Therapeutic Advances in Ophthalmology最新文献

{"title":"Evaluation of the usability, efficacy and safety of a novel ophthalmic eye drop dispenser designed to deliver preservative-free artificial tears for the treatment of dry eye disease.","authors":"Gamze Ozkan, Jesus Pujol-Marti, Stefan Hellbardt, Matthias Birkhoff, Semra Akkaya Turhan","doi":"10.1177/25158414261489406","DOIUrl":"10.1177/25158414261489406","url":null,"abstract":"<p><strong>Background: </strong>Ocular conditions are often managed with eye drops but conventional dispensers may be difficult to use for some.</p><p><strong>Objectives: </strong>A novel device has been designed to overcome limitations of traditional eye drop dispensers, and its ability to deliver artificial tears was tested.</p><p><strong>Design: </strong>A single centre, prospective study of 24 patients with Dry Eye Disease (DED).</p><p><strong>Methods: </strong>Regular users of artificial tears tested the novel dispenser over 4 weeks, evaluating: DED symptoms with the Dry Eye Questionnaire 5; ocular parameters including the non-invasive tear breakup time (NI-TBUT), the Schirmer I test and surface staining; and tear meniscus parameters (height, depth and area measured by AS-OCT before and after application). The patients used questionnaires to evaluate the usability and their satisfaction with the dispenser, and report any adverse reactions.</p><p><strong>Results: </strong>Tear stability improved after 4 weeks using the dispenser, with a significantly higher NI-TBUT-first (6.48 ±3.65 s) and NI-TBUT-average (7.45 ±3.59 s) relative to baseline (4.52 ±3.18 and 5.95 ±3.39, respectively: p=0.001), coupled to milder ocular surface staining (0.54 ±0.65) relative to baseline (1.08 ±0.77: p=0.042). Artificial tear instillation using the dispenser significantly improved tear meniscus parameters, which persisted for ≥5 min, and the lower mean DEQ-5 score after 4 weeks (9.79 ±3.23) relative to baseline (11.20 ±3.37: p=0.006) indicated DED symptoms also improved. The patients rated the new dispenser as very easy (58%) or easy (33.3%) to use, and many felt very comfortable using it. Patients were satisfied (54.2%) or very satisfied (16.7%) with the new dispenser, 87.5% preferring it over conventional systems (p<0.001) and with a desire to continue using it. No adverse reactions were reported.</p><p><strong>Conclusion: </strong>The Beat the Blink™ dispenser was feasible, easy to use, well tolerated, and highly accepted over 4 weeks. Clinical signs and patient-reported symptoms improved during use with preservative-free artificial tears.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"18 ","pages":"25158414261489406"},"PeriodicalIF":2.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life and its determinants among glaucoma patients attending Berhan Aini Ophthalmic National Referral Hospital: A cross-sectional study.","authors":"Nuru Abdu, Saleh Idrisnur, Hanae Said, Lude Kifle, Lwam Semereab, Semira Ghirmai, Kahsay Fessehazion, Eyasu H Tesfamariam","doi":"10.1177/25158414261489414","DOIUrl":"10.1177/25158414261489414","url":null,"abstract":"<p><strong>Background: </strong>Glaucoma is a leading cause of irreversible blindness, and its increasing global prevalence profoundly affects patients' physical, psychological, and social well-being. While clinical measurements are essential, they do not fully capture the disease's subjective impact on daily life. This highlights the need for patient-reported outcomes, such as health-related quality of life (HRQoL).</p><p><strong>Objectives: </strong>This study aimed to linguistically and psychometrically validate the Eritrean version of the Glaucoma Quality of Life-36 (GlauQoL-36) questionnaire and to assess HRQoL and its determinants among glaucoma patients in Eritrea.</p><p><strong>Design: </strong>A cross-sectional study was conducted among glaucoma patients attending the Berhan Aini Ophthalmic National Referral Hospital in Asmara, Eritrea, between August and November 2024.</p><p><strong>Methods: </strong>A systematic random sampling technique was used to enroll participants. Data were collected through structured interviews using the Eritrean version of the GlauQoL-36. The tool was linguistically and psychometrically validated. Analysis of Co-variance (ANCOVA) was employed at the multivariable level to assess the determinants of HRQoL using generalized linear model in Statistical Package for Social Sciences (SPSS) (version 26.0). Reliability, confirmatory factor analysis and the error plot were performed in R Studio (version 4.4.3).