Surv Ophthalmol [JOURNAL]
Sun
200 papers
Ocular frailty: A concept analysis.
Huang L, Chen A, Zhang Q … +2 more , Zhu J, Cheng Y
Surv Ophthalmol · 2026 · PMID 41616921 · Publisher ↗
The concept of ocular frailty remains inadequately defined with respect to its clinical manifestations, etiological pathways, and consequential impacts. We delineate the concept of ocular frailty in order to furnish a we...
The concept of ocular frailty remains inadequately defined with respect to its clinical manifestations, etiological pathways, and consequential impacts. We delineate the concept of ocular frailty in order to furnish a well-defined and operationalizable conceptual basis for advancing research in the aging population. A total of 15 articles were included for analysis and synthesis. The attributes of ocular frailty were hypofunction, loss of resilience, association with systemic frailty, potential reversibility or modifiability, and multidimensionality. Antecedents of ocular frailty were classified into 2 categories, namely, sociodemographic characteristics and comorbidity. Consequences of ocular frailty include 4 themes: increased risk of adverse outcomes, high tendency for depression, low autonomy, and the possibility of social isolation. Ocular frailty, an age-related manifestation characterized by diminished ocular functional capacity, represents a state of heightened vulnerability in the visual system. The outcomes of this concept analysis facilitate theoretical clarification and operational delineation of ocular frailty. Ocular frailty, clarified through Rodgers' evolutionary concept analysis, is defined by its attributes, antecedents, and consequences, providing a structured framework for clinical risk stratification and future research in geriatric populations.
Exploring successful treatments for upper eyelid retraction in thyroid eye disease: A scoping review.
Salh D, Pickard MR, Al-Mehiawi A … +2 more , Parker R, Hussain A
Surv Ophthalmol · 2026 · PMID 41592668 · Publisher ↗
Graves-associated upper eyelid retraction (GAUER) is a functionally and cosmetically significant manifestation of thyroid eye disease. This scoping review maps the breadth of evidence on medical and surgical management o...
Graves-associated upper eyelid retraction (GAUER) is a functionally and cosmetically significant manifestation of thyroid eye disease. This scoping review maps the breadth of evidence on medical and surgical management of GAUER, synthesizes outcomes, and identifies evidence gaps. A systematic search identified 65 studies published between 1965 and 2025. Studies were categorized as medical or surgical interventions, with marginal reflex distance 1 serving as the most consistently reported outcome for weighted analysis. Among medical interventions, triamcinolone acetonide remains the most widely studied, though recent randomized clinical trials suggest betamethasone achieves faster and longer-lasting improvement with fewer injections. Botulinum toxin A and hyaluronic acid fillers offer safe, reversible options for transient or mild retraction, while the biologic teprotumumab shows modest but consistent benefit, particularly in muscle-predominant disease. Surgical correction remains the standard for fibrotic or refractory cases, with full-thickness anterior blepharotomy and levator-Müller complex recession yielding the most predictable, durable, and aesthetically balanced results. Interpretation of available data is limited by methodological heterogeneity and a lack of standardized endpoints. Aesthetic outcomes were inconsistently reported. Future prospective comparative studies incorporating both functional and aesthetic outcomes are essential to establish evidence-based, phase-specific treatment strategies for GAUER.
Too much of a good thing.
Varghese D, Abdelsalam D, Ibrahim S … +2 more , Lee AG, Bhatti MT
Surv Ophthalmol · 2026 · PMID 41520798 · Publisher ↗
A 38-year-old man with poorly controlled type 2 diabetes mellitus and arterial hypertension on semaglutide presented with acute, painless, vision loss in the left eye. Ophthalmic examination revealed optic disc edema (OD...
A 38-year-old man with poorly controlled type 2 diabetes mellitus and arterial hypertension on semaglutide presented with acute, painless, vision loss in the left eye. Ophthalmic examination revealed optic disc edema (ODE) in the left eye and optic disc pallor (ODP) in the right eye, accompanied by severe nonproliferative diabetic retinopathy and cystoid macular edema in both eyes. The combination of ODE in one eye and ODP in the fellow eye raised concern for the Foster Kennedy syndrome secondary to an intracranial mass; however, neuroimaging and systemic evaluation were unremarkable. Ultimately, it was decided the ODP was due to a prior unrecognized non-arteritic anterior ischemic optic neuropathy (NAION) event, and the ODE was the result of an acute NAION in the symptomatic fellow eye (i.e. pseudo-Foster Kennedy syndrome).
