International journal of ophthalmology最新文献

Aim: To evaluate the therapeutic effects of ranibizumab on optic disc and macular microvascular perfusion in central retinal vein occlusion (CRVO) with macular edema (ME).

Methods: Optical coherence tomography angiology (OCTA) parameters, including optic disc vessel density (VD; including whole-disc VD, intra-disc VD, and peripapillary VD), superficial/deep capillary plexus (SCP/DCP) VD, and central macular thickness (CMT) were analyzed. Additional assessments included best-corrected visual acuity (BCVA) via Early Treatment Diabetic Retinopathy Study (ETDRS) chart and hemorheological profiling. CRVO patients received monthly intravitreal ranibizumab injections for three consecutive months. Pre- and post-treatment parameters were statistically compared.

Results: The study comprised 60 CRVO-ME patients (28 males; 32 females), aged 50-78y (mean 63.3±7.6y) and 60 age-/sex-matched healthy controls. As compared with participants exhibiting normal funduscopic findings, CRVO patients demonstrated significantly elevated levels of low-shear-rate whole blood viscosity (LSR-WBV), high-shear-rate whole blood viscosity (HSR-WBV), and aggregation index (AI, all P<0.05). In CRVO-affected eyes, vertical cup-to-disc (C/D) ratio and optic cup volume were significantly smaller, whereas retinal nerve fiber layer (RNFL) thickness was significantly greater, compared to both unaffected contralateral eyes and normal control eyes (all P<0.05). Following treatment, VD of the entire optic disc (P<0.05), intra-disc VD (P<0.05), and peripapillary VD (P<0.05) all increased significantly relative to baseline. CMT decreased significantly (P<0.05), whereas macular SCP-VD and macular DCP-VD showed non-significant slight reductions (P>0.05). At baseline, BCVA of CRVO eyes correlated with whole-disc VD (r=-0.276, P=0.033), intra-disc VD (r=-0.342, P=0.009), and peripapillary VD (r=-0.335, P=0.007), with intra-disc VD demonstrating the strongest association. Besides, BCVA improvement, after the treatment, correlated positively with whole-disc VD (r=0.342, P=0.008) and intra-disc VD (r=0.396, P=0.002).

Conclusion: Optic disc blood perfusion is more closely associated with visual acuity than macular perfusion, suggesting intra-disc VD may serve as a potential biomarker for monitoring visual acuity changes in CRVO. Multiple ranibizumab injections significantly improve optic disc perfusion but may have exerted detrimental effects on the macula. CRVO patients shows higher hemorheological parameters than those with normal fundi. Reduced vertical C/D ratio and optic cup volume may be linked to CRVO incidence, potentially acting as susceptibility factors.

Rhegmatogenous retinal detachment (RRD) is a serious ocular condition marked by the separation of the neuroretina from the retinal pigment epithelium (RPE). The pathogenesis of RRD involves intricate molecular and cellular mechanisms, including inflammation, cell migration, and the activation of proliferative signaling pathways. One of the most challenging complications of RRD is proliferative vitreoretinopathy (PVR), which refers to the proliferation and contraction of fibrocellular membranes on the retinal surface and in the vitreous cavity. PVR is a major cause of surgical failure in RRD, as it can lead to recurrent retinal detachment and severe vision loss. However, the pathogenesis of PVR is not yet fully understood, and the treatment options are quite limited. Recent advances in analytical techniques have offered valuable insights into the molecular alterations present in the subretinal fluid (SRF) of patients with RRD. This review seeks to consolidate the current knowledge regarding the SRF profile in RRD and PVR, emphasizing potential biomarkers and therapeutic targets.

Aim: To evaluate the efficacy of the total computer vision syndrome questionnaire (CVS-Q) score as a predictive tool for identifying individuals with symptomatic binocular vision anomalies and refractive errors.

Methods: A total of 141 healthy computer users underwent comprehensive clinical visual function assessments, including evaluations of refractive errors, accommodation (amplitude of accommodation, positive relative accommodation, negative relative accommodation, accommodative accuracy, and accommodative facility), and vergence (phoria, positive and negative fusional vergence, near point of convergence, and vergence facility). Total CVS-Q scores were recorded to explore potential associations between symptom scores and the aforementioned clinical visual function parameters.

