{"title":"Expanding Access to Monoclonal Antibody Treatment by the Adoption of Biosimilar Agents","authors":"Michael Goggin","doi":"10.1111/ceo.14553","DOIUrl":"https://doi.org/10.1111/ceo.14553","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 5","pages":"453-454"},"PeriodicalIF":4.9,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144573599","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}
Matt Trinh, Annita Duong, Rene Cheung, Simon Chen, David Ng, Jeff Friedrich, Chris Hodge, Lisa Nivison-Smith, Angelica Ly
Background
The updated simplified AREDS risk model predicts progression to late age-related macular degeneration (AMD) by person, describing up to nine observations across both eyes and 10 annual risk scores (0–4, with/without reticular pseudodrusen [RPD]). This study proposes an abridged model to enable inter-eye comparisons and potentially enhance clinical efficiency.
Methods
This retrospective cohort study included 269 participants with early/intermediate AMD over 7 years. The full, person-level updated simplified AREDS risk model was compared to eye-level candidate risk models, derived by removing the least predictive biomarkers. The main outcomes were prognostic performance (AUC) and risk score separability (χ2).
Results
At 1–3 years, the full model showed prognostic performance (AUC ± SE) up to 84.52% ± 5.93%, with overlap between most risk scores (χ2 ≤ 2.08). Removing large drusen and pigmentary abnormalities in the fellow eye, intermediate drusen in both eyes, and redefining RPD presence as eye-specific maintained prognostic performance (up to 84.71% ± 4.72%). Assigning one point per retained biomarker, based on similar adjusted risks, improved risk score separability (χ2 ≥ 3.85, p < 0.05) while reducing the number of annual scores from 10 to five.
Conclusions
The updated simplified AREDS risk model can be essentially halved without compromising prognostic performance by deriving eye-specific biomarkers and assigning one point per biomarker (large drusen, pigmentary abnormalities, and RPD in the primary eye, and late AMD in the fellow eye). This eye-level risk stratification may improve clinical efficiency and inter-eye study designs when one eye is of particular interest. An example of 3-year risks (scores 0–4) was ≈4%, 8%, 16%, 32%, and 64%.
{"title":"Proposal of a Simpler Eye-Level Risk Model Incorporating Reticular Pseudodrusen for the Clinical Prediction of Late Age-Related Macular Degeneration","authors":"Matt Trinh, Annita Duong, Rene Cheung, Simon Chen, David Ng, Jeff Friedrich, Chris Hodge, Lisa Nivison-Smith, Angelica Ly","doi":"10.1111/ceo.14576","DOIUrl":"10.1111/ceo.14576","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The updated simplified AREDS risk model predicts progression to late age-related macular degeneration (AMD) by person, describing up to nine observations across both eyes and 10 annual risk scores (0–4, with/without reticular pseudodrusen [RPD]). This study proposes an abridged model to enable inter-eye comparisons and potentially enhance clinical efficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included 269 participants with early/intermediate AMD over 7 years. The full, person-level updated simplified AREDS risk model was compared to eye-level candidate risk models, derived by removing the least predictive biomarkers. The main outcomes were prognostic performance (AUC) and risk score separability (<i>χ</i>\u0000 <sup>2</sup>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At 1–3 years, the full model showed prognostic performance (AUC ± SE) up to 84.52% ± 5.93%, with overlap between most risk scores (<i>χ</i>\u0000 <sup>2</sup> ≤ 2.08). Removing large drusen and pigmentary abnormalities in the fellow eye, intermediate drusen in both eyes, and redefining RPD presence as eye-specific maintained prognostic performance (up to 84.71% ± 4.72%). Assigning one point per retained biomarker, based on similar adjusted risks, improved risk score separability (<i>χ</i>\u0000 <sup>2</sup> ≥ 3.85, <i>p</i> < 0.05) while reducing the number of annual scores from 10 to five.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The updated simplified AREDS risk model can be essentially halved without compromising prognostic performance by deriving eye-specific biomarkers and assigning one point per biomarker (large drusen, pigmentary abnormalities, and RPD in the primary eye, and late AMD in the fellow eye). This eye-level risk stratification may improve clinical efficiency and inter-eye study designs when one eye is of particular interest. An example of 3-year risks (scores 0–4) was ≈4%, 8%, 16%, 32%, and 64%.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 8","pages":"936-945"},"PeriodicalIF":5.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ceo.14576","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Meibomian gland dysfunction (MGD) is a group of chronic abnormalities of meibomian glands (MGs), which is recognised as the leading cause of evaporative dry eye. MGD is characterised by obstruction of the terminal ducts and/or alterations in the glandular secretion, which culminates in alterations in tear film stability, inflammation and ocular irritation. Lately, several physical therapies have been developed clinically, including warming compress and massage, eyelid hygiene, as well as advanced approaches such as intraductal probing, thermal pulsation and intense pulsed light therapy. Recently, there is increasing awareness regarding the pharmaceutical therapies for MGD, which have shown potential. Here, we summarise current pharmaceutical therapies for MGD from four aspects including ameliorating microenvironment, inhibiting keratinisation, regulating secretory function and therapies targeting stem cells based on basic and clinical research, discuss their applications and limitations, and provide perspectives for future studies in the field.
