OPTICAL COHERENCE TOMOGRAPHY
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200 papers
A novel bioactive contact lens for corneal epithelial regeneration in a rabbit model.
Rafati N, Asefnejad A, Heidari-Keshel S … +1 more , Aghamollaei H
Sci Rep · 2026 Jun · PMID 42310363 · Full text
Persistent corneal epithelial defects (PEDs) and microbial keratitis are major contributors to vision loss. Current treatments, including topical eye drops, are constrained by low bioavailability and inadequate patient a...
Persistent corneal epithelial defects (PEDs) and microbial keratitis are major contributors to vision loss. Current treatments, including topical eye drops, are constrained by low bioavailability and inadequate patient adherence. This study introduces a multifunctional, biocompatible contact lens composed of gelatin (G), amniotic membrane (AM), and the antimicrobial peptide CM11 (P). It is specifically developed to promote corneal healing and provide sustained drug delivery. Three hydrogel scaffolds (G, G-AM, and G-AM-P) were fabricated and systematically characterized, with emphasis on peptide release dynamics, antibacterial performance, and cytocompatibility, as these parameters are central to their therapeutic functionality. In vivo efficacy and safety were evaluated in a rabbit model using slit-lamp examination, anterior segment optical coherence tomography, and histopathological analysis. G-AM-P demonstrated acceptable optical clarity, significant porosity (~ 94%), moderate hydrophilicity (contact angle ≈ 70°), and an elastic modulus of ~ 0.55 MPa. Also, a biphasic release characterized by an initial rapid phase followed by plateau for up to 72 h. G-AM-P inhibited Staphylococcus aureus with a 15 mm zone of inhibition. This scaffold showed no cytotoxicity on the human corneal epithelial cells with viability exceeding 80%, after 72 h. In rabbits, G-AM-P exhibited ocular tolerance, facilitated re-epithelialization, and did not provoke inflammation, neovascularization, or stromal haze. This study demonstrates, the development of a protein-releasing G-AM-P therapeutic contact lens that integrates optical transparency, mechanical robustness, biocompatibility, and targeted antibacterial activity against Gram-positive pathogens. These findings highlight its potential as a promising platform for corneal epithelial repair with in vitro antibacterial activity, supporting further investigation toward clinical translation.
A web-based semi-supervised deep learning platform for automated AS-OCT assessment and monitoring of infectious keratitis.
Sun Y, Jin P, Cai J … +9 more , Chen P, Maimaiti N, Wang Y, Liu X, Hu Z, Qian G, Jia G, Xu P, Ye J
NPJ Digit Med · 2026 Jun · PMID 42310120 · Publisher ↗
Infectious keratitis (IK) is a leading cause of corneal blindness globally. Accurate severity assessment is critical but remains limited by the subjective and limited nature of slit-lamp and anterior segment optical cohe...
Infectious keratitis (IK) is a leading cause of corneal blindness globally. Accurate severity assessment is critical but remains limited by the subjective and limited nature of slit-lamp and anterior segment optical coherence tomography (AS-OCT) assessments. This study presents the 'Intelligent Quantitative Keratitis Image Analysis Platform', a web-based deep learning system for automated IK assessment through lesion segmentation, parameterization, stratification, and three-dimensional (3D) visualization based on AS-OCT data. A semi-supervised framework combining U-Net and Swin Transformer architectures was trained on 3130 AS-OCT images to address imaging artifacts, low contrast, scale variation, and irregular lesion boundaries. The model achieved Dice scores of 0.922 for corneal tissue and 0.834 for infiltrative lesions. Lesion characteristics were quantified within a polar coordinate system for radial stratification, yielding classification accuracies of 0.802 for infiltration thickness (IT) and 0.905 for infiltration width (IW). Intraclass correlation coefficients (ICCs) between AI and ground truth were 0.961 (IT) and 0.960 (IW), numerically exceeding the inter-expert agreement (ICCs: 0.786-0.955). Multimodel visualization via 3D corneal reconstructions aligned with slit-lamp images enabled anatomically coherent monitoring of disease progression. Overall, the platform provides a non-invasive, objective, and efficient approach for IK evaluation and monitoring.
Plaque characteristics and clinical outcomes of non-culprit long lesions in patients with acute myocardial infarction.
Cui L, Zhao J, Gao Y … +16 more , Chen Y, Guo J, Zhao R, Ma X, Dong F, Chen J, Wang Y, Li L, Chen T, Xing L, Yu H, Hou J, Dai J, Fang C, Mintz GS, Yu B
Int J Cardiol · 2026 Oct · PMID 42309490 · Publisher ↗
BACKGROUND: This study aimed to investigate plaque characteristics and long-term outcomes associated with long non-culprit lesions (NCLs) in patients with acute myocardial infarction (AMI). METHODS: A total of 1278 AMI p...
