AJO International最新文献

{"title":"Retinal detachment risk in a cohort of von hippel-lindau patients at a Major U.S. tertiary care facility","authors":"Konstantinos G. Baroutis,&nbsp;Gustavo Sakuno,&nbsp;Sandra Hoyek,&nbsp;Nimesh A. Patel,&nbsp;Joan W. Miller,&nbsp;Demetrios G. Vavvas","doi":"10.1016/j.ajoint.2025.100183","DOIUrl":"10.1016/j.ajoint.2025.100183","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the retinal findings, cumulative incidence of retinal capillary hemangioblastoma (RCH), retinal detachment (RD) outcomes, and risk factors in a large cohort of von Hippel-Lindau (VHL) patients within a major U.S. Tertiary Care Facility.</div></div><div><h3>Design</h3><div>A retrospective cohort study was conducted between January 2005 and August 2024.</div></div><div><h3>Methods</h3><div>VHL patients were identified from Mass General Brigham’s Research Patient Data Repository. Manual chart review confirmed those with ophthalmologic examinations. A nested 1:2 matched case-control study compared RD cases with controls (VHL patients with RCH but without RD). Kaplan-Meier analysis estimated cumulative RCH incidence, and conditional logistic regression identified RD risk factors. Patients without RCH were censored at the last follow-up.</div></div><div><h3>Results</h3><div>Among 159 VHL patients, 104 had comprehensive eye examinations with a median follow-up of 7 years [IQR, 2–11]; 95% attended at least one follow-up appointment. The incidence rate of RCH was 2.3 per 100 person-years, calculated from person-time starting at birth and ending at age of first RCH diagnosis (for cases) or last follow-up visit (for non-cases). Eighteen eyes (14 patients, 13% of the cohort; 95% CI, 8%-22%) developed RD, predominantly combined rhegmatogenous/tractional (94%), with 29% bilateral involvement. Notably, no patient without an RCH developed an RD in our cohort. A case-control study found that each additional prior focal treatment significantly lowered the risk of RD (OR = 0.15, 95% CI 0.03–0.63; p = 0.01), while the presence of renal cell carcinoma and pancreatic cysts were associated with increased risk, possibly indicating more advanced systemic disease. All RD cases exhibited proliferative vitreoretinopathy (PVR; Grade C: 89%, Grade B: 11%) at the time of diagnosis. Overall, 12 of 16 eyes (75%) achieved reattachment, 11 of which (69%) required multiple surgeries (median, 2 [IQR, 1–3]), but visual outcomes remained poor (median final logMAR BCVA, 2.3 [IQR, 0.55–2.7], counting fingers).</div></div><div><h3>Conclusions</h3><div>VHL patients face a high lifetime risk of RCH and associated RD. PVR frequently complicates the surgical treatment of RD and yields limited visual recovery, underscoring the need for proactive surveillance and timely therapeutic intervention. The universal presence of PVR in these RD eyes is a novel finding that warrants investigation into a possible, though currently speculative, molecular link to pVHL dysregulation.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145320533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of ocular pathology among homeless and housed adults visiting a safety-net hospital","authors":"Hongan Chen ,&nbsp;Jintong Liu ,&nbsp;Jennifer L Patnaik ,&nbsp;Cristos Ifantides","doi":"10.1016/j.ajoint.2025.100182","DOIUrl":"10.1016/j.ajoint.2025.100182","url":null,"abstract":"<div><h3>Purpose</h3><div>People experiencing homelessness have a higher risk for chronic illness and mortality compared to the general population. Furthermore, visual impairment is an independent risk-factor for mortality. We sought to characterize the prevalence of ophthalmic conditions and visual impairment among homeless individuals.</div></div><div><h3>Methods</h3><div>A retrospective chart review between January 1, 2018, to February 9, 2022 conducted at Denver Health and Hospital Authority in Denver, CO, USA. Adults 18 years of age or older identified as homeless in the electronic medical record system and randomly selected controls among all eye clinic patients seen during the same period were included for analysis. Visual acuity was recorded as best-corrected or pinhole occluder visual acuity when available, or otherwise presenting visual acuity (with or without correction).</div></div><div><h3>Results</h3><div>A total of 718 homeless and 240 control patients were identified within the specified time frame. Compared to the housed controls, homeless patients had a higher prevalence of trauma-related injuries (25.2% versus 2.7%, p&lt;0.001) and worse best-reported visual acuities. The most common ocular diagnoses among the homeless cohort were refractive error (43.5%), trauma-related injury (25.2%), and cataract (24.2%).