Romanian journal of ophthalmology最新文献

{"title":"MOGAD-Associated Recurrent Optic Neuritis Unresponsive to Corticosteroids: Clinical, Visual Field, and OCT Correlation.","authors":"Cansu Kostakoğlu Duman, Büşra Gülhan, Yelda Yıldız Taşçı, Gönül Vural","doi":"10.22336/rjo.2026.21","DOIUrl":"10.22336/rjo.2026.21","url":null,"abstract":"<p><strong>Background: </strong>Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare autoimmune demyelinating disorder. In adults, optic neuritis is the most common initial manifestation.</p><p><strong>Case presentation: </strong>We report the case of a 23-year-old woman presenting with right eye vision loss and severe optic disc edema. The condition was unresponsive to intravenous corticosteroids. Plasmapheresis led to marked improvement. Two months later, a second episode occurred in the left eye, despite ongoing steroid therapy.</p><p><strong>Investigations: </strong>Initial brain and orbital MRI were normal. Optical coherence tomography (OCT) showed increased RNFL thickness in the acute phase and progressive thinning during follow-up. Anti-MOG antibodies were detected at a 1:100 titer in serum, confirming the diagnosis.</p><p><strong>Treatment and outcome: </strong>The patient was treated with plasmapheresis, oral steroids, and azathioprine during the first attack. After the second relapse, rituximab was initiated. The patient achieved visual recovery and has remained relapse-free for two years.</p><p><strong>Conclusion: </strong>Corticosteroid-unresponsive recurrent optic neuritis should prompt evaluation for MOGAD, especially in the presence of bilateral involvement and optic disc edema. OCT is valuable for monitoring disease activity and structural damage.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 1","pages":"158-165"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966357","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 Network Biology Framework for Exploring Molecular Mechanisms in Cystoid Macular Edema.","authors":"Mehrdad Motamed Shariati","doi":"10.22336/rjo.2026.09","DOIUrl":"10.22336/rjo.2026.09","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the molecular mechanisms underlying cystoid macular edema (CME) through protein-protein interaction (PPI) network analysis, identifying key regulatory proteins, functional modules, and enriched biological pathways relevant to its pathogenesis.</p><p><strong>Methods: </strong>A curated list of 18 CME-associated human proteins was compiled through a literature review, including inflammatory cytokines, angiogenic factors, and regulators of vascular permeability. High-confidence PPI data were obtained from the STRING database (confidence score ≥ 0.700) and visualized as an undirected graph using NetworkX in Python. Centrality metrics (degree, betweenness, closeness, eigenvector), Louvain modularity analysis, and functional enrichment (GO: BP, KEGG, Reactome) were performed using GSEAPY and Enrichr to identify topologically and biologically important nodes and clusters.</p><p><strong>Results: </strong>The final network consisted of 91 nodes and 217 edges, with a graph density of 0.0505 and an average clustering coefficient of 0.0554. ANGPT2, FLT1, KDR, TNF, and VEGFA appeared as central hub proteins across multiple centrality measures. Louvain clustering identified eight distinct functional communities, including inflammatory mediators, angiogenic signaling components, and tight junction regulators. Enrichment analyses showed significant involvement of cytokine-mediated signaling, endothelial cell migration, the AGE-RAGE pathway, TNF signaling, and interleukin-4/10/13 signaling, highlighting the dual roles of angiogenesis and inflammation in CME.</p><p><strong>Discussion: </strong>The findings of this study highlight the intricate network of molecular mechanisms underlying cystoid macular edema (CME), with particular emphasis on angiogenesis, inflammation, and vascular permeability. The identification of key regulatory proteins such as ANGPT2, FLT1, and TNF underscores the complexity of CME pathogenesis, which involves both vascular and inflammatory pathways.</p><p><strong>Conclusions: </strong>CME is driven by a complex, modular molecular network involving inflammation, vascular remodeling, and cytokine signaling. ANGPT2, FLT1, TNF, and IL6 are key regulatory proteins and potential therapeutic targets. This systems biology approach offers a comprehensive framework for discovering new insights and guiding personalized treatment strategies in CME.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 1","pages":"62-70"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966307","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":"Ophthalmic manifestations at high altitude: A comprehensive study of anterior segment conditions.","authors":"Anchal Tripathi, Mohini Agarwal, Atul Bhirud, Avinash Mishra, Vinod Baranwal, Debashish Mukherjee","doi":"10.22336/rjo.2026.08","DOIUrl":"10.22336/rjo.2026.08","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to comprehensively analyze ophthalmic manifestations in individuals from low-altitude (< 2,400 meters above sea level) areas who are exposed to high-altitude (HA) environments (3,500 meters above sea level), with a focus on anterior segment conditions and cranial nerve pathologies.</p><p><strong>Methods: </strong>We conducted a prospective observational study of individuals at HA locations who presented with ocular complaints. Outcome parameters included age, gender, duration of exposure to HA, altitude of the location, duration of symptomatology, best corrected visual acuity (BCVA) at presentation, final BCVA post resolution, diagnosis based on signs and symptoms, treatment undertaken, time elapsed for resolution/hospital stay, associated laboratory findings, recurrences (if any), and need for de-induction/descent.