PurposeTo evaluate adverse events (AEs) associated with teprotumumab in the reatment of thyroid eye disease (TED).MethodsReports involving teprotumumab were extracted from the U.S.FDA Adverse Event Reporting System (FAER...PurposeTo evaluate adverse events (AEs) associated with teprotumumab in the reatment of thyroid eye disease (TED).MethodsReports involving teprotumumab were extracted from the U.S.FDA Adverse Event Reporting System (FAERS) from the first quarter of 2020 to the first quarter of 2025. After data standardization, disproportionality analyses were performed using multiple signal detection algorithms, including the Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Empirical Bayesian Geometric Mean (EBGM).ResultsA total of 1,357 reports were identified. Detected signals at the system organ class (SOC) level included ear and labyrinth disorders, eye disorders, social circumstances and reproductive system and breast disorders. A total of 143 Preferred Terms (PTs) met the criteria of four algorithms. Among these, signals within the "Ear and labyrinth disorders" SOC were predominant ( = 598). Tinnitus was the most frequently reported PT ( = 146). The highest disproportionality signals, based on ROR values, were observed for permanent deafness (ROR 10,021.8; 95% CI 5,544.31-18,115.24), autophony (ROR 3,282.12; 95% CI 1,333.19-8,080.12), and patulous eustachian tube (ROR 1,401.68;95% CI 499.54-3,932.99).ConclusionThese findings provide important real-world safety evidence and may support safer clinical use of teprotumumab.
AimTo evaluate and compare the performance of five artificial intelligence (AI) chatbots-ChatGPT (OpenAI 4), Google Gemini, Grok (xAI), DeepSeek, and Meta Llama -in delivering accurate, clear, educational, and safe respo...AimTo evaluate and compare the performance of five artificial intelligence (AI) chatbots-ChatGPT (OpenAI 4), Google Gemini, Grok (xAI), DeepSeek, and Meta Llama -in delivering accurate, clear, educational, and safe responses to caregiver-facing queries related to strabismus.MethodsSixteen standardized caregiver questions on strabismus were presented to each chatbot in independent sessions. Five fellowship-trained pediatric ophthalmologists rated each response across four domains-Accuracy, Clarity, Educational Value, and Safety-using a 5-point Likert scale (1 = Poor, 5 = Excellent). Between-chatbot differences were analyzed using cumulative link mixed models (CLMMs) with odds ratios (OR) and 95% confidence intervals (CI). Holm-adjusted pairwise contrasts corrected for multiple comparisons. Inter-rater reliability was assessed using quadratic-weighted Fleiss' κ and Gwet's AC1 to address prevalence and bias effects.ResultsChatGPT achieved the highest proportion of top ratings (≥4) for Accuracy (65%) and Clarity (59%), followed by Llama (41% and 47.5%, respectively). For Educational Value, Llama (43.8%) and Gemini (42.5%) performed slightly better, while Safety ratings were highest for Gemini (40%) and Llama (37.5%). CLMM analysis showed significant between-chatbot differences for Accuracy, Clarity, and Educational Value ( < 0.05) but not for Safety. Compared with ChatGPT, lower odds of higher ratings were seen for Grok (OR 0.48) and DeepSeek (OR 0.61). Inter-rater reliability indicated moderate agreement (Fleiss' κ = 0.59) and strong consensus (Gwet's AC1 = 0.87).ConclusionChatGPT showed superior accuracy and clarity, while Gemini and Llama excelled in educational value and safety. High expert agreement supports AI chatbots as adjuncts in pediatric ophthalmology education requiring continued validation.
To review the pathogenesis, clinical presentation, and management of inflammatory optic disc neovascularization (ODN). ODN is a rare but vision-threatening complication of uveitis. Traditionally associated with retinal i...To review the pathogenesis, clinical presentation, and management of inflammatory optic disc neovascularization (ODN). ODN is a rare but vision-threatening complication of uveitis. Traditionally associated with retinal ischemia, recent evidence shows that ODN can arise even in well-perfused eyes, driven by chronic inflammation. A total of 102 reported cases of ODN in uveitic eyes without angiographic evidence of retinal ischemia were reviewed, analysing the underlying conditions, anatomical patterns, complications, and therapeutic responses. The optic disc was the exclusive site of neovascularization, often linked to prolonged inflammation. Diagnosis relied on angiographic and OCT-A imaging. Anti-inflammatory treatment was the cornerstone, with corticosteroids and immunosuppressants showing good efficacy. Anti-VEGF agents offered adjunctive benefits, especially in acute or haemorrhagic cases. An illustrative case of acute anterior uveitis with isolated ODN is presented; the neovascularization resolved after combined steroid and anti-VEGF therapy. ODN may emerge as a complication of uveitis even in the absence of ischemia. Recognizing its inflammatory nature is essential for appropriate treatment and to prevent vision-threatening sequelae.
