Acta Ophthalmologica最新文献

{"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}

{"title":"Progression of diabetic retinopathy during pregnancy: Retrospective study from birmingham and solihull","authors":"Ahmad Khalifa,&nbsp;Joseph Sobha","doi":"10.1111/aos.17423","DOIUrl":"https://doi.org/10.1111/aos.17423","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Aims/Purpose:</b> To assess the progression of diabetic retinopathy (DR) in pregnant women with pre-existing diabetes in the Birmingham and Solihull area and to evaluate adherence to recommended screening guidelines.</p>\u0000 \u0000 <p><b>Methods:</b> A retrospective review was conducted over 12 months (01/09/2022-31/08/2023) using data from the Diabetic Eye Screening Program (DESP) and hospital records (Medisoft, OCT, and retina images). The study included pregnant women with pre-existing diabetes who received maternity services at University Hospitals Birmingham (UHB) and were referred to DESP. Patients with gestational diabetes were excluded. Data collected included demographics, DR screening attendance, progression rates, and clinical outcomes.</p>\u0000 \u0000 <p><b>Results:</b> Out of 149 pregnant women with pre-existing diabetes, 54 (36.2%) were not referred for initial screening by 12 weeks due to late presentation and delayed diabetes status confirmation. Of the total, 88 (59%) missed the 12-week screening, 57 (40%) missed the 16-20 week screening, and 67 (48%) missed the 28-week screening. At 12 weeks, 27% were R0M0, 9% R1M0, 3% R1M1, and 1% R2M0/R2M1, with 8 referred to HES. At 16-20 weeks, 43% were R0M0, 16% R1M0, 1% R3SM0, and 1% were unable to assess, with 2 referred to HES. By 28 weeks, 37% were R0M0, 12% R1M0, 1% R3SM1, and 2% were still being graded, with 1 referred to HES. The study highlighted significant cases, including one patient who progressed to severe NPDR and required bilateral PRP and Ozurdex treatment, and another who developed DMO treated with Ozurdex.</p>\u0000 \u0000 <p><b>Conclusions:</b> Diabetic retinopathy progression during pregnancy remains a significant concern, with many patients missing critical screening appointments, leading to advanced DR stages and severe visual impairment. Despite adherence to screening guidelines, patient non-compliance and late referrals hinder effective management. Improved patient education and follow-up strategies are essential to enhance screening attendance and outcomes, thereby preventing severe DR progression during pregnancy. Further research is necessary to develop targeted interventions for better compliance and timely treatment.</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.17423","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116603","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":"Six-month efficacy of red-light therapy and customised orthokeratology for myopia control in Spanish children","authors":"Fernando Fernandez Velazquez,&nbsp;María Fernández Fidalgo,&nbsp;Victoria Ferigo Ferrel","doi":"10.1111/aos.17156","DOIUrl":"https://doi.org/10.1111/aos.17156","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Aims/Purpose:</b> To evaluate the efficacy and safety of repeated low-level red-light (RLRL) therapy with customised orthokeratology (Ortho-K) for myopia control in Spanish children.</p>\u0000 \u0000 <p><b>Methods:</b> This single-site, randomised, parallel-group, non-blinded trial enrolled 26 children aged 10-13 years with myopia. A total of 26 children were enrolled, completing the 6-month follow-up in May 2024. Children were randomly assigned to either the RLRL combined with the Ortho-K or the Ortho-K-only group. The Ortho-K group was required to wear Ortho-K lenses for at least 8 hours per night. In addition to wearing Ortho-K lenses in the adjunct therapy group, daily RLRL therapy was administered twice a day for 3 minutes per session. The primary outcome was the axial length (AL) change measured at 6 months relative to baseline.