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

{"title":"Type 4 macular neovascularization in eyes with diabetic retinopathy.","authors":"Dina Baddar, Yousef Fouad, Noha Ossama Salem, Alessandro Feo, Mohamed Nowara, David Sarraf","doi":"10.1097/IAE.0000000000004948","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004948","url":null,"abstract":"<p><strong>Purpose: </strong>To report recently described type 4 macular neovascularization (T4MNV) in eyes with diabetic retinopathy (DR).</p><p><strong>Methods: </strong>A retrospective analysis including nine eyes with DR (and without any features of age related macular degeneration or AMD) that displayed T4MNV with optical coherence tomography (OCT) and OCT angiography (OCTA).</p><p><strong>Results: </strong>The mean age of the patients was 64 years, and the mean duration of diabetes mellitus was 20 years. All patients displayed unilateral T4MNV with an average visual acuity of 20/500 in the affected eye. Seven of the nine patients (77.8%) were diagnosed with proliferative DR, and the remaining exhibited severe non-proliferative DR. Central posterior hyaloid fibrosis was detected in 7/9 eyes (77.8%) and showed flow on OCTA in 4/9 eyes (44.4%). All 9 eyes showed subretinal hyperreflective material (SHRM) on OCT corresponding to Type 2 (and Type 1) MNV on OCT and OCTA. Drusen were not detected in any of the 9 affected or fellow eyes.</p><p><strong>Conclusion: </strong>T4MNV can occur in eyes with long-standing DR without signs of AMD. It is possible that early identification of T2MNV and timely anti-VEGF intervention may potentially mitigate progression to T4MNV, but this requires validation with prospective analysis. Early recognition of T4MNV imaging features is important in counseling patients about the poor visual prognosis.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622555","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":"CHARACTERISTICS OF INFECTIOUS AND NON-INFECTIOUS VITRITIS IN BOSTON KERATOPROSTHESIS TYPE I: 18 YEARS OF EXPERIENCE AND OUTCOMES FROM A SPANISH REFERENCE CENTER. Abbreviated tittle: VITRITIS IN BOSTON KERATOPROSTHESIS.","authors":"Ana Orive Bañuelos, Marta Vior Fernández, Raquel Feijóo Lera, Alaitz Santamaría Carro, Noelia Andollo Victoriano, Jaime Etxebarria Ecenarro","doi":"10.1097/IAE.0000000000004951","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004951","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the incidence, characteristics, management and outcomes after infectious and non-infectious vitritis in patients with Boston type 1 Keratoprosthesis (BKPro1).</p><p><strong>Methods: </strong>A retrospective chart review was conducted of all patients who developed vitritis following BKPro1 surgery at Cruces University Hospital between June 2006 and June 2024. The main outcomes analyzed were: type of vitritis, treatment and management, etiopathogenesis, and pre- and post-vitritis visual acuity (BCVA).</p><p><strong>Results: </strong>Over 18 years, 79 eyes underwent BKPro1 surgery. The mean follow-up was 8.25 ± 5.34 years. A total of 18 eyes suffered from vitritis, corresponding to an incidence of 22.7%. Out of 18 vitritis, 38.9% were diagnosed as reactive vitritis, 5.5% as idiopathic vitritis, and 55.6% as endophthalmitis. The median time to develop vitritis was 6.5 months [2 - 25.75]. PPV was performed in 100% of cases. Most identified pathogens were Gram-positive, mainly Staphylococcus epidermidis. In the endophthalmitis group, 30% of patients achieved a final BCVA similar to their pre-infectious baseline. Patients who underwent surgery on the same day as diagnosis were able to maintain the implant and BCVA. Failure to improve BCVA in the reactive vitritis group was mainly due to postoperative complications. In the idiopathic vitritis case, visual recovery occurred at 3.85 weeks after treatment.</p><p><strong>Conclusion: </strong>These three vitritis patterns may represent variations of the same underlying process. Given the low morbidity of modern vitrectomy, early surgical intervention should be considered in cases of diagnostic uncertainty, as this is a vision-threatening condition that requires prompt recognition and management.