{"title":"Current Pharmaceutical Therapies for Meibomian Gland Dysfunction: From Basic Research to Clinical Practice","authors":"Sai Luo, Yuli Guo, Zuguo Liu","doi":"10.1111/ceo.14577","DOIUrl":"10.1111/ceo.14577","url":null,"abstract":"<div>\u0000 \u0000 <p>Meibomian gland dysfunction (MGD) is a group of chronic abnormalities of meibomian glands (MGs), which is recognised as the leading cause of evaporative dry eye. MGD is characterised by obstruction of the terminal ducts and/or alterations in the glandular secretion, which culminates in alterations in tear film stability, inflammation and ocular irritation. Lately, several physical therapies have been developed clinically, including warming compress and massage, eyelid hygiene, as well as advanced approaches such as intraductal probing, thermal pulsation and intense pulsed light therapy. Recently, there is increasing awareness regarding the pharmaceutical therapies for MGD, which have shown potential. Here, we summarise current pharmaceutical therapies for MGD from four aspects including ameliorating microenvironment, inhibiting keratinisation, regulating secretory function and therapies targeting stem cells based on basic and clinical research, discuss their applications and limitations, and provide perspectives for future studies in the field.</p>\u0000 </div>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 8","pages":"1039-1055"},"PeriodicalIF":5.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562031","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}
To compare the clinical and angiographic outcomes of aggressive retinopathy of prematurity (A-ROP) and type 1 retinopathy of prematurity (ROP) treated with intravitreal injection of ranibizumab (IVR) or aflibercept (IVA).
Methods
This retrospective, non-randomised study included a consecutive series of patients with type 1 ROP or A-ROP who initially treated with ranibizumab (0.25 mg/0.025 mL) or aflibercept (1.0 mg/0.025 mL) between October 2017 and November 2020. Clinical data and long-term vascular characteristics were analysed.
Results
A total of 297 eyes of 151 infants were included. Compared to IVA, IVR was a significant risk factor for reactivation in multivariate regression analysis. The risk time of reactivation in A-ROP and Type 1 Zone I ROP was shorter in the IVR group (p < 0.001). Fewer injections were required in the IVA group for patients with A-ROP and Type 1 Zone I ROP (p = 0.012). More vascular abnormalities were observed in the IVA group during reactivation, with increased arteriovenous shunting (p = 0.028) in Type 1 Zone II ROP and more tortuosity (p = 0.047), dilation (p = 0.047) and plus disease (p = 0.020) in Type 1 Zone I ROP and A-ROP. In fundus fluorescein angiography, staining of the vessel wall and telangiectasia were more frequent in the IVA group.
Conclusions
Ranibizumab treatment was associated with a higher rate of reactivation and a shorter risk period for reactivation compared to aflibercept, potentially requiring more frequent injections, though some differences did not reach statistical significance. However, there were more signs of vascular abnormalities after receiving aflibercept treatment.