</p><p><strong>Results: </strong>Of the 2,043 patients who visited the eye outpatient department with ocular complaints, we included 130 lowlanders, with a mean age of 25.67 ± 5.14 years. The mean altitude was 3,560 meters above sea level. The mean duration of stay at HA ranged from 10 weeks to 21 weeks. The anterior segment manifestations that were observed included acute anterior uveitis (AAU) (n=12), Herpes Simplex Virus (HSV) Keratitis (n=30), HSV Keratitis with Iridocyclitis (n=4), Photokeratitis (n=30), Herpes Zoster Ophthalmicus (HZO) (n=10), facial nerve palsy with or without exposure keratopathy (n=24), non-resolving/chronic inflammatory conjunctivitis (n=20). Most cases responded well to treatment. However, 50% of AAU cases, 25% of HSV keratitis cases, 20% of HZO cases, and 33.33% of facial nerve palsy cases recurred within one year and therefore had to be de-inducted to a lower sea level.</p><p><strong>Discussion: </strong>Delayed resolution was attributed to hypoxia-induced immune dysregulation, increased ultraviolet exposure, and frequent misdiagnosis of red eye at peripheral healthcare settings. High altitude appeared to exacerbate inflammatory and infectious ocular conditions and to precipitate sight-threatening posterior segment pathology.</p><p><strong>Conclusion: </strong>This study provided a comprehensive understanding of ophthalmic challenges faced in HA environments. Awareness of these possible manifestations, along with accurate, timely diagnosis and, if necessary, referral to a specialist, is crucial to ensure optimal ocular health for individuals stationed at high altitudes.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 1","pages":"55-61"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966433","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":"Retinal Detachment in the eye of Albino - A review.","authors":"Abdullah Al Marshood","doi":"10.22336/rjo.2026.05","DOIUrl":"10.22336/rjo.2026.05","url":null,"abstract":"<p><p>Ocular manifestations in oculocutaneous albinism (OCA), a hereditary condition, are well documented. Retinal detachment in individuals with OCA is uncommon and poses challenges for retina specialists in terms of diagnosis and management. We reviewed the literature on the presentation and management of retinal detachment (RD) in oculocutaneous albinism (OCA). Identifying retinal breaks in the absence of retinal and choroidal pigments can be challenging. Chorioretinal sealing around retinal holes and breaks achieved through photocoagulation and/or diathermy is less effective compared to that achieved by cryopexy. Intraocular tamponade may also need to remain in the eye for an extended duration, and its side effects may affect the functions of the viable retina. The presence of macular hypoplasia and significant visual function impairment in OCA complicates the evaluation of the functional success of retinal detachment surgeries. More research, both in vivo and in vitro, is needed to identify effective management strategies, including low-vision rehabilitation and monitoring protocols, and to assess the impact of interventions for retinal detachment in OCA.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 1","pages":"35-41"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966352","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":"Managing Cataract in a Myopic Eye with Iridocorneal Endothelial Syndrome and Horizontal Nystagmus: a Rare Clinical Association.","authors":"Paul-Gabriel Borodi, Iulia-Maria Gavriș, Al Masri Malaz, Maria-Monica Gavriș","doi":"10.22336/rjo.2026.25","DOIUrl":"10.22336/rjo.2026.25","url":null,"abstract":"<p><strong>Objectives: </strong>To report a rare clinical association of iridocorneal endothelial (ICE) syndrome with high myopia, horizontal nystagmus, and cataract, and to highlight the preoperative and intraoperative considerations required to achieve successful cataract surgery in such complex cases.</p><p><strong>Case report: </strong>A 41-year-old female presented with progressive visual deterioration. Examination revealed horizontal nystagmus, narrow palpebral fissures, corneal opacities, iris atrophic changes with superotemporal corectopia, and significant cortico-nuclear lens opacities. Best-corrected visual acuity was 1/50 in the right eye and 2/50 in the left eye, with intraocular pressures within normal limits. The patient underwent phacoemulsification with a foldable hydrophobic acrylic IOL implanted in the capsular bag. Retrobulbar anesthesia stabilized the globe; four iris retractors were used for inadequate pupillary dilation, and trypan blue facilitated capsulorhexis. The soft-shell technique and reduced phacoemulsification parameters were employed to protect the corneal endothelium. No intraoperative complications occurred. At one month postoperatively, BCVA was 2/50 with stable refraction (-2.75 D) and no corneal decompensation.</p><p><strong>Discussion: </strong>ICE syndrome complicates cataract surgery due to endothelial compromise, iris abnormalities, and the risk of intraoperative complications. Individualized surgical strategies, including globe stabilization, pupil expansion, careful endothelial protection, and modified phacoemulsification parameters, were critical to achieving a favorable outcome.</p><p><strong>Conclusion: </strong>Cataract surgery in patients with ICE syndrome complicated by high myopia and horizontal nystagmus is feasible with meticulous preoperative assessment and tailored intraoperative techniques. Favorable visual outcomes can be achieved, but long-term follow-up is essential to monitor for progressive glaucoma and corneal decompensation.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 1","pages":"184-187"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966426","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":"Fat Infiltration in Eyelids: An Uncommon Clinical Case with Long-Term Monitoring.","authors":"Maria Amparo Mora Villate, Jhon Alexander Cortes Tribaldos","doi":"10.22336/rjo.2026.20","DOIUrl":"10.22336/rjo.2026.20","url":null,"abstract":"<p><strong>Objective: </strong>To describe a rare case of fatty tissue infiltration in the eyelids, leading to enophthalmos, and its successful surgical management with long-term follow-up.