Clinical ophthalmology (Auckland, N.Z.)最新文献

{"title":"Preliminary Feasibility of Contrast Sensitivity Testing Using the IMO vifa Perimeter After Cataract Surgery.","authors":"Tetsutaro Oki, Koji Komatsu, Yuri Shinohe, Yoshiaki Kabata, Kotaro Oki, Tadashi Nakano","doi":"10.2147/OPTH.S644954","DOIUrl":"https://doi.org/10.2147/OPTH.S644954","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the feasibility of contrast sensitivity (CS) testing using a head-mounted binocular perimeter (IMO vifa) and to describe postoperative CS in eyes implanted with three types of intraocular lenses (IOLs).</p><p><strong>Patients and methods: </strong>This retrospective single-center study included 102 eyes of 71 patients who underwent uncomplicated cataract surgery with implantation of a segmented refractive IOL (Lentis Comfort [LC], 38 eyes), an enhanced monofocal IOL (Tecnis Eyhance DIB00V [DIB], 33 eyes), or a standard monofocal IOL (Tecnis DCB00V [DCB], 31 eyes). CS was measured in each eye with both eyes open under photopic room lighting 1 month postoperatively, and the area under the log CS function (AULCSF) was calculated. Groups were compared using age-adjusted linear regression accounting for inter-eye correlation.</p><p><strong>Results: </strong>Testing required approximately 5 min per patient. Mean AULCSF was 1.35 ± 0.27, 1.19 ± 0.26, and 1.30 ± 0.24 in the LC, DIB, and DCB groups, respectively. No statistically significant difference was detected among the groups after age adjustment (p = 0.304). Compared with DCB, the adjusted differences were 0.017 (95% CI -0.113 to 0.148) for LC and -0.082 (95% CI -0.213 to 0.049) for DIB.</p><p><strong>Conclusion: </strong>CS testing with the IMO vifa was feasible at routine postoperative visits under ambient room lighting. Further prospective studies are needed to assess its repeatability and agreement with established CS tests.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"644954"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231338","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":"Who Knows How to Prevent Trachoma? Caregiver Preventive Knowledge and Associated Factors in Moroto District, Uganda.","authors":"Nelson Bunani, Caroline Birungi, Godfrey Tumwizere, Enid Sarah Kabajungu, Samuel Kabwigu, Mary Abwola Olwedo","doi":"10.2147/OPTH.S631957","DOIUrl":"10.2147/OPTH.S631957","url":null,"abstract":"<p><strong>Background: </strong>Trachoma remains the leading infectious cause of blindness globally. In Moroto District, Uganda, the prevalence of trachomatous inflammation-follicular (TF) among children aged 1-9 years remained at 10-29.9% in 2023, at least twice the elimination threshold. Caregivers directly influence children's hygiene, yet evidence on their preventive knowledge is limited. This study assessed trachoma preventive knowledge and associated factors among caregivers of children aged 1-9 years in Moroto District.</p><p><strong>Methods: </strong>This was a community-based cross-sectional study conducted among 620 randomly selected caregivers of children aged 1-9 years in selected communities in Moroto District. Data were collected using a pretested structured questionnaire in Kobo Collect, with knowledge items adapted from published trachoma knowledge tools. Knowledge was measured with 12 items (score 0-12), and caregivers scoring above the mean were classified as having good knowledge. Bivariate and multivariable logistic regression were used to determine the factors associated with trachoma preventive knowledge at the 95% confidence level.</p><p><strong>Results: </strong>Overall, 75.3% (467/620) of caregivers demonstrated good knowledge of trachoma prevention. In multivariable analysis, factors positively associated with trachoma preventive knowledge were being a male caregiver (AOR=4.21, 95% CI: 1.63-10.86, p=0.003), washing the child's face twice a day (AOR=2.46, 95% CI: 1.20-5.04, p=0.014), and more than twice a day (AOR=2.51, 95% CI: 1.04-6.06, p=0.040). Caregivers with no formal education (AOR=0.56, 95% CI: 0.34-0.91, p=0.019), those who dumped waste in open fields/bushes (AOR=0.38, 95% CI: 0.22-0.66, p<0.001), and those who did not receive trachoma prevention messages (AOR=0.25, 95% CI: 0.10-0.61, p=0.002) were negatively associated with trachoma preventive knowledge.