{"title":"Reproducibility in the identification of retinal positions on serial fundus photographs: Theory and limitations.","authors":"Toke Bek, Giovanni Ometto","doi":"10.1111/aos.17566","DOIUrl":"https://doi.org/10.1111/aos.17566","url":null,"abstract":"<p><strong>Background: </strong>Imaging of the retina is accompanied by distortions so that positions in fundus photographs cannot be linearly translated to positions in the retinal fundus. The purpose of this study was to describe an algorithm and evaluate its reproducibility in identifying points on the retina from their representation on serial fundus photographs.</p><p><strong>Methods: </strong>A mathematical formalism was derived to describe how the location of the fovea and the optic disc in fundus photographs, together with the centre-nodal point distance (d) and the curvature radius (r) of the eye, can be used to calculate spatial coordinates on the retina that correspond to given locations in the photograph. The effect of manual markings of the fovea and the optic disc as reference points was evaluated, and the formalism was tested on 105 photographs recorded with different image modalities and centring from 10 different patients.</p><p><strong>Results: </strong>Retinal locations could be identified in serial fundus photographs with a reproducibility of at least 50 μm when the centre-nodal point distance and the curvature radius were set to those in Gullstrand's standard eye. A main source of the variability was the manual identification of the fovea and optic disc used as reference points.</p><p><strong>Conclusions: </strong>The reproducibility in the identification of locations on the retina from serial fundus photographs depends on the accuracy in the definition of the fovea and optic disc used as reference points. This affects the potential for describing locations, distances, areas and changes in retinal lesions on serial photographs over time.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Chiara Gelmi, Gulçin Gezgin, Ellen Kapiteijn, T H Khanh Vu, Martine J Jager, Robert M Verdijk
{"title":"Tumour progression shows decrease in PD-L1 expression in matched metastases/primary uveal melanomas.","authors":"Maria Chiara Gelmi, Gulçin Gezgin, Ellen Kapiteijn, T H Khanh Vu, Martine J Jager, Robert M Verdijk","doi":"10.1111/aos.17559","DOIUrl":"https://doi.org/10.1111/aos.17559","url":null,"abstract":"<p><strong>Purpose: </strong>Immune checkpoint inhibitors (ICI) have revolutionised the treatment of several malignancies. However, the results of ICI therapy remain unsatisfactory in metastatic uveal melanoma (UM). We analysed the expression of PD1, PD-L1, T-cell and macrophage markers in a set of matched primary and metastatic UM in an attempt to better understand the low effectiveness of ICI in metastatic UM.</p><p><strong>Methods: </strong>Thirty-two samples (19 metastases and 13 primary UM) were stained for PD-L1, PD1, CD3, CD4, CD8, CD68, CD163, HLA class I and BAP1. T-cell markers were scored quantitatively, while PD-L1, CD68, CD163 and BAP1 were scored semiquantitatively. The immunohistochemical (IHC) scores were compared between all primary and metastatic UM samples and between matched cases.</p><p><strong>Results: </strong>Both the general and the matched analyses revealed that the IHC scores for PD-L1 expression on tumour cells were lower in metastatic UM than in primary UM. Conversely, T-cell markers, including PD1, were significantly higher in UM metastases than primary UM, while macrophages did not show a difference. Metastases with a low HLA Class I expression lacked PD-L1 and PD1 expression. BAP-1 loss was associated with increased lymphocytic infiltration.</p><p><strong>Conclusions: </strong>While UM metastases had higher lymphocytic infiltrates than primary UM, PD-L1 showed a lower expression in metastases. We believe that the low effectiveness of ICI in the treatment of metastatic UM may be partly explained by the low PD-L1 expression. We propose that primary tumours may be more responsive to ICI therapy than metastases and could be targeted in a (neo)adjuvant setting for patients at high risk of developing metastases.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H Burkhard Dick, Ronald D Gerste, Sorcha Ní Dhubhghaill
