Ophthalmology [JOURNAL]
Sun
200 papers
Socioeconomic Differences in Glaucoma Medication Spending under Medicare Part D: Evidence on Price vs. Utilization.
Kim T, Vu A, Weng CH
Ophthalmol Glaucoma · 2026 Jun · PMID 42229853 · Publisher ↗
OBJECTIVE: To examine whether socioeconomic differences in Medicare Part D glaucoma medication spending are more strongly associated with price exposure (spending per claim) than with utilization intensity. DESIGN: An ec...
OBJECTIVE: To examine whether socioeconomic differences in Medicare Part D glaucoma medication spending are more strongly associated with price exposure (spending per claim) than with utilization intensity. DESIGN: An ecologic observational study using state-year-level data. PARTICIPANTS: Medicare Part D beneficiaries receiving glaucoma medications across 50 states and the District of Columbia from 2019 through 2023 (255 state-years). METHODS: We analyzed Centers for Medicare & Medicaid Services Medicare Part D Prescribers-by-Geography and Drug public use files. State-level socioeconomic context was measured using Area Deprivation Index (ADI) national rank and median household income (sensitivity analysis). Outcomes included inflation-adjusted spending per beneficiary and per claim, as well as utilization measures (claims and 30-day fills per beneficiary) and brand spending and claims shares. Multivariable linear regression models included year fixed effects and state-clustered standard errors. MAIN OUTCOME MEASURES: Spending per beneficiary and spending per claim. RESULTS: Median spending per beneficiary was $403.81 (interquartile range [IQR], $359.74-$444.73), and median spending per claim was $104.22 (IQR, $89.49-$118.41). Higher median household income was associated with greater spending per beneficiary ($18.18 per $10,000; 95% confidence interval [CI], $1.30-$35.06) and per claim ($6.99; 95% CI, $1.95-$12.03). Higher ADI was associated with lower spending per claim, although estimates were imprecise (-$3.69 per 10-point increase; 95% CI, -$7.51 to $0.13). Utilization intensity varied minimally across socioeconomic strata (claims per beneficiary, 3.8-4.0), and neither ADI nor income was consistently associated with brand spending or claims share. CONCLUSIONS: State-level socioeconomic context was associated with modest differences in glaucoma medication spending per claim, with minimal differences in utilization intensity. These findings suggest that socioeconomic variation in Medicare Part D glaucoma drug spending is more consistent with differences in price exposure than with differences in volume of use. FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any materials discussed in this article.
Primary Open Angle Glaucoma Polygenic Risk Score is Associated with Disease Progression.
Bineshfar N, Aziz K, Zhao H … +10 more , Zhao Y, Singh Parmar UP, Thi Vy HM, Rocheleau G, Do R, Kang JH, Segrè AV, Pasquale LR, Wiggs JL, Zebardast N
Ophthalmol Glaucoma · 2026 Jun · PMID 42229852 · Publisher ↗
PURPOSE: To evaluate whether a polygenic risk score (PRS) for primary open-angle glaucoma (POAG) is associated with open-angle glaucoma (OAG) progression and treatment burden in a multi-ancestry population. DESIGN: Longi...
PURPOSE: To evaluate whether a polygenic risk score (PRS) for primary open-angle glaucoma (POAG) is associated with open-angle glaucoma (OAG) progression and treatment burden in a multi-ancestry population. DESIGN: Longitudinal cohort study. SUBJECTS, PARTICIPANTS, AND/OR CONTROLS: A total of 950 individuals with OAG and serial Humphrey visual field (VF) testing were included, comprising 713 participants from the Mass General Brigham (MGB) Biobank and 237 from the Mount Sinai BioMe Biobank. METHODS: A POAG PRS was generated using summary statistics from a cross-ancestry genome-wide association study. Association between PRS and VF progression, defined as a mean deviation (MD) slope worse than -0.25 dB/year, was tested with logistic regression models adjusted for age, sex, and ancestry. Associations with treatment burden, defined by a weighted score of medications, laser, and surgical interventions, were analyzed using logistic regression. Association between PRS and surgical interventions were assessed using Cox proportional hazards models. MAIN OUTCOMES AND MEASURES: OAG progression described by MD slope and treatment intensity. RESULTS: Among 950 individuals with OAG, the mean age at baseline was 71.2 ± 10.5 years; 54.7% were female, and 65.5% were of European descent. The median follow-up duration was 6.5 years. Each standard-deviation (SD) increase in PRS was associated with a faster rate of VF decline (β = -0.02 dB/year per SD higher PRS; 95% CI, -0.04 to -0.01; P = 0.007) and 22% higher odds of progression (OR = 1.22 per SD higher PRS; 95% CI, 1.04-1.42; P = 0.014). Higher PRS was also associated with greater treatment burden (OR = 1.47 per SD; 95% CI, 1.27-1.71; P < 0.001). In the MGB cohort, higher PRS predicted shorter time to glaucoma procedures (HR = 1.34 per SD; 95% CI, 1.12-1.59; P = 0.001), and this association persisted among eyes with normal or mild baseline disease (HR = 1.33 per SD; 95% CI, 1.10-1.60; P = 0.003). CONCLUSIONS: In two independent biobank cohorts, higher POAG PRS was associated with faster VF progression and greater treatment burden in OAG. These findings support the potential utility of genetic risk profiling for prognostication of disease trajectory and management intensity in glaucoma.
