Survey of ophthalmology最新文献

{"title":"Risk factors for retinal breaks following surgical induction of posterior vitreous detachment: A scoping review.","authors":"Jai Ethan Paris, Carmelo Zak Macri, Stewart R Lake, Weng Onn Chan","doi":"10.1016/j.survophthal.2025.08.007","DOIUrl":"10.1016/j.survophthal.2025.08.007","url":null,"abstract":"<p><p>Surgical induction of posterior vitreous detachment (IPVD) is a well-known risk factor for retinal breaks (RB) during vitrectomy; however, risk factors for breaks in the subgroup of eyes requiring IPVD are poorly characterised. We summarize and explore existing literature on demographic, clinical, and operative risk factors for RB in eyes that require IPVD. We conducted a comprehensive search of electronic databases (PubMed, Ovid MEDLINE, EMBASE, and Google Scholar) in August, 2024. We included English-language meta-analyses, randomised control trials, and observational studies or series that reported data addressing risk factors for retinal breaks during surgical IPVD. Case reports, conference abstracts, and pharmacological IPVD were excluded. A total of 10 studies were included, comprising observational studies (n = 4) and case series (n = 6). Risk factors identified in existing literature included age, surgical indication and gauge size. Younger age was associated with higher RB risk during IPVD (OR 0.959, 95 % CI 0.924, 0.996, p = 0.028). Surgical indication findings were conflicting, suggesting either macular hole or epiretinal membrane surgery may increase the rate of RB. Gauge size had no consistent impact on RB rates. Weak evidence exists that 20-G may increase RB rate compared to 23-G (23 G 3.1 % vs 20-G 15.8 %, p = 0.0234). The wide range in IPVD-related RB reflects highly heterogenous study designs, differences in IPVD induction technique, and failure to discriminate between IPVD-related and sclerotomy-related breaks. There remains no large-scale studies or meta-analyses exploring risk factors for RB during IPVD. Younger age is a risk factor for RB in IPVD. The impact of gauge size and surgical indication is conflicting in existing literature, and claims are supported by weak evidence. There is a lack of exploration of risk factors for RB during IPVD in existing literature. Further exploration of patient and operative risk factors is needed and may impact risk counselling and surgical approaches for eyes requiring IPVD.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856371","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}

{"title":"Clinical Implications of heavy silicon oil (Densiron®) endotamponade after pars plana vitrectomy: A systematic review and meta-analysis.","authors":"Karim Dirani, Chaesik Kim, Jeff Park, Andrew Gregory, Ahsan Mir, Gary Abrams, Brittany Hodges, Vivian Rajeswaren, Zach Saad, Pradeepa Yoganathan","doi":"10.1016/j.survophthal.2025.08.001","DOIUrl":"https://doi.org/10.1016/j.survophthal.2025.08.001","url":null,"abstract":"<p><p>Rhegmatogenous retinal detachments (RRDs) with inferior retinal breaks (IRBs) pose significant surgical challenges, lacking a universally accepted treatment standard. Heavy silicone oils (HSOs), specifically Densiron® 68 and Densiron XTRA, have emerged as promising endotamponade agents because of their specific gravity, which is greater than that of water, allowing effective tamponade in the inferior retina. Unlike earlier HSO formulations, these newer variants show reduced rates of intraocular inflammation while maintaining favorable anatomical outcomes, even when compared with concomitant scleral buckle (SB) use; however, their usage remains limited, particularly in the U.S. This systematic review assessed clinical indications, anatomical reattachment rates, and intraocular inflammation linked to Densiron 68 and Densiron XTRA. A comprehensive search of Ovid MEDLINE, EMBASE, and Cochrane CENTRAL identified 616 references, of which 22 studies involving 970 eyes met the inclusion criteria. Pooled analyses revealed a 16.7% rate of oil dispersion and emulsification, 13.0% incidence of intraocular inflammation, and 7.1% occurrence of oil migration into the anterior chamber. Notably, anatomical retinal reattachment following endotamponade removal was achieved in 80.1% of cases. These findings underscore the efficacy of Densiron 68 and Densiron XTRA in managing complex primary and secondary RRDs, offering a potentially viable solution with lower complication rates than prior HSOs. Their demonstrated success in achieving high anatomical reattachment rates positions them as promising tools in advancing RRD treatment.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812335","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}

