Ophthalmology science最新文献

{"title":"Decreased Choriocapillaris Vessel Density in the Ipsilateral Eye after Carotid Artery Revascularization Detected by Widefield Swept-Source OCT Angiography","authors":"Li Zhang MD ,&nbsp;Jia-Wei Liu MD ,&nbsp;Qing-Qing Tang MD ,&nbsp;Chun-Yan Lei MD ,&nbsp;Xue Lin MD ,&nbsp;Sheng Gao MD ,&nbsp;Tian-Yu Yang BS ,&nbsp;Fa-Yun Hu MD ,&nbsp;Mei-Xia Zhang MD","doi":"10.1016/j.xops.2024.100654","DOIUrl":"10.1016/j.xops.2024.100654","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the short-term blood flow changes and image features of the retina and choroid in patients who underwent carotid artery revascularization (CAR) for severe carotid artery stenosis using widefield swept-source OCT angiography (OCTA).</div></div><div><h3>Design</h3><div>Prospective study.</div></div><div><h3>Participants</h3><div>This prospective study included 112 eyes (56 eyes on the ipsilateral side and 56 eyes on the contralateral side) of 56 participants with severe carotid artery stenosis.</div></div><div><h3>Methods</h3><div>Participants were examined using widefield swept-source OCTA covering an area of 16 × 16 mm centered on the fovea before and after CAR. Retinal parameters including central macular thickness, vessel density of the retinal superficial vascular complex (VDRSVC), vessel density of the retinal deep vascular complex, and vessel density of the retina (VDR) and choroidal parameters, including central choroidal thickness (CCT), vessel density of the choriocapillaris (VDCC), vessel density of the medium and large choroidal vessels, choroidal vessel volume ratio (CVV/a), and 3-dimensional choroidal vascularity index (3D-CVI) were measured. Besides, preoperative and postoperative OCTA images were screened and compared.</div></div><div><h3>Main Outcome Measures</h3><div>Retinal and choroidal parameters obtained from swept-source OCTA.</div></div><div><h3>Results</h3><div>In the ipsilateral eye (56 eyes), an increase in VDRSVC, VDR, CVV/a, CCT, and 3D-CVI and a decrease in VDCC was found after CAR. Thirteen patients were identified with postoperative ipsilateral choriocapillaris flow voids (PICCFVs) with OCTA images, and the presence of PICCFVs was associated with greater postoperative VDCC decrease. In the contralateral eye (56 eyes), we found an increase in VDRSVC, vessel density of the retinal deep vascular complex, and VDR, whereas no difference in choroidal parameters after CAR and no findings of PICCFVs were found.</div></div><div><h3>Conclusions</h3><div>The findings of this study suggest that ocular microvascular perfusion is improved after CAR in the ipsilateral eye and the contralateral eye within a wide field of the fundus. The VDCC is decreased in the ipsilateral eye, which may indicate infarctions of choriocapillaris or ischemia–reperfusion injury of the choriocapillaris after CAR.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 2","pages":"Article 100654"},"PeriodicalIF":3.2,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985670","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":"Re: Rubin et al: Eccentric Viewing Training for Age-related Macular Disease: Results of a Randomized Controlled Trial (the EFFECT Study)","authors":"Sylvie Cantin MA ,&nbsp;Laurence Lapointe-Girard MSc ,&nbsp;Isabelle Boisvert MEd ,&nbsp;Judith Renaud OD, PhD ,&nbsp;Walter Wittich PhD","doi":"10.1016/j.xops.2024.100645","DOIUrl":"10.1016/j.xops.2024.100645","url":null,"abstract":"","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 2","pages":"Article 100645"},"PeriodicalIF":3.2,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973510","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":"Differentiating Choroidal Melanomas and Nevi Using a Self-Supervised Deep Learning Model Applied to Clinical Fundoscopy Images","authors":"Max Jackson MPhys ,&nbsp;Helen Kalirai BSc, PhD ,&nbsp;Rumana N. Hussain MBBS, MD ,&nbsp;Heinrich Heimann MD, PhD ,&nbsp;Yalin Zheng MEng, PhD ,&nbsp;Sarah E. Coupland MBBS, PhD","doi":"10.1016/j.xops.2024.100647","DOIUrl":"10.1016/j.xops.2024.100647","url":null,"abstract":"<div><h3>Purpose</h3><div>Testing the validity of a self-supervised deep learning (DL) model, RETFound, for use on posterior uveal (choroidal) melanoma (UM) and nevus differentiation.</div></div><div><h3>Design</h3><div>Case-control study.