Frontiers in ophthalmology最新文献

{"title":"Global challenges for lens and cataract research.","authors":"Michael Wormstone","doi":"10.3389/fopht.2026.1949916","DOIUrl":"10.3389/fopht.2026.1949916","url":null,"abstract":"<p><p>The lens is sadly too often dismissed as a less important tissue within the eye, but this neglects to appreciate the role it plays in the wellbeing and quality of life of individuals, the economic burden lens pathologies place on society and the true biological wonder it is! A normal healthy lens in isolation, looks like a jewel, formed from biological glass. The lens is made of cells enveloped in a soft collagen shell. No blood supply, no nerves. There is slow cell growth that occurs progressively over a lifetime and little cell death takes place. Furthermore, the lens is not a static system and has to quite literally accommodate and manage ongoing mechanical changes due to shape-changing accommodation. Despite these challenges, lens cells are orchestrated to perfect harmony to generate an anatomy conducive to transparency, refraction and accommodation. Pathologies of the lens compromise wellbeing. Congenital and early onset cataract can lead to blindness in tens of thousands of people, while in later life age-related cataracts lead to visual deterioration and blindness in tens of millions. The only treatment for cataract is surgery with intraocular lens (IOL) implantation. Cataract surgery is the most common operation in the world and IOLs the most common medical implant. Despite the success of cataract surgery, wound-healing responses lead to secondary visual loss, known as posterior capsule opacification, in approximately 20% of patients. This can be resolved by Nd: YAG Capsulotomy, but this is not without risk; this is the second most common operation in the world. In addition, presbyopia commonly present in middle age and affects billions, impacting personal wellbeing and ability to perform specific roles. Collectively, these conditions compromise individuals and place significant financial burdens on healthcare providers. The need to undertake lens and cataract research therefore remains a key health priority. As a community the lens field faces both medical and political challenges that need to be considered, appreciated and addressed. In the current article the lens and cataract research landscape is assessed and evaluated with potential strategies proposed to build on existing strengths and address areas of underused potential to continue advancing knowledge and impact on the health and wellbeing of millions and potentially billions of patients.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1949916"},"PeriodicalIF":2.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076938","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":"Editorial: Interventional modalities for the prevention and management of childhood myopia.","authors":"Rohit Saxena, Vinay Gupta, Meghal Gagrani, Jaspreet Sukhija","doi":"10.3389/fopht.2026.1941158","DOIUrl":"10.3389/fopht.2026.1941158","url":null,"abstract":"","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1941158"},"PeriodicalIF":2.4,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018980","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":"Selective laser trabeculoplasty for anti-VEGF associated intraocular pressure elevation in steroid-naïve eyes.","authors":"Anindya Samanta, Chelsey Krambeer, Addie Flowers, Matthew Porter","doi":"10.3389/fopht.2026.1675048","DOIUrl":"10.3389/fopht.2026.1675048","url":null,"abstract":"<p><strong>Purpose: </strong>Selective Laser Trabeculoplasty (SLT) is utilized in cases of primary and certain secondary open-angle glaucoma to decrease intraocular pressure (IOP). SLT effectiveness has been demonstrated in patients with increased IOP secondary to intraocular steroids. In addition to intravitreal steroids, intravitreal anti-vascular endothelial growth factor (VEGF) injections are commonly used in patients with diabetic retinopathy and age-related macular degeneration. Some patients receiving anti-VEGF injections experience increases in IOP. No studies have evaluated the effectiveness of SLT for anti-VEGF-associated glaucoma.</p><p><strong>Methods: </strong>This was a retrospective, single-center study. Anti-VEGF-associated IOP increase was defined as an eye receiving at least one anti-VEGF intravitreal injection prior to SLT. IOP and the number of pressure-lowering drops were measured at 3-, 6-, 9-, and 12-month post-SLT follow-up appointments. Outcomes included changes in IOP, and the number of IOP-lowering drops prescribed.