Acta Ophthalmologica最新文献

{"title":"Aqueous humour concentrations of HB-EGF, EGF and VEGF-A and axial length in humans.","authors":"Wen-Da Zhou, Li Dong, Yu-Hang Yang, Yuan He, Xiao-Zhen Wang, Han-Qing Zhao, Rui-Heng Zhang, Jost B Jonas, Wen-Bin Wei","doi":"10.1111/aos.17504","DOIUrl":"https://doi.org/10.1111/aos.17504","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate relationships between the intraocular concentrations of heparin-binding epidermal growth factor (HB-EGF), epidermal growth factor (EGF) and vascular endothelial growth factor A (VEGF-A) in dependence on axial length in humans.</p><p><strong>Design: </strong>Clinical interventional cohort study.</p><p><strong>Participants: </strong>Patients with cataract who underwent routine cataract surgery. Inclusion criterion was the absence of any retinal or optic nerve disease except for myopic macular degeneration (MMD) without myopic choroidal neovascularization.</p><p><strong>Methods: </strong>Using a Luminex system, we measured the concentrations of HB-EGF, EGF and VEGF-A in aqueous humour samples taken from patients during cataract surgery.</p><p><strong>Main outcome measures: </strong>Intracameral concentration of EGF, HB-EGF and VEGF; Axial length.</p><p><strong>Results: </strong>The study included 68 patients (age: 61.1 ± 11 years; range: 44-85 years) with a mean axial length of 27.11 ± 3.11 mm (range: 22.09-35.64 mm). The HB-EGF concentration (mean: 3.17 ± 0.99 pg/mL) increased with longer axial length (β = 0.43; p < 0.001) and was not associated with age (p = 0.10) and intracameral EGF concentration (p = 0.22). The EGF concentration (mean: 0.22 ± 0.12 pg/mL) increased with longer axial length (β = 0.35; p = 0.004) and higher prevalence of advanced MMD (β = 0.35; p = 0.008) and was not associated with age (p = 0.28) and intracameral VEGF-A concentration (p = 0.09). The VEGF-A concentration (mean: 118 ± 150 pg/mL) decreased with longer axial length (β = -0.54; p < 0.001), higher intracameral concentration of HB-EGF (β = -0.26; p = 0.03) and lower MMD prevalence (β = -0.31; p = 0.02) and was not associated with age (p = 0.47) and intracameral EGF concentration (p = 0.09).</p><p><strong>Conclusions: </strong>With the concentrations of HB-EGF and EGF increasing with longer axial length, the study supports a potential role of the EGFR signalling pathway activation in human axial myopia. The inverse relationship between VEGF-A concentration and longer axial length agrees with a protective effect of axial myopia against diabetic retinopathy and age-related macular degeneration.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053936","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":"Outcome and safety of multiple photodynamic therapy sessions in chronic central serous chorioretinopathy.","authors":"Jennifer M Chang-Wolf, Elon H C van Dijk, Kamal El Boujdaini, Mitchel van Straaten, Thomas J van Rijssen, Reinier O Schlingemann, Camiel J F Boon, Roselie M H Diederen","doi":"10.1111/aos.17507","DOIUrl":"https://doi.org/10.1111/aos.17507","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the effectiveness and safety of multiple PDT sessions for cases of persistent and recurrent subretinal fluid (SRF) in chronic central serous chorioretinopathy (CSC).</p><p><strong>Methods: </strong>This multicentre, retrospective cohort study included patients aged ≥18 years with chronic CSC who received at least two sessions of PDT at Amsterdam University Medical Center or Leiden University Medical Center between August 2009 and February 2025. Outcomes included the resolution of SRF, changes in visual acuity (VA), subfoveal choroidal thickness (SFCT) and continuity of the external limiting membrane (ELM) and ellipsoid zone (EZ).</p><p><strong>Results: </strong>The study included 88 patients with chronic CSC, of whom 88.6% were male. Of the 105 eyes treated, 62.5% had persistent SRF after the first PDT, while 37.5% achieved complete SRF resolution. After the second PDT, SRF resolved completely in 62.8% of eyes overall, with 53.1% in the persistent SRF group and 64.1% in the recurrent SRF group. Following the third PDT, 67.7% of patients showed complete SRF resolution. VA improved by 3 ± 2 letters (p = 0.033) above baseline after the second PDT, with the recurrent SRF group showing greater improvements. SFCT was lower than baseline after PDT treatments in both groups. ELM and EZ continuity also generally showed improvements on optical coherence tomography, particularly in the recurrent SRF group, suggesting retinal integrity restoration rather than atrophic changes.