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Three-Month Comprehensive Outcomes of Topography-Guided LASIK Versus Keratorefractive Lenticule Extraction (KLEx): A Prospective Contralateral Study. 地形图引导 LASIK 与角膜屈光性扁桃体摘除术 (KLEx) 的三个月综合疗效:一项前瞻性对侧研究。
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-08-01 Epub Date: 2024-07-01 DOI: 10.1007/s40123-024-00987-y
Kayvon A Moin, Garrett N Manion, Srujay Pandiri, Phillip C Hoopes, Majid Moshirfar

Introduction: The aim of this study was to compare outcomes of topography-guided laser-assisted in situ keratomileusis (TG-LASIK) and small incision lenticule extraction (SMILE®) for correcting myopia and myopic astigmatism.

Methods: In this prospective, randomized contralateral study, 34 patients (68 eyes) received TG-LASIK in one eye, and SMILE in their fellow eye. Efficacy, safety, predictability, higher-order aberrations, corneal tomography, biomechanics, and patient-reported outcomes (PROs) were assessed preoperatively and up to 3 months postoperatively.

Results: Both platforms showed comparable efficacy at 3 months (TG-LASIK 1.08 ± 0.19; SMILE 0.98 ± 0.17, p = 0.055). However, TG-LASIK demonstrated quicker visual recovery, with 63% and 89% achieving uncorrected distance visual acuity (UDVA) of 20/16 or better at 1 day and 1 week, respectively, compared to SMILE (34% and 63%; p < 0.05). Safety index at 3 months did not significantly differ between TG-LASIK and SMILE (p = 0.223). TG-LASIK and SMILE had 44% and 56% of eyes within 0.13 D of spherical equivalent (SEQ) target, respectively. SMILE induced more total higher-order aberrations (HOAs), vertical coma, and oblique trefoil than TG-LASIK at 3 months (p < 0.05). Both platforms showed similar increases in epithelial remodeling, but SMILE induced thicker epithelium than TG-LASIK at the 7.0-mm nasal zonal area. No significant differences were found in corneal hysteresis (CH) or corneal resistance factor (CRF) at 3 months (p > 0.05). Reported symptoms of glare, halos, rings, starbursts, or dry eye did not significantly differ between groups at 3 months (p > 0.05). Overall, 59% of patients preferred their TG-LASIK treated eye at 1 month, but 65% of patients had no specific eye preference at 3 months.

Conclusion: TG-LASIK and SMILE demonstrate excellent and comparable efficacy, safety, and predictability at 3 months, but TG-LASIK offers faster postoperative visual recovery at 1 day and 1 week. TG-LASIK induces fewer HOAs than SMILE, but both procedures affect corneal biomechanics similarly.

Trial registration: ClincialTrials.gov identifier, NCT05611294.

简介:本研究旨在比较地形图引导激光辅助原位角膜磨镶术(TG-LASIK)和小切口皮瓣摘除术(SMILE®)矫正近视和近视散光的效果:在这项前瞻性随机对侧研究中,34 名患者(68 只眼)的一只眼接受了 TG-LASIK 手术,另一只眼接受了 SMILE 手术。对术前和术后 3 个月的疗效、安全性、可预测性、高阶像差、角膜层析成像、生物力学和患者报告结果(PROs)进行了评估:结果:两个平台在术后3个月的疗效相当(TG-LASIK 1.08 ± 0.19;SMILE 0.98 ± 0.17,p = 0.055)。不过,TG-LASIK 的视力恢复更快,与 SMILE(34% 和 63%;P 0.05)相比,分别有 63% 和 89% 的患者在 1 天和 1 周后达到 20/16 或更好的未矫正远距离视力 (UDVA)。3 个月后,各组患者报告的眩光、光晕、光环、星光或干眼症状没有明显差异(P > 0.05)。总体而言,59%的患者在1个月时更喜欢接受TG-LASIK治疗的眼睛,但65%的患者在3个月时没有特定的眼睛偏好:结论:TG-LASIK 和 SMILE 术后 3 个月的疗效、安全性和可预测性相当出色,但 TG-LASIK 术后 1 天和 1 周的视力恢复更快。与SMILE相比,TG-LASIK引起的HOA更少,但两种手术对角膜生物力学的影响相似:试验注册:ClincialTrials.gov identifier,NCT05611294。
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引用次数: 0
Vectored Thermal Pulsation as a Treatment for Meibomian Gland Dysfunction: A Review Spanning 15 Years. 作为睑板腺功能障碍治疗方法的定向热脉冲疗法:跨越 15 年的回顾。
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-15 DOI: 10.1007/s40123-024-00976-1
Caroline A Blackie, David Murakami, Eric Donnenfeld, Heather S Oliff

