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

{"title":"Is vitreoretinal traction the cause of 'Combined Hamartoma of the Retina and Retinal Pigment Epithelium' (CHRRPE)? A case series and proposal for 'Traction-Induced Retinal and Retinal Pigment Epithelium Lesion' (TRIPEL).","authors":"Shivesh Varma, Verity Moynihan, Siegfried K Wagner, Sarah E Coupland, Mandeep S Sagoo, Sui Chien Wong, Robert H Henderson","doi":"10.1097/IAE.0000000000004965","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004965","url":null,"abstract":"<p><strong>Purpose: </strong>Combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) is traditionally described as arising from hamartomatous proliferation. We hypothesize that posterior hyaloid membrane (PHM) traction is the primary driver with secondary retinal/RPE changes, supported by imaging and surgical outcomes.</p><p><strong>Methods: </strong>Dual-center retrospective series of 64 eyes with 'CHRRPE' and OCT imaging.</p><p><strong>Results: </strong>Mean age was 16.2±16.9 years. The PHM was adherent and thickened on OCT in 97%, with broad (>1500µm) attachment in 76%. Traction was present in all eyes (mini-peaks 69%, maxi-peaks in 73%).Thirty-six eyes had follow-up (mean 6.3±5.7 years). Those undergoing surgery (n=15) were younger (6.6 vs 15.0 years, p=0.010), more likely to have macular phenotype (80% vs 50%, p=0.008), and had worse baseline visual acuity (1.01±0.62logMAR [20/200] vs 0.52±0.38logMAR [20/66], p=0.024) versus observation.Surgery resulted in greater reduction in CST (-183±168µm vs -47.4±179µm, p=0.007), reduction in clinically apparent pigmentary change (100% vs 15%, p<0.001), and visual acuity improvement (-0.26±0.46logMAR [13 letter gain] vs +0.29±0.67logMAR [15 letter loss], p=0.045) versus observation, including after adjustment for follow-up. Traction features resolved postoperatively in all cases.</p><p><strong>Conclusion: </strong>Traction appears to be a defining feature of CHRRPE. We propose the term 'Traction-Induced Retinal and Retinal Pigment Epithelium Lesion' (TRIPEL) to reflect the pathophysiology.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820246","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":"Diagnostic Accuracy of Multimodal Large Language Models in Retinal Fundus Photography.","authors":"Lia Huo, Astha Chandra, Michael Balas, Marko Popovic, Peng Yan, Peter J Kertes, Radha Kohly, Rajeev Muni","doi":"10.1097/IAE.0000000000004986","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004986","url":null,"abstract":"<p><strong>Purpose: </strong>Artificial intelligence in ophthalmology has mostly used task-specific convolutional neural networks. The performance of general-purpose multimodal large language models (LLMs) for fundus image diagnosis remains largely unexplored. This study evaluated and compared the performance of four multimodal LLMs in diagnosing retinal diseases from color fundus photographs.</p><p><strong>Methods: </strong>A total of 800 images (100 per category across 8 conditions) were randomly sampled and evaluated by ChatGPT-4o, Claude 3.5 Sonnet, Gemini 1.5, and Grok-2. Each model received a standardized prompt with a single fundus photograph and was asked to provide a free-text diagnosis, confidence rating (1-10), and justification type, defined as the reasoning category behind its diagnosis. Primary outcome was overall diagnostic accuracy. Secondary outcomes included sensitivity, specificity, F1-scores, misclassification patterns, justification-accuracy association, confidence-accuracy correlation, Cohen's κ agreement across models, and mean response time per image.</p><p><strong>Results: </strong>ChatGPT achieved the highest diagnostic accuracy (75%; 603/800), far exceeding Claude (18%), Grok (18%), and Gemini (14%). Unlike other models, ChatGPT demonstrated a meaningful association between justification type and diagnostic correctness and showed a positive correlation between confidence and accuracy (r = 0.19; P < 0.001). Claude and Gemini exhibited weaker confidence-accuracy correlations, while Grok showed none. Agreement across models was consistently low (κ = 0.11-0.16 with ChatGPT; κ ≈ 0.05 among Claude, Gemini, and Grok).</p><p><strong>Conclusions: </strong>ChatGPT demonstrated the strongest accuracy, justification-accuracy association, and confidence-accuracy correlation compared with Claude, Gemini, and Grok. While promising, refinement, validation, and workflow integration are essential before clinical deployment.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820270","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":"Comment on: \"Impact of GLP-1 Receptor Agonists for Type 2 Diabetes Mellitus on the Development and Progression of Age-Related Macular Degeneration\".","authors":"Cheng-Hsien Hung, Tsung-Wei Chang","doi":"10.1097/IAE.0000000000004994","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004994","url":null,"abstract":"","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820258","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":"Understanding Disorganization of Retinal Layers and the (potential) role in staging and management of Diabetic Retinal Disease.","authors":"Stela Vujosevic, Camilla Alovisi, Chui Ming Gemmy Cheung, Amani Fawzi, Anat Loewenstein, Tunde Peto, Sobha Sivaprasad, Jennifer K Sun","doi":"10.1097/IAE.0000000000004990","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004990","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetic retinal disease (DRD) is increasingly recognized as a neurovascular disorder involving both microvascular and neurodegenerative damage. Optical coherence tomography (OCT) biomarkers such as disorganization of retinal inner layers (DRIL) and outer layers (DROL) serve as indicators of neuroretinal injury. This review examines their pathophysiology, clinical importance, and prognostic value.