Survey of ophthalmology最新文献

{"title":"Clinical features, diagnosis, management, and prognosis of circumscribed choroidal hemangioma","authors":"Zuyi Yang , Dianzhe Tian , Zhixuan Xie , Tiantian Cheng , Youxin Chen , Xinyu Zhao","doi":"10.1016/j.survophthal.2025.01.001","DOIUrl":"10.1016/j.survophthal.2025.01.001","url":null,"abstract":"<div><div>Because of its benign nature and rarity, circumscribed choroidal hemangioma (CCH) often receives limited attention, leading to a high rate of misdiagnosis and a lack of standardized treatment protocols. We provide a thorough clarification of the demographics, clinical features, diagnosis, management, and prognosis of CCH. We conducted a systematic search of the PubMed, EMBASE, and Ovid databases up to December, 2023, to identify relevant studies. The study included 106 studies encompassing 3854 patients with CCH. The demographic profile revealed a male preponderance (62 %, 95 % CI 61–64 %) and a peak incidence in the working-age population (30–50 years, 48 %, 95 % CI 39–57 %), with the right eye being involved in 50 % of cases (95 % CI 48–53 %). Clinically, the most common symptom was decreased vision (90 %, 95 % CI 78–99 %), followed by blurred vision, visual field defect, and metamorphopsia. Fundus examination frequently revealed an orange-colored tumor (80 %, 95 % CI 58–96 %) located subfoveally (48 %, 95 % CI 42–53 %), often accompanied by subretinal fluid (SRF) (84 %, 95 % CI 78–89 %) and sometimes exudative retinal detachment (69 %, 95 % CI 51–85 %). The proportion of correctly diagnosed CCH upon first presentation was 13 % (95 % CI 3–26 %), with CCH commonly misdiagnosed as unspecified choroidal tumors, choroidal metastasis, and central serous chorioretinopathy. Photodynamic therapy (PDT) was the most widely researched treatment, taking up 18 % (95 % CI 8–31 %), followed by observation, transpupillary thermotherapy (TTT), and laser photocoagulation. When no treatment was applied, 33 % of patients experienced visual acuity improvement, which increased to 76 % (95 % CI 58–90 %) with radiotherapy and 58 % (95 % CI 50–67 %) with PDT. In terms of tumor shrinkage, radiotherapy was most effective (100 %), with PDT close behind (95 % CI 96–100 %), and TTT at 63 % (95 % CI 45–80 %). PDT led to SRF resolution in 89 % (95 % CI 77–97 %) of patients and cystoid macular edema (CME) resolution in 73 % (95 % CI 38–97 %), while radiotherapy achieved the highest efficacy with 100 % SRF resolution (95 % CI: 99–100 %) and 100 % CME resolution (95 % CI: 83–100 %). Complication rates were highest with radiotherapy (14 %, 95 % CI 5–25 %) and PDT (9 %, 95 % CI 4–16 %). First-line treatment failure rates were highest for TTT (71 %, 95 % CI 44–92 %) and laser (70 %, 95 % CI 28–99 %), with radiotherapy showing the lowest rate (0 %, 95 % CI 0–2 %). Recurrence rates were highest for laser (68 %, 95 % CI 17–100 %) and TTT (62 %, 95 % CI 26–93 %), whereas radiotherapy had the lowest recurrence rate (0 %, 95 % CI 0–1 %). CCH predominantly affects the working-age male population, often leading to vision impairment and SRF. The diagnosis of CCH remains challenging, with low accuracy and frequent misdiagnoses. While PDT is the most widely researched treatment, radiotherapy offers superior outcomes in visual acuity, tumor shrinkage, and resolution of SRF and CME, t","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 389-400"},"PeriodicalIF":5.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An update on ocular effects of antidiabetic medications","authors":"Elham Sadeghi ,&nbsp;Elham Rahmanipour ,&nbsp;Nicola Valsecchi ,&nbsp;Saloni Kapoor ,&nbsp;Maria Vittoria Cicinelli ,&nbsp;Jay Chhablani","doi":"10.1016/j.survophthal.2025.01.010","DOIUrl":"10.1016/j.survophthal.2025.01.010","url":null,"abstract":"<div><div>The global increase in the prevalence of type 2 diabetes has led to the development and implementation of new classes of antidiabetic medications, introducing advanced therapeutic options for the management of the disease. These new medications, though primarily designed to regulate blood glucose levels, also have applications in weight management, potentially transforming the current approaches to diabetes treatment. Newer medications, however, have ophthalmic side effects with controversies in trials and real-life data. We comprehensively assessed the ocular benefits and adverse effects of traditional and newer-generation anti-diabetic drugs. Our primary focus is on how these newer medications affect the stage of diabetic retinopathy. Additionally, we explore the associations between these medications and other ocular conditions, including age-related macular degeneration, glaucoma, orbital conditions, and diseases impacting the ocular surface. Furthermore, we provide contextual background by discussing the ocular effects of traditional anti-diabetic drugs.