</p><p><strong>Results: </strong>Twenty-three eyes from 18 patients were included in this study. The IOP was 18.26 ± 3.33 with 2.6 ± 1. drops prescribed at baseline. Two eyes required repeat SLT. Over the study period, IOP was reduced by 3 to 4.5 mm Hg, with all p-values <0.001. Eight eyes in the study were drop-naïve (no IOP-lowering drops prescribed prior to SLT). Of these, 6/8 (75%) remained drop-free at the end of the observation period. At their final clinic visit, 78.3% of patients were controlled on SLT without further surgical or medical intervention.</p><p><strong>Conclusions: </strong>To the best of our knowledge, this is the first study to demonstrate the long-term effectiveness of SLT in anti-VEGF-associated open-angle glaucoma in steroid-naïve eyes.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1675048"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978905","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":"Two-year outcomes of PRESERFLO MicroShunt implantation in a real-world heterogeneous glaucoma cohort: a retrospective single-center study.","authors":"Anina Zeier, Markus Tschopp, Daniel Barthelmes, Anthia Papazoglou","doi":"10.3389/fopht.2026.1835844","DOIUrl":"10.3389/fopht.2026.1835844","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate intraocular pressure (IOP), medication burden, best-corrected visual acuity (BCVA), and safety outcomes after <i>ab externo</i> PRESERFLO MicroShunt (PreserFlo) implantation in routine clinical practice.</p><p><strong>Methods: </strong>This retrospective single-center study included patients undergoing PreserFlo implantation (standalone or combined with phacoemulsification) between 2019 and 2022. IOP, BCVA, and glaucoma medications were collected preoperatively and postoperatively (day 1, week 1, month 1, year 1, and year 2). Hypotony was defined as IOP ≤ 5 mmHg. Complete success at 2 years required IOP ≤ 21 mmHg with ≥20% reduction from baseline without glaucoma medication.</p><p><strong>Results: </strong>Eighty-one eyes of 74 patients (mean age 73.2 years) were included. Mean baseline IOP was 24.0 ± 10.2 mmHg, decreasing to 12.5 ± 3.8 mmHg at year 1 (p < 0.0001) and 13.5 ± 3.4 mmHg at year 2 (p = 0.0005). Mean BCVA was 0.63 ± 0.30 at baseline, 0.70 ± 0.31 at year 1, and 0.73 ± 0.27 at year 2, indicating stable visual acuity during follow-up. Mean IOP reduction was 39.6% at year 1 and 33.8% at year 2; 75.6% and 73.3% achieved ≥20% IOP reduction at years 1 and 2, respectively. Medications decreased from 3.09 ± 1.02 to 0.44 ± 0.97 (year 1) and 0.45 ± 0.85 (year 2), and their medication-free rates were 80.5% and 73.3%, respectively. Complications occurred in 55.6% of eyes; 27.2% required postoperative interventions (needling 20.9%); 15.0% required further glaucoma surgery. Complete success rates were 60.2% (year 1) and 52.0% (year 2).</p><p><strong>Conclusions: </strong>PreserFlo implantation provided sustained mid-term IOP reduction with substantial medication sparing and stable BCVA.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1835844"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978852","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":"Corneal neurotization for neurotrophic keratopathy: a case report of two patients from different age groups.","authors":"Hamad M Alsulaiman, Huda AlGhadeer","doi":"10.3389/fopht.2026.1892069","DOIUrl":"10.3389/fopht.2026.1892069","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the techniques and the successful outcomes of corneal neurotization (CN) for the treatment of neurotrophic keratopathy (NK) in two patients from different age groups.</p><p><strong>Methods: </strong>A detailed clinical examination and comprehensive systemic workup were performed to determine the etiology of NK. Both cases were managed surgically with CN and followed for 3 years postoperatively at the King Khaled Eye Specialist Hospital & Research Center, Riyadh, Saudi Arabia.</p><p><strong>Results: </strong>Two eyes of a 66-year-old male and a 22-month-old boy who were diagnosed with NK and refractory to conservative therapy underwent CN. The first patient underwent indirect corneal neurotization for the management of NK in the right eye from the ipsilateral infraorbital nerve using a sural nerve interposition graft from the left leg, while the second patient underwent indirect corneal neurotization for the management of NK in the left eye from the contralateral right supraorbital nerve using a sural nerve interposition graft from the left leg. The symptoms improved following the procedure as well as the corneal sensation, with improvement of the NK in both patients. At the three-year follow-up, our patients showed no complications or NK recurrence.