Acta Ophthalmologica最新文献

{"title":"Occult GCA: A rare variant of Giant Cell Arteritis","authors":"Lorenzo Huang, Fariba Fallahzadeh, Gauti Jóhannesson","doi":"10.1111/aos.16731","DOIUrl":"10.1111/aos.16731","url":null,"abstract":"<p>An 82-year-old Scandinavian woman with hypertension and diabetes mellitus type 2 experienced 1–2 seconds of blurred vision alternating between right and left eye, never together. There were no associated symptoms such as fatigue, headache or jaw claudication, no sign of temporary visual field loss or ‘dark curtain’. The visual acuity was 0.6/0.6 Snellen explained by moderate cataract with pseudo exfoliation, normal bilateral intraocular pressure and fundoscopy that revealed optic disks with normal size and features bilaterally. There was bilateral calcification-like deposit on the central cornea, initially thought to explain her brief visual disturbances. She was discharged with tear substitutes and instructed to return in case of worsening of symptoms.</p><p>The patient contacted the clinic a week later, reporting altitudinal lower visual field loss in her left eye that worsened to almost total visual loss (Figure 1a). Upon examination, the patient confirmed again absence of the above-mentioned symptoms (no temporal/generalized headache, jaw claudication, scalp pain while combing hair or polymyalgia rheumatica symptoms), no signs of confusion, tiredness, neurological abnormalities, pain in the eye, weight loss or fever. She was a non-smoker and did not have sleep apnoea. Her left eye had 0.4 Snellen visual acuity, optic disc swelling (Figure 1b), no signs of retinal ischemia and a positive left relative afferent pupillary defect (RAPD). C-reactive protein (CRP) and sedimentation rate (SR) were normal, orbital magnetic resonance imaging (MRI) showed no optic abnormalities that could explain the visual field loss. Despite the lack of giant cell arteritis (GCA) symptoms, a rheumatologist was consulted and according to his assessment, an ultrasound (US) evaluation was not deemed necessary. The patient was diagnosed with left sided non-arteritic anterior ischemic optic neuropathy (NA-AION) with a referral to the general practitioner for further cardiovascular risk evaluation.</p><p>The patient was followed up with periodical visual field and visual acuity assessment without reporting new vision deterioration. An additional neck-brain angiography showed no significant findings such as endangering stenosis and the patient was treated with 40 mg oral prednisolone for 2 weeks. Over 2 months of follow up, the left visual field improved from visual field index (VFI) 8–24% and the left optic disc swelling regressed to optic atrophy.</p><p>The patient contacted the eye clinic 3 weeks before the planned final-check due to sudden upper altitudinal hemianopia in her right eye and worsening of her remaining left visual field (Figure 2a). Like before, the patient was totally asymptomatic, no symptoms as listed above besides the sudden right visual field loss. The examinations revealed worsening of visual acuity (0.4/0.3), a fresh right optic disc swelling (Figure 2b) and optic disc atrophy on the left (Figure 2c). Due to bilateral worsening with neither GCA sy","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 8","pages":"968-973"},"PeriodicalIF":3.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.16731","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141503823","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 possible association between intraocular pressure changes and pigment epithelial detachment in central serous chorioretinopathy","authors":"Chandrakumar Balaratnasingam,&nbsp;Christine A. Curcio,&nbsp;William H. Morgan,&nbsp;Elon H. C. van Dijk","doi":"10.1111/aos.16730","DOIUrl":"10.1111/aos.16730","url":null,"abstract":"<p>Central serous chorioretinopathy (CSC) is a frequently occurring chorioretinal disease, that is commonly associated with subretinal fluid accumulation in a generally young population. Even though choroidal abnormalities have been found to be of importance, the exact pathogenesis of CSC is still being learned. The origin of pigment epithelial detachments, seen in many CSC patients, is also unclear. Based on the follow-up of a CSC patient for more than 5 years, we hypothesize that intraocular pressure and, by extension, the pressure gradient across the Bruch's membrane, may be one factor in the pathogenesis of pigment epithelial detachments in CSC, which might very well have implications for the occurrence of and possible ways to prevent subretinal fluid in CSC.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 7","pages":"843-848"},"PeriodicalIF":3.