Acta Ophthalmologica最新文献

{"title":"Imaging modalities in optic disc drusen: A literature review and proposed diagnostic algorithm.","authors":"Robin Van Compernolle, Sophie Lemmens, Catherine Cassiman","doi":"10.1111/aos.17530","DOIUrl":"https://doi.org/10.1111/aos.17530","url":null,"abstract":"<p><p>Optic disc drusen (ODD) concern highly prevalent anatomical features that are increasingly recognised as a risk factor for various pathological conditions. In clinical practice, differentiation between ODD and true papilloedema poses considerable challenges, often resulting in the effectuation of unnecessary, potentially invasive examinations. Furthermore, recent years have witnessed a notable expansion in imaging modalities employed to map ODD, primarily novel optical coherence tomography (OCT) modalities. A growing necessity arises for literature providing a profound comparison between most of the various available techniques, as well as furnishing clinicians with practical guidelines to manage a patient with suspected ODD. A comprehensive search of the current literature formed the foundation of this narrative review. We primarily focused on data from recent studies, each of which was thoroughly analysed and interpreted by all the authors. We formulate a straightforward diagnostic model to approach a patient with suspected ODD, wherein a primary distinction is made between patients with a high and low suspicion for papilloedema. Enhanced Depth Imaging OCT (EDI-OCT) emerges as the most potent modality and is thus recommended as the new gold standard technique. Fluorescein angiography exhibits excellent specificity and therefore proves useful to exclude papilloedema, although not with full certainty. Fundus autofluorescence and ultrasonography appear to be most beneficial for screening purposes and in a population with very low suspicion of papilloedema. This narrative review is the first to present a clinically relevant diagnostic model to discriminate between ODD and papilloedema, identifying EDI-OCT as the primary imaging modality in ODD diagnosis.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273925","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":"Consensus-based recommendations for indications and procedures in retinal laser treatment of Telangiectatic capillaries (TelCaps) in vascular macular oedema: A Delphi study.","authors":"Marie-Noëlle Delyfer, Jean-François Girmens, Corinne Dot, Mohamed Bennani, Marie-Benedicte Rougier, Stéphanie Baillif, Pascale Massin, Vincent Gualino, Michel Paques, Bénédicte Dupas","doi":"10.1111/aos.17535","DOIUrl":"https://doi.org/10.1111/aos.17535","url":null,"abstract":"<p><strong>Purpose: </strong>The identification of telangiectatic capillaries (TelCaps) in chronic macular oedema (ME) resistant to conventional intravitreal injections (IVIs) has renewed interest in focal laser treatment. However, the indications and modalities of this laser treatment remain to be clarified.</p><p><strong>Methods: </strong>A modified Delphi approach was used to establish a consensus among French macular laser specialists regarding recommendations on assessment of TelCaps, indications for laser treatment, treatment procedures and follow-up.</p><p><strong>Results: </strong>Presence of TelCaps should be considered in cases of recurrent vascular oedema that do not respond, or partially respond, to IVIs. A strong consensus has emerged on treating TelCaps with laser when they are located ≥1000 μm from the fovea and associated with thickening of the surrounding retina, usually in combination with IVIs. For TelCaps located <1000 μm from the centre, IVIs alone were preferred. ICG-guided laser treatment was advised to target TelCaps but was not considered mandatory if TelCaps were visible on fundus photography or OCT. Assessment of the effectiveness of laser treatment should be based on reduction in macular thickness on OCT after 3 months, before a second laser session may be considered. Although experts have recommended the use of small, short-duration impacts allowing greying of the lesion, no consensus has been reached on the optimal numerical parameters for the laser procedure.