Hao Q, Qin Y, Yan L
… +3 more, Wang Y, Li J, Fan F
BMC Ophthalmol
· 2026 Jul · PMID 42401889
·
Full text
OBJECTIVE: To evaluate the initial and longitudinal alterations of peripapillary optic disc vessel index in eyes with a history of acute primary angle closure (APAC) and to explore the better predictor of glaucoma progre...OBJECTIVE: To evaluate the initial and longitudinal alterations of peripapillary optic disc vessel index in eyes with a history of acute primary angle closure (APAC) and to explore the better predictor of glaucoma progression. METHODS: Twenty-one consecutive Chinese patients who were successfully treated for a unilateral episode of APAC were included in the study. The observation group consisted of eyes with the history of acute episode, while the contralateral eyes without an attack served as the control group. All APAC eyes underwent phacoemulsification cataract extraction, intraocular lens implantation and goniosynechialysis one day after the remission of episode. Moreover, the contralateral eyes were performed laser peripheral iridotomy (LPI). Patients were followed-up at 1 day after remission of APAC and 1 week, 1 month, 3 months, 6 months, and 1 year after surgery. All participants underwent ophthalmic examinations after remission of the acute episode but before surgery, including best-corrected visual acuity (BCVA), intraocular pressure (IOP), axial length (AL), visual field (VF), and retinal nerve fiber layer (RNFL) thickness and circumpapillary vessel density (cpVD) obtained by swept-source optical coherence tomography(SS-OCT). Correlation analysis was performed to identify the cpVD as a predictor of glaucoma progression. RESULTS: The vascular network was visibly attenuated and focal capillary dropout was evident in APAC eyes. The cpVD 1 day after APAC episode and 1 week postsurgery in APAC eyes was 45.96% (45.96 ± 3.41), and 46.19% (46.19 ± 3.15) which were significantly (P=0.020 and P༝0.035) reduced compared to 48.35% in the unaffected eyes. However, it remained stable during the follow-up in the subsequent year. The retinal nerve fiber layer (RNFL) thickness initially showed thickening at 1 day (P༝0.05), and followed by a progressive thinning from 1 week (P༝0.04) to 6 months (P༝0.02), and eventually reached a stable state. At the last follow-up in APAC eyes, peripapillary retinal VD was positively correlated with RNFL thickness (P༝0.01) and negatively correlated with VF mean deviation (P༝0.04). CONCLUSION: In APAC eyes, the circumpapillary VD decreased significantly 1 day after the APAC episode was fully resolved, and remained stable during the follow-up. However, the RNFL thickness ultimately plateaued at a stable level at 6 months. Thus, cpVD may be the more sensitive predictor than the RNFL thickness for the glaucomatous progression of APAC patients. CLINICAL TRIAL REGISTRATION NUMBER IF REQUIRED: Not applicable.
BMC Ophthalmol
· 2026 Jul · PMID 42401859
·
Full text
BACKGROUND: Diabetic macular edema (DME) is a leading cause of visual impairment and blindness among the diabetic population, and leads to abnormal retinal morphology, distorted layer boundaries and blurred structures in...BACKGROUND: Diabetic macular edema (DME) is a leading cause of visual impairment and blindness among the diabetic population, and leads to abnormal retinal morphology, distorted layer boundaries and blurred structures in optical coherence tomography (OCT) images. Accurate segmentation of retinal layers and pathological fluid regions is critical for clinical diagnosis, but remains challenging due to irregular fluid distribution and low boundary contrast. This study aims to develop an effective segmentation method to jointly extract retinal layers and fluid regions for assisting clinical screening. METHODS: A novel dual-decoder multi-task network with graph attention mechanism was proposed for joint segmentation. A primary decoder completed region segmentation, while an auxiliary decoder focused on boundary detection. A cross-decoder spatial attention module was designed for bidirectional feature interaction, and a global reasoning module was embedded to capture long-range anatomical dependencies. Experiments were conducted on the public Duke DME dataset with five-fold subject-independent cross-validation, and paired t-tests were adopted for statistical significance analysis. RESULTS: The proposed method outperformed comparative mainstream segmentation models in overall and category-wise evaluation. It achieved stable accuracy in normal retinal layer segmentation and obtained competitive performance in identifying fluid regions, effectively reducing the interference of pathological changes and improving boundary consistency of segmentation results. CONCLUSIONS: The proposed method enables accurate joint segmentation of retinal layers and fluid regions. It provides a reliable automated analysis tool for diabetic macular edema, and can serve as an effective auxiliary reference for routine clinical screening and quantitative evaluation.
