Acta Ophthalmologica最新文献

{"title":"Objective measurement of accommodation in patients with an accommodating intraocular lens compared to phakic, presbyopic, and pseudophakic eyes","authors":"Timo Eppig,&nbsp;Manuel Seer,&nbsp;Violetta Müller,&nbsp;Saskia Schütz,&nbsp;Michiel Rombach,&nbsp;Willem van Lawick","doi":"10.1111/aos.17278","DOIUrl":"https://doi.org/10.1111/aos.17278","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Aims/Purpose:</b> The restoration of accommodation after cataract surgery remains to be one of the biggest challenges in ophthalmology. Numerous concepts for restoration of accommodation have failed due to a lack of objective accommodation measurement. The purpose of this study was to demonstrate the dynamic pseudophakic accommodation in patients with an accommodative AIOL by means of an objective accommodation measurement and to compare the data with a young phakic, a presbyopic and a monofocal pseudophakic person.</p>\u0000 \u0000 <p><b>Methods:</b> We included 3 patients in the study who had a Lumina AIOL implanted in both eyes. All patients had completed at least the 6 month follow-up. In addition, we included both eyes of 3 comparative persons with different status of the lens (phakic, presbyopic and pseudophakic). We used a binocular open-field videorefractor (PowerRef 3, Plusoptix GmbH, Germany) to measure the change of refraction, pupil diameter and ocular convergence while patients were asked to focus on an ETDRS chart. The ETDRS chart was then continuously moved from 6m distance to 33 cm distance while the patients were asked to focus on a single letter. The resulting curves were then compared to demonstrate the objective change in refraction.</p>\u0000 \u0000 <p><b>Results:</b> The data exhibit a continuous change of binocular refraction which follows the pupil constriction and decrease of pupil distance (convergence) in the young phakic person and the AIOL patients. The maximum accommodative change was up to 2.5 D in the AIOL patients and up to 3 D in the young phakic person for a stimulus distance of 33 cm. The presbyopic patient and the monofocal pseudophakic patient showed pupil constriction and convergence but the accommodative range was less pronounced with a maximum change of 1 D.</p>\u0000 \u0000 <p><b>Conclusions:</b> The PowerRef 3 allows for an objective proof of pseudophakic accommodation in patients with an AIOL. AIOL eyes show defined change of refractive power that can be maintained constant for the time of fixation to a near target compared to presbyopic and monofocal pseudophakic eyes that show only little modulation, which can be attributed to pseudo-accommodative effects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.17278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116369","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":"Isolated corneal intraepithelial neoplasia: An unheard variety","authors":"Luis Maria Carles-Cerban,&nbsp;Maria Noelia Moraña-Borrageiros,&nbsp;Andrea Alvarez-Novoa-Rodriguez-Cadarso,&nbsp;Roberto Alvarez-Rodriguez,&nbsp;Victoria De-Rojas-Silva","doi":"10.1111/aos.17336","DOIUrl":"https://doi.org/10.1111/aos.17336","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Aims/Purpose:</b> The purpose of this clinical case is to present the symptoms, as well as biomicroscopical, tomographical and histological findings of the isolated corneal intraepithelial neoplasia, a very rare variety of ocular surface squamous neoplasia.</p>\u0000 \u0000 <p><b>Methods:</b> We present the case of a 78-year-old woman with foreign body sensation in her right eye for four months. The cornea presented, apart from crocodile shagreen, a white patch in the temporal-inferior quadrant, separate from the limbus. This lesion showed punctate staining and contained a thin line of normal aspect. The optical coherence tomography (OCT) showed hyperreflective and thickened epithelium with sudden transition to normal cornea.</p>\u0000 \u0000 <p>On suspicion of corneal intraepithelial neoplasia, excisional biopsy was indicated, with Shields's non-touch technique, 2 mm surgical margins and absolute-alcohol application on the limbus.</p>\u0000 \u0000 <p>Furthermore, a review of the past 25 years literature has been performed, using the following key words: <i>corneal intraepithelial neoplasia</i>; <i>ocular surface squamous neoplasia</i>.</p>\u0000 \u0000 <p><b>Results:</b> The histological result showed a corneal intraepithelial neoplasia with non-assessable margins. One week after surgery, the defect had already been replaced by normal epithelium, and we added two cycles of co-adjuvant topical mitomycin C (0.04%). Two years after surgery, the patient is asymptomatic and with no signs of recurrence.</p>\u0000 \u0000 <p>Regarding the review, only 10 cases of isolated corneal intraepithelial neoplasia have been described in the past 25 years. No references of crocodile shagreen concurrence have been found, whereas there is some consensus of surgery as main treatment and OCT as useful diagnostic tool.