</p><p><strong>Conclusion: </strong>Most caregivers had good trachoma-preventive knowledge, but knowledge was lower among female caregivers, those with no formal education, those who disposed of waste in open fields and those not reached by prevention messages. Health education in Moroto should prioritise these groups and be delivered alongside sanitation and hygiene interventions.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"631957"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229581","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 Corneal Nerve and Ocular Surface Findings After COVID-19 Requiring Hospitalisation: An Observational Follow-Up Study.","authors":"Andreas Guttmann, Nora Woltsche, Astrid Heidinger, Paul Wintersteller, Nika Medic Ajdnik, Gernot Steinwender, Julia Aschauer, Felix Innauer, Gerold Schwantzer, Jutta Horwath-Winter","doi":"10.2147/OPTH.S653150","DOIUrl":"10.2147/OPTH.S653150","url":null,"abstract":"<p><strong>Purpose: </strong>Persistent ocular symptoms have been reported after COVID-19, but their relationship to ocular surface findings and corneal nerve morphology after hospitalization remains unclear. Therefore we evaluated long-term ocular surface and corneal nerve findings after SARS-CoV-2 infection in previously hospitalised patients.</p><p><strong>Methods: </strong>In this observational study, 26 patients from a cohort of reverse transcriptase-PCR-confirmed COVID-19 cases hospitalised during the first pandemic wave underwent one ophthalmic examination after a median follow-up of 2.77 years (1.67-3.86 years). Based on follow-up symptoms, patients were classified as the post-COVID ocular symptom group (P-COSG, n = 16) or the COVID-19 recovered without ocular symptoms group (CRWOS, n = 10). Examinations included symptom questionnaires, tear film and ocular surface assessment, meibography, corneal sensitivity testing, and in vivo confocal microscopy (IVCM) to assess corneal sub-basal nerve morphology.</p><p><strong>Results: </strong>Among the analysed follow-up participants, persistent ocular symptoms were present in 92.3% (12/13) of initially symptomatic patients, whereas 30.8% (4/13) of initially asymptomatic patients developed new symptoms. Symptom burden was significantly higher in P-COSG than in CRWOS, with higher Ocular Surface Disease Index scores (41.5 ± 17.7 vs 21.8 ± 11.3; p = 0.005) and FACE scores (4.25 ± 1.13 vs 2.00 ± 2.00; p = 0.001). Objective tear film, ocular surface, and IVCM-derived corneal nerve parameters did not differ significantly between groups. Dendritic cells were detected in 100% of P-COSG and 90% of CRWOS patients, and microneuromas in 62.5% and 50.0%, respectively. In P-COSG, older age was associated with lower corneal nerve fibre density and length. Symptoms were not relieved by topical oxybuprocaine in 43.8% of symptomatic participants.</p><p><strong>Conclusions: </strong>Ocular symptoms may persist or emerge years after COVID-19 without significant differences in measured tear film and ocular surface findings between symptom groups. This symptom-sign discordance is compatible with a possible neuropathic or neuroinflammatory component.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"653150"},"PeriodicalIF":0.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221129","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":"One-Year Outcomes of Green Laser Endoscopic Cyclophotocoagulation and Factors Associated with Surgical Failure: A Retrospective Observational Study.","authors":"Yoshiaki Takahashi, Shun Nakayama, Akira Imai, Junya Kitahara, Shinji Kakihara, Takao Hirano, Toshinori Murata","doi":"10.2147/OPTH.S625216","DOIUrl":"10.2147/OPTH.S625216","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated the 1-year outcomes of green laser endoscopic cyclophotocoagulation (ECP), a newly developed procedure approved in Japan.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 29 eyes of 26 patients who underwent green laser ECP. Intraocular pressure (IOP), glaucoma medication burden, and laser flare were evaluated preoperatively and at 1, 3, 6, 9, and 12 months postoperatively. Kaplan-Meier survival analysis was used to estimate the 12-month success rate. Surgical success was defined as meeting all of the following criteria: IOP ≤21 mmHg, a ≥20% reduction from baseline, and no additional glaucoma surgery. Univariate and multivariable Cox proportional hazards analyses were performed to evaluate factors associated with surgical failure.