Deng G, Yuan M, Wang T
… +5 more, Ma J, Li L, Liu J, Li S, Lu H
BMC Ophthalmol
· 2026 Jul · PMID 42401843
·
Full text
PURPOSE: To identify clinical determinants of axial length (AL) before and after early surgery in infantile persistent fetal vasculature (PFV). METHODS: Single-center retrospective cohort of 58 unilateral PFV eyes (2019-...PURPOSE: To identify clinical determinants of axial length (AL) before and after early surgery in infantile persistent fetal vasculature (PFV). METHODS: Single-center retrospective cohort of 58 unilateral PFV eyes (2019-2022). All infants underwent lensectomy, posterior capsulectomy, vitrectomy, and targeted cauterization under general anesthesia before 12 months. Baseline AL, phenotype, and structural findings (enlarged ciliary processes, retrolental membrane, posterior capsular defect, corneal opacity, posterior synechiae, retinal detachment, Morning Glory disc anomaly) were recorded. Mean follow-up was 21.9 ± 11.4 months (12-48). PRIMARY ENDPOINT: poor growth, defined a priori as an absolute postoperative inter-eye AL difference ≥ 2.0 mm at last visit. SECONDARY OUTCOMES: preoperative inter-eye asymmetry and postoperative AL change (ΔAL). Multivariable models evaluated predictors. RESULTS: All surgeries occurred < 12 months. Preoperatively, anterior PFV, corneal opacity, posterior synechiae, retinal detachment, and Morning Glory anomaly were associated with shorter AL versus the fellow eye (all P < 0.05), whereas posterior capsular defect correlated with longer AL (P < 0.05). Postoperatively, greater ΔAL occurred when enlarged ciliary processes, retrolental membrane, and posterior capsular defect were absent (all P < 0.05). Poor growth occurred in 12.1%; presentation ≤ 6 months independently predicted poor growth (OR 11.62; 95% CI 1.20-112.46; P = 0.034). CONCLUSIONS: In infantile PFV, age at onset, phenotype, and specific structural abnormalities determine AL trajectories. Early standardized surgery may favorably modify growth, whereas complicated cataract in early infancy signals risk for subnormal postoperative elongation and warrants closer surveillance.
BMC Ophthalmol
· 2026 Jul · PMID 42399857
·
Full text
BACKGROUND: We report a case of severe macular displacement occurring after multiple vitrectomy surgeries for recurrent rhegmatogenous retinal detachment (RRD) associated with severe proliferative vitreoretinopathy (PVR)...BACKGROUND: We report a case of severe macular displacement occurring after multiple vitrectomy surgeries for recurrent rhegmatogenous retinal detachment (RRD) associated with severe proliferative vitreoretinopathy (PVR). CASE PRESENTATION: A 32-year-old African male underwent multiple vitrectomy surgeries for RRD with PVR. Sequential fundus photographs and Optical Coherence Tomography (OCT) documented the significant foveal displacement and macular dragging. After multiple vitrectomies the retina was successfully reattached, but a severe inferior displacement of the macula with foveal ectopia occurred, caused by the development of proliferative membranes along the chorioretinectomy edge. CONCLUSIONS: This report highlights a case of severe macular displacement and foveal ectopia, a rare and devastating complication of PVR that prevents favourable visual outcomes in these complex RRD scenarios. Our case contributes to the limited literature on PVR outcomes in Black Africans, suggesting a potential role of ethnic variations in the fibrotic healing responses that warrants further investigation.