</p>\u0000 \u0000 <p><b>Conclusions:</b> Isolated corneal intraepithelial neoplasia should always be included in differential diagnosis when it comes to a thickened and atypical lesion in the cornea. In this context, OCT can be useful, whereas final diagnosis and treatment should include excisional biopsy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.17336","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116512","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 polarity effect of direct current stimulation on the vascular regulation of the inner retina","authors":"Stefanie Freitag,&nbsp;Dietmar Link,&nbsp;Sascha Klee","doi":"10.1111/aos.17399","DOIUrl":"https://doi.org/10.1111/aos.17399","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Aims/Purpose:</b> Electrical stimulation is not only a suitable method for researching the human nervous system but also for treating neuronal disorders. In ophthalmology, it is applied to patients suffering from various retinal diseases like retinitis pigmentosa. It is known that in the application of direct current stimulation (DCS), the polarity of the current determines the increase or decrease in neuronal activity and enables different therapeutic approaches. However, the polarisation-dependent effect of the current on the vascular processes in the retina has not yet been investigated. This study examined the effect of anodal and cathodal DCS on the temporal vessels of the inner retina.</p>\u0000 \u0000 <p><b>Methods:</b> The study was conducted on 24 healthy subjects (14w, 10m, mean age 25.5 ± 3.2yr) who were randomly assigned to either an anodal or a cathodal DCS group (symmetrical design). To test the effect of the DCS (800μA; ring-shaped electrode placed surrounding the eye, square electrode placed at the occiput) on vascular regulation, the DCS was combined with visual flicker stimulation using the Dynamic Vessel Analyzer (DVA, Imedos Systems GmbH; standard protocol). Exclusion criteria were ocular and systemic diseases. We investigated two primary vessel segments (superior temporal artery (STa) and vein (STv)) located between 0.5 and 2.0 disc diameters from the optic disc. For each subject the DVA was performed two times (first baseline DVA1, followed by a 20-minute DCS (different polarity depending on the group), and directly afterwards a second DVA2). For statistical analysis, the t-test for paired samples was used and Bonferroni corrected.</p>\u0000 \u0000 <p><b>Results:</b> The mean vascular responses (STa/STv) for the anodal DCS group were DVA1: 3.7 ± 1.7%/3.4 ± 1.6%; DVA2: 3.5 ± 1.3%/5.4 ± 3.2% and for the cathodal DCS group DVA1: 3.2 ± 2.0%/4.0 ± 2.6%; DVA2: 3.2 ± 1.4%/2.5 ± 1.3%. For the venous vascular response, we found a significant increase after anodal DCS (<i>p</i> = 0.019) and a significant decrease after cathodal DCS (<i>p</i> = 0.018).</p>\u0000 \u0000 <p><b>Conclusions:</b> We were able to successfully determine the effect of different DCS polarities on the retinal vascular system. We found significant effects on the veins. The absence of effects on the arteries indicates different regulatory pathways in the retina. This should be investigated by further selective stimulation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.17399","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116519","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":"Investigating the temporal variability of the tear fluid proteome for biomarker discovery","authors":"Erika Ponzini,&nbsp;Carlo Santambrogio,&nbsp;Rita Grandori,&nbsp;Silvia Tavazzi","doi":"10.1111/aos.17020","DOIUrl":"https://doi.org/10.1111/aos.17020","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Aims/Purpose:</b> This study aims to investigate the intraday and day-to-day variability in the tear fluid proteome to better exploit its potential as a source of non-invasive biomarkers by assessing the consistency of tear protein abundance over time.</p>\u0000 \u0000 <p><b>Methods:</b> Tear protein composition was monitored in two individuals over three weeks. Tears were collected weekly, both in the morning and in the afternoon, by microcapillary tube sampling. Ultrahigh-resolution shotgun proteomics was used to analyze the tear fluid samples, providing a detailed profile of the tear proteome.</p>\u0000 \u0000 <p><b>Results:</b> The differential analysis of proteomics data provided a comprehensive overview of the tear fluid proteome. The majority of the identified proteins maintained consistent levels throughout the monitoring period. Specifically, only 25 proteins exhibited significant intraday variation, but no day-to-day fluctuation. These variations were observed in the morning and afternoon samples, indicating that while some proteins may be up- or downregulated within a day, the overall proteome remains largely stable.</p>\u0000 \u0000 <p>The proteins that showed significant variation included those involved in immune response, protein synthesis, and cellular stress response. These findings suggest that while the tear proteome is generally stable, certain proteins may be sensitive to external factors or physiological changes occurring throughout the day.