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Real-World Treatment Outcomes of an Artificial Tear Containing Arabinogalactan, Hyaluronic Acid and Trehalose Among Subjects with Dry Eye. 含有阿拉伯半乳聚糖、透明质酸和海藻糖的人工泪液在干眼症患者中的实际治疗效果。
Pub Date : 2025-01-07 eCollection Date: 2025-01-01 DOI: 10.2147/OPTH.S480668
Andrea Bedei, Pedro Rocha Cabrera, Luis Oliveira, Laura Castellini, Giulia De Grazia, Stefano Remiddi

Purpose: To assess the efficacy, adherence, and tolerability of a new artificial tear based on arabinogalactan, hyaluronic acid, and trehalose in a population with dry eye disease (DED).

Methods: A retrospective, real-world, post-marketing study identified 96 adult patients (aged 18-80 years) with signs and symptoms of dry eye. These patients received fixed combination therapy with eye drops containing arabinogalactan, hyaluronic acid, and trehalose at various dosing schedules. The data for this study were collected from April 2022 to June 2023. Patients underwent evaluation at baseline (T0) and after a follow-up period of two-three months (T1) using a patient-reported questionnaire.

Results: In 96 adult patients (71 women and 25 men) with dry eye due to various conditions, the results indicated a 98% positive response to therapy. This response included improvements in vision (13%), comfort (39%), redness (13%), itching (16%), photophobia (4%), and tearing (14%). Additionally, 61% of the patients experienced 1-2 hours of comfort following instillation.

Conclusion: This real-life post-marketing study demonstrated clinical improvement of signs and symptoms in patients with dry eye disease using a new artificial tear medical device based on arabinogalactan, hyaluronic acid, and trehalose.

目的:评估一种基于阿拉伯半乳聚糖、透明质酸和树胶糖的新型人工泪液在干眼症(DED)患者中的疗效、依从性和耐受性:一项回顾性、真实世界、上市后研究确定了 96 名有干眼症症状和体征的成年患者(18-80 岁)。这些患者接受了含有阿拉伯半乳聚糖、透明质酸和曲哈洛糖的滴眼液的固定组合疗法,用药剂量各不相同。本研究的数据收集时间为 2022 年 4 月至 2023 年 6 月。患者在基线期(T0)和随访两三个月后(T1)接受了评估,评估使用的是患者报告问卷:在 96 名因各种原因导致干眼症的成年患者(71 名女性和 25 名男性)中,结果显示 98% 的患者对治疗产生了积极反应。这种反应包括视力改善(13%)、舒适度改善(39%)、眼红改善(13%)、瘙痒改善(16%)、畏光改善(4%)和流泪改善(14%)。此外,61%的患者在注射后 1-2 小时内感觉舒适:这项真实的上市后研究表明,使用一种基于阿拉伯半乳聚糖、透明质酸和三卤糖的新型人工泪液医疗设备,干眼症患者的体征和症状得到了临床改善。
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引用次数: 0
Untargeted Metabolomic Study of Patients with Macular Edema Secondary to Retinal Vein Occlusion in Aqueous Humor. 房水中视网膜静脉阻塞继发黄斑水肿患者的非靶向代谢组学研究。
Pub Date : 2025-01-06 eCollection Date: 2025-01-01 DOI: 10.2147/OPTH.S500860
Qingquan Wei, Liying Luo, Yingjun Min, Yingying Gong, Li Wang

Purpose: The aim of this study was to identify metabolic biomarkers and investigate the metabolic changes associated with aqueous humor in retinal vein occlusion macular edema (RVO-ME).

Methods: Aqueous humor (AH) samples were collected from patients, including those diagnosed with central retinal vein occlusion macular edema (CRVO-ME), branch retinal vein occlusion macular edema (BRVO-ME), and a control group undergoing cataract surgery. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was utilized to analyze the metabolomic profiles in aqueous humor.

Results: A total of 28 metabolites were identified as potential biomarkers capable of distinguishing RVO-ME patients from the control group. Of these, 26 metabolites were specific for distinguishing CRVO-ME patients from controls, and 24 metabolites were specific for differentiating BRVO-ME patients from controls. Additionally, 9 metabolites were identified that could differentiate CRVO-ME patients from BRVO-ME patients.

Conclusion: This study successfully identified significant metabolic biomarkers that enhance our understanding of the pathogenesis of RVO-ME. These findings may offer new avenues for the treatment of RVO-ME and aid in differentiating between CRVO-ME and BRVO-ME patients.

目的:本研究的目的是鉴定代谢生物标志物,并研究视网膜静脉闭塞性黄斑水肿(RVO-ME)中房水代谢变化的相关因素。方法:收集房水(AH)样本,包括诊断为视网膜中央静脉闭塞性黄斑水肿(CRVO-ME)、视网膜分支静脉闭塞性黄斑水肿(BRVO-ME)的患者,以及行白内障手术的对照组。采用液相色谱-串联质谱法(LC-MS/MS)分析了房水中的代谢组学特征。结果:共有28种代谢物被确定为能够区分RVO-ME患者与对照组的潜在生物标志物。其中,26种代谢物是区分CRVO-ME患者与对照组的特异性代谢物,24种代谢物是区分BRVO-ME患者与对照组的特异性代谢物。此外,还鉴定出9种能够区分CRVO-ME患者和BRVO-ME患者的代谢物。结论:本研究成功鉴定了重要的代谢生物标志物,增强了我们对RVO-ME发病机制的理解。这些发现可能为RVO-ME的治疗提供新的途径,并有助于区分CRVO-ME和BRVO-ME患者。
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引用次数: 0
Effect of Posterior Corneal Surgically Induced Astigmatism on Toric Intraocular Lens Power Calculations. 角膜后部手术引起的散光对散光眼内透镜功率计算的影响。
Pub Date : 2025-01-06 eCollection Date: 2025-01-01 DOI: 10.2147/OPTH.S488571
Stephen Stewart, Tun Kuan Yeo, Salissou Moutari, Richard N McNeely, Jonathan E Moore