</p><p><strong>Results: </strong>The mean IOP decreased from 23.4 ± 8.5 mmHg preoperatively to 17.4 ± 6.9, 16.9 ± 5.2, and 17.5 ± 7.3 mmHg at 1, 3, and 6 months postoperatively, respectively, with significant reductions maintained through 6 months (p < 0.01). However, IOP increased to 21.1 ± 7.9 and 22.3 ± 11.8 mmHg at 9 and 12 months, respectively, with no significant differences from baseline. The glaucoma medication score decreased significantly through 3 months postoperatively (p = 0.02) but returned to baseline levels thereafter. Laser flare increased significantly through 1 month postoperatively (p < 0.01) and decreased numerically through 3 months. The 12-month estimated success rate was 0.36. In multivariable Cox analysis, higher preoperative IOP was significantly associated with a greater risk of surgical failure (HR, 1.10; 95% CI, 1.05-1.15; p < 0.001), whereas age and postoperative laser flare were not significantly associated with failure.</p><p><strong>Conclusion: </strong>Green laser ECP significantly lowered IOP through 6 months postoperatively; however, the estimated 12-month surgical success rate was 36%. Optimization of laser parameters and treatment strategies may be needed to improve long-term outcomes.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"625216"},"PeriodicalIF":0.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224846","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":"Outcomes of Simultaneous Three- or Four-Horizontal Muscle Surgery for Very Large-Angle Convergence Insufficiency-Type and Basic-Type Exotropia.","authors":"Ayaka Yagasaki, Teiji Yagasaki, Kazuo Ichikawa","doi":"10.2147/OPTH.S643692","DOIUrl":"10.2147/OPTH.S643692","url":null,"abstract":"<p><strong>Purpose: </strong>We investigated the outcomes of simultaneous three- or four-horizontal muscle surgery for very large-angle exotropia (> 60 prism diopters [Δ]).</p><p><strong>Subjects and methods: </strong>This retrospective study included 24 patients (16 with convergence insufficiency-type and 8 with basic-type exotropia). The deviation angle was measured using the alternate prism and cover test, and stereopsis was evaluated. Patients were classified into three groups (F: ≤ 60 arcsec (\"), C: 60\"<, and N: nil stereoacuity). A successful motor outcome was defined as ≤ 10Δ of orthotropia. Pre- and postoperative results were compared.</p><p><strong>Results: </strong>Mean preoperative exodeviation at distance and near were 75.2 ± 13.0Δ and 89.2 ± 18.0Δ, respectively. Mean age at surgery was 47.8 ± 16.5 years, and mean follow-up period was 3.6 ± 4.2 years. Thirteen and 11 patients underwent four- and three-muscle surgeries, respectively. The mean distant and near deviations at 3 months postoperatively and at the final visit were 5.3 ± 10.4Δ and 8.4 ± 9.5Δ, 5.5 ± 8.6Δ and 9.4 ± 9.0Δ, respectively. No differences were found in the near and distant deviations between the two time points. The motor success rates at both time points were 63%. Stereopsis at the final visit improved significantly from F:4%, C:38%, and N:58% before surgery to F:38%, C:50% and N:13% at the final visit (P = 0.002, McNemar-Bowker test).</p><p><strong>Conclusions: </strong>Three- or four-horizontal muscle surgeries for very large-angle exotropia are effective in achieving favorable motor outcomes and stereopsis.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"643692"},"PeriodicalIF":0.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Paul Glaucoma Implant versus the Ahmed and Baerveldt Glaucoma Implants: A Systematic Review and Bayesian Network Meta-Analysis.","authors":"Mohamed N Elshabrawi, Bara M Hammadeh, Ayodeji Arobo, Nader Elfar, Elsayed S Moubarak, Rami Al-Dwairi, Seren Al Beiruti, Hashem Abu Serhan","doi":"10.2147/OPTH.S640039","DOIUrl":"10.2147/OPTH.S640039","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the efficacy and safety of the Paul Glaucoma Implant (PGI) with those of the two established glaucoma drainage devices, the Ahmed Glaucoma Valve (AGV) and the Baerveldt Glaucoma Implant (BGI).