Eye最新文献

Background/objectives: To characterise the infraorbital artery (IOA) and its orbital branch, which are key structures encountered during inferior orbital explorations, with potential for orbital haemorrhage and vision loss if inappropriately handled.

Methods: Thirteen embalmed heads (26 orbits) were dissected. The following parameters were measured: orientation of the IOA in relation to the infraorbital nerve (ION); presence or absence of the orbital branch of the IOA; and the distance between the orbital branch of the IOA to the inferior orbital rim.

Results: In the pterygopalatine fossa, the orientation of the IOA relative to V2 was medial (n = 9, 34.6%), inferior (n = 4, 15.4%), lateral (n = 4, 15.4%), inferolateral (n = 3, 11.5%), superolateral (n = 3, 11.5%), inferomedial (n = 2, 7.7%) and superior (n = 1, 3.8%). In the infraorbital canal, the IOA in relation to the ION was as follows: superomedial (n = 12, 46.2%), medial (n = 9, 34.6%), superior (n = 2, 7.7%), inferomedial (n = 2, 7.7%) and superolateral (n = 1, 3.8%). An orbital branch of the IOA was identified in 21/26 orbits (80.8%). The mean distance of the orbital branch to the inferior orbital rim was 13.0 ± 4.8 mm (range 2.0-23.0 mm).

Conclusions: The IOA is an important vascular structure to recognise during inferior orbitotomies. The most common configuration is an IOA that runs medially to V2 in the pterygopalatine fossa, then superomedially to the ION within the infraorbital canal. The orbital branch of the IOA emerges 13 mm posterior to the inferior orbital rim. Recognition of these arterial branches and appropriate cauterization are paramount for avoiding significant operative complications.

Objective: This study aimed to analyse the correlation between corneal astigmatism and disparity in corneal thickness.

Methods: In this retrospective analysis, data from 342 patients (684 eyes) were collected. The Sirius three-dimensional corneal topography system was utilised to ascertain the mean corneal thickness of the meridians. Correlation analyses were conducted between the mean difference in corneal thickness along the two principal meridians and the astigmatic values computed by simulated keratometry values (Sim-K) for total corneal astigmatism (TCA) and posterior corneal astigmatism (PCA), respectively. Variability in differential corneal thickness (DCT) values at different TCA levels was analysed. The variability of DCT within the 3-mm corneal range at different differences between whole-eye astigmatism and TCA (Difference between corneal astigmatism and computer optometry, DWT) levels was analysed.

Results: Within the ranges of 3, 4.5, and 6 mm, the mean corneal thickness of the meridian with the maximum refractive power (Sim-K₂) was greater than that of the meridian with the minimum refractive power (Sim-K₁) (P < 0.05). The TCA showed a negative correlation with DCT across all three ranges (P < 0.001), whereas PCA exhibited a positive correlation with DCT (P < 0.001). A difference was observed among the TCA groups within each range, with DCT increasing alongside the dioptre of astigmatism (P < 0.05). In the 3 mm corneal range, an increase in the difference in corneal thickness was associated with an increase in the difference between whole-eye astigmatism and TCA (P < 0.05).

Conclusion: The meridian with the maximum refractive power had a thicker mean corneal thickness than the meridian with the minimum refractive power. The difference in corneal thickness is closely related to the severity of corneal astigmatism. The extent of residual astigmatism is influenced by this thickness difference.

Objectives: To explore the changes in eye structures over time in the Chinese population from the perspective of birth year.

Methods: We collected measurement data of intraocular lens Master from patients who underwent intraocular lens Master biometry for a routine cataract or refractive examination (ametropia and presbyopia) between April 2012 and October 2023, then screened them. Selected patients were divided into ten groups of 10 years each according to their year of birth (called birth decades). Birth-year-dependent changes in axial length and corneal curvature were compared between the groups.

