Surv Ophthalmol [JOURNAL]
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200 papers
Relentless placoid chorioretinitis.
Hooper CY, Ferreira LB, Vaze A … +4 more , Vasconcelos-Santos DV, Goldstein DA, Gertig D, Smith JR
Surv Ophthalmol · 2026 · PMID 40706821 · Publisher ↗
Relentless placoid chorioretinitis (RPC) is a rare, vision-threatening posterior uveitis that predominantly affects young adults. The hallmark clinical findings are numerous scattered placoid chorioretinal lesions involv...
Relentless placoid chorioretinitis (RPC) is a rare, vision-threatening posterior uveitis that predominantly affects young adults. The hallmark clinical findings are numerous scattered placoid chorioretinal lesions involving the midperipheral and far peripheral fundus as well as the posterior pole and a persistent or recurrent course resulting in lesions at different chronological stages, with fresh creamy placoid lesions and healing pigmented lesions being present at the same time. Although RPC is frequently described as a disease that is intermediate between acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and serpiginous choroiditis, it more closely resembles APMPPE. It is important to identify those patients with RPC who present with an APMPPE phenotype so that appropriate immunomodulatory therapy is instituted without delay, as most cases of RPC are refractory to corticosteroid monotherapy. Examination findings may help differentiate RPC and APMPPE. Multimodal imaging, including ultra-widefield imaging, and selective investigations aid in distinguishing RPC from other placoid diseases and types of posterior uveitis.
Artificial intelligence in thyroid eye disease imaging: A systematic review.
Zhang H, Li Z, Chan HC … +3 more , Song X, Zhou H, Fan X
Surv Ophthalmol · 2026 · PMID 40706820 · Publisher ↗
Thyroid eye disease (TED) is a common, complex orbital disorder characterized by soft-tissue changes visible on imaging. Artificial intelligence (AI) offers promises for improving TED diagnosis and treatment; however, no...
Thyroid eye disease (TED) is a common, complex orbital disorder characterized by soft-tissue changes visible on imaging. Artificial intelligence (AI) offers promises for improving TED diagnosis and treatment; however, no systematic review has yet characterized the research landscape, key challenges, and future directions. We followed PRISMA guidelines to search multiple databases until January, 2025, for studies applying AI to computed tomography (CT), magnetic resonance imaging, and nuclear, facial or retinal imaging in TED patients. Using the APPRAISE-AI tool, we assessed study quality and included 41 studies covering various AI applications. Sample sizes ranged from 33 to 2288 participants, predominantly East Asian. CT and facial imaging were the most common modalities, reported in 16 and 13 articles, respectively. Studies addressed clinical tasks-diagnosis, activity assessment, severity classification, and treatment prediction-and technical tasks-classification, segmentation, and image generation-with classification being the most frequent. Researchers primarily employed deep-learning models, such as residual network (ResNet) and Visual Geometry Group (VGG). Overall, the majority of the studies were of moderate quality. Image-based AI shows strong potential to improve diagnostic accuracy and guide personalized treatment strategies in TED. Future research should prioritize robust study designs, the creation of public datasets, multimodal imaging integration, and interdisciplinary collaboration to accelerate clinical translation.
Quantitative ophthalmic posterior segment optical coherence tomography angiography and systemic conditions.
Drakopoulos M, Nadel A, Bains HK … +6 more , Bisen JB, Sikora H, Zhang KX, Marchese A, Fahey J, Mirza RG
Surv Ophthalmol · 2026 · PMID 40701499 · Publisher ↗
Optical coherence tomography angiography (OCTA) noninvasively and quantitatively images the microvasculature of the eye's posterior segment in 3 dimensions. OCTA has known utility in the diagnosis and management of certa...
Optical coherence tomography angiography (OCTA) noninvasively and quantitatively images the microvasculature of the eye's posterior segment in 3 dimensions. OCTA has known utility in the diagnosis and management of certain ocular conditions and is now being used to assess systemic conditions, including respiratory, cardiovascular, renal, obstetric, neurologic, rheumatologic, and genetic conditions, among others. OCTA may improve our understanding of the pathophysiology of systemic conditions and identify biomarkers useful in their diagnosis, prognosis, and management. We detail known associations between quantitative retinal, optic nerve head, and choriocapillaris OCTA findings and clinically relevant features of systemic conditions, including laboratory markers and disease severity and prognosis. We find that the breadth and depth of such correlations solidify OCTA's role in the emerging field of oculomics, which seeks to identify ocular imaging biomarkers for use in the study and management of nonocular conditions.