BACKGROUND: This study aimed to investigate plaque characteristics and long-term outcomes associated with long non-culprit lesions (NCLs) in patients with acute myocardial infarction (AMI). METHODS: A total of 1278 AMI patients undergoing three-vessel optical coherence tomography (OCT) were retrospectively enrolled, and 5131 NCLs were identified. A long lesion was defined as an OCT lesion ≥20 mm in length. Patients were followed for up to 5 years, and NCL-related major adverse cardiovascular events (NCL-MACE) were recorded. RESULTS: Both at the patient and lesion level, long NCLs were more stenotic and had more frequent thin-cap fibroatheroma (TCFA) and other vulnerable plaque features than short NCLs (all P < 0.001). During a median follow-up of 4.1 years, patients with ≥1 long NCL had a significantly higher incidence of NCL-MACE than patients without long NCL (7.3% vs. 2.9%, adjusted HR: 2.26, 95%CI: 1.19-4.29). Similar findings were identified when patients were grouped by angiographic lesion length. In the lesion-level analysis, OCT-detected long NCLs remained significantly associated with NCL-MACE after adjustment for TCFA (adjusted HR: 1.97, 95%CI: 1.11-3.52), whereas angiography-detected long NCLs showed no prognostic value. Notably, OCT-detected long TCFA had highest lesion-specific risk (5.4% vs. 1.1%, adjusted HR: 3.69, 95%CI: 1.87-7.27), whereas risk of OCT-detected short TCFA was comparable to that of non-TCFA (1.1% vs. 1.1%, P = 0.986). CONCLUSIONS: Long NCLs were indicative of higher levels of pancoronary plaque vulnerability, irrespective of detection via OCT or angiography. Importantly, OCT-detected long NCLs, especially long TCFA, offered significant predictive value for 5-year adverse events. However, angiography-detected long NCLs lacked prognostic significance.
Scleral remodeling in myopia: mechanisms and therapeutic approaches.
Vogels DHJ, Ma Q, Boote C … +3 more , Klaver CCW, LaPointe VLS, Dickman MM
Prog Retin Eye Res · 2026 Jun · PMID 42309346 · Publisher ↗
High myopia is the leading cause of visual impairment worldwide, driven by excessive axial elongation resulting in biomechanical weakening of the sclera, and increasing the risk of complications such as posterior staphyl...
High myopia is the leading cause of visual impairment worldwide, driven by excessive axial elongation resulting in biomechanical weakening of the sclera, and increasing the risk of complications such as posterior staphyloma, myopic macular degeneration, retinal detachment, cataract, and glaucoma. Conventional myopia management strategies aim to slow axial elongation in childhood, leaving patients with high myopia at risk of vision-threatening complications as they age. For these individuals, targeted therapies that strengthen the weakened sclera represent a promising, yet still experimental, approach. This review provides an overview of the role of the sclera in myopia progression, emphasizing changes in extracellular matrix composition, collagen organization, biomechanical integrity, and signaling pathways. Investigational scleral therapies are discussed, including posterior scleral reinforcement techniques, crosslinking modalities, pharmacological strategies, and tissue engineering approaches, with discussion of their mechanisms, preclinical and clinical evidence, and translational challenges. Particular attention is given to translational barriers, such as safe delivery to the posterior pole, retinal safety, and the absence of standardized outcome measures that link biomechanical reinforcement to functional benefit. Advances in imaging and in vivo biomechanical assessment, such as polarization-sensitive optical coherence tomography, Brillouin microscopy, and ultrasound-based elastography, hold promise for earlier risk stratification and treatment monitoring. By integrating insights from biomechanics, molecular biology, and therapeutic innovation, this review highlights the sclera as both a key driver of myopia pathology and a promising therapeutic target. Continued interdisciplinary collaboration will be essential to translate these experimental approaches into clinically viable treatments capable of reducing the growing burden of high myopia worldwide.
RETINAL PIGMENT EPITHELIAL TUMORS IN 948 EYES OF 926 PATIENTS.
Shields CL, Attaseth T, Chou Y … +4 more , Shields CN, Medina RJ, Lally SE, Shields JA
Retina · 2026 Jul · PMID 42308469 · Publisher ↗
PURPOSE: To better define the frequency and types of retinal pigment epithelial (RPE) tumors. METHODS: Retrospective review of all computer-coded RPE tumors over a five-decade period. RESULTS: Of 926 consecutive patients...
PURPOSE: To better define the frequency and types of retinal pigment epithelial (RPE) tumors. METHODS: Retrospective review of all computer-coded RPE tumors over a five-decade period. RESULTS: Of 926 consecutive patients with RPE tumors, the specific diagnosis included solitary congenital hypertrophy of the retinal pigment epithelium (n = 727, 79%), multifocal congenital hypertrophy of the RPE (n = 42, 4%), torpedo maculopathy (n = 7, 1%), RPE hamartomas associated with familial adenomatous polyposis (n = 10, 1%), congenital simple hamartoma of the RPE (n = 5, 1%), combined hamartoma of the retina and RPE (n = 99, 11%), benign RPE adenoma (n = 34, 3%), and malignant RPE adenocarcinoma (n = 2, <1%). There were differences in RPE tumors regarding patient age (P < 0.01), race (P < 0.01), sex (P < 0.01), presenting visual acuity (P < 0.01), number of tumors (P < 0.01), tumor basal diameter (P < 0.01), tumor thickness (P < 0.01), and distance to the optic disc (P < 0.01) and foveola (P < 0.01). There were differences in RPE tumors regarding imaging with ultrasonography (P < 0.01), optical coherence tomography (P < 0.01), and prevalence of macular epiretinal membrane, cystoid macular, edema, and subretinal fluid on optical coherence tomography (P < 0.01). By autofluorescence and fluorescein angiography, nearly all lesions that were imaged were hypoautofluorescent/hypofluorescent except for combined hamartoma of the retina and RPE (P < 0.01). Outcomes revealed visual acuity loss ≥3 lines (≥15 letters) at 10 years more often in combined hamartoma of the retina and RPE (20%), adenoma (21%), and adenocarcinoma (100%) (P < 0.01) and 10-year nodular growth in congenital hypertrophy of the RPE (1%), adenoma (9%), and adenocarcinoma (100%) (P < 0.01). CONCLUSION: Retinal pigment epithelial tumors comprise a spectrum in demographics, clinical features, and outcomes. Most remain stable over time with little impact on visual acuity except for combined hamartoma of the retina and RPE, adenoma, and adenocarcinoma.