BMC Ophthalmol
· 2026 Jul · PMID 42399825
·
Full text
BACKGROUND: Flanged scleral fixation techniques are increasingly used in the management of intraocular lens dislocation and aphakia. However, complications such as conjunctival erosion and scleral migration remain a conc...BACKGROUND: Flanged scleral fixation techniques are increasingly used in the management of intraocular lens dislocation and aphakia. However, complications such as conjunctival erosion and scleral migration remain a concern. Flange geometry may play a critical role in anchoring stability. This study investigates the thermoplastic properties of various suture materials to identify optimal conditions for flange formation. METHODS: A disposable electrocautery device with a power supply and tip temperature of 392 °C was used for standardised application. Seven suture materials were used: polypropylene (6/0), polyamide 6 (6/0), polyamide 6.6 (6/0), vinylidene fluoride-co-hexafluoropropylene (PVDF) (6/0), polyester (5/0), and polytetrafluoroethylene (PTFE) (5/0 and 6/0). All sutures were heated 0.5, 1, 2, 3, 4, and 5 mm from the distal end and examined in 4 repeat measurements. The prepared flanges were photographed and measured using a digital microscope. The flange dimensions and geometry were assessed. Ratios of flange width to flange length and flange width to suture diameter were calculated. RESULTS: All suture materials except polyamide 6.6 (6/0) and PTFE (5/0) formed a flange shape due to the increase in temperature as demonstrated by repeated measurements with a high degree of reproducibility. While polypropylene and PVDF took on a mushroom/rhomboid shape, the flange shape of polyamide 6 and polyester was spherical. The flange geometry of PTFE was funnel-shaped with sharp edges. With increasing duration of heat exposure, the flange length of polypropylene and PVDF increased more significantly than the flange width. CONCLUSION: Polypropylene and PVDF demonstrate favorable thermoplastic properties for flanged scleral fixation, enabling reproducible flange formation with short heating times. A heating length of approximately 1 mm appears optimal for controlled flange geometry. Further biomechanical and in vivo studies are required to validate clinical performance.
BMC Ophthalmol
· 2026 Jul · PMID 42399812
·
Full text
BACKGROUND: Central Serous Chorioretinopathy(CSC) is a chorioretinal disorder, predominantly affects young to middle-aged adults, resulting serious vision disorder. This study aimed to develop a Bayesian network model to...BACKGROUND: Central Serous Chorioretinopathy(CSC) is a chorioretinal disorder, predominantly affects young to middle-aged adults, resulting serious vision disorder. This study aimed to develop a Bayesian network model to predict the key factors influencing the early therapeutic efficacy of 577 nm-SML in patients with CSC. METHODS: A total of 159 patients (159 eyes) diagnosed with CSC and treated with 577 nm-SML at the First Affiliated Hospital of Guangxi Medical University from January 2019 to November 2023 were retrospectively analyzed. Baseline data including age, sex, eye side, disease course, and past medical history were collected. Ophthalmic imaging detects central macular thickness (CMT), macular foveal volume (MFV within 1mm, 3mm, 6mm diameter), height and area of subretinal fluid (SRF), structural changes in the outer retinal layers (ORL), type and area of leakage lesions, etc. Influential variables significantly associated with 577nm-SML efficacy were screened using LASSO regression, then construct a Bayesian network model to predict factors that significantly affect the therapeutic effect. RESULTS: LASSO regression identified 19 significant variables related to treatment outcomes from the 40 possible risk factors included, including disease duration, sex, eye Side, smoking, hormone, macular foveal volumes (3 mm and 6 mm diameters), and the height and area of SRF, ORL integrity, typical PED, location of PED, location of RPE bulging, heterogeneity of NPL, HF of ORL, HF of choroid, leakage type, leakage location, leakage correlate with OCT. The Bayesian network presents complex interactions among these factors, shows that patients with smaller macular foveal volumes (within 3 mm diameter), shorter disease duration, and focal leakage exhibited superior responses to 577nm-SML treatment. CONCLUSION: The therapeutic response to 577nm-SML in CSC is influenced by multifactorial dynamics. Bayesian network can well present the complex network relationship between the therapeutic effect of 577nm-SML and related influencing factors, and identify potential risk factors that affect early efficacy.