</p>\u0000 \u0000 <p><b>Conclusions:</b> The stability of the tear proteome indicates its viability for non-invasive diagnostic applications, making it a promising source of biomarkers for personalized medical approaches. The study underscores the need for further research into the temporal variability of tear proteins to fully harness their potential.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.17020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116523","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 responses of the aging retina are sexually divergent in Ephx2−/− mice","authors":"Caroline Manicam,&nbsp;Elahe Zare,&nbsp;Norbert Pfeiffer,&nbsp;Natarajan Perumal","doi":"10.1111/aos.17097","DOIUrl":"https://doi.org/10.1111/aos.17097","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Aims/Purpose:</b> Aberrant molecular changes are a major driver of age-related retinopathies. Furthermore, sexual dimorphism is a key variable in disease predilection, although it is not well defined in preclinical studies. Among the potential targets for mitigating age-related proteome modifications attributed to vision impairment, we recently unraveled the protective effects of soluble epoxide hydrolase (sEH/ <i>Ephx2</i>) inhibition in glaucoma. Here, we hypothesized that molecular responses of the aging retina are also sexually divergent in the <i>Ephx2</i>^<i>-/-</i> (KO) mice.</p>\u0000 \u0000 <p><b>Methods:</b> Retinae were isolated from 160 young (3-5 months) and old (12-24 months) wild type (WT) and KO mice of both sexes. Samples were pooled (<i>n</i> = 5 mice/group/replicate) with 4 biological replicates per group and subjected to robust proteomic and bioinformatic analyses to elucidate the underlying mechanistic changes.</p>\u0000 \u0000 <p><b>Results:</b> We observed age- and sex-related body weight changes in mice of both sexes, with no significant differences between the WT and KO mice. Proteome profiling showed significant (<i>p</i> &lt; 0.05) differential expression of proteins between the genders, with a significant involvement in the eIF2 and ferroptosis signaling pathways in both sexes. Remarkably, the female sex exhibited striking resilience against ferroptosis, while the male counterpart demonstrated profound activation of this pathway in both WT (<i>p</i> = 4.2×10^-4; z-score: 1.3) and KO mice (<i>p</i> = 4.2×10^-4; z-score: 2). Intriguingly, aged WT females were highly susceptible to retinal diseases (<i>p</i> = 9.6×10^-4) and neurodegeneration (<i>p</i> = 9.9×10^-4), but KO significantly regulated proteins related to synaptogenesis (<i>p</i> = 3.8×10^-2) and neurotransmission (<i>p</i> = 1.7×10^-2). In addition, KO significantly activated neuritogenesis (<i>p</i> = 5.4×10^-5) and cell-cell contact (<i>p</i> = 1.2×10^-3) in both sexes. It is noteworthy that a major upstream transcription regulator, X-box binding protein 1 (XBP1), which is responsible for maintaining protein homeostasis by ameliorating ER stress, was found only in aged male retinae (WT: <i>p</i> = 3.9×10^-4; KO: <i>p</i> = 8.1×10^-3).</p>\u0000 \u0000 <p><b>Conclusions:</b> Taken together, we showed for the first time a sex-related trend in the proteome of aging KO retina, which is crucial for understanding the pathomechanistic underpinnings of age-related retinal diseases and potential targeted intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.17097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116529","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":"Intravitreal anti-vegf agents and combination treatment in proliferative diabetic retinopathy","authors":"Maciej Gawęcki","doi":"10.1111/aos.16882","DOIUrl":"https://doi.org/10.1111/aos.16882","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p>Proliferative diabetic retinopathy (PDR) poses as a significant threat to patient's vision if untreated or treated insufficiently. Panretinal photocoagulation (PRP) has long been a mainstay treatment for this condition. The advent of anti-VEGF therapy provided an additional option for the management of this condition. The aim of the presentation is to present the effects of anti VEGF treatment in PDR with special emphasis on the combination: PRP with anti-VEGF therapy. Results of treatment with these modalities, especially regression of neovascularization, together with the incidence of potential complications will be discussed. Additional aspects of such therapy, such as BCVA improvement and central retinal thickness reduction will also be presented. Potential indications for such treatment will be outlined as well as possible treatment schedules for such management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.16882","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116551","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":"Development of resources for training machine learning systems for the eye","authors":"Salil A. Lachke","doi":"10.1111/aos.16867","DOIUrl":"https://doi.org/10.1111/aos.16867","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p>Regulation