Int Ophthalmol [JOURNAL]
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Outcome of accelerated corneal cross-linking with 0.25% riboflavin in progressive keratoconus patients.
Yeh C, Huang K, Liang KK … +2 more , Hu C, Cheng S
Int Ophthalmol · 2026 Mar · PMID 41848799 · Publisher ↗
BACKGROUND: To present the one-year outcomes of accelerated corneal collagen cross-linking (CXL) with 0.25% riboflavin in the management of progressive keratoconus in the East Asian population. METHODS: A retrospective a...
BACKGROUND: To present the one-year outcomes of accelerated corneal collagen cross-linking (CXL) with 0.25% riboflavin in the management of progressive keratoconus in the East Asian population. METHODS: A retrospective analysis was performed on twenty-four patients (32 eyes) diagnosed with progressive keratoconus treated in Taiwan. Exclusion criteria included corneas with a stromal thickness of less than 400 μm. A 15-min soak with 0.25% riboflavin was followed by UVA light exposure at 18 mW/cm for 5 min, achieving a total energy of 5.4 J/cm. Corrected distance visual acuity, corneal topography, subjective refraction, endothelial cell density, corneal thickness were evaluated at baseline, 1, 3, 6, and 12 months postoperatively. The primary efficacy criterion was the changes in maximum keratometry (Kmax) at the 12-month follow-up. RESULTS: The mean Kmax decreased from 61.74 ± 9.9 to 60.05 ± 9.1 D at one-year follow-up (P = 0.002). Central corneal pachymetry decreased significantly from 464.16 ± 28.6 to 442.73 ± 87.6 μm (P < 0.001) at one year. The mean demarcation line depth was 375.91 ± 53.4 μm at one-month follow-up. Mean corrected distance visual acuity, manifest refraction and endothelial cell density remained unchanged. CONCLUSIONS: Our findings demonstrate the safety and efficacy of accelerated CXL with 0.25% riboflavin for progressive keratoconus, providing an effective option in clinical management. TRIAL REGISTRATION: This study retrospectively registered and approved by the Institutional Review Board (IRB) of the Shin Kong Wu Ho-Su Memorial Hospital. (IRB number: 20240403R).
Corneal and lens densitometry in newly diagnosed polycystic ovary syndrome patients: a quantitative analysis using pentacam HR.
Demir ET, Gündogan K, Gündogan AO … +2 more , Tora N, Oltulu R
Int Ophthalmol · 2026 Mar · PMID 41843292 · Publisher ↗
PURPOSE: To compare corneal and lens densitometry values between newly diagnosed polycystic ovary syndrome (PCOS) patients and healthy controls using Pentacam HR. METHODS: This cross-sectional comparative study included...
PURPOSE: To compare corneal and lens densitometry values between newly diagnosed polycystic ovary syndrome (PCOS) patients and healthy controls using Pentacam HR. METHODS: This cross-sectional comparative study included 48 newly diagnosed PCOS patients and 33 non-obese (BMI < 30 kg/m) healthy controls of similar age. All participants underwent comprehensive ophthalmologic examination and anterior segment imaging using Pentacam HR. Corneal topographic parameters, anterior chamber measurements, corneal densitometry values across different zones and depths, and lens densitometry parameters were recorded. Statistical analyses were performed to compare measurements between groups. RESULTS: There was no significant difference in age between the groups (p = 0.37). Keratometric values (K1, K2, K-mean, and K-max) were significantly higher in the PCOS group compared with controls (all p < 0.01), while anterior chamber depth was significantly lower in PCOS patients (p = 0.012). Central corneal thickness did not differ significantly between groups. Regional corneal densitometry analysis revealed significantly higher densitometry values in the PCOS group in the central and paracentral zones (0-2 mm, 2-6 mm, and 6-10 mm; all p < 0.05). Mean lens densitometry values were also significantly higher in PCOS patients compared with controls (p < 0.001), whereas maximum and standard deviation values showed no significant differences. CONCLUSIONS: Newly diagnosed PCOS patients demonstrate alterations in corneal curvature, anterior chamber depth, and both corneal and lens densitometry parameters compared with healthy controls. These findings suggest that PCOS may affect the microstructural properties of ocular tissues even at an early stage. In particular, increased lens densitometry represents a novel finding and may indicate early subclinical lens changes in young women with PCOS.
Pigmented paravenous retinochoroidal atrophy (PPRCA): a systematic review.
Phiri P, Delanerolle G, Sajid S … +5 more , Shi JQ, Tombolini B, Frisina R, Kalogeropoulos D, De Salvo G
Int Ophthalmol · 2026 Mar · PMID 41843216 · Publisher ↗
PURPOSE: Pigmented paravenous retinochoroidal atrophy (PPRCA) is a rare, poorly understood chorioretinal disorder characterised by perivenous atrophy and pigment clumping. This systematic review aimed to synthesise the c...