</p><p><strong>Conclusion: </strong>This study provides precise guidelines on laser treatment for vascular ME in cases of TelCaps, and emphasizes the need for standardized lesion selection and laser parameters to ensure safe and effective ME management.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257078","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":"Intravitreal anti-vascular endothelial growth factor injections and risks of stroke in patients with neovascular age-related macular degeneration-A registry-based cohort study.","authors":"A H Falemban, K Söderberg-Löfdal, F Jonsson, S Almlöf-Sarman, M von Euler, I Westborg","doi":"10.1111/aos.17534","DOIUrl":"https://doi.org/10.1111/aos.17534","url":null,"abstract":"<p><strong>Background: </strong>Intravitreal Anti-Vascular Endothelial Growth Factor (VEGF) rescues retinal vasculatures and prevents disease progression in patients with neovascular Age-Related Macular Degeneration (nAMD). However, systemic anti-VEGF may increase the risk of thromboembolic related complications including stroke and TIA. This study aims to explore the association between stroke and intravitreal anti-VEGF agents; ranibizumab, aflibercept and bevacizumab.</p><p><strong>Methods: </strong>This nationwide, population- registry-based case-control study used registered data 2007-2019. Data from the Swedish Stroke Registry (Riksstroke) and the Swedish Macula Register (SMR) were cross-linked to identify nAMD patients who developed stroke/TIA within 90 days after intravitreal anti-VEGF injection. Each stroke case was matched with three controls from Riksstroke with stroke/TIA but no anti-VEGF treatment.</p><p><strong>Results: </strong>A total of 33 585 patients with nAMD underwent intravitreal anti-VEGF agent injections. A stroke occurred in 1693 patients of this group, and 936 of them within 90 days of treatment. Compared with nonuse, intravitreal anti-VEGF agent use was associated with an increased risk of stroke within 90 days of anti-VEGF treatment in 2.9% of the nAMD-patients [Risk Ratio (RR) 1.27, 95% confidence interval (CI) 1.22; 1.33] compared to non-users. The RR within 30, 31-60 and 61-90 days were 1.36 (1.15; 1.66), 1.40 (1.09; 1.79) and 0.58 (0.52; 0.65), respectively.</p><p><strong>Conclusions: </strong>Even though the risk is small, intravitreal injections with anti-VEGF agents for the treatment of nAMD are associated with an increased risk of stroke/TIA. The risk seems to be higher within 60 days of last injection. An assessment of high-risk populations and risk-benefit weighting is necessary before intravitreal anti-VEGF injections are considered.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245663","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":"Quality of life and participation after corneal transplantation and potential predictors: A multicenter prospective cohort study.","authors":"E B M Elsman, D Van der Meij, H P A Van der Aa, N Santana, M C Bartels, M Zaal, Y Y Cheng, R M M A Nuijts, G H M B Van Rens, R M A Van Nispen","doi":"10.1111/aos.17529","DOIUrl":"https://doi.org/10.1111/aos.17529","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the long-term effect of corneal transplantation on health- and vision-related quality of life, visual functioning, and societal participation, and to assess potential predictors.</p><p><strong>Methods: </strong>We conducted a multicenter prospective cohort study in 11 Dutch hospitals and eye clinics. Patients awaiting corneal transplantation (n = 238) completed the Low Vision Quality of Life (LVQOL) questionnaire, Catquest-9SF, Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P), and EuroQol-5 Dimensions (EQ-5D) at baseline and 3, 6, 12, and 24 months post-transplantation. Potential predictors included sociodemographic and clinical characteristics. Linear mixed models analysed changes over time for most outcomes, and generalized estimating equations assessed EQ-5D outcomes.