Macular Buckling During Silicone Oil Removal in Pathologic Myopia with Macular Detachment or Persistent Macular Hole.
Sun G, Zhan J, Xu X … +3 more , Huang X, Lu L, Zhao X
Ophthalmol Retina · 2026 Jun · PMID 42229851 · Publisher ↗
PURPOSE: To evaluate anatomic and functional outcomes of macular buckling (MB) performed during silicone oil removal in highly myopic eyes with persistent macular retinal detachment (RD), with or without macular hole (MH...
PURPOSE: To evaluate anatomic and functional outcomes of macular buckling (MB) performed during silicone oil removal in highly myopic eyes with persistent macular retinal detachment (RD), with or without macular hole (MH), after prior pars plana vitrectomy. METHODS: This retrospective consecutive case series included 62 highly myopic eyes with silicone oil tamponade and persistent or recurrent macular detachment after vitrectomy. Eyes were classified as having MH-related RD (MH-RD, n = 51) or tractional RD (TRD, n = 11). All eyes underwent MB with silicone oil removal. The primary outcomes were retinal reattachment at 1 year and successful silicone oil removal at final follow-up, defined as an oil-free status without reinjection. Secondary outcomes included best-corrected visual acuity (BCVA) and MH status at 1 year. RESULTS: Retinal reattachment at 1 year was achieved in 59 of 62 eyes (95.2%), including 48 of 51 MH-RD eyes (94.1%) and all 11 TRD eyes (100%). Silicone oil was successfully removed in 50 eyes (80.6%). Among MH-RD eyes, 43 (84.3%) achieved type 2 MH closure, whereas 8 (15.7%) remained unclosed; no cases of type 1 closure were observed. Despite the absence of complete hole closure, durable retinal reattachment was maintained in the majority of MH-RD eyes. BCVA improved significantly in the MH-RD group (from 1.57 ± 0.50 to 1.31 ± 0.48 logarithm of the minimum angle of resolution, P = 0.005), but not in the TRD group (P = 0.139). CONCLUSION: In highly myopic eyes with persistent macular detachment after vitrectomy, MB at the time of silicone oil removal provided effective structural support, achieved high retinal reattachment rates at 1 year, and allowed successful oil removal in most eyes. FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any materials discussed in this article.
Glucagon Like Peptide 1 Receptor Agonists and Age-Related Macular Degeneration Incidence.
Hallaj S, Nishida T, Kamalipour A … +4 more , Longhurst CA, Freeman WR, Baxter SL, Boussina A
Ophthalmol Retina · 2026 Jun · PMID 42229850 · Publisher ↗
PURPOSE: To evaluate the association between glucagon-like peptide-1 receptor agonist (GLP-1RA) use and the incidence of age-related macular degeneration (AMD) and neovascular AMD (nAMD) among adults with diabetes. DESIG...
PURPOSE: To evaluate the association between glucagon-like peptide-1 receptor agonist (GLP-1RA) use and the incidence of age-related macular degeneration (AMD) and neovascular AMD (nAMD) among adults with diabetes. DESIGN: Retrospective, propensity score-matched cohort study. PARTICIPANTS: Adults with diabetes initiating a GLP-1RA or another non-insulin antidiabetic agent. In Epic Cosmos, 2,797,686 GLP-1RA users were matched 1:1 to 2,797,686 active comparators. METHODS: We analyzed de-identified electronic health record data from Epic Cosmos and independently replicated the primary analyses in the University of California Health Data Warehouse. Individuals with prevalent AMD or nAMD and those with prior anti-vascular endothelial growth factor treatment were excluded. One-to-one nearest-neighbor propensity score matching balanced demographics, diabetes duration, comorbidities, smoking, diabetic retinopathy, obesity, and eye-care utilization. Cumulative incidence at 1, 5, and 10 years was estimated using Kaplan-Meier methods, and adjusted associations were evaluated using multivariable Cox proportional hazards models. MAIN OUTCOME MEASURES: Incident any AMD and incident nAMD. RESULTS: In the matched Epic Cosmos cohort (total N=5,595,372), GLP-1RA use was associated with lower cumulative incidence of any AMD at 1 year (0.187% [95% CI, 0.182%-0.192%] vs 0.294% [95% CI, 0.287%-0.301%]), 5 years (0.924% [95% CI, 0.907%-0.941%] vs 1.278% [95% CI, 1.260%-1.296%]), and 10 years (5.561% [95% CI, 4.719%-6.549%] vs 6.540% [95% CI, 6.017%-7.108%]); all P<.001. Unadjusted cumulative incidence of nAMD was also lower among GLP-1RA users at 1 year (0.047% vs 0.065%), 5 years (0.280% vs 0.340%), and 10 years (1.874% vs 2.393%); all P<.001. In multivariable Cox models, GLP-1RA use was independently associated with lower hazard of any AMD (hazard ratio [HR], 0.84; 95% CI, 0.83-0.86; P<.001) and was not associated with increased hazard of nAMD (HR, 1.00; 95% CI, 0.97-1.04; P=.79). In the independent University of California Health Data Warehouse cohort, GLP-1RA use was likewise associated with lower AMD incidence at 5 and 10 years, whereas nAMD incidence did not differ significantly between groups. CONCLUSIONS: Among adults with diabetes, GLP-1RA use was associated with lower incident AMD and was not associated with increased nAMD risk. These findings provide reassurance regarding ocular safety and support a potential protective association for earlier AMD phenotypes.
