Asia-Pacific Journal of Ophthalmology最新文献

{"title":"Two-year outcomes of combined surgical peripheral iridectomy, goniosynechialysis, and goniotomy for advanced primary angle-closure glaucoma without cataract: A multicenter study.","authors":"Fengbin Lin, Liu Li, Ping Lu, Li Tang, Yao Zhang, Lin Xie, Xiaomin Zhu, Guangxian Tang, Hengli Zhang, Lan Lu, Meichun Xiao, Jiangang Xu, Yunhe Song, Yuying Peng, Xiaoyan Li, Weirong Chen, Fengqi Zhou, Ningli Wang, Keith Barton, Ki Ho Park, Tin Aung, Robert N Weinreb, Clement C Tham, Dennis S C Lam, Sujie Fan, Ying Han, Xiulan Zhang","doi":"10.1016/j.apjo.2025.100166","DOIUrl":"https://doi.org/10.1016/j.apjo.2025.100166","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the two-year outcomes of combined surgical peripheral iridectomy (SPI), goniosynechialysis (GSL), and goniotomy (GT) for advanced primary angle-closure glaucoma (PACG) without cataract.</p><p><strong>Design: </strong>Multicenter prospective study.</p><p><strong>Methods: </strong>The study included patients who received a combined SPI + GSL + GT for advanced PACG without cataract, all completed a 24-month follow-up. Outcome measures included changes in intraocular pressure (IOP), best-corrected visual acuity (BCVA), use of anti-glaucoma medications, surgical success, and postoperative complications over the 24-month period.</p><p><strong>Results: </strong>A total of 63 eyes from 51 patients with advanced PACG were included in the study. Among these, 37 eyes (58.7 %) achieved complete success, and 55 eyes (87.3 %) achieved qualified success. The mean IOPs at baseline and after 24 months were 28.8 ± 7.51 mm Hg and 15.8 ± 4.40 mm Hg, respectively (P < 0.001). The average number of anti-glaucoma medications decreased from 1.9 ± 1.4-0.8 ± 1.2 over the 24-month period (P < 0.001). The overall BCVA was stable during the follow-up period (P = 0.225). The primary complications observed included IOP spike (n = 9), hyphema (n = 7), and shallow anterior chamber (n = 3), all of which occurred within the first month postoperatively. Regression analysis showed that older age was positively associated with both complete success [odds ratio (OR) = 1.05; P = 0.030] and qualified success (OR = 1.08; P = 0.024).</p><p><strong>Conclusions: </strong>SPI + GSL + GT demonstrated safety and effectiveness in treating advanced PACG without cataract over the 24-month study period. This combined surgical approach should be considered a viable alternative to trabeculectomy for these patients.</p>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100166"},"PeriodicalIF":3.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumbling pseudo-Krukenberg spindle.","authors":"Jonathan T W Au Eong, Das Avranil, Kah-Guan Au Eong","doi":"10.1016/j.apjo.2025.100170","DOIUrl":"10.1016/j.apjo.2025.100170","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100170"},"PeriodicalIF":3.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-inverted and single-layer \"plastic bag\" ILM flap novel technique to treat large macular holes.","authors":"Tian Tian, Dian Jiao, Xiang Zhang, Mingyang Wang, Shipeng Guo, Jiao Lyu, Peiquan Zhao","doi":"10.1016/j.apjo.2025.100164","DOIUrl":"10.1016/j.apjo.2025.100164","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the efficacy and safety of a novel non-inverted, free single-layer internal limiting membrane (ILM) flap technique for treating large full-thickness macular holes (FTMHs).</p><p><strong>Methods: </strong>Patients with FTMHs underwent a standard 3-port pars plana vitrectomy using the 23-gauge vitrectomy system. Unique to this technique, a \"tongue-shaped\" ILM flap was initially created, followed by the formation of two \"handles\" and the bottom of \"plastic bag\" ILM flaps. Under perfluoro-n-octane (PFO), the two-point fixed \"plastic bag\" ILM flap was transferred to the free flap and dragged to cover MH using the ocular viscoelastic device (OVD) to cover the margin of the ILM flap, followed by gas tamponade. Preoperative and postoperative assessments included best-corrected visual acuity (BCVA) and spectral domain optical coherence tomography (SD-OCT).</p><p><strong>Results: </strong>The 13 patients (mean age 64.38 ± 8.08 years, macular diameter 664.85 ± 153.38μm) demonstrated a significant improvement in BCVA from 1.03 ± 0.22 logMAR preoperatively to 0.78 ± 0.26 logMAR postoperatively (P = 0.0004). In all cases, successful closure of the MH was accomplished, including 10 (76.92 %) U-shaped closure, 1 (7.69 %) flat closure, 1 (7.69 %) W-shaped closure, 1 (7.69 %) flap closure, with no ILM flap dislocations.