Acta Ophthalmologica最新文献

{"title":"Prototype master protocol for benchmarking of real-world follow-up data in glaucoma.","authors":"Pekko Hujanen, Anja Tuulonen, Sanna Leinonen, Kristian Vepsäläinen, Gauti Jóhannesson, Anu Vaajanen, Eemil Lehtonen, Hannele Uusitalo-Jarvinen","doi":"10.1111/aos.17453","DOIUrl":"https://doi.org/10.1111/aos.17453","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to create a prototype master protocol for benchmarking glaucoma real-world data (RWD). Benchmarking is part of the digital innovation strategy of the Finnish aces-rwm ecosystem (automation of care and evaluation of the system with real-world monitoring).</p><p><strong>Methods: </strong>We collected glaucoma RWD in 2012-17 at Tampere University Hospital (Tays) and compared them to six published RWD sets (one in Sweden and five in England). Visual field (VF) data at Tays were retrieved from the perimeter, and clinical RWD were collected manually. At baseline, VF data were available in 2511 of 4121 glaucoma patients (61%), of whom 1413 patients (56%) had 5 years of VF follow-up by 2017 (34% of all 4121 patients). Mean deviation (MD) data were analysed in multiple ways, considering also age and intraocular pressure (IOP).</p><p><strong>Results: </strong>In most data sets, higher age was related to faster progression. At Tays, the distributions of progression rates were similar in better and worse eyes. The proportions of eyes at Tays with the medium rate of MD progression (17% for 0.5-1.5 dB/year) and the fast rate (6% for >1.5 dB/year) were similar to the published RWD trial in England. The published datasets show significant variability in how their findings were reported.</p><p><strong>Conclusions: </strong>This study represents a first step toward the development of a master protocol for real-world benchmarking of glaucoma care. Further refinement of the protocol will encourage and require national and international collaboration in order to produce comprehensive and comparable real-world EHR data sets.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405099","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":"Can the choice of artificial tears harm patients? A narrative review with an overview of the Nordic market.","authors":"K N Mikha, C E Ø Rasmussen, S N G Ahrensberg, J Freiberg, R A Wozniak, U M K Alnoor, F Fineide, T P Utheim, S Heegaard, M Kolko","doi":"10.1111/aos.17455","DOIUrl":"https://doi.org/10.1111/aos.17455","url":null,"abstract":"<p><strong>Purpose: </strong>To provide an overview of artificial tears marketed in the following Nordic countries: Denmark, Finland, Norway, Iceland and Sweden. Furthermore, this review aimed to highlight the different preservatives and other constituents found in artificial tears in the Nordic market, focussing on adverse effects.</p><p><strong>Methods: </strong>Artificial tears appearing in online pharmacies in Denmark, Norway, Sweden, Finland and Iceland were included, and tables listing their components were created. Based on the preservatives and other constituents found in the artificial tears on the Nordic market, a literature search was conducted to investigate differences and potential adverse effects. This was achieved using PubMed with MeSH and free text search terms. Included articles were (i) studies performed on humans in vivo or in vitro human models, (ii) published between 2000 and 2023 and (iii) focussing on adverse effects, preservatives, toxicity, other constituents and preservative-free artificial tears.</p><p><strong>Results: </strong>A total of 88 artificial tears were found on the Nordic market. Approximately 32% (28 out of 88) of the artificial tears contain preservatives. Eleven of these are preserved with benzalkonium chloride (BAK) or cetrimide. After a thorough literature search, evidence has been found for the toxic effects of BAK and cetrimide. There is no evidence of toxic effects of lubricants, osmoprotectants and lipids.</p><p><strong>Conclusions: </strong>The findings of this review highlight the paradoxical fact that many treatments for ocular surface diseases contain toxic preservatives that may lead to worsening of the condition. In particular, long-time toxic effects of BAK may contribute to disease progression.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373451","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":"Neuroprotection of retinal ganglion cells by agonism of the beta but not the alpha oestrogen receptor in the axotomized retina of male and female mice.","authors":"Kristy T Rodríguez-Ramírez, Caridad Galindo-Romero, Fernando Lucas-Ruiz, Manuel Vidal-Sanz, Marta Agudo-Barriuso","doi":"10.1111/aos.17454","DOIUrl":"https://doi.org/10.1111/aos.17454","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the course of retinal ganglion cell (RGC) loss following optic nerve crush (ONC) in male and female mice and to assess the neuroprotective potential of intravitreally administered oestrogen receptor alpha (ERα) or beta (ERβ) agonists.