</p><p><strong>Methods: </strong>A review of experimental and clinical evidence was conducted to evaluate the structural and functional implications of DRIL and DROL as seen on spectral domain OCT (SD-OCT) and OCT-Angiography (OCT-A). The associations between these biomarkers, neurovascular unit (NVU) dysfunction, diabetic macular ischemia (DMI), and visual outcomes were analyzed.</p><p><strong>Results: </strong>DRIL reflects disruption of inner retinal layers involving bipolar, amacrine, horizontal, and Müller cells, associated with impaired synaptic organization and neuroglial dysfunction. It strongly correlates with DR severity and reduced vision, especially with DMI and capillary non-perfusion in the deep capillary plexus. DROL indicates more advanced outer retinal involvement, such as disruption of the ellipsoid zone and photoreceptors, indicative of disease progression. The extent and persistence of DRIL predict visual outcomes and treatment response, often better than traditional metrics.</p><p><strong>Conclusion: </strong>DRIL and DROL are key OCT biomarkers of neuroretinal damage, revealing NVU integrity. Their assessment enhances disease staging, prognosis, and treatment decisions, supporting a shift from a purely microvascular model to a neurovascular paradigm in DRD.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820279","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":"Microvascular Factors and Surgical Outcomes in Macular Telangiectasia Type 2-Associated Macular Holes Versus Idiopathic Macular Holes.","authors":"Ji Hye Lee, Bo-Een Hwang, Young Gun Park, Young-Hoon Park","doi":"10.1097/IAE.0000000000004987","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004987","url":null,"abstract":"<p><strong>Purpose: </strong>Macular holes (MHs) associated with macular telangiectasia (MacTel) type 2 represent a clinically distinct subset in which visual outcomes and surgical responses may differ from those of idiopathic MHs (IMHs); however, their retinal microvascular characteristics remain poorly characterized. This study aimed to clarify these differences by using optical coherence tomography angiography (OCTA).</p><p><strong>Methods: </strong>This retrospective case-control study was conducted at a tertiary referral center. It included 31 eyes with MacTel type 2-associated MHs and 30 eyes with IMHs that underwent pars plana vitrectomy between March 2017 and October 2025. Retinal microvascular changes were analyzed using OCTA, and quantitative measurements were performed using ImageJ software (version 1.54).</p><p><strong>Results: </strong>Parafoveal superficial vascular plexus vessel density (SVP VD) was significantly lower in MacTel type 2-associated MHs compared with IMHs (31.59±5.61% vs. 42.00±7.21%, p<0.001), with consistent reductions across all quadrants (superior, inferior, temporal, and nasal). No significant differences were observed in deep capillary plexus (DCP) or choriocapillaris parameters between the two groups. In multivariate regression analysis, preoperative visual acuity and MH etiology were independently associated with postoperative visual outcomes (p=0.04 and p<0.001, respectively). Microvascular parameters were not significant predictors.</p><p><strong>Conclusion: </strong>MacTel type 2-associated MHs demonstrated significantly reduced SVP VD without corresponding changes in DCP or choriocapillaris, indicating a distinct microvascular profile compared to IMHs. However, SVP VD was not independently associated with short-term postoperative visual outcomes, suggesting that these alterations may reflect disease-specific microvascular characteristics rather than functional determinants of early visual recovery.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820277","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":"Long-Term Outcomes of Gore-Tex Sutured Scleral-Fixated Intraocular Lenses and Pars Plana Vitrectomy.","authors":"Luis Acaba-Berrocal, Jake Mathew, Mitchell S Fineman, Marc J Spirn, Jason Hsu, James Vander, Allen C Ho, Sunir J Garg, Allen Chiang, Arunan Sivalingam, Omesh P Gupta","doi":"10.1097/IAE.0000000000004989","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004989","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate long-term visual and anatomical outcomes and complications following combined pars plana vitrectomy (PPV) and scleral fixation of intraocular lenses (IOLs) using Gore-Tex (polytetrafluoroethylene, PTFE) suture. With an average follow up of 10 years, this study provides longitudinal data on this increasingly common technique.