Romanian journal of ophthalmology最新文献

{"title":"Treatment strategies for amblyopia in adults: an overview of conventional methods and new technologies.","authors":"Przemysław Ciszewski","doi":"10.22336/rjo.2025.74","DOIUrl":"10.22336/rjo.2025.74","url":null,"abstract":"<p><strong>Aim: </strong>This review evaluates the efficacy of conventional and emerging therapies for amblyopia in adults, challenging the traditional notion of limited neuroplasticity beyond childhood. The study aims to compare the effectiveness of methods such as perceptual learning, dichoptic training, virtual reality (VR), and pharmacological interventions in improving visual acuity, binocular vision, and perceptual functions.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Google Scholar, Scopus, and Web of Science (1996-2025). Keywords included amblyopia treatment, adult neuroplasticity, dichoptic training, and VR therapy. Inclusion criteria prioritized clinical trials, systematic reviews, and meta-analyses focusing on adult amblyopia. Studies on pediatric populations, animal models, and non-scientific articles were excluded.</p><p><strong>Results: </strong>The reviewed studies indicated that conventional treatments, such as refractive correction and occlusion therapy, offer limited efficacy in adult amblyopia, with modest improvements in visual acuity. In contrast, emerging therapeutic strategies-including dichoptic training, virtual reality-based interventions, neuromodulation techniques, and selected pharmacological agents-demonstrated more substantial and sustained gains in both acuity and binocular function. These modern approaches appear to leverage neuroplasticity more effectively, particularly when combined with engaging, perceptually balanced stimuli and periodic reinforcement.</p><p><strong>Discussion: </strong>The reviewed evidence indicated that although conventional therapies offer limited improvement in adults, modern neuroplasticity-based methods provide more substantial and consistent benefits. Emerging techniques such as perceptual learning, dichoptic stimulation, and VR/AR interventions demonstrate significant gains not only in visual acuity but also in binocular integration. However, heterogeneous study designs and limited long-term data highlight the need for standardized protocols and further clinical validation.</p><p><strong>Conclusions: </strong>Adult amblyopia therapy is feasible due to retained neuroplasticity. Emerging technologies (VR, dichoptic training) and neuromodulation outperform conventional methods, particularly for binocular vision. However, individualized protocols and long-term efficacy studies are needed. Future research should optimize cost-effective, standardized treatments for clinical adoption.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"467-474"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679965","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":"Assessing the Role of Statins as an Adjunctive Anti-VEGF Therapy for Clinically Significant Macular Edema (CSME) in Type 2 Diabetes Mellitus.","authors":"Ashish Markan, Aniruddha Agarwal, Deeksha Katoch, Sanjay Bhadadaxys, Vishali Gupta, Reema Bansal","doi":"10.22336/rjo.2025.80","DOIUrl":"10.22336/rjo.2025.80","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to evaluate the effectiveness of statin therapy as an adjunctive treatment to anti-VEGF therapy in type 2 diabetic patients with non-proliferative diabetic retinopathy (NPDR) and clinically significant macular edema (CSME).</p><p><strong>Materials and methods: </strong>In this prospective, randomized interventional study, patients were randomized into two groups: Group A received low-dose atorvastatin (10-20 mg), and Group B received high-dose atorvastatin (30-40 mg). All participants also received three loading doses of intravitreal ranibizumab (0.5 mg) at monthly intervals, followed by pro re nata treatment over six months. Primary outcomes included the number of anti-VEGF injections required, best-corrected visual acuity (BCVA), and central macular thickness (CMT). Serum VEGF levels were measured at baseline and six months.</p><p><strong>Results: </strong>The mean number of injections over six months was 3.4, with no significant difference between Group A (3.55) and Group B (3.33) (p = 0.24). Group A demonstrated substantial improvement in BCVA at both 3 and 6 months, accompanied by a notable reduction in CMT. In contrast, Group B's BCVA improvement was only significant at 3 months, with less consistent CMT reduction at 6 months. Serum VEGF levels decreased in Group A but increased in Group B, though these changes were not statistically significant.