Pub Date : 2025-03-05DOI: 10.1016/j.apjo.2025.100172
Yi-Ting Hou, Le-Yu Chen, I-Hung Lin, Wei-Li Chen
{"title":"Enhanced visualization and removal of epithelial ingrowth after SMILE and LASIK using a fiberoptic illuminator.","authors":"Yi-Ting Hou, Le-Yu Chen, I-Hung Lin, Wei-Li Chen","doi":"10.1016/j.apjo.2025.100172","DOIUrl":"10.1016/j.apjo.2025.100172","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100172"},"PeriodicalIF":3.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584419","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}
Purpose: To evaluate the correlation between hyperreflective foci (HRF), the biomarker of activated microglia, and subretinal fluid (SRF), representing the dysfunction of retinal pigment epithelium (RPE), in treatment-naïve patients with diabetic macular edema (DME).
Methods: Sixty-one treatment-naïve patients (61 eyes) with DME were included in the research. Participants were divided into two categories based on the presence or absence of SRF. Basic characteristics were recorded. The parameters, including the HRF number in inner and outer retina, central macular thickness (CMT), intraretinal cyst (IRC), as well as the width, height and area of SRF, were analyzed with optical coherence tomography angiography (OCTA). The correlations between HRF and the parameters including SRF, IRC and CMT were analyzed accordingly.
Results: The mean CMT in DME with SRF group was much thicker than that in DME without SRF group (P < 0.0001). The mean HRF number in the outer retina and whole retina was markedly higher in DME patients with the presence of IRC or SRF when compared to those without IRC or SRF (P < 0.05). Further analysis showed that the width, height and area of SRF were positively correlated with the HRF number in the outer retina and the ratio of outer/whole retina HRFs (P < 0.05).
Conclusion: The positive correlation between the increased number of HRF, especially in the outer retina, and the formation of SRF in patients with DME supports the hypothesis that microglia activation represented by HRF might cause the dysfunction of RPE and the breakdown of the outer blood-retinal barrier (oBRB), which leads to the increased fluid leakage in subretinal space.
{"title":"Hyperreflective foci and subretinal fluid predicts microglia activation involved in the breakdown of outer blood-retinal barrier in treatment-naïve patients with diabetic macular edema.","authors":"Yiyang Shu, Chaoyang Zhang, Yanlong Bi, Jingfa Zhang","doi":"10.1016/j.apjo.2025.100168","DOIUrl":"10.1016/j.apjo.2025.100168","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the correlation between hyperreflective foci (HRF), the biomarker of activated microglia, and subretinal fluid (SRF), representing the dysfunction of retinal pigment epithelium (RPE), in treatment-naïve patients with diabetic macular edema (DME).</p><p><strong>Methods: </strong>Sixty-one treatment-naïve patients (61 eyes) with DME were included in the research. Participants were divided into two categories based on the presence or absence of SRF. Basic characteristics were recorded. The parameters, including the HRF number in inner and outer retina, central macular thickness (CMT), intraretinal cyst (IRC), as well as the width, height and area of SRF, were analyzed with optical coherence tomography angiography (OCTA). The correlations between HRF and the parameters including SRF, IRC and CMT were analyzed accordingly.</p><p><strong>Results: </strong>The mean CMT in DME with SRF group was much thicker than that in DME without SRF group (P < 0.0001). The mean HRF number in the outer retina and whole retina was markedly higher in DME patients with the presence of IRC or SRF when compared to those without IRC or SRF (P < 0.05). Further analysis showed that the width, height and area of SRF were positively correlated with the HRF number in the outer retina and the ratio of outer/whole retina HRFs (P < 0.05).</p><p><strong>Conclusion: </strong>The positive correlation between the increased number of HRF, especially in the outer retina, and the formation of SRF in patients with DME supports the hypothesis that microglia activation represented by HRF might cause the dysfunction of RPE and the breakdown of the outer blood-retinal barrier (oBRB), which leads to the increased fluid leakage in subretinal space.</p>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100168"},"PeriodicalIF":3.7,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565935","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}
Polypoidal choroidal vasculopathy (PCV) may have frequent recurrences after fluid resolution, but time to recurrence is unclear. This study explored time to first polypoidal recurrence after 1-year fixed-dosing aflibercept treatments.