{"title":"A brief history of keratoplasty.","authors":"H Burkhard Dick, Ronald D Gerste, Sorcha Ní Dhubhghaill","doi":"10.1111/aos.17567","DOIUrl":"https://doi.org/10.1111/aos.17567","url":null,"abstract":"<p><p>The first successful corneal transplantation, performed by Eduard Zirm in 1905, marked a turning point in treating corneal blindness. This breakthrough was preceded by centuries of conceptual development, dating back to Galen's theoretical approach to corneal transparency restoration in ancient Rome. Erasmus Darwin later proposed corneal trephination in the 18th century, though without practical implementation. The 19th century saw a surge in experimental keratoplasty, with Karl Himley suggesting cross-species corneal transplants and Franz Reisinger coining the term 'keratoplasty'. Johann Dieffenbach and Samuel Bigger further explored transplantation in animal models. Arthur von Hippel's innovations in trephination laid the foundation for Zirm's success, who performed the first human-to-human corneal transplant using strict aseptic techniques. Subsequent advancements, including the establishment of eye banks, immunosuppressive therapies and modern lamellar keratoplasty techniques like DSAEK and DMEK, have significantly improved graft survival and visual outcomes. This historical perspective highlights the continuous evolution of corneal transplantation, underscoring the contributions of numerous pioneers whose innovations have shaped modern ophthalmology.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sanna Leinonen, Hanna-Mari Mäkelä, Chi Li, Leopold Schmetterer, Jacqueline Chua
{"title":"Unilateral optic neuritis and thinning of retinal layers in the affected and unaffected eyes.","authors":"Sanna Leinonen, Hanna-Mari Mäkelä, Chi Li, Leopold Schmetterer, Jacqueline Chua","doi":"10.1111/aos.17552","DOIUrl":"https://doi.org/10.1111/aos.17552","url":null,"abstract":"<p><strong>Purpose: </strong>Multiple sclerosis (MS)-related optic neuritis (ON) causes thinning of inner retinal layers. It remains unclear whether unilateral MSON also affects the unaffected contralateral eye. The purpose of this study was to compare macular retinal layer thicknesses in MS eyes with unilateral optic neuritis (MSON), their unaffected contralateral eyes and MS participants without a history of ON (MSnON).</p><p><strong>Methods: </strong>This cross-sectional screening study included 101 MSON and 106 MSnON participants. Retinal layer thicknesses were measured using optical coherence tomography scans at the standardized zones of the macula (central circle, inner ring and outer ring) and compared between the groups.</p><p><strong>Results: </strong>The unaffected contralateral non-ON eyes of MSON participants had thinner inner retinal layers including a thinner retinal nerve fibre layer (p values, 0.003-0.009), a thinner ganglion cell layer (p values, <0.001-0.006) and a thinner inner plexiform layer (p values, 0.004-0.012) compared to MS participants without a history of ON. Affected MSON eyes had thinner inner retinal layers compared to both unaffected fellow eyes and to MSnON participants (p < 0.001 for all comparisons). Additionally, in MSON eyes, the inner nuclear layer and outer retina were thicker at the inner and outer rings compared to contralateral eyes (p < 0.001 for all comparisons), but not when compared to the MSnON participants.</p><p><strong>Conclusion: </strong>We recommend bilateral examination, OCT imaging and follow-up for MS patients with unilateral acute ON to monitor also the contralateral eyes, which present with thinner inner retina layers than MSnON participants' eyes.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Iswariyaraja Sridevi Gurubaran, Ali Koskela, Hanna Heloterä, Kai Kaarniranta