Identifying MicroRNA Biomarkers in Idiopathic Intracranial Hypertension: A Pilot Study.
Hill LJ, Begum G, Thomas CN … +12 more , Hubbard JC, Mugo C, Alimajstorovic Z, Botfield HF, Lyons HS, Thaller M, Yiangou A, Ludwig C, Grech O, Mitchell JL, Mollan SP, Sinclair AJ
Neurology · 2026 Jul · PMID 42308437 · Full text
BACKGROUND AND OBJECTIVES: Idiopathic intracranial hypertension (IIH) is characterized by raised intracranial pressure (ICP). It predominantly affects women with obesity and can cause disabling headaches and permanent vi...
BACKGROUND AND OBJECTIVES: Idiopathic intracranial hypertension (IIH) is characterized by raised intracranial pressure (ICP). It predominantly affects women with obesity and can cause disabling headaches and permanent visual loss. IIH is misdiagnosed in up to 40% of cases. Diagnosis and monitoring often rely on frequent invasive lumbar puncture. This pilot study aimed to identify serum microRNA (miRNA) markers associated with a diagnosis of IIH and disease activity and to assess their relevance in the CNS through identification in CSF. METHODS: Serum and CSF samples from participants in the IIH-Weight Trial (a randomized controlled trial comparing the effectiveness of bariatric surgery with that of a community weight management intervention in lowering ICP, recruited 2014-2017) were analyzed at baseline (active disease) and 12 months (participants in remission with no papilledema). Eligible participants were adult women with active IIH (those without papilledema were excluded). Disease activity was assessed by quantifying the degree of papilledema using Spectralis spectral-domain optical coherence tomography. A panel of 40 candidate miRNAs was assessed. Comparator groups included participants with obesity or migraine. Analyses used Student tests and one-way ANOVA followed by Tukey multiple comparisons test. Differentially expressed miRNAs were evaluated in relation to clinical disease activity and metabolic profiles, using linear regression analysis. RESULTS: Five of 40 serum miRNAs showed significantly lower expression in active IIH (n = 9; 100% female, mean 30.25 ± 4.75 years) compared with IIH in remission. Serum hsa-miR-16-5p had the highest diagnostic performance for active IIH (area under the curve 0.951). Serum hsa-miR-16-5p ( < 0.0001; CI -7.286 to -2.503) and hsa-miR-7-5p ( = 0.0032; CI -7.240 to -1.372) were significantly lower in active IIH compared with obesity controls (n = 9; 100% female, mean 38.22 ± 7.99 years). Serum hsa-miR-7a-5p were significantly higher in active IIH compared with migraine (n = 12; 100% female, mean 44.67 ± 8.88 years). Only hsa-miR-16-5p differentiated active IIH from both participants with migraine and obesity. hsa-miR-16-5p also differentiated active IIH from IIH remission in CSF ( = 0.0354; CI -3.062 to -0.1282). Serum and CSF hsa-miR-16-5p correlated significantly with ICP (serum < 0.0001; CI -0.1660 to -0.0732; CSF = 0.046; CI 0.0018-0.1841), papilledema (serum = 0.0236; CI -0.01548 to -0.0001; CSF = 0.0241; CI 0.002-0.033). hsa-miR-16-5p was associated with metabolites involved in fatty acid metabolism and lipid biosynthesis. DISCUSSION: Serum hsa-miR-16-5p emerged as a candidate biomarker associated with active IIH. It differentiated active disease from remission, migraine, and obesity. It correlated with clinical and metabolic markers of disease activity. These findings warrant validation in larger studies to assess its potential as a minimally invasive biomarker for IIH diagnosis and monitoring. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that serum microRNA markers may potentially distinguish active idiopathic intracranial hypertension from remission and controls in adult women.
OVD-assisted press injection in gasless surgery for sectorial inverted internal limiting membrane flap stabilization.
Li H, Zhou Y, Chen X … +2 more , Liang M, Li X
Graefes Arch Clin Exp Ophthalmol · 2026 Jun · PMID 42307764 · Publisher ↗
PURPOSE: To describe and evaluate an ophthalmic viscosurgical device (OVD)-assisted press injection technique for stabilizing a sectorial inverted internal limiting membrane (ILM) flap in full-thickness macular hole (MH)...