Prognostic factors after rhegmatogenous retinal detachment repair: An overview of the clinical and imaging insights.
La Rosa A, Feo A, Govetto A … +2 more , Rossi T, Romano MR
Surv Ophthalmol · 2026 · PMID 41519175 · Publisher ↗
Rhegmatogenous retinal detachment (RRD) is a major cause of vision loss requiring prompt surgical intervention. Recent advances in multimodal retinal imaging, especially macular and peripheral optical coherence tomograph...
Rhegmatogenous retinal detachment (RRD) is a major cause of vision loss requiring prompt surgical intervention. Recent advances in multimodal retinal imaging, especially macular and peripheral optical coherence tomography (OCT), have significantly improved our understanding of the various factors and biomarkers influencing the clinical outcomes after RRD repair. Several visual disturbances, such as metamorphopsia and aniseikonia, typically persist despite successful reattachment, significantly impacting patients' quality of life. Factors influencing recovery include the timing of surgery, the extent of retinal displacement, and structural integrity of retinal layers. Additionally, recent research is increasingly highlighting the relevant role of numerous OCT biomarkers, including hyperreflective dots, ellipsoid zone, external limiting membrane and outer retinal disruption, and bacillary layer detachment in prognosis. We provide an overview on the above-mentioned factors implied in RRD-related postsurgical prognosis in order to optimize clinical practice.
Corneal transplantation triple procedures.
Nair S, Deshmukh R, Mohan S … +3 more , Agarwal T, Sharma N, Vajpayee RB
Surv Ophthalmol · 2026 · PMID 41485730 · Publisher ↗
The corneal triple procedure, combining keratoplasty, cataract extraction, and intraocular lens implantation, remains a valuable option for patients with concurrent corneal opacity and cataract. We synthesize historical...
The corneal triple procedure, combining keratoplasty, cataract extraction, and intraocular lens implantation, remains a valuable option for patients with concurrent corneal opacity and cataract. We synthesize historical and contemporary evidence on penetrating keratoplasty (PKP), anterior lamellar keratoplasty (ALK), and endothelial keratoplasty (EK) triple procedures, highlighting their indications, surgical techniques, outcomes, and evolving trends. PKP triple is indicated for full-thickness scarring, keratoconus with central scarring, and cases with anterior segment abnormalities, but remains technically demanding due to open-sky cataract surgery and postoperative refractive unpredictability. ALK triple offers tectonic and visual rehabilitation in stromal disorders sparing the endothelium, though technically challenging. EK triple procedures, particularly Descemet stripping automated endothelial keratoplasty and Descemet membrane endothelial keratoplasty, are increasingly preferred in endothelial disorders such as Fuchs endothelial corneal dystrophy, offering faster recovery, more predictable refraction, and better graft survival. Advances in capsulotomy, nucleus management, intraocular lens power calculation, and perioperative strategies have improved safety and refractive outcomes across triple procedures. Long-term studies reveal that although visual and anatomical success rates remain high, complications such as graft rejection, glaucoma, and posterior capsular opacification persist. Careful patient selection and tailored surgical planning are essential, as triple procedures continue to evolve toward safer and more predictable outcomes.
Glucagon-like peptide-1 receptor agonists: What ophthalmologists need to know.
Bala S, Allan KC, Decker NL … +5 more , Abbass NJ, Joo JH, Zhao A, Talcott KE, Rachitskaya AV
Surv Ophthalmol · 2026 · PMID 41482136 · Publisher ↗
Initially designed for the treatment of type-2 diabetes, glucagon-like peptide-1 receptor agonists (GLP-1RA) are multifaceted agents with promising neuroprotective and anti-inflammatory properties. The majority of the re...
Initially designed for the treatment of type-2 diabetes, glucagon-like peptide-1 receptor agonists (GLP-1RA) are multifaceted agents with promising neuroprotective and anti-inflammatory properties. The majority of the research exploring the relationship between GLP-1RA use and ophthalmic disease comes from large database studies or secondary-analysis of randomized controlled trials investigating GLP-1RAs in cardiovascular disease and obesity. Current evidence regarding the impact of GLP-1 receptor agonists on ophthalmic diseases remains inconsistent, with studies reporting both protective and detrimental effects. For example, there are conflicting findings of an effect on diabetic retinopathy and non-arteritic anterior ischemic optic neuropathy, as well as age-related macular degeneration, with GLP-1RA use. In contrast, GLP-1RAs have more consistently demonstrated a protective effect against idiopathic intracranial hypertension, glaucoma and dry-eye disease. Importantly, the majority of the clinical ophthalmic studies are from large electronic health record databases. Overall, limitations in the design of these studies, such as the lack of manual chart review and potential miscoding of diagnosis or treatments, prohibit a more granular analysis of comprehensive ocular endpoints. As a heterogenous medication class with differing structures, potencies, and mechanisms of action, we outline the ophthalmic effects of all Food and Drug Administration-approved GLP-1RAs. We discuss the proposed mechanisms of ocular effects and GLP-1RA use, examine the current literature investigating the impact of GLP-1RAs on ophthalmic disease, discuss the effects of specific GLP-1RAs, and outline the perioperative considerations of this medication class.
