Ophthalmology [JOURNAL]
Sun
200 papers
The association between objective visual quality, retinal structure, and dynamic visual acuity.
Li R, Wang Z, Wang Y
BMC Ophthalmol · 2026 Jun · PMID 42249354 · Full text
BACKGROUND: The dynamic visual acuity (DVA) is crucial to assess dynamic visual function in clinical ophthalmology. The impact of objective ocular parameters on DVA remained unknown, which limits the clinical applicabili...
BACKGROUND: The dynamic visual acuity (DVA) is crucial to assess dynamic visual function in clinical ophthalmology. The impact of objective ocular parameters on DVA remained unknown, which limits the clinical applicability and interpretability of the DVA test. Thus, the present research aims to investigate the impact of objective visual quality and retinal structure on DVA. METHODS: Healthy young myopic adults aged 18 to 35 years were recruited. Binocular dynamic visual acuity (DVA) was evaluated at a 1-meter distance with habitual spectacles. The test comprised four sequential assessments of horizontal motion DVA at increasing velocities of 20, 40, 60, and 80 degrees per second (dps). Modulation transfer function (MTF) and higher-order aberrations (HOA) were measured to evaluate visual quality. Retinal structure, including retinal thickness and capillary density in the optic disc and macula was measured with optical coherence tomography angiography (OCTA). RESULTS: Thirty participants were enrolled with a mean age of 23.0 ± 3.7 years. DVA differed significantly across velocities (P < 0.001). DVA at 20 dps (r = -0.537, P = 0.002) and 60 dps (r = -0.430, P = 0.018) were negatively correlated with the binocular mean sphere. DVA at 20 and 60 dps was significantly associated with MTF value from 5 to 30 cycle/degree (c/d), and 80 dps DVA was associated with MTF value at spatial frequencies from 10 to 20 c/d (P < 0.05, respectively). The Z9 aberration showed a positive association with DVA at 20 dps (P = 0.047), and the Z7 aberration showed a significant positive association with DVA at 80 dps (P = 0.030). Limited associations were observed between DVA and retinal thickness or capillary density in the optic disc and macula. CONCLUSIONS: In healthy myopic adults, better objective visual quality, as measured by MTF, might be associated with better DVA at both low and high speeds, whereas retinal structural parameters had a limited association with DVA. The conclusions are limited by applicating habitual spectacle during the DVA test, which precludes full quantification of optical confounding.
The influence of pterygium size on corneal refractive properties and higher-order aberrations.
Shen J, Chen Y, Chen Y … +2 more , Gou B, Cui H
BMC Ophthalmol · 2026 Jun · PMID 42249342 · Full text
OBJECTIVE: To evaluate associations between pterygium size parameters and corneal refractive properties and higher-order aberrations (HOAs). METHODS: In 41 patients with unilateral pterygium, thickness, length, and width...
OBJECTIVE: To evaluate associations between pterygium size parameters and corneal refractive properties and higher-order aberrations (HOAs). METHODS: In 41 patients with unilateral pterygium, thickness, length, and width were measured by anterior segment optical coherence tomography(AS-OCT). Corneal refractive parameters, irregularity indices, and HOAs were assessed using Pentacam HR. Correlation analyses evaluated relationships between pterygium dimensions and corneal parameters. RESULTS: Pterygium length and width significantly correlated with multiple corneal parameters in the 3-7 mm zone. Moderate correlations were found with K1 (length: |r| = 0.376-0.473; width: |r| = 0.361-0.415; all p < 0.05), and stronger correlations with corneal astigmatism (length: r = 0.582-0.642; width: r = 0.529-0.581; all p < 0.001) and irregularity indices (ISV, IVA, IHD) (length: r = 0.623-0.637; width: r = 0.566-0.596; all p < 0.001). Length positively correlated with total, third-, and fourth-order HOA RMS across the anterior and posterior surface, and entire cornea (r = 0.455-0.691, p < 0.05), primarily driven by vertical trefoil, vertical coma, and tetrafoil. Width also correlated with anterior and total corneal HOAs (r = 0.519 to 0.645, p < 0.05). Posterior surface correlations for width were weaker (r = 0.313 to 0.472, p < 0.05) but remained significant for total RMS, third-order RMS, and several specific aberrations. CONCLUSION: Pterygium length and width are key parameters associated with deteriorated corneal refractive status, irregularity, and HOAs. Width, being easily standardized, serves as a practical indicator for predicting pterygium-induced visual quality deterioration.
Early postoperative alignment as a predictor of recurrence after unilateral recession-plication for basic-type intermittent exotropia in children.
Ren Y, Jin K, Cao D … +4 more , Wang Y, Liu L, Li L, Jiang J
BMC Ophthalmol · 2026 Jun · PMID 42249332 · Full text
PURPOSE: This study aimed to identify clinical factors associated with early motor recurrence after unilateral lateral rectus recession with medial rectus plication (RP) in children with basic-type intermittent exotropia...