</p><p><strong>Results: </strong>LVQOL subscale scores improved significantly from baseline to 24 months, with large effect sizes (Basic aspects: 44.5 vs. 24.7, p < 0.001; Mobility: 36.0 vs. 18.7, p < 0.001; Adjustment: 24.1 vs. 9.5, p < 0.001; Reading and Fine work: 28.0 vs. 12.2, p < 0.001), as did Catquest scores (57.6 vs. 79.8, p < 0.001). USER-P Restrictions and Satisfaction improved (Restrictions: 83.6 vs. 88.0, p < 0.001; Satisfaction: 68.2 vs. 73.9, p < 0.001), while the Frequency subscale deteriorated (32.7 vs. 29.4, p < 0.001). Effect sizes were all small. The proportion with a perfect EQ-5D score increased (47.7% vs. 56.5%, p = 0.04). Male sex, having work, and Fuchs' dystrophy predicted better outcomes, whereas visual impairment and (dry) eye complaints predicted worse outcomes.</p><p><strong>Conclusion: </strong>Health- and vision-related quality of life, visual functioning, and societal participation are positively impacted by corneal transplantation, and important predictors were identified. The results of this study can be used by ophthalmologists to inform patients about realistic expectations of corneal transplantation.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223978","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":"Incidence and risk factors of rhegmatogenous retinal detachment following paediatric cataract surgery: A systematic review and meta-analysis.","authors":"Hashem Abu Serhan, Saad Ashraf, Ayesha Shaukat, Ajeet Singh, Hasnaa Abdelrhem, Hamza Irfan, Fariha Arif, Abdullah Ahmed","doi":"10.1111/aos.17533","DOIUrl":"https://doi.org/10.1111/aos.17533","url":null,"abstract":"<p><p>To determine the incidence and identify risk factors of rhegmatogenous retinal detachment (RRD) following paediatric cataract surgery. This systematic review and meta-analysis adhered to PRISMA guidelines and was registered in PROSPERO (CRD42024538383). A comprehensive search was conducted across multiple databases, including Cochrane CENTRAL, PubMed/MEDLINE, SCOPUS, Web of Science, ScienceDirect and Google Scholar, up to December 2024. Studies were included if they reported on RRD following cataract surgery in paediatric populations (0-18 years) with a minimum follow-up of 4 months. Data extraction was performed independently by two authors, with disagreements resolved through consultation with a third author. Risk of bias was assessed using the Newcastle-Ottawa Scale, and statistical analysis was performed using R software version 4.5.0, with leave-one-out analysis conducted for outcomes with substantial heterogeneity (I² > 50%). The meta-analysis included data from 5922 eyes across nine studies. The mean age of the participants was 7.08 ± 3.13 years, with a mean follow-up duration of 4.02 years. The pooled incidence of RRD after paediatric cataract surgery was 2.4% [95% CI: 0.7%; 5.0%], with significant heterogeneity observed (I² = 85.8%). Patients without primary intraocular lens (IOL) implantation exhibited a numerically higher incidence of RRD (6.1% [95% CI: 0.6%; 15.9%]) compared to those with IOL implantation (1.9% [95% CI: 0.0%; 6.8%]); however, this difference was not found to be statistically significant (p = 0.2667). Similarly, the incidence of RRD was 1.0% [95% CI: 0.3%; 2.2%] in unilaterally operated eyes and numerically higher at 2.1% [95% CI: 1.0%; 3.6%] in bilaterally operated eyes, though this difference was also not statistically significant (p = 0.2563). Children with mental retardation demonstrated a significantly higher risk of RRD, with an incidence of 11.0% [95% CI: 6.6%; 16.4%]. Paediatric cataract surgery carries a notable risk of rhegmatogenous retinal detachment, with significant variability in incidence across different patient populations. While numerically higher incidences of RRD were observed in patients without primary IOL implantation and in bilaterally operated eyes compared to their counterparts, these differences did not reach statistical significance in this meta-analysis. The presence of mental retardation was identified as a significant risk factor. Enhanced postoperative monitoring and individualised surgical approaches are recommended, particularly for high-risk groups. Future research should focus on prospective studies with standardised protocols and longer follow-up periods to better understand causal relationships and refine preventive strategies.