Background: To determine whether accounting for posterior corneal surgically induced astigmatism (SIA) would improve toric intraocular lens power calculation prediction error.

Methods: A total of 189 eyes of 148 patients undergoing routine cataract surgery were included in the study. Standard and posterior keratometry were measured pre- and postoperatively. Centroid SIA with standard keratometry and posterior keratometry were calculated separately. Prediction errors for postoperative refractive astigmatism at 4 weeks postoperatively were compared for Barrett Toric with predicted posterior corneal astigmatism (PPCA); Barrett Toric with preoperative measured posterior corneal astigmatism (MPCA); Barrett Toric with postoperative MPCA, which accounts for posterior corneal SIA.

Results: There was a significant increase in PCA magnitude postoperatively (p < 0.001), although a change of >0.3D occurred in only 3% of eyes. There was a postoperative rotation in the steep meridian of >10° in 32% of eyes. The Barrett Toric formula with PPCA yielded a significantly smaller refractive astigmatism prediction error compared to when a postoperative MPCA value was used (p < 0.01). Postoperative MPCA had a lower proportion of eyes within 0.50, 0.75 and 1.00D of predicted refractive astigmatism than PPCA or preoperative MPCA, although this was not statistically significant.

Conclusion: This study demonstrated postoperative changes in posterior corneal astigmatism magnitude and the orientation of the steep meridian. However, accounting for posterior keratometric SIA in the Barrett Toric formula does not improve refractive astigmatism prediction accuracy.

背景:确定考虑后角膜手术性散光(SIA)是否会改善环形人工晶状体度数计算预测误差。方法:对148例常规白内障手术患者189只眼进行研究。术前和术后分别测量标准角膜和后角膜。质心SIA分别计算标准角膜测量和后验角膜测量。比较Barrett Toric与预测后角膜散光(PPCA)的术后4周屈光性散光预测误差;Barrett Toric与术前测量角膜后散光(MPCA);Barrett Toric与术后MPCA,这说明了角膜后SIA。结果:虽然只有3%的眼睛发生了>.3 3d的变化,但术后PCA强度明显增加(p < 0.001)。术后32%的眼睛在bbb10°陡经络处出现旋转。与术后使用MPCA值相比,使用Barrett Toric公式预测屈光散光的误差明显更小(p < 0.01)。术后MPCA预测屈光散光在0.50、0.75和1.00D范围内的眼睛比例低于PPCA或术前MPCA,但差异无统计学意义。结论:本研究证实了术后角膜后散光大小和陡经络方向的变化。然而,在Barrett Toric公式中考虑后角测量SIA并不能提高屈光散光预测的准确性。
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引用次数: 0
Is Thermal Pulsation Therapy Effective for Dry Eyes Before and After Cataract Surgery? A Systematic Review and Meta-Analysis. 热脉冲治疗对白内障手术前后干眼症有效吗?系统回顾和荟萃分析。
Pub Date : 2025-01-06 eCollection Date: 2025-01-01 DOI: 10.2147/OPTH.S498869
Kai-Yang Chen, Hoi-Chun Chan, Chi Ming Chan

Background: Meibomian gland dysfunction (MGD) is a primary cause of evaporative dry eye disease (DED), which is often exacerbated by cataract surgery due to surgical trauma and inflammation. Thermal pulsation therapy (TPT) aims to enhance meibomian gland function and relieve dry eye symptoms. We conducted a systematic review and meta-analysis to evaluate the effectiveness of TPT in managing dry eye symptoms associated with cataract surgery.

Methods: A systematic search was performed in December 2024 across PubMed, ScienceDirect, CINAHL, and the Cochrane Central Register of Controlled Trials to identify original research on the efficacy of TPT in addressing cataract surgery-related dry eye symptoms. The quality of the included studies was evaluated using the Risk of Bias in Non-Randomized Studies of Interventions tool, with results visualized through the Robvis 2.0 tool developed by the Cochrane Collaboration.

Results: The search yielded 365 records, of which seven studies met the inclusion criteria for this meta-analysis. Key outcomes analyzed included the meibomian gland yielding liquid secretion (MGYLS) score, tear break-up time (TBUT), ocular surface disease index (OSDI) score, and lipid layer thickness (LLT). The meta-analysis revealed a moderate effect of TPT, with a small but clinically significant improvement observed in MGYLS scores (Cohen's d = 0.29, p = 0.033) and TBUT (Cohen's d = 0.15, p = 0.029). However, the effects on OSDI scores and LLT were not statistically significant. Study heterogeneity varied, with some outcomes exhibiting considerable variability.