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 4","pages":"Pages 704-712"},"PeriodicalIF":5.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041424","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":"Anatomical and functional changes after internal limiting membrane peeling","authors":"Elham Sadeghi ,&nbsp;Maria F. Colorado-Zavala ,&nbsp;Hussein Almuhtaseb ,&nbsp;Ramesh Venkatesh ,&nbsp;Barbara Parolini ,&nbsp;Jay Chhablani","doi":"10.1016/j.survophthal.2025.01.008","DOIUrl":"10.1016/j.survophthal.2025.01.008","url":null,"abstract":"<div><div>Internal limiting membrane (ILM) peeling has been an acceptable step in vitrectomy surgeries for various retinal diseases such as macular hole, chronic macular edema following epiretinal membrane (ERM), and vitreoretinal traction. Despite all the benefits, this procedure has some side effects, which may lead to structural damage and functional vision loss. Light and dye toxicity may induce reversible and irreversible retina damage, which will be observed in postoperative optical coherence tomography scans. Retinal nerve fiber layer damage is attributed to ganglion cell degeneration and axonal transport alteration and dissociated optic nerve fiber layer is due to Müller cell damage. Eccentric MHs and recurrence of previous MHs may also lead to vision loss. Iatrogenic retinal damage may cause structural retinal changes without significant vision loss or progression to choroidal neovascularization. The mechanism of persistent macular edema after membrane peeling is still unclear, but it has been related to tractional trauma and blood-retina barrier damage. The reappearance of ERM is another cause of decreased vision after ILM peeling, which might be secondary to incomplete membrane removal. In glaucoma patients, ILM peeling is associated with significantly worsening the mean deviation on the visual field test after the surgery. We discussed various causes of vision loss and structural changes following ILM peeling. These causes may be attributed to the surgical procedure itself or the associated steps, instruments, and dyes used during the ILM peeling procedure.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 357-368"},"PeriodicalIF":5.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive review of structure-function correlations in age-related macular degeneration: Contributions of microperimetry","authors":"Cristina Ţurcaş ,&nbsp;Simona Delia Nicoară","doi":"10.1016/j.survophthal.2025.01.009","DOIUrl":"10.1016/j.survophthal.2025.01.009","url":null,"abstract":"<div><div>Age-related macular degeneration (AMD) is a leading cause of visual impairment and irreversible blindness worldwide. High-resolution imaging techniques have been pivotal in characterizing the morphological alterations in the retina and in identifying structural biomarkers with prognostic significance. In clinical practice, visual function is primarily assessed through visual acuity testing, which, however, does not completely reflect the functional deficits experienced by patients. Microperimetry provides a more comprehensive evaluation of macular function, enabling a direct correlation with retinal structure. We examine the current literature on the correlation between morphological biomarkers – identified via optical coherence tomography, optical coherence tomography angiography, and fundus autofluorescence – and retinal sensitivity, as assessed by microperimetry. By encompassing all stages of AMD, we explore the association between retinal sensitivity and a broad spectrum of structural parameters, including distinct drusen phenotypes, hyperreflective foci, the integrity and thickness of various retinal layers, the junctional zone of geographic atrophy, exudative features of neovascular AMD, choriocapillaris flow deficits, and diverse patterns of autofluorescence, among numerous other relevant structural markers. By offering a deeper understanding of the structure-function correlations in disease progression, we provide critical up-to-date insights into the underlying mechanisms of AMD. Moreover, as novel therapeutic strategies continue to emerge, these correlations may serve as more robust endpoints for future clinical trials.