</p><p><strong>Results: </strong>A total of 306 respondents with a mean age of 65.1 (Standard Deviation (SD): 11.9) years were included. The confirmatory factor analysis demonstrated an acceptable model fit, with a root mean square error of approximation (RMSEA) of 0.064, and strong fit indices for comparative fit index (0.973) and Tucker-Lewis index (0.970). The overall internal consistency of the 33-item tool (excluding the driving domain) was excellent, with a Cronbach's alpha of 0.89. The overall mean HRQoL score was 74.05 (SD: 13.71) out of 100. The constraint domain had a significantly higher (<i>p</i><0.001) mean score (M: 91.0, SD: 13.50) than both the anxiety domain (M: 71.3, SD: 22.45) and the daily life domain (M: 63.5, SD: 23.56). Being an urban resident (<i>p</i><0.001) and employed (<i>p</i> = 0.008) were significantly associated with higher HRQoL.</p><p><strong>Conclusion: </strong>The Eritrean GlauQoL-36 is a valid, reliable tool for assessing patient-reported outcomes. The disease significantly impairs daily functioning and psychosocial well-being, highlighting the need for holistic, patient-centered care.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"18 ","pages":"25158414261489414"},"PeriodicalIF":2.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autologous platelet-rich plasma eyedrops for severe dry eye disease unresponsive to autologous serum: A prospective single-arm interventional study.","authors":"Thapakorn Sirirattanasoporn, Parichart Taweekitikul, Susama Choksuwattanaskul, Thanachaporn Kittipibul, Vannarut Satitpitakul","doi":"10.1177/25158414261487082","DOIUrl":"10.1177/25158414261487082","url":null,"abstract":"<p><strong>Background: </strong>Some patients with dry eye disease (DED) respond sub-optimally to autologous serum (AS) therapy. Platelet-rich plasma (PRP), a blood-derived preparation with higher platelet-derived growth factor concentrations, may benefit patients refractory to AS.</p><p><strong>Objectives: </strong>To evaluate the short-term efficacy and safety of topical autologous PRP eyedrops in patients with severe DED unresponsive to AS.</p><p><strong>Design: </strong>Prospective single-arm interventional study with AS re-challenge.</p><p><strong>Methods: </strong>Twenty eyes (10 patients) with severe DED unresponsive to 100% AS were enrolled. Participants applied 100% autologous PRP eyedrops six times daily for 6 weeks, then 100% AS eyedrops for 6 weeks. Ocular Surface Disease Index (OSDI) scores, conjunctival and corneal staining (NEI scores), tear film break-up time (TBUT), Schirmer test were evaluated at baseline, weeks 1, 4, 6, and 12. Subbasal nerve and dendritic cell density were assessed by in vivo confocal microscopy (IVCM) in the worse eye at baseline, week 6 and 12. Data were analyzed using a mixed-effects model with patient identity as a random effect and Bonferroni correction.</p><p><strong>Results: </strong>OSDI scores improved significantly at weeks 1, 4, and 6 (adjusted P = 0.04, <0.01, <0.01). Conjunctival staining improved at weeks 4 and 6, corneal staining at week 1, and TBUT at weeks 1 and 6 (all P <0.05). After transitioning to AS, no statistically significant differences from baseline were observed for any parameter at week 12. Schirmer test, subbasal nerve density, and dendritic cell density showed no significant changes throughout. No adverse events were reported.</p><p><strong>Conclusions: </strong>Autologous PRP eyedrops were associated with short-term improvements in symptoms and selected ocular surface signs in AS-refractory severe DED, which were not sustained after switching to AS.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"18 ","pages":"25158414261487082"},"PeriodicalIF":2.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluocinolone Acetonide Implant as a Baseline Therapy for Diabetic Macular Edema: Results from the Randomized Phase 4 NEW DAY Study.","authors":"Michael A Singer, Charles C Wykoff, Christopher D Riemann, Victor H Gonzalez, Christina Y Weng, Kamel Alkhatib, Scott Moody, Mary Pao","doi":"10.1177/25158414261477639","DOIUrl":"https://doi.org/10.1177/25158414261477639","url":null,"abstract":"&lt;p&gt;&lt;p&gt;This summary explains the findings of the NEW DAY study, which examined two ways of starting treatment for diabetic macular edema (DME). DME is an eye condition that can affect people with diabetes and can cause blurred vision or vision loss if not treated. In the 18-month study, adults with DME who had little or no previous treatment started therapy with