{"title":"The human amniotic membrane in vitreoretinal surgery: Applications, outcomes and limitations.","authors":"Matteo Mario Carlà, Federico Giannuzzi, Lorenzo Hu, Clara Rizzo, Emanuele Crincoli, Fiammetta Catania, Gloria Gambini, Tomaso Caporossi, Carlos Mateo, Stanislao Rizzo","doi":"10.1016/j.survophthal.2025.08.004","DOIUrl":"10.1016/j.survophthal.2025.08.004","url":null,"abstract":"<p><p>The human amniotic membrane (hAM) has gained recognition as a valuable biological adjunct in vitreoretinal surgery, with its applications rapidly expanding since its initial use for macular holes (MHs). We examine the development and present applications of hAM in vitreoretinal surgery, assessing its use in treating various pathological conditions such as MHs, retinal detachments (RDs) with proliferative vitreoretinopathy (PVR), high myopia-associated MHs with posterior staphyloma, optic pit maculopathy, and other vitreoretinal disorders. We evaluate the differences between cryopreserved and lyophilized hAM preparations and compares outcomes of subretinal and epiretinal placement techniques. Evidence from the literature suggests that hAM serves as an important therapeutic option for complex vitreoretinal conditions, demonstrating anatomical success rates ranging from 80 % to 95 % across various indications. The strongest evidence indicates its efficacy in refractory MHs (closure rates 85-100 %), myopic macular holes associated with posterior staphyloma (86-92 %), and complex RDs with proliferative vitreoretinopathy (76-92 %). Both cryopreserved and lyophilized preparations exhibit efficacy; however, their surgical handling characteristics and biological properties vary, which may affect outcomes in particular indications. Current evidence suggests that subretinal positioning is typically used for large, highly myopic, or refractory MHs, whereas epiretinal placement is preferred in cases of PVR and optic pit maculopathy. While the results are promising, it is essential to standardize techniques, obtain long-term follow-up data, and conduct randomized controlled trials comparing hAM to conventional approaches to establish definitive recommendations.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800374","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}

{"title":"Retinal degenerative diseases: Complement system-microglia crosstalk.","authors":"Jia Gao, Wei Wang, Ya Mo","doi":"10.1016/j.survophthal.2025.08.005","DOIUrl":"10.1016/j.survophthal.2025.08.005","url":null,"abstract":"<p><p>Retinal degenerative diseases (RDD) are a group of age-related blinding eye diseases characterized by progressive degeneration and functional impairment of retinal photoreceptors or ganglion cells, for which there are currently no effective treatments. The complement system is an important innate immune system in the human body, activated through 3 pathways (classical pathway, lectin pathway, and alternative pathway) to ultimately form a membrane attack complex that acts on target cells. Microglia are the innate immune cells of the retina, responsible for maintaining retinal homeostasis. Complement system activation and microglial activation have been identified in RDD. Complement activation products C3 and C5 generate anaphylatoxins C3a and C5a, whose receptors C3aR and C5aR1 can activate microglia. Activated microglia can further produce complement C1q to activate the complement system, forming a positive feedback loop that exacerbates retinal damage. In this review, we focus on the crosstalk between the complement system and microglia in age-related macular degeneration, diabetic retinopathy, glaucoma, and pathological myopia-related retinal degeneration, and summarize clinical studies targeting the complement system and microglia for the treatment of RDD.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800373","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}

{"title":"Laser-induced histopathological changes to the retina: A review.","authors":"Akash Gowda, John P M Wood, Glyn Chidlow, Robert J Casson","doi":"10.1016/j.survophthal.2025.08.002","DOIUrl":"10.1016/j.survophthal.2025.08.002","url":null,"abstract":"<p><p>Although the indications for retinal laser have diminished over the past 2 decades due to the rise of intravitreal injection therapy, retinal laser remains a useful clinical tool, with novel laser technologies continuing to emerge. Continuous wave photocoagulation remains the most well-characterized laser in terms of its histopathological effects. Information about the histological effects of newer retinal laser modalities is relatively scarce. Available evidence supports the notion that short pulse applications result in less collateral damage to the neurosensory retina, but that at sufficient energy settings thermal injury is observed irrespective of the laser type.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795542","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}

{"title":"Response to the letter: Optimizing the detection of vitreous cortex remnants: The underestimated role of triamcinolone concentration.","authors":"Roberto dell'Omo","doi":"10.1016/j.survophthal.2025.07.014","DOIUrl":"10.1016/j.survophthal.2025.07.014","url":null,"abstract":"","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776188","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}

{"title":"Deep learning in central serous chorioretinopathy.","authors":"Hosein Nouri, Nasiq Hasan, Seyed-Hossein Abtahi, Hamid Ahmadieh, Jay Chhablani","doi":"10.1016/j.survophthal.2025.07.011","DOIUrl":"10.1016/j.survophthal.2025.07.011","url":null,"abstract":"<p><p>Less than a decade has passed since deep learning (DL) was first applied in ophthalmology. With tremendous growth in this field since then, DL is expected to transform and enhance the efficiency of traditional ophthalmology practice. Central serous chorioretinopathy (CSC) is a common chorioretinal disorder whose etiopathogenesis remains largely unknown. The diagnosis and management of CSC rely heavily on multimodal imaging data, detailed analysis of which may exceed the capacity of many practices. In this comprehensive review, we examine how DL can address such issues through automated analysis of CSC-related imaging biomarkers, including subretinal fluid, pigment epithelial detachment, subretinal hyperreflective material, hyperreflective foci, retinal pigment epithelium atrophy, ellipsoid zone loss, and choroidal layer, sublayers, vessels, and neovascularization. Their prognostic yield and therapeutic implications are covered as well. We describe how DL enables rapid, noninvasive visualization of choroidal vasculature, a primary source of pathology in CSC, in unprecedented detail. We also review the state-of-the-art DL models designed for automated CSC diagnosis, classification, prognostication, and treatment outcome prediction based on imaging data. We highlight the challenges and gaps in this field, discuss some recommended counter measures, and suggest future research directions.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769118","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}

