Medical Science Monitor最新文献

{"title":"Correlation Between Paravertebral Muscles Degeneration and Spinopelvic Parameters in Patients With Osteoporotic Vertebral Compression Fractures.","authors":"De-Chao Miao, Bao-Yue Zhang, Tong Tong, Feng Wang, Lin-Feng Wang","doi":"10.12659/MSM.954947","DOIUrl":"10.12659/MSM.954947","url":null,"abstract":"<p><p>BACKGROUND Osteoporotic vertebral compression fractures (OVCFs) are correlated with thoracolumbar sagittal imbalance associated with paravertebral muscles (PVM) atrophy and fatty infiltration (FI). This study investigated PVM degeneration and its correlation with spinopelvic parameters in patients with OVCFs. MATERIAL AND METHODS This retrospective case-control study enrolled 50 patients with OVCFs and 50 controls with lumbar degeneration, frequency-matched for age (±5 years). Complete sex matching was not achieved. Primary comparisons were adjusted for age, sex, BMI, and lumbar bone mineral density (BMD); subgroup analyses were exploratory and unadjusted. MRI measured the PVM from T11 to L2 and the cross-sectional area (CSA) and FI of the multifidus (MF) and erector spinae (ES) at L3. RESULTS Patients with OVCFs showed reduced CSA and increased FI (P<0.05). After adjustment, sagittal vertical axis, thoracic kyphosis, and pelvic tilt increased and lumbar lordosis (LL) decreased (all P≤0.003), whereas sacral slope (P=0.538) and pelvic incidence (P=0.602) did not differ. MF and ES CSA correlated negatively with SVA and positively with LL, while FI showed the opposite (all P<0.01). In exploratory analyses, patients aged ≥65 years had a larger SVA (P=0.040), and women a smaller LL and lower BMD (both P<0.05); no PVM differences were seen across subgroups. CONCLUSIONS In this cross-sectional cohort, PVM degeneration correlated with sagittal malalignment after adjustment for measured confounders (adjusted cross-sectional associations). Advanced age correlated with greater SVA, and female sex with smaller LL and lower BMD. No PVM differences were detected across subgroups. Further trials are required to validate targeted paravertebral rehabilitation strategies.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e954947"},"PeriodicalIF":2.5,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Pattern of Radiological Resolution in Chronic Subdural Hematoma After Middle Meningeal Artery Embolization: A Prospective 2-Center Study.","authors":"Xuan Hai Dao, Thanh Dung Le, Cuong Tran Chi, Giang Nguyen Luu, He Dong Van, Thong Pham Minh","doi":"10.12659/MSM.954012","DOIUrl":"10.12659/MSM.954012","url":null,"abstract":"<p><p>BACKGROUND Middle meningeal artery embolization (MMAE) treats chronic subdural hematoma (cSDH) by devascularizing the hematoma membrane, but the timing of radiological resolution remains incompletely defined. This prospective 2-center study evaluated computed tomography (CT) outcomes at 1 and 3 months after MMAE in Vietnam. MATERIAL AND METHODS Consecutive patients treated from November 2021 through December 2024 were enrolled. Maximum hematoma thickness and midline shift were measured on baseline imaging and follow-up non-contrast-enhanced CT. Paired measurements were compared using paired t tests. Analyses were performed at the hematoma level using available paired observations. RESULTS The cohort included 67 patients with 90 cSDHs. Follow-up CT was available for 76 hematomas at 1 month and 40 at 3 months. Mean hematoma thickness decreased from 14.2±5.3 mm at baseline to 8.7±10.2 mm at 1 month and 3.5±5.6 mm at 3 months (both P<0.001). Mean midline shift decreased from 6.1±4.3 mm to 0.81±1.54 mm and 0.69±1.93 mm, respectively (both P<0.001). Complete resolution was observed in 12 of 76 hematomas (15.8%) at 1 month and 23 of 40 (57.5%) at 3 months. CONCLUSIONS MMAE was associated with a gradual reduction in hematoma thickness and midline shift among hematomas with available follow-up imaging. These findings suggest that residual hematoma on early post-treatment imaging may not necessarily indicate treatment failure. However, the delayed radiological trajectory should be interpreted cautiously because 3-month imaging follow-up was incomplete and may be affected by attrition bias.