PURPOSE: This study aimed to identify clinical factors associated with early motor recurrence after unilateral lateral rectus recession with medial rectus plication (RP) in children with basic-type intermittent exotropia (IXT). METHODS: This retrospective cohort study enrolled children with basic-type IXT who underwent unilateral RP between January 2022 and December 2023. The primary outcome was early motor recurrence, defined as an exodeviation greater than 10 prism diopters (PD) at near at 6 months postoperatively. Early motor success was defined as horizontal exodeviation or esodeviation of 10 PD or less. Deviation at distance and near, fusion, and stereopsis were evaluated at predefined postoperative time points. Multivariable logistic regression and receiver operating characteristic (ROC) analyses were used to assess factors associated with early recurrence and final motor outcomes. RESULTS: Ninety-one patients were included (mean age, 8.10 ± 3.06 years; mean follow-up, 16.81 months). Thirty-one patients met criteria for early motor recurrence, and 60 achieved early motor success. The early recurrence group had significantly larger residual exodeviation at distance and near during the first postoperative week (P < 0.05). In adjusted logistic regression analyses, both near and distance deviations within the first postoperative week were independently associated with early motor recurrence at 6 months (near: OR = 0.738, 95% CI 0.609-0.895, P = 0.002; distance: OR = 0.736, 95% CI 0.606-0.893, P = 0.002) and with final motor failure (near: OR = 0.798, 95% CI 0.683-0.932, P = 0.004; distance: OR = 0.796, 95% CI 0.681-0.930, P = 0.004). Alignment at 6 months showed stronger adjusted associations with final motor outcome at both near and distance. ROC analysis showed moderate discriminative performance for near deviation within 1 week in identifying early recurrence (AUC = 0.7315) and stronger discrimination for near deviation at 6 months in identifying final motor outcome (AUC = 0.8461); these thresholds require external validation. At final follow-up, fusion was more frequent in the early motor success group (P = 0.011). CONCLUSIONS: Among children with basic-type IXT undergoing unilateral RP, early postoperative alignment at near and distance was associated with early motor recurrence and final motor failure. Alignment at 6 months showed stronger associations with final motor outcome and should be interpreted as a mid-term prognostic marker rather than an independent early predictor. These findings support careful monitoring of near and distance alignment during the first 6 postoperative months, while acknowledging that the proposed cutoff values require validation in larger, independent cohorts.
Mask-associated dry eye disease following short-term facemask wear with or without nasal bridge taping among health workers at a Nigerian tertiary care facility: a cross-over randomized clinical trial.
Amaefuna KP, Morgan RE, Bekibele CO
BMC Ophthalmol · 2026 Jun · PMID 42249316 · Full text
BACKGROUND: Mask-Associated Dry Eye disease (MADE) has been linked to facemask wear predominantly because of the upward flow of expired air towards the eyes. Taping the rim of the mask to the nasal bridge has been propos...
BACKGROUND: Mask-Associated Dry Eye disease (MADE) has been linked to facemask wear predominantly because of the upward flow of expired air towards the eyes. Taping the rim of the mask to the nasal bridge has been proposed to reduce MADE. This study compared dry eye disease rates following short-term face mask wear with or without taping the nasal bridge among health workers in National Hospital Abuja. METHODS: This was a cross-over randomized clinical trial conducted between February and July 2024 at National Hospital Abuja. It involved 77 health workers recruited according to their work environments (Open = 38 and Restricted = 39) using a stratified sampling method. Participants completed a modified MADE Questionnaire to assess MADE risk factors and symptoms. Dry eye symptom scores, Schirmer's test values, Tear Break-Up Time (TBUT), and Oxford ocular surface staining scores were measured before and after six hours of facemask wear, with and without nasal bridge taping, on two separate days. Participants were randomized into group A or B corresponding to facemask wear without taping or with taping on the 1st day. MADE was defined as presence of dry eye symptoms plus an abnormal TBUT, Schirmer's or Oxford corneal staining score post-facemask wear. Descriptive statistics, paired T-test, ANOVA, binary logistic regression and crossover analysis were used to analyze data using SPSS version 26, with statistical significance set at p < 0.05. RESULTS: The mean age of participants was 32.40 ± 9.14 years, with a male to female ratio of 1:2.21. There was a statistically significant difference in all outcome variables pre and post facemask wear with and without taping at the nasal bridge (p < 0.05). TBUT and Oxford scores showed greater improvement post-taped mask wear when compared with mask wear without taping (7.40 ± 2.24 s vs. 5.63 ± 1.82 s; and 0.23 ± 0.43 vs. 0.51 ± 0.70; p < 0.001). MADE developed in 14.3% of participants after facemask wear without taping, versus 3.9% with taping. Working in open environments was identified as a predictor of MADE in the non-taping group (OR: 0.111, p = 0.019). Crossover analysis showed significant carry-over effects in outcome variables. CONCLUSIONS: Short-term facemask wear can result in dry eye disease and taping facemasks at the nasal bridge can reduce these effects. TRIAL REGISTRATION: Retrospectively registered with the Pan African Clinical Trial Registry ( https://pactr.samrc.ac.za/ ) on August 1, 2025 PACTR202508721722676.
Early retinal, optic disc and choriocapillaris microvascular alterations in children with type 1 diabetes without clinical retinopathy: an OCTA-based case-control study.
