Pub Date : 2025-08-06DOI: 10.1016/j.survophthal.2025.08.005
Jia Gao , Wei Wang , Ya Mo
Retinal degenerative diseases (RDD) are a group of age-related blinding eye diseases characterized by progressive degeneration and functional impairment of retinal photoreceptors or ganglion cells, for which there are currently no effective treatments. The complement system is an important innate immune system in the human body, activated through 3 pathways (classical pathway, lectin pathway, and alternative pathway) to ultimately form a membrane attack complex that acts on target cells. Microglia are the innate immune cells of the retina, responsible for maintaining retinal homeostasis. Complement system activation and microglial activation have been identified in RDD. Complement activation products C3 and C5 generate anaphylatoxins C3a and C5a, whose receptors C3aR and C5aR1 can activate microglia. Activated microglia can further produce complement C1q to activate the complement system, forming a positive feedback loop that exacerbates retinal damage. In this review, we focus on the crosstalk between the complement system and microglia in age-related macular degeneration, diabetic retinopathy, glaucoma, and pathological myopia-related retinal degeneration, and summarize clinical studies targeting the complement system and microglia for the treatment of RDD.
{"title":"Retinal degenerative diseases: Complement system-microglia crosstalk","authors":"Jia Gao , Wei Wang , Ya Mo","doi":"10.1016/j.survophthal.2025.08.005","DOIUrl":"10.1016/j.survophthal.2025.08.005","url":null,"abstract":"<div><div>Retinal degenerative diseases (RDD) are a group of age-related blinding eye diseases characterized by progressive degeneration and functional impairment of retinal photoreceptors or ganglion cells, for which there are currently no effective treatments. The complement system is an important innate immune system in the human body, activated through 3 pathways (classical pathway, lectin pathway, and alternative pathway) to ultimately form a membrane attack complex that acts on target cells. Microglia are the innate immune cells of the retina, responsible for maintaining retinal homeostasis. Complement system activation and microglial activation have been identified in RDD. Complement activation products C3 and C5 generate anaphylatoxins C3a and C5a, whose receptors C3aR and C5aR1 can activate microglia. Activated microglia can further produce complement C1q to activate the complement system, forming a positive feedback loop that exacerbates retinal damage. In this review, we focus on the crosstalk between the complement system and microglia in age-related macular degeneration, diabetic retinopathy, glaucoma, and pathological myopia-related retinal degeneration, and summarize clinical studies targeting the complement system and microglia for the treatment of RDD.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"71 2","pages":"Pages 346-360"},"PeriodicalIF":5.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-05DOI: 10.1016/j.survophthal.2025.08.002
Akash Gowda MBBS , John P.M. Wood DPhil , Glyn Chidlow DPhil , Robert J. Casson DPhil FRANZCO
Although the indications for retinal laser have diminished over the past 2 decades due to the rise of intravitreal injection therapy, retinal laser remains a useful clinical tool, with novel laser technologies continuing to emerge. Continuous wave photocoagulation remains the most well-characterized laser in terms of its histopathological effects. Information about the histological effects of newer retinal laser modalities is relatively scarce. Available evidence supports the notion that short pulse applications result in less collateral damage to the neurosensory retina, but that at sufficient energy settings thermal injury is observed irrespective of the laser type.
