Current Opinion in Ophthalmology最新文献

{"title":"Role of microbiome in ocular surface disease: interpreting biology in a low-biomass environment.","authors":"Meltem Yashar, Uma Yogesh Thigale, Sezen Karakus","doi":"10.1097/ICU.0000000000001228","DOIUrl":"https://doi.org/10.1097/ICU.0000000000001228","url":null,"abstract":"<p><strong>Purpose of review: </strong>Growing use of sequencing technologies has accelerated investigation of the ocular surface microbiome, yet this environment is characterized by extremely low microbial biomass, complicating data interpretation. This review assesses current evidence linking microbial communities to ocular surface disease, discusses methodological and biological factors influencing interpretation of microbiome-disease associations, and proposes a framework in which microbial roles may be considered as drivers, modifiers, or markers.</p><p><strong>Recent findings: </strong>Studies across multiple ocular surface diseases report alterations in microbial composition, including reduced α-diversity and shifts in dominant taxa. Genera such as Staphylococcus, Corynebacterium, and Cutibacterium are frequently reported as resident members of the ocular surface microbiome, although their abundance varies across individuals and sampling sites. Across diseases, microbial patterns often overlap and remain inconsistent between studies. Emerging mechanistic evidence has identified specific microbial products, such as lipoteichoic acid, that promote ocular surface inflammation through defined signaling pathways, providing initial support for a potential driver or modifier role. In low-biomass environments such as the ocular surface, contamination, host DNA predominance, and methodological variability can strongly influence detected microbial signals.</p><p><strong>Summary: </strong>Interpretation of ocular surface microbiome data remains inherently challenging in this low-biomass context. However, the emergence of mechanistic studies suggests a transition from purely associative observations toward functional and translational investigation. Future studies should be designed to better define microbial roles by integrating standardized methodologies with multiomics approaches and detailed clinical phenotyping. Until such evidence emerges, microbiome research is best viewed as advancing biological insight rather than informing clinical decision-making.</p>","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845613","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":"Surgical technology update for ophthalmic surgery: heads-up display, artificial intelligence, instrumentation, and robotics.","authors":"Kareena Chawla, Prashant D Tailor, Jayanth Sridhar","doi":"10.1097/ICU.0000000000001222","DOIUrl":"https://doi.org/10.1097/ICU.0000000000001222","url":null,"abstract":"<p><strong>Purpose of review: </strong>Rapid advances in surgical visualization, microsurgical instrumentation, artificial intelligence (AI), and robotic assistance are reshaping ophthalmic surgery. This review evaluates current clinical and experimental evidence to determine how these technologies influence surgical efficiency, precision, safety, and patient outcomes.</p><p><strong>Recent findings: </strong>Three-dimensional (3D) heads-up display systems (HUDS) subjectively improve surgeon ergonomics and permit lower illumination levels while maintaining complication rates equivalent to conventional microscopy. Advances in surgical instrumentation, including smaller-gauge vitrectomy systems, high-speed cutters, preloaded intraocular lens (IOL) delivery systems, and device-based glaucoma implants demonstrate gains in operative efficiency without compromising anatomic success. AI-based systems enable automated surgical phase recognition, real-time instrument tracking, and outcome prediction with high accuracy. Robotic platforms offer the promise of sub-millimeter instrument stabilization and feasibility of high-precision maneuvers across ophthalmic subspecialties.</p><p><strong>Summary: </strong>Emerging technologies have enhanced technical performance in ophthalmic surgery. However, most demonstrated benefits concentrate on ergonomics, workflow efficiency, and motion stability, with fewer studies showing consistent improvements in long-term clinical outcomes. Larger multicenter trials are needed to define true clinical value, cost-effectiveness, and optimal clinical integration.</p>","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864719","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":"Advances in anterior segment imaging.","authors":"Daniel Henick, Jessica Chow","doi":"10.1097/ICU.0000000000001235","DOIUrl":"https://doi.org/10.1097/ICU.0000000000001235","url":null,"abstract":"<p><strong>Purpose of review: </strong>Ophthalmologists use anterior segment imaging for diagnosis, measurement, monitoring, and treatment of a variety of conditions. Imaging modalities continue to improve in their precision and reliability, and as such research is needed to discover and demonstrate additional utilities and applications that can further enhance the ophthalmologist's diagnostic toolkit. This review summarizes key research studies over the past 12-18 months and explains how ophthalmologists, ranging from comprehensive to cornea and keratorefractive surgeons, can integrate these imaging techniques into their practice.</p><p><strong>Recent findings: </strong>Recent research in anterior segment imaging techniques, particularly optical coherence tomography of the anterior segment, epithelial thickness mapping, and wavefront aberrometry, has demonstrated how these modalities can be integrated to improve diagnostic precision and augment the clinical exam. Increased knowledge about these techniques has allowed ophthalmologists to use imaging to diagnose and monitor conditions of the anterior segment very closely, even in cases with subtle findings that may not be easily seen on slit lamp examination.</p><p><strong>Summary: </strong>Ophthalmologists benefit from advanced imaging technologies that enhance diagnosis and clinical decision-making, and recent research on developments in anterior segment imaging demonstrate how these modalities can be integrated in a wide variety of settings to improve patient care.</p>","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845567","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":"Update on topography and tomography for refractive surgery.","authors":"Victoria Moreira Fernandes, Cameron McGlone, Karen Brian Fernandez, Karolinne Maia Rocha","doi":"10.1097/ICU.0000000000001226","DOIUrl":"https://doi.org/10.1097/ICU.0000000000001226","url":null,"abstract":"<p><strong>Purpose of review: </strong>To review and summarize the current literature on recent advances in corneal topography and anterior segment tomography, highlighting emerging technological advances and the integration of artificial intelligence, and their clinical applications in screening, planning, and optimizing outcomes of modern refractive surgery.</p><p><strong>Methods: </strong>A comprehensive review of the recent literature was conducted using the PubMed, Scopus, and Web of Science databases to identify peer-reviewed articles published within the last 18  months that focus on advancements in corneal imaging technologies, including Placido-based topography, Scheimpflug imaging, and swept-source anterior segment optical coherence tomography (SS-ASOCT). Comparative studies, diagnostic accuracy reports, and new indices and software for ectasia risk assessment were analyzed.</p><p><strong>Recent findings: </strong>Recent innovations in corneal topography and tomography have greatly improved the ability to detect subclinical keratoconus, evaluate corneal biomechanics, and develop personalized surgical plans. The integration of 3D corneal mapping, epithelial thickness profiling, and artificial intelligence-based analysis has increased diagnostic accuracy and safety in refractive procedures. These developments enable earlier detection of at-risk corneas and more accurate prediction of postoperative stability.</p><p><strong>Summary: </strong>Advances in topography and tomography continue to improve the safety and predictability of refractive surgery. The use of multimodal imaging and AI-based diagnostics is transforming preoperative assessment and postoperative care, leading to more personalized and reliable visual outcomes.</p>","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845606","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":"Geographic atrophy: From slowing lesions to preserving vision.","authors":"Kaitlyn Mang, David Eichenbaum, Priya Vakharia","doi":"10.1097/ICU.0000000000001224","DOIUrl":"https://doi.org/10.1097/ICU.0000000000001224","url":null,"abstract":"<p><strong>Purpose of review: </strong>Geographic atrophy, the advanced form of dry age-related macular degeneration (AMD), has historically been evaluated using structural endpoints and best-corrected visual acuity (BCVA). This review examines the growing rationale for a function-first approach.</p><p><strong>Recent findings: </strong>Emerging data demonstrate that functional deficits often decline earlier and more profoundly than BCVA. Recently approved complement inhibitors have shown slowing of geographic atrophy lesion growth but without consistent improvements in traditional visual acuity endpoints. Extension studies and post hoc analyses suggest some functional benefits. Next-generation therapies are increasingly incorporating functional endpoints into trial design.</p><p><strong>Summary: </strong>Structural slowing alone does not fully capture therapeutic value in geographic atrophy. Functional measures provide a more sensitive and patient-centered assessment of disease progression and treatment impact.</p>","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864706","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":"Tranexamic acid in oculofacial plastic surgery: a review of current evidence.","authors":"Narmien Murdock, Alison H Watson","doi":"10.1097/ICU.0000000000001221","DOIUrl":"https://doi.org/10.1097/ICU.0000000000001221","url":null,"abstract":"<p><strong>Purpose of review: </strong>Oculofacial plastic and orbital surgery is performed in an anatomic region where even modest bleeding can result in significant morbidity. Tranexamic acid (TXA) use in the perioperative period has demonstrated safety and efficacy in reduce intraoperative bleeding and postoperative ecchymosis. This review discusses perioperative TXA use and antithrombotic management in oculofacial surgery.</p><p><strong>Recent findings: </strong>Prospective and randomized studies in eyelid, periocular, nasolacrimal, and facial aesthetic surgery demonstrate that intravenous, oral, and local TXA reduce postoperative ecchymosis and edema, and in some settings decrease intraoperative blood loss and operative time. Safety data across surgical specialties consistently show no increased risk of thromboembolic complications. However, prospective evidence guiding perioperative continuation vs. cessation of antithrombotic therapy in oculofacial surgery remains limited.</p><p><strong>Summary: </strong>TXA is a safe, cost-effective adjunct that improves postoperative recovery in oculofacial plastic surgery. While current evidence supports its routine use in selected procedures, further research is needed to define its role in orbital surgery and in patients maintained on chronic antithrombotic therapy.</p>","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864683","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":"Imaging in anterior segment disorders.","authors":"Neha Kapur, Abha Gour, Virender Sangwan","doi":"10.1097/ICU.0000000000001234","DOIUrl":"https://doi.org/10.1097/ICU.0000000000001234","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review highlights the rapid advancements in anterior segment imaging and their relevance in enhancing the diagnosis and management of corneal disorders.</p><p><strong>Recent findings: </strong>Innovations in imaging - including anterior segment optical coherence tomography (AS-OCT), Scheimpflug imaging, and in-vivo confocal microscopy (IVCM) - have transformed the evaluation of anterior segment pathology. These modalities enable detailed assessment of corneal morphology, thickness, and cellular integrity across various conditions such as keratitis, peripheral ulcerative keratitis, keratoconus, pellucid marginal degeneration, and Fuchs' endothelial dystrophy. AS-OCT and IVCM are increasingly used to guide treatment decisions and monitor disease progression or surgical outcomes.In refractive surgery and ectatic disorder screening, devices like Pentacam and UBM offer critical preoperative insights. Aberrometry and meibography are key in enhancing postoperative outcomes. Intraoperative OCT (iOCT) improves precision in keratoplasty, while artificial intelligence enhanced imaging platforms offer real-time pathology recognition and risk stratification. The growing use of smartphone adapters and telemedicine platforms further supports remote care and follow-up, particularly in resource-limited settings.</p><p><strong>Summary: </strong>Multimodal imaging has become integral to anterior segment disease management, enabling early diagnosis, refined surgical planning, and improved visual outcomes. Ongoing research into artificial intelligence and integrated imaging systems promises even greater clinical efficiency and diagnostic accuracy in the near future.</p>","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864667","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":"Eying up predatory bacteria: living antimicrobials for ocular infections.","authors":"Robert M Q Shanks, Eric G Romanowski, Dhara R Patel, Daniel E Kadouri","doi":"10.1097/ICU.0000000000001200","DOIUrl":"10.1097/ICU.0000000000001200","url":null,"abstract":"<p><strong>Purpose of review: </strong>The growing threat of antibiotic-resistant pathogens, particularly in ocular infections like bacterial keratitis, necessitates alternative therapeutic strategies. This review evaluates the potential therapeutic role of predatory bacteria as novel live antimicrobials, offering a timely exploration of their potential in overcoming resistance mechanisms such as biofilm formation and persister cell development.</p><p><strong>Recent findings: </strong>Predatory bacteria, including Bdellovibrio bacterovorus and Micavibrio aerguinosavorus selectively target Gram-negative bacteria, including Pseudomonas aeruginosa , while sparing Gram-positive ocular surface. They exhibit rapid bactericidal activity and efficacy against biofilms, persister cells, and antibiotic-resistant pathogens, but induce little inflammation. Advances in storage and delivery methods, such as lyophilization, cryomicroneedles, and thermoresponsive hydrogels, have potential to increase their therapeutic feasibility. However, in-vivo efficacy remains variable and their narrow spectrum limits effectiveness against Gram-positive pathogens.</p><p><strong>Summary: </strong>Predatory bacteria present a promising alternative to traditional antibiotics in ocular therapeutics, particularly for drug-resistant infections. Integration of predatory bacteria with bacteriophages or conventional antibiotics may further optimize their potential. Continued translational research is essential to address current limitation and to validate their safety and efficacy for human or veterinary applications.</p>","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":"244-250"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662626","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":"Opportunities and challenges in leveraging multiomics and biobanks for vision science.","authors":"Dolly Ann Padovani-Claudio, Lisa Bastarache","doi":"10.1097/ICU.0000000000001209","DOIUrl":"10.1097/ICU.0000000000001209","url":null,"abstract":"<p><strong>Purpose of review: </strong>Emerging biobank resources allow large-scale integration of eye-specific phenotypes with clinical, genomic, and multiomic data. This convergence enables unprecedented opportunities to systematically dissect the genetic architecture, epidemiology, and mechanistic pathways of both rare monogenic and common polygenic diseases. The review aims to critically examine how contemporary data extraction, multiomics, and analytic methodologies are reshaping disease classification, genetic discovery, and translational research in ophthalmology, while highlighting the associated challenges in leveraging these advanced tools.</p><p><strong>Recent findings: </strong>Recent literature demonstrates the utility of genome-wide and phenome-wide association studies, transcriptomic analyses, and artificial intelligence in uncovering novel risk loci, endophenotypes, and biomarkers relevant to eye diseases. Furthermore, advances in multiancestry sampling show substantial population-specific genetic variation, enriching disease models for conditions such as glaucoma and age-related macular degeneration. Finally. integrative approaches, including Mendelian randomization and enrichment analyses, are helping elucidate shared genetic architecture between ocular and systemic diseases, informing therapeutic target identification, and refining risk prediction models.</p><p><strong>Summary: </strong>The convergence of biobank-derived multimodal data and sophisticated analytic techniques is catalyzing a path to personalized medicine in ophthalmology. For these approaches to fully translate into clinical practice ensuring scientifically robust and equitable outcomes, future research must address cohort diversity, mechanistic validation, and practical cost-effectiveness.</p>","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":"236-243"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and surgical approach to retinoschisis.","authors":"Shreya Swaminathan, Matthew R Starr","doi":"10.1097/ICU.0000000000001204","DOIUrl":"10.1097/ICU.0000000000001204","url":null,"abstract":"<p><strong>Purpose of review: </strong>To summarize the recent literature on the clinical and surgical management of retinoschisis.</p><p><strong>Recent findings: </strong>Novel analyses of the existing imaging modalities, including ultra wide-field imaging, near-infrared imaging, blue light reflectance, and color Doppler ultrasound, can be adjuncts to existing diagnostic tools such as ocular coherence tomography (OCT) and clinical examination to differentiate between rhegmatogenous retinal detachment (RRD) and retinoschisis.</p><p><strong>Summary: </strong>Degenerative retinoschisis can be challenging to differentiate from a RRD through clinical examination. Although ocular coherence tomography (OCT) is the typical approach to diagnosing retinoschisis, there have been many promising diagnostic developments to better prognosticate and differentiate between similar entities. Given the difficulty in managing these cases, medical and surgical management are typically at the discretion of the treating physician.</p>","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":"168-172"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042154","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}