Srilekha Sundaramurthy, Sivasankar Malaichamy, Parveen Sen, Ramya Sachidanandam, Isabelle Audo, Christina Zeitz, Sripriya Sarangapani, Nagasamy Soumittra
{"title":"Genetic analysis of congenital stationary night blindness and Oguchi disease in an Indian cohort.","authors":"Srilekha Sundaramurthy, Sivasankar Malaichamy, Parveen Sen, Ramya Sachidanandam, Isabelle Audo, Christina Zeitz, Sripriya Sarangapani, Nagasamy Soumittra","doi":"10.1111/aos.17531","DOIUrl":"https://doi.org/10.1111/aos.17531","url":null,"abstract":"<p><strong>Background: </strong>Congenital stationary night blindness (CSNB) is a group of genetically and clinically heterogeneous non-progressive retinal disorders and can be classified based on fundus abnormalities as found in Oguchi disease or fundus albipunctatus (FA) or based on the absence of severe fundus abnormalities but altered electroretinography (ERG) findings. Here, we report the clinical and genetic findings of 46 CSNB families, with 18 families showing fundus abnormalities and 28 families without fundus abnormalities but having an altered ERG, showing complete CSNB (cCSNB) and Riggs type CSNB.</p><p><strong>Methodology: </strong>Ophthalmic examinations including full-field ERG recordings, colour vision test, optical coherence tomography and fundus autofluorescence were performed and candidate genes for CSNB were screened by panel-based next-generation sequencing using an Illumina MiSeq platform. Subsequently, Sanger sequencing was performed to validate the identified variants and to confirm segregation with the phenotype in available family members.</p><p><strong>Results: </strong>In 69% (11/16) of the Oguchi patients', pathogenic variants were found in SAG and GRK1, with p.(R292*) and p.(D537Vfs*7) variants being the most frequent mutations identified in this cohort in the two genes, respectively. A likely pathogenic variant p.(G238A) in RDH5 was identified in one of the two FA patients. In 92% of the CSNB (26/28) families without fundus abnormalities, pathogenic variants were found in NYX, leading to X-linked cCSNB; in GRM6, TRPM1, GPR179, LRIT3, leading to autosomal recessive cCSNB and in GNAT1, leading to autosomal recessive Riggs type CSNB. No significant copy number variants were identified.</p><p><strong>Conclusion: </strong>Combing this study with our previous report on CSNB from India, the most prevalent gene defects were variants in TRPM1 (37%) followed by GRM6 (32%) > NYX (10%) > SLC24A1 (5%) > GPR179 (5%), GNAT1 (3%) and LRIT3 (3%). In the current study, which included Oguchi disease and FA families as well, variants in SAG (38%) and GRK1 (31%) were identified in the Oguchi disease cases, and in the RDH5 gene in one of the two (50%) FA cases. Unsolved 8/56 (14%) (combined cohorts) cases may harbour variants in novel genes or intronic variants or structural variants undetectable by the screening method used herein.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473717","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":"Test-retest variability of the full-field stimulus test in patients with retinitis pigmentosa: REPEAT Study Report No. 4.","authors":"J S Karuntu, S B A E Tulp, C J F Boon","doi":"10.1111/aos.17532","DOIUrl":"https://doi.org/10.1111/aos.17532","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate test-retest variability (TRV) of the full-field stimulus test (FST) in patients with retinitis pigmentosa (RP) and poor best-corrected visual acuity (BCVA; ≤20/50 Snellen; ≥0.40 logMAR), and to assess the reliability of FST as a clinical endpoint in future RP trials.</p><p><strong>Methods: </strong>In this prospective cohort study, 28 patients with clinically diagnosed RP performed FST (Diagnosys) on two different days, 2 weeks apart. Retinal sensitivity estimates on FST for blue, red, and white stimuli were determined, and the difference between blue and red thresholds was calculated to identify photoreceptor mediation type. TRV was analysed using Bland-Altman analyses and coefficients of repeatability (CoRs).</p><p><strong>Results: </strong>Patients had a median age of 38.0 years (interquartile range [IQR]: 24.5-57.5), and a median BCVA of 1.1 logMAR (IQR: 0.6-1.2). Following Bland-Altman analyses, learning effects (biases) across the FST measurements were minimal, ranging from -0.02 to 0.02 log units. The CoRs were ± 0.38 log units (95% confidence interval [CI]: 0.30-0.52) for blue stimuli, ±0.30 log units (95%CI: 0.23-0.40) for red stimuli, ±0.59 log units (95%CI: 0.47-0.81) for white stimuli, and ± 0.30 log units (95%CI: 0.24-0.41) for the blue-red difference. Patients with mixed photoreceptor mediation had a higher TRV than those with rod or cone mediation. Age was a significant predictor of TRV on blue light FST (p = 0.028).