Int Ophthalmol [JOURNAL]
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200 papers
Evaluation of the association between myopia and ocular biometric parameters by scheimpflug technology in Saudi Arabia.
Elagamy A, Alghamdi M, Berika M
Int Ophthalmol · 2026 Apr · PMID 41954846 · Publisher ↗
PURPOSE: This study aimed to evaluate the anterior segment parameters and axial length (AXL) in myopic Saudi adults, using Pentacam AXL. STUDY DESIGN: This study was a non-randomized, cross-sectional, observational, and...
PURPOSE: This study aimed to evaluate the anterior segment parameters and axial length (AXL) in myopic Saudi adults, using Pentacam AXL. STUDY DESIGN: This study was a non-randomized, cross-sectional, observational, and quantitative study. SUBJECTS AND METHODS: The study included 98 myopic eyes (from only right eyes) of 98 healthy Saudi females aged 19 to 30 years. Each subject underwent autorefraction without cycloplegia. Subjective refraction with fogging was conducted to relax accommodation. Maximum and minimum keratometry, anterior chamber depth (ACD), corneal horizontal diameter, central corneal thickness, corneal asphericity (Q), and AXL were measured using the Pentacam AXL® single rotation Scheimpflug camera. RESULTS: A strong correlation was observed between SE and AXL (r = 0.565, p < 0.001), indicating that longer AXL was associated with more myopic SE. Additionally, AXL showed a moderate negative correlation with a patient's age at the onset of myopia (r = - 0.290 & p = .004). However, AXL showed no significant correlation with the patients' age, mean keratometry, maximum keratometry, minimum keratometry, or corneal horizontal diameter, ACD, central corneal thickness, and Q. CONCLUSION: This study provided valuable insights into the complex interplay between multiple variables that contribute to myopia progression. This understanding is crucial for early detection, tracking of progression, and treatment of this condition.
Evaluation of the triglyceride-glucose index, serum inflammatory biomarkers and lipid profile in patients with neovascular age-related macular degeneration.
Eker S, Erdem A, Acar U … +1 more , Gönül Ş
Int Ophthalmol · 2026 Apr · PMID 41954837 · Publisher ↗
PURPOSE: To evaluate the triglyceride-glucose index (TyG), novel systemic inflammatory biomarkers, and lipid profile in patients with neovascular age-related macular degeneration (nAMD), and to investigate their potentia...
PURPOSE: To evaluate the triglyceride-glucose index (TyG), novel systemic inflammatory biomarkers, and lipid profile in patients with neovascular age-related macular degeneration (nAMD), and to investigate their potential relationship with disease presence. METHODS: This retrospective case-control study included 59 patients diagnosed with nAMD and 67 age- and sex-matched healthy controls. Demographic characteristics, fasting biochemical tests, lipid profile, complete blood count, and serum inflammatory indices were recorded. Triglyceride-glucose index, systemic inflammatory indices derived from various hematological parameters and lipid levels were calculated. Laboratory parameters and calculated indexes were compared between the two groups using Statistical Package for the Social Sciences (SPSS). RESULTS: Triglyceride-glucose index was significantly higher in the nAMD group than in controls (4.84 ± 0.27 vs. 4.69 ± 0.17, p = 0.0001). Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels were also elevated in the nAMD group (p = 0.0001 for both). Among hematological markers, white blood count (WBC), neutrophil, and monocyte counts were significantly increased in nAMD patients (p = 0.012, p = 0.001, p = 0.015, respectively). Inflammatory indices including neutrophil/lymphocyte ratio (NLR) (p = 0.015), monocyte/HDL-C ratio (MHR) (p = 0.003), systemic inflammation aggregate index (AISI) (p = 0.025), and C reactive protein/albumine ratio (CAR) (p = 0.006) were significantly higher in the nAMD group, whereas the systemic immune inflammation index (SII), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) showed no significant differences (p > 0.05). Serum lipid levels and atherogenic lipid ratios did not differ between the groups. DISCUSSION: Patients with nAMD exhibit increased systemic inflammatory activity and metabolic stress, reflected by elevated NLR, MHR, AISI, and CAR levels. In addition, TyG, a novel indicator of systemic insulin resistance, was found to be elevated in nAMD patients. These findings suggest that metabolic dysregulation and chronic low-grade systemic inflammation may contribute to nAMD pathogenesis independently of serum lipid levels. The TyG and inflammation-derived biomarkers may serve as potential systemic indicators for nAMD risk or disease activity.
The effect of parenteral iron treatment on ocular vascularity in female patients with iron deficiency anemia.
Aydın N, Tufek M, Capraz M … +3 more , Akman B, Altınok SN, Kara C
Int Ophthalmol · 2026 Apr · PMID 41954824 · Publisher ↗
PURPOSE: To evaluate the effect of parenteral iron treatment on the choroidal thickness, retinal nerve fiber layer (RNFL) thickness and retrobulbar blood flow in females with iron deficiency anemia (IDA) and to explore t...
