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

{"title":"Comparing Park Table - Augmented and Standard Surgical Doses in Acute Acquired Comitant Esotropia: A Retrospective Analysis.","authors":"Worapot Srimanan","doi":"10.2147/OPTH.S530750","DOIUrl":"10.2147/OPTH.S530750","url":null,"abstract":"<p><strong>Purpose: </strong>Acquired comitant esotropia (ACE) is a rare condition characterized by the sudden onset of inward eye deviation. In non-recovered cases, surgery was performed. The standard surgical dose typically leads to undercorrection, and multimodal approaches were used to enhance outcomes. The current study aimed to explore the clinical course and identify factors influencing surgical success in patients with ACE at a tertiary hospital.</p><p><strong>Patients and methods: </strong>This retrospective study reviewed the electronic medical records of 99 patients diagnosed with ACE at Phramongkutklao Hospital between 2014 and 2024. Data collected included patient demographics, underlying etiologies, clinical presentations, treatment approaches, and surgical outcomes. Surgical cases were categorized based on the use of either the standard Park surgical dosage or an augmented dose, defined as an additional 0.5 mm beyond the standard amount. Factors associated with successful surgical outcomes were also evaluated through statistical analysis.</p><p><strong>Results: </strong>The mean age at diagnosis was 28.97 ± 19.67 years, with a slight predominance of men. ACE was classified as types I (Swan type), II (Burian-Franceschetti), and III (Bielschowsky) in 8.08% (8/99), 46.46% (46/99), and 45.45% (45/99), respectively. All cases were idiopathic, with neuroimaging abnormalities detected in 4.04% (4/99) of patients. Surgical intervention was required in 79.8% (79/99) of cases. One year postoperatively, 75% (54/72) of patients demonstrated substantial improvement in ocular alignment. Based on subgroup analysis, the success rate was 91.18% in the augmented group and 60.53% in the non-augmented group. Logistic regression analysis indicated that an augmented surgical dose was significantly associated with favorable surgical outcomes (adjusted odds ratio: 5.50; 95% confidence interval [95% CI], 1.32-22.89).</p><p><strong>Conclusion: </strong>This study demonstrates a high surgical success rate in patients with ACE, supporting the potential use of augmented surgical doses. Further research is warranted to identify additional prognostic factors and refine treatment strategies for optimal ACE management.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"2211-2220"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638907","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":"Correlation Between Tear Film Stability and Myopia in Children.","authors":"Pei-Wei Huang, Yu-Kai Kuo, Nan-Ni Chen, Ju-Hsien Li, Cheng-Hsiu Wu, Ho-Min Chen, Kuan-Wen Su, Chi-Chin Sun","doi":"10.2147/OPTH.S527012","DOIUrl":"10.2147/OPTH.S527012","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the correlation between dry eye and myopia in Taiwanese school children.</p><p><strong>Methods: </strong>This retrospective cohort study enrolled children aged 5-14-years-old between January 2021 and April 2022. The Ocular Surface Disease Index (OSDI) and an activity questionnaire were used to assess the severity of dry eye and the children's lifestyle. Dry eye was assessed using Schirmer's I test, tear break-up time (TBUT), corneal fluorescein staining, and the lid abnormality score. The correlation between dry eye and myopia was determined by linear regression analysis.</p><p><strong>Results: </strong>In total, 31 non-myopic (mean age, 9.03 years) and 34 myopic (mean age, 8.44 years) children were included in the final analysis. Children with myopia had a significantly higher mean OSDI than children without myopia (4.79 ± 6.90 versus 1.68 ± 3.46, <i>P</i> = 0.024). The prevalence of dry eye disease was higher in myopic children (11.7%) than non-myopic children (3.2%) without significant difference. There were no significant differences in the Schirmer test, TBUT, corneal fluorescein staining score, or lid abnormality score between groups. Multiple regression analyses showed the OSDI was significantly associated with more negative spherical power (regression coefficient [B] = -0.74, 95% confidence interval = -1.48 to -0.01, <i>P</i> = 0.048) and presence of myopia (B = 3.44, 95% CI = 0.72 to 6.16, <i>P</i> = 0.014) after adjusting for age.</p><p><strong>Conclusion: </strong>Children with myopia have a higher OSDI and higher prevalence of dry eye than children without myopia. After adjusting for age, the OSDI was associated with more negative spherical power and the presence of myopia.