Conclusion: TPT provides moderate and clinically meaningful improvements in MGYLS scores and TBUT for patients experiencing dry eye symptoms after cataract surgery, although improvements in OSDI scores and LLT did not achieve statistical significance. The variability in study quality and heterogeneity highlights the need for well-designed, high-quality research to confirm these findings and evaluate the durability of TPT's therapeutic effects both before and after cataract surgery.

背景:睑板腺功能障碍(MGD)是蒸发性干眼病(DED)的主要原因,由于手术创伤和炎症,白内障手术往往会加重这种疾病。热脉冲疗法(TPT)旨在增强睑板腺功能,缓解干眼症状。我们进行了一项系统回顾和荟萃分析,以评估TPT治疗白内障手术相关干眼症状的有效性。方法:于2024年12月在PubMed、ScienceDirect、CINAHL和Cochrane中央对照试验登记中心进行系统检索,以确定TPT治疗白内障手术相关干眼症状疗效的原始研究。纳入研究的质量采用干预措施非随机研究的偏倚风险(Risk of Bias)工具进行评估,结果通过Cochrane Collaboration开发的Robvis 2.0工具可视化。结果:检索得到365条记录,其中7项研究符合本荟萃分析的纳入标准。分析的主要结局包括睑板腺产液分泌(MGYLS)评分、泪液破裂时间(TBUT)、眼表疾病指数(OSDI)评分和脂质层厚度(LLT)。荟萃分析显示,TPT的效果中等,MGYLS评分(Cohen’s d = 0.29, p = 0.033)和TBUT (Cohen’s d = 0.15, p = 0.029)有轻微但具有临床意义的改善。然而,对OSDI评分和LLT的影响无统计学意义。研究的异质性各不相同,一些结果表现出相当大的可变性。结论:TPT对白内障术后干眼症状患者的MGYLS评分和TBUT有中度且有临床意义的改善,但对OSDI评分和LLT的改善没有统计学意义。研究质量的可变性和异质性突出表明需要精心设计的高质量研究来证实这些发现,并评估白内障手术前后TPT治疗效果的持久性。
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引用次数: 0
Demographic Profile and Clinical Characteristics of Fuchs Endothelial Corneal Dystrophy in Thai Patients: A Retrospective Cohort in a Tertiary Referral Center. 泰国福氏内皮性角膜营养不良症患者的人口统计学特征和临床特征:一家三级转诊中心的回顾性队列研究。
Pub Date : 2025-01-06 eCollection Date: 2025-01-01 DOI: 10.2147/OPTH.S498122
Trakanta Wannapanich, Vilavun Puangsricharern, Vannarut Satitpitakul, Thanachaporn Kittipibul, Kanya Suphapeetiporn

Purpose: To describe the demographic profile, clinical characteristics, and treatment trends of Fuchs endothelial corneal dystrophy (FECD) in Thai patients, reflecting the evolving landscape of corneal transplantation in this region.

Patients and methods: This retrospective cohort study included 900 patients (1,743 eyes) diagnosed with FECD at a tertiary referral center in Thailand between January 2017 and June 2023. Demographic, clinical, and surgical data were analyzed, focusing on best-corrected visual acuity (BCVA), central corneal thickness (CCT), endothelial cell density (ECD), surgical interventions, and graft survival rate.

Results: The mean age was 63.9 years, with 77.2% of patients being female. Most eyes were classified as Adamis grade I (83.7%). Diabetes mellitus and hypertension were prevalent in 17.4% and 38.6% of patients, respectively. The rate of corneal transplantation was 8.1%, with DMEK accounting for 69.3% of transplants. Graft survival rates were 94.3% at 1 year and 76.2% at 5 years. The average post-operative ECD declined from 1667.8 ± 668.0 cells/mm² at 1 year to 1140.7 ± 684.4 cells/mm² at 5 years. Cataract surgery was performed in 20.4% of phakic eyes, with only 2.2% requiring corneal transplantation within five years.

Conclusion: FECD in Thailand, as reflected by this large cohort, predominantly presents at an early stage, allowing for conservative management. The growing use of DMEK highlights the shift towards less invasive procedures, mirroring global trends in Southeast Asia. These findings emphasize the importance of advancing surgical techniques and improving eye banking practices in the region.