Cao S, Wu T, Pan C
… +3 more, Wei S, Zhou H, Liu Y
BMC Ophthalmol
· 2026 Jul · PMID 42399801
·
Full text
BACKGROUND: Myelin oligodendrocyte glycoprotein antibody-associated optic neuritis (MOG-ON) is a subtype of demyelinating optic neuritis (ON) characterized by a considerable risk of relapse; however, the demographic and...BACKGROUND: Myelin oligodendrocyte glycoprotein antibody-associated optic neuritis (MOG-ON) is a subtype of demyelinating optic neuritis (ON) characterized by a considerable risk of relapse; however, the demographic and clinical factors associated with recurrence remain poorly defined, posing ongoing challenges for patient management. METHODS: A retrospective analysis was conducted on adult-onset MOG-ON patients diagnosed in the Ophthalmology Department of the Chinese People's Liberation Army General Hospital (PLAGH) from January 2019 to January 2024. Patients were divided into two groups based on their experience of a relapse course: the relapsing group and the monophasic group. Multivariate analysis was performed to examine the effects of various clinical factors on the risk of recurrence. RESULTS: Among 126 screened participants, 56 were excluded. A total of 70 patients (median [IQR] age at onset, 35.50 [30.00, 48.75] years; 46 females [65.71%]) were included. During a median follow-up of 31.50 (IQR 21.25-52.75) months, disease relapse occurred in 54.29% (38/70) of patients. Multivariate analysis revealed that being female significantly elevated recurrence risk (hazard ratio [HR] 3.92, 95% CI 1.63-9.42, p = 0.002), while administration of immunosuppressive maintenance therapy after the first episode was associated with a lower likelihood of recurrence (HR 0.30, 95% CI 0.10-0.87, p = 0.026). At the final follow-up, the relapsing group had significantly worse visual outcomes compared with the monophasic group (median [IQR] VA, 0.40 [0.16-0.82] logMAR vs. 0.22 [0.10-0.40] logMAR; p = 0.012). CONCLUSION: In adult-onset MOG-ON, female sex is associated with an increased risk of recurrence, whereas early maintenance immunosuppressive therapy is associated with a lower recurrence risk. Furthermore, patients with a relapsing disease course exhibit poorer visual outcomes at follow-up compared with those with a monophasic course.
Pan X, Zhang Y, Zhang Q
… +14 more, Feng H, Xiang F, Li C, Zhang M, Ji Q, Li Z, Jiang N, Yang Y, Hu Z, Cao K, Ruan MZC, Fan N, Han Y, Li S
BMC Ophthalmol
· 2026 Jul · PMID 42399728
·
Full text
BACKGROUND: Primary angle-closure glaucoma (PACG) is a leading cause of irreversible blindness in Asian populations. However, the topographic distribution of angle narrowing across different quadrants remains incompletel...BACKGROUND: Primary angle-closure glaucoma (PACG) is a leading cause of irreversible blindness in Asian populations. However, the topographic distribution of angle narrowing across different quadrants remains incompletely characterized in primary angle-closure suspects (PACS), and routine clinical assessments often rely solely on horizontal scans. The study aims to identify the narrowest anterior chamber angle quadrant in PACS using Anterior Segment Optical Coherence Tomography (AS-OCT). METHODS: In this community-based cross-sectional study, 218 right eyes of 218 PACS subjects were recruited. All participants underwent standardized questionnaire surveys and ophthalmic examinations. AS-OCT parameters including angle opening distance (AOD), trabecular iris space area (TISA) and trabecular iris angle (TIA) were measured at 500 μm from the sclera spur (SS) in the superior, inferior, nasal and temporal quadrants. As iridotrabecular contact (ITC) in more than one quadrant precluded identification of the narrowest quadrant, only narrow-angle eyes (ITC in < 2 quadrants) were included in the analysis. Quadrant-wise comparisons and multivariate linear regression analyses were performed. RESULTS: Significant differences in angle width were observed across all four quadrants (P<0.001 for AOD500, TISA500, and TIA500). The superior quadrant exhibited the narrowest angle, followed by the inferior, nasal, and temporal quadrants in narrow-angle eyes. Multivariate linear regression analysis revealed that superior anterior chamber volume (ACV- superior)was positively associated (P<0.001), while superior iris thickness at 750 μm (IT750-superior) was negatively associated (P = 0.049) to superior AOD500. CONCLUSION: The superior quadrant is consistently the narrowest in PACS eyes, highlighting the necessity of including vertical cross-sectional scans in routine AS-OCT examination protocols for this population. TRIAL REGISTRATION: The study was registered in the Chinese Clinical Trial Registry on September 4th, 2020 (Registration Number: ChiCTR2000037944).
