Clinical and Experimental Ophthalmology最新文献

{"title":"Predictive Correction Model for Corneal Back Surface Astigmatism With IOLMaster700 Keratometry Data in a Cataractous Population.","authors":"Achim Langenbucher, Peter Hoffmann, Alan Cayless, Nóra Szentmáry, Kamran Riaz, Damien Gatinel, Oliver Findl, Seth Pantanelli, Tun Kuan Yeo, Giacomo Savini, Jascha Wendelstein","doi":"10.1111/ceo.70009","DOIUrl":"https://doi.org/10.1111/ceo.70009","url":null,"abstract":"<p><strong>Background: </strong>To develop and validate various models to predict total keratometry (TK) power vector components TKC0 and TKC45 from classical keratometry (K) KC0 and KC45 based on a large dataset of pre cataract surgery IOLMaster 700 measurements.</p><p><strong>Methods: </strong>Retrospective cross-sectional multicentric study evaluating a dataset containing 13 6378 IOLMaster 700 measurements including K and TK. Left eyes were mirrored about the facial axis. Based on 80% training data, we developed a global and segmented constant model (CM and CMS), a global and segmented (according to the angle A1 of the flat keratometric meridian) linear model (LM and LMS), a harmonic model (HM) and compared these to a classical constant (CMR) and linear models (LMR) segmented into with-the-rule, against-the-rule and oblique astigmatism. The performance was cross-validated using the root-mean-squared model fit error (RMSE).</p><p><strong>Results: </strong>In the 20% test data, RMSE was 0.173 D before correction and was reduced by 40%-42% to 0.100 and 0.104 D with the correction models. The segmented models performed slightly better than the global models, and the linear models performed slightly better than the constant models. With the individually adjusted changepoints, the CMS and LMS performed slightly better than the reference models CMR and LMR. There was no systematic difference between the RMSE with training and test data, indicating no overfit of the models.</p><p><strong>Conclusion: </strong>As the performance is quite similar for all tested correction models, we recommend using a simple global constant model to predict TK vector components. This could easily be implemented in any consumer software.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369233","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":"Tattoo-Associated Uveitis: An Emerging Eye Health Challenge.","authors":"Ezann Siebert, Verity Moynihan, Noha Ali, Anthony Hall, Peter Heydon, Anthony Dunlop, Lyndell L Lim, Josephine Richards","doi":"10.1111/ceo.70012","DOIUrl":"https://doi.org/10.1111/ceo.70012","url":null,"abstract":"<p><strong>Background: </strong>Tattoo-associated uveitis is a potentially sight-threatening condition driven by a presumed immune reaction to tattoo ink. Case numbers may be rising as tattooing becomes more popular. Australian uveitis specialists collaborated to collect cases and better define this entity and its implications.</p><p><strong>Methods: </strong>Multicentre retrospective case review of collaborating uveitis specialists from January 2023 to January 2025. Following literature review, patients were recruited from public and private practices in Australian cities. Demographic information, clinical findings, investigations, treatment and disease course were collected.</p><p><strong>Results: </strong>The majority of affected individuals (21/40, 52.5%) were young adults of Caucasian or European ethnicity (28/40, 70%) with a predominance of bilateral (38/40, 95%) and anterior (28/40, 70%) uveitis. Inflammation within tattoos was present in all cases, most commonly associated with black ink. Systemic treatment was needed in 27/40 (67.5%) of whom 25/40 (62.5%) required steroid-sparing immunosuppression, most commonly methotrexate. Biological DMARDs were required in 17/40 (42.5%). Only 10 (25%) patients were adequately treated with topical treatment alone and just 11/40 (27.5%) had enduring remission off treatment during the reporting period. Complications included cataracts, cystoid macular oedema, and glaucoma. Only 3 patients had no visual loss during the course of their care.</p><p><strong>Conclusions: </strong>Forty cases of tattoo-associated uveitis were identified, indicating that this previously rare condition has become a regular entity in Australian uveitis clinics in a population where 25% of people have tattoos. Vision was commonly affected, and 63% required long-term immunosuppression, including with biological DMARDs in 42%, making this a public eye health issue of concern.