OCT-Defined Foveal Restoration Is Associated with Visual Recovery after Vitrectomy for Lamellar Macular Hole: A Multicenter Study: LMH Report No. 1.
Fukushima M, Akai R, Inoue R … +21 more , Matoba R, Ando T, Goto H, Funatsu R, Wakabayashi T, Kato T, Maruyama K, Hayashi A, Kusaka S, Iwase T, Morizane Y, Terashima H, Akagi T, Miyata K, Mori Y, Kubota N, Okamoto F, Terasaki H, Kamei M, Tsuboi K, LMH Study Group
Ophthalmol Retina · 2026 Jun · PMID 42229849 · Publisher ↗
PURPOSE: Anatomic restoration after vitrectomy for lamellar macular hole (LMH) is not always achieved. However, the impact of unresolved LMH on visual outcomes remains unclear. We evaluated postoperative outcomes in eyes...
PURPOSE: Anatomic restoration after vitrectomy for lamellar macular hole (LMH) is not always achieved. However, the impact of unresolved LMH on visual outcomes remains unclear. We evaluated postoperative outcomes in eyes with unresolved LMH and postoperative full-thickness macular hole (FTMH) to reassess the meaning of anatomic success after LMH surgery. DESIGN: Multicenter, retrospective cohort study. SUBJECTS: One hundred sixty-six consecutive eyes of 166 patients who underwent vitrectomy for LMH. METHODS: Anatomic success was defined as restoration of foveal configuration, whereby the postoperative OCT findings no longer met the diagnostic criteria for LMH. Postoperative anatomic outcomes were classified as anatomic success, unresolved LMH (including both persistent or recurrent LMH), or postoperative FTMH. MAIN OUTCOME MEASURES: Incidence and risk factors of unresolved LMH and postoperative FTMH, and best-corrected visual acuity (BCVA). RESULTS: Anatomic success was achieved in 141 eyes (84.9%), whereas 14 eyes (8.4%) had unresolved LMH and 11 eyes (6.6%) progressed to FTMH during follow-up (mean, 17.8 months). At 12 months, BCVA was significantly worse in eyes with unresolved LMH than in those with anatomic success (0.24 ± 0.24 vs. 0.09 ± 0.19 logarithm of the minimum angle of resolution [LogMAR]; P = 0.041). Internal limiting membrane (ILM) peeling was significantly associated with a reduced risk of unresolved LMH (odds ratio [OR], 0.011; 95% confidence interval [CI], 0.002-0.062; P < 0.001). Postoperative FTMH was significantly associated with epiretinal proliferation (P = 0.018), thinner preoperative central foveal thickness (P = 0.017), and no ILM peeling (P = 0.001). Multivariable analysis confirmed that ILM peeling was an independent factor preventing postoperative FTMH (OR, 0.080; 95% CI, 0.010-0.620; P = 0.001). Postoperative FTMH achieved closure in 9 eyes (82%) with additional treatment or observation, whereas the final BCVA was significantly worse in eyes that developed FTMH than in those with anatomic success (0.50 ± 0.32 vs. 0.12 ± 0.20 LogMAR; P < 0.001). CONCLUSIONS: Although most eyes achieved anatomic success after vitrectomy for LMH, approximately 15% developed unresolved LMH or postoperative FTMH, both of which were associated with the absence of ILM peeling. Because anatomic failure was associated with poorer visual outcomes, foveal restoration on OCT may represent a more clinically meaningful anatomic endpoint after LMH surgery. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Semaglutide and Neovascular Age-Related Macular Degeneration Among Adults with Type 2 Diabetes: An OHDSI Network Study.
Cai CX, Toy B, Martin B … +44 more , Fan R, Westlund E, Tran D, Nishimura A, Lee H, Leng T, Nagy P, Mathioudakis N, Zhang L, Hribar M, Chen A, Armbrust K, Goetz K, Baxter S, Boland MV, Brown EN, Tsui E, Barkmeier AJ, Wang S, Mehta N, Stocking JC, O'Keefe G, Lee CS, Payne PRO, O'Brien WJ, DuVall S, Alshammari T, Falconer T, Dorr DA, Humes I, McCoy D, Adibuzzaman M, Mahmood R, Morgan-Cooper H, Desai P, Kothari SY, Sena A, Blacketer C, Ostropolets A, Shoaibi A, Rao G, Hripcsak G, Ryan P, Suchard MA
Ophthalmology · 2026 Jun · PMID 42229813 · Full text
OBJECTIVE: or Purpose: To investigate the potential association of semaglutide and neovascular age-related macular degeneration (NVAMD) DESIGN: Retrospective study across 12 databases in the Observational Health Data Sci...
