Translational Vision Science & Technology最新文献

{"title":"Identification of Subtypes of Herpetic Anterior Uveitis and Characterization of Their Clinical Features and Visual Outcome in a Chinese Population.","authors":"Hui Liu, Suo Guo, Yaning Liu, Guannan Su, Peizeng Yang","doi":"10.1167/tvst.14.4.2","DOIUrl":"10.1167/tvst.14.4.2","url":null,"abstract":"<p><strong>Purpose: </strong>To identify the subtypes among patients clinically diagnosed as herpetic anterior uveitis (HAU) and characterize their clinical features and visual prognosis.</p><p><strong>Methods: </strong>Three hundred and seventeen patients were clinically diagnosed as HAU in our department. Aqueous humor (AqH) and serum were collected from 43 of 317 HAU patients during eye surgery. Pathogens were identified using droplet digital polymerase chain reaction and the Goldmann-Witmer coefficient. The AqH levels of 10 inflammatory cytokines were measured. The demographics, clinical features, treatment, and visual prognosis of the subtypes of HAU identified by AqH analysis were analysed.</p><p><strong>Results: </strong>DNA for herpes simplex virus (HSV), varicella-zoster virus (VZV), and cytomegalovirus (CMV) were identified in 13,18 and 12 eyes, respectively. The AqH levels of interleukin-13, interferon-γ, and tumor necrosis factor-α were significantly higher in VZV-AU as compared with HSV-AU and CMV-AU (all P < 0.05). In general, all these three subtypes of HAU had clinical features in common, including mutton-fat keratic precipitates usually toned with pigmentation, iris atrophy, elevated intraocular pressure (IOP), and posterior synechia with pupil pulling appearance unlike that caused by other uveitis. A much higher IOP and poor visual acuity at first visit were more commonly observed in VZV-AU and CMV-AU as compared with HSV-AU (both P < 0.05). A poor visual prognosis was noted in VZV-AU as compared with HSV-AU and CMV-AU (P = 0.010).</p><p><strong>Conclusions: </strong>Our study identified three subtypes of HAU and characterized their clinical features. VZV-AU is frequently associated with much higher IOP and a poor visual prognosis.</p><p><strong>Translational relevance: </strong>We addressed the similarity and difference regarding clinical features and visual prognosis among three subtypes of HAU and also found droplet digital polymerase chain reaction is a sensitive technique for identifying its subtypes throughout the disease course.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 4","pages":"2"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Directional Reflectance in Corneal Tissue: A Comprehensive Optical Coherence Tomography Analysis.","authors":"Jad F Assaf, Jiachi Hong, Yan Li, David Huang","doi":"10.1167/tvst.14.4.7","DOIUrl":"10.1167/tvst.14.4.7","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the directional reflectance properties of the cornea using optical coherence tomography (OCT) imaging and develop a mathematical model describing corneal reflectance as a function of depth and incidence angle across different corneal layers.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on OCT scans from normal subjects using the Visionix Avanti OCT system (840 nm). Reflectance values for the epithelium, Bowman's layer, stroma, and endothelium/Descemet's membrane were extracted and analyzed as functions of incidence angle and corneal depth. Reflectance distributions were assessed for normality. Exponential functions were fitted to the mean and 97th percentile reflectance data to model directional reflectance for each corneal layer.</p><p><strong>Results: </strong>Reflectance values exhibited non-normal leptokurtic distributions with right-tailed skewness, requiring non-parametric methods for percentile calculations. The exponential model incorporating angular dependence achieved R² values of 0.987 and 0.963 for mean and 97th percentile reflectance, respectively. The mean reflectance of the epithelium was modeled by a single exponential function, with half-reflectance angles of 15.9° to 26.6°. The stromal layers required two exponential components, with the anterior stroma exhibiting the highest reflectance and most pronounced directionality (half-reflectance angle of 0.17°). The 97th percentile reflectance differed, with higher reflectance values in the middle and posterior stroma. No statistically significant age or gender related variability in reflectance was measured.