PURPOSE: Pigmented paravenous retinochoroidal atrophy (PPRCA) is a rare, poorly understood chorioretinal disorder characterised by perivenous atrophy and pigment clumping. This systematic review aimed to synthesise the current evidence on its clinical features, diagnostic modalities, and management strategies, while identifying knowledge gaps and opportunities for future consensus guidelines. METHODS: A systematic review was conducted following PRISMA guidelines and registered in PROSPERO (CRD42022346753). Nine databases were searched for English-language publications between January 1980 and April 2025. Eligible studies included case reports, case series, reviews, and commentaries reporting clinical, diagnostic, or therapeutic data on PPRCA. Data were extracted by independent reviewers, risk of bias was assessed with the CASP checklist, and findings were synthesised thematically and descriptively. RESULTS: Seventy-two studies reporting on 162 patients were included. The mean age was 38 years, with a slight female predominance (54%). Ophthalmoscopic findings-most notably chorioretinal atrophy (42%) and pigment clumping (35%)-were the most frequently described features. Imaging techniques such as ultra-wide field fundus photography and fluorescein angiography were widely used but lacked diagnostic uniformity. Electroretinography revealed variable functional deficits. Management was largely supportive, targeting associated complications (e.g., macular oedema, glaucoma), with limited long-term follow-up data. CONCLUSION: PPRCA remains a clinically heterogeneous and under-recognised condition without standardised diagnostic or therapeutic protocols. This review highlights the need for consensus diagnostic criteria, longitudinal registries, and collaborative studies to improve clinical care and inform future research into its pathogenesis and management.
Comparison of functional outcomes between femtosecond laser-assisted cataract surgery and phacoemulsification in post-radial keratotomy cataract.
Parihar JKS, Sachdev MS, Dhar S … +2 more , Sharma M, Parihar AKS
Int Ophthalmol · 2026 Mar · PMID 41838230 · Publisher ↗
PURPOSE: To compare the functional outcomes between femtosecond laser-assisted cataract surgery (FLACS) and phacoemulsification in post-radial keratotomy (RK) cataract. SETTING: Postgraduate teaching institute in a corpo...
PURPOSE: To compare the functional outcomes between femtosecond laser-assisted cataract surgery (FLACS) and phacoemulsification in post-radial keratotomy (RK) cataract. SETTING: Postgraduate teaching institute in a corporate setting, based in Northern India. DESIGN: Retrospective comparative observational study. METHODS: The study included 70 post-RK eyes that underwent cataract surgery by FLACS in 38 eyes and by phacoemulsification in the remaining 32 eyes over the past 5 years, with nuclear cataract grades II-IV. Preoperative astigmatism ranged from ± 0.50 to 5.50 D in both groups and was managed with Toric IOL implantation. Barrett True-K and SRK/T were used to calculate IOL power. Follow-up ranged from 1 to 4 years. RESULTS: Incomplete Rhexis, Inadequate Nucleotomy, and wound dehiscence were noted constraints in both groups. The mean postoperative uncorrected visual acuity (LogMAR) was 0.23 ± 0.09 in the PHACO group (n = 32), 0.22 ± 0.06 in the FLACS group (n = 38), and 0.22 ± 0.08 in the combined group, with a P value of 0.885. Residual astigmatism or spherical error ranged from plus or minus 0.75 to 3.25 dioptres. The FLACS group had a higher mean astigmatism correction (1D) than the phacoemulsification group (0.25D), attributable to precision in incision, rhexis, Nucleotomy, and rotational stability of the Toric IOL implant. CONCLUSIONS: The Barrett True-K formula provided better predictive accuracy for the presumed IOL power than SRK/T in these cases. Both groups showed statistically significant improvement after FLACS or phacoemulsification, with slightly better outcomes after FLACS with laser energy modulation.
Restoring functional vision in moderate-advanced keratoconus: quality-of-life outcomes with hybrid contact lenses.
Cakmak-Cengiz E, Karaman-Atasever F, Can E
Int Ophthalmol · 2026 Mar · PMID 41831166 · Publisher ↗
PURPOSE: To evaluate the clinical, functional, and quality-of-life outcomes of next-generation SynergEyes UltraHealth® hybrid contact lenses (HCLs) in patients with moderate to advanced keratoconus or irregular astigmati...
PURPOSE: To evaluate the clinical, functional, and quality-of-life outcomes of next-generation SynergEyes UltraHealth® hybrid contact lenses (HCLs) in patients with moderate to advanced keratoconus or irregular astigmatism who failed to achieve adequate visual rehabilitation with conventional optical correction methods. METHODS: This retrospective study included 31 patients diagnosed with keratoconus or irregular astigmatism who were intolerant of, or inadequately corrected with, silicone hydrogel soft lenses, or rigid gas-permeable (RGP) lenses. During follow-up, 3 patients (6 eyes) discontinued HCL use due to intolerance, leaving 53 eyes of 28 patients for analysis. All patients were fitted with SynergEyes UltraHealth® HCLs. Best corrected visual acuity (BCVA) with RGP lenses or soft lenses and HCL-corrected visual acuity (HCVA) were recorded at baseline and at 6 months. Kmax, central corneal thickness, and apex values were recorded using Pentacam®. Vision-related quality of life was assessed using the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). RESULTS: The mean Kmax was 58.5 ± 6.3 D, indicating predominantly moderate-to-advanced keratoconus. HCVA improved significantly from 0.42 ± 0.22 logMAR to 0.13 ± 0.11 logMAR (p = 0.02). HCVA of 0.22 logMAR or better was achieved in 88.6% of eyes. NEI-VFQ-25 scores demonstrated marked improvements, particularly in general vision, near and distance activities, social functioning, and vision-related mental health (all p < 0.05). Additionally, there was an increase in eye pain scores (higher scores indicate less pain according to this scale), with higher scores associated with better outcomes; only three patients (six eyes) discontinued hybrid contact lens use due to intolerance, and no serious eye complications were observed. CONCLUSION: Next-generation hybrid contact lenses provide significant improvements in visual acuity and vision-related quality of life in patients with advanced keratoconus and irregular astigmatism. SynergEyes UltraHealth® lenses are an effective and well-tolerated alternative, particularly for patients intolerant of RGP lenses.