{"title":"Secretory autophagy and epithelial-to-mesenchymal transition in cadaveric AMD samples: Novel pathways in disease progression.","authors":"Iswariyaraja Sridevi Gurubaran, Ali Koskela, Hanna Heloterä, Kai Kaarniranta","doi":"10.1111/aos.17558","DOIUrl":"https://doi.org/10.1111/aos.17558","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the presence of secretory autophagy and epithelial-mesenchymal transition (EMT) in the macular retinal pigment epithelium (RPE) of human cadaver eyes with different forms of age-related macular degeneration (AMD).</p><p><strong>Methods: </strong>Human cadaver macula samples representing dry and wet AMD, as well as age-matched controls, were analyzed using immunohistochemistry. Markers of secretory autophagy, EMT, and inflammation were evaluated in RPE cells.</p><p><strong>Results: </strong>Increased expression of proteins associated with secretory autophagy and EMT was detected in the RPE of AMD samples compared to controls. These changes were observed in both dry and wet AMD forms.</p><p><strong>Conclusion: </strong>Secretory autophagy and EMT are elevated in the macular RPE of AMD-affected eyes. These observations offer novel insight into AMD progression and potential therapeutic approaches.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juan Arbelaez, Robert Herber, Jorge L Alio Del Barrio, Maria C Arbelaez, Paolo Vinciguerra, Frederik Raeiskup, Alex Gonzales, Riccardo Vinciguerra
{"title":"Assessment of measurement repeatability by keratoconus severity using an OCT and Placido-based tomographer.","authors":"Juan Arbelaez, Robert Herber, Jorge L Alio Del Barrio, Maria C Arbelaez, Paolo Vinciguerra, Frederik Raeiskup, Alex Gonzales, Riccardo Vinciguerra","doi":"10.1111/aos.17557","DOIUrl":"https://doi.org/10.1111/aos.17557","url":null,"abstract":"<p><strong>Purpose: </strong>Current criteria for assessing keratoconus progression rely heavily on Scheimpflug technology. However, this technology has demonstrated limitations in measurement repeatability, particularly in advanced keratoconus, and it applies a uniform standard across all disease stages. We aim to evaluate the repeatability of diagnostic indices for keratoconus screening using an anterior segment OCT coupled with Placido disc tomographer (MS-39) across different keratoconus stages to establish severity-based thresholds for progression.</p><p><strong>Design: </strong>Retrospective, multicentre cohort study.</p><p><strong>Methods: </strong>This retrospective study included 1103 eyes diagnosed with keratoconus, with three scans per eye acquired using the MS-39. The repeatability of curvature, elevation, and thickness indices was assessed using the coefficient of variation (CV%), confidence interval (CI), and coefficient of repeatability (CR). The study analysed the variability of these indices across different stages of keratoconus severity.</p><p><strong>Results: </strong>The MS-39 demonstrated high repeatability across most indices. Variability increased in advanced stages of keratoconus, particularly in posterior elevation and thickness parameters. For K flat and K steep, CR values remained below 1 D, with the highest CR for K flat being 0.53 up to a keratometry reading of 50 D, and for K steep being 0.74 up to a reading of 56 D. A thinnest point CR below 6 μm was observed for corneas up to 460 μm, while below 420 μm, the CR increased to 10.8 μm.</p><p><strong>Conclusion: </strong>OCT coupled with Placido disc tomographers offers an overall high repeatability of keratoconus diagnostic indices. Our findings allow us to establish new progression criteria tailored to the severity of the disease.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Changes in choroidal thickness and blood flow in myopic children with 0.01% atropine or orthokeratology and atropine combination therapy.","authors":"Saiko Matsumura, Takashi Itokawa, Momoko Kawakami, Tadashi Matsumoto, Hitoshi Ishikawa, Yuichi Hori","doi":"10.1111/aos.17537","DOIUrl":"https://doi.org/10.1111/aos.17537","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate changes in choroidal thickness (CT), choroidal blood flow and axial length (AL) after therapy with either 0.01% atropine eye drops (AT) or the combination of orthokeratology and 0.01% AT (OKA) among Japanese myopic children.