Clinical and Experimental Ophthalmology最新文献

Systemic anti-cancer treatment has evolved rapidly with the introduction of immunotherapy and targeted therapies, substantially improving survival across a broad spectrum of malignancies. However, as their use expands, ophthalmic toxicities are increasingly recognised as clinically significant adverse effects. This review outlines the pathophysiology, clinical spectrum and management strategies for ophthalmic adverse events linked to immune checkpoint inhibitors, MEK, BRAF, FGFR, ERK, EGFR, HER2, BTK, FLT-3, Bcr-Abl, ALK inhibitors and antibody-drug conjugates.

Background: Intraocular inflammation (IOI) is a rare but potentially sight-threatening complication that can occur after intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections. This adverse event has been under scrutiny in recent years due to an increased incidence, particularly with some of the newer anti-VEGF agents, such as Brolucizumab. Faricimab is a new anti-VEGF medication that has been approved by the United States Food and Drug Administration. As it is relatively new on the market, long-term safety data is still being collected.

Methods: This is a retrospective case series of 8 eyes in 5 patients with IOI that occurred after faricimab intravitreal injections.

Results: All patients were diagnosed with significant uveitis with anterior vitreous involvement and 4 out of the 5 patients presented subacutely with high intraocular pressure while the remaining patient presented acutely within 4 days following IVT with normal intraocular pressure. The patients received, on average, 4.875 faricimab injections prior to development of IOI and the inflammation resolved in all patients following cessation of faricimab injections and initiation of oral and topical non-steroidal anti-inflammatory agents and topical steroids.

Conclusion: Non-infectious hypertensive uveitis can occur subacutely after intravitreal faricimab injections. It is imperative that intraocular pressure is promptly managed to reduce the risk of permanent glaucomatous damage. As all our patients presented with anterior vitreous involvement, it is also practical that such cases of IOI are not mistaken for infectious exogenous endophthalmitis to avoid unnecessary treatment with intravitreal antibiotics and surgery.

Intraocular lymphomas, including vitreoretinal and choroidal lymphoma, can simulate the clinical presentation of other benign and malignant ocular diseases resulting in diagnostic delays. Multimodal imaging features can raise early clinical suspicion to support appropriate subspecialty referrals and treatment for patients affected by these conditions. This review synthesises current evidence on the diagnostic and prognostic value of characteristic imaging features of these rare malignancies. Findings are reviewed based on imaging modality, including fundus photography, optical coherence tomography, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, optical coherence tomography angiography, and ultrasound. We emphasise discriminative biomarkers that heighten suspicion for either vitreoretinal or choroidal lymphoma, as well as key findings to discriminate between lymphoma and alternative diagnoses. We further describe longitudinal changes in multimodal imaging features that can facilitate tracking disease progression or treatment response. By consolidating modality-specific findings, this review aims to facilitate early referral and accurate diagnosis of these rare malignancies.

Background: To characterise stromal curvature and curvature ratios in keratoconus (KCN) using anterior segment OCT, and to evaluate the implications of using single-, two-, and three-surface refractive models for corneal power estimation in ectatic eyes.

Methods: Retrospective observational study. Anterior segment OCT measurements (MS-39, CSO) were analysed. Anterior, stromal, and posterior curvature radii were computed across five concentric zones (2.0-6.0 mm) using a floating best-fit sphere, and curvature ratios were subsequently derived: anterior-to-stromal (ASR), stromal-to-posterior (SPR), and anterior-to-posterior (APR). Corneal power was calculated using one-, two-, and three-surface models. KCN severity was classified according to the Belin ABC grading stage and ASR, SPR, and APR were stratified accordingly.

Results: Data from 944 keratoconic eyes were analysed. Peripheral zones (6.0 mm) exhibited reduced variability in curvature measurement compared to central zones (3.0 mm). Differences between simplified (one- and two-surface) and three-surface power models correlated moderately with increased APR and SPR values. ASR, SPR, and APR all increased progressively with advancing ABC grade.

Conclusion: In advanced keratoconus, three-surface modelling yields different corneal power estimates versus simplified models in KC; prospective outcome studies are needed to assess clinical impact. Stromal curvature and its derived ratios provide novel structural metrics that change with KCN severity. Curvature ratio increase -especially APR and SPR- reflects posterior steepening and anterior-posterior decoupling, with possible implications for staging and surgical planning.