Retina-The Journal of Retinal and Vitreous Diseases最新文献

{"title":"High Frequency of Paracentral Acute Middle Maculopathy among symptomatic post-cardiac surgery patients.","authors":"Lia Agliati, Lorenzo Ferro Desideri, Felicitas Mayer, Martin S Zinkernagel, Robin Willixhofer, Matthias Siepe, Ishita Srivastava","doi":"10.1097/IAE.0000000000004925","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004925","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the incidence, clinical presentation, optical coherence tomography (OCT) features, and visual outcomes of paracentral acute middle maculopathy (PAMM) in patients presenting with visual symptoms after cardiac surgery.</p><p><strong>Methods: </strong>Retrospective observational study of patients who developed new visual symptoms after cardiac surgery and underwent ophthalmologic consultation at a tertiary referral center within 6 weeks from surgery. Collected data included visual symptoms, best-corrected visual acuity (BCVA), and OCT features.</p><p><strong>Results: </strong>Among 67 patients evaluated, 16 (23.9%) were diagnosed with PAMM. Mean age was 64.6 ± 10.8 years. Paracentral scotomas were reported in 31% of patients, while other frequently reported symptoms included photopsia (53%), floaters (38%), and blurred vision (25%). Cotton wool spots and retinal ischemic perivascular lesions were observed in 43.8% and 25% of patients, respectively. Among patients with available follow-up (n = 10), mean BCVA improved from 20/34 (logMAR 0.23) at presentation to 20/20 (logMAR 0.00) at last follow-up (p = 0.021).</p><p><strong>Conclusions: </strong>PAMM is a frequent finding in patients with visual symptoms after cardiac surgery, reflecting a substantial burden of retinal microvascular ischemia in this high-risk population. OCT enables identification of retinal microvascular ischemia despite often preserved visual acuity.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551521","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":"GENERALIZABILITY OF DEEP LEARNING MODELS FOR REFERABLE DIABETIC RETINOPATHY DETECTION: A CROSS-POPULATION STUDY.","authors":"Ceren Durmaz Engin, Mustafa Alper Selver, Seher Köksaldı, Mustafa Kayabaşı","doi":"10.1097/IAE.0000000000004924","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004924","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate cross-population performance of deep learning models for referable diabetic retinopathy (DR) detection and assess whether inclusion of local data improves robustness in a Turkish external validation setting.</p><p><strong>Methods: </strong>Global datasets (DDR, IDRiD, Messidor) and a Turkish real-world clinical dataset were used. Images were re-graded by three ophthalmologists and binarized as referable/non-referable DR. Five architectures were evaluated: EfficientNet-B0, EfficientNet-V2, ResNet50, ConvNeXt-V2-Tiny, and Swin V2 CR Small. Models were tested under three settings: Global Train-Global Test, Global Train-Local Test, and Mixed Train-Mixed Test. Performance metrics included accuracy, sensitivity, specificity, NPV, ROC-AUC, and PR-AUC; Grad-CAM was used for explainability.</p><p><strong>Results: </strong>The global training set included 9,881 images; two external test sets (2,042 images each) were used. Inter-grader agreement was high (ICC[3,1]=0.84; ICC[3,k]=0.96). Swin V2 CR Small achieved the highest performance in Global Train-Global Test (accuracy 0.938; ROC-AUC 0.985). Performance declined in Global Train-Local Test, where ConvNeXt-V2-Tiny performed best (accuracy 0.823; sensitivity 0.940; ROC-AUC 0.913). In Mixed Train-Mixed Test, ConvNeXt-V2-Tiny remained the most balanced model (accuracy 0.823; sensitivity 0.939; NPV 0.948; ROC-AUC 0.875).</p><p><strong>Conclusion: </strong>Models performed strongly under matched conditions but degraded across populations. ConvNeXt-V2-Tiny showed the most stable screening performance, supporting the need for local validation before deployment.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551489","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":"Community-Level Variation in On-Label Versus Off-Label Anti-VEGF Use and Medicare Part B Spending.","authors":"Jovany J Franco, Amy Song, Warren W Pan, George A Williams, Mark W Johnson, Thomas J Wubben","doi":"10.1097/IAE.0000000000004920","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004920","url":null,"abstract":"<p><strong>Purpose: </strong>To examine whether community-level sociodemographic characteristics are associated with differences in on-label versus off-label anti-VEGF agent use under Medicare Part B and to estimate differential spending attributable to variation in community-level agent mix.