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622613","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 Access to Retinal Care in the United States.","authors":"Jovany J Franco, Owais Fazal, Warren W Pan, Thomas J Wubben, Mark W Johnson","doi":"10.1097/IAE.0000000000004929","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004929","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the geographic coverage of U.S. medical and surgical retina specialists and identify community-level sociodemographic factors associated with reduced access.</p><p><strong>Methods: </strong>For this population-based, cross-sectional study, fellowship-trained retina specialists were identified using professional society membership databases, private practice websites, academic department profiles, and Centers for Medicare and Medicaid Services data. Practice addresses were geocoded, and 15-, 30-, and 60-min drive-time service areas were generated. U.S. Census tracts enriched with 2019-2023 American Community Survey sociodemographic data were overlaid, with tract proximity defined by the shortest service area capturing the tract centroid. Multivariable logistic regression was used to identify tract-level sociodemographic characteristics associated with inadequate access to care (i.e., >60-min). Odds ratios (ORs) were scaled per 10-percentage point increase in each predictor.</p><p><strong>Results: </strong>Approximately 5.0% of U.S. residents lived >60-min from the nearest retina specialist. After adjusting for urbanicity, higher odds of inadequate access were observed amongst tracts with higher proportions of Medicare-aged residents (OR 1.61 [95% confidence interval, 1.58-1.64]) and greater racial homogeneity (1.15 [1.14-1.16]). Higher proportions of college-educated residents were associated with reduced odds of inadequate access (0.89 [0.88-0.90]). Weaker associations were observed between inadequate access and higher proportions of uninsured (1.05 [1.02-1.08]) and Hispanic/Latino residents (1.08 [1.07-1.09]). No association was observed for proportion very low-income residents (1.00 [0.99-1.02]).</p><p><strong>Conclusions: </strong>Approximately 1 in 20 U.S. residents lived >60-min from a retina specialist, with several sociodemographic characteristics associated with reduced access. These findings highlight specific communities that may benefit most from targeted interventions.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610133","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":"Predictors of Visual Outcomes in Surgically Managed Hemorrhagic Choroidal Detachment.","authors":"Alexander J Shaer, Tadashi Yokoi, Taku Wakabayashi, Sudheshna Vemula, Kristine Wang, Bita Momenaei, Trisha Ortiz, Omar Masoud, Naphat Orprayoon, Sunir J Garg, Jason Hsu, Marc J Spirn, Omesh P Gupta, Jordan D Deaner, David Xu, Samir N Patel, Joshua H Uhr, Ajay E Kuriyan, Yoshihiro Yonekawa, Meera D Sivalingham, Michael N Cohen","doi":"10.1097/IAE.0000000000004933","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004933","url":null,"abstract":"<p><strong>Purpose: </strong>To identify predictors of visual acuity (VA) after surgical management of hemorrhagic choroidal detachment (HCD) and assess whether surgical timing or drainage technique affects anatomic outcomes and postoperative rhegmatogenous retinal detachment (RRD).</p><p><strong>Methods: </strong>Retrospective cohort of surgically managed HCD eyes. Timing was categorized as 0-6, 7-14, or ≥15 days from diagnosis. Primary outcome was postoperative month-6 (POM6) best available VA (logMAR) analyzed with multivariable linear regression. Secondary outcomes included HCD resolution and postoperative RRD.</p><p><strong>Results: </strong>Sixty-seven eyes were included (mean age 74.8 ± 12.1 years; 44.8% female). Median time to surgery was 8-days (IQR, 3-14). Mean VA improved from 2.57 ± 0.34 logMAR (Snellen 20/8000) to 2.07 ± 0.79 logMAR (Snellen 20/2400) at POM6 (p<0.001). Using 7-14 days as reference, 0-6-day surgery independently predicted worse POM6 VA (p=0.008), whereas ≥15 days surgery did not. Worse baseline VA, appositional choroidal detachments, and trauma were also independently associated with poorer POM6 VA (p<0.05). Time to HCD resolution did not differ by timing or drainage technique; however, all five repeat drainages occurred in the 0-6-day group. Postoperative RRD occurred in 20 eyes (29.9%) and was independently associated with traumatic etiology.