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 426-450"},"PeriodicalIF":5.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric blepharokeratoconjunctivitis: A challenging ocular surface disease","authors":"Gustavo Ortiz-Morales ,&nbsp;Raul E. Ruiz-Lozano ,&nbsp;Nallely R. Morales-Mancillas ,&nbsp;J. Homar Paez-Garza ,&nbsp;Alejandro Rodriguez-Garcia","doi":"10.1016/j.survophthal.2025.01.006","DOIUrl":"10.1016/j.survophthal.2025.01.006","url":null,"abstract":"<div><div>Pediatric blepharokeratoconjunctivitis (PBKC) is a chronic and recurrent ocular surface inflammatory disorder affecting children in early life. It is frequently under- or late- diagnosed, representing a potential cause of severe visual morbidity worldwide. An expert panel consensus recently agreed on its definition and proposed diagnostic criteria for suspected and definitive PBKC to reduce confusion and avoid varied terminology previously used in the literature, improving early and precise diagnosis. Previous evidence has pointed to the role of the adaptive immune system in recognizing and handling antigenic eyelid bacterial products, particularly from the cell wall, and the direct toxic and inflammatory effects of their cytolytic exotoxins on the ocular surface. PBKC is a frequent referral in pediatric and cornea clinics characterized by a history of recurrent chalazia, blepharitis, meibomian gland dysfunction, conjunctival hyperemia, phlyctenules formation, and corneal infiltrates with vascularization and scarring. The latter is a major cause of significant visual loss and amblyopia. Current treatment strategies aim to control inflammation on the ocular surface, halt disease progression, and avoid corneal involvement. Further research on pathogenic mechanisms will shed light on novel potential therapeutic strategies. Awareness of PBKC should enhance early diagnosis, prompt adequate treatment, and improve outcomes. We compile current evidence on epidemiology, pathophysiology, clinical spectrum of disease, diagnostic criteria, and management strategies for PBKC.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 516-535"},"PeriodicalIF":5.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011729","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 structural alterations in patients with epilepsy taking antiepileptic drugs: A systematic review and meta-analysis of OCT findings","authors":"Kia Bayat ,&nbsp;Parisa Pooyan ,&nbsp;Mehdi Azizmohammad Looha ,&nbsp;Kosar Namakin ,&nbsp;Andrew R. Carey ,&nbsp;J. Fernando Arevalo ,&nbsp;Hamid Ahmadieh","doi":"10.1016/j.survophthal.2025.01.002","DOIUrl":"10.1016/j.survophthal.2025.01.002","url":null,"abstract":"<div><div>The impact of various neurodegenerative diseases on the retina has been investigated in recent years using optical coherence tomography (OCT). Epilepsy, classified as a neurodegenerative disorder, has been indicated to affect the structural integrity of the retina. Moreover, there is ongoing debate regarding the relative contribution of the disease pathogenesis and the consumption of anti-epileptic drugs (AEDs) to these retinal changes. The lack of systematic reviews has hindered our understanding of the true effects of epilepsy and AEDs on retinal health, as well as the efficacy of OCT in detecting these alterations. To comprehensively review the impact of epilepsy and AEDs on the structure of retina, we thoroughly searched the PubMed, EMBASE, and Web of Science databases to identify relevant articles published until July 7, 2024, and performed a meta-analysis. We updated our search in November, 2024. Random effect models have been used to calculate pooled effect estimates. Nineteen studies with a total number of 1851 eyes were identified. Adult patients showed significant reduction with respect of retinal nerve fiber layer (RNFL) thickness; average, as well as all quadrants. Significant reductions were also detected in all quadrants of ganglion cell complex (GCC). Conversely, average GCC and central macular thickness did not differ significantly between cases