Asia-Pacific Journal of Ophthalmology最新文献

{"title":"Updates on medical and surgical managements of diabetic retinopathy and maculopathy","authors":"Yen-Ting Chen ,&nbsp;Nishant V. Radke ,&nbsp;Sohani Amarasekera ,&nbsp;Dong Ho Park ,&nbsp;Nelson Chen ,&nbsp;Jay Chhablani ,&nbsp;Nan-Kai Wang ,&nbsp;Wei-Chi Wu ,&nbsp;Danny S.C. Ng ,&nbsp;Pramod Bhende ,&nbsp;Shobhit Varma ,&nbsp;Enne Leung ,&nbsp;Xiulan Zhang ,&nbsp;Fei Li ,&nbsp;Shaochong Zhang ,&nbsp;Dong Fang ,&nbsp;Jia Liang ,&nbsp;Zheming Zhang ,&nbsp;Huanyu Liu ,&nbsp;Peiquan Zhao ,&nbsp;Dennis S.C. Lam","doi":"10.1016/j.apjo.2025.100180","DOIUrl":"10.1016/j.apjo.2025.100180","url":null,"abstract":"<div><div>Diabetic retinopathy (DR) and diabetic macular edema (DME) are leading causes of vision loss globally. This is a comprehensive review focused on both medical and surgical management strategies for DR and DME. This review highlights the epidemiology of DR and DME, with a particular emphasis on the Asia-Pacific region, urban-rural disparities, ethnic variations, and grading methodologies. We examine various risk factors for DR, including glycemic control, hypertension, hyperlipidemia, obesity, chronic kidney disease, sex, myopia, pregnancy, and cataract surgery. Furthermore, we explore potential biomarkers in serum, proteomics, metabolomics, vitreous, microRNA, and genetics that may aid in the detection and management of DR. In addition to medical management, we review the evidence supporting systemic and ocular treatments for DR/DME, including anti–vascular endothelial growth factor (anti-VEGF) agents, anti-inflammatory agents, biosimilars, and integrin inhibitors. Despite advancements in treatment options such as pan-retinal photocoagulation and anti-VEGF agents, a subset of cases still progresses, necessitating vitrectomy. Challenging diabetic vitrectomies pose difficulties due to complex fibrovascular proliferations, incomplete posterior vitreous detachment, and fragile, ischemic retinas, making membrane dissection risky and potentially damaging to the retina. In this review, we address the question of challenging diabetic vitrectomies, providing insights and strategies to minimize complications. Additionally, we briefly explore newer modalities such as 3-dimensional vitrectomy and intra-operative optical coherence tomography as potential tools in diabetic vitrectomy. In conclusion, this review provides a comprehensive overview of both medical and surgical management options for DR and DME. It underscores the importance of a multidisciplinary approach, tailored to the needs of each patient, to optimize visual outcomes and improve the quality of life for those affected by these sight-threatening conditions.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 2","pages":"Article 100180"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eye sustainability here and now","authors":"Francesc March de Ribot,&nbsp;Vivek Pravin Dave,&nbsp;Tham Chee Yung Clement,&nbsp;Paisan Ruamviboonsuk,&nbsp;David Chang,&nbsp;Oliver Findl","doi":"10.1016/j.apjo.2025.100181","DOIUrl":"10.1016/j.apjo.2025.100181","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 2","pages":"Article 100181"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From evidence to action: Public health approaches to reducing screen time and mitigating myopia risk","authors":"Fan Wu ,&nbsp;Yih-Chung Tham ,&nbsp;Charumathi Sabanayagam ,&nbsp;Seang-Mei Saw","doi":"10.1016/j.apjo.2025.100177","DOIUrl":"10.1016/j.apjo.2025.100177","url":null,"abstract":"<div><div>The global burden of myopia continues to expand, and the prevalence of myopia in East Asian populations is of particular concern. With the substantial increase in screen-based electronic devices, screen time has emerged as a potential risk factor. This review examined the relationship between screen viewing duration and myopia risk and public health strategies to reduce screen exposure among children. We conducted an evidence-based review of only meta-analyses investigating screen time and myopia association, searching PubMed from inception to January 20, 2025. Four of the six meta-analyses reviewed supported an association between prolonged screen use (&gt; 2 or 3 hours/day) and increased myopia risk. However, methodological limitations include the predominance of cross-sectional study designs, self-reported screen time measurements, and the lack of cycloplegic refraction in some studies within the meta-analyses. Current public health strategies focus mainly on banning mobile phones in schools and limiting screen time. Technology-based solutions, such as anti-addiction systems, support and complement these strategies. Healthcare providers play a crucial role in assessing screen time patterns in children and providing evidence-based recommendations. Future studies should employ objective screen time measurements, conduct longitudinal analyses with cycloplegic refraction, and evaluate the effectiveness of screen time interventions in myopia prevention through randomized controlled trials. In addition, examining the combined effects of traditional near-work activities and screen time may provide more comprehensive insights into myopia risk factors.