{"title":"Comparison of Clinical and Angiographic Outcomes of Ranibizumab and Aflibercept in Type 1 and Aggressive Retinopathy of Prematurity","authors":"Wenting Zhang, Haonan Ma, Jianhui Wang, Zhijun Chen, Xuerui Zhang, Haodong Xiao, Huanyu Liu, Yuan Yang, Jiawei Yin, Mingyang Wang, Jie Peng, Yu Xu, Peiquan Zhao","doi":"10.1111/ceo.14575","DOIUrl":"10.1111/ceo.14575","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To compare the clinical and angiographic outcomes of aggressive retinopathy of prematurity (A-ROP) and type 1 retinopathy of prematurity (ROP) treated with intravitreal injection of ranibizumab (IVR) or aflibercept (IVA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective, non-randomised study included a consecutive series of patients with type 1 ROP or A-ROP who initially treated with ranibizumab (0.25 mg/0.025 mL) or aflibercept (1.0 mg/0.025 mL) between October 2017 and November 2020. Clinical data and long-term vascular characteristics were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 297 eyes of 151 infants were included. Compared to IVA, IVR was a significant risk factor for reactivation in multivariate regression analysis. The risk time of reactivation in A-ROP and Type 1 Zone I ROP was shorter in the IVR group (<i>p</i> < 0.001). Fewer injections were required in the IVA group for patients with A-ROP and Type 1 Zone I ROP (<i>p</i> = 0.012). More vascular abnormalities were observed in the IVA group during reactivation, with increased arteriovenous shunting (<i>p</i> = 0.028) in Type 1 Zone II ROP and more tortuosity (<i>p</i> = 0.047), dilation (<i>p</i> = 0.047) and plus disease (<i>p</i> = 0.020) in Type 1 Zone I ROP and A-ROP. In fundus fluorescein angiography, staining of the vessel wall and telangiectasia were more frequent in the IVA group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ranibizumab treatment was associated with a higher rate of reactivation and a shorter risk period for reactivation compared to aflibercept, potentially requiring more frequent injections, though some differences did not reach statistical significance. However, there were more signs of vascular abnormalities after receiving aflibercept treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 8","pages":"956-966"},"PeriodicalIF":5.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ceo.14575","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jiyeon Kim, Louis S. Han, Logan Robinson, Tafadzwa Young-Zvandasara
Background
The intravitreal injection (IVI) is one of the most performed vitreoretinal procedures in ophthalmology. Subconjunctival anaesthesia (SCA) with 2% lidocaine is a commonly used modality to reduce procedural pain and patient distress. Currently, there is no unifying recommended wait time between SCA and IVI. The purpose of this study is to determine the optimal wait time between the two, whilst maintaining clinical efficiency.
Methods
Single-blinded randomised clinical trial. Two hundred and forty patients were randomly assigned to one of four groups: wait time of 2, 3, 4 or 5 min. The primary outcome was pain level graded by the patient on a 10-point visual analogue scale. The secondary outcome was the willingness to receive further IVI with the current pain level. Data points were collected on patient demographics and characteristics.
Results
The mean pain scores showed a decreasing trend with increasing wait times, 2.27 (2 min), 1.03 (3 min), 0.67 (4 min) and 0.58 (5 min). More patients were willing to receive further IVI with increasing wait times, 92% (2 min), 97% (3 and 4 min), and 100% (5 min). These differences were statistically significant at each time interval.
Conclusion
Longer wait times post-SCA were associated with better anaesthetic effect and higher patient acceptance to continue receiving IVI. The most marked difference was observed between 2- and 3-min groups. Based on our findings, a minimum wait time of 3 min should be recommended as the group had reported acceptably low pain scores (1.03) while maintaining high patient satisfaction (97%).