Assessing the 3 pillars of housing for eye and vision health outcomes: A scoping review.
Parellada SE, Avaiya K, Elnour KM … +8 more , Armstrong ML, Spaulding TR, Saylor KM, Woodward MA, Elam AR, Mehdipanah R, Newman-Casey PA, Hicks PM
Surv Ophthalmol · 2026 · PMID 41482135 · Full text
In this scoping review, we examine the implications of 3 pillars (housing conditions and quality, residential consistency, and housing affordability) of healthy housing on vision health outcomes. We examine barriers base...
In this scoping review, we examine the implications of 3 pillars (housing conditions and quality, residential consistency, and housing affordability) of healthy housing on vision health outcomes. We examine barriers based on geographical locations of the studies and World Health Organization income levels. We identified 11,190 abstracts, with 10,996 articles retrieved. Sixty-three met inclusion criteria. Among these, housing conditions emerged as the most frequently observed housing pillar associated with adverse vision health outcomes, cited in 62.1 % of the studies. Environmental pollution, particularly indoor air quality and exposure to harmful substances, was the most common condition associated with poor vision outcomes.
Comparative effectiveness and safety of intra-arterial chemotherapy and intravenous chemotherapy for retinoblastoma: A systematic review and meta-analysis.
Chen KY, Chan HC, Chan CM
Surv Ophthalmol · 2026 · PMID 41482134 · Publisher ↗
Intra-arterial chemotherapy (IAC) has emerged as a targeted alternative to intravenous chemotherapy (IVC) for retinoblastoma; however, the comparative effectiveness and safety of these approaches remain incompletely defi...
Intra-arterial chemotherapy (IAC) has emerged as a targeted alternative to intravenous chemotherapy (IVC) for retinoblastoma; however, the comparative effectiveness and safety of these approaches remain incompletely defined. We performed a systematic review and meta-analysis to evaluate whether IAC-based regimens are associated with improved clinical outcomes compared with IVC in pediatric retinoblastoma. Twelve studies were included. Comparative studies contributed to the quantitative synthesis, whereas selected non comparative IAC series were summarized qualitatively to provide contextual evidence. Overall survival demonstrated a consistent association favoring IAC across both early and advanced disease categories, with a pooled effect estimate of OR 4.72 (95% CI 2.69-8.28). In early-stage disease, the pooled OR was 12.61 (95% CI 3.82-41.58), while advanced-stage disease showed a pooled OR of 3.56 (95% CI 1.88-6.74). Heterogeneity was negligible within subgroups (I² = 0%). Event-free survival favored IAC-based treatment overall with a pooled RR of 1.36 (95% CI 1.13-1.62). When stratified by treatment approach, IAC alone showed a pooled RR of 1.30 (95% CI 1.01-1.66) with moderate heterogeneity (I² = 61%), whereas IAC combined with IVC sequencing demonstrated a pooled RR of 1.43 (95% CI 1.10-1.86) with no heterogeneity (I² = 0%). Globe salvage outcomes were improved with IAC, with a pooled RR of 1.33 (95% CI 1.23-1.42; I² = 9%). Avoidance of enucleation also favored IAC overall, with a pooled RR of 1.69 (95% CI 1.34-2.12). Subgroup analyses indicated a modest and non-significant effect in early-stage disease (RR 1.27, 95% CI 0.89-1.80) and a clearer effect in advanced-stage disease (RR 2.08, 95% CI 1.54-2.80), with minimal heterogeneity (I² = 0%). Metastatic events were rare across studies; nevertheless, pooled analysis suggested lower odds of metastasis in IAC-based regimens compared with IVC (OR 0.42, 95% CI 0.19-0.91; I² = 0%), with no evidence of subgroup differences between IAC alone and IAC plus IVC sequencing. In conclusion, IAC-based strategies were associated with favorable outcomes in survival, disease control, globe salvage, and avoidance of enucleation compared with IVC, with consistently low heterogeneity across major endpoints and metastatic events remaining uncommon in both arms. These findings support the role of IAC as an important component of contemporary retinoblastoma management, particularly in settings with appropriate technical expertise and multidisciplinary resources.
