Acta Ophthalmologica最新文献

{"title":"Prenatal and childhood exposure to smoking and retinal nerve fibre layer thickness: A meta-analysis of three independent birth cohorts.","authors":"Linna Zhu, Inger Christine Munch, Samantha Sze-Yee Lee, David A Mackey, Tamo Sultan, Klaus Bønnelykke, Bo Chawes, Michael Larsen, Nicklas Brustad","doi":"10.1111/aos.70109","DOIUrl":"10.1111/aos.70109","url":null,"abstract":"<p><strong>Purpose: </strong>To examine retinal nerve fibre layer (RNFL) characteristics in relation to prenatal and postnatal smoking exposure in three independent birth cohorts: two Danish and one Australian cohort.</p><p><strong>Methods: </strong>A combined meta-analysis of peripapillary retinal nerve fibre thickness in the Copenhagen Prospective Studies on Asthma in Childhood 2000 cohort (COPSAC2000), the Copenhagen Child Cohort 2000 (CCC2000), and Generation 2 of the Raine Study, utilizing optical coherence tomography.</p><p><strong>Results: </strong>Compared with participants not exposed to smoking (COPSAC2000 = 209, CCC2000 = 1008, Raine Study Gen2 = 991), 35 COPSAC2000 participants exposed to smoking throughout pregnancy had the most prominent deficits in peripapillary RNFL thickness in the inferior (-10.4% (-16.7; -4.2%), p = 0.001) and nasal (-10.0% (-18.3; -1.7%), p = 0.02) sectors, while 221 CCC2000 participants exposed to smoking had the most prominent deficit in the inferonasal sector (-8.4% (-11.3; -5.4%), p < 0.001), and 112 Raine Study Gen2 participants exposed to smoking (more than 10 cigarettes per day) had the most prominent deficit in the inferonasal sector (-8.9% (-13.0; -4.8%), p < 0.001). In a combined meta-analysis of the three cohorts, deficits in both the global and sectoral (superior, nasal, inferior and temporal) RNFL were observed from exposure to prenatal smoking.</p><p><strong>Conclusions: </strong>Prenatal smoking was associated with deficits in the peripapillary RNFL both globally and sectorally in combined meta-analyses of the three cohorts, which suggest an overall adverse effect of early life smoking exposure on later RNFL status.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":"e686-e694"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372124","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":"Relearning Bradford Hill through our final patient in the Tenecteplase in Central Retinal Artery Occlusion Study.","authors":"Øystein Kalsnes Jørstad, Stephen James Ryan, Morten Carstens Moe, Anne Hege Aamodt","doi":"10.1111/aos.70107","DOIUrl":"10.1111/aos.70107","url":null,"abstract":"","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":"e723"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146155642","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":"High prevalence of undetected visual impairment in older adults receiving municipal home-care.","authors":"Birte Bay, Andrea Nedergaard Jensen, Maria Kristiansen, Torben Lykke Sørensen","doi":"10.1111/aos.70133","DOIUrl":"10.1111/aos.70133","url":null,"abstract":"","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":"e721-e723"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687256","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":"Ultrasound, PET/CT or temporal artery biopsy for giant cell arteritis? A prospective diagnostic accuracy study (the GAME-study).","authors":"Michael S Hansen, Lene Terslev, Uffe M Døhn, Viktoria Fana, Jane M Brittain, Anne K Wiencke, Steffen Heegaard, Mads R Jensen, Oliver N Klefter, Yousif Subhi, Steffen Hamann","doi":"10.1111/aos.70114","DOIUrl":"10.1111/aos.70114","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the diagnostic performance of ultrasound, 2-deoxy-2-[¹⁸F]fluoro-D-glucose positron emission tomography/computed tomography (2-[¹⁸F]FDG PET/CT) and temporal artery biopsy (TAB) in giant cell arteritis (GCA).