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223977","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":"Visual acuity, amblyopia and refractive error in preterm children with and without retinopathy of prematurity - Results from the Gutenberg Prematurity Study Young (GPSY).","authors":"Achim Fieß, Sandra Gißler, Alica Hartmann, Eva Mildenberger, Heike Elflein, Panagiotis Laspas, Christina Korb, Bernhard Stoffelns, Norbert Pfeiffer, Stephanie Grabitz, Alexander K Schuster","doi":"10.1111/aos.17515","DOIUrl":"https://doi.org/10.1111/aos.17515","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to assess visual outcomes in children born preterm, stratified by gestational age, hypo- and hypertrophy, and the presence of retinopathy of prematurity (ROP) and its treatment.</p><p><strong>Methods: </strong>This is a prospective observational cohort study (n = 949, 1889 eyes) assessing visual acuity, amblyopia, refractive error, and lens opacifications in a large sample of children born preterm and full-term aged 4-17 years. Covariates included gestational age, birth weight percentile, ROP status and treatment, maternal smoking, placental insufficiency, preeclampsia, breastfeeding, and perinatal adverse events with an adjustment for sex and age. Logistic regression analysis was conducted to evaluate associations.</p><p><strong>Results: </strong>Amblyopia prevalence was mainly associated with a gestational age ≤ 28 weeks (OR = 2.92, p = 0.03), placental insufficiency (OR = 3.84, p = 0.01), and ROP treatment (OR = 15.71, p ≤ 0.001). Distant corrected visual acuity (DCVA) in the better eye was significantly correlated with gestational age (ρ = -0.083; p = 0.01), birth weight (ρ = -0.096; p = 0.004), birth weight percentile (ρ = -0.064; p = 0.05), ROP (ρ = 0.13; p <0.001), ROP treatment (ρ = 0.21; p <0.001), and perinatal adverse events (ρ = 0.135; p <0.001). The spherical equivalent was associated only with ROP treatment [β = -2.91, p < 0.001]. Lens opacifications were significantly larger in the group treated for ROP (p ≤ 0.01).</p><p><strong>Conclusions: </strong>This study highlights that perinatal factors associated with prematurity affect visual acuity and refractive error as well as the development of amblyopia in children. Mainly, extreme prematurity ≤28 weeks as well as ROP and its treatment are the most important factors affecting visual development.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155408","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":"Comparison of retinal function and macular structure after 27G pars plana vitrectomy with minimal heads-up versus standard illumination in patients with idiopathic epiretinal membranes: A pilot randomized study.","authors":"Wojciech Lubiński, Tomasz Charabin, Karolina Podborączyńska-Jodko, Maciej Mularczyk, Ewelina Lachowicz-Gosławska","doi":"10.1111/aos.17526","DOIUrl":"https://doi.org/10.1111/aos.17526","url":null,"abstract":"<p><strong>Purpose: </strong>To analyse the clinical benefits of using the NGENUITY 3D Visualization System in vitreoretinal surgery with low levels of endoillumination, focusing on functional and structural retinal protection in patients with idiopathic epiretinal membranes (ERM).</p><p><strong>Design: </strong>Prospective, randomized, comparative study.</p><p><strong>Methods: </strong>Forty pseudophakic patients (29♀, 11♂; age 60-80 years) with ERM underwent 27G pars plana vitrectomy (PPV) and were randomly divided into two groups: Group I (20 eyes, 3D heads-up NGENUITY system, endoillumination 0.5 Lm) and Group II (20 eyes, standard microscope [Hi-R 900], endoillumination 3.2 Lm). Preoperative and 6-months postoperative evaluations included slit-lamp examination, intraocular pressure (IOP, Pascal tonometer), Distance Best Corrected Visual Acuity (DBCVA, logMAR), Central Subfoveal Thickness (CST), Retinal Nerve Fibre Layer Thickness (RNFL, OCT), Pattern ERG (PERG), multifocal ERG (mfERG), flash ERG (ERG, ISCEV standards), and retinal sensitivity (HFA macula test). Surgery time, xenon light exposure, ERM/ILM peeling time, fundus autofluorescence (FAF), metamorphopsia incidence, and intra-/postoperative adverse events were analysed. Results were statistically evaluated (p < 0.05).