</p><p><strong>Discussion: </strong>The findings suggest that low-dose atorvastatin, when used in conjunction with anti-VEGF therapy, may provide superior functional and anatomical outcomes in patients with CSME compared to high-dose statin therapy. The observed reduction in central macular thickness and improvement in visual acuity indicate a potential adjunctive benefit of statins, likely due to their pleiotropic effects, including anti-inflammatory and anti-angiogenic properties. Although the number of injections required was similar between groups, the better response in the low-dose group highlights the need for further investigation into the dose-dependent effects of statins in the management of diabetic macular edema.</p><p><strong>Conclusions: </strong>Low-dose atorvastatin (10-20 mg) as an adjunct to anti-VEGF therapy resulted in better functional and anatomical outcomes in diabetic patients with CSME compared to high-dose atorvastatin. These findings suggest potential additional benefits of low-dose statins in managing patients with chronic subdural hematoma (CSME).</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"519-527"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular Sarcoidosis: Contemporary Insights and Future Directions.","authors":"Călina-Anda Sandu, Vlad Constantin Donica, Cosmin-Victor Ganea, Mădălina-Ioana Bîlha, Anisia-Iuliana Alexa, Camelia Margareta Bogdănici","doi":"10.22336/rjo.2025.77","DOIUrl":"10.22336/rjo.2025.77","url":null,"abstract":"<p><strong>Background: </strong>Ocular sarcoidosis (OcSar) is a complex manifestation of systemic sarcoidosis that affects more than half of patients. Characterized by non-caseating granulomas, it can involve any ocular structure, from anterior uveitis to optic neuropathy. Its clinical heterogeneity has earned it the nickname \"The Great Chameleon\", as diagnosis often requires integration of ophthalmic, systemic, and laboratory findings.</p><p><strong>Methods: </strong>A targeted literature search was conducted in PubMed for publications from the last five years on OcSar, including clinical studies, systematic reviews, and meta-analyses. Non-English articles, abstracts, and preprints were excluded. Forty-two relevant studies were analyzed to summarize current diagnostic and therapeutic strategies.</p><p><strong>Results: </strong>Diagnosis is guided by the revised International Workshop on Ocular Sarcoidosis (IWOS-2019) and the Standardization of Uveitis Nomenclature (SUN) criteria. High-resolution computed tomography (HRCT) and positron emission tomography with 2-deoxy-2-fluoro-D-glucose (18F-FDG PET/CT) improve systemic assessment, while soluble interleukin-2 receptor (sIL-2R), angiotensin-converting enzyme (ACE), and lymphopenia support diagnostic accuracy. Enhanced depth imaging optical coherence tomography (EDI-OCT) identifies subclinical choroidal inflammation, and molecular markers such as dysregulated micro ribonucleic acids (microRNAs) and fatty acid-related gene signatures offer potential non-invasive diagnostic tools. The Ferning test also provides insight into tear film alterations associated with ocular sarcoidosis. Treatment progresses from corticosteroids to immunosuppressants (methotrexate, mycophenolate) and biologics (adalimumab, infliximab), with pars plana vitrectomy reserved for refractory or complicated cases.</p><p><strong>Discussion: </strong>The evolving understanding of ocular sarcoidosis shows that conventional clinical evaluation alone is insufficient to capture the full spectrum of disease activity. Integrating structural imaging with tear-film analysis and molecular profiling not only enhances diagnostic confidence but also reveals previously underrecognized pathways of inflammation. These insights highlight the systemic nature of the disease and underscore the need to reassess monitoring strategies and therapeutic sequencing in light of emerging evidence.</p><p><strong>Conclusion: </strong>Ocular sarcoidosis remains a diagnostic and therapeutic challenge due to its variability and risk of irreversible vision loss. Combining advanced imaging, molecular biomarkers, and targeted biologic therapies enables precision-based management, improving visual outcomes and patient quality of life.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"488-494"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679597","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":"Study of Correlation of Severity of Diabetic Retinopathy with Corneal Thickness and Endothelial Parameter Changes in Diabetic Patients.","authors":"Simran Dhami, Avadhesh Oli","doi":"10.22336/rjo.2025.87","DOIUrl":"10.22336/rjo.2025.87","url":null,"abstract":"<p><strong>Background and objective: </strong>Corneal endothelium plays an essential role in maintaining corneal transparency and hydration. Conditions or events causing endothelial cell loss beyond the threshold value can lead to loss of corneal transparency. Our study aimed to assess the effects of duration of Type 2 Diabetes Mellitus and diabetic retinopathy (DR) severity on the corneal endothelium using non-contact specular microscopy.