目的:描述泰国富克斯内皮性角膜营养不良症(FECD)患者的人口统计学特征、临床特征和治疗趋势,反映该地区角膜移植手术不断发展的情况:这项回顾性队列研究纳入了2017年1月至2023年6月期间在泰国一家三级转诊中心确诊为FECD的900名患者(1743只眼)。研究分析了人口统计学、临床和手术数据,重点关注最佳矫正视力(BCVA)、角膜中央厚度(CCT)、内皮细胞密度(ECD)、手术干预和移植物存活率:患者平均年龄为 63.9 岁,77.2% 为女性。大多数眼球被归类为阿达米斯 I 级(83.7%)。17.4%的患者患有糖尿病,38.6%的患者患有高血压。角膜移植率为 8.1%,其中 DMEK 移植占 69.3%。移植角膜1年的存活率为94.3%,5年的存活率为76.2%。术后平均ECD从1年时的1667.8 ± 668.0 cells/mm²下降到5年时的1140.7 ± 684.4 cells/mm²。20.4%的有晶体眼接受了白内障手术,只有2.2%的有晶体眼需要在五年内接受角膜移植手术:结论:从这一庞大的队列中可以看出,泰国的角膜缺损症主要发生在早期阶段,因此可以采取保守治疗。DMEK的使用越来越多,突显了向微创手术的转变,反映了东南亚的全球趋势。这些发现强调了在该地区提高手术技术和改善眼库实践的重要性。
{"title":"Demographic Profile and Clinical Characteristics of Fuchs Endothelial Corneal Dystrophy in Thai Patients: A Retrospective Cohort in a Tertiary Referral Center.","authors":"Trakanta Wannapanich, Vilavun Puangsricharern, Vannarut Satitpitakul, Thanachaporn Kittipibul, Kanya Suphapeetiporn","doi":"10.2147/OPTH.S498122","DOIUrl":"10.2147/OPTH.S498122","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the demographic profile, clinical characteristics, and treatment trends of Fuchs endothelial corneal dystrophy (FECD) in Thai patients, reflecting the evolving landscape of corneal transplantation in this region.</p><p><strong>Patients and methods: </strong>This retrospective cohort study included 900 patients (1,743 eyes) diagnosed with FECD at a tertiary referral center in Thailand between January 2017 and June 2023. Demographic, clinical, and surgical data were analyzed, focusing on best-corrected visual acuity (BCVA), central corneal thickness (CCT), endothelial cell density (ECD), surgical interventions, and graft survival rate.</p><p><strong>Results: </strong>The mean age was 63.9 years, with 77.2% of patients being female. Most eyes were classified as Adamis grade I (83.7%). Diabetes mellitus and hypertension were prevalent in 17.4% and 38.6% of patients, respectively. The rate of corneal transplantation was 8.1%, with DMEK accounting for 69.3% of transplants. Graft survival rates were 94.3% at 1 year and 76.2% at 5 years. The average post-operative ECD declined from 1667.8 ± 668.0 cells/mm² at 1 year to 1140.7 ± 684.4 cells/mm² at 5 years. Cataract surgery was performed in 20.4% of phakic eyes, with only 2.2% requiring corneal transplantation within five years.</p><p><strong>Conclusion: </strong>FECD in Thailand, as reflected by this large cohort, predominantly presents at an early stage, allowing for conservative management. The growing use of DMEK highlights the shift towards less invasive procedures, mirroring global trends in Southeast Asia. These findings emphasize the importance of advancing surgical techniques and improving eye banking practices in the region.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"45-57"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preoperative Retinal Detachment Variables Causing Macular Detachment. 术前视网膜脱离引起黄斑脱离的变量。
Pub Date : 2025-01-03 eCollection Date: 2025-01-01 DOI: 10.2147/OPTH.S499960
Shunsuke Nishimura, Tetsuhiko Okuda, Tomomi Higashide, Kazuhisa Sugiyama

Purpose: The factors that contribute to the progression of macular involvement in RRD have not been extensively investigated. The purpose of this study is to evaluate the association between the preoperative characteristics and macular status of the eyes with rhegmatogenous retinal detachment (RRD).

Methods: This is a retrospective cohort study. All patients with RRDs who underwent initial pars plana vitrectomy or scleral buckling were included. Patients with RRD and macular hole retinal detachment, traumatic RD, proliferative diabetic retinopathy, proliferative vitreoretinopathy grade C or higher, diabetic retinopathy, or retinal vein occlusion were excluded. High myopia was defined as an axial length > of 26.5 mm.

Results: A total of 1026 eyes of 1026 patients (mean, 55.4±15.5 years) were included. There was a significant difference in the male (68.4%) to female (31.6%) ratio (the chi-squared test: P < 0.001). A total of 351 patients (34.2%) had high myopia. The 50-59 years age group had the highest number of eyes with high myopia. The proportion of highly myopic eyes in the 40-49 years group was the highest. Multiple logistic regression analysis indicated that prior cataract extraction and shorter axial length (≤24.5 mm) were significantly associated with macula-off RRD (P = 0.018, P = 0.043, respectively). Superior and temporal retinal breaks significantly increased and superior nasal retinal breaks significantly decreased the odds ratio of macular detachment (P = 0.018, P < 0.001, and P < 0.001, respectively).

Conclusion: Previous cataract extraction, shorter axial length, and superior and temporal retinal breaks are important risk factors for macular detachment.