Perioperative ischemic optic neuropathy: a comprehensive review of anesthetic implications, hemodynamic pathophysiology, and risk stratification.
Surya A, Salman S, Phadke R … +8 more , Sporn K, Yaldo L, Kumar R, Paladugu P, Ong J, Waisberg E, Masalkhi M, Tavakkoli A
Int Ophthalmol · 2026 Mar · PMID 41831067 · Publisher ↗
INTRODUCTION: Perioperative visual loss (POVL) is a rare but catastrophic complication of non-ocular surgery, most commonly attributable to ischemic optic neuropathy (ION). Spine and cardiac surgeries account for the maj...
INTRODUCTION: Perioperative visual loss (POVL) is a rare but catastrophic complication of non-ocular surgery, most commonly attributable to ischemic optic neuropathy (ION). Spine and cardiac surgeries account for the majority of cases, with posterior ION (PION) predominating after prone spine procedures and anterior ION (AION) more frequently observed following cardiac surgery. Despite its low incidence, the permanent nature of vision loss necessitates a clear understanding of underlying mechanisms and modifiable perioperative risk factors. METHODS: This narrative review synthesizes evidence from epidemiologic studies, the American Society of Anesthesiologists (ASA) POVL Registry, large administrative databases, and physiologic investigations. Particular emphasis is placed on optic nerve anatomy and vascular supply, ocular perfusion pressure dynamics, intraocular pressure changes during prone positioning, and multivariate risk factors identified in registry-based analyses. RESULTS: The optic nerve's limited collateral circulation and confinement within rigid anatomic boundaries render it uniquely vulnerable to ischemia. Registry and physiologic data support a perfusion-failure model in which reductions in mean arterial pressure, anemia, and sustained elevations in intraocular and venous pressures converge to critically reduce ocular perfusion pressure. In spine surgery, PION is strongly associated with prolonged operative duration, prone positioning, venous congestion, obesity, blood loss, and fluid strategies that promote interstitial edema. In contrast, cardiac surgery-associated AION more often reflects preexisting vascular disease and perioperative hypotension. Embolic mechanisms account for a minority of cases. CONCLUSIONS: Perioperative ION most commonly results from global failure of optic nerve perfusion rather than focal vascular occlusion. Recognition of distinct pathophysiologic mechanisms across surgical contexts underscores the importance of prevention. Strategies that preserve ocular perfusion pressure, minimize venous congestion, limit interstitial edema, and avoid prolonged hypotension during high-risk procedures may reduce the incidence of this devastating complication.
Treatment-aware artificial intelligence for keratoconus progression prediction.
Bair H
Int Ophthalmol · 2026 Mar · PMID 41831031 · Publisher ↗
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Efficacy of adalimumab in chronic non-infectious anterior uveitis: a retrospective study.
Ding G, Xie G, Ding G … +1 more , Lei S
Int Ophthalmol · 2026 Mar · PMID 41817860 · Publisher ↗
PURPOSE: To evaluate the real-world efficacy and safety of adalimumab (ADA) combined with conventional therapy in patients with chronic non-infectious anterior uveitis (NIAU). METHODS: This retrospective cohort study inc...
PURPOSE: To evaluate the real-world efficacy and safety of adalimumab (ADA) combined with conventional therapy in patients with chronic non-infectious anterior uveitis (NIAU). METHODS: This retrospective cohort study included 114 patients with chronic NIAU treated at a single tertiary center between May 2022 and May 2025. Patients were divided into a study group receiving ADA plus conventional therapy (n = 58) and a control group receiving conventional therapy alone (n = 56). Anterior chamber (AC) cell count, best-corrected visual acuity (BCVA), treatment response, adjunctive therapy use, complications and adverse events were compared over 6 months. Multivariate logistic regression was performed to identify factors associated with complete remission. RESULTS: At 3 and 6 months, the ADA group showed significantly lower AC cell counts and greater BCVA improvement than controls (all P < 0.05). At 6 months, complete remission was achieved in 84.5% of the ADA group versus 64.3% of controls, with lower relapse rates (13.8% vs. 28.6%, both P < 0.05). After adjustment, ADA use was independently associated with complete remission (adjusted OR = 2.85, 95% CI 1.15-7.05). The ADA group required less adjunctive corticosteroid and immunosuppressive therapy and had lower rates of cataract and ocular hypertension. Most adverse events were mild, with one serious infection leading to discontinuation. CONCLUSION: In real-world practice, adalimumab combined with conventional therapy is associated with improved inflammation control, visual outcomes and reduced relapse in chronic NIAU, with an acceptable safety profile.