The LipiFlow Thermal Pulsation System received its first marketing clearance for the treatment of meibomian gland dysfunction (MGD) 13 years ago. Since then, the evidence evaluating the effectiveness and safety of LipiFlow as a treatment for MGD has grown significantly. The objective of this comprehensive review was to summarize all clinical reports evaluating the effectiveness and safety of LipiFlow over the past 15 years. The literature was systematically reviewed, and 55 unique articles had subjective (patient-reported outcomes) and objective (meibomian gland function, tear production, and ocular staining) outcomes for extraction. Data were collected from 2101 patients and 3521 eyes treated with LipiFlow. Of these, effectiveness was evaluated in 2041 patients and 3401 eyes, and safety was evaluated in 1448 patients and 2443 eyes. Taken together, the studies demonstrate that a single 12-min treatment with LipiFlow safely improves signs and symptoms of MGD and associated evaporative dry eye disease (DED), and the benefits persist up to 3 years in some cases. The findings are corroborated by multiple meta-analyses and consensus guidelines. While some studies showed that daily eyelid hygiene, warm compress, and/or massage had a similar benefit to a single LipiFlow, these treatments were limited by inconvenience, discomfort, and non-compliance. The majority of studies evaluating safety reported no discomfort or pain associated with LipiFlow treatment, which supports the patient acceptability of LipiFlow therapy. All adverse events (AEs) related to LipiFlow were transient, non-vision-threatening, and did not require treatment. No studies reported serious AEs. The data obtained from 55 studies conducted globally overwhelmingly show that LipiFlow is effective and safe for the treatment of MGD and associated evaporative DED. The conclusions are supported by the diversity of the patient populations (geography, race, disease severity, and diagnosis), the large population treated with LipiFlow, the meta-analyses, and that this review analyzed all published clinical studies to date.

13 年前,LipiFlow 热脉冲系统首次获得了治疗睑板腺功能障碍 (MGD) 的上市许可。从那时起,评估 LipiFlow 治疗睑板腺功能障碍的有效性和安全性的证据显著增加。本次全面综述的目的是总结过去 15 年中评估 LipiFlow 有效性和安全性的所有临床报告。我们对文献进行了系统性的回顾,其中 55 篇文章对主观(患者报告结果)和客观(睑板腺功能、泪液分泌和眼部染色)结果进行了提取。收集了 2101 名患者和 3521 只接受过 LipiFlow 治疗的眼睛的数据。其中,对 2041 名患者和 3401 只眼睛进行了有效性评估,对 1448 名患者和 2443 只眼睛进行了安全性评估。总之,这些研究表明,使用 LipiFlow 进行 12 分钟的单次治疗可安全地改善并发症和相关的蒸发性干眼症 (DED) 的症状和体征,在某些病例中,疗效可持续 3 年之久。这些研究结果得到了多项荟萃分析和共识指南的证实。一些研究表明,日常眼睑卫生、热敷和/或按摩与单次使用 LipiFlow 的疗效相似,但这些疗法受到不便、不适和不依从性的限制。大多数评估安全性的研究报告称,LipiFlow疗法不会带来不适或疼痛,这证明了患者对LipiFlow疗法的可接受性。所有与 LipiFlow 相关的不良事件(AEs)都是短暂的,不会危及视力,也不需要治疗。没有研究报告严重的不良反应。从全球进行的 55 项研究中获得的数据压倒性地表明,LipiFlow 对治疗镁光泪管发育不良和相关的蒸发性 DED 有效且安全。患者群体的多样性(地域、种族、疾病严重程度和诊断)、大量接受 LipiFlow 治疗的人群、荟萃分析以及本综述分析了迄今为止已发表的所有临床研究都支持上述结论。
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引用次数: 0
Advancements in Imaging and Therapeutic Options for Dry Age-Related Macular Degeneration and Geographic Atrophy. 干性老年性黄斑变性和地理萎缩的成像和治疗方案进展。
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-04 DOI: 10.1007/s40123-024-00970-7
Andrea Servillo, Riccardo Sacconi, Gloria Oldoni, Eugenio Barlocci, Beatrice Tombolini, Marco Battista, Federico Fantaguzzi, Federico Rissotto, Cecilia Mularoni, Mariacristina Parravano, Ilaria Zucchiatti, Lea Querques, Francesco Bandello, Giuseppe Querques

Age-related macular degeneration (AMD) is a leading cause of vision loss in the elderly, with dry AMD (d-AMD) leading to geographic atrophy (GA) and significant visual impairment. Multimodal imaging plays a crucial role in d-AMD diagnosis and management, allowing for detailed classification of patient phenotypes and aiding in treatment planning and prognosis determination. Treatment approaches for d-AMD have recently witnessed profound change with the development of specific drugs targeting the complement cascade, with the first anticomplement agents recently approved for GA treatment. Additionally, emerging strategies such as gene therapy and laser treatments may offer potential benefits, though further research is needed to fully establish their efficacy. However, the lack of effective therapies capable of restoring damaged retinal cells remains a major challenge. In the future, genetic treatments aimed at preventing the progression of d-AMD may emerge as a powerful approach. Currently, however, their development is still in the early stages.

老年性黄斑变性(AMD)是老年人视力丧失的主要原因,其中干性AMD(d-AMD)会导致地理萎缩(GA)和严重的视力损伤。多模态成像在 d-AMD 的诊断和管理中起着至关重要的作用,可对患者的表型进行详细分类,并有助于制定治疗计划和确定预后。随着针对补体级联的特效药物的开发,d-AMD 的治疗方法最近发生了深刻变化,首批抗补体药物最近被批准用于 GA 治疗。此外,基因治疗和激光治疗等新兴疗法也可能带来潜在的益处,但要完全确定其疗效还需要进一步的研究。然而,缺乏能够恢复受损视网膜细胞的有效疗法仍然是一大挑战。未来,旨在预防 d-AMD 病程进展的基因治疗可能会成为一种强有力的方法。但目前,这种疗法的开发仍处于早期阶段。
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引用次数: 0
Evaluation of the Accuracy of Intraocular Lens Power Calculation Formulas in Phacovitrectomy. 评估虹膜切除术中眼内透镜功率计算公式的准确性。
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-14 DOI: 10.1007/s40123-024-00971-6
Yuichiro Tanaka, Kazutaka Kamiya, Akihito Igarahi, Nobuyuki Shoji, Hiroshi Tsuchiya, Shinya Takahashi, Eri Ishikawa, Tadahiko Kozawa

Introduction: The aim of this study was to evaluate the refractive error in patients undergoing combined phacovitrectomy with and without gas tamponade.