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350238","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":"FLVCR1 Deficiency Impairs Mitochondrial Homeostasis in Retinal Degeneration: Choline as a Potential Therapy.","authors":"Yi Wang, Hongjing Li, Yingjie Gao, Qianxiong He, Jinrui Cai, Rong Zou, Xianjun Zhu, Lin Zhang","doi":"10.1111/ceo.70014","DOIUrl":"https://doi.org/10.1111/ceo.70014","url":null,"abstract":"<p><strong>Background: </strong>The Feline Leukaemia Virus Subgroup C Receptor 1 (FLVCR1) has been recognized as a heme exporter essential for erythropoiesis, and emerging research identifies its novel function as a choline transporter. Mutations in FLVCR1 have been associated with the pathogenesis of retinitis pigmentosa (RP); however, the roles of FLVCR1 in retina remain unexplored. This study aims to elucidate the connection between FLVCR1 and RP and investigate potential therapeutic interventions.</p><p><strong>Methods: </strong>Utilizing CRISPR/Cas9 technology, we established retina-specific Flvcr1 knockout (SKO) and rod-specific Flvcr1 knockout (RKO) mouse models to investigate the in vivo functions of FLVCR1 in the retina. We performed optical coherence tomography (OCT) to assess the retinal thickness, electroretinography (ERG) to test the retinal function and histopathological sections and staining to analyse the pathological changes. Additionally, we administered choline supplementation treatment (CST) to evaluate its potential efficacy in alleviating symptoms of retinal degeneration.</p><p><strong>Results: </strong>Genotyping and immunoblotting analyses confirmed the successful establishment of the SKO and RKO mouse models. Retinal degeneration in SKO mice manifested at postnatal day 14, while its onset in RKO mice occurred at P25, including diminished scotopic electroretinogram (ERG) responses, progressive degeneration of photoreceptor cells, infiltration of microglia into the outer nuclear layer (ONL) and disruption of mitochondrial homeostasis. Notably, we found that choline supplementation in RKO mice alleviated the associated phenotypes.</p><p><strong>Conclusions: </strong>We developed two innovative mouse models and revealed that FLVCR1 is critical for maintaining mitochondrial homeostasis and supporting photoreceptor survival. Choline supplementation serves as a therapeutic intervention for RP caused by FLVCR1 mutations.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350235","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":"Re-Thinking Wound Healing in Glaucoma Surgery: The Promise of Targeted Antifibrotics.","authors":"Geoffrey Zhi Peng Chan","doi":"10.1111/ceo.70006","DOIUrl":"https://doi.org/10.1111/ceo.70006","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350182","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":"Repeat Intraocular Sampling and Microbiological Testing in Infectious Endophthalmitis: A 27-Year Prospective Observational Study at an Australian Statewide Tertiary Referral Centre.","authors":"Pravena Kumaran, Maedbh Rhatigan, Zelia Chiu, Jasmine Lichtenstein, Penelope J Allen, Rosie C H Dawkins","doi":"10.1111/ceo.70003","DOIUrl":"https://doi.org/10.1111/ceo.70003","url":null,"abstract":"<p><strong>Background: </strong>Endophthalmitis requiring multiple ocular tissue sampling for microbiological testing is uncommon and has not been previously studied. This study aims to analyse cases with at least two ocular tissue samplings and testing of different ocular samples against culture yields.</p><p><strong>Methods: </strong>A 27-year prospective observational study using data from the Victorian Endophthalmitis Registry, managed through the REDCap data platform. The study included 314 patients (317 eyes) who underwent at least two aqueous or vitreous specimen collections. The primary outcome measures included microbiological culture results from repeat and multiple intraocular samples and identification of isolated microorganisms.</p><p><strong>Results: </strong>The overall initial culture positivity rate was 75.7%, while the culture positivity rate at the second intervention was 34.7%. First vitreous taps had the highest culture yield (72.6%) among different sample types. Notably, 19.5% of eyes with initial negative vitreous cultures had subsequent positive results. Further analysis showed that 24.4% of eyes with initial negative vitreous cultures had corresponding positive aqueous cultures. Additionally, 12.2% of eyes with negative initial vitreous taps yielded positive cultures from vitreous biopsies or washings from vitrectomy. Staphylococcus and Streptococcus species were the main pathogens isolated (40.4% and 31.3% of cases respectively).</p><p><strong>Conclusions: </strong>Our study demonstrated the trends and utility of repeated and different ocular tissue sampling in challenging endophthalmitis. Aqueous taps are most useful at the first biopsy, beyond which it has little diagnostic value. A second sampling can be valuable in patients who are initially culture-negative. Surgical specimens contribute meaningfully to the overall culture yield and enhance cumulative culture positivity.