Advances in ophthalmology practice and research最新文献

{"title":"Advances and challenges of CRISPR/Cas gene editing for corneal diseases","authors":"Yuqi Han ,&nbsp;Ruoqi Chen ,&nbsp;Xingchao Shentu","doi":"10.1016/j.aopr.2025.11.002","DOIUrl":"10.1016/j.aopr.2025.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Corneal diseases are a major cause of global visual impairment, and current treatments remain inadequate for severe or refractory cases. The CRISPR/Cas system offers robust and precise gene-editing capabilities, yet its therapeutic potential for corneal disorders remains largely unexplored.</div></div><div><h3>Main text</h3><div>This narrative review introduces the CRISPR/Cas system and summarizes its recent advances in treating various corneal diseases, including inherited corneal dystrophies, infectious keratitis, corneal injury, and pathological neovascularization. We outline emerging preclinical and clinical studies, and analyze key issues that should be addressed for translation, including administration strategies, vector platform optimization and the mitigation of off-target toxicity.</div></div><div><h3>Conclusions</h3><div>This review provides a comprehensive and integrated overview of the current translational directions and challenges of CRISPR/Cas technology in corneal diseases from a novel perspective. It offers valuable guidance for future research and may accelerate the development of gene-editing therapies toward clinical application.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"6 1","pages":"Pages 68-79"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of a modified haptic on preventing toric IOL rotation in high rotation risk eyes","authors":"Shuyu Liu ,&nbsp;Chao Chen ,&nbsp;Jitong Zhou ,&nbsp;Kaiwen Cheng ,&nbsp;Yu Du ,&nbsp;Jiaqi Meng ,&nbsp;Yi Lu ,&nbsp;Wenwen He ,&nbsp;Xiangjia Zhu","doi":"10.1016/j.aopr.2025.11.003","DOIUrl":"10.1016/j.aopr.2025.11.003","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the rotational stability and astigmatic correction of a C-loop frosted haptic toric intraocular lens (IOL) compared with a plate-haptic toric IOL with/without capsular tension ring (CTR) implantation in cataractous eyes with high rotation risk due to large white-to-white (WTW) distance.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 90 cataractous eyes with WTW &gt; 11.8 mm, which received implantation of either a C-loop frosted haptic toric IOL (Group ZCU), a plate-haptic toric IOL (Group 709), or a plate-haptic toric IOL with CTR (Group 709 + CTR). IOL rotation and residual astigmatism were assessed one month postoperatively.</div></div><div><h3>Results</h3><div>Group ZCU demonstrated significantly better rotational stability, with a mean rotation of 1.87° ± 1.03°, compared to 4.63° ± 2.12° in Group 709 and 4.13° ± 1.86° in Group 709 + CTR (both <em>P</em> &lt; 0.05). Residual astigmatism was also significantly lower in Group ZCU (0.36 ± 0.26 D), compared to Group 709 (0.54 ± 0.43 D) and Group 709 + CTR (0.65 ± 0.27 D; both <em>P</em> &lt; 0.05). A positive correlation between WTW and IOL rotation was found in Group 709 (<em>r</em> = 0.419, <em>P</em> = 0.021) and Group 709 + CTR (<em>r</em> = 0.403, <em>P</em> = 0.027), but not in Group ZCU (<em>r</em> = −0.180, <em>P</em> = 0.341). Lens thickness and WTW were identified as independent predictors of rotation in Group 709, whereas only WTW was significant in Group 709 + CTR.</div></div><div><h3>Conclusions</h3><div>In eyes with high rotation risk due to large WTW (&gt; 11.8 mm), the ZCU IOL exhibits superior rotational stability and astigmatic correction compared to the 709 IOL, regardless of whether CTR is used.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"6 1","pages":"Pages 50-55"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Instrument-based, non-cycloplegic versus cycloplegic refraction in pediatric and young adult populations (≤25 years): A systematic review and meta-analysis","authors":"Ana Roque ,&nbsp;Amélia Fernandes Nunes ,&nbsp;Henrique Nascimento ,&nbsp;Clara Martinez-Perez","doi":"10.1016/j.aopr.2025.11.004","DOIUrl":"10.1016/j.aopr.2025.