and controls. Additionally, in terms of various volume measurements in the retina, significant losses were observed in macular RNFL, ganglion cell-inner plexiform layer and total macula volumes in adult patients. In contrast, the inner nuclear layer volume remained comparable between the 2 groups. In pediatric patients with epilepsy receiving valproic acid, significant reductions was observed in the average RNFL thickness, as well as in the nasal and inferior quadrants; however, there were no significant changes in the thickness of the superior and temporal quadrants of RNFL, nor in foveal thickness. The analysis of pediatric patients receiving levetiracetam indicated no significant changes in retinal structural measurements across various RNFL categories, or in foveal thickness. This meta-analysis revealed the structural retinal alterations following AEDs administration in patients with epilepsy (PwE). OCT appears to be a reliable device that reflects retinal toxicity with AED consumption in PwE.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 412-425"},"PeriodicalIF":5.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011930","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":"Perifoveal vascular anomalous complex and telangiectatic capillaries: An overview of two entities potentially sharing a common pathophysiology","authors":"Paolo Forte ,&nbsp;Michel Paques ,&nbsp;Jennifer Cattaneo ,&nbsp;Bénédicte Dupas ,&nbsp;Daniela Castro-Farias ,&nbsp;Jean-François Girmens ,&nbsp;Mehdi Siab ,&nbsp;Francesco Biagini ,&nbsp;Massimo Nicolò ,&nbsp;Chiara Maria Eandi ,&nbsp;Riccardo Sacconi ,&nbsp;Giuseppe Querques","doi":"10.1016/j.survophthal.2025.01.007","DOIUrl":"10.1016/j.survophthal.2025.01.007","url":null,"abstract":"<div><div>Focal capillary ectasia in the macular region can manifest in distinct clinical scenarios, which can be categorized into 2 main entities: perifoveal vascular anomalous complex (PVAC) and telangiectatic capillaries (TelCaps). PVAC represents a primary, idiopathic condition, whereas TelCaps occur secondary to underlying vascular disorders, including diabetic macular edema and retinal vein occlusion. We provide a comprehensive analysis of these 2 entities, encompassing their clinical presentations, multimodal imaging findings, histological evidence, and differential diagnosis from other retinal microvascular abnormalities, such as Type 1 macular telangiectasia, adult-onset Coats disease, Type 3 macular neovascularization in age-related macular degeneration, and retinal arterial macroaneurysms. Although PVAC and TelCaps are distinct entities, they may share common pathogenic mechanisms, including progressive endothelial dysfunction, pericyte loss, and intraluminal deposition of blood components. Selective laser photocoagulation has emerged as a promising therapeutic approach for both conditions. The proposed standardization of nomenclature for accurate reporting and meaningful cross-study comparisons is expected to facilitate future advancements in this field, ultimately leading to improved patient outcomes.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 369-379"},"PeriodicalIF":5.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011765","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":"Extracellular vesicles in dry eye disease and Sjögren’s syndrome: A systematic review on their diagnostic and therapeutic role","authors":"Prakshi Chopra ,&nbsp;Asra Fatima ,&nbsp;Sonali Mohapatra ,&nbsp;Kavipriya Murugaiyan ,&nbsp;Geeta K. Vemuganti ,&nbsp;Aravind Kumar Rengan ,&nbsp;Stephanie L. Watson ,&nbsp;Vivek Singh ,&nbsp;Sayan Basu ,&nbsp;Swati Singh","doi":"10.1016/j.survophthal.2025.01.003","DOIUrl":"10.1016/j.survophthal.2025.01.003","url":null,"abstract":"<div><div>Extracellular vesicles (EVs), defined as membrane-bound vesicles released from all cells, are being explored for their diagnostic and therapeutic role in dry eye disease (DED). We systematically shortlisted 32 articles on the role of EVs in diagnosing and treating DED. We cover the progress in the last 2 decades on the classification and isolation of EVs and their role in DED. The diagnostic predictability of exosomes was evaluated in Sjögren syndrome (SS) patients' tears, plasma, and saliva, where upregulation of inflammatory proteins was reported uniformly across studies. Also, we evaluate the therapeutic effects