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304415","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":"Unveiling Endothelial Cell Expression Profiles in FEVR: Identification of Key Genes Associated With Pathological Neovascularisation in a FZD4^M105V Mouse Model.","authors":"Huijuan Xu, Yunqi He, Xianjun Zhu, Rulian Zhao, Lin Zhang, Zhenglin Yang","doi":"10.1111/ceo.70011","DOIUrl":"https://doi.org/10.1111/ceo.70011","url":null,"abstract":"<p><strong>Background: </strong>Familial exudative vitreoretinopathy (FEVR) is a disorder of retinal blood vessel development characterised by impaired retinal angiogenesis. While FZD4 mutations are established genetic causes of FEVR, the molecular mechanisms underlying pathological neovascularisation remain poorly understood.</p><p><strong>Methods: </strong>CRISPR/Cas9 was used to generate the Fzd4^M105V mouse model. Comprehensive vascular phenotyping entailed retinal wholemount imaging, analysis of hyaloid vessel regression and immunohistochemical evaluation of the deep retinal vasculature. Flow cytometry sorting and single-cell RNA sequencing (scRNA-seq) were used to characterise the expression profiles of retinal endothelial cells (ECs) in mice.</p><p><strong>Results: </strong>The FZD4^M105V model recapitulated key FEVR features including retinal aneurysmal vessels in adult mice, developmental abnormalities in juveniles, impaired deep vascular formation, delayed hyaloid regression, vascular leakage and reduced endothelial proliferation. ScRNA-seq revealed distinct transcriptional profiles in pathological EC clusters and tip cells. KEGG analysis revealed that the EC clusters were enriched in focal adhesion, Rap1, PI3K-Akt and apelin signalling pathways, whereas tip cells were enriched in the VEGF, chemokine, NF-κB and TNF signalling pathways. We further identified four novel candidate markers of pathological neovascularisation: Ctss, Ccl4, Ccl3 and Apoe. Subsequent validation confirmed the upregulation of CTSS and CCL4 within neovascular lesions, supporting their functional role in pathological angiogenesis.</p><p><strong>Conclusions: </strong>We established a novel mouse model of pathological neovascularisation with a missense mutation and elucidated the expression profiles of retinal ECs. The identified pathways and novel biomarkers-particularly CTSS and CCL4-provide new insights for further pathogenesis investigation of FEVR.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310088","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":"Continuing Professional Development","authors":"","doi":"10.1111/ceo.14603","DOIUrl":"https://doi.org/10.1111/ceo.14603","url":null,"abstract":"<p>RANZCO Fellows can claim CPD points by reading the following two articles which appear in this issue, and answering the five questions. Half an hour is awarded for each set of five questions answered. Please remember to claim your points.</p><p>\u0000 <b>Answers to questions published in previous issue</b>\u0000 </p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 7","pages":"884-887"},"PeriodicalIF":5.6,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ceo.14603","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272978","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":"Real-World Adoption of Artificial Intelligence in Diabetic Retinopathy Screening: What Is the Current Status?","authors":"Paul Nderitu,&nbsp;Pearse A. Keane","doi":"10.1111/ceo.14605","DOIUrl":"https://doi.org/10.1111/ceo.14605","url":null,"abstract":"&lt;p&gt;The prevalence of diabetes is projected to reach 783 million individuals by 2045 [&lt;span&gt;1&lt;/span&gt;]. This rise will inevitably lead to a substantial increase in the prevalence of diabetic retinopathy (DR), which affects ~30% to 40% of people with diabetes and progresses to sight-threatening disease in 10% [&lt;span&gt;2&lt;/span&gt;]. Timely screening reduces DR-related sight loss and has contributed to a decline in certifiable blindness in the United Kingdom, which has a national DR screening programme [&lt;span&gt;3&lt;/span&gt;]. Despite the benefits of screening and the rising global burden of DR, an estimated 80% of people with diabetes worldwide lack access to regular screening [&lt;span&gt;2&lt;/span&gt;]. This gap is particularly pronounced in low and middle-income countries (LMICs), where resource constraints and personnel shortages hinder the establishment and maintenance of effective DR screening programmes [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Artificial intelligence (AI) has emerged as a promising tool for automating DR grading, offering the potential to efficiently scale DR screening and alleviate a reliance on human graders. IDx-DR (Luminetics Core) was the first autonomous AI system in medicine to receive Food and Drug Administration (FDA) authorisation in 2018 for more-than-mild