Ophthalmology [JOURNAL]
Sun
200 papers
Unsupervised phenotyping of suspect keratoconus based on posterior tomography and epithelial remodeling.
Salman A
BMC Ophthalmol · 2026 Jun · PMID 42365260 · Full text
PURPOSE: To characterize structural heterogeneity within suspect keratoconus (SKC) using an unsupervised phenotyping strategy integrating posterior tomographic and epithelial remodeling parameters. METHODS: In this cross...
PURPOSE: To characterize structural heterogeneity within suspect keratoconus (SKC) using an unsupervised phenotyping strategy integrating posterior tomographic and epithelial remodeling parameters. METHODS: In this cross-sectional study, 55 eyes with clinically defined SKC underwent Scheimpflug-Placido tomography and anterior segment optical coherence tomography. Posterior asymmetry indices (Symmetry Index Back [SIb] and Keratoconus Vertex Back [KVb]) and epithelial redistribution metrics (Minimum-Maximum epithelial thickness difference [Min-Max ET] and Superonasal-Inferotemporal epithelial thickness difference [SN-IT ET], 2-5 mm zone) were entered into k-means clustering without predefined diagnostic thresholds. Demographic and refractive variables were compared between derived phenotypes. Independent anterior surface elevation and keratometric parameters were analyzed for structural validation. Cluster robustness and multidimensional separation within the SKC cohort were assessed using silhouette analysis, principal component analysis (PCA), posterior-only sensitivity analysis, and hierarchical clustering sensitivity analysis. RESULTS: Two distinct structural phenotypes emerged. A posterior-asymmetric phenotype (26 eyes) demonstrated significantly higher SIb and KVb (both p < 0.001) together with greater epithelial redistribution (p ≤ 0.002). A second phenotype (29 eyes) exhibited comparatively milder structural alterations. No significant differences were observed in age, sex distribution, visual acuity, refractive error, or minimum corneal thickness (all p > 0.05). Simulated keratometric indices (K1, K2, Kavg) did not distinguish between phenotypes, whereas anterior elevation parameters differed significantly. PCA loading analysis and posterior-only sensitivity analysis supported posterior tomographic abnormalities as the principal axis of phenotype separation. The two-cluster solution showed a silhouette coefficient of 0.29, and hierarchical clustering sensitivity analysis supported its robustness (agreement = 87.5%, Cohen's κ = 0.729). CONCLUSIONS: Suspect keratoconus is not a structurally uniform entity but comprises distinct structural phenotypes driven principally by posterior tomographic asymmetry and accompanied by epithelial remodeling. Epithelial remodeling provided complementary structural information rather than serving as the dominant driver of cluster separation. Because longitudinal and biomechanical data were unavailable, the future clinical significance and progression risk of these phenotypes remain unknown and require further investigation.
Baseline visual acuity gaps in age-related macular degeneration: AREDS smokers and non-smokers.
Pan M, Sunkara N, Digbeu BDE … +1 more , Gupta PK
BMC Ophthalmol · 2026 Jun · PMID 42363196 · Full text
BACKGROUND: Age-related macular degeneration (AMD) is a leading cause of blindness in developed countries. Smoking is the only modifiable risk factor and is associated with faster AMD progression. While Age-Related Eye D...
BACKGROUND: Age-related macular degeneration (AMD) is a leading cause of blindness in developed countries. Smoking is the only modifiable risk factor and is associated with faster AMD progression. While Age-Related Eye Disease Study (AREDS) supplements are recommended for intermediate AMD, their impact on visual acuity over time remains unclear. OBJECTIVE: To describe baseline disparities and visual acuity trajectories in patients with intermediate dry AMD stratified by AREDS use and smoking status. DESIGN: Retrospective observational study of patients with intermediate dry AMD conducted under IRB protocol 22-0267. Data collected from January 1, 2014 to January 1, 2024. SETTING: Single academic medical center. PARTICIPANTS: A total of 450 patients (759 eligible eyes) with intermediate dry AMD (ICD code H35.3192) were included. Patients were stratified by smoking status and AREDS use. Participants with fewer than three ophthalmology visits during the 10-year study period were excluded. EXPOSURE: AREDS supplementation (AREDS1 or AREDS2) and smoking status (current/former vs. never). MAIN OUTCOMES AND MEASURES: Visual acuity measured in Logarithm of the Minimum Angle of Resolution (LogMAR) at first and final clinic visits. ANOVA, Chi-square tests, and mixed effect regression models were used for analysis. Changes in LogMAR over time were calculated descriptively. RESULTS: Among 450 patients (mean age, 82.32 years), 255 were smokers (423 eyes) and 195 were non-smokers (336 eyes). Baseline vision was better in non-smokers (mean LogMAR 0.28; SD 0.28) and smokers (mean LogMAR 0.30; SD 0.33) taking AREDS compared to non-smokers (mean LogMAR 0.48; SD 0.44) and smokers (mean LogMAR 0.45; SD 0.47) not taking AREDS (P < 0.0001). All groups experienced visual acuity decline from baseline with no significant differences in final visual acuity among the groups in a mean follow up period of 3.62 years. In a sub-analysis of greater than 5 years follow up mean years of 6.93 ± 1.55 years), a statistically significant difference in final LogMAR values across groups was observed (p = 0.033). The Smokers & AREDS group demonstrated the best final visual acuity (mean 0.39, SD 0.40), followed by Smokers & No-AREDS (mean 0.44, SD 0.43), Non-smokers & AREDS (mean 0.46, SD 0.47), and Non-smokers & No-AREDS (mean 0.72, SD 0.60). CONCLUSIONS AND RELEVANCE: These results suggest that less than 5 years AREDS users had larger decline in vision from baseline, protective associations of AREDS supplementation may become more discernible over longer follow-up horizons. Real-world observational findings should be interpreted cautiously and do not contradict AREDS efficacy shown in randomized trials.
Association of early anti-VEGF Therapy anatomical response with renal function and OCT biomarkers in diabetic macular edema.
Chen H, Shang Y, Yang P … +2 more , Zhou Y, Yuan Y
BMC Ophthalmol · 2026 Jun · PMID 42363174 · Full text
PURPOSE: To investigate the predictors of anatomical response in patients with diabetic macular edema (DME) following anti-vascular endothelial growth factor (anti-VEGF) therapy and establish a nomogram model for predict...