</p><p><strong>Methods: </strong>This was a prospective single-centre diagnostic accuracy study (ClinicalTrials.gov NCT05248906). One hundred and ten patients suspected of GCA were considered, of which 103 were analysed, 100 had a final diagnosis and 58 had complete data for all modalities. Ultrasound, 2-[¹⁸F]FDG PET/CT and TAB were performed after clinical examination and blood sampling. The main outcome included diagnostic accuracy measures with final clinical expert diagnosis at 6-month follow-up as the comparator.</p><p><strong>Results: </strong>Sixty-one patients had GCA, 39 had non-GCA and 3 had inconclusive. The sensitivities were 82% (95% CI: 66%-92%), 74% (95% CI: 57%-87%) and 68% (95% CI: 51%-83%) for ultrasound, 2-[¹⁸F]FDG PET/CT and TAB, respectively. The corresponding specificities were 90% (95% CI: 68%-99%), 100% (95% CI: 83%-100%) and 100% (95% CI: 83%-100%), the positive predictive values 94% (95% CI: 81%-98%), 100% (95% CI: 88%-100%) and 100% (95% CI: 87%-100%), the negative predictive values 72% (95% CI: 57%-84%), 67% (95% CI: 54%-77%) and 63% (95% CI: 51%-73%) and accuracies 85% (95% CI: 73%-93%), 83% (95% CI: 71%-91%) and 79% (95% CI: 67%-89%). When ultrasound was inconclusive, 2-[¹⁸F]FDG PET/CT had a higher sensitivity of 75% (95% CI: 35%-97%) vs. 38% (95% CI: 9%-76%) for TAB, with equal specificity of 100% (both 95% CI: 69%-100%). Results were inconclusive in 22 of 99 ultrasounds, 3 of 102 2-[¹⁸F]FDG PET/CTs and 4 of 90 TABs.</p><p><strong>Conclusion: </strong>Ultrasound had high diagnostic accuracy for GCA, supporting this as the first imaging modality in suspected GCA. 2-[¹⁸F]FDG PET/CT combined a high diagnostic accuracy with fewer inconclusive results, suggesting it may be used for second-line testing when ultrasound is inconclusive, reserving TAB for third-line testing. A fast-track setup may facilitate efficient diagnostics.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":"e695-e708"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372110","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":"Predictive factors for injection interval extension after switching to faricimab in neovascular AMD: The FAR WEST multicentre study.","authors":"Antoine Posnic, Sami Yagoub, Chloé Lebastard, Mathilde Vaast, Alexandra Poinas, Estelle Le Pabic, Jean-Paul Bellamy, Christian Delhay, Samy Faure, Jean-François Le Rouic, Adrien Henry, Olivier Lebreton, Helene Masse, Francois Susini, Tremeur Guillaumie, Isabelle Fournier, Adam Mainguy, Marie-Laure Le Lez, Raoul Kanav Khanna, Geoffroy Mortemousque, Arnaud George, Valentin Pipelart, Yan Bernard, Pierre Grimbert, Driss Mazhar, Mounir Benzerroug, Bénédicte Briend, Manon Clement, Henry-Pierre Jammes-Veaux, Marie-Pascale Posnic, Alexandre Bonissent, Charlène Guyot, Nicolas Rousseau, Benoît Trinh Van Dam, Lucas Bellot, Raphaëlle Ferron, Guylène Le Meur, Frédéric Mouriaux, Michel Weber, Yann Maucourant, Jean-Baptiste Ducloyer","doi":"10.1111/aos.70134","DOIUrl":"10.1111/aos.70134","url":null,"abstract":"<p><strong>Purpose: </strong>To assess whether switching to faricimab allowed extending injection intervals after 12 months (M12) in patients with neovascular age-related macular degeneration (nAMD) and to identify predictive factors for interval extension.</p><p><strong>Design: </strong>FAR WEST was a multicentre, observational, retrospective cohort study.</p><p><strong>Participants: </strong>Patients with nAMD treated with intravitreal anti-vascular endothelial growth factor (VEGF) injections for at least 1 year before switching to faricimab.</p><p><strong>Methods: </strong>The reason for switching (clinician's intent to extend the interval in the absence or presence of a recurrence or refractory status), and the switch strategy (whether an induction phase comprising 2, 3 or 4 injections was performed using the same or a shorter interval, or whether the interval was immediately extended from the second injection without induction) were left to the physician's discretion.</p><p><strong>Main outcome measures: </strong>The following data were collected from the medical records at the time of the decision to switch to faricimab (M0) and at the M12 follow-up visit: recurrence-free interval, last injection interval, best-corrected visual acuity (BCVA), central macular thickness (CMT), exudation status and intraocular inflammation events.