Methods: This was a retrospective chart review including patients undergoing phacoemulsification alone (Group 1), combined phacovitrectomy for epiretinal membrane (Group 2), and combined phacovitrectomy with gas tamponade for rhegmatogenous retinal detachment (RRD) (Group 3). Axial length and keratometry were measured using an optical biometric system (Argos, Alcon Laboratories. Inc.), and a three-piece intraocular lens (IOL; NX-70S) was implanted in all groups. In each group, the prediction error at 3 months was calculated using IOL power calculation formulas (SRK/T, Hill-RBF, Kane, and Barrett Universal II) for each eye. Outcome measures included the mean prediction error (MPE), its standard deviation (SD), and the mean absolute error (MAE). The change in IOL position at 3 months was also assessed using anterior segment optical coherence tomography.

Results: A total of 104 eyes were included (Group 1: 30; Group 2: 34; Group 3: 40 eyes). The MPE was -0.08 ± 0.37 diopters (D), -0.26 ± 0.32 D, and -0.59 ± 0.34 D in Group 1, Group 2, and Group 3, respectively, using the Barrett Universal II formula (P < 0.01, ANOVA). The movement forward in the IOL position was 0.95 ± 0.16 mm, 0.94 ± 0.12 mm, and 1.07 ± 0.20 mm in Group 1, Group 2, and Group 3, respectively (P < 0.01). No significant difference was shown in MPE among the four formulas after combined phacovitrectomy with gas (P = 0.531).

Conclusions: Phacovitrectomy in RRD induced a significant myopic shift using any of the clinically available formulas. This suggests that myopic shift should be taken into consideration for better refractive outcomes in phacovitrectomy with gas tamponade in RRD.

简介本研究的目的是评估有无气体填塞联合超声乳化切除术患者的屈光不正:这是一项回顾性病历审查,包括单独接受超声乳化术(第 1 组)、因视网膜上膜而接受联合超声乳化术(第 2 组)以及因流变性视网膜脱离(RRD)而接受联合超声乳化术加气体填塞术(第 3 组)的患者。使用光学生物测量系统(Argos,Alcon Laboratories.Inc.)测量轴长和角膜度数,并在所有组中植入三片式眼内人工晶体(IOL;NX-70S)。在每组中,使用人工晶体功率计算公式(SRK/T、Hill-RBF、Kane 和 Barrett Universal II)计算每只眼睛 3 个月时的预测误差。结果测量包括平均预测误差 (MPE)、标准差 (SD) 和平均绝对误差 (MAE)。此外,还使用前节光学相干断层扫描评估了 3 个月时人工晶体位置的变化:共纳入 104 只眼睛(第一组:30 只;第二组:34 只;第三组:40 只)。采用巴雷特通用 II 公式计算,第 1 组、第 2 组和第 3 组的 MPE 分别为-0.08±0.37 屈光度(D)、-0.26±0.32 D 和 -0.59±0.34 D(P 结论:巴雷特通用 II 公式计算出的 MPE 值为-0.08±0.37(D)、-0.26±0.32 D 和-0.59±0.34 D):使用任何一种临床可用的公式,RRD 的磷状体切除术都会引起明显的近视偏移。这表明,RRD 的气体填塞法相卵巢切除术应考虑近视偏移,以获得更好的屈光疗效。
{"title":"Evaluation of the Accuracy of Intraocular Lens Power Calculation Formulas in Phacovitrectomy.","authors":"Yuichiro Tanaka, Kazutaka Kamiya, Akihito Igarahi, Nobuyuki Shoji, Hiroshi Tsuchiya, Shinya Takahashi, Eri Ishikawa, Tadahiko Kozawa","doi":"10.1007/s40123-024-00971-6","DOIUrl":"10.1007/s40123-024-00971-6","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the refractive error in patients undergoing combined phacovitrectomy with and without gas tamponade.</p><p><strong>Methods: </strong>This was a retrospective chart review including patients undergoing phacoemulsification alone (Group 1), combined phacovitrectomy for epiretinal membrane (Group 2), and combined phacovitrectomy with gas tamponade for rhegmatogenous retinal detachment (RRD) (Group 3). Axial length and keratometry were measured using an optical biometric system (Argos, Alcon Laboratories. Inc.), and a three-piece intraocular lens (IOL; NX-70S) was implanted in all groups. In each group, the prediction error at 3 months was calculated using IOL power calculation formulas (SRK/T, Hill-RBF, Kane, and Barrett Universal II) for each eye. Outcome measures included the mean prediction error (MPE), its standard deviation (SD), and the mean absolute error (MAE). The change in IOL position at 3 months was also assessed using anterior segment optical coherence tomography.</p><p><strong>Results: </strong>A total of 104 eyes were included (Group 1: 30; Group 2: 34; Group 3: 40 eyes). The MPE was -0.08 ± 0.37 diopters (D), -0.26 ± 0.32 D, and -0.59 ± 0.34 D in Group 1, Group 2, and Group 3, respectively, using the Barrett Universal II formula (P < 0.01, ANOVA). The movement forward in the IOL position was 0.95 ± 0.16 mm, 0.94 ± 0.12 mm, and 1.07 ± 0.20 mm in Group 1, Group 2, and Group 3, respectively (P < 0.01). No significant difference was shown in MPE among the four formulas after combined phacovitrectomy with gas (P = 0.531).</p><p><strong>Conclusions: </strong>Phacovitrectomy in RRD induced a significant myopic shift using any of the clinically available formulas. This suggests that myopic shift should be taken into consideration for better refractive outcomes in phacovitrectomy with gas tamponade in RRD.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2197-2208"},"PeriodicalIF":2.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11246384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ten-Year Effectiveness and Safety of Trabecular Micro-Bypass Stent Implantation with Cataract Surgery in Patients with Glaucoma or Ocular Hypertension. 小梁微旁路支架植入术与白内障手术在青光眼或眼压过高患者中的十年有效性和安全性。
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-21 DOI: 10.1007/s40123-024-00984-1
Tobias H Neuhann, Raphael T Neuhann, Dana M Hornbeak