</div></div><div><h3>Subjects</h3><div>Ultrawidefield fundoscopy images, both color and autofluorescence, were used for this study, obtained from 4255 patients seen at the Liverpool Ocular Oncology Center between 1995 and 2020.</div></div><div><h3>Methods</h3><div>After excluding poor-quality images, a total of 18 510 UM, 8671 nevi, and 1192 healthy eye images were analyzed. RETFound, a self-supervised DL model for fundus images, was fine-tuned initially for binary classification of UM versus nevi and then retuned for tertiary classification including the healthy eyes.</div></div><div><h3>Main Outcome Measures</h3><div>The performance metrics used to evaluate the model were: area under the receiver operating characteristic curve (AUROC), accuracy, specificity, sensitivity, F1-score, and Matthew’s correlation coefficient.</div></div><div><h3>Results</h3><div>For the binary classification task, the model achieved an accuracy of 0.83 and an AUROC of 0.90 demonstrating good performance for UM versus nevi differentiation. Similarly, for the tertiary classification task, the model showed a mean accuracy of 0.82 and an AUROC of 0.92.</div></div><div><h3>Conclusions</h3><div>Our findings demonstrate the feasibility of using a self-supervised DL model for differentiation between UM and nevi with high accuracy, in a large cohort with imbalances between images derived from a single center. Validation studies on similarly sized external cohorts are planned to test our model’s potential, considering variation of images of choroidal melanoma and nevi in the clinical setting.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 2","pages":"Article 100647"},"PeriodicalIF":3.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973345","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":"Visual Acuity, Full-field Stimulus Thresholds, and Electroretinography for 4 Years in The Rate of Progression of USH2A-related Retinal Degeneration (RUSH2A) Study","authors":"David G. Birch PhD ,&nbsp;Peiyao Cheng PhD ,&nbsp;Maureen G. Maguire PhD ,&nbsp;Jacque L. Duncan MD ,&nbsp;Allison R. Ayala MS ,&nbsp;Janet K. Cheetham PharmD ,&nbsp;Nicole R. Doucet MPH ,&nbsp;Todd A. Durham PhD ,&nbsp;Abigail T. Fahim MD, PhD ,&nbsp;Frederick L. Ferris III MD ,&nbsp;Rachel M. Huckfeldt MD, PhD ,&nbsp;Michele Melia ScM ,&nbsp;Michel Michaelides MD (Res) ,&nbsp;Mark E. Pennesi MD, PhD ,&nbsp;José-Alain Sahel MD ,&nbsp;Katarina Stingl MD ,&nbsp;Ajoy Vincent MBBS, MS ,&nbsp;Christina Y. Weng MD, MBA ,&nbsp;Foundation Fighting Blindness Clinical Consortium Investigator Group","doi":"10.1016/j.xops.2024.100648","DOIUrl":"10.1016/j.xops.2024.100648","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe progression of best-corrected visual acuity (BCVA), full-field stimulus thresholds (FST), and electroretinography (ERG) over 4 years in the <em>USH2A</em>-related Retinal Degeneration study and to assess their suitability as clinical trial endpoints.</div></div><div><h3>Design</h3><div>Prospective natural history study.</div></div><div><h3>Participants</h3><div>Participants (n = 105) with biallelic disease-causing sequence variants in USH2A and BCVA letter scores of ≥54 were included.</div></div><div><h3>Methods</h3><div>BCVA, FST, fundus-guided microperimetry, static perimetry, and spectral domain OCT were performed annually and ERG at baseline and 4 years only. Mixed effects models were used to estimate annual rates of change with 95% confidence intervals. Associations of change from baseline to 4 years between BCVA, FST, ERG, and other metrics were assessed with Spearman correlation coefficients (r_s).</div></div><div><h3>Main Outcome Measures</h3><div>Best-corrected visual acuity, FST, and ERG.</div></div><div><h3>Results</h3><div>The annual rate of decline in BCVA was 0.83 (95% confidence interval: 0.65−1.02) letters/year. For FST, the change was 0.09 (0.07−0.11) log cd.s/m²/year for white threshold, 0.10 (0.08−0.12) log cd.s/m²/year for blue threshold, and 0.05 (0.04−0.06) log cd.s/m²/year for red threshold. Changes were 22.6 (17.4−28.2)%/year for white threshold, 26.0 (20.3−32.1)%/year for blue threshold, and 12.3 (8.7−16.0)%/year for red threshold. The high percentage of eyes with undetectable ERGs at baseline limited assessment of change.