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

{"title":"Real-World Analysis of Switching Between Ranibizumab Biosimilars: Safety and Results - a Multicenter Retrospective Observational Study.","authors":"Debdulal Chakraborty, Tushar Kanti Sinha, Rupak Kanti Biswas, Aniruddha Maiti, Manab Jyoti Barman, Ranabir Bhattacharya, Subhendu Boral, Arnab Das","doi":"10.2147/OPTH.S624886","DOIUrl":"10.2147/OPTH.S624886","url":null,"abstract":"<p><strong>Purpose: </strong>To describe disease-specific visual, anatomical, treatment-exposure, and documented safety outcomes over 24 weeks among eyes undergoing availability-driven switching between ranibizumab biosimilars in routine retinal practice in India.</p><p><strong>Methods: </strong>This multicenter retrospective observational cohort study reviewed records from January to December 2024. Baseline was the index-switch visit, before administration of the substituted ranibizumab biosimilar. Only one eye per patient was included; when both eyes were eligible, the right eye was selected by convention. Eligible eyes had at least one documented availability-driven biosimilar-to-biosimilar switch and complete 24-week follow-up. Outcomes were summarized descriptively because there was no non-switch comparator group.</p><p><strong>Results: </strong>Of 742 screened eyes, 595 eyes from 595 patients met the inclusion criteria and received 1625 intravitreal ranibizumab biosimilar injections over 24 weeks (mean, 2.73 injections per eye). One switch was recorded in 466 eyes (78.3%) and two switches in 129 eyes (21.7%). Mean BCVA improved from 0.57 logMAR at baseline to 0.26 at 12 weeks and 0.32 at 24 weeks; the early visual improvement therefore attenuated modestly by week 24 but remained better than baseline. Mean central macular thickness decreased from 490.4 micrometers at baseline to 273.6 micrometers at 24 weeks. At final follow-up, 369 eyes (62.0%) gained at least two lines and 488 eyes (82.0%) maintained or improved vision. No endophthalmitis, retinal detachment, or treatment-related systemic adverse event was documented in the available clinical records.</p><p><strong>Conclusion: </strong>Eyes exposed to availability-driven switching between ranibizumab biosimilars showed favorable short-term visual and anatomical outcomes over 24 weeks. Because this retrospective study lacked a non-switch comparator and protocol-mandated safety or immunogenicity surveillance, it cannot establish an effect attributable to switching, comparative safety, equivalence, or formal interchangeability.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"624886"},"PeriodicalIF":0.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009656","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":"Longitudinal Changes in Corneal Epithelial and Central Corneal Thickness in Type 2 Diabetes Assessed by AS-OCT: A Real-World Study.","authors":"İhsan Boyacı, Göktuğ Demirci","doi":"10.2147/OPTH.S636441","DOIUrl":"10.2147/OPTH.S636441","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate longitudinal changes in central corneal epithelial thickness (CCET) and central corneal thickness (CCT) using anterior segment optical coherence tomography (AS-OCT) over 12 months in adults with type 2 diabetes receiving one of two routinely prescribed oral antidiabetic regimens, and to explore their association with glycemic changes.</p><p><strong>Methods: </strong>In this retrospective observational cohort study, 40 adults with type 2 diabetes receiving one of two routinely prescribed treatment regimens (vildagliptin-metformin, n=19; empagliflozin-metformin, n=21) underwent AS-OCT at baseline, 3 months, and 12 months. Glycated hemoglobin and fasting plasma glucose were assessed at each visit. Precision analysis indicated detectable between-group differences of 4.7 µm for CCT and 6.1 µm for CCET.</p><p><strong>Results: </strong>Both groups showed significant within-group glycated hemoglobin improvement (mean reduction: -2.28% and -2.88% in the vildagliptin-metformin and empagliflozin-metformin groups, respectively; p<0.05) without between-group differences. CCT and CCET showed no statistically detectable longitudinal change over 12 months, with no significant differences in longitudinal change between groups. Glycated hemoglobin change showed a modest independent association with CCT change (β = 0.81 µm per 1% glycated hemoglobin; 95% CI 0.20-1.42; p=0.011; n=32).