</p><p><strong>Methods: </strong>PubMed, Embase, Scopus, Web of Science, Cochrane CENTRAL, ClinicalTrials.gov, ScienceDirect and Google Scholar were searched. Eligible studies were randomised or comparative observational studies reporting outcomes in patients who received the PGI alongside a concurrent AGV or BGI comparator. The primary outcomes were intraocular pressure (IOP) reduction, surgical success rate, and reduction in glaucoma medications. A Bayesian network meta-analysis was performed, with treatment ranking summarized by surface under the cumulative ranking curve (SUCRA). Quality assessment and evidence certainty was performed using the Cochrane Risk of Bias tool and GRADE framework respectively.</p><p><strong>Results: </strong>Five comparative studies (238 patients) were included. Relative to the AGV, the PGI was associated with a mean difference in IOP at 12 months of -3.344 (95% CrI -7.743 to 1.058) mmHg, and relative to the BGI of 4.387 (95% CrI -0.288 to 9.074) mmHg. Corresponding differences in medication number at 12 months were]-0.186 (95% CrI -0.858 to 0.545) and 0.444 (95% CrI -0.358 to 1.272). Credible intervals crossed the null for 29 of the 30 primary contrasts. Ranking probabilities favoured the AGV for IOP reduction from 3 to 12 months (SUCRA 0.885 to 0.976) and the PGI for early medication reduction (SUCRA 0.769 at 1 month), but these rankings were derived from imprecise estimates. Safety estimates were based on small numbers of events and several were unstable. Certainty of evidence was low to very low for most comparisons.</p><p><strong>Conclusion: </strong>Within the limits of a small and predominantly non-randomised evidence base, the PGI achieved intraocular pressure and medication reduction broadly comparable to those of the AGV and BGI over the first postoperative year, with a distinct complication profile. The rankings reported here are hypothesis-generating and should not by themselves determine device selection. Adequately large randomised comparisons with follow-up beyond one year are required.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"640039"},"PeriodicalIF":0.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217438","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":"One-Year Outcomes of PreserFlo MicroShunt implantation Using Intraoperative Sub-Tenon Triamcinolone Acetonide.","authors":"Yuki Takagi, Shota Shiroyama, Ryo Asano, Mitsunori Watanabe","doi":"10.2147/OPTH.S650640","DOIUrl":"10.2147/OPTH.S650640","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the 1-year efficacy, postoperative intervention burden, and safety of PreserFlo MicroShunt (PMS) implantation using intraoperative sub-Tenon triamcinolone acetonide (STTA).</p><p><strong>Patients and methods: </strong>This two-center retrospective study included 107 eyes of 107 consecutive patients who underwent standalone PMS implantation between December 2023 and May 2025. Mitomycin C (0.4 mg/mL) was applied for 5 min, followed by 20 mg STTA. Complete success was defined as an intraocular pressure (IOP) of 6-12 mmHg, with at least a 20% reduction from baseline, without medication or additional surgery. Qualified success allowed the use of glaucoma medications. Needling-free complete success was considered when the first needling procedure failed. Kaplan-Meier analysis was used to estimate success rates, and Cox proportional hazards regression analysis was used to evaluate factors associated with surgical failure.</p><p><strong>Results: </strong>Median preoperative IOP was 22.0 mmHg (interquartile range [IQR], 17.0-28.0), and median medication score was 5.0 (IQR, 4.0-5.0). At 12 months, median IOP decreased to 9.0 mmHg (IQR, 6.0-12.0), and median medication score decreased to 0.0 (IQR, 0.0-0.0; both P<0.001). The estimated 12-month complete, qualified, and needling-free complete success rates were 83.1%, 85.0%, and 67.7%, respectively. Needling was performed in 18 eyes (16.8%), and 16 of those eyes (88.9%) met the complete success criteria at the final assessment within 12 months. Hypotony was present at 1 month in 37 eyes (34.6%), including persistent hypotony in 25 eyes (23.4%). Most hypotony-related events resolved without surgery. One eye developed suprachoroidal hemorrhage with severe visual loss. No significant baseline predictors of failure were identified.</p><p><strong>Conclusion: </strong>This protocol achieved substantial IOP and medication reduction with favorable 12-month success rates. Needling is an important component of postoperative management, and persistent numerical hypotony is common, but usually resolves without surgery. Comparative studies are needed to determine the specific contributions of STTA.