Dong Ju Kim, Dong Geun Kim, Hyun Duck Kwak, Jae Yong Jang, Yong-Sok Ji, Seung Hyun Lee, Eun Kyoung Lee, Kyu Hyung Park, Jae Hui Kim, Jun Sung Lee, Yumi Song, Seong Taeck Kim, Min Ho Shin, Min Kim, Sang Jun Park, Kwangsic Joo, Min Sagong, Christopher Seungkyu Lee, Se Joon Woo
Purpose
To investigate the long-term efficacy and safety of intravitreal brolucizumab (BRZ) injections in patients with typical neovascular age-related macular degeneration (typical nAMD) and polypoidal choroidal vasculopathy (PCV).
Methods
This multicentre retrospective study included 401 eyes of 398 patients with nAMD who received BRZ injection(s), with a follow-up duration of ≥12 months. Changes in best-corrected visual acuity (BCVA), retinal fluid evaluation and central subfield thickness (CST) on optical coherence tomography were assessed. The efficacy of BRZ was compared between typical nAMD and PCV groups.
Results
Analyses were conducted with 280 eyes of 278 patients with typical nAMD and 121 eyes of 120 patients with PCV (mean age, 71.1 ± 8.6 years). 29 eyes (7.2%) were treatment naïve. The mean follow-up period was 15.3 ± 2.8 months; the mean number of BRZ injections within 1 year was 4.5 ± 1.7. BCVA was maintained during the follow-up period, and CST significantly improved from the first injection month and was maintained for 12 months in both the typical nAMD and PCV groups. The dry macula proportion increased from 2.7% at baseline to 56.1% at 1 month and 42.9% at 12 months. Among the 18 eyes that underwent indocyanine green angiography both before and after treatment, 10 (55.6%) showed polyp regression. Overall, the incidence of intraocular inflammation (IOI), retinal vasculitis and occlusive retinal vasculitis was 9.4% (38 eyes), 1.2% (5 eyes) and 0.5% (2 eyes), respectively. IOI occurred from the first to the sixth injections, with an average IOI onset of 28.5 ± 1.4 days. All eyes achieved IOI resolution, although the two eyes with occlusive retinal vasculitis showed a severe visual decline after IOI resolution.
Conclusion
Brolucizumab was effective in maintaining BCVA and managing fluid in eyes with nAMD for up to 1 year, exhibiting a high polyp regression rate. However, the not uncommon incidence of IOI and the severe visual decline caused by the rare occlusive retinal vasculitis following BRZ treatment underscore the importance of careful monitoring and timely management.
{"title":"Long-term efficacy and safety of brolucizumab in neovascular age-related macular degeneration: A multicentre retrospective real-world study","authors":"Dong Ju Kim, Dong Geun Kim, Hyun Duck Kwak, Jae Yong Jang, Yong-Sok Ji, Seung Hyun Lee, Eun Kyoung Lee, Kyu Hyung Park, Jae Hui Kim, Jun Sung Lee, Yumi Song, Seong Taeck Kim, Min Ho Shin, Min Kim, Sang Jun Park, Kwangsic Joo, Min Sagong, Christopher Seungkyu Lee, Se Joon Woo","doi":"10.1111/aos.16699","DOIUrl":"10.1111/aos.16699","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To investigate the long-term efficacy and safety of intravitreal brolucizumab (BRZ) injections in patients with typical neovascular age-related macular degeneration (typical nAMD) and polypoidal choroidal vasculopathy (PCV).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicentre retrospective study included 401 eyes of 398 patients with nAMD who received BRZ injection(s), with a follow-up duration of ≥12 months. Changes in best-corrected visual acuity (BCVA), retinal fluid evaluation and central subfield thickness (CST) on optical coherence tomography were assessed. The efficacy of BRZ was compared between typical nAMD and PCV groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analyses were conducted with 280 eyes of 278 patients with typical nAMD and 121 eyes of 120 patients with PCV (mean age, 71.1 ± 8.6 years). 29 eyes (7.2%) were treatment naïve. The mean follow-up period was 15.3 ± 2.8 months; the mean number of BRZ injections within 1 year was 4.5 ± 1.7. BCVA was maintained during the follow-up period, and CST significantly improved from the first injection month and was maintained for 12 months in both the typical nAMD and PCV groups. The dry macula proportion increased from 2.7% at baseline to 56.1% at 1 month and 42.9% at 12 months. Among the 18 eyes that underwent indocyanine green angiography both before and after treatment, 10 (55.6%) showed polyp regression. Overall, the incidence of intraocular inflammation (IOI), retinal vasculitis and occlusive retinal vasculitis was 9.4% (38 eyes), 1.2% (5 eyes) and 0.5% (2 eyes), respectively. IOI occurred from the first to the sixth injections, with