{"title":"Clinical features, management, and prognosis factors of traumatic optic neuropathy.","authors":"Meiqian He, Zuyi Yang, Zhengming Shi, Youxin Chen, Xinyu Zhao","doi":"10.1016/j.survophthal.2025.07.012","DOIUrl":"10.1016/j.survophthal.2025.07.012","url":null,"abstract":"<p><p>We provide a comprehensive clarification of the demographics, clinical features, management, prognostic factors, and complications of traumatic optic neuropathy (TON). About 6068 patients from 109 studies were included. The pooling results indicated that TON was male-dominated (84 %) with road traffic accidents as the leading cause (67 %). After trauma, 46 % of cases had no light perception (NLP), and the most frequent associated injury was craniofacial fractures (70 %). Optic canal fractures (OCF) were detected in 34 % of cases via computed tomography and in 47 % intraoperatively. The general visual improvement rate of conservative treatment, steroid pulse therapy (SPT), optic nerve decompression (OND) and intravenous erythropoietin injection were 34 %, 48 %, 56 %, and 61 %, respectively. OND and SPT showed similar efficacy in patients with both NLP (37 % vs. 28 %) and residual vision (76 % vs. 73 %), but were superior to observation only in patients with residual vision. Patients without OCF also responded similarly to OND (57 %) and SPT (62 %), whereas those with OCF showed a higher response rate to OND (53 %) compared to SPT (24 %). Early intervention (within 7 days post-trauma) improved outcomes for both OND and SPT. Complications from OND were rare. TON mainly affects males, causes severe vision impairment, and is often associated with craniofacial fractures. OND may provide greater benefit than SPT for patients with OCF, while both treatments appear similarly effective for those without OCF, regardless of baseline vision status; however, heterogeneity in the definition and diagnostic criteria of TON, as well as variability in study designs, warrants cautious interpretation of these findings.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765530","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}

{"title":"Optimizing the detection of vitreous cortex remnants: The underestimated role of triamcinolone concentration.","authors":"Abdullah Ağın, Ozgur Artunay","doi":"10.1016/j.survophthal.2025.07.013","DOIUrl":"10.1016/j.survophthal.2025.07.013","url":null,"abstract":"","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765531","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}

{"title":"Vitreoretinal interface abnormalities in age-related macular degeneration: Prevalence, pathophysiology, and reciprocal influence.","authors":"Matteo Mario Carlà, Francesco Mottola, Mattia Cusato, Gianmarco Oreste, Giorgia Campaniello, Carlos Mateo, Aude Couturier, Elise Philippakis, Tomaso Caporossi, Stanislao Rizzo","doi":"10.1016/j.survophthal.2025.07.010","DOIUrl":"https://doi.org/10.1016/j.survophthal.2025.07.010","url":null,"abstract":"<p><p>Age-related macular degeneration (AMD) represents a leading cause of vision loss worldwide, while vitreoretinal interface (VRI) abnormalities constitute a dynamic boundary where posterior vitreous interacts with the retinal surface. We explore the intricate relationship between VRI abnormalities and AMD, examining prevalence, underlying pathophysiological mechanisms, and their reciprocal influence on disease development, progression, and treatment outcomes. Evidence suggests a higher prevalence of vitreomacular adhesion in exudative versus nonexudative AMD, while complete posterior vitreous detachment may exert protective effects against AMD progression. Tractional forces, inflammatory mediators, and structural disruption associated with VRI abnormalities may promote AMD progression and confound assessment of anti-vascular endothelial growth factor therapy efficacy. Recent findings underscore that epiretinal membranes might act as physical barriers reducing drug penetration, while VMT/VMA can alter macular morphology, potentially mimicking or obscuring therapeutic response. Surgical management of VRI abnormalities in AMD can achieve anatomical success, though visual outcomes may be limited by underlying macular pathology. Early detection and characterization of VRI abnormalities in AMD patients could improve risk stratification, guide treatment timing, and potentially lead to novel preventive strategies, highlighting the importance of comprehensive evaluation and individualized management approaches for optimizing outcomes in this complex patient population.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718702","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}