OBJECTIVE: or Purpose: To investigate the potential association of semaglutide and neovascular age-related macular degeneration (NVAMD) DESIGN: Retrospective study across 12 databases in the Observational Health Data Sciences and Informatics (OHDSI) network during the study period from 12/1/2017-12/31/2024 SUBJECTS, PARTICIPANTS, AND/OR CONTROLS: Adults with type 2 diabetes (T2D) on semaglutide, other glucagon-like peptide-1 receptor agonists (GLP-1RAs) (dulaglutide, exenatide), or non-GLP-1RAs (empagliflozin, sitagliptin, glipizide) METHODS, INTERVENTION OR TESTING: The association between semaglutide and NVAMD was assessed using two approaches: an active-comparator cohort design and a self-controlled case-series (SCCS) analysis. The cohort design used propensity score-adjusted Cox proportional hazards models to estimate hazard ratios (HRs). The SCCS used conditional Poisson regression models to estimate incidence rate ratios (IRRs). A random-effects meta-analysis was used to generate network-wide HR and IRR estimates. MAIN OUTCOME MEASURES: Two definitions of NVAMD, one based on condition codes alone (NVAMD-C) or condition codes and procedures (NVAMD-CP). RESULTS: A total of 227,971 new users of semaglutide were included in the study. The risk of NVAMD among semaglutide users was similar to users of dulaglutide (NVAMD-C HR 0.57, 95% CI 0.21 to 1.57, P=.28; NVAMD-CP HR 0.25, 95% CI 0.05 to 1.27, P=.10), empagliflozin (NVAMD-C HR 0.98, 95% CI 0.54 to 1.79, P=.94; NVAMD-CP HR 0.79, 95% CI 0.38 to 1.64, P=.52), sitagliptin (NVAMD-C HR 2.08, 95% CI 0.90 to 4.83, P=.09; NVAMD-CP HR 1.80, 95% CI 0.55 to 5.86, P=.33), and glipizide (NVAMD-C HR 0.83, 95% CI 0.35 to 2.02, P=0.69; NVAMD-CP HR 0.50, 95% CI 0.21 to 1.19, P=.12). There was no evidence of increased or decreased risk for NVAMD associated with semaglutide exposure (NVAMD-C: incidence rate ratio [IRR] 0.92, 95% CI 0.67 to 1.26, P=.60; NVAMD-CP IRR 1.02, 95% CI 0.76 to 1.36, P=.92) nor any of the other GLP-1RA or non-GLP-1RAs. CONCLUSIONS: We detected no differences in the risk of NVAMD associated with semaglutide use among adults with T2D.
Phacoemulsification with goniosynechialysis for nanophthalmos with secondary angle-closure or secondary angle-closure glaucoma: a 20-case series and stepwise management strategy.
Zhu H, Wu Z, Wang Y … +3 more , Zhan X, Lv J, Ye L
BMC Ophthalmol · 2026 Jun · PMID 42226170 · Full text
BACKGROUND: Nanophthalmos is a rare congenital ocular disorder characterized by a short axial length (AL), which predisposes to secondary angle-closure and secondary angle-closure glaucoma. Surgical management is challen...
BACKGROUND: Nanophthalmos is a rare congenital ocular disorder characterized by a short axial length (AL), which predisposes to secondary angle-closure and secondary angle-closure glaucoma. Surgical management is challenging due to high complication risks. This study aimed to evaluate the feasibility and efficacy of phacoemulsification with intraocular lens implantation and goniosynechialysis (Phaco + IOL+GSL) in nanophthalmos with secondary angle-closure or secondary angle-closure glaucoma, and to propose a stepwise complication management strategy. METHODS: This retrospective case series included 20 eyes of 20 patients diagnosed with nanophthalmos (AL < 20 mm) and PAC (2 eyes) or ACG (18 eyes) who underwent Phaco + IOL+GSL between January 2022 and Jun 2025. Patients were divided into three groups based on AL: Group A (14 mm ≤ AL < 16 mm, 9 eyes), Group B (16 mm ≤ AL < 18 mm, 4 eyes), and Group C (18 mm ≤ AL < 20 mm, 7 eyes). Preoperative and postoperative uncorrected visual acuity (UCVA, logMAR) and best-corrected visual acuity (BCVA, logMAR) were recorded, intraocular pressure (IOP), number of antiglaucoma medications, and intraoperative and postoperative complications were analyzed. RESULTS: At the final follow-up (6-12 months postoperatively), the median IOP significantly decreased from 25.5 [16.0, 35.0] mmHg to 16.0 [14.0, 19.0] mmHg (P < 0.05). The median number of antiglaucoma medications decreased from 2.5 [0.0, 4.0] to 0.0 [0.0, 0.0] (P < 0.05). UCVA improved from 1.30 [1.00, 1.70] to 0.40 [0.12, 1.10] (P < 0.05), and BCVA improved from 0.82 [0.40, 1.30] to 0.50 [0.30, 0.90] (P < 0.05).The qualified success rate was 95.0% (19/20), and the complete success rate was 80.0% (16/20). The intraoperative complication rate was 25.0% (5/20), primarily shallow anterior chamber. The postoperative complication rate was 40.0% (8/20), primarily shallow anterior chamber with elevated IOP. Complications were concentrated in Groups A and B. A stepwise management strategy-initiating with medical/laser therapy, escalating to cyclophotocoagulation, and reserving pars plana vitrectomy for refractory cases-achieved successful complication management. CONCLUSION: For nanophthalmos with secondary angle-closure glaucoma, Phaco + IOL+GSL appears to be a feasible and effective procedure, particularly when combined with a stepwise complication management strategy. It may serve as an initial surgical option before resorting to more invasive combined procedures. However, the high complication rate in eyes with AL < 16 mm warrants extreme caution and readiness for escalation. The retrospective design and small sample size limit the generalizability of our findings; larger prospective studies are needed to confirm these results.