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"2221-2228"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638909","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 Repeat Deep Anterior Lamellar Keratoplasty in Keratoconus: Case Series.","authors":"Omar Kirat, Rafah Fairaq, Mohammed AlMutlak, Raneem S AlQahtani, Ghadah A AlHussein, Sara AlHilali","doi":"10.2147/OPTH.S528658","DOIUrl":"10.2147/OPTH.S528658","url":null,"abstract":"<p><strong>Purpose: </strong>To report the incidence, indications, and clinical outcomes of repeat deep anterior lamellar keratoplasty (DALK) in keratoconus patients.</p><p><strong>Methods: </strong>Case series.</p><p><strong>Results: </strong>This retrospective study included all repeat DALK procedures for keratoconus performed at King Khaled Eye Specialist Hospital (KKESH) between 2016 and 2024. Patient demographics, surgical techniques, complications, and outcomes were analyzed. Among 2136 primary DALK procedures, only 0.66% (14 eyes) required repeat keratoplasty. The mean age at the time of repeat DALK was 32 and the mean follow-up duration was 30 months. Indications included lipid keratopathy (28.6%), persistent epithelial defect with severe immune reaction (14.3%), high irregular astigmatism (14.3%), and stromal scarring (7.1%). Graft exchange alone was sufficient in most cases (64%), while larger trephination and further dissection (22%) were performed for stromal scars or host rim ectasia. Postoperative complications (43%) included loose sutures (36%), elevated intraocular pressure (7%), and cataract formation (7%). The overall graft survival rate was 93%, with one failure due to poor compliance with postoperative steroids and follow-ups. Visual recovery was favorable, with 57% achieving 20/40 or better.</p><p><strong>Conclusion: </strong>Repeat DALK is a safe and effective alternative to penetrating keratoplasty (PK) for failed primary DALK, offering high graft survival and favorable visual outcomes while minimizing immune-related complications. Postoperative adherence and timely steroid management are critical for optimizing success. Further studies comparing repeat DALK and repeat PK are needed to assess long-term endothelial health and visual stability.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"2203-2209"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638910","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":"Serum Apolipoprotein B and B/A1 Ratio as Early Negative Biomarkers for OCT- and OCTA-Detected Retinal Changes in Diabetic Macular Edema.","authors":"Soefiandi Soedarman, Madarina Julia, Tjahjono Darminto Gondhowiardjo, King Hans Kurnia, Alberthus Donni Budi Prasetya, Ichsan Fauzi Triyoga, Muhammad Bayu Sasongko","doi":"10.2147/OPTH.S527436","DOIUrl":"10.2147/OPTH.S527436","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to explore the relationships between serum apolipoprotein A1 (ApoA1) and B (ApoB) levels and the ApoB/A1 ratio with structural and vascular changes in the retinas of patients with diabetic macular edema (DME), as assessed through optical coherence tomography (OCT) and OCT angiography (OCTA).</p><p><strong>Methods: </strong>62 eyes from 38 treatment-naive diabetic retinopathy patients were assessed. Baseline and 6-month evaluations included clinical exams, fundus photography, blood tests for cholesterol, ApoA1, and ApoB, as well as imaging with OCT and OCTA. Associations between apolipoproteins and changes in central retinal thickness (CRT), foveal avascular zone (FAZ), and vessel/perfusion density were analyzed.</p><p><strong>Results: </strong>In DME patients, elevated ApoB levels (>122.5 mg/dL) were significantly linked with increased CRT, FAZ expansion, and reduced perfusion density at the 6-month follow-up (p = 0.026, 0.046, and 0.025). Higher ApoB/A1 ratio (>0.85) was significantly associated with decreased perfusion density (p = 0.011).</p><p><strong>Conclusion: </strong>Elevated ApoB levels and ApoB/A1 ratio were linked with reduced perfusion and vessel density, increased CRT, and FAZ expansion, highlighting their potential as negative biomarkers for OCT-detected retinomacular changes.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"2165-2178"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628012","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":"Relationship Between Intraocular Pressure-Lowering Effects and Alterations in Anterior Segment Scleral Birefringence Following Micropulse Cyclophotocoagulation.","authors":"Hotaka Nemoto, Megumi Honjo, Michiaki Okamoto, Sou Tominaga, Masahiro Yamanari, Yurika Aoyama, Takahiro Arai, Yukako Ishiyama, Koichiro Sugimoto, Rei Sakata, Hitomi Saito, Takashi Fujishiro, Makoto Aihara","doi":"10.2147/OPTH.S530136","DOIUrl":"10.2147/OPTH.S530136","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the changes in anterior segment scleral birefringence (ASSB), a marker of collagen-related fibrotic responses, following micropulse cyclophotocoagulation (MP-CPC) using polarization-sensitive optical coherence tomography (PS-OCT).