Pub Date : 2026-02-05DOI: 10.1038/s41433-026-04277-8
Maria Grazia Pignataro, Alba Chiara Termite, Enrico Borrelli, Giacomo Boscia, Michele Reibaldi, Luisa Micelli Ferrari, Giulia Ribezzi, Alice Carra, Stefano Dore, Federica Evangelista, Giovanni Alessio, Francesco Boscia, Pasquale Viggiano
Purpose: To evaluate hyperreflective choroidal foci (HCF) in Sattler's and Haller's layers as predictive biomarkers for treatment response and pachychoroid macular atrophy (pMA) development in chronic central serous chorioretinopathy (CSC).
Methods: Retrospective analysis of 70 treatment-naïve patients with recurrent CSC classified according to Chhablani's criteria. HCF were quantified separately in choroidal layers using spectral-domain OCT at baseline and 12-month follow-up. Patients received photodynamic therapy (n = 20), eplerenone (n = 16), or subthreshold micropulse laser (n = 34). Primary outcomes included treatment response (complete fluid resolution) and pMA development.
Results: At baseline, no significant differences in HCF counts existed between future responders (n = 36) and non-responders (n = 34). At 12 months, responders showed significant HCF reduction in Sattler's layer (-9.17 foci, p = 0.001) and Haller's layer (-3.19 foci, p = 0.039), while non-responders demonstrated increased Sattler's foci (+4.62, p = 0.041). pMA developed in 15 patients (21.4%), more frequently in non-responders (32.4% vs 11.1%, p = 0.001). Baseline total HCF count was the strongest predictor of pMA development (β = 0.465, R² = 0.324, p < 0.001), with final HCF counts showing even stronger associations (β = 0.512, R² = 0.348, p < 0.001).
Conclusions: Layer-specific HCF quantification provides valuable prognostic information for treatment response and pMA risk in chronic CSC. These biomarkers may guide therapeutic decisions and identify patients requiring closer monitoring for atrophy development.
{"title":"Hyperreflective choroidal foci may predict pachychoroid macular atrophy development in central serous chorioretinopathy.","authors":"Maria Grazia Pignataro, Alba Chiara Termite, Enrico Borrelli, Giacomo Boscia, Michele Reibaldi, Luisa Micelli Ferrari, Giulia Ribezzi, Alice Carra, Stefano Dore, Federica Evangelista, Giovanni Alessio, Francesco Boscia, Pasquale Viggiano","doi":"10.1038/s41433-026-04277-8","DOIUrl":"https://doi.org/10.1038/s41433-026-04277-8","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate hyperreflective choroidal foci (HCF) in Sattler's and Haller's layers as predictive biomarkers for treatment response and pachychoroid macular atrophy (pMA) development in chronic central serous chorioretinopathy (CSC).</p><p><strong>Methods: </strong>Retrospective analysis of 70 treatment-naïve patients with recurrent CSC classified according to Chhablani's criteria. HCF were quantified separately in choroidal layers using spectral-domain OCT at baseline and 12-month follow-up. Patients received photodynamic therapy (n = 20), eplerenone (n = 16), or subthreshold micropulse laser (n = 34). Primary outcomes included treatment response (complete fluid resolution) and pMA development.</p><p><strong>Results: </strong>At baseline, no significant differences in HCF counts existed between future responders (n = 36) and non-responders (n = 34). At 12 months, responders showed significant HCF reduction in Sattler's layer (-9.17 foci, p = 0.001) and Haller's layer (-3.19 foci, p = 0.039), while non-responders demonstrated increased Sattler's foci (+4.62, p = 0.041). pMA developed in 15 patients (21.4%), more frequently in non-responders (32.4% vs 11.1%, p = 0.001). Baseline total HCF count was the strongest predictor of pMA development (β = 0.465, R² = 0.324, p < 0.001), with final HCF counts showing even stronger associations (β = 0.512, R² = 0.348, p < 0.001).</p><p><strong>Conclusions: </strong>Layer-specific HCF quantification provides valuable prognostic information for treatment response and pMA risk in chronic CSC. These biomarkers may guide therapeutic decisions and identify patients requiring closer monitoring for atrophy development.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-05DOI: 10.1038/s41433-026-04266-x
Sam Sherratt-Mayhew, Charles Page, Michael Lowe, Susan P Mollan, Gabriele Berman
{"title":"Infographic: Randomized trial of bilateral gene therapy injection for m.11778 G > A MT-ND4 Leber optic neuropathy (REFLECT Trial).","authors":"Sam Sherratt-Mayhew, Charles Page, Michael Lowe, Susan P Mollan, Gabriele Berman","doi":"10.1038/s41433-026-04266-x","DOIUrl":"https://doi.org/10.1038/s41433-026-04266-x","url":null,"abstract":"","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-04DOI: 10.1038/s41433-026-04267-w
Eleonora Riotto, Francesca Lamanna, Adnan H Khan, Sridevi Thottarath, Hagar Khalid, Swati Chandak, Jessica Bennett, Sarah Hill, Livia Faes, Dun Jack Fu
{"title":"Leveraging structured EMR data for efficient patient prescreening: a practical approach to reducing screen-failure rates in Light Touch Trial.","authors":"Eleonora Riotto, Francesca Lamanna, Adnan H Khan, Sridevi Thottarath, Hagar Khalid, Swati Chandak, Jessica Bennett, Sarah Hill, Livia Faes, Dun Jack Fu","doi":"10.1038/s41433-026-04267-w","DOIUrl":"https://doi.org/10.1038/s41433-026-04267-w","url":null,"abstract":"","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-03DOI: 10.1038/s41433-026-04275-w
Vijayalakshmi A Senthilkumar
{"title":"Exposure of the Supramid suture-an uninvited disaster.","authors":"Vijayalakshmi A Senthilkumar","doi":"10.1038/s41433-026-04275-w","DOIUrl":"https://doi.org/10.1038/s41433-026-04275-w","url":null,"abstract":"","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-03DOI: 10.1038/s41433-026-04265-y
Tan Do, Ha Thi Thu Pham, Andrea Servillo, Tin Aung
Objective: To assess the outcomes of surgical management of aqueous misdirection (AM) by endoscopic pars plana vitrectomy with hyaloido-zonulo-iridectomy.