PURPOSE: To investigate the predictors of anatomical response in patients with diabetic macular edema (DME) following anti-vascular endothelial growth factor (anti-VEGF) therapy and establish a nomogram model for predicting the probability of anatomical response. METHODS: This study enrolled 200 DME patients treated with anti-VEGF regimen. Based on the reduction rate of central macular thickness (CMT) following treatment, patients were classified into an anatomical weak responder group (CMT reduction < 20%) and an anatomical responder group (CMT reduction ≥ 20%). Baseline clinical data and OCT biomarkers were analyzed with multivariate logistic regression. A nomogram model was constructed by using R software. Bootstrapping was used for model validation, receiver operating characteristic (ROC) curve and calibration curve were used for evaluating the discrimination and calibration of prediction model, and decision analysis curve (DCA) was used for evaluating the practicality of model. RESULTS: Predictors for anatomical response in DME patients are serum creatinine (Scr), CMT, photoreceptor outer segment length (PROSL), and cystoid macular edema (CME) presence as independent variables. The nomogram prediction model based on the above four predictors had good representativeness (Bootstrap method: precision: 0.820), differentiation [the area under curve (AUC) value: 0.819], and the DCA analysis showed that the prediction model, whose threshold probability was in the range of 0 to 1, had clinical practical value. CONCLUSION: The anatomical response to anti-VEGF treatment for DME is independently associated with baseline Scr, CMT, PROSL, and the presence of CME.
Painful acute esotropia as a presenting sign of presumed post-infectious orbital myositis in a child: a case report.
Alhaimi F, Alluhaidan R, Alsanea N
BMC Ophthalmol · 2026 Jun · PMID 42363153 · Full text
PURPOSE: To describe a self-limited presentation of pediatric orbital myositis and discuss its implications for management. OBSERVATIONS: A previously healthy 9-year-old boy presented with acute painful diplopia and esot...
PURPOSE: To describe a self-limited presentation of pediatric orbital myositis and discuss its implications for management. OBSERVATIONS: A previously healthy 9-year-old boy presented with acute painful diplopia and esotropia following a recent febrile upper respiratory tract infection and presumed viral conjunctivitis. Best-corrected visual acuity was 20/40 OD and 20/40 OS. Examination demonstrated an esotropia of 30 prism diopters (PD) at corrected distance and 35 PD at corrected near, bilateral abduction limitation (- 1), and localized temporal conjunctival injection over the lateral rectus insertions, with clinical features also suggestive of lacrimal gland involvement. Magnetic resonance imaging (MRI) of the orbits revealed bilateral enlargement and post-contrast enhancement of the lateral rectus muscles with mild tendon involvement and surrounding inflammatory changes, consistent with orbital myositis within the spectrum of idiopathic orbital inflammation (IOI). Dacryoadenitis was also suggested by imaging findings. Clear clinical improvement in pain, diplopia, and conjunctival injection was observed within 24 h of presentation, prior to initiation of any medical therapy. Although oral antibiotics and systemic corticosteroids were prescribed, corticosteroid therapy was not initiated due to intolerance. At three-month follow-up, the patient was orthophoric with full restoration of extraocular motility. CONCLUSIONS AND IMPORTANCE: This case illustrates a self-limited presentation of presumed post-infectious pediatric orbital myositis manifesting as painful acute esotropia, with bilateral lateral rectus muscle involvement and spontaneous recovery without corticosteroid therapy. Careful clinical and imaging assessment is essential to distinguish orbital myositis from neurogenic, accommodative, and infectious causes of acute esotropia in children. The reduced best-corrected visual acuity may reflect underlying refractive amblyopia and/or significant astigmatism and warrants continued monitoring. This report highlights an unusual but recognizable phenotype within the spectrum of pediatric idiopathic orbital inflammation and underscores the importance of comprehensive diagnostic evaluation and longer-term follow-up.
Combining structural and microvascular parameters via machine learning for enhanced diagnosis of normal-tension glaucoma among highly myopic eyes: a prospective cross-sectional diagnostic accuracy study.
He CZ, Qiu Q, Lai H … +3 more , Lai CY, He Y, Jing L
BMC Ophthalmol · 2026 Jun · PMID 42363089 · Full text
PURPOSE: This study aimed to evaluate whether a combination of optical coherence tomography (OCT) and OCT angiography (OCTA) parameters could improve the discrimination between clinically diagnosed normal-tension glaucom...
PURPOSE: This study aimed to evaluate whether a combination of optical coherence tomography (OCT) and OCT angiography (OCTA) parameters could improve the discrimination between clinically diagnosed normal-tension glaucoma (NTG) and non-glaucomatous high myopia (HM) within a highly myopic population. METHODS: In this prospective cross-sectional diagnostic accuracy study, we consecutively enrolled two groups of participants: patients with high myopia (HM) and those with HM complicated by normal-tension glaucoma (HM-NTG). All clinical and imaging data were collected at a single time point using standardized protocols. Baseline clinical data were collected for all participants. Optic disc structural parameters were acquired using optical coherence tomography (OCT), while optic disc perfusion parameters were obtained via OCT angiography (OCTA). Receiver operating characteristic (ROC) curve analysis was first conducted to evaluate the diagnostic performance of individual parameters. Least absolute shrinkage and selection operator (LASSO) regression was employed for preliminary dimensionality reduction and feature selection, followed by multivariate logistic regression (backward stepwise method) to identify the optimal parameter combination. A diagnostic model was developed based on logistic regression and rigorously validated through bootstrap resampling, calibration assessment, decision curve analysis, and clinical impact curve. A machine learning diagnostic model was constructed using the support vector machine (SVM) algorithm and compared with the conventional regression model. Finally, Shapley additive explanations (SHAP) were applied to interpret the SVM model's decision-making mechanism and elucidate the individualized contribution of each feature to the prediction outcomes. RESULTS: A total of 87 patients were enrolled, comprising 42 in the HM group and 45 in the HM-NTG group. Overall, OCT parameters demonstrated superior diagnostic clarity compared with OCTA microvascular indices. The inferior macular ganglion cell complex (GCC) exhibited the strongest discriminatory performance, with an area under the receiver operating characteristic curve (AUC) of 0.85. Among OCTA parameters, the inferior optic disc vessel density (VD) achieved the best diagnostic performance (AUC = 0.72). LASSO regression combined with multivariate logistic regression identified three variables for model construction: inferior GCC thickness (odds ratio [OR] = 0.72), temporal-inferior retinal nerve fiber layer (RNFL) thickness (OR = 0.82), and inferior VD (OR = 0.77). The OCT + OCTA combined model achieved an AUC of 0.909 (95% CI: 0.833-0.984). While this did not significantly exceed the OCT-only model (AUC = 0.888, 95% CI: 0.803-0.973; DeLong test, P = 0.164), the addition of OCTA-derived inferior vessel density yielded significant net reclassification improvement (NRI = 0.679, P = 0.003) and integrated discrimination improvement (IDI = 0.067, P = 0.029), indicating enhanced risk stratification. Bootstrap resampling with 500 iterations yielded an AUC of 0.861 (95% CI: 0.773-0.949). The Hosmer-Lemeshow goodness-of-fit test indicated adequate calibration (χ² = 6.64, P = 0.575), with a Brier score of 0.109. Calibration curves demonstrated close adherence to the ideal diagonal across both low-risk and high-risk probability thresholds. Decision curve analysis indicated favorable net benefit. An SVM model constructed using the same three predictors achieved a comparable AUC of 0.908 (95% CI: 0.833-0.982), providing cross-algorithmic validation of the logistic model's robustness. SHAP analysis was applied to elucidate individualized feature contributions to patient-specific predictions, confirming that lower values of inferior GCC thickness exerted the greatest directional influence on HM-NTG classification. CONCLUSIONS: Within highly myopic eyes, the combination of inferior GCC thickness, temporal-inferior RNFL thickness, and inferior VD may help distinguish clinically diagnosed HM-NTG from non-glaucomatous HM. The addition of OCTA microvascular parameters did not significantly increase the AUC but improved patient risk reclassification. This multimodal approach, paired with conventional regression and machine learning, offers a promising adjunctive tool for diagnostic evaluation in highly myopic eyes.