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 2","pages":"Article 100177"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating photodynamic therapy as an adjuvant treatment for neovascular AMD: A comprehensive meta-analysis","authors":"Swara M. Sarvepalli ,&nbsp;Ishani Kapoor ,&nbsp;Kubra Sarici ,&nbsp;Sunir J. Garg ,&nbsp;Majda Hadziahmetovic","doi":"10.1016/j.apjo.2025.100173","DOIUrl":"10.1016/j.apjo.2025.100173","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to assess the role of photodynamic therapy (PDT) as an adjunct to anti-vascular endothelial growth factor (Anti-VEGF) intravitreal injections in the treatment of neovascular age-related macular degeneration (nvAMD).</div></div><div><h3>Methods</h3><div>PubMed, Cochrane Library, and ClinicalTrials.gov were searched for keywords “macular degeneration” and “photodynamic therapy” and “placebo” or “ranibizumab” or “bevacizumab” or “aflibercept” from inception to 2023. Included studies were peer-reviewed primary data reporting 12-month treatment results of nvAMD with anti-VEGF and PDT, anti-VEGF alone, intravitreal triamcinolone, or placebo. 23 studies were included in the final analysis. The major outcomes were best-corrected visual acuity (BCVA), central retinal thickness (CRT), and injection burden at 12 months.</div></div><div><h3>Results</h3><div>Anti-VEGF + PDT had better BCVA at 12 months compared to anti-VEGF (MD −0.07; 95 % CI −0.12, −0.01; <em>P</em> = 0.02). There was no significant difference in CRT at 12 months in anti-VEGF + PDT group versus anti-VEGF (MD −3.66; 95 % CI −10.28, 2.98; <em>P</em> = 0.28). Anti-VEGF + PDT group had significantly fewer injections compared to anti-VEGF (MD −1.76; 95 % CI −1.95, −1.58; <em>P</em> &lt; 0.0001). There was no significant difference in pooled ocular adverse events between anti-VEGF + PDT versus anti-VEGF (MD 0.96; 95 % CI 0.68, 1.36; <em>P</em> = 0.41).</div></div><div><h3>Conclusions</h3><div>PDT is a successful adjunctive to anti-VEGF injections for the treatment of nvAMD. The combination of the therapies leads to improved BCVA at 12 months, decreased injection burden, and no difference in ocular safety.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 2","pages":"Article 100173"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug delivery systems in glaucoma – Current innovations and future perspectives","authors":"Shayne S. Tan,&nbsp;Tina T. Wong","doi":"10.1016/j.apjo.2025.100163","DOIUrl":"10.1016/j.apjo.2025.100163","url":null,"abstract":"<div><div>Glaucoma is the leading cause of irreversible visual loss worldwide, and as yet, there is no cure. The only evidence-based treatment to slow progression is by lowering intraocular pressure (IOP). Despite the development of new topical medications to reduce IOP, the major limitation of eyedrops lies in human and anatomical factors, namely patient compliance and poor bioavailability, making current medical glaucoma treatment ineffective. In this manuscript, we summarise the limitations of traditional topical anti-glaucoma therapy and study current drug delivery systems to lower IOP, with focus on the only two that have made FDA-approval- Durysta and iDose TR. We highlight their limitations and discuss real-world economic challenges that make it prohibitively difficult for these drug delivery systems to be more widely adopted in daily practice. In this perspective, we also introduce gene therapy as a novel therapeutic option to target downstream pathways of IOP regulation, neuroprotection of the optic nerve, and reducing mitochondrial stress to delay the progression of glaucoma. We discuss promising results of gene therapy for glaucoma treatment in in vivo animal models as well. We also explore the concept of novel nanoparticle-based drug delivery systems, which have the advantage of being highly modifiable and customisable, able to incorporate large amounts of cargo while maintaining a high transfection efficacy, and at a fraction of the cost. Lastly, we propose that nanomedicine, in conjunction with gene therapy, offers a promising solution to the aforementioned challenges of current glaucoma therapy, and can herald a new era of sustained glaucoma treatment.