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Accurate refractive assessment in children and young adults is critical to prevent amblyopia and strabismus, conditions that may arise from uncorrected hyperopia. Although non-cycloplegic autorefractors and photoscreeners are increasingly used for vision screening due to their practicality and high testability, residual accommodation often introduces systematic measurement bias. The debate regarding the necessity of cycloplegia has intensified, particularly in large-scale epidemiological studies and screening programs, highlighting the need for an evidence-based synthesis.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis, conducted according to PRISMA and AMSTAR-2 standards and registered in PROSPERO (CRD420251134665), synthesized data from 54 comparative studies, with 24 included in quantitative analyses.</div></div><div><h3>Results</h3><div>Compared with cycloplegic reference methods, non-cycloplegic autorefractors and photoscreeners consistently underestimated refractive error, showing pooled mean differences of −0.65 D (95% CI: −0.84 to −0.45; 95% PI: −1.50 to +0.20 D) and −0.78 D (95% CI: −1.12 to −0.44; 95% PI: −1.70 to +0.10 D), respectively. These prediction intervals illustrate the wide variability expected across future studies and populations. The bias was most pronounced in younger children and hyperopic eyes, reflecting the impact of accommodative tone. Despite device-specific differences, no method fully corrected this systematic error. Testability exceeded 95% across most devices, reinforcing their feasibility for population-level screening. However, the certainty of evidence was rated as low due to heterogeneity and observational design limitations.</div></div><div><h3>Conclusions</h3><div>Non-cycloplegic methods systematically underestimate hyperopia and therefore cannot replace cycloplegia for definitive diagnosis or spectacle prescription in pediatric populations. Cycloplegic assessment remains essential to detect amblyogenic refractive errors accurately. Non-cycloplegic methods may be integrated into large-scale screening programs for initial case detection, but positive or borderline cases must undergo cycloplegic confirmation to ensure safe and effective clinical management.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"6 1","pages":"Pages 56-67"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nothing in life is to be feared; it is only to be understood","authors":"Johanna Wiedemann ,&nbsp;Claus Cursiefen ,&nbsp;Peter Wiedemann","doi":"10.1016/j.aopr.2025.09.002","DOIUrl":"10.1016/j.aopr.2025.09.002","url":null,"abstract":"","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"5 4","pages":"Pages 303-304"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TOC","authors":"","doi":"10.1016/S2667-3762(25)00061-7","DOIUrl":"10.1016/S2667-3762(25)00061-7","url":null,"abstract":"","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"5 4","pages":"Pages iii-iv"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration of virtual reality applications in myopia: A systematic review","authors":"Xiaona Ping,&nbsp;Juno Kim,&nbsp;Nayuta Yoshioka,&nbsp;Padmaja Sankaridurg","doi":"10.1016/j.aopr.2025.10.002","DOIUrl":"10.1016/j.aopr.2025.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Multiple interventions are available to prevent or slow myopia progression, the rapidly rising prevalence highlights the need to enhance both the development of novel approaches and adherence to existing strategies. Virtual reality (VR) is an emerging technology in ophthalmology and vision science, yet its potential applications in myopia remain underexplored.</div></div><div><h3>Main text</h3><div>To explore the prior application, if any, of VR in myopia research. A systematic search was conducted across nine databases, including PubMed, Cochrane Library, Embase, Scopus, Web of Science, IEEE Xplore, ACM Digital Library, SpringerLink, and ScienceDirect, to identify journal articles and conference proceedings reporting application of VR in myopia. The search terms used were \"Virtual Reality\", \"VR\", \"myopia\", \"nearsightedness\", \"shortsightedness\", \"refractive errors\", and \"refractive disorder\". The search covered publications from inception to April 6, 2025. Risk of bias was assessed using the Revised Cochrane risk-of-bias tool and the Joanna Briggs Institute Critical Appraisal Checklist, with assessments performed independently by two authors.