Acta Ophthalmologica最新文献

{"title":"Variable proficiency attainment following virtual reality cataract training: Implications for a mastery learning approach.","authors":"Amalie Carlsson, Lars Konge, Morten la Cour, Anton Quoc Dung Le, Ann Sofia Skou Thomsen","doi":"10.1111/aos.70254","DOIUrl":"https://doi.org/10.1111/aos.70254","url":null,"abstract":"<p><strong>Purpose: </strong>Virtual reality simulation (VRS)-based training is widely used to prepare novice cataract surgeons, yet unstandardized training regimens result in variable competence at the transition to surgery. In many settings, training follows a directed self-regulated learning approach, where progression is based on self-assessed competence. In contrast, mastery learning requires trainees to reach a predefined proficiency benchmark. This study evaluated whether participants using directed self-regulated learning attained proficiency on a simulation-based test with established validity evidence, whether baseline aptitude predicted proficiency attainment, and the time required to reach the benchmark.</p><p><strong>Methods: </strong>This prospective cohort study included ophthalmology residents and research associates at the Department of Ophthalmology, Rigshospitalet-Glostrup, with ≥6 months of clinical ophthalmology experience. Participants completed a baseline test on the EyeSi Surgical Simulator and trained until they felt ready to attempt a simulation-based test. Passing required reaching a predefined proficiency benchmark. Participants who did not reach the benchmark repeated testing until proficiency attainment or training was discontinued.</p><p><strong>Results: </strong>Forty participants were included; 25 (63%) reached the proficiency benchmark. Baseline score was not significantly associated with proficiency attainment (OR per 1 SD = 1.60, 95% CI 0.82 to 3.32; p = 0.18). Median time to proficiency was 13 h 21 min (range, 6 h 57 min-31 h 37 min).</p><p><strong>Conclusion: </strong>Directed self-regulated learning did not ensure proficiency attainment among all participants. No statistically significant association was found between baseline score and proficiency attainment, and variation in training time supports the rationale for evaluation and implementation of a mastery learning approach.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178606","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":"Higher plasma vitamin D levels are not causally associated with less age-related macular degeneration.","authors":"Sabina O Beheshti, Michael Larsen, Børge G Nordestgaard, Shoaib Afzal","doi":"10.1111/aos.70253","DOIUrl":"https://doi.org/10.1111/aos.70253","url":null,"abstract":"<p><strong>Purpose: </strong>Higher levels of plasma 25-hydroxyvitamin D have been associated with a lower risk of age-related macular degeneration (AMD). We investigated observational and potential causal associations of plasma 25-hydroxyvitamin D with the risk of AMD in two large contemporary population-based prospective studies and a genetic case-control consortium.</p><p><strong>Methods: </strong>Observationally, we studied 25 445 individuals with measured baseline plasma 25-hydroxyvitamin D (536 incident AMD events) in the Copenhagen General Population Study (CGPS) and 372 477 individuals (7842 incident AMD events) in the UK Biobank using Cox regression analysis for hazard ratios. Causally, we studied 107 793 individuals (1474 incident AMD events) in the CGPS, 406861 individuals (9183 incident AMD events) in the UK Biobank and 31 858 individuals (17 411 AMD cases) in the International AMD Genomics Consortium with genetic variants leading to life-long elevated plasma 25-hydroxyvitamin D. These genetic variants were combined to plasma 25-hydroxyvitamin D-increasing unweighted and weighted allele scores and genetic associations to AMD risk were tested using Cox regression and logistic regression for hazard ratios and odds ratios.</p><p><strong>Results: </strong>Observationally, higher plasma 25-hydroxyvitamin D was associated with higher AMD risk in CGPS and lower risk in UK Biobank. Genetically, each increase in the 25-hydroxyvitamin D-increasing weighted CGPS allele score was associated with a hazard ratio of 1.01 (95% confidence interval: 1.00-1.02) in CGPS, with similar results in the other studies.</p><p><strong>Conclusion: </strong>These findings do not support a causal role of plasma 25-hydroxyvitamin D in the risk of AMD.