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 2","pages":"Article 100163"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward a greener vision: A review on advancing sustainability in ophthalmology","authors":"Onnisa Nanegrungsunk,&nbsp;Paradee Kunavisarut","doi":"10.1016/j.apjo.2025.100182","DOIUrl":"10.1016/j.apjo.2025.100182","url":null,"abstract":"<div><div>The growing environmental impact from healthcare sector necessitates the adoption of sustainable strategies to reuse, recycle, reduce waste, lower carbon emissions, etc. In ophthalmology, surgical waste poses a significant environmental challenge, particularly due to the high volume of surgeries, along with single-use instruments, packaging materials and disposable surgical supplies. Examples of practical strategies to reduce surgical waste include adopting reusable surgical instruments when safe and feasible, minimizing unnecessary packaging and optimizing operating room protocols, e.g., multidose topical drops on multiple patients. An education regarding sustainability for medical personnel can further decrease waste production in the long term. Collaboration between healthcare providers, manufacturers and policymakers is essential to developing and integrating sustainability into ophthalmic practice. By implementing these strategies, ophthalmologists can contribute to a more environmentally responsible healthcare system without compromising patient safety.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 2","pages":"Article 100182"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vision loss following mountain trip with intraocular gas","authors":"Ting-An Chang,&nbsp;Ming-Shan He","doi":"10.1016/j.apjo.2025.100175","DOIUrl":"10.1016/j.apjo.2025.100175","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 2","pages":"Article 100175"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric evaluation and computerized adaptive testing simulations of age-related macular degeneration quality of life item banks","authors":"Eva K. Fenwick ,&nbsp;Ryan E.K. Man ,&nbsp;Anna C.S. Tan ,&nbsp;Raymond P. Najjar ,&nbsp;Dan Milea ,&nbsp;Ester P.X. Lee ,&nbsp;Tien Yin Wong ,&nbsp;Gavin S.W. Tan ,&nbsp;Hwei Wuen Chan ,&nbsp;Augustinus Laude ,&nbsp;Kelvin Y.C. Teo ,&nbsp;Shu Yen Lee ,&nbsp;Ian Yew San Yeo ,&nbsp;Ranjana Mathur ,&nbsp;Gemmy C.M. Cheung ,&nbsp;Ecosse L. Lamoureux","doi":"10.1016/j.apjo.2025.100178","DOIUrl":"10.1016/j.apjo.2025.100178","url":null,"abstract":"<div><h3>Purpose</h3><div>To optimize the psychometric properties of age-related macular degeneration (AMD) quality of life (QoL) item banks (IBs), and evaluate their performance using computerized adaptive testing (CAT) simulations.</div></div><div><h3>Design</h3><div>Cross-sectional, clinical study.</div></div><div><h3>Methods</h3><div>261 AMD patients answered 219 items within seven IBs: Activity Limitation (AL); Lighting (LT); Mobility (MB); Emotional (EM); Concerns (CN); AMD Management (AM); and Work (WK), referred to collectively as “MacCAT”. The psychometric properties of each IB (e.g. measurement precision; item “fit”; differential item functioning (DIF)) were assessed using Rasch analysis. The mean number of items required for “high” and “moderate” measurement precision was determined using CAT simulations.</div></div><div><h3>Results</h3><div>Of the 261 participants (mean age 70.5 ± 7.6 years), 69 (26.4 %), 35 (13.4 %), 80 (30.7 %) and 77 (29.5 %) had no, early, intermediate and late AMD (better eye), respectively. AL, EM, CN and AM displayed good psychometric properties overall after collapsing response categories and deleting items for misfit and/or DIF. Despite similar reengineering efforts, LT and MB had suboptimal measurement precision but were retained due to otherwise good psychometric performances. Owing to unresolvable psychometric issues, WK was not considered further. Targeting for all IBs was suboptimal. In CAT simulations on the six remaining IBs, the mean number of items required per IB ranged from 8 (AL) to 13 (MB) for moderate, and 13 (AL) to19 (MB) for high measurement precision.</div></div><div><h3>Conclusions</h3><div>Six IBs demonstrated acceptable psychometric properties and potential CAT efficiency, suggesting MacCAT provides a comprehensive measurement of the QoL impact of AMD and associated treatments. Further testing in larger clinical cohorts is needed.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 2","pages":"Article 100178"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Effect of school entrance age on myopia among primary schoolchildren using mixed-effect model: The Shantou Myopia Study (SMS)” [Asia-Pac J Ophthalmol 2024 13 (6) 100121]","authors":"Hongxi Wang ,&nbsp;Linrong Wu ,&nbsp;Yuancun Li ,&nbsp;Xin Tan ,&nbsp;Jianwei Lin ,&nbsp;Kunliang Qiu ,&nbsp;Yali Du ,&nbsp;Shengjie Yin ,&nbsp;Binyao Chen ,&nbsp;Jiao Jiang ,&nbsp;Hailiu Chen ,&nbsp;Mingzhi Zhang","doi":"10.1016/j.apjo.2025.100179","DOIUrl":"10.1016/j.apjo.2025.100179","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 2","pages":"Article 100179"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"70 MHz ultrahigh frequency ultrasound imaging in spontaneous sclerocorneal fistula.","authors":"Mathilde Kaspi, Jean Luc Perrot, Vincent Borderie, Thibaud Garcin","doi":"10.1016/j.apjo.2025.100171","DOIUrl":"10.1016/j.apjo.2025.100171","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100171"},"PeriodicalIF":3.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530975","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}