhibitors: Reticular corneal epithelial edema.","authors":"Omar Nusair, Mohammad Soleimani","doi":"10.1016/j.survophthal.2025.09.020","DOIUrl":"10.1016/j.survophthal.2025.09.020","url":null,"abstract":"","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Response to "Additional observations on ROCK inhibitors: reticular corneal epithelial edema". 对“ROCK抑制剂的额外观察:网状角膜上皮水肿”的回应。
IF 5.9 2区 医学
Survey of ophthalmology Pub Date : 2025-10-03 DOI: 10.1016/j.survophthal.2025.09.022
Christin Henein, Jit Kai Tan, David H Steel, Sajjad Ahmad, Ananth Viswanathan, Rashmi G Mathew, Peng Tee Khaw
{"title":"Response to \"Additional observations on ROCK inhibitors: reticular corneal epithelial edema\".","authors":"Christin Henein, Jit Kai Tan, David H Steel, Sajjad Ahmad, Ananth Viswanathan, Rashmi G Mathew, Peng Tee Khaw","doi":"10.1016/j.survophthal.2025.09.022","DOIUrl":"10.1016/j.survophthal.2025.09.022","url":null,"abstract":"","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Retinal imaging options for differentiating degenerative retinoschisis from retinal detachment: A scoping review. 鉴别退行性视网膜裂与视网膜脱离的视网膜影像学选择:范围回顾。
IF 5.9 2区 医学
Survey of ophthalmology Pub Date : 2025-10-03 DOI: 10.1016/j.survophthal.2025.08.018
Jai Ethan Paris, Carmelo Zak Macri, Yong Min Lee, Weng Onn Chan
{"title":"Retinal imaging options for differentiating degenerative retinoschisis from retinal detachment: A scoping review.","authors":"Jai Ethan Paris, Carmelo Zak Macri, Yong Min Lee, Weng Onn Chan","doi":"10.1016/j.survophthal.2025.08.018","DOIUrl":"10.1016/j.survophthal.2025.08.018","url":null,"abstract":"<p><p>Degenerative retinoschisis (RS) can mimic retinal detachment (RD), posing a diagnostic challenge.We summarixe the utility and limitations of current retinal imaging modalities in evaluating degenerative RS. We conducted a systematic search of PubMed, Embase, Scopus, Cochrane Library, and Google Scholar from January 1, 1973, to February 5, 2025. Studies evaluating imaging modalities in degenerative RS were reviewed, including spectral-domain OCT (SD-OCT), B-scan ultrasound (US), ultrasound biomicroscopy (UBM), fundus autofluorescence (FAF), infrared reflectance (IR), OCT angiography (OCTA), and color doppler ultrasound (CDUS). Twenty-two studies met inclusion criteria. SD-OCT remains the most reliable modality, providing high-resolution layer differentiation and detection of schisis-detachment, though its peripheral reach is limited. B-scan ultrasonography and UBM can overcome this limitation and are particularly useful in cases with media opacity. where FAF and IR imaging yield inconsistent and non-reproducible results, limiting their diagnostic utility. CDUS and CEUS may offer additional diagnostic value, particularly in perfusion-based differentiation of RS from RD, though they remain underexplored in schisis-detachment. OCTA is useful in characterising the vascular abnormalities seen in RS; its added B-scan capability may offer advantages over UBM in select cases. We apply the use of different multimodal imaging approaches to cases with diagnostic uncertainty, and apply the use of new imaging options for cases where OCT was unavailable. A multimodal imaging approach is recommended in diagnostically uncertain cases of degenerative RS. Larger prospective studies are needed to validate newer modalities, particularly in schisis-detachment.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medical and surgical approaches to prevent corneal graft rejection in high-risk recipients. 预防高危受者角膜移植排斥反应的医学和外科方法
IF 5.9 2区 医学
Survey of ophthalmology Pub Date : 2025-10-01 DOI: 10.1016/j.survophthal.2025.09.024
Sepehr Feizi, Firouze Hatami, Sina Khosravi Mirzaei, Kia Bayat