Age-related choroidal atrophy: A systematic review of multimodal imaging, clinical features, and differentiation from other forms of macular degeneration.
Lai A, Issa M, Pereira A … +5 more , Ghafri MA, Dollin M, Hurley B, Chhablani J, Yan P
Surv Ophthalmol · 2026 · PMID 41421557 · Publisher ↗
We conducted a systematic review on the clinical and imaging characteristics of age-related choroidal atrophy (ARCA) that distinguish ARCA from age-related macular degeneration (AMD) and geographic atrophy (GA). Studies...
We conducted a systematic review on the clinical and imaging characteristics of age-related choroidal atrophy (ARCA) that distinguish ARCA from age-related macular degeneration (AMD) and geographic atrophy (GA). Studies were included if they reported on ARCA using clinical or multimodal imaging criteria and differentiated it from AMD and GA. Extracted data included subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI), inner retinal layer thicknesses, and fundus findings. Risk of bias was assessed using the Joanna Briggs Institute checklists. Narrative synthesis and descriptive statistics were performed (PROSPERO (ID: CRD420251041101)). Seven studies (n = 329 patients) met inclusion criteria. ARCA was characterized by choroidal thinning (mean SFCT: 69.8-96.45 µm), preserved retinal pigment epithelium (RPE) on fundus autofluorescence, scleral visibility, and fundus features including peripapillary atrophy (83.3 %), tessellated fundus, and pseudodrusen. Compared to control, patients with ARCA had significantly thinner peripapillary nerve fiber layer (mean: 84.2 µm vs. 90.2 µm; p = 0.047) and reduced mean ganglion cell layer, macular internal plexiform layer and CVI. ARCA contrasts with AMD and GA by its distinct imaging features, less severe visual impairment, higher glaucoma prevalence (35.3 %), and more favorable response to anti-vascular endothelial growth factor agents when choroidal neovascularization is present. ARCA is a distinct clinical entity characterized by specific choroidal and retinal findings on multimodal imaging including lower CVI, thin SFCT, preserved RPE with scleral visibility, peripapillary atrophy, and inner retinal thinning. Further studies are warranted to standardize diagnostic criteria and understand long-term outcomes of ARCA.
The diagnostic potential of aqueous humor: Unlocking ocular and systemic insights.
Chychko L, Son HS, Friedrich M … +3 more , Yildirim TM, Auffarth GU, Augustin VA
Surv Ophthalmol · 2026 · PMID 41419165 · Publisher ↗
The anatomy and physiology of aqueous humor (AH) are essential to maintaining ocular health and managing diseases such as glaucoma, diabetic retinopathy, and Fuchs endothelial corneal dystrophy (FECD). This review compil...
The anatomy and physiology of aqueous humor (AH) are essential to maintaining ocular health and managing diseases such as glaucoma, diabetic retinopathy, and Fuchs endothelial corneal dystrophy (FECD). This review compiles recent findings on AH dynamics, molecular composition, and clinical applications. AH, produced by the ciliary processes, supports intraocular pressure regulation, nourishes avascular tissues, and preserves immune privilege within the eye. Production occurs through diffusion, ultrafiltration, and active secretion, while drainage relies on trabecular and uveoscleral pathways. Imbalances in these processes can lead to ocular diseases. Elevated levels of cytokines, oxidative stress markers, and growth factors in AH have been associated with conditions such as glaucoma, diabetic retinopathy, and postoperative inflammation. Advanced technologies, including proteomics, metabolomics, and aqueous angiography, have revealed the diagnostic and therapeutic potential of AH analysis. Specific cytokine and metabolic profile changes in diabetic patients correlate with disease severity, while cytokine alterations can influence surgical outcomes in FECD and cataract surgery. Understanding the composition and behaviour of AH is critical for developing precise diagnostic tools and treatments for ocular diseases. Additionally, insights into AH's role in surgical recovery emphasize the importance of customized perioperative care, particularly for patients with conditions such as FECD or diabetes.
Prognostic factors for age-related macular degeneration progression: An overview of systematic reviews.