PURPOSE: To describe and evaluate an ophthalmic viscosurgical device (OVD)-assisted press injection technique for stabilizing a sectorial inverted internal limiting membrane (ILM) flap in full-thickness macular hole (MH) surgery without perfluorocarbon liquid or endotamponade. METHODS: Twenty-eight eyes (28 patients) with full-thickness MH underwent 27-gauge pars plana vitrectomy with a superior sectorial inverted ILM flap. An OVD was first placed over the MH before indocyanine green (ICG) staining to minimize direct dye exposure to the fovea. After ILM flap creation, gentle OVD press injection was performed to flatten and secure the inverted flap over the hole. Postoperative outcomes included best-corrected visual acuity (BCVA), macular hole closure on optical coherence tomography (OCT), and surgical complications. RESULTS: All surgeries were completed successfully using the OVD-assisted press injection technique. Anatomical closure of the macular hole was achieved in all eyes (100%). OCT demonstrated stable ILM flap coverage throughout follow-up. Mean BCVA improved significantly from 0.92 ± 0.29 log MAR preoperatively to 0.60 ± 0.29 log MAR at 3 months postoperatively (P < 0.001). No retinal detachment, MH reopening, or clinical evidence of ICG-related toxicity occurred. Intraocular pressure remained stable; transient hypotony occurred in two eyes and resolved within 1 week. CONCLUSION: OVD-assisted press injection provides reliable mechanical stabilization of the inverted flap and enables macular hole closure without the need for perfluorocarbon liquids or endotamponade. CLINICAL TRIAL NUMBER: Not applicable.
Choroidal Changes in Cerebral Amyloid Angiopathy Studied by Optical Coherence Tomography Angiography.
Ye J, Ye X, Jia Y … +4 more , Li X, Liu X, Zhu S, Huang S
Transl Stroke Res · 2026 Jun · PMID 42307684 · Publisher ↗
Background cerebral amyloid angiopathy (CAA) involves amyloid-β deposition in cerebral vessels. Its effects on the ocular circulation remain unclear. Using swept-source optical coherence tomography angiography (SS-OCTA),...
Background cerebral amyloid angiopathy (CAA) involves amyloid-β deposition in cerebral vessels. Its effects on the ocular circulation remain unclear. Using swept-source optical coherence tomography angiography (SS-OCTA), this study quantitatively characterized choroidal parameters in CAA patients and their correlation with MRI neuroimaging markers. Method CAA patients and matched controls were enrolled. We used SS-OCTA to obtain choroidal parameters including thickness, choriocapillaris flow density, choroidal vascular volume (CVV), and choroidal vascular index (CVI). The correlations between these parameters and CAA-specific neuroimaging markers on MRI were then analyzed. Results in the study comprising 23 eyes from 23 CAA patients and 23 eyes from 23 healthy controls, we interrogated choroidal parameters using SS-OCTA. The CAA group exhibited a significantly lower choriocapillaris flow density compared to controls (P < 0.05). Furthermore, this parameter showed a nominal inverse association with the burden of subcortical spot white matter hyperintensities, which did not survive correction for multiple comparisons (FDR-adjusted q > 0.05). Conclusion our study suggests that reduction in choriocapillaris density may serve as a potential cross-sectional biomarker for CAA, pending validation in longitudinal studies.
Integrated Coronary CT Angiography Assessment of Plaque Vulnerability and Clinical Outcomes: The Morphology-Inflammation-Burden (MIB) Score.
Andreaggi S, Scalamera R, Kim S … +8 more , Kim K, McNulty I, Lee H, Dey D, Dijkstra J, Banning AP, Kakuta T, Jang IK
JACC Cardiovasc Imaging · 2026 Jun · PMID 42307514 · Publisher ↗
BACKGROUND: Invasive intracoronary imaging represents the gold standard for identifying vulnerable coronary plaques, but it is not suitable for widespread clinical use. Coronary computed tomography angiography (CTA) may...
BACKGROUND: Invasive intracoronary imaging represents the gold standard for identifying vulnerable coronary plaques, but it is not suitable for widespread clinical use. Coronary computed tomography angiography (CTA) may offer a noninvasive alternative. OBJECTIVES: This study aims to integrate coronary CTA-derived plaque morphology, pericoronary inflammation, and plaque burden into a unified morphology-inflammation-burden (MIB) score and to evaluate its association with plaque vulnerability and clinical outcomes. METHODS: Patients undergoing coronary CTA followed by optical coherence tomography (OCT) and intravascular ultrasound (IVUS) were followed for a median of 31 months. High-risk plaque, pericoronary adipose tissue attenuation, and total plaque burden (TPB) were quantified and compared with invasive imaging. A vulnerable lesion was defined as ≥2 vulnerability features on OCT. RESULTS: A total of 438 patients (median age 67 years) and 1,038 plaques were included; 45.4% presented with non-ST-segment elevation acute coronary syndrome. High-risk plaque, elevated pericoronary adipose tissue attenuation, and high TPB were independently associated with OCT-defined vulnerability (P < 0.05 for all). TPB correlated with IVUS percent atheroma volume (Pearson's r = 0.69; P < 0.001). The MIB score demonstrated a stepwise increase in vulnerability, exceeding a predicted risk of 90% in the highest category. Vulnerable patients, defined by the presence of ≥1 untreated lesion with a high MIB score, had a significantly higher rate of cardiac death, acute coronary syndrome, or revascularization (15.3% vs 4.4%; P < 0.001). CONCLUSIONS: A coronary CTA-derived MIB score correlates with plaque vulnerability by intracoronary imaging and identifies patients at increased risk for adverse events. These findings support the value of coronary CTA for noninvasive risk stratification in clinical practice. (Massachusetts General Hospital and Tsuchiura Kyodo General Hospital Coronary Imaging Collaboration; NCT04523194).