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"650640"},"PeriodicalIF":0.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217429","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":"Semaglutide Use and Risk of Diabetic Retinopathy and Non-Arteritic Anterior Ischemic Optic Neuropathy in Type 2 Diabetes: A Single-Center Retrospective Cohort Study.","authors":"Parinee Kemchoknatee, Pawin Pakaymaskul, Nathorn Piyawannarat","doi":"10.2147/OPTH.S629343","DOIUrl":"10.2147/OPTH.S629343","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1RAs), including semaglutide, are increasingly adopted for type 2 diabetes mellitus (T2DM) due to improvements in glycemic control and weight loss. Although concerns have been raised about a potential association with non-arteritic anterior ischemic optic neuropathy (NAION), this relationship remains uncertain.</p><p><strong>Objective and method: </strong>In this single-center retrospective cohort study, we reviewed patients with T2DM treated with semaglutide at Rajavithi Hospital. A Kaplan-Meier time-to-event analysis was conducted to estimate the incidence of NAION and proliferative diabetic retinopathy (PDR) progression.</p><p><strong>Results: </strong>Among 100 patients with T2DM treated with semaglutide, no cases of NAION were observed over 299 person-years of follow-up (crude incidence rate: 0 per 1,000 person-years; 95% CI: 0-6.17). PDR and diabetic macular edema (DME) were the main findings, accounting for 10.00% and 3.00%, respectively. Ophthalmic complications group (13 patients) demonstrated higher body mass index (23.72 ± 1.38 vs 21.18 ± 2.51 kg/m²; p < 0.001), higher fasting plasma glucose (197.77 ± 48.28 vs 148.70 ± 27.84 mg/dL; p < 0.001), and worse baseline best-corrected visual acuity ([BCVA]; 1.71 ± 0.74 vs 0.45 ± 0.39 logarithm of the Minimum Angle of Resolution [logMAR]; p < 0.001). Final BCVA remained significantly worse in the complication group (p < 0.001). Ophthalmic complication remained stable over the 60-month follow-up; longer diabetes duration (>60 months) was modestly associated with better survival (log-rank p = 0.049). By contrast, other demographic, optic disc characteristics, and concomitant systemic vascular diseases were not significantly linked to ophthalmic complication.</p><p><strong>Conclusions: </strong>No NAION events were observed over 299 person-years; however, the limited sample size precludes definitive conclusions about NAION risk. A modest trend toward higher proliferative diabetic retinopathy rates suggests that ophthalmic monitoring may be warranted in at-risk patients. Larger prospective studies are needed to confirm these preliminary findings.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"629343"},"PeriodicalIF":0.0,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolving Landscape of Dry Eye Disease Risk Factors: A Comparative Analysis of the TFOS DEWS II (2017) and DEWS III (2025) Reports.","authors":"Reza A Badian","doi":"10.2147/OPTH.S614576","DOIUrl":"10.2147/OPTH.S614576","url":null,"abstract":"<p><strong>Objective: </strong>To systematically compare the classification of risk factors for dry eye disease (DED) between the Tear Film and Ocular Surface Society (TFOS) International Dry Eye Workshop (DEWS) II (2017) and DEWS III (2025) reports, highlighting changes in the level of evidence certainty, modifiability status, and clinical implications.</p><p><strong>Methods: </strong>The TFOS DEWS II Epidemiology Report and the TFOS DEWS III reports were analyzed. Risk-factor classifications were extracted and compared along two axes: evidence certainty (consistent, probable, inconclusive) and modifiability (non-modifiable, modifiable). Key changes were identified, grouped into categories that included upgrades, downgrades, and reclassifications, and then reorganized and transformed into a practical table format based on the level of evidence certainty.