OBJECTIVE: Post hoc analysis of the PULSAR Phase 3 trial (NCT04423718) to describe whether dosing interval outcomes were associated with key baseline disease characteristics. DESIGN: Exploratory post hoc analysis of PULS...OBJECTIVE: Post hoc analysis of the PULSAR Phase 3 trial (NCT04423718) to describe whether dosing interval outcomes were associated with key baseline disease characteristics. DESIGN: Exploratory post hoc analysis of PULSAR, a 96-week, double-masked, active-controlled, randomized clinical trial in patients with treatment-naïve neovascular age-related macular degeneration (nAMD) treated with aflibercept 8 mg or aflibercept 2 mg. For the main analysis, patients receiving aflibercept 8 mg were grouped according to their last assigned dosing interval at Weeks 48 and 96. PARTICIPANTS: Patients with treatment-naïve nAMD who were randomly assigned to receive aflibercept 8 mg in PULSAR. INTERVENTION: Aflibercept 8 mg was administered every 12 weeks (8q12) or 16 weeks (8q16) following 3 initial monthly injections. Dosing intervals could be shortened in Year 1 based on prespecified disease activity criteria, whereas in Year 2, both interval shortening and extension were allowed. Patients were monitored every 4 weeks but assessed for interval modification at dosing visits only. MAIN OUTCOME MEASURES: Baseline best-corrected visual acuity (BCVA), central retinal thickness (CRT), and macular neovascularization (MNV) area were assessed in patients grouped by their last assigned dosing interval (Q8, Q12, Q16, Q20, or Q24) at Weeks 48 and 96. RESULTS: In 86.6% and 78.4% of patients assigned to the 8q12 and 8q16 arms in PULSAR, respectively, randomized dosing intervals were maintained or extended through Week 96. In the 8q12 arm, no trends were observed in baseline BCVA, CRT, and MNV area across groups based on patients' last assigned dosing intervals. In the 8q16 arm, no trends were observed in baseline BCVA across treatment arms; however, patients with shorter last assigned dosing intervals (Q8 and Q12) at Weeks 48 and 96 tended to have a greater baseline CRT or MNV area compared with patients with longer dosing intervals (Q16 to Q24). CONCLUSIONS: Overall, findings from this PULSAR post hoc analysis of key baseline characteristics in patients grouped by dosing interval suggest that the aflibercept 8q12 and 8q16 regimens were suitable for most patients across a broad range of baseline BCVA, CRT, and MNV area values, with a large proportion of patients able to achieve and maintain extended dosing intervals through Week 96.
PURPOSE: To determine whether tractional inner retinal changes, including schisis of the retinal nerve fiber layer (sRNFL) and inner limiting membrane (ILM) tears, represent a surgically irreversible stage of the epireti...PURPOSE: To determine whether tractional inner retinal changes, including schisis of the retinal nerve fiber layer (sRNFL) and inner limiting membrane (ILM) tears, represent a surgically irreversible stage of the epiretinal membrane (ERM). DESIGN: Retrospective study. PARTICIPANTS: Patients who underwent vitrectomy with ERM and ILM peeling. METHODS: Visual acuity and metamorphopsia were assessed at baseline and at 1, 3, 6, and 12 months postoperatively, whereas retinal sensitivity was evaluated at baseline and 3, 12 months postoperatively. Metamorphopsia was quantified using M-CHARTS, and retinal sensitivity was measured within the central 10° of the macula using microperimetry. Visual outcomes were compared between eyes with and without sRNFL and ILM tears. MAIN OUTCOME MEASURES: Visual acuity, metamorphopsia, and retinal sensitivity at 12 months and their changes from baseline. RESULTS: Among 129 eyes (129 patients), sRNFL was observed in 62 eyes (48%) and ILM tears in 49 eyes (38%), both of which co-occurred with sRNFL. Eyes with sRNFL or ILM tears had worse baseline