</p>\u0000 \u0000 <p><b>Results:</b> Twenty-six children completed the study (11 in the RLRL + Ortho-K group and 15 in the Ortho-K group). After 6 months, the mean AL change was -0.06 mm (95% CI, -0.12 to 0.01 mm) in the RLRL +Ortho-K group, significantly lower than in the Ortho-K group (0.04 mm [-0.12 to 0.01 mm], <i>p</i> = 0.001). In the RLRL + Ortho-K group, 5 children (45.5%) achieved significant axial shortening (AL changes &lt; = -0.05 mm). The mean change in macular thickness was 0.66 μm (95% CI, 0.05 to 1.28 μm) in the RLRL + Ortho-K group, significantly greater than in the Ortho-K group (0.08 μm [0.001 to 0.15 μm], <i>p</i> = 0.022). No severe adverse events were reported, such as vision loss, scotoma, functional visual loss, or structural damage on OCT scans. No significant corneal findings were observed.</p>\u0000 \u0000 <p><b>Conclusions:</b> Combining RLRL therapy with customised Ortho-K shows promise for controlling myopia progression in Spanish children. This approach may provide clinical benefits in managing myopia without severe adverse 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.17156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116605","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":"Systems pharmacology demonstrates broad-spectrum efficacy in animal models of retinopathies","authors":"Henri Leinonen,&nbsp;Katri Vainionpää,&nbsp;Ahmed Montaser,&nbsp;Umair Seemab,&nbsp;Jianye Zhang,&nbsp;Laurence Occelli,&nbsp;Alexander Kolesnikov,&nbsp;Vladimir Kefalov,&nbsp;Philip Kiser,&nbsp;Marcin Tabaka,&nbsp;Simon Petersen-Jones,&nbsp;Krzysztof Palczewski","doi":"10.1111/aos.16935","DOIUrl":"https://doi.org/10.1111/aos.16935","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Aims/Purpose:</b> Excessive levels of the intracellular second messengers Ca²⁺ and cAMP have been linked with photoreceptor cell death during retinal degeneration (RD). We investigated if a combination (TMB) of common clinical drugs; tamsulosin and metoprolol (alpha- and beta-adrenergic antagonists, Gq- and Gs-coupled, respectively), and bromocriptine (a D2-like dopamine-receptor agonist, Gi-coupled), that inhibit intracellular Ca²⁺ and cAMP signaling could be repurposed to mitigate RD.</p>\u0000 \u0000 <p><b>Methods:</b> Drug efficacy was tested in four distinct RD models: rd10, P23H, and <i>Rpe65</i>^{−<i>/</i>−} mice; and <i>PDE6A</i>^{−<i>/</i>−} dogs. The duration of the drug trials ranged from 1-wk to 7-months. Drug serum levels were measured by liquid chromatography-mass spectrometry (LC-MS). We used primarily photopic and scotopic electroretinography (ERG) and optical coherence tomography (OCT) to assess drug efficacy. Molecular biology methods such as immunohistochemistry, immunoblotting, and RNA-sequencing (bulk and single cell) were used to document therapeutic mechanisms, as well as to confirm therapeutic effects.</p>\u0000 \u0000 <p><b>Results:</b> Dietary TMB improved cone function and slowed cone degeneration in P23H mice. In rd10 mice, both rod and cone function were significantly improved by TMB; and cone degeneration was significantly slowed. In dark-reared rd10 mice, the drug efficacy was associated with decreased lipid peroxidation preceding the onset of cone degeneration. Dietary TMB improved retinal function and optomotor responses in <i>Rpe65</i>^{−<i>/</i>−} mice but did not halt rod or cone degeneration. Seven-month-long subcutaneous sustained infusion of TMB into <i>PDE6A</i>^{−<i>/</i>−} dogs led to higher cone counts at the end of the trial. TMB mitigated forskolin-induced cAMP activity in an <i>ex vivo</i> retina preparation.</p>\u0000 \u0000 <p><b>Conclusions:</b> Our results suggest that simultaneous inhibition of Gs- and Gq-coupled receptors and activation of Gi-coupled receptors by a combination of existing drugs is a viable therapeutic strategy for RD.