The use of time-driven activity-based costing in ophthalmology: A scoping review.
Zhang HY, Smith AW, Laferriere HE … +2 more , Finn AP, Berkowitz ST
Surv Ophthalmol · 2026 · PMID 40691905 · Publisher ↗
In healthcare economics, time-driven activity-based costing (TDABC) and activity-based costing (ABC) are increasingly utilized, yet their applications within ophthalmology remain undefined and non-standardized. A literat...
In healthcare economics, time-driven activity-based costing (TDABC) and activity-based costing (ABC) are increasingly utilized, yet their applications within ophthalmology remain undefined and non-standardized. A literature search was performed using the standards of Preferred Reporting Items for Systemic Reviews and Meta-Analyses extension for Scoping Reviews (PRIMSA-ScR). Studies were subjected to 3 rounds of screening, with 3 separate data extractions to summarize study characteristics, TDABC-specific parameters, and secondary or sensitivity analysis. Out of the 27 included articles, 11 utilized ABC, 12 utilized TDABC, and 4 were micro-costing studies with activity-based elements. The 2 most common ophthalmologic processes being studied were surgery only (41 %), and clinical services only (19 %). Process flow was delineated through direct observation and interviews (22 %), a mix of direct observation and electronic health record (EHR) (15 %), EHR only (11 %), direct observation only (11 %), interviews only (3.7 %) and often unspecified (37.2 %). Estimated average capacity cost rates found in TDABC articles for operating room (OR) spaces, non-OR spaces, surgeons, anesthesia, registered nurses, and other staff were reported. We observed an increase in publications utilizing activity-based costing, particularly the use of TDABC over the preceding 2 decades, with heterogenous methodologies. Standardized approaches with more detailed reporting of data sources and additional analyses are needed to increase the accessibility of TDABC in ophthalmology.
Multimodal artificial intelligence in ophthalmology: Applications, challenges, and future directions.
Jin K, Yu T, Grzybowski A
Surv Ophthalmol · 2026 · PMID 40683606 · Publisher ↗
With the rapid development of artificial intelligence (AI) technology, multimodal AI that integrates multiple data modalities has shown tremendous potential in the field of ophthalmology. We systematically evaluate the c...
With the rapid development of artificial intelligence (AI) technology, multimodal AI that integrates multiple data modalities has shown tremendous potential in the field of ophthalmology. We systematically evaluate the current applications, technical characteristics, and clinical value of multimodal AI in ophthalmology. We conducted a systematic review following the PRISMA guidelines. We searched relevant literature published from 2018 to 2025 in PubMed, Web of Science, Scopus, and Google Scholar databases. A total of 10 studies were included in the final analysis. The main applications of multimodal AI in ophthalmology include glaucoma, age-related macular degeneration, corneal diseases, ophthalmic emergency triage, cognitive impairment screening, diabetes complication screening, and chatbot-based ophthalmic consultation. Multimodal systems showed superior performance compared to unimodal systems across various application areas, with an Area Under the Curve improvements of 4-5 % and accuracy improvements of 2-7 %. Multimodal AI demonstrates broad application prospects in ophthalmology, providing more comprehensive and accurate diagnostic information. Future research should focus on clinical validation, novel fusion methods, interpretability, and lightweight models to promote the clinical translation of multimodal AI in ophthalmology.
Chorioretinal folds: A review and update of new and old etiologies.
Cheng JY, Hsu D, Feo A … +3 more , Liu V, Mafi M, Sarraf D
Surv Ophthalmol · 2026 · PMID 40680864 · Publisher ↗
Chorioretinal or choroidal folds are wrinkles or undulations involving contiguous tissues including the anterior choroid, Bruch membrane, the retinal pigment epithelium, and in some cases the overlying neurosensory retin...