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e954012"},"PeriodicalIF":2.5,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Bile Acid Receptors in Non-Infectious Diarrhea: A Narrative Review.","authors":"Liying Pan, Pancen Ran, Fengxian Jiang, Yahui Wang, Weihao Wang, Rui Zhao, Huaiqian Mu, Guobin Fu","doi":"10.12659/MSM.952723","DOIUrl":"10.12659/MSM.952723","url":null,"abstract":"<p><p>Non-infectious diarrhea constitutes a prevalent gastrointestinal pathology that severely compromises patient well-being. Its etiology is progressively associated with gut-liver axis dysfunction, although exact molecular pathways remain undefined. This narrative review consolidates the existing research to investigate 5 distinct bile acid-activated receptors: farnesoid X receptor (FXR), Takeda G protein-coupled receptor 5 (TGR5/GPBAR1), pregnane X receptor (PXR), vitamin D receptor (VDR), and retinoid-related orphan receptor gamma t (RORγt). These molecules function as pivotal hubs linking bile acid metabolism, microbial community structure, and intestinal homeostatic balance. Synthesized hepatically and biotransformed by commensal bacteria, bile acids signal through these receptors; specifically, FXR governs bile acid biosynthesis and epithelial barrier strength, TGR5 modulates motility and inflammatory responses, and PXR and VDR attenuate inflammation via nuclear factor-kappa B (NF-kappaB) suppression, while RORγt regulates immunity through T helper 17 (Th17) cell modulation. Perturbations within this axis-manifesting as defective bile acid reclamation, microbiota dysbiosis, or receptor malfunction-compromise intestinal permeability, provoke electrolyte imbalances, and disrupt immune equilibrium, thereby driving bile acid diarrhea, diarrhea-predominant irritable bowel syndrome, and post-surgical diarrheal conditions. Current data suggest FXR activation is essential for driving bile acid diarrhea management, whereas TGR5 overactivation underlies the hypermotility observed in diarrhea-predominant irritable bowel syndrome. Additionally, rifaximin, acting as a PXR agonist, provides therapeutic benefit. This manuscript evaluates bile acid receptor contributions to non-infectious diarrhea, emphasizing the translational potential of targeting these signaling cascades.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e952723"},"PeriodicalIF":2.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Radiotherapy After Breast-Conserving Surgery in T1-2N0M0 Luminal (HR+/HER2-) Breast Cancer Stratified by Tumor Quadrant Location.","authors":"Yajing Huang, Hao Wu","doi":"10.12659/MSM.953757","DOIUrl":"10.12659/MSM.953757","url":null,"abstract":"<p><p>BACKGROUND The survival association of adjuvant radiotherapy (RT) in early-stage node-negative luminal (HR+/HER2-) breast cancer remains under evaluation, and whether this association is modified by tumor quadrant location is unknown. MATERIAL AND METHODS We identified 5831 patients with T1-2N0M0 luminal breast cancer treated with breast-conserving surgery from the Surveillance, Epidemiology, and End Results (SEER) database (2010-2017), stratified by RT receipt. Breast cancer-specific survival (BCSS) was analyzed using Kaplan-Meier, Cox regression, and Fine-Gray competing-risk models, with a prespecified RT-by-quadrant interaction test. RESULTS RT was independently associated with a lower hazard of breast cancer-specific death (hazard ratio=0.623, 95% confidence interval: 0.512-0.792, P<0.001) in the Cox regression analysis. In the competing-risk Fine-Gray model, the subdistribution hazard ratio was 0.661 (95% confidence interval: 0.530-0.825, P<0.001). A significant interaction was observed between RT and tumor quadrant (P=0.019). Quadrant-stratified analyses showed a significant adjusted association between RT and a lower hazard of breast cancer-specific death for upper-inner and lower-outer quadrant tumors; estimates for upper-outer and lower-inner quadrant tumors were in the same direction but did not display statistical significance. Sensitivity analyses using the Fine-Gray model and E-value calculations were consistent with the primary findings. CONCLUSIONS In this observational study of T1-2N0M0 luminal breast cancer, a significant statistical interaction was observed between postoperative RT and tumor quadrant location, generating the hypothesis that the association between RT and BCSS varies according to primary tumor quadrant. These findings require prospective validation before informing individualized treatment decisions.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953757"},"PeriodicalIF":2.