Bolat S, Sönmez ÖA, Topuz HN … +1 more , Özbaş M
BMC Ophthalmol · 2026 Jun · PMID 42243767 · Full text
AIM: To assess retinal, optic disc, and choriocapillaris microvascular changes in children with type 1 diabetes mellitus (T1DM) using optical coherence tomography angiography (OCTA). MATERIALS AND METHODS: This cross-sec...
AIM: To assess retinal, optic disc, and choriocapillaris microvascular changes in children with type 1 diabetes mellitus (T1DM) using optical coherence tomography angiography (OCTA). MATERIALS AND METHODS: This cross-sectional study included 154 children, comprising 77 children with T1DM and 77 healthy controls. One eye from each participant was analyzed. OCTA was used to evaluate vessel density in the superficial and deep capillary plexuses, foveal avascular zone area, radial peripapillary capillary vessel density, and choriocapillaris non-perfused area (NPCA) ratios. Foveal thickness and subfoveal choroidal thickness were measured using optical coherence tomography. Age, sex, body mass index, and HbA1c levels were recorded for all participants, along with disease duration and daily insulin dose in the T1DM group. RESULTS: Superficial capillary plexus vessel density and foveal avascular zone parameters did not differ significantly between the T1DM and control groups (p > 0.05). Deep capillary plexus vessel density was also comparable between groups across most regions; however, superior hemi-area vessel density was higher in the T1DM group on unadjusted analysis (p < 0.05). Radial peripapillary capillary vessel density in the peripapillary region and whole-image analysis showed no significant differences between groups (p > 0.05). In contrast, intrapapillary vessel density was lower in children with T1DM (p < 0.05). Choriocapillaris NPCA ratio and foveal thickness were increased in the T1DM group (p < 0.05), while subfoveal choroidal thickness showed no significant difference between groups (p > 0.05). CONCLUSION: Children with T1DM without clinical retinopathy may show early microvascular alterations on OCTA, particularly increased central choriocapillaris non-perfusion and reduced intrapapillary vessel density. These findings support the potential value of OCTA in detecting preclinical ocular microvascular involvement in pediatric T1DM before clinically detectable retinopathy develops.
Central and peripheral optical quality after FS-LASIK, SMILE, and phakic ICL implantation for moderate to high myopia.
Lin Y, Wei X, Huang B … +3 more , Li Y, Su H, Huang M
BMC Ophthalmol · 2026 Jun · PMID 42243759 · Full text
BACKGROUND: FS-LASIK, small-incision lenticule extraction (SMILE), and phakic intraocular lens (ICL) implantation are widely used for correcting moderate to high myopia, yet their effects on peripheral optical quality re...
BACKGROUND: FS-LASIK, small-incision lenticule extraction (SMILE), and phakic intraocular lens (ICL) implantation are widely used for correcting moderate to high myopia, yet their effects on peripheral optical quality remain incompletely understood. This study compared central and peripheral optical outcomes after these three procedures using on-axis and off-axis wavefront measurements. METHODS: This retrospective comparative study included 598 eyes (18-35 years) that underwent FS-LASIK, SMILE, or phakic ICL implantation. Wavefront aberrations were measured preoperatively and at 6 months postoperatively, both centrally and at ± 30° eccentric fixation, using a modified Shack-Hartmann aberrometer. The measurements were reconstructed over a 4.5-mm pupil, ensuring consistency across subjects.Second-, third-, and fourth-order RMS aberrations, peripheral relative defocus, astigmatic vector J0, and horizontal coma were analyzed pre- and postoperatively, with inter-group comparisons and correlations with preoperative spherical equivalent (SE). RESULTS: All procedures achieved high refractive accuracy with minimal surgically induced astigmatism. Second-order aberrations were substantially reduced in all groups. Third-order aberrations increased postoperatively, most prominently after FS-LASIK, followed by SMILE and then ICL implantation, while fourth-order changes were small and similar among groups. Peripheral relative defocus shifted toward hyperopia after all procedures, greatest after FS-LASIK. Induced higher-order aberrations and peripheral defocus were significantly correlated with preoperative SE, particularly in the FS-LASIK group. CONCLUSIONS: Although FS-LASIK, SMILE, and phakic ICL implantation all provided effective correction of moderate to high myopia, they were associated with different patterns of postoperative central and peripheral optical change. In this cohort, phakic ICL implantation showed relatively smaller changes in peripheral optical quality measures, whereas FS-LASIK was associated with greater spherical equivalent-dependent increases in higher-order aberrations and peripheral hyperopic defocus. Peripheral wavefront assessment may provide clinically relevant information beyond central aberrometry.
Gildeuretinol Acetate vs Placebo for Geographic Atrophy Secondary to Age-Related Macular Degeneration: The SAGA Randomized Clinical Trial.
Boyer DS, Saad L, Washington I … +10 more , Melamud A, Graham KB, O'Malley AE, DeBartolomeo GM, Jiang H, Harris LD, Kay CN, Ferrone PJ, Khan S, SAGA Study Team
Ophthalmol Retina · 2026 Jun · PMID 42242606 · Publisher ↗
OBJECTIVE: To assess the effects of gildeuretinol acetate (C20D3-vitamin A) in geographic atrophy (GA). DESIGN: 24-month, double-masked, multicenter, randomized, placebo-controlled trial. PARTICIPANTS: Participants ≥60 y...