Chorioretinal or choroidal folds are wrinkles or undulations involving contiguous tissues including the anterior choroid, Bruch membrane, the retinal pigment epithelium, and in some cases the overlying neurosensory retina. These folds consist of alternating light and dark lines that may radiate from the optic disc or can be isolated to the macula or periphery. Chorioretinal folds can be the result of primary or secondary etiologies. Primary chorioretinal folds are due to hyperopia or idiopathic causes. Secondary folds are the result of secondary processes, such as mass compression, traction, or hypotony. Visual and anatomic outcomes and management strategies depend on the etiology of the folds. Multimodal imaging including color fundus photography, fundus autofluorescence, optical coherence tomography , fluorescein angiogram, and B-scan ultrasonography are integral to the diagnosis of chorioretinal folds and determination of the etiology. We summarize the principal mechanisms leading to chorioretinal folds and will review the diverse spectrum of etiologies, new and old. Choroidal folds-related maculopathy will also be described, a sequela of chorioretinal folds that can lead to vision loss.
Ocular trauma in microgravity: In-flight diagnostics and extraterrestrial strategies for management.
Suh A, Szeto JJ, Ong J … +8 more , Armstrong GW, Robert Gibson C, Mader TH, Lipsky W, Waisberg E, Berdahl J, Hinkle DM, Lee AG
Surv Ophthalmol · 2026 · PMID 40675196 · Publisher ↗
Long-duration spaceflight missions (including the International Space Station [ISS]) are in one of the most remote and harsh environments humans live and work in. Medical emergencies in space are even more complicated in...
Long-duration spaceflight missions (including the International Space Station [ISS]) are in one of the most remote and harsh environments humans live and work in. Medical emergencies in space are even more complicated in an already high-risk environment. Despite training, ISS crewmembers face many challenges in diagnosing and managing disease with limited diagnostic capability and equipment on the ISS, restricted medication availability, delayed access to medical professionals; and the latency of space missions. Ocular trauma (e.g., cabin contact with equipment, chemical exposure, and foreign body entry) has been well-documented in previous ISS missions, highlighting the vulnerability of crewmembers' vision. While no serious vision loss has yet occurred, the risk of ocular injuries during future commercial and lunar missions remains significant. We review the utilization of onboard diagnostic tools and potential management modalities with current ISS resources for mitigating long-term effects of ocular trauma in the unique microgravity environment of spaceflight. We aim to assess the overall medical preparedness for future space exploration to ensure the well-being and ocular health of crewmembers during extended missions to the Moon, Mars, and beyond.
The influence of scleral buckle on choroidal architecture: An unexplored link with the spectrum of acquired overload choroidopathy?
Carlà MM, Couturier A, Mottola F … +5 more , Cusato M, Oreste G, Campaniello G, Mateo C, Rizzo S
Surv Ophthalmol · 2025 · PMID 40645378 · Publisher ↗
Scleral buckling (SB) has been a cornerstone in the surgical management of rhegmatogenous retinal detachment for decades, achieving success rates above 85 %; however, its impact on choroidal architecture and hemodynamics...
Scleral buckling (SB) has been a cornerstone in the surgical management of rhegmatogenous retinal detachment for decades, achieving success rates above 85 %; however, its impact on choroidal architecture and hemodynamics has been less thoroughly explored until recent advancements in ocular imaging techniques. We synthesize current evidence on the effects of SB surgery on choroidal structure and circulation, examining its implications for postoperative complications and exploring a potential link with the newly described spectrum of acquired venous overload choroidopathy (AVOC). Various imaging modalities including indocyanine green angiography, optical coherence tomography (OCT), and OCT angiography have demonstrated that SB induces both transient and sometimes persistent alterations in choroidal thickness, blood flow patterns, and vascular morphology, with encircling buckles showing more pronounced and enduring effects than segmental approaches. Notably, persistent subretinal fluid (PSF), a known complication following SB surgery, appears associated with alterations in choroidal architecture, particularly in eyes with preexisting pachychoroid features, suggesting potential overlap with the AVOC spectrum characterized by impaired venous outflow from the choroid. The mechanical indentation of the sclera by the buckle may compress vortex veins, disrupt the Starling resistor mechanism regulating choroidal fluid dynamics, and contribute to venous congestion, with implications for long-term visual outcomes. While vascular adaptations often mitigate these effects through the development of collateral circulation, in some cases, particularly with encircling bands, persistent choroidal alterations may contribute to complications like PSF. Further research is needed to establish a definitive link between SB-induced choroidal changes and the AVOC spectrum, which could significantly influence patient selection, surgical technique, and postoperative management strategies for RRD.
Trabecular meshwork: A pivotal target for evolving glaucoma treatments.