Materials and methods: In this prospective, longitudinal, noncomparative interventional study, 53 eyes from 46 patients with AM refractory to medical and laser therapy after intraocular surgery were enrolled. All eyes underwent lens removal (if phakic), endoscopic pars plana vitrectomy, and hyaloido-zonulo-iridectomy. Primary outcomes included intraocular pressure (IOP), best-corrected visual acuity (BCVA), anterior chamber depth (ACD), postoperative complications, relapse rate, and composite surgical success. Surgical success was defined as the combination of IOP control and anterior chamber reformation, using two alternative IOP thresholds ( ≥ 6 and ≤18 mmHg, or ≥6 and ≤21 mmHg). Continuous variables were analysed using linear mixed models and expressed as estimated means (est)± standard error.
Results: Mean age was 59.7 ± 12.2 years. The est. IOP decreased from 34.36 ± 0.82 mmHg to 17.47 ± 0.82 mmHg at 12 months (p < 0.001). The est. BCVA improved from 1.50 ± 0.07 to 0.70 ± 0.07 logMAR at 12 months (p < 0.001). The est. ACD increased from 0.70 ± 0.06 to 3.34 ± 0.06 mm (p < 0.001), with complete anterior chamber reformation in all eyes. Postoperative complications occurred in 22 eyes (41.8%), mostly transient and resolved with medical or YAG laser treatment; only one required glaucoma surgery. At 12 months, overall success was 98.1% using the ≤21 mmHg criterion and 75.5% using the ≤18 mmHg criterion. No relapses were observed.
Conclusions: Surgical management using lens removal, endoscopic anterior vitrectomy, and hyaloido-zonulo-iridectomy is a significantly effective and safe treatment for AM.
{"title":"Surgical management of aqueous misdirection by endoscopic vitrectomy with Hyaloido-Zonulo-Iridectomy.","authors":"Tan Do, Ha Thi Thu Pham, Andrea Servillo, Tin Aung","doi":"10.1038/s41433-026-04265-y","DOIUrl":"https://doi.org/10.1038/s41433-026-04265-y","url":null,"abstract":"<p><strong>Objective: </strong>To assess the outcomes of surgical management of aqueous misdirection (AM) by endoscopic pars plana vitrectomy with hyaloido-zonulo-iridectomy.</p><p><strong>Materials and methods: </strong>In this prospective, longitudinal, noncomparative interventional study, 53 eyes from 46 patients with AM refractory to medical and laser therapy after intraocular surgery were enrolled. All eyes underwent lens removal (if phakic), endoscopic pars plana vitrectomy, and hyaloido-zonulo-iridectomy. Primary outcomes included intraocular pressure (IOP), best-corrected visual acuity (BCVA), anterior chamber depth (ACD), postoperative complications, relapse rate, and composite surgical success. Surgical success was defined as the combination of IOP control and anterior chamber reformation, using two alternative IOP thresholds ( ≥ 6 and ≤18 mmHg, or ≥6 and ≤21 mmHg). Continuous variables were analysed using linear mixed models and expressed as estimated means (est)± standard error.</p><p><strong>Results: </strong>Mean age was 59.7 ± 12.2 years. The est. IOP decreased from 34.36 ± 0.82 mmHg to 17.47 ± 0.82 mmHg at 12 months (p < 0.001). The est. BCVA improved from 1.50 ± 0.07 to 0.70 ± 0.07 logMAR at 12 months (p < 0.001). The est. ACD increased from 0.70 ± 0.06 to 3.34 ± 0.06 mm (p < 0.001), with complete anterior chamber reformation in all eyes. Postoperative complications occurred in 22 eyes (41.8%), mostly transient and resolved with medical or YAG laser treatment; only one required glaucoma surgery. At 12 months, overall success was 98.1% using the ≤21 mmHg criterion and 75.5% using the ≤18 mmHg criterion. No relapses were observed.</p><p><strong>Conclusions: </strong>Surgical management using lens removal, endoscopic anterior vitrectomy, and hyaloido-zonulo-iridectomy is a significantly effective and safe treatment for AM.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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