</p><p><strong>Conclusions: </strong>These findings support the use of FST as a reliable measurement of retinal sensitivity in patients with RP, and provide a strong foundation for developing clinical endpoints for FST based on the CoRs to improve assessment of changes in RP, for example, before and after treatment.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315742","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":"The incidence of serious complications after selective laser trabeculoplasty.","authors":"Eeva S Ojanen, Joni A Turunen, Mika Harju","doi":"10.1111/aos.17536","DOIUrl":"https://doi.org/10.1111/aos.17536","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the incidence of serious complications after selective laser trabeculoplasty (SLT).</p><p><strong>Methods: </strong>All patients who underwent SLT at the Department of Ophthalmology, Helsinki University Hospital, were eligible for the study from 1 January 2012 to 31 December 2018. Data regarding patients' demographics, procedure details, complications, predisposing factors and clinical outcomes were extracted retrospectively from electronic medical records. The primary outcome measures were serious complications, including corneal oedema, corneal scarring, hyperopic shift, synechia, anterior chamber bleeding and hyphema.</p><p><strong>Results: </strong>A total of 6081 SLTs (4601 eyes) of 2812 patients were analysed. Twelve patients had bleeding in the anterior chamber angle (incidence 2/1000 SLT laser treatments), and four of them developed hyphema (incidence 0.7/1000 SLT laser treatments). Corneal oedema or Descemet's membrane folds were reported in six treated eyes, resulting in an incidence of 1/1000. One myopic eye had a permanent corneal scarring, thinning and irregular astigmatism with a hyperopic shift (5.3 D with recovery to 1.25 D in three years), resulting in poor visual acuity (from preoperative 0.9 to 0.4 at the last control). The incidence was less than 0.2/1000 for all SLT treatments (95% CI ≤0.1 to 1.0) and 1/648 for SLT laser treatments in high myopia (spherical equivalent ≤-5.00 D).</p><p><strong>Conclusions: </strong>After SLT, the number of complications was low, with only one permanent vision deterioration after 6081 treatments. These findings may help clinicians reassure patients about SLT safety when offering SLT as a first-line treatment for ocular hypertension or open-angle glaucoma.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293142","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}
Robin Van Compernolle, Sophie Lemmens, Catherine Cassiman
{"title":"Imaging modalities in optic disc drusen: A literature review and proposed diagnostic algorithm.","authors":"Robin Van Compernolle, Sophie Lemmens, Catherine Cassiman","doi":"10.1111/aos.17530","DOIUrl":"https://doi.org/10.1111/aos.17530","url":null,"abstract":"<p><p>Optic disc drusen (ODD) concern highly prevalent anatomical features that are increasingly recognised as a risk factor for various pathological conditions. In clinical practice, differentiation between ODD and true papilloedema poses considerable challenges, often resulting in the effectuation of unnecessary, potentially invasive examinations. Furthermore, recent years have witnessed a notable expansion in imaging modalities employed to map ODD, primarily novel optical coherence tomography (OCT) modalities. A growing necessity arises for literature providing a profound comparison between most of the various available techniques, as well as furnishing clinicians with practical guidelines to manage a patient with suspected ODD. A comprehensive search of the current literature formed the foundation of this narrative review. We primarily focused on data from recent studies, each of which was thoroughly analysed and interpreted by all the authors. We formulate a straightforward diagnostic model to approach a patient with suspected ODD, wherein a primary distinction is made between patients with a high and low suspicion for papilloedema. Enhanced Depth Imaging OCT (EDI-OCT) emerges as the most potent modality and is thus recommended as the new gold standard technique. Fluorescein angiography exhibits excellent specificity and therefore proves useful to exclude papilloedema, although not with full certainty. Fundus autofluorescence and ultrasonography appear to be most beneficial for screening purposes and in a population with very low suspicion of papilloedema. This narrative review is the first to present a clinically relevant diagnostic model to discriminate between ODD and papilloedema, identifying EDI-OCT as the primary imaging modality in ODD diagnosis.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273925","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}