</p><p><strong>Conclusions: </strong>Corneal structural parameters showed no statistically detectable longitudinal change or between-group difference over 12 months. Given the modest sample size and observational design, these findings should be considered hypothesis-generating and require confirmation in larger prospective studies.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"636441"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009677","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 Safety and Effectiveness of STREAMLINE Canaloplasty with Phacoemulsification in a Hispanic Population with Open-Angle Glaucoma.","authors":"Gabriel Lazcano-Gomez, Claudio Orlich, Elysia Ison, Malik Y Kahook","doi":"10.2147/OPTH.S622094","DOIUrl":"10.2147/OPTH.S622094","url":null,"abstract":"<p><strong>Purpose: </strong>To report long-term clinical outcomes from a multicenter study evaluating STREAMLINE® Surgical System (STREAMLINE) canaloplasty, a minimally invasive glaucoma surgery (MIGS), combined with phacoemulsification in eyes with mild to moderate open-angle glaucoma (OAG).</p><p><strong>Design: </strong>Retrospective extension of a prospective, multicenter, interventional study.</p><p><strong>Participants: </strong>Participants were those in the original study who provided consent for retrospective long-term data collection.</p><p><strong>Methods: </strong>All eyes in this single-arm, retrospective extension study underwent STREAMLINE canaloplasty performed in combination with phacoemulsification between November 2021 and April 2022 at two sites in Latin America.</p><p><strong>Main outcome measures: </strong>The primary effectiveness outcome was the reduction in mean intraocular pressure (IOP) from Screening to last follow-up. Secondary effectiveness outcomes included mean change in topical IOP-lowering medication count from Screening compared to last follow-up. Safety assessments included visual acuity, visual field mean deviation, and incidence of adverse events (AEs).</p><p><strong>Results: </strong>Participants (n=28) at 2 of the 3 sites in the original study (n=43, 65.1%) consented to have retrospective data collected as part of this extension study. Average length of follow-up was 24.2±4.4 months (M24). Mean IOP (17.1±3.0 mmHg) and IOP-lowering medication count (1.86±0.80) at Screening decreased to 15.13±3.25 mmHg (p=0.002) and 0.54±1.17 (p<0.001), respectively. At M24, 92.9% of eyes were on the same or fewer medications compared to screening and 78.6% were medication free. No AEs were reported in the extension study (M12 to last follow-up).</p><p><strong>Conclusions: </strong>Canaloplasty with the STREAMLINE® Surgical System in combination with phacoemulsification provides clinically and statistically significant reduction in both IOP and the need for IOP-lowering medications in eyes with mild-moderate OAG in a Hispanic adult population through an average of 24 months post-operatively.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"622094"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009679","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":"Clinical and Multimodal Imaging Features of Familial Exudative Vitreoretinopathy: The Genetic and Phenotypic Spectrum.","authors":"Tülin Öğreden, Ilkay Kilic Muftuoglu, Gürkan Erdoğan","doi":"10.2147/OPTH.S632710","DOIUrl":"https://doi.org/10.2147/OPTH.S632710","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to characterize the genetic, clinical, and multimodal imaging findings in a cohort of patients with familial exudative vitreoretinopathy (FEVR).</p><p><strong>Methods: </strong>This retrospective cross-sectional study included patients diagnosed with FEVR at a tertiary referral center. Clinical findings, fluorescein angiography, optical coherence tomography (OCT), OCT angiography (OCTA), treatment records, and whole-exome sequencing results were reviewed.