Ocular Surface最新文献

{"title":"Interdisciplinary management of belantamab mafodotin-associated ocular toxicity in clinical practice","authors":"Mattan Arazi ,&nbsp;Aya Wattad ,&nbsp;Hila Magen ,&nbsp;Abraham Avigdor ,&nbsp;Nirit Agay ,&nbsp;Yoav Berger ,&nbsp;Irina S. Barequet","doi":"10.1016/j.jtos.2025.09.003","DOIUrl":"10.1016/j.jtos.2025.09.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Belantamab mafodotin (BLENREP), an antibody–drug conjugate for relapsed/refractory multiple myeloma (RRMM), is associated with corneal toxicity driven by limbal stem cell dysfunction and corneal epithelial damage. We examined how keratopathy severity relates to hematologic management decisions in clinical practice.</div></div><div><h3>Methods</h3><div>Retrospective cohort at a tertiary referral center, including RRMM patients treated with belantamab mafodotin (2019–2022). Ophthalmic examinations were performed at baseline and before each cycle; keratopathy was graded using the Keratopathy and Visual Acuity (KVA) scale. The primary outcome was the association between KVA severity (modeled as a time-dependent covariate) and management (dose reduction, treatment holiday, or discontinuation). Secondary outcomes included predictors of severe KVA, impact of management on immediate KVA change, and timing of the first management change.</div></div><div><h3>Results</h3><div>Among 41 patients (mean age 67.10 ± 11.78 years; 23/41 [56.1 %] female), 38/41 (92.68 %) developed KVA keratopathy. The median time to first KVA occurrence was 4.14 weeks, and to first management change was 7.29 weeks. Higher KVA grade was associated with earlier management change (HR 1.514; 95 % CI 1.048–2.187; p = 0.0270). At the first assessment after the initial intervention, KVA worsened after treatment holidays (+0.70 ± 0.114 grades) and improved after dose reductions (−0.20 ± 0.084; p = 0.0165). Overall, during follow-up, the most common intervention was a treatment holiday (23/37, 56.1 %), followed by dose reduction (16/37, 39.0 %) and discontinuation (6/37, 16.2 %).</div></div><div><h3>Conclusion</h3><div>KVA keratopathy occurred more frequently than in clinical trials, and nearly all patients required treatment modification. Given the strong relationship between KVA severity and management decisions, close ophthalmic monitoring from Grade 1 is warranted to mitigate progression and reduce vision-related morbidity.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 324-329"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of vision-related quality of life in patients treated for filamentous fungal keratitis","authors":"N.V. Prajna ,&nbsp;N. Radhakrishnan ,&nbsp;Prajna Lalitha ,&nbsp;Revathi Rajaraman ,&nbsp;Sarah Abdelrahman ,&nbsp;Benjamin F. Arnold ,&nbsp;Thomas M. Lietman ,&nbsp;Jennifer Rose-Nussbaumer ,&nbsp;Alejandro Arboleda","doi":"10.1016/j.jtos.2025.09.001","DOIUrl":"10.1016/j.jtos.2025.09.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify clinical characteristics that predict vision-related quality of life (QoL) in patients with fungal keratitis three months after treatment.</div></div><div><h3>Methods</h3><div>Patients with fungal keratitis enrolled in the Cross-Linking Assisted Infection Reduction trial were treated with topical natamycin 5 % or amphotericin 0.15 %, with or without adjuvant corneal cross-linking (CXL). Demographic data, ulcer characteristics, clinical course, and responses to the Indian Visual Function Questionnaire (IND-VFQ) were collected at baseline and follow-up. Logistic regression models were used to assess factors associated with patient-reported vision-related QoL at three months. Analyses included the average IND-VFQ score as well as Rasch-derived subscale scores for vision-specific mobility, activity limitation, psychosocial impact, and visual symptoms.