</p><p><strong>Conclusion: </strong>Early surgery was associated with worse 6-month visual outcomes compared with surgery at 7-14 days. Neither drainage technique nor surgical timing influenced anatomic resolution or postoperative RRD risk. These findings support delayed intervention until clot liquefaction when appropriate and identify trauma-associated HCD as a higher-risk subgroup.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610147","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":"Hispanic versus non-Hispanic patients with Central Serous Chorioretinopathy: MICRoN report 18.","authors":"Shreyaa Rohindra Lall, Niroj Kumar Sahoo, Nasiq Hasan, Arman Zarnegar, Priyanka Gandhi, Jessica Cao, Charles C Wykoff, Gabriele Piccoli, Stela Vujosevic, Lisa Checchin, Lorenzo Pili, Maurizio Battaglia Parodi, Halit Winter, Manjot Gill, Felicia Hertkorn, Lorenzo Ferro Desideri, Marion R Munk, Carmen Antia Rodriguez Fernandes, Luis Arias Barquet, Adrian T Fung, Jay C Wang, Rahul N Khurana, Yusuf Ashfaq, Zachary Kroeger, Luiz H Lima, Giulia Gregori, Marco Lupidi, Priya Shah, Panisa Singhanetr, Elizabeth Rossin, Francisco J Rodriguez, Carol Villafeurte-Trisolini, Glenn Yiu, Kent Small, Lihteh Wu, Jay Kumar Chhablani","doi":"10.1097/IAE.0000000000004926","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004926","url":null,"abstract":"<p><strong>Purpose: </strong>To compare baseline characteristics and clinical course between Hispanic and non-Hispanic patients with Central Serous Chorioretinopathy (CSC).</p><p><strong>Methods: </strong>This retrospective, multicentre study from the Macula Society CSC Research Network (MICRoN) included Hispanic and non-Hispanic patients with CSC. Demographic characteristics and multimodal imaging variables were compared between groups. Regression analyses identified factors associated with visual outcomes, structural changes, and disease recurrence/persistence.</p><p><strong>Results: </strong>A total of 480 patients were included (130 Hispanic, 350 non-Hispanic). Non-Hispanic patients were significantly older at presentation (48.8±11.1 vs 45.3±11.6 years, p=0.003) and had better baseline best recorded visual acuity (BRVA; 20/25 vs 20/40, p<0.001). A significantly higher percentage of Hispanic patients presented with complex CSC (73.8% vs 28.3%, p<0.001), multifocal RPE alterations (58.5% vs 9.7%, p<0.001), and greater neurosensory detachment height (NSD; 193 [IQR 100-301] vs 113 [IQR 66-193] microns, p<0.001). Conversely, non-Hispanic patients demonstrated larger areas of RPE alteration (1.5 [IQR 1-3] vs 1 [IQR 0.25-1.5] disc areas, p<0.001). At last follow-up, both groups showed significant improvement in BRVA (Hispanics: 20/40 to 20/25, p<0.001; non-Hispanics: 20/25 to 20/20, p<0.001), with no significant difference in rates of recurrence (40% vs 35.7%, p=0.08) or persistence (11.5% vs 13.1%, p=0.08).</p><p><strong>Conclusion: </strong>In our cohort, Hispanic patients more commonly presented with complex CSC, multifocal RPE alterations, and greater NSD height, while non-Hispanic patients were older with better baseline vision and larger areas of RPE alteration. Despite these differences, visual outcomes improved meaningfully in both groups, with comparable rates of recurrence and persistence.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594628","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":"Correspondence.","authors":"Julian E Klaas, Siegfried Priglinger","doi":"10.1097/IAE.0000000000004931","DOIUrl":"10.1097/IAE.0000000000004931","url":null,"abstract":"","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610188","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":"Commentary on \"Surgeon Volume and Success Rate in Primary Rhegmatogenous Retinal Detachment\".","authors":"Edwin H Ryan, John B Davies","doi":"10.1097/IAE.0000000000004938","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004938","url":null,"abstract":"","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594686","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":"Inner foveal irregularities are Foveal Abnormalities associated with epiretinal Tissue of medium reflectivity and Increased blue-light fundus Autofluorescence Signal.","authors":"Roberto dell'Omo","doi":"10.1097/IAE.0000000000004930","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004930","url":null,"abstract":"","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594461","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":"Do