{"title":"Laser-induced histopathological changes to the retina: A review","authors":"Akash Gowda MBBS , John P.M. Wood DPhil , Glyn Chidlow DPhil , Robert J. Casson DPhil FRANZCO","doi":"10.1016/j.survophthal.2025.08.002","DOIUrl":"10.1016/j.survophthal.2025.08.002","url":null,"abstract":"<div><div>Although the indications for retinal laser have diminished over the past 2 decades due to the rise of intravitreal injection therapy, retinal laser remains a useful clinical tool, with novel laser technologies continuing to emerge. Continuous wave photocoagulation remains the most well-characterized laser in terms of its histopathological effects. Information about the histological effects of newer retinal laser modalities is relatively scarce. Available evidence supports the notion that short pulse applications result in less collateral damage to the neurosensory retina, but that at sufficient energy settings thermal injury is observed irrespective of the laser type.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"71 1","pages":"Pages 53-60"},"PeriodicalIF":5.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-05DOI: 10.1016/j.survophthal.2025.07.014
Roberto dell’Omo
{"title":"Response to the letter: Optimizing the detection of vitreous cortex remnants: The underestimated role of triamcinolone concentration","authors":"Roberto dell’Omo","doi":"10.1016/j.survophthal.2025.07.014","DOIUrl":"10.1016/j.survophthal.2025.07.014","url":null,"abstract":"","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"71 1","pages":"Pages 277-278"},"PeriodicalIF":5.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-05DOI: 10.1016/j.survophthal.2025.07.011
Hosein Nouri , Nasiq Hasan , Seyed-Hossein Abtahi , Hamid Ahmadieh , Jay Chhablani
Less than a decade has passed since deep learning (DL) was first applied in ophthalmology. With tremendous growth in this field since then, DL is expected to transform and enhance the efficiency of traditional ophthalmology practice. Central serous chorioretinopathy (CSC) is a common chorioretinal disorder whose etiopathogenesis remains largely unknown. The diagnosis and management of CSC rely heavily on multimodal imaging data, detailed analysis of which may exceed the capacity of many practices. In this comprehensive review, we examine how DL can address such issues through automated analysis of CSC-related imaging biomarkers, including subretinal fluid, pigment epithelial detachment, subretinal hyperreflective material, hyperreflective foci, retinal pigment epithelium atrophy, ellipsoid zone loss, and choroidal layer, sublayers, vessels, and neovascularization. Their prognostic yield and therapeutic implications are covered as well. We describe how DL enables rapid, noninvasive visualization of choroidal vasculature, a primary source of pathology in CSC, in unprecedented detail. We also review the state-of-the-art DL models designed for automated CSC diagnosis, classification, prognostication, and treatment outcome prediction based on imaging data. We highlight the challenges and gaps in this field, discuss some recommended counter measures, and suggest future research directions.
{"title":"Deep learning in central serous chorioretinopathy","authors":"Hosein Nouri , Nasiq Hasan , Seyed-Hossein Abtahi , Hamid Ahmadieh , Jay Chhablani","doi":"10.1016/j.survophthal.2025.07.011","DOIUrl":"10.1016/j.survophthal.2025.07.011","url":null,"abstract":"<div><div>Less than a decade has passed since deep learning (DL) was first applied in ophthalmology. With tremendous growth in this field since then, DL is expected to transform and enhance the efficiency of traditional ophthalmology practice. Central serous chorioretinopathy (CSC) is a common chorioretinal disorder whose etiopathogenesis remains largely unknown. The diagnosis and management of CSC rely heavily on multimodal imaging data, detailed analysis of which may exceed the capacity of many practices. In this comprehensive review, we examine how DL can address such issues through automated analysis of CSC-related imaging biomarkers, including subretinal fluid, pigment epithelial detachment, subretinal hyperreflective material, hyperreflective foci, retinal pigment epithelium atrophy, ellipsoid zone loss, and choroidal layer, sublayers, vessels, and neovascularization. Their prognostic yield and therapeutic implications are covered as well. We describe how DL enables rapid, noninvasive visualization of choroidal vasculature, a primary source of pathology in CSC, in unprecedented detail. We also review the state-of-the-art DL models designed for automated CSC diagnosis, classification, prognostication, and treatment outcome prediction based on imaging data. We highlight the challenges and gaps in this field, discuss some recommended counter measures, and suggest future research directions.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"71 2","pages":"Pages 718-748"},"PeriodicalIF":5.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-30DOI: 10.1016/j.survophthal.2025.07.012
Meiqian He M.D. , Zuyi Yang M.D. , Zhengming Shi Ph.D. , Youxin Chen M.D., Ph.D. , Xinyu Zhao M.D.