Corneal endothelial morphology in vitiligo: a cross-sectional study with subgroup analysis of periocular involvement.
Kocamış Ö, Sütiçen H
BMC Ophthalmol · 2026 Jun · PMID 42363079 · Full text
PURPOSE: To evaluate corneal endothelial morphology and anterior segment parameters in patients with vitiligo and to investigate the potential impact of periocular involvement on endothelial characteristics. METHODS: In...
PURPOSE: To evaluate corneal endothelial morphology and anterior segment parameters in patients with vitiligo and to investigate the potential impact of periocular involvement on endothelial characteristics. METHODS: In this cross-sectional observational study, 50 patients with vitiligo and 50 age- and sex-matched healthy controls were enrolled. Vitiligo patients were subdivided according to the presence or absence of periocular involvement. All participants underwent comprehensive ophthalmologic examination including autokeratorefractometry, Goldmann applanation tonometry, slit-lamp biomicroscopy, axial length measurement, and specular microscopy. Corneal endothelial parameters including endothelial cell density (CD), hexagonality (HEX), coefficient of variation (CV), and total cell count (N) were analyzed. Statistical comparisons were performed using appropriate parametric and non-parametric tests. RESULTS: Age and sex distribution were comparable between groups (p>0.05). No significant differences were observed between vitiligo and control groups in spherical equivalent, axial length, central corneal thickness, or endothelial parameters (CD, HEX, CV, N) (p>0.05 for all). Subgroup analysis revealed significantly higher endothelial cell density in the periocular vitiligo group compared with the non-periocular subgroup (p=0.008), while other endothelial indices remained similar. CONCLUSION: Corneal endothelial morphology appears preserved in patients with vitiligo. The disease does not seem to confer clinically significant reduction in endothelial reserve or increased surgical risk related to endothelial compromise. Periocular involvement may represent a biologically distinct subset; however, no evidence of endothelial vulnerability was observed. Longitudinal studies incorporating multimodal imaging are warranted.
Statin Intensity and the Risk of Noninfectious Uveitis.
Muayad J, Chauhan MZ, Butt FR … +3 more , Tao BK, Dahr SS, Sallam AB
Ophthalmol Retina · 2026 Jun · PMID 42361978 · Publisher ↗
PURPOSE: To evaluate whether the 5-year risk of incident noninfectious uveitis (NIU) is associated with the intensity of statin therapy in patients with hyperlipidemia. DESIGN: Retrospective, propensity score-matched coh...
PURPOSE: To evaluate whether the 5-year risk of incident noninfectious uveitis (NIU) is associated with the intensity of statin therapy in patients with hyperlipidemia. DESIGN: Retrospective, propensity score-matched cohort study. SUBJECTS: Patients diagnosed with hyperlipidemia within a nationwide federated electronic medical record network (TriNetX). Patients initiating high-, medium-, or low-intensity statin therapy were compared to two mutually exclusive control cohorts: an active comparator control (proton pump inhibitor [PPI] users) and an unexposed control cohort. Patients with prior uveitis or any history of fibrate use were excluded. METHODS: Each statin intensity cohort underwent 1:1 propensity score matching with both control groups to balance baseline demographics and systemic comorbidities. MAIN OUTCOME MEASURES: 5-year hazard ratios (HR) with 95% confidence intervals (CI) for incident overall NIU, anterior uveitis, and posterior/panuveitis. RESULTS: Prior to matching, the study identified 32,434 high-intensity, 16,955 medium-intensity, and 4,843 low-intensity statin users. Following matching, high-intensity statin therapy was associated with a significantly reduced 5-year risk of overall NIU compared to the unexposed control (HR 0.81, 95% CI: 0.69-0.95) with a statistically significant reduction against the active control (HR 0.73, 95% CI: 0.57-0.94). This protective effect was primarily driven by significant reductions in anterior uveitis against both the unexposed control (HR 0.77, 95% CI: 0.65-0.92) and the active control (HR 0.72, 95% CI: 0.55-0.94). Medium-intensity statin therapy yielded a significant risk reduction for overall NIU (HR 0.81, 95% CI: 0.66-0.99) and anterior uveitis (HR 0.84, 95% CI: 0.68-1.03) against the unexposed control but did not reach statistical significance against the active control. Low-intensity statin regimens did not significantly alter the risk of NIU or any anatomical subtype across either comparison group. Negative control outcome analysis demonstrated null associations across all cohorts, supporting the validity of the observed findings. CONCLUSIONS: Statin therapy is associated with an intensity-dependent reduction in the 5-year risk of noninfectious uveitis. High-intensity statin regimens confer the most robust and sustained protective benefit, suggesting that higher-potency dosing is necessary to achieve clinically significant modulation of ocular inflammation.