</div></div><div><h3>Conclusion</h3><div>A total of sixteen articles fit the criteria and were included in the review. Of these, seven investigated VR-based interventions for myopia, an additional four were focused on testing and diagnostic applications, three articles reported on vision training, and the remaining two articles were related to educational uses. None were related to myopia control. All studies were published between 2016 and 2024. With respect to the VR technologies, eleven studies utilized commercial VR headsets and/or smartphones paired with VR viewers as experimental devices. Fully immersive virtual environments or systems were also commonly employed in the included studies. Most studies focused on the usability and validity of VR technologies in this context.</div></div><div><h3>Conclusions</h3><div>None of the articles reported on the efficacy of VR in preventing or slowing myopia progression, however, our review identified the potential of VR in auxiliary aspects of myopia, including testing, diagnosis, intervention, vision training, and education. Further research is warranted to evaluate the practical feasibility, clinical effectiveness, safety, and broader applicability of VR technologies in myopia.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"5 4","pages":"Pages 305-314"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benchmarking large multimodal models for ophthalmic visual question answering with OphthalWeChat","authors":"Pusheng Xu ,&nbsp;Xia Gong ,&nbsp;Xiaolan Chen ,&nbsp;Weiyi Zhang ,&nbsp;Jiancheng Yang ,&nbsp;Bingjie Yan ,&nbsp;Meng Yuan ,&nbsp;Yalin Zheng ,&nbsp;Mingguang He ,&nbsp;Danli Shi","doi":"10.1016/j.aopr.2025.10.006","DOIUrl":"10.1016/j.aopr.2025.10.006","url":null,"abstract":"<div><h3>Purpose</h3><div>To develop a bilingual multimodal visual question answering (VQA) benchmark for evaluating Vision–language models (VLMs) in ophthalmology.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, ophthalmic image posts and associated captions published between Jan 1, 2016, and Dec 31, 2024, were collected from WeChat Official Accounts. Based on these captions, bilingual question–answer (QA) pairs in Chinese and English were generated using GPT-4o-mini. QA pairs were categorized into six subsets by question type and language: binary (Binary_CN, Binary_EN), single-choice (Single-choice_CN, Single-choice_EN), and open-ended (Open-ended_CN, Open-ended_EN). The benchmark was used to evaluate six VLMs: GPT-4o, Gemini 2.0 Flash, Qwen2.5-VL-72B-Instruct, Janus-Pro-7B, InternVL3-8B, and HealthGPT-L14. Primary outcome was overall accuracy; secondary outcomes included subset-, subspeciality-, and modality-specific accuracy. Performance on open-ended questions were also quantified using language-based metrics, including AlignScore, BARTScore, BERTScore, BLEU, CIDEr, METEOR, and ROUGE_L. Error types in open-ended responses were manually analyzed through stratified sampling.</div></div><div><h3>Results</h3><div>OphthalWeChat included 3469 images and 30120 QA pairs cover 9 ophthalmic subspecialties, 548 conditions, 29 imaging modalities, and 68 modality combinations. Gemini 2.0 Flash achieved the highest overall accuracy (0.555), significantly outperforming GPT-4o (0.527), Qwen2.5-VL-72B-Instruct (0.520), HealthGPT-L14 (0.502), InternVL3-L14 (0.453), and Janus-Pro-7B (0.333) (all <em>P</em> &lt; 0.001). It also led in both Chinese (0.551) and English subsets (0.559). By subset, Gemini 2.0 Flash excelled in Binary_CN (0.687) and Single-choice_CN (0.666); HealthGPT-L14 performed best in Single-choice_EN (0.739); while GPT-4o ranked highest in Binary_EN (0.717), Open-ended_CN (0.254), and Open-ended_EN (0.271). Language-based metrics showed inconsistent rankings relative to accuracy in open-ended subsets. Performance varied across subspecialties and modalities, with Gemini 2.0 Flash leading in 6 of 9 subspecialties and 11 of top-15 imaging modalities. Error types analysis revealed lesion/diagnosis errors as the most frequent (35.6%–50.6%), followed by anatomical location errors (28.3%–37.5%).