{"title":"Randomised Controlled Trial: Influence of Subconjunctival Anaesthesia Duration on Pain Perception During Intravitreal Injections","authors":"Jiyeon Kim, Louis S. Han, Logan Robinson, Tafadzwa Young-Zvandasara","doi":"10.1111/ceo.14579","DOIUrl":"10.1111/ceo.14579","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The intravitreal injection (IVI) is one of the most performed vitreoretinal procedures in ophthalmology. Subconjunctival anaesthesia (SCA) with 2% lidocaine is a commonly used modality to reduce procedural pain and patient distress. Currently, there is no unifying recommended wait time between SCA and IVI. The purpose of this study is to determine the optimal wait time between the two, whilst maintaining clinical efficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Single-blinded randomised clinical trial. Two hundred and forty patients were randomly assigned to one of four groups: wait time of 2, 3, 4 or 5 min. The primary outcome was pain level graded by the patient on a 10-point visual analogue scale. The secondary outcome was the willingness to receive further IVI with the current pain level. Data points were collected on patient demographics and characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean pain scores showed a decreasing trend with increasing wait times, 2.27 (2 min), 1.03 (3 min), 0.67 (4 min) and 0.58 (5 min). More patients were willing to receive further IVI with increasing wait times, 92% (2 min), 97% (3 and 4 min), and 100% (5 min). These differences were statistically significant at each time interval.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Longer wait times post-SCA were associated with better anaesthetic effect and higher patient acceptance to continue receiving IVI. The most marked difference was observed between 2- and 3-min groups. Based on our findings, a minimum wait time of 3 min should be recommended as the group had reported acceptably low pain scores (1.03) while maintaining high patient satisfaction (97%).</p>\u0000 </section>\u0000 </div>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 8","pages":"918-924"},"PeriodicalIF":5.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546183","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}
Chieh-Yu Lin, Wen-Yi Shau, Chia-Ying Tsai, Tso-Ting Lai
Background
The use of vitrectomy in treating endogenous Klebsiella pneumoniae endophthalmitis (EKPE) remains controversial. This study aims to compare visual and anatomical outcomes of EKPE with and without vitrectomy.
Methods
A meta-analysis of individual participant data with relevant studies identified from PubMed, Embase and Web of Science. Patients were classified into the vitrectomy and non-vitrectomy groups (patients who received IVI antibiotics alone). Poor visual acuity (VA) was defined as hand motion (HM) or worse. A generalised linear mixed model (for within-study comparisons) and generalised estimating equations (for single-arm studies) were used in the first stage of data synthesis, followed by a secondary meta-analysis to integrate the effect estimates through a fixed-effect model. The primary outcomes included differences in VA improvements, risks of poor final VA and risks of globe preservation failure between the vitrectomy and non-vitrectomy groups.
Results
Of 68 retrospective studies, 324 patients (383 eyes) were included. Overall, VA improvement was significantly better in the vitrectomy group (mean differences [MD] = −0.27; p < 0.01). When stratified by initial VA, the result remained robust in eyes with poor initial VA (MD = −0.35; p < 0.01). There were no significant differences in risks of poor final VA (odds ratio [OR] = 0.84; p = 0.64) and risks of globe preservation failure (OR = 0.42; p = 0.09) between the two groups.
Conclusions
Vitrectomy results in greater VA improvement than IVI antibiotics alone in the management of EKPE, especially in eyes with an initial VA of HM or worse.