Design
Retrospective cohort study.
Methods
Treatment-naïve PCV eyes treated between April 2015 to May 2019 were identified and included with criteria including: (1) received fixed-dosing 2 mg aflibercept in the first year, (2) became “inactive” (absence of both intraretinal and subretinal fluid on OCT) at post-treatment year-1 (PTY1) and managed as needed (PRN) thereafter, (3) FU ≥ 12 months after PTY1. Fundus photography, indocyanine green angiography (ICGA), and OCT graded to identify timing and risk factors for recurrence (defined as fluid on OCT).
Results
Of 37 study eyes [37 patients; median age was 64 years (IQR 59–69); median aflibercept injection number was 8 (IQR 8–8); median FU 38 months (IQR, 30–50 months)]; 18 eyes (49 %) had recurrence during FU. Fourteen (78 %) of 18 had recurrence within 12 months after PTY1 visit. Risk factors for recurrence included: incomplete polypoidal regression on post-treatment ICGA [P = .004, Hazard ratio (HR) = 4.4, 95 % confidence interval (CI) 1.6–11.9] and PED with internal heterogeneous reflectivity on post-treatment OCT (P = .04, HR = 2.7, 95 % CI 1.1–6.9).
Conclusions
Nearly half of inactive PCV eyes following 1-year fixed-dosing aflibercept treatments had recurrent polypoidal lesions. Eyes with high-risk features for recurrence, some of which can be detected with OCT without the need for ICGA, may warrant close monitoring.
{"title":"Recurrent polypoidal lesions after achieving inactive polypoidal choroidal vasculopathy following 1-year fixed-dosing aflibercept treatments","authors":"Voraporn Chaikitmongkol , Wantip Tadadoltip , Direk Patikulsila , Titipol Srisomboon , Chanusnun Narongchai , Janejit Choovuthayakorn , Nawat Watanachai , Paradee Kunavisarut , Apisara Sangkaew , Phit Upaphong , Neil M. Bressler","doi":"10.1016/j.apjo.2025.100176","DOIUrl":"10.1016/j.apjo.2025.100176","url":null,"abstract":"<div><h3>Purpose</h3><div>Polypoidal choroidal vasculopathy (PCV) may have frequent recurrences after fluid resolution, but time to recurrence is unclear. This study explored time to first polypoidal recurrence after 1-year fixed-dosing aflibercept treatments.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>Treatment-naïve PCV eyes treated between April 2015 to May 2019 were identified and included with criteria including: (1) received fixed-dosing 2 mg aflibercept in the first year, (2) became “inactive” (absence of both intraretinal and subretinal fluid on OCT) at post-treatment year-1 (PTY1) and managed as needed (PRN) thereafter, (3) FU ≥ 12 months after PTY1. Fundus photography, indocyanine green angiography (ICGA), and OCT graded to identify timing and risk factors for recurrence (defined as fluid on OCT).</div></div><div><h3>Results</h3><div>Of 37 study eyes [37 patients; median age was 64 years (IQR 59–69); median aflibercept injection number was 8 (IQR 8–8); median FU 38 months (IQR, 30–50 months)]; 18 eyes (49 %) had recurrence during FU. Fourteen (78 %) of 18 had recurrence within 12 months after PTY1 visit. Risk factors for recurrence included: incomplete polypoidal regression on post-treatment ICGA [<em>P</em> = .004, Hazard ratio (HR) = 4.4, 95 % confidence interval (CI) 1.6–11.9] and PED with internal heterogeneous reflectivity on post-treatment OCT (<em>P</em> = .04, HR = 2.7, 95 % CI 1.1–6.9).</div></div><div><h3>Conclusions</h3><div>Nearly half of inactive PCV eyes following 1-year fixed-dosing aflibercept treatments had recurrent polypoidal lesions. Eyes with high-risk features for recurrence, some of which can be detected with OCT without the need for ICGA, may warrant close monitoring.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 2","pages":"Article 100176"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539759","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}
{"title":"Utilizing generative AI in ophthalmic medical paper writing: Applications, limitations, and practical tools","authors":"Fang-Yu Hu , Le-Yu Chen , Pin-Jung Cheng, Jen-Yu Liu, Jo-Hsuan Wu, Wei-Li Chen","doi":"10.1016/j.apjo.2025.100174","DOIUrl":"10.1016/j.apjo.2025.100174","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 2","pages":"Article 100174"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539762","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}
Pub Date : 2025-03-01DOI: 10.1016/j.apjo.2024.100115
Kaidi Xiang , Jingjing Wang , Zhuoting Zhu , Xinzi Zhang , Bo Zhang , Jun Chen , Jinliuxing Yang , Linlin Du , Zhijian Ai , Xiangui He , Xun Xu
Purpose
To investigate longitudinal changes in choroidal thickness (ChT) after 1-year treatment of repeated low-level red-light (RLRL) and their predictive value in efficacy on myopia prevention and myopic shift among pre-myopic children.