an average IOI onset of 28.5 ± 1.4 days. All eyes achieved IOI resolution, although the two eyes with occlusive retinal vasculitis showed a severe visual decline after IOI resolution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Brolucizumab was effective in maintaining BCVA and managing fluid in eyes with nAMD for up to 1 year, exhibiting a high polyp regression rate. However, the not uncommon incidence of IOI and the severe visual decline caused by the rare occlusive retinal vasculitis following BRZ treatment underscore the importance of careful monitoring and timely management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 7","pages":"e1018-e1028"},"PeriodicalIF":3.0,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140846358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>The VL Nordic Congress of Ophthalmology (NOK) will be held on 5–8 August 2024, in Kuopio, Finland (www.nok2024.fi). The NOK is a joint program of the Danish, Finnish, Iceland's, Norwegian and Swedish Ophthalmology Societies, represented by the NOK Committee. The NOK concept was first proposed by the Finnish ophthalmologist Gustaf A. Nordman (Ehinger and Grzybowski <span>2011</span>). He was the first President of the Finnish Ophthalmological Society in 1911 (Kivelä, <span>2012</span>). Officially, NOK was initiated by Swedish ophthalmologist and Nobel laureate Allvar Gullstrand at the 9th International Ophthalmological Congress in Utrecht in 1899. The first NOK meeting was organized by Allvar Gullstrand and held 1 year later in Stockholm. Allvar Gullstrand is the only ophthalmologist who has won a Nobel Prize (Ehinger & Grzybowski, <span>2011</span>). The second NOK meeting was held in Copenhagen in 1903, and the third meeting was planned in Kristiania in 1906. In the meantime, Norway became a free country, and the meeting was postponed until 1907 (Ehinger & Grzybowski, <span>2011</span>; Seregard, <span>2014</span>). Currently, the NOK is held biennially instead of the original 3-year interval. An assortment of world crisis has forced NOK postponements (Seregard, <span>2014</span>). The longest rest period (9 years) took place during World War II, and the COVID-19 pandemic postponed NOK from 2020 to 2022 in Reykjavik.</p><p>The Acta Ophthalmologica Award 2024 will be given to Professor Jesper Hjortdal (Denmark) for his achievements in cornea research. The KKK Lundsgaard Silver Medal will be given for the best Acta Ophthalmologica publication during the last 2 years between NOK congresses. This time, the best publication prize during the 2022–2024 follow-up period goes to Sirks MJ, van Dijk EHC, Rosenberg N, Hollak CEM, Aslanis S, Cheung CMG, Chowers I, Eandi CM, Freund KB, Holz FG, Kaiser PK, Lotery AJ, Ohno-Matsui K, Querques G, Subhi Y, Tadayoni R, Wykoff CC, Zur D, Diederen RMH, Boon CJF, Schlingemann RO in Netherlands, Sweden, Singapore, Israel, Switzerland, United States, Germany, United Kingdom, Italy, Denmark and France (Sirks et al., <span>2022</span>). The authors discussed the clinical impact of the worldwide shortage of verteporfin.</p><p>The scientific program of NOK 2024 consists of 36 sessions, of which 2 are keynotes, 25 symposia, 1 course, 6 industry-organized lunch symposiums, Acta Ophthalmologica Gold and Silver Medal donation ceremony, posters and free paper short talks. Keynote talks will be by Professors Jennifer Thorne from the Wilmer Eye Institute for uveitis and Prof. Rikhard Spaide at Vitreous, Retina, Macula Consultants of New York, who updates current retina diseases. Two symposia have been organized together with Baltic colleagues.</p><p>Acta Ophthalmologica and the European Association for Vision and Eye Research (EVER) signed a collaboration agreement in 2006 (Kaarniranta and Stefánsson <span>2021</span>)
{"title":"The VL Nordic Congress of Ophthalmology 2024","authors":"Kai Kaarniranta, Einar Stefánsson","doi":"10.1111/aos.16703","DOIUrl":"10.1111/aos.16703","url":null,"abstract":"<p>The VL Nordic Congress of Ophthalmology (NOK) will be held on 5–8 August 2024, in Kuopio, Finland (www.nok2024.fi). The NOK is a joint program of the Danish, Finnish, Iceland's, Norwegian and Swedish Ophthalmology Societies, represented by the NOK Committee. The NOK concept was first proposed by the Finnish ophthalmologist Gustaf A. Nordman (Ehinger and Grzybowski <span>2011</span>). He was the first President of the Finnish Ophthalmological Society in 1911 (Kivelä, <span>2012</span>). Officially, NOK was initiated by Swedish ophthalmologist and Nobel laureate Allvar Gullstrand at the 9th