PURPOSE: To evaluate the effect of parenteral iron treatment on the choroidal thickness, retinal nerve fiber layer (RNFL) thickness and retrobulbar blood flow in females with iron deficiency anemia (IDA) and to explore the mediation role of the changes in Doppler flow parameters in this relationship. METHODS: A total of 55 eyes of 55 females in the reproductive period with a diagnosis of IDA were included in this prospective observational study. The hematologic values and the choroidal thickness at the subfoveal area and 500, 1000, 1500 µm nasal and temporal to the fovea, RNFL thickness, and central retinal artery (CRA) and ophthalmic artery (OA) parameters one day before and 8-12 weeks after parenteral iron treatment were evaluated in the patients. RESULTS: The choroidal thickness at all measurement points and the RNFL thickness in all quadrants were significantly higher than the pre-treatment values following treatment (p < 0.05). The CRA peak systolic velocity (PSV) and end-diastolic velocity (EDV) values and the OA PSV values were statistically significantly lower after treatment compared to the pre-treatment values (p < 0.001, p < 0.01, p = 0.05, respectively). According to the mediation analysis, changes in hemoglobin (Hb), hematocrit (Hct), and mean corpuscular volume indirectly affected the superior RNFL thickness via the changes observed in OA EDV and the pulsatile index. CONCLUSIONS: Parenteral iron treatment leads to significant improvement in both the hematological parameters and the retinal and choroidal circulation. This improvement was found to occur in a balanced manner through the changes in the retrobulbar blood flow parameters.
A hypothetical circadian‒endocrine pathway linking melanopsin-expressing ipRGC dysfunction in autoimmune retinopathy to sexual dysfunction.
Antony Rajan RJ, Esther AR
Int Ophthalmol · 2026 Apr · PMID 41949765 · Publisher ↗
BACKGROUND: Autoimmune Retinopathy (AIR) is a rare, immune-mediated retinal degeneration caused by circulating autoantibodies targeting retinal antigens. Although classically associated with photoreceptor loss, multiple...
BACKGROUND: Autoimmune Retinopathy (AIR) is a rare, immune-mediated retinal degeneration caused by circulating autoantibodies targeting retinal antigens. Although classically associated with photoreceptor loss, multiple clinical and experimental studies suggest broader inner retinal involvement, including retinal ganglion cells. METHODS: This review proposes a novel, hypothesis-generating model based on existing literature, exploring whether AIR may contribute to circadian disruption and sexual dysfunction-particularly erectile dysfunction (ED)-through immune-mediated injury to melanopsin-expressing intrinsically photosensitive retinal ganglion cells (ipRGCs). RESULTS: ipRGCs project to the suprachiasmatic nucleus (SCN) and are essential for synchronizing circadian rhythms and regulating neuroendocrine function. While direct evidence of ipRGC damage in AIR is lacking, ipRGC pathway dysfunction has been reported in glaucoma and diabetic retinopathy-conditions that share pathological mechanisms with AIR. Circadian misalignment may disrupt testosterone secretion, melatonin rhythms, and nitric oxide signaling, all of which are implicated in ED. CONCLUSION: This interdisciplinary framework integrates ocular immunology, circadian biology, and sexual medicine to highlight a potentially overlooked systemic dimension of AIR. Future studies are warranted to evaluate ipRGC integrity and circadian-endocrine markers in AIR patients and validate this conceptual pathway.
Tenon Patch Graft in Management of Impending or Full Thickness Corneal Perforation in Pediatric Patients.
Mazar HME, Al Makhlasawy MM, Basiony AI
Int Ophthalmol · 2026 Apr · PMID 41949676 · Publisher ↗
PURPOSE: To evaluate the outcomes of autologous Tenon's patch graft (TPG) in impending or full thickness corneal perforations in pediatric patients with infectious keratitis. PATIENTS AND METHODS: In this prospective, in...
PURPOSE: To evaluate the outcomes of autologous Tenon's patch graft (TPG) in impending or full thickness corneal perforations in pediatric patients with infectious keratitis. PATIENTS AND METHODS: In this prospective, interventional case series, 26 eyes of 26 children (age ≤ 16 years) presenting with 3-5 mm impending or full thickness corneal perforations secondary to bacterial or fungal keratitis underwent autologous TPG. Tenon's tissue was harvested, fashioned to slightly exceed the defect diameter, and secured with interrupted 10-0 nylon sutures, followed by bandage contact lens placement. Postoperative topical antimicrobial therapy was tailored to the causative organism. Patients were examined preoperatively and followed up for 3 months. Outcome measures included best corrected visual acuity (BCVA), Seidel testing, anterior chamber depth evaluation, time of epithelialization and scar formation, and assessment by anterior segment optical coherence tomography (AS-OCT). RESULTS: The cohort comprised 14 males and 12 females, mean age 9.4 ± 3.3 years. At three months, 24 eyes (92.3%) achieved complete anatomical healing, with 25 eyes (96.2%) maintaining a formed anterior chamber and testing Seidel negative. Mean LogMAR BCVA improved from 1.75 ± 0.59 to 1.32 ± 0.56 at 3 months (p = 0.001). AS-OCT demonstrated complete stromal integration without leucoma in 17 eyes (65.4%) and healed grafts with adherent leucoma in 7 eyes (26.9%). Two eyes (7.7%) required therapeutic penetrating keratoplasty for ongoing infection; one eye (3.8%) needed suture augmentation. No major intraoperative complications occurred. CONCLUSION: Autologous Tenon's patch graft for medium sized infectious corneal perforations in pediatric patients yields high anatomical success, significant visual improvement, and minimal complications. It represents a valuable option in settings where donor tissue is scarce or emergency intervention is required.