Methods
278 pre-myopic (-0.50 D < spherical equivalent refraction, SER ≤ 0.50 D) participants were assigned to the RLRL group and control group randomly and evenly. The OCT, visual acuity, AL, SER and other parameters were measured before enrollment and every 3 months after intervention. The data from both eyes of the included participants were analyzed.
Results
A total of 463 eyes were analyzed. Due to the COVID-19 pandemic, 176 participants in the RLRL group had treatment interrupted. The continued RLRL group, interrupted RLRL group and control group were well balanced in baseline characteristics. In the continued and interrupted RLRL group, the average ChT increased significantly at 3-month visit (all P < 0.001) and the subfoveal ChT thickened evidently. The area under the curve (AUC) for the models including gender and 3-month change in ChT to predict satisfactory myopia prevention at 12 months was 0.983. The efficacy of the models that also used the combined indicators of baseline age, gender and the 3-month change in ChT to predict AL progression control over 12 months reached 0.944.
Conclusions
Continued RLRL intervention induced notable thickening of ChT in premyopic population, especially at the subfoveal sector. For participants received RLRL treatment, the 3-month change in ChT combined with other baseline factors have acceptable predictive discrimination of myopia prevention efficacy.
目的：探讨反复低水平红灯（RLRL）治疗1年后，准近视儿童脉络膜厚度（ChT）的纵向变化及其对近视预防和近视转移效果的预测价值。方法：278例近视前期患者（-0.50 D <球面等效屈光度，SER≤0.50 D）随机均匀分为RLRL组和对照组。在入组前及干预后每3个月测量一次OCT、视力、AL、SER等参数。对被试者双眼的数据进行分析。结果：共分析463只眼。由于COVID-19大流行，RLRL组的176名参与者的治疗中断。继续RLRL组、中断RLRL组和对照组的基线特征平衡良好。在RLRL持续组和中断组，平均ChT在3个月时显著增加（均P < 0.001），中央凹下ChT明显增厚。包括性别和3个月ChT变化的模型预测12个月时满意的近视预防的曲线下面积（AUC）为0.983。同时使用基线年龄、性别、3个月ChT变化联合指标预测12个月AL进展控制的模型的疗效达到0.944。结论：持续的RLRL干预在近视人群中引起了明显的ChT增厚，特别是在中央凹下区。对于接受RLRL治疗的参与者，3个月的ChT变化结合其他基线因素对近视预防效果具有可接受的预测性区分。
{"title":"Changes in choroidal thickness in pre-myopic children after repeated low-level red-light therapy and their role in predicting myopia prevention and controlling myopic shift","authors":"Kaidi Xiang , Jingjing Wang , Zhuoting Zhu , Xinzi Zhang , Bo Zhang , Jun Chen , Jinliuxing Yang , Linlin Du , Zhijian Ai , Xiangui He , Xun Xu","doi":"10.1016/j.apjo.2024.100115","DOIUrl":"10.1016/j.apjo.2024.100115","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate longitudinal changes in choroidal thickness (ChT) after 1-year treatment of repeated low-level red-light (RLRL) and their predictive value in efficacy on myopia prevention and myopic shift among pre-myopic children.</div></div><div><h3>Methods</h3><div>278 pre-myopic (-0.50 D < spherical equivalent refraction, SER ≤ 0.50 D) participants were assigned to the RLRL group and control group randomly and evenly. The OCT, visual acuity, AL, SER and other parameters were measured before enrollment and every 3 months after intervention. The data from both eyes of the included participants were analyzed.