Holt CA, Niedert C, Gedtal M … +3 more , Virgili G, Hogg RE, Qureshi R
Surv Ophthalmol · 2026 · PMID 41412300 · Publisher ↗
Age-related macular degeneration (AMD) is a progressive and irreversible degenerative disease of the retina. Slowing progression to late AMD is the only way to prevent vision loss. Given that AMD treatments are noncurati...
Age-related macular degeneration (AMD) is a progressive and irreversible degenerative disease of the retina. Slowing progression to late AMD is the only way to prevent vision loss. Given that AMD treatments are noncurative, understanding the personal characteristics associated with progression is of critical importance for people with increased AMD risk. We conducted an overview of systematic reviews and meta-analyses (SRMAs) to assess the scope of the existing literature on prognostic factors (PFs) for AMD progression. We included all systematic reviews of PFs for the progression of AMD from early or intermediate to late. We used the Cochrane Eyes and Vision Database of Systematic Reviews (current to September, 2024). We identified 64 potentially relevant studies in the database and included 17 SRMAs, which most commonly studied functional or structural ocular (10/17), lifestyle (7/17), and intervention-related factors (7/17). Across all reviews, 218 PFs were reported. We extracted 79 and grouped these into 20 distinct types of PFs across 8 categories. The modifiable PFs with most evidence for slowing progression were increased dietary supplementation with antioxidants and multivitamins and reduced smoking. Most PFs were non modifiable. Although most PFs may not be targetable, by integrating high-risk optical coherence tomography findings, monitoring relevant comorbidities, and considering individual lesion characteristics, clinicians may better predict disease trajectories and support patients in slowing progression and preserving vision. Notably, no reviews studied social determinants as potential PFs for AMD progression, representing a critical gap in the evidence base. Future reviews should investigate social, systemic, and AI-identified biomarkers to provide a more comprehensive understanding of AMD progression.
Prospective validation of deep-learning algorithms for diabetic retinopathy screening: A systematic review and meta-analysis.
Wang TW, Luo WT, Tu YK … +2 more , Chou YB, Wu YT
Surv Ophthalmol · 2026 · PMID 41344407 · Publisher ↗
Deep-learning (DL) algorithms are widely promoted for diabetic-retinopathy (DR) screening, yet their prospective diagnostic accuracy is not well defined. PubMed, EMBASE and ClinicalTrials.gov were searched to April, 2025...
Deep-learning (DL) algorithms are widely promoted for diabetic-retinopathy (DR) screening, yet their prospective diagnostic accuracy is not well defined. PubMed, EMBASE and ClinicalTrials.gov were searched to April, 2025, for prospective evaluations of DL systems using color-fundus images. Two reviewers screened records, extracted data, and applied QUADAS-2. Hierarchical bivariate random-effects models produced pooled sensitivity and specificity for referable and vision-threatening DR), analyzed separately at patient and eye level. Twenty-one prespecified moderators were explored with uni- and multi-variate meta-regression; publication bias was assessed with Deeks' test Seventy-three studies from 23 countries (255,330 examinations) met the criteria. Pooled patient-level sensitivity was 0.94 (95 % CI 0.92-0.95) and specificity 0.90 (95 % CI 0.87-0.93); eye-level values were 0.93 (95 % CI 0.91-0.95) and 0.94 (95 % CI 0.92-0.96). DR subtype, retinal-field strategy, camera form factor, and prevalence independently explained heterogeneity (p < 0.05). Performance matched or exceeded pivotal FDA trials (IDx-DR, EyeArt). AI gradability was ≥ 95 % in 60 % of cohorts, including handheld and smartphone systems. DL-based DR screening achieves consistent, high accuracy across devices and care settings, enabling scalable deployment in primary care, pharmacies, and mobile clinics. Quality assurance and ongoing monitoring are essential to maximize population-level benefits.
Retinal nerve fiber layer thickness as a biomarker of uveitis activity: A systematic review.
Nabavi A, Haddock LJ, Mahmoudi A … +2 more , Salabati M, Yousefi S
Surv Ophthalmol · 2026 · PMID 41344406 · Full text
Optical coherence tomography (OCT)-derived peripapillary retinal nerve fiber layer thickness (pRNFL) has emerged as a promising surrogate for inflammatory activity in uveitis. We conducted a PRISMA-compliant systematic s...