of MSC-derived EVs in <em>in vitro</em> and <em>in vivo</em> studies of SS and DED mouse models. A significant response occurs at a functional level with improved tear production and saliva flow rate and at a cellular level with reduced lymphocyte infiltration, improved corneal structural integrity, decreased epithelial cell apoptosis, and dampening of the inflammatory cytokine response. The proposed mechanisms of EV action include PD-L1, PRDM, NLRP-3, and Nf-kb pathways, and an increase in M2 macrophage phenotype. Current use of exosomes in DED is limited due to their cumbersome isolation techniqus. Further research on human subjects is needed, in addition to optimizing exosome isolation and delivery methods.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 499-515"},"PeriodicalIF":5.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacillary layer detachment: Updates on its clinical and prognostic significance in retinal disease","authors":"Alessandro Feo ,&nbsp;Elisa Stradiotto ,&nbsp;Andrea Govetto ,&nbsp;Paolo Forte ,&nbsp;Giacomo Boscia ,&nbsp;Massimo Nicolò ,&nbsp;Jennifer Cattaneo ,&nbsp;Chiara M. Eandi ,&nbsp;Martina Angi ,&nbsp;Prithvi Ramtohul ,&nbsp;Mario R. Romano","doi":"10.1016/j.survophthal.2025.01.005","DOIUrl":"10.1016/j.survophthal.2025.01.005","url":null,"abstract":"<div><div>Bacillary layer detachment (BALAD) refers to the distinctive splitting at the level of the photoreceptor inner segment myoid and accumulation of intraretinal fluid, as seen on optical coherence tomography (OCT). BALAD is an increasingly recognized OCT biomarker of numerous heterogeneous chorioretinal diseases, including posterior uveitis, age-related macular degeneration and macular neovascularization, neoplastic and paraneoplastic retinal disorders, rhegmatogenous retinal detachment, blunt ocular trauma, and miscellaneous conditions. The recognition of BALAD is clinically relevant because, based on the specific etiology, BALAD may require simple observation, ocular or systemic medical treatment, or even surgical intervention, with subsequent different prognosis. We discuss and summarize the clinical and prognostic significance of BALAD in the different chorioretinal disorders in which it has been described.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 401-411"},"PeriodicalIF":5.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011543","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":"Nociplastic pain among individuals with chronic ocular surface pain: One cause for “pain without stain”?","authors":"Lindsey B. De Lott ,&nbsp;Chelsea Kaplan ,&nbsp;Steven Harte ,&nbsp;Daniel J. Clauw ,&nbsp;Anat Galor ,&nbsp;Jelle Vehof ,&nbsp;Roni M. Shtein","doi":"10.1016/j.survophthal.2025.01.004","DOIUrl":"10.1016/j.survophthal.2025.01.004","url":null,"abstract":"<div><div>Chronic ocular surface pain (COSP) refers to interrelated symptoms such as burning, aching, and irritation and can occur as an isolated condition or comorbid with numerous ocular disorders, including dry eye syndrome Treatments for COSP are largely aimed at the ocular surface and modulating pain arising from damaged corneal nerves; however, the average impact of these treatments on COSP are low to absent. A potential explanation for this is that, in a subset of patients with COSP, individuals have amplified and/or dysregulated neural signaling and sensory processing within the central nervous system (CNS). As in other chronic pain conditions, this might be the pathogenic mechanism primarily responsible for maintaining pain - a phenomenon now referred to as nociplastic pain. The key clinical features of nociplastic pain include symptoms out of proportion to signs, regional or widespread pain, the presence of other chronic pain conditions, and non-pain CNS mediated symptoms (e.g., sleep disorders). We provide an overview for eye care clinicians of nociplastic pain and delineate the emerging evidence for the presence of nociplastic pain among some individuals with COSP. We highlight gaps in our current understanding of nociplastic pain in COSP and provide clinicians with specific tools that may aid in the assessment and management of nociplastic pain.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 536-543"},"PeriodicalIF":5.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011727","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}