</p><p><strong>Results: </strong>Slit-lamp examination and IOP results were normal in both groups. DBCVA improved significantly (p = 0.005) in both groups but was better for Group I, albeit not statistically significant. CST and RNFL thickness decreased significantly in both groups (p = 0.01) and did not differ between them. In Group I, increased cone and ganglion cell function was registered, with PERG showing significantly higher increases in P50 and N95 wave amplitudes (p = 0.01) compared with Group II. In mfERG, an increase in P1-wave response density in Ring 1 (p = 0.01) was observed only in Group I. In ERG, Group I showed better rod (Ab, p = 0.04), cone (Aa, p = 0.03), and amacrine cell (scotopic OPS ∑A01 + A02 + A03, p = 0.02) function compared with Group II. Foveal threshold in the HFA macula test increased significantly only in Group I (p = 0.03). No significant differences were found in autofluorescence results, surgery times, xenon light exposure, or ERM and ILM peeling times between groups. Postoperatively, the frequency of absent or reduced severity of metamorphopsia was higher in Group I (71.4%) compared with Group II (61.5%). No intraoperative or postoperative adverse events occurred.</p><p><strong>Conclusion: </strong>Our preliminary results suggest that in patients with idiopathic ERM, 6 months after PPV using the NGENUITY 3D system with low levels of endoillumination, better retinal function was achieved compared with the standard PPV procedure, possibly due to reduced retinal phototoxicity. Further long-term studies are necessary to confirm that conclusion.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126433","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":"Validation of a deep learning model for the automated detection and quantification of cystoid macular oedema on optical coherence tomography in patients with retinitis pigmentosa.","authors":"Hind Almushattat, Jonathan Hensman, Yasmine El Allali, Coen de Vente, Clara I Sánchez, Camiel J F Boon","doi":"10.1111/aos.17518","DOIUrl":"https://doi.org/10.1111/aos.17518","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate assessment of cystoid macular oedema (CMO) in patients with retinitis pigmentosa (RP) on spectral-domain optical coherence tomography (SD-OCT) is crucial for tracking disease progression and may serve as a therapeutic endpoint. Manual CMO segmentation is labour-intensive and prone to variability, making artificial intelligence (AI) an appealing solution to improve accuracy and efficiency. This study aimed to validate a deep learning (DL) model for automated CMO detection and quantification on SD-OCT scans in patients with RP.</p><p><strong>Methods: </strong>A segmentation model based on the no-new-Unet (nnU-Net) architecture was trained on 112 OCT volumes from the RETOUCH dataset (70 for training, 42 for validation). The model was externally tested on 37 SD-OCT scans from RP patients, with annotations from three expert graders. Performance was assessed using the Dice similarity coefficient and intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>For randomly selected central B-scans, the model achieved a mean Dice score of 0.889 ± 0.002 standard deviation (SD), while observers scored 0.878 ± 0.007 SD. The ICC for the model was 0.945 ± 0.014 SD, compared to 0.979 ± 0.008 SD for observers. On manually chosen central B-scans, Dice scores were 0.936 ± 0.005 SD for the model and 0.946 ± 0.012 SD for observers, with ICC values of 0.964 ± 0.011 SD and 0.981 ± 0.011 SD, respectively.</p><p><strong>Conclusions: </strong>This DL model reliably segments CMO in RP, achieving performance comparable to human graders. It can enhance the efficiency and precision of CMO quantification, reducing variability in clinical practice and trials.