Optical coherence tomography (OCT)-derived peripapillary retinal nerve fiber layer thickness (pRNFL) has emerged as a promising surrogate for inflammatory activity in uveitis. We conducted a PRISMA-compliant systematic search of PubMed and Embase to identify studies that measured pRNFL in infectious and noninfectious uveitis. Twenty-three studies comprising 2632 eyes met our criteria. Risk of bias was appraised with the ROBINS-I tool and ranged from low to serious, predominantly moderate (13/23) and serious (9/23). Between study heterogeneity was substantial across OCT platforms, anatomic locations, and etiologies. In cross-sectional cohorts, eyes with active uveitis demonstrated an average pRNFL thickening ranging from + 12 to + 44 µm in adults and 8-25 µm in children, when compared with inactive, fellow, or healthy control eyes. Optic discs with angiographic leakage had greater pRNFL thickness, and in one pediatric series, a pRNFL threshold of 130 µm achieved 79 % sensitivity and 85 % specificity for detecting optic disc leakage. Longitudinal analyses demonstrated reversibility of pRNFL thickening, with reductions ranging from approximately 6-47 % of baseline values as inflammation subsided over 1-12 months. Thickening was most pronounced in intermediate, posterior, and panuveitic eyes and least pronounced in isolated anterior uveitis, whereas Fuchs uveitis syndrome showed little or no change. These findings indicate that pRNFL thickening may reflect uveitic activity and warrant further validation.
The downside of tamponade: Silicone oil emulsification and its ocular impact.
Jayadev C, Tendulkar K, Vidyasagar S … +4 more , Gambhir V, Prabhu V, Hande P, Venkatesh R
Surv Ophthalmol · 2026 · PMID 41344405 · Publisher ↗
Silicone oil (SO) remains an essential intraocular tamponade in vitreoretinal surgery, particularly for complex retinal detachments; however, its long-term use is associated with significant complications, of which emuls...
Silicone oil (SO) remains an essential intraocular tamponade in vitreoretinal surgery, particularly for complex retinal detachments; however, its long-term use is associated with significant complications, of which emulsification is the most clinically impactful. We offer a comprehensive synthesis of the pathophysiology, clinical presentation, imaging features, and management of SO emulsification. We begin by outlining the chemical structure and biophysical properties of SO, emphasizing the role of viscosity, interfacial tension, and molecular purity in emulsification resistance. The manufacturing process and its relevance to residual impurities, including surfactant-like components, are highlighted as critical contributors to emulsification risk. Clinical risk factors spanning preoperative inflammation, intraoperative techniques, and postoperative dynamics are detailed. Multimodal imaging including optical coherence tomography, ultrasound biomicroscopy, and fundus autofluorescence provides diagnostic insight into emulsified SO, while standardized grading systems offer a framework for clinical assessment. We also address pharmacokinetic alterations in SO-filled and emulsified eyes, impacting drug distribution and efficacy of anti-vascular endothelial growth factor agents, steroids, and antimicrobials. Management strategies include individualized algorithmic decision-making approach regarding the timing and technique of SO removal, acknowledging the challenges in achieving complete elimination of microdroplets. Emerging innovations in SO formulations, surface modifications, fluorinated oils, and AI-driven imaging tools are discussed as future solutions. Ultimately, our review underscores the need for an integrative approach combining material science, surgical expertise, and personalized care to mitigate the complications of SO emulsification and optimize long-term outcomes in retinal surgery.
Comparison of the efficacy of unilateral amblyopia treatments: A systematic review and network meta-analysis.
Tan JH, Zhao W, Ren H … +4 more , Zhang BW, Fu W, Tan QQ, Aljohani S
Surv Ophthalmol · 2026 · PMID 41314552 · Publisher ↗
Amblyopia, a disorder that impairs visual acuity, encompasses a spectrum of clinical interventions. The true efficacy of these treatments, however, remains elusive. Consequently, we elucidate the effectiveness of each in...
Amblyopia, a disorder that impairs visual acuity, encompasses a spectrum of clinical interventions. The true efficacy of these treatments, however, remains elusive. Consequently, we elucidate the effectiveness of each intervention, providing critical insights into optimal therapeutic strategies. We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library for randomized controlled trials up to August 12, 2024, including amblyopic patients without residual amblyopia. Interventions included spectacles alone, 2-hour patching, 6-hour patching, full-time patching (FTP), atropine eye drops (daily or weekly), optical penalization, and Bangerter filters, among others. Change in best-corrected visual acuity was the primary outcome. Study quality was assessed using the Cochrane risk-of-bias tool. A frequentist network meta-analysis was performed using a multivariate random-effects model. Twenty-two studies were included in this network meta-analysis. Compared to spectacles, both FTP combined with video games (MD = 0.27; 95 % CI [0.06, 0.48]) and combined atropine with patching therapy (MD = 0.25; 95 % CI [0.06, 0.45]) demonstrated significantly better effectiveness. No statistically significant differences were observed in the effectiveness of other treatments. FTP combined with video games and combined atropine with patching therapy showed significantly better therapeutic effects compared to spectacles alone, providing valuable insights for amblyopia treatment. SYSTEMATIC REVIEW REGISTRATION: CRD42024607532.