</div></div><div><h3>Conclusions</h3><div>This study presents the first bilingual VQA benchmark for ophthalmology, distinguished by its real-world context and inclusion of multiple examinations per patient. The dataset enables quantitative evaluation of VLMs, supporting the development of accurate and specialized AI systems for eye care.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"6 1","pages":"Pages 33-41"},"PeriodicalIF":3.4,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of three toric intraocular lenses: clinical outcomes and rotational stability in patients with corneal astigmatism","authors":"Qiaomei Tang ,&nbsp;Wenxin Yang ,&nbsp;Yueyang Zhong ,&nbsp;Xiaohui Song ,&nbsp;Jianghua Hu ,&nbsp;Zhenwei Qin ,&nbsp;Yinhui Yu ,&nbsp;Yibo Yu","doi":"10.1016/j.aopr.2025.10.007","DOIUrl":"10.1016/j.aopr.2025.10.007","url":null,"abstract":"<div><h3>Pu<em>r</em>poses</h3><div>This study aims to evaluate the clinical outcomes and rotational stability of three different toric intraocular lenses (IOLs; Tecnis ZCT, Tecnis ZCU and AcrySof IQ) used in femtosecond laser-assisted cataract surgery (FLACS) and investigate potential variables that may impact the rotational stability.</div></div><div><h3>Methods</h3><div>This retrospective study involved 126 eyes from 111 patients who received FLACS with toric IOL implantation. Patients were allocated to three groups: one received the AcrySof IQ toric IOL, another the Tecnis ZCT, and the other the Tecnis ZCU. Ophthalmic parameters such as axial length (AL), anterior chamber depth (ACD), and white-to-white (WTW) distance, were determined preoperatively. Postoperative evaluations were conducted at 3 months.</div></div><div><h3>Results</h3><div>No significant differences in BCDVA or residual astigmatism (RAS) postoperatively were observed among the groups (<em>P</em> &gt; 0.05). No significant differences were found among the three toric IOLs in mean absolute rotation or directional distribution (<em>P</em> &gt; 0.05). In eyes with axial length ≥ 24.00 mm, the Tecnis ZCT toric IOL demonstrated significantly poorer rotational stability compared to the AcrySof IQ (Tecnis ZCT: 6.41 ± 5.23°, AcrySof IQ: 3.40 ± 2.95°, <em>P</em> = 0.032). Pairwise comparisons showed significant differences in capsule-IOL overlap between the AcrySof IQ and Tecnis ZCT groups (<em>P</em> = 0.014), as well as between the Tecnis ZCT and Tecnis ZCU groups (<em>P</em> &lt; 0.001), but not between the AcrySof IQ and Tecnis ZCU (<em>P</em> = 0.187). There was no significant difference (<em>P</em> &gt; 0.05) in IOL decentration among the three groups. In the Tecnis ZCT group, toric IOL rotation demonstrated a statistically significant association with the WTW distance (Pearson's <em>r</em> = 0.313, <em>P</em> = 0.034). For Tecnis ZCU, a significant correlation was observed between toric IOL rotation and the AL (Pearson's <em>r</em> = 0.325, <em>P</em> = 0.041),</div></div><div><h3>Conclusions</h3><div>The three toric IOLs showed comparable visual and refractive outcomes at 3 months. The Tecnis ZCT demonstrated inferior performance in rotational stability and postoperative alignment compared to the AcrySof IQ and Tecnis ZCU.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"6 1","pages":"Pages 42-49"},"PeriodicalIF":3.4,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the accuracy of six intraocular lens power calculation methods in post-myopic-LASIK eyes","authors":"Qingying Yang,&nbsp;Wenwen He,&nbsp;Kaiwen Cheng,&nbsp;Jiaqi Meng,&nbsp;Xiangjia Zhu","doi":"10.1016/j.aopr.2025.10.005","DOIUrl":"10.1016/j.aopr.2025.10.005","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare the accuracy of six intraocular lens (IOL) power calculation methods in post-myopic-LASIK eyes.</div></div><div><h3>Methods</h3><div>Post-myopic-LASIK patients scheduled for cataract surgery were enrolled. Mean error (ME), mean absolute error (MAE), and median absolute error (MedAE) of ASCRS (ASCRS-Max, ASCRS-Average, ASCRS-Min), EVO 2.0, Pearl-DGS, Barrett True-K no-history, Shammas-PL, and Haigis-L were compared. The ASCRS method employed four formulas, including Shammas-PL, Haigis-L, Potvin-Hill Pentacam, and Barrett True-K no-history. Trueness, precision, and accuracy indices were evaluated by comparing trimmed-mean values with heteroscedasticity adjustment. Subgroup analyses were performed based on K value, axial length (AL), and corneal decentered ablation, respectively. Factors influencing prediction errors were analyzed.