</p><p><strong>Conclusion: </strong>Repeated PDT is an effective and safe treatment for both persistent and recurrent chronic CSC, with improvements in SRF, VA, SFCT and retinal layer continuity.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958999","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":"Comparative efficacy of intravitreal anti-VEGF therapy for neovascular age-related macular degeneration: A systematic review with network meta-analysis.","authors":"Emilie T S Butler, Andreas Arnold-Vangsted, Marianne G Schou, Rodrigo Anguita, Jakob Bjerager, Enrico Borrelli, Lasse J Cehofski, Lorenzo Ferro Desideri, Elon H C van Dijk, Carsten Faber, Jakob Grauslund, Javad N Hajari, Josef Huemer, Oliver N Klefter, Marie Krogh Nielsen, M Cem Sabaner, Miklos Schneider, Yousif Subhi","doi":"10.1111/aos.17506","DOIUrl":"https://doi.org/10.1111/aos.17506","url":null,"abstract":"<p><p>The aim of this review was to evaluate the comparative efficacy of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy for neovascular AMD. We searched 12 literature databases for randomised clinical trials (RCT) on anti-VEGF therapy for neovascular AMD and extracted data on: change from baseline to 12 months in best-corrected visual acuity (BCVA) and central retinal thickness (CRT), and cumulative number of injections at 12 months. The reference for comparison was monthly ranibizumab. Comparisons were made using network meta-analyses. Forty-nine RCTs including 23 257 eyes of 23 257 patients were included. No anti-VEGF drug or treatment regimen provided a better BCVA response compared to the reference. For CRT, small but statistically significant improvements over the reference were observed for brolucizumab 3 mg (-27.9 μm) or 6 mg (-38.1 μm) in loading dose (LD) then every 8-12 weeks, aflibercept 8 mg in LD then every 12 (-26.9 μm) or 16 weeks (-32.1 μm), faricimab 6 mg in LD then treat-and-extend (-18.1 μm) and aflibercept 2 mg in LD then every 8 weeks (-11.3 μm). For the cumulative number of injections, a range of anti-VEGF drugs and treatment regimens provided a statistically significant and clinically meaningful reduction compared to the reference. When results are considered simultaneously, faricimab 6.0 mg or aflibercept 8.0 mg in a treatment regimen with an LD followed by either a treat-and-extend regimen or a fixed 12- or 16-week regimen appears to provide the optimal balance between visual outcomes, anatomical outcomes and the lowest treatment burden. However, studies of the long-term efficacy of newer anti-VEGF drugs are warranted.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959090","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":"Impact of diabetes and diabetic retinopathy on neovascular exudative age-related macular degeneration.","authors":"Pasquale Viggiano, Michele Santoro, Giacomo Boscia, Annamaria Porreca, Enrico Borrelli, Daniela Bacherini, Luca Lombardi, Rosita Fumarola, Maria Oliva Grassi, Alba Chiara Termite, Michele Reibaldi, Giovanni Alessio, Srinivas Sadda, Francesco Boscia","doi":"10.1111/aos.17502","DOIUrl":"https://doi.org/10.1111/aos.17502","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the functional and morphological changes in patients with nAMD undergoing anti-VEGF therapy, focusing on the impact of concomitant diabetes with or without diabetic retinopathy.</p><p><strong>Methods: </strong>This retrospective cohort study included 1096 eyes from 916 patients with nAMD treated at the retina department of the University of Bari between August 2017 and May 2023. Patients were divided into two groups: 892 eyes without diabetes and 204 eyes with diabetes. Best-corrected visual acuity (BCVA), central retinal thickness (CRT) and presence of intraretinal fluid (IRF), subretinal fluid (SRF), subretinal hyperreflective material (SHRM) and atrophy were assessed at baseline, post-loading phase and at 12-month follow-up.