</p><p><strong>Results: </strong>A total of 845 eyes of 718 patients were included in 23 centres. The recurrence-free injection interval increased significantly from 5.7 weeks at M0 to 8.6 weeks at M12 (difference: +2.9 weeks, p < 0.001). The proportion of exudative patients decreased from 571 (68%) to 337 (42%) (- 41%, p < 0.001). BCVA decreased from 0.33 (20/40) to 0.35 logMAR (20/40) (p = 0.0038). Among 238 refractory cases at M0, 84 (35%) achieved a dry macula at M12. In multivariable analysis, absence of an induction phase was associated with greater injection interval gain. (p < 0.001). There were no differences according to time since the first injection, type of neovascularization. The number of injections per year decreased from 8.7 at M0 to 6.1 at M12 (-2.6, p < 0.001), and the number of consultations decreased from 6.1 at M0 to 5.2 at M12 (-0.9, p < 0.001). The intraocular inflammation rate was 1.6% (n = 14).</p><p><strong>Conclusion: </strong>Switching to faricimab allowed significantly extending the recurrence-free injection interval, decreasing the proportion of exudative patients and reducing the therapeutic burden in nAMD patients. Further studies are needed to determine the most appropriate switching modalities and which patients actually require an induction phase.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":"e662-e670"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728059","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":"Dropless cataract surgery: Time to simplify postoperative care.","authors":"Bita Manzouri, Andrzej Grzybowski","doi":"10.1111/aos.70231","DOIUrl":"https://doi.org/10.1111/aos.70231","url":null,"abstract":"","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838796","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":"Evaluation of spatial distribution of initial marking strategy among inexperienced graders in diabetic retinopathy: A retrospective cross-sectional analysis.","authors":"Simon Joel Ellerup Lowater, Andrea Blasi Núñez, Jakob Kristian Holm Andersen, Sebastian Dinesen, Thiusius Rajeeth Savarimuthu, Jakob Grauslund","doi":"10.1111/aos.70224","DOIUrl":"https://doi.org/10.1111/aos.70224","url":null,"abstract":"<p><strong>Background: </strong>Manual diabetic retinopathy (DR) grading may prefer certain regions and underestimate others. It is unclear if inexperienced graders' initial marking strategy reflects a specialist's marking pattern.</p><p><strong>Aims: </strong>By the virtual ocular learning platform (VIOLA), we evaluated if initial DR-lesion markings among inexperienced graders spatially corresponded to a specialist-based lesion map.</p><p><strong>Materials and methods: </strong>We used retinal 6-field VIOLA images with at least 500 DR-lesion markings covering all DR-levels (0-4) according to the international clinical diabetic retinopathy (ICDR) scale. We divided images into quadrants and counted the initial three markings per lesion type, per image, per grader. A retinal specialist served reference for annotation of all DR-lesions. The primary outcome was difference in spatial distribution of DR-markings across quadrants relative to the reference, further characterised with spatial metrics. p-Value < 0.05 indicated statistical significance.</p><p><strong>Results: </strong>Across 24 images, 97 graders marked 16 925 DR-lesions: 1633 microaneurysms (MA), 3228 haemorrhages, 1549 hard exudates (HE), 3081 cotton wool spots (CWS), 3844 intraretinal microvascular abnormalities (IRMA), 1832 new vessels (NV) and 1758 panretinal photocoagulation scars (PRP). A difference was observed across all lesion types (χ²-test, p < 0.001) relative to the reference lesion map.</p><p><strong>Discussion: </strong>Most lesion types demonstrated high sensitivity, but low PPV, indicating a liberal marking approach. Distribution of initial markings from inexperienced graders spatially misaligns with a specialist-derived lesion map across all lesion types.