Introduction: This study evaluated 10-year results of implanting one iStent trabecular micro-bypass stent during cataract surgery in eyes with open-angle glaucoma (OAG) or ocular hypertension.

Methods: This retrospective, non-randomized study examined 10-year outcomes of iStent trabecular micro-bypass stent implantation with cataract surgery by one surgeon in eyes with OAG [including primary OAG (POAG) and pseudoexfoliative glaucoma (PXG)] or ocular hypertension at a multi-specialty German ophthalmology center. Study visits were conducted preoperatively and at 2.5, 3, 5, and 10 years postoperatively; examinations included intraocular pressure (IOP), medications, corrected-distance visual acuity (CDVA), and adverse events.

Results: A total of 63 eyes of 45 patients with OAG (n = 60 eyes) or ocular hypertension (n = 3 eyes) and data through 10 years were analyzed. Mean preoperative IOP was 18.6 ± 4.4 mmHg on 1.83 ± 1.03 mean medications. At study visits through 10 years postoperative, mean IOP reduced by 12.9-19.0% (p < 0.005 at all points), and mean medication burden reduced by 37.8-51.4% (p ≤ 0.006 at all points). At 10 years postoperatively, 77.8% of eyes had IOP ≤ 18 mmHg and 47.6% had IOP ≤ 15 mmHg (vs. 50.8% and 25.4% preoperatively, respectively; p = 0.016). One-third (33.3%) of eyes were medication-free vs. 3.2% preoperatively (p < 0.001); 17.5% were on 2-5 medications (vs. 55.6% preoperatively, p = 0.005); and 93.7% of eyes were on the same or fewer medications vs. preoperative. Post-phacoemulsification CDVA improvement was maintained; no filtering surgeries were completed over 10-year follow-up.

Conclusions: Significant and safe IOP and medication reductions were observed through 10 years after iStent implantation with cataract surgery in patients with OAG or ocular hypertension.

简介:本研究评估了开角型青光眼(OAG)或眼压过高患者在白内障手术中植入一个 iStent 小梁微搭桥支架的 10 年效果:本研究评估了开角型青光眼(OAG)或眼压过高患者在白内障手术中植入一个 iStent 小梁微旁路支架的 10 年效果:这项回顾性非随机研究考察了德国一家多专科眼科中心的一名外科医生在白内障手术中植入 iStent 小梁微孔旁路支架的 10 年疗效,这些患者均患有开角型青光眼(包括原发性开角型青光眼(POAG)和假性角膜外翻性青光眼(PXG))或眼压过高。研究访问在术前和术后 2.5 年、3 年、5 年和 10 年进行,检查内容包括眼压 (IOP)、用药、矫正视力 (CDVA) 和不良反应:共分析了 45 名 OAG(n = 60 眼)或眼压过高(n = 3 眼)患者的 63 只眼睛和 10 年来的数据。术前平均眼压为 18.6 ± 4.4 mmHg,平均用药 1.83 ± 1.03 次。在术后 10 年的研究访问中,平均眼压降低了 12.9%-19.0%(p 结论:术后 10 年的研究访问中,平均眼压降低了 12.9%-19.0%:在白内障手术中植入 iStent 后,OAG 或眼压过高患者的眼压和用药量在 10 年内都有显著而安全的降低。
{"title":"Ten-Year Effectiveness and Safety of Trabecular Micro-Bypass Stent Implantation with Cataract Surgery in Patients with Glaucoma or Ocular Hypertension.","authors":"Tobias H Neuhann, Raphael T Neuhann, Dana M Hornbeak","doi":"10.1007/s40123-024-00984-1","DOIUrl":"10.1007/s40123-024-00984-1","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated 10-year results of implanting one iStent trabecular micro-bypass stent during cataract surgery in eyes with open-angle glaucoma (OAG) or ocular hypertension.</p><p><strong>Methods: </strong>This retrospective, non-randomized study examined 10-year outcomes of iStent trabecular micro-bypass stent implantation with cataract surgery by one surgeon in eyes with OAG [including primary OAG (POAG) and pseudoexfoliative glaucoma (PXG)] or ocular hypertension at a multi-specialty German ophthalmology center. Study visits were conducted preoperatively and at 2.5, 3, 5, and 10 years postoperatively; examinations included intraocular pressure (IOP), medications, corrected-distance visual acuity (CDVA), and adverse events.</p><p><strong>Results: </strong>A total of 63 eyes of 45 patients with OAG (n = 60 eyes) or ocular hypertension (n = 3 eyes) and data through 10 years were analyzed. Mean preoperative IOP was 18.6 ± 4.4 mmHg on 1.83 ± 1.03 mean medications. At study visits through 10 years postoperative, mean IOP reduced by 12.9-19.0% (p < 0.005 at all points), and mean medication burden reduced by 37.8-51.4% (p ≤ 0.006 at all points). At 10 years postoperatively, 77.8% of eyes had IOP ≤ 18 mmHg and 47.6% had IOP ≤ 15 mmHg (vs. 50.8% and 25.4% preoperatively, respectively; p = 0.016). One-third (33.3%) of eyes were medication-free vs. 3.2% preoperatively (p < 0.001); 17.5% were on 2-5 medications (vs. 55.6% preoperatively, p = 0.005); and 93.7% of eyes were on the same or fewer medications vs. preoperative. Post-phacoemulsification CDVA improvement was maintained; no filtering surgeries were completed over 10-year follow-up.</p><p><strong>Conclusions: </strong>Significant and safe IOP and medication reductions were observed through 10 years after iStent implantation with cataract surgery in patients with OAG or ocular hypertension.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2243-2254"},"PeriodicalIF":2.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11246400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Response to: Letter to the Editor Regarding "VIVEX-A Formula for Calculating Individual Vitreous Volume: A New Approach Towards Tailored Patient Dosing Regime in Intravitreal Therapy". 回应:致编辑的信,内容涉及 "VIVEX--计算个体玻璃体容量的公式:一种在玻璃体内治疗中为患者量身定制用药方案的新方法"。
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-10 DOI: 10.1007/s40123-024-00975-2
Andreas F Borkenstein, Eva-Maria Borkenstein, Achim Langenbucher
{"title":"A Response to: Letter to the Editor Regarding \"VIVEX-A Formula for Calculating Individual Vitreous Volume: A New Approach Towards Tailored Patient Dosing Regime in Intravitreal Therapy\".","authors":"Andreas F Borkenstein, Eva-Maria Borkenstein, Achim Langenbucher","doi":"10.1007/s40123-024-00975-2","DOIUrl":"10.1007/s40123-024-00975-2","url":null,"abstract":"","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2287-2292"},"PeriodicalIF":2.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11246316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analytical Characterization for Similarity Assessment Between an Aflibercept Biosimilar SB15 and Reference Product (Eylea®). 用于评估阿非利贝拉西普生物仿制药 SB15 与参考产品 (Eylea®) 相似性的分析表征。
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-15 DOI: 10.1007/s40123-024-00977-0
Hangyeore Lee, Jongcheol Huh, Dayoung Kim, Soye Lee, Jaeil Lee, Jungmin Lee, Beom Chan Kim, Jinsu Song