</p><p><strong>Results: </strong>At baseline, no significant differences were observed between groups. Post-loading phase, both groups showed significant improvements in BCVA and reductions in CRT. However, SRF persistence was notably more frequent in the diabetic group (64.2% vs. 27.2%, p < 0.001). At 12 months, SRF was present in 53.7% of the diabetic group compared to 34.9% of the non-diabetic group (p < 0.001). Diabetic patients with moderate diabetic retinopathy (DR) exhibited significantly higher SRF persistence compared to those with mild DR or no DR.</p><p><strong>Conclusions: </strong>While anti-VEGF therapy improves visual and anatomical outcomes in both diabetic and non-diabetic patients with nAMD, diabetic patients, particularly those with more severe DR, experience a higher rate of persistence of SRF. This suggests a less than optimal anatomic treatment response and the potential need for more tailored management strategies in this patient population.</p><p><strong>Precis: </strong>This retrospective cohort study investigated the impact of diabetes mellitus and diabetic retinopathy on neovascular age-related macular degeneration treatment outcomes. The study analysed 1096 eyes from 916 patients undergoing anti-VEGF therapy over 12 months.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143951892","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":"Efficacy of interventions for myopia control in children: A systematic review with network meta-analyses.","authors":"Diana Chabané Schmidt, Anders Hvid-Hansen, Nina Jacobsen, Trine Møldrup Jakobsen, Per Michael Larsen, Kjersti Kristin Lindblad, Flemming Møller, Annette Slyngborg, Yousif Subhi, Line Kessel","doi":"10.1111/aos.17496","DOIUrl":"https://doi.org/10.1111/aos.17496","url":null,"abstract":"<p><p>To determine the effectiveness of various interventions in reducing myopia progression in children. Literature databases were searched on December 2, 2023: PubMed, Embase, the Cochrane Central, Web of Science Core Collection, BIOSIS Previews, Current Contents Connect, Data Citation Index, Derwent Innovations Index, KCI-Korean Journal Database, Preprint Citation Index, ProQuest™ Dissertations and Theses Citation Index and SciELO Citation Index. PRISMA guidelines and the Cochrane Handbook recommendations were followed. All unique interventions were analyzed individually in order to generate clinically applicable results. The main outcome was axial length progression. Secondary outcomes were incident corneal infiltrates, photophobia, development of an allergic response towards the intervention, visual acuity at near and distance and drop-out from allocated intervention/control. We identified 74 RCTs involving 12 154 participants aged 6-18 years. Network meta-analysis compared axial length after 1 year between 45 interventions and placebo or single-vision spectacles. The most effective interventions reported in weighted mean difference and 95% confidence interval were low-level red-light (-0.33 mm (-0.40, -0.25)), ortho-K with 5 mm treatment zone (-0.32 mm (-0.41, -0.24)), ortho-K with aspheric base curve (-0.29 mm (-0.37, -0.22)), atropine 1.0% (-0.28 mm (-0.30, -0.26)), combined atropine 0.01% and ortho-K (-0.24 mm (-0.37, -0.11)), spectacles with highly aspherical lenslets (-0.23 mm (-0.26, -0.19)), ortho-K with increased compression factor (-0.23 mm (-0.28, -0.17), atropine 0.05% (-0.21 mm (-0.30, -0.13)) and defocus incorporated multiple segments spectacles (-0.21 mm (-0.27, -0.15)). Photophobia and reduced near-visual acuity were reported for atropine, and lower adherence to treatment was found for atropine at 1.0%. There was no significant association between any interventions and corneal infiltrates or allergic reactions. Over 70% of the studies were conducted in Asian populations. This systematic review and network meta-analysis highlights the efficacy of various interventions, including orthokeratology lenses, atropine, highly aspherical lenslets and defocus incorporated multiple segments spectacles in slowing axial elongation in children. Low-level red-light therapy also slowed axial length progression, but further research is needed to assess the potential side effects. Future studies should include diverse populations and standardized methodologies to enhance the applicability and comparability of results.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958308","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":"Macular ridges: Prevalence and associated factors-The Beijing Eye Study.","authors":"Jost B Jonas, Songhomitra Panda-Jonas, Jie Xu, Wen Bin Wei, Ya Xing Wang","doi":"10.1111/aos.17494","DOIUrl":"https://doi.org/10.1111/aos.17494","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the prevalence and associated factors of macular ridges in a population-based study sample.