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

{"title":"Unequal Referral Patterns to Ophthalmology Subspecialists Based on Race and Ethnicity in Diabetes Mellitus: A Retrospective Analysis.","authors":"Katherine Guerra O'Neill, Seth E Buscho, Biai Dominique Elmir Digbeu, Zachary Dezeeuw, Kevin H Merkley, Praveena K Gupta","doi":"10.2147/OPTH.S519979","DOIUrl":"10.2147/OPTH.S519979","url":null,"abstract":"<p><strong>Purpose: </strong>Previous research has shown that racial disparities exist regarding the prevalence of and associated vision loss from diabetic retinopathy. Unfortunately, little is known about potential racial and ethnic disparities of diabetic eye exam referral patterns by primary care providers. Understanding referral patterns to ophthalmic specialists is key to understanding the steps needed to prevent progression of this vision-threatening condition, particularly in minority populations.</p><p><strong>Patients and methods: </strong>Patients who were diagnosed with type II diabetes mellitus (DM) at a tertiary medical center between 2015 and 2023 were retrospectively identified from the electronic medical record (n = 10,995). Patient demographics, comorbidities, presence or absence of ophthalmology referral, HbA1c and insulin dependence at time of referral, time from referral to first ophthalmic appointment, as well as diabetic retinopathy presence/stage at first ophthalmic exam after referral were collected.</p><p><strong>Results: </strong>Of the white patients who were diagnosed with DM, 79.3% were referred for ophthalmology screening, compared to 78.55% of Hispanic patients (RR: 1.03 [95% CI: 0.92, 1.15]) and 75.75% of black patients (RR: 0.83 [95% CI: 0.74, 0.93]) (p = 0.0009). 56.38% of White patients had a HbA1c ≥ 7% at referral compared to 61.33% of Hispanic patients (RR: 1.16 [95% CI: 1.00, 1.34]) and 53.48% of Black patients (RR 0.86 [95% CI: 0.73, 1.01]) (p = 0.0004). 5.69% of referred white patients were diagnosed with diabetic retinopathy compared to 10.22% of Black patients (RR: 1.88 [95% CI 1.58, 2.23) and 10.91% of Hispanic patients (RR: 1.58 [95% CI 1.32, 1.89]) (p < 0.0001).</p><p><strong>Conclusion: </strong>Black patients were less likely to receive an ophthalmology referral at the time of DM diagnosis, and Hispanic patients were more likely to be referred at a more severe HbA1c compared to white patients. Both black and Hispanic patients were more likely to be diagnosed with diabetic retinopathy at first ophthalmic appointment than white patients.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1609-1616"},"PeriodicalIF":0.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121695","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":"Twelve-Month Outcomes of Faricimab for Patients with Sub-Optimally Responsive Diabetic Macular Oedema: A Retrospective Single-Centre Study.","authors":"Kamal El-Badawi, Benjamin Scrivens, Oluwaniyi Eke, Rehab Ismail, Lina Kobayter, Serena Salvatore","doi":"10.2147/OPTH.S513009","DOIUrl":"10.2147/OPTH.S513009","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the visual and anatomical outcomes of switching diabetic macular oedema (DMO) patients with suboptimal response to aflibercept 2mg to faricimab over a 12-month period.</p><p><strong>Patients and methods: </strong>This retrospective single centre study enrolled 62 eyes from 50 patients with diabetic macular oedema (DMO) who demonstrated a sub-optimal response to aflibercept 2mg. Sub-optimal response was defined by a central subfield thickness (CST) exceeding 325µm or greater than 20% increase from the best CST despite receiving aflibercept 2mg at intervals of 8 weeks or less. Patients had received at least six 4-weekly doses of aflibercept 2mg. Faricimab was administered as four intravitreal loading injections at 4-weekly intervals, followed by a treat-and-extend approach. Outcome measures, including best-recorded visual acuity (BRVA), CST, and treatment intervals, were assessed at baseline, post-loading (6.5 ± 1.9 weeks) and at the latest clinic review (57.1 ± 19.7 weeks). Statistical analysis included paired t-tests (normal distribution) and Wilcoxon signed-rank tests (non-normal distribution), with p < 0.05 considered statistically significant.