</p><p><strong>Results: </strong>A total of 28 patients were included in the analysis, of whom 22 (78.6%) were probands and 6 (21.4%) were family members.Fifteen patients (53.6%) were male and 13 (46.4%) female. Mean age was 11.75±9.63 (2-47) years, with a mean follow-up of 21.57±14.24 (2-50) months. Visual acuity ranged from light perception to 20/20, with a median BCVA of 20/32. Among 56 eyes, mild disease (stage 1-2) was observed in 67.9%, compared with 32.1% for advanced disease (stage 3-5). Genetic variants were identified in 17 patients (60.7%), whereas no disease-associated variant was detected in 11 (39.3%). The most commonly affected genes were FZD4 (21.4%), LRP5 (17.9%), KIF11 (14.3%), TSPAN12 (3.6%), and NDP (3.6%). Clinical manifestations ranged from asymptomatic peripheral vascular anomalies to advanced retinal detachment and severe vision loss. One LRP5-mutant patient exhibited PFV, stage 5 disease, and glaucoma. The four KIF11-mutant cases demonstrated marked phenotypic variability. A FEVR phenotype was also identified in a case with an EPHA2 mutation. OCT, OCT-A, and fluorescein angiography were available in 29 (51.8%), 10 (17.9%), and 27 eyes (48.2%), respectively. Combined imaging revealed posterior pole, vitreoretinal interface, and retinal microvascular abnormalities, including foveal and vitreomacular alterations, that were not fully reflected by stage classification alone. Laser photocoagulation was performed in 26.8% of eyes, combination therapy in 14.2%, and anti-VEGF monotherapy in 1.8%.</p><p><strong>Conclusion: </strong>FEVR demonstrated marked genetic and phenotypic heterogeneity, while multimodal imaging provided complementary information beyond conventional stage classification.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"632710"},"PeriodicalIF":0.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993207","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":"Short-Term Changes in Peripapillary RNFL and Disc-Fovea Angle After Horizontal Rectus Muscle Surgery in Comitant Strabismus.","authors":"Xiyu Zhao, Jingjing Jiang, Li Li, Xiaogang Wang, Junhong Li","doi":"10.2147/OPTH.S611851","DOIUrl":"https://doi.org/10.2147/OPTH.S611851","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate short-term changes in peripapillary retinal nerve fiber layer (pRNFL) thickness and disc-fovea angle (DFA) after horizontal rectus muscle surgery in patients with comitant strabismus.</p><p><strong>Patients and methods: </strong>This retrospective cohort study included 73 eyes of 73 patients with comitant strabismus who underwent horizontal rectus muscle surgery. Patients were divided according to the number of horizontal rectus muscles operated on in the analyzed eye: Group 1, in which the analyzed eye underwent one-horizontal-rectus-muscle surgery, and Group 2, in which the analyzed eye underwent two-horizontal-rectus-muscle surgery. Optical coherence tomography (OCT) was performed preoperatively, on postoperative day 1, and at postoperative week 2. Global and sectoral pRNFL parameters and the absolute DFA (|DFA|) were analyzed.</p><p><strong>Results: </strong>Baseline demographic, refractive, pRNFL, and |DFA| parameters were comparable between the two groups. In Group 1, several pRNFL parameters showed significant early postoperative changes on postoperative day 1, mainly involving G, PMB, T, TI, and NI, and most values returned toward baseline by postoperative week 2. In Group 2, pRNFL changes were more limited, with only TI showing a significant change on postoperative day 1, whereas |DFA| remained significantly different from baseline at postoperative week 2. Between-group comparisons showed greater day 1 changes in G, N, and NI in Group 1, while only the change in |DFA| remained significantly different between groups at week 2.</p><p><strong>Conclusion: </strong>Horizontal rectus muscle surgery was associated with mild, transient, and region-specific changes in the pRNFL in patients with comitant strabismus. One-horizontal-muscle surgery was associated with broader early postoperative fluctuations, whereas surgery involving two horizontal muscles was more closely associated with persistent short-term DFA changes.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"611851"},"PeriodicalIF":0.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993174","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":"Clinical and Patient-Reported Outcomes of Premium Intraocular Lenses in Glaucoma Patients Undergoing Combined Cataract and Minimally Invasive Glaucoma Surgery.","authors":"Jack Wolsky, Christianah Jemiyo, Michael Greenwood","doi":"10.2147/OPTH.S628605","DOIUrl":"https://doi.org/10.2147/OPTH.S628605","url":null,"abstract":"<p><strong>Background: </strong>Premium intraocular lenses (IOLs), including multifocal, extended depth-of-focus (EDOF), and light adjustable lenses (LALs) are used to reduce spectacle dependence after cataract surgery. However, their use in glaucoma patients remains controversial due to concerns that reduced contrast sensitivity and pre-existing visual field loss limits functional benefits from these optics. Increasing use of minimally invasive glaucoma surgery (MIGS) at the time of cataract surgery has made combined refractive and glaucoma management more common, but data on real world outcomes remains limited.