OCTA morphological patterns in neovascular AMD actually matter? A scoping review of clinical utility and terminological overlap.","authors":"Daniela Bacherini, Ken Kawamoto, Gianni Virgili, Clara Rizzo, Caroline R Baumal, Usha Chakravarthy, Christine A Curcio, Livia Faes, K Bailey Freund, David Huang, Marion R Munk, Michael Pircher, Giuseppe Querques, Eric Souied, Nadia K Waheed, Roy Schwartz","doi":"10.1097/IAE.0000000000004936","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004936","url":null,"abstract":"<p><strong>Purpose: </strong>Optical coherence tomography angiography (OCTA) has enabled detailed in vivo imaging of macular neovascularization (MNV) in neovascular age-related macular degeneration (nAMD), leading to a proliferation of morphological descriptive terms. This scoping review aimed to systematically map the existing literature on OCTA-based MNV morphology and evaluate its correlation with disease activity.</p><p><strong>Methods: </strong>A systematic literature search covering publications through 2025 was performed. After screening 2,445 titles and obtaining 60 full texts, 43 studies were included. Data on morphological terminology, study design, and correlation with disease activity were extracted and synthesized.</p><p><strong>Results: </strong>The included studies, encompassing a total of 2,712 eyes, identified a vast and heterogeneous lexicon of qualitative descriptors, including terms such as \"medusa,\" \"sea-fan,\" and \"glomerulus\", characterized by significant terminological overlap and inconsistent definitions across studies. Inconsistent, low-certainty associations between specific OCTA morphologies and MNV activity were identified across studies, with findings limited by significant methodological heterogeneity. The evidence for these patterns as reliable biomarkers of disease activity is weak and often contradictory, and several studies were found to use OCTA features to define activity, creating circular arguments that undermine their conclusions.</p><p><strong>Conclusion: </strong>The current terminology for OCTA morphology in nAMD is fragmented and inconsistently applied. The link between these patterns and disease activity is poorly established, severely limiting their clinical utility. These findings highlight a need for a standardized, consensus-based framework for describing and interpreting OCTA findings in nAMD.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594636","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":"Surgeon Volume and Success Rate in Primary Rhegmatogenous Retinal Detachment.","authors":"Ahmed F Shakarchi, Muhammad Z Chauhan, Xiaoran Zhang, Andrew Brown, Porter Jones, Sami H Uwaydat, Ahmed B Sallam","doi":"10.1097/IAE.0000000000004937","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004937","url":null,"abstract":"<p><strong>Purpose: </strong>Evaluate the incidence and predictors of primary rhegmatogenous retinal detachment (RD) revision among Medicare beneficiaries.</p><p><strong>Methods: </strong>We included adult patients undergoing RD repair using scleral buckle and/or vitrectomy. We extracted patient demographics and information pertaining to the RD (using ICD-10 modifiers) and surgical repair (using CPT codes). Surgeon-level factors included the surgeon volume of RD in the dataset, surgeon graduation year, practice volume and setting (teaching vs not and urban vs rural). Surgeon volume was categorized as: 10-25 surgeries, 26-50 surgeries and > 50 surgeries. RD revision was defined as repeat surgery or pneumatic retinopexy in the same eye within 2 years.</p><p><strong>Results: </strong>25,456 surgeries were included. Average age was 70.4 ± 8.3 and 9,105 (35.8%) were female. Revision was needed in 3,649 (14.3%). The median time to RD revision was 73 days. The main predictors of RD revision were GRT (RR=1.39; 95% CI=1.13-1.72), total RD (RR=1.30; 95% CI=1.15-1.47), and complex vitrectomy +/- buckle (RR=1.29; 95% CI=1.09-1.53).</p><p><strong>Conclusions: </strong>RD revision was needed in 14.3%. The main factors associated with increased risk of RD revision were the need for complex vitrectomy, GRT and total RD. Surgeon and practice volumes were not significant predictors.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594448","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}