Analysis of optic nerve and macula microvasculature in patients with polycythemia vera using optical coherence tomography angiography.
Ekici E, Okka M, Mirza E
Int Ophthalmol · 2026 Mar · PMID 41817598 · Publisher ↗
OBJECTIVE: We aimed to investigate the microvascular structure of the macula and optic nerve head in patients with polycythemia vera (PV) by using optical coherence tomography (OCT) and OCT angiography (OCTA). MATERIALS...
OBJECTIVE: We aimed to investigate the microvascular structure of the macula and optic nerve head in patients with polycythemia vera (PV) by using optical coherence tomography (OCT) and OCT angiography (OCTA). MATERIALS AND METHODS: Thirty patients with no systemic disease other than PV and 27 healthy individuals between the ages of 18 and 60 were included in the study. The patients underwent a detailed ophthalmologic evaluation including best corrected visual acuity (BCVA), OCT and OCTA measurements, as well as blood tests. RESULTS: In the macula, superficial capillary plexus (SCP) vascular density (VD) (%) values were found to be significantly lower in the patient group compared to the control group in the inferior half (p = 0.015), parafoveal (superior, temporal, and inferior regions; p = 0.02-0.044) and in the inferior area of the perifovea (p = 0.043). Deep capillary plexus (DCP) VD values were significantly lower in the patient group compared to controls in the total area, as well as in the superior and inferior hemifields and the parafoveal and perifoveal regions (p ≤ 0.008). When radial peripapillary capillary plexus (RPCP) VD values from the optic disc were investigated, significantly lower values were observed in the peripapillary (p = 0.007) and nasal superior (p = 0.004) quadrants in the patient group. Correlation analyses revealed significant negative associations between hematocrit levels and DCP and RPCP VD measurements (all p < 0.05). In addition, the systemic immune-inflammation index (SII) was negatively associated with DCP VD, whereas no significant association was observed with RPCP VD. CONCLUSION: Lower SCP, DCP, and RPCP VD values in the patient group may be associated with increased blood viscosity and microcirculatory disturbances in PV. Platelet activation-related vasoconstriction and hyperviscosity-induced slowing of retinal and choriocapillaris blood flow may contribute to this reduction. These findings suggest that OCTA-derived VD measurements may be useful for assessing microvascular involvement in PV.
Risk factors for posterior capsule opacification following phacovitrectomy: a six-year retrospective analysis.
Lachota M, Frajdenberg A, Steiner KR … +3 more , Hautz W, Johansson B, Czajka MP
Int Ophthalmol · 2026 Mar · PMID 41811530 · Full text
PURPOSE: To study risk factors for Nd:YAG capsulotomy (YAG-CT) due to visually disturbing posterior capsule opacification (PCO) after combined cataract surgery and vitrectomy, phaco-vitrectomy (PhV). METHODS: Single-cent...
PURPOSE: To study risk factors for Nd:YAG capsulotomy (YAG-CT) due to visually disturbing posterior capsule opacification (PCO) after combined cataract surgery and vitrectomy, phaco-vitrectomy (PhV). METHODS: Single-center retrospective comparative cohort study. We included 196 patients (197 eyes) undergoing PhV. Electronic medical records provided baseline patient data, data on indication for vitrectomy, surgery data including intra-ocular lens (IOL) type, complications, and YAG-CT incidence during 6-year follow-up after PhV. Univariate and multivariate regression analyses assessed associations of various factors with YAG-CT incidence. RESULTS: Fifty-four eyes (27.41%) underwent YAG-CT during the follow-up period. One of the three hydrophilic acrylic IOLs showed the lowest YAG-CT incidence. Adjusted Odds Ratios (aORs) for YAG-CT were significantly higher for the hydrophobic acrylic IOL (aOR = 5.85, p < .05), and the two other hydrophilic acrylic IOLs (aOR = 29.0, p < 0.001 and aOR = 79.4, p < 0.001). Compared with PhV for macular hole, PhV for epiretinal membranes (aOR = 9.9, p < 0.01), retinal detachment (aOR = 25.4, p < 0.01), and silicon oil removal (aOR = 22.4, p < 0.05) correlated with higher YAG-CT incidence. Type 2 diabetes correlated with increased YAG-CT incidence (aOR = 6.7, p < 0.01). CONCLUSION: IOL type is a key factor in development of visually disturbing PCO after phacovitrectomy. One hydrophilic acrylic IOL outperformed other examined IOLs in reducing YAG-CT incidence after PhV. Retinal disease, as well as type 2 diabetes, correlated with YAG-CT, and should motivate a choice of an IOL type associated with a low YAG-CT incidence for PhV.
Corneal biomechanics alterations and increased risk for corneal ectasia in Turner syndrome.