</div></div><div><h3>Results</h3><div>A total of 463 eyes were analyzed. Due to the COVID-19 pandemic, 176 participants in the RLRL group had treatment interrupted. The continued RLRL group, interrupted RLRL group and control group were well balanced in baseline characteristics. In the continued and interrupted RLRL group, the average ChT increased significantly at 3-month visit (all <em>P</em> < 0.001) and the subfoveal ChT thickened evidently. The area under the curve (AUC) for the models including gender and 3-month change in ChT to predict satisfactory myopia prevention at 12 months was 0.983. The efficacy of the models that also used the combined indicators of baseline age, gender and the 3-month change in ChT to predict AL progression control over 12 months reached 0.944.</div></div><div><h3>Conclusions</h3><div>Continued RLRL intervention induced notable thickening of ChT in premyopic population, especially at the subfoveal sector. For participants received RLRL treatment, the 3-month change in ChT combined with other baseline factors have acceptable predictive discrimination of myopia prevention efficacy.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 2","pages":"Article 100115"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765660","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}
Pub Date : 2025-03-01DOI: 10.1016/j.apjo.2025.100162
Chanchan Wang , Yong Ma , Qiong Zou , Hai He , Yaoqi Ba , Jianling Xiao , Xingtao Zhou , Shengtao Liu
Background
To assess the characteristics of the ciliary sulcus in patients with myopia with different axial lengths using ultrasound biomicroscopy (UBM).
Methods
A total of 108 eyes from 54 patients were recruited between January and March 2024. Patients were matched for age, cylinder and white-to-white (WTW) ratio, and further divided into a control axial length (AL) group (CON, AL < 26.5 mm, 54 eyes) and a long AL group (L-AL, AL ≥ 26.5 mm, 54 eyes). Anterior and posterior chamber parameters were examined based on UBM. Anterior chamber parameters included sulcus-to-sulcus distance (STS) in the horizontal and vertical orientation, lens anterior surface to ciliary sulcus distance (STSL), anterior segment length (ASL) and anterior chamber depth (ACD). Posterior chamber parameters included ciliary process length (CPL), trabecular–ciliary process distance, trabecular–ciliary angle (TCA), iris–ciliary angle (ICA) and maximum ciliary body thickness in four spatial directions.
Results
The anterior chamber parameters, including STS, STSL and ASL, were significantly lower in the horizontal direction than those in the vertical direction in both groups, whereas STS was significantly lower in the CON group than in the L-AL group. Posterior chamber parameters, including CPL, TCA and ICA, showed significant spatial differences between the two groups. Furthermore, STSL correlated significantly with ACD, mean keratometry and WTW.
Conclusions
Significant spatial differences in ciliary sulcus and ciliary body morphology were observed in patients with axial myopia. In ICL size selection and vault prediction, STS and STSL are potential indicators in preoperative ICL assessment.