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.16730","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141299686","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":"Risk of post-injection endophthalmitis peaks within the first three injections of anti-vascular endothelial growth factor therapy: A nationwide registry-based study","authors":"Benjamin Sommer Thinggaard,&nbsp;Frederik Pedersen,&nbsp;Ryo Kawasaki,&nbsp;Jimmi Wied,&nbsp;Yousif Subhi,&nbsp;Jakob Grauslund,&nbsp;Lonny Stokholm","doi":"10.1111/aos.16727","DOIUrl":"10.1111/aos.16727","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To report the incidence of post-injection endophthalmitis (PIE) and the cumulative risk associated with repeated injections of intravitreal anti-vascular endothelial growth factor (anti-VEGF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We employed nationwide registries in Denmark to include all individuals aged ≥40 years who received at least one intravitreal anti-VEGF injection in 2007–2022. Our primary endpoint PIE was identified using specific diagnostic codes for endophthalmitis and procedure codes for vitreous biopsy within 10 days prior to and 120 days post-injection. Patients were stratified according to the underlying diagnoses for which they received the treatment. The relative risk (RR) for PIE was calculated between groups based on the number of injections received by the patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 60 825 patients who received intravitreal anti-VEGF treatment during study time, with a median age of 77.2 years and females constituting 58.1%. We identified 232 cases of PIE after 1 051 549 injections during follow-up, resulting in an incidence of 0.022% [95% CI 0.019%–0.025%]. Despite a linear growth in annual anti-VEGF use, the incidence remained stable at 0.020% [95% CI 0.017%–0.023%] from 2013 to 2022. Compared to patients receiving 1–3 injections, RR for patients receiving 4–20, 21–40, and &gt;40 injections were 0.46 [95% CI 0.34–0.63], 0.32 [95% CI 0.21–0.50], and 0.54 [95% CI 0.36–0.81], respectively. Findings were similar across the different diagnoses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Based on 16 years of nationwide registry data, this study identified a low and stable incidence of PIE. Notably, the highest risk of endophthalmitis was within the first three anti-VEGF injections.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 8","pages":"953-962"},"PeriodicalIF":3.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.16727","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199224","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":"Long-term visual outcomes and ocular complications in children with Marner's hereditary cataracts operated in the period 1940–2021","authors":"Diana Chabané Schmidt,&nbsp;Daniella Bach-Holm,&nbsp;Line Kessel","doi":"10.1111/aos.16729","DOIUrl":"10.1111/aos.16729","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To investigate visual development and long-term complications after cataract surgery in childhood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study included patients from a family with Marner's hereditary cataracts who had cataract surgery before 18 years of age. The study was conducted from 1 January 2022 until 31 December 2022. The patients contributed to their medical files and participated in an updated ophthalmologic examination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 52 patients (101 eyes, 34 females). The median age at cataract surgery was 7 years (IQR: 5–10) and the age at examination was 40 years (IQR: 21–54). Primary and secondary intraocular lens implantation had been performed in 47.5% (25 patients, 48 eyes) and 16.8% (10 patients, 17 eyes). Visual acuity was ≤0.3 logMAR in 77% (78 eyes), and &lt;0.5 logMAR in 8% (8 eyes). Glaucoma was present in 17% (9 patients, 12 eyes), ocular hypertension in 6% (3 patients, 4 eyes), and 10% (5 patients, 5 eyes) had prior retinal detachment. Mild visual field loss (2 &lt; mean defect (MD) ≤ 6 dB) was found in 62% (63 eyes) and moderate to advanced visual field loss (MD &gt; 6 dB) in 24% (24 eyes). Thirty-five patients (67%) held a driver's licence, and three were not allowed to drive due to low visual function. All patients were employed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>After cataract surgery in childhood, many patients achieve normal visual acuity, but mild visual field loss is common. Long-term follow-up is important due to the high risk of glaucoma.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 8","pages":"914-921"},"PeriodicalIF":3.