Frontiers in ophthalmology最新文献

{"title":"Knowledge gaps and practices for glaucoma among adults in Palestine: a cross-sectional study.","authors":"Mohammad W Awlad Mohammad, Basel Bader, Mohammad Fuad Sayes, Alhareth M Amro, Toqa W Awlad Mohammad, Essa Hasheem, Mohammad Amro, Darwish M Mosameh, Dania Amwas, Abdallah Qawasmeh, Farid K Abu Sham'a","doi":"10.3389/fopht.2026.1953940","DOIUrl":"https://doi.org/10.3389/fopht.2026.1953940","url":null,"abstract":"<p><strong>Background: </strong>Glaucoma is a leading cause of irreversible blindness globally, often progressing asymptomatically until advanced stages. Awareness and knowledge of glaucoma are critical determinants of early diagnosis and treatment-seeking behavior. Data on glaucoma awareness in Palestine are scarce. This study aimed to assess the level of awareness, knowledge, and attitudes regarding glaucoma among the general Palestinian population and to identify sociodemographic factors associated with inadequate knowledge.</p><p><strong>Methods: </strong>A population-based cross-sectional study was conducted from December 1 to December 30, 2025, using an online questionnaire distributed to adults (≥18 years) residing in the West Bank and Jerusalem. The questionnaire included sociodemographic information, glaucoma awareness, knowledge, attitudes, and practices. Reliability was assessed using Cronbach's alpha (α = 0.87). Knowledge scores were calculated with a maximum of 8 points; good knowledge was defined as ≥6 correct answers. Data were analyzed using SPSS v23, employing chi-square tests and multivariable logistic regression.</p><p><strong>Results: </strong>A total of 741 participants completed the survey (50.2% male, 49.8% female). Overall, 54% had heard of glaucoma, but only 13.8% demonstrated good knowledge. Prior awareness of glaucoma was the strongest predictor of good knowledge (aOR = 7.89, p < 0.001). Knowledge gaps were notable regarding the asymptomatic nature of early disease (20.9%), irreversible vision loss (57%), and key risk factors including age ≥40 years (49%), family history (44.9%), and diabetes (55.1%). Older adults, rural residents, and individuals with lower educational levels had significantly lower knowledge scores. Only 26.9% of participants reported eye examinations within the preceding year, and screening intentions were associated with better knowledge (p = 0.015).</p><p><strong>Conclusions: </strong>Although awareness of glaucoma is moderate in Palestine, comprehensive knowledge remains low, particularly among high-risk populations. Public health interventions should target education beyond name recognition, emphasizing asymptomatic progression, irreversible vision loss, and risk factors. Integrating glaucoma education into clinical visits and community-based programs may improve early detection and prevent blindness.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1953940"},"PeriodicalIF":2.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activating transcription factor 6 is involved in the beneficial effects of growth hormone-releasing hormone antagonists in the corneal endothelium.","authors":"Md Matiur Rahman Sarker, Saikat Fakir, Madan Sigdel, Nektarios Barabutis","doi":"10.3389/fopht.2026.1946815","DOIUrl":"10.3389/fopht.2026.1946815","url":null,"abstract":"<p><p>The corneal endothelium maintains eye transparency through fluid regulation, and its dysfunction has been associated with impaired vision. This study is focused on the possible involvement of activating transcription factor 6 (ATF6) in the beneficial effects of Growth Hormone - Releasing Hormone antagonists (GHRHAnt) in corneal cells. ATF6 is a UPR sensor involved in barrier function, previously shown to exert anti-inflammatory activities. The aim of this study is to evaluate involvement of ATF6 in the effects of GHRHAnt in the corneal endothelium. MTT assay was used to measure the cell viability of ATF6 modulator. We demonstrated the efficient ATF6 manipulation by AA147 and Ceapin-A7, which are specific ATF6 modulators. Western blot analysis was used to detect the protein expression levels. FITC-dextran assay and DCFDA were utilized to measure paracellular permeability and reactive oxygen species generation, respectively. AA147 enhanced Grp94 and BiP expression, both being downstream ATF6 targets, whereas Ceapin-A7 exerted the opposite effects. Then, we investigated the possible involvement of ATF6 in the protective activities of GHRHAnt in the corneal endothelium. ATF6 activation enhanced the protective effects of GHRHAnt by reducing paracellular permeability and ROS generation, while ATF6 inhibition exerted the opposite effects. Our study suggests that ATF6 mediates - at least in part - the beneficial effects of GHRHAnt in the cornea.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1946815"},"PeriodicalIF":2.