Prevalence of floppy eyelid syndrome and keratoconus in Egyptian patients with obstructive sleep apnea.
Ahmed ISH, Ramadan A, Khamis KM … +2 more , Bahgat AY, Said A
Int Ophthalmol · 2026 Apr · PMID 41949668 · Publisher ↗
PURPOSE: To describe prevalence of floppy eyelid syndrome (FES) and keratoconus (KC) in a cohort of Egyptian patients with obstructive sleep apnea (OSA). METHODS: Six hundred patients with confirmed OSA were evaluated by...
PURPOSE: To describe prevalence of floppy eyelid syndrome (FES) and keratoconus (KC) in a cohort of Egyptian patients with obstructive sleep apnea (OSA). METHODS: Six hundred patients with confirmed OSA were evaluated by 2 ophthalmologists for BCVA, slit-lamp examination, the presence of FES using vertical pull test on the upper eyelids and anterior eyelid distraction tests. All the patients underwent bilateral corneal imaging by the Scansys TA517 3D anterior segment analyzer tomography. Tomographic scans were analyzed using the manufacturer integrated KC grading software for both the front and the back corneal surface. RESULTS: The study included 1200 eyes of OSA 600 patients with the mean age 55.02 ± 7.11 years. Two hundred sixteen patients (36%) were female. Thirty patients (5%) had a positive family history of KC. FES was identified in 96 eyes (8%) and KC in 24 eyes (2%). While univariate analysis showed a significantly higher prevalence and odds ratio for both conditions in patients with severe OSA, these associations did not remain significant in the multivariate regression model after adjusting for age, gender, and body mass index (BMI). CONCLUSIONS: FES and KC were present in Egyptian patients with OSA. Particularly in those with higher disease severity. However, the lack of independent association in multivariate analysis suggests that systemic factors, such as BMI, may play a mediating role. Routine ophthalmological screening may be beneficial in OSA patients' multidisciplinary care.
Visual outcomes following implantation of intracorneal rings with sharp and round triangular cross-section designs in keratoconus.
Soleimani S, Pirhadi S, Jadidi K … +6 more , Mirzajani A, Abolghasemi J, Bagherzadeh O, Heidari H, Alio JL, Momeni-Moghaddam H
Int Ophthalmol · 2026 Apr · PMID 41949665 · Publisher ↗
PURPOSE: To compare the visual, refractive, corneal curvature, and aberrometry outcomes one year following implantation of two intra-stromal corneal rings (ICRS) with different cross-sectional designs. METHODS: This retr...
PURPOSE: To compare the visual, refractive, corneal curvature, and aberrometry outcomes one year following implantation of two intra-stromal corneal rings (ICRS) with different cross-sectional designs. METHODS: This retrospective longitudinal study included 40 keratoconus eyes implanted with ICRSs with similar characteristics except for their cross-sectional design, Keraring with sharp corners triangular cross-section (n = 20 eyes) and Keratacx Plus with round corners triangular cross-section (n = 20 eyes). The two rings were similar in terms of arc length (355°) and outer diameter (5.7 mm). The uncorrected and corrected distance visual acuity (UDVA & CDVA), refraction, corneal topography, and aberrometry indices were compared before and one year after surgery. RESULTS: Despite a significant change in VA, spherical equivalent, astigmatism, and keratometry readings, there was no statistically significant difference in their mean changes between the two rings. (P > 0.05) The mean corneal asphericity expressed by the Q-value showed a statistically significant change toward less prolateness after surgery and was the only parameter with a significant mean change between the two groups (P = 0.04). In comparing the mean changes of corneal aberrometry indices between two rings, a statistically significant difference was seen for total aberration (P = 0.03), lower order aberrations (LOA, P = 0.03), and defocus (P = 0.03). Subgroup analysis based on keratoconus severity (mild and moderate stages) showed a statistically significant difference in Q-value (P = 0.019), total aberration (P = 0.040), LOA (P = 0.041), and defocus (P = 0.027) only for the moderate keratoconus group between the two rings. CONCLUSIONS: Both rings provided a significant improvement in visual, refractive, and keratometric parameters so that the triangular cross-sectional design of Keratacx Plus with round corners is not superior to Keraring with sharp corners in terms of visual quality and higher order aberrations (HOAs).
