Survey of ophthalmology最新文献

Keratoconus (KC) is a progressive corneal disorder that typically manifests during adolescence characterized by corneal thinning and irregularity. Recent studies have revealed that pathoanatomical abnormalities may not be limited to the anterior segment. Posterior segment alterations may also occur in KC patients. We provide a comprehensive review of the posterior segment changes in KC and assess the role of optical coherence tomography (OCT) in detecting these alterations. An initial systematic search of PubMed, EMBASE, and Web of Science was conducted on November 28, 2024. To identify any newly published literature, the search was updated on September 1, 2025. Random-effects models were employed to calculate pooled effect estimates. A total of 38 studies involving 4584 eyes were reviewed, and 26 studies (3124 eyes) met our eligibility criteria for meta-analysis. The remaining 12 studies, although not included in the quantitative synthesis, were reviewed and their findings integrated. Our systematic analysis revealed significant reductions in several macular measurements, including average and temporal parafoveal (inner ring) thickness as well as temporal and superior perifoveal (outer ring) thickness. Peripapillary parameters also showed notable decreases, specifically in lamina cribrosa thickness, average retinal nerve fiber layer (RNFL) thickness, and RNFL thickness in the superior, temporal, and inferior quadrants. By contrast, subfoveal choroidal thickness was significantly increased in KC patients. Additionally, optic nerve head parameters, including cup area and cup volume, showed significantly greater values. When comparing different stages of the disease, patients with moderate KC exhibited significantly higher superotemporal RNFL thickness than those with severe disease. This meta-analysis underscores the concept that keratoconus, primarily a corneal disease, is associated with retinal and choroidal structural abnormalities. Changes in the posterior segment were similar across mild and advanced stages of the corneal disease. OCT monitoring in KC patients can facilitate detection of these alterations.

Age-related macular degeneration (AMD) is one of the most common types of eye diseases that generally affect the elderly population over 50 years of age. The effects of AMD on the quality of vision and life are devastating. We systematically review applications and performance of machine/deep learning algorithms for AMD detection and prediction using color fundus photos. We reviewed the studies that focused on machine learning and deep learning techniques and algorithms to analyze the fundus images for AMD. The data were collected by searching Scopus, PubMed (Medline), Web of Science and IEEE Xplore databases. After screening, 42 papers were included. The findings showed that the studies used different architectures for model training and testing. Convolutional neural networks (CNN) are used mostly in the diagnosis of AMD. ResNet architecture (11 studies) was used more than other architectures. Twenty-two studies used AREDS dataset. CNN algorithm with ResNet architecture had the highest performance compared to other architectures. Studies have shown that machine learning can diagnose AMD from fundus images with high accuracy; however, calibration, fairness, explainability, external validation, generalization, prospective validation in clinical settings and regulatory requirements should be considered in the future.

Dry anophthalmic socket syndrome (DASS) is a complex and multifaceted condition that commonly affects patients who have undergone enucleation or evisceration and wear an ocular prothesis. The diagnosis and management of DASS poses significant challenges due to the absence of a standardized diagnostic criteria and evidence-based treatment protocol. Though DASS symptoms can be disproportionate to observable clinical signs, patient-reported outcomes and scoring systems remain the cornerstone of its diagnostic framework. While a dearth of literature exists, parallels can be drawn from other ocular surface conditions, including dry eye disease and contact lens-associated dry eye, regarding inflammatory pathways and surface interactions. DASS is postulated to be related to disruptions to tear film homeostasis, lid margin disease, and chronic inflammation driven by mechanical friction between the prosthesis and socket tissues. We provide a comprehensive review of the pathophysiological processes underlying DASS, discussing current and evolving diagnostic approaches, including use of symptom questionnaires and objective biomarkers such as tear film osmolarity and matrix metalloproteinase-9. Emerging concepts, such as detailed mechanisms of chronic inflammation and the precise nature of mechanical interactions will also be evaluated, alongside future directions for research aimed at optimising guidelines to improve patients' quality of life.