</div></div><div><h3>Results</h3><div>Of 111 participants enrolled, 86 had complete data at both timepoints. Multivariable models identified baseline IND-VFQ score, scar size, and presence of hypopyon as significant predictors of 3-month IND-VFQ scores. A 1-point change in best spectacle corrected visual acuity is correlated with a 13.4-point change in the opposite direction in average IND-VFQ (P=0.001). Patients with adverse events requiring surgery had lower 3-month IND-VFQ scores than those managed medically (P=0.001). Ulcer characteristics including location, depth, symptom duration, repeat culture positivity, organism type, and fungal genus were not associated with final IND-VFQ scores.</div></div><div><h3>Conclusions</h3><div>Vision-related QoL after fungal keratitis is significantly influenced by change in visual acuity, need for surgical intervention, and select baseline factors including scar size, initial IND-VFQ score, and presence of hypopyon. Vision-related QoL did not differ by antifungal treatment or adjuvant CXL use.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 319-323"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor regarding “Corneal sensory nerve regulation of tear production through stimulation of transient receptor potential melastatin 8 (TRPM8) channel: A potential new approach for treating dry eye disease”","authors":"Parth Aphale,&nbsp;Shashank Dokania,&nbsp;Himanshu Shekhar","doi":"10.1016/j.jtos.2025.09.002","DOIUrl":"10.1016/j.jtos.2025.09.002","url":null,"abstract":"","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Page 318"},"PeriodicalIF":5.6,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Downregulation of the core circadian gene Nr1d2 in the lacrimal gland contributes to postoperative dry eye disease by impairing lipid metabolism","authors":"Shiji Liu ,&nbsp;Yuke Huang ,&nbsp;Xi Chen ,&nbsp;Huanhuan Ren,&nbsp;Jiaxin Chen,&nbsp;Qingqing Mu,&nbsp;Jiejie Zhuang,&nbsp;Yan Li,&nbsp;Jin Qiu,&nbsp;Keming Yu,&nbsp;Jing Zhuang","doi":"10.1016/j.jtos.2025.08.009","DOIUrl":"10.1016/j.jtos.2025.08.009","url":null,"abstract":"<div><h3>Purpose</h3><div>Dry eye disease (DED) is a prevalent complication after refractive surgery, and its underlying mechanisms are not fully understood. Given that circadian rhythm tightly regulates tear secretion, this study aims to investigate the circadian changes in the lacrimal gland after corneal refractive surgery and the associated mechanisms.</div></div><div><h3>Methods</h3><div>C57/BL6 mice underwent corneal epithelial abrasion and stromal severing. DED was assessed using phenol red thread and fluorescein staining. RNA sequencing identified differentially expressed genes (DEGs) related to circadian rhythm, validated by RT-qPCR and Western blotting. Immunofluorescence, TUNEL staining, untargeted metabolomics, Oil-Red-O staining, and TEM were performed to analyze the lacrimal gland changes. Clinically, DED symptoms were evaluated using the OSDI questionnaire in 867 post-surgical patients and 705 controls.</div></div><div><h3>Results</h3><div>Corneal epithelial abrasion and stromal severing induced DED symptoms and lacrimal dysfunction, including reduced tear volume, ocular surface inflammation, and lacrimal pathophysiological changes. Nr1d2, the key circadian rhythm gene, was significantly down-regulated in the lacrimal gland compared to the control. Activation of Nr1d2 with SR9011 restored the lacrimal gland function and alleviated DED symptoms. Furthermore, the down-regulation of Nr1d2 significantly impaired lipid metabolism and mitochondrial function in the lacrimal gland, which SR9011 reversed. Clinically, the incidence of DED was markedly higher in the surgical cohort, with symptom occurrence exhibiting diurnal variation and peaking in the early morning and late evening.</div></div><div><h3>Conclusions</h3><div>Disruption of circadian rhythms, specifically Nr1d2 downregulation, contributes to post-surgical DED. Targeting Nr1d2 may offer a novel therapeutic approach to restore lacrimal gland function and alleviate DED.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 290-301"},"PeriodicalIF":5.