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164071","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":"Low-level light therapy for dry eye disease and meibomian gland dysfunction: A systematic review and meta-analysis.","authors":"Sjur Reppe, Yousif Subhi, Tore Steinkjer, Mazyar Yazdani, Miriam Kolko, Tor P Utheim, Fredrik Andreas Fineide","doi":"10.1111/aos.70252","DOIUrl":"https://doi.org/10.1111/aos.70252","url":null,"abstract":"<p><p>A healthy tear film is vital for ocular surface integrity and relies on the coordinated function of the lacrimal glands, meibomian glands and conjunctival goblet cells. Dysfunction in any of these elements can lead to dry eye disease (DED). This systematic review and meta-analysis evaluated the efficacy of low-level light therapy (LLLT) as a standalone DED treatment. Although evidence for LLLT's therapeutic potential is growing, prior reviews have focused on short-term outcomes or combined LLLT with intense pulsed light. This meta-analysis consolidates current findings to clarify the clinical value of LLLT monotherapy in DED management. We systematically searched MEDLINE, Embase, Scopus and the Cochrane Central Register of Controlled Trials for studies evaluating LLLT for DED. Study selection and data extraction were conducted according to pre-specified inclusion and exclusion criteria. Meta-analyses were performed for Ocular Surface Disease Index (OSDI), non-invasive break-up time (NIBUT) and tear meniscus height (TMH). Ten clinical studies were eligible for our systematic review, which included a total of 473 participants. Irradiation protocols included treatment sessions using wavelengths of 625-640 nm and/or 810-850 nm, with each session lasting a minimum of 10 min. In our meta-analyses, LLLT monotherapy was associated with significant improvements in OSDI (weighted mean difference [WMD] -11.42, p < 0.00001), NIBUT (WMD +1.49 s, p = 0.005), and TMH (WMD +0.04 mm, p = 0.007). Sensitivity analyses restricted to eligible RCTs confirmed significant effects on OSDI and NIBUT, but not on TMH. No adverse events were reported. LLLT appears to be well tolerated and may improve signs and symptoms of DED, particularly ocular discomfort. It may represent a promising standalone treatment option for patients in whom combination regimens involving IPL treatment are contraindicated.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164877","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":"Intraocular lens power calculation in highly myopic eyes with axial length ≥ 28 mm: Impact of two corneal keratometries and anterior segment parameters","authors":"Yiwei Wu,&nbsp;Lingyun Chi,&nbsp;Bijun Zhu,&nbsp;Baojiang Li,&nbsp;Ying Zheng,&nbsp;Yuyu Miao,&nbsp;Qian Sun,&nbsp;Mingxing Wu,&nbsp;Haidong Zou,&nbsp;Huiyi Jin","doi":"10.1111/aos.70153","DOIUrl":"10.1111/aos.70153","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare the accuracy of 12 intraocular lens (IOL) formulas in eyes with axial length (AL) ≥ 28 mm and to identify the anterior segment parameters independently affecting prediction error (PE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 415 eyes undergoing phacoemulsification with IOL implantation at Shanghai General Hospital were included in this retrospective observational study. Refractive PEs were calculated for 5 conventional formulas (Haigis, Hoffer Q, Holladay 1, Holladay 2 and SRK/T) with optimization and 7 new-generation formulas (Barrett Universal II [BUII], Cooke K6, EVO 2.0, Hoffer QST, Kane, Ladas Super Formula [LSF] and Pearl-DGS). Predicted postoperative spherical equivalent (SE) was calculated using keratometry (K) and total keratometry (TK) measured by IOLMaster 700. <i>Q</i> values, posterior mean keratometry, corneal volume, anterior chamber volume and angle and back-to-front corneal radius ratio were measured by Pentacam. Stepwise linear regression identified parameters associated with PE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Using the K method, BUII, EVO 2.0, Hoffer QST, Holladay 2, Kane and Pearl-DGS showed the lowest median absolute PE (MedAE = 0.32, 0.31, 0.32, 0.30, 0.30 and 0.32 D) and highest formula performance index (FPI = 0.74, 0.80, 0.69, 0.68, 0.60 and 0.69). BUII, Cooke K6, EVO 2.0, Holladay 2 and Pearl-DGS performed stably across axial groups (<i>p</i> &gt; 0.05). K achieved lower AE than TK for all formulas (<i>p</i> &lt; 0.05), except Hoffer QST (<i>p</i> = 0.497), Holladay 2 (<i>p</i> = 0.140) and Pearl-DGS (<i>p</i> = 0.912), with Kane performing better using TK (<i>p</i> = 0.024). Lens thickness (LT) independently affected PE for Holladay 2 and all new-generation formulas, with greater LT associated with myopic shifts (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EVO 2.0 formula provided the most accurate predictions with K method. Except for Kane, K outperformed TK. LT independently influences PE and should be considered in future IOL calculations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"104 7","pages":"e757-e767"},"PeriodicalIF":3.