</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.16935","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116630","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":"Defocus incorporated multiple segments lenses and 0.025% atropine for myopia control in European children: 12-month results of a randomized controlled trial","authors":"Noemi Guemes Villahoz,&nbsp;Paula Talavero-Gonzalez,&nbsp;Rafael Bella-Gala,&nbsp;Paloma Porras-Angel,&nbsp;Elena Hernandez-Garcia,&nbsp;Beatriz Martin-Garcia,&nbsp;Alicia Ruiz-Pomeda,&nbsp;C. Nunila Gomez-de-Liano,&nbsp;Rakhee Shah,&nbsp;Julian Garcia Feijoo,&nbsp;Rosario Gomez-de-Liano","doi":"10.1111/aos.16930","DOIUrl":"https://doi.org/10.1111/aos.16930","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Purpose:</b> Defocus Incorporated Multiple Segments (DIMS) lenses and atropine have proven standalone efficacy in controlling myopia progression in children. However, there is a scarcity of evidence of their efficacy when used in combination. This randomized controlled trial (RCT) aims to evaluate the efficacy of combination treatment using 0.025% atropine and DIMS spectacle lenses compared to 0.025% atropine and single vision (SV) lenses in slowing myopia progression in European myopic children.</p>\u0000 \u0000 <p><b>Methods:</b> RCT conducted on children aged 4-16 years with myopia between -1.00 and -6.00D and astigmatism ≤2.00D. Children were randomly assigned to the 0.025% atropine and SV lenses treatment group (group A) or 0.025% atropine and DIMS lenses treatment group (group B). Cycloplegic spherical equivalent refraction (SER) and axial length (AL) were measured at baseline, 6 and 12 months. Statistical analyses (Mann-Whitney U-test or Chi-squared test) were performed to test for significance between the two groups.</p>\u0000 \u0000 <p><b>Results:</b> 79 patients completed the 12 month-follow-up: <i>n</i> = 38 (48.1%) in group A (47.4% female), mean age 9.00 ± 2.74 years; <i>n</i> = 41 (51. 9%) in group B (46.3% female), mean age 9.68 ± 2.65 years. There was no significant association between group and sex (<i>p</i> = 0.93) or age difference between the groups (<i>p</i> = 0.26). At 12 months, mean AL ± SD change was 0.16 ± 0.13mm in group A and 0.09 ± 0.16mm in group B, mean difference 0.07 ± 0.02 mm (95%CI 0.03-0.12, <i>p &lt;</i> 0.001). Mean SER ± SD progression was -0.16 ± 0.31D and -0.16 ± 0.36D in group A and B, respectively (<i>p</i> = 0.61). 39.5% of the children in Group B had no axial elongation over 12 months, compared to 14.5% of the children in group A (<i>p &lt;</i> 0.001).</p>\u0000 \u0000 <p><b>Conclusions:</b> Combination treatment with 0.025% atropine and DIMS spectacle lenses is more effective in controlling axial elongation than 0.025% atropine with SV lenses in European children. The differences in SER between the groups were not significant. The AL increase in group B was less than that previously reported with DIMS lenses alone in Asian and European children over 12 months, suggesting that other factors, such as pupil size, may enhance the DIMS lens efficacy in controlling axial elongation.</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.16930","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116645","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":"Aniridia associated keratopathy – molecular and clinical mechanisms leading to keratopathy development","authors":"Nora Szentmary","doi":"10.1111/aos.16806","DOIUrl":"https://doi.org/10.1111/aos.16806","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p>Congenital aniridia is a rare, panocular disease with PAX6 haploinsufficiency in 90% of the cases. In addition to PAX6, other factors appear to play a role in aniridia associated keratopathy (AAK) development. FOXC1, DSG1, FOSL2 and FABP5 are genes that are crucial for eye development, differentiation of limbal stem cells and for the regulation of lipid metabolism in epithelial cells. Recent data also indicate the importance of microRNA 204-5p and microRNA 138-5p in AAK. The Lagali AAK classification well describes the progressive nature of AAK, from a mild peripheral to a central corneal vascularization with corneal pannus formation. Ocular surface inflammation, as much as previous ocular surgery seem to have a role in AAK progression. Nevertheless, the corneal endothelium might possess slightly better quantitative reserves in congenital aniridia, than in healthy subjects and corneal endothelial deposition seems to be independent from the developmental abnormalities but may be related to up to date undescribed endothelial inflammatory or metabolic changes.</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.16806","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116685","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}