</p><p><strong>Methods: </strong>From the participants of the population-based Beijing Eye Study (n = 3468), we included all eyes with an axial length of ≥25 mm and a randomized sample of the remaining myopic eyes. Using optical coherence tomographic images, we assessed the prevalence and height of macular ridges, defined as an elevation of the foveal region in one meridian.</p><p><strong>Results: </strong>Among 366 study eyes, 50 (13.7%; 95% CI: 10.1, 17.2) showed macular ridges. Macular ridge prevalence increased from 0/78 (0%) in the group with an axial length of ≤23 mm to 18/71 (25.4%), 7/27 (25.9%) and 15/29 (51.7%) in axial length groups of 26-26.99 mm, 27-27.99 mm and ≥28 mm, respectively. Higher macular ridge prevalence was associated (multivariable analysis) with longer axial length (OR: 1.79; 95% CI: 1.48, 2.16; p < 0.001) and older age (OR: 1.08; 95% CI: 1.04, 1.12; p < 0.001). Macular ridge height (mean:128 ± 79 μm) increased with longer axial length (0.31; B: 7.84; 95% CI: 5.39, 10.3; p < 0.001) and older age (beta: 0.16; B: 0.88; 95% CI: 0.34, 1.42; p < 0.001). Macular ridge orientation was most often in the horizontal meridian (28/50 eyes; 56%), followed by the vertical meridian (9/50 eyes; 18%) and the 7 o'clock-to-1 o'clock meridian (8/50 eyes; 16%). It was not significantly (p = 0.17) associated with the axis of cylindrical corneal refractive error.</p><p><strong>Conclusions: </strong>Macular ridges were relatively common in myopic eyes, with macular ridge prevalence and height increasing with longer axial length and older age in a curvilinear manner. They were not significantly associated with corneal astigmatism or best-corrected visual acuity. They may be explained by an inter-plane asymmetry in axial elongation-associated enlargement of Bruch's membrane in the fundus midperiphery.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959096","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":"Risk factors of ocular graft-versus-host disease after allogeneic haematopoietic stem cell transplantation in Denmark","authors":"Helene Jeppesen","doi":"10.1111/aos.17481","DOIUrl":"https://doi.org/10.1111/aos.17481","url":null,"abstract":"&lt;p&gt;Allogeneic haematopoietic stem cell transplantation (HSCT) is used to cure both malignant and non-malignant haematological diseases. HSCT can be either myeloablative (MA) or non-myeloablative (NMA) depending on the conditioning regimen given to the patient before transplantation. Despite HSCT having been available for more than 50 years, chronic graft-versus-host disease (cGVHD) remains a difficult immunologically mediated challenge, which increases morbidity and mortality after transplantation. When cGVHD targets the eyes, it causes reduced tears and inflammation, which lead to red, irritated eyes, corneal damage and blindness in worst cases. Furthermore, ocular cGVHD significantly reduces the quality of life after HSCT. More knowledge of who develops the disease and why is needed to predict the disease and optimize treatment in this patient group.&lt;/p&gt;&lt;p&gt;The overall aim of this PhD project (Jeppesen &lt;span&gt;2025&lt;/span&gt;) was to investigate the incidence and risk factors for developing ocular cGVHD in both adults and children. Furthermore, the aim was to investigate possible associations between ocular cGVHD and cGVHD in other organs and mortality after HSCT.&lt;/p&gt;&lt;p&gt;The studies were based on data from ophthalmological and haematological medical records from a large group of consecutive patients receiving HSCT at Copenhagen University Hospital, Rigshospitalet, during 1980–2016, &lt;i&gt;N&lt;/i&gt; = 1936 (1452 adults and 484 children). According to the hospital guidelines, the patients had a baseline ophthalmological examination performed before HSCT, annually up to 5 years after HSCT, and more frequently if ocular symptoms occurred.