OBJECTIVE: To assess the effects of gildeuretinol acetate (C20D3-vitamin A) in geographic atrophy (GA). DESIGN: 24-month, double-masked, multicenter, randomized, placebo-controlled trial. PARTICIPANTS: Participants ≥60 years with GA. INTERVENTIONS: Randomized 2:1 to oral gildeuretinol acetate 14 mg daily or placebo. MAIN OUTCOME MEASURES: The primary endpoint was GA growth rate from baseline to 24 months. A prespecified sensitivity analysis accounted for a 6-month delay in onset of therapeutic effect. Secondary endpoints included change from baseline in low luminance visual acuity (LLVA), best-corrected visual acuity (BCVA), Visual Function Questionnaire (VFQ)-25, and Functional Reading Independence (FRI) Index. RESULTS: Among 198 randomized participants (mean [SD] age 78.4 [7.0] years; 68.7% female), 69.2% completed the 24-month study. In the gildeuretinol and placebo groups, baseline mean (SD) total GA lesion area in mm was 7.72 (6.10) and 7.09 (4.16); BCVA letter scores were 56.2 (21.3) (Snellen equivalent: ∼20/80) and 58.8 (18.0) (∼20/70); and LLVA letter scores were 31.1 (19.0) (∼20/200) and 31.6 (17.8) (∼20/250), respectively. Mean GA growth rates were 1.62 mm/year with gildeuretinol and 1.87 mm/year with placebo (least squares [LS] mean difference: -0.25 mm/year; 95% CI: -0.53, 0.03; P = 0.075), a 13.4% relative reduction for gildeuretinol vs placebo. The LS mean (SE) GA growth rates from 6 to 24 months were 1.90 (0.12) mm/year (placebo) and 1.61 (0.08) mm/year (gildeuretinol), a 15.3% relative reduction (-0.29 mm/year; 95% CI: -0.576, -0.004; nominal P = 0.047). At 24 months, LLVA declined 3.9 and 8.3 ETDRS letters in the gildeuretinol and placebo groups, respectively (difference: 4.4 letters; 95% CI: 0.40, 8.41; nominal P = 0.031). BCVA declined 6.9 letters with gildeuretinol and 10.2 letters with placebo (difference: 3.3 letters; 95% CI: -0.63, 7.23; P = 0.099). VFQ-25 scores declined 4.81 fewer points with gildeuretinol than placebo (95% CI: 0.87, 8.76; nominal P = 0.017) and FRI scores declined 0.35 fewer points (95% CI: 0.11, 0.58; nominal P = 0.004). CONCLUSIONS: The prespecified primary endpoint was not met. Prespecified piecewise and secondary functional/patient-reported analyses favored gildeuretinol with nominal P values; these exploratory findings support further evaluation in adequately powered trials.
Large Language Model Authorship in Ophthalmic Publications.
Fortenbach CR, Wu YS, Mungra PM … +1 more , Van Gelder RN
Ophthalmology · 2026 Jun · PMID 42242387 · Publisher ↗
PURPOSE: To assess for the likely presence of artificial intelligence (AI)-generated text in the published ophthalmology literature. METHODS: Abstract text from 27,142 research articles published in 22 journals between M...
PURPOSE: To assess for the likely presence of artificial intelligence (AI)-generated text in the published ophthalmology literature. METHODS: Abstract text from 27,142 research articles published in 22 journals between May 2020 and May 2025 were evaluated for changes in word-frequency usage with a focus on stylistic words previously found to be associated with LLM-generated text. Four commercial AI-detection services (ZeroGPT, Writer.com, Winston AI, GPTZero) were first validated against control articles with GPTZero showing the best performance, which was then used to detect the presence of AI-generated text in 50 full articles from each journal. For the large-scale screening, research articles and commentary publications (e.g., editorials) were scored at the section and sentence level and compared in the pre- versus post-ChatGPT publication time periods. RESULTS: Since the release of ChatGPT in 2022, a marked increase in previously rarely used stylistic words was observed with at least a two-fold usage increase observed in 20% of ophthalmology abstracts. With full article text evaluation, GPTZero scores increased after the release of ChatGPT across all research article sections (e.g., abstract, introduction, etc) and commentary articles. By 2025, 25.7% of sampled research articles and 21.6% of commentary articles contained AI-likelihood scores of >2 standard deviations above the baseline. Sentence-level analysis showed that among those publications containing outlier scores, 22.3% of sentences in research articles and 90% of sentences in commentary articles were likely written by AI. AI use was not disclosed among any of the publications with outlier scores. CONCLUSIONS: AI brings significant promise in its ability to facilitate both scientific and medical advances. As these tools become more powerful, disclosure regarding the manner of their use becomes increasingly important. Here we show that LLM-generated text is increasingly present in the ophthalmic literature and is rarely disclosed. Without disclosure requirements and editorial oversight, there is a significant risk that undisclosed LLM usage will continue to increase and may jeopardize authorship integrity and long-term reliability of published findings.
Orbital Leukemic Infiltration Masquerading as Ocular Inflammation.
Codina Alonso V, Malclès A, Gigon E
Ophthalmology · 2026 Jun · PMID 42240542 · Publisher ↗
Abstract loading — click title to view on PubMed.