Wan Y, Guo X, Wang N
Surv Ophthalmol · 2025 · PMID 40639440 · Publisher ↗
The trabecular meshwork (TM) is a key regulator of intraocular pressure (IOP) through its role in facilitating aqueous humor outflow. Pathological alterations in the TM-such as reduced cellularity, impaired extracellular...
The trabecular meshwork (TM) is a key regulator of intraocular pressure (IOP) through its role in facilitating aqueous humor outflow. Pathological alterations in the TM-such as reduced cellularity, impaired extracellular matrix turnover, and increased biomechanical stiffness-raise outflow resistance, leading to elevated IOP and contributing to glaucoma pathogenesis. We summarize the TM's anatomical structure, cellular heterogeneity, and biomechanical properties, emphasizing its central role in maintaining IOP homeostasis. It also outlines TM alterations across different glaucoma subtypes and highlights key molecular mechanisms underlying TM dysfunction, including dysregulation of Rho GTPase signaling, nitric oxide (NO) pathways, TGF-β2-induced fibrosis, lipid signaling, and endoplasmic reticulum stress. Advancements in TM-targeted therapies include pharmacologic interventions (e.g., Rho kinase inhibitors, NO donors), non-invasive approaches (e.g., laser trabeculoplasty, ultrasound, sonic therapies), and minimally invasive glaucoma surgeries. Emerging gene therapies that target TM outflow pathway show promise for long-lasting IOP control. Additionally, cell-based therapies aiming to restore TM cellularity and function represent a novel regenerative strategy. Despite significant progress, challenges remain in optimizing delivery methods, sustaining therapeutic efficacy, and ensuring safety. We highlight the evolving landscape of TM-targeted interventions and underscore the importance of continued innovation in glaucoma management.
Age-related changes in optical coherence tomography glaucoma-related parameters: A systematic review.
Vilares-Morgado R, Verbruggen K, Stalmans I … +1 more , Barbosa-Breda J
Surv Ophthalmol · 2026 · PMID 40615051 · Publisher ↗
The specificity of optical coherence tomography (OCT) to detect glaucoma progression can be compromised by the non-adjustment to the healthy aging of OCT glaucoma-related parameters. We summarize the age-related changes...
The specificity of optical coherence tomography (OCT) to detect glaucoma progression can be compromised by the non-adjustment to the healthy aging of OCT glaucoma-related parameters. We summarize the age-related changes of glaucoma-related parameters on OCT in the healthy population. Fifty-one longitudinal studies met our inclusion criteria. Retinal nerve fiber layer (RNFL) thickness change was -0.47 ± 0.27 μm/year for Spectralis® OCT, -0.44 ± 0.17 μm/year for Cirrus® OCT and -0.25 ± 0.21 μm/year for Optovue® OCT. Ganglion cell-inner plexiform layer change was -0.24 ± 0.08 μm/year on Cirrus® OCT. Ganglion cell complex change was -0.40 ± 0.26 μm/year on Optovue® OCT. Bruch membrane opening-minimum rim width change was -1.61 ± 0.14 μm/year on Spectralis® OCT. Vessel density change was -0.33 ± 0.50 %/year on OCTA, measured with Optovue® OCT. Aging in the healthy population leads to a progressive decrease of glaucoma-related parameters. This needs to be considered when assessing glaucoma patients for possible progression measured through OCT or OCT-angiography.
Corrigendum to "Iris melanoma: Prognostication for metastasis"[Survey Ophthalmol 68 (2023) 957-963].
Melendez-Moreno A, Yeşiltaş YS, Jacquelyn Wrenn NP … +1 more , Singh AD
Surv Ophthalmol · 2025 · PMID 40603131 · Publisher ↗
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Retinopathy of prematurity training and education: A systematic review.
Song A, Lee E, Ostmo SR … +5 more , Jonas KE, Chervinko MA, Coyner AS, Campbell JP, Chan RVP
Surv Ophthalmol · 2026 · PMID 40541843 · Full text
Globally, management of retinopathy of prematurity (ROP) is limited by a shortage of ophthalmologists who are adequately trained in identifying disease due to limited exposure in ophthalmology residencies and fellowships...