Association between retinal microvascular pathology and lacunar infarction: a systematic review and meta-analysis.
Al-Shammari YM, Alrabiah M, Alnabhan RM … +2 more , Al-Awadhi MA, AlDorai AJ
Int Ophthalmol · 2026 Apr · PMID 41944890 · Publisher ↗
INTRODUCTION: Lacunar infarctions, a subtype of cerebral small vessel disease, arise from occlusion of deep penetrating arterioles and contribute substantially to ischemic stroke burden and long-term disability. Because...
INTRODUCTION: Lacunar infarctions, a subtype of cerebral small vessel disease, arise from occlusion of deep penetrating arterioles and contribute substantially to ischemic stroke burden and long-term disability. Because the retinal microvasculature shares anatomical and physiological features with cerebral arterioles, retinal imaging provides a noninvasive proxy for studying systemic microvascular pathology. Evidence linking retinal vascular abnormalities to lacunar infarction has been inconsistent, warranting systematic evaluation. METHODS: We systematically searched PubMed, Embase, Scopus, Web of Science, and the Cochrane Library for studies examining associations between retinal vascular changes and lacunar infarction. The primary outcome was lacunar infarction (confirmed by imaging or clinical diagnosis), while retinal vascular features (focal arteriolar narrowing, arteriovenous nicking, retinopathy, and venular dilation) were analyzed as exposure variables. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Risk of bias was assessed using the NIH Quality Assessment Tool for Observational Studies. RESULTS: Eight studies (n = 7277 participants) were included. All studies demonstrated good methodological quality based on the NIH Quality Assessment Tool for Observational Studies. Meta-analyses showed significant associations between lacunar infarction and focal arteriolar narrowing (OR = 1.77, 95% CI 1.14-2.74, p = 0.01, I = 81%), arteriovenous nicking (OR = 1.70, 95% CI 1.05-2.76, p = 0.03, I = 69%), retinopathy (OR = 1.99, 95% CI 1.21-3.25, p = 0.006, I = 46%), and venular dilation (OR = 1.46, 95% CI 1.11-1.93, p = 0.007, I = 56%). Heterogeneity ranged from moderate to high and was partly reduced in sensitivity analyses. Funnel plot asymmetry suggested potential publication bias for several parameters, supported by Egger's test (focal arteriolar narrowing p = 0.04; arteriovenous nicking p = 0.041; retinopathy p = 0.032), while no significant bias was detected for venular dilation (p = 0.08). CONCLUSION: Retinal microvascular abnormalities are significantly associated with lacunar infarction, supporting the retina as a window into cerebral small vessel pathology. These findings emphasize the prospective role of retinal imaging as a noninvasive biomarker for identifying individuals at risk of lacunar stroke. Future large-scale, prospective studies are needed to confirm causality and improve clinical translation.
Residence and insurance inequities in the timeliness of access to first-eye cataract surgery in Eastern China.
Qin C, Zhu J, Yang T
Int Ophthalmol · 2026 Apr · PMID 41941059 · Full text
PURPOSE: To quantify residence and insurance inequities in the timeliness of access to first-eye cataract surgery in Eastern China, using better-eye best-corrected visual acuity (BCVA) at surgical-pathway entry as an ele...
PURPOSE: To quantify residence and insurance inequities in the timeliness of access to first-eye cataract surgery in Eastern China, using better-eye best-corrected visual acuity (BCVA) at surgical-pathway entry as an electronic health record-derived indicator. METHODS: We conducted a retrospective cohort study of consecutive first-eye cataract surgeries at a tertiary hospital in Yangzhou, China (August 2024-July 2025). Analyses were restricted to local insured residents; non-local and self-pay patients were excluded. The primary outcome was better-eye BCVA (logMAR), defined as the better (lower logMAR) value between the two eyes measured at the admission-registration (pathway-entry) assessment. Adjusted differences were estimated using multivariable linear regression with surgeon fixed effects and heteroskedasticity-consistent (HC3) robust standard errors. Prespecified categorical analyses used multinomial logistic regression. RESULTS: Among 1438 eligible patients, bilateral BCVA was measured at pathway entry in 1437 (99.9%). Compared with Urban-Employee patients, adjusted better-eye BCVA was worse in Urban-Resident (0.09 logMAR; 95% CI 0.01-0.17), Rural-Employee (0.11; 0.01-0.21), and Rural-Resident patients (0.17; 0.11-0.24); adjusted marginal means were 0.32, 0.41, 0.43, and 0.49 logMAR, respectively. Rural-Resident patients were less likely to enter in the early category (RRR 0.52; 95% CI 0.39-0.69) and more likely to enter in the late category (RRR 1.76; 95% CI 1.15-2.69). CONCLUSION: Residence and insurance inequities in the timeliness of access to first-eye cataract surgery were evident. Better-eye BCVA at pathway entry is a low-cost, scalable metric that can complement coverage and postoperative outcomes to guide pathway and financing interventions.
Outcomes of blepharoplasty for orbital fat prolapse in thyroid eye disease: a clinical study.