</p><p><strong>Patients and methods: </strong>Eighteen eyes of sixteen patients with glaucoma who underwent MP-CPC at the University of Tokyo Hospital in Japan from July 2022 to August 2023 were included. The procedure utilized a Cyclo G6 glaucoma laser system (IRIDEX, Mountain View, CA, USA) with laser power set at 2,500 mW and an 80-second duration per hemisphere. Clinical outcomes and ASSB were assessed for 6 months. The principal assessment was the evaluation of post-procedure ASSB. Anterior segment images were captured before MP-CPC, and at 1 week, 1 month, 3 months, and 6 months after MP-CPC, using PS-OCT (ROCTIA; Tomey Corporation, Nagoya, Japan) to assess the ASSB. We also assessed the correlation between intraocular pressure (IOP) reduction and changes in birefringence.</p><p><strong>Results: </strong>The IOP was significantly lower after than before MP-CPC (pretreatment: 24.8 ± 1.8, 1 week: 13.9 ± 1.1, 1 month: 17.4 ± 1.1, 3 months: 20.1 ± 1.7, and 6 months: 19.0 ± 1.6 mmHg). ASSB increased significantly after treatment (pretreatment: 1.00 ± 0.08, 1 week: 1.20 ± 0.11, 1 month: 1.27 ± 0.06, 3 months: 1.42 ± 0.07, and 6 months: 1.26 ± 0.15), suggesting post-laser collagen remodeling in the sclera. Notably, a significant positive correlation was found between the rate of IOP reduction and the degree of birefringence elevation at 3 and 6 months post-procedure.</p><p><strong>Conclusion: </strong>We observed a significant increase in ASSB after MP-CPC, and this increase was positively correlated with IOP reduction. These findings point to the potential mechanism underlying IOP reduction and emphasize the clinical relevance of the birefringence value.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"2179-2188"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628011","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":"Comparing The Existing Myopic Keratorefractive Lenticule Extraction (KLEx) Platforms: A Narrative Review.","authors":"Sabrina M Miller, Mina M Sitto, Kayvon A Moin, Phillip C Hoopes, Majid Moshirfar","doi":"10.2147/OPTH.S532742","DOIUrl":"10.2147/OPTH.S532742","url":null,"abstract":"<p><p>Kerato-refractive lenticule extraction (KLEx) is an evolving technique in corneal refractive surgery. The objective of this narrative review is to compare laser settings, visual outcomes, and higher order aberrations (HOAs) across the five currently available myopic KLEx platforms, specifically SmartSight, corrective lenticule extraction for advanced refractive correction (CLEAR), smooth incision lenticular keratomileusis (SILK^TM), small incision lenticule extraction (SMILE^®), and SMILE Pro^®. A comprehensive literature search was conducted in April 2025 using the PubMed, Scopus, and Embase databases, focusing on publications related to SmartSight, CLEAR, SILK, and SMILE Pro. For SMILE, a representative set of sources was selected due to the volume of available data. In total, 26 articles were included for this review. At the 1-day follow-up, 79% of eyes using SmartSight achieved an uncorrected distance visual acuity of 20/20, compared to 63% using SILK. These findings suggest that low pulse energy and high pulse frequency contribute to improved early visual outcomes, though the lenticule cut pattern also plays an important role. At 6 months, CLEAR, SILK, SMILE, and SMILE Pro showed high predictability, with over 85% of eyes achieving a spherical equivalent within ± 0.50 D. All platforms demonstrated excellent cylindrical correction, as over 87% of eyes achieved outcomes within ± 0.50 D. HOAs increased across all platforms, with significant induction of vertical coma. Overall, the five platforms demonstrated safety, efficacy, and refractive stability. This narrative review provides an overview of the current KLEx platforms and their clinical performance to compare differences in laser parameters and the factors influencing visual recovery, astigmatism correction, and HOA induction.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"2189-2202"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638908","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":"Treat and Extend Regimen of Aflibercept in the Treatment of Type 1 Choroidal Neovascularization Secondary to Chronic Central Serous Chorioretinopathy: Three-year Follow-Up.","authors":"Taras B Kustryn, Oleg S Zadorozhnyy, Illia O Nasinnyk, Alla O Nevska, Kseniia V Troianovska, Nataliya V Pasyechnikova, Andrii R Korol","doi":"10.2147/OPTH.S532424","DOIUrl":"10.2147/OPTH.S532424","url":null,"abstract":"<p><strong>Purpose: </strong>To report three-year treatment results of intravitreal aflibercept using a treat-and-extend (TAE) regimen for type 1 choroidal neovascularization (CNV) in chronic central serous chorioretinopathy (CSC).