{"title":"Medical and surgical approaches to prevent corneal graft rejection in high-risk recipients.","authors":"Sepehr Feizi, Firouze Hatami, Sina Khosravi Mirzaei, Kia Bayat","doi":"10.1016/j.survophthal.2025.09.024","DOIUrl":"10.1016/j.survophthal.2025.09.024","url":null,"abstract":"<p><p>A substantial number of corneal transplantations are performed in the vascularized and inflamed environments of high-risk recipients, which increases the risk of graft rejection. Managing high-risk keratoplasty is challenging and encompasses numerous pre-, intra-, and post-operative measures. Preoperative measures include treating ocular surface inflammation and corneal neovascularization. Intraoperative measures mainly involve performing lamellar keratoplasty, if possible, to reduce the loads of alloantigens introduced to the recipient's immune system. The key step in the prevention of immunologic rejection in high-risk recipients is the administration of topical and systemic immunosuppressive medications for a long term. Topical corticosteroids are frequently administered after corneal transplantation; however, they are insufficient to prevent graft rejection following high-risk keratoplasty. In such cases, various systemic immunosuppressive medications can be employed with inconstant success rates. Nonetheless, these agents can result in potentially serious and sometimes life-threatening adverse reactions. Furthermore, the ideal method of administration, dosage, frequency, and duration of application of these medications have not been identified for individual cases of high-risk keratoplasty. New strategies, including targeted biological treatments and tolerance-inducing protocols, may hold promise in decreasing the risk of corneal graft rejection in high-risk settings without the adverse reactions of systemic immunosuppressive treatment.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Isolated tattoo-associated uveitis without systemic sarcoidosis: A systematic review of case reports. 无系统性结节病的孤立性纹身相关葡萄膜炎:病例报告的系统回顾。
IF 5.9 2区 医学
Survey of ophthalmology Pub Date : 2025-10-01 DOI: 10.1016/j.survophthal.2025.09.021
Seyyedehfatemeh Ghalibafan, William Ross Herskowitz, Brandon Graham Chou, Landon J Rohowetz, Naomi E Gutkind, Stephanie M Llop, Nicolas A Yannuzzi
{"title":"Isolated tattoo-associated uveitis without systemic sarcoidosis: A systematic review of case reports.","authors":"Seyyedehfatemeh Ghalibafan, William Ross Herskowitz, Brandon Graham Chou, Landon J Rohowetz, Naomi E Gutkind, Stephanie M Llop, Nicolas A Yannuzzi","doi":"10.1016/j.survophthal.2025.09.021","DOIUrl":"10.1016/j.survophthal.2025.09.021","url":null,"abstract":"<p><p>We systematically review and characterize cases of tattoo-associated uveitis without systemic sarcoidosis, focusing on clinical presentation, diagnostic workup, management, and outcomes. We conducted a comprehensive literature search across PubMed, Google Scholar, Scopus, Web of Science, and Embase from 1969 to April 2025, following PRISMA guidelines. Eligible studies included case reports and series documenting tattoo-related uveitis in the absence of confirmed systemic sarcoidosis. Thirty-three studies encompassing 44 patients (86 eyes) were included. Most patients were male (75 %), with a mean age of 31.9 ± 11.5 years. Tattoos were typically permanent (97.7 %), extensive in size (61.4 %), and placed on the arms (77.3 %), with black pigment most common (61.3 %). Skin inflammation was reported in 88.6 % of patients, typically preceding or coinciding with uveitis onset. Anterior uveitis (52.3 %) and bilateral involvement (95.5 %) were predominant. Common findings included anterior chamber inflammation (56.8 %), vitritis (38.6 %), and cystoid macular edema (27.3 %). No significant associations were found, except between number of tattoos and uveitis laterality (p = 0.046). Work-up frequently