Coronary CT Angiography: New Insights in Search of Vulnerable Plaques and Patients.
Koskinas KC, Windecker S
JACC Cardiovasc Imaging · 2026 Jun · PMID 42307513 · Publisher ↗
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Qualitative and Quantitative Assessment of Restored Capillary Perfusion on OCT Angiography in Diabetic Macular Ischemia.
Yoshida M, Murakami T, Ishihara K … +3 more , Mori Y, Iga Y, Tsujikawa A
Transl Vis Sci Technol · 2026 Jun · PMID 42307175 · Full text
PURPOSE: The purpose of this study was to investigate characteristics of restored capillary perfusion on optical coherence tomography angiography (OCTA) in diabetic retinopathy (DR). METHODS: We prospectively obtained OC...
PURPOSE: The purpose of this study was to investigate characteristics of restored capillary perfusion on optical coherence tomography angiography (OCTA) in diabetic retinopathy (DR). METHODS: We prospectively obtained OCTA images from 106 eyes of 106 patients with DR and analyzed them within a 2.5-mm-diameter circle. The area was divided into 15 × 15-pixel squares; those without vascular edge signals were defined as nonperfusion squares (NPSs) at baseline and 3 years after image registration. Qualitative assessment identified OCTA findings representing restored perfusion: newly developed uniform-caliber vessels ("rod-like vessels"), vessels with distal enlargement ("bulb sign"), loop-forming vessels ("loop vessel"), and "vessel reappearance" suggestive of reperfusion. RESULTS: In the superficial layer, eyes with advanced diabetic macular ischemia (DMI) showed NPS reduction in the central subfield more frequently than those with mild DMI (P < 0.001). Baseline NPS counts were negatively correlated with 3-year NPS changes in the central sector of the superficial and deep layers (P < 0.05). In the deep layer, NPS reduction in the parafoveal sectors was observed more frequently in eyes with advanced DMI (P < 0.05). Qualitative assessment showed rod-like vessels, bulb signs, loop vessels, and vessel reappearance in 81, 75, 11, and 93 eyes, respectively. Rod-like vessels and bulb signs were more frequently observed outside the foveal avascular zone (FAZ) than within it in the superficial layer (P < 0.001 for both comparisons). CONCLUSIONS: Quantitative and qualitative analyses demonstrated restored capillary perfusion on OCTA in some eyes with DMI, suggesting revascularization and reperfusion. TRANSLATIONAL RELEVANCE: Advanced DMI exhibits both progressive capillary nonperfusion and restored capillary perfusion on OCTA.
Correlation Between RPE Aperture and Photoreceptor Integrity in Non-Neovascular AMD: A Longitudinal Study Using OCT and 3D Morphological Analysis.
Su Y, He Y, Pu J … +4 more , Zhuang X, Zhang X, Gan Y, Wen F
Transl Vis Sci Technol · 2026 Jun · PMID 42307174 · Full text
PURPOSE: The purpose of this study was to investigate longitudinal morphological changes of retinal pigment epithelium (RPE) apertures within pigment epithelial detachment (PED) and their association with photoreceptor i...
PURPOSE: The purpose of this study was to investigate longitudinal morphological changes of retinal pigment epithelium (RPE) apertures within pigment epithelial detachment (PED) and their association with photoreceptor integrity in non-neovascular age-related macular degeneration (AMD). METHODS: This retrospective analysis included 22 eyes from 21 patients with RPE apertures within PED. During a mean follow-up of 11.4 ± 5.8 months, optical coherence tomography (OCT) with 3D volumetric analysis was used to measure RPE aperture diameter/area, PED dimensions, and areas of ellipsoid zone (EZ) loss and outer nuclear layer (ONL) thinning. Correlation and multivariate regression analyses were performed. RESULTS: RPE apertures significantly enlarged in diameter and area, accompanied by progressive EZ loss and ONL thinning (all P ≤ 0.001). PED height (P = 0.018) and volume (P = 0.031) decreased, whereas PED width increased (P = 0.019). RPE aperture size showed strong cross-sectional and longitudinal correlations with photoreceptor damage (r up to 0.942 and 0.928, respectively, all P < 0.001, remaining significant after false discovery rate [FDR] correction). Multivariate regression demonstrated that change in RPE aperture diameter was independently associated with concurrent changes in EZ loss (β = 1.009, P < 0.001) and ONL thinning (β = 0.679, P = 0.001). Additionally, a larger baseline aperture diameter was an independent factor associated with greater visual acuity decline (P = 0.015). CONCLUSIONS: RPE apertures enlarge over time and are closely associated with worsening photoreceptor damage, supporting RPE aperture progression as a dynamic biomarker of ongoing photoreceptor degeneration in non-neovascular AMD. TRANSLATIONAL RELEVANCE: Quantitative OCT-based assessment of RPE aperture expansion enables clinically applicable monitoring of photoreceptor degeneration and visual risk in non-neovascular AMD.
A call for neurovascular monitoring in an era of longer missions and broader spaceflight participation. Commentary.