Choroidal Neovascularization after Accidental Aesthetic Laser Exposure.
El-Haig W, Ponti L, Querques G
Ophthalmol Retina · 2026 Jun · PMID 42240528 · Publisher ↗
Abstract loading — click title to view on PubMed.
Serum microRNA-34a as a circulating biomarker for age-related macular degeneration and short-term anti-VEGF response in neovascular AMD.
Kong M, Jin R, Cheng T … +2 more , Sun L, Tong N
BMC Ophthalmol · 2026 Jun · PMID 42237272 · Full text
OBJECTIVE: To evaluate whether serum microRNA-34a (miR-34a) is associated with age-related macular degeneration (AMD) and whether baseline serum miR-34a has the potential to predict short-term response to anti-vascular e...
OBJECTIVE: To evaluate whether serum microRNA-34a (miR-34a) is associated with age-related macular degeneration (AMD) and whether baseline serum miR-34a has the potential to predict short-term response to anti-vascular endothelial growth factor (anti-VEGF) therapy in patients with neovascular AMD (nAMD). METHODS: In a cross-sectional cohort recruited at Qingdao Municipal Hospital between January and December 2024, serum miR-34a was quantified in 160 AMD patients and 122 age- and sex-matched healthy controls. AMD was staged according to Age-related Eye Disease Study (AREDS) criteria. Patients with nAMD received three consecutive monthly intravitreal anti-VEGF injections during the loading phase and were classified as good or poor responders according to prespecified anatomical and functional criteria based on optical coherence tomography (OCT) and best-corrected visual acuity (BCVA) after the loading phase. Peripheral blood samples were collected, and serum miR-34a expression was quantified using standard qPCR protocols. RESULTS: Serum miR-34a was significantly higher in patients with AMD than in controls (p < 0.001). Receiver operating characteristic (ROC) analysis yielded an area under the curve (AUC) of 0.740 (95% CI 0.681-0.799; p < 0.0001) for discriminating AMD from controls. Across AMD subgroups, serum miR-34a differed significantly overall; patients with geographic atrophy (GA) exhibited higher miR-34a levels than those with nAMD (p < 0.05). Among patients with nAMD, baseline serum miR-34a was remarkably higher in good responders than in poor responders after the loading phase (p < 0.001). ROC analysis showed an AUC of 0.772 (95% CI 0.687-0.857; p < 0.0001) for predicting treatment response, and multivariable logistic regression identified higher serum miR-34a as independently associated with lower odds of poor response (OR 0.143, 95% CI 0.042-0.489; p = 0.002). CONCLUSION: Elevated serum miR-34a is associated with AMD and may serve as a minimally invasive biomarker for distinguishing AMD from controls. In nAMD, baseline serum miR-34a also showed potential for predicting short-term response to loading-phase anti-VEGF therapy. These findings warrant validation in larger, longitudinal, and preferably multicenter cohorts.
Comparison of spectral-domain optical coherence tomography biometry measurements with partial coherence interferometry optical biometry.
Yakar K, Özgür G
BMC Ophthalmol · 2026 Jun · PMID 42237101 · Full text
PURPOSE: This study aimed to evaluate the agreement and interchangeability between a spectral-domain optical coherence tomography (SD-OCT)-based biometer (REVO FC) and a partial coherence interferometry (PCI) device (AL...
PURPOSE: This study aimed to evaluate the agreement and interchangeability between a spectral-domain optical coherence tomography (SD-OCT)-based biometer (REVO FC) and a partial coherence interferometry (PCI) device (AL Scan). METHODS: This prospective comparative cross-sectional study included 60 right eyes of 60 patients aged 40-82 years, diagnosed with senile cataracts. Measurements of axial length (AL), anterior chamber depth (ACD), keratometry (K1, K2), and astigmatism vector components (J0, J45) were conducted using both devices. Paired comparisons were performed using appropriate statistical tests. Agreement was evaluated using Bland-Altman analysis, while correlation and reliability were assessed using Pearson correlation coefficients and interclass correlation coefficients (ICC). RESULTS: No statistically significant differences were observed in AL (p = 0.507) or ACD (p = 0.218), with excellent correlations (AL: r = 0.998; ACD: r = 0.945). Bland-Altman analysis demonstrated excellent agreement for AL measurements, with a mean difference (bias) of - 0.01 mm and narrow 95% limits of agreement (LoA: -0.245 to 0.225 mm). For ACD, the mean difference was 0.02 mm, with a moderately wider LoA (- 0.244 to 0.288 mm), indicating an acceptable but less robust agreement compared to AL. The keratometric values were significantly higher with REVO FC (K1: +0.76 D; K2: +0.94 D; both p < 0.001), indicating a systematic bias. Despite strong correlations (K1: r = 0.980; K2: r = 0.924), the Bland-Altman analysis revealed wide limits of agreement. J0 exhibited no significant difference (p = 0.889), whereas J45 differed significantly (p = 0.028). Both vector components demonstrated moderate agreement, with relatively wide limits of agreement. CONCLUSION: REVO FC and AL Scan demonstrate excellent agreement for AL and ACD measurements and may be used interchangeably for these parameters. However, significant discrepancies in keratometric and astigmatic measurements limit their interchangeability.