</p><p><strong>Results: </strong>Mean age was 63.9 (±11.4) years, 56% participants were male. At baseline, the mean BRVA was 67.6 (±11.8) letters, and CST measured 406.4 (±105.9) µm. The initial mean treatment interval was 6.5 (±1.8) weeks. BRVA increased to 70.4 (±12.7) letters (<i>p</i>=0.008), while CST reduced to 372.8 (±132.0) µm (<i>p</i>=0.002). The mean injection interval extended to 7.4 (±2.6) weeks (<i>p</i>=0.03). At the latest follow-up BRVA was maintained at 68.7 (±14.6) letters (<i>p</i>=0.572), and CST reduced further to 343.1 (±117.5) µm (<i>p</i>=0.020). At the final follow-up 53.2% were on ≥8-weekly intervals. The mean injection interval increased to 9.2 (±3.2) weeks (p < 0.001), and a mean of 7.92 (±2.53) faricimab injections was administered.</p><p><strong>Conclusion: </strong>DMO patients with sub-optimal response to aflibercept 2mg experienced improved anatomical outcomes and extended treatment intervals while maintaining vision on faricimab, with no new safety concerns.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1583-1591"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112947","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":"Transfer Learning and Multi-Feature Fusion-Based Deep Learning Model for Idiopathic Macular Hole Diagnosis and Grading from Optical Coherence Tomography Images.","authors":"Ye-Ting Lin, Xu Xiong, Ying-Ping Zheng, Qiong Zhou","doi":"10.2147/OPTH.S521558","DOIUrl":"10.2147/OPTH.S521558","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic macular hole is an ophthalmic disease that seriously affects vision, and its early diagnosis and treatment have important clinical significance to reduce the occurrence of blindness. At present, OCT is the gold standard for diagnosing this disease, but its application is limited due to the need for professional ophthalmologist to diagnose it. The introduction of artificial intelligence will break this situation and make its diagnosis efficient, and how to build an effective predictive model is the key to the problem, and more clinical trials are still needed to verify it.</p><p><strong>Objective: </strong>This study aims to evaluate the role of deep learning systems in Idiopathic Macular Hole diagnosis, grading, and prediction.</p><p><strong>Methods: </strong>A single-center, retrospective study used binocular OCT images from IMH patients at the First Affiliated Hospital of Nanchang University (November 2019 - January 2023). A deep learning algorithm, including traditional omics, Resnet101, and fusion models incorporating multi-feature fusion and transfer learning, was developed. Model performance was evaluated using accuracy and AUC. Logistic regression analyzed clinical factors, and a nomogram predicted surgical risk. Analysis was conducted with SPSS 22.0 and R 3.6.3. <i>P</i> < 0.05 was statistically significant.</p><p><strong>Results: </strong>Among 229 OCT images, the traditional omics, Resnet101, and fusion models achieved accuracies of 93%, 94%, and 95%, respectively, in the training set. In the test set, the fusion model and Resnet101 correctly identified 39 images, while the traditional omics model identified 35. The nomogram had a C-index of 0.996, with macular hole diameter most strongly associated with surgical risk.</p><p><strong>Conclusion: </strong>The deep learning system with transfer learning and multi-feature fusion effectively diagnoses and grades IMH from OCT images.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1593-1607"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112945","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":"Revolutionizing Retinal Therapy: The Role of Nanoparticle Drug Carriers in Managing Vascular Retinal Disorders.","authors":"Huihui Lu, Na He, Lina Zhang, Yayan You, Zhigang Lv","doi":"10.2147/OPTH.S503273","DOIUrl":"10.2147/OPTH.S503273","url":null,"abstract":"<p><p>Vascular Retinopathy (VR), such as diabetic retinopathy, pose significant challenges to vision and overall health. Traditional treatment methods often face limitations in efficacy and delivery. Vascular retinopathy is a common and potentially blinding group of eye diseases with core pathologic mechanisms involving vascular injury, ischemia, exudation, and neovascularization. Clinical management relies heavily on etiologic control (eg, diabetes, hypertension), anti-VEGF therapy, laser therapy, and surgical intervention. Recent advancements in nanotechnology have led to the development of innovative nanoparticle drug carriers, which offer promising solutions for targeted and sustained drug delivery in the retinal environment. This review explores the application of both conventional and novel nanoparticle carriers in treating VR. We discuss various types of nanoparticles, including liposomes, polymeric nanoparticles, and metal-based carriers, highlighting their unique properties, mechanisms of action, and therapeutic benefits. Finally, we provide insights into future perspectives for nanoparticle-based therapies in retinal disorders, emphasizing the potential for improved patient outcomes and the need for further research to optimize these advanced drug delivery systems.