{"title":"Ciliary sulcus characteristics in patients with axial myopia using ultrasound biomicroscope","authors":"Chanchan Wang , Yong Ma , Qiong Zou , Hai He , Yaoqi Ba , Jianling Xiao , Xingtao Zhou , Shengtao Liu","doi":"10.1016/j.apjo.2025.100162","DOIUrl":"10.1016/j.apjo.2025.100162","url":null,"abstract":"<div><h3>Background</h3><div>To assess the characteristics of the ciliary sulcus in patients with myopia with different axial lengths using ultrasound biomicroscopy (UBM).</div></div><div><h3>Methods</h3><div>A total of 108 eyes from 54 patients were recruited between January and March 2024. Patients were matched for age, cylinder and white-to-white (WTW) ratio, and further divided into a control axial length (AL) group (CON, AL < 26.5 mm, 54 eyes) and a long AL group (L-AL, AL ≥ 26.5 mm, 54 eyes). Anterior and posterior chamber parameters were examined based on UBM. Anterior chamber parameters included sulcus-to-sulcus distance (STS) in the horizontal and vertical orientation, lens anterior surface to ciliary sulcus distance (STSL), anterior segment length (ASL) and anterior chamber depth (ACD). Posterior chamber parameters included ciliary process length (CPL), trabecular–ciliary process distance, trabecular–ciliary angle (TCA), iris–ciliary angle (ICA) and maximum ciliary body thickness in four spatial directions.</div></div><div><h3>Results</h3><div>The anterior chamber parameters, including STS, STSL and ASL, were significantly lower in the horizontal direction than those in the vertical direction in both groups, whereas STS was significantly lower in the CON group than in the L-AL group. Posterior chamber parameters, including CPL, TCA and ICA, showed significant spatial differences between the two groups. Furthermore, STSL correlated significantly with ACD, mean keratometry and WTW.</div></div><div><h3>Conclusions</h3><div>Significant spatial differences in ciliary sulcus and ciliary body morphology were observed in patients with axial myopia. In ICL size selection and vault prediction, STS and STSL are potential indicators in preoperative ICL assessment.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 2","pages":"Article 100162"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439683","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}
Pub Date : 2025-03-01DOI: 10.1016/j.apjo.2025.100180
Yen-Ting Chen , Nishant V. Radke , Sohani Amarasekera , Dong Ho Park , Nelson Chen , Jay Chhablani , Nan-Kai Wang , Wei-Chi Wu , Danny S.C. Ng , Pramod Bhende , Shobhit Varma , Enne Leung , Xiulan Zhang , Fei Li , Shaochong Zhang , Dong Fang , Jia Liang , Zheming Zhang , Huanyu Liu , Peiquan Zhao , Dennis S.C. Lam
Diabetic retinopathy (DR) and diabetic macular edema (DME) are leading causes of vision loss globally. This is a comprehensive review focused on both medical and surgical management strategies for DR and DME. This review highlights the epidemiology of DR and DME, with a particular emphasis on the Asia-Pacific region, urban-rural disparities, ethnic variations, and grading methodologies. We examine various risk factors for DR, including glycemic control, hypertension, hyperlipidemia, obesity, chronic kidney disease, sex, myopia, pregnancy, and cataract surgery. Furthermore, we explore potential biomarkers in serum, proteomics, metabolomics, vitreous, microRNA, and genetics that may aid in the detection and management of DR. In addition to medical management, we review the evidence supporting systemic and ocular treatments for DR/DME, including anti–vascular endothelial growth factor (anti-VEGF) agents, anti-inflammatory agents, biosimilars, and integrin inhibitors. Despite advancements in treatment options such as pan-retinal photocoagulation and anti-VEGF agents, a subset of cases still progresses, necessitating vitrectomy. Challenging diabetic vitrectomies pose difficulties due to complex fibrovascular proliferations, incomplete posterior vitreous detachment, and fragile, ischemic retinas, making membrane dissection risky and potentially damaging to the retina. In this review, we address the question of challenging diabetic vitrectomies, providing insights and strategies to minimize complications. Additionally, we briefly explore newer modalities such as 3-dimensional vitrectomy and intra-operative optical coherence tomography as potential tools in diabetic vitrectomy. In conclusion, this review provides a comprehensive overview of both medical and surgical management options for DR and DME. It underscores the importance of a multidisciplinary approach, tailored to the needs of each patient, to optimize visual outcomes and improve the quality of life for those affected by these sight-threatening conditions.