either a single fluocinolone acetonide (FAc) implant or a series of aflibercept injections. The FAc implant is a small device placed inside the eye and is designed to slowly release a corticosteroid up to 3 years. Aflibercept is a medicine given as a series of eye injections. After the planned starting treatment, people in both groups could receive extra (\"rescue\") aflibercept injections if their vision worsened or if eye scans showed worsening DME (retina swelling). After the planned starting treatments, both groups needed a similar number of rescue injections. However, counting the planned starting treatments plus the rescue injections, people who received the FAc implant had fewer total injections and went longer before needing their first rescue injection. Vision and retina swelling improved similarly between groups. Side effects such as cataracts and increases in eye pressure were more common with the FAc implant. Such side effects are expected when steroids are given in the eye and manageable with regular checkups and treatment. Overall, compared with starting DME treatment with aflibercept, starting with the FAc implant reduced the total number of injections while providing similar vision and eye scan improvements. What is this summary about? This is a plain language summary of the results of the NEW DAY study published in &lt;i&gt;Ophthalmology&lt;/i&gt; 2026 Jul;133(7):837-851. doi: 10.1016/j.ophtha.2026.03.019. NEW DAY compared ILUVIEN&lt;sup&gt;®&lt;/sup&gt;, a &lt;b&gt;fluocinolone acetonide&lt;/b&gt; implant (&lt;b&gt;FAc&lt;/b&gt;), with &lt;b&gt;aflibercept&lt;/b&gt; in people with &lt;b&gt;diabetic macular edema&lt;/b&gt; (&lt;b&gt;DME&lt;/b&gt;) who had minimal or no prior treatment for that condition. DME is a complication of diabetes that affects the eye, causing blurred vision and potential vision loss if left untreated. DME happens when small blood vessels are damaged in the &lt;b&gt;retina&lt;/b&gt; (an area at the back of the eye where specialized cells sense light and send signals to the brain so that we can see). These damaged blood vessels become leaky and cause swelling (edema) in a central area of the &lt;b&gt;retina&lt;/b&gt; called the &lt;b&gt;macula&lt;/b&gt;. Current &lt;b&gt;treatments&lt;/b&gt; for DME include medicines that reduce inflammation (called &lt;b&gt;corticosteroids&lt;/b&gt;) and medicines that block a protein called vascular endothelial growth factor (&lt;b&gt;VEGF&lt;/b&gt;) that causes blood vessels to leak (these are called &lt;b&gt;anti-VEGFs&lt;/b&gt;). The purpose of the NEW DAY study was to compare the &lt;b&gt;FAc implant&lt;/b&gt; (a &lt;b&gt;corticosteroid&lt;/b&gt;) with &lt;b&gt;aflibercept&lt;/b&gt; (an &lt;b&gt;anti-VEGF&lt;/b&gt;) injections as a treatment for people with DME who had either minimal or no prior treatment. Worsening DME may ","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"18 ","pages":"25158414261477639"},"PeriodicalIF":2.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An unusual case of iris and lens colobomas: A case report.","authors":"Cong Ren, Zhang-Chen-Xi Gu, Jun-Guo Guo, Jing Pang, Bin Guo, Zhong-En Li","doi":"10.1177/25158414261487062","DOIUrl":"10.1177/25158414261487062","url":null,"abstract":"<p><p>Ocular colobomas are unusual congenital anomalies arising from abnormal ocular development and may involve different ocular structures, including the iris and lens. Typical ocular colobomas predominantly involve the inferonasal quadrant, in accordance with the inferonasal location and closure pattern of the fetal fissure. Atypical colobomas outside this region are unusual and may complicate clinical evaluation and surgical planning. We report the case of a 49-year-old male with congenital inferonasal iris coloboma associated with a superotemporal lens coloboma, sectorial cataract, superior posterior subcapsular cataract and localized zonular absence. Ultrasound biomicroscopy demonstrated localized lens thickening and increased sphericity corresponding to the area of zonular defect. Given the limited extent of zonular involvement and intraoperative capsular bag stability, phacoemulsification with in-the-bag intraocular lens implantation was performed without additional capsular support. Postoperatively, the intraocular lens remained well centered during two-year follow-up, and best-corrected visual acuity improved significantly.