Roszkowska AM, Mancini M, Gargiulo L … +4 more , Pepe G, Gargano R, Aversa T, Wasniewska M
Int Ophthalmol · 2026 Mar · PMID 41801548 · Publisher ↗
PURPOSE: To assess corneal tomographic parameters and biomechanics of patients with Turner syndrome. METHODS: Thirty-four eyes of 17 patients with Turner Syndrome (TS) and 20 eyes of 10 healthy females were evaluated for...
PURPOSE: To assess corneal tomographic parameters and biomechanics of patients with Turner syndrome. METHODS: Thirty-four eyes of 17 patients with Turner Syndrome (TS) and 20 eyes of 10 healthy females were evaluated for corneal parameters and biomechanics. The main outcome measures were anterior and posterior keratometry (K-meanAnt and K-meanPost) anterior and posterior elevation (AE, PE), central corneal thickness (CCT), anterior and posterior Q values (QAnt and QPost), corneal volume (CV), Belin-Ambrosio Tomographic Index (BAD), and biomechanical parameters such as Corneal Biomechanical Index (CBI), and Tomography-Biomechanical Index (TBI). The group of patients with TS was compared to a control group for all evaluated parameters. RESULTS: Significantly higher values of PE, CCT, CV, BAD, and TBI were observed in Turner Syndrome. The TS group displayed significantly lower K-meanPost, QAnt, and QPost values. BAD, CBI, and TBI values exceeding the cut off were observed in nine eyes (26.47%) in the TS group and three eyes (15%) in the control group. Patients with TS showed altered BAD values (odds ratio of 4.88). The TBI index was altered, with an odds ratio of 7.33, suggestive for significantly higher risk of ectasia. The CBI index was unvaried between groups. The cases with pathological BAD value were observed in individuals with mosaicism, suggesting a potential link between this karyotype and BAD alterations. CONCLUSIONS: Patients with TS exhibit altered biomechanical values indicating a significant risk for corneal ectasia. Periodic monitoring of corneal parameters in this population is necessary to detect early signs of ectasia.
Bacterial and fungal keratitis in Northeast Mexico: demographic, predisposing, and microbiological differences among non-contact lens, optical contact lens, and bandage contact lens wearers.
Mohamed-Noriega K, Saldaña-Rodríguez KM, Ayala-De la Cruz S … +7 more , Morales-Wong F, Cavazos-Támez AJ, Martínez-Morales EE, González-Morones G, Villareal-Méndez G, Llaca-Díaz JM, Mohamed-Hamsho J
Int Ophthalmol · 2026 Mar · PMID 41801491 · Full text
PURPOSE: Contact lens wear is a major risk factor for infectious keratitis, this study compared demographics, predisposing factors, and microorganisms in infectious keratitis between non-contact lens (NCL), optical conta...
PURPOSE: Contact lens wear is a major risk factor for infectious keratitis, this study compared demographics, predisposing factors, and microorganisms in infectious keratitis between non-contact lens (NCL), optical contact lens (OCL) and bandage contact lens (BCL) wearers. METHODS: This was a cross-sectional observational study based on retrospectively collected data from a consecutive series of patients with bacterial or fungal keratitis conducted between 2009 and 2020. Data collected included demographics, clinical characteristics, predisposing factors, and associated microorganisms. RESULTS: 536 infectious keratitis were analyzed (NCL: 362, 67.5%; CL: 174, 32.5%). Of the CL-group, 31 (17.8%) used BCL and 143 (82.2%) OCL. NCL-group was older than CL-group (47 vs. 25 years; p < 0.001). Females were more common in CL than NCL-wearers (119/174, 68.4% vs. 143/342, 39.5%; p < 0.001). NCL-group, as compared to CL-wearers, showed more vegetal (34/362, 9.4% vs. 2/174, 1.1%; p < 0.001) and non-vegetal (58/362, 16.0% vs. 6/174, 3.4%; p < 0.001) trauma. The positive culture rate was 56.7% (304/536). NCL-group, as compared to CL-wearers, had more gram-positive (110/362, 54.5% vs. 27/174, 26.5%; p < 0.001), more fungal (50/362, 24.8% vs. 10/174, 9.8%; p = 0.01), and fewer gram-negative (64/362, 31.6% vs. 73/174, 71.6%; p < 0.001). BCL, as compared to OCL, showed more gram-positive (10/31, 55.6% vs. 17/143, 20.2%; p = 0.01) and fewer gram-negative (10/31, 55.6%vs. 63/143, 75.0%; p = 0.01) bacteria. Pseudomonas aeruginosa was the primary bacteria, and Fusarium spp. was the primary fungus. P. aeruginosa was more common in CL-wearers than NCL-group (67/174, 65.7% vs. 46/362, 22.8%; p = 0.02). Gram-negative was associated with OCL use (OR 1.96, CI 1.06-3.64; p = 0.03) and hypopyon (OR 3.39, CI 2.07-5.56; p < 0.001). Vegetal trauma was associated with fungal keratitis (OR 3.11, CI 1.20-8.05; p = 0.02). CONCLUSIONS: CL use and trauma were key predisposing factors for infectious keratitis. P. aeruginosa and Fusarium spp. predominated, with higher P. aeruginosa rates in CL-wearers, fungal infections in NCL-wearers, and more gram-negative isolates in OCL- than in BCL-wearers. These findings provide insight into microbiological trends in Mexico and support targeted preventive strategies.
