Romanian journal of ophthalmology最新文献

{"title":"Nab-Paclitaxel Induced Cystoid Macular Oedema: Case Report and Literature Review.","authors":"Tejas Shivarthi, Sujithra Haridas, Keechilat Pavithran","doi":"10.22336/rjo.2025.76","DOIUrl":"https://doi.org/10.22336/rjo.2025.76","url":null,"abstract":"<p><strong>Introduction: </strong>Nab-paclitaxel, a nanoparticle formulation of paclitaxel, is commonly used to treat solid tumors but is associated with rare adverse effects, including cystoid macular oedema (CMO). This case highlights the CMO in a patient undergoing nab-paclitaxel treatment for metastatic pancreatic cancer.</p><p><strong>Methods: </strong>A 72-year-old male receiving nab-paclitaxel and gemcitabine presented with progressive bilateral vision loss. Ophthalmological evaluation, including spectral-domain optical coherence tomography (SD-OCT), confirmed bilateral CMO. Nab-paclitaxel was discontinued, and the chemotherapy regimen was adjusted accordingly.</p><p><strong>Results: </strong>Visual symptoms improved significantly within 1 month of nab-paclitaxel cessation. Follow-up OCT and best-corrected visual acuity (BCVA) assessments showed significant improvement.</p><p><strong>Discussion: </strong>In this case, nab-paclitaxel-induced cystoid macular oedema (CMO) was confirmed by OCT and resolved rapidly after drug cessation. Review of 32 cases revealed predominantly bilateral involvement with highly variable onset and recovery times. In pancreatic cancer patients (n=8), cessation was the main management, with symptom onset ranging from 1-6 months and recovery typically within weeks to months. The variability in presentation may reflect acute toxic effects on Müller cells, disrupting retinal fluid homeostasis. Cases treated with carbonic anhydrase inhibitors showed faster resolution, supporting their role in modulating subretinal fluid dynamics. Alternative therapies such as NSAIDs or anti-VEGF agents demonstrated limited benefit, highlighting a non-inflammatory pathogenesis.</p><p><strong>Conclusions: </strong>Nab-paclitaxel-induced CMO is a rare but reversible condition that requires prompt cessation. Carbonic anhydrase inhibitors or anti-VEGF agents may expedite recovery in refractory cases. This report underscores the importance of early recognition and management of ocular toxicity in patients receiving nab-paclitaxel.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"482-487"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679089","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":"Traumatic Brain Injury and Its Ophthalmologic Implications.","authors":"Vlad Liviu Hârtie, Nicoleta Anton, Otilia Boișteanu, Maria Paula Comanescu, Emilia Pătrășcanu, Emilia Bologa, Daniela Șulea, Ciprian Danielescu, Mihaela Dana Turliuc","doi":"10.22336/rjo.2025.75","DOIUrl":"https://doi.org/10.22336/rjo.2025.75","url":null,"abstract":"<p><p>\"Traumatic brain injury (TBI) frequently produces visual symptoms along the visual pathway, from the eye and optic nerve to cortical visual processing and oculomotor control. Manifestations include decreased visual acuity and visual fields, traumatic optic neuropathy (TON), oculomotor dysfunctions (saccades, vergence, tracking), photophobia/\"visual snow\", and higher-level visuo-perceptual problems. Recognition of these symptoms by ophthalmologists and optometrists is essential, as many deficits are treatable (vision therapy, optical aids, medical/surgical management for TON, multidisciplinary rehabilitation), yet underdiagnosis is common. Significant gaps include standardized diagnostic protocols, objective biomarkers, and high-quality studies on rehabilitation strategies. Recent advances in imaging methods allow noninvasive quantification of retinal thickness, retinal vessel density, blood flow, and oxygen saturation. SD-OCTA provides high-resolution three-dimensional (3D) images of blood flow and vessel density in the superficial and deep retinal plexuses. This novel, noninvasive imaging technique may offer insights into neural pathologies with vascular components, such as TBI.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"475-481"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679895","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 factors in determining the urgency of cataract referral.","authors":"Kah Long Aw, Sirindhra Suepiantham, Ashraf Khan","doi":"10.22336/rjo.2025.84","DOIUrl":"https://doi.org/10.22336/rjo.2025.84","url":null,"abstract":"<p><strong>Objective: </strong>Patients with cataract experience various symptoms that reduce the quality of life. This study aims to investigate the characteristics of patients who were referred for urgent versus routine cataract surgery.