</p><p><strong>Methods: </strong>Optic nerve crush was performed on the left optic nerve of male and female C57BL/6 mice. RGC loss was evaluated at 3-21 days post-lesion. ERα and ERβ agonists (PPT and DPN, respectively) were injected either immediately after ONC with retinas analysed at 5 days or immediately post-ONC and again at 9 days, with retinas analysed at 21 days post-lesion. Intact retinas served as controls. The total population of Brn3a⁺RGCs was quantified in retinal flat mounts. To assess the retinal expression of ERα and ERβ, immunodetection was performed on cross sections, and the percentage of RGCs expressing each receptor was determined in flat mounts.</p><p><strong>Results: </strong>Retinal ganglion cell loss in both sexes followed two distinct linear phases: A rapid phase up to 9 days post-lesion, followed by a slower phase. However, the onset of RGC loss was earlier in males than in females. Both ERα and ERβ were expressed in all retinal layers and by the majority of RGCs. While ERα agonism did not confer RGC protection, ERβ agonism was neuroprotective during the second phase of axotomy-induced RGC loss.</p><p><strong>Conclusions: </strong>Preclinical results may be influenced by pooling data from male and female mice. The neuroprotective effects of ERβ during the second phase of RGC loss, likely linked to neuroinflammation, suggest potential therapeutic applications for chronic conditions such as glaucoma.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363164","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":"Extremely asymmetric ectasia: Tomographically unilateral keratoconus.","authors":"Hasan Shabani, Wishal D Ramdas, Magda A Meester-Smoor, Dimitris Rizopoulos, Caroline C W Klaver, Bart T H van Dooren, Annette J M Geerards","doi":"10.1111/aos.17456","DOIUrl":"https://doi.org/10.1111/aos.17456","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the characteristics of apparently stable forms of tomographically unilateral keratoconus (KC).</p><p><strong>Methods: </strong>In this retrospective case-control study, strict unilaterality criteria were applied to select tomographically unilateral cases with ≥3 years of follow-up. For comparison, a healthy cohort and two bilateral KC cohorts were matched to the tomographically unilateral cases. All patients were selected from The Rotterdam Eye Hospital, whereas healthy controls were selected from the population-based Rotterdam Study. After cohort selection, several risk factors and 25 Pentacam features were assessed. Unaffected (i.e. tomographically non-keratoconic) eyes from the tomographically unilateral cases were compared to matched healthy eyes, matched bilateral KC eyes and affected unilateral KC eyes. Furthermore, affected tomographically unilateral KC eyes were compared to matched bilateral KC eyes. Statistical analysis relied on Wilcoxon signed-rank tests and conditional logistic regression.</p><p><strong>Results: </strong>From 1006 assessed cases, 18 (1.8%) tomographically unilateral cases were selected. Their median (interquartile range) follow-up was 5.7 (4.3-8) years. Eczema and asthma were more prevalent among tomographically unilateral patients (28% each) compared to bilateral patients (6% and 9%) (p = 0.01 and p = 0.05, signed-rank test). We could not detect meaningful Pentacam differences between unaffected unilateral eyes and matched healthy eyes. Expectedly, significant differences were detected between unaffected unilateral eyes and affected (bilateral or unilateral) eyes. Lastly, the ectatic features of affected unilateral eyes seemed comparable to their bilateral counterparts, but their high-order aberrations were significantly lower.</p><p><strong>Conclusion: </strong>Our findings support the existence of tomographically unilateral KC. Understanding how tomographic unilaterality ensues may offer valuable insights into KC aetiology.