Effect of optical coherence tomography biomarkers on treatment outcomes in patients with diabetic macular edema.
Kaplan OC, Yazar Z, Onen M … +1 more , Sahin M
Int Ophthalmol · 2026 Mar · PMID 41790319 · Publisher ↗
PURPOSE: This study aimed to evaluate pre-treatment optical coherence tomography (OCT) biomarkers in patients with diabetic macular edema (DME) and to assess changes in these parameters and their impact on visual prognos...
PURPOSE: This study aimed to evaluate pre-treatment optical coherence tomography (OCT) biomarkers in patients with diabetic macular edema (DME) and to assess changes in these parameters and their impact on visual prognosis one year after intravitreal (IV) anti-VEGF and steroid treatment. METHODS: This retrospective study included 250 eyes of 250 patients with DME. Best-corrected visual acuity (BCVA) and routine ophthalmologic examinations were evaluated at baseline and at 4, 6, and 12 months after treatment. Spectral-domain OCT biomarkers assessed were central macular thickness (CMT), serous retinal detachment (SRD), disorganization of retinal inner layers (DRIL), hyperreflective dots (HRD), integrity of the ellipsoid zone (EZ) and external limiting membrane (ELM), intraretinal cyst (IRC) size, vitreomacular adhesion (VMA), epiretinal membrane (ERM), and macular cube volume (MCV). Patients were classified according to letter gain as good (> 10 letters), moderate (5-10 letters), or poor (< 5 letters) responders. Statistical analyses included one-way ANOVA and Kruskal-Wallis tests with post-hoc multiple comparisons. RESULTS: BCVA improved significantly at 4, 6, and 12 months after treatment (p < 0.001). Mean CMT, IRC, HRD, and MCV values showed significant reductions at all follow-up visits (p < 0.001). The good responder group had significantly lower baseline BCVA and higher baseline CMT, IRC, and HRD values (p < 0.001). In contrast, the poor responder group showed a significantly higher baseline presence of DRIL (p < 0.001). CONCLUSION: IV anti-VEGF and dexamethasone treatments provide significant anatomical and functional improvement in DME. High baseline CMT, HRD, and IRC values may indicate a favorable visual prognosis, whereas the presence of DRIL at baseline is associated with limited visual gain. Providing accurate prognostic information at treatment initiation may improve patient compliance.
Simultaneous quantification of lifitegrast and Rebamipide in hydrogel-based contact lenses using spectroscopic method.
Patel YR, Ranch KM, Bodiwala K … +5 more , Jani H, Lalwani R, Gajjar A, Chidrawar VR, Singh S
Int Ophthalmol · 2026 Mar · PMID 41790315 · Publisher ↗
BACKGROUND: Lifitegrast (LIF) and Rebamipide (REB) are used in effective therapies of dry eye disease (DED). However, conventional eye drops often suffer from poor ocular bioavailability due to rapid pre-corneal clearanc...
BACKGROUND: Lifitegrast (LIF) and Rebamipide (REB) are used in effective therapies of dry eye disease (DED). However, conventional eye drops often suffer from poor ocular bioavailability due to rapid pre-corneal clearance and short residence time. Drug-eluting contact lenses have emerged as a promising platform for sustained ocular drug delivery, yet no validated method exists for the simultaneous estimation of LIF and REB in such systems. OBJECTIVE: The present study aimed to develop and validate a simple, robust, and cost-effective UV spectrophotometric method for the simultaneous quantification of LIF and REB in hydrogel-based contact lenses using Vierordt's method. METHODS: Simultaneous estimation was carried out in methanol and simulated tear fluid using Vierordt's simultaneous equation approach. The method was validated according to ICH Q2 (R1) guidelines. Drug-loaded hydrogel contact lenses were prepared by free radical polymerization and evaluated for drug content, sterilization-induced leaching, and in-vitro release behavior. RESULTS: Maximum absorbance was observed at 259 nm for LIF and 229 nm for REB. Calibration curves demonstrated excellent linearity (R = 0.9999). The method tested showed high accuracy (99.9-100.5% recovery), precision (RSD < 1.5%), and sensitivity. Average drug loading per lens was 199.67 ± 0.38 µg for LIF and 80.08 ± 0.17 µg for REB. Furthermore, in-vitro release studies demonstrated sustained release for both drugs, with LIF completing release by 5 h and REB by 7 h. CONCLUSION: The validated UV spectrophotometric method provides a novel and practical analytical tool for the simultaneous estimation of Lifitegrast and Rebamipide in therapeutic contact lenses. Its simplicity and reliability support its translational potential for routine quality control and formulation development in ocular drug delivery for DED.
Management of submacular hemorrhage: from a case report to a comprehensive review of current treatment strategies.