</div></div><div><h3>Conclusions</h3><div>Best-corrected visual acuity was not a sensitive measure of progression over 4 years. Full-field stimulus threshold was a more sensitive measure; however, additional information on the clinical relevance of changes in FST is needed before this test can be adopted as an endpoint for clinical trials.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 2","pages":"Article 100648"},"PeriodicalIF":3.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985700","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":"Long-term Impact of Carotid Endarterectomy on Choroidal and Choriocapillaris Perfusion: The INFLATE Study","authors":"Alessandro Berni MD ,&nbsp;Yi Zhang PhD ,&nbsp;Sandy Zhou Wenting MD ,&nbsp;Natalie Noam MD ,&nbsp;David Rabinovitch BSc ,&nbsp;Basheer Sheick Yousif MD ,&nbsp;Gissel Herrera MD ,&nbsp;Mengxi Shen MD, PhD ,&nbsp;Robert O’Brien PhD ,&nbsp;Giovanni Gregori PhD ,&nbsp;Ruikang K. Wang PhD ,&nbsp;Philip J. Rosenfeld MD, PhD ,&nbsp;Omer Trivizki MD","doi":"10.1016/j.xops.2024.100651","DOIUrl":"10.1016/j.xops.2024.100651","url":null,"abstract":"<div><h3>Purpose</h3><div>When performed for clinically significant carotid artery stenosis (CAS), the long-term impact of carotid endarterectomy (CEA) on choroidal and choriocapillaris (CC) circulation was studied using swept-source OCT angiography.</div></div><div><h3>Design</h3><div>Prospective observational study.</div></div><div><h3>Participants</h3><div>Patients with clinically significant CAS undergoing unilateral CEA.</div></div><div><h3>Methods</h3><div>Swept-source OCT angiography scans were performed on both eyes at baseline (before CEA), within 1 week post-CEA (short-term follow-up [FU]), and ≥30 days post-CEA (long-term FU). Using validated algorithms, we measured mean choroidal thickness (MCT), choroidal vascularity index (CVI), choroidal vessel volume (CVV), CC flow deficit percentage (CC FD%), and CC thickness within the 5-mm circle centered on the fovea for both the eye ipsilateral to CEA (surgical side) and the contralateral eye (nonsurgical side). Multivariable regression analysis was conducted to evaluate the impact of baseline demographic and clinical factors on the changes in choroidal and CC parameters.</div></div><div><h3>Main Outcome Measures</h3><div>Both the short- and long-term changes in MCT, CVI, CVV, CC FD%, and CC thickness.</div></div><div><h3>Results</h3><div>The study included 58 eyes from 29 patients. Significant short-term improvements in MCT (<em>P</em> &lt; 0.001) and CC thickness (<em>P</em> = 0.006) were observed post-CEA on the surgical side. Long-term FU showed sustained increases in MCT compared with baseline (<em>P</em> = 0.02), while CC thickness was not significantly different from baseline (<em>P</em> = 0.10). The CVI did not change significantly from baseline at either short-term (<em>P</em> = 0.45) or long-term (<em>P</em> = 0.22) FU on the surgical side. While CVV demonstrated a short-term rise immediately post-CEA (<em>P</em> &lt; 0.001), the difference was not statistically significant at the long-term evaluation (<em>P</em> = 0.06). No significant improvement in CC FD% from baseline was observed at any visit post-CEA (short-term <em>P</em> = 0.81, long-term <em>P</em> = 0.91). The nonsurgical side only showed a significant reduction in CVI at the long-term FU visit compared with before CEA (<em>P</em> = 0.01). Clinical variables such as age, degree of stenosis, diabetes, hypertension, and smoking status did not greatly impact the outcomes.</div></div><div><h3>Conclusions</h3><div>Unilateral CEA demonstrated a sustained increase in MCT, suggesting persistent improvements in choroidal perfusion in the ipsilateral eye.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 2","pages":"Article 100651"},"PeriodicalIF":3.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030390","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":"CANBERRA: A Phase II Randomized Clinical Trial to Test the Therapeutic Potential of Oral Vicasinabin in Diabetic Retinopathy","authors":"Beatriz G. Armendariz PhD ,&nbsp;Ulrich F.O. Luhman PhD ,&nbsp;Brian Berger MD ,&nbsp;Jules Hernandez-Sanchez PhD ,&nbsp;Katrijn Bogman PhD ,&nbsp;Nikolaos Mitrousis PhD ,&nbsp;Martina Wollenhaupt MD ,&nbsp;David Kent MD ,&nbsp;Andreas Wenzel PhD ,&nbsp;Sascha Fauser MD, PhD","doi":"10.1016/j.xops.2024.100650","DOIUrl":"10.1016/j.xops.2024.100650","url":null,"abstract":"<div><h3>Objective</h3><div>Nonproliferative diabetic retinopathy (NPDR) is a progressive disease that can lead to blindness. Current therapies for NPDR are invasive and not extensively used or accessible until the disease progresses, pointing to the need for an early noninvasive treatment. The objective of CANBERRA was to assess the safety, tolerability, and efficacy of oral administration of vicasinabin (RG7774) on the severity of diabetic retinopathy (DR) in participants with moderately severe to severe NPDR and good vision.