</p><p><strong>Methods: </strong>This single-center, IRB-approved retrospective observational study with cross-sectional survey analysis included glaucoma patients who underwent bilateral cataract surgery with implantation of multifocal, EDOF, or LAL IOLs with concurrent MIGS from 2020 to 2025. Postoperative visual outcomes, intraocular pressure (IOP), glaucoma medication burden, spectacle dependence, dysphotopsias, and patient satisfaction were assessed. Longitudinal outcomes were analyzed using mixed-effects models adjusted for baseline glaucoma severity (mean deviation). Satisfaction was evaluated using proportional odds logistic regression adjusting for age and baseline disease severity.</p><p><strong>Results: </strong>Seventy-nine patients (Multifocal n=43, EDOF n=24, LAL n=12) were included. All groups demonstrated significant postoperative improvement in distance visual acuity and reduction in IOP and glaucoma medication burden. Adjusted IOP trajectories and most recent IOP were similar between groups. Distance visual acuity outcomes were similar between groups after adjustment for baseline glaucoma severity. Near visual acuity favored multifocal IOLs, while LAL demonstrated the highest spectacle dependence. Dysphotopsias were more frequent with multifocal lenses and lowest in LAL. Satisfaction was high across all groups, with predicted probabilities of being \"very\" or \"somewhat satisfied\" of 94% (multifocal), 88% (EDOF), and 87% (LAL).</p><p><strong>Conclusions: </strong>In appropriately selected glaucoma patients undergoing cataract surgery with MIGS, multifocal, EDOF, and LAL IOLs provide comparable visual outcomes, excellent IOP control, and high satisfaction. Differences in spectacle dependence and dysphotopsia support individualized IOL selection.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"628605"},"PeriodicalIF":0.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993246","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":"Genetic Architecture and Clinical Phenotypes of Primary Open-Angle Glaucoma: An Updated Review of Mendelian Genes, GWAS Loci, and Polygenic Risk.","authors":"Khaled K Abu-Amero, Shereen Abualkhair, Hajar AlOtaibi, Gorka Sesma","doi":"10.2147/OPTH.S623649","DOIUrl":"https://doi.org/10.2147/OPTH.S623649","url":null,"abstract":"<p><strong>Purpose: </strong>To synthesize the genetic architecture of primary open-angle glaucoma (POAG) across the full variant spectrum and map each genetic subtype to its clinical phenotype, IOP profile, optic nerve morphology, systemic associations, and treatment response.</p><p><strong>Methods: </strong>PubMed/MEDLINE was searched from inception through April 2025 for POAG genetics, susceptibility genes, GWAS loci, polygenic risk scores, and gene-specific clinical correlations. Eligible designs included peer-reviewed original research, GWAS meta-analyses, candidate-gene studies, family-based linkage analyses, cohort and case-control studies, and PRS development in human subjects. Genetic association studies were appraised using Q-Genie; observational clinical studies were appraised using the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Seven high-penetrance Mendelian genes (MYOC, OPTN, TBK1, WDR36, NTF4, FOXC1, CYP1B1) account for fewer than 10% of cases, each defining a clinically distinct subtype: juvenile high-tension glaucoma (MYOC), normal-tension neurodegeneration (OPTN, TBK1), and syndromic developmental glaucoma (FOXC1, CYP1B1). GWAS meta-analyses have identified 100 to 127 susceptibility loci converging on five biological axes: trabecular meshwork dysfunction, retinal ganglion cell survival, autophagy and protein homeostasis, neuroinflammation, and extracellular matrix integrity. Polygenic risk scores combined with clinical variables achieve an AUC of 0.89.</p><p><strong>Conclusion: </strong>POAG comprises genetically and clinically distinct subtypes defined by dominant molecular axes. Gene-specific data reveal actionable pharmacogenomic signals: ROCK inhibitors for ARHGEF12 and AFAP1 carriers, nicotinamide for OPTN and TXNRD2 subtypes, and goniotomy for CYP1B1-associated congenital glaucoma. IOP-centric management is insufficient for normal-tension subtypes driven by autophagy failure and neuroinflammation. The framework supports genotype-guided decisions on screening intensity, IOP targets, and neuroprotective adjuncts.