Globally, management of retinopathy of prematurity (ROP) is limited by a shortage of ophthalmologists who are adequately trained in identifying disease due to limited exposure in ophthalmology residencies and fellowships. We review the current state of ROP education and training and propose strategies to addressing the ROP workforce shortage. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was performed using PubMed, Embase, and SCOPUS. Terms that were used in the database searches include telemedicine, tele-education, tele-health, retinopathy of prematurity, artificial intelligence, medical education, training. Advancements in tele-education and artificial intelligence have paved the way for increased accessibility to ROP training, particularly in low- and middle-income countries; however, to ensure that these new modalities are effective in clinical practice and training, ophthalmology residency and fellowship programs must implement relevant education and training into their curricula.
Advances in diagnosing and treating giant cell arteritis: New hope for arteritic anterior ischemic optic neuropathy.
von der Emde L, Petzinna SM, Herwig-Carl MC … +9 more , Adamson MS, Bauer CJ, Esser J, Isaak A, Wall K, Terheyden JH, Holz FG, Schäfer VS, Ach T
Surv Ophthalmol · 2026 · PMID 40541842 · Publisher ↗
Giant cell arteritis (GCA) is an autoimmune disease of medium and large sized vessels. It is the most prevalent form of primary vasculitis in the western world. Vascular inflammation in GCA can lead to vascular occlusion...
Giant cell arteritis (GCA) is an autoimmune disease of medium and large sized vessels. It is the most prevalent form of primary vasculitis in the western world. Vascular inflammation in GCA can lead to vascular occlusion. Severe neuro-ophthalmological complications, such as arteritic anterior ischemic optic neuropathy (AAION), may present with sudden partial or complete vision loss or diplopia. Visual impairment is often refractory to corticosteroid therapy, underscoring the critical importance of early diagnosis. Delayed diagnosis and initiation of high-dose corticosteroids can lead to contralateral eye involvement and bilateral irreversible vision loss. Recent advances in expedited diagnostics have significantly improved outcomes in GCA patients, particularly by reducing ischemic neuro-ophthalmological events. Thus, a key factor has been the introduction of Fast-Track Clinics that have successfully decreased the incidence of permanent blindness in GCA patients. In these clinics, imaging modalities such as vascular ultrasound, magnetic resonance imaging, and positron emission tomography-computed tomography play a critical role in both diagnosis and disease monitoring, enabling timely and accurate intervention. On the therapeutic front, cytokine-specific inhibitors have improved GCA management, enhancing remission rates and reducing glucocorticoid use. Tocilizumab, an IL-6 receptor (IL-6R) inhibitor, has become a cornerstone of GCA treatment; however, since some patients do not respond to IL-6R inhibition, ongoing research is exploring alternative disease-modifying therapies. These new approaches aim to reduce glucocorticoid dependency, mitigate side effects, enhance visual outcomes, and improve patient outcomes, highlighting a shift towards more individualized treatment approaches.
Artificial intelligence in the prediction of glaucoma development and progression: A systematic review.
Yang WYL, Wong HJ, Fu CE … +3 more , Rojas-Carabali W, Agrawal R, Ang BCH
Surv Ophthalmol · 2026 · PMID 40541841 · Publisher ↗
Glaucoma remains the leading cause of irreversible blindness worldwide. Artificial intelligence (AI) may help enhance predict glaucoma development and progression. We provide a consolidated review of AI usage in predicti...
Glaucoma remains the leading cause of irreversible blindness worldwide. Artificial intelligence (AI) may help enhance predict glaucoma development and progression. We provide a consolidated review of AI usage in predicting the (a) development of glaucoma in glaucoma suspects and normal patients, (b) progression of existing glaucoma, and (c) progression towards the occurrence of surgery. We searched PubMed, EMBASE, Scopus, ScienceDirect, and CENTRAL for observational studies and clinical trials comparing different AI models or AI models versus physician performance published in English from Aug 17, 2013, to Dec 5, 2024. We excluded studies describing AI models that required physician assistance or were designed to diagnose glaucoma. A total of 44 studies (7 studies for the development of glaucoma in glaucoma suspects and normal patients, 30 studies for progression of existing glaucoma, and 7 studies for progression towards the occurrence of surgery) were included. AI demonstrates favorable performance in predicting glaucoma development in glaucoma suspects and normal patients, as well as glaucomatous progression in diagnosed patients. There is significant potential for AI to aid the surveillance of glaucoma in those without a prior history. Moreover, its ability to predict future glaucomatous progression in diagnosed patients could improve systems-of-care targeted at halting disease progression.
Brillouin microscopy for focal biomechanical measurements in normal and keratoconic corneas: A narrative review.