involved chest imaging (72.7 %), skin biopsy (88.6 %), and infectious screening. Management included corticosteroids (70.5 %), immunosuppressants (38.6 %), and tattoo excision (15.9 %). Inflammation was controlled in 70.5 %, though 50 % required long-term corticosteroids and 15.9 % required intraocular pressure management. Tattoo-associated uveitis is an emerging entity that can mimic sarcoidosis, often presenting with delayed ocular inflammation and concurrent skin findings. Clinicians should inquire about tattoos in uveitis patients and monitor for potential systemic involvement. Multidisciplinary evaluation and tailored treatment, including immunosuppression or tattoo removal, may be needed to achieve disease control.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prefilled syringes and post-intravitreal injection endophthalmitis: A network meta-analysis. 预充式注射器和玻璃体内注射后眼内炎:一项网络荟萃分析。
IF 5.9 2区 医学
Survey of ophthalmology Pub Date : 2025-10-01 DOI: 10.1016/j.survophthal.2025.09.025
Brendan K Tao, Jiwon Hwang, Shihyun Park, David Mikhail, Angelica Hanna, Ryan S Huang, Andrew Mihalache, Jim S Xie, Marko M Popovic, Yaping Jin, Parampal Grewal, Bernard Hurley, Peter Kertes, Amin Kherani, Matthew Tennant, John Chen, Eduardo Navajas, Wai-Ching Lam, Rajeev H Muni, Peng Yan
{"title":"Prefilled syringes and post-intravitreal injection endophthalmitis: A network meta-analysis.","authors":"Brendan K Tao, Jiwon Hwang, Shihyun Park, David Mikhail, Angelica Hanna, Ryan S Huang, Andrew Mihalache, Jim S Xie, Marko M Popovic, Yaping Jin, Parampal Grewal, Bernard Hurley, Peter Kertes, Amin Kherani, Matthew Tennant, John Chen, Eduardo Navajas, Wai-Ching Lam, Rajeev H Muni, Peng Yan","doi":"10.1016/j.survophthal.2025.09.025","DOIUrl":"https://doi.org/10.1016/j.survophthal.2025.09.025","url":null,"abstract":"<p><p>Optimally, syringe-filling technique may reduce the risk of post-injection endophthalmitis (PIE), yet there is wide variation between ophthalmologists and jurisdictions regarding syringe-filling practices. This frequentist network meta-analysis (PROSPERO: CRD42024555196) of rare events sought to compare the odds of PIE between manufactured prefilled syringes (PFS), compounded syringes, and traditional vial preparation of syringes (VPS) for intravitreal anti-vascular endothelial growth factor therapy. Given outcome rarity, we included studies whose primary outcome was PIE incidence. From 20 observational studies (3,746 PIE events; 41,611,960 injections), the odds of PIE were significantly lower with PFS (OR: 0.45, 95% confidence interval [CI]: 0.40-0.49) and compounded syringes (OR: 0.69, 95% CI: 0.64-0.74) compared to VPS. The odds of PIE were significantly lower with PFS compared to compounded syringes (OR: 0.65, 95% CI: 0.58-0.72). The odds of culture-positive PIE were significantly lower with PFS than both VPS (OR: 0.15, 95% CI: 0.06-0.41) and compounded syringes (OR: 0.15, 95% CI: 0.05-0.44). No significant difference in culture-positive PIE was observed between VPS and compounded syringes (OR: 1.02, 95% CI: 0.66-1.58). Low certainty evidence supports that PFS significantly reduce the rate of clinical and culture-positive PIE compared to VPS and compounded syringes. Future studies should further characterize the role of confounding.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnostic accuracy of next generation sequencing-based genetic research for primary glaucoma: A systematic review and meta-analysis. 下一代测序基因研究对原发性青光眼的诊断准确性:一项系统综述和荟萃分析。
IF 5.9 2区 医学
Survey of ophthalmology Pub Date : 2025-10-01 DOI: 10.1016/j.survophthal.2025.09.023
Yong Liu, Di Gong, Kuanrong Dang, Junhong Guo, Zhichao Yan, Xiaoli Shen, Jiantao Wang