背景：玻璃体切除术治疗内源性肺炎克雷伯菌眼内炎（EKPE）仍有争议。本研究旨在比较玻璃体切除术前后EKPE的视觉和解剖结果。方法：对来自PubMed、Embase和Web of Science的相关研究的个体参与者数据进行荟萃分析。患者分为玻璃体切除术组和非玻璃体切除术组（仅使用IVI抗生素的患者）。视力差（VA）定义为手部运动（HM）或更差。在数据综合的第一阶段使用了广义线性混合模型（用于研究内比较）和广义估计方程（用于单臂研究），随后进行了二次荟萃分析，通过固定效应模型整合效果估计。主要结果包括玻璃体切割组和非玻璃体切割组之间室内外动脉改善的差异、最终室内外动脉不良的风险和眼球保存失败的风险。结果：68项回顾性研究共纳入324例患者（383只眼）。总体而言，玻璃体切除术组VA改善明显更好(平均差异[MD] = -0.27；结论：在EKPE的治疗中，玻璃体切除术比单独使用IVI抗生素更能改善VA，特别是在初始VA为HM或更差的眼睛中。
{"title":"Outcomes of Endogenous Klebsiella pneumoniae Endophthalmitis With and Without Vitrectomy: A Meta-Analysis of Individual Participant Data","authors":"Chieh-Yu Lin, Wen-Yi Shau, Chia-Ying Tsai, Tso-Ting Lai","doi":"10.1111/ceo.14569","DOIUrl":"10.1111/ceo.14569","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The use of vitrectomy in treating endogenous \u0000 <i>Klebsiella pneumoniae</i>\u0000 endophthalmitis (EKPE) remains controversial. This study aims to compare visual and anatomical outcomes of EKPE with and without vitrectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A meta-analysis of individual participant data with relevant studies identified from PubMed, Embase and Web of Science. Patients were classified into the vitrectomy and non-vitrectomy groups (patients who received IVI antibiotics alone). Poor visual acuity (VA) was defined as hand motion (HM) or worse. A generalised linear mixed model (for within-study comparisons) and generalised estimating equations (for single-arm studies) were used in the first stage of data synthesis, followed by a secondary meta-analysis to integrate the effect estimates through a fixed-effect model. The primary outcomes included differences in VA improvements, risks of poor final VA and risks of globe preservation failure between the vitrectomy and non-vitrectomy groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 68 retrospective studies, 324 patients (383 eyes) were included. Overall, VA improvement was significantly better in the vitrectomy group (mean differences [MD] = −0.27; <i>p</i> < 0.01). When stratified by initial VA, the result remained robust in eyes with poor initial VA (MD = −0.35; <i>p</i> < 0.01). There were no significant differences in risks of poor final VA (odds ratio [OR] = 0.84; <i>p</i> = 0.64) and risks of globe preservation failure (OR = 0.42; <i>p</i> = 0.09) between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Vitrectomy results in greater VA improvement than IVI antibiotics alone in the management of EKPE, especially in eyes with an initial VA of HM or worse.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 7","pages":"813-824"},"PeriodicalIF":5.6,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369614","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}
Yifei Sheng, Xiaojing Yang, Jianfeng Qiu, Weizhao Lu
Background
Primary open-angle glaucoma (POAG) has been increasingly viewed as a neurodegenerative condition, yet whether there are changes in the brain glymphatic function in patients with POAG has remained unclear. This study aimed to investigate the changes of glymphatic function in POAG based on multi-modal magnetic resonance imaging (MRI).
Methods
Thirty-eight patients with POAG and 25 age- and sex-matched healthy controls underwent structural MRI and functional MRI scans to assess abnormalities in cerebrospinal fluid circulation by choroid plexus (CP) volume and cortical glymphatic system clearance function by blood-oxygen-level-dependent signals and cerebrospinal fluid signals (BOLD-CSF) coupling. Comparisons of CP volume and BOLD-CSF coupling were conducted between the control and POAG groups. Correlation analysis was performed to assess the association between the function of the glymphatic system and clinical scales of POAG.
Results
The CP volume and the ratio of CP volume to intracranial volume was significantly higher in patients with POAG compared to healthy controls (pFDR < 0.001). Additionally, the strength of BOLD-CSF coupling in the middle and posterior cortical regions were significantly weaker in POAG patients compared to controls (pFDR < 0.05). Negative correlations of glymphatic functional indicators with the thickness of the retinal nerve fibre layer (RNFL) (r from −0.427 to −0.351, p from 0.033 to 0.045) were observed, and positive correlations between BOLD-CSF of the posterior region and intraocular pressure were found (r = 0.375, p = 0.033).
Conclusions
POAG patients experienced impaired glymphatic function, which may be related to the pathophysiology of the disease.