Hammoud B, Schumacher JS, Zhang H … +4 more , Dutra BAL, Susanna BN, Scarcelli G, Randleman JB
Surv Ophthalmol · 2026 · PMID 40513991 · Full text
Corneal mechanical weakness is widely recognized as the root cause of keratoconus and a primary driver for undesirable refractive surgery outcomes. Theory, finite element modeling, and initial data predict that focal rat...
Corneal mechanical weakness is widely recognized as the root cause of keratoconus and a primary driver for undesirable refractive surgery outcomes. Theory, finite element modeling, and initial data predict that focal rather than generalized weakening precipitates corneal mechanical decompensation. Direct, 3-dimensionally (3-D) localized in vivo corneal mechanical measurements thus have the potential to revolutionize keratoconus management and the surgical correction of myopia. Collagen microarchitecture and mechanical profiles in normal and keratoconic corneas have been evaluated ex vivo, but significant gaps remain in our understanding of the earliest subclinical manifestations that can eventually lead to clinical disease. Nonperturbative Brillouin microscopy has emerged as a novel approach for measuring corneal mechanics by analyzing Brillouin light scattering, which encodes the corneal elastic modulus (longitudinal modulus). Early ex vivo works demonstrated the technique's ability to identify depth-dependent (axial) anisotropy in the normal cornea, focal weakening in the keratoconic cornea, and stiffening after corneal cross-linking. Recent advances using motion-tracking Brillouin imaging, which employs optical coherence tomography and eye tracking to facilitate 3-D signal localization, have provided novel insights into keratoconus at the subclinical stage. Locally reduced Brillouin shift values in the anterior cornea have differentiated subclinical keratoconic cornea from normal controls and outperformed current clinical standard morphologic evaluation using Scheimpflug technology. Herein, we highlight the development of Brillouin microscopy for in vivo corneal analysis, current imaging advances and technological limitations, and future directions for in vivo analysis of subclinical keratoconus to advance our understanding of keratoconus diagnosis, disease evolution, and management.
Inherited retinal disease in global Indigenous populations: A scoping review.
Tovey Crutchfield EC, Vincent AL, Anjou MD … +6 more , Taylor HR, Tatipata S, Tsosie KS, Carvalho LS, Ayton LN, Britten-Jones AC
Surv Ophthalmol · 2026 · PMID 40513990 · Publisher ↗
Accurate diagnosis is essential for accessing emerging gene-targeted treatments for inherited retinal diseases (IRDs), but many minoritised communities face additional barriers to diagnosis. This scoping review synthesis...
Accurate diagnosis is essential for accessing emerging gene-targeted treatments for inherited retinal diseases (IRDs), but many minoritised communities face additional barriers to diagnosis. This scoping review synthesised clinical studies on the prevalence and diagnosis of IRDs among Indigenous Peoples worldwide. Medline, Embase, Global Health, Informit and CINAHL were searched on December 4, 2023. We included articles reporting Indigenous Peoples with IRDs from all global regions published between 1974 and 2023; 73 studies (581 cases) of IRDs in Indigenous Peoples from 24 countries were included, mostly reporting participants indigenous to the Middle East (34 %), Oceania (27 %) and North America (23 %). Studies of specific IRD cases showed geographical or cultural group associations, such as rod-cone dystrophy among the Diné (Navajo Nation) or Bardet-Biedl syndrome in Bedouin populations of the Middle East. With dedicated programs, population-specific IRD gene variants in the Middle Eastern Bedouin populations, New Zealand Māori and other Pacific peoples are the most well-characterised, and this has enabled improved diagnostic approaches. There is limited knowledge of the relative prevalence and support needs for IRDs among most other global Indigenous groups. Engagement, co-designed approaches and collective efforts, including raising awareness, may address challenges limiting equitable access to IRD diagnosis for Indigenous Peoples, facilitating access to emerging treatments.
Impact of neighborhood-level deprivation on glaucoma prevalence and treatment: A review of the literature.
Woo J, Chopra S, Liu K … +2 more , Tuttle B, Muir KW
Surv Ophthalmol · 2026 · PMID 40505698 · Publisher ↗
We summarize the existing literature describing the associations between neighborhood-level socioeconomic indices and various glaucoma-related health outcomes. Glaucoma remains one of the leading causes of blindness worl...