</p><p><strong>Methods: </strong>Single-center retrospective review of patients who underwent combined PPV and PTFE scleral sutured IOL fixation between 2012 and 2016 with a minimum follow-up of 7 years. Main outcome measures were best-corrected visual acuity (BCVA) at 3 months, 1 year, 5 years, and final follow-up, as well as the incidence and type of postoperative complications.</p><p><strong>Results: </strong>A total of 55 eyes of 55 patients with a mean follow-up of 10 years (range, 7-12) were included. The mean age was 65 years (range, 32-91), and 71% were male. Mean BCVA improved from 20/300 (1.17 ± 0.92 logMAR) preoperatively to 20/70 (0.55 ± 0.72 logMAR) at 3 months postoperatively (p<0.001). Statistically significant visual improvement was maintained at 1 year (p=0.01), 5 years (p=0.03), and final follow up (p=0.02). Postoperative complications included cystoid macular edema in 6 eyes (11%), persistent corneal edema in 2 eyes (3.6%) that required corneal transplantation, visually significant IOL tilt in 2 eyes (3.6%), and suture exposure in 2 eyes (3.6%). There were no cases of endophthalmitis or suture breakage.</p><p><strong>Conclusion: </strong>Scleral fixation of IOLs using PTFE suture demonstrates significant visual improvement and a low rate of suture-related complications and reoperations over a 10-year follow-up period.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820307","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":"Systemic Hypertension as an Independent Risk Factor for Polypoidal Choroidal Vasculopathy: Evidence from Indian Case-Control Study.","authors":"Rupak Kanti Biswas, Jay U Sheth, Krishnendu Nandi, Tirna Halder, Jasmeet Kaur, Sudipta Das, Swakshyar Saumya Pal, Sourav Sinha","doi":"10.1097/IAE.0000000000004970","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004970","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the association between hypertension and polypoidal choroidal vasculopathy (PCV), and to identify demographic subgroups with enhanced susceptibility.</p><p><strong>Methods: </strong>This retrospective case-control study enrolled 101 patients with PCV and 101 age-matched controls without retinal disease. The primary outcome was the odds ratio (OR) for PCV comparing both groups. Secondary analyses examined age- and gender-stratified associations. Logistic regression adjusted for age and gender.</p><p><strong>Results: </strong>Hypertension was significantly more prevalent in PCV cases (84.2%, 85/101) compared to controls (60.4%, 61/101), with an unadjusted OR of 3.48 (95% CI: 1.79-6.78; P<0.001). The association was particularly strong in patients older than 70 years (OR=7.14, P=0.001) and in males (OR=3.34, P=0.002). After adjustment for age and gender, hypertension remained an independent risk factor for PCV (adjusted OR=3.43, 95% CI: 1.72-6.82; P<0.001). Multicollinearity was absent (all Variance Inflation Factor [VIF]<3).</p><p><strong>Conclusion: </strong>Hypertension is a significant independent risk factor for PCV, with increased risk in elderly and male patients. These findings suggest a mechanistic link between systemic hypertensive vascular disease and choroidal vasculopathy development and may inform clinical screening and risk stratification in hypertensive populations.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809442","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":"Identification and localization of myopic macular neovascularization using deep learning.","authors":"Hanna Moalem, Einav Baharav Shlezinger, Alon Tiosano, Noam Fradkin, Bar Yacobi, Shannie Chacham, Yariv Keshet, Gilad Rabina, Assaf Dotan, Irit Bahar, Orly Gal-Or","doi":"10.1097/IAE.0000000000004977","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004977","url":null,"abstract":"<p><strong>Purpose: </strong>Myopia is rapidly increasing worldwide, with macular neovascularization (MNV) representing a major cause of vision loss. Early diagnosis remains challenging. Our study aims to incorporate a deep learning (DL) model to identify and localize myopic MNV using OCT images.</p><p><strong>Methods: </strong>A total of 6,215 OCT B-scan images of patients with pathologic myopia were included, of which 1,664 contained MNV. MNV lesions were manually annotated and validated by retina specialists. The dataset included additional myopia-related pathologies to account for factors affecting model robustness. Data were split into training and validation sets using patient-level 5-fold cross-validation. A YOLOv11 (You Only Look Once) object detection model was trained to localize MNV. Two postprocessing pipelines using either non-maximum suppression (NMS) or weighted box fusion (WBF) were tested. Model performance was evaluated at 25% intersection over union (IoU) using precision, recall, and mean average precision (mAP25).</p><p><strong>Results: </strong>The YOLOv11 models achieved mean precision ranging from 0.73 to 0.79 and recall from 0.76 to 0.80. The highest mAP25 reached 0.84. Adapting the model's output into an image-level binary classification yielded precision up to 0.85, recall up to 0.88, and F1-score up to 0.85.