{"title":"Diagnostic accuracy of next generation sequencing-based genetic research for primary glaucoma: A systematic review and meta-analysis.","authors":"Yong Liu, Di Gong, Kuanrong Dang, Junhong Guo, Zhichao Yan, Xiaoli Shen, Jiantao Wang","doi":"10.1016/j.survophthal.2025.09.023","DOIUrl":"10.1016/j.survophthal.2025.09.023","url":null,"abstract":"<p><p>Our study aims to assess the utility of various next-generation sequencing (NGS) technologies and explore their role in primary glaucoma genetic research. We conducted a systematic review as of January 19, 2025, using PubMed, Scopus, and Web of Science, with study quality evaluated using the QUADAS-2 checklist. We assessed the diagnostic rates of various NGS technologies across different glaucoma subtypes. The study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42024614663). We included 19 studies utilizing whole exome sequencing (WES), whole genome sequencing (WGS), and panel sequencing for assessing genetic features in primary angle-closure glaucoma (PACG), primary congenital glaucoma (PCG), primary open-angle glaucoma (POAG), and juvenile open-angle glaucoma (JOAG). The overall diagnostic rate of NGS technologies was 26.2 % (95 % CI: 15.9 %-36.5 %). WES showed superior performance in PCG (46.7 %), POAG (8.9 %), and JOAG (12.4 %), while panel sequencing achieved a higher rate in PACG (56.4 %). Subtype-specific genes included CYP1B1 in PCG, MYOC in JOAG, and WDR36 in POAG/PACG. Notably, all CYP1B1 gene variant loci are concentrated in 2 specific regions on chromosome 2. This study underscores the significance of NGS in primary glaucoma genetic research, advocating for subtype-specific sequencing strategies to facilitate precise diagnosis and treatment.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Altered ocular surface microbiome in nasolacrimal duct obstruction: Clinical Implications for intraocular surgery. 鼻泪管阻塞时眼表微生物群的改变:眼内手术的临床意义。
IF 5.9 2区 医学
Survey of ophthalmology Pub Date : 2025-09-22 DOI: 10.1016/j.survophthal.2025.09.018
Bahram Eshraghi, Leila Babaei, Ali Aghajani
{"title":"Altered ocular surface microbiome in nasolacrimal duct obstruction: Clinical Implications for intraocular surgery.","authors":"Bahram Eshraghi, Leila Babaei, Ali Aghajani","doi":"10.1016/j.survophthal.2025.09.018","DOIUrl":"https://doi.org/10.1016/j.survophthal.2025.09.018","url":null,"abstract":"<p><p>Nasolacrimal duct obstruction (NLDO) significantly alters the ocular surface microbiome, increasing bacterial load, polymicrobial colonization, and the presence of drug-resistant organisms. This microbial shift poses a serious risk for postoperative endophthalmitis following intraocular surgery. Patients with NLDO have up to a 100% conjunctival culture positivity rate, compared to 40% in normal eyes, with increased prevalence of pathogenic species such as Pseudomonas aeruginosa and Streptococcus pneumoniae. Preoperative screening using the Regurgitation on Pressure over the Lacrimal Sac (ROPLAS) test is recommended for all patients undergoing intraocular surgery; however, its low sensitivity necessitates selective use of lacrimal irrigation in high-risk individuals. Definitive management with dacryocystorhinostomy (DCR) reduces microbial burden, with normalization of flora typically occurring around 4 weeks postoperatively. In cases where DCR cannot be performed, alternative strategies such as topical/systemic antibiotics or dacryocystectomy may help mitigate infection risk. Even after successful DCR, ocular surface microbiome may resemble nasal microbiota, requiring continued vigilance during the perioperative period. These findings highlight the importance of identifying and managing NLDO before intraocular procedures to reduce the risk of vision-threatening complications.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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