Distinct retinal remodeling and visual prognostic factors in advanced epiretinal membranes with and without associated retinal break.
Valsecchi N, Rapezzi G, Elifani M … +4 more , Finzi A, Moramarco A, Fontana L, Mete M
BMC Ophthalmol · 2026 Jun · PMID 42237099 · Full text
PURPOSE: To compare retinal remodeling and predictors of visual outcomes in advanced epiretinal membranes with retinal break (RB + ERM) and without retinal break (RB - ERM). METHODS: Retrospective observational study con...
PURPOSE: To compare retinal remodeling and predictors of visual outcomes in advanced epiretinal membranes with retinal break (RB + ERM) and without retinal break (RB - ERM). METHODS: Retrospective observational study conducted on consecutive patients with stage 3 and 4 ERM who underwent pars plana vitrectomy with ERM peeling. Baseline and post-operative clinical and optical coherence tomography parameters-including ectopic inner foveal layer (EIFL) thickness, and presence of hyperreflective foci (HF)-were assessed. Multivariate analyses were conducted separately for the two conditions to examine the relationship between postoperative best-corrected visual acuity (BCVA) and a set of predictor variables. RESULTS: A total of 80 eyes from 80 patients were included: RB-ERM (n = 55) and RB + ERM (n = 25). At baseline, RB + ERM showed higher proportion of stage 4 ERMs compared to RB-ERM (p = 0.004), greater EIFL thickness (p = 0.003), and a higher number of HF in the EIFL (p = 0.042). After surgery, RB + ERM exhibited significantly greater reduction in EIFL thickness (p = 0.036) and in HF count within the EIFL compared to RB-ERM (p = 0.023). BCVA improvement was similar between the two groups (p = 0.917). In RB-ERM, multivariate regression identified older age, worse baseline BCVA, greater baseline EIFL and central macular thickness (CMT), and higher HF count within the EIFL as significant predictors of worse postoperative BCVA (p < 0.05), whereas in RB + ERM, presence of preoperative intraretinal cysts, and older age showed a significant association with worse BCVA after surgery (p < 0.05). CONCLUSIONS: RB + ERM demonstrated more pronounced retinal remodeling and distinct predictors of postoperative BCVA compared with RB-ERM, suggesting different underlying pathophysiology, despite similar improvements in visual outcomes. Further prospective and longitudinal studies incorporating histopathological analyses are warranted to confirm these observations.
Predictors of treatment response to subthreshold micropulse laser and oral spironolactone therapy for central serous chorioretinopathy.
Gao S, Zhang Y, Ge G … +1 more , Zhang M
BMC Ophthalmol · 2026 Jun · PMID 42237096 · Full text
OBJECTIVES: To identify the specific predictors of treatment response to subthreshold micropulse laser (SML) and oral spironolactone therapy in patients with central serous chorioretinopathy (CSC). METHODS: Patients diag...
OBJECTIVES: To identify the specific predictors of treatment response to subthreshold micropulse laser (SML) and oral spironolactone therapy in patients with central serous chorioretinopathy (CSC). METHODS: Patients diagnosed with CSC and treated with SML or spironolactone were included in this cohort study. Baseline characteristics, systemic factors, and various imaging characteristics were included as potential predictors of treatment response. Univariate and multivariate analysis was performed to identify predictive factors for the disease. RESULTS: A total of 103 eyes from 97 patients were included and divided into SML group (52 eyes) and spironolactone group (51 eyes). SRF resolution and OCT parameters, including CRT (p = 0.018) and SRF height (p < 0.001), decreased significantly in both groups, but SFCT decreased only in the spironolactone group. Regression analysis revealed that baseline SRF area was correlated with disease resolution in both SML (p = 0.005) and spironolactone (p = 0.016) groups, whereas changes in CRT and SFCT were correlated with a history of hyperuricemia (p = 0.047) and drinking (p = 0.035) only in the spironolactone group. CONCLUSION: Both SML and oral spironolactone are alternative therapies with similar efficacy. The SRF area at baseline can be a predictor of disease resolution. A history of hyperuricemia and drinking correlates with worse efficacy with spironolactone treatment. TRIAL REGISTRATION: The study was registered on Chinese Clinical Trial Registry (identifier: ChiCTR2100044356) at 17 March 2021.
Positive Airway Pressure and Long-Term Glaucoma Risk in Obstructive Sleep Apnea: A Real-World Cohort Study.
Nishida T, Mittal R, Weinreb RN … +7 more , Soltani G, Hashemi SM, de Oliveira Pereira A, Hallaj S, Baxter SL, Maghsoudipour M, Moghimi S
Ophthalmol Glaucoma · 2026 Jun · PMID 42235822 · Publisher ↗
PURPOSE: To evaluate the association between obstructive sleep apnea (OSA), recorded positive airway pressure (PAP) device use, and incident glaucoma in a large multicenter electronic health record (EHR) cohort. DESIGN:...