目的:导致RRD黄斑受累进展的因素尚未得到广泛的研究。本研究的目的是评估术前特征与孔源性视网膜脱离(RRD)眼睛黄斑状态之间的关系。方法:回顾性队列研究。所有的rrd患者都接受了最初的玻璃体切割或巩膜扣合。排除RRD合并黄斑孔视网膜脱离、外伤性RD、增殖性糖尿病视网膜病变、增殖性玻璃体视网膜病变C级及以上、糖尿病视网膜病变、视网膜静脉闭塞的患者。高度近视定义为眼轴长度为26.5 mm。结果:共纳入1026例患者1026只眼(平均55.4±15.5岁)。男性(68.4%)与女性(31.6%)的比例差异有统计学意义(卡方检验:P < 0.001)。高度近视351例(34.2%)。50-59岁年龄组高度近视发生率最高。高度近视的比例以40 ~ 49岁年龄组最高。多元logistic回归分析显示,既往白内障摘除和较短的眼轴长度(≤24.5 mm)与黄斑离体RRD显著相关(P = 0.018, P = 0.043)。上、颞视网膜断裂显著增加,鼻上视网膜断裂显著降低黄斑脱离的优势比(P = 0.018, P < 0.001, P < 0.001)。结论:既往白内障摘除、眼轴短、上颞视网膜断裂是黄斑脱离的重要危险因素。
{"title":"Preoperative Retinal Detachment Variables Causing Macular Detachment.","authors":"Shunsuke Nishimura, Tetsuhiko Okuda, Tomomi Higashide, Kazuhisa Sugiyama","doi":"10.2147/OPTH.S499960","DOIUrl":"https://doi.org/10.2147/OPTH.S499960","url":null,"abstract":"<p><strong>Purpose: </strong>The factors that contribute to the progression of macular involvement in RRD have not been extensively investigated. The purpose of this study is to evaluate the association between the preoperative characteristics and macular status of the eyes with rhegmatogenous retinal detachment (RRD).</p><p><strong>Methods: </strong>This is a retrospective cohort study. All patients with RRDs who underwent initial pars plana vitrectomy or scleral buckling were included. Patients with RRD and macular hole retinal detachment, traumatic RD, proliferative diabetic retinopathy, proliferative vitreoretinopathy grade C or higher, diabetic retinopathy, or retinal vein occlusion were excluded. High myopia was defined as an axial length > of 26.5 mm.</p><p><strong>Results: </strong>A total of 1026 eyes of 1026 patients (mean, 55.4±15.5 years) were included. There was a significant difference in the male (68.4%) to female (31.6%) ratio (the chi-squared test: <i>P</i> < 0.001). A total of 351 patients (34.2%) had high myopia. The 50-59 years age group had the highest number of eyes with high myopia. The proportion of highly myopic eyes in the 40-49 years group was the highest. Multiple logistic regression analysis indicated that prior cataract extraction and shorter axial length (≤24.5 mm) were significantly associated with macula-off RRD (<i>P</i> = 0.018, <i>P</i> = 0.043, respectively). Superior and temporal retinal breaks significantly increased and superior nasal retinal breaks significantly decreased the odds ratio of macular detachment (<i>P</i> = 0.018, <i>P</i> < 0.001, and <i>P</i> < 0.001, respectively).</p><p><strong>Conclusion: </strong>Previous cataract extraction, shorter axial length, and superior and temporal retinal breaks are important risk factors for macular detachment.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"11-18"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Safety and Efficacy of Combination Therapy with Anti-Vascular Endothelial Growth Factor and Laser for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis. 抗血管内皮生长因子联合激光治疗早产儿视网膜病变的安全性和有效性:一项系统综述和荟萃分析。
Pub Date : 2025-01-03 eCollection Date: 2025-01-01 DOI: 10.2147/OPTH.S496737
Anas Alamoudi, Ahmed N Alnabihi, Ali Saleh Alsudais, Naif Almufarriji, Waleed T Batais, Abdulaziz Khalid Aldahlawi, Abdullah Altalhi, Hassan A Al-Dhibi, Adel G Alakeely

Aim: This systematic review and meta-analysis aimed to evaluate the safety and efficacy of combined laser and anti-VEGF therapy for (retinopathy of prematurity ROP), focusing on both structural and functional outcomes.

Methods: A comprehensive search was conducted in multiple databases to identify randomized controlled trials (RCTs) that investigated combination therapy for ROP. The PRISMA guidelines were followed. Data were extracted and analyzed using risk ratios and 95% confidence intervals (CIs). The Cochrane Risk of Bias tool was used to assess the risk of bias.

Results: Three RCTs involving a total of 162 premature infants were included in the meta-analysis. Combination therapy of anti-VEGF and laser photocoagulation was compared with other interventions. The pooled analysis of favorable structural outcomes did not show a statistically significant difference between combination therapy with anti-VEGFs and laser therapy compared to the interventions in the control groups (P=0.25). The incidence of adverse events was comparable between the combination therapy group and other intervention groups.

Conclusion: This systematic review and meta-analysis suggest that risk ratio of combination therapy with anti-VEGF and laser for ROP is associated with favorable outcomes, albeit insignificant. The safety profile of combination therapy appears to be similar to other interventions. However, due to the limited number of included studies, further research is needed.