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"18 ","pages":"25158414261487062"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the retinal and choroidal microvasculature in retinitis pigmentosa using OCT-angiography: a meta-analysis.","authors":"Evita Evangelia Christou, Amandeep S Josan, Robert E MacLaren","doi":"10.1177/25158414261471361","DOIUrl":"10.1177/25158414261471361","url":null,"abstract":"<p><strong>Background: </strong>Retinitis pigmentosa (RP) comprises a group of genetically and clinically heterogeneous retinal dystrophies characterized by progressive retinal degeneration, leading to deterioration of vision. Optical coherence tomography angiography (OCTA) enables non-invasive assessment of retinal and choroidal microvasculature and has increasingly been used in the assessment of microvascular changes in PR.</p><p><strong>Objectives: </strong>To assess current evidence regarding the retinal and choroidal microvasculature using optical coherence tomography angiography in patients with RP.</p><p><strong>Design: </strong>Meta-analysis.</p><p><strong>Data sources and methods: </strong>A comprehensive literature search was performed in the PubMed database, including studies published up to July 2025. Eligible journal articles were quality and consistency assessed prior to inclusion. Mean difference (MD) and variances were calculated from reported means and standard deviations in patient and control groups. Heterogeneity was evaluated based on the values of <i>I</i> ² and <i>p</i>-values. Group mean differences were reported with 95% confidence intervals (CIs) and 95% predicted intervals (PIs).</p><p><strong>Results: </strong>Nineteen eligible studies were included for this meta-analysis. The foveal perfusion density of RP patients was significantly lower than that of the control group for superficial capillary plexus, MD = -6.09% (95% CI: -9.75, -2.43), and deep capillary plexus, MD = -4.57% (95% CI: -7.22, -1.91). The parafoveal perfusion density of RP patients was significantly lower than that of the control group for superficial capillary plexus, MD = -8.72% (95% CI: -11.71, -5.74) and deep capillary plexus, MD = -6.55% (95% CI: -12.14, -0.96). The foveal avascular zone area of RP patients was significantly increased as compared to that of the control group for superficial capillary plexus, MD = 0.10 mm² (95% CI: 0.02, 0.17), and deep capillary plexus, MD = 0.12 mm² (95% CI: 0.02, 0.23). The perfusion density in the choriocapillaris of RP patients was not significantly lower than that of the control group in the foveal region, MD = -1.41% (95% CI: -6.73, 3.91), but was significantly lower in the parafoveal region, MD = -2.44% (95% CI: -3.85, -1.03). Significant heterogeneity was present across studies, resulting in PIs encompassing zero difference for all measures.</p><p><strong>Conclusion: </strong>The findings suggest an association between retinitis pigmentosa and reduced retinal and choroidal microvasculature parameters. However, substantial interstudy heterogeneity and wide PIs limit the certainty and generalizability of the results. Microvascular attenuation is likely occurring secondary to retinal degeneration and may share a similar mechanism to the peripheral large vessel attenuation, which is typically described peripherally in advanced RP.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"18 ","pages":"25158414261471361"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When trifocal IOLs disappoint: diagnostic and management pathway.","authors":"Masoud Khorrami-Nejad, Ahmed Mohammed Noori, Khosrow Jadidi, Foroozan Narooie-Noori, Mehdi Khodaparast","doi":"10.1177/25158414261471349","DOIUrl":"10.1177/25158414261471349","url":null,"abstract":"<p><p>Trifocal presbyopia-correcting intraocular lenses (IOLs) are widely used in cataract surgery and refractive lens exchange to expand functional vision across distance, intermediate, and near ranges and to reduce spectacle dependence. Despite generally favorable visual outcomes, some patients experience postoperative dissatisfaction related to dysphotopsia, reduced visual quality, or unmet functional expectations. Evidence suggests that, at 1 year, trifocal IOLs show no clear differences versus bifocal IOLs in uncorrected distance or near visual acuity, while uncorrected intermediate acuity may be improved, although certainty is low and reporting of adverse visual phenomena and quality-of-life outcomes is limited. Comparative studies with bifocal and extended depth-of-focus lenses suggest that trifocal IOLs may provide stronger near performance and greater spectacle independence, although photic phenomena such as halos may occur more frequently in some