Efficacy of Prophylactic Laser treatment of Lattice Degeneration in the Fellow Eyes of Patients with Retinal Break(s) in the First Eye.
Ni RL, Adams OE, Momenaei B … +5 more , Yu J, Chiang A, Fineman MS, Spirn MJ, Hsu J
Ophthalmol Retina · 2026 Jun · PMID 42361977 · Publisher ↗
OBJECTIVE: To assess the effect of prophylactic treatment of lattice degeneration on retinal break and rhegmatogenous retinal detachment (RRD) risk in fellow eyes of patients with bilateral lattice degeneration treated f...
OBJECTIVE: To assess the effect of prophylactic treatment of lattice degeneration on retinal break and rhegmatogenous retinal detachment (RRD) risk in fellow eyes of patients with bilateral lattice degeneration treated for retinal break(s) without RD in the first eye. DESIGN: Retrospective cohort study SUBJECTS: Patients diagnosed with lattice degeneration in both eyes who were treated for retinal break(s) in one eye. Patients with < 2-years of follow-up since first eye treatment, prior RRD, pars plana vitrectomy (PPV), bilateral retinal breaks, or laser treatment in either eye before the first visit were excluded. METHODS: Incidence of new retinal break(s) and RD were compared between fellow eyes that received prophylactic treatment vs. fellow eyes that did not. MAIN OUTCOME MEASURES: Proportion of eyes developing retinal breaks or RRD in fellow eyes that received prophylactic treatment compared to those that did not. RESULTS: A total of 802 patients were included. The mean (SD) age was 53.5 (14.2) years, with a mean follow-up duration of 5.2 (2.3) years. Among the fellow eyes, 83 (10.3%) received prophylactic treatment for lattice degeneration after a mean (SD) interval of 22.3 (25.7) months following initial treatment of the first eye, while 719 fellow eyes (89.7%) did not. During the follow-up period, RRD occurred in 5 of the 83 eyes (6%) with prophylactic treatment and in 36 of the 719 eyes (5%) without, with no significant difference between the two groups (P = 0.603). Additionally, new retinal break(s) were observed in 18 (16 retinal tears and 2 retinal holes) of the 83 eyes (21.7%) with prophylactic treatment and in 157 (156 retinal tears and 1 retinal hole) of the 719 (21.8%) without, also showing no significant difference (P >0.99). The composite endpoint of new retinal break(s) or RRD occurred in 19 of 83 (22.9%), prophylactically treated eyes (4 eyes with both new break and RRD), and 179 of 719 (24.9%) non-prophylactically treated eyes (14 eyes with both new break and RRD) (P = 0.69) CONCLUSION: Subsequent prophylactic treatment of fellow eyes did not lower the risk of retinal break(s) or RRD development in patients with bilateral lattice degeneration who developed retinal break(s) in the first eye over a mean follow-up period of 5 years.
Systemic Anemia and the Risk of Diabetic Macular Edema and Anti-VEGF Injections.
Muayad J, Butt FR, Loya A … +5 more , Chauhan MZ, Hussain ZS, Lee AG, Sallam AB, Dahr SS
Ophthalmol Retina · 2026 Jun · PMID 42361976 · Publisher ↗
PURPOSE: To investigate a severity gradient between anemia and the 1-year risk of developing diabetic macular edema (DME) and the need for anti-VEGF injections in patients with type 2 diabetes (T2DM). DESIGN: Multicenter...
PURPOSE: To investigate a severity gradient between anemia and the 1-year risk of developing diabetic macular edema (DME) and the need for anti-VEGF injections in patients with type 2 diabetes (T2DM). DESIGN: Multicenter retrospective cohort study. PARTICIPANTS: Patients with newly recorded T2DM and no prior diabetic eye disease in the TriNetX US Collaborative Network, with a documented ambulatory encounter in the 12 months preceding the index T2DM diagnosis. Exclusions included hemolytic and aplastic anemias, bone marrow failure syndromes, and retinal vascular occlusions. METHODS: Patients were stratified by hemoglobin level into combined and sex-specific cohorts. A sensitivity analysis evaluated patients with hemoglobin <12.0 g/dL receiving iron supplementation within 6 months of index versus matched controls. Independent 1:1 propensity score matching was performed for all sub-analyses. Pre-specified negative control outcomes (chalazion, ingrown toenail) and E-value analyses were performed to assess unmeasured confounding. MAIN OUTCOME MEASURES: 1-year risk of developing DME and 1-year risk of receiving anti-VEGF injections. RESULTS: In the combined cohort (N=127,260), risk of DME rose stepwise across anemia severity compared to controls with normal hemoglobin: mild (HR 1.47, 95% CI 1.36-1.59), moderate-low (HR 1.66, 1.50-1.84), moderate-high (HR 1.99, 1.75-2.28), and severe (HR 2.32, 1.84-2.91). Risk of anti-VEGF injection rose through moderate-high anemia (HR 1.86) and plateaued in severe anemia (HR 1.78). Sex-stratified analyses confirmed this gradient across both subgroups. In the sensitivity analysis (N=19,214), initiating iron supplementation reduced 1-year DME risk (HR 0.86, 0.75-0.99). Negative control outcomes demonstrated null associations across all severity strata; E-values for the primary outcome ranged from 2.30 to 4.07, supporting robustness to unmeasured confounding. CONCLUSIONS: Declining hemoglobin levels are associated with a graded increase in DME risk and anti-VEGF treatment burden across both sexes. The reduced risk observed with iron supplementation suggests anemia may serve as a modifiable systemic factor in DME pathogenesis, warranting prospective investigation.
Early dynamic response on spectral-domain OCT predicts long-term visual outcome in diabetic macular edema treated with aflibercept.
Deng A, Gan Y, Da J … +2 more , Ning Q, Tian R
BMC Ophthalmol · 2026 Jun · PMID 42351090 · Full text
OBJECTIVE: A retrospective evaluation of the long-term visual recovery prediction in patients with diabetic macular edema (DME) following aflibercept treatment, based on spectral-domain optical coherence tomography (SD-O...