International Ophthalmological Congress in Utrecht in 1899. The first NOK meeting was organized by Allvar Gullstrand and held 1 year later in Stockholm. Allvar Gullstrand is the only ophthalmologist who has won a Nobel Prize (Ehinger & Grzybowski, <span>2011</span>). The second NOK meeting was held in Copenhagen in 1903, and the third meeting was planned in Kristiania in 1906. In the meantime, Norway became a free country, and the meeting was postponed until 1907 (Ehinger & Grzybowski, <span>2011</span>; Seregard, <span>2014</span>). Currently, the NOK is held biennially instead of the original 3-year interval. An assortment of world crisis has forced NOK postponements (Seregard, <span>2014</span>). The longest rest period (9 years) took place during World War II, and the COVID-19 pandemic postponed NOK from 2020 to 2022 in Reykjavik.</p><p>The Acta Ophthalmologica Award 2024 will be given to Professor Jesper Hjortdal (Denmark) for his achievements in cornea research. The KKK Lundsgaard Silver Medal will be given for the best Acta Ophthalmologica publication during the last 2 years between NOK congresses. This time, the best publication prize during the 2022–2024 follow-up period goes to Sirks MJ, van Dijk EHC, Rosenberg N, Hollak CEM, Aslanis S, Cheung CMG, Chowers I, Eandi CM, Freund KB, Holz FG, Kaiser PK, Lotery AJ, Ohno-Matsui K, Querques G, Subhi Y, Tadayoni R, Wykoff CC, Zur D, Diederen RMH, Boon CJF, Schlingemann RO in Netherlands, Sweden, Singapore, Israel, Switzerland, United States, Germany, United Kingdom, Italy, Denmark and France (Sirks et al., <span>2022</span>). The authors discussed the clinical impact of the worldwide shortage of verteporfin.</p><p>The scientific program of NOK 2024 consists of 36 sessions, of which 2 are keynotes, 25 symposia, 1 course, 6 industry-organized lunch symposiums, Acta Ophthalmologica Gold and Silver Medal donation ceremony, posters and free paper short talks. Keynote talks will be by Professors Jennifer Thorne from the Wilmer Eye Institute for uveitis and Prof. Rikhard Spaide at Vitreous, Retina, Macula Consultants of New York, who updates current retina diseases. Two symposia have been organized together with Baltic colleagues.</p><p>Acta Ophthalmologica and the European Association for Vision and Eye Research (EVER) signed a collaboration agreement in 2006 (Kaarniranta and Stefánsson <span>2021</span>)","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 5","pages":"504-505"},"PeriodicalIF":3.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.16703","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140830731","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}
Achim Langenbucher, Jascha Wendelstein, Nóra Szentmáry, Alan Cayless, Peter Hoffmann, Guillaume Debellmaniere, Damien Gatinel
PurposeTo investigate the performance of a simple prediction scheme for the formula constants optimised for a mean refractive prediction error.MethodsAnalysis based on a dataset of 888 eyes before and after cataract surgery with IOL implantation (Hoya Vivinex). IOLMaster 700 biometric data, power of the implanted lens and postoperative spherical equivalent refraction were used to calculate the optimised constants (.)opt for SRKT, HofferQ, Holladay and Haigis formula with an iterative nonlinear optimisation. For detuning start values by ±1.5 from (.)opt, the predicted formula constants (.)pred were calculated and compared with (.)opt. Formula performance metrics mean (MPE), median (MEDPE), mean absolute (MAPE), median absolute (MEDAPE), root mean squared (RMSPE) and standard deviation (SDPE) of the formula prediction error were analysed for (.)opt and (.)pred.Results(.)pred – (.)opt showed a 2nd order parabolic behaviour with maximal deviations up to 0.09 at the tails of detuning and a minimal deviation up to −0.01 for all formulae. The performance curves of different metrics of PE as functions of detuning variations show that the formula constants for zeroing MPE and MEDPE yield almost identical formula constants, optimisation for MAPE, MEDAPE and RMSPE yielded formula constants very close to (.)opt, and optimisation for SDPE could result in formula constants up to 0.5 off (.)opt which is unacceptable for clinical use.ConclusionThis simple prediction scheme for formula constant optimisation for zero mean refraction error performs excellently in our monocentric dataset, even for larger deviations of the start value from (.)opt. Further studies with multicentric data and larger sample sizes are required to investigate the performance in a clinical setting further.