visual function across all three parameters, greater central foveal thickness, and a more advanced ERM stage (all p < 0.01). However, visual function in eyes with sRNFL or ILM tears significantly improved (p < 0.001), resulting in comparable postoperative outcomes regardless of their presence. Multivariate analyses showed that baseline visual function independently predicted postoperative visual acuity (β = 0.292, p = 1.5×10), metamorphopsia (β = 0.251, p = 0.017), and retinal sensitivity (β = 0.422, p = 4.9×10), excluding sRNFL or ILM tears. In functional changes, sRNFL remained independently associated with greater improvements in visual acuity (β = -0.144, p = 5.9 × 10), and retinal sensitivity (β = 1.140, p = 0.028), whereas ILM tears were associated only with visual acuity improvement (β = -0.167, p = 1.0×10) after adjusting for age, sex, and phacovitrectomy. CONCLUSIONS: SRNFL and ILM tears represent extrafoveal tractional markers in ERM and do not necessarily indicate irreversible visual dysfunction. Recovery patterns may differ across visual function domains with increasing inner retinal tractional changes, while visual acuity may remain recoverable even in eyes with advanced traction. These findings may help inform prognostic counseling before surgery.
PURPOSE: To identify retinal diseases that mimic macular telangiectasia type 2 (MacTel), categorize these masquerading entities based on multimodal imaging characteristics, and evaluate the diagnostic performance of indi...PURPOSE: To identify retinal diseases that mimic macular telangiectasia type 2 (MacTel), categorize these masquerading entities based on multimodal imaging characteristics, and evaluate the diagnostic performance of individual imaging modalities for differentiation from true MacTel. DESIGN: Retrospective, cross-sectional observational study analyzing data from the MacTel Natural History Observation Registry. SUBJECTS: Eyes of patients submitted to the registry with a potential diagnosis of MacTel, which was not confirmed by the central reading center were included if spectral-domain optical coherence tomography (OCT) and fundus autofluorescence (FAF) were available. METHODS: Two independent retina specialists assigned the most likely diagnosis for each eye based on full multimodal imaging, with adjudication by senior graders when required. Diagnoses were grouped into clusters of similar etiology or imaging phenotype. Discrimination between MacTel and masquerading diseases was tested by calculating the sensitivity of detecting masquerading diseases for each imaging modality. MAIN OUTCOME MEASURES: Frequency of different clusters of masquerading diseases and sensitivity for their detection based on different imaging modalities. RESULTS: Of 172 eyes reviewed, 108 eyes with confirmed pathological findings were included in the final analysis; 6 eyes were reclassified as true MacTel and 58 eyes showed no pathological changes and were therefore excluded. The most frequent MacTel mimickers were vitreomacular interface disorders (29%), large retinal capillary aneurysms (22%), and central serous chorioretinopathy (19%). OCT showed the highest sensitivity in detecting mimicking disease (Sensitivity 90%), followed by FAF (81%), fluorescein angiography (77%) and blue-light reflectance (75%) and was poor for colour fundus photographs (59%). Intergrader agreement was substantial across all imaging modalities (κ = 0.69-0.78). CONCLUSIONS: Several retinal disorders can closely mimic MacTel, most commonly vitreomacular interface abnormalities and large retinal capillary aneurysms. Multimodal imaging-particularly OCT and FAF-enables reliable differentiation in most cases. These findings underscore the importance of comprehensive imaging assessment and provide a practical framework for avoiding MacTel misdiagnosis in clinical practice and clinical trials.