Kumar SV, Kumar V, Mishra SK … +3 more , Sati A, Kumar NV, Kaushik J
Int Ophthalmol · 2026 Apr · PMID 41941041 · Publisher ↗
PURPOSE: This study evaluates the functional and aesthetic outcomes of Blepharoplasty for orbital fat bags in patients diagnosed with inactive thyroid eye disease (TED). METHODS: A prospective observational study was con...
PURPOSE: This study evaluates the functional and aesthetic outcomes of Blepharoplasty for orbital fat bags in patients diagnosed with inactive thyroid eye disease (TED). METHODS: A prospective observational study was conducted on 40 patients (72 eyelids) with stable TED undergoing various types of blepharoplasty for visible orbital fat bags between January 2023 and January 2025. Patients were followed for 06 months. The primary outcomes were changes in marginal reflex distance 1 (MRD 1), marginal reflex distance 2 (MRD 2), and patient satisfaction as measured by the Visual Analog Scale (VAS). Measurements were recorded preoperatively and postoperatively on day 1, 1 week, and at 1, 3, and 6 months. The secondary outcomes focused on the occurrence of postoperative complications during the 6-month postoperative follow-up. RESULTS: MRD 1 increased significantly postoperatively from a mean of 2.42 ± 0.70 to 4.28 ± 0.271 at 6 months (p < 0.001), indicating restoration of upper eyelid position and improved eyelid contour. MRD 2 decreased significantly from 6.04 ± 0.07 to 5.2 ± 0.353 mm (p < 0.001), reflecting correction of lower eyelid bulge. VAS scores improved markedly from a preoperative mean of 2.1 to 8.9 postoperatively (p < 0.001), indicating high patient satisfaction.Minor complications observed were transient chemosis and lid retraction. Asymmetry was noted in 2 eyelids (2.8%), which required revision surgery. No major complications were observed. CONCLUSION: All types of blepharoplasty can be safely and effectively used to manage orbital fat prolapse in TED when tailored to the patient's anatomy and disease status. Aesthetic and functional outcomes are excellent, especially with a conservative, anatomy-based approach.
Effect of peripapillary atrophy on parameters of the optic nerve head, the peripapillary region and the macula in eyes with myopia.
Gumus Akgun G, Caglar K, Altan C … +3 more , Alagoz N, Cakir I, Yasar T
Int Ophthalmol · 2026 Apr · PMID 41941022 · Publisher ↗
BACKGROUND: To examine the impact of peripapillary atrophy (PPA) on retinal nerve fibre layer (RNFL), ganglion cell-inner plexiform layer (GCL-IPL), and Bruch's membrane opening-minimum rim width (BMO-MRW) in non-glaucom...
BACKGROUND: To examine the impact of peripapillary atrophy (PPA) on retinal nerve fibre layer (RNFL), ganglion cell-inner plexiform layer (GCL-IPL), and Bruch's membrane opening-minimum rim width (BMO-MRW) in non-glaucomatous myopic eyes. METHODS: Patients with myopic refractive errors greater than -4.00 dioptres and with normal intraocular pressure (10-21 mmHg) were included in the study. Eyes without PPA were included in group 1, and those with PPA in group 2. RNFL (3.5, 4.1, 4.7 mm) and BMO-MRW were measured with Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany); GCL-IPL with Cirrus HD-OCT 5000 (Carl Zeiss Meditec, Dublin, CA, USA). RESULTS: There were 50 eyes in group 1 and 77 eyes in group 2. Mean age, refractive error, axial length, disc area, rim area, cup-to-disc ratio, mean RNFL and GCL-IPL (mean and minimum) were similar in both groups (p > 0.05 for all). Mean nasal RNFL thickness measured with Cirrus HD-OCT and mean nasal RNFL thicknesses at 3.5 mm and 4.1 mm measured with Spectralis OCT were significantly lower in group 2 (p < 0.05 for all). Nasal RNFL thickness at 4.7 mm and RNFL thicknesses in the other regions at different diameters (3.5 mm, 4.1 mm and 4.7 mm) and BMO-MRW in all regions were similar in both groups (p > 0.05 for all). DISCUSSION: RNFL thickness at 4.7 mm, BMO-MRW, and GCL-IPL did not significantly differ with PPA. These stable measurements may assist in diagnosing and monitoring glaucoma in myopic eyes with PPA.
Retinal image-based cardiovascular risk prediction using AI-CRS: a multi-modal deep learning framework.
Mariswari C, Balasubramanian K
Int Ophthalmol · 2026 Apr · PMID 41941015 · Publisher ↗
This study presents AI-CRS, an AI-driven deep learning framework for cardiovascular risk assessment using retinal images. By combining convolutional neural networks (CNNs), attention mechanisms, and vasculature segmentat...