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363523","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":"Subfoveal choroidal thickness in pregnancy: A systematic review with meta-analyses.","authors":"Maria Prehn Larsen, Hunan Iqbal, Jakob Grauslund, Oliver Niels Klefter, Marie Krogh Nielsen, Line Petersen, Özge Yanik, Yousif Subhi","doi":"10.1111/aos.17459","DOIUrl":"https://doi.org/10.1111/aos.17459","url":null,"abstract":"<p><p>Pregnancy induces a variety of changes in the eye. Mapping these changes provides a pathophysiological basis for understanding pregnancy-associated ocular disorders. In this systematic review and meta-analysis, our aim was to determine how pregnancy affects subfoveal choroidal thickness and to explore temporal changes in subfoveal choroidal thickness during pregnancy and postpartum. On April 7, 2024, we searched eight literature databases for studies which used macular optical coherence tomography to evaluate subfoveal choroidal thickness in healthy pregnant women. We identified 26 studies summarizing data from 1935 healthy women, of which 1096 were pregnant and 839 non-pregnant. We found that pregnant women had a subfoveal choroidal thickness which was 31.1 μm (95% CI: 19.4-42.7 μm) thicker than non-pregnant women. No statistically significant changes were observed throughout trimesters. From the 3rd trimester to postpartum, we found a reduction in the subfoveal choroidal thickness at -41.9 μm (95% CI: -68.5 to -15.2 μm). In conclusion, in healthy women without ocular disease, pregnancy is associated with a thicker subfoveal choroid indicating a higher choroidal perfusion. Choroidal thickness remains stable across trimesters and is reduced postpartum, indicating a temporary physiological adaptation during pregnancy.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143253977","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":"VEGFR3 pathway in corneal transplantation.","authors":"Mariateresa Laborante, Alessandra Micera, Daniele Gaudenzi, Andrea De Luca, Chiara De Gregorio, Francesco Cutrupi, Graziana Esposito, Bijorn Omar Balzamino, Antonio Laborante, Marco Coassin, Antonio Di Zazzo","doi":"10.1111/aos.17457","DOIUrl":"https://doi.org/10.1111/aos.17457","url":null,"abstract":"<p><strong>Purpose: </strong>Corneal transplantation, a common procedure in ophthalmology, faces challenges in high-risk (HR) cases due to inflammation and vascularization of the host bed, leading to graft rejection. Despite advancements in surgical techniques and therapeutics, preventing rejection in HR cases remains elusive. This study investigates the role of the vascular endothelial-derived growth factor (VEGF)-C/D-VEGFR3 pathway in corneal transplantation, focusing on its impact on inflammation and immune response.</p><p><strong>Methods: </strong>In this study, 42 eyes of 42 patients were evaluated, 24 of whom underwent corneal transplantation, with follow-up visits at 90, 180 and 360 days post-transplantation. Clinical assessments included visual acuity, corneal oedema, endothelial cell count and vascularization. Molecular analyses were performed to measure VEGFR3, VEGF-C, VEGF-D, VEGF-A and inflammatory markers.</p><p><strong>Results: </strong>Results revealed a distinct pattern of VEGF-C/D and VEGFR3 expression in HR versus low-risk (LR) transplants, correlating with inflammatory markers and clinical outcomes. In HR cases, elevated VEGFR3 expression was associated with increased inflammatory markers (Intercellular Adhesion Molecule 1 (ICAM-1) and Human Leukocyte Antigen - DR isotype (HLA-DR)) and graft rejection risk.</p><p><strong>Conclusion: </strong>These findings underscore the importance of understanding the VEGF-C/D-VEGFR3 pathway in modulating immune responses and inflammation in corneal transplantation, particularly in HR cases. Targeting this pathway could offer novel therapeutic avenues to mitigate inflammation and improve graft survival. Further research is warranted to elucidate the underlying mechanisms and validate these findings, potentially enhancing transplant outcomes, especially in HR patients.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143253982","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 impact of neovascular age-related macular degeneration on driving from a patient perspective.","authors":"Benjamin Sommer Thinggaard, Yousif Subhi, Jakob Grauslund, Lonny Stokholm","doi":"10.1111/aos.17448","DOIUrl":"https://doi.org/10.1111/aos.17448","url":null,"abstract":"","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143121766","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":"CORONIS symposium 2023: Scientific and clinical frontiers in ocular surface innervation.","authors":"Anat Galor, Juana Gallar, M Carmen Acosta, Víctor Meseguer, José Manuel Benítez-Del-Castillo, Oliver Stachs, Nóra Szentmáry, Piera Versura, Wolfgang G K Müller-Lierheim, Carlos Belmonte, Jesús Pujol-Martí","doi":"10.1111/aos.17450","DOIUrl":"https://doi.org/10.1111/aos.17450","url":null,"abstract":"<p><p>The 5th CORONIS Symposium, held during the 2023 Congress of the European Association for Vision and Eye Research (EVER), highlighted the growing importance of ocular surface innervation in eye surface disorders. This article summarises the insights and perspectives shared during the symposium, which focused on the clinical relevance of ocular surface innervation, as well as on the development of innovative diagnostic and therapeutic approaches for ocular surface pathologies linked to disturbed sensory innervation. Through robust interdisciplinary collaborations, these developments hold great potential to improve patient outcomes and quality of life.