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109161","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":"Visual acuity outcomes up to 12 years and risk factors for visual impairment in a national cohort of extremely preterm born children - The Extremely Preterm Infants in Sweden Study (EXPRESS).","authors":"Despoina Tsamadou, Karin Källén, Abbas Al-Hawasi, Ann Hellström, Gerd Holmström, Fatima Pedrosa-Domellöf, Kristina Tornqvist, Ulrika Kjellström, Lisa B Thorell, Lena Hellström-Westas, Andreas Ohlin, Ulrika Ådén, Kerstin Hellgren","doi":"10.1111/aos.17525","DOIUrl":"https://doi.org/10.1111/aos.17525","url":null,"abstract":"<p><strong>Purpose: </strong>The Extremely Preterm Infants in Sweden Study (EXPRESS) followed a national cohort of extremely preterm born (EPT, i.e. <27 weeks) children until 12 years of age. This study aimed to investigate the longitudinal development of visual acuity (VA) in children born EPT, explore the predictive value of early visual assessments, and evaluate risk factors for visual impairment at the age of 12 years.</p><p><strong>Methods: </strong>All 462 children born EPT in Sweden during April 2004-March 2007, and surviving to age 6.5 years, and full-term born matched controls were invited to participate in the 12-year follow-up. VA was assessed at 12 years and the results were compared with values at 2.5 and 6.5 years.</p><p><strong>Results: </strong>At age 12, 332 (72%) EPT survivors and 189 controls were examined. The mean VA in the EPT group was lower than in the control group (1.15, 95%CI [1.12-1.19] vs. 1.33, 95% CI [1.29-1.37]). Fifteen (4.5%) EPT had visual impairment. The examination at age 2.5 failed to identify most of them, while the examination at 6.5 could predict the final visual outcome at 12. Risk factors for visual impairment were low gestational age, moderate and severe intraventricular haemorrhage, treatment-requiring retinopathy of prematurity, cerebral palsy, and cognitive disability.</p><p><strong>Conclusion: </strong>In this national cohort, the VA outcome at age 12 was lower in children born EPT than full-term controls. As eye examination at 2.5 years did not reliably identify visual impairment, clinical risk factors should be considered in the screening of children born EPT to early identify the visually impaired.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101314","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":"Progression and topographic subtypes of Terrien marginal degeneration.","authors":"Minna Ruutila, Pauliina Repo, Annamari T Immonen, Joni A Turunen, Marja-Liisa Lokki, A Inkeri Lokki, Jukka Moilanen, Kari Krootila, Tero T Kivelä","doi":"10.1111/aos.17524","DOIUrl":"https://doi.org/10.1111/aos.17524","url":null,"abstract":"<p><strong>Purpose: </strong>To report long-term outcomes and to search for immunological and genetic risk factors in Terrien marginal degeneration (TMD).</p><p><strong>Methods: </strong>Retrospective, in part prospective, hospital-based longitudinal follow-up study of 32 eyes of 16 Finnish patients from 2012 to 2023. Median follow-up was 7.3 years (range, 0.3-15.2). Symptoms, best corrected visual acuity, pattern in axial power map, astigmatism, corneal thickness, higher order irregularity, cavities, progression and human leukocyte antigen genes were analysed. In 13 blood samples, 483 corneal and inflammatory disease-related genes were analysed with exome sequencing.</p><p><strong>Results: </strong>The median age at first examination was 61 years (range, 13-89). Eleven (69%) patients were male, and 13 (81%) had bilateral disease. The median annual rate of progression of topographic astigmatism and new thinning was 0.03 D (range, -1.50 to 3.60) and 12.9 μm (range, -107.8 to 93.0), respectively; 0.15 D (range -1.50 to 1.17) and 21.6 μm (range, 1.3-93.0) in 6 (38%) patients with fast progression, and 0.02 D (range, -0.06 to 3.60) and 4.1 μm (range, -107.8 to 24.7) in 10 (72%) patients with slow progression. Topographic pattern, unilaterality, cavities, sectoral hyperaemia, poor response to medical treatment and new thinning after surgery were associated with fast progression. Thickness at maximal thinning fell below 450 μm only with fast progression. Five eyes changed the topographic pattern. Coexisting keratitis fugax hereditaria was found in one patient.</p><p><strong>Conclusions: </strong>A subtype of TMD progresses faster. The most sensitive indicators of progression were thinning and topographic astigmatism. No shared genetic cause for TMD was identified.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092556","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}