</p><p><strong>Results: </strong>The DEWS II framework classified risk factors into a 2×3 matrix, whereas DEWS III introduced a more detailed 4-quadrant risk-factor matrix. This study effectively reorganized and transformed the aforementioned risk-factor matrix into a practical table format designed to maximize its clinical utility. The most notable change was the reclassification of meibomian gland dysfunction (MGD) from a non-modifiable to a modifiable risk factor, reflecting a shift toward early intervention and advances in treatment options. Other key updates included elevating thyroid disease, sarcoidosis, and anticholinergics from probable to consistent evidence, and downgrading hormone replacement therapy and air pollution from consistent to probable evidence. Several conditions, such as rosacea, pterygium, and psychiatric disorders, were reclassified from non-modifiable to modifiable. DEWS III also introduced revised diagnostic thresholds and a refined subtype classification system.</p><p><strong>Conclusions: </strong>The shift from DEWS II to DEWS III marks a significant development reflecting an evolution in the understanding of DED risk factors. The reclassification of MGD as a modifiable risk factor has profound implications for clinical practice, emphasizing the importance of early detection and proactive management. By incorporating the updated criteria and providing this newly reorganized and transformed practical table, this framework can serve as a practical tool that facilitates the application of the consensus framework for researchers and clinicians, with the goal of improving clinical diagnostic precision and enhancing personalized patient care. These changes underscore the need for revised and updated clinical guidelines and support the identification of future research priorities.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"614576"},"PeriodicalIF":0.0,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217376","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":"Real-World Multicenter Evaluation of Ab-Interno Canaloplasty Using a New Canaloplasty Device with and without Concomitant Phacoemulsification in Uncontrolled Open-Angle Glaucoma: 12-Month Outcomes.","authors":"Julia Agapov, Austin Bell, David Lubeck, Richard G Morshedi, J Morgan Micheletti, Erin A Doe, Billy Pan, Justin Spaulding, Zachary Vest, Marshall Huang, Audrey C Mok, Irene F Sasaki, Avneet K Sodhi Gaur, George R Reiss, Shamil Patel","doi":"10.2147/OPTH.S647168","DOIUrl":"10.2147/OPTH.S647168","url":null,"abstract":"<p><strong>Purpose: </strong>To report real-world outcomes of ab-interno canaloplasty using the second-generation iTrack Advance in patients with open-angle glaucoma (OAG).</p><p><strong>Patients and methods: </strong>This retrospective, observational, multicenter study reviewed consecutive ab-interno canaloplasty procedures performed using the iTrack Advance (Nova Eye Medical, US) across 11 US sites between 2022 and 2024. Eligible eyes had mild-to-moderate OAG, uncontrolled baseline intraocular pressure (IOP) ≥18 mmHg and <36 mmHg and at least 12 months of follow-up. Outcome measures included IOP and topical medication burden at 1, 6 and 12 months postop. Secondary outcomes included surgical success according to American Academy of Ophthalmology (AAO) criteria. Safety outcomes included complications, visual field mean deviation (VF MD), and additional glaucoma procedures.</p><p><strong>Results: </strong>Eighty-two eyes of 82 patients (mean age 72.0±7.5 years) were included; 78 (95%) underwent canaloplasty combined with phacoemulsification and 4 (5%) underwent standalone canaloplasty. IOP in combined eyes decreased significantly from 20.7±2.9 mmHg preoperatively to 15.0±3.8 mmHg at 12 months (-27%; p<0.001), and medication burden reduced from 1.45±1.2 to 1.06±1.2 (-26.5%; p=0.013). Success by AAO criteria was achieved in 64% of combined eyes. Among all 82 eyes, 85% achieved IOP ≤18 mmHg and 40% were medication-free. Postoperative complications were mild and transient, with no sight-threatening complications related to canaloplasty. VF MD remained stable at 12 months. One eye (1.2%) required an additional glaucoma procedure.</p><p><strong>Conclusion: </strong>In real-world practice, ab-interno canaloplasty performed using iTrack Advance in mild-to-moderate uncontrolled OAG achieved significant and sustained reductions in IOP and medication burden over 12 months with a favorable safety profile.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"647168"},"PeriodicalIF":0.0,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198511","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}