This study presents AI-CRS, an AI-driven deep learning framework for cardiovascular risk assessment using retinal images. By combining convolutional neural networks (CNNs), attention mechanisms, and vasculature segmentation, AI-CRS overcomes the limitations of traditional methods, such as reliance on handcrafted features and single-modality data. The model integrates multi-modal information, fusing vasculature segmentation maps with raw image data to capture subtle vascular changes indicative of cardiovascular diseases. Experimental validation demonstrates that AI-CRS outperforms conventional diagnostic techniques in cardiovascular risk stratification, achieving superior sensitivity, specificity, and accuracy. The model excels in detecting early-stage disease and subtle vascular anomalies, and it shows strong generalizability across diverse datasets, patient demographics, and varying image qualities. Beyond cardiovascular risk, AI-CRS also shows promise in assessing systemic health conditions like hypertension and diabetes, demonstrating the broader utility of retinal imaging in health monitoring. The attention-driven architecture enhances model interpretability, providing clinicians with visual explanations of disease-associated vascular patterns, which is essential for clinical adoption. AI-CRS offers a non-invasive, scalable solution that can be integrated into routine clinical practice, supporting early diagnosis, personalized care, and population-wide screening. Its automated analysis reduces the need for manual feature extraction and subjective interpretation, streamlining workflows and improving efficiency. Ultimately, AI-CRS represents a significant step toward precision medicine by enabling timely interventions, reducing healthcare costs, and improving patient outcomes through non-invasive digital biomarkers.
Ultra-short-term refractive outcomes after Yamane technique scleral-fixated intraocular lens implantation: a comparison of anterior vitrectomy and pars plana vitrectomy.
Liew TKW, Goh CH, Tajunisah I … +1 more , Rahman WMHWA
Int Ophthalmol · 2026 Apr · PMID 41941014 · Publisher ↗
BACKGROUND: The Yamane technique for sutureless scleral-fixated intraocular lens (YTSFIOL) implantation is an established option for visual rehabilitation in eyes without capsular support. However, evidence on ultra-shor...
BACKGROUND: The Yamane technique for sutureless scleral-fixated intraocular lens (YTSFIOL) implantation is an established option for visual rehabilitation in eyes without capsular support. However, evidence on ultra-short-term refractive outcomes and the influence of different vitreous management strategies remains limited. METHODS: This retrospective observational cohort study included consecutive adult patients who underwent YTSFIOL implantation by a single surgeon at a tertiary centre. Ultra-short-term outcomes were defined as visual and refractive outcomes assessed at six weeks postoperatively. Best-corrected visual acuity (BCVA), spherical equivalence (SE), refractive astigmatism, and corneal astigmatism were analysed and compared between eyes that underwent anterior vitrectomy (AV) and pars plana vitrectomy (PPV). RESULTS: Thirty-one eyes of 30 patients were included. Mean BCVA improved significantly from 0.25 ± 0.24 logMAR preoperatively to 0.14 ± 0.10 logMAR at six weeks postoperatively (p = 0.041). Mean SE improved from + 4.83 ± 7.39 D to - 0.70 ± 0.90 D (p < 0.001). Both refractive and corneal astigmatism increased significantly at six weeks. No statistically significant differences were observed between AV and PPV groups in postoperative BCVA, SE, refractive astigmatism, corneal astigmatism, or SE prediction error (all p > 0.05). Early postoperative complication rates were comparable between groups (p = 0.335). CONCLUSION: YTSFIOL implantation provides significant improvement in visual acuity and predictable refractive outcomes as early as six weeks postoperatively, irrespective of vitreous management strategy.
Ocular surface disease and psychological distress in central serous chorioretinopathy.
Eröz P, Özer Ö, Doğan L … +1 more , Baysal Z
Int Ophthalmol · 2026 Apr · PMID 41941007 · Publisher ↗
PURPOSE: To evaluate ocular surface parameters and psychological status in patients with central serous chorioretinopathy (CSCR) and to investigate the relationship between tear film dysfunction and psychological distres...
PURPOSE: To evaluate ocular surface parameters and psychological status in patients with central serous chorioretinopathy (CSCR) and to investigate the relationship between tear film dysfunction and psychological distress. METHODS: This prospective case-control study included 55 patients with CSCR and 50 age- and sex-matched healthy controls. Ocular surface assessment comprised the Ocular Surface Disease Index (OSDI), non-invasive tear break-up time (NIBUT) measured with Sirius (CSO, Italy), Schirmer I test, and corneal fluorescein staining graded by the Oxford scale. Psychological status was evaluated using the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). RESULTS: Patients with CSCR demonstrated significantly higher OSDI, BAI and BDI scores, and significantly lower NIBUT and Schirmer values compared with controls (all, p < 0.001). Oxford staining scores were significantly higher in the CSCR group (p < 0.001). OSDI scores were positively correlated with anxiety and depression scores, while NIBUT and Schirmer values were negatively correlated with psychological parameters (all, p < 0.001). CONCLUSION: CSCR is associated with impaired ocular surface parameters and increased psychological distress. The observed correlations suggest a potential interaction between tear film instability and psychological factors, emphasizing the importance of comprehensive clinical evaluation in patients with CSCR.