Marie-Noëlle Delyfer, Jean-François Girmens, Corinne Dot, Mohamed Bennani, Marie-Benedicte Rougier, Stéphanie Baillif, Pascale Massin, Vincent Gualino, Michel Paques, Bénédicte Dupas
{"title":"Consensus-based recommendations for indications and procedures in retinal laser treatment of Telangiectatic capillaries (TelCaps) in vascular macular oedema: A Delphi study.","authors":"Marie-Noëlle Delyfer, Jean-François Girmens, Corinne Dot, Mohamed Bennani, Marie-Benedicte Rougier, Stéphanie Baillif, Pascale Massin, Vincent Gualino, Michel Paques, Bénédicte Dupas","doi":"10.1111/aos.17535","DOIUrl":"https://doi.org/10.1111/aos.17535","url":null,"abstract":"<p><strong>Purpose: </strong>The identification of telangiectatic capillaries (TelCaps) in chronic macular oedema (ME) resistant to conventional intravitreal injections (IVIs) has renewed interest in focal laser treatment. However, the indications and modalities of this laser treatment remain to be clarified.</p><p><strong>Methods: </strong>A modified Delphi approach was used to establish a consensus among French macular laser specialists regarding recommendations on assessment of TelCaps, indications for laser treatment, treatment procedures and follow-up.</p><p><strong>Results: </strong>Presence of TelCaps should be considered in cases of recurrent vascular oedema that do not respond, or partially respond, to IVIs. A strong consensus has emerged on treating TelCaps with laser when they are located ≥1000 μm from the fovea and associated with thickening of the surrounding retina, usually in combination with IVIs. For TelCaps located <1000 μm from the centre, IVIs alone were preferred. ICG-guided laser treatment was advised to target TelCaps but was not considered mandatory if TelCaps were visible on fundus photography or OCT. Assessment of the effectiveness of laser treatment should be based on reduction in macular thickness on OCT after 3 months, before a second laser session may be considered. Although experts have recommended the use of small, short-duration impacts allowing greying of the lesion, no consensus has been reached on the optimal numerical parameters for the laser procedure.</p><p><strong>Conclusion: </strong>This study provides precise guidelines on laser treatment for vascular ME in cases of TelCaps, and emphasizes the need for standardized lesion selection and laser parameters to ensure safe and effective ME management.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257078","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}
A H Falemban, K Söderberg-Löfdal, F Jonsson, S Almlöf-Sarman, M von Euler, I Westborg
{"title":"Intravitreal anti-vascular endothelial growth factor injections and risks of stroke in patients with neovascular age-related macular degeneration-A registry-based cohort study.","authors":"A H Falemban, K Söderberg-Löfdal, F Jonsson, S Almlöf-Sarman, M von Euler, I Westborg","doi":"10.1111/aos.17534","DOIUrl":"https://doi.org/10.1111/aos.17534","url":null,"abstract":"<p><strong>Background: </strong>Intravitreal Anti-Vascular Endothelial Growth Factor (VEGF) rescues retinal vasculatures and prevents disease progression in patients with neovascular Age-Related Macular Degeneration (nAMD). However, systemic anti-VEGF may increase the risk of thromboembolic related complications including stroke and TIA. This study aims to explore the association between stroke and intravitreal anti-VEGF agents; ranibizumab, aflibercept and bevacizumab.</p><p><strong>Methods: </strong>This nationwide, population- registry-based case-control study used registered data 2007-2019. Data from the Swedish Stroke Registry (Riksstroke) and the Swedish Macula Register (SMR) were cross-linked to identify nAMD patients who developed stroke/TIA within 90 days after intravitreal anti-VEGF injection. Each stroke case was matched with three controls from Riksstroke with stroke/TIA but no anti-VEGF treatment.