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1565-1582"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103319","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":"Image Recognition Performance of GPT-4V(ision) and GPT-4o in Ophthalmology: Use of Images in Clinical Questions.","authors":"Kosei Tomita, Takashi Nishida, Yoshiyuki Kitaguchi, Koji Kitazawa, Masahiro Miyake","doi":"10.2147/OPTH.S494480","DOIUrl":"https://doi.org/10.2147/OPTH.S494480","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the diagnostic accuracy of Generative Pre-trained Transformer with Vision (GPT)-4, GPT-4 with Vision (GPT-4V), and GPT-4o for clinical questions in ophthalmology.</p><p><strong>Patients and methods: </strong>The questions were collected from the \"Diagnosis This\" section on the American Academy of Ophthalmology website. We tested 580 questions and presented ChatGPT with the same questions under two conditions: 1) multimodal model, incorporating both the question text and associated images, and 2) text-only model. We then compared the difference in accuracy using McNemar tests among multimodal (GPT-4o and GPT-4V) and text-only (GPT-4V) models. The percentage of general correct answers was also collected from the website.</p><p><strong>Results: </strong>Multimodal GPT-4o performed the best accuracy (77.1%), followed by multimodal GPT-4V (71.0%), and then text-only GPT-4V (68.7%); (P values < 0.001, 0.012, and 0.001, respectively). All GPT-4 models showed higher accuracy than the general correct answers on the website (64.6%).</p><p><strong>Conclusion: </strong>The addition of information from images enhances the performance of GPT-4V in diagnosing clinical questions in ophthalmology. This suggests that integrating multimodal data could be crucial in developing more effective and reliable diagnostic tools in medical fields.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1557-1564"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060775","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":"Demographic and Clinical Factors Associated with Mechanisms of Open Globe Injury in the United States: A Multi-Center Study.","authors":"Shruti Anant, Alicia Casella, Jason A Greenfield, Sarah C Miller, Kristine Y Wang, Bita Momenaei, Karen Lee, Hana A Mansour, Grant A Justin, Kevin G Makhoul, Racquel A Bitar, Alice Lorch, Grayson W Armstrong, Taku Wakabayashi, Yoshihiro Yonekawa, Kara M Cavuoto, Fasika Woreta","doi":"10.2147/OPTH.S520082","DOIUrl":"https://doi.org/10.2147/OPTH.S520082","url":null,"abstract":"<p><strong>Purpose: </strong>We sought to examine the demographic and clinical risk factors associated with specific mechanisms of open globe injuries (OGIs) and identify predictors of Zone III injuries across multiple tertiary eye care centers.</p><p><strong>Patients and methods: </strong>1570 patients with OGIs presenting to the Wilmer Eye Institute, the Bascom Palmer Eye Institute, Massachusetts Eye and Ear, and Wills Eye Hospital between 2018-2021 were retrospectively reviewed. Multinomial and binomial logistic regression models were used to evaluate associations between demographic and clinical risk factors with injury mechanisms and Zone III injuries.</p><p><strong>Results: </strong>Among the study population (74.2% male, mean age 48.2 years), falls (21.3%), construction work (16.2%), and assaults (10.0%) were the most common injury mechanisms. Black patients had higher risk of assault-related OGIs (relative risk ratio [RRR], 6.41; 95% confidence interval [CI], 2.06-19.93; p<0.001) and elderly patients >61 years showed increased risk for falls (RRR, 10.45; 95% CI, 2.22-49.10; p=0.003). Eyelid laceration was significantly associated with assaults (RRR, 5.58; 95% CI, 1.59-19.65; p=0.007) and falls (RRR, 4.81; 95% CI, 1.61-14.34; p=0.005), while iris prolapse was associated with assaults (RRR, 3.23; 95% CI, 1.12-9.32; p=0.03) and construction work injuries (RRR, 1.99; 95% CI, 1.12-3.52; p=0.02). Zone III injuries were independently associated with eyelid laceration (prevalence ratio [PR], 1.62; 95% CI, 1.20-2.18; p<0.001), relative afferent pupillary defect (RAPD) (PR, 2.42; 95% CI, 1.71-3.43; p<0.001), and retrobulbar hemorrhage (PR, 2.77; 95% CI, 1.76-4.36; p<0.001).