We provide a comprehensive clarification of the demographics, clinical features, management, prognostic factors, and complications of traumatic optic neuropathy (TON). About 6068 patients from 109 studies were included. The pooling results indicated that TON was male-dominated (84 %) with road traffic accidents as the leading cause (67 %). After trauma, 46 % of cases had no light perception (NLP), and the most frequent associated injury was craniofacial fractures (70 %). Optic canal fractures (OCF) were detected in 34 % of cases via computed tomography and in 47 % intraoperatively. The general visual improvement rate of conservative treatment, steroid pulse therapy (SPT), optic nerve decompression (OND) and intravenous erythropoietin injection were 34 %, 48 %, 56 %, and 61 %, respectively. OND and SPT showed similar efficacy in patients with both NLP (37 % vs. 28 %) and residual vision (76 % vs. 73 %), but were superior to observation only in patients with residual vision. Patients without OCF also responded similarly to OND (57 %) and SPT (62 %), whereas those with OCF showed a higher response rate to OND (53 %) compared to SPT (24 %). Early intervention (within 7 days post-trauma) improved outcomes for both OND and SPT. Complications from OND were rare. TON mainly affects males, causes severe vision impairment, and is often associated with craniofacial fractures. OND may provide greater benefit than SPT for patients with OCF, while both treatments appear similarly effective for those without OCF, regardless of baseline vision status; however, heterogeneity in the definition and diagnostic criteria of TON, as well as variability in study designs, warrants cautious interpretation of these findings.
我们提供了一个全面的人口统计，临床特点，管理，预后因素和并发症的创伤性视神经病变（TON）的澄清。来自109项研究的约6068名患者被纳入研究。汇总结果显示，TON以男性为主（84%），道路交通事故是主要原因（67%）。创伤后，46%的病例没有光知觉（NLP），最常见的相关损伤是颅面骨折（70%）。术中视神经管骨折（OCF）的检出率为47%，计算机断层扫描检出率为34%。保守治疗、类固醇脉冲治疗（SPT）、视神经减压（OND）和静脉注射促红细胞生成素的总体视力改善率分别为34%、48%、56%和61%。OND和SPT对NLP患者（37% vs. 28%）和残视力患者（76% vs. 73%）的疗效相似，但优于仅对残视力患者进行观察。没有OCF的患者对OND（57%）和SPT（62%）也有类似的反应，而OCF患者对OND（53%）的反应率高于SPT（24%）。早期干预（创伤后7天内）改善了OND和SPT的预后。OND的并发症很少见。TON主要影响男性，导致严重的视力障碍，并常伴有颅面骨折。对于有OCF的患者，OND可能比SPT提供更大的益处，而对于没有OCF的患者，无论基线视力状况如何，两种治疗似乎同样有效；然而，由于TON的定义和诊断标准的异质性以及研究设计的可变性，需要对这些发现进行谨慎的解释。
{"title":"Clinical features, management, and prognosis factors of traumatic optic neuropathy","authors":"Meiqian He M.D. , Zuyi Yang M.D. , Zhengming Shi Ph.D. , Youxin Chen M.D., Ph.D. , Xinyu Zhao M.D.","doi":"10.1016/j.survophthal.2025.07.012","DOIUrl":"10.1016/j.survophthal.2025.07.012","url":null,"abstract":"<div><div>We provide a comprehensive clarification of the demographics, clinical features, management, prognostic factors, and complications of traumatic optic neuropathy (TON). About 6068 patients from 109 studies were included. The pooling results indicated that TON was male-dominated (84 %) with road traffic accidents as the leading cause (67 %). After trauma, 46 % of cases had no light perception (NLP), and the most frequent associated injury was craniofacial fractures (70 %). Optic canal fractures (OCF) were detected in 34 % of cases via computed tomography and in 47 % intraoperatively. The general visual improvement rate of conservative treatment, steroid pulse therapy (SPT), optic nerve decompression (OND) and intravenous erythropoietin injection were 34 %, 48 %, 56 %, and 61 %, respectively. OND and SPT showed similar efficacy in patients with both NLP (37 % vs. 28 %) and residual vision (76 % vs. 73 %), but were superior to observation only in patients with residual vision. Patients without OCF also responded similarly to OND (57 %) and SPT (62 %), whereas those with OCF showed a higher response rate to OND (53 %) compared to SPT (24 %). Early intervention (within 7 days post-trauma) improved outcomes for both OND and SPT. Complications from OND were rare. TON mainly affects males, causes severe vision impairment, and is often associated with craniofacial fractures. OND may provide greater benefit than SPT for patients with OCF, while both treatments appear similarly effective for those without OCF, regardless of baseline vision status; however, heterogeneity in the definition and diagnostic criteria of TON, as well as variability in study designs, warrants cautious interpretation of these findings.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"71 1","pages":"Pages 168-178"},"PeriodicalIF":5.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-30DOI: 10.1016/j.survophthal.2025.07.013
Abdullah Ağın, Ozgur Artunay