目的:本系统综述和荟萃分析旨在评估激光联合抗vegf治疗(早产儿视网膜病变ROP)的安全性和有效性,重点关注结构和功能结局。方法:在多个数据库中进行综合检索,以确定研究ROP联合治疗的随机对照试验(rct)。遵循了PRISMA准则。采用风险比和95%置信区间(ci)提取数据并进行分析。采用Cochrane偏倚风险工具评估偏倚风险。结果:meta分析纳入了3项随机对照试验,共涉及162名早产儿。将抗vegf联合激光光凝治疗与其他干预措施进行比较。有利结构结果的汇总分析显示,与对照组干预相比,抗vegf联合治疗和激光治疗之间没有统计学上的显著差异(P=0.25)。联合治疗组与其他干预组的不良事件发生率相当。结论:本系统综述和荟萃分析表明,抗vegf联合激光治疗ROP的风险比与良好的预后相关,尽管不显著。联合治疗的安全性似乎与其他干预措施相似。然而,由于纳入的研究数量有限,需要进一步研究。
{"title":"Safety and Efficacy of Combination Therapy with Anti-Vascular Endothelial Growth Factor and Laser for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis.","authors":"Anas Alamoudi, Ahmed N Alnabihi, Ali Saleh Alsudais, Naif Almufarriji, Waleed T Batais, Abdulaziz Khalid Aldahlawi, Abdullah Altalhi, Hassan A Al-Dhibi, Adel G Alakeely","doi":"10.2147/OPTH.S496737","DOIUrl":"https://doi.org/10.2147/OPTH.S496737","url":null,"abstract":"<p><strong>Aim: </strong>This systematic review and meta-analysis aimed to evaluate the safety and efficacy of combined laser and anti-VEGF therapy for (retinopathy of prematurity ROP), focusing on both structural and functional outcomes.</p><p><strong>Methods: </strong>A comprehensive search was conducted in multiple databases to identify randomized controlled trials (RCTs) that investigated combination therapy for ROP. The PRISMA guidelines were followed. Data were extracted and analyzed using risk ratios and 95% confidence intervals (CIs). The Cochrane Risk of Bias tool was used to assess the risk of bias.</p><p><strong>Results: </strong>Three RCTs involving a total of 162 premature infants were included in the meta-analysis. Combination therapy of anti-VEGF and laser photocoagulation was compared with other interventions. The pooled analysis of favorable structural outcomes did not show a statistically significant difference between combination therapy with anti-VEGFs and laser therapy compared to the interventions in the control groups (P=0.25). The incidence of adverse events was comparable between the combination therapy group and other intervention groups.</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis suggest that risk ratio of combination therapy with anti-VEGF and laser for ROP is associated with favorable outcomes, albeit insignificant. The safety profile of combination therapy appears to be similar to other interventions. However, due to the limited number of included studies, further research is needed.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Visual Performance Correlation with Corneal Aberrometric Profile and Pupil Size After Implantation of a Trifocal Hydrophobic IOL. 三焦疏水人工晶体植入术后视力与角膜像差和瞳孔大小的关系。
Pub Date : 2024-12-31 eCollection Date: 2024-01-01 DOI: 10.2147/OPTH.S500386
Camille Bosc, Eloïse Le Maléfan, Pauline Boury, Mélanie Bernier, Anne Barrucand

Purpose: To evaluate clinical outcomes obtained after cataract surgery involving the implantation of a trifocal hydrophobic intraocular lens (IOL) and to determine if pupil size and the corneal aberrometric profile correlate to visual acuity at different distances.

Methods: 49 patients (98 eyes) underwent bilateral cataract surgery with the placement of FineVision HP IOLs for presbyopia and were assessed at 1- and 3- to 6-months post-surgery. Postoperatively, refraction, monocular and binocular uncorrected and corrected distance visual acuity (UDVA and CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA) and the binocular defocus curve were measured. Pupil size and corneal aberrations (higher-order and low-order aberrations; HOA and LOA) were also measured using a Scheimpflug 3D camera.

Results: Sphere, cylinder and spherical equivalent decreased significantly after surgery (p<0.05) and CDVA had improved significantly 1-month post-surgery (p=0.007). The sphere, cylinder, spherical equivalent and CDVA values remained stable at the 3- to 6-month follow-up (p>0.05). Binocular UDVA was 0 logMAR or better for 79.2% of patients and binocular UNVA was 0.1 logMAR or better for 91.7%. The binocular defocus curve showed average maximum visual acuity values at -0.07±0.06 logMAR, 0.01±0.06 logMAR, and 0.01±0.06 logMAR, for far, intermediate and near distances, respectively. Neither the UDVA nor UNVA values correlated with patient pupil diameter (UDVA: r=0.035, p=0.744; UNVA: r=-0.073, p=0.492). Neither the UDVA nor UNVA values correlated with patient HOA or LOA (UDVA versus HOA: r=0.016, p=0.872; UDVA versus LOA: r=0.032, p=0.759; UNVA versus HOA: r=0.056, p=0.582; UNVA versus LOA: r=0.059, p=0.568).

Conclusion: This study shows that the FineVision HP IOL provides excellent refractive and visual outcomes at different distances. Pupil size does not correlate with UDVA and UNVA and quality of vision does not seem to correlate with the corneal aberrometric profile.