</div></div><div><h3>Results</h3><div>Totally, 87 eyes were analyzed. ASCRS-Min had the lowest MAE (0.79 D) and MedAE (0.62 D), followed by EVO 2.0, Pearl-DGS, and Barrett True-K no-history. It also had the highest percentage of absolute errors within 1.00 D. All methods outperformed ASCRS-Max in accuracy indices, and ASCRS-Min and EVO 2.0 showed superior accuracy indices compared to Shammas-PL and Haigis-L. In the subgroups of lower K value, longer AL, and larger decentration of ablation zone, ASCRS-Min, EVO 2.0, Pearl-DGS, and Barrett True-K no-history generated statistically lower MedAEs than ASCRS-Max. The accuracy of Shammas-PL was associated with AL; the accuracy of Haigis-L was associated with K value and AL; no other significant associations were found.</div></div><div><h3>Conclusions</h3><div>Generally, ASCRS-Min, EVO 2.0, Pearl-DGS, and Barrett True-K no-history achieve relatively better accuracy than the other methods, which might be considered as first choices for IOL power calculation in post-myopic-LASIK eyes.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"6 1","pages":"Pages 26-32"},"PeriodicalIF":3.4,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting intravitreal treatment response using ultrawide-field angiographic biomarkers in diabetic retinopathy","authors":"Karthik Reddy ,&nbsp;Callie Deng ,&nbsp;Boonkit Purt ,&nbsp;Yue Liang ,&nbsp;Nikhil Bommakanti ,&nbsp;Gina Yu ,&nbsp;Julie Rosenthal ,&nbsp;Yannis M. Paulus","doi":"10.1016/j.aopr.2025.10.003","DOIUrl":"10.1016/j.aopr.2025.10.003","url":null,"abstract":"<div><h3>Background</h3><div>Diabetic retinopathy (DR) is a sight-threatening retinal disease with pathological mediation by vascular endothelial growth factor (VEGF). Intravitreal anti-VEGF injections are commonly used to manage DR. Ultra-wide-field fluorescein angiography (UWF-FA) can assess DR severity and characterize the amount of non-perfused retina (non-perfusion area, NP), neovascularization (neovascular area, NV), and foveal avascular zone (FAZ). However, the association between anti-VEGF treatment and NP, NV, and FAZ characterized by UWF-FA is not well established.</div></div><div><h3>Methods</h3><div>A retrospective, single-center cohort study involved eyes of patients with Type 1 or 2 diabetes mellitus with at least one UWF-FA image. The area of the FAZ, NP area, and NV area of UWF-FA images was calculated. Stepwise multivariate logistic regression was used to identify patient and eye-level factors that were significant predictors of FAZ, NP, and NV. Causal model analyses estimated intravitreal treatment effects on FAZ, NP, and NV over time.</div></div><div><h3>Results</h3><div>The study included 705 eyes from patients with a mean (SD) age of 59.2 (13.2) years, and 56.3% were male. Eyes were treated with a mean (SD) of 5.6 (7.7) anti-VEGF and 0.63 (1.94) intravitreal steroid injections. Each incremental increase in Early Treatment Diabetic Retinopathy Study (ETDRS) severity of DR on initial presentation by clinical exam was associated with a 12.86 mm² increase in total NP and a 0.73 mm² increase in NV area. Anti-VEGF and steroid treatment had no significant impact on FAZ area. The presence of intravitreal steroid treatment was associated with an estimated decrease of −0.909 mm² in total NV area (<em>P</em> = 0.009). Each additional anti-VEGF injection decreased NV area by −0.239 mm² (<em>P</em> = 0.031). Any steroid use also led to an estimated −10.79 mm² decrease in NP (<em>P</em> = 0.041). Each additional anti-VEGF injection was predictive of a −2.54 mm² decrease in NP (<em>P</em> = 0.019). Each additional steroid injection was predictive of a −13.68 mm² decrease in NP (<em>P</em> = 0.001).</div></div><div><h3>Conclusions</h3><div>Intravitreal treatment was significantly associated with reduced NV and NP on UWF-FA. Intravitreal treatments were not predictive of FAZ changes. These findings suggest total retinal NV and NP areas may provide utility as UWF-FA biomarkers for assessing intravitreal treatment response.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"6 1","pages":"Pages 20-25"},"PeriodicalIF":3.4,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}