Pub Date : 2024-10-22DOI: 10.1016/j.ophtha.2024.09.029
Muhammad Hanif, Muhammad Saad, Mujjaddad Rehman
{"title":"Double Crystalline Lens in a 3-Year-Old Child.","authors":"Muhammad Hanif, Muhammad Saad, Mujjaddad Rehman","doi":"10.1016/j.ophtha.2024.09.029","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.09.029","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-22DOI: 10.1016/j.ophtha.2024.09.018
Yating Zhou, Fei Xue
{"title":"Re: Potter et al.: Concordance between self-reported visual difficulty and objective visual impairment: The National Health and Aging Trends Study (Ophthalmology. 2024 Jun 12:S0161-6420(24)00363-4.doi: 10.1016/j.ophtha.2024.06.009. Online ahead of print.).","authors":"Yating Zhou, Fei Xue","doi":"10.1016/j.ophtha.2024.09.018","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.09.018","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-22DOI: 10.1016/j.ophtha.2024.09.003
Leo A Kim, Maureen G Maguire, Christina Y Weng, Justine R Smith, Nieraj Jain, Christina J Flaxel, Shriji Patel, Stephen J Kim, Steven Yeh
<p><strong>Purpose: </strong>To assess the safety and efficacy of the multiple therapeutic modalities for the treatment of central serous chorioretinopathy (CSCR).</p><p><strong>Methods: </strong>A literature search of English-language studies in the PubMed database with no date restrictions was last conducted in May 2024. The combined searches yielded 612 citations, 31 of which were selected for full-text review and for inclusion in this assessment. The panel methodologist assigned a level of evidence rating to each study. Six were assigned a level I rating, 23 were assigned a level II rating, and 2 were assigned a level III rating. Studies were categorized based on treatment modalities: laser-based therapy, intravitreal therapy, laser-based therapy versus intravitreal therapy, and systemic therapies. Within those categories, they were separated based on treatments for acute versus chronic CSCR.</p><p><strong>Results: </strong>One level I study showed that photodynamic therapy (PDT) using half-dose verteporfin for acute CSCR led to a significant decrease in subretinal fluid (SRF) with 95% of treated patients having no SRF at 12 months compared with 58% of untreated eyes with acute CSCR (P = 0.001). Anatomically, the mean CFT at 1 year was significantly lower in the treated group (161 ± 65 μm) versus the observation group (278 ± 92 μm) (P = 0.001). A second level I study compared half-dose verteporfin PDT versus 30%-dose verteporfin PDT and found that 94.6% in the half-dose PDT group had no SRF at 12 months compared with 75.4% in the 30%-dose PDT group (P = 0.004). The noninferiority of the 30%-dose PDT compared with half-dose PDT was not demonstrated. The VICI trial was a level I study that found no benefit with the use of mineralocorticoid antagonism with eplerenone for the treatment of chronic CSCR. With respect to the primary outcome of visual acuity (VA), the VICI trial found no significant difference at 12 months: 79.5 letters in the placebo group and 80.4 letters in the eplerenone group (P = 0.24). In general, the results from the other evaluated studies were inconsistent and thus inconclusive. There were no level I studies that supported the role of intravitreal anti-VEGF injections or systemic beta-blockers for patients with CSCR. A small level I study showed potential efficacy of Helicobacter pylori therapy for CSCR.</p><p><strong>Conclusions: </strong>There is evidence to support half-dose PDT for the treatment of acute CSCR regarding anatomic improvement, but less robust evidence supports improvement in VA or sustained anatomic benefit beyond 12 months. Intravitreal anti-VEGF injections and oral beta-blockers demonstrate inconsistent anatomic and visual benefits in patients with CSCR. The mineralocorticoid antagonist eplerenone has not been demonstrated as efficacious for treatment of chronic CSCR. The treatment of H. pylori infection may have some anatomic and visual benefit in the treatment of either acute or chronic CSCR. Acute CSC