</p><p><strong>Conclusions: </strong>This study provides a detailed mathematical model of corneal directional reflectance, highlighting the importance of incidence angle and layer depth in OCT image analysis.</p><p><strong>Translational relevance: </strong>The developed cornea reflectance model may improve OCT-based diagnostics by identifying early microstructural changes, aiding in the diagnosis and management of corneal diseases.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 4","pages":"7"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on Xie et al.'s Study on Artificial Intelligence-Assisted Perfusion Density as Biomarker for Screening Diabetic Nephropathy.","authors":"James Lin, Ting-Wan Kao","doi":"10.1167/tvst.14.4.11","DOIUrl":"https://doi.org/10.1167/tvst.14.4.11","url":null,"abstract":"","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 4","pages":"11"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Per- and Polyfluoroalkyl Substance Exposure With Cataract Prevalence Among U.S. Adults: A NHANES Analysis (2005-2008).","authors":"Yuti Liu, Jiazhen Yao, Mingxue Ren, Lingxia Ye, An-Peng Pan, Xu Xu","doi":"10.1167/tvst.14.4.1","DOIUrl":"10.1167/tvst.14.4.1","url":null,"abstract":"<p><strong>Purpose: </strong>Cataract, a major health concern among the elderly, can be influenced by environmental exposures. This study examines the association between per- and polyfluoroalkyl substance (PFAS) exposure and cataract prevalence.</p><p><strong>Methods: </strong>Six serum PFAS concentrations were detected among 2119 U.S. adults aged 40 years or older based on the National Health and Nutrition Examination Survey. Multivariable models, including weighted logistic regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression, were used to assess the association between individual and overall PFAS exposure and cataract prevalence. A mediation analysis was conducted for inflammation biomarkers.</p><p><strong>Results: </strong>Single exposure to perfluorohexane sulfonic acid (PFHS) and perfluorononanoic acid (PFNA) was found to be markedly associated with cataract prevalence after adjustment for covariates (PFHS: odds ratio [OR], 1.579; 95% CI, 1.003-2.514; PFNA: OR, 1.629; 95% CI, 1.065-2.506). The WQS index was significantly associated with cataract (OR, 1.441; 95% CI, 1.130-1.837). PFNA and PFHS were the most influential exposures in the PFAS mixture. In the Bayesian kernel machine regression model, PFNA and PFHS exhibited the highest group posterior inclusion probability, aligning with the WQS results. Moreover, serum albumin and neutrophil counts were found to mediate the relationship between PFHS and cataract, accounting for -26.20% and -5.95% of the mediation effect, respectively.</p><p><strong>Conclusions: </strong>Exposure to PFAS was positively associated with cataract, primarily driven by PFHS and PFNA. Mediation of serum albumin and neutrophil count was observed.</p><p><strong>Translational relevance: </strong>This study links PFAS exposure to cataract prevalence, suggesting reducing exposure could help in cataract prevention.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 4","pages":"1"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Change in Retinal Nerve Fiber Layer Thickness and Intraocular Pressure in Young Adults.","authors":"Samantha Sze-Yee Lee, Gareth Lingham, Alex W Hewitt, David A Mackey","doi":"10.1167/tvst.14.4.3","DOIUrl":"10.1167/tvst.14.4.3","url":null,"abstract":"<p><strong>Purpose: </strong>Age-related changes in glaucoma endophenotypes have been described thoroughly, yet, there are limited data on the normal age-related changes in young adults. This study profiles the 8-year longitudinal change in peripapillary retinal nerve fiber layer (pRNFL), intraocular pressure (IOP), and central corneal thickness (CCT) in young adults.</p><p><strong>Methods: </strong>A community-based cohort of young adults from the Raine Study underwent eye examinations that included optical coherence tomography of the optic disc, tonometry, and pachymetry when they were 20 and 28 years old. The main outcome measures were the changes in pRNFL thickness, IOP, and CCT over 8 years, adjusted for sex, ethnicity, and other potential confounders.