Development and validation of a novel and graded colour saturation threshold test, the LSS-8.
Stepnicka K, Sarossy A, McGrath H … +1 more , Sarossy M
BMC Ophthalmol · 2026 May · PMID 42226163 · Full text
Colour vision changes are a key clinical feature of many acquired retinal and optic nerve disorders. Current clinical tests are often labour-intensive or designed for congenital defects. We introduce the novel LSS-8 test...
Colour vision changes are a key clinical feature of many acquired retinal and optic nerve disorders. Current clinical tests are often labour-intensive or designed for congenital defects. We introduce the novel LSS-8 test, which measures colour saturation thresholds across eight hues. Three cohorts with mixed ocular health underwent testing in a diagnostic crossover study. The reliability cohort was tested with LSS-4 on different days (n = 30 eyes). The screen independence cohort used LSS-8 with 11-inch versus 13-inch screens in random order (n = 27 eyes). Brightness independence testing used LSS-8 at 115 cd/m versus 230 cd/m (n = 19 eyes). Scores for each plate set and total scores were recorded. Intraclass correlation coefficients (ICC) and absolute difference frequency distributions were calculated. Data from 74 eyes (74 subjects; mean age 62.4 ± 19.1 years; range 20-85; 39% female) were analysed. LSS-4 test-retest reliability with ICC(2,1) was excellent (mauve 0.93, red 0.95, green 0.87, blue 0.91, total score 0.96). LSS-8 screen independence testing showed excellent reliability for mauve, green, pink and total scores (ICC(2,k) 0.74-0.98), and moderate to good reliability for other hues. Varying screen brightness did not produce significant score differences in most participants. The LSS is a simple, reliable test with potential for rapid quantification of acquired colour vision defects.
THRIVE: A Phase 3, Randomized, Double-Masked, Placebo-Controlled Study of Veligrotug for Active Thyroid Eye Disease.
Yen MT, Cockerham K, Saeed P … +19 more , Leibowitz S, Mudumbai RC, Schittkowski MP, Lee V, Abrams J, Turbin RE, Pío-Rendón JB, Bertelmann E, Eade E, Nijhawan N, Pérez-López M, Sales-Sanz M, Zhang-Nunes S, Kossler AL, Pajak A, Narvekar A, Tripuraneni R, Garrido-Hermosilla AM, THRIVE Study Group
Ophthalmology · 2026 Jun · PMID 42223386 · Publisher ↗
PURPOSE: Thyroid eye disease (TED) is a debilitating autoimmune disease with significant unmet needs. This study's objective was to assess the efficacy and safety of veligrotug, a full antagonist monoclonal antibody to t...
PURPOSE: Thyroid eye disease (TED) is a debilitating autoimmune disease with significant unmet needs. This study's objective was to assess the efficacy and safety of veligrotug, a full antagonist monoclonal antibody to the insulin-like growth factor-1 receptor, in patients with active TED. DESIGN: Veligrotug was assessed in THRIVE, a global, multicenter, randomized, double-masked, placebo-controlled phase 3 trial. PARTICIPANTS: Adult patients with moderate-to-severe active TED (onset ≤ 15 months, proptosis ≥ 3 mm above normal, and clinical activity score [CAS] ≥ 3) received either veligrotug or placebo. METHODS: Patients were randomized 2:1 to receive 10 mg/kg veligrotug or placebo administered every 3 weeks for a total of 5 IV infusions. MAIN OUTCOME MEASURES: The primary end point at week 15 was the proptosis responder rate (PRR; ≥ 2-mm reduction by Hertel exophthalmometry) or overall responder rate (ORR; PRR and ≥ 2-point reduction in CAS), depending on geographic region. Efficacy and safety were assessed through week 52. RESULTS: A total of 113 patients received veligrotug (n = 75) or placebo (n = 38). Baseline characteristics were balanced between the 2 arms. Improvements were observed at week 3, with a significantly greater response at week 15 for veligrotug versus placebo (P < 0.001) across all primary and secondary end points including: PRR by Hertel, 70% versus 5%; PRR by magnetic resonance imaging (MRI) or computed tomography (CT), 71% versus 9%; ORR, 67% versus 5%; mean proptosis reduction, 2.90 mm versus 0.48 mm (Hertel) and 2.96 mm versus 0.58 mm (MRI/CT); diplopia improvement, 59% versus 20%; and diplopia resolution, 49% versus 12%. At week 52, 70% of initial responders maintained proptosis response. Veligrotug was generally well tolerated, with a 4% treatment discontinuation rate. Most adverse events were mild and resolved, with no serious treatment-related adverse events and no changes in the safety profile through week 52. CONCLUSIONS: A 5-infusion course of veligrotug administered over 12 weeks was generally well tolerated and led to rapid and significant improvements in diplopia, proptosis, and disease activity, with a durable response through week 52. Veligrotug may become a promising new treatment option for active TED. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Leveraging Big Data to Advance Our Understanding of Pigmentary Glaucoma.