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073022","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":"Advances in primary eye care and ophthalmic imaging contribute to earlier detection of uveal melanoma.","authors":"Vilde Bjertnæs, Anna Dalseng Hatling, Olav H Haugen, Jørgen Krohn","doi":"10.1111/aos.17449","DOIUrl":"https://doi.org/10.1111/aos.17449","url":null,"abstract":"<p><strong>Purpose: </strong>To report how the evolving role of optometrists in primary eye care and advances in ophthalmic imaging have affected diagnosis and management of posterior uveal melanoma (UM).</p><p><strong>Methods: </strong>Retrospective, single-centre cohort study of patients diagnosed with UM from 1993 to 2022 in Bergen, Norway.</p><p><strong>Results: </strong>Four hundred nine patients were included, and comparisons were made between those diagnosed from 1993 to 2007 and from 2008 to 2022. The median tumour diameter decreased from 13.3 to 11.3 mm (p = 0.002), and the median tumour thickness decreased from 6.9 to 4.5 mm (p < 0.001). The median distance from the tumour border to the optic disc and to the foveola increased from 3.5 to 4.5 mm (p = 0.011), and from 3.0 to 4.0 mm (p < 0.001), respectively. Two hundred sixty-two patients (64%) experienced symptoms associated with UM, with a median duration of 152.5 and 81 days in the first and second half of the study period, respectively (p < 0.001). The median best corrected visual acuity at diagnosis improved from 0.5 logMAR (Snellen equivalent, 6/19) in the first half to 0.2 logMAR (Snellen equivalent, 6/9.5) in the second half of the period (p < 0.001). The proportion of asymptomatic patients was 23.5% in the first and 41.9% in the second half of the period (p < 0.001). The proportion of UMs incidentally detected by optometrists increased from 3.0% to 18.1% (p = 0.009), and the proportion of UMs incidentally detected by fundus photography increased from 1.5% to 18.1% (p < 0.001).</p><p><strong>Conclusions: </strong>The temporal changes in patient and tumour characteristics suggest that UMs are now being diagnosed at an earlier stage. This may in part be attributed to the introduction of widefield fundus cameras and increased opportunistic screening of asymptomatic patients.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073456","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":"Effect of panretinal photocoagulation on retinal oxygen metabolism and ocular blood flow in diabetic retinopathy.","authors":"Ahmed M Abu El-Asrar, Waleed K Alsarhani, Abdulrahman F AlBloushi, Abdullah Alzubaidi, Priscilla Gikandi, Einar Stefánsson","doi":"10.1111/aos.17442","DOIUrl":"https://doi.org/10.1111/aos.17442","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effects of panretinal photocoagulation (PRP) on retinal oxygen metabolism, calibre of retinal vessels, and blood flow velocity in the optic nerve head (ONH) and choroid in patients with severe nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR).</p><p><strong>Methods: </strong>In this retrospective study, 37 patients (37 eyes) were studied. Retinal oximetry and laser speckle flowgraphy measurements were performed at baseline and after PRP.</p><p><strong>Results: </strong>After PRP, oxygen saturation of retinal arterioles (p = 0.003) and arteriovenous oxygen saturation difference (p = 0.005) significantly increased. On the other hand, the calibre of retinal arterioles significantly decreased (p = 0.016). In the ONH, mean blur rate (MBR)-vessel (p = 0.002), representing blood flow velocity in the retinal vessels, and MBR-tissue (p = 0.002), representing ONH blood flow velocity, and choroidal MBR (p = 0.012) significantly decreased. At baseline, there were significant negative correlations between ONH MBR-overall (r = -0.382, p = 0.026) and ONH MBR-tissue (r = -0.455, p = 0.007) and arteriovenous oxygen saturation difference. After PRP, choroidal MBR had a significant negative correlation with arteriolar oxygen saturation (r = -0.415, p = 0.016).</p><p><strong>Conclusions: </strong>The effects of PRP are correlated with increased arteriovenous oxygen saturation difference, reduction in the calibre of retinal arterioles, and reduction of retinal and choroidal blood flow velocities.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062910","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}