Results: The average axial length increased from 23.52 mm to 25.95 mm, and the corneal curvature dropped from 44.20 D to 43.33 D in patients born in before-1930 and 1990s. The proportion of short average axial length and steep corneal curvature decreased, whereas the proportion of long average axial length increased with the birth decade. The proportion of patients with corneal curvature < 40 D was 4.18% in 1970s, 5.73% in 1980s, and 3.38% in 1990s, which were significantly higher than those of other age groups. The average axial length of the eyes among primary school students was 23.96 mm, and among college students, it was 25.86 mm.

Conclusions: Overall, with the birth decade, average axial length increased and corneal curvature decreased. There were generational differences in ocular biological parameters, changes in the eye might affect the incidence of eye diseases such as glaucoma and fundus diseases, which in turn might lead to changes in the spectrum of eye diseases.

For the conduct of future interventional age-related macular degeneration (AMD) trials, the availability of clinical study endpoints is key. However, no endpoints have been accepted by regulators for evaluation of treatment for intermediate (i) AMD, i.e. the AMD stage at highest risk of developing irreversible geographic atrophy or macular neovascularization. The European MACUSTAR consortium has recruited more than 700 individuals to develop and validate structural, functional and patient-reported endpoints, enabling future iAMD trials based on a prospective observational, multi-centre cohort study. Reliably assessing candidate endpoints in a setting that involves multiple clinical sites across countries comes with a plurality of challenges in the study set-up, quality of data, recruitment of participants and study conduct. Therefore, the MACUSTAR consortium has established a framework that successfully addresses these topics, provides relevant insights into the natural history of iAMD and its sub-phenotypes, and will open new regulatory pathways. The MACUSTAR study is registered on ClinicalTrials.gov under NCT03349801.

Diabetic retinopathy (DR) is a leading cause of preventable blindness and has emerged as a global health challenge, necessitating the development of robust management strategies. As DR prevalence continues to rise, advancements in screening methods have become increasingly critical for timely detection and intervention. This review examines three key advancements in DR screening: a shift from specialist to generalist approach, the adoption of telemedicine strategies for expanded access and enhanced efficiency, and the integration of artificial intelligence (AI). In particular, AI offers unprecedented benefits in the form of sustainability and scalability for not only DR screening but other aspects of eye health and the medical field as a whole. Though there remain barriers to address, AI holds vast potential for reshaping DR screening and significantly improving patient outcomes globally.

Background: Proliferative diabetic retinopathy (PDR) may lead to vision loss and blindness. The cost-effectiveness of various anti-vascular endothelial growth factor (anti-VEGF) drugs and panretinal photocoagulation (PRP) was assessed to supplement the NICE guideline for treating PDR.

Methods: A Markov model including eight levels of visual acuity (ranged between >85 and ≤25 letters) was developed to compare the cost-effectiveness of ranibizumab, aflibercept and bevacizumab with PRP (alone or in combination). Clinical inputs in the model were based on literature, while a published network meta-analysis (NMA) informed visual outcomes. Costs were estimated from a UK NHS perspective.

Results: Assuming initial treatment effects from the NMA continued to be applied for the remainder of lifetime, the probabilistic analysis resulted in bevacizumab plus PRP producing the highest net monetary benefit (NMB [95% CI]) of £221,374 [£203,941-£238,388] at £20,000 per quality-adjusted life-year. However, assuming initial treatment effects stabilised over time resulted in PRP alone producing the highest NMB of £223,416 [£209,318-£236,866]. Results were associated with large uncertainty due to wide confidence intervals around vision-based treatment effects of anti-VEGFs versus PRP, particularly for bevacizumab as data were drawn from trials with small sample size and high risk of bias. Using confidential prices for aflibercept and ranibizumab did not change the overall findings.

Conclusions: PRP is likely to be more cost-effective than anti-VEGFs for PDR. However, the results should be interpreted with caution given the scarcity of long-term visual outcomes with anti-VEGFs in this population. Further research on long-term visual outcomes may resolve these uncertainties.