</p><p><strong>Conclusions: </strong>CN is a valuable surgical technique for the management of recalcitrant NK and possibly for restoring corneal sensation in some with NK prior to the development of irreversible stromal damage.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1892069"},"PeriodicalIF":2.4,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914633","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":"Editorial: Global perspectives on genetic diagnosis and treatments for inherited retinal diseases.","authors":"Yusuke Murakami, Pei-Kang Liu, Dyah Ayu Windy, Arjun Shrestha","doi":"10.3389/fopht.2026.1943908","DOIUrl":"https://doi.org/10.3389/fopht.2026.1943908","url":null,"abstract":"","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1943908"},"PeriodicalIF":2.4,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914698","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":"The application of ultrasonography in the differential diagnosis of orbital lesions.","authors":"Bernadete Ayres, Hakan Demirci","doi":"10.3389/fopht.2025.1679711","DOIUrl":"10.3389/fopht.2025.1679711","url":null,"abstract":"<p><p>The imaging studies play an important role in the diagnosis and management of orbital lesions. This article provides a comprehensive overview of ultrasonographic imaging features and its practical application in the evaluation of orbital lesions. In this article, we review the features of common orbital lesions using ultrasonography, computed tomography, and magnetic resonance imaging correlation. The topics will include tumors, inflammatory diseases, congenital malformations, and orbital trauma. Each condition is reviewed in relation to its clinical presentation and imaging characteristics.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"5 ","pages":"1679711"},"PeriodicalIF":2.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889618","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":"SPECT/CT imaging in thyroid eye disease: an emerging role in assessing sub-clinical activity.","authors":"Kelsey A Roelofs, Kimberly M Papp, Kate S Lim, Ezekiel Weis","doi":"10.3389/fopht.2026.1792332","DOIUrl":"10.3389/fopht.2026.1792332","url":null,"abstract":"<p><p>Thyroid eye disease (TED) diagnosis is made based on the presence of a constellation of clinical, laboratory, and radiologic findings. Currently, computed tomography (CT) and magnetic resonance imaging (MRI) are the most commonly used imaging modalities; however, they provide indirect indicators of underlying inflammation, resulting in limited specificity. Our narrative review explored the role of Single Photon Emission Computed Tomography (SPECT)/CT in TED with the goal of enhancing our ability to correlate structure with function in TED. A non-systematic narrative search of major electronic databases was conducted to identify literature on SPECT/CT in TED, using targeted selection and thematic narrative synthesis to analyze the findings. Technetium-99m diethylenetriaminepentaacetic acid (^99mTc-DTPA) is the most common tracer used in SPECT/CT and it undergoes extravasation in the presence of inflammatory mediators. The uptake ratio (UR) of this tracer in orbital tissues can be calculated and compared with a reference tissue to provide a way of direct spatial visualization of function and corresponding structure. The UR was consistently higher in patients with a clinical activity score (CAS) ≥ 3. The UR was also consistently elevated in those identified as having active TED on MRI, indicating good correspondence. Lastly, the UR was reduced in the extraocular muscle after introducing triamcinolone injection, highlighting the usefulness of SPECT/CT in identifying anatomic disease activity and guiding treatment among a cohort of CAS-negative patients. While the quantitative calculation of the ^99mTc-DTPA UR provides an objective metric for evaluating active disease, its clinical use in TED is still limited by substantial inter-study variability and intrinsic technical limitations. Monitoring UR may be better suited for monitoring each patient's progression within the same institution.