目的:评价白内障手术植入三焦疏水人工晶状体(IOL)后的临床效果,并确定瞳孔大小和角膜像差分布是否与不同距离下的视力相关。方法:49例(98眼)行双侧白内障手术,植入FineVision HP人工晶状体治疗老花眼,分别于术后1个月、3 ~ 6个月进行评估。术后测量屈光度、单眼和双眼未矫正和矫正的距离视力(UDVA和CDVA)、未矫正的中间视力(UIVA)、未矫正的近视力(UNVA)及双眼离焦曲线。瞳孔大小与角膜像差(高阶和低阶像差);使用Scheimpflug 3D相机测量HOA和LOA。结果:术后球、柱、球当量均显著降低(p0.05)。79.2%的患者双眼UDVA为0 logMAR或更好,91.7%的患者双眼UNVA为0.1 logMAR或更好。双眼离焦曲线显示,远、中、近距离的平均最大视力值分别为-0.07±0.06 logMAR、0.01±0.06 logMAR和0.01±0.06 logMAR。UDVA和UNVA值与患者瞳孔直径均无相关性(UDVA: r=0.035, p=0.744;UNVA: r=-0.073, p=0.492)。UDVA和UNVA值与患者HOA或LOA均无相关性(UDVA vs HOA: r=0.016, p=0.872;UDVA vs LOA: r=0.032, p=0.759;UNVA vs HOA: r=0.056, p=0.582;UNVA vs LOA: r=0.059, p=0.568)。结论:FineVision HP人工晶状体在不同距离下具有良好的屈光和视力效果。瞳孔大小与UDVA和UNVA无关,视力质量似乎与角膜像差无关。
{"title":"Visual Performance Correlation with Corneal Aberrometric Profile and Pupil Size After Implantation of a Trifocal Hydrophobic IOL.","authors":"Camille Bosc, Eloïse Le Maléfan, Pauline Boury, Mélanie Bernier, Anne Barrucand","doi":"10.2147/OPTH.S500386","DOIUrl":"https://doi.org/10.2147/OPTH.S500386","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate clinical outcomes obtained after cataract surgery involving the implantation of a trifocal hydrophobic intraocular lens (IOL) and to determine if pupil size and the corneal aberrometric profile correlate to visual acuity at different distances.</p><p><strong>Methods: </strong>49 patients (98 eyes) underwent bilateral cataract surgery with the placement of FineVision HP IOLs for presbyopia and were assessed at 1- and 3- to 6-months post-surgery. Postoperatively, refraction, monocular and binocular uncorrected and corrected distance visual acuity (UDVA and CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA) and the binocular defocus curve were measured. Pupil size and corneal aberrations (higher-order and low-order aberrations; HOA and LOA) were also measured using a Scheimpflug 3D camera.</p><p><strong>Results: </strong>Sphere, cylinder and spherical equivalent decreased significantly after surgery (p<0.05) and CDVA had improved significantly 1-month post-surgery (p=0.007). The sphere, cylinder, spherical equivalent and CDVA values remained stable at the 3- to 6-month follow-up (p>0.05). Binocular UDVA was 0 logMAR or better for 79.2% of patients and binocular UNVA was 0.1 logMAR or better for 91.7%. The binocular defocus curve showed average maximum visual acuity values at -0.07±0.06 logMAR, 0.01±0.06 logMAR, and 0.01±0.06 logMAR, for far, intermediate and near distances, respectively. Neither the UDVA nor UNVA values correlated with patient pupil diameter (UDVA: r=0.035, p=0.744; UNVA: r=-0.073, p=0.492). Neither the UDVA nor UNVA values correlated with patient HOA or LOA (UDVA versus HOA: r=0.016, p=0.872; UDVA versus LOA: r=0.032, p=0.759; UNVA versus HOA: r=0.056, p=0.582; UNVA versus LOA: r=0.059, p=0.568).</p><p><strong>Conclusion: </strong>This study shows that the FineVision HP IOL provides excellent refractive and visual outcomes at different distances. Pupil size does not correlate with UDVA and UNVA and quality of vision does not seem to correlate with the corneal aberrometric profile.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"18 ","pages":"4053-4061"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Oral Isotretinoin-Associated Ocular Effects and Risk Factors: A Cross-Sectional Study. 口服异维甲酸相关的眼部效应和危险因素:一项横断面研究。
Pub Date : 2024-12-30 eCollection Date: 2024-01-01 DOI: 10.2147/OPTH.S491757
Ismail I Abuallut, Mohammed Q Dibaji, Ahmad Assiri, Wedad Mawkili, Ahmed Y Najmi, Safa Abdu Ageeli, Amaal Abdulaziz Hamdi, Raum Abdu Ayoub, Abdulaziz Yahya Muyidi, Hussam T Hakami, Abrar Khalid Alhazmi, Moayad Hassan Rekini

Purpose: Oral isotretinoin is a derivative of vitamin A, used to treat acne vulgaris. One of its effects is altering the corneal surface and ocular glands, resulting in eye dryness and various other symptoms. This study aimed to analyze the impact of systemic isotretinoin treatment on ocular health and investigate the potential risk factors contributing to ocular pathology.

Patients and methods: This cross-sectional study was conducted on 489 participants in the Jazan region using a convenience sampling method. An online questionnaire composed of five sections, including the Arabic version of the validated Ocular Surface Disease Index (OSDI), was used to assess the presence of ocular symptoms associated with isotretinoin usage as well as the potential contributing risk factors.

Results: A significant association was established between oral isotretinoin use and specific eye symptoms, including a gritty feeling in the eye (66.4%), sore eyes (68.6%), blurry vision (75.9%), and the need for moisturizing drops (35%). OSDI severity varied according to isotretinoin usage status, with severe OSDI grades reported in 56.9% of current users, 51.2% of those who stopped < 2 months ago, and 38.8% of those who stopped ≥ 2 months ago. Furthermore, significant risk factors associated with worse OSDI grades included contact lens use and isotretinoin dose, with contact lens use being associated with a 17.5-point increase in OSDI scores, while each 10 mg increase in isotretinoin dose was linked to a 0.20-point rise in OSDI score.

Conclusion: This study emphasizes the importance of assessing individual risk factors before starting isotretinoin therapy and monitoring ocular health in patients undergoing therapy. Clinicians should be aware of preventive methods and should consider high-risk patients to an ophthalmologist for interventions, such as punctal plugs, that can reduce complications. Further research targeting specific populations with shared risk factors is needed to validate these findings.

