Acta Ophthalmologica最新文献

{"title":"Associations of fundus tessellation, myopic diffuse chorioretinal atrophy and choroidal thickness with visual acuity in myopia.","authors":"Jost B Jonas, Songhomitra Panda-Jonas, Jie Xu, Wen Bin Wei, Ya Xing Wang","doi":"10.1111/aos.17480","DOIUrl":"https://doi.org/10.1111/aos.17480","url":null,"abstract":"<p><strong>Purpose: </strong>To explore associations between stages of myopic macular degeneration (MMD) and visual acuity and influencing parameters.</p><p><strong>Methods: </strong>Participants of the population-based study Beijing Eye Study (n = 3468 participants) underwent a detailed ocular and systemic examination.</p><p><strong>Results: </strong>Assessable images were available for 3040 (87.7%) individuals (age: 64.0 ± 9.7 years). In multivariable analysis, worse best-corrected visual acuity (BCVA) (i.e. higher logMAR values) was associated with higher MMD stage (beta: 0.11; B: 0.06; 95% CI: 0.04, 0.08; p < 0.001) and thinner subfoveal choroidal thickness (beta: -0.06; p = 0.002), with adjustments for age, sex, educational level, cognitive function, degree of any cataract and prevalence of glaucoma, diabetic retinopathy and age-related macular degeneration. If only eyes with MMD grade 1 or no MMD were included, worse BCVA was associated (multivariable analysis) with higher prevalence of MMD stage 1 (beta: 0.11; B: 0.07; 95% CI: 0.05, 0.09; p < 0.001) and thinner medium-sized choroidal vessel layer thickness. Correspondingly, BCVA was worse in eyes with MMD stage 1 than in eyes without MMD (0.13 ± 0.27 logMAR vs. 0.04 ± 0.14; p < 0.001). Including only eyes without vision-influencing disorders (except myopia), BCVA was also worse in eyes with MMD stage 1 than in eyes without MMD (0.06 ± 0.13 logMAR vs. -0.01 ± 0.08 logMAR; p < 0.001). In these eyes without vision-influencing ocular disorders, worse BCVA was associated with thinner total subfoveal choroidal thickness (beta: -0.15; R: 0.000; 95% CI: 0.000, 0.000; p < 0.001) and longer axial length (beta: 0.14; R: 0.01; 95% CI: 0.01, 0.02; p < 0.001), or alternatively with higher MMD staging (beta: 0.24; R: 0.09; 95% CI: 0.01, 0.11; p < 0.001).</p><p><strong>Conclusions: </strong>MMD stage 1 (fundus tessellation) is associated with decreased BCVA and may be considered pathological. Independently of longer axial length, thinner choroidal thickness is a factor associated with lower BCVA in myopic eyes, including eyes with MMD stage 1.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603380","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":"Influence of outdoor time on the spherical equivalent and axial length in childhood myopia: A meta-analysis.","authors":"Clara Martinez-Perez, Miguel Angel Sanchez-Tena, José-María Sánchez-González, Cesar Villa-Collar, Cristina Alvarez-Peregrina","doi":"10.1111/aos.17478","DOIUrl":"https://doi.org/10.1111/aos.17478","url":null,"abstract":"<p><p>This meta-analysis investigates the effectiveness of outdoor activities in reducing the onset of myopia in children and adolescents by analysing changes in axial elongation and spherical equivalent refractive error. Following PRISMA guidelines and registered in PROSPERO (CRD42024592971), the study included randomized controlled trials (RCTs) and observational studies. The eligibility criteria targeted children and adolescents aged 6 to 18 years with varying levels of outdoor exposure. Primary outcomes were axial elongation and spherical equivalent change. Studies were assessed for quality using GRADE and AMSTAR-2 tools, and data were analysed using Review Manager 5.4, with random-effects models applied when heterogeneity was significant. Fifteen studies (9 RCTs and 6 observational) were included, with a total of 16 597 participants. Outdoor activities significantly reduced or delayed the onset of myopia, with a mean axial length difference of -0.08 mm per year (95% CI: -0.09 to -0.07) and a spherical equivalent difference of 0.16 diopters per year (95% CI: 0.07 to 0.25). These differences were observed after 1 year of intervention and sustained for up to 3 years, with daily outdoor exposure ranging from 40 to 120 min. Heterogeneity was moderate to high, but sensitivity analyses confirmed the robustness of the results. While higher outdoor exposure appeared more effective in reducing myopia progression, the certainty of this evidence was rated as low due to suspected publication bias, as indicated by the GRADE analysis. Outdoor activities, especially with prolonged exposure to intense light, effectively reduce or delay the onset of myopia in children and adolescents. This study emphasizes the importance of light intensity in maximizing the benefits of outdoor interventions and highlights regional differences in effectiveness, suggesting that environmental factors play a significant role in the outcomes.