PURPOSE: To evaluate the association between obstructive sleep apnea (OSA), recorded positive airway pressure (PAP) device use, and incident glaucoma in a large multicenter electronic health record (EHR) cohort. DESIGN: Retrospective cohort study. PARTICIPANTS: Adults in Epic Cosmos were included if they had an index encounter for OSA evaluation between January 1, 2010, and October 31, 2025, no prior glaucoma diagnosis, and at least 180 days of follow-up. Patients were categorized as sleep-tested controls without OSA, OSA without a PAP device record, or OSA with a PAP device record within 180 days. METHODS: Follow-up began at a 180-day landmark after the index OSA evaluation and continued until incident glaucoma, death, or last encounter. PAP exposure was defined using a code-based EHR proxy for PAP therapy within 180 days. Cox proportional hazards models adjusted for baseline covariates were used to estimate associations with incident glaucoma. Incidence rates were calculated per 1,000 person-years from the landmark to censoring. MAIN OUTCOME MEASURES: Incident glaucoma, defined as at least two glaucoma diagnosis codes within 365 days, with the first qualifying diagnosis occurring after the 180-day landmark. RESULTS: The cohort included 12,516,607 patients with a mean (SD) age of 60.4 (11.6) years; 43.7% were women. Over a mean (SD) follow-up of 5.2 (3.7) years, 153,083 incident glaucoma events occurred. Crude incidence rates per 1,000 person-years were 1.74 in controls, 2.38 in OSA without a PAP device record, and 3.39 in OSA with a PAP device record. Compared with sleep-tested controls, adjusted hazards of incident glaucoma were higher in OSA without a PAP device record (hazard ratio [HR], 1.27; 95% CI, 1.22-1.32) and OSA with a PAP device record (HR, 2.10; 95% CI, 1.80-2.45). At 10 years, cumulative incidence was 1.58%, 2.30%, and 3.86%, respectively. CONCLUSIONS: OSA was associated with a higher risk of incident glaucoma compared with sleep-tested controls. The observed risk gradient does not establish whether PAP itself increases or decreases glaucoma risk relative to untreated OSA because residual confounding by OSA severity and treatment indication is likely. Ophthalmic monitoring may be warranted in patients undergoing clinical evaluation or treatment for OSA.
Indolent Localized Orbital Aspergillosis Mimicking Breast Cancer Metastasis.
Wu X, Li J, Ma J
Ophthalmology · 2026 Jun · PMID 42233937 · Publisher ↗
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Late-onset bullous keratopathy after iris-fixated phakic intraocular lens implantation: a case report.
Ferrand S, Bogdanova-Bennett A, Cornelius DT … +1 more , Ferrand RA
BMC Ophthalmol · 2026 Jun · PMID 42231248 · Full text
BACKGROUND: This article presents a case report of bullous keratopathy occurring 12 years after implantation of iris-fixated anterior chamber phakic intraocular lenses (AC pIOL), which eventually required Descemet Membra...
BACKGROUND: This article presents a case report of bullous keratopathy occurring 12 years after implantation of iris-fixated anterior chamber phakic intraocular lenses (AC pIOL), which eventually required Descemet Membrane Endothelial Keratoplasty (DMEK). This represents a much longer period of endothelial decompensation following implantation than that reported in other studies. CASE PRESENTATION: A 44-year-old woman presented with pain and reduced vision which was diagnosed as uveitis; it was unresponsive to topical steroids. Twelve years earlier, she had iris-fixated AC pIOLs (Myopia Artiflex 6 mm) implanted in both eyes for correction of myopia. Substantial endothelial loss with a bullous keratopathy was identified and both intraocular lenses were explanted. Owing to endothelial decompensation in the left eye, the patient required a left Descemet Membrane Endothelial Keratoplasty. CONCLUSIONS: As the same models of AC pIOLs are still in use today, clinicians should be aware of this serious complication when considering different refractive error correction procedures. Our report highlights that endothelial decompensation as a complication of AC pIOL implantation can occur many years after lens implantation, and emphasizes the need for long-term endothelial monitoring.
Functional and anatomical outcomes of Yamane technique-based scleral fixation after complicated cataract surgery versus IOL extraction.
Kahramanoğlu F, Albayrak MT, Ayas S
BMC Ophthalmol · 2026 Jun · PMID 42231235 · Full text
PURPOSE: To evaluate and compare the anatomical and functional outcomes of Yamane scleral-fixated intraocular lens (IOL) implantation in aphakic eyes following complicated cataract surgery (CCS) or prior IOL extraction (...
PURPOSE: To evaluate and compare the anatomical and functional outcomes of Yamane scleral-fixated intraocular lens (IOL) implantation in aphakic eyes following complicated cataract surgery (CCS) or prior IOL extraction (IE), using standardized outcome measures. METHODS: This retrospective study included 50 eyes of 50 patients who underwent Yamane scleral-fixated IOL implantation (CCS: n = 13; IE: n = 37). Best-corrected visual acuity (BCVA), intraocular pressure (IOP), refractive outcomes, endothelial cell density (ECD), and central macular thickness (CMT) were evaluated preoperatively and at 6 months postoperatively. Standardized changes (ΔlogMAR, ΔECD%, ΔCMT%) were calculated. RESULTS: BCVA and spherical equivalent improved significantly in both groups (p < 0.001), with no significant difference in visual gain between groups (p = 0.063). Absolute astigmatism decreased significantly in the IE group (p = 0.036) but not in the CCS group (p = 0.124). IOL-related astigmatism remained low and comparable between groups (p = 0.765). IOP decreased significantly in the CCS group (p = 0.036) but remained stable in the IE group (p = 0.476). ECD decreased significantly in both groups, with no between-group difference in percentage loss (p = 0.382). CMT remained stable, with no significant differences (p = 0.974). Complication rates were low, with no severe adverse events. CONCLUSION: Yamane scleral fixation provides safe and effective short-term anatomical and functional outcomes in aphakic eyes following both CCS and IE. Despite differences in surgical history, outcomes were largely comparable between groups across most parameters. Intraocular pressure decreased in eyes undergoing CCS and remained stable in previously operated eyes, reflecting expected physiological responses. These findings further support the Yamane technique as a reliable and versatile option for secondary IOL implantation, with outcomes largely independent of prior lens status. CLINICAL TRIAL NUMBER: This study is a retrospective study conducted using data obtained from patient records. It does not involve an interventional clinical trial; therefore, a clinical trial registration number is not applicable.