</p><p><strong>Conclusions: </strong>The non-inverted single-layer \"plastic bag\" ILM flap technique has been demonstrated to be both a safe and effective method for managing large FTMHs, offering a promising alternative to traditional methods with improved anatomical restorations and stable visual outcomes.</p>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100164"},"PeriodicalIF":3.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The whole life cycle myopia management.","authors":"Moxin Chen, Qin Shu, Fang Li, Lin Li, Xianqun Fan","doi":"10.1016/j.apjo.2025.100161","DOIUrl":"10.1016/j.apjo.2025.100161","url":null,"abstract":"<p><p>Myopia stands as a prevalent ocular condition with global implications, impacting individuals at various life stages. In school-age children and adolescents, uncorrected myopia impedes reading and academic performance. Among middle-aged and elderly populations, myopia poses severe risks such as macular degeneration, macular holes and retinal detachment, leading to irreversible visual impairment. The term \"myopia management\" is widely embraced by ophthalmic practitioners and optometry associations worldwide, encompassing strategies to correct refractive errors and ongoing assessment of disease progression, aiming to reduce the progression of myopia and axial elongation. To date, current management strategies for myopia include public health policies, optical solutions, medical interventions and surgical options, but these interventions are general and lack age specificity. Despite existing interventions, we propose the concept of \"Whole Life Cycle Myopia Management\" in this review. This approach outlined major risk factors of myopia through the whole life cycle, discussed current interventions for myopia and provided age-specific management strategies for myopia of eight different life stages-infancies, toddlers, preschoolers, school-age children, adolescents, young adults, middle-age and old-age, including the prevention of myopia onset, slowing of myopia progression and monitoring of myopia complications. Achieving the \"Whole Life Cycle Myopia Management\" requires collaborations efforts from government, schools, hospitals and families, to restore vision and enhance the quality of life for those individuals affected by myopia.</p>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100161"},"PeriodicalIF":3.7,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of caffeine in slowing progression of myopia: 1-year results from a prospective, longitudinal clinical trial","authors":"Huy D.M. Tran ,&nbsp;Yen H. Tran ,&nbsp;Thao T.X. Ha ,&nbsp;Tuan D. Tran ,&nbsp;Monica Jong ,&nbsp;Minas Coroneo ,&nbsp;Padmaja Sankaridurg","doi":"10.1016/j.apjo.2025.100138","DOIUrl":"10.1016/j.apjo.2025.100138","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the role of topical caffeine in slowing progression of myopia, both as a standalone treatment and in combination with atropine.</div></div><div><h3>Methods</h3><div>In a prospective, randomized, dispensing clinical trial, 96 children with myopia, aged 6–13 years, spherical equivalent (SE) from –0.50 diopters (D) to –6.00 D and astigmatism less than 2.00 D were randomly assigned to nightly use of either 2 % caffeine, 0.02 % atropine with 2 % caffeine (combination) or 0.02 % atropine eye drops. An additional 86 children with myopia were enrolled in a concurrent parallel group to wear single-vision (SV) spectacles. The primary outcomes were changes in SE and axial length (AL) over a period of 12 months for each group.</div></div><div><h3>Results</h3><div>All groups progressed in myopia. At 12 months, the mean change in SE/AL was –0.76 ± 0.51 D / 0.37 ± 0.20 mm and –0.70 ± 0.55 D / 0.35 ± 0.23 mm with SV and 2 % caffeine, respectively. In comparison, progression was slower at –0.46 ± 0.50 D / 0.24 ± 0.19 mm and –0.47 ± 0.38 D / 0.23 ± 0.18 mm with atropine monotherapy and combination groups, respectively. Compared to the change in AL with SV, the change in AL was significantly less with 0.02 % atropine and the combination group (post hoc analysis, <em>P</em> = 0.024 and 0.007, respectively). Similarly, the change in SE was significantly less with 0.02 % atropine compared to the SV group (<em>P</em> = 0.027).</div></div><div><h3>Conclusions</h3><div>Used as a standalone treatment, topical 2 % caffeine did not slow myopia progression. When combined with atropine, caffeine had no impact on the efficacy of atropine in slowing myopia.