</p><p><strong>Conclusion: </strong>This multi-institutional study identified distinct demographic risk profiles for different OGI mechanisms and clinical predictors of severe injuries. These findings suggest opportunities for targeted prevention strategies and may aid in early identification and triage of severe OGIs.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1543-1556"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000139","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":"Efficacy and Safety of Epi-On vs Epi-Off Corneal Cross-Linking in Corneal Ectasia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Reem O Nughays, Abdullah S Bazayd, Lujain A Alshamekh, Reemas A Alshammari, Mohammed A Alenezi, Hashem Y Dahlan, Jana A Alsubhi, Sara G Alshammri, Nouf A AlQurashi, Abdulaziz H Aldajani, Abdulrahman H Alrammah, Mariam N Alenezi, Areej Abdullah Almutairi, Abdulaziz F Alomayri, Saeed Alghamdi","doi":"10.2147/OPTH.S508618","DOIUrl":"https://doi.org/10.2147/OPTH.S508618","url":null,"abstract":"<p><p>Corneal ectasias are progressive conditions that impair vision and quality of life. Corneal collagen cross-linking (CXL) aims to halt disease progression by strengthening the cornea. This review compares two CXL methods, epithelium-on (epi-on) and epithelium-off (epi-off), to assess their safety and effectiveness for managing corneal ectasia. A systematic search up to July 2024 of PubMed, Medline, Web of Science, Cochrane Central, Google Scholar, and Scopus identified 13 randomized controlled trials (RCTs) involving 872 patients and 1041 eyes. Data were analyzed following PRISMA guidelines using fixed-effects and random-effects models. The primary outcome was the change in maximal keratometry (Kmax) at 12 months, with secondary outcomes including safety profile, best-corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), spherical equivalent (SE), and endothelial cell count (ECC). The findings revealed no statistically significant differences between epithelium-on (epi-on) and epithelium-off (epi-off) CXL in Kmax, BCVA, UCVA, SE, or corneal curvature parameters. However, epithelium-off (epi-off) CXL was associated with less endothelial cell loss and higher rates of side effects, including corneal haze and postoperative discomfort. The choice of treatment should be tailored to individual patient needs, balancing clinical goals and safety considerations. This review highlights the need for further studies to optimize CXL approaches and improve outcomes while minimizing complications.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1531-1541"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014356","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 Treatment in Ocular Myasthenia Gravis Based on Minimal Manifestation: A Real-World Retrospective Cohort Study.","authors":"Parinee Kemchoknatee, Boonravee Santitamrongvtit, Thansit Srisombut","doi":"10.2147/OPTH.S520136","DOIUrl":"https://doi.org/10.2147/OPTH.S520136","url":null,"abstract":"<p><strong>Background: </strong>Myasthenia gravis (MG) is a chronic autoimmune disorder characterized by muscle weakness caused by autoantibodies targeting acetylcholine receptors. Prednisolones improve symptoms by reducing autoantibody activity, but its optimal use, particularly in ocular myasthenia gravis (OMG), remains unclear due to limited trials and variable responses.</p><p><strong>Objective: </strong>To evaluate the clinical efficacy, optimal dosing, and predictors of first minimal manifestation (MM) with oral prednisolone in myasthenia gravis, based on the Myasthenia Gravis Foundation of America Post-Intervention Status (MGFA-PIS).</p><p><strong>Methods: </strong>Patients with OMG treated with oral prednisolones between 1st January 2015 and 31st December 2022 at Rajavithi Hospital were retrospectively reviewed. Baseline data, dosing, efficacy, and outcomes were analyzed using Cox regression and survival curves to identify predictors and time to first MM.</p><p><strong>Results: </strong>Of the 101 OMG, 81 patients (80.2%) achieved MM. The mean age was 46.6 ±6.9 years in the MM group and 46.2 ± 6.0 years in the non-MM group. The mean daily dose of pyridostigmine was significant higher in the MM group (152.68 ± 32.38 mg/day) compared to the non-MM group (133 ± 34.50 mg/day) (p = 0.018). The prednisolone dosage was comparable between the two groups. Seropositivity of AChRAb, thymoma, thymectomy, concurrent autoimmune diseases were notably observed in non-MM group (p < 0.05, respectively). Cox proportional hazards analysis and survival curves revealed higher pyridostigmine dosage (HR 1.713, 95% CI: 1.029-2.849, p = 0.038). Prednisolone initiation at 6-12 months reduced MM (HR 0.527, 95% CI: 0.297-0.936, p = 0.029), with further reduction observed beyond 12 months (HR 0.165, 95% CI: 0.073-0.368, p < 0.001). The presence of AChRAb, thymoma, prednisolones dosage and ophthalmic manifestations demonstrated no significant association with the achievement of minimal manifestation.