</p><p><strong>Patients and methods: </strong>This prospective, single-center interventional study completed 34 patients (34 eyes) (16 patients previously treated by photodynamic therapy (PDT) and 18 naive patients) treated with 2.0 mg intravitreal aflibercept. All patients received 3 initial loading intravitreal injections every 4 weeks, followed by a TAE protocol. The primary outcome was decimal best-corrected visual acuity (BCVA) at year 3.</p><p><strong>Results: </strong>Overall, mean decimal BCVA increased significantly from 0.44 (SD; 0.35) at baseline to 0.59 (SD; 0.31) at the final visit (p˂0.001). At year 3, mean decimal BCVA in the PDT-treated group compared to the naive group was statistically different, 0.48 (SD; 0.29) vs 0.71 (SD; 0.31), respectively (p=0.04). Overall, complete resolution of fluid was noted in 73% at 3 years. Complete resolution of fluid in the PDT-treated group and the naive group was 56% and 89% (p=0.01), respectively. The total mean number of aflibercept injections was 18.0 (SD; 5.6). Mean number of injections was 20.1 (SD; 5.3) in the PDT-treated group and 15.9 (SD; 5.8) in the naive group (p=0.03).</p><p><strong>Conclusion: </strong>Intravitreal aflibercept using a TAE regimen improved visual and anatomical outcomes of patients with type 1 CNV secondary to chronic CSC in long-term follow-up. Naive patients had a better visual outcome and a higher incidence of complete fluid resolution than PDT-treated patients.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"2153-2163"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628013","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":"Ocular Manifestations of Perinatal HIV Infection in Kenyan Children on HAART: A Cross-Sectional Comparative Study.","authors":"Ludovico Alisi, Marta Armentano, Giacomo Visioli, Mpekethu Sam Mingaine, Giuseppe Maria Albanese, Luca Lucchino, Alice Bruscolini","doi":"10.2147/OPTH.S530332","DOIUrl":"10.2147/OPTH.S530332","url":null,"abstract":"<p><strong>Introduction: </strong>Human Immunodeficiency Virus (HIV) remains a global health concern, particularly in Africa. Highly Active Antiretroviral Therapy (HAART) has transformed HIV into a manageable chronic condition, but potential side effects, including ocular manifestations, are recognized. While ophthalmic complications in the pre-HAART era are well-documented, the current landscape in perinatally acquired HIV requires further investigation. This study aims to report the prevalence of ocular involvement in a cohort of children with perinatally acquired HIV.</p><p><strong>Methods: </strong>This cross-sectional study recruited 73 HIV-positive and 59 HIV-negative age-matched children in Kenya. All HIV+ children were on HAART. Comprehensive ophthalmological examinations included visual acuity, stereopsis, ocular motility assessment, tear film tests (BUT, Schirmer, Oxford staining), corneal esthesiometry, and an ocular allergy questionnaire. Clinical data on HIV parameters and HAART regimens were collected for the HIV+ group.</p><p><strong>Results: </strong>Visual acuity was comparable between groups. Both groups' ocular surface parameters (BUT, Schirmer, Oxford score) were within normal limits. Ocular allergy prevalence was similar, but HIV+ children reported fewer symptoms (p=0.030). Strabismus was significantly more frequent in the HIV+ group (24.7% vs 8.5%, p=0.015), particularly in patients in treatment with abacavir (p=0.026). No significant correlation was found between HIV-related parameters and ocular surface findings.</p><p><strong>Conclusion: </strong>This study suggests that in the HAART era, perinatally HIV-infected children with well-managed viral loads show visual function and largely normal ocular surface health, contrasting with pre-HAART literature. The increased frequency of strabismus in HIV+ children and its potential association with abacavir warrant further investigation into HAART-related ocular motility side effects.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"2143-2151"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628010","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":"Prevalence of Refractive Errors Among School-Age Children and Adolescents in Saudi Arabia: A Systematic Review and Meta-Analysis.","authors":"Abdulmajeed Al Khathami, Mohamed Baklola, Anwar Ali Alshehri, Lujain Hussain Alnasser, Razan Saleh Alshehri, Mohammed A Salawi, Rahaf Hussain Alwadai, Mohammed Al Ghazwi, Amira Ahmed Qadim Alanazi, Asayel Mojidea Alshammari, Naji Al-Bawah, Mayas Hafez, Abdullah Abu Melha","doi":"10.2147/OPTH.S539808","DOIUrl":"10.2147/OPTH.S539808","url":null,"abstract":"<p><strong>Background: </strong>Refractive errors, including myopia, hyperopia, and astigmatism, are a leading cause of visual impairment among children worldwide. In Saudi Arabia, the prevalence of these conditions among school-age children and adolescents remains poorly understood, with significant variations reported across studies. This systematic review and meta-analysis aimed to provide a comprehensive estimate of the pooled prevalence of refractive errors in this population and explored factors influencing their distribution.