Results: The cohort included 54 males (38.3%) with a mean age of 23.9±0.58y and 87 age-matched females (61.7%) with a mean age of 23.9±0.53y. The multiple regression model was statistically significant [R²=0.60, F=13.28, degrees of freedom (DF=17 122, P<0.001]. This indicates that 60% of the variance in total CVS-Q scores (reflecting reported symptoms) could be explained by four clinical measurements: amplitude of accommodation, positive relative accommodation, exophoria at distance and near, and positive fusional vergence at near.

Conclusion: The total CVS-Q score is a valid and reliable tool for predicting the presence of various non-strabismic binocular vision anomalies and refractive errors in symptomatic computer users.

Aim: To summarize publication trends in the field of strabismus over the past 30y and predict future research hotspots.

Methods: A total of 2915 English-language articles and reviews on strabismus, published between 1993 and 2022, were retrieved from the Web of Science Core Collection. Bibliometric analyses were performed using VOSviewer and CiteSpace software to explore publication trends, as well as the contributions and collaborative networks of countries/regions, authors, institutions, and journals.

Results: The annual number of publications on strabismus showed a consistent upward trend. The United States (USA) maintained a leading position in this research field while Republic of Korea and China emerged as rapidly advancing contributors over the last decade. The University of California, Los Angeles ranked as the most productive institution, and Jonathan M. Holmes from USA was the most productive author. Journal of AAPOS was the leading journal with the most strabismus publications, whereas the two most highly cited articles were both published in Ophthalmology. Co-occurrence analysis identified pivotal keywords and burst terms, including intermittent exotropia (IXT), acute acquired comitant esotropia (AACE), functional magnetic resonance imaging (fMRI), and surgical treatment, which were confirmed as predominant and frontier topics.

Conclusion: This study provides a comprehensive bibliometric analysis of strabismus research, revealing the evolution of research hotspots over the past 30y and outlining several cutting-edge directions for future investigation.

Aim: To compare the tear film quantity and stability parameters in keratoconus (KCN) and normal eyes using test breakup time (TBUT), noninvasive TBUT (NITBUT), and Schirmer test.

Methods: All participants (n=166), including patients with KCN and age-matched healthy individuals with normal corneas, were recruited from those referred to Farabi Eye Hospital, Iran, in 2023. To better account for genetic and environmental factors, the control group comprised healthy individuals who were relatives of KCN patients and had normal corneal topography. Tear quantity parameters were evaluated in the following order: NITBUT, TBUT, and Schirmer tests.

Results: The mean age of cases in KCN (61.7% males) and normal (63.5% males) participants was 27.54±5.44y (range 19 to 38) and 27.52±5.63y (range 20 to 38), respectively (P=0.976). NIBUT, TBUT, and Schirmer's tests were significantly lower in KCN group compared to normal controls (all P<0.001). The mean difference for NIBUT was -7.81s (P<0.001), and for TBUT was -7.61s (P<0.001). Schirmer test values were also significantly lower in the KCN group, with a mean difference of -5.61 mm compared to normal people (P<0.001).

Conclusion: Our findings demonstrate significant tear film impairment in KCN. The reductions in NIBUT, TBUT and Schirmer scores highlight an underlying tear film dysfunction in KCN that extends beyond the morphological changes of the cornea.

Aim: To report and analyze cases of sterile intraocular inflammation (IOI) following intravitreal faricimab injections in patients treated for neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME).

Methods: This double-center case series included nine eyes of six patients who developed uveitis after faricimab therapy. Comprehensive clinical evaluation was performed, including slit-lamp examination, intraocular pressure (IOP) measurement, fluorescein and indocyanine green angiography (ICGA), and laboratory tests. Inflammatory responses were treated with topical or systemic corticosteroids, and patients were monitored for visual acuity and inflammatory activity.