</p><p><strong>Results: </strong>A total of 693, 712, and 680 participants were included in the pRNFL, IOP, and CCT analyses, respectively. Over the 8 years, the global pRNFL reduced from a mean of 100.6 ± 9.3 to 97.9 ± 9.4 µm, at an average rate of 0.27 µm/year (95% confidence interval [CI], 0.24-0.30). Sectoral pRNFL similarly thinned by 0.06 to 0.38 µm/year, but this thinning was not statistically significant at the superotemporal and inferonasal sectors. IOP decreased and CCT increased between 20 and 28 years old, at an average rate of 0.18 mm Hg/year (95% CI, 0.15-0.20) and 0.18 µm/year (95% CI, 0.10-0.27), respectively.</p><p><strong>Conclusions: </strong>During the third decade of life, there is a decrease in pRNFL thickness and IOP in healthy adults.</p><p><strong>Translational relevance: </strong>The current study findings will enable clinicians to differentiate potential pathological change from normal age-related variations in these measures.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 4","pages":"3"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Humphrey Field Analyzer and MP-3 Microperimeter in Patients With Glaucoma, Classified by Severity and Misalignment of Test Points.","authors":"Taiga Inooka, Ryo Tomita, Taro Kominami, Marie Mochizuki, Koji M Nishiguchi, Kenya Yuki","doi":"10.1167/tvst.14.4.6","DOIUrl":"10.1167/tvst.14.4.6","url":null,"abstract":"<p><strong>Purpose: </strong>To compare Nidek MP-3 microperimetry and ZEISS Humphrey Field Analyzer (HFA) visual field (VF) results in patients with primary open-angle glaucoma (POAG), classified by VF defect severity and to describe a novel method for simulating sensitivity distribution changes assumed to be due to fixation errors.</p><p><strong>Methods: </strong>This retrospective study used the MP-3 and HFA 10-2 tests to examine the VF in eyes with mild, moderate, or severe POAG, using 68 identical test points. Reliability indices and measurement durations were compared. The relationship between pointwise sensitivities of the devices was analyzed.</p><p><strong>Results: </strong>Thirty-five eyes from 23 patients (10 mild, 12 moderate, and 13 severe POAG) were evaluated. In the severe POAG group, the MP-3 had a significantly lower false-positive (FP) rate and higher false-negative rate than those of the HFA 10-2 (all, P = 0.03). A significant negative correlation existed between the root mean square error, derived from regression analysis comparing the VF sensitivity between devices at each test point, and VF sensitivity of the MP-3 (P < 0.01). In 18 eyes, a shift in the sensitivity distribution occurred, with a significant correlation between the HFA 10-2 mean deviation and the presence of this shift (P < 0.01).</p><p><strong>Conclusions: </strong>Reliability indices differed significantly between the two devices in severe POAG cases. A shift in the sensitivity of the test points of the two VF tests was detected in approximately one-half of the eyes.</p><p><strong>Translational relevance: </strong>The MP-3 provides lower FP rates in advanced POAG and may assist in the management of this patient cohort.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 4","pages":"6"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural Updates to the Implant and Refill Needle of the Port Delivery Platform.","authors":"Dante J Pieramici, Peter A Campochiaro, Margaret Chang, Ian Pearce, Carl D Regillo, Shamika Gune, Nancy Holekamp, Carlos Quezada-Ruiz, Shrirang V Ranade, Natasha Singh, Geoffrey Wise, Joshua Horvath","doi":"10.1167/tvst.14.4.8","DOIUrl":"https://doi.org/10.1167/tvst.14.4.8","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to report the impact of component-level changes and manufacturing process improvements on septum durability in the ocular implant of the Port Delivery Platform (PD-P), more commonly known as the Port Delivery System with ranibizumab (PDS) with its current formulation.</p><p><strong>Methods: </strong>Laboratory tests were conducted to determine (1) the bond strength of the septum to the overmold, (2) the amount of force utilized for the refill needle to puncture the septum, and (3) septum durability over 50 years. To simulate multiple refill-exchanges over long-term clinical use, implants were aged at elevated temperature in saline and the septum was repetitively punctured at random locations using the refill needle every 3.5 days, simulating 6 months of use.