&lt;/p&gt;&lt;p&gt;Our studies showed that in adults, the 5-year cumulative incidence of ocular cGVHD was 18% after MA and 35% after NMA regimen (Jeppesen et al., &lt;span&gt;2021&lt;/span&gt;). Several factors were associated with a higher risk of ocular cGVHD after both conditioning regimens. In the MA group, malignant disease, Schirmer's test ≤10 mm/5 min before HSCT, the use of a matched unrelated donor or female donor, peripheral blood as stem cell source and acute GVHD (grades III–IV) increased the risk of ocular cGVHD. In the NMA group, Schirmer's test ≤10 mm/5 min before transplantation and higher recipient age increased the risk of ocular cGVHD (Jeppesen et al., &lt;span&gt;2021&lt;/span&gt;).&lt;/p&gt;&lt;p&gt;In children, the incidence of ocular cGVHD was 6%, and therefore less common than in adults (Jeppesen, Kielsen, et al., &lt;span&gt;2022&lt;/span&gt;). Ocular cGVHD was more frequent in patients with extensive cGVHD and when other ectodermal-derived organs were involved (skin, mouth, genitals and nails). (Jeppesen, Gjærde, et al., &lt;span&gt;2022&lt;/span&gt;) The frequency of ocular cGVHD was especially high in patients with skin sclerosis as a manifestation of cGVHD (70%) (Jeppesen, Gjærde, et al., &lt;span&gt;2022&lt;/span&gt;). Our studies suggest that target antigens in ectodermal-derived organs might be involved in the complex pathophysiology of ocular cGVHD, but more studies are needed to ","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 3","pages":"363-364"},"PeriodicalIF":3.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.17481","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818457","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":"A narrative literature review about alpha-lipoic acid role in dry eye and ocular surface disease.","authors":"Antonio J Mateo Orobia, José Manuel Benítez Del Castillo, Margarita Calonge, Christophe Baudouin, Marc Labetoulle","doi":"10.1111/aos.17486","DOIUrl":"https://doi.org/10.1111/aos.17486","url":null,"abstract":"<p><p>Ocular surface diseases (OSD) include various conditions that affect the eye's surface, causing discomfort and pain. One such condition, dry eye disease (DED), is a multifactorial disorder that significantly impacts patients' quality of life, with prevalence rates ranging from 5% to 50% and higher incidence in women. DED involves tear film instability, inflammation and neurosensory abnormalities, making its management challenging due to diverse underlying mechanisms. Conventional treatments typically focus on symptom relief, but new approaches targeting the disease's pathogenesis are emerging. Alpha-lipoic acid (ALA) is gaining attention for its potential in treating OSD and DED. ALA acts as a potent antioxidant, neutralizing reactive oxygen species. It protects cell membranes by interacting with vitamin C and glutathione, potentially recycling vitamin E. Its antioxidative properties are particularly relevant in meibomian gland dysfunction, a condition implicated in DED. By scavenging free radicals and modulating redox status in the meibomian glands, ALA can reduce oxidative damage, preserve glandular function and decrease inflammation. In diabetic patients with DED, ALA administration has been found to improve tear film parameters, reduce corneal defects, enhance antioxidant status and potentially prevent diabetic retinopathy and keratopathy. Its therapeutic effects on neurosensory abnormalities, especially in diabetic polyneuropathy and other neuropathies, are primarily due to its antioxidant, anti-inflammatory and metal-chelating properties. In summary, ALA holds promise as a therapeutic agent for DED and OSD and could be a promising treatment option for diabetic retinopathy and keratopathy, although further research is needed to confirm its efficacy.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954953","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":"Ocular graft-versus-host disease: Risk factors of ocular graft-versus-host disease after allogeneic haematopoietic stem cell transplantation in Denmark","authors":"Helene Jeppesen","doi":"10.1111/aos.17452","DOIUrl":"https://doi.org/10.1111/aos.17452","url":null,"abstract":"<p>Allogeneic haematopoietic stem cell transplantation (HSCT) is used to cure both malignant and non-malignant haematological diseases. Despite HSCT has been available for more than 50 years, chronic graft-versus-host disease (cGVHD) remains a difficult immunologically mediated challenge, which increases morbidity and mortality after transplantation. When cGVHD targets the eyes, it causes reduced tears and inflammation which lead to red, irritated eyes, corneal damage and blindness in worst cases. Ocular cGVHD significantly reduces quality of life after HSCT. We need to gain further knowledge about this disease to help this patient group.