Cusumano A, Falsini B, Martelli F … +1 more , Lombardo M
Ann Ist Super Sanita · 2026 · PMID 42307123 · Publisher ↗
Spaceflight-Associated Neuro-ocular Syndrome (SANS) has emerged as a critical neuro-ophthalmic risk for human space exploration, particularly as mission duration increases and access to space expands. Current spaceflight...
Spaceflight-Associated Neuro-ocular Syndrome (SANS) has emerged as a critical neuro-ophthalmic risk for human space exploration, particularly as mission duration increases and access to space expands. Current spaceflight ocular surveillance and research protocols have prioritized structural imaging and selected neuroimaging/physiological assessments. However, accumulating evidence suggests that SANS is not confined to the posterior pole as a purely structural optic nerve head phenomenon but may also involve vascular and hemodynamic alterations. At the same time, structural changes at the optic nerve head may not fully capture the functional integrity of the afferent visual pathway. We therefore propose to define a more targeted extension of current SANS surveillance protocols incorporating ultra-widefield swept-source optical coherence tomography angiography (UWF-SS-OCTA), visual evoked potentials (VEPs) and pattern electroretinogram (ERG) into standardized pre-flight, in-flight (when feasible), and post-flight assessments. Beyond its relevance to astronaut health, this topic may also be of translational interest to the broader scientific and clinical community.
Worsening abducens paresis and chronic orbital venous congestion after carotid-cavernous fistula embolization: long-term motility outcomes.
Francisco C, Cerqueira CM, Lemos A
Strabismus · 2026 Jun · PMID 42307121 · Publisher ↗
PURPOSE: Carotid-cavernous fistulas (CCFs) produce abnormal arteriovenous communication between the carotid circulation and the cavernous sinus, leading to orbital venous hypertension and neuro-ophthalmic manifestations....
PURPOSE: Carotid-cavernous fistulas (CCFs) produce abnormal arteriovenous communication between the carotid circulation and the cavernous sinus, leading to orbital venous hypertension and neuro-ophthalmic manifestations. Although endovascular embolization is the treatment of choice and usually results in rapid hemodynamic normalization, delayed ocular motor sequelae after successful closure remain incompletely characterized. We report a case of persistent and worsening abducens nerve paresis and chronic orbital venous congestion following embolization of a direct CCF. METHODS: This case report describes longitudinal neuro-ophthalmologic follow-up over more than four years. Clinical assessment included best-corrected visual acuity, slit-lamp examination, intraocular pressure measurement, dilated fundus examination, and structured ocular motility evaluation using serial Hess chart testing. Retinal morphology was assessed with spectral-domain optical coherence tomography, and orbital and intracranial vascular structures were evaluated with MRI and time-of-flight MR angiography. RESULTS: A 78-year-old woman presented with intermittent diplopia and mild right abduction deficit. Imaging confirmed a right-sided direct CCF, which was successfully treated with endovascular embolization. Shortly after treatment, she developed marked worsening of right abducens nerve paresis with constant diplopia and transient visual acuity reduction. Retinal venous complications developed after treatment, with central retinal vein occlusion and macular edema resolving after intravitreal aflibercept. Persistent VI nerve paresis gradually improved after botulinum toxin injection into the right medial rectus muscle, and serial Hess chart analysis documented progressive expansion of the binocular single vision field, indicating partial functional recovery of abducens nerve function. Long-term imaging showed persistent asymmetry of orbital venous drainage and later development of >50% stenosis of the intracavernous-ophthalmic segment of the internal carotid artery without recurrent fistulous flow. CONCLUSION: This case highlights that delayed neuro-ophthalmic complications and venous congestion may occur despite successful CCF embolization. Post-embolization worsening of the abducens nerve paresis may reflect hemodynamic alterations affecting the cavernous sinus and orbital venous circulation. Gradual functional improvement was observed during long-term follow-up, although interpretation of the natural recovery trajectory is limited by botulinum toxin treatment. These findings further support that angiographic cure does not necessarily indicate complete functional recovery and emphasize the importance of long-term neuro-ophthalmologic and motility follow-up after CCF embolization.
Bilateral Serous Retinal Detachment in Severe Preeclampsia: A Report of Two Cases.
Oumaiouf L, Mourouth H, Essafti M … +2 more , Rebahi H, El Adib AR
Cureus · 2026 May · PMID 42306384 · Full text
Serous retinal detachment (SRD) is an uncommon but vision-threatening manifestation of hypertensive disorders of pregnancy, particularly in the context of severe preeclampsia and hemolysis, elevated liver enzymes, and lo...
Serous retinal detachment (SRD) is an uncommon but vision-threatening manifestation of hypertensive disorders of pregnancy, particularly in the context of severe preeclampsia and hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. We report two cases of young primigravid women who developed bilateral SRD associated with HELLP syndrome. Both patients presented with acute bilateral vision loss and were diagnosed using optical coherence tomography. Management included antihypertensive therapy, magnesium sulfate, and delivery without any ophthalmological intervention. Both patients experienced complete visual recovery within two weeks. This report underscores the importance of prompt recognition, appropriate obstetric management, and the typically favorable visual prognosis of SRD in preeclampsia.
Central Retinal Vein Occlusion in a Young Healthy Man Following Strenuous Exercise: Multimodal Imaging and Treatment Response.