PurposeTo evaluate the visual, refractive, and anatomical outcomes, as well as the early safety and stability of the sclerocorneal flanged monofixation technique in eyes with advanced zonular dialysis undergoing cataract...PurposeTo evaluate the visual, refractive, and anatomical outcomes, as well as the early safety and stability of the sclerocorneal flanged monofixation technique in eyes with advanced zonular dialysis undergoing cataract extraction.MethodsThis retrospective interventional case series included 22 eyes of 17 patients who underwent phacoemulsification and in-the-bag IOL implantation using the Telegin sclerocorneal flanged monofixation technique between January 2022 and June 2023. Postoperative evaluations included best-corrected visual acuity (BCVA), intraocular pressure (IOP), Scheimpflug-based analysis of IOL tilt and decentration, anterior segment optical coherence tomography (AS-OCT) assessment of flange depth, and endothelial cell density (ECD) measurement by specular microscopy. Supplementary Video 1 demonstrates the surgical steps.ResultsThe mean age was 62.4 ± 4.7 years. BCVA improved significantly from 0.27 ± 0.19 preoperatively to 0.83 ± 0.32 at 6 months ( < 0.001), with no significant change in IOP ( = 0.764). The mean IOL tilt was 0.7 ± 0.3°, mean decentration 0.11 ± 0.06 mm, and mean flange depth 225 ± 40 µm. The mean pre- and postoperative ECD values were 2,374 ± 423 and 2,356 ± 390 cells/mm, respectively ( = 0.18). No intraoperative or postoperative complications occurred, and only one patient (4.5%) reported transient dysphotopsia that resolved by 3 months.ConclusionThe sclerocorneal flanged monofixation technique offers excellent early IOL stability, minimal endothelial cell loss, and high visual performance in eyes with zonular dialysis. Its simplicity, reproducibility, and lack of suture-related complications make it a promising, cost-effective alternative to traditional modified capsular tension ring or double-flanged haptic techniques.
PurposeTo examine the visual outcomes and complication rates for IOL (intraocular lens) exchange, analysed by combination of surgical indication and secondary IOL implantation site.DesignRetrospective case series of IOL...PurposeTo examine the visual outcomes and complication rates for IOL (intraocular lens) exchange, analysed by combination of surgical indication and secondary IOL implantation site.DesignRetrospective case series of IOL exchange procedures performed between June 1998 and July 2018 from a single tertiary referral centre, London, United Kingdom.MethodsConsecutive IOL exchange procedures with pre-operative and 6-month post-operative visual acuity and complication data were eligible.Results318 eyes from 288 patients were included. Mean best-corrected visual acuity (BCVA) improved from 0.82 ± 0.77 to 0.47 ± 0.60 LogMAR at 6 months ( < 0.001), in particular following complete IOL dislocation (adjusted < 0.001), partial IOL dislocation (adjusted = 0.001), refractive indications (adjusted = 0.02), and pseudophacodonesis (adjusted = 0.02). The most performed and the greatest BCVA improvement was found with subsequent anterior chamber IOL implantation (-0.44 ± 0.72 LogMAR, = 214, 67%). The poorest BCVA at 6 months was following IOL exchange for corneal oedema (1.13 ± 0.81 LogMAR, = 16, 5%). 26% of cases underwent concurrent pars plana vitrectomy, and 15% underwent anterior vitrectomy, with 8% experiencing post-operative cystoid macular oedema.ConclusionsIOL exchange is safe and effective, however careful patient selection and pre-operative counselling assisted by such data should determine when surgery should be undertaken.
PurposeTo systematically evaluate retinal and choroidal structural alterations measured by optical coherence tomography (OCT) in individuals with a history of retinopathy of prematurity (ROP) compared with healthy contro...PurposeTo systematically evaluate retinal and choroidal structural alterations measured by optical coherence tomography (OCT) in individuals with a history of retinopathy of prematurity (ROP) compared with healthy controls, and to identify sources of heterogeneity across studies.MethodsA PROSPERO-registered systematic review (CRD42023422605) was conducted in accordance with PRISMA guidelines. PubMed, Scopus, and EMBASE were searched from inception through July 26, 2023. Human observational studies reporting OCT-derived retinal or choroidal thickness metrics in ROP with healthy controls were included. Random-effects meta-analyses were performed using standardized mean differences (SMD) and weighted mean differences. Meta-regression and subgroup analyses explored heterogeneity.ResultsEleven studies (1,019 participants; 351 ROP, 668 controls) were included. Compared with controls, eyes with ROP demonstrated significantly thinner macular ganglion cell-inner plexiform layer (GCIPL) thickness (SMD -1.07; = 0.002) and thinner superior and temporal perifoveal retina, alongside significantly increased foveal retinal thickness (SMD 1.41; < 0.0001). No significant difference was observed in subfoveal choroidal thickness. Substantial heterogeneity was present across most outcomes (I frequently >75%). Meta-regression identified younger age at imaging as significantly associated with greater foveal thickening ( = 0.002). OCT platform and geographic location also contributed to variability.ConclusionsIndividuals with prior ROP exhibit persistent, layer-specific and region-specific macular alterations consistent with disrupted neurovascular development and foveal hypoplasia. However, substantial methodological heterogeneity limits transportability of thickness-based biomarkers. Standardized, age-aware prospective OCT studies are required before structural metrics can be adopted for clinical risk stratification or longitudinal surveillance.
PurposeTo evaluate the safety and efficacy of yellow laser photocoagulation for deep conjunctival nevi.MethodologyThis prospective interventional case series included patients with clinically stable conjunctival nevi for...PurposeTo evaluate the safety and efficacy of yellow laser photocoagulation for deep conjunctival nevi.MethodologyThis prospective interventional case series included patients with clinically stable conjunctival nevi for ≥6 months. Treatment was performed using the Iridex yellow laser (577 nm) under topical anesthesia, with a 200-micron spot, 80 ms exposure, and 300-600 mW power. The lesion was removed with sterile cotton buds post-laser, and topical steroids were prescribed for one week. Follow-up was at day 1, week 1, month 1, and month 3, assessing ocular surface health and lesion resolution. Examinations included Schirmer Test 1, Oxford corneal staining, Ocular Surface Disease Index (OSDI), tear meniscus height, and non-invasive keratograph break-up time (NIKBUT).ResultsThe study included 10 eyes from 9 patients. Mean age was 30 years (range: 6-63), with a 1:1 sex ratio. Anterior segment OCT confirmed subepithelial lesions in all, with intralesional cysts in 60%. Mean nevus diameter was 4.2 mm (range: 2-11), and 70% showed severe pigmentation. Laser treatment was completed in one session for 90% of eyes; one required a second due to large size. No significant changes were observed in ocular surface parameters. At a mean follow-up of 10.5 months (range: 3-17), 85% (6/7) of eyes had complete resolution when the laser was fully applied. No recurrence occurred. One patient developed conjunctival scarring from inadvertent Tenon's capsule application.ConclusionYellow laser photocoagulation is a safe, effective, minimally invasive outpatient treatment for conjunctival nevi, including deeply pigmented cases. It yields excellent cosmetic outcomes with minimal side effects, supporting its role as a potential standard of care.
PurposeMany studies have focused on the presence of corneal enantiomorphism in patients with keratoconus, and single reports have presented its occurrence among healthy individuals. This study aimed to evaluate the magni...PurposeMany studies have focused on the presence of corneal enantiomorphism in patients with keratoconus, and single reports have presented its occurrence among healthy individuals. This study aimed to evaluate the magnitude of enantiomorphism in a Polish general practice population representing different age groups.MethodsThis cross-sectional study involved patients registered with a general practitioner. Corneal measurements were conducted using a rotating Scheimpflug corneal tomography system, and the symmetry between stereometric parameters of the cornea was analyzed.ResultsThe study included 590 patients (241 men and 349 women) of Polish nationality with a mean age of 53.35 ± 16.70 years. The mean keratometry values were 43.26 ± 1.40 D for the right eye and 43.27 ± 1.36 for the left eye (mean absolute interocular difference 0.01 ± 0.37 D). A difference in mean keratometry values greater than or equal to 0.75 D was noted in 29 patients (4.9%), with a difference of greater than 1 D in 10 patients (1.7%). Corneal astigmatism equal to or greater than 0.75 D was noted in 396 (67.0%) of patients, while 225 patients (38.1%) had astigmatism in both eyes. Isorule astigmatism was noted in 88.4% (199/225) patients having astigmatism in both eyes. The absolute interocular difference in central corneal thickness was 7.74 ± 6.26 µm ( < 0.01), and correlated with the level of astigmatism ( = 0.02), but not with age or mean keratometry.ConclusionThe degree of corneal enantiomorphism was high in our study population, with interocular differences in keratometric power being relatively small. This study provides reference values for interocular corneal symmetry, contributing to the understanding of enantiomorphic patterns.
PurposeThis study aimed to evaluate the effect of axial length on the surgical results of bilateral lateral rectus recession (BLR) in patients with basic-type intermittent exotropia (IXT).MethodsThis retrospective study...PurposeThis study aimed to evaluate the effect of axial length on the surgical results of bilateral lateral rectus recession (BLR) in patients with basic-type intermittent exotropia (IXT).MethodsThis retrospective study included patients aged 4-10 years with basic-type IXT who underwent standard symmetric BLR and had at least 6 months of follow-up. The magnitude of deviation was assessed at postoperative day 1, week 1, month 1, month 3, and month 6. The amount of correction per millimeter of recession was analyzed. Age-adjusted axial length (AL) percentiles were calculated based on normative data. Multivariate linear regression analysis was performed to evaluate the association between AL and surgical outcomes while adjusting for age, sex, and postoperative deviation at 1 week.ResultsA longer AL was associated with a smaller amount of correction per millimeter of recession at postoperative day 1 and week 1 at both distance and near (p < 0.05). However, this association was not observed after 1 month postoperatively. In multivariable analysis, AL percentile was not independently associated with postoperative deviation at 6 months.ConclusionsAxial length was associated with the early surgical response after BLR in children with basic-type IXT, but this effect diminished over time. Adjustment of surgical dosage based solely on AL may not be necessary for long-term outcomes.
BackgroundTo assess short-term clinical outcomes in patients with retinal vein occlusion (RVO)-related macular edema switched to Faricimab after a suboptimal response to previous intravitreal therapy.MethodsIn our retros...BackgroundTo assess short-term clinical outcomes in patients with retinal vein occlusion (RVO)-related macular edema switched to Faricimab after a suboptimal response to previous intravitreal therapy.MethodsIn our retrospective single-center analysis, functional and anatomical changes of eyes affected by macular edema secondary to RVO were analyzed at baseline and four weeks after completing a three-injection Faricimab upload phase. Visual acuity (LogMAR) was analyzed as functional outcome measure, while central retinal thickness (CRT) and central retinal volume (CRV) were investigated as anatomical outcome measures. Further, a subgroup analysis compared treatment-related factors between patients exhibiting concurrent functional and anatomical improvements (full-responders) and those who did not (reduced-responders).ResultsA total of 21 eyes from 20 patients were included. Mean visual acuity improved modestly from 0.50 ± 0.52 to 0.40 ± 0.31 LogMAR, without reaching statistical significance ( = 0.257). Significant reductions in CRT (350.2 ± 124.5 to 302.6 ± 74.6 µm; = 0.037) and CRV (2.53 ± 0.46 to 2.34 ± 0.29 mm; = 0.011) were noted. A positive correlation between CRT reduction and VA improvement was observed (r = 0.499; = 0.021). In comparison, full-responders exhibited a significantly worse baseline LogMAR ( = 0.041) and CRT ( = 0.026).ConclusionIn our study assessing the short-term effect of switching to intravitreal Faricimab, significant anatomical improvements were observed. Although no significant functional improvements were observed, likely reflecting a ceiling effect, visual acuity remained stable. Further studies are necessary to evaluate especially sustained functional outcomes under long-term Faricimab therapy.
PurposeTo investigate the incidence and risk factors of oculocardiac reflex (OCR) during inferior rectus (IR) muscle recession under general anesthesia in patients with thyroid eye disease (TED).MethodsThis retrospective...PurposeTo investigate the incidence and risk factors of oculocardiac reflex (OCR) during inferior rectus (IR) muscle recession under general anesthesia in patients with thyroid eye disease (TED).MethodsThis retrospective study included 68 patients with TED who underwent IR muscle recession. Demographic, imaging, surgical, and anesthetic data were analyzed. OCR was defined as a heart rate decrease of > 20% from baseline during surgery. Logistic regression was used to assess risk factors.ResultsOCR occurred in 14 patients (20.6%). Logistic regression analysis identified the presence of intramuscular fat degeneration as a significant factor to reduce the risk of OCR (odds ratio, 0.010; = 0.014). Additionally, patients with OCR had a higher baseline heart rate compared to those without OCR (65.4 ± 12.4 bpm vs. 57.8 ± 8.9 bpm; = 0.031), but the result of logistic regression analysis did not reach the statistical significance (odds ratio, 1.128; = 0.088). No association was found between OCR and other variables.ConclusionThe absence of intramuscular fat degeneration significantly increases the risk of OCR during IR muscle recession under general anesthesia in TED. These findings provide valuable insights for perioperative strategies to improve safety in strabismus surgeries for TED.