</p><p><strong>Methods: </strong>We present the case of a 32-year-old woman with a three-year history of progressive, painless swelling of the right upper and lower eyelids. Clinical and radiologic evaluation included physical examination and magnetic resonance imaging (MRI). Histopathological analysis confirmed the diagnosis. Surgical resection was performed, and the patient was followed for over 24 months.</p><p><strong>Results: </strong>Examination revealed increased soft tissue volume in the right eyelids, narrowing of the palpebral fissure, and subtle hyperpigmentation. MRI showed fatty infiltration of the eyelids and reduced intraconal orbital fat, resulting in right-sided enophthalmos. No systemic, autoimmune, or infectious causes were identified. Histopathology confirmed fatty tissue infiltration and excluded neoplastic processes. Surgical excision of the abnormal tissue via upper and lower eyelid blepharoplasty was performed. At 14-month follow-up, the patient showed no signs of recurrence and was satisfied with the functional and cosmetic outcome, although enophthalmos persisted.</p><p><strong>Discussion: </strong>No instances of fatty tissue infiltration in the eyelid were discovered despite a thorough search for comparable cases in the literature. A few examples of lipomas affecting just one eyelid have been documented. But unlike a lipoma, this fat infiltration lacks fibrous septa and is poorly confined.</p><p><strong>Conclusions: </strong>Fatty infiltration of the eyelids is an exceptionally rare presentation, especially when accompanied by intraconal fat loss and enophthalmos. This case highlights the importance of thorough imaging and histological analysis in atypical eyelid swelling. Surgical resection may offer a definitive and lasting solution. To our knowledge, this is the first reported case of its kind.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 1","pages":"154-157"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966381","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":"Recalcitrant sterile keratolysis of corneal graft associated with systemic flare-up of rheumatoid arthritis: A case report and review of literature.","authors":"Manasi Tripathi, Shraddha Sneha, Manpreet Kaur, Ashish Markan","doi":"10.22336/rjo.2026.02","DOIUrl":"10.22336/rjo.2026.02","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To report a rare case of recalcitrant sterile corneal graft melt following routine optical penetrating keratoplasty in a patient with rheumatoid arthritis (RA), and to highlight the role of systemic disease exacerbation and tumor necrosis factor-alpha (TNF-α) inhibition in stabilizing the condition.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 54-year-old female with well-controlled RA underwent an optical triple procedure for a visually significant central adherent leukoma. Postoperative follow-up revealed recurrent sterile keratolysis of the donor cornea coinciding with systemic flare-ups of RA. A standard microbiological and serological workup was performed to rule out infectious and other systemic causes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Despite appropriate topical and systemic therapy, including corticosteroids and re-suturing with amniotic membrane transplant, the corneal melt persisted and recurred. All infectious causes were ruled out. A significant rise in inflammatory markers correlated with systemic RA activity. Initiation of adalimumab led to stabilization of the corneal melt within two weeks, along with marked improvement in systemic symptoms. At 6 months, the graft remained opaque but tectonically stable, and the globe's structural integrity was preserved. No recurrence was noted at 18-month follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Sterile corneal melt has been described in association with surgical interventions, drug toxicity, and systemic autoimmune diseases, particularly rheumatoid arthritis (RA), where dysregulated inflammatory pathways lead to keratolysis, typically presenting as peripheral ulcerative keratitis. In contrast, our case is unique in that keratolysis was confined predominantly to the donor corneal graft and graft-host junction following an otherwise uneventful optical penetrating keratoplasty. Infectious causes, NSAID toxicity, dry eye disease, and Sjögren syndrome were excluded. At the same time, the selective involvement of the donor tissue, negative microbiology, and elevated rheumatoid factor and inflammatory markers supported an immune-mediated graft melt related to rheumatic eye disease. Unlike in previously reported cases after lamellar or endothelial keratoplasty, in which melts originated in the host cornea or were associated with epithelial healing defects or Sjögren syndrome, our patient had complete initial graft epithelialization and normal ocular surface parameters. The temporal association of graft melt with a systemic RA flare, high RA factor titers, and involvement of the graft-host junction suggests a strong link between systemic inflammatory activity and graft survival. This case highlights a rare presentation of autoimmune-mediated sterile graft melt after routine penetrating keratoplasty. It underscores the importance of recognizing systemic disease activity as a critical factor in postoperative corneal outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This case highlights the","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 1","pages":"2-8"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966393","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":"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":"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":"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":"Patient factors in determining the urgency of cataract referral.","authors":"Kah Long Aw, Sirindhra Suepiantham, Ashraf Khan","doi":"10.22336/rjo.2025.84","DOIUrl":"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}