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.16729","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199223","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":"Atrial fibrillation and flutter and ocular diseases. The Ural eye and medical study and the Ural very old study","authors":"Mukharram M. Bikbov,&nbsp;Gyulli M. Kazakbaeva,&nbsp;Ellina M. Rakhimova,&nbsp;Songhomitra Panda-Jonas,&nbsp;Albina A. Fakhretdinova,&nbsp;Azaliia M. Tuliakova,&nbsp;Iulia A. Rusakova,&nbsp;Jost B. Jonas","doi":"10.1111/aos.16726","DOIUrl":"10.1111/aos.16726","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To assess associations between atrial fibrillation/atrial flutter (AF) and ocular parameters and diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The population-based Ural Eye and Medical Study (UEMS) and the Ural Very Old Study (UVOS) included 4894 individuals (age: 40+ years) and 835 individuals (age: 85+ years), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the UEMS, AF prevalence (80/4894; 1.6%; 95% CI: 1.3, 2.0) increased from 1/1029 (0.1%) in the age group of 40 to &lt;50 years to 29/619 (4.7%) and 12/159 (7.5%) in the age groups of 70 to &lt;80 years and 80+ years, respectively. Higher AF prevalence correlated with older age (OR: 1.08; 95% CI: 1.04, 1.12; <i>p</i> &lt; 0.001), urban region of habitation (OR: 1.08; 95% CI: 1.04, 1.12; <i>p</i> &lt; 0.001), higher prevalence of cardiovascular disease/stroke (OR: 2.50; 95% CI: 1.32, 4.72; <i>p</i> &lt; 0.001) and lower prevalence of neck pain (OR: 0.35; 95% CI: 0.14, 0.85; <i>p</i> = 0.02), higher serum concentration of bilirubin (OR: 1.03; 95% CI: 1.02, 1.05; <i>p</i> &lt; 0.001) and lower prothrombin index (OR: 0.96; 95% CI: 0.93, 0.99; <i>p</i> = 0.003), higher stage of arterial hypertension (OR: 1.52; 95% CI: 1.01, 2.28; <i>p</i> = 0.04) and higher ankle-brachial index (OR: 22.1; 95% CI: 4.45, 1.10; <i>p</i> &lt; 0.001). In that model, AF prevalence was not associated with ocular parameters such as intraocular pressure (<i>p</i> = 0.52), retinal nerve fibre layer thickness (<i>p</i> = 0.70), refractive error (<i>p</i> = 0.13), axial length (<i>p</i> = 0.14), nuclear cataract degree (<i>p</i> = 0.50) and prevalence (<i>p</i> = 0.40), cortical cataract degree (<i>p</i> = 0.43) and presence (<i>p</i> = 0.17), lens pseudoexfoliation (<i>p</i> = 0.58), status after cataract surgery (<i>p</i> = 0.38), age-related macular degeneration prevalence (<i>p</i> = 0.63), open-angle glaucoma presence (<i>p</i> = 0.90) and stage (<i>p</i> = 0.55), angle-closure glaucoma prevalence (<i>p</i> = 0.99) and stage (<i>p</i> = 0.99), diabetic retinopathy prevalence presence (<i>p</i> = 0.37) and stage (<i>p</i> = 0.32), and myopic macular degeneration (<i>p</i> = 0.98). In the UVOS, similar results were obtained.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In these multi-ethnic populations from Russia, AF prevalence was not associated with any major ocular disease and may not play a major role in the pathogenesis of these disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 7","pages":"e1057-e1065"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141185963","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":"Topical glaucoma medications − Possible implications on the meibomian glands","authors":"Fredrik Fineide,&nbsp;Morten Magnø,&nbsp;Kristian Dahlø,&nbsp;Miriam Kolko,&nbsp;Steffen Heegaard,&nbsp;Jelle Vehof,&nbsp;Tor Paaske Utheim","doi":"10.1111/aos.16728","DOIUrl":"10.1111/aos.16728","url":null,"abstract":"<p>One of the most common causes of blindness on a global scale is glaucoma. There is a strong association between glaucoma and increased intraocular pressure (IOP). Because of this, adequate IOP-lowering is the most important treatment strategy, mostly through topical eyedrops. Well-functioning meibomian glands are paramount for maintaining a stable tear film, and their dysfunction is the most common cause of dry eye disease. There is a growing concern that both topical glaucoma medications themselves and their added preservatives damage the meibomian glands, and consequently, the ocular surface. Preserved topical glaucoma medications appear to cause dysfunction and atrophy of the meibomian glands. Upon comparison, preserved formulations caused more symptoms of dry eye, tear film instability, inflammatory changes and meibomian gland dropout than the preservative-free counterpart. However, although seemingly less detrimental, unpreserved alternatives may diminish glandular efficacy, and, depending on the active ingredient, lead to glandular death. This negatively impacts quality of life, adherence to treatment regimens and prognosis. In this review, we explore the available evidence regarding the effects of IOP-lowering eye drops on the meibomian glands.