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 1","pages":"Article 100138"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142997784","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":"How to diagnose glaucoma in myopic eyes by detecting structural changes?","authors":"Yong Woo Kim ,&nbsp;Ki Ho Park","doi":"10.1016/j.apjo.2025.100135","DOIUrl":"10.1016/j.apjo.2025.100135","url":null,"abstract":"<div><div>Myopia is rapidly escalating globally, especially in East and Southeast Asia, where its prevalence among younger populations reaches alarming levels of 80–90 %. This surge contributes to a myopia epidemic linked to several ocular complications, including glaucoma. As myopic individuals age, the risk of developing glaucoma increases, and an additional concern arises from the growing frequency of refractive surgeries among younger individuals, making precise optic nerve assessments critical before surgery. Evaluating the optic nerve head (ONH) in myopic eyes is challenging, as structural changes due to myopia often resemble glaucomatous alterations. Techniques such as optical coherence tomography (OCT) have improved the examination of ONH microstructures, but interpreting results remains complex due to potential false-positive findings. Myopic eyes exhibit unique changes, such as peripapillary atrophy and altered neuroretinal rim configurations, making it crucial to distinguish these from true glaucomatous signs. Recent advancements in OCT technology and the establishment of myopia-specific normative databases have enhanced diagnostic accuracy. Parameters such as minimum rim width, ganglion cell–inner plexiform layer thickness and temporal raphe sign show promise in differentiating between glaucomatous and nonglaucomatous changes. Ultimately, a comprehensive approach incorporating multiple OCT metrics is essential for accurately diagnosing glaucoma in myopic patients. By integrating various structural evaluations and leveraging advanced imaging techniques, clinicians can better navigate the complexities of glaucoma diagnosis amidst the challenges posed by myopia. This review highlights the need for increased attention and tailored strategies in managing glaucoma risk within this increasingly affected population.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 1","pages":"Article 100135"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969517","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":"Triterpenoid saponin–mediated recovery of visual deficits in age-related macular degeneration (AMD): Double-blind, placebo-controlled, randomised clinical trial","authors":"Yunhee Lee ,&nbsp;Eun-Jung Ahn ,&nbsp;Soo-Wan Chae ,&nbsp;Ali Aijaz Hussain","doi":"10.1016/j.apjo.2025.100143","DOIUrl":"10.1016/j.apjo.2025.100143","url":null,"abstract":"<div><h3>Purpose</h3><div>Recovery rate of rod photoreceptor sensitivity (S2 gradient) following a bleach is reduced in age-related macular degeneration (AMD) due to diminished delivery of retinol across a grossly altered Bruch's membrane. Since triterpenoid saponins are known to improve transport across Bruch's, we have assessed their possible use for reversing the visual deficits in AMD.</div></div><div><h3>Design</h3><div>Double-blind, placebo controlled randomised clinical trial.</div></div><div><h3>Methods</h3><div>Altogether 11 AMD patients and seven age-matched control subjects were recruited to undertake a small proof-of-principle study. Dark adaptation curves were obtained and S2 gradients evaluated using a Humphrey Field Analyser. Following basal determination of S2 gradients, oral supplementation of saponins (200 mg/day) or placebo regime was instigated for a period of 4 months. S2 gradients were re-evaluated at two and four months.</div></div><div><h3>Results</h3><div>Basal S2 gradients of the AMD cohort were determined as 0.41 ± 0.24 dB/min and those of the control subjects as 1.44 ± 0.1 dB/min. After two months of the saponin treatment, AMD subjects showed improved S2 gradients of 0.92 ± 0.23 dB/min (<em>P</em> &lt; 0.005) with a further increase to 1.35 ± 0.19 dB/min at four months (<em>P</em> &lt; 0.01), the latter not being significantly different from control subjects. S2 gradients in placebo subjects were unaltered.</div></div><div><h3>Conclusions</h3><div>Oral supplementation with saponins results in reversing the reduced S2 gradients in AMD. This improvement in the transport properties of Bruch's is expected to slow, halt or reverse the progression of AMD.