OBJECTIVE: A retrospective evaluation of the long-term visual recovery prediction in patients with diabetic macular edema (DME) following aflibercept treatment, based on spectral-domain optical coherence tomography (SD-OCT) parameters at one and four months post-treatment. METHODS: This study involved 112 eyes of 112 DME patients which received at least one injection of aflibercept. SD-OCT parameters at 1 and 4 months post-aflibercept treatment-including central subfield thickness (CST), the continuity of external limiting membrane (ELM)/ellipsoid zone (EZ) and cone outer segment tip (COST), as well as the counts of retinal hyperreflective retinal foci (HRF), along with best-corrected visual acuity (BCVA) improvement at 12 months post-treatment-were analyzed. The correlation between SD-OCT parameters and BCVA improvement was evaluated using the chi-square or Wilcoxon test, and the predicted value of SD-OCT parameters was assessed via receiver operating characteristic (ROC) curve and binary logistic regression model. RESULTS: Twelve months after aflibercept treatment, BCVA was improved from 0.66 ± 0.46 to 0.48 ± 0.42 logMAR (p = 0.002). The SD-OCT parameters were significantly improved: CST was decreased from 397.05 ± 199.60 to 289.08 ± 119.39 μm; the affected eyes with damaged ELM/EZ and COST decreased from 46 (41.1%) and 71 (63.4%) to 31 (27.7%) and 43 (38.4%), respectively; the number of HRF decreased from 11.00 ± 11.38 to 8.03 ± 9.58. The AUC values for predicting BCVA gain of ≥ 5 letters at 12 months based on SD-OCT parameters at 1 and 4 months post-aflibercept treatment and their combination were 0.812, 0.824, and 0.873, respectively. Multivariate logistic analysis revealed that CST, ELM/EZ, COST, and HRF at 1 and 4 months were all independent predictors of long-term visual improvement outcomes. CONCLUSION: Intravitreal injection of aflibercept can effectively improve the vision and fundus structure of DME patients. Improvements in short- and medium-term CST, ELM/EZ, COST integrity, and HRF values are key physiological indicators for visual recovery.
Epidemiology of eyelid disorders in an elderly population: Tehran Geriatric Eye Study.
Hashemi H, Mohammadi A, Aghamirsalim M … +2 more , Hashemi A, Khabazkhoob M
BMC Ophthalmol · 2026 Jun · PMID 42351045 · Full text
PURPOSE: To determine the prevalence and risk factors of some eyelid disorders in adults aged 60 years and older. METHODS: This population-based, cross-sectional study was conducted in Tehran, Iran, in 2019. Participants...
PURPOSE: To determine the prevalence and risk factors of some eyelid disorders in adults aged 60 years and older. METHODS: This population-based, cross-sectional study was conducted in Tehran, Iran, in 2019. Participants were selected via a multistage, stratified random-cluster sampling method. After selection and transportation to the examination site, all participants underwent a standard optometric examination, including visual acuity testing, manifest and subjective refraction. A subsequent comprehensive ophthalmic examination, including slit-lamp biomicroscopy, was performed by an ophthalmologist who diagnosed all eyelid disorders. RESULTS: Of the 3761 individuals selected, 3310 participated in the study. Complete eyelid examinations were performed for 3267 participants (1895 [58%] female; mean age 68.2 ± 49.6 years, range 60-97). Prevalence varied widely by disorder, from 0.23% (entropion) to 55.15% (dermatochalasis). The full prevalence rates were as follows: floppy eyelid syndrome, 0.25%; ectropion, 0.68%; entropion, 0.23%; ptosis, 0.48%; brow ptosis, 5.01%; dermatochalasis, 55.15%; madarosis, 7.8%; trichiasis, 2.45%; poliosis, 3.07%; and eyelid tumors, 2.25%. The prevalence of most disorders increased with age. The most pronounced age-related increase was observed for poliosis, which rose from 1.78% in the 60-64 year age group to 8.45% in those aged 80 years and older. Multiple logistic regression analysis identified the following significant associations: Floppy eyelid syndrome was significantly more common in men. Ectropion was directly associated with age and inversely associated with diabetes. Ptosis was significantly more common in individuals with diabetes. Dermatochalasis was more common in men and was directly associated with both age and body mass index. Madarosis was directly associated with age and inversely associated with female sex. Trichiasis was directly associated with age and inversely associated with diabetes. Poliosis was more common in women and increased with age. CONCLUSION: This study demonstrates that the prevalence of eyelid disorders increases with age in older adults. We observed significant sex-based differences in several conditions, most notably in eyelid tumors and malpositions, suggesting that aging interacts distinctively with environmental and genetic risk factors between men and women. Furthermore, systemic factors such as diabetes and obesity were also associated with specific eyelid pathologies, underscoring the importance of considering these comorbidities during geriatric examinations.
Phacoemulsification combined with bent ab interno needle goniectomy versus high-frequency deep sclerotomy: a comparative study of surgical outcomes in open-angle glaucoma.
Yayla U, Orenc P
BMC Ophthalmol · 2026 Jun · PMID 42351022 · Full text
BACKGROUND: This study aims to compare intraocular pressure (IOP) reduction, surgical success, antiglaucoma medication (AGM) usage, complication profiles, and structural and functional outcomes between phacoemulsificatio...
BACKGROUND: This study aims to compare intraocular pressure (IOP) reduction, surgical success, antiglaucoma medication (AGM) usage, complication profiles, and structural and functional outcomes between phacoemulsification combined with bent ab interno needle goniectomy (Phaco-BANG) and high-frequency deep sclerotomy (Phaco-HFDS) in patients with open-angle glaucoma (OAG), given the lack of direct head-to-head comparisons. METHODS: This retrospective comparative study included 70 eyes from 70 patients (35 per group). The primary outcome was the change in IOP from baseline to postoperative month 12. Secondary outcomes included surgical success rate, changes in AGM use, complications, and structural and functional parameters, such as retinal nerve fiber layer (RNFL) thickness, central macular thickness (CMT), and visual field mean deviation (MD). Surgical success was defined as a reduction in AGM without an increase in IOP, or an IOP of ≤21 mmHg with a ≥ 20% reduction from baseline. RESULTS: At 12 months, mean IOP decreased by -4.3 ± 5.2 mmHg in the Phaco-BANG group and -4.0 ± 4.3 mmHg in the Phaco-HFDS group. Both groups showed significant IOP reduction at all postoperative time points compared to baseline (p < 0.05), with no statistically significant differences between groups (p > 0.05). Surgical success (IOP ≤ 21 mmHg with ≥20% reduction and/or ≥1 medication reduction without IOP increase) was achieved in 80.0% and 77.1% of eyes in the Phaco-BANG and Phaco-HFDS groups, respectively, with similar Kaplan-Meier survival outcomes (all p > 0.05). AGM use was also significantly reduced in both groups, with no statistically significant differences between groups (p > 0.05). The mean reduction in AGM at 12 months was -2.1 ± 1.3 in the Phaco-BANG group and -1.4 ± 0.9 in the Phaco-HFDS group (p = 0.143). No statistically significant differences were observed between the groups regarding structural and functional outcomes. Early postoperative complications were more frequent in the Phaco-BANG group, primarily due to transient hyphema; however, no vision-threatening complications or need for additional glaucoma surgery occurred. CONCLUSIONS: Both Phaco-BANG and Phaco-HFDS were associated with reductions in IOP and AGM use at 12 months in patients with OAG. No statistically significant differences were observed between the two groups regarding IOP reduction, medication burden, surgical success rates, or structural and functional outcomes. Although transient hyphema was more common following Phaco-BANG, both procedures demonstrated favorable safety profiles.