Jain P, Pradhan A, Rangari P … +1 more , Dutta P
Cureus · 2026 May · PMID 42306351 · Full text
Central retinal vein occlusion (CRVO) is uncommon in young, otherwise healthy individuals and is often associated with underlying systemic or hematological risk factors. We report a case of a 23-year-old healthy man who...
Central retinal vein occlusion (CRVO) is uncommon in young, otherwise healthy individuals and is often associated with underlying systemic or hematological risk factors. We report a case of a 23-year-old healthy man who presented with sudden painless diminution of vision in the right eye shortly after engaging in strenuous physical exercise involving heavy weightlifting. Best-corrected visual acuity at presentation was 6/18. Fundus examination revealed optic disc edema, dilated and tortuous retinal veins, and widespread intraretinal hemorrhages consistent with non-ischemic CRVO. Optical coherence tomography (OCT) demonstrated significant cystoid macular edema with a central macular thickness of 823 µm and associated subretinal fluid. Comprehensive systemic evaluation, including hematological, metabolic, coagulation, autoimmune, cardiac, and carotid workup, was unremarkable. The patient was treated with intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy, resulting in marked anatomical improvement and visual recovery to 6/9 on follow-up. Although CRVO in young patients is rare and often idiopathic, intense physical exertion may act as a potential precipitating factor through transient hemodynamic changes such as increased venous pressure, Valsalva-like mechanisms, and hemoconcentration. This case highlights the importance of considering recent physical stressors in the clinical history and demonstrates a favorable treatment response with anti-VEGF therapy.
Multi-OCT-SelfNet: integrating self-supervised learning with multi-source data fusion for enhanced multi-class retinal disease classification.
Jannat FE, Gholami S, Lim JI … +3 more , Leng T, Alam MN, Tabkhi H
Front Syst Biol · 2026 · PMID 42306243 · Full text
Acquiring large and diverse medical imaging datasets remains challenging because of privacy, annotation cost, and institutional variability. This limitation can reduce the generalization ability of deep learning models,...
Acquiring large and diverse medical imaging datasets remains challenging because of privacy, annotation cost, and institutional variability. This limitation can reduce the generalization ability of deep learning models, particularly when they are trained on small or domain-specific retinal datasets. To address this issue, we propose Multi-OCT-SelfNet, a self-supervised framework based on a SwinV2 transformer backbone for multi-class retinal disease classification from optical coherence tomography (OCT) images. The framework combines multi-source OCT datasets during masked autoencoder-based self-supervised pre-training to learn transferable image representations, followed by supervised fine-tuning on individual downstream datasets. We evaluated Multi-OCT-SelfNet across three benchmark OCT datasets (DS1, DS2, and DS3) and compared its performance with two baselines: ResNet-50 and traditional SwinV2 trained without the proposed self-supervised multi-source pre-training strategy. In on-domain evaluation, Multi-OCT-SelfNet-SwinV2 achieved AUC-ROC scores of 0.97 on DS1, 0.97 on DS2, and 0.89 on DS3, demonstrating competitive or improved performance compared with both baselines. The advantage of the proposed framework was more evident in cross-dataset evaluation, especially for smaller datasets. When trained on DS2 and tested on DS3, Multi-OCT-SelfNet-SwinV2 improved AUC-ROC from 0.59 with ResNet-50 and 0.61 with traditional SwinV2 to 0.90. Similarly, when trained on DS3 and tested on DS2, the proposed model achieved an AUC-ROC of 0.94, compared with 0.60 for ResNet-50 and 0.81 for traditional SwinV2. Under limited-data settings using only 50% of the training samples, Multi-OCT-SelfNet-SwinV2 maintained stronger robustness than ResNet-50, achieving AUC-ROC of 0.77 on DS2 compared with 0.68 for ResNet-50, and 0.76 on DS3 compared with 0.49 for ResNet-50. Ablation analyses further showed that multi-source data fusion and self-supervised pre-training substantially improved generalization, particularly for DS2 and DS3. Statistical evaluation using the Wilcoxon signed-rank test also supported the consistency of the proposed model's improvements across paired train-test settings. These findings suggest that Multi-OCT-SelfNet-SwinV2 can learn more transferable OCT representations than conventional supervised baselines, making it a promising approach for robust AI-assisted retinal disease classification under data-limited and domain-shifted clinical conditions.
A Case Report of Presumed West Nile Virus Chorioretinitis in a Non-Endemic Area: Atypical Serology and Imaging Features of Old and New Lesions.
Belletti M, Perez Jimenez Y, Neri P … +1 more , Pichi F
Case Rep Ophthalmol · 2026 · PMID 42305768 · Full text
INTRODUCTION: West Nile virus (WNV) infection is a recognized cause of neuroinvasive disease and chorioretinitis, typically reported in endemic regions and often associated with positive IgM serology. However, atypical p...