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603002","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 outcome including visual field defects after treatment of paediatric optic pathway glioma: A nationwide cohort study.","authors":"C A M Bennebroek, J van Zwol, M C Montauban van Swijndregt, S E Loudon, A L W Groot, N J C Bauer, J W Pott, I C Notting, A J van Sorge, M M van Genderen, P de Graaf, A Y N Schouten-van Meeteren, P Saeed, G L Porro","doi":"10.1111/aos.17476","DOIUrl":"https://doi.org/10.1111/aos.17476","url":null,"abstract":"<p><strong>Purpose: </strong>To examine long-term visual impairment and visual field examination (VF) after diverse treatments for paediatric optic pathway glioma (OPG), and to determine prognostic factors for long-term severe visual impairment or blindness.</p><p><strong>Methods: </strong>A nationwide retrospective cohort study (1995-2018) was performed on paediatric OPGs that received various (successive) therapies. The analysis of severe VI or blindness was represented by the outcome of both BCVA and VF testing. Prognostic factors for long-term severe VI or blindness were identified.</p><p><strong>Results: </strong>Data on BCVA and VF were available in 117 of 136 children (86.0%) who received treatment. After a median follow-up of 8.3 years (range: 0.1-23.8 years) after the start of treatment, severe VI or blindness (>1.0 LogMAR) was observed in both eyes in 18.8% of 117 patients and in 34.6% of 234 included eyes. This impairment was more common in sporadic OPGs. Monocular VF defects were present in 80.0% of a subgroup of 110 eyes (47.0%), predominantly represented by hemianopia in 69.3% and various scotomas in 28.4%. Independent prognostic factors for severe VI or blindness included starting therapy under the age of 2 years and hypothalamic involvement of the OPG.</p><p><strong>Conclusion: </strong>In this study, long-term binocular severe VI or blindness appeared in almost one in five patients and in one in three eyes after diverse treatment for paediatric OPG. Visual field data were available in only one in two children; VF defects were present in four out of five eyes. Children starting therapy under the age of 2 years were particularly at risk for long-term severe VI or blindness. Future prospective studies need to include VF analysis as an outcome parameter and should analyse treatment effects on both monocular and binocular BCVA.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584145","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":"Semaglutide and non-arteritic anterior ischaemic optic neuropathy: Review and interpretation of reported association.","authors":"Abdullah Amini, Steffen Hamann, Michael Larsen","doi":"10.1111/aos.17473","DOIUrl":"https://doi.org/10.1111/aos.17473","url":null,"abstract":"<p><p>This review covers a seminal study of the relation between exposure to the glucagon-like peptide 1 (GLP-1) agonist semaglutide and incident non-arteritic anterior ischaemic optic neuropathy (NAION) in a neuro-ophthalmology clinic setting, subsequent studies in unselected populations, a meta-analysis of clinical trials and pathophysiology studies of the optic disc and retina that may help elucidate the relation between semaglutide and NAION in patients with diabetes or obesity. In the matched cohort study of neuro-ophthalmology patients, those treated using agents other than semaglutide had NAION rates, orders of magnitude higher than a background population, presumably because referral patterns led to the enrichment of the study populations with patients at high risk of NAION. With semaglutide, the rates of NAION were 4.28 and 7.64 times higher for type 2 diabetes (T2D) and obesity, respectively, and onset of NAION was within 14 months of treatment initiation, whereas non-semaglutide NAION was evenly distributed over the 3 years of follow-up. Of four health care registry studies, each covering more than 100 000 patients, two found relative rates of NAION two to three times higher with semaglutide than without semaglutide, one found a trend towards semaglutide being associated with NAION in patients with type 2 diabetes