{"title":"Glymphatic Function Abnormality and Its Association With Pathophysiology in Primary Open-Angle Glaucoma","authors":"Yifei Sheng, Xiaojing Yang, Jianfeng Qiu, Weizhao Lu","doi":"10.1111/ceo.14574","DOIUrl":"10.1111/ceo.14574","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Primary open-angle glaucoma (POAG) has been increasingly viewed as a neurodegenerative condition, yet whether there are changes in the brain glymphatic function in patients with POAG has remained unclear. This study aimed to investigate the changes of glymphatic function in POAG based on multi-modal magnetic resonance imaging (MRI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty-eight patients with POAG and 25 age- and sex-matched healthy controls underwent structural MRI and functional MRI scans to assess abnormalities in cerebrospinal fluid circulation by choroid plexus (CP) volume and cortical glymphatic system clearance function by blood-oxygen-level-dependent signals and cerebrospinal fluid signals (BOLD-CSF) coupling. Comparisons of CP volume and BOLD-CSF coupling were conducted between the control and POAG groups. Correlation analysis was performed to assess the association between the function of the glymphatic system and clinical scales of POAG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The CP volume and the ratio of CP volume to intracranial volume was significantly higher in patients with POAG compared to healthy controls (pFDR < 0.001). Additionally, the strength of BOLD-CSF coupling in the middle and posterior cortical regions were significantly weaker in POAG patients compared to controls (pFDR < 0.05). Negative correlations of glymphatic functional indicators with the thickness of the retinal nerve fibre layer (RNFL) (<i>r</i> from −0.427 to −0.351, <i>p</i> from 0.033 to 0.045) were observed, and positive correlations between BOLD-CSF of the posterior region and intraocular pressure were found (<i>r</i> = 0.375, <i>p</i> = 0.033).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>POAG patients experienced impaired glymphatic function, which may be related to the pathophysiology of the disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 8","pages":"900-907"},"PeriodicalIF":5.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327800","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}
The advent of minimally invasive glaucoma surgery (MIGS) has expanded the treatment options available for glaucoma by providing options for reducing intraocular pressure without the serious complication profile associated with incisional glaucoma surgery. MIGS devices aim to enhance aqueous outflow through the trabecular pathway or to bypass this pathway with drainage of fluid into the suprachoroidal or subconjunctival spaces. Having a wide range of glaucoma treatment options available helps tailor treatment to patients' individual intraocular pressure targets and aetiologies of glaucoma. This review will describe the categories and mechanisms of MIGS, comment on their relative efficacies, safety data, advantages and limitations and explore potential future changes in the glaucoma treatment paradigm in relation to MIGS.
{"title":"Minimally Invasive Glaucoma Surgery: Is It Here to Stay?","authors":"Neeranjali Jain, Jennifer C. Fan Gaskin","doi":"10.1111/ceo.14571","DOIUrl":"10.1111/ceo.14571","url":null,"abstract":"<p>The advent of minimally invasive glaucoma surgery (MIGS) has expanded the treatment options available for glaucoma by providing options for reducing intraocular pressure without the serious complication profile associated with incisional glaucoma surgery. MIGS devices aim to enhance aqueous outflow through the trabecular pathway or to bypass this pathway with drainage of fluid into the suprachoroidal or subconjunctival spaces. Having a wide range of glaucoma treatment options available helps tailor treatment to patients' individual intraocular pressure targets and aetiologies of glaucoma. This review will describe the categories and mechanisms of MIGS, comment on their relative efficacies, safety data, advantages and limitations and explore potential future changes in the glaucoma treatment paradigm in relation to MIGS.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 8","pages":"1025-1038"},"PeriodicalIF":5.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ceo.14571","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benjamin Cook, Thomas Muecke, Stephen Bacchi, Weng Onn Chan
<p>Ophthalmology researchers typically rely upon grant funding, from government and non-government sources, to enable their research. Therefore, these grants have significant influence over the types of research that can be conducted. Grant applications usually involve a rigorous process that assesses the quality of the proposed research project, the qualifications and experience of the investigator(s), and the potential impact that the project will have on the community. Despite the scrutiny applied to individual grant applications, less time is devoted to assessing the grant opportunities and application processes themselves. Discrepancies in the distribution of research funding between subspecialities may limit researchers’ abilities to perform research in their desired area. Through examination of this distribution of grant opportunities, areas requiring further grant funding may be identified.