</div></div><div><h3>Conclusions</h3><div>To our knowledge, this is the largest clinic-based retrospective cohort study of ocular pathology among individuals experiencing homelessness. Our study reinforces the importance of providing access to ophthalmic care to the homeless population while highlighting specific priorities distinct from the general patient population, namely management of higher rates of ocular trauma.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100182"},"PeriodicalIF":0.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior capsule rupture as a performance indicator in resident cataract surgery: An eight-year audit","authors":"Fatma F Shakarchi ,&nbsp;Sam Karimaghaei ,&nbsp;Jamal Azhari ,&nbsp;Alex Kilgore ,&nbsp;Ahmed F Shakarchi ,&nbsp;Andrew Melson ,&nbsp;Paul H. Phillips ,&nbsp;Ahmed B. Sallam","doi":"10.1016/j.ajoint.2025.100181","DOIUrl":"10.1016/j.ajoint.2025.100181","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze intraoperative rates of posterior capsule rupture (PCR) and postoperative visual and refractive outcomes in resident-performed cataract surgeries.</div></div><div><h3>Design</h3><div>Prospective continuous audit.</div></div><div><h3>Methods</h3><div>We performed a continuous prospective audit for all residents’ cataract surgeries from July 2017 to January 2025. We grouped residents into senior trainees, in their final postgraduate year (PGY-4) of ophthalmology residency, and junior trainees, in PGY-2 and PGY-3. We used a funnel plot to visualize the variations in PCR rates across and within grades. The primary outcome measure was PCR rate, and the other outcomes were best corrected visual acuity (BCVA) and deviation from refractive target (±1.0 diopter).</div></div><div><h3>Results</h3><div>Our study included 3985 cataract surgeries performed by 23 residents. Senior residents (PGY-4) performed 3186 (80%) of these surgeries. Resident-performed cataract surgeries had an overall PCR rate of 3.5%, with significantly higher rates among junior compared to senior trainees (6.5% vs 2.7%; RR=0.42, P &lt; 0.001) and greater inter-surgeon variability early in training and below the 100 surgeries mark. In multivariable analysis, senior residents remained significantly less likely to have PCR (adjusted RR = 0.38, 95% CI: 0.27–0.53), while complex cases were independently associated with a four-fold higher risk (adjusted RR = 4.15, 95% CI: 2.98–5.73). Most patients (91.7%) achieved a BCVA of 20/40 or better, and 91.4% achieved a refraction within ±1D of the refractive target.</div></div><div><h3>Conclusion</h3><div>Cataract surgeries performed by residents have an acceptable PCR rate and excellent BCVA and refractive outcomes. Appropriate outcome tracking is essential for resident surgical development, and a continuous audit of surgical logbooks can help bridge the gap created by unstructured reporting of surgical complications.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100181"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of a 13-year war on the reality of ophthalmology services and education in Syria","authors":"Oase Sbei ,&nbsp;Waleed Kojan ,&nbsp;Ibrahim Abboud ,&nbsp;Lana Kuziez ,&nbsp;Asad Loya ,&nbsp;Ahmed Amer Zanabli ,&nbsp;Fares Alahdab ,&nbsp;Ahmad Al-Moujahed","doi":"10.1016/j.ajoint.2025.100180","DOIUrl":"10.1016/j.ajoint.2025.100180","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the impact of the Syrian conflict on ophthalmology services, residency training, and clinical infrastructure, and to identify areas requiring urgent reform in the post-conflict healthcare reconstruction period.</div></div><div><h3>Design</h3><div>A mixed-methods study combining a comprehensive scoping review with two national cross-sectional surveys of ophthalmology residents and public ophthalmology hospitals across Syria.</div></div><div><h3>Methods</h3><div>A scoping review of English-language ophthalmology-related literature concerning Syria (1979–2025) was conducted using five major databases and grey literature. Two structured surveys were administered: one targeting ophthalmology residents to assess training quality and educational structure, and another targeting public hospitals to evaluate equipment, service delivery, and patient volume. Descriptive statistics and thematic analysis were used to analyze survey data.