only, and one found statistically insignificant imbalances between the two alternatives. The meta-analysis of various GLP-1 receptor agonists versus placebo or active comparator found no significant difference in rates of NAION. Prior reports of long-term glycaemia reduction being associated with early worsening of retinopathy and with NAION indicate that semaglutide may promote such events in proportion to its antihyperglycaemic potency. The association of NAION with small, crowded discs, optic disc oedema and peripapillary exudation suggests that semaglutide-related NAION may result from changes in perfusion that lead to venous dilation and, presumably, to venous congestion during relative hypoglycaemia. Given the retrospective nature of the epidemiological studies, causality cannot be inferred, but a cautious approach to the use of semaglutide and other powerful glycaemia-reducing agents seems warranted, particularly in patients with crowded optic discs, a characteristic that can be identified by proactive eye examination for disc-at-risk characteristics by the use of optical coherence tomography.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584141","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":"Choroidal changes and association with Gaussian curvature in high myopic eyes with posterior staphyloma in ultra-wide-field optical coherence tomography angiography.","authors":"Qing Zhao, Linxin Wei, Huan Chen, Yan Luo, Youxin Chen, Zhikun Yang","doi":"10.1111/aos.17477","DOIUrl":"https://doi.org/10.1111/aos.17477","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate choroidal changes in high myopic (HM) patients with posterior staphyloma (PS) and explore their association with Gaussian curvature (K) using ultra-wide-field optical coherence tomography angiography (UWF-OCTA).</p><p><strong>Methods: </strong>HM patients with wide macular PS (Type I PS) and without any PS (control) were recruited. Highest K values (K_max) and choroidal parameters-vessel flow density (VFD), choroidal vascularity volume (CVV) and index (CVI), thickness, and volume-were compared in central and peripheral regions, and the fovea-centered 12-mm ETDRS quadrants of 24 × 20 mm UWF-OCTA images. Associations between choroidal parameters and K values in Type I PS eyes were analysed using multiple linear regression analysis, controlling for the confounding effect of AL.</p><p><strong>Results: </strong>Type I PS eyes showed increased K_max in various subregions (p < 0.05), except the 12-mm ETDRS superior quadrant. CVV, choroidal thickness, and volume were higher in the peripheral region of the UWF-SS-OCTA image in Type I PS eyes (p < 0.05). Central CVI and large and medium choroidal vascular layer-VFD were significantly lower in Type I PS eyes (p < 0.05). Correlation analysis revealed a negative association between macular K_max and central CVI (p < 0.05). In the peripheral region, K_max showed a positive correlation with choroidal thickness and volume (p < 0.05). These correlations were partially confirmed across several quadrants of the 12-mm ETDRS grid.</p><p><strong>Conclusion: </strong>Type I PS eyes exhibit attenuated choroidal perfusion and a potentially reorganized choroidal structure and circulation, associated with Gaussian curvature severity. UWF-OCTA shows promise for non-invasive visualization of the choroidal alterations in PS.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571916","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":"Secondary ocular hypertension as an adverse effect of treatment with intravitreal dexamethasone implant: A retrospective Swedish cohort study.","authors":"Imadeddin Abu Ishkheidem, Martin Breimer, Saba Kamal, Madeleine Zetterberg, Abbas Al-Hawasi, Marita Andersson Grönlund","doi":"10.1111/aos.17475","DOIUrl":"https://doi.org/10.1111/aos.17475","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the incidence and risk factors for secondary ocular hypertension (SOHT) following intravitreal dexamethasone implants (Ozurdex®) in patients with diabetic macular oedema (DME) and macular oedema secondary to retinal vein occlusion (RVO) in a Swedish cohort.</p><p><strong>Methods: </strong>This retrospective study included 309 eyes from 249 patients treated with Ozurdex® at Sahlgrenska University Hospital, Mölndal, Sweden, from 1 January 2016 to 31 December 2023. Electronic medical records were reviewed for data including patient demographics, number of injections, incidence of and treatment modalities for SOHT and rate of Ozurdex® discontinuation.