</div></div><div><h3>Design</h3><div>CANBERRA was a global, multicentric randomized, double-masked, parallel-group, placebo-controlled, phase II study. The study duration was 36 months.</div></div><div><h3>Participants</h3><div>A total of 139 treatment-naïve patients with type 1 or type 2 diabetes mellitus and Diabetic Retinopathy Severity Scale (DRSS) levels of 47 or 53 in ≥1 eye were enrolled.</div></div><div><h3>Intervention</h3><div>Eligible patients were randomized 1:1:1 to 36 weeks of daily oral placebo, vicasinabin 30 mg, or vicasinabin 200 mg. Participants were followed for an additional 12 weeks.</div></div><div><h3>Main Outcome Measures</h3><div>The primary safety objective was to evaluate the safety and tolerability of vicasinabin by the frequency and severity of adverse events (AEs). The primary efficacy objective was to assess the effect of vicasinabin on the severity of DR, assessing the proportion of participants with ≥2-step improvement in DRSS from baseline at week 36 in the study eye.</div></div><div><h3>Results</h3><div>Results are presented in the following order: placebo, vicasinabin 30 mg, vicasinabin 200 mg; 47, 48, and 44 participants were enrolled. Baseline characteristics were balanced. Adherence to treatment was approximately 90%, and pharmacokinetic analysis showed dose-dependent plasma exposure to vicasinabin. The primary efficacy endpoint was not met: the percentage of participants who improved their DRSS by ≥2 steps at week 36 from baseline were 7.9, 9.5, and 5.7, without statistically significant differences. The systemic and ocular safety profiles of vicasinabin were favorable, and AEs distributed evenly across arms. Vicasinabin did not induce changes in glycemic control or any kidney function or cardiovascular parameters. Three patients in the placebo arm discontinued the study due to serious AEs not related to the drug.</div></div><div><h3>Conclusions</h3><div>At the doses tested, vicasinabin did not improve DRSS in participants with NPDR. The role of the cannabinoid system in DR remains elusive.</div></div><div><h3>Trial Registration</h3><div>ClinicalTrials.gov identifier: NCT04265261. EUDRACT number: 2019-002067-10.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 2","pages":"Article 100650"},"PeriodicalIF":3.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973868","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":"Longitudinal Assessment of Structural and Functional Changes in Rod-cone Dystrophy: A 10-year Follow-up Study","authors":"Alexis Ceecee Britten-Jones BOptom (Hons), PhD ,&nbsp;Chi D. Luu BOrth (Hons), PhD ,&nbsp;Jasleen K. Jolly MSc, DPhil ,&nbsp;Carla J. Abbott BOptom, PhD ,&nbsp;Penelope J. Allen MBBS, FRANZCO ,&nbsp;Tina Lamey PhD ,&nbsp;Terri McLaren BSc ,&nbsp;Jennifer A. Thompson PhD ,&nbsp;John De Roach PhD ,&nbsp;Thomas L. Edwards PhD, FRANZCO ,&nbsp;Lauren N. Ayton BOptom, PhD","doi":"10.1016/j.xops.2024.100649","DOIUrl":"10.1016/j.xops.2024.100649","url":null,"abstract":"<div><h3>Purpose</h3><div>Emerging clinical trials for inherited retinal disease (IRD) require an understanding of long-term progression. This longitudinal study investigated the genetic diagnosis and change in retinal structure and function over 10 years in rod-cone dystrophies (RCDs).</div></div><div><h3>Design</h3><div>Longitudinal observational follow-up study.</div></div><div><h3>Participants</h3><div>Individuals initially diagnosed with retinitis pigmentosa who underwent baseline assessment between 2010 and 2013.</div></div><div><h3>Methods</h3><div>Baseline and follow-up assessments included best-corrected visual acuity (VA), Goldmann visual field (GVF) perimetry, spectral-domain OCT imaging, electroretinogram, and panel-based genetic testing. Linear mixed models were used to investigate disease progression and interaction between progression rate and baseline measurement. Interocular symmetry in disease progression was assessed using intraclass correlation coefficients (ICCs).