{"title":"Updates on medical and surgical managements of diabetic retinopathy and maculopathy","authors":"Yen-Ting Chen , Nishant V. Radke , Sohani Amarasekera , Dong Ho Park , Nelson Chen , Jay Chhablani , Nan-Kai Wang , Wei-Chi Wu , Danny S.C. Ng , Pramod Bhende , Shobhit Varma , Enne Leung , Xiulan Zhang , Fei Li , Shaochong Zhang , Dong Fang , Jia Liang , Zheming Zhang , Huanyu Liu , Peiquan Zhao , Dennis S.C. Lam","doi":"10.1016/j.apjo.2025.100180","DOIUrl":"10.1016/j.apjo.2025.100180","url":null,"abstract":"<div><div>Diabetic retinopathy (DR) and diabetic macular edema (DME) are leading causes of vision loss globally. This is a comprehensive review focused on both medical and surgical management strategies for DR and DME. This review highlights the epidemiology of DR and DME, with a particular emphasis on the Asia-Pacific region, urban-rural disparities, ethnic variations, and grading methodologies. We examine various risk factors for DR, including glycemic control, hypertension, hyperlipidemia, obesity, chronic kidney disease, sex, myopia, pregnancy, and cataract surgery. Furthermore, we explore potential biomarkers in serum, proteomics, metabolomics, vitreous, microRNA, and genetics that may aid in the detection and management of DR. In addition to medical management, we review the evidence supporting systemic and ocular treatments for DR/DME, including anti–vascular endothelial growth factor (anti-VEGF) agents, anti-inflammatory agents, biosimilars, and integrin inhibitors. Despite advancements in treatment options such as pan-retinal photocoagulation and anti-VEGF agents, a subset of cases still progresses, necessitating vitrectomy. Challenging diabetic vitrectomies pose difficulties due to complex fibrovascular proliferations, incomplete posterior vitreous detachment, and fragile, ischemic retinas, making membrane dissection risky and potentially damaging to the retina. In this review, we address the question of challenging diabetic vitrectomies, providing insights and strategies to minimize complications. Additionally, we briefly explore newer modalities such as 3-dimensional vitrectomy and intra-operative optical coherence tomography as potential tools in diabetic vitrectomy. In conclusion, this review provides a comprehensive overview of both medical and surgical management options for DR and DME. It underscores the importance of a multidisciplinary approach, tailored to the needs of each patient, to optimize visual outcomes and improve the quality of life for those affected by these sight-threatening conditions.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 2","pages":"Article 100180"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584432","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}
Pub Date : 2025-03-01DOI: 10.1016/j.apjo.2025.100181
Francesc March de Ribot, Vivek Pravin Dave, Tham Chee Yung Clement, Paisan Ruamviboonsuk, David Chang, Oliver Findl
{"title":"Eye sustainability here and now","authors":"Francesc March de Ribot, Vivek Pravin Dave, Tham Chee Yung Clement, Paisan Ruamviboonsuk, David Chang, Oliver Findl","doi":"10.1016/j.apjo.2025.100181","DOIUrl":"10.1016/j.apjo.2025.100181","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 2","pages":"Article 100181"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613309","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}
Pub Date : 2025-03-01DOI: 10.1016/j.apjo.2025.100177
Fan Wu , Yih-Chung Tham , Charumathi Sabanayagam , Seang-Mei Saw
The global burden of myopia continues to expand, and the prevalence of myopia in East Asian populations is of particular concern. With the substantial increase in screen-based electronic devices, screen time has emerged as a potential risk factor. This review examined the relationship between screen viewing duration and myopia risk and public health strategies to reduce screen exposure among children. We conducted an evidence-based review of only meta-analyses investigating screen time and myopia association, searching PubMed from inception to January 20, 2025. Four of the six meta-analyses reviewed supported an association between prolonged screen use (> 2 or 3 hours/day) and increased myopia risk. However, methodological limitations include the predominance of cross-sectional study designs, self-reported screen time measurements, and the lack of cycloplegic refraction in some studies within the meta-analyses. Current public health strategies focus mainly on banning mobile phones in schools and limiting screen time. Technology-based solutions, such as anti-addiction systems, support and complement these strategies. Healthcare providers play a crucial role in assessing screen time patterns in children and providing evidence-based recommendations. Future studies should employ objective screen time measurements, conduct longitudinal analyses with cycloplegic refraction, and evaluate the effectiveness of screen time interventions in myopia prevention through randomized controlled trials. In addition, examining the combined effects of traditional near-work activities and screen time may provide more comprehensive insights into myopia risk factors.