Accuracy and clinical utility of ultrasound biomicroscopy in extraocular muscle imaging: A systematic review and meta-analysis.
Mirmohammadsadeghi A, Sadeghi E, Akbari MR … +4 more , Sadeghi M, Masoomian B, Farrokhi R, Sahraian A
Surv Ophthalmol · 2026 · PMID 41265711 · Publisher ↗
We evaluate the accuracy of ultrasound biomicroscopy (UBM) for localizing extraocular muscle (EOM) insertions and factors affecting its diagnostic performance. We conducted a systematic search across 5 databases from Jan...
We evaluate the accuracy of ultrasound biomicroscopy (UBM) for localizing extraocular muscle (EOM) insertions and factors affecting its diagnostic performance. We conducted a systematic search across 5 databases from January, 2000, to December, 2024, identifying studies that compared UBM measurements with intraoperative caliper measurements in strabismus surgery. Pooled accuracy was defined as the proportion of UBM measurements within 1 mm of the intraoperative reference measurements. Pooled accuracy and 95 % confidence interval were estimated using a random-effects model, with between-study variance (τ²) calculated via the restricted maximum likelihood method. Subgroup analyses and meta-regression were performed to investigate sources of heterogeneity, including population characteristics, imaging timing, surgery type, and muscle type. Eleven studies (616 measurements) met inclusion criteria. The pooled accuracy of UBM was 79 % (95 % CI: 70-87 %), with substantial heterogeneity (I² = 83.8 %). Preoperative imaging showed significantly higher accuracy (83 %) than postoperative (62 %; p = 0.0018). UBM achieved 82 % accuracy in primary surgeries and 69 % in reoperations (p = 0.0173). In pediatric populations, accuracy reached 88 % (95 % CI: 63-100 %), but subgroup differences were not statistically significant (p = 0.3355). Meta-regression analysis indicated that population, imaging timing, and surgery type collectively explained 41 % of the variability in UBM accuracy. Nevertheless, substantial heterogeneity remained unexplained. UBM demonstrates context-dependent accuracy for EOM localization, with reduced performance in reoperations and postoperative settings. Selective use is recommended, potentially in combination with anterior segment optical coherence tomography for reoperations. Persistent heterogeneity and methodological variations highlight the need for standardized protocols and further research.
Updates on surgical and nonsurgical innovations for macular hole treatment.
Grieco G, Carlà MM, Di Stefano G … +6 more , Scampoli A, Governatori L, Tombolini B, Radice P, Rizzo S, Caporossi T
Surv Ophthalmol · 2026 · PMID 41237971 · Publisher ↗
We explore the evolving landscape of macular hole (MH) management, highlighting key advancements in surgical and nonsurgical treatments. While pars plana vitrectomy with internal limiting membrane (ILM) peeling remains t...
We explore the evolving landscape of macular hole (MH) management, highlighting key advancements in surgical and nonsurgical treatments. While pars plana vitrectomy with internal limiting membrane (ILM) peeling remains the gold standard for MH less than 500 μm in width and in chronic or highly myopic cases, novel techniques have expanded treatment options, including ILM flap approaches, biomaterial grafts, and regenerative therapies. Additionally, emerging nonsurgical modalities, such as pharmacological agents and stem cell-based therapies, present promising alternatives. We synthesize the current evidence in MH management, focusing on clinical implications and limitations of each technique. Furthermore, we discuss future directions to optimize anatomical and functional outcomes of complex and refractory MHs.
A scoping review of adverse visual outcomes among preterm infants without, versus those with, retinopathy of prematurity.
Porteny JR, Scudder P, Darlow BA … +2 more , Vanderveen DK, Dammann O
Surv Ophthalmol · 2026 · PMID 41232696 · Full text
Adverse visual outcomes (AVOs) are common among preterm infants and retinopathy of prematurity (ROP) is a well-known risk factor; however, there is limited information available regarding AVOs in preterm infants without...