Gedde SJ
Ophthalmology · 2026 May · PMID 42218693 · Publisher ↗
Abstract loading — click title to view on PubMed.
Anterior capsule polishing prevents anterior capsule fibrosis after phacovitrectomy without intraocular lens implantation.
Liao X, Zhang Q, Huang Y … +3 more , Chen W, Grzybowski A, Chen H
BMC Ophthalmol · 2026 May · PMID 42218440 · Full text
OBJECTIVE: To investigate whether anterior capsule polishing can prevent the fibrosis of the anterior capsule in phacovitrectomy without intraocular lens (IOL) implantation. METHODS AND ANALYSIS: A retrospective study in...
OBJECTIVE: To investigate whether anterior capsule polishing can prevent the fibrosis of the anterior capsule in phacovitrectomy without intraocular lens (IOL) implantation. METHODS AND ANALYSIS: A retrospective study including seventy cases of phacovitrectomy without IOL implantation was conducted. Fifty cases received 360-degree anterior capsule polishing, and 20 cases did not receive polishing. The severity of anterior capsule fibrosis was calculated by adding the score (from 0 to 3) of each clock hour. The fibrosis severity was compared in the groups with and without polishing using Mann-Whitney U test. The risk factors of anterior capsule fibrosis were explored using single and multiple linear regression. The location of secondary intraocular lens implantation was compared between the polishing and non-polishing groups with Chi-square test. RESULTS: The median severity score of the polishing group was significantly less than that of the non-polishing group (6 vs. 24 out of 36, P < 0.001). Multiple regression showed that diabetes (b = 14.634, P = 0.001), silicone oil tamponade (b = 8.734, P < 0.001), and non-polishing (b = 13.731, P < 0.001) were the risk factors of anterior capsule fibrosis. Anterior capsule polishing was associated with a higher chance of secondary in-the-bag IOL implantation (OR = 4.889, P = 0.004). CONCLUSION: Polishing the anterior capsule is associated with reduced fibrosis of the anterior capsule in phacovitrectomy without primary IOL implantation, and more chance of secondary in-the-bag IOL implantation.
Timing of height growth peaks and axial elongation in atropine-treated myopic children.
Surl D, Han J, Seo Y
BMC Ophthalmol · 2026 May · PMID 42218416 · Full text
PURPOSE: To investigate the association between systemic height growth rate and ocular axial elongation rate in atropine-treated children with myopia, and to explore whether the timing of height growth provides clinicall...
PURPOSE: To investigate the association between systemic height growth rate and ocular axial elongation rate in atropine-treated children with myopia, and to explore whether the timing of height growth provides clinically relevant information regarding periods of axial elongation during treatment. METHODS: Children with myopia (< 15 years) who underwent serial ocular biometry and anthropometric measurements over ≥ 3 visits spanning > 1 year were included. Participants were classified into a control group (no atropine) and an atropine group (0.05% nightly, initiated for axial elongation ≥ 0.4 mm/year). Axial elongation and height growth rates were calculated for each inter-visit interval. Peak growth ages were defined as those with the greatest inter-visit changes. Subgroup analyses in the atropine group were based on the median peak height growth age (10.45 years) and median annual axial elongation rate (0.21 mm/year). RESULTS: A total of 139 eyes from 70 children were analyzed (56 control, 83 atropine-treated). Height growth rate and axial elongation rate were not significantly correlated in either group. In the control group, peak height growth age and peak axial elongation age showed similar unimodal distributions. In the atropine group, however, the distribution of peak height growth age showed a broadened pattern with marginal deviation from unimodality (P = 0.051) and associated strongly with peak axial elongation age (β = 0.91, P < 0.01). Children with earlier height growth peaks had greater annual axial elongation (0.27 ± 0.17 vs. 0.15 ± 0.12 mm/year; P < 0.01) despite identical dosing. CONCLUSIONS: Among atropine-treated children, earlier systemic growth peaks were associated with faster axial elongation. Monitoring height growth timing may help identify rapid ocular growth periods and optimize treatment strategies.
Choroidal watershed infarction due to medial posterior ciliary artery occlusion with hemi-retinal ischemia, a case report.
Alsakran WA, Alyousef N, Alenazi M … +2 more , Badawi AH, Magliyah MS
BMC Ophthalmol · 2026 May · PMID 42218413 · Full text
BACKGROUND AND PURPOSE: To describe a rare case of combined medial long posterior ciliary occlusion associated with nasal hemiretinal ischemia due to atherosclerotic disease and to outline the possible hemodynamic mechan...
BACKGROUND AND PURPOSE: To describe a rare case of combined medial long posterior ciliary occlusion associated with nasal hemiretinal ischemia due to atherosclerotic disease and to outline the possible hemodynamic mechanisms that can explain this association. CASE PRESENTATION: A 65-year-old female patient presented with iris neovascularization with angiographic evidence of watershed choroidal infarction in the setting of non-filling of the nasal choroid and the nasal half of the optic disc on fluorescein and indocyanine green angiography associated with superior and inferior amalric triangular infarcts. The nasal retinal arteries and veins showed significant filling delays. An extensive work-up was carried out, including neurovascular imaging, which was unremarkable except for the known atherosclerotic disease. CONCLUSIONS AND IMPORTANCE: The best explanation for this appearance is a sectoral hemodynamic failure across the standard watershed zone between the medial posterior ciliary artery (MPCA) and the nasal branches of the central retinal artery (CRA). MPCA obstruction most likely produced nasal choroidal and optic-disc ischemia, as well as subsequent hypoperfusion of adjacent nasal CRA branches. Recognizing this pattern emphasizes the intricate interconnectedness of the retinal and choroidal circulations and precludes misdiagnosis as abnormal CRA or venous blockage.