</p><p><strong>Results: </strong>Of the 309 eyes, 217 (70.2%) were in the DME group and 92 (29.8%) in the RVO group. Overall, 117 eyes (37.9%) developed SOHT (intraocular pressure (IOP) ≥25 mmHg or a rise of ≥10 mmHg from baseline); this included 77 of 217 DME eyes (35.5%) and 40 of 92 RVO eyes (43.5%). Men were more than twice as likely as women to develop SOHT (adjusted odds ratio [aOR]: 2.53, p < 0.001). Each unit increase in baseline IOP was associated with an 8% increase in the odds of SOHT (aOR: 1.08 p = 0.025). Of all eyes, 30.5% received IOP-lowering treatment, primarily prostaglandins. None required invasive surgery.</p><p><strong>Conclusion: </strong>Our finding that 30.5% of eyes received IOP-lowering treatment confirms that SOHT is a prevalent complication following intravitreal dexamethasone implants. Male gender and higher baseline IOP were key indicators for developing SOHT after Ozurdex® treatment, emphasizing the need for vigilant monitoring. Most cases were managed with IOP-lowering eye drops, indicating that while common, SOHT is typically manageable without invasive interventions.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565748","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":"Is there a predisposition for developing corneal hydrops in keratoconus?-Tomographic and biomechanical analysis of the fellow eyes.","authors":"Vesna Bosic, Hajra Mudassar, Berthold Seitz, Elias Flockerzi","doi":"10.1111/aos.17474","DOIUrl":"https://doi.org/10.1111/aos.17474","url":null,"abstract":"<p><strong>Aim: </strong>Fellow eyes (FE) of 73 keratoconus (KC) patients with acute corneal hydrops (ACH) and 130 KC patients without ACH (total 236 eyes, 110 more severely affected), serving as control groups, were retrospectively analysed to identify potential risk factors associated with the development of ACH.</p><p><strong>Methods: </strong>Tomographic (Pentacam^®) and biomechanical analysis (Corvis ST^®, both Oculus, Germany) were performed. Tomographic parameters are as follows: K-max, thinnest corneal thickness (TCT), Belin/Ambrósio deviation (BAD-D) and the tomographic ABCDE-staging. Biomechanical analysis included Integrated Radius (IR), DA Ratio (1 and 2 mm), stiffness parameter A1 (SP-A1), Ambrósio's relational thickness horizontal (ARTh), Corvis Biomechanical Index (CBI), Corvis Biomechanical Factor (CBiF) and the biomechanical E-staging.</p><p><strong>Results: </strong>Among ACH patients, most were males (77%), with pre-existing conditions including allergies (36%), asthma (10%) and frequent eye rubbing (61%), with no significant differences to the control group (CG). The ABCDE staging showed significantly different distribution patterns, with the ACH-FE predominantly showing stage B4, contrasting with a more heterogeneous distribution in both control groups. ACH-FE showed significantly lower SP-A1 levels than the CG (71 vs. 80 for CG all eyes, p < 0.001 and 71 vs. 76 for more severely affected control eyes, p = 0.01; Mann-Whitney U test).</p><p><strong>Conclusions: </strong>ACH-FE showed a predominant presence in stage B4, yet a heterogenic distribution in the other tomographic parameters ('A'|'C'). Lower SP-A1 values suggest that these eyes may be less stiff and resistant to mechanical stress. Our results potentially indicate a histopathological weakness in the posterior cornea that could predispose one to the development of ACH.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555587","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":"Corneal decompensation after PreserFlo Microshunt surgery.","authors":"Iben Bach Damgaard, Anders Ivarsen, Jesper Hjortdal, Daniella Bach-Holm, Niklas Telinius","doi":"10.1111/aos.17472","DOIUrl":"https://doi.org/10.1111/aos.17472","url":null,"abstract":"","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539853","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":"Juvenile idiopathic arthritis during 20 years in Sweden: Characteristics of children, therapy interventions, occurrence of uveitis and ocular complications.","authors":"Pia Lundgren, Maria Papadopoulou, Rebecka Jernkrok, Natasha Abedi, Eva Karlsson, Michael Damgaard, Stefan Berg, Marita Andersson Grönlund","doi":"10.1111/aos.17466","DOIUrl":"https://doi.org/10.1111/aos.17466","url":null,"abstract":"<p><strong>Purpose: </strong>To assess and compare the characteristics, therapy interventions, occurrence of uveitis and ocular complications in children with juvenile idiopathic arthritis (JIA) screened and examined for uveitis in Gothenburg, Sweden, over 20 years. Biological immunomodulatory treatment was increasingly used during the second half of the over 20 years.