Phaco tip-chopper flip technique for epinucleus removal in cataract surgery.
Xie W, Tian T, Ying L
BMC Ophthalmol · 2026 Jun · PMID 42231217 · Full text
PURPOSE: To introduce the Phaco Tip-Chopper Flip Technique in removing epinucleus during phacoemulsification, and to report the preliminary clinical outcomes in patients who underwent this technique. METHODS: Sixteen eye...
PURPOSE: To introduce the Phaco Tip-Chopper Flip Technique in removing epinucleus during phacoemulsification, and to report the preliminary clinical outcomes in patients who underwent this technique. METHODS: Sixteen eyes with various conditions that underwent the Phaco Tip-Chopper Flip technique were retrospectively reviewed. The key steps of this technique consisted of retaining the phaco tip in the irrigation/aspiration (I/A) mode after nuclear fragment removal, using low-to-moderate vacuum to aspirate the folded portion of the epinucleus while the chopper was used to push the interior edge. The coordinated application of these forces flipped the epinucleus away from the capsular bag, enabling its rapid removal. RESULTS: All surgeries were completed successfully without any intraoperative or postoperative complications, notably without posterior capsule rupture. Thick and adherent epinucleus was smoothly aspirated in the vast majority of cases under I/A mode using a high vacuum (400 mmHg). Postoperative corrected distance visual acuity improved as expected in all cases at both 1-day and 1-week follow-ups. CONCLUSION: The Phaco Tip-Chopper Flip Technique appears to be a safe and efficient method for epinucleus removal based on this preliminary experience, and is suitable for various types of cataract scenarios.
Iridocorneal endothelial syndrome manifesting 4.5 years after toric implantable collamer lens implantation: a case report.
Wang K, Zhang Z, Wang J … +2 more , Zhang H, Fu M
BMC Ophthalmol · 2026 Jun · PMID 42231204 · Full text
BACKGROUND: Iridocorneal endothelial syndrome (ICE) is a rare unilateral disorder with subtle early manifestations and is therefore easily overlooked in clinical practice. Reports of ICE occurring after implantable colla...
BACKGROUND: Iridocorneal endothelial syndrome (ICE) is a rare unilateral disorder with subtle early manifestations and is therefore easily overlooked in clinical practice. Reports of ICE occurring after implantable collamer lens (ICL) implantation remain exceedingly rare. In the present case, localized peripheral anterior synechiae (PAS) were identified preoperatively, whereas corneal endothelial morphology and endothelial cell density (ECD) were essentially normal. The eye remained clinically stable throughout long-term follow-up until classic features of ICE became apparent 4.5 years later, underscoring the novelty and clinical significance of this case. CASE PRESENTATION: A 19-year-old woman with high myopia underwent bilateral toric implantable collamer lens (TICL) implantation in 2021. Preoperative examination revealed localized PAS and mild superior pupillary displacement in the right eye, while the cornea was clear and ECD was within the normal range. Early and intermediate postoperative follow-up was largely unremarkable. At 4.5 years after surgery, the patient presented with blurred vision in the right eye. Ophthalmic examination demonstrated corneal edema, segmental iris atrophy, progression of PAS, corectopia, and secondary ocular hypertension. In vivo confocal microscopy using the Heidelberg Retina Tomograph III with the Rostock Cornea Module (HRT-RCM) showed disorganized endothelial cell architecture, cellular enlargement, and a marked focal reduction in endothelial cell density. Based on these clinical findings, ICE syndrome of the right eye was diagnosed. The patient subsequently underwent viscocanalostomy, trabeculectomy, and peripheral iridectomy, after which intraocular pressure remained well controlled.Given the patient's history of extreme myopia, ICL explantation was deferred to avoid marked anisometropia and substantial impairment of visual function, and careful follow-up was continued. CONCLUSION: In patients with preoperative localized PAS or subtle iris abnormalities, underlying ICE cannot be definitively excluded, even when the cornea is clear and ECD is normal. This case suggests that ICE syndrome may exist in a subclinical stage before ICL implantation, with its characteristic features emerging only later in the disease course. Long-term follow-up after ICL implantation is therefore essential, with particular attention to serial assessment of the corneal endothelium, anterior chamber angle, and iris configuration, to enable early recognition of occult progressive disease.
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