</p><p><strong>Results: </strong>Updates to the septum-overmold interface of the implant and manufacturing process improvements doubled the bond strength between the overmold and septum (1.2 N to 2.4 N). Light lubrication of the refill needle reduced needle insertion force into the septum by >50% (1 N to 0.4 N). Together, these modifications increased long-term septum durability, with no septum dislodgements being observed after over 50 years of simulated use.</p><p><strong>Conclusions: </strong>Structural updates to the PD-P implant and refill needle have met and exceeded performance specifications, mitigating the risk of future septum dislodgement in the updated product.</p><p><strong>Translational relevance: </strong>Structural updates to the PD-P implant and refill needle resulted in the ability to withstand the equivalent of over 50 years of simulated use without septum dislodgement and should improve the longevity of the device in clinical use.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 4","pages":"8"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Corneal Biomechanical Changes After Discontinuation of Long-Term Orthokeratology: A 2-Year Prospective Study.","authors":"Hou-Ren Tsai, Jeng-Hung Wang, Cheng-Jen Chiu","doi":"10.1167/tvst.14.4.5","DOIUrl":"10.1167/tvst.14.4.5","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the long-term changes in the corneal biomechanical properties (CBPs) during and shortly after orthokeratology (ortho-k). We further explored the associations between selected CBPs and the effectiveness of ortho-k in mitigating axial elongation in patients with myopia.</p><p><strong>Methods: </strong>This prospective 25-month follow-up study included children ages 8 to 16 years with low to moderate myopia undergoing ortho-k treatment. They underwent 24 months of ortho-k followed by 1-month discontinuation. Their ocular biometric parameters and CBPs were monitored throughout the study. Axial length was measured at baseline, at 1 month, and then every 6 months after ortho-k treatment.</p><p><strong>Results: </strong>Dynamic changes in CBPs were observed during the 24-month ortho-k treatment. Parameters such as the stiffness parameter at the first applanation time (SP-A1), biomechanically corrected intraocular pressure, and Ambrósio's relational horizontal thickness showed initial reductions. After the 1-month discontinuation, most CBPs returned to baseline levels, except biomechanically corrected intraocular pressure and SP-A1. Multiple linear regression analysis revealed that differences in the deformation amplitude ratio or SP-A1 during the initial 2 weeks independently predicted axial elongation at 1 and 2 years after treatment initiation.</p><p><strong>Conclusions: </strong>Long-term ortho-k treatment may lead to sequential variations in CBPs; however, most of these variations may be reversed within 1 month of discontinuation. Further, changes in the deformation amplitude ratio or SP-A1 values during the early stages of treatment may predict subsequent axial elongation.</p><p><strong>Translational relevance: </strong>This study highlights the value of corneal biomechanics in guiding myopia control during orthokeratology treatment in clinical practice.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 4","pages":"5"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Score Predicting Primary Open-Angle Glaucoma Patients With Vascular Predisposition.","authors":"Nana Takahashi, Yukihiro Shiga, Naoki Kiyota, Masayuki Yasuda, Naoki Takahashi, Kota Sato, Ryutaro Arita, Akiko Kikuchi, Shin Takayama, Tadashi Ishii, Toru Nakazawa","doi":"10.1167/tvst.14.4.9","DOIUrl":"https://doi.org/10.1167/tvst.14.4.9","url":null,"abstract":"<p><strong>Purpose: </strong>We tested the hypothesis that a questionnaire-based risk score predicts the prevalence of patients with primary open-angle glaucoma (POAG) with vascular predisposition.</p><p><strong>Methods: </strong>The Flammer Syndrome Questionnaire (FSQ) was used to determine vascular risk scores in 823 healthy subjects and 512 patients with POAG. Next, we characterized blood flow pulsatility changes within the optic nerve head (ONH) in Flammer syndrome (FS) using laser speckle flowgraphy (LSFG) in 358 eyes of 206 patients with normal-tension glaucoma (NTG). Last, we examined the association between changes in Mean blur rate (MBRAve), an LSFG-derived ONH blood flow measurement, during cold provocation and the FSQ risk score in 56 eyes of 56 patients with NTG.