of distinct molecular pathways in coordinately developing tissues drives eye development. This process involves factors in signaling, transcription, translation and post-transcriptional control that together determine the proteome of individual cells. Characterizing these regulatory events and their relationships with each other in distinct ocular tissues will lead to the derivation of gene regulatory networks (GRNs) for eye development, which in turn will allow building of the “developmental oculome” (Lachke, Maas (2010) Wiley Interdiscip Rev Syst Biol Med 2(3):305-323 doi: 10.1002/wsbm.59). Toward this goal, we generated and analyzed various omics datasets on developing eye tissues, performed functional characterization of key molecules, and developed a web resource called iSyTE (Anand, Lachke (2017) Exp Eye Res 156:22-33 PMC5026553; Kakrana et al (2018) Nucleic Acids Res 46(D1): D875-D885 doi: 10.1093/nar/gkx837; Lachke (2022) Exp Eye Res 214:108889 PMC8792301). To extract further insights from these omics data, it is necessary to analyze them in the context of experimentally verified data on the eye. These data can be used for training machine learning systems to develop models for eye development. The data used for training represents a an important factor in machine learning systems, i.e. the quality of these data is a key contributor that determines the robustness of the resulting models. There is a wealth of molecular functional (i.e. experimental evidence-based) data on the eye that has been generated by researchers worldwide over the past several decades. These individual regulatory data “nodes” (regulators and targets) – currently “static” in the literature with limited connectivity – hold rich potential to define detailed, and importantly, experimentally validated GRNs that can be used for training machine learning systems. As proof of principle, we have focused on ocular lens development and curated mechanistic data from individual gene perturbation evidences in the mouse from &gt;100 original research articles. This has led to definition of thousands of experimentally validated relationships (edges) between key factors and their targets (nodes) in lens development. These resources serve as strong foundational data for training machine learning systems and represent the essential first step toward advancing our understanding of the natural computing governing eye development, and how its perturbation results in ocular developmental disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.16867","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116579","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":"Dalk – when and how","authors":"Mohamed Goweida","doi":"10.1111/aos.16861","DOIUrl":"https://doi.org/10.1111/aos.16861","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p>Deep anterior lamellar keratoplasty (DALK) is a surgical procedure that involves replacing the anterior portion of the cornea with donor tissue while preserving the patient's endothelium. This technique has gained popularity in recent years as an alternative to traditional penetrating keratoplasty (PK) due to its potential advantages in terms of visual outcomes, graft survival and reduced risk of endothelial rejection.</p>\u0000 \u0000 <p>The decision to perform DALK in keratoconus is based on various factors, including the keratometric readings, corneal thickness, corneal clarity and RGP tolerability.</p>\u0000 \u0000 <p>Surgical technique plays a critical role in the success of DALK. Several approaches have been described to perform the DALKs; the big bubble technique is considered the most convenient for all surgeons. Other techniques were used according to the associated pathology.</p>\u0000 \u0000 <p>This presentation is a quick journey into DALK indications and various techniques used in eyes with keratoconus.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.16861","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116581","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 vitrectomy in the management of diabetic macular oedema","authors":"Odysseas Georgiadis","doi":"10.1111/aos.16873","DOIUrl":"https://doi.org/10.1111/aos.16873","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;p&gt;Diabetic macular oedema (DMO) poses a significant challenge in the management of diabetic retinopathy (DR), contributing to substantial visual impairment in diabetic patients. Over the years, vitrectomy has emerged as a valuable surgical approach in the armamentarium against DMO, and has evolved to play a pivotal role in addressing cases refractory to conventional therapies, either as a standalone or as adjunctive therapy. The rationale behind this approach lies in the ability of vitrectomy to directly remove the vitreous scaffold, which is implicated in the pathogenesis of DMO via two basic mechanisms, the tractional and the biochemical.