</div></div><div><h3>Results</h3><div>The scoping review included 49 studies categorized into five themes: war-related ocular trauma, disease prevalence, refugee eye health, ophthalmology education, and public awareness. The residency survey (<em>n</em> = 135) revealed that 63.5 % of respondents lacked structured curricula, 67.2 % reported no surgical case tracking, and 91.9 % reported absence of formal evaluation rubrics. The facility-based survey received responses from 4 of 13 hospitals, revealing critical equipment shortages, high patient loads, and unequal access to subspecialty and surgical services. The survey revealed significant shortages of functional ophthalmic equipment, including slit lamps, fundus cameras, perimeters, OCT machines, keratometers, tonometers, and YAG lasers. Many hospitals reported outdated or non-functional devices, with essential diagnostic and surgical tools either unavailable or in critical need of repair.</div></div><div><h3>Conclusion</h3><div>Ophthalmology services and education in Syria have been severely affected by conflict-related damage, infrastructure collapse, and displacement. This study underscores the urgent need for national reconstruction efforts focused on standardizing residency curricula, upgrading hospital infrastructure, and ensuring equitable access to advanced ophthalmic care. International partnerships, targeted investments, and sustainable reform strategies will be critical in rebuilding Syria’s ophthalmic healthcare and education system.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100180"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145320530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammation and increased intraocular pressure associated with intravitreal aflibercept 8 mg: A systematic review and meta-analysis","authors":"Nikoline Skindhøj Rebsdorf ,&nbsp;Marie Martine Michaelsen ,&nbsp;Natasja Kærmose Ølholm ,&nbsp;Suffía Olsen ,&nbsp;Celine Lee ,&nbsp;Yousif Subhi ,&nbsp;Marie Ørskov ,&nbsp;Henrik Vorum ,&nbsp;Lasse Jørgensen Cehofski","doi":"10.1016/j.ajoint.2025.100179","DOIUrl":"10.1016/j.ajoint.2025.100179","url":null,"abstract":"<div><h3>Topic</h3><div>Aflibercept 8 mg was recently approved for the treatment of neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). The increased intravitreal injection volume and higher drug concentration has raised concerns regarding the potential risks of adverse events. The purpose of this review was to evaluate the current evidence on intraocular inflammation (IOI) and intraocular pressure (IOP) associated with aflibercept 8 mg.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted in the PubMed and Embase databases on the 13th of July 2025. Four authors conducted the screening of the titles and abstracts followed by a full text review of the remaining studies for potential eligibility. For data extraction and risk of bias assessment, two independent evaluations of each study were performed.</div></div><div><h3>Results</h3><div>A total of 16 studies were identified, comprising 2019 eyes treated with 9481 injections of aflibercept 8 mg in total. Twenty-eight incidences of IOI were reported out of 8834 injections (0.32 %), in which the incidence rates differed between clinical trials (0.15 %) and real-world studies (0.93 %). IOP elevation was observed in 28 out of 8889 injections (0.31 %), including three events of IOP <span><math><mo>≥</mo></math></span> 35 mmHg pre- or post-injection. No real-world studies reported any IOP elevation. Six studies comprising of a total of 1897 injections, reported on long term pre-injection IOP and three studies with a total of 206 injections investigated short-term post-injection IOP.</div></div><div><h3>Conclusion</h3><div>A fairly low incidence of IOP-related adverse events was observed following administration of aflibercept 8 mg, despite the increased injection volume and higher concentration. The incidence of IOI was generally low, but a higher incidence of IOI was identified in real-world studies, highlighting the need for monitoring potential high-risk patients in daily clinical practice. Further insights related to the safety profile of aflibercept 8 mg may be gained through generation of real-world evidence and standardized reporting of adverse events.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100179"},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Propensity score analysis of treat-and-extend therapy with aflibercept versus faricimab in age-related macular degeneration","authors":"Akira Obana,&nbsp;Ryo Asaoka,&nbsp;Kaori Ishii,&nbsp;Risa Nakazawa,&nbsp;Kei Asaoka,&nbsp;Norikazu Matsumura,&nbsp;Yuko Gohto","doi":"10.1016/j.ajoint.2025.100178","DOIUrl":"10.1016/j.ajoint.2025.100178","url":null,"abstract":"<div><h3>Purpose</h3><div>This study compared the 15-month outcomes of treat-and-extend (TAE) therapy with aflibercept (Af) and faricimab (Fa) in comparable cases selected by propensity score matching (PSM).</div></div><div><h3>Design</h3><div>Retrospective observational study.