Socioeconomic factors affecting visual acuity in cataract camps.
Kim E, White E, Choi D … +1 more , Park DW
Int Ophthalmol · 2026 Apr · PMID 41940882 · Publisher ↗
BACKGROUND: Cataracts are the leading cause of reversible blindness worldwide. Though temporary and resource-intensive, cataract camps provide large-scale treatment of the condition. This study sought for associations be...
BACKGROUND: Cataracts are the leading cause of reversible blindness worldwide. Though temporary and resource-intensive, cataract camps provide large-scale treatment of the condition. This study sought for associations between country-level socioeconomic factors and short-term improvements in visual acuity observed in cataract camps across 17 countries. METHODS: This observational study represents 52 camps in 17 low- and middle-income countries. Nested mixed-effects linear regression models were used to analyze associations between changes in LogMAR score of uncorrected visual acuity (UCVA) one to four days post-operation and socioeconomic factors including per capita GDP, Human Development Index, Cataract Surgical Rate, and density of in-country ophthalmologists. FINDINGS: Among 4110 patients, after accounting for age and sex, LogMAR UCVA significantly decreased over the first four days postoperatively (p < 0·0001). This decrease was also associated with the number of ophthalmologists per million performing cataract surgery (p = 0·0227). Patients who underwent extracapsular cataract extraction (ECCE) exhibited a greater decrease in LogMAR UCVA per day post-op (p < 0·0001). Per capita GDP was not significantly associated with the change in LogMAR UCVA per day post-op. INTERPRETATION: This ecological analysis shows that countries with fewer ophthalmologists performing cataract surgery correlated with the most short-term improvement in vision. Considering that cataract camps often target populations with severe baseline cataracts, training local ophthalmologists to perform ECCE surgery may help lift a high burden of cataract-induced blindness in low-resource settings.
Psychological and motor outcomes of botulinum toxin in hemifacial spasm and blepharospasm.
Yaka EC, Şener U
Int Ophthalmol · 2026 Apr · PMID 41934473 · Publisher ↗
PURPOSE: Hemifacial spasm (HFS) and blepharospasm (BSP) impair motor function and psychosocial health. This study assessed anxiety, depression, and self-esteem changes following botulinum toxin A (BoNT-A) treatment. METH...
PURPOSE: Hemifacial spasm (HFS) and blepharospasm (BSP) impair motor function and psychosocial health. This study assessed anxiety, depression, and self-esteem changes following botulinum toxin A (BoNT-A) treatment. METHODS: In this prospective study, 158 adult patients (HFS: n = 112, BSP: n = 46) receiving ongoing BoNT-A treatment were recruited. Motor severity was assessed using the Hemifacial Spasm Grading Scale (HSGS) for HFS and the Modified Jankovic Rating Scale (MJRS) for BSP. Psychological status was measured using the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Rosenberg Self-Esteem Scale (RSES) at baseline and two months after injection. Paired and independent statistical tests evaluated within- and between-group differences, with significance set at p <0.05. RESULTS: BoNT-A treatment significantly improved motor severity and anxiety in both HFS and BSP groups, with significant improvements in depression and self-esteem predominantly observed in HFS patients (all p < 0.001). BSP patients exhibited higher baseline anxiety and lower self-esteem compared with HFS patients. Psychiatric comorbidity was associated with higher baseline anxiety and depression and larger psychological improvements in HFS patients, whereas change scores in the BSP group did not reach statistical significance. Correlation analyses revealed inverse associations between mood and self-esteem and between motor severity and self-esteem. CONCLUSION: BoNT-A treatment provides significant dual motor and psychological benefits in hemifacial spasm and blepharospasm, highlighting the potential need for integrated psychotherapeutic assessment in patient management.
Systemic immunosuppressive therapy in juvenile idiopathic arthritis-associated uveitis.
Baris ME, Bagci D, Ates H … +1 more , Guven S
Int Ophthalmol · 2026 Apr · PMID 41925948 · Full text
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Comparing the readability of online patient education materials for LASIK and cataract surgery.
Mothy D, Reddy AP, Choudhry HS … +1 more , Dastjerdi MH
Int Ophthalmol · 2026 Apr · PMID 41925902 · Publisher ↗
PURPOSE: This study compares the readability and thoroughness of patient education materials for LASIK and cataract surgery. METHODS: Online patient education materials for LASIK and cataract surgery were collected from...