Introduction: SB15 is a proposed biosimilar product of reference aflibercept (Eylea®), an approved biological drug product for retinal diseases including neovascular age-related macular degeneration (nAMD). This study aimed to assess the analytical similarity between SB15 and its commercially available reference product (RP) sourced from the United States (US-aflibercept) and European Union (EU-aflibercept) in terms of structural, physicochemical, and biological properties.

Methods: A panel of state-of-the-art analytical methods was used for the comprehensive characterization of SB15 and US/EU-aflibercept. In terms of the structural and physicochemical properties, primary structure; post-translational modifications (PTM); higher-order structure; purity and impurities; charge variants; and glycosylation were compared. In addition, biological characterization including mechanism of action (MoA)-related and Fc-related biological activities was conducted.

Results: Analytical similarity between SB15 and US/EU-aflibercept was demonstrated. The primary and higher-order structure of SB15 was confirmed to be comparable to that of US/EU-aflibercept. In addition, there were no meaningful differences in the physicochemical properties in terms of size and charge heterogeneity between SB15 and its RP. SB15 and RP were similar in biological activities including MoA-related binding activities, potencies, and Fc-related biological functions. Consequently, SB15 was confirmed to be highly similar to US/EU-aflibercept.

Conclusions: Based on a comprehensive analytical similarity assessment of structural, physicochemical, and biological properties, SB15 was demonstrated to be highly similar to US/EU-aflibercept RP, supporting safe and effective use of SB15.