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in Indocyanine Green Near-Infrared Fluorescence for Extrahepatic Biliary Identification in Laparoscopic Cholecystectomy for Acute Cholecystitis: A Narrative Review.","authors":"Zhihui Jin, Xusheng Yang, Yuntian Liu, Lei Song, Xuewen Chen, Yue Wang, Xiaoping Cheng, Lu Liang, Bihui Yao","doi":"10.12659/MSM.953667","DOIUrl":"10.12659/MSM.953667","url":null,"abstract":"<p><p>Laparoscopic cholecystectomy, a minimally invasive procedure with rapid recovery, remains the standard surgical intervention for acute cholecystitis. Acute inflammation of the gallbladder can cause severe edema, dense adhesions, and anatomical distortion within Calot's triangle, frequently obscuring tissue planes and increasing the risk of iatrogenic bile duct injury, a significant surgical complication. Indocyanine green fluorescence serves as a valuable intraoperative navigation tool. Its hepatobiliary metabolic characteristics enable real-time near-infrared visualization of extrahepatic bile ducts, thereby compensating for the limitations of visual and tactile identification during routine cholecystectomy. This narrative review compiles published clinical evidence regarding the application of indocyanine green fluorescence in acute cholecystitis operations. We summarize its advantages in inflamed operative fields and categorize practical application experiences across varying grades of inflammation. Current data indicate enhanced biliary visualization and reduced operative time; however, robust high-level trials confirming a reduction in bile duct injury risks remain lacking. Additionally, we discuss emerging technical advancements, such as artificial intelligence and multispectral imaging. This article aims to evaluate the practical value of indocyanine green near-infrared fluorescence for the recognition of extrahepatic bile ducts in laparoscopic cholecystectomy performed on patients with acute cholecystitis.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953667"},"PeriodicalIF":2.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Exposure to a Parent's Alcohol Use Disorder as an Adverse Childhood Experience: Neurobiological and Clinical Consequences in Adulthood.","authors":"Izabela Staszewska, Alicja Mastej, Dominika Mech, Mikołaj Tomasz Marynowski, Ewelina A Soroka","doi":"10.12659/MSM.953946","DOIUrl":"10.12659/MSM.953946","url":null,"abstract":"<p><p>Adverse childhood experiences (ACEs) are a significant determinant of health across the life course and exhibit a dose-dependent relationship with the risk of mental and physical disorders in adulthood. One common yet under-recognized ACE is growing up in a family with an alcohol problem. The objective of this study was to review current data on the neurobiological mechanisms and clinical consequences of early exposure to parental alcohol use disorder, considered an ACE, along with implications for medical practice. A review was conducted of the literature on ACEs, with a particular focus on exposure to parental alcohol use disorder, the co-occurrence of other developmental adversities, and health outcomes in adulthood. Data on ACE screening and the trauma-informed care approach were also included. Parental alcohol use disorder often co-occurs with violence, neglect, and mental health disorders among caregivers, increasing overall stress exposure. Chronic developmental stress is associated with hypothalamic-pituitary-adrenal axis dysregulation and persistent inflammation, as well as an increased risk of depression, anxiety disorders, posttraumatic stress disorder, and substance use disorders. Somatic consequences are also described, including a higher risk of type 2 diabetes and cardiovascular disease, as well as a poorer response to treatment in individuals with ACE exposure. The term adult children of alcoholics is descriptive in nature and does not constitute a diagnostic entity. Early exposure to a parent's alcohol use disorder as an ACE is associated with multidimensional health consequences in adulthood. Further research is needed on the efficacy and safety of ACE screening and the implementation of trauma-informed care.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953946"},"PeriodicalIF":2.