</p><p><strong>Materials and methods: </strong>A prospective study was conducted on 200 eyes of diabetic patients and their age-matched controls. On their first visit, a detailed history including diabetic status, duration of diabetes, and previous eye surgeries was taken. A comprehensive ophthalmic evaluation was done. Corneal endothelial parameters like Central Corneal Thickness (CCT), Endothelial Cell Density (ECD), Coefficient of Variation (CV), and hexagonality were obtained using a non-contact Specular microscope. Data was tabulated and analysed using appropriate statistical tests, and a \"p\" value of less than 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Endothelial cell hexagonality and duration of diabetes were found to be significantly correlated (p value of 0.001 using an independent t-test), indicating that a longer duration of diabetes causes morphological changes in the corneal endothelium. Other parameters, such as CCT, CV, and ECD, did not correlate significantly with HbA1c levels, diabetes duration, or DR severity.</p><p><strong>Discussion: </strong>In our study, we evaluated all endothelial parameters and correlated them with the duration of DM (<10 yrs and >10 yrs). Average ECD, CV, and HEX in the two subgroups were 2494.3 ± 405.2 cells/mm² and 2473.1 ± 321.1 cells/mm², 39.1 ± 4.8% and 37.8 ± 4.6%, and 45.6 ± 6.5% and 43 ± 6%, respectively. A significant positive correlation (p value of 0.00) was found between the duration of DM and HEX; however, no significant correlation was found between the duration of DM and ECD (p value of 0.774) and CV (p value of 0.154). Decreased HEX with increasing DM duration suggested that, over time, diabetes induces morphological changes that may eventually compromise endothelial health.</p><p><strong>Interpretation and conclusion: </strong>Our findings indicate that corneal endothelial cells undergo morphological changes with increasing duration of Diabetes. The findings of this study add to the literature on the effects of Diabetes on endothelial health, which might help improve the management of these patients. Future longitudinal studies with larger, diverse cohorts are recommended to validate these associations and explore therapeutic interventions to preserve corneal health in diabetes.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"567-574"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679865","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":"Exploring the Association Between Lipid-Lowering Medications and Dry Eye Disease in COVID-19 Patients.","authors":"Konstantin Yaakov Gushansky, Pinja Sutinen, Sohee Jeon, Raimo Tuuminen","doi":"10.22336/rjo.2025.82","DOIUrl":"10.22336/rjo.2025.82","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the associations between systemic lipid-lowering medications and dry eye disease (DED) in patients hospitalized for SARS-CoV-2.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed electronic medical records of SARS-CoV-2 patients hospitalized at Shaare Zedek Medical Center from April 1, 2020, to December 31, 2024. Adults without a previous DED diagnosis who had an ophthalmologic examination confirming no DED within the year preceding hospitalization were included. Exclusions included ICU admissions, specific systemic conditions, ocular surgeries, and systemic medications known to induce DED. Patients were categorized into those who developed DED within six months post-hospitalization and those who did not.</p><p><strong>Results: </strong>Among the 1,165 patients, 167 (14.3%) developed DED post-hospitalization. After adjusting for age, gender, and SARS-CoV-2 vaccination status, an inverse association between statins and dry eye disease was evident. Treatment with any statin was associated with reduced odds of developing dry eye disease (OR 0.289, p<0.001), particularly with atorvastatin (OR 0.374, p<0.001) and simvastatin (OR 0.297, p<0.001).</p><p><strong>Discussion: </strong>The inverse association observed in this study supports a potential protective effect of statins, consistent with their known anti-inflammatory properties and their ability to reduce cholesterol-driven Meibomian gland dysfunction.</p><p><strong>Conclusion: </strong>Statin use is inversely associated with the development of DED in SARS-CoV-2 hospitalized patients. The anti-inflammatory and cholesterol-lowering effects of statins provide a robust framework for understanding the underlying pathophysiological mechanisms.