简介:SB15是阿弗利百普(Eylea®)的拟生物类似药,阿弗利百普是一种已获批准的治疗视网膜疾病(包括新生血管性年龄相关性黄斑变性(nAMD))的生物药。本研究旨在评估SB15与其来自美国(US-aflibercept)和欧盟(EU-aflibercept)的市售参比产品(RP)在结构、理化和生物特性方面的分析相似性:采用一组最先进的分析方法对 SB15 和美国/欧盟-阿夫利拜因进行了综合表征。在结构和理化特性方面,比较了一级结构、翻译后修饰(PTM)、高阶结构、纯度和杂质、电荷变异和糖基化。此外,还进行了生物学特性分析,包括与作用机制(MoA)相关的生物活性和与 Fc 相关的生物活性:结果:SB15与US/EU-aflibercept之间的分析相似。经证实,SB15的一级结构和高阶结构与US/EU-aflibercept相似。此外,SB15 与其 RP 在大小和电荷异质性方面的理化性质没有明显差异。SB15 和 RP 的生物活性相似,包括与 MoA 相关的结合活性、效力和与 Fc 相关的生物功能。因此,SB15 被证实与 US/EU-aflibercept 高度相似:基于结构、理化和生物学特性的综合分析相似性评估,SB15被证实与US/EU-aflibercept RP高度相似,支持安全有效地使用SB15。
{"title":"Analytical Characterization for Similarity Assessment Between an Aflibercept Biosimilar SB15 and Reference Product (Eylea<sup>®</sup>).","authors":"Hangyeore Lee, Jongcheol Huh, Dayoung Kim, Soye Lee, Jaeil Lee, Jungmin Lee, Beom Chan Kim, Jinsu Song","doi":"10.1007/s40123-024-00977-0","DOIUrl":"10.1007/s40123-024-00977-0","url":null,"abstract":"<p><strong>Introduction: </strong>SB15 is a proposed biosimilar product of reference aflibercept (Eylea<sup>®</sup>), an approved biological drug product for retinal diseases including neovascular age-related macular degeneration (nAMD). This study aimed to assess the analytical similarity between SB15 and its commercially available reference product (RP) sourced from the United States (US-aflibercept) and European Union (EU-aflibercept) in terms of structural, physicochemical, and biological properties.</p><p><strong>Methods: </strong>A panel of state-of-the-art analytical methods was used for the comprehensive characterization of SB15 and US/EU-aflibercept. In terms of the structural and physicochemical properties, primary structure; post-translational modifications (PTM); higher-order structure; purity and impurities; charge variants; and glycosylation were compared. In addition, biological characterization including mechanism of action (MoA)-related and Fc-related biological activities was conducted.</p><p><strong>Results: </strong>Analytical similarity between SB15 and US/EU-aflibercept was demonstrated. The primary and higher-order structure of SB15 was confirmed to be comparable to that of US/EU-aflibercept. In addition, there were no meaningful differences in the physicochemical properties in terms of size and charge heterogeneity between SB15 and its RP. SB15 and RP were similar in biological activities including MoA-related binding activities, potencies, and Fc-related biological functions. Consequently, SB15 was confirmed to be highly similar to US/EU-aflibercept.</p><p><strong>Conclusions: </strong>Based on a comprehensive analytical similarity assessment of structural, physicochemical, and biological properties, SB15 was demonstrated to be highly similar to US/EU-aflibercept RP, supporting safe and effective use of SB15.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2209-2225"},"PeriodicalIF":2.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11246345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Investigating the Influence of Temperature and Supplementation Timing on Antifungal Efficacy in Storage Medium for Corneal Transplantation. 研究温度和补充时间对角膜移植储存介质抗真菌功效的影响
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-03 DOI: 10.1007/s40123-024-00969-0
Hsin-Yu Liu, Pao-Yu Chen, Hsiao-Sang Chu, Ya-Ting Chiu, Yee-Chun Chen, Fung-Rong Hu

Introduction: Although antifungal supplementation reduces the fungal load in the corneal storage medium, consensus is lacking on the influence of dosing and temperature. The study aims to evaluate the impact of eye bank warming protocol and timing of antifungal supplements on efficacy in Optisol-GS and tissue.

Methods: Corneoscleral rims contaminated with Candida albicans (C. albicans) were incubated in Optisol-GS, either without antifungal agents or with the addition of amphotericin B or voriconazole at various concentrations (2 ×, 5 ×, 10 ×, and 20 × MIC), at different time points, and under various preservation temperatures (2-8 °C versus 2 h-room temperature exposure). Antifungal efficacy was evaluated by counting viable yeast colonies cultured from Optisol-GS samples. Tissue sterility was determined through direct tissue culture and histological examination of the contaminated rims after a 14-day incubation period.

Results: Room temperature exposure did not increase colony growth at the same multiple MIC of antifungal agents. Although antifungal addition reduced C. albicans growth in a concentration-dependent manner, yeast growth was still observed in all Optisol-GS samples with a single supplementation after a 14-day incubation. Only groups with additional antifungal supplementation on either day 2 or day 6 showed a 99% or greater reduction of C. albicans growth in Optisol-GS samples and yielded negative results in direct tissue culture.

Conclusions: The eye bank warming protocol did not compromise antifungal efficacy. To sustain the required concentration and effectively reduce C. albicans growth in Optisol-GS and contaminated tissue, additional antifungal supplementation on either day 2 or day 6 was necessary during a 2-week preservation period.