patients. Contemporary evidence indicates that dissatisfaction is multifactorial and may involve residual refractive error, dysphotopsia, ocular surface disease, neuroadaptation failure, and IOL-capsule complex abnormalities such as tilt, decentration, capsular contraction, or posterior capsule opacification. This narrative review synthesizes current evidence on the epidemiology and contributors to trifocal IOL dissatisfaction and proposes a pragmatic diagnostic and management framework. The approach emphasizes symptom characterization, rigorous refraction and binocular testing, early ocular surface optimization, targeted evaluation of the IOL-capsule complex, and stepwise intervention sequencing, including deferring Nd:YAG capsulotomy until IOL exchange is unlikely. Standardized outcome sets and prospective trials of staged care pathways are needed to improve comparability and guide individualized treatment decisions.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"18 ","pages":"25158414261471349"},"PeriodicalIF":2.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wharton's jelly-derived mesenchymal stem cells in keratoconus.","authors":"Masoud Khorrami-Nejad, Rawshan Qasim Jumah, Hossein Aghamollaei, Foroozan Narooie-Noori, Hesam Hashemian, Khosrow Jadidi","doi":"10.1177/25158414261475131","DOIUrl":"https://doi.org/10.1177/25158414261475131","url":null,"abstract":"<p><p>This review examines the potential of Wharton's jelly-derived mesenchymal stem cells (WJ-MSCs) as regenerative therapies for corneal ectasia, with an emphasis on keratoconus. Current standards, including corneal cross-linking, intrastromal corneal ring segments, and keratoplasty, stabilize or reshape the cornea but do not restore native extracellular matrix (ECM) architecture or correct underlying cellular dysfunction. WJ-MSCs offer a scalable, ethically accessible cell source with high proliferative capacity, low immunogenicity, and robust paracrine activity. Preclinical studies suggest that WJ-MSCs may acquire corneal epithelial- and keratocyte-like characteristics under in vitro induction conditions and may promote epithelial healing, reduce inflammation and haze, and improve stromal organization and biomechanics, collectively supporting their potential role in corneal regeneration. Early clinical experiences with MSC-based therapies in ocular surface disease indicate favorable safety and preliminary evidence of efficacy, while a phase 1b clinical trial of locally delivered allogeneic bone marrow-derived MSCs supports the feasibility and short-term safety of ocular MSC administration, providing indirect translational support for future WJ-MSC studies. Mechanistically, WJ-MSCs act via coordinated paracrine signaling and extracellular vesicles, immunomodulation (TGF-β, IL-10, IDO, HLA-G), anti-fibrotic effects, ECM remodeling, and potential neurotrophic support. Cell-free derivatives (secretome/EVs) may replicate therapeutic benefits with simplified manufacturing and repeat dosing. Key challenges include optimizing dose, route, and timing; enhancing intrastromal persistence and potency (e.g., via biomaterials and preconditioning); and standardizing Good Manufacturing Practice (GMP) production. Rigorous, multicenter randomized trials with harmonized imaging, biomechanical, and patient-reported outcomes are needed to confirm durability and clinical benefit, including in combination strategies with cross-linking. The regulatory pathway also requires early engagement with relevant regulatory agencies, science-based chemistry, manufacturing, and controls (CMC), standardized product characterization, validated potency assays, ethical umbilical-cord sourcing, and appropriate preclinical toxicology before clinical implementation. With disciplined clinical development, WJ-MSC-based therapies, including cells or cell-free products, could evolve into disease-modifying options that complement existing care and, in selected cases, reduce reliance on keratoplasty.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"18 ","pages":"25158414261475131"},"PeriodicalIF":2.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State-of-the-art advances in tissue-engineered corneal substitutes: a systematic review (2020-2025).","authors":"Mario Bonmatí-Echevarría, Carmen González-Gallardo, Miguel Alaminos","doi":"10.1177/25158414261464536","DOIUrl":"10.1177/25158414261464536","url":null,"abstract":"<p><strong>Background: </strong>Corneal blindness remains a major global health burden, limited by donor shortage and graft-related complications. Tissue-engineered corneal substitutes have emerged as a promising alternative, aiming to restore corneal structure and function through bioengineered constructs.