DR detection [&lt;span&gt;4&lt;/span&gt;]. Deep learning-based AI systems have consistently demonstrated high diagnostic accuracy for referable DR detection in numerous retrospective and prospective validation studies [&lt;span&gt;4&lt;/span&gt;]. AI systems are continually advancing, with Daley et al., in this issue of &lt;i&gt;Clinical and Experimental Ophthalmology&lt;/i&gt; (CEO), describing the development of a dual-modality system which uses fundus photographs and optical coherence tomography scans [&lt;span&gt;5&lt;/span&gt;]. In addition to accuracy, AI systems have demonstrated cost-effectiveness, enhanced clinical workflow efficiency and improved screening completion rates [&lt;span&gt;6, 7&lt;/span&gt;]. Reflecting this progress, a recent review identified multiple approved AI systems for DR detection in the United States (3), European Union (21), United Kingdom (7) and Australia (8), collectively representing over half of all approved ophthalmic image analysis AI systems [&lt;span&gt;8&lt;/span&gt;]. However, despite these regulatory achievements and promising validation data, the implementation of AI in clinical settings remains limited relative to the vast at-risk population.&lt;/p&gt;&lt;p&gt;In the United States, FDA-approved AI systems for DR screening have been deployed in primary care and diagnostic centres, with billing records indicating over 15 000 uses between 2018 and 2021 [&lt;span&gt;9&lt;/span&gt;]. Deployment has predominantly occurred in higher-income urban areas associated with academic institutions [&lt;span&gt;9&lt;/span&gt;]. The growth of AI-based DR screening in the United States has been modest, increasing by 1% between 2021 and 2023 compared to 185% for traditional fundus imaging used for DR screening in the same period [&lt;span&gt;10&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In Singapore, the SELENA+ AI","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 7","pages":"741-743"},"PeriodicalIF":5.6,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ceo.14605","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272975","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":"Inherited Retinal Disease or Age-Related Macular Degeneration: Predictive Value of Genetic Testing in Macular Disease With Atypical Atrophy.","authors":"Alexis Ceecee Britten-Jones, Fred K Chen, Heather G Mack, Maria Kolic, Janise Hermawan, Doron G Hickey, Thomas L Edwards, Lauren N Ayton, Robyn H Guymer, Carla J Abbott","doi":"10.1111/ceo.70008","DOIUrl":"https://doi.org/10.1111/ceo.70008","url":null,"abstract":"<p><strong>Background: </strong>Both age-related macular degeneration (AMD) and inherited retinal disease (IRD) can present with outer retinal atrophy at the macula. Distinguishing between IRD and geographic atrophy (GA) secondary to AMD is important for appropriate management, particularly as disease-specific treatments become available. This study investigates the utility of genetic testing for suspected IRDs in individuals with atypical macular atrophy.</p><p><strong>Methods: </strong>Twenty-four participants aged over 50, presenting with macular atrophy atypical for AMD, underwent clinical assessments, multimodal retinal imaging and exome-based sequencing covering known IRD genes. Three retinal ophthalmologists reviewed genetic and clinical data to reach a consensus for the underlying cause of macular atrophy and identified a set of features that challenge an AMD diagnosis and suggest a higher likelihood of an IRD.</p><p><strong>Results: </strong>The panel judged 58% of atypical atrophy cases as likely being an IRD. Of these suspected cases, 57% (33% of the entire cohort) received IRD genetic confirmation (PRPH2, ABCA4 or MT-TL1 [m.3243A>G]-related IRD). The remaining cases were classified as GA (29%) or did not reach consensus on the likely diagnosis (13%). Clinical features aiding in the differentiation of IRD from GA included symptom onset before age 50, family history, distinctive autofluorescence patterns (speckled, reticular or widespread), extensive atrophy and absence of subretinal drusen.</p><p><strong>Conclusion: </strong>IRD genetic testing is valuable if a positive identification is achieved, but negative results neither rule out IRD nor confirm AMD. Limitations in our ability to robustly differentiate IRD-related atrophy from GA, especially in advanced lesions, need further research to improve diagnostic accuracy.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287766","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":"A Chat About Peer Review.","authors":"Justine R Smith, Syed B Ali, Binoy Appukuttan, Stewart R Lake","doi":"10.1111/ceo.70007","DOIUrl":"https://doi.org/10.1111/ceo.70007","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281735","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}