简介:尽管抗真菌补充剂可减少角膜储存介质中的真菌负荷,但对剂量和温度的影响尚缺乏共识。本研究旨在评估眼库加温方案和补充抗真菌剂的时间对 Optisol-GS 和组织疗效的影响:方法:将被白色念珠菌(C. albicans)污染的角膜巩膜边缘放入 Optisol-GS 中培养,在不同的时间点和不同的保存温度(2-8 °C 与室温暴露 2 小时)下,不添加抗真菌剂或添加不同浓度(2 ×、5 ×、10 × 和 20 × MIC)的两性霉素 B 或伏立康唑。抗真菌效果通过计数从 Optisol-GS 样品中培养出的有活力酵母菌菌落进行评估。组织无菌性是通过直接组织培养和 14 天培养期后对受污染的边缘进行组织学检查来确定的:结果:在相同的多重 MIC 抗真菌剂条件下,室温暴露不会增加菌落的生长。虽然抗真菌剂的添加以浓度依赖的方式减少了白僵菌的生长,但在培养 14 天后,所有添加了单一抗真菌剂的 Optisol-GS 样品中仍能观察到酵母菌的生长。只有在第 2 天或第 6 天补充抗真菌剂的组别才显示 Optisol-GS 样品中的白僵菌生长减少了 99% 或更多,并在直接组织培养中产生了阴性结果:眼库加温方案不会影响抗真菌效果。要维持所需的浓度并有效减少白僵菌在 Optisol-GS 和受污染组织中的生长,必须在 2 周的保存期内于第 2 天或第 6 天补充抗真菌剂。
{"title":"Investigating the Influence of Temperature and Supplementation Timing on Antifungal Efficacy in Storage Medium for Corneal Transplantation.","authors":"Hsin-Yu Liu, Pao-Yu Chen, Hsiao-Sang Chu, Ya-Ting Chiu, Yee-Chun Chen, Fung-Rong Hu","doi":"10.1007/s40123-024-00969-0","DOIUrl":"10.1007/s40123-024-00969-0","url":null,"abstract":"<p><strong>Introduction: </strong>Although antifungal supplementation reduces the fungal load in the corneal storage medium, consensus is lacking on the influence of dosing and temperature. The study aims to evaluate the impact of eye bank warming protocol and timing of antifungal supplements on efficacy in Optisol-GS and tissue.</p><p><strong>Methods: </strong>Corneoscleral rims contaminated with Candida albicans (C. albicans) were incubated in Optisol-GS, either without antifungal agents or with the addition of amphotericin B or voriconazole at various concentrations (2 ×, 5 ×, 10 ×, and 20 × MIC), at different time points, and under various preservation temperatures (2-8 °C versus 2 h-room temperature exposure). Antifungal efficacy was evaluated by counting viable yeast colonies cultured from Optisol-GS samples. Tissue sterility was determined through direct tissue culture and histological examination of the contaminated rims after a 14-day incubation period.</p><p><strong>Results: </strong>Room temperature exposure did not increase colony growth at the same multiple MIC of antifungal agents. Although antifungal addition reduced C. albicans growth in a concentration-dependent manner, yeast growth was still observed in all Optisol-GS samples with a single supplementation after a 14-day incubation. Only groups with additional antifungal supplementation on either day 2 or day 6 showed a 99% or greater reduction of C. albicans growth in Optisol-GS samples and yielded negative results in direct tissue culture.</p><p><strong>Conclusions: </strong>The eye bank warming protocol did not compromise antifungal efficacy. To sustain the required concentration and effectively reduce C. albicans growth in Optisol-GS and contaminated tissue, additional antifungal supplementation on either day 2 or day 6 was necessary during a 2-week preservation period.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"2151-2161"},"PeriodicalIF":2.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11246334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Real-World Outcomes of a Loading Phase with Intravitreal Faricimab in Neovascular Age-Related Macular Degeneration (n-AMD) and Diabetic Macular Edema (DME). 静脉注射法利西单抗治疗新生血管性老年黄斑变性 (n-AMD) 和糖尿病性黄斑水肿 (DME) 负荷阶段的实际效果。
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-04 DOI: 10.1007/s40123-024-00980-5
Ermete Giancipoli, Antonella Guglielmi, Anna Valeria Bux, Giulia Maria Emilia Clima, Francesco Pignatelli, Francesco Boscia, Pasquale Viggiano, Giacomo Boscia, Francesca Fortunato, Gianluca Besozzi, Alfredo Niro, Stefano Dore, Cristiana Iaculli

Introduction: The aims of this work were to evaluate the real-world efficacy and safety of a loading dose of intravitreal faricimab in eyes with active neovascular age-related macular degeneration (n-AMD) or diabetic macular edema (DME) and to analyze the treatment outcome in relation to specific biomarkers.

Methods: Patients with active n-AMD or DME, treated with four monthly intravitreal injections of faricimab, were enrolled in this retrospective, uncontrolled study. Best-corrected visual acuity (BCVA), central subfield thickness (CST), presence of retinal fluid (RF) on optical coherence tomography (OCT), and adverse events were assessed at baseline and at weeks 4, 8, 12, and 16. Predefined biomarkers were evaluated at baseline (BL) and at last visit.

Results: Sixteen eyes of 15 patients with n-AMD (n-AMD group) and 15 eyes of 12 patients with DME (DME group) were included. Mean (± standard deviation) logarithm of minimum angle of resolution (logMAR) BL BCVA changed from 0.68 (± 0.43) to 0.53 (± 0.36; P = 0.13) and from 0.51 (± 0.34) to 0.32 (± 0.24; P: 0.048) at week 16 in n-AMD and DME group, respectively. A statistically significant mean CST reduction was reported in both groups at last visit (n-AMD: - 166.5 μm; P = 0.0009/DME: - 110.8 μm; P = 0.0086). Seventy-five and 33% of eyes with n-AMD and DME respectively achieved complete RF resolution at last visit. Subfoveal inner and outer retinal damage correlated with a lower final BCVA in n-AMD group. The presence of large (> 100 μm) juxtafoveal microaneurysms (MAs) was significantly correlated with a higher chance of residual fluid in eyes with DME.

Conclusions: Both n-AMD and DME groups achieved satisfactory anatomical results after a loading-dose of intravitreal faricimab. BCVA improvement might be hampered by pre-existing retinal damage in eyes with n-AMD. Large, juxtafoveal MAs might represent a hallmark of a slower anatomical response to the treatment in eyes with DME.