{"title":"Optimizing the detection of vitreous cortex remnants: The underestimated role of triamcinolone concentration","authors":"Abdullah Ağın, Ozgur Artunay","doi":"10.1016/j.survophthal.2025.07.013","DOIUrl":"10.1016/j.survophthal.2025.07.013","url":null,"abstract":"","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"71 1","pages":"Pages 275-276"},"PeriodicalIF":5.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Age-related macular degeneration (AMD) represents a leading cause of vision loss worldwide, while vitreoretinal interface (VRI) abnormalities constitute a dynamic boundary where posterior vitreous interacts with the retinal surface. We explore the intricate relationship between VRI abnormalities and AMD, examining prevalence, underlying pathophysiological mechanisms, and their reciprocal influence on disease development, progression, and treatment outcomes. Evidence suggests a higher prevalence of vitreomacular adhesion in exudative versus nonexudative AMD, while complete posterior vitreous detachment may exert protective effects against AMD progression. Tractional forces, inflammatory mediators, and structural disruption associated with VRI abnormalities may promote AMD progression and confound assessment of anti-vascular endothelial growth factor therapy efficacy. Recent findings underscore that epiretinal membranes might act as physical barriers reducing drug penetration, while VMT/VMA can alter macular morphology, potentially mimicking or obscuring therapeutic response. Surgical management of VRI abnormalities in AMD can achieve anatomical success, though visual outcomes may be limited by underlying macular pathology. Early detection and characterization of VRI abnormalities in AMD patients could improve risk stratification, guide treatment timing, and potentially lead to novel preventive strategies, highlighting the importance of comprehensive evaluation and individualized management approaches for optimizing outcomes in this complex patient population.
{"title":"Vitreoretinal interface abnormalities in age-related macular degeneration: Prevalence, pathophysiology, and reciprocal influence","authors":"Matteo Mario Carlà , Francesco Mottola MD , Mattia Cusato MD , Gianmarco Oreste MD , Giorgia Campaniello MD , Carlos Mateo , Aude Couturier , Elise Philippakis , Tomaso Caporossi , Stanislao Rizzo","doi":"10.1016/j.survophthal.2025.07.010","DOIUrl":"10.1016/j.survophthal.2025.07.010","url":null,"abstract":"<div><div>Age-related macular degeneration (AMD) represents a leading cause of vision loss worldwide, while vitreoretinal interface (VRI) abnormalities constitute a dynamic boundary where posterior vitreous interacts with the retinal surface. We explore the intricate relationship between VRI abnormalities and AMD, examining prevalence, underlying pathophysiological mechanisms, and their reciprocal influence on disease development, progression, and treatment outcomes. Evidence suggests a higher prevalence of vitreomacular adhesion in exudative versus nonexudative AMD, while complete posterior vitreous detachment may exert protective effects against AMD progression. Tractional forces, inflammatory mediators, and structural disruption associated with VRI abnormalities may promote AMD progression and confound assessment of anti-vascular endothelial growth factor therapy efficacy. Recent findings underscore that epiretinal membranes might act as physical barriers reducing drug penetration, while VMT/VMA can alter macular morphology, potentially mimicking or obscuring therapeutic response. Surgical management of VRI abnormalities in AMD can achieve anatomical success, though visual outcomes may be limited by underlying macular pathology. Early detection and characterization of VRI abnormalities in AMD patients could improve risk stratification, guide treatment timing, and potentially lead to novel preventive strategies, highlighting the importance of comprehensive evaluation and individualized management approaches for optimizing outcomes in this complex patient population.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"71 2","pages":"Pages 321-333"},"PeriodicalIF":5.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-22DOI: 10.1016/j.survophthal.2025.07.008
Haiyang Zhang , Ziyuan Li , Hoi Chi Chan, Xuefei Song, Huifang Zhou, Xianqun Fan
Thyroid eye disease (TED) is a common, complex orbital disorder characterized by soft-tissue changes visible on imaging. Artificial intelligence (AI) offers promises for improving TED diagnosis and treatment; however, no systematic review has yet characterized the research landscape, key challenges, and future directions. We followed PRISMA guidelines to search multiple databases until January, 2025, for studies applying AI to computed tomography (CT), magnetic resonance imaging, and nuclear, facial or retinal imaging in TED patients. Using the APPRAISE-AI tool, we assessed study quality and included 41 studies covering various AI applications. Sample sizes ranged from 33 to 2288 participants, predominantly East Asian. CT and facial imaging were the most common modalities, reported in 16 and 13 articles, respectively. Studies addressed clinical tasks—diagnosis, activity assessment, severity classification, and treatment prediction—and technical tasks—classification, segmentation, and image generation—with classification being the most frequent. Researchers primarily employed deep-learning models, such as residual network (ResNet) and Visual Geometry Group (VGG). Overall, the majority of the studies were of moderate quality. Image-based AI shows strong potential to improve diagnostic accuracy and guide personalized treatment strategies in TED. Future research should prioritize robust study designs, the creation of public datasets, multimodal imaging integration, and interdisciplinary collaboration to accelerate clinical translation.