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;Vitrectomy can eliminate both the anterior-posterior traction caused by the vitreous, and the tangential forces on the macula, caused by epiretinal membranes, both common contributors to DMO. Clearance of the vitreomacular interface alleviates the mechanical stress on the macula, leading to improvements in central retinal thickness and visual acuity. Furthermore, improved visualisation of the macula facilitates the monitoring and management of the DMO and the DR in the long term.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;In terms of the biochemical component, vitrectomy can play a significant role in modulating oxygen consumption of the vitreous and alleviating retinal hypoxia. The vitreous humour serves as a conduit for oxygen diffusion to the avascular inner retina. In diabetic eyes, vitreous liquefaction and retinal vascular deficiency disrupt oxygen transport, exacerbating retinal hypoxia and promoting VEGF production and neovascularisation. Studies have shown that vitrectomy can increase the oxygen delivery to the retina and improve the perifoveal capillary blood flow. Oxygen is known to suppress VEGF, and thus reduce vascular permeability leading to DMO improvement. Moreover, recent studies have shown that removal of the vitreous reduces the levels of histamine, VEGF, and free radicals in the preretinal space. Additionally, the foveal avascular zone has been shown to decrease after vitrectomy, which might indicate a protective effect on DMO, similar to anti-VEGF injections.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;However, the exact mechanisms by which vitrectomy may improve DMO are not yet fully understood, neither is the prognosis for post-operative visual improvement. The functional outcomes in different studies are very heterogenous and vary from significant vision gain to no improvement despite good anatomical results. The preoperative integrity of the external limiting membrane and the pre-existing damage to the outer retina often limit the outcome. Additionally, a subretinal fluid component of DMO seems to affect the visual prognosis, while the advantage of inner limiting membrane peeling, in the cases of non-tractional DMO, remains controversial, as there is no substantial data available to clarify its efficacy.&lt;/p&gt;\u0000 ","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.16873","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116585","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":"Iris, ciliary body and choroid metastasis from salivary duct carcinoma of parotid gland: Case report","authors":"Vasco Lobo,&nbsp;Bernardo Monteiro,&nbsp;Rafael Whitfield,&nbsp;Cecília Alvim,&nbsp;Filomena Pinto","doi":"10.1111/aos.17335","DOIUrl":"https://doi.org/10.1111/aos.17335","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Aims/Purpose:</b> Report a rare case of salivary duct carcinoma (SDC) of the left parotid gland metastatic to the iris, ciliary body and choroid.</p>\u0000 \u0000 <p><b>Methods:</b> Data collection from clinical records.</p>\u0000 \u0000 <p><b>Results:</b> A 70-year-old woman with a history of stage IV SDC of the left parotid (pT2 cNx cM1) diagnosed in November 2020, treated with palliative chemotherapy with cisplatin since October 2021, presented to Ophthalmology department in Hospital de Santa Maria, Lisbon, Portugal in November 2021 due to a solid lesion in the anterior chamber and progressive declining vision of the left eye. Ultrasound biomicroscopy showed a 6.7x12.0x4.7mm cupuliform mass in the iris, with high reflectivity and heterogeneous internal structure, involving the ciliary body and displacing posteriorly the intraocular lens. Posterior segment ultrasound revealed a solid cupuliform lesion of the ocular wall, approximately 3 mm thick, with high reflectivity and a heterogeneous structure. The ultrasound characteristics were consistent with secondary intraocular lesion of the iris, ciliary body and choroid and orbital MRI supported this diagnosis. In December 2021, due to global systemic progression after three cycles of cisplatin, the patient was switched to 9 cycles of doxorubicin+cyclophosphamide, with apparent stabilization of the systemic disease. In September 2022, there was a significant reduction in the size of the iris metastasis, even though the posterior segment ultrasound demonstrated progression of the intraocular disease, now with multifocal choroidal metastasis in both eyes, associated with exudative detachment of the retina in the right eye. Due to multiple cerebral metastasis, the patient underwent holocranial radiotherapy 30 Gy/10 fractions, with ophthalmological findings being unchanged in October 2022. She underwent two more cycles of paclitaxel, which was suspended due to clinical deterioration. The patient died in December 2022, with a survival of 25 months (13 months since diagnosis of intraocular metastases).</p>\u0000 \u0000 <p><b>Conclusions:</b> The case reports a rare presentation of metastatic SDC to the eye.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.17335","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116595","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}