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1792332"},"PeriodicalIF":2.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889645","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":"24-month outcomes of a combined 180-degree phacogoniotomy with KDB procedure.","authors":"Panagiotis Tsoutsanis, Ananth Ranjit, Afifa Islam, Siddharth Agrawal","doi":"10.3389/fopht.2026.1910636","DOIUrl":"10.3389/fopht.2026.1910636","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to evaluate the 24-month efficacy and safety of combined 180-degree phacogoniotomy with Kahook Dual Blade (KDB) in patients with various forms of glaucoma.</p><p><strong>Methods: </strong>This retrospective, single-centre study included 66 eyes from 66 patients who underwent combined phacogoniotomy with KDB surgery at Rochdale Infirmary, UK, between November 2021 and January 2023. Patients with moderate-to-advanced open-angle, secondary, or narrow-angle glaucoma were included. Primary outcomes were changes in mean intraocular pressure (IOP) and number of IOP-lowering medications from baseline to 24 months. Secondary outcomes included surgical success, defined according to the criteria of Dorairaj et al. and the American Academy of Ophthalmology (AAO) criteria.</p><p><strong>Results: </strong>Mean IOP significantly decreased from 19.4 ± 6.6 mmHg at baseline to 14.1 ± 4.3 mmHg at 24 months, representing a mean reduction of 5.3 mmHg (27%) (p < 0.0001). The mean number of IOP-lowering medications was reduced from 3.0 ± 0.7 to 1.7 ± 1.2 at 24 months, a mean reduction of 1.3 medications (43%) (p < 0.0001). At 24 months, 92% of eyes achieved success by Dorairaj's criteria, and 76% achieved qualified success and 19% absolute success according to AAO standards. Visual acuity improved slightly but not significantly.</p><p><strong>Conclusion: </strong>Combined 180-degree phacogoniotomy with KDB provides a significant and sustained 24-month reduction in intraocular pressure and medication burden, with a favourable safety profile. These findings support phacogoniotomy with KDB as an effective minimally invasive option for patients with coexisting cataract and glaucoma.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1910636"},"PeriodicalIF":2.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882606","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":"Enhancing early diabetic retinopathy detection: a fine-tuned NASNet framework with robust validation and external generalization.","authors":"Nisha R, M A P Manimekalai, K Martin Sagayam, Syed Immamul Ansarullah, Sami Alshmrany, Shafat Khan, Khair Ul Nisa","doi":"10.3389/fopht.2026.1762381","DOIUrl":"10.3389/fopht.2026.1762381","url":null,"abstract":"<p><p>Early detection of diabetic retinopathy (DR) is critical for preventing irreversible vision loss among patients with diabetes mellitus. Automated screening systems based on deep learning have demonstrated substantial promise in improving diagnostic efficiency and scalability. This study proposes a robust multiclass DR classification framework using a fine-tuned NASNetLarge architecture applied to retinal fundus images. The model leverages transfer learning from ImageNet and incorporates a structured fine-tuning protocol to adapt high-level features to DR-specific patterns. Experiments were conducted on the publicly available APTOS 2019 Blindness Detection dataset, comprising five DR severity classes. The model was evaluated using accuracy, precision, recall, F1-score, sensitivity, specificity, and receiver operating characteristic-area under the curve (AUC) metrics. To ensure robustness, experiments were repeated across five independent runs and reported as mean ± standard deviation. External validation was performed using the EyePACS dataset to assess generalisability. The fine-tuned NASNet model achieved 97.52% ± 0.42 accuracy with strong per-class AUC values (≥ 0.98). External validation yielded 93.42% accuracy and an AUC value of 0.941, confirming generalization capability. Comparative analysis against EfficientNet-B4, DenseNet121, and Vision Transformer (ViT-B16) demonstrated superior performance under identical conditions. The proposed framework shows strong potential as an automated DR screening tool for early-stage detection and large-scale population screening.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1762381"},"PeriodicalIF":2.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882622","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}