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831527","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":"The optical coherence tomography and microperimetry biomarker evaluation in patients with geographic atrophy (OMEGA) study: Geographic atrophy progression in fundus autofluorescence - OMEGA report 3","authors":"Philippe Valmaggia,&nbsp;Georg Ansari,&nbsp;Nadja Inglin,&nbsp;Nils Schärer,&nbsp;Hanna Zuche,&nbsp;Chrysoula Gabrani,&nbsp;Faady Yahya,&nbsp;Marco Cattaneo,&nbsp;Kristina Pfau,&nbsp;Andrea Giani,&nbsp;Marieh Esmaeelpour,&nbsp;Taffeta Chingning Yamaguchi,&nbsp;Christian Prünte,&nbsp;Hendrik P. N. Scholl,&nbsp;Nicolas Feltgen,&nbsp;Leopold Schmetterer,&nbsp;Maximilian Pfau,&nbsp;Peter M. Maloca","doi":"10.1111/aos.70119","DOIUrl":"10.1111/aos.70119","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To measure the progression of geographic atrophy (GA) in subjects with age-related macular degeneration (AMD) in a natural history study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed fundus autofluorescence (FAF) images using a semiautomatic method (RegionFinder) to quantify the GA area in a monocentric study. Three independent graders analysed each eye. Patient visits were scheduled at baseline, 12, 24 and 48 weeks. The primary endpoint was the progression of GA area per eye. Potential correlations with clinical and imaging-based parameters were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The annual GA progression rate was 1.16 mm²/year (95% CI: 0.76–1.56; <i>p</i> &lt; 0.001), with faster growth in eyes with larger baseline lesions (<i>R</i>² = 0.74). After square root transformation, the progression rate was 0.34 mm/year (95% CI: 0.26–0.43; <i>p</i> &lt; 0.001), and the size dependency was reduced (adjusted <i>R</i>² = 0.16). Multivariable mixed-effects models identified a significant association between larger GA lesion sizes per eye and the number of smoking pack-years (<i>p</i> = 0.017), the presence of perilesional hyperautofluorescence (<i>p</i> = 0.044) and a multifocal configuration of the GA lesions (<i>p</i> = 0.038). Intermediate AMD in the fellow eye was significantly associated with faster GA progression (<i>p</i> = 0.041).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>GA progression in AMD is significantly influenced by baseline lesion size and a larger number of smoking pack-years is associated with larger GA lesions. The marked variability between individuals underscores the multifactorial nature of GA dynamics. Quantitative FAF analysis is a reliable method for assessing lesion progression and may inform risk-based monitoring strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"104 7","pages":"750-759"},"PeriodicalIF":3.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.70119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147375728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of intraocular lens calculation formulas in aphakic eyes undergoing simultaneous silicone oil removal and intraocular lens implantation","authors":"Guodong Xie,&nbsp;Kunliang Qiu,&nbsp;Haoyu Chen,&nbsp;Honghe Xia,&nbsp;Chuang Jin,&nbsp;Yuqiang Huang","doi":"10.1111/aos.70116","DOIUrl":"10.1111/aos.70116","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate the accuracy of intraocular lens (IOL) power calculation formulas in aphakic eyes undergoing simultaneous silicone oil removal (SOR) and IOL implantation, including in-the-bag implantation and ciliary sulcus implantation, and assess the effect of ‘Rule of 9s’ adjustment for ciliary sulcus implantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The performance of six formulas (BUII, EVO, LSF, Hoffer Q, Holladay 1, SRK/T) was evaluated. Outcomes were assessed using mean prediction error (ME) for trueness, standard deviation (SD) for precision, and median absolute error (MedAE) for accuracy. Ciliary sulcus implantation was analysed with and without the ‘Rule of 9s’ adjustment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 282 eyes (143 in-the-bag, 139 sulcus). For in-the-bag implantation, new-generation formulas (EVO, LSF, BUII) demonstrated higher precision (SD: 0.58 D) and accuracy (MedAE: 0.46–0.47 D) compared to traditional formulas (SD: 0.62–0.71 D; MedAE: 0.50–0.62 D; <i>p</i> &lt; 0.05). Unadjusted sulcus implantation showed low trueness with a significant myopic shift (ME: −0.88 D to −1.12 D). The ‘Rule of 9s’ adjustment significantly improved trueness (ME: −0.32 D to −0.54 D). Post-adjustment, EVO achieved the best accuracy (MedAE: 0.53 D), significantly better than traditional formulas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>New-generation formulas provide improved precision and accuracy in combined SOR-IOL surgery. The ‘Rule of 9s’ adjustment optimized trueness for sulcus-placed IOLs, where new-generation formulas maintained higher accuracy and precision.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"104 7","pages":"e768-e776"},"PeriodicalIF":3.