BMC Ophthalmology最新文献

Purpose: To evaluate the efficacy of EVO-ICL implantation combined with a corneal relaxing incision for the correction of moderate to high myopia with low astigmatism.

Design: Prospective non-randomized clinical trial.

Methods: This study included 35 eyes of 35 patients with astigmatism corrected by corneal relaxing incision (CRI) on the steep meridian and 30 eyes of 30 patients who underwent conventional temporal incision as controls. Visual acuity, refractive parameters, keratometry, corneal astigmatism, and corneal aberration were measured preoperatively and 1 and 3 months postoperatively.

Results: The refractive astigmatism of the CRI group decreased significantly from 0.89 ± 0.22 preoperatively to 0.39 ± 0.25 D at 1 month and 0.35 ± 0.30 D at 3 months postoperatively, and from 0.46 ± 0.32 D to 0.45 ± 0.34 D and 0.44 ± 0.30 D in the control group, respectively (P < 0.001). The preoperative anterior corneal astigmatism of the CRI group was significantly higher than the control group (P < 0.001) and decreased significantly from 1.03 ± 0.32 D preoperatively to 0.74 ± 0.36 D at 1 month and 0.69 ± 0.39 D at 3 months postoperatively (P < 0.001). The preoperative posterior corneal astigmatism of the CRI group decreased significantly from 0.32 ± 0.11 D preoperatively to 0.28 ± 0.12 D at 1 month and 0.25 ± 0.10 D at 3 months postoperatively (P < 0.001). There were significant differences in the postoperative RMS of trefoil aberration and total HOAs of the whole cornea, anterior cornea, and posterior cornea between the two groups (P < 0.05).

Conclusion: EVO-ICL implantation combined with a corneal relaxing incision to correct moderate-to-high myopia with low astigmatism is safe and effective with good short-term stability.

Purpose: Diabetic macular edema (DME) is a leading cause of vision loss in patients with diabetes. In developed countries, intravitreal (IVT) anti-vascular endothelial growth factor (VEGF) injections are the standard-of-care first-line treatment for DME. However, despite the efficacy of anti-VEGF and associated improvements in prognosis, some patients show only a partial response and continue to require monthly injections. The aim of this study was to investigate the effect of switching from aflibercept 2.0 mg to faricimab (which targets both angiopoietin-2 [Ang-2] and VEGF-A) on visual function, retinal anatomy and intraretinal fluid (IRF) dynamics in patients with refractory DME.

Methods: A single-center, observational study of patients with aflibercept-resistant DME who switched to IVT faricimab treatment, comprising a 3-month loading phase, during which faricimab was administered monthly (total of four injections), followed by a treat-and-extend regimen. Visual acuity, anatomical parameters, and fluid dynamics were assessed from baseline to Month 6 in an interim analysis.

Results: Fourteen eyes from 10 patients were included. At Month 6, mean best-corrected visual acuity improved by + 2.7 Early Treatment Diabetic Retinopathy Study (ETDRS) letters (not statistically significant). Mean changes in central macular thickness and outer nuclear layer (ONL) thickness at Month 6 were not significant. However, ONL thickness was significantly reduced in multiples ETDRS macular grid subfields at Month 4. Subretinal fluid volume was negligible through Month 6, with most fluid located in the intraretinal layers (97.8-100%). Total IRF decreased by 22% at Month 4, reaching a nadir of - 37% at Month 2. There was no significant change in mean vascular density from Month 0 to Month 4.

Conclusion: Faricimab treatment led to modest early improvements in visual acuity and retinal anatomy overall in patients with refractory DME. The reduction in total IRF at Month 4 may be attributable to Ang-2 inhibition in these patients, who had previously not responded to anti-VEGF treatment alone. Longer-term studies are needed to evaluate the durability and long-term efficacy of faricimab for the treatment of refractory DME.

Objective: The increasing prevalence of refractive errors in children has raised interest in exploring potential associations with physical development. This study aimed to explore a potential relationship between refractive status and growth parameters among children aged 7-10 years.

Methods: A multistage stratified random sampling method was adopted to select 1260 primary school students in Pinggu District of Beijing in 2023, to measure their height and weight to calculate the body mass index (BMI). The height-for-age z-score (HAZ) and body mass index z-score(z-BMI) were calculated using the Least Mean Squares (LMS) method. Cycloplegic refraction was performed to determine spherical equivalent (SE). Ocular biometric data were collected, including axial length (AL) and anterior chamber depth (ACD). The ratio of AL to average corneal curvature (AL/CR) were calculated. Group comparisons used χ² test, t-test, analysis of variance (ANOVA) and Wilcoxon rank-sum test. Multiple linear regression models were used to analyze correlations between HAZ, z-BMI and ocular parameters.

Results: The myopia rate was 21.19% and increased with age. Compared to girls, boys had significantly longer AL, deeper ACD, steeper CR, and higher AL/CR. As myopia severity increased, AL lengthened, ACD deepened, CR steepened and AL/CR increased. In the overall group, HAZ showed a positive correlation with AL (β = 0.208, Adjusted R²=0.084) and CR (β = 0.201, Adjusted R²=0.049), z-BMI showed a positive correlation with AL (β = 0.136, Adjusted R²=0.084) and AL/CR (β = 0.108, Adjusted R²=0.014), and a negative correlation with SE (β=-0.069, Adjusted R²=0.007). In the emmetropia group, pre-myopia group, and myopia group, HAZ showed a positive correlation with both AL and CR, while z-BMI demonstrated a positive correlation with AL.

Conclusions: This exploratory study suggests that accelerated physical growth shows statistically significant but clinically modest correlations with axial elongation and myopia development. The findings do not demonstrate causal relationships between growth and refractive changes. AL/CR appears to be a key biometric predictor of refractive error. These hypothesis-generating results underscore the potential value of growth monitoring in myopia prevention and for further investigation into distinct physiological pathways in ocular development.