Suprachoroidal effusion with angle-closure glaucoma in a patient with active systemic lupus erythematosus: a case report.
Guo X, Li Y, Wang J … +2 more , Zhang Y, Wu P
BMC Ophthalmol · 2026 May · PMID 42218403 · Full text
BACKGROUND: Systemic lupus erythematosus (SLE) uncommonly presents with ocular manifestations as the initial feature. Uveal effusion syndrome (UES) is typically described in eyes with nanophthalmos and scleral abnormalit...
BACKGROUND: Systemic lupus erythematosus (SLE) uncommonly presents with ocular manifestations as the initial feature. Uveal effusion syndrome (UES) is typically described in eyes with nanophthalmos and scleral abnormalities. This case is noteworthy for two reasons. First, the patient had normal axial length and no marked diffuse scleral thickening on ultrasound biomicroscopy(UBM), with a massive annular uveal/suprachoroidal effusion resembling a type III UES-like phenotype; however, concurrent active SLE, hypoalbuminaemia and polyserositis suggested a secondary systemic trigger. Second, ocular recovery appeared to accelerate after periocular corticosteroid therapy, despite inadequate response to systemic immunosuppression. CASE PRESENTATION: A 38-year-old woman presented with three days of bilateral ocular pain and visual deterioration. Initial examination revealed intraocular pressure of 38.7 mmHg in the right eye and 32.7 mmHg in the left, shallow anterior chambers, and axial length of 21.85 mm bilaterally. Bilateral angle-closure glaucoma was diagnosed, and laser peripheral iridotomy was performed along with topical antiglaucoma agents and corticosteroids. One week later, systemic symptoms including fever and polyarthralgia developed. Laboratory tests showed strongly positive autoimmune markers (ANA: antinuclear antibody, ANSA༚anti-nucleosome antibody, ARPA༚anti-ribosomal P protein antibody), low complement levels (C3༚complement 3, C4༚complement 4). Inflammatory markers were elevated (CRP༚C-reactive protein 84.08 mg/L, ESR༚erythrocyte sedimentation rate 83 mm/h), severe hypoalbuminaemia (27.4 g/L). Imaging revealed pleural, pericardial, and peritoneal effusions. Active SLE with polyserositis and lupus nephritis was diagnosed. Intravenous methylprednisolone, cyclophosphamide, hydroxychloroquine and telitacicept were initiated. However, ultrasonography showed progressive 360-degree annular choroidal detachment with anterior displacement of the lens-iris diaphragm. Bilateral periocular triamcinolone acetonide 20 mg was administered, followed by periocular dexamethasone 5 mg. Choroidal detachment rapidly resolved, anterior chamber depth increased from 1.57 mm to 2.93 mm, and the retina reattached spontaneously. One month later, best-corrected visual acuity improved from 20/500 to 20/50 in both eyes, and intraocular pressure normalised. CONCLUSIONS: This case illustrates that systemic serous leakage in SLE can cause massive suprachoroidal effusion with secondary angle-closure glaucoma, even in eyes with normal axial length. Periocular corticosteroid therapy may serve as a useful adjunct by increasing local ocular drug exposure and promoting fluid resorption.
Low-Dose Brachytherapy for Choroidal Melanoma: A Preliminary Report.
Bouhout S, Zhang Z, Suh JH … +1 more , Singh AD
Ophthalmol Retina · 2026 May · PMID 42217755 · Publisher ↗
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Clinical Outcomes of a New Topical Corticosteroid with Greater Theoretical Potency.
Chang DF
Ophthalmology · 2026 May · PMID 42216938 · Publisher ↗
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The Ethical Imperative of Disclosure: Communicating Trust and Transparency.
O'Donnell HL, Siegfried CJ
Ophthalmology · 2026 May · PMID 42216937 · Publisher ↗
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Comparative analysis of optical coherence tomography angiography metrics in primary open-angle glaucoma and ocular hypertension.
Karadağ B, İzgi B, Bayraktar Ş
BMC Ophthalmol · 2026 May · PMID 42216126 · Full text
PURPOSE: To evaluate macular ganglion cell complex (GCC) thickness and parafoveal vessel density (pfVD) using optical coherence tomography angiography (OCT-A) in patients with ocular hypertension (OHT) and early- to inte...