{"title":"Performance of a simplified strategy for formula constant optimisation in intraocular lens power calculation","authors":"Achim Langenbucher, Jascha Wendelstein, Nóra Szentmáry, Alan Cayless, Peter Hoffmann, Guillaume Debellmaniere, Damien Gatinel","doi":"10.1111/aos.16692","DOIUrl":"https://doi.org/10.1111/aos.16692","url":null,"abstract":"PurposeTo investigate the performance of a simple prediction scheme for the formula constants optimised for a mean refractive prediction error.MethodsAnalysis based on a dataset of 888 eyes before and after cataract surgery with IOL implantation (Hoya Vivinex). IOLMaster 700 biometric data, power of the implanted lens and postoperative spherical equivalent refraction were used to calculate the optimised constants (.)<jats:sub>opt</jats:sub> for SRKT, HofferQ, Holladay and Haigis formula with an iterative nonlinear optimisation. For detuning start values by ±1.5 from (.)<jats:sub>opt</jats:sub>, the predicted formula constants (.)<jats:sub>pred</jats:sub> were calculated and compared with (.)<jats:sub>opt</jats:sub>. Formula performance metrics mean (MPE), median (MEDPE), mean absolute (MAPE), median absolute (MEDAPE), root mean squared (RMSPE) and standard deviation (SDPE) of the formula prediction error were analysed for (.)<jats:sub>opt</jats:sub> and (.)<jats:sub>pred</jats:sub>.Results(.)<jats:sub>pred</jats:sub> – (.)<jats:sub>opt</jats:sub> showed a 2nd order parabolic behaviour with maximal deviations up to 0.09 at the tails of detuning and a minimal deviation up to −0.01 for all formulae. The performance curves of different metrics of PE as functions of detuning variations show that the formula constants for zeroing MPE and MEDPE yield almost identical formula constants, optimisation for MAPE, MEDAPE and RMSPE yielded formula constants very close to (.)<jats:sub>opt</jats:sub>, and optimisation for SDPE could result in formula constants up to 0.5 off (.)<jats:sub>opt</jats:sub> which is unacceptable for clinical use.ConclusionThis simple prediction scheme for formula constant optimisation for zero mean refraction error performs excellently in our monocentric dataset, even for larger deviations of the start value from (.)<jats:sub>opt</jats:sub>. Further studies with multicentric data and larger sample sizes are required to investigate the performance in a clinical setting further.","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"44 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140830721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yanhong Hou, Wei Zhang, Viet Nhat Hung Le, Shuya Deng, Karina Hadrian, Mert Mestanoglu, Gwen Musial, Felix Bock, Claus Cursiefen
Purpose
To compare safety and efficacy of isolated and combined UV-light corneal crosslinking (CXL) and fine-needle diathermy (FND) to regress pathological corneal vessels in vivo.
Methods
Mice with inflamed and pathologically vascularized corneas received CXL or FND as monotherapy or a combination of both treatments. Corneal pathological blood and lymphatic vessels, immune cells and the morphology of anterior segment structures were evaluated.
Results
All three approaches were able to regress blood and lymphatic vessels in mice. A comparative analysis of the three methods revealed that the FND monotherapy and the CXL + FND combination were significantly more effective than the CXL monotherapy, one and 2 weeks after therapy and especially in regressing lymphatic vessels. Furthermore, the combination therapy induced significantly less immune cell recruitment compared to the monotherapies. All three methods were safe to use in regards of corneal integrity.
Conclusions
A combination of FND and CXL led to regression of pathological corneal lymphatic and blood vessels and reduced the infiltration of immune cells into inflamed murine corneas. This approach offers a new effective, safe and clinically usable strategy to treat eyes with mature pathological blood vessels and even more so for lymphatic vessels, for example prior to high-risk corneal transplantation.
{"title":"Efficacy and safety of combined UV-light corneal crosslinking and fine-needle diathermy to regress pathological murine corneal (lymph)angiogenesis in vivo","authors":"Yanhong Hou, Wei Zhang, Viet Nhat Hung Le, Shuya Deng, Karina Hadrian, Mert Mestanoglu, Gwen Musial, Felix Bock, Claus Cursiefen","doi":"10.1111/aos.16696","DOIUrl":"10.1111/aos.16696","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare safety and efficacy of isolated and combined UV-light corneal crosslinking (CXL) and fine-needle diathermy (FND) to regress pathological corneal vessels in vivo.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Mice with inflamed and pathologically vascularized corneas received CXL or FND as monotherapy or a combination of both treatments. Corneal pathological blood and lymphatic vessels, immune cells and the morphology of anterior segment structures were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All three approaches were able to regress blood and lymphatic vessels in mice. A comparative analysis of the three methods revealed that the FND monotherapy and the CXL + FND combination were significantly more effective than the CXL monotherapy, one and 2 weeks after therapy and especially in regressing lymphatic vessels. Furthermore, the combination therapy induced significantly less immune cell recruitment compared to the monotherapies. All three methods were safe to use in regards of corneal integrity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A combination of FND and CXL led to regression of pathological corneal lymphatic and blood vessels and reduced the infiltration of immune cells into inflamed murine corneas. This approach offers a new effective, safe and clinically usable strategy to treat eyes with mature pathological blood vessels and even more so for lymphatic vessels, for example prior to high-risk corneal transplantation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 7","pages":"e1002-e1010"},"PeriodicalIF":3.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.16696","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140831002","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}
Titus Ovik, Alexandra Lind, Zoran Popovic, Jovanna Dahlgren, Eva Aring, Marita Andersson Grönlund
Purpose
It is well established that children born very preterm are at increased risk for ocular abnormalities including altered foveal morphology. However, little is known about how children born moderate-to-late preterm (MLP), gestational age 32 + 0–36 + 6 weeks, are affected later in life. This study investigates foveal avascular zone (FAZ) area, vascular density (VD), central foveal thickness (CFT) and ganglion cell layer thickness (GCL++) of adolescents born MLP without history of retinopathy of prematurity and compare the results with full-term controls.
Methods
In a prospective population-based cohort study, 50 adolescents (26 girls; mean age 16.5 years) born MLP were examined with optical coherence tomography (OCT) and OCT angiography (OCT-A). FAZ and VD were obtained from OCT-A scans and adjusted for ocular magnification. CFT and GCL++ were obtained from the OCT scans. The results from the MLP individuals were compared with the results from 49 healthy full-term controls (29 girls; mean age 16.7 years).