</div></div><div><h3>Main Outcome Measures</h3><div>Change in VA, GVF area, and ellipsoid zone (EZ) width over 10 years in RCD.</div></div><div><h3>Results</h3><div>A total of 23 participants attended follow-up (mean age 63 ± 15 years at follow-up; 48% female), with 20 classified as having RCD and 3 reclassified as having cone-rod dystrophy based on genetic diagnosis. At 10-year follow-up, only 60% of RCD participants showed progression of ≥15 letters in either or both eyes, and 40% did not meet the criteria in either eye. Between the eye with poorer versus better VA at baseline, high symmetry in disease progression was observed for GVF area (ICC = 0.87; 95% confidence interval [CI]: 0.68–0.95), and moderate interocular symmetry in disease progression was observed for VA (ICC = 0.50 [95% CI: 0.07–0.77]) and EZ width (ICC = 0.64 [95% CI: 0.25–0.85]). Baseline values influenced progression for VA and percentage change in GVF area, whereas total percentage change in EZ width did not differ across baseline values.</div></div><div><h3>Conclusions</h3><div>Many individuals with RCD did not have a significant 15-letter decline in VA over a 10-year follow-up, highlighting the challenges of relying on VA as a measure of disease progression. Symmetry between eyes varies, emphasizing a key consideration for selection of outcome measures in IRD clinical trials.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 2","pages":"Article 100649"},"PeriodicalIF":3.2,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985675","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":"Autologous Neurosensory Retinal Flap Transplantation in a Porcine Model of Retinal Hole","authors":"Madeline E. Olufsen MD ,&nbsp;Jens Hannibal MD ,&nbsp;Nina B. Soerensen MD ,&nbsp;Anders T. Christiansen MD ,&nbsp;Ulrik C. Christensen MD ,&nbsp;Grazia Pertile MD ,&nbsp;David H. Steel MD ,&nbsp;Steffen Heegaard MD ,&nbsp;Jens F. Kiilgaard MD","doi":"10.1016/j.xops.2024.100644","DOIUrl":"10.1016/j.xops.2024.100644","url":null,"abstract":"<div><h3>Purpose</h3><div>Autologous retinal transplantation has been successfully employed in the treatment of large and myopic macular holes that are refractory to standard surgical treatments. Patients transplanted with a peripheral neurosensory retinal graft have shown unexpected improvements in visual acuity. The study aims to investigate if neural integration of the graft takes place in a porcine model of retinal hole.</div></div><div><h3>Design</h3><div>Experimental animal study.</div></div><div><h3>Subjects</h3><div>Left eyes of 10 Danish landrace pigs.</div></div><div><h3>Methods</h3><div>The pigs underwent vitrectomy under general anesthesia, and a subretinal bleb was created within the visual streak on both sites of the optic disc. A retinal hole, approximately 1900 to 4000 microns in size, was cut temporally using a vitrector. A graft of matching size was harvested from the nasal retina. The graft was gently moved toward the retinal hole under perfluoro-n-octane and placed within it. Endolaser was applied around the donor site, and either air or oil tamponade was used. OCT and color fundus photography were performed 2 and 6 weeks after surgery. At the end of follow-up, the eyes were enucleated for histological examination, including immunohistochemical analysis with antibodies against retinal glial cells, photoreceptors, and inner retinal neurons.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome measures were the morphology of the graft and the junctional area between the host and the graft.</div></div><div><h3>Results</h3><div>Retinal hole closure was achieved in 9 of 10 cases, with the graft remaining in situ in 6 cases. In 4 cases, OCT scans indicated preservation of the outer retinal layers, and in 2 of these cases, there was apparent integration with the adjacent host retina. Corresponding histology confirmed the preservation of the photoreceptor layer in 3 cases, but there was no evidence of graft integration with degeneration of the inner retina in all cases. The distance between the margins of the retinal hole decreased during follow-up, suggesting that the graft contracts and drags the surrounding retina toward the center.