Circumferential quantitative analysis of iris angiography reveals progressive pupillary-margin leakage across stages of diabetic retinopathy.
Yang Q, Zhang H, Ke Y … +2 more , Li X, Zhang L
BMC Ophthalmol · 2026 Jun · PMID 42351005 · Full text
OBJECTIVE: To investigate the value of a circumference-based quantitative analysis of iris angiography (IA) in evaluating iris vascular changes across different stages of diabetic retinopathy (DR). METHODS: This observat...
OBJECTIVE: To investigate the value of a circumference-based quantitative analysis of iris angiography (IA) in evaluating iris vascular changes across different stages of diabetic retinopathy (DR). METHODS: This observational study included 66 healthy subjects and 185 patients with diabetes, classified as no apparent retinopathy, non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR). All participants underwent ultrawide-field fundus fluorescein angiography and IA, including iris fluorescein angiography and iris indocyanine green angiography. A custom-built software was used to quantify fluorescein leakage at the pupillary margin by measuring leakage time (LT) and circumferential leakage range (LR, degrees). Comparisons among groups were performed using one-way analysis of variance. RESULTS: No fluorescein leakage was observed at the pupillary margin in healthy subjects aged 20-39 years, whereas mild and transient leakage was detected in older healthy patients. In patients with DR, LT was significantly shorter in the PDR group than in the no-retinopathy and NPDR groups (25.67 ± 5.03 s vs. 33.14 ± 3.03 s and 32.45 ± 5.17 s, respectively; all P < 0.001). The LR increased with DR severity, measuring 21.21 ± 30.06° in the no-retinopathy group, 62.48 ± 42.17° in the NPDR group, and 141.31 ± 73.61° in the PDR group (all P < 0.001). LR values in the NPDR and PDR groups were significantly greater than those in age-matched healthy subjects. CONCLUSION: Circumference-based quantitative analysis of IA enables quantitative assessment of pupillary-margin fluorescein leakage and was associated with DR severity. This method may provide additional information for evaluating anterior segment vascular involvement in patients with diabetic retinopathy, particularly when posterior segment examination is limited. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2400081639), registered on Mar 7, 2024.
Short-term outcomes of selective laser trabeculoplasty in pseudophakic primary angle-closure glaucoma after iridotomy: a retrospective pilot comparison with primary open-angle glaucoma.
Hsieh YC, Lu WY, Chen YL … +1 more , Chiu SL
BMC Ophthalmol · 2026 Jun · PMID 42351004 · Full text
BACKGROUND: Selective laser trabeculoplasty (SLT) is a widely accepted treatment for primary open-angle glaucoma (POAG), but its role in primary angle-closure glaucoma (PACG) remains less defined. This study aimed to eva...
BACKGROUND: Selective laser trabeculoplasty (SLT) is a widely accepted treatment for primary open-angle glaucoma (POAG), but its role in primary angle-closure glaucoma (PACG) remains less defined. This study aimed to evaluate the short-term outcomes of SLT in pseudophakic PACG patients who had undergone prior laser peripheral iridotomy (LPI), and to compare outcomes with those in POAG patients. METHODS: This retrospective study included pseudophakic patients diagnosed with PACG after LPI or POAG who underwent SLT. Intraocular pressure (IOP) and topical antiglaucoma medication use were assessed at baseline and at 1, 2, and 3 months after SLT. Changes in IOP over time were analyzed, and multivariable linear regression was performed to evaluate factors associated with IOP reduction at 1 month. RESULTS: A total of 123 patients were included, comprising 89 with POAG and 34 with PACG. The PACG group was older and had a higher proportion of female patients. The mean IOP reduction was numerically comparable between groups at each follow-up visit. At 1 month, a statistically significant reduction in IOP was observed in the POAG group. The PACG group also demonstrated a numerical reduction in IOP, although this did not reach statistical significance. However, the between-group comparison at 1 month should be interpreted cautiously given the limited sample size and multiple comparisons. The number of glaucoma medications remained unchanged during the follow-up period in both groups. In multivariable analysis, baseline IOP was associated with greater IOP reduction at 1 month, whereas SLT energy parameters were not significantly associated with treatment response. No major complications were recorded during the study period. CONCLUSIONS: SLT demonstrated a short-term IOP-lowering effect in pseudophakic PACG after LPI, with outcomes numerically similar to those in pseudophakic POAG. These findings should be considered preliminary and warrant confirmation in larger prospective studies with longer follow-up.
Early macular microvascular attenuation in moderate myopia: projection artifact-removed and magnification-corrected optical coherence tomography angiography in an Iranian adult cohort.
Naderi A, Afshar F, Nasrollahi K … +3 more , Ghanbari H, Salehi A, Ramezani Majd A
BMC Ophthalmol · 2026 Jun · PMID 42343323 · Full text
BACKGROUND: This study aimed to evaluate macular and peripapillary optical coherence tomography angiography (OCTA) parameters in mild and moderate myopic eyes compared with emmetropic controls, utilizing built-in project...