</p><p><strong>Methods: </strong>A 7-month retrospective study was performed on 140 patients referred by opticians for cataract surgery in the Princess Alexandra Eye Pavilion, UK. Basic demographic information, including the Scottish Index of Multiple Deprivation (SIMD), number of symptoms (nVFQ), visual acuity (VA), urgency of referral by the optometrist, and triage status by the doctor (urgent versus routine), was collected. Sub-group analysis of differences between routine and urgent cases was performed using a two-sample t-test or a Chi-squared test. Logistic regression was used to examine factors associated with an increased odds of urgent presentation. Parameters found to be significant on univariate regression analyses were further investigated using multivariable regression analyses.</p><p><strong>Results: </strong>Sub-group analysis showed that nVFQ was associated with triage status by doctors (p=0.01) and urgency of referral by optometrists (p<0.0001). VA was not associated with referral urgency or triage status. Univariate logistic regression demonstrated that the nVFQ is associated with triage status by doctors (OR=1.70, CI=1.11-2.60, p=0.014) and urgency of referral by optometrists (OR=2.22, CI=1.44-3.41, p=0.0003). ANOVA testing showed a significant association between SIMD quintile and nVFQ (p=0.036).</p><p><strong>Discussion: </strong>While visual acuity did not affect prioritisation, patients reporting more symptoms were more likely to receive urgent referrals. Symptom reporting increased with higher socioeconomic status, suggesting reliance on symptoms alone may disadvantage more deprived patients, who already face a higher cataract burden and poorer access to care. These findings align with NICE guidance prioritising lifestyle impact over visual acuity and highlight the need for improved patient education and standardised symptom assessment to promote equitable care.</p><p><strong>Conclusion: </strong>Our study demonstrated an association between higher cataract symptom reporting, but not visual acuity, with urgency of referral and triage status. Lower socioeconomic deprivation was associated with higher reporting of cataract symptoms. Further research should explore the factors that contribute to the relationship between socioeconomic background and symptom reporting.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"552-556"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679579","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":"Early-onset drusen in Malattia Leventinese with <i>EFEMP1</i> mutation differ from drusen in age-related macular degeneration.","authors":"Areeba Shakeel, Darshan Bhatt, Sarangapani Sripriya, Dhanashree Ratra","doi":"10.22336/rjo.2025.93","DOIUrl":"https://doi.org/10.22336/rjo.2025.93","url":null,"abstract":"<p><strong>Purpose: </strong>To study the clinical, genetic, and phenotypic aspects of Malattia Leventinese (ML)/Doyne honeycomb retinal dystrophy (DHRD) and to differentiate it from age-related macular degeneration (AMD).</p><p><strong>Methods: </strong>Three cases of ML/DHRD from the Indian population were evaluated, including fundus examination, fundus autofluorescence (FAF), and swept-source optical coherence tomography (SSOCT). Genetic investigations involved screening for an inherited retinal gene panel using the Illumina MiSeq platform for one case. Pedigree charting, blood collection, DNA extraction, and variant annotation were performed, followed by pathogenicity assessment of the identified variants using multiple bioinformatics tools.</p><p><strong>Results: </strong>All cases exhibited early-onset central vision loss and small, radially distributed drusen, consistent with ML/DHRD. Genetic analysis done in patient one revealed a heterozygous, autosomal dominant, pathogenic mutation (c.1033C>T p.ARG345Trp) in the <i>EFEMP1</i> gene, confirming the ML diagnosis. Patient 1 had no late-stage complications, whereas patients 2 and 3 developed macular neovascularization (MNV). OCT showed gross thickening of the retinal pigment epithelium with hyperreflectivity, along with outer retinal tubulations (ORT) and interlaminar bridges, indicating outer retinal degeneration.