{"title":"Artificial intelligence in thyroid eye disease imaging: A systematic review","authors":"Haiyang Zhang , Ziyuan Li , Hoi Chi Chan, Xuefei Song, Huifang Zhou, Xianqun Fan","doi":"10.1016/j.survophthal.2025.07.008","DOIUrl":"10.1016/j.survophthal.2025.07.008","url":null,"abstract":"<div><div>Thyroid eye disease (TED) is a common, complex orbital disorder characterized by soft-tissue changes visible on imaging. Artificial intelligence (AI) offers promises for improving TED diagnosis and treatment; however, no systematic review has yet characterized the research landscape, key challenges, and future directions. We followed PRISMA guidelines to search multiple databases until January, 2025, for studies applying AI to computed tomography (CT), magnetic resonance imaging, and nuclear, facial or retinal imaging in TED patients. Using the APPRAISE-AI tool, we assessed study quality and included 41 studies covering various AI applications. Sample sizes ranged from 33 to 2288 participants, predominantly East Asian. CT and facial imaging were the most common modalities, reported in 16 and 13 articles, respectively. Studies addressed clinical tasks—diagnosis, activity assessment, severity classification, and treatment prediction—and technical tasks—classification, segmentation, and image generation—with classification being the most frequent. Researchers primarily employed deep-learning models, such as residual network (ResNet) and Visual Geometry Group (VGG). Overall, the majority of the studies were of moderate quality. Image-based AI shows strong potential to improve diagnostic accuracy and guide personalized treatment strategies in TED. Future research should prioritize robust study designs, the creation of public datasets, multimodal imaging integration, and interdisciplinary collaboration to accelerate clinical translation.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"71 1","pages":"Pages 142-157"},"PeriodicalIF":5.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-22DOI: 10.1016/j.survophthal.2025.07.009
Claire Y. Hooper FRANZCO , Lisia Barros Ferreira MD, PhD , Anagha Vaze FRANZCO, MPhil , Daniel V. Vasconcelos-Santos MD, PhD , Debra A. Goldstein MD , Demi Gertig MOpt , Justine R. Smith FRANZCO, PhD
Relentless placoid chorioretinitis (RPC) is a rare, vision-threatening posterior uveitis that predominantly affects young adults. The hallmark clinical findings are numerous scattered placoid chorioretinal lesions involving the midperipheral and far peripheral fundus as well as the posterior pole and a persistent or recurrent course resulting in lesions at different chronological stages, with fresh creamy placoid lesions and healing pigmented lesions being present at the same time. Although RPC is frequently described as a disease that is intermediate between acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and serpiginous choroiditis, it more closely resembles APMPPE. It is important to identify those patients with RPC who present with an APMPPE phenotype so that appropriate immunomodulatory therapy is instituted without delay, as most cases of RPC are refractory to corticosteroid monotherapy. Examination findings may help differentiate RPC and APMPPE. Multimodal imaging, including ultra-widefield imaging, and selective investigations aid in distinguishing RPC from other placoid diseases and types of posterior uveitis.