INTRODUCTION: West Nile virus (WNV) infection is a recognized cause of neuroinvasive disease and chorioretinitis, typically reported in endemic regions and often associated with positive IgM serology. However, atypical presentations with discordant serology can occur, particularly in non-endemic settings, posing diagnostic challenges. CASE PRESENTATION: A 58-year-old woman developed acute encephalitis and bilateral panuveitis shortly after travel to a non-endemic region. Serum and cerebrospinal fluid testing showed positive WNV IgG and negative IgM. Multimodal retinal imaging revealed the coexistence of inactive-appearing chorioretinal scars and active full-thickness retinitis, with characteristic wedge-shaped and linear lesion patterns. Fundus autofluorescence, fluorescein angiography, indocyanine green angiography, and optical coherence tomography allowed differentiation of lesions with varying morphology and stages of activity. Although these findings do not confirm viral relapse or reactivation, they suggest prior infection with possible delayed or recurrent ocular and central nervous system involvement. Systemic and topical corticosteroid therapy resulted in rapid clinical and imaging improvement. CONCLUSION: This case highlights the diagnostic value of multimodal imaging in suspected WNV chorioretinitis and underscores the limitations of serology alone. Atypical serological profiles in non-endemic settings require careful interpretation, and multimodal imaging may provide critical insights into disease activity and staging.
High-Resolution Anterior Segment Optical Coherence Tomography Characteristics of Conjunctival Tumors.
Ocaktan O, Horozoglu F, Sener H … +1 more , Özer F
J Clin Pract Res · 2026 Apr · PMID 42305277 · Full text
OBJECTIVE: This study aimed to assess the demographic, clinical, histological classifications, and anterior segment optical coherence tomography (AS-OCT) features of conjunctival malignancies. The goal was to identify fa...
OBJECTIVE: This study aimed to assess the demographic, clinical, histological classifications, and anterior segment optical coherence tomography (AS-OCT) features of conjunctival malignancies. The goal was to identify factors associated with tumor malignancy. MATERIALS AND METHODS: This retrospective analysis included 37 patients with conjunctival tumors. Data collected comprised age, gender, tumor coloration, histological type, location, corneal involvement, subepithelial reflectivity of the lesion on AS-OCT, lesion homogeneity on AS-OCT, and the presence of intralesional cysts on AS-OCT. Statistical analysis was performed using chi-square and t-tests, with a significance level of α<0.05. The study protocol was approved by the Erciyes University Health Sciences Research Ethics Committee (Approval Number: 2025/365, Date: 09.07.2025). RESULTS: Malignant tumors were identified in significantly older patients. No significant gender differences were found regarding malignancy. Amelanotic appearance was significantly more common in malignant tumors. The types of tumors identified included conjunctival nevus, conjunctival ocular surface squamous neoplasia (OSSN), conjunctival lymphoma, conjunctival melanoma, and conjunctival cyst. No significant relationship was found between tumor location and malignancy. Corneal involvement was significantly associated with malignancy. On AS-OCT, malignant tumors exhibited a hyporeflective subepithelial lesion with homogeneous internal reflectivity. Although benign tumors contained more intralesional cysts on AS-OCT, this finding was not statistically significant. CONCLUSION: Conjunctival tumors exhibit various characteristics. Advanced age, amelanotic pigmentation, corneal involvement, and a hyporeflective homogeneous lesion on AS-OCT are significant indicators of malignancy, highlighting the importance of detailed examination and increased vigilance.
The Prognostic Value of Different Patterns of Neoatherosclerosis and Treatment Modality in Patients With Coronary In-Stent Restenosis.
Shen Y, Gu N, Liu Z … +7 more , Zhang W, Shen C, Wang X, Deng C, Xia Q, Zhao Y, Shi B
Cardiovasc Ther · 2026 · PMID 42304939 · Full text
BACKGROUND: Neoatherosclerosis (NA) and treatment modality may influence outcomes in patients with in-stent restenosis (ISR). This study evaluated the prognostic impact of different NA patterns and percutaneous coronary...
BACKGROUND: Neoatherosclerosis (NA) and treatment modality may influence outcomes in patients with in-stent restenosis (ISR). This study evaluated the prognostic impact of different NA patterns and percutaneous coronary intervention (PCI) strategies guided by optical coherence tomography (OCT). METHODS: We retrospectively analyzed 288 ISR lesions with OCT-defined NA treated between January 2015 and December 2023. Lesions were classified as lipidic, calcified, or mixed NA. The primary endpoint was 1-year target lesion failure (TLF), defined as a composite of cardiac death, nonfatal myocardial infarction, and clinically driven target lesion revascularization (CD-TLR). Cox regression, interaction analysis, and propensity score matching (PSM) were performed. RESULTS: No significant differences in TLF (p = 0.420) or CD-TLR (p = 0.650) were observed among NA patterns. After adjustment for clinical and procedural covariates, DES reimplantation was associated with a lower risk of TLF (hazard ratio [HR] 0.390, 95% confidence interval [CI] 0.157-0.974; p = 0.044) and CD-TLR (HR: 0.341, 95% CI: 0.114-0.925; p = 0.039) compared with DCB angioplasty. In patients with lipidic NA, a similar trend was observed (TLF: HR: 0.287; 95% CI: 0.097-0.849; p = 0.024; CD-TLR: HR: 0.171; 95% CI: 0.039-0.750; p = 0.019). However, no significant interaction was observed between the NA pattern and treatment modality (p for interaction = 0.543). CONCLUSION: No significant differences in clinical outcomes were observed across NA patterns. Although DES showed numerically favorable outcomes in lipidic NA, no significant interaction between NA pattern and treatment modality was detected. And these findings are hypothesis-generating and may relate to the additional mechanical scaffolding and plaque sealing provided by DES in lipidic NA.
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