</p><p><strong>Methods: </strong>Data were retrospectively collected from children with JIA examined for uveitis at the Queen Silvia Children's Hospital between 2012 and 2021. These data were compared with those from a previously published study of children (the first cohort) screened between 2002 and 2011 in the same setting.</p><p><strong>Results: </strong>The first 10-year cohort (2002-2011) included 299 children, while the second cohort (2012-2021) included 253 children. The median age at JIA diagnosis was 5 years (range: 1-15 years) in both cohorts (p = 0.72), and girls were overrepresented in both groups, 68.9% and 72.7%, respectively (p = 0.32). Oligoarthritis was less frequent in the first cohort than in the second, 57.5% versus 73.9% (p < 0.001). The presence of anti-nuclear antibodies (ANAs) was similar between the cohorts, 57.6% versus 57.9% (p = 0.95). Uveitis occurred less frequently in the first cohort, 10.7% versus 17.0% in the second (p = 0.032). However, uveitis children had (not significantly) more ocular complications in the first cohort, 46.9% versus 34.9% in the second (p = 0.34) and complications were more often affecting both eyes, 73.3% versus 40.0% (p = 0.14). Systemic treatments, particularly biological immunomodulatory therapies, were less commonly used in the first cohort, 24.4% versus 42.7% in the second cohort (p < 0.001).</p><p><strong>Conclusion: </strong>Over 20 years, we observed a higher occurrence of uveitis in children with JIA in the second 10-year cohort. However, despite being statistically insignificant, we found fewer ocular complications, and less frequent in both eyes. This may indicate a beneficial effect of the increased use of biological immunomodulatory therapy.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539855","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":"Evaluating the efficacy of postoperative topical antibiotics in cataract surgery: A systematic review and meta-analysis.","authors":"Maria Laura Passaro, Matteo Posarelli, Fabio Claudio Avolio, Mariantonia Ferrara, Ciro Costagliola, Francesco Semeraro, Gianni Virgili, Mor M Dickman, Vito Romano","doi":"10.1111/aos.17469","DOIUrl":"https://doi.org/10.1111/aos.17469","url":null,"abstract":"<p><strong>Purpose: </strong>Cataract surgery is the most frequently performed surgical procedure worldwide, but postoperative endophthalmitis remains a serious complication that can lead to vision loss. While intracameral (IC) antibiotics are well established in significantly reducing the risk of postoperative infections, there is no consensus on the use of postoperative topical antibiotics. This systematic review and meta-analysis aimed to evaluate the efficacy of topical antibiotics in preventing endophthalmitis in patients already receiving IC antibiotics.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Scopus and Cochrane databases yielded 31 studies that met the inclusion criteria, involving patients who underwent cataract surgery via phacoemulsification. The patients were divided into two groups: those receiving IC antibiotics alone and those receiving additional postoperative topical antibiotics. The primary outcome was the incidence of postoperative endophthalmitis.</p><p><strong>Results: </strong>A total of 1 235 051 eyes were included in the meta-analysis, with 608 302 in the IC + T group, which received intraoperative intracameral antibiotics combined with postoperative topical antibiotics, and 626 749 in the IC group, which received intracameral antibiotics alone. The pooled analysis revealed no statistically significant difference in the incidence of endophthalmitis between the two groups (p = 0.97), with an incidence of 0.0004 (95% CI: 0.0003-0.0005) in both groups. These results suggest that the addition of topical antibiotics does not provide further benefit in preventing infections beyond IC antibiotics alone.</p><p><strong>Conclusions: </strong>IC antibiotics as a sole prophylactic measure may be sufficient, and the routine use of postoperative topical antibiotics could be unnecessary. Reducing the use of topical antibiotics may also help mitigate the risk of antimicrobial resistance.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522453","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}