</p><p><strong>Conclusion: </strong>A YOLOv11-based deep learning model reliably detects and localizes myopic MNV on OCT imaging, overcoming the challenge of structurally complex eyes with coexisting myopic pathologies. This tool may serve as an automated reader to assist with earlier diagnosis and timely anti-VEGF intervention in patients with pathologic myopia.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801581","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":"Histologic and biochemical evaluation of three eyes with Autosomal Dominant Neovascular Inflammatory Vitreoretinopathy (ADNIV).","authors":"Madeleine K Jennisch, Jeremy M Hoffmann, Nasreen A Syed, Budd A Tucker, Edwin M Stone, Robert F Mullins, Timothy M Boyce","doi":"10.1097/IAE.0000000000004973","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004973","url":null,"abstract":"<p><strong>Purpose: </strong>Autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV) is a rare inherited retinal disease caused by mutations in CAPN5. We report clinicopathologic and histologic findings from donor eyes representing multiple stages of ADNIV, including early-stage disease, and evaluate calpain-5 (CAPN5) expression and localization in affected tissue.</p><p><strong>Methods: </strong>Histopathologic staining and immunofluorescence were performed on eyes from three patients with genetically confirmed ADNIV (stages II, IV, and V). Labeling targeted glial, immune, and vascular markers, as well as CAPN5 distribution. Western blotting of aqueous- and detergent-soluble fractions was performed on retinal and RPE/choroid tissue from the stage II donor and an age- and sex-matched control. Clinical history from the stage IV donor was reviewed.</p><p><strong>Results: </strong>All three ADNIV eyes in this series demonstrated lymphocytic infiltration predominantly confined to the choroid. The stage II eye showed preserved retinal organization with early Müller cell gliosis and microglial activation. Later stages exhibited neuroretinal disorganization and fibrovascular encapsulation. RPE preservation was noted in all 3 eyes. CAPN5 was expressed throughout retinal and choroidal tissues. Western blot and fractionation analysis of the stage II eye showed no difference in CAPN5 abundance or distribution compared with control tissue.</p><p><strong>Conclusion: </strong>These findings support a disease process characterized by early choroidal inflammation and progressive retinal degeneration in ADNIV. Stable CAPN5 localization in early disease suggests that pathogenic effects may arise from altered mutant protease activity rather than from changes in protein abundance or localization. Recognition of early inflammatory changes may inform future diagnostic and therapeutic approaches in this rare condition.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801617","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":"Influence of distractions and meditation on the surgical performance of vitreoretinal surgeons using the EyeSi Simulator.","authors":"Cyril Erne, Thomas Sartoretti, Omar Hommayda, Daniel Barthelmes, Marc Stahel, Roman Eberhard, Bernhard Henrich, George Moussa, Ch'ng Soon, Siddharth Subramani, Andrew S Davis, Emma Linton, Walter Andreatta","doi":"10.1097/IAE.0000000000004971","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004971","url":null,"abstract":"<p><strong>Purpose: </strong>Vitreoretinal surgery is a highly technical subspecialty that requires exceptional precision and concentration. External factors, such as distractions and meditation, have been identified as potential influencing factors of surgical performance across various microsurgical specialties. This study assesses the effects of distractions and meditation on the performance of senior vitreoretinal surgeons using a validated surgical simulator.</p><p><strong>Methods: </strong>A multicentre prospective interventional study was conducted with fully trained vitreoretinal surgeons (n = 10). Three validated modules resembling posterior eye surgery were completed under three different conditions. Distractions were simulated via clinical questioning, while meditation consisted of guided one-minute breathing exercises. These were compared to a baseline performance where the candidate could complete the modules undisturbed. Performance metrics were analysed (baseline vs intervention) using a Wilcoxon signed-rank test.</p><p><strong>Results: </strong>Distractions significantly reduced overall task scores in two out of three modules (p < 0.001). Meditation did not significantly improve performance scores across the modules. Distractions consistently increased task completion time across all modules (p < 0.001), whereas meditation only reduced time significantly in one module (p = 0.007).</p><p><strong>Conclusion: </strong>Distractions negatively impacted surgical performance, increasing errors and prolonging task duration. Meditation showed limited but positive effects. Minimizing distractions during surgery is essential to optimize surgical outcomes.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801632","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}