</p><p>We aimed to examine the various ophthalmology-specific grant opportunities in Australia in order to gauge the distribution of research funding dedicated to various ophthalmology subspecialties. We then sought to compare this funding to the burden of various forms of ophthalmic disease such as retinal diseases, glaucoma or refractive disease. Additionally, ophthalmology grant opportunities were examined for opportunities pertaining specifically to contemporary topics such as artificial intelligence, sustainability and First Nations health.</p><p>We selected regularly-awarded Australian grants dedicated to ophthalmology or vision science research. Four methods were used to identify grants: examining websites of key ophthalmology organisations, including RANZCO; using Google with advanced search settings set to Australia; searching the Australian Charities and Not-for-profit Commission; and examining the websites of Australian universities. These four processes are detailed in Supporting Information.</p><p>We identified 24 ophthalmic grants in Australia, summarised in Table 1, with 11 of 24 having a specific subspeciality focus within ophthalmology. Of the subspeciality-focused grants, the majority (6/11) were dedicated to retinal disease, including age-related macular degeneration, inherited retinal disease, and diabetic retinopathy. Comparatively, 1 of 11 grants each was provided to research in glaucoma, refractive error, paediatric ophthalmology, sustainability, and First Nations and rural eye health. No grants were identified for artificial intelligence in ophthalmology, nor for cataracts or dry eye. Distribution of research funding between ophthalmic research sub-areas is displayed in Table 2.</p><p>Our study has identified substantial differences in both the number of grants dedicated to certain ophthalmology research areas, as well as the sum of money offered by individual grants. A lack of funding was identified for cataracts, refractive error, and dry eye disease, as well as the topics of sustainability in ophthalmology and artificial intel
{"title":"Distribution of Ophthalmology Grant Opportunities and Variation Amongst Subspecialties in Australia","authors":"Benjamin Cook, Thomas Muecke, Stephen Bacchi, Weng Onn Chan","doi":"10.1111/ceo.14568","DOIUrl":"10.1111/ceo.14568","url":null,"abstract":"<p>Ophthalmology researchers typically rely upon grant funding, from government and non-government sources, to enable their research. Therefore, these grants have significant influence over the types of research that can be conducted. Grant applications usually involve a rigorous process that assesses the quality of the proposed research project, the qualifications and experience of the investigator(s), and the potential impact that the project will have on the community. Despite the scrutiny applied to individual grant applications, less time is devoted to assessing the grant opportunities and application processes themselves. Discrepancies in the distribution of research funding between subspecialities may limit researchers’ abilities to perform research in their desired area. Through examination of this distribution of grant opportunities, areas requiring further grant funding may be identified.</p><p>We aimed to examine the various ophthalmology-specific grant opportunities in Australia in order to gauge the distribution of research funding dedicated to various ophthalmology subspecialties. We then sought to compare this funding to the burden of various forms of ophthalmic disease such as retinal diseases, glaucoma or refractive disease. Additionally, ophthalmology grant opportunities were examined for opportunities pertaining specifically to contemporary topics such as artificial intelligence, sustainability and First Nations health.</p><p>We selected regularly-awarded Australian grants dedicated to ophthalmology or vision science research. Four methods were used to identify grants: examining websites of key ophthalmology organisations, including RANZCO; using Google with advanced search settings set to Australia; searching the Australian Charities and Not-for-profit Commission; and examining the websites of Australian universities. These four processes are detailed in Supporting Information.</p><p>We identified 24 ophthalmic grants in Australia, summarised in Table 1, with 11 of 24 having a specific subspeciality focus within ophthalmology. Of the subspeciality-focused grants, the majority (6/11) were dedicated to retinal disease, including age-related macular degeneration, inherited retinal disease, and diabetic retinopathy. Comparatively, 1 of 11 grants each was provided to research in glaucoma, refractive error, paediatric ophthalmology, sustainability, and First Nations and rural eye health. No grants were identified for artificial intelligence in ophthalmology, nor for cataracts or dry eye. Distribution of research funding between ophthalmic research sub-areas is displayed in Table 2.</p><p>Our study has identified substantial differences in both the number of grants dedicated to certain ophthalmology research areas, as well as the sum of money offered by individual grants. A lack of funding was identified for cataracts, refractive error, and dry eye disease, as well as the topics of sustainability in ophthalmology and artificial intel","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 8","pages":"1056-1060"},"PeriodicalIF":5.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ceo.14568","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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