</p><p><strong>Conclusion: </strong>As the ICDR-scale depends on identifying the most severe lesion type, systematically inconsistent search strategies may pose a risk for overlooking important lesions under time constraints. The results support the promotion of attention guiding during DR-training.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823713","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":"Concurrent macular neovascularization in shallow irregular retinal pigment epithelium elevation phenotypes in age-related macular degeneration and chronic central serous chorioretinopathy: A systematic review and meta-analysis.","authors":"Mehmet Cem Sabaner, Irem Gunes, Rodrigo Anguita, Elon H C van Dijk, Lorenzo Ferro Desideri, Lasse Jørgensen Cehofski, Prithvi Ramtohul, Yousif Subhi","doi":"10.1111/aos.70226","DOIUrl":"https://doi.org/10.1111/aos.70226","url":null,"abstract":"<p><p>This systematic review and meta-analysis synthesized the reported frequency of concurrent macular neovascularization (MNV) among selected eyes with author-defined shallow irregular retinal pigment epithelium (RPE) elevations in age-related macular degeneration (AMD) and chronic central serous chorioretinopathy (CSC). Nine databases were searched on 3 May 2026 for observational studies assessing contemporaneous MNV in phenotype-positive eyes. Studies were classified according to phenotype definition, disease context, unit of analysis and MNV ascertainment directness. Principal quantitative syntheses were restricted to clinically comparable Tier 1 eye-level cohorts, while Tier 2 evidence was examined in a restricted sensitivity analysis. Random-effects meta-analysis of logit-transformed proportions was performed separately by disease, with binomial-normal generalized linear mixed models (GLMM) used as sensitivity analyses. Certainty was assessed using a GRADE-style framework, and the review was registered in PROSPERO (CRD420261384416). Twenty-two reports were included, comprising five AMD and 17 CSC reports. Three selected fellow-eye AMD cohorts contributed 160 double-layer sign (DLS)-positive eyes to the principal AMD analysis; the pooled frequency of contemporaneous MNV was 52% (95% confidence interval [CI], 19%-84%; I² = 72.52%). Five selected chronic CSC cohorts contributed 232 flat irregular pigment epithelial detachment (FIPED)-positive eyes to the principal CSC analysis; the pooled frequency was 43% (95% CI, 25%-63%; I² = 61.32%). A restricted Tier 1 plus Tier 2 CSC sensitivity analysis yielded 39% (95% CI, 23%-57%; I² = 77.89%). GLMM sensitivity analyses produced similar point estimates, although confidence and prediction intervals remained wide. Certainty of evidence was very low. In selected phenotype-positive cohorts, contemporaneous MNV was identified in approximately one-half of DLS-positive AMD eyes and two-fifths of FIPED-positive chronic CSC eyes, but the estimates were imprecise. These findings should not be interpreted as diagnostic, prognostic, population-prevalence or treatment thresholds. Structural OCT phenotypes should prompt disease-contextualized multimodal characterization rather than stand-alone inference of MNV activity or treatment need.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811757","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":"Grading-labour cost analysis of AI-assisted versus human-only diabetic retinopathy screening in two Danish healthcare settings.","authors":"Lars Grønlykke, Sebastian Wiberg, Alex Carter, Peter Heilbo Ratgen, Simon Joel Lowater, Jakob Kristian Holm Andersen, Thiusius Rajeeth Savarimuthu, Jakob Grauslund","doi":"10.1111/aos.70225","DOIUrl":"https://doi.org/10.1111/aos.70225","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetic retinopathy (DR) screening is essential to prevent vision loss, yet rising diabetes prevalence threatens to outpace ophthalmology capacity. Artificial intelligence (AI) systems can triage retinal images to reduce clinician workload, but economic evidence from high-income, tax-funded health systems remains limited. This study presents a cost-minimisation analysis (CMA) of clinician grading labour comparing deep-learning models (DLM)-assisted screening versus human-only DR screening.