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"623649"},"PeriodicalIF":0.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993235","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":"Comparative Efficacy of Cyclosporine, Tacrolimus, and Neurostimulatory Nasal Sprays for Moderate-to-Severe Dry Eye Disease: A Systematic Review and Network Meta-Analysis.","authors":"Asim Marwan Bogari, Nada Omar Taher, Reem Omar Nughays, Mohammed Albadri, Hind Mohammed Aljabri, Mohammed Abdulaziz Taha, Mahmood Jameel Showail","doi":"10.2147/OPTH.S608369","DOIUrl":"10.2147/OPTH.S608369","url":null,"abstract":"<p><strong>Aim: </strong>To compare the efficacy and tolerability of topical cyclosporine A (CsA) 0.05%, 0.09%, and 0.1%; tacrolimus 0.03%; and neurostimulatory nasal sprays (varenicline and simpinicline) in moderate-to-severe dry eye disease (DED), focusing on tear production, ocular surface integrity, and tear film stability.</p><p><strong>Clinical relevance: </strong>DED management remains complex due to heterogeneous presentation and variable therapeutic responses. While immunomodulators like CsA and tacrolimus are widely used, novel neuromodulatory agents such as varenicline nasal spray are emerging. Comparative data across these treatment classes remain scarce.</p><p><strong>Methods: </strong>A systematic search of MEDLINE, Embase, and CENTRAL was performed up to January 2025. Randomized controlled trials assessing CsA 0.05%, 0.09%, or 0.1%; tacrolimus 0.03%; or nicotinic acetylcholine receptor agonist nasal sprays in moderate-to-severe DED were included. Primary endpoints included Schirmer test score (STS), tear break-up time (TBUT), corneal fluorescein staining (CFS), and ocular surface disease index (OSDI). A Bayesian network meta-analysis estimated comparative efficacy using the surface under the cumulative ranking curve (SUCRA).</p><p><strong>Results: </strong>Twenty-nine RCTs (n = 8453 patients) were included in the systematic review; fourteen qualified for network meta-analysis. CsA 0.09% and 0.1% ranked highest for CFS improvement at the evaluated time points. Tacrolimus 0.03% showed favorable early STS and TBUT trends but did not consistently improve longer-term ocular surface outcomes. Varenicline improved tear production but lacked CFS data. Placebo ranked favorably for STS and TBUT at 3 months and beyond, possibly because several vehicles had lubricating or tear-stabilizing effects. CsA 0.05% showed modest efficacy.</p><p><strong>Conclusion: </strong>CsA 0.09% and 0.1% showed the most favorable corneal healing outcomes, while tacrolimus 0.03% showed an early tear-stimulating effect. Varenicline offers a distinct neurostimulatory mechanism but requires further comparative validation. These findings support phenotype-guided therapy and future head-to-head trials.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"608369"},"PeriodicalIF":0.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042660","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":"Digital Visual Acuity and Reading Performance with Positive and Negative Display Polarities After Bilateral Diffractive Multifocal Intraocular Lens Implantation: A Longitudinal Observational Study.","authors":"Thanapong Somkijrungroj, Nuntachai Surawatsatien, Waraluck Supawatjariyakul, Thanaporn Wiriyabanditkul, Thananop Pothikamjorn","doi":"10.2147/OPTH.S617151","DOIUrl":"10.2147/OPTH.S617151","url":null,"abstract":"<p><strong>Introduction: </strong>Traditional acuity charts may not fully capture visual performance during everyday digital device use. Digital screen-based assessments may better reflect contemporary visual demands, and display polarity may influence reading performance in patients with multifocal intraocular lenses (MF-IOLs). Furthermore, display polarities differ in luminance and contrast characteristics, which may influence pupil size and reading performance in patients with MF-IOLs. We aimed to compare digital visual acuity (VA) between positive (black-on-white) and negative (white-on-black) display polarities and evaluated reading speed and critical print size (CPS) in patients with bilateral diffractive MF-IOLs.