</p><p><strong>Results: </strong>A total of 33 585 patients with nAMD underwent intravitreal anti-VEGF agent injections. A stroke occurred in 1693 patients of this group, and 936 of them within 90 days of treatment. Compared with nonuse, intravitreal anti-VEGF agent use was associated with an increased risk of stroke within 90 days of anti-VEGF treatment in 2.9% of the nAMD-patients [Risk Ratio (RR) 1.27, 95% confidence interval (CI) 1.22; 1.33] compared to non-users. The RR within 30, 31-60 and 61-90 days were 1.36 (1.15; 1.66), 1.40 (1.09; 1.79) and 0.58 (0.52; 0.65), respectively.</p><p><strong>Conclusions: </strong>Even though the risk is small, intravitreal injections with anti-VEGF agents for the treatment of nAMD are associated with an increased risk of stroke/TIA. The risk seems to be higher within 60 days of last injection. An assessment of high-risk populations and risk-benefit weighting is necessary before intravitreal anti-VEGF injections are considered.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245663","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}
E B M Elsman, D Van der Meij, H P A Van der Aa, N Santana, M C Bartels, M Zaal, Y Y Cheng, R M M A Nuijts, G H M B Van Rens, R M A Van Nispen
{"title":"Quality of life and participation after corneal transplantation and potential predictors: A multicenter prospective cohort study.","authors":"E B M Elsman, D Van der Meij, H P A Van der Aa, N Santana, M C Bartels, M Zaal, Y Y Cheng, R M M A Nuijts, G H M B Van Rens, R M A Van Nispen","doi":"10.1111/aos.17529","DOIUrl":"https://doi.org/10.1111/aos.17529","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the long-term effect of corneal transplantation on health- and vision-related quality of life, visual functioning, and societal participation, and to assess potential predictors.</p><p><strong>Methods: </strong>We conducted a multicenter prospective cohort study in 11 Dutch hospitals and eye clinics. Patients awaiting corneal transplantation (n = 238) completed the Low Vision Quality of Life (LVQOL) questionnaire, Catquest-9SF, Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P), and EuroQol-5 Dimensions (EQ-5D) at baseline and 3, 6, 12, and 24 months post-transplantation. Potential predictors included sociodemographic and clinical characteristics. Linear mixed models analysed changes over time for most outcomes, and generalized estimating equations assessed EQ-5D outcomes.</p><p><strong>Results: </strong>LVQOL subscale scores improved significantly from baseline to 24 months, with large effect sizes (Basic aspects: 44.5 vs. 24.7, p < 0.001; Mobility: 36.0 vs. 18.7, p < 0.001; Adjustment: 24.1 vs. 9.5, p < 0.001; Reading and Fine work: 28.0 vs. 12.2, p < 0.001), as did Catquest scores (57.6 vs. 79.8, p < 0.001). USER-P Restrictions and Satisfaction improved (Restrictions: 83.6 vs. 88.0, p < 0.001; Satisfaction: 68.2 vs. 73.9, p < 0.001), while the Frequency subscale deteriorated (32.7 vs. 29.4, p < 0.001). Effect sizes were all small. The proportion with a perfect EQ-5D score increased (47.7% vs. 56.5%, p = 0.04). Male sex, having work, and Fuchs' dystrophy predicted better outcomes, whereas visual impairment and (dry) eye complaints predicted worse outcomes.</p><p><strong>Conclusion: </strong>Health- and vision-related quality of life, visual functioning, and societal participation are positively impacted by corneal transplantation, and important predictors were identified. The results of this study can be used by ophthalmologists to inform patients about realistic expectations of corneal transplantation.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223978","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}
Hashem Abu Serhan, Saad Ashraf, Ayesha Shaukat, Ajeet Singh, Hasnaa Abdelrhem, Hamza Irfan, Fariha Arif, Abdullah Ahmed