Results: The incidence of IOI was 0.8% per patient (Innsbruck) and 0.23% (Czechia), with inflammation typically occurring between the third and sixth injection (mean interval: 10d post-injection). Inflammatory presentations ranged from anterior uveitis to posterior segment involvement. One notable case demonstrated novel choroidal hypofluorescent lesions on angiography, suggesting deeper ocular involvement. The mean patient age was 76y; five of six affected patients were female. All cases responded to local and systemic corticosteroids, with full recovery of initial visual acuity.

Conclusion: Sterile IOI after faricimab appears to be a rare but relevant adverse event. Although the incidence falls within expected ranges for anti-vascular endothelial growth factor (anti-VEGF) agents, the observed choroidal involvement represents a potentially new safety signal. Prompt diagnosis and corticosteroid therapy are effective in all cases. Our findings support the need for vigilant post-marketing surveillance and further studies to better understand the underlying mechanisms and risk factors of faricimab-associated inflammation.

Aim: To investigate the effects of shortening the duration of silicone oil tamponade on retinal structure and function in patients undergoing silicone oil removal (SOR) after surgery for primary rhegmatogenous retinal detachment (RRD).

Methods: A total of 58 eligible patients were enrolled and randomly assigned to two groups based on tamponade duration: the short-term group (30-45d) and the conventional group (≥90d). Comprehensive evaluations were performed before and after SOR, including slit-lamp examination, best-corrected visual acuity (BCVA) measurement, intraocular pressure (IOP) testing, optical coherence tomography (OCT), optical coherence tomography angiography (OCTA), microperimetry, electroretinography (ERG), and visual evoked potential (VEP) assessment.

Results: A total of 33 patients (23 males and 10 females; 33 eyes) were enrolled in the short-term SO tamponade group with mean age of 52.45±9.35y, and 25 patients (15 males and 10 females; 25 eyes) were enrolled in the conventional SO tamponade group with mean age of 50.80±12.06y. Compared with the conventional group, the short-term silicone oil tamponade group had a significantly lower incidence of silicone oil emulsification and cataract progression, with no significant difference in retinal reattachment success rate. Structurally, short-term tamponade was associated with increased thickness of the retinal ganglion cell layer (RGCL) in the nasal and superior macular regions and improved recovery of superficial retinal vascular density in these areas. Functionally, the short-term group showed better BCVA and retinal sensitivity both before and 1mo after SOR; additionally, the P100 amplitude in VEP tests was significantly increased in this group.

Conclusion: Shortening the duration of silicone oil tamponade effectively reduces damage to retinal structure and function without compromising the success rate of retinal reattachment in patients with primary RRD.

Aim: To identify early biomarkers associated with glaucomatous visual field (VF) progression in patients with normal-tension glaucoma (NTG).

Methods: This study included patients were divided into two groups based on disease progression status. Tear samples were collected for proteomic analysis. Data-independent acquisition (DIA) mass spectrometry combined with bioinformatic analyses was performed to identify and validate potential protein biomarkers for NTG progression. Additionally, differentially expressed proteins (DEPs) were evaluated using mediating effect models and receiver operating characteristic (ROC) curve analysis.

Results: A total of 19 patients (20 eyes) with NTG participated in this study, including 10 patients (4 males and 6 females; 10 eyes) in the progression group with mean age of 67.70±9.03y and 10 patients (4 males and 6 females; 10 eyes) in the non-progression group with mean age of 68.60±7.58y. A total of 158 significantly differentially expressed proteins were detected. UniProt database annotation identified 3 upregulated proteins and 12 downregulated proteins. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that these DEPs were mainly enriched in pathways such as oocyte meiosis. Gene Ontology (GO) enrichment analysis revealed functional clusters related to cellular processes. Weighted gene co-expression network analysis (WGCNA) indicated that the core proteins were primarily involved in the neurodegeneration-multiple diseases pathway and cellular processes. Mediating effect analysis identified PRDX4 (L) as a potential protein biomarker. ROC curve analysis showed that GNAI1 had the largest area under the curve (AUC=0.889).

Conclusion: This study identifies 15 differentially expressed proteins in the tear fluid of NTG patients, including PRDX4 (L). PRDX4 (L) plays a key role in oxidative stress.