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Pub Date : 2025-03-01DOI: 10.1016/j.apjo.2025.100173
Swara M. Sarvepalli , Ishani Kapoor , Kubra Sarici , Sunir J. Garg , Majda Hadziahmetovic
Purpose
This study aimed to assess the role of photodynamic therapy (PDT) as an adjunct to anti-vascular endothelial growth factor (Anti-VEGF) intravitreal injections in the treatment of neovascular age-related macular degeneration (nvAMD).
Methods
PubMed, Cochrane Library, and ClinicalTrials.gov were searched for keywords “macular degeneration” and “photodynamic therapy” and “placebo” or “ranibizumab” or “bevacizumab” or “aflibercept” from inception to 2023. Included studies were peer-reviewed primary data reporting 12-month treatment results of nvAMD with anti-VEGF and PDT, anti-VEGF alone, intravitreal triamcinolone, or placebo. 23 studies were included in the final analysis. The major outcomes were best-corrected visual acuity (BCVA), central retinal thickness (CRT), and injection burden at 12 months.
Results
Anti-VEGF + PDT had better BCVA at 12 months compared to anti-VEGF (MD −0.07; 95 % CI −0.12, −0.01; P = 0.02). There was no significant difference in CRT at 12 months in anti-VEGF + PDT group versus anti-VEGF (MD −3.66; 95 % CI −10.28, 2.98; P = 0.28). Anti-VEGF + PDT group had significantly fewer injections compared to anti-VEGF (MD −1.76; 95 % CI −1.95, −1.58; P < 0.0001). There was no significant difference in pooled ocular adverse events between anti-VEGF + PDT versus anti-VEGF (MD 0.96; 95 % CI 0.68, 1.36; P = 0.41).
Conclusions
PDT is a successful adjunctive to anti-VEGF injections for the treatment of nvAMD. The combination of the therapies leads to improved BCVA at 12 months, decreased injection burden, and no difference in ocular safety.
{"title":"Evaluating photodynamic therapy as an adjuvant treatment for neovascular AMD: A comprehensive meta-analysis","authors":"Swara M. Sarvepalli , Ishani Kapoor , Kubra Sarici , Sunir J. Garg , Majda Hadziahmetovic","doi":"10.1016/j.apjo.2025.100173","DOIUrl":"10.1016/j.apjo.2025.100173","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to assess the role of photodynamic therapy (PDT) as an adjunct to anti-vascular endothelial growth factor (Anti-VEGF) intravitreal injections in the treatment of neovascular age-related macular degeneration (nvAMD).</div></div><div><h3>Methods</h3><div>PubMed, Cochrane Library, and ClinicalTrials.gov were searched for keywords “macular degeneration” and “photodynamic therapy” and “placebo” or “ranibizumab” or “bevacizumab” or “aflibercept” from inception to 2023. Included studies were peer-reviewed primary data reporting 12-month treatment results of nvAMD with anti-VEGF and PDT, anti-VEGF alone, intravitreal triamcinolone, or placebo. 23 studies were included in the final analysis. The major outcomes were best-corrected visual acuity (BCVA), central retinal thickness (CRT), and injection burden at 12 months.</div></div><div><h3>Results</h3><div>Anti-VEGF + PDT had better BCVA at 12 months compared to anti-VEGF (MD −0.07; 95 % CI −0.12, −0.01; <em>P</em> = 0.02). There was no significant difference in CRT at 12 months in anti-VEGF + PDT group versus anti-VEGF (MD −3.66; 95 % CI −10.28, 2.98; <em>P</em> = 0.28). Anti-VEGF + PDT group had significantly fewer injections compared to anti-VEGF (MD −1.76; 95 % CI −1.95, −1.58; <em>P</em> < 0.0001). There was no significant difference in pooled ocular adverse events between anti-VEGF + PDT versus anti-VEGF (MD 0.96; 95 % CI 0.68, 1.36; <em>P</em> = 0.41).</div></div><div><h3>Conclusions</h3><div>PDT is a successful adjunctive to anti-VEGF injections for the treatment of nvAMD. The combination of the therapies leads to improved BCVA at 12 months, decreased injection burden, and no difference in ocular safety.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"14 2","pages":"Article 100173"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555437","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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