</p><p><strong>Discussion: </strong>Malattia Leventinese is a rare autosomal dominant macular dystrophy caused by a single <i>EFEMP1</i> missense mutation (R345W), leading to early-onset radial or honeycomb drusen and central vision loss in the third decade. In this series, all patients showed typical radial drusen, with macular neovascularization in two cases, and demonstrated interlaminar bridges and ORTs on OCT. The mutant <i>EFEMP1</i> protein misfolds and accumulates abnormally between the RPE and Bruch's membrane, accelerating drusen formation. Some phenotypic variability, including intrafamilial differences, likely reflects additional genetic or environmental modifiers. The presence of the R345W mutation, age at onset, and drusen distribution pattern are crucial for differentiating ML/DHRD from AMD.</p><p><strong>Conclusion: </strong>The identified pathogenic <i>EFEMP1</i> mutation (R345W) established a molecular link to ML/DHRD. Typical phenotypic patterns and drusen characteristics can differentiate ML/DHRD from AMD.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"598-605"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679782","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":"Diagnostic Dilemma: Incipient Non-Arteritic Anterior Ischemic Optic Neuropathy vs. Steroid-Responsive Inflammatory Optic Neuropathy.","authors":"Aahan Shah, Mary Stephen, Amit Kumar Deb, Kalyan Basa","doi":"10.22336/rjo.2025.94","DOIUrl":"https://doi.org/10.22336/rjo.2025.94","url":null,"abstract":"<p><strong>Objective: </strong>To highlight the diagnostic challenge of differentiating incipient non-arteritic anterior ischemic optic neuropathy (NAION) from inflammatory optic neuropathy in resource-limited settings.</p><p><strong>Methods: </strong>A male in his mid-50s with four days of painless progressive left-eye vision loss. Examination: OD crowded disc (CDR 0.3), OS 360°-disc edema (OCT RNFL 182 μm), Grade 1 RAPD, 360° visual field constriction. Investigations: OCT 30-2 fields, FFA (delayed disc filling, late leakage), HRCT brain/orbit, B-scan (ONSD 6.02 mm), labs (BP 126/82, PP2BS 146 mg/dL, elevated lipids and ESR, nonreactive VDRL). Treatment: aspirin 75 mg OD + prednisolone 1 mg/kg OD for a one-week trial.</p><p><strong>Results: </strong>At one week: OS edema resolved (RNFL 104 μm), vision improved to 6/9 OS, RAPD resolved; steroids tapered over 10 days. At two weeks: OS 6/6, fields markedly improved. At 10 weeks: maintained on pred 5 mg OD + aspirin; no recurrence.</p><p><strong>Discussion: </strong>The case highlights the complexity of distinguishing incipient NAION from steroid-responsive inflammatory optic neuropathy, particularly when clinical and angiographic features overlap. The dramatic improvement following a short steroid trial suggested an underlying inflammatory component despite the presence of structural risk factors for NAION. This therapeutic response emphasizes the diagnostic value of monitored steroid trials in ambiguous presentations. In resource-limited environments, such an approach may offer a pragmatic adjunct to standard diagnostic protocols.</p><p><strong>Conclusions: </strong>Rapid steroid response favored an inflammatory component over pure NAION. A crowded OD disc predisposed to NAION underscores the necessity for nuanced, individualized management. Therapeutic trials may aid diagnosis where advanced tests are inaccessible.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"606-610"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679775","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":"A Giant Acquired Dacryocystocele in Congenital Nasolacrimal Duct Obstruction.","authors":"Prabrisha Banerjee, Abhishek Gupta, Prabhakar Singh, Abhishek Verma, Shreeyaa Mohanty, Mahuya Chattopadhyay","doi":"10.22336/rjo.2025.92","DOIUrl":"https://doi.org/10.22336/rjo.2025.92","url":null,"abstract":"<p><strong>Introduction: </strong>Dacryocystoceles are cystic dilatations of the lacrimal sac and nasolacrimal duct (NLD) due to the outflow obstruction at the Rosenmuller valve and the Hasner valve. Dacryocystoceles are rare in adults.</p><p><strong>Materials and methods: </strong>A retrospective case report.