</p><p><strong>Objectives: </strong>To systematically review recent advances (2020-2025) in tissue-engineered corneal substitutes, classifying them according to the corneal layer replaced and evaluating their biological, optical, and functional performance, as well as their translational potential for clinical application.</p><p><strong>Design: </strong>A systematic review.</p><p><strong>Data sources and methods: </strong>A systematic review was conducted following Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2020 guidelines. Searches were performed in PubMed/MEDLINE, Scopus, and Web of Science using predefined keywords related to corneal tissue engineering. Eligible studies included experimental, preclinical, or clinical studies published between January 2020 and June 2025 describing cell-based corneal substitutes. Studies focused on keratoprostheses (KPros), acellular scaffolds, or non-cellular biomaterials were excluded.</p><p><strong>Results: </strong>Fourteen studies met the inclusion criteria: five endothelial, three stromal, one epithelial, and five epithelium-stroma substitutes. Endothelial models demonstrated cell viability, expression of tight junction proteins (ZO-1, Na⁺/K⁺-ATPase), and partial restoration of corneal transparency in animal and ex vivo systems. Stromal models incorporated advanced biofabrication techniques such as 3D bioprinting and neuronal co-culture, achieving > 80% optical transmittance and adequate biomechanical properties. The single epithelial model achieved complete re-epithelialization in a rabbit limbal deficiency model. Multilayered epithelium-stroma substitutes, including the NANOULCOR (Tissue Engineering Group, University of Granada, Granada, Spain) construct, exhibited safety and feasibility in preclinical and early clinical studies.</p><p><strong>Conclusion: </strong>Recent progress in corneal tissue engineering has yielded increasingly functional and biocompatible substitutes that replicate native corneal architecture. However, most studies remain limited by small sample sizes, short follow-up, and reliance on animal models. Further standardized clinical trials are required for clinical translation.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"18 ","pages":"25158414261464536"},"PeriodicalIF":2.0,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Podcast reassurance to equity of implementation: Expanding the therapeutic potential of charles bonnet syndrome education.","authors":"Rajeev Kumar Jha, Ranjay Kumar Choudhary, Mulavagili Vijayasimha","doi":"10.1177/25158414261475127","DOIUrl":"10.1177/25158414261475127","url":null,"abstract":"<p><p>Charles Bonnet syndrome (CBS) is a condition that can cause people with vision loss to see things that are not actually present, such as patterns, objects, animals, or people. Although these experiences are usually not a sign of mental illness, many individuals feel worried, confused, or reluctant to discuss their symptoms with healthcare professionals. A recent study in Therapeutic Advances in Ophthalmology showed that an educational podcast helped people with CBS better understand their condition and reduced some of the emotional distress associated with hallucinations. This finding highlights the value of simple, accessible educational tools in supporting patients. In our letter, we suggest that educational podcasts should be viewed as the first step in a broader support strategy. Education can help patients feel reassured, but it should be combined with routine screening, opportunities to discuss symptoms with healthcare providers, and clear pathways for referral when additional support is needed. We also emphasize the importance of making educational resources available in different languages and formats so they can reach people with varying levels of digital access and health literacy. By combining patient education with structured clinical support, healthcare systems may improve awareness of CBS, reduce stigma, encourage earlier disclosure of symptoms, and enhance quality of life for people living with this often-overlooked condition. Our goal is to promote practical, equitable, and patient-centred approaches that can be adopted in eye care services worldwide.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"18 ","pages":"25158414261475127"},"PeriodicalIF":2.0,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}