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L009 peptide as a novel antiangiogenic agent for corneal neovascularization via regulation of the TNFSF15-VEGF axis","authors":"Ke Yan ,&nbsp;Yiran Yang ,&nbsp;Yi Han ,&nbsp;Yuhan Zhang ,&nbsp;Tong Zhou ,&nbsp;Wenxin Sun ,&nbsp;Ruochen Wang ,&nbsp;Zhaolin Liu ,&nbsp;Qinghe Zhang ,&nbsp;Linfangzi Zhu ,&nbsp;Meidi Tan ,&nbsp;Caihong Huang ,&nbsp;Jiaoyue Hu ,&nbsp;Qiuping Liu ,&nbsp;Zhaoqiang Zhang ,&nbsp;Zuguo Liu","doi":"10.1016/j.jtos.2025.08.008","DOIUrl":"10.1016/j.jtos.2025.08.008","url":null,"abstract":"<div><div>Corneal neovascularization (CNV) is a leading cause of vision impairment, with existing therapeutic options offering limited efficacy. This study presents L009, a novel antiangiogenic agent derived from the Kringle 5 domain of human plasminogen, specifically a heptapeptide, designed to treat CNV. In preclinical models, L009 demonstrated substantial efficacy by markedly inhibiting endothelial cell proliferation and migration, reducing vascular permeability, and maintaining ocular safety. Mechanistically, L009 exerts its effects by upregulating tumor necrosis factor superfamily member 15 (TNFSF15), downregulating vascular endothelial growth factor receptor 2 (VEGFR2), and increasing the expression of soluble VEGFR1. These actions restore vascular homeostasis and enhance vascular stability through the upregulation of the tight junction protein VE-cadherin. By specifically targeting the TNFSF15-VEGF axis, L009 offers a distinctive therapeutic approach, differentiating it from conventional anti-VEGF therapies. Its dual action of anti-angiogenesis and promotion of vascular stability highlights its potential as a next-generation treatment for CNV. Further investigation into its long-term efficacy and potential for synergy with existing therapies is warranted.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 274-289"},"PeriodicalIF":5.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144914097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two models of the structures of the lamellae in human meibum and the tear film lipid layer, TFLL","authors":"P. Ewen King-Smith ,&nbsp;Carolyn G. Begley ,&nbsp;Richard J. Braun","doi":"10.1016/j.jtos.2025.08.006","DOIUrl":"10.1016/j.jtos.2025.08.006","url":null,"abstract":"<div><div>Two models of meibum and the TFLL are proposed. The first model is based on a reanalysis of x-ray studies which show the predominance of 11 nm thick lamellae above 30 °C, but below 30 °C, 5 nm thick lamellae predominate. By analogy to skin lipid, we denote these the long (LPP) and short period phase (SPP), respectively. In the model, the SPP lamellae are interdigitated bilayers of cholesteryl esters (CEs) oriented towards one surface and wax esters (WEs) oriented towards the other surface, with the long interdigitated CE and WE chains tilted. These lamellae are stacked with the same polarity, e.g., CE surface uppermost. At ocular surface temperature, the polarity of alternate layers is reversed, forming the LPP. This doubles the periodicity, but the tilt of the LPP long chains is reduced to render the periodicity more than twice the SPP. The model is consistent with changes in meibum near 30 °C found in calorimetry, viscoelasticity, infrared spectra, birefringence, reflectance, and high resolution images of meibum spread on saline. A secondary model explains the finding that most long saturated chains in CEs and WEs are branched. We propose a ‘bump and hollow’ model where a ‘bump’ is a branch on a WE chain fitting into a ‘hollow’, the linking oxygen atom in a neighboring CE chain; likewise, a bump on a CE chain fits a hollow on a WE chain. We aim to stimulate further development of lipid layer models, including the role of other molecules, to aid understanding of dry eye disease (DED).</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 251-259"},"PeriodicalIF":5.6,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IVCM image analysis for limbal stem cell deficiency: quantitative diagnostics of the corneal epithelium post-transplant recovery","authors":"Patrick Parkinson ,&nbsp;Irina Makarenko ,&nbsp;Oliver J. Baylis ,&nbsp;Gustavo S. Figueiredo ,&nbsp;Majlinda Lako ,&nbsp;Anvar Shukurov ,&nbsp;Francisco C. Figueiredo ,&nbsp;Laura E. Wadkin","doi":"10.1016/j.jtos.2025.08.005","DOIUrl":"10.1016/j.jtos.2025.08.