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"536-543"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13074829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694489","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":"The importance of optical coherence tomographic sectioning in a case with unilateral subtle visual disturbance related to a vertical intraretinal hyperreflective line.","authors":"Özlem Özkan, Ziya Ayhan, Ali Osman Saatci","doi":"10.22336/rjo.2025.88","DOIUrl":"10.22336/rjo.2025.88","url":null,"abstract":"<p><p>A 60-year-old otherwise healthy man presented with the complaint of missing letters while reading with his right eye. Best-corrected visual acuity (BCVA) was 10/10 in both eyes. Slit-lamp examination was unremarkable, and the intraocular pressure was within normal range bilaterally. Multimodal imaging was performed, and spectral domain and swept source optical coherence tomography (OCT) revealed a foveolar vertically oriented intraretinal hyperreflective line (IHL) in the right eye. Microperimetric examination revealed a lower fixation stability and macular integrity in the right eye compared to the left. The patient recalled an episode of a severe blow to his head a few years before. The intraretinal hyperreflective line is an optical coherence tomographic finding that is often detectable only with careful tomographic sectioning. The present case underscores the importance of careful OCT sectioning and multimodal imaging to elucidate the cause of even subtle visual disturbances.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"575-579"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679936","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":"The Eye-Heart Connection: Exploring the unique ocular features in tetralogy of Fallot.","authors":"Airy Megha, Singh Kumar Basant, Singh Kumar Vinod, Kumar Santosh, Srivastava Anamika, Rawat Ayusha","doi":"10.22336/rjo.2025.91","DOIUrl":"10.22336/rjo.2025.91","url":null,"abstract":"<p><p>This is a case report of an 18-year-old male who presented with a 7-year history of diminished vision in the right eye. Ophthalmological examination revealed light perception with accurate projection of rays in both eyes, broken posterior synechiae, and a membranous calcified cataract in the right eye. The left eye showed grade 2+ aqueous cells and proliferative vitreoretinopathy (PVR). A general examination revealed cyanosis, hypertrophic osteoarthropathy, and growth retardation. Echocardiography confirmed Tetralogy of Fallot (TOF). Blood tests showed elevated haemoglobin and RBC count. The patient was planned for cataract surgery with PMMA (polymethyl methacrylate) lens implantation and intravitreal triamcinolone acetate injection.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"592-594"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679860","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":"Bilateral neurotrophic keratitis associated with Gilteritinib therapy in a patient with acute myeloid leukemia: a case report.","authors":"Mihai-Luca Cioboată, Suher Abduraman, Bogdana Maliș, Radu Burcea, Miruna Cioboată","doi":"10.22336/rjo.2025.95","DOIUrl":"10.22336/rjo.2025.95","url":null,"abstract":"<p><strong>Introduction: </strong>We report the first documented case of bilateral neurotrophic keratitis potentially associated with Gilteritinib therapy.</p><p><strong>Case presentation: </strong>A 52-year-old male patient presented with bilateral blurred vision and photophobia due to neurotrophic keratitis, which developed after two years of treatment with Gilteritinib - a second-generation tyrosine kinase inhibitor (TKI) used for relapsed or refractory acute myeloid leukemia (AML) with a confirmed FMS-like tyrosine kinase 3 (FLT3) mutation. His best-corrected visual acuity (BCVA) was 20/100 in the right eye and 20/40 in the left eye. Biomicroscopic examination revealed persistent epithelial defects, reduced corneal sensitivity, and no tear-film abnormalities or eyelid pathology. Gilteritinib was discontinued in consultation with the hematology team, and topical insulin with preservative-free lubricants was initiated. Within one week, the epithelial defects had healed, and at one month, visual acuity had improved to 20/20 in the left eye and 20/32 in the right eye, with residual central leukoma.</p><p><strong>Discussion: </strong>Neurotrophic keratitis is a rare corneal disorder caused by impaired innervation and defective epithelial healing. After exclusion of all known etiologies, prolonged Gilteritinib therapy was considered the most likely cause in our patient, possibly due to off-target effects on pathways involved in corneal nerve and epithelial homeostasis. Treatment with artificial tears and topical insulin led to favorable epithelial healing, underscoring the need for awareness of potential ocular surface toxicity with newer tyrosine kinase inhibitors.</p><p><strong>Conclusion: </strong>This case highlights potential ocular neurotoxicity associated with Gilteritinib, a targeted therapy not previously linked to corneal nerve dysfunction. Increased clinical awareness is recommended for ophthalmologists and hematologists managing patients with FLT3-mutated AML who are receiving targeted therapies.