Results
The results showed statistically significant differences in FAZ area (0.22 vs 0.28 mm2; p = 0.0032) and CFT (198.1 vs 187.1 μm; p = 0.0010) between the MLP group and controls. Strong correlations between FAZ area and CFT (r = −0.773, p < 0.0001) and GCL++ (r = −0.924, p < 0.0001) were found in the MLP group. There were no differences in VD.
Conclusions
Our results show that adolescents born MLP have a smaller FAZ area and an increased CFT compared with full-term controls. These results indicate that adolescents born MLP have similar parafoveal changes as children born extreme or very preterm.
{"title":"Foveal thickness and vascular variables in adolescents born moderate-to-late preterm","authors":"Titus Ovik, Alexandra Lind, Zoran Popovic, Jovanna Dahlgren, Eva Aring, Marita Andersson Grönlund","doi":"10.1111/aos.16702","DOIUrl":"10.1111/aos.16702","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>It is well established that children born very preterm are at increased risk for ocular abnormalities including altered foveal morphology. However, little is known about how children born moderate-to-late preterm (MLP), gestational age 32 + 0–36 + 6 weeks, are affected later in life. This study investigates foveal avascular zone (FAZ) area, vascular density (VD), central foveal thickness (CFT) and ganglion cell layer thickness (GCL++) of adolescents born MLP without history of retinopathy of prematurity and compare the results with full-term controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a prospective population-based cohort study, 50 adolescents (26 girls; mean age 16.5 years) born MLP were examined with optical coherence tomography (OCT) and OCT angiography (OCT-A). FAZ and VD were obtained from OCT-A scans and adjusted for ocular magnification. CFT and GCL++ were obtained from the OCT scans. The results from the MLP individuals were compared with the results from 49 healthy full-term controls (29 girls; mean age 16.7 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results showed statistically significant differences in FAZ area (0.22 vs 0.28 mm<sup>2</sup>; <i>p</i> = 0.0032) and CFT (198.1 vs 187.1 μm; <i>p</i> = 0.0010) between the MLP group and controls. Strong correlations between FAZ area and CFT (<i>r</i> = −0.773, <i>p</i> < 0.0001) and GCL++ (<i>r</i> = −0.924, <i>p</i> < 0.0001) were found in the MLP group. There were no differences in VD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results show that adolescents born MLP have a smaller FAZ area and an increased CFT compared with full-term controls. These results indicate that adolescents born MLP have similar parafoveal changes as children born extreme or very preterm.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 7","pages":"797-804"},"PeriodicalIF":3.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.16702","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140810202","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}
Fiammetta Catania, Thibaut Chapron, Emanuele Crincoli, Alexandra Miere, Youssef Abdelmassih, William Beaumont, Ismael Chehaibou, Florence Metge, Sebastien Bruneau, Sophie Bonnin, Eric H. Souied, Georges Caputo
Purpose
To elaborate a deep learning (DL) model for automatic prediction of late recurrence (LR) of rhegmatogenous retinal detachment (RRD) using pseudocolor and fundus autofluorescence (AF) ultra-wide field (UWF) images obtained preoperatively and postoperatively.
Materials and Methods
We retrospectively included patients >18 years who underwent either scleral buckling (SB) or pars plana vitrectomy (PPV) for primary or recurrent RRD with a post-operative follow-up >2 years. Records of RRD recurrence between 6 weeks and 2 years after surgery served as a ground truth for the training of the deep learning (DL) models. Four separate DL models were trained to predict LR within the 2 postoperative years (binary outputs) using, respectively, UWF preoperative and postoperative pseudocolor images and UWF preoperative and postoperative AF images.
Results
A total of 412 eyes were included in the study (332 eyes treated with PPV and 80 eyes with SB). The mean follow-up was 4.0 ± 2.1 years. The DL models based on preoperative and postoperative pseudocolor UWF imaging predicted recurrence with 85.6% (sensitivity 86.7%, specificity 85.4%) and 90.2% accuracy (sensitivity 87.0%, specificity 90.8%) in PPV-treated eyes, and 87.0% (sensitivity 86.7%, specificity 87.0%) and 91.1% (sensitivity 88.2%, specificity 91.9%) in SB-treated eyes, respectively. The DL models using preoperative and postoperative AF-UWF imaging predicted recurrence with 87.6% (sensitivity 84.0% and specificity 88.3%) and 91.0% (sensitivity 88.9%, specificity 91.5%) accuracy in PPV eyes, and 86.5% (sensitivity 87.5%; specificity 86.2%) and 90.6% (sensitivity 90.0%, specificity 90.7%) in SB eyes, respectively. Among the risk factors detected with visualisation methods, potential novel ones were extensive laser retinopexy and asymmetric staphyloma.
Conclusions
DL can accurately predict the LR of RRD based on UWF images (especially postoperative ones), which can help refine follow-up strategies. Saliency maps might provide further insight into the dynamics of RRD recurrence.