PURPOSE: This study compares the readability and thoroughness of patient education materials for LASIK and cataract surgery. METHODS: Online patient education materials for LASIK and cataract surgery were collected from the top 30 U.S. ophthalmology programs, the American Academy of Ophthalmology (AAO), and generated using Doximity GPT. Materials were assessed using eight readability metrics that produced an average reading level score. Materials were also assessed for inclusion of information pertaining to description of the procedure, patient eligibility and contraindications, procedural risks, and post-operative care. Average readability and thoroughness were then compared between materials for each procedure. RESULTS: Of 30 ophthalmology programs, 27 had online patient education materials for LASIK and 19 for cataract surgery. There was no significant difference between the readability of LASIK and cataract surgery materials (grade level of 10.11 vs. 10.77, p = 0.100). A greater proportion of LASIK materials discussed patient eligibility (81.5% vs. 10.5%, p < 0.001), though there was no difference in the frequency of information pertaining to procedural risks and post-operative care. The AAO's materials were more readable than those from top ophthalmology programs (LASIK: 8.06 vs. 10.10, p < 0.001; cataract surgery: 8.73 vs. 10.77, p < 0.001), as were the Doximity GPT-generated materials (LASIK: 5.82 vs. 10.10, p < 0.001; cataract surgery: 7.32 vs. 10.77, p < 0.001). CONCLUSIONS: Online patient education materials for both LASIK and cataract surgery exceed a tenth-grade level, making them inaccessible to many patients. Ophthalmologists may consider using Doximity GPT to generate more readable materials.
Imaging biomarkers associated with visual acuity in central serous chorioretinopathy: a multimodal analysis.
Faiz Turan M, Ozkaya A
Int Ophthalmol · 2026 Apr · PMID 41925898 · Publisher ↗
OBJECTIVE: To assess the relationship between best-corrected visual acuity (BCVA) and multimodal imaging findings including optical coherence tomography (OCT), fluorescein angiography (FA), and indocyanine green angiogra...
OBJECTIVE: To assess the relationship between best-corrected visual acuity (BCVA) and multimodal imaging findings including optical coherence tomography (OCT), fluorescein angiography (FA), and indocyanine green angiography (ICGA) in patients diagnosed with central serous chorioretinopathy (CSC). METHODS AND MATERIALS: We retrospectively analyzed 249 eyes of 164 patients with CSC. OCT parameters included central macular thickness (CMT), neurosensory and pigment epithelial detachments, outer retinal integrity, and degenerative changes. FA and ICGA findings were also evaluated. Associations between multimodal imaging features and BCVA were analyzed. RESULTS: BCVA differed significantly among CSC subgroups (p < 0.001), with the sequelae group showing the best visual acuity. CMT varied across subgroups (p < 0.001) and was negatively correlated with BCVA in the overall cohort, driven primarily by acute cases. Outer retinal alterations on OCT and angiographic markers of disease activity were associated with worse BCVA. In multivariable analysis, intraretinal and/or subretinal hyperreflective dots, cystoid macular degeneration, FA leakage, and choroidal neovascularization remained independent predictors of poorer visual acuity. CONCLUSION: Visual acuity in CSC varies across disease subtypes and is associated with distinct OCT, FA, and ICGA features. These findings highlight the value of multimodal imaging in the assessment of visual prognosis and in supporting individualized follow-up and treatment strategies in CSC.
Anterior segment optical coherence tomography: imaging characteristics suggestive of microbial etiology in infectious keratitis.
Akcay P, Kupal BA, Aykur M … +2 more , Aydemir SS, Palamar M
Int Ophthalmol · 2026 Mar · PMID 41915283 · Publisher ↗
PURPOSE: To evaluate anterior segment optical coherence tomography (AS-OCT) features in infectious keratitis, to characterize possible findings associated with different microbial etiologies, and to assess quantitative c...
PURPOSE: To evaluate anterior segment optical coherence tomography (AS-OCT) features in infectious keratitis, to characterize possible findings associated with different microbial etiologies, and to assess quantitative changes observed during follow-up. METHODS: This retrospective study included 40 eyes of 40 patients diagnosed with infectious keratitis at a tertiary referral center between January 2024 and July 2025, with a minimum follow-up of 6 months. All patients underwent slit-lamp examination, standardized anterior segment photography, and swept-source AS-OCT imaging for follow-up comparability. Corneal scrapings were obtained from all eyes for Gram staining and culture, and polymerase chain reaction was used to support the diagnosis of Acanthamoeba keratitis. RESULTS: The mean age was 53.6 ± 19.7 years (range, 8-90), with a female-to-male ratio of 23:17. Microbiological culture was positive in 34 eyes (85.0%). Etiologies included bacterial (n = 14), fungal (n = 8), herpetic (n = 5), and Acanthamoeba keratitis (n = 7). On AS-OCT, mean infiltration width and stromal depth were 2199.8 ± 453.2 µm and 461.5 ± 210.2 µm, respectively. Central corneal thickness decreased significantly after treatment (mean paired difference, 240 µm; 95% CI, 189.6-291.2 µm; p < 0.001). Endothelial plaques were observed in 14 eyes (35%), in both fungal and bacterial keratitis. Posterior stromal or endothelial undulation and intrastromal cystic spaces were identified in 2 eyes, both with fungal keratitis. CONCLUSIONS: AS-OCT enables noninvasive, depth-resolved evaluation of infectious keratitis and allows quantitative monitoring during follow-up. A range of features observed on AS-OCT may provide supportive information for etiologic assessment, particularly when microbiological confirmation is delayed or inconclusive.
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