</p><p><strong>Results: </strong>Five FSQ-related symptoms were significantly associated in patients with POAG patients; cold hands/feet (odds ratio [OR] = 1.82), low blood pressure (BP; OR = 3.29), increased response to drugs (OR = 2.27), underweight (OR = 1.99), and tendency toward perfectionism (OR = 1.88). The vascular risk score showed the best discriminative accuracy in differentiating healthy subjects from patients with NTG (area under the curve [AUC] = 0.73). In the NTG eyes, ONH pulsatile blood flow in the FS group was characterized by greater pulsatility. Moreover, the negative correlation between the high FSQ risk score and the cold-induced ONH blood flow reduction was pronounced in eyes with NTG (correlation coefficient = -0.41).</p><p><strong>Conclusions: </strong>The FSQ risk score can be a screening tool to identify patients with POAG with increased vascular stiffness and further reduced ONH blood flow during cold stress.</p><p><strong>Translational relevance: </strong>The vascular risk score may help tailor individual glaucoma care.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 4","pages":"9"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Emerging Global Threat of Mycotic Keratitis Caused by Uncommon Fungal Species: A Systematic Review and Meta-Analysis.","authors":"Megha Gautam, Babu Lal, Smita Patel, Rajiv R Mohan, Arivarasan Barathi, Nikita Yadav, Sunil Kumar Verma, Richa Nyodu, Ananyan Sampath, Darshna Koshti, Bhavana Sharma","doi":"10.1167/tvst.14.4.4","DOIUrl":"10.1167/tvst.14.4.4","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to analyze epidemiological characteristics, clinical spectrum, and treatment outcome of mycotic keratitis (MK) caused by uncommon species.</p><p><strong>Methods: </strong>The systematic review in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines has been registered on \"PROSPERO\" (CRD42023410825), whereas the systematic literature search was conducted on PubMed, Cochrane, Google Scholar, and Semantic Scholar on uncommon MK from January 1963 to March 2023. The main keywords for the literature search comprised: \"mycotic keratitis,\" \"fungal keratitis,\" \"keratomycosis,\" \"oculomycosis,\" \"uncommon,\" \"rare,\" \"emerging,\" \"atypical,\" \"unusual,\" and various combinations of it.</p><p><strong>Results: </strong>The study identified a pool of 13,662 articles. Five hundred sixty-six studies were deemed suitable, and 186 studies met the inclusion criteria to ascertain the pooled prevalence. A total of 154 uncommon fungal species/genera were identified among 61 countries. Australia exhibited the highest pooled prevalence, whereas India reported the maximum number of cases, genera, and species. Clinical presentation varied from mild to severe disease with unequivocal response to standard therapeutic regimes. Microbiologically proven species with reported sensitivity had better visual and structural outcomes.</p><p><strong>Conclusions: </strong>The study provides the first-ever global prevalence estimate of MK caused by uncommon species, estimating 154 fungal genera/species with varying severity, assuming that several culture-negative cases with specific predispositions would also qualify as cases of MK. Microbiologically proven species with reported sensitivity have better visual and structural outcomes. Cases that fail to respond to standard therapy should be re-evaluated for uncommon species with a high index of suspicion. Prompt diagnosis with culture and sensitivity analysis, PCR or in vivo confocal microscopy (IVCM)-based test and timely treatment remain the most important factors in salvaging visual and structural function.</p><p><strong>Translational relevance: </strong>This review catalogues the epidemiological, clinical, and morphological traits of rare fungi implicated in atypical MK and also provides a global prevalence estimate. Further, it emphasizes the role of implementation of specialized diagnostic techniques and collaborative efforts to combat the visual disability stemming from afflictions due to rare or atypical fungal species. Information on continent and country wise prevalence of atypical species would be helpful in appropriate management of such cases, in event of inconclusive diagnosis and consequent suboptimal response to treatment.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 4","pages":"4"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}