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 7","pages":"735-748"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.16728","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141185964","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":"Comparing the impact of surgical expert versus non-ophthalmologist instructors on virtual-reality surgical performance: A randomized controlled trial","authors":"Lars Christian Boberg-Ans,&nbsp;Daniel Ethan Hutter,&nbsp;Morten La Cour,&nbsp;Lars Konge,&nbsp;Anton Le,&nbsp;Andreas Vangsted,&nbsp;Ann Sofia Skou Thomsen","doi":"10.1111/aos.16719","DOIUrl":"10.1111/aos.16719","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare Manual Small Incision Cataract Surgery (MSICS) microsurgical performance in course participants who received virtual reality simulation-based training by either a surgical expert or a non-ophthalmologist instructor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Randomized controlled trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Residents and specialists in ophthalmology with no prior MSICS experience were included to receive virtual reality simulation training in MSICS using the HelpMeSee simulator. The participants were randomly allocated to receive training from either an experienced MSICS surgeon or a non-ophthalmologist, also known as near-peer teaching. The performances of the participants were evaluated at baseline and post-training using a MSICS proficiency-based test with evidence of validity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty participants were included in the study and 29 completed the course. There was no significant difference in final test score between the two groups (<i>p</i> = 0.13). The performance score of both groups of participants increased significantly after receiving the training (<i>p</i> &lt; 0.001). All participants passed the proficiency-based test after receiving the training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We found no significant difference in surgical proficiency-level whether the participants were trained by a surgical expert or a non-ophthalmologist instructor for MSICS in a virtual-reality based setting. The findings of this study suggest that near-peer teaching within microsurgical performance potentially could be applied with teaching outcomes comparable to a surgical expert-instructor.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 8","pages":"906-913"},"PeriodicalIF":3.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.16719","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141178627","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":"Foveal thickness and its association with visual acuity in adults born preterm with very low birth weight: A two-country birth cohort study","authors":"Anna P. M. Jørgensen,&nbsp;Maarit Kulmala,&nbsp;Dordi Austeng,&nbsp;Kari Anne I. Evensen,&nbsp;Eero Kajantie,&nbsp;Anna Majander,&nbsp;Tora Sund Morken","doi":"10.1111/aos.16725","DOIUrl":"10.1111/aos.16725","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To explore foveal and parafoveal thickness in adults born preterm with very low birth weight (VLBW) and its association with best-corrected visual acuity (BCVA) and gestational age (GA) compared to adults born at term.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a joint study of the Helsinki Study of Very Low Birth Weight Adults (Finland) and the NTNU Low Birth Weight Life study (Norway), 106 VLBW and 143 term-born controls were examined with spectral-domain optical coherence tomography and BCVA at age 31–43 years. Thickness of retinal layers was segmented in the foveal and parafoveal areas of the macula.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The total retinal thickness in the foveal area was thicker in VLBW adults compared with controls; mean (SD): 292.5 μm (28.2) and 272.4 μm (20.2); <i>p</i> &lt; 0.001, and thinner in the parafoveal areas of the macula. These findings could be explained by a thicker inner retinal layer in the foveal area found in VLBW adults compared with controls (mean difference 20.4 μm; CI: 15.0 to 25.9), where a thicker fovea was associated with lower GA, but not BCVA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Adults born preterm with VLBW had a thicker retina in the foveal area than controls and this was associated with GA, but not with BCVA. These changes seem to be related to a thicker inner retinal layer in VLBW adults. The findings imply that signs of macular underdevelopment are still present in adulthood, but not necessarily related to reduced visual function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 