Adverse visual outcomes (AVOs) are common among preterm infants and retinopathy of prematurity (ROP) is a well-known risk factor; however, there is limited information available regarding AVOs in preterm infants without ROP. A librarian (PS) conducted searches for studies in MEDLINE (PubMed), and Scopus (Elsevier), from January 1, 2007, to July 13, 2023. The search was designed to capture articles containing the concepts of ROP and adverse visual outcomes using relevant subject headings and text words adapted for the syntax of each database. Following deduplication, Rayyan was utilized for title abstract and full text screening to identify studies reporting specific AVOs separately for preterm infants with and without ROP. The available literature suggests that ROP is associated with an increased risk for specific AVOs, including low vision and blindness, amblyopia, and strabismus. Astigmatism and color vision abnormalities were not strongly linked to ROP. Preterm infants without ROP still experience AVOs, albeit at lower percentages. While ROP is a risk factor for some AVOs, not all AVOs among preterm infants are associated with ROP. Further research is warranted to better understand the factors contributing to AVOs in preterm infants without ROP.
Pseudophakic mini-monovision.
Kang S, Hsu J, Yoo SH
Surv Ophthalmol · 2026 · PMID 41232695 · Publisher ↗
Cataracts and presbyopia represent leading global causes of visual impairment, and demand for spectacle independence after cataract surgery continues to rise. Pseudophakic mini-monovision, a refined adaptation of traditi...
Cataracts and presbyopia represent leading global causes of visual impairment, and demand for spectacle independence after cataract surgery continues to rise. Pseudophakic mini-monovision, a refined adaptation of traditional monovision employing milder anisometropia (-0.75 to -1.50 diopter), has emerged as an effective and versatile strategy to address this need. Compared with conventional monovision, mini-monovision better preserves stereopsis and binocular vision while providing satisfaction and spectacle independence approaching that of multifocal intraocular lenses (IOLs). Success is influenced by factors such as neuroadaptive capacity, ocular dominance, pupil size, and precision of refractive targeting. Advances in IOL technologies, including enhanced monofocal, extended depth of focus, and light-adjustable lenses, have further expanded mini-monovision's applicability, offering customizable visual outcomes. Careful preoperative evaluation and accurate biometry remain critical to screening candidates and optimizing refractive accuracy. Alternative designs, including crossed and hybrid monovision, extend its clinical versatility. By integrating with modern IOL innovations, mini-monovision provides a cost-conscious, patient-centered approach that balances spectacle independence with visual quality, reinforcing its relevance in personalized refractive cataract surgery.
Efficacy and safety of aflibercept biosimilars compared to reference aflibercept for retinal diseases: A systematic review and meta-analysis.
Rashid M, Azeem S, Shahid IF … +5 more , Ali MKB, Shahid F, Fatima A, Rashid A, Azeem E
Surv Ophthalmol · 2026 · PMID 41232694 · Publisher ↗
Aflibercept biosimilars offer cost-effective alternatives to reference aflibercept for retinal diseases such as neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). By inhibiting vascular...
Aflibercept biosimilars offer cost-effective alternatives to reference aflibercept for retinal diseases such as neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). By inhibiting vascular endothelial growth factor-mediated vascular damage, they aim to improve visual outcomes with comparable safety and efficacy, increasing treatment access while reducing cost burden. We evaluate their performance against the reference drug. A comprehensive search was done across Cochrane, Embase, PubMed, Scopus and ClinicalTrials.gov. Randomized controlled trials were included, and quality was assessed via RoB 2.0 tool. A random-effects model estimated standardized mean differences (SMD) and risk ratios. 11 studies (4064 participants) were analyzed, 8 focused on nAMD and 2 on DME. No significant differences in best-corrected visual acuity changes were observed between biosimilars and reference aflibercept in studies on nAMD (SMD = -0.04, 95 % confidence inerval [CI]: -0.15-0.06) or DME (SMD = 0.11, 95 % CI: -0.12-0.33). Central subfield thickness change at week 4 and the endpoint also showed no significant differences. Similarly, no significant differences were seen in choroidal neovacularization size, vision maintenance, anti-drug antibody development, treatment-emergent adverse events, or ocular adverse effects. Biosimilar aflibercept show similar efficacy and safety to the original for nAMD and DME, with no significant differences in key outcomes. They offer a cost-effective alternative that offers similar clinical benefits while improving treatment accessibility.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe