BMC Ophthalmol [JOURNAL]
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200 papers
Outcomes of hang-back recession for restrictive strabismus associated with thyroid eye disease.
Kaldırım H, Bayraktar H, Dinçer MT … +2 more , Savur F, Oyur G
BMC Ophthalmol · 2026 May · PMID 42129679 · Full text
BACKGROUND: To evaluate the outcomes of hang-back recession applied to mechanically restricted rectus muscles in patients with thyroid eye disease (TED)-related strabismus, focusing on alignment stability and surgical su...
BACKGROUND: To evaluate the outcomes of hang-back recession applied to mechanically restricted rectus muscles in patients with thyroid eye disease (TED)-related strabismus, focusing on alignment stability and surgical success. METHODS: This retrospective observational study included patients with TED who underwent hang-back recession of mechanically restricted rectus muscles for diplopia and/or restrictive ocular motility. Surgical dose was determined based on preoperative deviation magnitude and intraoperative findings rather than a fixed nomogram, and postoperative alignment outcomes were assessed at standardized follow-up visits. RESULTS: Fourteen patients (17 eyes) were included. Mean age was 48.8 ± 10.2 years, and all patients presented with diplopia. Horizontal deviation (10 eyes) showed a significant reduction at all postoperative time points at both near and distance fixation (p = 0.005), while vertical deviation (8 eyes) also demonstrated significant improvement throughout follow-up (p ≤ 0.012). Improvement was evident from the first postoperative week, with stable alignment achieved by the third postoperative month. No overcorrection occurred after horizontal surgery, and a mild vertical overcorrection (4 prism diopters) was observed in one patient. Based on a success criterion of postoperative deviation within ± 5 prism diopters, surgical success was achieved in 100% of cases, and no reoperation was required. CONCLUSIONS: Hang-back recession may provide effective and stable correction of TED-related strabismus. This tension-free approach was associated with favorable postoperative alignment and a low incidence of clinically significant overcorrection in the present series. These findings should be interpreted considering the relatively small cohort and the absence of a control group.
Comparison of early postoperative dry eye after KLEx and FS-LASIK: a contralateral eye study.
Küçüködük A, Aksoy M
BMC Ophthalmol · 2026 May · PMID 42121105 · Full text
OBJECTIVE: To compare early postoperative dry eye outcomes in contralateral eyes of the same patients undergoing Keratorefractive Lenticule Extraction (KLEx) versus Femtosecond Laser-Assisted Laser In Situ Keratomileusis...
OBJECTIVE: To compare early postoperative dry eye outcomes in contralateral eyes of the same patients undergoing Keratorefractive Lenticule Extraction (KLEx) versus Femtosecond Laser-Assisted Laser In Situ Keratomileusis (FS-LASIK), with tear film osmolarity defined as the primary outcome measure. METHODS: This study was conducted at Dunyagoz Izmır Hospital and involved patients who underwent corneal refractive surgery between June 2021 and December 2024. Patients with pre-existing dry eye disease were excluded from the study. Patients underwent KLEx in one eye and FS-LASIK in the fellow eye. Tear film osmolarity (primary outcome) was measured preoperatively and postoperatively using the TearLab system. Secondary outcome measures included tear break-up time (tBUT) and subjective symptoms assessed via the Ocular Symptom Questionnaire Scores (OSDI). RESULTS: A total of 34 eyes of 17 patients (7 females and 10 males) were evaluated. Group 1 (KLEx) included 17 eyes and group 2 (FS-LASIK) included contralateral 17 eyes. The mean postoperative follow-up period was 34.2 days. Mean tear osmolarity was 297.7 ± 8.3 mOsm/L in the group 1 and 315.3 ± 10.2 mOsm/L in the group 2 (p < 0.001). Mean tBUT was 10.3 ± 3.1 s for group 1 and 7 ± 2.32 s for group 2 (p < 0.001). The mean postoperative OSDI scores were 32.5 for group 1 and 42 for group 2, with a preoperative baseline of 10.2 (both groups; p < 0.001). CONCLUSIONS: KLEx demonstrated superior early postoperative ocular surface stability compared to FS-LASIK in contralateral eyes. The procedure resulted in significantly less tear hyperosmolarity and better subjective comfort, suggesting it may be a preferable surgical option for minimizing dry eye induced by corneal refractive surgery.
Bilateral refractory macular holes related to tamoxifen use and full anatomic restoration of the fovea with autologous retinal graft.
Yanık Ö, Demirel S, Batıoğlu F
BMC Ophthalmol · 2026 May · PMID 42121080 · Full text
BACKGROUND: Low-dose tamoxifen use may cause degenerative changes progressing to full-thickness macular holes, mimicking other degenerative causes for macular holes instead of well-known features of tamoxifen retinopathy...
BACKGROUND: Low-dose tamoxifen use may cause degenerative changes progressing to full-thickness macular holes, mimicking other degenerative causes for macular holes instead of well-known features of tamoxifen retinopathy. The aim of this report is to present a case of bilateral refractory macular holes related to tamoxifen use and full anatomic restoration of the fovea with autologous retinal graft. CASE PRESENTATION: A 35-year-old female presented with decreased vision in both eyes and was initially diagnosed with a macular hole in the left eye, followed by a subsequent diagnosis in the right eye. Standard internal limiting membrane (ILM) peeling with gas endotamponade for the left eye and inverted ILM flap with gas endotamponade for the right eye both failed to close the macular hole. Therefore, autologous neurosensory retinal grafting was performed for refractory macular holes in both eyes. She was not receiving tamoxifen at the time of presentation; however, she had previously undergone tamoxifen treatment for breast cancer. During the postoperative period, full reconstitution of the ellipsoid zone and the external limiting membrane, as well as foveal pit formation, were achieved with a dramatic increase in visual acuity. CONCLUSIONS: Autologous retinal grafting may be an effective and safe surgical approach not only for macular holes secondary to posterior hyaloid-related traction but also for the management of refractory degenerative macular holes secondary to drug side effects. This approach achieved excellent functional outcome and successful anatomical improvement, as demonstrated on longitudinal optical coherence tomography scans.
The assessment of posterior ocular structures in Turkish children with anisometropic amblyopia.
Çelenk EH, Acar BT
BMC Ophthalmol · 2026 May · PMID 42116029 · Full text
BACKGROUNDS: To investigate whether unilateral amblyopia in childhood is associated with structural alterations in the retina, optic nerve head, and lamina cribrosa by means of optical coherence tomography (OCT). METHODS...
BACKGROUNDS: To investigate whether unilateral amblyopia in childhood is associated with structural alterations in the retina, optic nerve head, and lamina cribrosa by means of optical coherence tomography (OCT). METHODS: In this cross-sectional study, 31 children with unilateral anisometropic amblyopia and 30 age- and sex-matched healthy controls were included. The amblyopia group contributed 31 amblyopic eyes and 31 fellow eyes, and both eyes of healthy controls were analyzed as right and left control eyes. Retinal layer segmentation, macular thickness, peripapillary retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), optic nerve head parameters, lamina cribrosa-related measurements, and subfoveal choroidal thickness were assessed using spectral-domain OCT. To account for within-subject inter-eye dependency, ocular parameters were analyzed using a linear mixed model with eye group as a fixed effect, subject identity as a random effect, and age as a covariate. RESULTS: Outer retinal layers and subfoveal choroidal thickness were comparable across groups. Macular thickness was significantly lower in both amblyopic and fellow eyes than in control eyes, whereas no difference was found between amblyopic and fellow eyes. Peripapillary RNFL analysis showed a sector-specific difference limited to the inferior quadrant, with thinner RNFL in fellow eyes than in control eyes, while GCC parameters did not differ significantly. Conventional optic disc morphometric parameters, including disc area, cup area, and horizontal and vertical cup-to-disc ratios, were similar among the groups. In contrast, linear mixed-model analysis identified sector-specific differences in several deep optic nerve head parameters, including BMO, BMO-MRW, LCD, and LCCI, particularly in the superior, inferior, temporal, and nasal sectors. CONCLUSIONS: Unilateral anisometropic amblyopia in children was associated with selective and region-specific posterior segment structural differences rather than diffuse retinal damage. The main findings were reduced macular thickness in both amblyopic and fellow eyes, a sector-specific difference confined to the inferior RNFL, and significant alterations in several deep optic nerve head parameters related to BMO, BMO-MRW, LCD, and LCCI, while outer retinal layers, GCC, conventional optic disc morphometric parameters, and subfoveal choroidal thickness remained largely preserved. The presence of similar changes in fellow eyes suggests that amblyopia may be associated with structural alterations beyond the clinically amblyopic eye.
Effects of coenzyme Q10 on retinal inflammation in streptozotocin-induced diabetic rats.
Akdoğan M, Karaca Ç, Demirel HH
BMC Ophthalmol · 2026 May · PMID 42116018 · Full text
BACKGROUND: Inflammation, oxidative stress, and apoptosis play important roles in diabetes-induced retinal injury. Coenzyme Q10 (CoQ10) is an endogenous antioxidant involved in mitochondrial energy metabolism and cellula...
BACKGROUND: Inflammation, oxidative stress, and apoptosis play important roles in diabetes-induced retinal injury. Coenzyme Q10 (CoQ10) is an endogenous antioxidant involved in mitochondrial energy metabolism and cellular protection. This study aimed to investigate the effects of CoQ10 on diabetes-induced retinal injury in a streptozotocin-induced diabetic rat model. METHODS: Diabetes was induced in rats using streptozotocin. The animals were divided into 1- and 2-month experimental groups, each consisting of control, diabetic, CoQ10-treated, and diabetic + CoQ10 groups. CoQ10 was administered via oral gavage at a dose of approximately 30 mg/kg/day. Blood samples were collected for biochemical analysis, and retinal tissues were evaluated using immunohistochemical staining for tumor necrosis factor-alpha (TNF-α), nuclear factor kappa-B (NFκB), Bcl-2-associated X protein (Bax), vascular endothelial growth factor (VEGF), and VEGF receptor (VEGFR). RESULTS: In the 2-month experimental group, SOD, GSH, and CAT levels were significantly higher in diabetic rats compared with the diabetic + CoQ10 group. Immunohistochemical analysis showed decreased staining intensities of VEGF, VEGFR, NFκB, and Bax in the diabetic + CoQ10 group compared with the diabetic group at the first month. In the second month, TNF-α, NFκB, and CD45 staining intensities were significantly reduced in the diabetic + CoQ10 group compared with the diabetic group. CONCLUSION: These findings suggest that CoQ10 may modulate inflammatory, apoptotic, and oxidative stress pathways in diabetes-induced retinal injury. However, the protective effects appear to vary depending on the duration of diabetes. Further studies are required to clarify the potential role of CoQ10 in diabetic retinal disease.
Dose-response association between metabolic abnormality burden and intraocular pressure in a population undergoing routine health examinations: a cross-sectional study.
Li H, Jiang C, Hu X … +6 more , Gao X, Wan J, Huang L, Long Y, Xu X, Xie Q
BMC Ophthalmol · 2026 May · PMID 42116004 · Full text
OBJECTIVE: To investigate the association between metabolic risk burden and intraocular pressure in individuals undergoing routine health examinations, and to assess the presence of a dose-response relationship, thereby...
OBJECTIVE: To investigate the association between metabolic risk burden and intraocular pressure in individuals undergoing routine health examinations, and to assess the presence of a dose-response relationship, thereby informing IOP risk stratification in health check-up settings. METHODS: This cross-sectional study included 2,048 adults who received health examinations at the Health Examination Center of the Army Medical Center between September 2024 and December 2025. Metabolic abnormalities were defined using five routinely collected components-waist circumference, blood pressure, fasting plasma glucose, triglycerides, and high-density lipoprotein cholesterol-and were summed to generate a metabolic risk burden score (range:0-5). Participants were categorized into four groups (0, 1, 2, and ≥ 3). The primary outcome was the mean IOP of both eyes. Associations were evaluated using one-way analysis of variance, multivariable linear regression, and tests for trend. RESULTS: IOP increased progressively with higher metabolic risk burden. After adjustment for age and sex, compared with participants with a score of 0, mean IOP was higher by 0.93, 1.24, and 1.80 mmHg in those with scores of 1, 2, and ≥ 3, respectively (all P < 0.001). Further adjustment for body mass index attenuated the associations, but they remained statistically significant (β = 0.77, 0.93, and 1.37 mmHg, respectively).Each one-category increase in metabolic burden was associated with a 0.46-mmHg higher IOP (P-trend < 0.001). In sensitivity analyses, higher metabolic burden was associated with increased odds of high IOP (≥ 3 vs. 0: OR = 3.05, 95% CI: 1.73-5.36). Among individual components, elevated blood pressure and elevated fasting glucose showed the strongest associations with IOP. CONCLUSIONS: In this cross-sectional study, metabolic risk burden was independently associated with higher IOP in a dose-response manner. These findings suggest a graded relationship between metabolic abnormalities and IOP; however, causal inference and clinical implications require confirmation in longitudinal studies.
Retinal and choroidal changes in young adults during near work and eye closure measured by wide-field OCTA.
Zhou F, Lhamo T, Yuan Y … +6 more , Yang T, Tan F, Tian L, Hua D, Chen C, Xu Y
BMC Ophthalmol · 2026 May · PMID 42115998 · Full text
BACKGROUND: Myopia is a major global public health concern, and near work has been identified as a key risk factor for its onset and progression. This study aimed to evaluate short-term retinal and choroidal vascular and...
BACKGROUND: Myopia is a major global public health concern, and near work has been identified as a key risk factor for its onset and progression. This study aimed to evaluate short-term retinal and choroidal vascular and structural responses to near work and subsequent eye-closure rest in young adults. METHODS: Thirty medical students (aged 18-24 years) underwent wide-field swept-source OCTA at baseline, after 20, 40, and 60 min of near work, and after 10, 20, and 30 min of eye-closure rest. Vascular parameters of the nerve fiber layer vascular plexus (NFLVP), superficial vascular complex (SVC), deep vascular complex (DVC), choriocapillaris, and choroid were analyzed. RESULTS: During near work, NFLVP vessel density (VD) and vessel diameter index increased in the temporal 1-3 mm and 6-9 mm sectors; the 6-9 mm temporal sector remained elevated above baseline throughout rest (all p < 0.05). SVC VD, small vessel density, and vessel length density in the superior 3-6 mm sector fell below baseline during rest (all p < 0.05). Choroidal perfusion area, thickness, and stromal volume declined significantly relative to pre-rest values at 20 min of rest (all p < 0.05). CONCLUSIONS: NFLVP perfusion in the temporal 6-9 mm sector increased during near work and remained elevated above baseline throughout the rest period; SVC perfusion in the same sector likewise remained above baseline during rest, while SVC perfusion in the superior 3-6 mm sector fell below baseline. These alterations may provide important insights into the vascular regulatory mechanisms underlying myopia development.
Clot-induced pupillary block and postoperative reverse pupillary block in Uveitis-Glaucoma-Hyphema syndrome associated with late in-the-bag IOL dislocation.
Berardi B, Valsecchi N, Finzi A … +3 more , Moramarco A, Fontana L, Mete M
BMC Ophthalmol · 2026 May · PMID 42115997 · Full text
BACKGROUND: Uveitis Glaucoma Hyphema (UGH) syndrome results from chafing between an intraocular implant and anterior chamber structures, and it typically presents with anterior chamber inflammation, elevated intraocular...
BACKGROUND: Uveitis Glaucoma Hyphema (UGH) syndrome results from chafing between an intraocular implant and anterior chamber structures, and it typically presents with anterior chamber inflammation, elevated intraocular pressure and recurrent microhyphema or hyphema. Herein, we report the case of a patient with atypical presentation: iridocorneal angle closure secondary to a clot-induced pupillary block. The same patient developed reverse pupillary block a few weeks after surgery. CASE PRESENTATION: A 77-year-old Caucasian woman presented with iridocorneal angle closure secondary to a clot induced pupillary block. The bleeding was caused by rubbing between a late in-the-bag dislocated intraocular lens and the iris in pseudoexfoliative syndrome. The diagnosis of UGH was initially delayed due to the unusual presentation. She underwent intraocular lens (IOL) exchange and secondary IOL scleral fixation, and subsequently developed reverse pupillary block. Both pupillary blocks were resolved by laser iridotomy. CONCLUSIONS: Uveitis Glaucoma Hyphema syndrome can rarely present with pupillary block, particularly in cases caused by late in-the-bag IOL dislocation in pseudoexfoliation syndrome. This case is unusual due to the occurrence of both pupillary block and subsequent reverse pupillary block in the same patient, highlighting the importance of recognizing these uncommon and atypical mechanisms.
Correlation between retinal defocus distribution and axial growth in myopic children wearing orthokeratology lenses.
Zhang J, Bao Q, Lin X … +4 more , Farheen T, Li S, Shi W, Gao H
BMC Ophthalmol · 2026 May · PMID 42115990 · Full text
INTRODUCTION: The purpose was to investigate the refractive status of different retinal regions in myopic children treated by orthokeratology (ortho-k) and its relationship with axial elongation. METHODS: This was a cros...
INTRODUCTION: The purpose was to investigate the refractive status of different retinal regions in myopic children treated by orthokeratology (ortho-k) and its relationship with axial elongation. METHODS: This was a cross-sectional study. Axial length measurements were retrospectively collected from 221 myopic children aged 9-15 years who underwent ortho-k lens wear for over 1 year. The relative peripheral refractive errors (RPREs) of different retinal zones were measured using multispectral refraction topography, and the distribution characteristics were analyzed. All subjects were divided into the fast progression (axial growth > 0.15 mm/y) and slow progression (axial growth ≤ 0.15 mm/y) groups. The linear and logistic regression were performed to evaluate the correlation between axial growth and retinal defocus. Receiver operating characteristic (ROC) curve analysis determined the diagnostic efficiency of regional retinal defocus in the two groups. RESULTS: After ortho-k lens wear, the myopic defocus was located in the circular regions of 0-15˚ and 15-30˚ of the retina and the superior-inferior quadrants. While hyperopic defocus predominated in other zones, the superior-inferior and nasal-temporal quadrants showed an asymmetric defocus distribution in the slow progression group (P < 0.001). The multivariate linear regression demonstrated that the annual axial growth was positively correlated with the superior retinal RPRE (standardized beta = 0.313, P < 0.001) but negatively correlated with age (standardized beta=-0.181, P = 0.005). The logistic regression analysis revealed that the smaller superior RPRE (odds ratio [OR] = 2.731; 95% confidence interval [CI], 1.298-5.747; P = 0.008) and older age (OR = 0.856; 95%CI, 0.740-0.990; P = 0.036) were protective factors against rapid axial growth. The superior REPE exhibited an area under the ROC curve of 0.619, indicating its limited efficiency in predicting axial growth. CONCLUSION: After ortho-k lens wear, myopic defocus and hyperopic defocus were located in different zones of the retina. The smaller superior retinal RPRE and older age are protective factors but poor standalone predictors for axial growth.
Fellow-eye herpes simplex virus type 1 uveitis after intravitreal bevacizumab: a case report.
Saturno MC, Gagliardi OM, La Cava M … +4 more , Armentano M, Alisi L, Giovannetti F, Iannetta D
BMC Ophthalmol · 2026 May · PMID 42106726 · Full text
BACKGROUND: Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is widely used for neovascular retinal diseases. Intraocular inflammation is a recognized adverse event and typically occurs in the inj...
BACKGROUND: Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is widely used for neovascular retinal diseases. Intraocular inflammation is a recognized adverse event and typically occurs in the injected eye. Inflammation in the fellow, uninjected eye is exceptionally rare and may be misinterpreted as sterile immune-mediated inflammation, potentially delaying appropriate treatment. We report a case of polymerase chain reaction (PCR)-confirmed herpes simplex virus type 1 (HSV-1) uveitis presenting in the fellow eye shortly after intravitreal bevacizumab administration. CASE PRESENTATION: An 84-year-old man with well-controlled type 2 diabetes mellitus received intravitreal bevacizumab (1.25 mg) in the left eye for neovascular age-related macular degeneration. Three days later, he developed acute granulomatous anterior uveitis with dense vitritis in the right, uninjected eye, while the treated eye remained quiescent. Best-corrected visual acuity decreased to 20/400. Given the severity of inflammation and limited fundus visualization, viral retinitis was suspected. Empirical systemic valacyclovir and topical corticosteroids were initiated. Aqueous humor PCR detected HSV-1 DNA, confirming herpetic uveitis. Inflammation resolved within 40 days with recovery of visual acuity to 20/20 and no progression to acute retinal necrosis. The patient remained recurrence-free under antiviral prophylaxis at last follow-up. CONCLUSIONS: Severe fellow-eye inflammation following intravitreal bevacizumab may reflect viral reactivation rather than sterile inflammation. Early diagnostic evaluation, including aqueous humor PCR when clinically indicated, is essential to guide appropriate therapy and prevent sight-threatening complications.
Clinical applications of the amniotic membrane in pediatric ocular pathology: a scoping review.
Suárez LVB, Ramírez LVH, Porras JEG … +4 more , López MPL, Martinez LBR, Mejia MAC, Regalado LGC
BMC Ophthalmol · 2026 May · PMID 42106715 · Full text
INTRODUCTION: The amniotic membrane (AM), which is derived from the placenta and is composed of columnar epithelium, a basement membrane, and an avascular stroma, is commonly preserved through cryopreservation. Its biolo...
INTRODUCTION: The amniotic membrane (AM), which is derived from the placenta and is composed of columnar epithelium, a basement membrane, and an avascular stroma, is commonly preserved through cryopreservation. Its biological properties-combining safety, versatility, and efficacy-have positioned it as an innovative therapeutic option in pediatric ophthalmology for multiple ocular pathologies. OBJECTIVE: To explore the available evidence on the clinical applications of the AM in pediatric ocular pathologies. METHODOLOGY: A scoping review was conducted in accordance with the PRISMA guidelines, using databases such as PubMed, LILACS, Scopus, SciELO, and EBSCO, without date restrictions. Sixteen studies published between 2002 and 2025 were included, encompassing retrospective studies, cohort studies, case reports, and narrative reviews. The evidence was categorized into general benefits, benign neoplasms, surface defects, severe hypersensitivity, cryptophthalmos, ocular trauma, and glaucoma. RESULTS: The reviewed studies demonstrated that AM, owing to its anti-inflammatory, antimicrobial, and antiangiogenic properties, is effective as a biological bandage in various pediatric ocular conditions. Its application promotes re-epithelialization, modulates inflammation, and improves healing. Nevertheless, further studies are needed to establish standardized protocols and validate their long-term effectiveness in this age group. CONCLUSIONS: The use of the AM has shown promising results as a safe and effective intervention in pediatric ophthalmology, highlighting its therapeutic value in challenging, multifactorial clinical scenarios.
Electronegative electroretinography in inherited retinal disease: a systematic review of genotype-phenotype correlations.
Taha I, Huraibat K, Al-Labadi L
BMC Ophthalmol · 2026 May · PMID 42106701 · Full text
BACKGROUND: The electronegative electroretinogram (ERG)-in which the dark-adapted bright-flash b-wave amplitude falls below the a-wave (b: a ratio < 1.0)-localizes dysfunction to the inner retina or photoreceptor-bipolar...
BACKGROUND: The electronegative electroretinogram (ERG)-in which the dark-adapted bright-flash b-wave amplitude falls below the a-wave (b: a ratio < 1.0)-localizes dysfunction to the inner retina or photoreceptor-bipolar synapse. In inherited retinal disease (IRD), this waveform has been associated with a restricted set of genetic etiologies, but the evidence has not been systematically synthesized. OBJECTIVE: To systematically identify and appraise the evidence on genetically confirmed IRD associated with electronegative ERG, characterizing reported gene-specific electrophysiologic patterns, structural correlates, and clinical features. METHODS: A systematic search of PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library was conducted from inception through March 2026, following PRISMA 2020 guidelines. Studies reporting patients with genetically confirmed IRD and electronegative full-field ERG were included. For this review, electronegative ERG was defined quantitatively as a dark-adapted bright-flash b: a amplitude ratio below 1.0 where numerical data were provided; studies using only qualitative descriptors without numerical ratios were included but flagged in sensitivity analysis, as qualitative labelling introduces subjectivity and reduces cross-study comparability. Quality was assessed using Joanna Briggs Institute checklists. Evidence was synthesized narratively, stratified by gene group, because clinical and methodological heterogeneity precluded meta-analysis. RESULTS: Eighty-seven studies (approximately 1,250 patients; 23 countries; 1986-2025) met inclusion criteria. The literature was dominated by case reports and small case series (83%), with substantial heterogeneity in ERG protocols and inconsistent ISCEV compliance (documented in 61%). The most frequently reported associations were with genes causing congenital stationary night blindness (NYX, CACNA1F, TRPM1, GRM6, GPR179, CABP4, LRIT3), X-linked retinoschisis (RS1), and cone dystrophy with supernormal rod responses (KCNV2). Electronegative ERG patterns were commonly described across the CSNB and XLRS literature, with the greatest consistency for complete CSNB and KCNV2. Structural imaging correlates showed gene-group specificity, particularly foveal schisis in RS1-associated disease. Evidence for rarer gene associations was limited to isolated case reports. Risk of bias was high across most included studies. These limitations directly inform the confidence ratings assigned to each gene-phenotype association throughout the review. CONCLUSIONS: Electronegative ERG appears to be a potentially useful phenotypic marker that may help narrow the genetic differential in IRD, particularly for CSNB, XLRS, and KCNV2-associated disease. This utility is most applicable in clinical settings where comprehensive genetic sequencing is not immediately accessible; ERG findings should be interpreted in conjunction with structural imaging and clinical context rather than in isolation. However, the evidence base is constrained by small sample sizes, heterogeneous methodology, likely publication bias, and limited longitudinal data. Importantly, conclusions regarding rarer gene associations should be treated as preliminary, given that they rest on isolated case reports with high risk of bias. Prospective studies with standardized ERG protocols and reporting are needed to validate the diagnostic patterns identified in this review.
Fungal interface keratitis following superficial anterior lamellar keratectomy for limbal dermoids: a case report.
Chowdhury T, Rana V
BMC Ophthalmol · 2026 May · PMID 42106691 · Full text
BACKGROUND: Infectious interface keratitis is an uncommon but potentially vision threatening complication of lamellar corneal surgery. While it has been described after deeper lamellar procedures, its occurrence followin...
BACKGROUND: Infectious interface keratitis is an uncommon but potentially vision threatening complication of lamellar corneal surgery. While it has been described after deeper lamellar procedures, its occurrence following superficial anterior lamellar keratectomy (SALK) is exceedingly rare. To the best of our knowledge, such cases following limbal dermoid excision have not been previously reported. We describe two pediatric cases of fungal interface keratitis following SALK for limbal dermoids. CASE PRESENTATION: Two children, a 12-year-old girl with Goldenhar syndrome and a 6-year-old boy with isolated limbal dermoids, underwent SALK for dermoid excision. Both had an uneventful early postoperative course. At 5 weeks and 4 weeks respectively, they developed graft infiltration with interface involvement. Initial microbiological evaluation was non-contributory, and both cases showed poor response to intensive topical antibacterial therapy. Due to progressive interface infiltrates, graft removal was performed. Microbiological analysis of explanted graft and host bed samples revealed fungal filaments, with culture confirming Aspergillus niger in both cases. Targeted antifungal therapy was initiated with topical natamycin and voriconazole, resulting in resolution of infection. Final visual acuity improved from 6/36 to 6/18 in the first case and from 6/18 to 6/9 in the second case, with no recurrence during follow up. CONCLUSIONS: Fungal interface keratitis can occur following SALK, although rare, and may present with delayed onset and poor response to antibacterial therapy. Early suspicion and timely graft removal are critical for diagnosis and management. Prompt initiation of antifungal therapy can lead to favorable anatomical and visual outcomes.
Association of preoperative corneal spherical aberration with intermediate-to-near visual acuity in enhanced monofocal intraocular lens implantation: a retrospective cross-sectional cohort study.
Lee JE, Kim DR, Whang WJ … +3 more , Hwang HS, Kim EC, Na KS
BMC Ophthalmol · 2026 May · PMID 42106659 · Full text
BACKGROUND: Enhanced monofocal intraocular lenses have been developed to improve intermediate vision; however, variability in postoperative outcomes suggests that preoperative corneal spherical aberration (SA) may play a...
BACKGROUND: Enhanced monofocal intraocular lenses have been developed to improve intermediate vision; however, variability in postoperative outcomes suggests that preoperative corneal spherical aberration (SA) may play a critical role in determining visual performance. This study aimed to investigate the association of preoperative corneal SA with visual performance following cataract surgery with enhanced monofocal intraocular lens (IOL) implantation (Tecnis Eyhance ICB00 or DIB00 and Eyhance Toric DIU). METHODS: In this retrospective cross-sectional cohort study, we included 45 eyes from 34 patients who received enhanced monofocal IOLs from January 2023 to March 2025. Pearson's correlation analysis evaluated the relationship between preoperative corneal SA and uncorrected intermediate visual acuity (UIVA). Receiver operating characteristic (ROC) analysis was used to determine the optimal cutoff value of SA for detecting UIVA > 0.1 logMAR. Patients were then divided into low and high SA groups based on this cutoff. Defocus curves (for a range of + 1.50 D to -5.00 D), Quality of Vision (QoV), and Spectacle Independence questionnaire scores were analyzed. RESULTS: Preoperative corneal SA significantly positively correlated with the UIVA in logMAR (r = 0.496, P = 0.001). ROC analysis estimated the corneal SA threshold as 0.2935 μm (Area under the curve = 0.752, P = 0.005). Compared to the high SA group, the low SA group showed better intermediate and near visual acuity from 100 to 20 cm (P < 0.05) and less frequent spectacle use (P < 0.05). Conversely, distance vision, contrast sensitivities, and QoV scores were comparable between both groups (all P > 0.05). CONCLUSIONS: Lower preoperative corneal SA was significantly associated with a wider depth of focus; thus, corneal SA may help guide preoperative counseling regarding possible intermediate visual performance and spectacle independence.
Analysis of the 36-month efficacy and safety of Kahook dual blade goniotomy combined with phacoemulsification in Chinese patients with open-angle glaucoma.
Yu J, Wang Y, Guan H … +1 more , Zhao L
BMC Ophthalmol · 2026 May · PMID 42106647 · Full text
PURPOSE: To evaluate the efficacy and safety of Kahook dual blade (KDB) goniotomy combined with phacoemulsification for open-angle glaucoma in Chinese patients. METHODS: We retrospectively enrolled 78 Chinese patients (1...
PURPOSE: To evaluate the efficacy and safety of Kahook dual blade (KDB) goniotomy combined with phacoemulsification for open-angle glaucoma in Chinese patients. METHODS: We retrospectively enrolled 78 Chinese patients (100 eyes) with open-angle glaucoma who underwent KDB goniotomy combined with phacoemulsification at the Third People's Hospital of Dalian, Liaoning Province, China, between September 2021 and December 2024, of whom 63 eyes had primary open-angle glaucoma (POAG) and 37 eyes had pseudoexfoliation glaucoma (PXFG). Intraocular pressure (IOP), the number of glaucoma medications used preoperatively and at 1 day, 1 week, 1 month, 3, 6, 12, and 36 months postoperatively, surgical success rates, and surgical complications were recorded. Surgical success was defined as: Criterion A (IOP reduction ≥ 20% with IOP ≤ 21 mmHg), Criterion B (IOP reduction ≥ 20% with IOP ≤ 18 mmHg), and Criterion C (IOP reduction ≥ 20% with IOP ≤ 15 mmHg). RESULTS: The mean IOP reduced from 25.25 ± 6.54 mmHg at baseline to 14.09 ± 3.48 mmHg at 36 months (P < 0.01). The number of medications decreased from 3.0 (2.0, 4.0) to 1.0 (0.0, 2.0) at 36 months (P < 0.01). Surgical success rates at 36 months, defined by Criteria A, B, and C, were 76.32%, 67.11%, and 48.68%. The mean IOP reduced from 24.57 ± 5.71 mmHg at baseline to 14.83 ± 3.35 mmHg at 36 months for POAG (P < 0.01) and from 26.41 ± 7.70 mmHg at baseline to 12.90 ± 3.40 mmHg at 36 months for PXFG (P < 0.01).The number of medications decreased from 3.0 (2.0, 4.0) to 1.0 (0.0, 2.0) for POAG (P < 0.01) and from 3.0 (2.0, 4.0) to 0.0 (0.0, 1.0) for PXFG (P < 0.01) at 36 months. Between the two groups, IOP showed no statistical difference at baseline, 3 months, and 36 months (P > 0.05). At 1 day, 1 week, 1 month, 6 months, 12 months, and 24 months, IOP in the PXFG group was significantly lower than that in the POAG group (P < 0.05). From 3 months to 36 months, the number of medications in the PXFG group was significantly lower than that in the POAG group (P < 0.05). Surgical success rates at 36 months according to Criterion A were 72.34% in POAG and 82.76% in PXFG (P = 0.127); according to Criterion B, 59.57% vs. 79.31% (P = 0.087); and according to Criterion C, 42.55% vs. 62.07% (P = 0.036). Twenty-four-hour IOP fluctuations at 12 months were 4.02 ± 2.01 mmHg in POAG and 3.69 ± 1.31 mmHg in PXFG, both significantly decreased compared with baseline (10.02 ± 3.58 mmHg and 10.39 ± 3.32 mmHg, respectively; P < 0.01 for both groups). Common surgical complications included hyphema and IOP spike. CONCLUSIONS: KDB goniotomy combined with phacoemulsification was safe and effectively reduced IOP and the medication burden in patients with POAG and PXFG. In the first and second year, significantly lower IOP was noted in PXFG compared with POAG.
Investigation of the impact of tear film dynamics on optical coherence tomography image quality in patients with dry eye disease.
Kesimal B, Kocamış Sİ
BMC Ophthalmol · 2026 May · PMID 42104329 · Full text
PURPOSE: To investigate the effect of tear film parameters on optical coherence tomography (OCT) signal strength index (SSI) in dry eye disease (DED) patients. METHODS: This cross-sectional study included 77 DED patients...
PURPOSE: To investigate the effect of tear film parameters on optical coherence tomography (OCT) signal strength index (SSI) in dry eye disease (DED) patients. METHODS: This cross-sectional study included 77 DED patients and 77 healthy controls. All participants underwent ocular surface index (OSDI) assessment, Schirmer I test, non-invasive break up time (NIBUT) measurement, and OCT imaging. SSI values from raster and optic nerve head (ONH) scans were recorded using the RTVue-100 device. Correlation and multivariate analyses were performed. RESULTS: DED patients exhibited significantly lower raster and ONH SSI values compared to controls (p < 0.001). SSI positively correlated with NIBUT and Schirmer, and negatively with OSDI scores (p < 0.001). NIBUT and OSDI were independent predictors of SSI in regression models. CONCLUSION: Tear film instability reduces OCT signal quality in DED, even without media opacities. Ocular surface optimization should be considered before OCT imaging to ensure accurate evaluation of measurements.
Neonatal conjunctivitis due to uncommon pathogen Streptococcus mitis/oralis: a case report.
Kılınç AK, Büyüksoy ND, Yeşiltaş YS … +1 more , Bozdayı AÜ
BMC Ophthalmol · 2026 May · PMID 42104291 · Full text
Neonatal conjunctivitis (NC), historically attributed to Neisseria gonorrhoeae, is now known to be caused by various pathogens, including Staphylococcus, Streptococcus, and Chlamydia trachomatis. Although viridans group...
Neonatal conjunctivitis (NC), historically attributed to Neisseria gonorrhoeae, is now known to be caused by various pathogens, including Staphylococcus, Streptococcus, and Chlamydia trachomatis. Although viridans group streptococci are generally regarded as commensal organisms, they may cause opportunistic conjunctival infections. Here, we present a case of NC caused by Streptococcus mitis/oralis, a member of the Mitis group of viridans group streptococci. A 15-day-old female neonate presented with bilateral severe eyelid edema and moderate hemopurulent discharge that precluded anterior segment evaluation. Symptoms began at nine days of age with serous discharge, which gradually worsened. The severe presentation initially raised concern for orbital cellulitis. Upon hospital admission, a conjunctival swab was obtained, and treatment was initiated with topical moxifloxacin and fusidic acid, along with empirical intravenous penicillin and gentamicin. Eyelid edema and discharge improved significantly within 24-48 h. Culture results confirmed Streptococcus mitis/oralis, which was sensitive to the administered antibiotics. Complete clinical recovery was subsequently achieved without complications. This case highlights the diagnostic challenge of differentiating severe NC from orbital cellulitis and underscores the potential of S. mitis/oralis to cause significant ocular morbidity in neonates. The prompt and dramatic response to antibacterial treatment prevented long-term complications, and this case supports the hypothesis of postnatal transmission from the neonate's own nasopharyngeal flora or that of the caregiver rather than exclusive acquisition from the birth canal.
Compliance to intravitreal anti-vascular endothelial growth factors for treatment of retinal diseases in Nigerians: a retrospective multicenter study.
Okonkwo ON, Hassan AO, Oronsaye DA … +3 more , Emelumadu C, Akanbi T, Agweye C
BMC Ophthalmol · 2026 May · PMID 42104267 · Full text
BACKGROUND: Little is known about compliance with intravitreal anti-vascular endothelial growth factor (VEGF) therapy for the treatment of macular and retinovascular diseases among Nigerians and Africans. The objective o...
BACKGROUND: Little is known about compliance with intravitreal anti-vascular endothelial growth factor (VEGF) therapy for the treatment of macular and retinovascular diseases among Nigerians and Africans. The objective of this study is to measure compliance to 3 or more and 6 or more intravitreal anti-VEGF injections for common macular and retinovascular diseases in Nigerian clinics and evaluate the impact on visual outcomes. METHOD: Retrospective multicenter chart review of 622 eyes/ 528 patients diagnosed with neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), retinal vein occlusions (RVOs), including branch, central, and hemiretinal (BRVO, CRVO, and HRVO), and non-AMD Choroidal Neovascular Membrane (CNVM) from five clinics (urban, semi-urban, and rural), collecting demographics, diagnosis, injection type/number, pre-/post-BCVA (converted to LogMAR), and follow-up. Treatments were intravitreal Bevacizumab (Avastin), Ranibizumab (Patizra), and Aflibercept (Eylea). Definitions of compliance: compliant; ≥3 injections (standard loading), also ≥ 6 injections. RESULTS: For all 622 eyes, presenting BCVA: 1.21 ± 0.84 and the final BCVA: 0.91 ± 0.80 (P = < 0.001). Overall compliance with ≥ 3 injections was 47.5%, and with ≥ 6 injections, 10.1%. Compliance to ≥ 3 injections by diagnosis was as follows: AMD 50.4%, Non-AMD CNVM 58.2%, BRVO 44.8%, CRVO 44.0%, HRVO 46.7%, DME 40.6%. Age (P = 0.264) and sex (P = 0.870) did not affect compliance to ≥ 3 injections. Clinic location significantly influenced compliance with ≥ 3 injections (P = 0.000), but not with 6 injections (P = 0.173). The highest rates of compliance with ≥ 3 injections were observed in urban tertiary centers. Injection type and cost were not significant factors (P = 0.36). Eyes with ≥ 3 injections achieved better vision (≥ 6/18) across all diagnoses; the most notable improvements were in non-AMD CNVM (+ 41.4%) and BRVO (+ 35%). Statistically significant LogMAR improvements were seen in CRVO (p = 0.049) and DME (p = 0.043). Postoperative endophthalmitis occurred in 2/622 eyes (0.0032) (both Avastin); no other serious adverse event was recorded. CONCLUSIONS: Real-world compliance is significantly lower than ideal. Urban and tertiary clinics show better adherence. Receiving the recommended loading doses is associated with improved visual outcomes for most diagnoses. Understanding the reasons for non-compliance, using a prospective approach, and addressing them will improve treatment outcomes for more Nigerian and presumably African patients receiving anti-VEGF drugs.
Outcomes of primary orbital implantation in evisceration/enucleation in patients with endophthalmitis in a tertiary hospital.
Alrashed S, Alnefaim M, Althaqib RN … +1 more , Alsulaiman HM
BMC Ophthalmol · 2026 May · PMID 42098714 · Full text
PURPOSE: To evaluate the safety and outcomes of primary orbital implantation during evisceration/enucleation for endophthalmitis, specifically analyzing the risk of implant exposure/extrusion. METHODS: Retrospective revi...
PURPOSE: To evaluate the safety and outcomes of primary orbital implantation during evisceration/enucleation for endophthalmitis, specifically analyzing the risk of implant exposure/extrusion. METHODS: Retrospective review of 98 endophthalmitis patients (90 eviscerations, 8 enucleations) who received a primary orbital implant (mostly PMMA) over 10 years. Follow-up averaged 27.5 months. RESULTS: Postoperative implant exposure/extrusion occurred in 10 patients (10.2%). This rate is comparable to established literature. The mean time to exposure was 140 days. Neither preoperative orbital cellulitis nor culture positivity (e.g., Pseudomonas) was statistically associated with a higher risk of exposure. Re-operations for exposure did not show evidence of active, ongoing infection. CONCLUSION: Primary orbital implantation in endophthalmitis patients is safe, carrying an exposure/extrusion risk (10.2%) comparable to reported rates. The procedure should be favored over a two-staged approach unless significant inflammation is noted intraoperatively. PRéCIS: The purpose of this paper is to study outcomes of primary orbital implantation in Endophthalmitis patient, and to review the exposure rate, and to also analyze possible risk factors for the exposure/extrusion.
Comparative evaluation of three trauma scoring systems: OTS, POTS, and MPOTS for predicting early visual outcomes in pediatric open-globe injuries.
Celik Yaprak D, Ozbek M, Oskan Yalcin S … +1 more , Kaplan AT
BMC Ophthalmol · 2026 May · PMID 42098697 · Full text
OBJECTIVE: To evaluate and directly compare the prognostic performance of three trauma scoring systems-Ocular Trauma Score (OTS), Pediatric Ocular Trauma Score (POTS), and Modified Pediatric Ocular Trauma Score (MPOTS)-i...
OBJECTIVE: To evaluate and directly compare the prognostic performance of three trauma scoring systems-Ocular Trauma Score (OTS), Pediatric Ocular Trauma Score (POTS), and Modified Pediatric Ocular Trauma Score (MPOTS)-in predicting visual outcomes in pediatric patients with open-globe injuries (OGI). METHODS: This retrospective cohort included 110 pediatric patients (≤ 18 years) who underwent surgical repair for OGI between January 2018 and December 2024. Demographic, clinical, and surgical data were extracted from standardized medical records. Prognostic factors for final visual acuity (VA) were analyzed, and OTS, POTS, and MPOTS were calculated for each patient. Visual outcomes were classified as favorable (VA > 20/200) or poor (VA ≤ 20/200). Predictive performance was assessed using Spearman's rank correlation and receiver operating characteristic (ROC) curve analysis. RESULTS: The mean age was 7.85 ± 4.73 years, and the mean follow-up was 20.36 ± 16.70 months. Presenting VA, injury zone, and associated ocular pathologies (hyphema, traumatic cataract, vitreous hemorrhage, retinal detachment, choroidal involvement, vitreous prolapse, and iris prolapse) were significant predictors of poor outcomes (all p < 0.05), whereas age, sex, and time to surgery were not. Mean VA improved significantly from baseline (1.40 ± 0.92 logMAR) to final follow-up (0.68 ± 1.04 logMAR; p < 0.001). All three trauma scores correlated strongly with final VA, with OTS (r = - 0.822) and POTS (r = - 0.807) outperforming MPOTS (r = - 0.690). ROC analysis confirmed excellent discriminative ability for all three models, with the highest areas under the curve (AUC) observed for POTS (0.983), followed by OTS (0.974) and MPOTS (0.948). CONCLUSIONS: OTS, POTS, and MPOTS are valuable tools for predicting visual outcomes in pediatric OGI. While POTS demonstrated the best discriminative performance in our cohort, OTS remained highly reliable, and MPOTS provided a simpler framework but with slightly reduced accuracy. OTS should continue to serve as a reference standard, with pediatric-specific scores offering complementary value in challenging clinical scenarios.
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