</p><p><strong>Methods: </strong>In this non-randomized, observational study, consecutive participants who underwent bilateral diffractive MF-IOL (AcrySof IQ PanOptix) implantation with repeated assessments at postoperative day 1, week 1, month 1, and month 3. Monocular and binocular uncorrected and corrected distance, intermediate, and near VA were assessed using a Snellen chart and MNREAD application on an iPad. Reading acuity between display polarities was compared using paired <i>t</i>-tests, while reading speed and CPS were assessed using the positive display polarity.</p><p><strong>Results: </strong>Twenty-six participants completed the study. At 3 months, uncorrected distance VA was -0.084 ± 0.079 logMAR. Digital VA at 60 cm and 40 cm was -0.115 ± 0.104 and -0.008 ± 0.084 logMAR, respectively. Reading performance did not differ significantly between positive and negative display polarities at 60 cm (p = 0.055). Mean CPS was 0.173 ± 0.0168 logMAR at 1 month and 0.238 ± 0.100 logMAR at 3 months. Mean reading speed was 84.63 ± 27.46 WPM at 1 month and 101.89 ± 72.62 WPM at 3 months (p = 0.133).</p><p><strong>Conclusions: </strong>Bilateral diffractive MF-IOLs provided favorable digital and conventional visual outcomes with small differences observed and were not considered clinically meaningful. Digital reading assessments provided complementary functional information, including reading speed and critical print size, without replacing conventional VA assessment.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"617151"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972348","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":"Patient-Reported Quality of Life and Treatment Experiences Among Patients with Neovascular Age-Related Macular Degeneration Receiving Intravitreal Aflibercept in Colombia: A Qualitative Study.","authors":"Maria Adelaida Piedrahita, Wanderley Augusto Arias-Ortiz, Claudia Patricia Acosta Cadavid, Eduardo Cadena Galvis, Fernando Yaacov Peña","doi":"10.2147/OPTH.S626968","DOIUrl":"10.2147/OPTH.S626968","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the experiences and perceptions of patients with neovascular age-related macular degeneration (AMD) receiving anti-VEGF therapy and understand how treatment influences their quality of life.</p><p><strong>Patients and methods: </strong>A qualitative study informed by a phenomenological perspective and employing a hybrid deductive-inductive thematic analysis was conducted at an ophthalmologic center in Medellín, Colombia. Fourteen patients with confirmed AMD undergoing intravitreal aflibercept treatment participated in semi-structured telephone interviews. Participants were selected through purposive sampling until meaning saturation was achieved, defined as the point at which no new experiential themes emerged. Interviews were transcribed verbatim and analyzed using a hybrid deductive-inductive thematic analysis guided by the Felce and Perry quality-of-life framework, supported by ATLAS.ti v24.</p><p><strong>Results: </strong>Patients described AMD as a condition strongly associated with fear, uncertainty, and emotional distress, particularly related to progressive visual loss and blindness. Intravitreal injections were initially perceived as invasive and anxiety-provoking; however, over time many participants associated treatment with hope, visual stability, and preservation of independence. Family support, religious beliefs, and trust in the treating ophthalmologist emerged as important factors for emotional coping and treatment adherence. Participants also reported subjective improvement in daily activities such as reading, mobility, self-care, and social interaction. Nevertheless, some continued to experience limitations related to transportation, dependence on others, and social isolation. Concerns about continuity of care and access to medication were frequently expressed.</p><p><strong>Conclusion: </strong>Quality of life in patients with AMD receiving anti-VEGF therapy extends beyond visual outcomes alone and is deeply influenced by emotional, social, and functional factors. Although treatment generated fear and discomfort at the beginning, it also represented an opportunity to maintain autonomy and social participation. These findings highlight the importance of patient-centered care strategies that integrate psychosocial support, clear communication, and continuous access to treatment.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"626968"},"PeriodicalIF":0.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963878","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}