BMC Ophthalmology最新文献

{"title":"Incremental contribution of Corvis ST dynamic biomechanical parameters to interpretable machine learning prediction of clinician-selected refractive procedures: a retrospective observational study.","authors":"Yinhao Li, Gang Li, Chuanyun Xu, Jiahui Wang, Xin Wang, Yanli Peng","doi":"10.1186/s12886-026-05208-7","DOIUrl":"10.1186/s12886-026-05208-7","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate whether structured preoperative variables can reproduce clinician-selected refractive procedure patterns and to assess the incremental contribution of Corvis ST dynamic biomechanical parameters beyond conventional refractive, tomographic, pachymetric, and risk-related features.</p><p><strong>Methods: </strong>We conducted a retrospective observational study of 395 patients (763 eyes) who underwent refractive surgery at Chongqing Aier Eye Hospital between October 2023 and November 2024. The outcome label was the procedure actually selected and performed by clinicians, including ICL, SMILE, LASIK, and SURFACE. Forty-eight structured preoperative features were analyzed, including demographic, refractive, visual, ocular-surface, tomographic, pachymetric, anterior-segment, Pentacam-derived deviation/risk, and Corvis ST-derived variables. Data were split at the patient level into a training cohort and an internal held-out test cohort. Multiple machine learning models were developed using patient-grouped cross-validation, and the final model was evaluated using accuracy, balanced accuracy, macro-F1 score, class-wise metrics, calibration analysis, patient-level clustered bootstrap resampling, and one-eye-per-patient sensitivity analysis. Structured feature-set ablation and SHAP analysis were performed to evaluate feature-domain contributions and model behavior.</p><p><strong>Results: </strong>The two-stage XGBoost-based model, which first separated ICL from corneal laser procedures and then classified laser procedures into SMILE, SURFACE, and LASIK, achieved the most favorable overall performance. Its estimated total validation accuracy was 83.36% ± 2.59%. On the internal held-out test cohort, the model achieved an end-to-end accuracy of 78.43%, balanced accuracy of 79.17%, macro-F1 score of 77.96%, and macro AUC of 93.77%. Ablation analysis showed that most predictive gain was derived from tomographic and pachymetric variables, whereas pure Corvis ST dynamic biomechanical parameters provided modest complementary information beyond the full non-pure-Corvis feature set. SHAP analysis indicated that refractive parameters were the dominant contributors, while tomographic, pachymetric, risk-related, and Corvis ST-derived variables contributed to procedure-specific model behavior.</p><p><strong>Conclusions: </strong>Structured preoperative variables can partially reproduce single-center clinician-selected refractive procedure patterns. Corvis ST-derived dynamic biomechanical parameters suggested modest complementary predictive information beyond conventional refractive, tomographic, pachymetric, and risk-related features. These findings support internally validated prediction of clinician-selected procedure patterns but do not establish optimal surgical recommendation or external generalizability.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paracentral acute middle maculopathy associated with peripheral retinal capillary hemangioma.","authors":"Seongyong Jeong, Chaewon Lim, Min Sagong","doi":"10.1186/s12886-026-05249-y","DOIUrl":"10.1186/s12886-026-05249-y","url":null,"abstract":"<p><strong>Background: </strong>Paracentral acute middle maculopathy (PAMM) has not previously been reported in association with peripheral retinal capillary hemangioma (RCH). We report a case of PAMM associated with a peripheral RCH, with multimodal imaging findings compatible with a localized venous congestion-related ischemic mechanism.