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Upper Limb Deformities in Arthrogryposis Multiplex Congenita: A Narrative Review.","authors":"Yongwei Shang, Lin Chen","doi":"10.12659/MSM.954073","DOIUrl":"10.12659/MSM.954073","url":null,"abstract":"<p><p>Arthrogryposis multiplex congenita (AMC) presents complex therapeutic challenges in upper limb reconstruction, in which establishing an optimal positioning-reaching-grasping axis is critical for patient independence. However, clinical evidence is often limited by low-level data and significant phenotypic heterogeneity, leaving management strategies fragmented. This review synthesizes current evidence to provide a strategic framework for managing complex upper extremity deformities in AMC. A selective literature search was conducted via the MEDLINE database in April 2026, focusing on advancements published between 2020 and 2025. Key keywords included \"arthrogryposis\", \"amyoplasia\", and \"upper limb deformities\", analyzing the multi-joint therapeutic hierarchy, nonoperative timelines, and surgical sequencing. The evidence identifies a shift toward a functional kinetic chain approach, prioritizing the restoration of self-care autonomy over simple anatomical realignment. Effective management begins with early, nonoperative mobilization to leverage neonatal tissue plasticity. Surgical strategy is often conceptualized as a hierarchical framework, typically addressing passive constraints through joint release or osteotomy to optimize the limb's spatial positioning before considering active motion reconstruction via functional tendon or muscle transfers. The therapeutic logic emphasizes the critical hand-to-mouth and personal hygiene pathways, in which the timing of intervention is tailored to the child's developmental milestones and compensatory patterns, ensuring that each segmental correction supports the overall synergy of the limb. Early, persistent nonoperative intervention serves as the foundational pillar, while surgical strategies must be tailored to the child's adaptive patterns. Future care should move toward precision functional restoration, supported by genomic insights, and standardized multicenter outcome measures.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e954073"},"PeriodicalIF":2.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization of the Sequence of Computed Tomography Angiography and Perfusion in One-Stop-Shop CT Imaging for Acute Ischemic Stroke.","authors":"Bo Gao, Jun Yuan, Jin Wang, Xueqing Lv, Yongren Wang","doi":"10.12659/MSM.952875","DOIUrl":"10.12659/MSM.952875","url":null,"abstract":"<p><p>BACKGROUND In the \"one-stop-shop\" stroke computed tomography (CT) scanning protocol, CT perfusion (CTP) can be performed either before or after CT angiography (CTA). This study analyzed the effect of different scanning strategies in one-stop-shop stroke CT on CTA image quality and perfusion parameters, aiming to optimize the scanning sequence of CTP and CTA in the one-stop-shop stroke CT protocol. MATERIAL AND METHODS We retrospectively analyzed 115 patients with suspected acute ischemic stroke admitted to our hospital between March and June 2024 and implemented 2 scanning strategies: CTP before CTA (group A, n=51) and CTA before CTP (group B, n=64) using 64-row CT equipment. The differences in CT values of the basilar artery, middle cerebral artery, superior sagittal sinus, and straight sinus, as well as craniocerebral perfusion parameter values and subjective scores of the CTA image quality, were compared between the 2 groups. The difference between venous CT values and the expert consensus-recommended intracranial venous CT value of 150 Hounsfield units (HU) was also compared. RESULTS There were no significant differences in arterial CT values or perfusion parameter values between groups A and B (P>0.0125). However, there was a significant difference in superior sagittal sinus CT values between the groups (P<0.0125). Group A showed more venous contamination (P<0.025), and its superior sagittal sinus CT value was significantly higher than the expert consensus-recommended value of 150 HU (P<0.0125). CONCLUSIONS CTA before CTP had no significant effect on perfusion parameters and was associated with reduced venous contamination. This strategy may serve as a practical alternative in similar 64-slice CT one-stop-shop stroke protocols.