BACKGROUND: This study aimed to evaluate macular and peripapillary optical coherence tomography angiography (OCTA) parameters in mild and moderate myopic eyes compared with emmetropic controls, utilizing built-in projection artifact removal (PAR) and rigorous magnification correction. METHODS: This prospective cross-sectional study included 218 eyes (90 emmetropic, 59 mild myopic, and 69 moderate myopic) of adults aged 20-52 years. Macular and optic disc OCTA scans were acquired using the RTVue-XR Avanti system with the built-in 3D-PAR algorithm enabled. Lateral magnification correction was performed post-hoc using the full Littmann-Bennett method ([Formula: see text]), with quadratic scaling applied to area measurements to ensure absolute mathematical precision. Eyes with axial length (AL) > 25.8 mm were excluded to minimize segmentation artifacts associated with posterior staphyloma and globe deformation. RESULTS: Deep macular vessel density (VD) demonstrated a significant stepwise reduction across groups: emmetropia (45.92% ± 8.83) → mild myopia (41.44% ± 7.94) → moderate myopia (39.64% ± 10.74) (ANOVA P < 0.001). In contrast, superficial macular VD showed no statistically significant difference between mild myopia and emmetropia, with a significant decline observed only in moderate myopia (P < 0.05). The Foveal Avascular Zone (FAZ) area was significantly enlarged in moderate myopia (0.35 ± 0.12 mm², P < 0.001) but remained stable in mild myopia. In multivariable regression, spherical equivalent (SE) was the dominant independent predictor of deep VD reduction (Standardized β = -0.41, P < 0.001). CONCLUSIONS: Retinal microvascular attenuation appears to begin early in the deep capillary plexus (even in mild myopia), whereas superficial plexus and FAZ changes are features of more advanced severity. These findings suggest that DCP vessel density is a sensitive population-level indicator of early pathophysiological remodeling, although its current diagnostic utility for individual clinical monitoring is limited by measurement variability relative to the effect size.
Hand-eye laterality and structural asymmetry between dominant and non-dominant eyes: a multi-modal study in 524 healthy volunteers.
Kiyat P, Palamar M
BMC Ophthalmol · 2026 Jun · PMID 42343322 · Full text
BACKGROUND: To investigate the relationship between ocular and hand dominance patterns in healthy volunteers and to evaluate structural differences between dominant and non-dominant eyes using anterior and posterior segm...
BACKGROUND: To investigate the relationship between ocular and hand dominance patterns in healthy volunteers and to evaluate structural differences between dominant and non-dominant eyes using anterior and posterior segment measurements. METHODS: This cross-sectional study included 524 healthy volunteers (50% female, age 20-60). Ocular dominance was determined using the hole-in-card test and hand dominance with the Edinburgh Handedness Inventory. Participants underwent Swept-Source Optical Coherence Tomography for retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), subfoveal choroidal thickness (SFCT), and choroidal vascularity index (CVI) measurements; Scheimpflug imaging for anterior segment parameters; and partial coherence interferometry for axial length determination. RESULTS: Right eye dominance was observed in 60.9% and left eye dominance in 39.1% of participants. A pronounced cross-lateralization pattern emerged: 93.6% of left eye dominant individuals exhibited right hand dominance, significantly higher than in right eye dominant participants (57.1% right-handed, p = 0.024; 42.9% left-handed, p = 0.016). After correction for multiple comparisons, dominant eyes demonstrated significantly greater central corneal thickness (p = 0.002). RNFL nasal quadrant thickness showed the strongest trend toward significance (p = 0.014). Axial length, additional RNFL quadrants, and GCC sectors demonstrated consistent trends toward significance. No differences were found in SFCT or CVI. CONCLUSIONS: Dominant eyes demonstrated significantly greater central corneal thickness after correction for multiple comparisons, with nasal RNFL thickness showing the strongest trend toward significance. A differential lateralization pattern was observed between ocular dominance groups, suggesting a potential association between ocular and manual preferences; however, this finding warrants cautious interpretation given the population-level prevalence of right-handedness. TRIAL REGISTRATION: This cross-sectional study was approved by the Institutional Ethics Committee of İzmir Democracy University, Buca Seyfi Demirsoy Training and Research Hospital (date: 26.03.2025; number: 2025/427) and adhered to the principles of the Declaration of Helsinki.
Diagnostic capability of ganglion cell complex thickness using spectral domain optical coherence tomography in glaucoma.
Poudel A, Gautam Adhikari P, Ghimire B … +1 more , Thapa M
BMC Ophthalmol · 2026 Jun · PMID 42343315 · Full text
BACKGROUND: This study had two main aims: first, aimed to document the normal values of macular ganglion cell complex (GCC) thickness among control eyes and glaucoma suspects and second, to evaluate the diagnostic abilit...
BACKGROUND: This study had two main aims: first, aimed to document the normal values of macular ganglion cell complex (GCC) thickness among control eyes and glaucoma suspects and second, to evaluate the diagnostic ability of GCC parameters in distinguishing Primary Open Angle Glaucoma (POAG), Glaucoma Suspects and Controls in a tertiary eye centre in Nepal. METHODS: A hospital-based cross-sectional observational study was conducted in Kathmandu, Nepal, from June 2020 to June 2021. GCC parameters (Average GCC, Superior GCC, and Inferior GCC) were measured using spectral-domain Optical Coherence Tomography (OCT). These parameters were compared among groups using Linear Mixed-effect Models, considering considerable inter-eye correlation. Receiver operating characteristic (ROC) curves were constructed, and area under the curve (AUC) values were calculated to assess diagnostic performance. RESULTS: A total of 203 patients (406 eyes) were included - 76 with POAG, 62 Glaucoma suspects, and 65 Controls. Average GCC, superior GCC and Inferior GCC thickness were 96.54 ± 10.09 μm, 96.68 ± 10.91 μm and 96.43 ± 9.60 μm, in controls; 83.30 ± 11.46 μm, 83.88 ± 12.29 μm, and 81.94 ± 13.19 μm in POAG, and 93.76 ± 7.74 μm, 94.02 ± 8.03 μm, and 93.82 ± 8.27 μm, respectively in glaucoma suspects. All GCC parameters were significantly lower in the POAG group compared with both glaucoma suspects and controls (p < 0.05), even after adjustment for age. The highest diagnostic accuracy was observed for average GCC (AUC = 0.83, 95% C.I. - 0.77-0.92) and inferior GCC (AUC = 0.83, 95% C.I. - 0.76-0.90), both demonstrating excellent discrimination between POAG and controls (AUC = 0.83). CONCLUSIONS: All GCC parameters demonstrated a significant diagnostic capability in detecting POAG, with average GCC and inferior GCC thickness showing the best performance. The single-centre cross-sectional study design, and lack of randomisation were the main limitations of this study.
Conjunctival goblet and epithelial cell changes in antidepressant-associated dry eye disease: a case-control study.