</div></div><div><h3>Methods</h3><div>Forty-seven eyes in the Af and Fa groups were matched for age, sex, baseline best-corrected visual acuity (BCVA), central macular thickness (CMT), age-related macular degeneration subtype, intraretinal fluid, and subretinal hyperreflective material. The TAE regimen consisted of three monthly injections, followed by monthly interval adjustments up to a maximum of four months. Changes in BCVA and CMT were assessed after 15 months.</div></div><div><h3>Results</h3><div>At 15 months, dry macula was achieved in 35 eyes (74.5 %) in the AF group and 37 eyes (78.7 %) in the Fa group. Both groups revealed significant improvements in the BCVA and CMT with no intergroup differences. The mean number of injections was identical (6.4 ± 0.7). No serious systemic adverse events occurred after 303 injections in either group. One Fa-treated eye developed a large subretinal hemorrhage that required displacement surgery, and no other serious ocular complications were noted.</div></div><div><h3>Conclusions</h3><div>PSM analysis demonstrated that Fa-based TAE was as effective as Af-based TAE in real-world practice, providing a foundation for evaluating long-term outcomes.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100178"},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between screen time and guardian-reported vision difficulty in children and adolescents: A population-based analysis","authors":"Andrew Mihalache ,&nbsp;Panthea Rahmdel ,&nbsp;Ryan S. Huang ,&nbsp;Marko M. Popovic ,&nbsp;Behnam Rahmdel ,&nbsp;Stacey Chong ,&nbsp;Crystal S.Y. Cheung ,&nbsp;Rajeev H. Muni","doi":"10.1016/j.ajoint.2025.100177","DOIUrl":"10.1016/j.ajoint.2025.100177","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate associations between screen time and guardian-reported vision difficulties among paediatric populations in the United States.</div></div><div><h3>Design</h3><div>Retrospective, population-based, cross-sectional study.</div></div><div><h3>Methods</h3><div>Using data from the 2020 and 2022 National Health Interview Survey, this study included participants aged 2-17 years with complete guardian-reported data pertaining to vision status and screen time usage. We performed logistic regressions to explore associations between screen time and vision difficulties, reporting odds ratios (ORs) and 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>A total of 5,112 participants (mean age: 10.1 ± 4.7 years) were included in 2020, and 6,473 participants (mean age: 9.9 ± 4.7 years) were included in 2022. In our univariable analysis, children who had a screen time of &gt;2 hours/day had a higher odds of guardian-reported vision difficulty in 2020 (OR=1.53, 95%CI=[1.08, 2.16], p=0.017) and in 2022 (OR=1.38, 95%CI=[1.02, 1.86], p=0.038). These findings were consistent in a subgroup of female children (p=0.002 in 2020 and p=0.014 in 2022). Our multivariable analysis of 2020 data found that the odds of guardian-reported vision difficulty among children with a screen time of &gt;2 hours/day was significantly higher in females (OR=1.73, 95%CI=[1.02, 2.93], p=0.040) and children residing in the Midwest (OR=2.41, 95%CI=[1.11, 5.20], p=0.026). No findings were significant in our adjusted analysis of 2022 data.</div></div><div><h3>Conclusion</h3><div>Screen time was associated with guardian-reported vision difficulties in paediatric populations in the United States in our univariable analysis. However, this association was not consistently observed in adjusted models of 2020 data, and no associations remained significant in the multivariable analysis of 2022 data. Public health initiatives aimed at promoting healthy screen time habits and regular eye care among vulnerable groups of children and adolescents are encouraged.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100177"},"PeriodicalIF":0.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-linear association between serum lipid levels and diabetic retinopathy in a nationally representative Korean population","authors":"Seowoong Jun ,&nbsp;Joon Yul Choi ,&nbsp;Tae Keun Yoo","doi":"10.1016/j.ajoint.2025.100176","DOIUrl":"10.1016/j.ajoint.2025.100176","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the associations between serum lipid levels and diabetic retinopathy (DR) in Korean adults with diabetes.</div></div><div><h3>Design</h3><div>Cross-sectional analysis of a nationally representative survey.