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, Web of Science, and ScienceDirect was conducted in accordance with PRISMA 2020 guidelines. Observational studies reporting the prevalence of refractive errors among Saudi school-aged children and adolescents were included. Data extraction and quality assessment were conducted using the Newcastle-Ottawa Scale. Pooled prevalence estimates with 95% confidence intervals (CIs) were calculated using a random-effects model, and heterogeneity was assessed with the I² statistic.</p><p><strong>Results: </strong>Nine studies including over 15,000 participants were analyzed. The pooled prevalence of myopia was 6.7% (95% CI: 3.0% to 14.2%), hyperopia was 3.6% (95% CI: 1.3% to 9.8%), and astigmatism was 7.7% (95% CI: 2.5% to 20.9%). Subgroup analysis revealed regional disparities, with the highest myopia prevalence reported in Taif (33.3%) and Bisha (22.5%), and the lowest in Medina (1.6%). Studies conducted after 2018 showed a significantly higher pooled myopia prevalence (16.4%, 95% CI: 8% to 30.5%) compared to those published before 2018 (3.3%, 95% CI: 1.4% to 7.5%) (p < 0.001). While studies using cycloplegic refraction reported a slightly higher myopia prevalence (7.2%, 95% CI: 4.7% to 11%) than those using non-cycloplegic methods (6.7%, 95% CI: 2.4% to 17.5%), the difference was not statistically significant (p = 0.9). No significant difference was observed between studies with smaller or larger sample sizes, although high heterogeneity persisted across all subgroups.</p><p><strong>Conclusion: </strong>Refractive errors, particularly astigmatism, represent a significant and growing public health issue among Saudi school-aged children and adolescents. The findings underscore the urgent need for standardized diagnostic protocols, including the use of cycloplegic refraction, and the implementation of school-based vision screening programs.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"2117-2132"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602467","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":"Systemic Immunomodulatory Therapy in Uveitis Related to Behçet's Disease: A 10-year Profile.","authors":"Mariana Almeida, Ana Margarida Ferreira, Joana R Araújo, Luís Figueira","doi":"10.2147/OPTH.S524282","DOIUrl":"10.2147/OPTH.S524282","url":null,"abstract":"<p><strong>Purpose: </strong>Behçet's disease (BD) is a systemic vasculitis which is often accompanied by intraocular inflammation. This study aims to determine the efficacy and safety of systemic immunomodulatory therapy (IMT) in Behçet's disease and the optimal timing for its discontinuation in patients who are in remission.</p><p><strong>Patients and methods: </strong>A retrospective single center longitudinal study was performed at the Centro Hospitalar Universitário São João (Porto, Portugal). A total of 38 records of patients with uveitis related to BD and on IMT were analyzed for demographic data, characteristics of their uveitis, treatment period, pattern of relapses, and first and final discontinuation outcomes. The statistical analyses were done with IBM SPSS^® software.</p><p><strong>Results: </strong>The mean follow-up duration was 122.5 ± 62.6 months. Anterior uveitis was the most common manifestation (36.8%), followed by retinal vasculitis (31.6%) and panuveitis (13.2%). Azathioprine (36.8%) and cyclosporine (28.9%) were the most used immunomodulatory agents. The median treatment duration was 63.5 months, significantly reducing relapse rates from 2 ± 2.0 to 1 ± 1.2 per year (p < 0.001). Biologic therapies showed a slight advantage in reducing relapses (p = 0.045). Among 16 patients (42.1%) who discontinued treatment, 30.8% experienced relapse after a median of 13 months. Patients treated for more than 6 years had no relapses.</p><p><strong>Conclusion: </strong>IMT effectively controls ocular inflammation in BD uveitis, significantly reducing relapse frequency. Azathioprine and cyclosporine remain first-line therapies. Discontinuing IMT after 4-6 years of sustained remission appears to be a safe strategy, particularly after 6 years.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"2133-2141"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602468","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}