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 1","pages":"Article 100143"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998447","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":"Treatment modalities and trends for hospitalized patients with neovascular glaucoma: A retrospective study of 10 years","authors":"Huishan Lin ,&nbsp;Xinbo Gao ,&nbsp;Zhuoyi Wu ,&nbsp;Wengian Tam ,&nbsp;Wei Huang ,&nbsp;Yue Dong ,&nbsp;Xi Qin ,&nbsp;Yao Liu ,&nbsp;Chengguo Zuo ,&nbsp;Mingkai Lin","doi":"10.1016/j.apjo.2025.100136","DOIUrl":"10.1016/j.apjo.2025.100136","url":null,"abstract":"<div><div>To analyze the treatment modalities and trends for neovascular glaucoma (NVG) over the past 10 years, we conducted a retrospective analysis at Zhongshan Ophthalmic Center on 1331 NVG inpatients who received 1459 treatments for 1383 eyes between January 1, 2012, and December 31, 2021. Over time, we observed a progressive annual increase in both the number of patients and the volume of surgeries for NVG, with an annual percentage change (APC) of 10.23 % (95 % confidence interval [CI]: 5.5–15.2 %, <em>P</em> = 0.001) and 11.59 % (95 % CI: 6.6–16.9 %, <em>P</em> = 0.001), respectively. Drainage valve implantation (46.88 %), cyclodestructive procedures (22.55 %) and trabeculectomy (6.24 %) were the three most commonly selected treatment options. The frequency of drainage valve implantation (APC = 6.59 %, 95 % CI = 0.9–12.6 %, <em>P</em> = 0.028), cyclodestructive procedures (APC = 17.26 %, 95 % CI = 9.3–25.8 %, <em>P</em> = 0.001) and trabeculectomy (APC = 21.93 %, 95 % CI = 1.6–46.3 %, <em>P</em> = 0.036) increased. The proportion of drainage valve implantation gradually decreased (APC = –4.48 %, 95 % CI = –8.6 to –0.2 %, <em>P</em> = 0.042), while that of cyclodestructive procedures increased (APC = 5.08 %, 95 % CI = 0.6–9.8 %, <em>P</em> = 0.042), with no significant alteration observed in the proportion of trabeculectomy (APC = 9.26 %, 95 % CI = –8.8–30.9 %, <em>P</em> = 0.290). Over the course of the study, both the cases of NVG and the volume of related surgeries escalated year by year. Among the three most frequently employed procedures—drainage valve implantation, cyclodestructive procedures and trabeculectomy—annual frequency trends revealed an increase in drainage valve implantation alongside a decreasing proportion, while cyclodestructive procedures exhibited a rising trend in both frequency and proportion; simultaneously, trabeculectomy showed an increasing frequency without a significant change in its proportion.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 1","pages":"Article 100136"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977396","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":"Clinical practices on acute acquired comitant esotropia: A consensus statement proposed by the Council of Asia-Pacific Strabismus and Pediatric Ophthalmology Society","authors":"Wen Wen ,&nbsp;Sonal K. Farzavandi ,&nbsp;Miho Sato ,&nbsp;Boon Long Quah ,&nbsp;Simon T. Ko ,&nbsp;T.S. Surendran ,&nbsp;An-Guor Wang ,&nbsp;Jeong-Min Hwang ,&nbsp;Rita S. Sitorus ,&nbsp;Shuan Dai ,&nbsp;Wei Zhang ,&nbsp;Kanxing Zhao ,&nbsp;Jason C. Yam ,&nbsp;Frank Martin ,&nbsp;Chen Zhao","doi":"10.1016/j.apjo.2025.100134","DOIUrl":"10.1016/j.apjo.2025.100134","url":null,"abstract":"<div><div>Acute acquired comitant esotropia (AACE) is a concomitant strabismus characterized by sudden onset, mostly associated with diplopia. The prevalence of AACE has significantly increased, and various management approaches have been recommended in recent years. This study by the Council of Asia-Pacific Strabismus and Pediatric Ophthalmology Society aimed to provide an overview of the clinical features, etiology and the nonsurgical and surgical treatment recommendations for the condition to equip strabismus specialists with the most updated knowledge.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 1","pages":"Article 100134"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977391","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":"Comment on the Article: Exaggerated immune response to fungal keratitis post-COVID19 vaccination","authors":"Yann Bertolani,&nbsp;Albert Arnaiz-Camacho,&nbsp;Sara Martín Nalda","doi":"10.1016/j.apjo.2025.100147","DOIUrl":"10.1016/j.apjo.2025.100147","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 1","pages":"Article 100147"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999192","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}