{"title":"Deep Learning for prediction of late recurrence of retinal detachment using preoperative and postoperative ultra-wide field imaging","authors":"Fiammetta Catania, Thibaut Chapron, Emanuele Crincoli, Alexandra Miere, Youssef Abdelmassih, William Beaumont, Ismael Chehaibou, Florence Metge, Sebastien Bruneau, Sophie Bonnin, Eric H. Souied, Georges Caputo","doi":"10.1111/aos.16693","DOIUrl":"10.1111/aos.16693","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To elaborate a deep learning (DL) model for automatic prediction of late recurrence (LR) of rhegmatogenous retinal detachment (RRD) using pseudocolor and fundus autofluorescence (AF) ultra-wide field (UWF) images obtained preoperatively and postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We retrospectively included patients >18 years who underwent either scleral buckling (SB) or pars plana vitrectomy (PPV) for primary or recurrent RRD with a post-operative follow-up >2 years. Records of RRD recurrence between 6 weeks and 2 years after surgery served as a ground truth for the training of the deep learning (DL) models. Four separate DL models were trained to predict LR within the 2 postoperative years (binary outputs) using, respectively, UWF preoperative and postoperative pseudocolor images and UWF preoperative and postoperative AF images.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 412 eyes were included in the study (332 eyes treated with PPV and 80 eyes with SB). The mean follow-up was 4.0 ± 2.1 years. The DL models based on preoperative and postoperative pseudocolor UWF imaging predicted recurrence with 85.6% (sensitivity 86.7%, specificity 85.4%) and 90.2% accuracy (sensitivity 87.0%, specificity 90.8%) in PPV-treated eyes, and 87.0% (sensitivity 86.7%, specificity 87.0%) and 91.1% (sensitivity 88.2%, specificity 91.9%) in SB-treated eyes, respectively. The DL models using preoperative and postoperative AF-UWF imaging predicted recurrence with 87.6% (sensitivity 84.0% and specificity 88.3%) and 91.0% (sensitivity 88.9%, specificity 91.5%) accuracy in PPV eyes, and 86.5% (sensitivity 87.5%; specificity 86.2%) and 90.6% (sensitivity 90.0%, specificity 90.7%) in SB eyes, respectively. Among the risk factors detected with visualisation methods, potential novel ones were extensive laser retinopexy and asymmetric staphyloma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DL can accurately predict the LR of RRD based on UWF images (especially postoperative ones), which can help refine follow-up strategies. Saliency maps might provide further insight into the dynamics of RRD recurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 7","pages":"e984-e993"},"PeriodicalIF":3.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140810172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Line Kessel, Hanne Jensen, Ann-Cathrine Larsen, Thomas Rosenberg, Kamilla Rothe Nissen
Purpose
The aim of the study was to describe the temporal changes in causes and prevalence of childhood visual impairment in Denmark based on the National Danish Registry of Children with Visual Impairment (NDRCVI).
Methods
Annual reports on the NDRCVI since its establishment in 1979 were reviewed and data on the number of registered children and the causes for registration with a visual impairment were evaluated.
Results
The average annual incidence of childhood visual impairment in Denmark is 2.8 per 1000 live-born children and the prevalence of childhood visual impairment is 1.6 per 1000 children <18 years. Today, fewer children are severely visually impaired (visual acuity ≤6/60) at the time of registration (31.6% since 2010 vs. 51.1% in the 1980s). Cerebral visual impairment and optic nerve atrophy have remained common causes of childhood visual impairment whereas sequelae to retinopathy of prematurity have been almost eliminated as a cause. Systemic comorbidities are more common now in children with visual impairment (seen in 63.9% in the last decades vs. 44.6%in the 1980-ties).
Conclusion
Whereas the prevalence of visual impairment has remained relatively stable over the years, the severity of visual impairment has improved, suggesting that more children will be able to live an active life supported by aids compensating vision loss. However, more children have systemic comorbidities in combination with their visual impairment suggesting that children with visual impairment face a life not only limited by the obstacles of poor vision. This calls for multidisciplinary management and support of affected children and families.