{"title":"Incidence and risk factors of rhegmatogenous retinal detachment following paediatric cataract surgery: A systematic review and meta-analysis.","authors":"Hashem Abu Serhan, Saad Ashraf, Ayesha Shaukat, Ajeet Singh, Hasnaa Abdelrhem, Hamza Irfan, Fariha Arif, Abdullah Ahmed","doi":"10.1111/aos.17533","DOIUrl":"https://doi.org/10.1111/aos.17533","url":null,"abstract":"<p><p>To determine the incidence and identify risk factors of rhegmatogenous retinal detachment (RRD) following paediatric cataract surgery. This systematic review and meta-analysis adhered to PRISMA guidelines and was registered in PROSPERO (CRD42024538383). A comprehensive search was conducted across multiple databases, including Cochrane CENTRAL, PubMed/MEDLINE, SCOPUS, Web of Science, ScienceDirect and Google Scholar, up to December 2024. Studies were included if they reported on RRD following cataract surgery in paediatric populations (0-18 years) with a minimum follow-up of 4 months. Data extraction was performed independently by two authors, with disagreements resolved through consultation with a third author. Risk of bias was assessed using the Newcastle-Ottawa Scale, and statistical analysis was performed using R software version 4.5.0, with leave-one-out analysis conducted for outcomes with substantial heterogeneity (I<sup>2</sup> > 50%). The meta-analysis included data from 5922 eyes across nine studies. The mean age of the participants was 7.08 ± 3.13 years, with a mean follow-up duration of 4.02 years. The pooled incidence of RRD after paediatric cataract surgery was 2.4% [95% CI: 0.7%; 5.0%], with significant heterogeneity observed (I<sup>2</sup> = 85.8%). Patients without primary intraocular lens (IOL) implantation exhibited a numerically higher incidence of RRD (6.1% [95% CI: 0.6%; 15.9%]) compared to those with IOL implantation (1.9% [95% CI: 0.0%; 6.8%]); however, this difference was not found to be statistically significant (p = 0.2667). Similarly, the incidence of RRD was 1.0% [95% CI: 0.3%; 2.2%] in unilaterally operated eyes and numerically higher at 2.1% [95% CI: 1.0%; 3.6%] in bilaterally operated eyes, though this difference was also not statistically significant (p = 0.2563). Children with mental retardation demonstrated a significantly higher risk of RRD, with an incidence of 11.0% [95% CI: 6.6%; 16.4%]. Paediatric cataract surgery carries a notable risk of rhegmatogenous retinal detachment, with significant variability in incidence across different patient populations. While numerically higher incidences of RRD were observed in patients without primary IOL implantation and in bilaterally operated eyes compared to their counterparts, these differences did not reach statistical significance in this meta-analysis. The presence of mental retardation was identified as a significant risk factor. Enhanced postoperative monitoring and individualised surgical approaches are recommended, particularly for high-risk groups. Future research should focus on prospective studies with standardised protocols and longer follow-up periods to better understand causal relationships and refine preventive strategies.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223977","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}
Achim Fieß, Sandra Gißler, Alica Hartmann, Eva Mildenberger, Heike Elflein, Panagiotis Laspas, Christina Korb, Bernhard Stoffelns, Norbert Pfeiffer, Stephanie Grabitz, Alexander K Schuster
{"title":"Visual acuity, amblyopia and refractive error in preterm children with and without retinopathy of prematurity - Results from the Gutenberg Prematurity Study Young (GPSY).","authors":"Achim Fieß, Sandra Gißler, Alica Hartmann, Eva Mildenberger, Heike Elflein, Panagiotis Laspas, Christina Korb, Bernhard Stoffelns, Norbert Pfeiffer, Stephanie Grabitz, Alexander K Schuster","doi":"10.1111/aos.17515","DOIUrl":"https://doi.org/10.1111/aos.17515","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to assess visual outcomes in children born preterm, stratified by gestational age, hypo- and hypertrophy, and the presence of retinopathy of prematurity (ROP) and its treatment.</p><p><strong>Methods: </strong>This is a prospective observational cohort study (n = 949, 1889 eyes) assessing visual acuity, amblyopia, refractive error, and lens opacifications in a large sample of children born preterm and full-term aged 4-17 years. Covariates included gestational age, birth weight percentile, ROP status and treatment, maternal smoking, placental insufficiency, preeclampsia, breastfeeding, and perinatal adverse events with an adjustment for sex and age. Logistic regression analysis was conducted to evaluate associations.