简介这项研究的目的是评估在活动性新生血管性老年黄斑变性(n-AMD)或糖尿病性黄斑水肿(DME)患者体内注射负荷剂量的法尼单抗的实际疗效和安全性,并分析治疗结果与特定生物标志物的关系:这项回顾性非对照研究招募了活动性n-AMD或DME患者,这些患者每月接受四次法尼单抗玻璃体内注射治疗。在基线和第4、8、12和16周时对最佳矫正视力(BCVA)、中央子场厚度(CST)、光学相干断层扫描(OCT)显示的视网膜积液(RF)以及不良反应进行评估。在基线(BL)和最后一次就诊时评估了预定义的生物标志物:结果:15 名 n-AMD 患者的 16 只眼睛(n-AMD 组)和 12 名 DME 患者的 15 只眼睛(DME 组)被纳入研究。第16周时,n-AMD组和DME组的BCVA最小解像角对数(± 标准差)分别从0.68(± 0.43)变为0.53(± 0.36;P = 0.13)和0.51(± 0.34)变为0.32(± 0.24;P:0.048)。在最后一次就诊时,两组的 CST 平均值均有统计学意义的下降(n-AMD:- 166.5 μm;P = 0.0009/DME:- 110.8 μm;P = 0.0086)。在最后一次就诊时,分别有 75% 和 33% 的 n-AMD 和 DME 眼球达到了完全的射频分辨率。在n-AMD组中,视网膜内部和外部的叶下损伤与较低的最终BCVA相关。在DME患者中,存在大的(> 100 μm)并眼底微动脉瘤(MAs)与较高的残留液体几率显著相关:n-AMD 组和 DME 组在使用了负荷剂量的玻璃体内法尼单抗后,都取得了令人满意的解剖效果。在 n-AMD 患者中,BCVA 的改善可能会受到先前存在的视网膜损伤的影响。在DME患者中,大的眼底MA可能是对治疗的解剖反应较慢的标志。
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引用次数: 0
Pre-Clinical Studies of a Novel Bispecific Fusion Protein Targeting C3b and VEGF in Neovascular and Nonexudative AMD Models. 针对 C3b 和血管内皮生长因子的新型双特异性融合蛋白在新生血管性和非渗出性老年性黄斑病变模型中的临床前研究。
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-21 DOI: 10.1007/s40123-024-00982-3
Yeri Lee, Donggeon Kim, Philip E D Chung, Minkyeong Lee, Nahmju Kim, Jihoon Chang, Byoung Chul Lee

Introduction: KNP-301 is a bi-specific fragment crystallizable region (Fc) fusion protein, which inhibits both C3b and vascular endothelial growth factor (VEGF) simultaneously for patients with late-stage age-related macular degeneration (AMD). The present study evaluated in vitro potency, in vivo efficacy, intravitreal pharmacokinetics (IVT PK), and injectability of KNP-301.

Methods: C3b and VEGF binding of KNP-301 were assessed by surface plasmon resonance (SPR) and enzyme-linked immunosorbent assay (ELISA), and cellular bioassays. A laser-induced choroidal neovascularization (CNV) model and a sodium iodate-induced nonexudative AMD model were used to test the in vivo efficacy of mouse surrogate of KNP-301. Utilizing fluorescein angiography (FA) and spectral-domain optical coherence tomography (SD-OCT) scans, the reduction in disease lesions were analyzed in a CNV mouse model. In the nonexudative AMD mouse model, outer nuclear layer (ONL) was assessed by immunofluorescence staining. Lastly, intravitreal pharmacokinetic study was conducted with New Zealand white rabbits via IVT administration of KNP-301 and injectability of KNP-301 was examined by a viscosity test at high concentrations.

Results: KNP-301 bound C3b selectively, which resulted in a blockade of the alternative pathway, not the classical pathway. KNP-301 also acted as a VEGF trap, impeding VEGF-mediate signaling. Our dual-blockade strategy was effective in both neovascular and nonexudative AMD models. Moreover, KNP-301 had an advantage of potentially less frequent dosing due to the long half-life in the intravitreal chamber. Our viscosity assessment confirmed that KNP-301 meets the criteria of the IVT injection.

Conclusions: Unlike current therapies, KNP-301 is expected to cover patients with late-stage AMD of both neovascular and nonexudative AMD, and its long-term PK profile at the intravitreal chamber would allow convenience in the dosing interval of patients.

简介KNP-301是一种双特异性片段可结晶区(Fc)融合蛋白,可同时抑制C3b和血管内皮生长因子(VEGF),用于晚期老年性黄斑变性(AMD)患者。本研究评估了 KNP-301 的体外效力、体内疗效、玻璃体内药代动力学(IVT PK)和可注射性:通过表面等离子体共振(SPR)、酶联免疫吸附试验(ELISA)和细胞生物测定评估了 KNP-301 的 C3b 和血管内皮生长因子结合情况。利用激光诱导的脉络膜新生血管(CNV)模型和碘酸钠诱导的非渗出性 AMD 模型来测试 KNP-301 小鼠替代物的体内疗效。利用荧光素血管造影(FA)和光谱域光学相干断层扫描(SD-OCT)扫描,分析了 CNV 小鼠模型中病变的减少情况。在非渗出性 AMD 小鼠模型中,通过免疫荧光染色评估了外核层(ONL)。最后,以新西兰白兔为实验对象,通过静脉注射 KNP-301 进行了玻璃体内药代动力学研究,并通过高浓度粘度测试检验了 KNP-301 的可注射性:结果:KNP-301 可选择性地结合 C3b,从而阻断替代途径,而不是经典途径。KNP-301 还能捕获血管内皮生长因子,阻碍血管内皮生长因子中介信号的传递。我们的双重阻断策略对新生血管性和非渗出性 AMD 模型均有效。此外,由于 KNP-301 在玻璃体腔内的半衰期较长,其优点是用药次数可能较少。我们的粘度评估证实,KNP-301符合IVT注射剂的标准:结论:与目前的疗法不同,KNP-301有望覆盖新生血管性和非渗出性AMD晚期患者,其在玻璃体内腔的长期PK曲线将为患者的用药间隔提供方便。
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引用次数: 0
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