We summarize the existing literature describing the associations between neighborhood-level socioeconomic indices and various glaucoma-related health outcomes. Glaucoma remains one of the leading causes of blindness worldwide, and while risk factors have been identified, there remains an incomplete understanding of the relationship between glaucoma and social determinants of health, especially at the neighborhood-level. This is particularly clinically relevant for the treatment of glaucoma due to the importance of early detection, access to specialty care, and long-term medication adherence in slowing disease progression. A review of the literature was completed in MEDLINE (Ovid) and Scopus (Elsevier) from inception to December 4, 2023, of publications describing an association between a neighborhood-level index and a glaucoma-related outcome, yielding 15 studies. A manual networking search was performed on March 1, 2024, and an additional search update was completed on September 19, 2024, resulting in the inclusion of 7 additional studies. After a comprehensive search and full-text review, 22 papers were included in our final analysis. Across all studies encompassing over 60 million total records, the mean patient age was 66.5 years, with 47.4 % being male. The most utilized neighborhood indices were the Social Vulnerability Index (SVI) and Index of Multiple Deprivation (IMD), and nearly all studies were based in either the United States or Europe. The majority of studies found an association between socioeconomic deprivation and 1) higher prevalence of glaucoma, 2) greater visual field loss at initial presentation, or 3) reduced access or delays associated with glaucoma treatment. Of these relationships, the strongest evidence was found linking neighborhood-level deprivation to increased glaucoma prevalence. Our review provides useful insight about the role of neighborhood-level socioeconomic factors and glaucoma, particularly by identifying important relationships that may otherwise remain unnoticed with aggregate, country-level data. The disparities involving glaucoma prevalence, presentation and treatment, especially in underresourced communities, indicate a vital need for earlier, more accessible intervention and greater investment into preventive care. Future studies might look to analyze prospectively patient outcomes and isolate the biggest drivers of disparities in health outcomes at the neighborhood-level, with significant clinical implications.
Efficacy and complications of microcatheter-assisted minimally invasive glaucoma surgery for open-angle glaucoma: A systematic review and network meta-analysis.
Han L, Mao Y, Sang Q … +2 more , Wan Y, Wang N
Surv Ophthalmol · 2025 · PMID 40484184 · Publisher ↗
Microcatheter-assisted minimally invasive glaucoma surgery (MIGS) procedures are increasingly being used as an alternative to trabeculectomy combined with mitomycin C (MMC Trab) for controlling intraocular pressure (IOP)...
Microcatheter-assisted minimally invasive glaucoma surgery (MIGS) procedures are increasingly being used as an alternative to trabeculectomy combined with mitomycin C (MMC Trab) for controlling intraocular pressure (IOP) in open-angle glaucoma (OAG), but there are no head-to-head trials comparing different microcatheter-assisted MIGS procedures and MMC Trab. We evaluate the relative efficacy and safety of microcatheter-assisted MIGS procedures, including microcatheter-assisted trabeculotomy (MAT), gonioscopy-assisted transluminal trabeculotomy (GATT), Ab-interno Canaloplasty(ABiC), ab externo canaloplasty(ABeC), and trabeculotome tunnelling trabeculoplasty surgery (3 T), through a network meta-analysis with a focus on their priority ranking in IOP reduction and medication use. MMC Trab was included as the reference standard to contextualize the performance of emerging microcatheter-assisted techniques. We conducted searches for studies published between 01/01/2009 and 16/10/2024, with no restrictions regarding participant age or language of publication. We followed a protocol registered on PROSPERO (CRD42024557637). PRISMA guidelines were followed for reporting. For observational studies and randomized clinical trials, use the Newcastle-Ottawa Quality Assessment Scale and Cochrane Risk of Bias tool for Randomized Trials (RoB 2) respectively for evaluation. Data extraction was conducted by 2 independent reviewers, and then checked and adjudicated by a third reviewer. The mean differences for continuous variables, risk ratios for binary variables, 95 % credible intervals, and ranks of interventions were estimated. The outcomes examined included the reduction (%) in IOP and the reduction in medication used from baseline at 3 months and 1 year. We also extracted adverse events reported, such as hyphema, IOP spike and hypotony. Sixteen studies (a total of 1081 eyes) were included in the NMA. For efficacy at 1 year, MAT showed no significant difference compared to MMC Trab in both percent reduction in IOP (MD -4.78 % (95 %CI -3.01-3.45 %), SUCRA 65.7) and reduction in medication used (MD 0.18 (95 %CI -0.19-0.54 %), SUCRA 97.4), GATT (MD -7.20 % (95 %CI -13.73 % to -0.67 %), SUCRA 53.1 %) showed no significant difference from MMC Trab in terms of reduction in medication use. For complications within 3 months postoperatively, all microcatheter-assisted MIGS procedures showed no significant difference versus MMC Trab in terms of postoperative IOP spike. GATT (RR 0.06 (95 %CI, 0.01-0.35), SUCRA 87 %) and ABeC (RR 0.3 (95 %CI, 0.1-2.92), SUCRA 44.3 %) were associated with a lower risk of hypotony compared to MMC Trab. All microcatheter-assisted MIGS procedures were associated with a higher risk of hyphema. Compared to MMC Trab, MAT showed no significant difference in efficacy at 1 year postoperatively, and certain microcatheter-assisted MIGS procedures have specific advantages over MMC Trab in terms of postoperative complications.