</p><p><strong>Case presentation: </strong>A 36-year-old woman presented with a superior paracentral visual field defect in the right eye with 20/20 vision. Fundus examination revealed multifocal parafoveal whitish lesions and an orange-red capillary hemangioma with surrounding hemorrhages in the inferotemporal peripheral retina, accompanied by venous dilation and tortuosity. Spectral-domain optical coherence tomography (OCT) demonstrated a hyperreflective band involving the inner plexiform, inner nuclear, and outer plexiform layers, consistent with PAMM. OCT angiography showed focal hypoperfusion at the deep capillary plexus with preserved superficial plexus. Ultra-widefield fluorescein angiography revealed early arterial filling, delayed venous drainage, and late peritumoral leakage, suggesting localized venous outflow impairment.</p><p><strong>Conclusions: </strong>This case broadens the clinical spectrum of RCH-related complications by illustrating a possible association between peripheral RCH, localized venous congestion, and PAMM, highlighting the importance of careful vascular assessment and longitudinal surveillance.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapidly progressive bilateral lens abnormalities following cataract surgery in a highly myopic patient.","authors":"Yanyun Wang, Qiao Wang, Pengcheng Wu","doi":"10.1186/s12886-026-05221-w","DOIUrl":"https://doi.org/10.1186/s12886-026-05221-w","url":null,"abstract":"<p><strong>Background: </strong>Axial high myopia (AHM) combined with complicated cataract elevates cataract surgery risks, and capsular contraction syndrome (CCS) is a rare postoperative complication with high myopia as a high-risk factor. Nevertheless, the simultaneous occurrence of postoperative CCS in one eye and spontaneous complete crystalline lens dislocation in the contralateral unoperated eye has not previously been reported in the AHM population.</p><p><strong>Case presentation: </strong>A 60-year-old woman with long-standing high myopia and bilateral nuclear cataract underwent right eye cataract surgery. The right eye developed rapidly progressive CCS with anterior capsular shrinkage and intraocular lens (IOL) decentration at 4 and 5 weeks postoperatively, requiring multiple surgical interventions including anterior vitrectomy and IOL replacement. During the same period, the untreated left eye developed spontaneous complete posterior dislocation of the crystalline lens into the vitreous cavity and was managed with pars plana vitrectomy (PPV), lensectomy, and secondary suture-suspended IOL implantation.</p><p><strong>Conclusions: </strong>This case underscores two core clinical recommendations for cataract surgery in patients with AHM. Rigorous preoperative counselling is essential to inform patients comprehensively about the risks of CCS, which may necessitate successive secondary surgical procedures ranging from neodymium-doped yttrium aluminum garnet (Nd: YAG) laser capsulotomy, IOL repositioning or exchange and scleral-fixated IOL implantation to anterior vitrectomy and PPV, and these interventions may result in permanent visual loss. Additionally, rigorous surveillance of zonular integrity and native lens stability in the contralateral eye is mandatory for high myopia patients diagnosed with postoperative CCS.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Lotrafilcon B and Balafilcon A bandage contact lenses on epithelial healing and visual symptoms after transepithelial photorefractive keratectomy in the hyperopic patients.","authors":"Ali Ayatollahi, Saeid Abdi, Maryam Dashti, Saeed Rahmani, Haleh Kangari, Mohammad Ghasemi Boroumand, Zahra Kamary Rad","doi":"10.1186/s12886-026-05232-7","DOIUrl":"10.1186/s12886-026-05232-7","url":null,"abstract":"<p><strong>Background: </strong>After laser treatment, a protective bandage contact lens (BCL) is placed over the eye to promote healing. During this period, patients may experience discomfort, including pain, light sensitivity, and blurred vision. This study aimed to evaluate the effectiveness of two types of silicone hydrogel BCLs in promoting postoperative epithelial healing and reducing patient discomfort following transepithelial photorefractive keratectomy (T-PRK).</p><p><strong>Methods: </strong>In this randomized, double-masked observational study, patients with pure hyperopia or compound hyperopic astigmatism in both eyes who had undergone bilateral T-PRK were assigned to wear either Lotrafilcon B (Group 1: 62 eyes) or Balafilcon A (Group 2: 64 eyes) contact lenses. Patients were assessed on the day of surgery and daily from postoperative days 1 to 10 until re-epithelialization was confirmed via slit-lamp biomicroscopy. Corneal healing investigated objectively using slit-lamp biomicroscopy and visual symptoms like photophobia, irritation, foreign body sensation, sudden wake-ups during sleep, and pain were collected through a questionnaire once re-epithelialization was complete.</p><p><strong>Results: </strong>There were no significant differences between the two groups in age (35.55 ± 10.72 vs. 37.38 ± 11.97 years, p = 0.52), gender distribution (58% vs. 65% male, p = 0.60), preoperative best-corrected visual acuity (BCVA) (0.02 ± 0.05 vs. 0.02 ± 0.07 LogMAR, p = 0.95), or spherical equivalent refraction (+ 3.29 ± 1.19 vs. +2.98 ± 1.30 diopters, p = 0.31). There were no significant differences between the two groups in photophobia, corneal healing, irritation, foreign body sensation, overall questionnaire scores, or reports of sudden wake-ups during sleep (p > 0.05 for all). However, statistical analysis revealed that eyes fitted with Lotrafilcon B lenses had significantly lower pain scores than those fitted with Balafilcon A lenses (p < 0.05).</p><p><strong>Conclusions: </strong>Lotrafilcon B bandage contact lenses are more effective than Balafilcon A lenses in reducing ocular pain during the postoperative period of T-PRK.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silicone oil-associated visual loss in macula-on rhegmatogenous retinal detachment - does the tamponade duration affect the outcome?","authors":"Teresa Barth, Horst Helbig, Maria-Andreea Gamulescu, David Märker","doi":"10.1186/s12886-026-05235-4","DOIUrl":"https://doi.org/10.1186/s12886-026-05235-4","url":null,"abstract":"<p><strong>Background: </strong>Silicone oil (SO)-associated unexplained visual loss (UVL) is a serious phenomenon after pars-plana-vitrectomy (ppV). Due to reports of UVL, we started earlier SO removal (SOR) in macula-on rhegmatogenous retinal detachments (RRD) in 2020. This study aims to investigate the effect of a shorter (≤ 60 days) compared to a long-term (> 60 days) SO tamponade.</p><p><strong>Methods: </strong>All consecutive macula-on RRDs (2020-2025) treated with ppV were retrospectively analysed comparing eyes with short-term vs. long-term SO tamponade regarding best corrected visual acuity (BCVA), intraocular pressure (IOP), central foveal thickness (CFT) and the incidence of UVL. Inclusion criteria were a detailed clinical documentation and a minimum follow-up (FU) of 2 months after SOR. If available, CFT values were analysed before, during, and after SO.</p><p><strong>Results: </strong>Overall, 37 eyes received ppV with SO for macula-on RRD. In 25 eyes (68%), SOR was performed within 60 days. Due to organizational issues (Covid, capacity) or patient-related factors (cancellation, illness), SO remained for longer than 60 days in 12 eyes (32%). Primary reattachment was achieved in all eyes. In the short-term group SOR was after 36 days (SD 13.4) and in the long-term cohort after 92 days (SD 20.9). UVL (≥ 2 Snellen lines BCVA loss without correlate) was significantly more common in the long-term (5/12) than in the short-term SO group (0/25) (p = 0,002). There were no differences in intra -and postoperative parameters (cut-suture time, IOP, CFT). Eyes with long-term SO had a final BCVA of logMAR 0.5 (SD 0.34) compared to a preoperative BCVA of logMAR 0.3 (SD 0.21). In eyes with short-term SO the BCVA before surgery (0.3; SD 0.29) and after SOR (0.3; SD 0.28) were comparable. The final BCVA after SOR was significantly better after short-term than after long-term tamponade (p = 0.033).</p><p><strong>Conclusion: </strong>Eyes with a shorter SO tamponade (≤ 60 days) had better postoperative BCVA, while 42% in the long-term group (> 60 days) experienced UVL Taking into account the limitations of our small cohort, the risk of UVL during SO tamponade should be considered, especially in macula-on cases. Currently, an early SOR is the only modifiable surgical approach to address this adverse event.</p><p><strong>Trial registration: </strong>The study was approved by the local ethics committee on 31st of October 2025 (Ethikkommission der Universität Regensburg, Votum 254385104) and was conducted in accordance with the ethical standards of the Declaration of Helsinki.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior segment optical coherence tomography-guided management of capsular contraction and anterior-posterior capsular adhesion after congenital cataract surgery: a case report.","authors":"Ayako Sadahide, Masahiko Takeda, Marina Eguchi, Fumiya Miyako, Noriko Nakasaki, Hirokazu Sakaguchi","doi":"10.1186/s12886-026-05243-4","DOIUrl":"https://doi.org/10.1186/s12886-026-05243-4","url":null,"abstract":"<p><strong>Background: </strong>Capsular changes after congenital cataract surgery may compromise the visual axis in infants and may necessitate secondary surgical intervention. In such situations, identifying a safe dissection plane can be challenging under conventional microscopic visualization, and adjunctive intraoperative imaging may be beneficial.</p><p><strong>Case presentation: </strong>A 2-month-old boy diagnosed with bilateral congenital cataracts underwent phacoaspiration, posterior capsulotomy, and anterior vitrectomy with planned aphakia. Despite continued topical treatment, the patient developed progressive posterior synechiae, anterior capsular contraction, and anterior-posterior capsular adhesion within 1 month postoperatively. Surgical dissection of the adhesion and enlargement of the anterior capsulotomy were performed under intraoperative anterior segment optical coherence tomography (AS-OCT) guidance. AS-OCT provided intraoperative cross-sectional information suggesting a narrow cleavage plane between the anterior and posterior capsules, which helped guide targeted viscodissection.</p><p><strong>Conclusions: </strong>Intraoperative AS-OCT may serve as a useful adjunct in the management of postoperative capsular adhesion after congenital cataract surgery by helping surgeons identify the dissection plane and guide intraoperative decision-making, particularly when conventional microscopic visualization is limited.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subconjunctival autologous platelet-rich plasma as an adjunctive therapy for limbal-scleral ischemia following acute ocular burns: a prospective randomized pilot trial.","authors":"Mehrnaz Atighehchian, Hamed Ghassemi, Siamak Zarei-Ghanavati, Golshan Latifi, Mehran Zarei-Ghanavati","doi":"10.1186/s12886-026-05225-6","DOIUrl":"10.1186/s12886-026-05225-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the feasibility and short-term outcomes of subconjunctival injection of autologous platelet-rich plasma (PRP) as an adjunct to topical PRP for limbal-scleral ischemic area (LSIA) following acute ocular burns.</p><p><strong>Methods: </strong>This prospective randomized pilot study included patients with LSIA within three weeks of chemical or thermal ocular burns. Sixteen eyes of 16 patients were randomized using permuted block randomization into two groups. Both groups received standard medical therapy including topical PRP eye drops. The intervention group additionally received a single session of subconjunctival PRP injection. Limbal-scleral ischemic area (LSIA) was quantified using ImageJ. Best-corrected visual acuity (BCVA) at 3 months was analyzed as a primary outcome. The secondary outcome was change in LSIA size and time to complete revascularization.</p><p><strong>Results: </strong>Sixteen eyes of 16 patients (mean age 35.37 ± 11.42 years; all male) were included. Mean BCVA improved from 1.44 ± 0.70 to 1.07 ± 0.95 logMAR (p > 0.05). Baseline LSIA was 57.03 ± 28.68 mm² in Group 1 and 55.83 ± 28.63 mm² in Group 2 (p = 0.916). Complete vascularization and healing occurred in both groups by month three. Mean healing time was 50 days (95% CI: 17.9-82.1) in Group 1 and 44.75 days (95% CI: 20.0-69.5) in Group 2. No injection-related adverse events were reported.</p><p><strong>Conclusion: </strong>Subconjunctival autologous PRP appears feasible and safe as an adjunct to topical PRP in acute ocular burns. However, no significant benefit in LSIA healing was demonstrated, and larger controlled trials are required to determine efficacy.</p><p><strong>Trial registration: </strong>This clinical trial was retrospectively registered with the Iranian Registry of Clinical Trials (IRCT; registration number: IRCT20231219060471N3 on July 30, 2026.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of serum C3, C3a, C4 levels between cataract patients with and without pseudoexfoliation and normal individuals.","authors":"Gülce Gökgöz Özışık, Hüseyin Kayadibi, İsmail Çağatay Çağlar, Hasan Basri Çakmak","doi":"10.1186/s12886-026-05210-z","DOIUrl":"10.1186/s12886-026-05210-z","url":null,"abstract":"<p><strong>Background: </strong>We aimed to compare serum complement C3, C3a, and C4 levels between cataract patients with and without pseudoexfoliation syndrome, and to compare these groups with the control group.</p><p><strong>Methods: </strong>There were three different groups in the study. The total of 150 patients, 50 in each group, were included. Group 1 consisted of cataract patients with pseudoexfoliation, Group 2 consisted of cataract patients without pseudoexfoliation, and Group 3 consisted of healthy individuals. After centrifugation of the blood samples, the serum portion was stored at - 80 °C until the analysis. Complement C3, C3a, and C4 levels were evaluated in these three groups using commercially available sandwich ELISA kits.</p><p><strong>Results: </strong>There was a statistically significant difference just between Group 1 and Group 2 regarding C4 values. However, after the age correction, this significance was disappeared.</p><p><strong>Conclusions: </strong>No statistically significant difference in serum complement C3, C3a, and C4 levels was found between cataract patients with and without pseudoexfoliation syndrome after correcting for age. As only serum was evaluated, this finding does not exclude local complement pathway activation within the eye, and should not be read as evidence against a role for complement in pseudoexfoliation.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical and functional outcomes and prognostic factors after idiopathic full-thickness macular hole surgery: a single-center retrospective cohort study.","authors":"Armağan Filik, Mısra Şirvanlıoğlu, Gaye Güner, Veysel Aydın, Ruveyda Rumeysa Ateşoğlu, Mertcan Aydın, Hayri Ferhat Budak, Hülya Güngel","doi":"10.1186/s12886-026-05240-7","DOIUrl":"https://doi.org/10.1186/s12886-026-05240-7","url":null,"abstract":"<p><strong>Background: </strong>To evaluate anatomical and functional outcomes after idiopathic full-thickness macular hole (FTMH) surgery and identify factors associated with anatomical closure and six-month visual outcome.</p><p><strong>Methods: </strong>This retrospective study included 74 eyes of 74 patients who underwent primary pars plana vitrectomy (PPV) between June 2014 and November 2025. Surgery was performed with either conventional internal limiting membrane (ILM) peeling or temporal inverted ILM flap surgery. Baseline clinical data, optical coherence tomography (OCT) parameters, including minimum linear diameter (MLD) and macular hole index (MHI), tamponade type, anatomical outcomes, reoperation status, and best-corrected visual acuity (BCVA) were analyzed. Primary anatomical closure was defined as closure after the initial surgery, whereas final anatomical closure was defined as closure at final follow-up, including closure after reoperation. An exploratory adjusted linear regression model evaluated factors associated with six-month BCVA.</p><p><strong>Results: </strong>Primary anatomical closure was achieved in 59 eyes (79.7%), and final anatomical closure increased to 64 eyes (86.5%) after reoperation. Median BCVA improved from 1.30 to 0.70 logMAR at postoperative months 3 and 6 (both p < 0.001). Reoperation was performed in 9 eyes with persistent macular hole and achieved closure in 5 eyes (55.6%). Poorer preoperative BCVA was associated with persistent anatomical failure after primary surgery and at final follow-up (p = 0.021 and p = 0.023). Primary surgical technique, MLD category, and MHI category were not associated with anatomical closure. Although eyes treated with temporal inverted ILM flap surgery had poorer preoperative BCVA and a numerically larger MLD, six-month BCVA gain was greater in these eyes in the unadjusted comparison (p = 0.036). However, after adjustment for preoperative BCVA and MLD, surgical technique was not independently associated with six-month postoperative BCVA (p = 0.155). Better preoperative BCVA and smaller MLD were associated with better six-month postoperative BCVA (p = 0.001 and p = 0.021).</p><p><strong>Conclusions: </strong>Surgery achieved anatomical closure in most eyes and significant six-month visual improvement. Baseline visual acuity and MLD may be clinically relevant markers of postoperative outcome, whereas the apparent unadjusted visual benefit of temporal inverted ILM flap surgery should be interpreted cautiously.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of 1-year fibrosis in treatment-naïve neovascular age-related macular degeneration: the role of baseline OCTA-derived MNV vessel density.","authors":"Yi Lin, Xianggui Zhang, Zhen Huang, Ya Ye, Ming Yan, Yanping Song","doi":"10.1186/s12886-026-05089-w","DOIUrl":"https://doi.org/10.1186/s12886-026-05089-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;To investigate baseline and post-loading optical coherence tomography angiography (OCTA) characteristics associated with 1-year fibrosis in treatment-naïve neovascular age-related macular degeneration (nAMD), and to evaluate whether baseline clinical variables combined with OCTA-derived biomarkers could improve fibrosis prediction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective, single-center study included treatment-naïve nAMD eyes with type 1 or type 2 macular neovascularization (MNV) that completed a 3 + PRN anti-VEGF loading regimen and had at least 12 months of follow-up. High-quality OCTA images were required at baseline and at the post-loading visit, defined as within 1 week after completion of the three-injection anti-VEGF loading phase. OCTA quantitative parameters, including fractal dimension, branch points, endpoints, segments, and MNV vessel density, were measured within the manually delineated MNV region of interest. Baseline clinical and imaging characteristics were compared between fibrosis and non-fibrosis groups. Univariate and multivariable logistic regression analyses were performed to identify factors associated with 1-year fibrosis, and receiver operating characteristic (ROC) curves were used to assess predictive performance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 72 patients (88 eyes) were included, of which 31 eyes developed fibrosis at 1 year and 57 did not. Compared with the non-fibrosis group, eyes that developed fibrosis had worse baseline best-corrected visual acuity (BCVA), greater baseline central macular thickness (CMT), and a higher prevalence of subretinal hyperreflective material (SHRM), retinal hemorrhage, type 2/mixed MNV, high pigment epithelial detachment, and intraretinal fluid. At baseline, the fibrosis group showed significantly higher MNV vessel density, whereas MNV fractal dimension showed a borderline difference. At the post-loading visit, MNV fractal dimension, MNV branch points, MNV endpoints, MNV segments, and MNV vessel density were all significantly higher in the fibrosis group. However, within-group comparisons between baseline and the post-loading visit revealed no significant changes in OCTA parameters in either group. In multivariable analysis, baseline BCVA (OR 1.162, 95% CI 1.024-1.319; P = 0.020), baseline CMT (OR 1.032, 95% CI 1.001-1.064; P = 0.043), and baseline MNV vessel density (OR 1.073, 95% CI 1.009-1.142; P = 0.025) remained independently associated with 1-year fibrosis, whereas SHRM did not. The combined model achieved the best predictive performance, with an area under the ROC curve of 0.787 (95% CI 0.688-0.874).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Eyes with treatment-naïve nAMD that developed fibrosis within 1 year had worse baseline disease status and distinct OCTA microvascular characteristics. Baseline BCVA, baseline CMT, and baseline MNV vessel density were independently associated with fibrosis. Integrating conventional clinical and st","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}