</p><p><strong>Case presentation: </strong>We describe the first case of an acquired dacryocystocele in a patient with bilateral congenital nasolacrimal duct obstruction (CNLDO). A 25-year-old treatment-naïve bilateral CNLDO male presented with a superolateral dystopia of the left globe, proptosis, and a non-tender cystic mass at the left medial canthal region for the past six months. Computed tomography (CT scan) revealed a cystic enlargement of the left lacrimal sac with a distended NLD forming a nasolacrimal duct mucocele. Bilaterally, external DCR was performed. Histopathology was consistent with chronic dacryocystitis.</p><p><strong>Discussion: </strong>Dacryocystoceles are rare in adults. They are either idiopathic or secondary to dacryocystitis, trauma, or dacryocystorhinostomy (DCR) surgery. In this case, the long-standing NLD obstruction has caused distention of the NLD and the lacrimal sac, leading to chronic fibroinflammatory changes in the Rosenmuller valve.</p><p><strong>Conclusion: </strong>Chronic fibroinflammatory changes in adult patients with untreated congenital nasolacrimal duct obstruction can cause dacryocystocele formation.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"595-597"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679802","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":"Progressive Inflammatory Coupling Drives Glaucoma Progression - a Longitudinal Analysis of Cytokine-RNFL Dynamics.","authors":"Raluca Neacșa, Daniela Manasia, Cristiana Tănase, Mădălina-Elena Tobă, Adina-Diana Moldovan","doi":"10.22336/rjo.2025.79","DOIUrl":"https://doi.org/10.22336/rjo.2025.79","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory biomarkers in glaucoma have shown promise but lack the longitudinal analysis necessary for clinical translation. We developed a comprehensive mixed-effects modeling approach to characterize temporal cytokine-RNFL dynamics and reveal patterns in the cytokine-RNFL progression.</p><p><strong>Methods: </strong>We analyzed a 24-month longitudinal cohort of 57 patients (19 each: controls, untreated POAG, treated POAG) using: (1) mixed-effects models with individual heterogeneity modeling; (2) censoring-informed cytokine analysis; and (3) temporal correlation network analysis.fi.</p><p><strong>Results: </strong>Mixed-effects models revealed significant group differences in RNFL progression: controls (-0.20 ± 0.10 μm/year), untreated POAG (-1.94 ± 0.54 μm/year), and treated POAG (-1.06 ± 0.49 μm/year). Cytokine censoring patterns provided biological validation-pro-inflammatory cytokines showed 1.37-fold higher detection in untreated POAG versus controls (TNF-alpha: 85.3% vs. 62.1%), independently confirming elevated disease inflammation. Temporal correlation analysis showed progressive inflammatory coupling, with the TNF-alpha of ~ IL6 correlation increasing from r = 0.23 to r = 0.49 over 24 months.</p><p><strong>Discussion: </strong>Our findings suggest that POAG pathogenesis can be linked to a progressive inflammatory dysregulation, in which other cytokines follow increases in an initial inflammatory cytokine. The doubling of the correlation between TNF alpha and IL6 over time could suggest that the disease progression could be self-amplifying.</p><p><strong>Conclusions: </strong>This study establishes that glaucoma involves progressive inflammatory coupling, in which initially independent cytokine signals evolve into self-reinforcing mechanisms. The differential censoring patterns provide compelling biological validation. These findings enable precision medicine approaches based on inflammatory phenotypes and support early intervention strategies targeting network establishment.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"512-518"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679603","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":"Augmented Reality in Ophthalmology.","authors":"Consuela-Mădălina Gheorghe","doi":"10.22336/rjo.2025.73","DOIUrl":"https://doi.org/10.22336/rjo.2025.73","url":null,"abstract":"","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"465-466"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679772","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":"Anatomical and functional results of plasma rich in growth factors as a treatment for poor-prognosis macular holes.","authors":"Marta Caminal-Caramés, Jaume Crespí Vilimelis, Carlos Oribio Quinto, Albert Saladrigas Pernias, Santiago Conversa, Alejandro Verdú Reyes, Jesús Díaz Cascajosa, Daniela Rego Lorca, Maria Pilar Piquer Pérez, José Ignacio Vela Segarra","doi":"10.22336/rjo.2025.81","DOIUrl":"https://doi.org/10.22336/rjo.2025.81","url":null,"abstract":"<p><strong>Purpose: </strong>The management of poor-prognosis full-thickness macular holes (FTMH), considered as large, myopic, recurrent, or persistent, is challenging, and there is no consensus on the most suitable option. Plasma rich in growth factors (PRGF) is a subtype of platelet-rich plasma with a higher concentration of growth factors, which promotes Müller cell proliferation and, therefore, closure of FTMH. This study aims to analyze the benefits of injectable plasma rich in growth factors (iPRGF) as an adjuvant to PPV in poor-prognosis FTMH.