{"title":"Therapies for Central Serous Chorioretinopathy: A Report by the American Academy of Ophthalmology.","authors":"Leo A Kim, Maureen G Maguire, Christina Y Weng, Justine R Smith, Nieraj Jain, Christina J Flaxel, Shriji Patel, Stephen J Kim, Steven Yeh","doi":"10.1016/j.ophtha.2024.09.003","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.09.003","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the safety and efficacy of the multiple therapeutic modalities for the treatment of central serous chorioretinopathy (CSCR).</p><p><strong>Methods: </strong>A literature search of English-language studies in the PubMed database with no date restrictions was last conducted in May 2024. The combined searches yielded 612 citations, 31 of which were selected for full-text review and for inclusion in this assessment. The panel methodologist assigned a level of evidence rating to each study. Six were assigned a level I rating, 23 were assigned a level II rating, and 2 were assigned a level III rating. Studies were categorized based on treatment modalities: laser-based therapy, intravitreal therapy, laser-based therapy versus intravitreal therapy, and systemic therapies. Within those categories, they were separated based on treatments for acute versus chronic CSCR.</p><p><strong>Results: </strong>One level I study showed that photodynamic therapy (PDT) using half-dose verteporfin for acute CSCR led to a significant decrease in subretinal fluid (SRF) with 95% of treated patients having no SRF at 12 months compared with 58% of untreated eyes with acute CSCR (P = 0.001). Anatomically, the mean CFT at 1 year was significantly lower in the treated group (161 ± 65 μm) versus the observation group (278 ± 92 μm) (P = 0.001). A second level I study compared half-dose verteporfin PDT versus 30%-dose verteporfin PDT and found that 94.6% in the half-dose PDT group had no SRF at 12 months compared with 75.4% in the 30%-dose PDT group (P = 0.004). The noninferiority of the 30%-dose PDT compared with half-dose PDT was not demonstrated. The VICI trial was a level I study that found no benefit with the use of mineralocorticoid antagonism with eplerenone for the treatment of chronic CSCR. With respect to the primary outcome of visual acuity (VA), the VICI trial found no significant difference at 12 months: 79.5 letters in the placebo group and 80.4 letters in the eplerenone group (P = 0.24). In general, the results from the other evaluated studies were inconsistent and thus inconclusive. There were no level I studies that supported the role of intravitreal anti-VEGF injections or systemic beta-blockers for patients with CSCR. A small level I study showed potential efficacy of Helicobacter pylori therapy for CSCR.</p><p><strong>Conclusions: </strong>There is evidence to support half-dose PDT for the treatment of acute CSCR regarding anatomic improvement, but less robust evidence supports improvement in VA or sustained anatomic benefit beyond 12 months. Intravitreal anti-VEGF injections and oral beta-blockers demonstrate inconsistent anatomic and visual benefits in patients with CSCR. The mineralocorticoid antagonist eplerenone has not been demonstrated as efficacious for treatment of chronic CSCR. The treatment of H. pylori infection may have some anatomic and visual benefit in the treatment of either acute or chronic CSCR. Acute CSC","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-21DOI: 10.1016/j.ophtha.2024.09.016
Yaoming Liu, Rong Lu
{"title":"Microphthalmia with Orbital Cyst.","authors":"Yaoming Liu, Rong Lu","doi":"10.1016/j.ophtha.2024.09.016","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.09.016","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-21DOI: 10.1016/j.ophtha.2024.08.027
Sandeep Ravindran PhD
{"title":"This Issue at a Glance","authors":"Sandeep Ravindran PhD","doi":"10.1016/j.ophtha.2024.08.027","DOIUrl":"10.1016/j.ophtha.2024.08.027","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"131 11","pages":"Page 1247"},"PeriodicalIF":13.1,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-21DOI: 10.1016/j.ophtha.2024.08.028
Sandeep Ravindran PhD
{"title":"Issue at a Glance","authors":"Sandeep Ravindran PhD","doi":"10.1016/j.ophtha.2024.08.028","DOIUrl":"10.1016/j.ophtha.2024.08.028","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"131 11","pages":"Page e3"},"PeriodicalIF":13.1,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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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