</p><p><strong>Methods: </strong>We analysed changes in CT, choroidal blood flow and AL among myopic children who received either 0.01% AT or the OKA therapy at Toho University Omori Hospital from January 2021 through December 2022 (n = 38 eyes, 8.26 ± 2.13 years old in the 0.01% AT group and n = 44 eyes, 8.36 ± 1.54 years old in the OKA group). Comprehensive ophthalmologic examinations were performed at baseline, 3, 6 and 12 months.</p><p><strong>Results: </strong>Subfoveal CT increased in the OKA group more than that in the AT group at 3, 6 and 12 months. Choroidal blood flow increase was greater in the OKA group compared to that in the AT group at 6 and 12 months. AL increase was less in the OKA group than that in the AT group at 6 and 12 months. AL changes were negatively correlated with choroidal blood flow and CT changes at both time points. In multivariate analysis, age, male, CT change and choroidal blood flow were independently associated with AL changes at 12 months.</p><p><strong>Conclusion: </strong>The increase in CT was more pronounced in the combination therapy group compared to the AT group. The increase in CT and choroidal blood flow was associated with a reduced AL progression.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Raimo Tuuminen, Sohee Jeon, Byung Ju Jung, Kun Moon
{"title":"Prognostic factors for dysphotopsia and spectacle-independent visual function after implantation of non-diffractive extending focus intraocular lenses.","authors":"Raimo Tuuminen, Sohee Jeon, Byung Ju Jung, Kun Moon","doi":"10.1111/aos.17560","DOIUrl":"https://doi.org/10.1111/aos.17560","url":null,"abstract":"<p><strong>Background: </strong>Intraocular lenses (IOLs) employing extending focus and multifocality technologies are becoming increasingly popular in cataract and lens surgeries. However, research on the preoperative factors affecting subjective surgical outcomes remains elusive.</p><p><strong>Methods: </strong>188 emmetropic bilaterally operated patients were analysed. We compared the outcomes of non-diffractive enhanced monofocal Tecnis Eyhance (N = 86) and non-diffractive extended depth-of-focus AcrySof Vivity (N = 102) IOLs in terms of visual acuities, dysphotopsia (graded from 0 to 100) and spectacle-independent visual function index (VF)-14 questionnaire scores. Next, we analysed correlations between the baseline ocular parameters and refractive outcomes with the dysphotopsia and VF-14 scores. Multivariable linear regression analyses were adjusted for patient age, sex and IOL type.</p><p><strong>Results: </strong>Acrysof Vivity provided better uncorrected near (0.19 ± 0.12 vs. 0.27 ± 0.13 LogMAR units, p < 0.001) and uncorrected intermediate visual acuities (0.11 ± 0.10 vs. 0.15 ± 0.10 LogMAR units, p = 0.033), and better spectacle-independent VF-14 scores (93.2 ± 5.7 vs. 80.9 ± 12.2; p < 0.001), but higher glare scores (8.60 ± 17.2 vs. 2.16 ± 5.74; p = 0.035) compared to Tecnis Eyhance. Photopic (r = 0.283; B 9.39, 95% CI 4.66 to 14.1; p = 0.006) and mesopic pupil size (r = 0.263; B 6.35, 95% CI 2.91 to 9.79; p = 0.045) were associated with overall dysphotopsia scores. The axial length of the eye (r = -0.374; B -3.47, 95% CI -4.73 to -2.22; p < 0.001), total corneal irregular astigmatism (r = -0.388; B -27.3, 95% CI -39.2 to -15.5; p < 0.001), and corneal higher-order aberrations (r = -0.219; B -14.3, 95% CI -26.5 to -1.98; p = 0.023) inversely associated with VF-14 scores. Angles kappa and alpha were not associated with the levels of dysphotopsia or VF-14 scores.</p><p><strong>Conclusions: </strong>Patient-related factors, including corneal irregularity, pupil size and axial length of the eye, may explain the high patient-reported outcome measures variability after the implantation of non-diffractive extending focus IOLs.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J S Suwandi, B A van der Wel, E H C van Dijk, S S Manning, M Manzulli, P Geeraert, S van Romunde, K Faridpooya
{"title":"Internal closure of a posterior perforation using amniotic membrane: A novel surgical technique.","authors":"J S Suwandi, B A van der Wel, E H C van Dijk, S S Manning, M Manzulli, P Geeraert, S van Romunde, K Faridpooya","doi":"10.1111/aos.17562","DOIUrl":"https://doi.org/10.1111/aos.17562","url":null,"abstract":"","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}