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Limbal stem cell deficiency (LSCD), a sight-threatening condition, is caused by dysfunction of the limbal stem cells (LSCs) which maintain the corneal epithelium. An effective treatment of LSCD is the transplantation of <em>ex-vivo</em> cultured LSCs from the patient's healthy other eye (in unilateral cases) or a donor eye (in bilateral cases) to the affected eye. Here we identify and quantify diagnostic and monitoring criteria for the recovery of the corneal epithelium post-LSC transplant using cellular images.</div></div><div><h3>Methods</h3><div>We consider the <em>in-vivo</em> confocal microscopy (IVCM) images from 10 patients with total unilateral LSCD caused by chemical burns, taken before and after LSC transplant. Images encompass the entire thickness of the corneal epithelium in the central and four peripheral regions. Approximately 1500 images were segmented using a bespoke algorithm to extract morphological data for analysis.</div></div><div><h3>Results</h3><div>The probability density of cell areas is shown to be a sensitive monitoring tool of corneal epithelial status. After a successful operation the distribution of cell areas is rather flat, reflecting an anomalously wide range of cell areas. As the cornea recovers, the distribution narrows with high statistical confidence and approaches that of the healthy cornea. We find a strong patient-to-patient variability in the epithelial cell area distribution and its variation with corneal depth. The corneal epithelial cell shape is independent of the cornea status despite a widespread expectation that healthy cells are roughly hexagonal.</div></div><div><h3>Conclusion</h3><div>Cell area is a sensitive and easily accessible marker of corneal epithelial recovery in LSCD patients post-LSC transplant.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 266-273"},"PeriodicalIF":5.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic burden of keratitis patients with inpatient care: a nationwide, multicenter registry study","authors":"He Xie ,&nbsp;Hai Liu ,&nbsp;Chenxi Wang ,&nbsp;Kexin Tang ,&nbsp;Qinxiang Zheng ,&nbsp;Kaisheng Wang ,&nbsp;Baihua Chen ,&nbsp;He Dong ,&nbsp;Feng Wen ,&nbsp;Tao Sun ,&nbsp;Jizhong Yang ,&nbsp;Yanning Yang ,&nbsp;Limin Chen ,&nbsp;Zhirong Liu ,&nbsp;Shaozhen Zhao ,&nbsp;Wei Qiang ,&nbsp;Qi Xie ,&nbsp;Yuping Han ,&nbsp;Linying Huang ,&nbsp;Man Yu ,&nbsp;Wei Chen","doi":"10.1016/j.jtos.2025.08.007","DOIUrl":"10.1016/j.jtos.2025.08.007","url":null,"abstract":"","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 262-265"},"PeriodicalIF":5.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pipeline: Patient, physician and developer view of drugs vs. devices","authors":"Gary D. Novack","doi":"10.1016/j.jtos.2025.08.004","DOIUrl":"10.1016/j.jtos.2025.08.004","url":null,"abstract":"","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 260-261"},"PeriodicalIF":5.6,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical recommendations for the management of Pythium insidiosum keratitis","authors":"Bhupesh Bagga ,&nbsp;Lakshminarayanan Gowtham ,&nbsp;Ali R. Djalilian ,&nbsp;Savitri Sharma","doi":"10.1016/j.jtos.2025.08.003","DOIUrl":"10.1016/j.jtos.2025.08.003","url":null,"abstract":"<div><div><em>Pythium insidiosum</em> has emerged as a challenging cause of keratitis in recent decades, due to its unique microbiological and clinical features, often is mistaken for fungal keratitis. Anti-fungal therapies have proven ineffective due to the organism's distinct cellular structure. Based on <em>in vitro</em> and <em>in vivo</em> models there has been a shift towards the use of antibacterial agents like linezolid and azithromycin, which have shown promising results. This concise review provides an update on the recommended diagnostic techniques and management strategies to assist clinicians in navigating this complex disease landscape.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 242-250"},"PeriodicalIF":5.6,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}