8","pages":"942-952"},"PeriodicalIF":3.0,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.16725","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141160005","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":"Early surgical treatment of retinal haemangioblastomas: 10-year follow-up","authors":"Koen A. van Overdam,&nbsp;Marc Veckeneer,&nbsp;Anass Hajjaj,&nbsp;Emine Kilic,&nbsp;Jennifer S. N. Verhoekx","doi":"10.1111/aos.16724","DOIUrl":"10.1111/aos.16724","url":null,"abstract":"<p>Retinal haemangioblastomas (RHs) are benign vascular tumours that can cause significant visual morbidity. They occur as solitary tumours or as part of von Hippel-Lindau (VHL) disease and may pose considerable challenges in treatment, depending on size, location, multifocality, bilaterality and tumour-related complications (Hajjaj et al., <span>2022</span>). Small peripheral RHs (&lt;1.5 mm) can be effectively treated with laser photocoagulation, whereas cryotherapy and plaque radiotherapy appear relatively safe and effective for peripheral tumours ranging from 1.5 to 4.5 mm in size. Anti-vascular endothelial growth factor (anti-VEGF) therapy, which may reduce exudation and inhibit RH growth, along with photodynamic therapy (PDT), are considered safer options for juxtapapillary lesions but less effective for complete destruction of peripheral RHs.</p><p>While emerging treatments such as systemic sunitinib and belzutifan show promise in managing VHL-related RHs, vitreoretinal surgery still remains inevitable for larger peripheral tumours (&gt;4.5 mm) and tumours complicated by exudation, traction and retinal detachment. Previously, we reported on the early surgical treatment of four patients with a large peripheral RH accompanied by traction and exudation (Van Overdam et al., <span>2017</span>). Here, we present an extended follow-up of at least 10 years to further discuss their clinical course (Table 1). The insights derived from this follow-up have proven beneficial for subsequent patients, especially those with a more complex presentation.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 7","pages":"836-842"},"PeriodicalIF":3.0,"publicationDate":"2024-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.16724","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155118","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 role of phacoemulsification surgery in the incidence rate of rhegmatogenous retinal detachment","authors":"Birgitte Romme Nielsen,&nbsp;Mark Alberti,&nbsp;Morten Lyng Høgild,&nbsp;Toke Bek,&nbsp;Benjamin Sommer Thinggaard,&nbsp;Jakob Grauslund,&nbsp;Ulrik Christensen,&nbsp;Morten la Cour","doi":"10.1111/aos.16723","DOIUrl":"10.1111/aos.16723","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To investigate changes in the incidence rate of primary rhegmatogenous retinal detachment (RRD) surgery over time and to determine to what extent these changes can be attributed to pseudophakia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This nationwide cohort study was based on national patient registries. The study population comprised individuals at risk of RRD aged 40 years and above from 2006 to 2021 in Denmark. The primary outcome was RRD incidence, and the exposure was phacoemulsification surgery. A chart review was conducted to validate and examine the lens status of the outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The crude and age-adjusted incidence rate of RRD in the Danish population increased significantly during the study period. The largest increase in RRD was seen in phakic RRD (phRRD) (65%), whereas pseudophakic RRD (pRRD) accounted for 35% of the total increase. A chart review revealed that 17% of phRRDs were misclassified as pseudophakic, resulting in pRRD accounting for a total of 45% of the increase in RRD. The prevalence of pseudophakia in Denmark grew significantly for all age groups and for both sexes (<i>p</i> = 10⁻⁶) from 2006 to 2021, but the 1-year incidence of pRRD in the pseudophakic population was constant throughout the entire period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The incidence rate of RRD is continuing to increase in Denmark. The increase in phRRD remains undetermined, and while the risk of pRRD seemed to be constant during the study period, 45% of the overall increase in RRD could be attributed to the rise of a growing pseudophakic population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 8","pages":"931-941"},"PeriodicalIF":3.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.16723","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086469","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}