Giannuzzi F, Hu L, Cusato M … +8 more , Cestrone V, De Vico U, Caputo CG, Rizzo C, Di Fede L, Carlà MM, Crincoli E, Rizzo S
Int Ophthalmol · 2026 Mar · PMID 41790302 · Full text
PURPOSE: To evaluate current pharmacological and surgical strategies for managing submacular hemorrhage (SMH), a vision-threatening complication which primarily occurs with macular neovascularization in age-related macul...
PURPOSE: To evaluate current pharmacological and surgical strategies for managing submacular hemorrhage (SMH), a vision-threatening complication which primarily occurs with macular neovascularization in age-related macular degeneration (AMD). METHODS: The research involved a literature review of recent studies about SMH treatment methods including anti-vascular endothelial growth factor (VEGF) therapy, tissue plasminogen activator (tPA), pneumatic displacement and pars plana vitrectomy techniques through meta-analyses, comparative studies and case series. RESULTS: SMH treatment is guided by hemorrhage size: small (≥ 1 to < 4 disc diameters), medium (≥ 4 disc diameters within the temporal arcade), massive (exceeding temporal arcades). Pharmacological management includes anti-VEGF monotherapy, which demonstrates efficacy comparable to surgical interventions for smaller hemorrhages, while offering a superior safety profile. Combined of tPA and anti-VEGF therapy achieves an 86% displacement success rate, with comparable efficacy between subretinal and intravitreal delivery methods. Surgical methods include pneumatic displacement, which achieves 85-100% efficacy in displacement and 45-80% rates of visual improvement, whereas pars plana vitrectomy is preferred for cases involving dense, organized hemorrhages. Retrospective studies indicate that outcomes are primarily influenced by patient-specific factors, such as hemorrhage size and baseline visual acuity, rather than the treatment modality employed. Intervention within 7 to 14 days has been shown to enhance outcomes, particularly when using a stepwise protocol that begins with less invasive techniques and escalates only as necessary. CONCLUSIONS: Modern SMH management emphasizes individualized, time-sensitive treatment based on hemorrhage characteristics. A stepwise approach, beginning with pharmacological therapy and moving to surgery only when necessary, tends to offer the best balance between visual recovery and safety. Timely diagnosis and intervention are essential factors for success due to the rapid damage of photoreceptors occurring within 24-72 h of onset.
Development trajectory and trends of ultrasound biomicroscopy in glaucoma research: a comprehensive 20-year bibliometric analysis.
Xu Y, Yang F, Zhang Q … +2 more , Fu Y, Wu H
Int Ophthalmol · 2026 Mar · PMID 41790279 · Full text
PURPOSE: This study conducts a comprehensive bibliometric analysis regarding the application of ultrasound biomicroscopy in glaucoma research over the past two decades. METHODS: Bibliometric analysis was performed on rel...
PURPOSE: This study conducts a comprehensive bibliometric analysis regarding the application of ultrasound biomicroscopy in glaucoma research over the past two decades. METHODS: Bibliometric analysis was performed on relevant literature published between 2005 and 2024. Data pertaining to authorship, affiliations, countries of origin, journals, keywords, and cited references were extracted. Visualization and analysis were executed utilizing VOSviewer and CiteSpace software. RESULTS: Bibliometric analysis of 557 articles revealed a quadratic growth trend in annual publication volume. The most productive authors, institutions, countries, and journals were identified and collaboration network maps were drawn. Keyword co-occurrence analysis identified five primary research clusters: angle-closure glaucoma pathogenesis, cataract surgery & complications, glaucoma surgery, ciliary body & iris, and iridocorneal angle. Burst detection and timeline analysis highlighted emerging research frontiers, including deep learning, 3D reconstruction, vitreous zonule imaging, and minimally invasive glaucoma surgery. These findings signal a shift in research priorities towards computational approaches and novel clinical applications. CONCLUSION: This bibliometric analysis delineates the dynamic evolution and broadening scope of ultrasound biomicroscopy application in glaucoma research over the past two decades. Collectively, these findings affirm the enduring value of ultrasound biomicroscopy and delineate promising avenues for future investigation.
Accuracy of twelve intraocular lens calculation formulas in highly myopic eyes.
Li GY, Li ZY, Yang ZH … +5 more , Zhao P, Li M, Xu J, Wan XH, Zhang JS
Int Ophthalmol · 2026 Mar · PMID 41784738 · Full text
PURPOSE: To investigate the accuracy, stability, and influencing factors of 12 intraocular lens (IOL) calculation formulas in highly myopic cataract patients. METHODS: Retrospective Case Series. Clinical data were collec...