目的:口服异维甲酸是维生素a的衍生物,用于治疗寻常性痤疮。它的影响之一是改变角膜表面和眼腺,导致眼睛干燥和其他各种症状。本研究旨在分析全身异维甲酸治疗对眼部健康的影响,并探讨导致眼部病理的潜在危险因素。患者和方法:本横断面研究采用方便抽样方法对吉赞地区的489名参与者进行了研究。一份由五个部分组成的在线问卷,包括经验证的眼表疾病指数(OSDI)的阿拉伯语版本,用于评估与异维甲酸使用相关的眼部症状的存在以及潜在的促成风险因素。结果:口服异维甲酸与特定眼部症状之间存在显著关联,包括眼砂砾感(66.4%)、眼痛(68.6%)、视力模糊(75.9%)和需要使用保湿滴剂(35%)。OSDI严重程度因异维甲酸使用状况而异,当前使用者中有56.9%报告严重OSDI等级,停药< 2个月者中有51.2%,停药≥2个月者中有38.8%。此外,与较差的OSDI评分相关的重要风险因素包括使用隐形眼镜和异维a酸剂量,使用隐形眼镜与OSDI评分增加17.5分相关,而异维a酸剂量每增加10毫克,OSDI评分上升0.20分。结论:本研究强调了在开始异维甲酸治疗前评估个体危险因素和监测患者眼部健康的重要性。临床医生应了解预防方法,并应考虑高风险患者到眼科医生进行干预,如点塞,可以减少并发症。需要针对具有共同风险因素的特定人群进行进一步研究,以验证这些发现。
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引用次数: 0
Real-World-Data of Treatment-Naïve and Previously Treated Patients Receiving Up to 3 Injections of Faricimab in Neovascular Age-Related Macular Degeneration. Treatment-Naïve和之前接受过3次Faricimab注射治疗的新生血管性年龄相关性黄斑变性患者的真实世界数据
Pub Date : 2024-12-28 eCollection Date: 2024-01-01 DOI: 10.2147/OPTH.S482948
Berenike Cornelia Kunzmann, Alexandra Stefanie Schweig, Karl Ulrich Bartz-Schmidt, Bianka Sobolewska

Purpose: To evaluate visual and anatomical outcome of consecutive patients who received intravitreal injections (IVI) of faricimab for the treatment of neovascular age-related macular degeneration (nAMD).

Patients and methods: A retrospective study of patients treated for nAMD with one to three IVIs of faricimab from October 2022 to January 2024. Demographic data, treatment history, best corrected visual acuity (BCVA), anatomic parameters, and adverse events (AEs) were collected.

Results: After one IVI of faricimab, previously treated (n=160) eyes with a mean of 33.51 IVIs and treatment-naïve (n=10) eyes showed a mean BCVA gain of +0.59±0.52 letters (p=0.364) and +5.00±6.50 letters (p=0.461), respectively, and a mean central subfield thickness (CST) reduction of -27.65±5.33 µm (p<0.001) and -94.10±39.74 μm (p=0.042), respectively. In treatment-refractory eyes after switching from aflibercept (n=108), mean BCVA increased by +0.42±0.66 (p=0.745) and the mean CST improved by -21.98±6.04 (p<0.001). After three IVIs of faricimab previously treated (n=106) and treatment-naïve (n=5) eyes showed a mean BCVA increase of +1.57±0.88 letters (p=0.051) versus +12.50±8.14 letters (p=0.185), and a mean CST reduction of -25.51±5.82 µm (p<0.001) versus -82.60±36.20 µm from baseline, respectively. In treatment-refractory eyes after switching from aflibercept (n=79), mean BCVA improved by +2.15±1.08 letters (p=0.029) and mean CST decreased by -27.46±7.04 µm (p<0.001). Mean pigment epithelial detachment (PED) was also significantly reduced even between the first and the third faricimab injection in previously treated eyes (p=0.03). The proportion of eyes with intraretinal fluid and subretinal fluid improved significantly in all eyes and treatment-refractory eyes after switching from aflibercept. Ocular AEs were reported in three out of 170 eyes, and one patient had two stroke events during faricimab therapy.

Conclusion: Three IVIs of faricimab have the potential to improve visual acuity and anatomical parameters even in treatment-refractory nAMD eyes with a mean dosing interval of more than 6 weeks.

目的:评价连续接受玻璃体内注射法利昔单抗治疗新生血管性年龄相关性黄斑变性(nAMD)患者的视觉和解剖学结果。患者和方法:对2022年10月至2024年1月期间接受1至3次静脉注射法利昔单抗治疗的nAMD患者进行回顾性研究。收集患者的人口学资料、治疗史、最佳矫正视力(BCVA)、解剖参数和不良事件(ae)。结果:faricimab 1次IVI后,既往治疗(n=160)眼(平均33.51 IVI)和treatment-naïve (n=10)眼(n=10)分别显示BCVA平均增益+0.59±0.52字母(p=0.364)和+5.00±6.50字母(p=0.461),平均中心子野厚度(CST)减少-27.65±5.33µm (p)结论:faricimab 3次IVI即使在治疗难治性nAMD眼(平均给药间隔超过6周)也有可能改善视力和解剖参数。
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引用次数: 0
期刊
Clinical ophthalmology (Auckland, N.Z.)
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