Chotaliya R, Mishra N, Prasad N … +3 more , Buch A, Kelkar P, Madan V
BMC Ophthalmol · 2026 Jun · PMID 42343308 · Full text
PURPOSE: Antidepressants influence tear film stability, but their effects on goblet cell density (GCD) and conjunctival epithelium remain underexplored. This study evaluated GCD and histomorphological changes in antidepr...
PURPOSE: Antidepressants influence tear film stability, but their effects on goblet cell density (GCD) and conjunctival epithelium remain underexplored. This study evaluated GCD and histomorphological changes in antidepressant users versus controls. METHODS: In this case-control study, 72 antidepressant users (cases), and 70 matched controls (aged 20-40 years) underwent tear break-up time (TBUT), Schirmer testing, Ocular Surface Disease Index (OSDI) assessment, corneal/conjunctival staining evaluation, and conjunctival impression cytology. GCD, nuclear-cytoplasmic (NC) fraction, cell-to-cell contact, and nuclear changes were evaluated at 400× magnification. ImageJ software was used for goblet cell counting and measuring NC fraction. Commonly prescribed antidepressants such as selective serotonin reuptake inhibitors, selective norepinephrine reuptake inhibitors and tricyclic antidepressants were included in the study. RESULTS: Cases showed reduced GCD (183 ± 157 vs. 366 ± 164 cells/mm², P < 0.001), NC fraction (0.34 ± 0.09 vs. 0.41 ± 0.08, P < 0.001), TBUT (6.7 ± 3.1 vs. 10.8 ± 4.1 s, P < 0.001), and Schirmer wetting (5.8 ± 2.4 vs. 7.6 ± 3.6 mm/5 min, P < 0.001), with higher OSDI scores (25.6 ± 17.6 vs. 12.3 ± 7.3, P < 0.001), corneal staining (OR 13.0, 95% CI 4.7-36.1), and conjunctival staining (P = 0.009). Morphological grades worsened in cases (all P < 0.001). GCD correlated positively with TBUT (r = 0.41, P < 0.001) and Schirmer (r = 0.43, P < 0.001). No differences existed across SSRI/SNRI/TCA subgroups. CONCLUSIONS: Antidepressant use associates with goblet cell loss, epithelial alterations, and dry eye disease (DED), warranting routine ocular monitoring.
Long-term outcomes of sutured and sutureless (Yamane) scleral-fixated intraocular lens implantation for lens subluxation in Marfan syndrome: a retrospective case series.
Doğruya S, Önal Artan FD, Erdoğan M … +2 more , Kayıkçıoğlu ÖC, Kayıkçıoğlu ÖR
BMC Ophthalmol · 2026 Jun · PMID 42343281 · Full text
PURPOSE: To describe scleral-fixation surgical approaches in patients with Marfan syndrome and lens subluxation and to evaluate postoperative visual outcomes and complications. DESIGN: Retrospective case series. METHODS:...
PURPOSE: To describe scleral-fixation surgical approaches in patients with Marfan syndrome and lens subluxation and to evaluate postoperative visual outcomes and complications. DESIGN: Retrospective case series. METHODS: Medical records of 9 patients (15 eyes) with Marfan syndrome who underwent surgery for lens subluxation between January 2015 and March 2023 were retrospectively reviewed. Surgical techniques included sutured scleral fixation, sutureless intrascleral fixation (Yamane technique), and vitrectomy-assisted procedures when indicated. Preoperative and postoperative best-corrected visual acuity (BCVA), postoperative complications, secondary interventions, and intraocular lens (IOL) position were analyzed. Outcomes according to fixation technique were assessed descriptively due to small and unbalanced subgroup sizes. RESULTS: Sutured scleral fixation was performed in 13 eyes, while sutureless intrascleral fixation using the Yamane technique was applied in 2 eyes. The mean patient age was 15.46 ± 15.88 years (range, 5-70 years), and the mean follow-up duration was 30.66 months (range, 7-120 months). BCVA improved significantly from 1.28 ± 0.76 logMAR preoperatively to 0.69 ± 0.80 logMAR postoperatively (p = 0.01). Postoperative complications occurred in 4 eyes (26.7%), including retinal detachment in one eye (6.7%) and intraocular lens subluxation or pupillary capture in three eyes (20%). All complications were successfully managed with secondary surgical interventions. Visual improvement was limited in two eyes due to pre-existing amblyopia. CONCLUSION: Scleral-fixated intraocular lens implantation is an effective option for visual rehabilitation in patients with Marfan syndrome and lens subluxation. However, observed complication patterns highlight the importance of individualized surgical planning and long-term postoperative surveillance. Comparisons between fixation techniques should be interpreted as descriptive.
Endoscope-assisted vitrectomy using a 25-gauge system for endophthalmitis: a case series.
Otsubo M, Konno S, Konno A … +2 more , Yokota H, Nagaoka T
BMC Ophthalmol · 2026 Jun · PMID 42343272 · Full text
PURPOSE: To present a series of seven cases of postoperative endophthalmitis managed with 25-gauge endoscope-assisted vitrectomy using a 10,000-pixel endoscope and to outline the surgical technique and clinical outcomes....
PURPOSE: To present a series of seven cases of postoperative endophthalmitis managed with 25-gauge endoscope-assisted vitrectomy using a 10,000-pixel endoscope and to outline the surgical technique and clinical outcomes. METHODS: This study included seven consecutive cases of postoperative endophthalmitis treated with 25-gauge endoscope-assisted vitrectomy at Asahikawa Medical University Hospital between November 2024 and September 2025. Anesthesia was selected based on ocular pain severity: sub-Tenon's for mild pain and retrobulbar for severe pain. Best-corrected visual acuity (BCVA) before surgery and at the final visit was compared using the Wilcoxon signed-rank test. RESULTS: Seven cases (5 males and 2 females) were included. The mean age was 74.0 ± 9.1 years. Prior surgeries included cataract surgery (PEA + IOL) in three cases, pars plana vitrectomy in one case, and filtration surgery in three cases. Preoperative visual acuity was light perception in one case and hand motion in six cases. Retrobulbar anesthesia was used in five cases and sub-Tenon's anesthesia in two cases. Peripheral vitreous shaving was successfully performed without scleral indentation in all cases. Visual acuity improved in all cases, with a mean final BCVA of logMAR 0.36 ± 0.35 (p = 0.022). CONCLUSION: Endoscope-assisted vitrectomy may be a useful surgical option for postoperative endophthalmitis.
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