Pathophysiology of intraoperative floppy iris syndrome: An unsettled debate.
Shen Y, Frauches R, Zhao J … +6 more , Lo CH, Ning K, Chen S, Liu Z, Zhang F, Sun Y
Surv Ophthalmol · 2026 · PMID 40472999 · Full text
Intraoperative floppy iris syndrome (IFIS)--characterized by iris blowing, prolapse, and progressive miosis during phacoemulsification surgery--poses significant challenges for eye surgeons. Despite being described almos...
Intraoperative floppy iris syndrome (IFIS)--characterized by iris blowing, prolapse, and progressive miosis during phacoemulsification surgery--poses significant challenges for eye surgeons. Despite being described almost 2 decades ago, its pathophysiology remains unclear. Initially, IFIS was thought to be a result of sympathetic signal blockage in the iris dilator muscle, since α-blockers such as tamsulosin were found to be a strong predisposing factor; however, many IFIS cases occur even in patients who discontinued α-blockers prior to cataract surgery. Several potential mechanisms through which α-blockers induces chronic changes in the iris - iris dilator atrophy, drug-melanin interaction, and loss of vascular tone - have been proposed as possible mechanisms. We address the prevailing theories on α-receptor-dependent mechanisms for IFIS and the current prophylactic measures undertaken to prevent IFIS-associated intraocular complications.
Optic disc drusen-associated neovascularization: A systematic review.
Alkhabaz A, Pujari R, Ren Y … +2 more , Smith SJ, Liao YJ
Surv Ophthalmol · 2025 · PMID 40441443 · Publisher ↗
We have integrated current evidence of visual outcomes in optic disc drusen-associated choroidal neovascularization (ODD-CNV). We systematically reviewed all published ODD-CNV cases from 1974 to 2024 using three database...
We have integrated current evidence of visual outcomes in optic disc drusen-associated choroidal neovascularization (ODD-CNV). We systematically reviewed all published ODD-CNV cases from 1974 to 2024 using three databases (PubMed, EMBASE, and Web of Science). Only studies reporting baseline visual acuity, follow-up visual acuity, and an intervention were included. Methodological quality was assessed using a standardized tool for case reports. Seventy-four eyes (65 patients) were identified from 48 eligible articles. The median age of the subjects was 13 years (range: 3-75), and 63.5 % were females. CNVs were mainly peripapillary, with 45.7 % of them progressing into the macula. On average, the eyes had a follow-up period of 21.5 months. Overall, treatment (of any type) showed better outcomes (0.53 LogMAR improvement, > 3 lines on Snellen chart) compared to observation only (0.09 LogMAR improvement). Anti-vascular endotheial growth factor (VEGF) injections and laser photocoagulation, the most frequently used interventions, showed 0.62 and 0.19 LogMAR improvement, respectively; however, the difference was not statistically significant (p = 0.05398). Among 24 pediatric eyes, anti-VEGF showed 0.71 LogMAR improvement with minimal side effects and recurrence in one eye only. When stratified by age, pediatric patients experienced a greater LogMAR improvement compared to adults, even when adjusting for anti-VEGF treatment (p = 0.0279). Our findings highlight the importance of intervention in ODD-CNV patients, particularly in the younger population, as they are more responsive to treatment. Anti-VEGF demonstrates great efficacy and safety profile in the pediatric population.
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