</p><p><strong>Methods: </strong>Part B claims data (2013-2023) were analyzed to identify providers billing for on-label (aflibercept, ranibizumab, faricimab, brolucizumab, and biosimilars) or off-label (bevacizumab) anti-VEGF injections. For each provider year, 15-min drive-time service areas were generated and overlaid on U.S. Census tracts enriched with American Community Survey-derived sociodemographic data. Community-level profiles were generated through population-weighted aggregation of tracts within each service area. Multivariable logistic regression estimated adjusted marginal effects (AMEs) of sociodemographic variables on on-label anti-VEGF proportion. Counterfactual simulations estimated Part B spending under alternative community-level agent mix scenarios.</p><p><strong>Results: </strong>From 2013-2023, 5,178 providers billed Part B for 34.5 million anti-VEGF injections. Higher on-label use was associated with greater community-level proportions of Medicare-aged (AME per 10-percentage-point [pp] increase: +6.1 pp [95% CI: 3.1-9.0]), Black/African American (+2.4 [1.5-3.3]), and college-educated residents (+3.2 [1.9-4.5]). An inverse association was observed for proportion very low-income residents (-3.1 [-5.3 to -0.8]), while no association was observed for proportion Hispanic/Latino residents (+0.4 [-0.6-1.3]) or population density (AME per doubling: +0.8 [-0.2-1.8]). Equalizing anti-VEGF mix to that of the highest-poverty quartile would have resulted in approximately $4.2 billion lower spending.</p><p><strong>Conclusions: </strong>Despite uniform reimbursement, significant community-level differences exist in on-label anti-VEGF use within Medicare Part B. These gradients produce billions of dollars in differential spending and raise questions of access, equity, and value-based care.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551544","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":"Post-Marketing Ocular Adverse Events Associated with Tamoxifen and Raloxifene: A Population-Based Pharmacovigilance Study.","authors":"Abdelrahman Abu Osba, Farah Saleh, Aaryamaan V Verma, Andrew Mihalache, Abd El Aziz Hendy, Roaa Abu Osba, Amit V Mishra, Peter J Kertes, Radha P Kohly, Rajeev H Muni, Marko Popovic","doi":"10.1097/IAE.0000000000004916","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004916","url":null,"abstract":"<p><strong>Purpose: </strong>Tamoxifen and raloxifene are selective estrogen receptor modulators used for breast cancer treatment, and osteoporosis prevention. While systemic adverse events (AEs) are well recognized, ocular AEs have been less comprehensively characterized. The purpose of this study was to evaluate postmarketing ocular AEs associated with tamoxifen and raloxifene using a pharmacovigilance database.</p><p><strong>Methods: </strong>The U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) data from Q4 2003 to Q2 2025 were analyzed using OpenVigil 2.1. Disproportionality analyses were conducted to calculate reporting odds ratios (RORs) for drug-AE pairs compared with all other drugs.</p><p><strong>Results: </strong>There were a total of 4,084 reports of AEs associated with tamoxifen (mean age 56.7 years), including 505 ocular AEs. The strongest signals were for corneal graft rejection (ROR 118.9), retrobulbar hemorrhage (104.6), ophthalmic vein thrombosis (82.7), retinal deposits (80.7), and macular hole (78.6). Additional events included maculopathy, retinopathy, and optic neuropathy. There were 5,600 reports of AEs associated with raloxifene (mean age 68.6 years), including 437 ocular AEs. The most prominent signals were vascular, including retinal vein thrombosis (ROR 340.0), retinal vascular thrombosis (133.8), retinal artery thrombosis (54.9), and retinal vein occlusion (42.9). Other events included reduced visual acuity, cataract, macular degeneration, and glaucoma.</p><p><strong>Conclusions: </strong>Tamoxifen and raloxifene had unique ocular AE profiles. Tamoxifen was primarily linked to retinal, optic nerve, and corneal disorders, whereas raloxifene was strongly associated with retinal vascular and thromboembolic events. These findings underscore the importance of clinician awareness and future prospective studies to further elucidate the risks.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426514","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":"ASSOCIATION BETWEEN BASELINE GLYCATED HEMOGLOBIN LEVELS AND FUNCTIONAL AND ANATOMICAL OUTCOMES AFTER FARICIMAB LOADING PHASE IN DIABETIC MACULAR EDEMA.","authors":"Alessandra Scampoli, Lorenzo Governatori, Antonio Solimeo, Carmen Plaitano, Vito Turco, Matteo Mario Carlà, Emanuele Crincoli, Stanislao Rizzo, Tomaso Caporossi","doi":"10.1097/IAE.0000000000004820","DOIUrl":"10.1097/IAE.0000000000004820","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether baseline glycosylated hemoglobin (HbA1C) levels play a predictive role in faricimab loading phase outcomes. In addition, the authors assessed the efficacy of faricimab loading phase for diabetic macular edema (DME).</p><p><strong>Methods: </strong>The authors conducted a retrospective, multicentric, interventional cohort study including 74 eyes, presenting with a central macular thickness (CMT) >280 µ m, visual acuity > 20/200, and optical coherence tomography-based diagnosis of DME.</p><p><strong>Results: </strong>A statistically significant negative correlation was found between baseline HbA1c and the change in visual acuity after intravitreal faricimab injections (ρ = -0.32, P = 0.006). In multivariable regression, this association was not significant (β ≈ -0.026 logMAR per 1% HbA1c; P = 0.26; ≈ +1.3 letters/1%). The correlation between baseline HbA1c and the change in CMT was not statistically significant (ρ = +0.13, P = 0.279). Visual acuity improved significantly from baseline to posttreatment (-0.18 ± 0.22 ΔLogMAR; P < 0.0001). The mean baseline CMT (440.4 ± 152.9 µ m) significantly decreased (310.9 ± 87.8 µ m, P < 0.0001). The authors observed a significant reduction of hyperreflective foci ( P < 0.0001) and intraretinal fluid ( P = 0.0014), and the subretinal fluid decreased from 29.7% to 10.8% after treatment ( P = 0.023).</p><p><strong>Conclusion: </strong>Systemic glycemic status may influence functional outcomes, supporting the importance of maintaining optimal HbA1c levels in the overall management of diabetic patients. However, baseline HbA1c did not emerge as an independent predictor in this cohort. Notably, faricimab provided clear anatomical and functional benefits regardless of glycemic control, confirming its efficacy as a treatment for DME.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":"1266-1271"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318916","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":"THE RISK OF RETINAL BREAKS OR DETACHMENT IN FELLOW EYE WITH LATTICE DEGENERATION AFTER PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT.","authors":"Leo Arnal, Yeabsira Mesfin, Anish Salvi, Karen M Wai, Ehsan Rahimy, Prithvi Mruthyunjaya, Chase A Ludwig","doi":"10.1097/IAE.0000000000004806","DOIUrl":"10.1097/IAE.0000000000004806","url":null,"abstract":"<p><strong>Purpose: </strong>Lattice poses risks to patients with prior detachments. This study evaluates such patients' likelihood of rhegmatogenous retinal detachments (RRD) and retinal breaks (RB) and assesses the efficacy of prophylactic laser retinopexy and cryopexy.</p><p><strong>Methods: </strong>Retrospective cohort study using the TriNetX registry. Patients either with or without prior contralateral RRD/RB and also with fellow eye lattice were included. Logistic regression calculated the likelihood of RRD/RB in the fellow eye. The number needed to treat (NNT) was calculated for prophylactic laser retinopexy and cryopexy.</p><p><strong>Results: </strong>Patients with prior unilateral RRD/RB had a higher likelihood of fellow eye RRD/RB than those without prior unilateral RRD/RB (OR: 4.47, 99% CI: 3.47-5.76). Myopia increased this likelihood (OR: 5.67, 99% CI: 3.80-8.48). The NNT to prevent one RRD was lower for patients with prior unilateral RRD (NNT: 4.63; 99% CI: 4.07-5.37) than those without (NNT: 43.29; 99% CI: 38.72-49.08). The NNT to prevent one RB was lower for patients with prior unilateral RB (NNT: 3.83; 99% CI: 3.37-4.44) than those without (NNT: 45.70; 99% CI: 39.99-53.30).</p><p><strong>Conclusion: </strong>Prior contralateral RRD/RB increases the likelihood of RRD/RB in fellow eyes with lattice. Prophylactic laser retinopexy and cryopexy reduce the number of fellow eye RRD/RB.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":"1170-1177"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASSOCIATIONS BETWEEN SLEEP DISORDERS AND AGE-RELATED MACULAR DEGENERATION: A Systematic Review and Meta-Analysis.","authors":"Lucas Macedo Nascimento, Ricardo Louzada, Dillan Cunha Amaral, Raíza Jacometti, Vitória Palazoni Viegas Mendonça, Benjamin Chamis, João Victor Pereira Gonzalez, Caio Toscano Lessa, Mário Luiz Ribeiro Monteiro, Daniela Ferrara","doi":"10.1097/IAE.0000000000004800","DOIUrl":"10.1097/IAE.0000000000004800","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the relationship between sleep disorders, including insomnia and obstructive sleep apnea (OSA), personal chronotype, and age-related macular degeneration (AMD).</p><p><strong>Methods: </strong>The authors systematically reviewed articles in PubMed, EMBASE, and Web of Science that provided information on AMD and sleep disorders, whether qualitative or quantitative. The authors systematically screened the abstracts of potentially eligible studies and subsequently assessed the full-text reports of those deemed relevant in detail. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</p><p><strong>Results: </strong>Twenty-two studies were included in their final review. Obstructive sleep apnea was associated with a higher risk of AMD, based on seven studies (hazard ratio 1.43; 95% confidence interval (CI) 1.14-1.79 P < 0.001; I 2 = 96%). The analysis showed a statistically significant association between the morning person chronotype and an increased odds of AMD (OR 1.19; 95% CI 1.10-1.30; P < 0.001; I 2 = 0%). The authors found little to no association between sleep duration (SD) and insomnia.</p><p><strong>Conclusion: </strong>Their meta-analyses, although based on a limited number of studies, indicate that sleep disorders, particularly OSA, are associated with increased odds of developing AMD. However, further research is needed to understand how SD affects disease progression and to determine the benefits of treating sleep disorders for AMD.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":"1147-1159"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146196137","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":"OBSERVATIONAL STUDY OF DARK WITHOUT PRESSURE IN MYOPIC PEOPLE BASED ON ULTRA-WIDEFIELD SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY AND ULTRA-WIDEFIELD COLOR FUNDUS PHOTOGRAPHY.","authors":"Xinru Ning, Li Chen, Hongmei Leng, Hongzhuang Cheng, Chuyun Guo, Xinzhi Liu, Yadan Shen, Yi Liu, Ruolan Ling, Yawen Qin, Lin Zhang, Jie Zhong, Xueming Ju, Jie Li","doi":"10.1097/IAE.0000000000004809","DOIUrl":"10.1097/IAE.0000000000004809","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the incidence and distribution characteristics of dark without pressure (DWOP), a relatively underexplored retinal feature, in myopic people based on ultra-widefield swept source optical coherence tomography angiography and ultra-wide field color fundus photography.</p><p><strong>Methods: </strong>Subjects were recruited from December 2021 to May 2024 at Sichuan Provincial People's Hospital. Each eye underwent a comprehensive ophthalmic examination, including ultra-wide field color fundus photography and 24 × 20-mm ultra-widefield swept source optical coherence tomography angiography. Eyes were categorized based on spherical equivalent into four groups: emmetropia, mild myopia, moderate myopia, and high myopia.</p><p><strong>Results: </strong>A total of 304 subjects (592 eyes) were recruited. The overall incidence of DWOP was 25.5%. It was significantly higher in the high myopia group (44.3%) compared with the emmetropia group (10.9%) ( P < 0.001). Axial length greater than 26 mm and spherical equivalent less than -6.0 D were associated with increased DWOP risk. DWOP was predominantly found in the inferotemporal mid-periphery (68.9%). Retinal thickness in the DWOP region was 205.0 ± 13.6 µ m, 1.70% lower than that in the normal region ( P = 0.001). Among the 34 eyes followed for 3 to 49 months, 52.4% of eyes showed an increase of DWOP area size, and 28.6% showed a decrease in area size.</p><p><strong>Conclusion: </strong>DWOP is commonly observed in high myopic eyes, primarily in the midperipheral inferior temporal region, with boundaries that change over time. These findings suggest a need for further investigation into the clinical significance of DWOP progression in myopic patients.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":"1298-1307"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RETINAL PIGMENT EPITHELIAL TUMORS IN 948 EYES OF 926 PATIENTS.","authors":"Carol L Shields, Taweevat Attaseth, YuBai Chou, Charlotte Nelle Shields, Robert J Medina, Sara E Lally, Jerry A Shields","doi":"10.1097/IAE.0000000000004827","DOIUrl":"10.1097/IAE.0000000000004827","url":null,"abstract":"<p><strong>Purpose: </strong>To better define the frequency and types of retinal pigment epithelial (RPE) tumors.</p><p><strong>Methods: </strong>Retrospective review of all computer-coded RPE tumors over a five-decade period.</p><p><strong>Results: </strong>Of 926 consecutive patients with RPE tumors, the specific diagnosis included solitary congenital hypertrophy of the retinal pigment epithelium (n = 727, 79%), multifocal congenital hypertrophy of the RPE (n = 42, 4%), torpedo maculopathy (n = 7, 1%), RPE hamartomas associated with familial adenomatous polyposis (n = 10, 1%), congenital simple hamartoma of the RPE (n = 5, 1%), combined hamartoma of the retina and RPE (n = 99, 11%), benign RPE adenoma (n = 34, 3%), and malignant RPE adenocarcinoma (n = 2, <1%). There were differences in RPE tumors regarding patient age (P < 0.01), race (P < 0.01), sex (P < 0.01), presenting visual acuity (P < 0.01), number of tumors (P < 0.01), tumor basal diameter (P < 0.01), tumor thickness (P < 0.01), and distance to the optic disc (P < 0.01) and foveola (P < 0.01). There were differences in RPE tumors regarding imaging with ultrasonography (P < 0.01), optical coherence tomography (P < 0.01), and prevalence of macular epiretinal membrane, cystoid macular, edema, and subretinal fluid on optical coherence tomography (P < 0.01). By autofluorescence and fluorescein angiography, nearly all lesions that were imaged were hypoautofluorescent/hypofluorescent except for combined hamartoma of the retina and RPE (P < 0.01). Outcomes revealed visual acuity loss ≥3 lines (≥15 letters) at 10 years more often in combined hamartoma of the retina and RPE (20%), adenoma (21%), and adenocarcinoma (100%) (P < 0.01) and 10-year nodular growth in congenital hypertrophy of the RPE (1%), adenoma (9%), and adenocarcinoma (100%) (P < 0.01).</p><p><strong>Conclusion: </strong>Retinal pigment epithelial tumors comprise a spectrum in demographics, clinical features, and outcomes. Most remain stable over time with little impact on visual acuity except for combined hamartoma of the retina and RPE, adenoma, and adenocarcinoma.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":"46 7","pages":"1160-1169"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273755","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":"SD-OCT AND OCTA: Distinct or Additional Information on Neovascular Activity? The COCTAEYL Study.","authors":"Francesca Amoroso, Alexandra Miere, Laurent Kodjikian, Aude Couturier, Jean-François Korobelnik, Camille Jung, Xavier Wang, Rocio Blanco-Garavito, Eric H Souied","doi":"10.1097/IAE.0000000000004815","DOIUrl":"10.1097/IAE.0000000000004815","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare exudative recurrence features detected by optical coherence tomography angiography (OCTA) with those identified by spectral domain optical coherence tomography (SD-OCT), considered the gold standard, and to characterize OCTA-derived profiles predictive of recurrence in patients with macular neovascularization (MNV) secondary to neovascular age-related macular degeneration (nAMD) treated with aflibercept.</p><p><strong>Methods: </strong>In this prospective observational cohort study, 49 patients were enrolled, yielding data from 686 examinations for concordance analysis between SD-OCT and OCTA. After a loading phase of three-monthly intravitreal injections of 2 mg aflibercept, patients were monitored monthly. Both SD-OCT and OCTA were performed at each visit, with intravitreal injections administered bimonthly (fixed regimen) for up to 12 months.</p><p><strong>Results: </strong>OCTA demonstrated a sensitivity of 72%, specificity of 27%, positive predictive value (PPV) of 59%, and negative predictive value (NPV) of 40% for detecting exudative activity. The area under the ROC curve (AUC) for OCTA-defined recurrence was 0.49, with an odds ratio (OR) of 0.95 for predicting neovascular activity in the next month ( P = 0.87). The net benefit (NB) was 0.13 for OCTA versus 0.19 for a general approach strategy. Relying on OCTA for recurrence detection instead of SD-OCT did not reduce unnecessary intravitreal injections.</p><p><strong>Conclusion: </strong>OCTA and SD-OCT provide complementary information, with OCTA focusing on flow remodeling and SD-OCT highlighting exudative features. OCTA provides complementary vascular flow information to the structural data acquired with SD-OCT, allowing a more comprehensive assessment of neovascular activity, although no modification in management was observed in this cohort.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":"1203-1211"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147319013","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}