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372078","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":"Hormonal replacement therapy in postmenopausal women ≥50 years is associated with the incidence of glaucoma: Evidence from 6576 females in Finland","authors":"Sirpa Loukovaara,&nbsp;Jari Haukka","doi":"10.1111/aos.70138","DOIUrl":"10.1111/aos.70138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Hormonal replacement therapy (HRT) in postmenopausal women appears to affect glaucoma risk, but findings are inconsistent. We aimed to explore whether the use of postmenopausal HRT plays a role in glaucoma development in Finland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The main outcome variable was glaucoma incidence measured by initiation of special reimbursement due to glaucoma. The population-based historic cohort consisted of female participants aged ≥50 years whose incident glaucoma was recorded between January 1st, 2015, and December 31st, 2017. The main exposure of interest was postmenopausal HRT with Anatomic Therapeutic Chemical codes G03C (oestrogens), G03D (progestogens), G03F (progestogens and oestrogens in combination). The HRT treatment was initiated during 2001–2010.</p>\u0000 \u0000 <p>Frequencies and odds ratios (ORs) with 95% confidence intervals (CIs) were analyzed with logistic regression models, unadjusted and adjusted for diabetes mellitus, hospital district, socioeconomic status and statin exposure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our nested-case-control study involved 1096 cases and 5480 age-matched controls. After adjustment for confounding factors, use of any HRT was associated with an increased risk for the development of glaucoma. The risk was found in estrogen users (adjusted OR, 1.33 [95% CI, 1.17–1.52]), in progestogen users (adjusted OR, 1.25 [95% CI, 1.02–1.53]) and in combinatory estrogen–progesterone users (adjusted OR, 1.19 [95% CI, 1.01–1.39]). In the POAG subgroup, the risk remained in estrogens-only users (adjusted OR, 1.31 [95% CI, 1.10–1.56]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our data suggests that use of any postmenopausal HRT may increase the glaucoma risk, but in POAG subgroup estrogen-only therapy remained significant. Further research is needed to confirm the associations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"104 7","pages":"742-749"},"PeriodicalIF":3.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.70138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147669799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infectious bacterial keratitis management in a Swedish region: Risk factors, treatment and time-to-resolution","authors":"Jenny Roth,&nbsp;Antonio Filipe Macedo,&nbsp;Sofia Somajo,&nbsp;Lukas Tannerfeldt,&nbsp;Baris Toprak,&nbsp;Neil Lagali","doi":"10.1111/aos.70141","DOIUrl":"10.1111/aos.70141","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To report treatment patterns, time-to-resolution (TTR) and aetiologies of bacterial keratitis (BK) infections treated in a specialized hospital-based cornea clinic in Sweden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective study based on electronic health records screened during the period 2010–2019. The study included only culture-confirmed cases of BK. TTR was defined as the number of days from the sample collection for microbiological culture to the date that the cornea healed. Factors affecting TTR were investigated with Cox regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Contact lens wear and severely ill/blind eye were the most common aetiologies among the 188 patients. Empirical treatment consisted of fluoroquinolones in combination with aminoglycosides in 50% of the patients. Median TTR was 22 days (95% CI: 12, 34) for contact lens–related BK and 90 days (95% CI: 55, 146) in complicated cases with miscellaneous or unknown aetiology. Hazard ratio (HR) for infections in females (HR = 1.93; 95% CI: 1.34, 2.79), contact lens wearers (HR = 2.72; 95% CI: 1.79, 4.14) and infections caused by Gram-positive pathogens (HR = 2.50; 95% CI: 1.50, 4.19) indicated that infections in these categories healed at a faster rate than their reference categories. Patients switching to treatment with chloramphenicol after it was absent in the empirical treatment had a slower rate of healing than those who received chloramphenicol as part of the empirical treatment (HR = 0.58; 95% CI: 0.38, 0.87).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The current study provides unique TTR estimates for BK. The results revealed that age, sex, aetiology, empirical treatment and Gram staining can affect TTR. In our sample, empirical treatment that includes chloramphenicol could potentially reduce TTR. These findings can be used to individualize disease management and prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"104 7","pages":"802-810"},"PeriodicalIF":3.