</p><p><strong>Results: </strong>Amblyopia prevalence was mainly associated with a gestational age ≤ 28 weeks (OR = 2.92, p = 0.03), placental insufficiency (OR = 3.84, p = 0.01), and ROP treatment (OR = 15.71, p ≤ 0.001). Distant corrected visual acuity (DCVA) in the better eye was significantly correlated with gestational age (ρ = -0.083; p = 0.01), birth weight (ρ = -0.096; p = 0.004), birth weight percentile (ρ = -0.064; p = 0.05), ROP (ρ = 0.13; p <0.001), ROP treatment (ρ = 0.21; p <0.001), and perinatal adverse events (ρ = 0.135; p <0.001). The spherical equivalent was associated only with ROP treatment [β = -2.91, p < 0.001]. Lens opacifications were significantly larger in the group treated for ROP (p ≤ 0.01).</p><p><strong>Conclusions: </strong>This study highlights that perinatal factors associated with prematurity affect visual acuity and refractive error as well as the development of amblyopia in children. Mainly, extreme prematurity ≤28 weeks as well as ROP and its treatment are the most important factors affecting visual development.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155408","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}
Wojciech Lubiński, Tomasz Charabin, Karolina Podborączyńska-Jodko, Maciej Mularczyk, Ewelina Lachowicz-Gosławska
{"title":"Comparison of retinal function and macular structure after 27G pars plana vitrectomy with minimal heads-up versus standard illumination in patients with idiopathic epiretinal membranes: A pilot randomized study.","authors":"Wojciech Lubiński, Tomasz Charabin, Karolina Podborączyńska-Jodko, Maciej Mularczyk, Ewelina Lachowicz-Gosławska","doi":"10.1111/aos.17526","DOIUrl":"https://doi.org/10.1111/aos.17526","url":null,"abstract":"<p><strong>Purpose: </strong>To analyse the clinical benefits of using the NGENUITY 3D Visualization System in vitreoretinal surgery with low levels of endoillumination, focusing on functional and structural retinal protection in patients with idiopathic epiretinal membranes (ERM).</p><p><strong>Design: </strong>Prospective, randomized, comparative study.</p><p><strong>Methods: </strong>Forty pseudophakic patients (29♀, 11♂; age 60-80 years) with ERM underwent 27G pars plana vitrectomy (PPV) and were randomly divided into two groups: Group I (20 eyes, 3D heads-up NGENUITY system, endoillumination 0.5 Lm) and Group II (20 eyes, standard microscope [Hi-R 900], endoillumination 3.2 Lm). Preoperative and 6-months postoperative evaluations included slit-lamp examination, intraocular pressure (IOP, Pascal tonometer), Distance Best Corrected Visual Acuity (DBCVA, logMAR), Central Subfoveal Thickness (CST), Retinal Nerve Fibre Layer Thickness (RNFL, OCT), Pattern ERG (PERG), multifocal ERG (mfERG), flash ERG (ERG, ISCEV standards), and retinal sensitivity (HFA macula test). Surgery time, xenon light exposure, ERM/ILM peeling time, fundus autofluorescence (FAF), metamorphopsia incidence, and intra-/postoperative adverse events were analysed. Results were statistically evaluated (p < 0.05).</p><p><strong>Results: </strong>Slit-lamp examination and IOP results were normal in both groups. DBCVA improved significantly (p = 0.005) in both groups but was better for Group I, albeit not statistically significant. CST and RNFL thickness decreased significantly in both groups (p = 0.01) and did not differ between them. In Group I, increased cone and ganglion cell function was registered, with PERG showing significantly higher increases in P50 and N95 wave amplitudes (p = 0.01) compared with Group II. In mfERG, an increase in P1-wave response density in Ring 1 (p = 0.01) was observed only in Group I. In ERG, Group I showed better rod (Ab, p = 0.04), cone (Aa, p = 0.03), and amacrine cell (scotopic OPS ∑A01 + A02 + A03, p = 0.02) function compared with Group II. Foveal threshold in the HFA macula test increased significantly only in Group I (p = 0.03). No significant differences were found in autofluorescence results, surgery times, xenon light exposure, or ERM and ILM peeling times between groups. Postoperatively, the frequency of absent or reduced severity of metamorphopsia was higher in Group I (71.4%) compared with Group II (61.5%). No intraoperative or postoperative adverse events occurred.</p><p><strong>Conclusion: </strong>Our preliminary results suggest that in patients with idiopathic ERM, 6 months after PPV using the NGENUITY 3D system with low levels of endoillumination, better retinal function was achieved compared with the standard PPV procedure, possibly due to reduced retinal phototoxicity. Further long-term studies are necessary to confirm that conclusion.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126433","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}