</p><p><strong>Methods: </strong>This CMA evaluates two Danish healthcare settings differing in DR prevalence: In tertiary diabetes centres with DR grade 2-4 prevalence of 41% and in publicly contracted private ophthalmology practices with DR grade 2-4 prevalence of 6%. Costs were estimated from the healthcare-system perspective over a one-year horizon, including clinician time and wages for image assessment and verification. Sensitivity analyses explored variations in staff time, DR prevalence, DLM false-positive rate, and reimbursement effect.</p><p><strong>Results: </strong>In the tertiary-centre setting (23 696 screens), total annual grading-labour costs were €282 192 for AI-assisted versus €421 425 for human-only screening (33% reduction). In private practice (84 494 screens), the AI-assisted pathway costs were €569 692 versus €1 502 698 (62% reduction). Savings were driven by reduced ophthalmologist time on cases the DLM classified as DR negative. Across all sensitivity analyses, the AI-assisted strategy remained cost-saving.</p><p><strong>Conclusion: </strong>AI-assisted DR screening was cost-minimising in both high- and low-prevalence settings within Denmark's tax-funded health system, with greater savings in lower-prevalence populations. Tariff structures strongly influence payer impact, suggesting that reimbursement models must align with efficiency gains to realise health-system savings from AI triage in routine DR screening.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786638","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":"Optic nerve head blood flow autoregulation during isometric exercise in primary open-angle glaucoma assessed by laser speckle flowgraphy.","authors":"Theresa Lindner, Viktoria Pai, Patrick Janku, Nikolaus Hommer, Anton Hommer, Liudmyla Petric, Ulrich Graf, Leopold Schmetterer, Gerhard Garhöfer, Doreen Schmidl","doi":"10.1111/aos.70230","DOIUrl":"https://doi.org/10.1111/aos.70230","url":null,"abstract":"<p><strong>Purpose: </strong>To assess optic nerve head blood flow (ONHBF) autoregulation in patients with early- to moderate-stage primary open-angle glaucoma (POAG) and age- and sex-matched healthy controls using laser speckle flowgraphy (LSFG) and isometric handgrip exercise.</p><p><strong>Methods: </strong>In this single-centre cross-sectional study, 26 patients with early- to moderate-stage POAG and 28 age- and sex-matched healthy controls were included. ONHBF was measured using LSFG at baseline, during isometric handgrip exercise, and after recovery. Mean arterial pressure (MAP) was recorded at each measurement time point. The relative change in ONHBF during handgrip (ΔBF) and a recovery index (RI) were calculated. Structural and vascular parameters including retinal nerve fibre layer thickness (RNFLT), retinal vessel diameters, and optical coherence tomography (OCT)-angiography-derived vessel density were assessed.</p><p><strong>Results: </strong>Glaucoma patients exhibited significantly lower RNFLT, ONHBF parameters, central retinal artery and vein equivalents, and selected vessel density parameters compared with controls (all p < 0.05). During isometric exercise, MAP increased similarly in both groups (glaucoma: +16 ± 11%; controls: +15 ± 8%; both p < 0.001 vs. baseline; p = 0.981 between groups). However, ONHBF increased significantly more in glaucoma patients (23 ± 16%) than in controls (6 ± 13%) (p = 0.001, group-by-time interaction). The RI did not differ significantly between groups (p = 0.132).</p><p><strong>Conclusion: </strong>Patients with early- to moderate-stage POAG exhibit an altered ONHBF response to isometric exercise despite a comparable increase in systemic blood pressure, suggesting impaired vascular autoregulatory capacity. LSFG combined with handgrip stimulation provides a feasible approach for assessing vascular regulation in glaucoma.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ID: NCT04596826.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786684","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}