BMC Ophthalmol
· 2026 Jul · PMID 42387427
·
Full text
PURPOSE: This systematic review aimed to characterize pathological retinal changes following ocular alkali burns (OAB), evaluate potential therapeutic interventions to preserve retinal structure and function, and summari...PURPOSE: This systematic review aimed to characterize pathological retinal changes following ocular alkali burns (OAB), evaluate potential therapeutic interventions to preserve retinal structure and function, and summarize reported human cases with retinal involvement. METHODS: A systematic search of PubMed, Embase, SCOPUS, and Web of Science, supplemented by manual reference screening, was independently performed by two reviewers in accordance with PRISMA 2020. Eligible studies, human or animal, investigated retinal damage directly attributable to OAB and/or interventions targeting retinal pathology. Screening and selection were performed, with disagreements resolved by consensus. Quality assessment used SYRCLE's Risk of Bias tool for animal studies and a modified NHLBI tool for case reports. The protocol was registered with PROSPERO (CRD42024598186). RESULTS: A total of 14 studies were included: 12 animal studies and 2 human case reports. Across animal models, seven therapeutic interventions were studied: anti-TNFα, mesenchymal stem cells (MSCs), N-acetylcysteine, tamoxifen, endoplasmic reticulum (ER) stress inhibitors, Solcoseryl gel, and anti-VEGF agents. Infliximab consistently improved retinal ganglion cell (RGC) survival and reduced apoptosis. MSCs, NAC, and TUDCA demonstrated strong anti-inflammatory effects, suppressing cellular infiltration and cytokine expression. ER stress inhibitors and tamoxifen preserved retinal architecture, while Solcoseryl gel offered structural protection but limited anti-inflammatory benefit. Anti-TNFα and anti-VEGF, either alone or in combination, reduced retinal inflammation and RGC loss, whereas anti-VEGF alone showed limited evidence. Among three human case reports, no posterior segment-directed therapies were administered, and visual outcomes ranged from full recovery to persistent vision loss. CONCLUSIONS: Retinal injury is a significant but under-recognized consequence of severe OAB. Preclinical studies demonstrate that treatments which offer neuroprotective and anti-inflammatory properties mitigate retinal damage in OAB models. However, clinical evidence remains limited. These findings underscore the importance of early retinal evaluation in OAB and highlight the need for future clinical studies to validate and implement effective treatment strategies.
Brosh K, Roditi E, Potter MJ
… +11 more, Semionov A, Hanhart J, Allon G, Abergel-Hollander E, Moisseiev E, Ehrlich R, Zlatkin R, Berco E, Shcolnik E, Hostovsky A, Katz G
PURPOSE: To evaluate the prevalence, direction, and characteristics of postoperative retinal displacement after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) repair using infrared image overlay...PURPOSE: To evaluate the prevalence, direction, and characteristics of postoperative retinal displacement after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) repair using infrared image overlay technique in a multicenter cohort. DESIGN: Multicenter retrospective cohort study. SUBJECTS: Patients undergoing PPVs for primary macula-involving rhegmatogenous retinal detachment with available high-quality pre-detachment and postoperative infrared (IR) imaging. METHODS: Pre- and post-RRD repair IR images were overlaid using a validated overlay technique that aligns deep retinal structures to assess displacement of the superficial retinal vessels. Retinal displacement was graded by masked readers based on magnitude (mild, moderate, severe), direction, and displacement vectors. Macular stretch or compression was assessed vertically and horizontally. Associations between clinical, surgical, and imaging variables and displacement outcomes were analyzed. MAIN OUTCOME MEASURES: Prevalence, magnitude, direction, and vector characteristics of retinal displacement following PPV for RRD repair. RESULTS: Seventy eyes of 70 patients met inclusion criteria. Postoperative retinal displacement was detected in 97% of eyes. All eyes with fovea-off RRD demonstrated retinal displacement, whereas 82% of fovea-on cases were displaced. Inferior displacement was the predominant direction (80%), most commonly oriented inferotemporally. Displacement severity was graded as mild, moderate and severe in 34%,42% and 23% of cases, respectively. Silicone oil tamponade was associated with reduced displacement severity and a higher rate of superior displacement compared with gas tamponade (P < 0.01). Intraoperative perfluorocarbon liquid (PFCL) use was significantly associated with horizontal macular stretch (P = 0.04). Extent of retinal detachment was the primary predictor of displacement severity on multivariable analysis. CONCLUSIONS: Retinal displacement occurs in nearly all eyes following PPV for macula-involving RRD repair when assessed using overlay-based infrared imaging, at rates substantially higher than previously reported using fundus autofluorescence. PFCL was associated with temporal macular stretch. Surgical factors, particularly tamponade choices, influence the severity and pattern of displacement.