</div></div><div><h3>Conclusions</h3><div>The outer retina of a retinal graft can be preserved, while the inner retina degenerates. No evidence of neuroretinal integration of the graft was observed. The retinal graft serves as a scaffold, promoting the centripetal migration of the edges of the hole, resulting in closure of large retinal holes.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 2","pages":"Article 100644"},"PeriodicalIF":3.2,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934009","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":"Cover","authors":"","doi":"10.1016/S2666-9145(24)00176-3","DOIUrl":"10.1016/S2666-9145(24)00176-3","url":null,"abstract":"","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"4 6","pages":"Article 100640"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721014","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":"Retinoblastoma with and without Extraocular Tumor Extension","authors":"Swathi Kaliki MD ,&nbsp;Vijitha S. Vempuluru MD ,&nbsp;Ido Didi Fabian MD","doi":"10.1016/j.xops.2024.100637","DOIUrl":"10.1016/j.xops.2024.100637","url":null,"abstract":"<div><h3>Purpose</h3><div>To study the treatment and outcomes of children with retinoblastoma (RB) with extraocular tumor extension (RB-EOE) and compare them with RB without extraocular tumor extension (RB-w/o-EOE).</div></div><div><h3>Design</h3><div>Multicenter intercontinental collaborative prospective study from 2017 to 2020. RB-EOE cases included those with overt orbital tumor extension in treatment-naive patients. Cases with microscopic orbital extension detected postenucleation were excluded from the study.</div></div><div><h3>Participants</h3><div>A total of 319 children with RB-EOE and 3116 children with RB-w/o-EOE.</div></div><div><h3>Intervention</h3><div>Chemotherapy, enucleation, exenteration, radiotherapy.</div></div><div><h3>Main Outcome Measures</h3><div>Systemic metastasis and death.</div></div><div><h3>Results</h3><div>Of the 3435 RB patients included in this study, 309 (9%) were from low-income countries (LIC), 1448 (42%) from lower-middle income, 1012 (29%) from upper-middle income, and 666 (19%) patients from high-income countries. There was an inverse relationship between the percentage of RB-EOE and national income level, with 96 (31%) patients from LIC, 197 (6%) lower-middle income, 20 (2%) upper-middle income, and 6 (1%) patients from high-income countries (<em>P</em> = 0.0001). The outcomes were statistically significant for RB-EOE compared with RB-w/o-EOE: systemic metastasis (32% vs. 4% respectively; <em>P</em> = 0.0001) and metastasis-related death (63% vs. 6% respectively; <em>P</em> = 0.0001). Multimodal treatment was the most common form of treatment (n = 177; 54%) for RB-EOE, with most cases undergoing a combination of intravenous chemotherapy and enucleation (n = 97; 30%). Adjuvant external beam radiotherapy (EBRT) after surgery (enucleation/orbital exenteration) was given in only 68 (21%) cases. Kaplan–Meier analysis for systemic metastasis and metastasis-related death in RB-EOE was 28% and 57% at 1 year, 29% and 60% at 2 years, and 29% and 61% at 3 years, respectively. Cox regression analysis revealed that the risk of death from RB-EOE was greater in patients aged &gt;4 years than &lt;2 years (hazard ratio, 2.912; <em>P</em> &lt; 0.001) and for unimodal (surgery or intravenous chemotherapy) and bimodal (surgery and intravenous chemotherapy) treatment than trimodal treatment (surgery, intravenous chemotherapy, and EBRT) (hazard ratio, 2.023; <em>P</em> = 0.004 and hazard ratio, 1.819; <em>P</em> = 0.027, respectively).</div></div><div><h3>Conclusions</h3><div>Retinoblastoma with extraocular tumor extension is associated with a higher risk of metastasis and death. Patients with RB-EOE are likely to benefit from trimodal treatment (intravenous chemotherapy, surgery, and EBRT) rather than treatment protocols excluding EBRT.</div></div><div><h3>Financial Disclosure(s)</h3><div>The authors have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 2","pages":"Article 100637"},"PeriodicalIF":3.2,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11696820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932777","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}