</div></div><div><h3>Methods</h3><div>We analyzed 1,378 adults with diabetes from the Korea National Health and Nutrition Examination Survey (2008–2011). DR was ascertained from fundus photographs and medical history. Lipids (total cholesterol, HDL, LDL, triglycerides, non-HDL) were modeled by quintiles and with restricted cubic splines. Multivariable logistic regression adjusted for age, sex, systolic blood pressure, hemoglobin A1c, and statin use. Sensitivity analyses used multiple imputation.</div></div><div><h3>Results</h3><div>DR was present in 301/1,378 participants (21.8%). Adjusted models showed no linear trends for cholesterol measures. In quintile analyses, total cholesterol exhibited higher odds of DR at both extremes versus the middle quintile (Q3): Q1 OR 1.63 (95% CI, 1.04–2.57); Q4 OR 1.64 (1.06–2.57); Q5 OR 1.59 (1.03–2.49); P for U-shape = 0.008 (Q2 OR 1.42 [0.90–2.23]). LDL and non-HDL also demonstrated U-shaped patterns (P for U-shape = 0.029 and 0.038). Spline models supported U-shaped association for total cholesterol (P = 0.031), LDL (P = 0.039), and non-HDL (P = 0.014). No consistent nonlinear associations were observed for HDL or triglycerides. Multiple-imputation results were concordant, reinforcing the U-shape for total cholesterol.</div></div><div><h3>Conclusions</h3><div>Total cholesterol, LDL, and non-HDL showed U-shaped nonlinear associations with DR, indicating elevated risk at both low and high concentrations. Maintaining lipids within an intermediate range may support retinal vascular health and refine metabolic risk stratification in diabetes.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100176"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on “Effectiveness of intracameral antibiotics in reducing postoperative endophthalmitis risk after cataract surgery: A meta-analysis”","authors":"Vikrant Abbot ,&nbsp;Arvind Kumar ,&nbsp;Pradnya Phalak ,&nbsp;Hariharan Srinivasan","doi":"10.1016/j.ajoint.2025.100175","DOIUrl":"10.1016/j.ajoint.2025.100175","url":null,"abstract":"","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100175"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proportion of eyes with visual-acuity improvement after vitrectomy for post-traumatic endophthalmitis: A meta-analysis","authors":"Muhammad Alfatih ,&nbsp;Ananda Kukuh Adishabri ,&nbsp;Ni Luh Putu Yunia Dewi ,&nbsp;Alfiani Zukhruful Fitri Rifa'i ,&nbsp;Michaela Kemuning ,&nbsp;Dillan Cunha Amaral ,&nbsp;Bruno Fortaleza de Aquino Ferreira ,&nbsp;Ricardo Noguera Louzada ,&nbsp;Ari Djatikusumo ,&nbsp;Hashem Abu Serhan","doi":"10.1016/j.ajoint.2025.100174","DOIUrl":"10.1016/j.ajoint.2025.100174","url":null,"abstract":"<div><h3>Purpose</h3><div>Post-traumatic endophthalmitis (PTE) is a leading cause of irreversible vision loss after ocular trauma; despite widespread vitrectomy, outcomes vary and predictors remain unclear. This study aims to systematically evaluate the proportion of eyes showing the best-corrected visual acuity (BCVA) improvement and final BCVA ≥ 20/200 after vitrectomy for PTE and to investigate potential determinants of outcome using meta-regression.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>We conducted a meta-analysis following the PRISMA guidelines and registered the protocol in PROSPERO (CRD42024606195). Eligible studies included ≥80 % of participants undergoing vitrectomy for PTE. The prespecified primary outcome was the proportion with any BCVA improvement; final BCVA ≥20/200 at last follow-up was assessed as an additional outcome. Random-effects meta-analysis was performed, and subgroup and meta-regression analyses were used to explore outcome modifiers. Certainty of evidence was assessed using GRADE.</div></div><div><h3>Results</h3><div>Nine studies (<em>n</em> = 448 eyes) were included. The pooled proportion of eyes with any BCVA improvement was 0.80 (95 % CI 0.63–0.90; I² = 90 %), significantly higher in adults (≥18 years; 0.91) than in children/adolescents (&lt;18 years; 0.65; <em>p</em> &lt; 0.01). Meta-regression suggested higher silicone-oil use and IOFB proportion correlated with BCVA improvement (<em>p</em> = 0.027; <em>p</em> = 0.017), while corneal-entry and baseline retinal detachment were not associated. The proportion achieving final BCVA ≥20/200 was 0.33 (95 % CI 0.23–0.45; I²=67.9 %) with no age difference (<em>p</em> = 0.45). Certainty was low to very low.</div></div><div><h3>Conclusion</h3><div>Vitrectomy for PTE often yielded visual improvement, particularly in adults, while ambulatory vision (≥20/200) was less common. Given the single-arm meta-analysis, substantial heterogeneity, and low-certainty ratings, these estimates should be interpreted cautiously. Multicenter randomized trials are needed to verify these findings and to evaluate the potential role of silicone-oil tamponade.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100174"},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}