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e952875"},"PeriodicalIF":2.5,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Mydriasis in Cataract Surgery: Efficacy and Safety of Intracameral Regimen vs Topical Cyclopentolate in RayOne EMV Implantation.","authors":"Adam Kabiesz, Karol Demel, Piotr Gościniewicz, Daria Jorg, Patryk Zemła","doi":"10.12659/MSM.953299","DOIUrl":"10.12659/MSM.953299","url":null,"abstract":"<p><p>BACKGROUND This study aimed to compare the safety and efficacy of phacoemulsification performed using topical cyclopentolate (Cykloftyal) vs standard intracameral mydriatic and anesthetic combination (Mydrane) in patients undergoing implantation of enhanced monofocal intraocular lenses. MATERIAL AND METHODS The medical records of 100 patients (100 eyes, 50 per group) were retrospectively analyzed. Patients received either intracameral Mydrane alone or topical cyclopentolate with intracameral lidocaine. Pupil diameter at the start and end of surgery, surgical duration, visual acuity, intraoperative complications, and postoperative adverse events were compared. RESULTS There was no statistically significant difference in surgical duration between the intracameral Mydrane group (8.80 min) and the topical cyclopentolate plus intracameral lidocaine group (9.24 min; P=0.54), nor in postoperative visual acuity at any distance. However, the initial pupil diameter was significantly larger in the topical cyclopentolate group (7.39±0.47 mm) than in the intracameral Mydrane group (6.08±1.05 mm; P<0.005), indicating a very large clinical effect size (Cohen's d=1.61). Pupil size at the end of the procedure showed no significant difference between the groups. No major intraoperative complications, such as posterior capsule rupture, were observed in either group. CONCLUSIONS In this cohort, topical cyclopentolate served as a safe and effective alternative to intracameral mydriasis, offering significantly wider initial pupil dilation while maintaining comparable surgical efficiency in uncomplicated cataract cases. Given its cost-effectiveness and wide accessibility, it remains a valuable strategy for resource-limited settings and complex cases requiring maximal visualization. Its potential utility in complex cases requiring maximal visualization remains a hypothesis to be evaluated in future prospective studies.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953299"},"PeriodicalIF":2.5,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjunctive Anti-VEGF Therapy Influences on Early Visual Recovery Without Affecting Long-Term Outcomes or Intraocular Pressure After Pars Plana Vitrectomy in Patients With Proliferative Diabetic Retinopathy.","authors":"Magdalena Kawka-Osuch, Martyna Machaj, Zuzanna Lelek, Julia Domańska, Dominika Janiszewsk-Bil, Anita Lyssek-Boroń","doi":"10.12659/MSM.953556","DOIUrl":"10.12659/MSM.953556","url":null,"abstract":"<p><p>BACKGROUND We evaluated the effect of adjunctive anti-vascular endothelial growth factor (anti-VEGF) therapy on postoperative visual recovery and intraocular pressure in patients undergoing pars plana vitrectomy (PPV) for intravitreal hemorrhage as a complication of proliferative diabetic retinopathy. MATERIAL AND METHODS This retrospective observational cohort study included 149 eyes with proliferative diabetic retinopathy that underwent PPV at a tertiary ophthalmology center. Patients were divided into 2 groups according to the use of adjunctive anti-VEGF therapy: 33 eyes received anti-VEGF treatment and 116 underwent PPV without anti-VEGF administration. Best-corrected visual acuity (BCVA, logMAR), and intraocular pressure were assessed preoperatively and at 1 and 6 months after surgery. Changes in BCVA over time were analyzed using a linear mixed-effects model with time, anti-VEGF treatment, and their interaction as fixed effects and patient as a random effect. Arterial hypertension was included as a covariate. RESULTS At 1 month after surgery, patients receiving anti-VEGF therapy demonstrated significantly better BCVA values compared with untreated patients (P<0.05). However, no significant differences in BCVA were observed between groups after 6 months (P>0.05). In the adjusted mixed-effects model, follow-up time was significantly associated with BCVA improvement, whereas anti-VEGF treatment was not independently associated with visual outcomes, and no significant interaction between treatment and time was identified. No significant differences in intraocular pressure were observed between groups either before or after surgery. CONCLUSIONS Adjunctive anti-VEGF therapy may accelerate early visual recovery after PPV without influencing long-term visual outcomes or intraocular pressure, supporting its safety as a perioperative adjunct in vitreoretinal surgery.</p>","PeriodicalId":48888,"journal":{"name":"Medical Science Monitor","volume":"32 ","pages":"e953556"},"PeriodicalIF":2.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}