PURPOSE: To evaluate macular ganglion cell complex (GCC) thickness and parafoveal vessel density (pfVD) using optical coherence tomography angiography (OCT-A) in patients with ocular hypertension (OHT) and early- to intermediate-stage primary open-angle glaucoma (POAG). MATERIAL AND METHODS: This cross-sectional study included 150 eyes from 56 patients with POAG and 32 patients with OHT who were under regular follow-up at the Glaucoma Unit of Istanbul University Faculty of Medicine, Department of Ophthalmology. Evaluations were conducted between November and December 2022. Additionally, 50 eyes from 25 healthy individuals were included as a control group. OCT-A imaging was performed using the Topcon DRI OCT Triton system (Topcon Corporation, Japan). Macular GCC thickness and pfVD in the superficial and deep capillary plexuses were measured and compared among groups. RESULTS: A total of 113 participants (74 females, 39 males) were included. No significant differences in macular GCC thickness or pfVD were observed between the control and OHT groups. In contrast, both parameters were significantly reduced in POAG eyes, with greater reductions observed in more advanced disease stages. The decrease in pfVD was more pronounced in the superficial capillary plexus compared to the deep plexus. In early-stage POAG, GCC thinning appeared more prominent than pfVD reduction. CONCLUSıON: Our findings suggest that macular GCC thickness and pfVD assessed by OCT-A are associated with glaucomatous changes. In particular, structural alterations in macular GCC may be more pronounced than vascular changes in early-stage POAG. These results indicate that macular GCC assessment may provide complementary information in the evaluation of early glaucomatous damage. However, due to the cross-sectional design of the study, no conclusions can be drawn regarding the temporal relationship between structural and vascular changes.
Rapid resolution of submacular hemorrhage in neovascular age-related macular degeneration using pneumatic displacement and faricimab.
Ji PX, Herman JE, Sivachandran N
BMC Ophthalmol · 2026 May · PMID 42216114 · Full text
BACKGROUND: Submacular hemorrhage (SMH) is a rare but visually devastating complication of neovascular age-related macular degeneration (nAMD) associated with poor long-term prognosis due to photoreceptor iron toxicity,...
BACKGROUND: Submacular hemorrhage (SMH) is a rare but visually devastating complication of neovascular age-related macular degeneration (nAMD) associated with poor long-term prognosis due to photoreceptor iron toxicity, subretinal fibrosis, and retinal pigment epithelial (RPE) damage. Pneumatic displacement (PD) combined with anti-vascular endothelial growth factor (anti-VEGF) therapy is an established approach for managing acute SMH; however, the role of faricimab, a novel dual inhibitor of VEGF-A and angiopoietin-2 (Ang-2), in this context has not been previously evaluated. CASE PRESENTATION: This study reports the outcomes of PD combined with faricimab injection in a case of a 75-year-old female with acute SMH secondary to nAMD. The patient with dense SMH and a large PED secondary to presumed polypoidal choroidal vasculopathy (PCV) underwent PD with 0.40 mL of sulfur hexafluoride and intravitreal faricimab injection (50 µL, 6 mg) on the same day as presentation, followed by 5 days of face-down positioning with excellent patient compliance confirmed by verbal verification. Two additional faricimab injections were administered at 4 and 8 weeks, followed by treat-and-extend protocol. CONCLUSIONS: The use of timely PD with appropriate head positioning can effectively manage patients with acute large SMH and improve visual outcomes. While the combined approach with serial faricimab injections showed longer-term benefits, the immediate improvement was likely due to mechanical techniques. The potential added benefit of faricimab's dual inhibition mechanism over other anti-VEGF therapies in SMH remains to be investigated through larger, comparative trials.
Accommodation-induced biometric changes in ciliary muscle, trabecular meshwork, and Schlemm's canal: comparison of eyes in high myopia.
Shao Y, Li Z, Wu X … +12 more , Wu X, Wan N, Chen H, Zhe N, Wang J, Zhao Y, Zhou Y, Nie L, Wang Y, Shen M, Lu F, Li Z
BMC Ophthalmol · 2026 May · PMID 42215972 · Full text
PURPOSE: To evaluate accommodation-induced changes in the ciliary muscle (CM), Schlemm's canal (SC), and trabecular meshwork (TM) in eyes with and without high myopia, and to assess the associations among these structure...
PURPOSE: To evaluate accommodation-induced changes in the ciliary muscle (CM), Schlemm's canal (SC), and trabecular meshwork (TM) in eyes with and without high myopia, and to assess the associations among these structures during accommodation. METHODS: 116 eyes from 57 healthy control (HC) and 59 high myopia (HM) were assessed across two experiments. In the first experiment, pilocarpine-induced accommodation was applied to 78 eyes, while in the second, a -5 diopter (D) accommodative stimulus was used on 38 eyes. Anterior segment images were captured via swept-source optical coherence tomography before and after each accommodation stimulus. Measurements included the maximum thickness of CM and the anterior length of CM, the length of TM, and the area of SC. Statistical analyses evaluated group differences and correlations. RESULTS: Drug-induced and - 5D stimulation increased the maximum thickness of CM and the area of SC's levels while decreasing the anterior length of CM's levels. In the HC group, the length of TM was larger in the accommodative state, mediating the relationship between changes in the maximum thickness of CM and the area of SC. Conversely, these changes and correlations in the length of TM were insignificant in HM eyes. The length of TM increased with axial length and elongation in the anterior length of CM across all subjects; however, accommodation-related changes diminished as axial length (AL) and the anterior length of CM increased. Causal mediation analysis demonstrated that the anterior length of CM mediated the relationship between AL and the length of TM elongation. CONCLUSIONS: In two trials, accommodation-induced changes in the CM, TM, and SC were observed in eyes with or without HM, with reduced TM and SC response in HM. Differences in CM, TM, and SC behavior during accommodation between the HC and HM groups suggest that CM contraction may reshape the aqueous humor outflow channels.
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