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"611-615"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679837","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":"The Evolution of Vision Therapy Software and Its Impact on Vision Care - A Comprehensive Major Review.","authors":"Inbarasi Nagendran, Lipika Roy, Pavitra Ravikumar, Prasanth Gireesh, Kirandeep Kaur, Bharat Gurnani","doi":"10.22336/rjo.2025.78","DOIUrl":"10.22336/rjo.2025.78","url":null,"abstract":"<p><p>The integration of vision therapy software (VTS) has brought about a paradigm shift in the treatment of various visual disorders, enhancing patient engagement, therapy effectiveness, and accessibility. The advent of VTS has revolutionized the management of binocular vision disorders, amblyopia, convergence insufficiency, and post-traumatic visual dysfunctions, providing a technologically advanced, accessible, and engaging alternative to traditional in-office therapy. VTS leverages artificial intelligence (AI), virtual reality (VR), augmented reality (AR), and wearable technologies to create interactive, adaptive, and personalized training environments that enhance neuroplasticity and visual rehabilitation. This review explores the evolution, mechanisms, and clinical applications of VTS, emphasizing its role in improving visual acuity, binocular coordination, vergence, and accommodative functions. Evidence from meta-analyses, clinical trials, and case studies supports its effectiveness, with notable benefits in patient adherence, treatment flexibility, and cost reduction. Additionally, telemedicine integration and remote monitoring have expanded access to vision therapy, particularly in underserved and remote populations. Despite its advantages, challenges remain, including the need for professional supervision, variability in patient response, lack of standardization, and data privacy concerns. Furthermore, long-term comparative studies are necessary to validate its efficacy against traditional vision therapy methods. Emerging AI-driven personalization, immersive VR/AR environments, and real-time biofeedback mechanisms are expected to enhance VTS, making it a crucial component of modern vision rehabilitation. As digital therapeutics continue to evolve, a hybrid model combining VTS with clinician-guided therapy appears to be the most effective approach. This paradigm shift underscores VTS's future potential to redefine vision care and bridge the gap between clinical expertise and innovative digital health solutions.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"495-511"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679896","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":"Allergic Rhinitis and Ocular Allergy: A Correlative Study of Serum IgE, Tear Histamine, and Peripheral Eosinophils.","authors":"Akash Chaudhary, Jung Bahadur Singh, Deependra Kumar Sinha, Ankita Singh, Ajit Kumar Singh, Ikjot Singh, Niloy Pathak","doi":"10.22336/rjo.2025.85","DOIUrl":"10.22336/rjo.2025.85","url":null,"abstract":"<p><strong>Background: </strong>Ocular allergies (OA) and allergic rhinitis (AR) commonly coexist, exacerbating patient symptoms and lowering quality of life. Dual diagnosis is still neglected despite this overlap.</p><p><strong>Objective: </strong>Assess peripheral eosinophil counts, tear histamine levels, and serum immunoglobulin E (IgE) in AR patients with and without ocular allergies, and correlate these with the intensity of visual symptoms.</p><p><strong>Methods: </strong>200 patients from a tertiary hospital were recruited for this prospective study: 100 with AR alone and 100 with AR+OA. Venous blood was used to measure eosinophils and serum IgE. Schirmer strips were used to measure tear histamine. A visual analogue scale (VAS) was used to score visual symptoms.</p><p><strong>Results: </strong>Patients with both AR and OA had significantly elevated serum IgE (230 ± 58 IU/mL), tear histamine (15.4 ± 4.2 ng/mL), and eosinophils (7.8 ± 2.1%) compared to AR-only patients (p<0.001). VAS scores were higher in the AR+OA group (7.1 ± 1.6 vs. 1.3 ± 0.6).</p><p><strong>Discussion: </strong>The findings demonstrate that combined AR and OA represent a more severe allergic phenotype, characterized by heightened systemic and local allergic responses. Elevated tear histamine strongly correlated with symptom severity, supporting its use as a practical, non-invasive marker of ocular involvement. The clear biomarker differences between groups highlight the need for routine ocular evaluation in AR patients to avoid underdiagnosis and to guide targeted therapy.</p><p><strong>Conclusion: </strong>Serum IgE, tear histamine, and eosinophils are elevated in AR+OA patients and may be used for screening, diagnosis, and monitoring of coexisting ocular allergy.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"69 4","pages":"557-561"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679819","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}