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.70141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147669819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between metabolic syndrome, macular structures and retinal vascular calibres in the Northern Finland Birth Cohort Eye Study","authors":"Jenni M. Huru,&nbsp;Oona Ahokas,&nbsp;Ilmari L. Leiviskä,&nbsp;Ville O. Saarela,&nbsp;M. Johanna Liinamaa","doi":"10.1111/aos.70131","DOIUrl":"10.1111/aos.70131","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>We aimed to evaluate the association of metabolic syndrome (MetS) with macular thickness and retinal vascular calibres in the population-based cohort (Northern Finland Birth Cohort).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The population of 2242 individuals was divided into MetS (<i>n</i> = 344) and control groups (<i>n</i> = 1898). Cirrus HD-OCT 4000 was used to measure total macular thickness. Central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were calculated from the fundus images. The MetS was defined according to the National Cholesterol Education Program (Adult Treatment Panel III).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A significant reduction in macular thickness was observed in subjects with MetS (279.4 ± 13.5 vs. 282.2 ± 14.1 μm, <i>p</i> &lt; 0.001); the difference was greatest in the nasal and inferior subfields in the outer perimeter (−3.18 μm, <i>p</i> &lt; 0.001 and − 3.68 μm, <i>p</i> &lt; 0.001). Among the MetS components, waist circumference (WC) was particularly associated with thinning of the macula. Furthermore, subjects with MetS displayed decreased CRAE (139.8 ± 13.2 vs. 141.8 ± 14.0 μm, <i>p</i> = 0.014) and increased CRVE (221.7 ± 20.5 vs. 218.3 ± 19.0 μm, <i>p</i> = 0.007). The elevated systolic blood pressure and WC were associated with arterial narrowing, while dyslipidemia, hypertriglyceridemia and low HDL cholesterol were associated with venular widening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We detected a thinning of the macula in the MetS in our population-based cohort. The diameters of the retinal arteries decreased, and the venules increased in MetS. These findings suggest that obesity is related to structural changes in the eyes in middle-aged subjects, which may have implications for ocular health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"104 7","pages":"760-768"},"PeriodicalIF":3.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.70131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy and safety of reducing intraocular pressure to single-digit levels in Normal-tension glaucoma: A systematic review and meta-analysis","authors":"Beatriz Araújo-Azevedo,&nbsp;Renato Ferreira-da-Silva,&nbsp;João Barbosa-Breda","doi":"10.1111/aos.70110","DOIUrl":"10.1111/aos.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This systematic review and meta-analysis aim to evaluate the efficacy and safety of further lowering intraocular pressure (IOP) to single-digit levels in treated patients with progressive normal-tension glaucoma (NTG).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A literature search was conducted in MEDLINE (via PubMed), Scopus and Web of Science. We selected studies that reported quantitative visual field (VF) data on the efficacy of the interventions. Study outcomes include VF progression rates, changes in IOP and IOP-lowering medication use. Meta-analysis was conducted for VF mean deviation (MD) slope (db/year) using R, with paired mean differences and 95% confidence intervals (CI) calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine observational studies, including 270 eyes, were analysed. Trabeculectomy was performed across all studies. One study compared trabeculectomy with prostaglandin analogues. On average, IOP decreased from 14.77 ± 0.95 mmHg preoperatively to 9.82 ± 1.55 mmHg postoperatively, reflecting a mean reduction of 33.65 ± 10.37%. This reduction slowed glaucoma progression, as indicated by a change in the mean VF MD slope from −0.91 ± 0.27 dB/year preoperatively to −0.25 ± 0.16 dB/year postoperatively. Meta-analysis showed a significant change in VF MD slope following trabeculectomy, with a pooled mean difference of 0.59 dB/year (95% CI: 0.38 to 0.80; <i>p</i> &lt; 0.0001). Single-digit IOP levels were shown to be both achievable and sustainable. The most common postoperative complications included hypotony-related complications and hyphema.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Achieving single-digit IOP levels is associated with a significant reduction in visual field progression rates. However, the balance between efficacy and safety must be considered, as aggressive IOP reduction is also associated with a higher risk of hypotony-related complications. Postoperative hypotony was relatively frequent but generally transient and did not appear to have a significant impact on long-term visual acuity. Copyright © 2026 Acta Ophthalmologica Scandinavica Foundation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"104 7","pages":"720-730"},"PeriodicalIF":3.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147484241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}