{"title":"Temporal changes in incidence, prevalence and causes of childhood visual impairment – Learnings from 45 years with the National Danish Registry of Children with Visual Impairment","authors":"Line Kessel, Hanne Jensen, Ann-Cathrine Larsen, Thomas Rosenberg, Kamilla Rothe Nissen","doi":"10.1111/aos.16700","DOIUrl":"10.1111/aos.16700","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of the study was to describe the temporal changes in causes and prevalence of childhood visual impairment in Denmark based on the National Danish Registry of Children with Visual Impairment (NDRCVI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Annual reports on the NDRCVI since its establishment in 1979 were reviewed and data on the number of registered children and the causes for registration with a visual impairment were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average annual incidence of childhood visual impairment in Denmark is 2.8 per 1000 live-born children and the prevalence of childhood visual impairment is 1.6 per 1000 children <18 years. Today, fewer children are severely visually impaired (visual acuity ≤6/60) at the time of registration (31.6% since 2010 vs. 51.1% in the 1980s). Cerebral visual impairment and optic nerve atrophy have remained common causes of childhood visual impairment whereas sequelae to retinopathy of prematurity have been almost eliminated as a cause. Systemic comorbidities are more common now in children with visual impairment (seen in 63.9% in the last decades vs. 44.6%in the 1980-ties).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Whereas the prevalence of visual impairment has remained relatively stable over the years, the severity of visual impairment has improved, suggesting that more children will be able to live an active life supported by aids compensating vision loss. However, more children have systemic comorbidities in combination with their visual impairment suggesting that children with visual impairment face a life not only limited by the obstacles of poor vision. This calls for multidisciplinary management and support of affected children and families.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 7","pages":"790-796"},"PeriodicalIF":3.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.16700","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140654079","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}
<p>Steadily increasing expenditures of healthcare predict an unsustainable fiscal future (Blumenthal & Dixon, <span>2012</span>). Concomitantly, the municipal sector economy in countries with ageing population is stressed by the ratio of declining fertility rate and the working-age population. In this situation, healthcare cost-optimization and improving effectiveness of care is inevitable, which means that the public sector cannot afford to provide low-value healthcare service.</p><p>Traditionally, the healthcare reimbursement system has relied solely on fee-for-service payment, incentivizing the production of larger services without acknowledging the actual value produced (Porter & Lee, <span>2013</span>). On the contrary, a value-based payment model would encourage the utilization of the most efficient treatment modalities in which the healthcare provider's compensations depend on both the quality and cost of care (Cutler & Ghosh, <span>2012</span>; Mechanic, <span>2015</span>). As a concrete model of the value-based payment model, bundled payment where the payer reimburses for the episode of care has proved to be promising in high-volume and relatively standardized elective procedures (Jacobs et al., <span>2015</span>). One such is the bundled payment for phacoemulsification surgery (Hurh et al., <span>2017</span>). The bundled payment contracts by, for example, Medicare, recorded significant savings for total allowed claims compared to non-bundled contracts (Dummit et al., <span>2016</span>).</p><p>Unnecessary scheduled visits and testing, and excess monitoring produce low-value care that limits attempts to address the demands for access, cost and quality likewise (Eloranta & Falck, <span>2017</span>; Grzybowski et al., <span>2020</span>; Kissick, <span>1994</span>; Nemet & Tuuminen, <span>2023</span>). Furthermore, complications, unnecessary hospital stay, reoperations and unscheduled visits cause significant expenses and reduce cost-effectiveness. Importantly, a substantial proportion of hospital re-attendances and re-admissions could be avoided with significant cost savings with correctly incentivized reimbursement (Gray et al., <span>2019</span>; Tucker et al., <span>2018</span>). As in other sectors of the economy, a focus on value is the key to an effective and sustainable healthcare system. Society would benefit from a better quality of medical services, improved operational efficiency and lower tax burden from a value-based payment system (Daniels et al., <span>2022</span>; Expert Panel on effective ways of investing in Health, <span>2019</span>; Teperi et al., <span>2009</span>). One of the notable megatrends in the healthcare sector is the increased freedom of choice for patients' healthcare providers using various marketing information, which is easily acceptable by the digitalized medical information. Thus, data on quality of care, as provided by Crozet et al. (<span>2024</span>) in this issue would benefit th
{"title":"Healthcare quality indicators for value-based reimbursement in ophthalmology","authors":"Sohee Jeon, Raimo Tuuminen","doi":"10.1111/aos.16698","DOIUrl":"10.1111/aos.16698","url":null,"abstract":"<p>Steadily increasing expenditures of healthcare predict an unsustainable fiscal future (Blumenthal & Dixon, <span>2012</span>). Concomitantly, the municipal sector economy in countries with ageing population is stressed by the ratio of declining fertility rate and the working-age population. In this situation, healthcare cost-optimization and improving effectiveness of care is inevitable, which means that the public sector cannot afford to provide low-value healthcare service.</p><p>Traditionally, the healthcare reimbursement system has relied solely on fee-for-service payment, incentivizing the production of larger services without acknowledging the actual value produced (Porter & Lee, <span>2013</span>). On the contrary, a value-based payment model would encourage the utilization of the most efficient treatment modalities in which the healthcare provider's compensations depend on both the quality and cost of care (Cutler & Ghosh, <span>2012</span>; Mechanic, <span>2015</span>). As a concrete model of the value-based payment model, bundled payment where the payer reimburses for the episode of care has proved to be promising in high-volume and relatively standardized elective procedures (Jacobs et al., <span>2015</span>). One such is the bundled payment for phacoemulsification surgery (Hurh et al., <span>2017</span>). The bundled payment contracts by, for example, Medicare, recorded significant savings for total allowed claims compared to non-bundled contracts (Dummit et al., <span>2016</span>).