</p><p><strong>Materials and methods: </strong>A prospective, non-randomized study was conducted in patients with poor-prognosis FTMH. Patients were treated with PPV associated with adjuvant iPRGF. Postoperative best corrected visual acuity (BCVA), FTMH closure, retinal layer restoration, and type of closure were analyzed.</p><p><strong>Results: </strong>A total of 12 eyes were included in the study. Complete closure of the FTMH was achieved in 92% of the patients, and BCVA improvement in 75%. Reconstitution of the external retinal layers was observed in 41% of the patients, and closure type 1A in 41%. No adverse effects were recorded.</p><p><strong>Discussion: </strong>The high closure rate and visual improvement suggest that iPRGF is a promising adjuvant in poor-prognosis FTMH, likely through Müller cell stimulation and glial-mediated tissue repair. Compared with more complex techniques such as inverted ILM flaps or autologous retinal transplants, iPRGF offers a more straightforward, safer, and faster approach, particularly in myopic or recurrent cases. The potential synergistic effect of combining iPRGF with ILM flap techniques warrants further investigation.</p><p><strong>Conclusion: </strong>The use of iPRGF may be an effective technique for achieving anatomical closure, restoring retinal layers, and improving final BCVA.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"528-535"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679807","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":"Comparison Between 3D Heads-Up Display System and Standard Operating Microscope in Diabetic Vitrectomy for Tractional Retinal Detachment.","authors":"Krinjeela Bazgain, Uday Pratap Singh Parmar, Deeksha Katoch, Basavaraj Tigari, Mohit Dogra, Ramandeep Singh","doi":"10.22336/rjo.2025.83","DOIUrl":"https://doi.org/10.22336/rjo.2025.83","url":null,"abstract":"<p><strong>Background: </strong>Proliferative diabetic retinopathy (PDR) remains a significant cause of vision loss worldwide, often requiring pars plana vitrectomy (PPV) for tractional retinal detachment (TRD). The introduction of the 3D Heads-Up Display (HUD) system offers ergonomic and visualization advantages.</p><p><strong>Methods: </strong>This prospective interventional study involved eyes that underwent PPV for TRD. Group A underwent surgery using 3D HUD, while Group B utilised a standard operating microscope (SOM). Outcomes were assessed for surgical time, anatomical success, visual recovery, intraoperative variables, and postoperative complications.</p><p><strong>Results: </strong>The study included 94 eyes from 90 patients (47 eyes per group). Retinal reattachment was achieved in 100% of cases in both groups at 3 months postoperatively. Mean surgical time was significantly shorter in the 3D HUD group (51.50 ± 24.06 minutes) compared to SOM (67.33 ± 31.27 minutes; p = 0.004). Both groups significantly improved visual acuity, with the 3D HUD showing a superior mean LogMAR BCVA improvement at 3 months. Endoillumination levels were markedly lower with the 3D HUD, reducing the risk of phototoxicity. Surgeons reported greater depth perception, manoeuvrability, and teaching utility with the 3D HUD.</p><p><strong>Discussion: </strong>In this study, 3D HUD provided anatomical outcomes comparable to SOM while offering shorter surgical times, lower illumination requirements, and favourable visual recovery. These advantages likely stem from enhanced depth perception and improved ergonomics inherent to the 3D system. Overall, our findings support 3D HUD as a safe and efficient alternative for managing complex TRD cases.</p><p><strong>Conclusions: </strong>The 3D HUD system demonstrated comparable anatomical success, shorter surgical times, enhanced ergonomic benefits, and favourable visual outcomes compared to SOM.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"544-551"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679834","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}