{"title":"Relentless placoid chorioretinitis","authors":"Claire Y. Hooper FRANZCO , Lisia Barros Ferreira MD, PhD , Anagha Vaze FRANZCO, MPhil , Daniel V. Vasconcelos-Santos MD, PhD , Debra A. Goldstein MD , Demi Gertig MOpt , Justine R. Smith FRANZCO, PhD","doi":"10.1016/j.survophthal.2025.07.009","DOIUrl":"10.1016/j.survophthal.2025.07.009","url":null,"abstract":"<div><div>Relentless placoid chorioretinitis (RPC) is a rare, vision-threatening posterior uveitis that predominantly affects young adults. The hallmark clinical findings are numerous scattered placoid chorioretinal lesions involving the midperipheral and far peripheral fundus as well as the posterior pole and a persistent or recurrent course resulting in lesions at different chronological stages, with fresh creamy placoid lesions and healing pigmented lesions being present at the same time. Although RPC is frequently described as a disease that is intermediate between acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and serpiginous choroiditis, it more closely resembles APMPPE. It is important to identify those patients with RPC who present with an APMPPE phenotype so that appropriate immunomodulatory therapy is instituted without delay, as most cases of RPC are refractory to corticosteroid monotherapy. Examination findings may help differentiate RPC and APMPPE. Multimodal imaging, including ultra-widefield imaging, and selective investigations aid in distinguishing RPC from other placoid diseases and types of posterior uveitis.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"71 2","pages":"Pages 467-482"},"PeriodicalIF":5.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-21DOI: 10.1016/j.survophthal.2025.07.005
Michael Drakopoulos MD,MPhil, Arnold Nadel MD, Harnaina K. Bains MD, Jay B. Bisen BS, Hayden Sikora BA, Kevin X. Zhang MD, PhD, Alessandro Marchese MD, Joseph Fahey MS, Rukhsana G. Mirza MD,MS
Optical coherence tomography angiography (OCTA) noninvasively and quantitatively images the microvasculature of the eye’s posterior segment in 3 dimensions. OCTA has known utility in the diagnosis and management of certain ocular conditions and is now being used to assess systemic conditions, including respiratory, cardiovascular, renal, obstetric, neurologic, rheumatologic, and genetic conditions, among others. OCTA may improve our understanding of the pathophysiology of systemic conditions and identify biomarkers useful in their diagnosis, prognosis, and management. We detail known associations between quantitative retinal, optic nerve head, and choriocapillaris OCTA findings and clinically relevant features of systemic conditions, including laboratory markers and disease severity and prognosis. We find that the breadth and depth of such correlations solidify OCTA’s role in the emerging field of oculomics, which seeks to identify ocular imaging biomarkers for use in the study and management of nonocular conditions.
{"title":"Quantitative ophthalmic posterior segment optical coherence tomography angiography and systemic conditions","authors":"Michael Drakopoulos MD,MPhil, Arnold Nadel MD, Harnaina K. Bains MD, Jay B. Bisen BS, Hayden Sikora BA, Kevin X. Zhang MD, PhD, Alessandro Marchese MD, Joseph Fahey MS, Rukhsana G. Mirza MD,MS","doi":"10.1016/j.survophthal.2025.07.005","DOIUrl":"10.1016/j.survophthal.2025.07.005","url":null,"abstract":"<div><div>Optical coherence tomography angiography (OCTA) noninvasively and quantitatively images the microvasculature of the eye’s posterior segment in 3 dimensions. OCTA has known utility in the diagnosis and management of certain ocular conditions and is now being used to assess systemic conditions, including respiratory, cardiovascular, renal, obstetric, neurologic, rheumatologic, and genetic conditions, among others. OCTA may improve our understanding of the pathophysiology of systemic conditions and identify biomarkers useful in their diagnosis, prognosis, and management. We detail known associations between quantitative retinal, optic nerve head, and choriocapillaris OCTA findings and clinically relevant features of systemic conditions, including laboratory markers and disease severity and prognosis. We find that the breadth and depth of such correlations solidify OCTA’s role in the emerging field of oculomics, which seeks to identify ocular imaging biomarkers for use in the study and management of nonocular conditions.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"71 2","pages":"Pages 423-455"},"PeriodicalIF":5.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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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