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orbital decompression with intraorbital corticosteroid injection during the active phase of thyroid eye disease: outcomes in a real-world cohort.","authors":"Adam J Neuhouser, Sarah Skender, Jane Z Spadaro, Alon Kahana","doi":"10.3389/fopht.2026.1935053","DOIUrl":"https://doi.org/10.3389/fopht.2026.1935053","url":null,"abstract":"<p><strong>Background: </strong>Orbital decompression is an effective surgery for reducing orbital congestion and proptosis for patients with thyroid eye disease (TED). However, it is commonly stated that elective orbital decompression, i.e., for reasons other than compressive optic neuropathy, should await the quiescent phase of the disease. The reason is to avoid inducing a flare-up of the orbitopathy secondary to surgical inflammation. Still, this means that patients with moderate to severe TED who are suffering from symptoms associated with TED must wait months to years before initiating surgical treatment. The purpose of this study is to evaluate the effectiveness of orbital apex decompression combined with intraorbital corticosteroid injection in patients with active TED, defined as Clinical Activity Score (CAS) ≥3.</p><p><strong>Methods: </strong>This retrospective, single-center cohort study included patients with active TED (pre-operative CAS ≥ 3) who underwent single or staged orbital decompression between February 2023 and September 2025. All lateral wall decompressions included an intraorbital injection of a combination triamcinolone and dexamethasone as part of the operative technique. Primary outcomes included change in CAS, change in proptosis, and postoperative disease progression (≥ 2-point increase in CAS at ≥ 8 weeks). Secondary analysis compared outcomes in patients with and without perioperative treatment using disease-modifying therapy (DMT).</p><p><strong>Results: </strong>Thirty-six patients met inclusion criteria; 14 had preoperative dysthyroid optic neuropathy. Mean CAS decreased from 4.7 to 1.6 (Δ -3.1; 95% CI -3.92 to -2.36), and mean proptosis decreased from 22.7 mm to 19.7 mm (Δ -3.0 mm; 95% CI -3.28 to -2.23). One patient with severe TED met criteria for postoperative disease progression. Outcomes were consistent across subgroups regardless of perioperative DMT exposure. No patients developed new-onset diplopia.</p><p><strong>Conclusions: </strong>Orbital decompression combined with intraorbital corticosteroid injection during active TED was associated with clinically meaningful reductions in CAS and proptosis, with infrequent postoperative deterioration and no major surgical complications. These findings provide real-world evidence supporting use of this combined approach during active disease, including in patients without dysthyroid optic neuropathy. These results are specific to a particular surgical technique and to the perioperative management of underlying thyroid status and risk factors associated with TED exacerbation.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1935053"},"PeriodicalIF":2.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Orbital and intracranial inflammatory syndrome in rheumatoid arthritis.","authors":"Cecelia Mans, Safa Ibrahim, Dina Abdelsalam, Andrew G Lee","doi":"10.3389/fopht.2026.1929961","DOIUrl":"https://doi.org/10.3389/fopht.2026.1929961","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a case of rheumatoid arthritis (RA)-associated orbital and intracranial inflammatory disorder (OIID).</p><p><strong>Background: </strong>RA is a systemic autoimmune disease associated with a multitude of extra-articular manifestations. Cigarette smoking increases the risk of RA vasculitis and adversely influences the expression of the proto-oncogene p53 in RA. Although ocular manifestations of RA are well known, orbital and intracranial inflammatory presentations are much less common.</p><p><strong>Case presentation: </strong>A 63-year-old woman with seropositive RA and a significant tobacco smoking history presented with intermittent jaw pain, headache, left temporal tenderness, blurred vision of the left eye, and intermittent diplopia. Serum laboratory studies demonstrated elevated RF and erythrocyte sedimentation rate (ESR). Cranial and orbital magnetic resonance imaging (MRI) showed left orbital apex enhancement with extension into the left cavernous sinus and Meckel cave. The patient improved with intravenous methylprednisolone and high-dose prednisone, but symptoms recurred with each steroid taper. 13 months later, the patient developed new contralateral right-sided orbital inflammation with cavernous sinus and superior orbital fissure involvement.</p><p><strong>Conclusions: </strong>Clinicians should be aware that orbital (e.g., orbital inflammatory pseudotumor) and intracranial presentations may occur in RA in addition to the more common ocular (e.g., scleritis) presentations.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1929961"},"PeriodicalIF":2.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior segment imaging clues to systemic malignancy: a phenotype-to-confirmation narrative review.","authors":"Nikola Denda, Sofija Davidović Terzić, Nemanja Maletin, Kristina Veljkov, Aleksandar Rasković, Ljiljana Jovančević, Siniša Babović","doi":"10.3389/fopht.2026.1917738","DOIUrl":"https://doi.org/10.3389/fopht.2026.1917738","url":null,"abstract":"<p><p>Systemic malignancies may affect the posterior segment through metastatic, paraneoplastic, hematologic or lymphomatous, and treatment-related mechanisms. Because routine ophthalmic imaging rarely establishes the underlying etiology, its principal clinical value is to identify suspicious patterns, prioritize competing diagnoses, and guide further investigation. This narrative review synthesizes malignancy-related posterior segment findings and proposes a clinically oriented phenotype-to-confirmation framework for multimodal interpretation. A literature search was conducted in PubMed, Scopus, and Web of Science for publications from January 2000 to May 18, 2026. The review included choroidal metastasis, paraneoplastic retinopathies and choroidopathies, vitreoretinal lymphoma, hematologic infiltration, leukemic retinopathy, and anticancer therapy-related toxicity. Owing to heterogeneity in disease entities, imaging protocols, diagnostic confirmation, and study designs, the evidence was synthesized qualitatively. Findings were organized into five suspicion-triggering phenotypes: exudative choroidal mass, RPE-choroidal remodeling, vitreoretinal infiltrative, diffuse neuroretinal dysfunction, and treatment-imprint phenotypes. Each phenotype was linked to its principal mimickers and to appropriate additional investigations, including targeted multimodal imaging, electrophysiology, ocular-fluid analysis, molecular testing, or systemic oncologic reassessment. These phenotypes should not be regarded as validated diagnostic categories, but as clinical entry points for differential exclusion and diagnostic escalation. Artificial intelligence may eventually support image registration, lesion tracking, and longitudinal comparison; however, its role in these rare and heterogeneous disorders remains investigational.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1917738"},"PeriodicalIF":2.4,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Bilateral optic disc edema with papillophlebitis-like features following combined cisplatin and capecitabine chemotherapy.","authors":"Shanshan Cao, Lu Wang, Wei Chen, Yong Liu","doi":"10.3389/fopht.2026.1961914","DOIUrl":"https://doi.org/10.3389/fopht.2026.1961914","url":null,"abstract":"<p><strong>Background: </strong>Ocular adverse events associated with cisplatin and capecitabine are uncommon, and bilateral optic disc edema with papillophlebitis-like features has rarely been reported. We describe a case of bilateral optic disc edema with papillophlebitis-like features following combined cisplatin and capecitabine chemotherapy in a patient with squamous cell carcinoma of the anal canal. We discuss the differential diagnosis, possible mechanisms, and clinical course in the context of the existing literature.</p><p><strong>Case presentation: </strong>A 50-year-old woman with squamous cell carcinoma of the anal canal received pelvic radiotherapy (28 fractions) combined with four cycles of cisplatin and oral capecitabine. Sixteen days after the final cycle of chemotherapy, she developed painless bilateral blurred vision. Fundus examination revealed bilateral optic disc edema and hyperemia, peripapillary flame-shaped hemorrhages, and dilated retinal veins. Fundus fluorescein angiography demonstrated leakage from the optic disc vasculature, while optical coherence tomography(OCT) showed bilateral thickening of the peripapillary retinal nerve fiber layer. Comprehensive systemic work-up, including complete blood count, inflammatory markers, tumor markers, a paraneoplastic antibody panel, contrast-enhanced brain magnetic resonance imaging, and multidisciplinary consultation, revealed no alternative systemic, neurologic, or paraneoplastic explanation. Intracranial hypertension, optic neuritis, and non-arteritic anterior ischemic optic neuropathy (NAION) were considered less likely based on the overall clinical findings. No systemic glucocorticoids were administered, and the patient was managed with close observation. At the two-month follow-up, best-corrected visual acuity had improved to 1.2 in both eyes, with complete resolution of the optic disc edema on fundus examination and OCT.</p><p><strong>Discussion: </strong>The temporal association with chemotherapy, bilateral presentation, papillophlebitis-like fundus findings, and spontaneous resolution after completion of treatment suggest a possible chemotherapy-associated toxic or vascular reaction. Cisplatin-related endothelial toxicity and capecitabine-associated vasospasm may be potential mechanisms. However, a direct causal relationship cannot be established from a single case.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1961914"},"PeriodicalIF":2.4,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution and factors associated with refractive errors among young adults attending ophthalmic clinics in Iraq: a multicenter cross-sectional study.","authors":"Hassan A Aljaberi, Saeed Rahmani, Ali Ayatollahi","doi":"10.3389/fopht.2026.1904325","DOIUrl":"10.3389/fopht.2026.1904325","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the clinic-based distribution of myopia, hyperopia, and astigmatism among young Iraqi adults and to examine demographic, social, familial, and self-reported behavioral factors associated with myopia and high-severity refractive errors.</p><p><strong>Materials and methods: </strong>This multicenter, clinic-based, cross-sectional study included 4,340 consecutive young adult attendees at three tertiary ophthalmic centers. Right-eye sphere and cylinder values were standardized to minus-cylinder notation before spherical equivalent (SE), and refractive outcomes were derived. Subgroup percentages were calculated using the relevant subgroup denominator, and multivariable logistic regression was used to evaluate associated factors.</p><p><strong>Results: </strong>In the analytic sample, myopia (SE ≤ -0.50 D) occurred in 51.2%, hyperopia (SE ≥ +0.50 D) in 37.0%, and astigmatism (|cylinder| ≥ 0.50 D) in 66.4%; astigmatism overlapped with spherical refractive status. Myopia was more frequent among women than men (53.6% vs 45.6%). In the adjusted model, female sex, age 28-32 years, a positive family history of refractive error, sleep duration ≤6 hours, and longer daily electronic-device use were associated with higher odds of myopia, whereas office work, manual work, and unemployment were associated with lower odds than student status.</p><p><strong>Conclusions: </strong>Refractive errors were frequent among young adults attending tertiary ophthalmic clinics in Iraq. The observed associations with demographic, familial, social, and behavioral factors provide clinically useful information for targeted refractive assessment, counseling, and service planning in young adults. Population-based longitudinal studies are needed to confirm the generalizability and temporal nature of these associations.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1904325"},"PeriodicalIF":2.4,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mentorship as metadata: clinical annotation and the limits of real-world data in oculoplastic surgery.","authors":"Itay Nitzan, Tehila Shlomov, Zvi Gur","doi":"10.3389/fopht.2026.1972892","DOIUrl":"10.3389/fopht.2026.1972892","url":null,"abstract":"<p><p>In oculoplastic surgery, real-world databases capture diagnosis and procedure codes but rarely the clinical variables that define surgical meaning: laterality, levator function, margin-reflex distance, inflammatory activity, operative intent, or the reason for revision. We propose that clinical supervision be recorded as <i>documented clinical interpretive annotation</i>: an explicit, written layer that defines the limits of routinely collected data before they are analyzed. \"Mentorship as metadata\" names the educational relationship that produces this annotation and is used throughout as a labelled metaphor, not as a claim of equivalence with formal metadata, data provenance, or research-governance documentation. Synthesizing established reporting and causal-inference frameworks with recently published oculoplastic database studies (2019-2026), we develop a three-layer model: code, phenotype, and judgment, together with a pre-analysis phenotype map that trainees and mentors can complete before a query is run. Central to this framework is the \"refusal point\": a documented, pre-specified boundary at which a dataset should not be used to answer a given clinical question, co-signed by the oculoplastic mentor, the trainee or lead analyst, and a methodologist and recorded as a routine study-design deliverable. The refusal point complements the estimand and target-trial frameworks by naming the adjacent, more tempting question that the data cannot answer. It introduces no new statistical construct; its contribution is documentary, procedural, and educational, and we state explicitly what each existing framework already requires and what remains unspecified. We advance one falsifiable hypothesis: that pre-specified, co-signed refusal-point documentation increases pre-analysis reframing of research questions and improves concordance between the protocol estimand and the estimand the published conclusions can support, and we set out a prospective programme capable of refuting it. Real-world data remain valuable for utilization, trends, and rare associations, but they are not self-interpreting. Training oculoplastic surgeon-scientists to name, in writing and before analysis, the boundary between code and clinical reality may make database research more transparent, restrained, and reproducible. In oculoplastics, mentorship is the clinical annotation that turns data into evidence.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1972892"},"PeriodicalIF":2.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening of natural compounds library for protection against endoplasmic reticulum stress in corneal endothelial cells.","authors":"Stephanie Lee, Anisha Kasi, Minwoo Kwon, Stefan Y Kim, Saba Qureshi, Varun Kumar","doi":"10.3389/fopht.2026.1945775","DOIUrl":"10.3389/fopht.2026.1945775","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Endoplasmic reticulum (ER) stress-mediated cell death contributes to many ocular diseases, including Fuchs corneal endothelial dystrophy (FECD). Natural compounds possess significant pharmacological activities necessary for vital cell signaling pathways and are considered protective in many ocular diseases such as diabetes, retinopathy, and glaucoma. However, there are limited studies examining the role of natural compounds in reducing sustained ER stress for improving corneal endothelial cell (CEnCs) survival. The purpose of this study is to identify readily available natural compounds to improve the viability of CEnCs under ER stress.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Human corneal endothelial cells (21T-HCEnC) were cultured and seeded in 384-well plates, pre-treated with 502 compounds from a natural product library (Enzo Screen-Well Natural Product library), and then subjected to ER stressor tunicamycin (1µg/mL) for 24 hours. Cell viability was measured using the Cell-Titer-Glo assay, and 74 compounds improved viability past the set threshold (≥ 30% increase in viability) and were selected for further dose-response testing. Further dose-response testing was performed using untreated F35T corneal endothelial cells, plated onto 384-well plates, and treated with a range of 6 log doses of each compound, from 10 pg/mL up to 1 μg/mL. After 24 hours of treatment, cell viability was measured again using the Cell-Titer Glo assay. Of the 4 natural compounds that improved viability past the set threshold at the lowest dose tested (0.00001 µg/mL), veratrine was analyzed further via western blotting, ranging from 10 pg/mL to 0.01 μg/mL. Apoptotic and unfolded protein response markers were also measured via western blotting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 502 compounds each administered at 0.01 µg/mL, we identified 74 compounds exhibiting 30% or more protection of 21T HCEnC cell viability in response to tunicamycin-induced stress. Of the 74 compounds that underwent further dose-response testing, 4 compounds improved cell viability by 30% or more at the lowest dose of compound tested compared to viability of F35T cells at baseline. Cevadine, or veratrine, was chosen for further analysis due to its function as a sodium channel agonist and its interaction with Na&lt;sup&gt;+&lt;/sup&gt;/K&lt;sup&gt;+&lt;/sup&gt; ATPase channels. Pretreatment with veratrine 0.01 µg/mL, along with tunicamycin, downregulated expression levels of cleaved caspase 9, PARP, cytochrome C, Bax, and cleaved caspase 3. Western blots of FECD cell line under tunicamycin-induced ER stress, pretreated with veratrine 0.01 µg/mL, also showed reduced markers from all three ER unfolded protein response pathways.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study provided insight into the role of natural compounds in regulating ER stress-mediated CEnC death associated with many corneal endothelial-associated diseases. Veratrine was found to have a protective effect on ER-stressed CEnCs, as ind","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1945775"},"PeriodicalIF":2.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective descriptive pilot feasibility case series of low-pressure cataract surgery with the Zeiss Quatera 700 in glaucoma patients.","authors":"Koen Willekens","doi":"10.3389/fopht.2026.1824059","DOIUrl":"10.3389/fopht.2026.1824059","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the feasibility of low-pressure cataract surgery using the Zeiss Quatera 700 system in patients with glaucoma.</p><p><strong>Patients and methods: </strong>This is a prospective, investigator-initiated case series of 10 eyes of 10 patients with glaucoma undergoing cataract surgery with the Quatera 700. The minimal intraocular pressure (IOP) settings (30 mmHg) were used for every step of the surgery. The primary outcome was defined as the occurrence of any surgical complication. All other outcome variables were prospectively classified as secondary and exploratory endpoints. Secondary outcomes included intraoperative parameters like phaco energy usage, postoperative IOP spikes (>30 mmHg), and visual function [best-corrected visual acuity (BCVA) and visual field mean deviation (MD)].</p><p><strong>Results: </strong>All surgeries were completed without intraoperative complications (0.0% event rate; exact 95% Clopper-Pearson CI: 0.0% to 30.8%). Mean effective phaco time was 3.24 s (± 2.01 s). Postoperative IOP spikes (>30 mmHg) occurred in two patients (20.0% event rate; exact 95% Clopper-Pearson CI: 2.5% to 55.6%) and were managed with additional acetazolamide. BCVA improved in 9 of 10 eyes (exact 95% CI: 55.5%, 99.8%). The median paired logMAR change from preoperative baseline to the 1-month postoperative follow-up was -0.10 logMAR (range: -1.30 to +0.10 logMAR, <i>p</i> = 0.0137), and visual field MD remained stable at 1 month postoperatively.</p><p><strong>Conclusion: </strong>This pilot study demonstrates that low-pressure cataract surgery at a target setting of 30 mmHg using the Zeiss Quatera 700 is clinically feasible in patients with glaucoma. Given the small sample size and short follow-up of this pilot series, larger randomized comparative trials are required to confirm these preliminary safety profiles and determine long-term clinical benefits in a broader glaucoma population.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1824059"},"PeriodicalIF":2.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}