</p><p>Unnecessary scheduled visits and testing, and excess monitoring produce low-value care that limits attempts to address the demands for access, cost and quality likewise (Eloranta & Falck, <span>2017</span>; Grzybowski et al., <span>2020</span>; Kissick, <span>1994</span>; Nemet & Tuuminen, <span>2023</span>). Furthermore, complications, unnecessary hospital stay, reoperations and unscheduled visits cause significant expenses and reduce cost-effectiveness. Importantly, a substantial proportion of hospital re-attendances and re-admissions could be avoided with significant cost savings with correctly incentivized reimbursement (Gray et al., <span>2019</span>; Tucker et al., <span>2018</span>). As in other sectors of the economy, a focus on value is the key to an effective and sustainable healthcare system. Society would benefit from a better quality of medical services, improved operational efficiency and lower tax burden from a value-based payment system (Daniels et al., <span>2022</span>; Expert Panel on effective ways of investing in Health, <span>2019</span>; Teperi et al., <span>2009</span>). One of the notable megatrends in the healthcare sector is the increased freedom of choice for patients' healthcare providers using various marketing information, which is easily acceptable by the digitalized medical information. Thus, data on quality of care, as provided by Crozet et al. (<span>2024</span>) in this issue would benefit th","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 6","pages":"625-626"},"PeriodicalIF":3.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.16698","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140664033","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}
Mathilde M. von Arenstorff, Afrouz Ahmadzadeh, Bo Simmendefeldt Schmidt, Line Kessel, Daniella Bach-Holm
Purpose
To determine vision-related quality of life (VR-QoL) and functional and structural parameters associated with VR-QoL in patients with glaucoma before and 12 months after trabeculectomy.
Methods
Fifty-eight patients undergoing trabeculectomy were included. Participants completed the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) prior to and 12 months after trabeculectomy. Functional (visual acuity and visual fields) and structural (ganglion cell layer volume) parameters were evaluated for their association with VR-QoL using multiple linear regression of VFQ-25 subscale scores. Intraocular pressure and the number of glaucoma medications were also included in the analyses.
Results
The VFQ-25 composite score did not change after trabeculectomy (before: 74.9; 12 months: 74.0; p = 0.512). The subscale mental health had a significantly higher score 12 months after trabeculectomy (before: 65.6; 12 months: 71.4; p = 0.017). The VFQ-25 scores for general health (before: 68.5; 12 months: 62.5; p = 0.009) and role difficulties (before: 78.9; 12 months: 53.7; p < 0.001) were significantly lower 12 months after trabeculectomy. No functional or structural parameters were associated with VFQ-25 composite score.
Conclusion
Overall, VR-QoL in glaucoma patients was similar before and after trabeculectomy, reflecting the procedure's stabilizing effect on both objective and subjective visual function. The absence of correlations between VR-QoL and clinical parameters emphasizes the multifaceted nature of VR-QoL and highlights the limitations of depending solely on objective clinical metrics to evaluate patients' subjective experiences. Using both objective measures and VR-QoL, clinicians can better understand the challenges patients face due to glaucoma and trabeculectomy, potentially leading to better solutions.
{"title":"Vision-related quality of life in patients with glaucoma before and after trabeculectomy","authors":"Mathilde M. von Arenstorff, Afrouz Ahmadzadeh, Bo Simmendefeldt Schmidt, Line Kessel, Daniella Bach-Holm","doi":"10.1111/aos.16697","DOIUrl":"10.1111/aos.16697","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To determine vision-related quality of life (VR-QoL) and functional and structural parameters associated with VR-QoL in patients with glaucoma before and 12 months after trabeculectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-eight patients undergoing trabeculectomy were included. Participants completed the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) prior to and 12 months after trabeculectomy. Functional (visual acuity and visual fields) and structural (ganglion cell layer volume) parameters were evaluated for their association with VR-QoL using multiple linear regression of VFQ-25 subscale scores. Intraocular pressure and the number of glaucoma medications were also included in the analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The VFQ-25 composite score did not change after trabeculectomy (before: 74.9; 12 months: 74.0; <i>p</i> = 0.512). The subscale <i>mental health</i> had a significantly higher score 12 months after trabeculectomy (before: 65.6; 12 months: 71.4; <i>p</i> = 0.017). The VFQ-25 scores for <i>general health</i> (before: 68.5; 12 months: 62.5; <i>p</i> = 0.009) and <i>role difficulties</i> (before: 78.9; 12 months: 53.7; <i>p</i> < 0.001) were significantly lower 12 months after trabeculectomy. No functional or structural parameters were associated with VFQ-25 composite score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, VR-QoL in glaucoma patients was similar before and after trabeculectomy, reflecting the procedure's stabilizing effect on both objective and subjective visual function. The absence of correlations between VR-QoL and clinical parameters emphasizes the multifaceted nature of VR-QoL and highlights the limitations of depending solely on objective clinical metrics to evaluate patients' subjective experiences. Using both objective measures and VR-QoL, clinicians can better understand the challenges patients face due to glaucoma and trabeculectomy, potentially leading to better solutions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"102 7","pages":"779-789"},"PeriodicalIF":3.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.16697","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140661800","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}
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