</p><p>The overall aim of this PhD project was to investigate the incidence and risk factors for developing ocular cGVHD in both adults and children. Furthermore, the objective was to investigate possible associations between ocular cGVHD and cGVHD in other organs, and mortality after HSCT.</p><p>A conditioning regimen is given to the patient before transplantation, which can be either myeloablative (MA) or non-myeloablative (NMA). Our studies showed that in adults, the 5-year cumulative incidence of ocular cGVHD was 18% after MA and 35% after NMA regimen. Several factors were associated with a higher risk of ocular cGVHD after both conditioning regimens. In the MA group, malignant disease, Schirmer's test ≤10 mm/5 min before HSCT, the use of a matched unrelated donor or female donor, peripheral blood as stem cell source and acute GVHD (grade III–IV) increased the risk of ocular cGVHD. In the NMA group, Schirmer's test ≤10 mm/5 min before transplantation and higher recipient age increased the risk of ocular cGVHD. In children, the incidence of ocular cGVHD was 6% and therefore less common than in adults. Ocular cGVHD was more frequent in patients with extensive cGVHD, and when other ectodermal derived organs were involved (skin, mouth, genitals and nails). The frequency of ocular cGVHD was especially high in patients with skin sclerosis as a manifestation of cGVHD (70%). Our studies suggest that target antigens in ectodermal derived organs might be involved in the complex pathophysiology of ocular cGVHD, but more studies are needed to explore this. Ocular cGVHD was furthermore found to be associated with a higher non-relapse mortality.</p><p>In conclusion, several risk factors for developing ocular cGVHD exists. This knowledge may be applied to guide clinical trials (i.e. power calculations), to inform patients of their risk of developing ocular cGVHD and to guide clinicians in scheduling patient follow-up. Because of the many patients with signs of dry eyes before HSCT (which increase the risk of ocular cGVHD), we recommend performing a baseline ophthalmological examination before HSCT.</p><p>More studies are needed to elucidate the pathophysiology of ocular GVHD. In the future, this could lead to better treatment options and potentially prevention of the disease.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S286","pages":"3-19"},"PeriodicalIF":3.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.17452","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818395","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":"Molecular and cellular mechanisms underlying gyrate atrophy: Why is the retina primarily affected?","authors":"Mark J N Buijs, Berith M Balfoort, Marion M Brands, Anneloor L M A Ten Asbroek, Camiel J F Boon, Roselie M H Diederen, Corrie Timmer, Margreet A E M Wagenmakers, Hans R Waterham, Ronald J A Wanders, Riekelt H Houtkooper, Clara D van Karnebeek, Arthur A Bergen","doi":"10.1111/aos.17498","DOIUrl":"https://doi.org/10.1111/aos.17498","url":null,"abstract":"<p><p>Gyrate atrophy of the choroid and retina (GACR; OMIM #258870) is a rare early-onset autosomal recessive disorder, caused by bi-allelic pathogenic variants in the gene coding for ornithine aminotransferase (OAT) resulting in hyperornithinaemia. Clinically, GACR is characterized by the concentric loss of visual fields due to progressive chorioretinal atrophy. Because OAT is systemically expressed, it is not clear why primarily the retina is damaged in GACR patients. In this review, we first provide an extensive overview of the clinical features and current treatment modalities for GACR. Next, we discuss the different pathways involved in ornithine metabolism, including the urea cycle, polyamine synthesis, creatine synthesis, proline synthesis and degradation and provide our vision on how OAT deficiency is thought to affect these pathways in the retinal pigment epithelium (RPE). We provide several hypotheses to explain the retinal pathology observed in GACR and discuss perspectives on future research.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794332","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}