</p><p><strong>Conclusion: </strong>Early prednisolone initiation (within 6 months) and higher pyridostigmine doses were linked to remission, highlighting treatment factors over demographics in OMG outcomes.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1505-1513"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059742","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":"Retinopathy of Prematurity (ROP): An Overview of Biomarkers in Various Samples for Prediction, Diagnosis, and Prognosis.","authors":"Dan Huang, ZhuoQi Liu, Yan Deng","doi":"10.2147/OPTH.S519292","DOIUrl":"https://doi.org/10.2147/OPTH.S519292","url":null,"abstract":"<p><p>Retinopathy of Prematurity (ROP) is a proliferative retinal vascular disease marked by abnormal development of retinal vessels in low birth weight preterm infants. It is one of the leading causes of blindness in preterm infants. Current ROP screening methods impose high demands on both the equipment and the expertise of ophthalmologists, which limits their widespread application, particularly in secondary hospitals and remote areas. Thus, the identification of relevant biomarkers and the development of simpler detection methods are important and promising. Non-invasive or minimally invasive sampling methods, along with biomarkers possessing high sensitivity and specificity, could greatly enhance neonatal screening, facilitate early diagnosis, and improve prevention of blindness in preterm infants. This review provides relevant medical insights for clinical practice. This review explored, compares and analyzes various sampling sources. It compares and analyzes research on ROP-related biomarkers derived from these samples.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1515-1530"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048749","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":"Prognostic Factors for Successful Surgical Outcomes in Trochlear Nerve Palsy: A Retrospective Study and Literature Review.","authors":"Worapot Srimanan","doi":"10.2147/OPTH.S525257","DOIUrl":"https://doi.org/10.2147/OPTH.S525257","url":null,"abstract":"<p><strong>Purpose: </strong>Trochlear nerve palsy is a common cause of double vision, particularly vertical diplopia. Surgery might be necessary if the condition does not improve independently. The success of the surgery can vary based on the method employed, and clear factors to predict its effectiveness are not evident. This study evaluates surgical techniques, success rates, and prognostic factors for trochlear nerve palsy at a tertiary hospital.</p><p><strong>Patients and methods: </strong>A retrospective chart review was conducted on patients undergoing strabismus surgery for trochlear nerve palsy at Phramongkutklao Hospital between April 2012 and July 2024. Collected data included demographics, visual acuity, stereopsis, etiology, preoperative angles, surgical methods, and postoperative outcomes. A literature review regarding surgical success and prognostic factors was also conducted.</p><p><strong>Results: </strong>Seventy-two cases were included, with 79.2% involving decompensated congenital trochlear nerve palsy. The overall surgical success rate was 76.39%, and inferior oblique myectomy was the most common and effective procedure (44.4% of cases). Based on multivariate logistic regression analysis, a preoperative hypertropia of ≤15 prism diopters was the significant factor for predicting successful outcomes in this study (OR 5.13, 95% CI 1.19-22.18).</p><p><strong>Conclusion: </strong>Inferior oblique muscle surgery effectively addresses small-angle deviations in trochlear nerve palsy. A <15 prism diopters vertical deviation strongly predicted positive surgical outcomes in this study. Further studies are needed to compare surgical techniques and explore additional prognostic factors to optimize long-term outcomes and improve patient care.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1489-1503"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063520","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}