PURPOSE: To investigate the accuracy, stability, and influencing factors of 12 intraocular lens (IOL) calculation formulas in highly myopic cataract patients. METHODS: Retrospective Case Series. Clinical data were collected from highly myopic cataract patients who underwent cataract extraction surgery at Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, between January 2024 and January 2025. Patients were stratified into subgroups based on axial length, keratometry, anterior chamber depth and axial length to corneal radius ratio (AL/r). The prediction error (PE), absolute error (AE), root-mean-square absolute prediction error (RMSAE) and the percentage of eyes with an absolute error within ± 0.25 D, ± 0.50 D, ± 0.75 D, and ± 1.00 D were recorded and compared for the following 12 IOL formulas: Barrett Universal II, Cooke K6, Castrop, Kane, EVO 2.0, Pearl-DGS, Hoffer QST, SRK-T, Haigis, Holladay 1, Holladay 2, and Hoffer Q. Statistical analysis was performed using Analysis of Variance (ANOVA), Friedman test, Kruskal-Wallis test, Dunn's test, and Cochran Q test. RESULTS: A total of 255 patients (255 eyes) were included in this study, comprising 113 males and 142 females, with a mean age of 57.8 ± 9.9 years. The difference in absolute errors among the 12 IOL formulas was statistically significant (χ = 327.59, P < 0.01). Among them, the Hoffer QST formula yielded the lowest absolute error (0.33 D), followed by Pearl-DGS (0.35 D) and Barrett UII 0.35 D), while the Hoffer Q formula showed the highest absolute error (0.75 D). Notably, only the Hoffer QST and Pearl-DGS formulas demonstrated no significant correlation between their absolute errors and axial length, corneal curvature, or anterior chamber depth (all P > 0.05). CONCLUSION: For highly myopic cataract patients, modern IOL formulas demonstrated superior accuracy compared to traditional formulas. The accuracy was predominantly influenced by axial length, with keratometry and anterior chamber depth playing minor roles. The Hoffer QST and Pearl-DGS formulas, in particular, showed consistent and stable performance.
Retinal and choroidal microvascular alterations in ıdiopathic pulmonary fibrosis: an OCTA study.
Balci A, Horozoglu Ceran T, Gobeka HH … +4 more , Yorukoglu Kayabas S, Inkaya Y, Senol Y, Dogan M
Int Ophthalmol · 2026 Mar · PMID 41784737 · Publisher ↗
PURPOSE: To evaluate retinal and choroidal microvascular changes in patients with idiopathic pulmonary fibrosis (IPF) using optical coherence tomography angiography (OCTA), and to explore whether IPF, traditionally consi...
PURPOSE: To evaluate retinal and choroidal microvascular changes in patients with idiopathic pulmonary fibrosis (IPF) using optical coherence tomography angiography (OCTA), and to explore whether IPF, traditionally considered a pulmonary disease, also manifests in the ocular microcirculation. METHODS: In this cross-sectional case-control study, 82 IPF patients and 82 age-, sex-, and eye-side-matched healthy controls were enrolled. All participants underwent comprehensive ophthalmic examination and macular OCTA imaging using the RTVue XR Avanti device. Vessel density (VD), foveal avascular zone (FAZ) area and perimeter (PERIM), flow area, selected area, and perfusion density were assessed in the superficial and deep capillary plexuses, outer retina, and choriocapillaris. RESULTS: The IPF group exhibited significantly lower superficial foveal vessel density (p = 0.030), reduced outer retina selected area (p = 0.010), and decreased choriocapillaris selected area (p = 0.003) compared to controls. No significant differences were observed in FAZ area or deep plexus vessel densities. CONCLUSION: Patients with IPF demonstrate measurable microvascular alterations in both the superficial retina and choriocapillaris, supporting the concept of IPF as a systemic disease with extra-pulmonary vascular involvement. OCTA may serve as a non-invasive imaging biomarker for detecting systemic microangiopathy in fibrotic lung disease.
Therapeutic effects of Chelidonium majus on ocular surface ınflammation and tear film homeostasis in a benzalkonium chloride-ınduced rat model of dry eye disease.
Unal A, Bozkurt Oflaz A, Cetin N … +5 more , Yayla M, Menevse E, Celik ZE, Tugay O, Bozkurt B
Int Ophthalmol · 2026 Mar · PMID 41774285 · Publisher ↗
PURPOSE: Dry eye disease (DED) is a multifactorial ocular surface disorder characterized by tear film instability and chronic inflammation. Natural compounds with anti-inflammatory activity have therefore attracted incre...
PURPOSE: Dry eye disease (DED) is a multifactorial ocular surface disorder characterized by tear film instability and chronic inflammation. Natural compounds with anti-inflammatory activity have therefore attracted increasing interest. Chelidonium majus (C. majus) latex contains bioactive alkaloids with proven anti-inflammatory properties; however, its potential role in DED has not yet been investigated. METHODS: Forty-six Wistar rats were randomized into six groups: Control, DED, Loteprednol etabonate (LE), and three C. majus latex dilutions (1/1, 1/10, 1/100). DED was induced by twice-daily instillation of 0.2% benzalkonium chloride (BAC) for 14 days. Following induction, LE or C. majus latex was administered according to group allocation; controls received vehicle. Tear volume (phenol red thread test), fluorescein corneal staining score (CSS), and Cochet-Bonnet esthesiometry were measured on days 0, 14, 21, and 28. On day 29, corneal tissues were analyzed by ELISA for TNF-α, IL-1β, IFN-γ, NF-κB, MMP-2, MMP-9, TIMP-2, AQP1, and AQP5, and underwent histopathological evaluation (H&E). Latex composition was characterized using LC-QTOF-MS. Statistical analysis included ANOVA with post hoc Tukey testing; p < 0.05 was considered significant. RESULTS: At week 2, the DED groups demonstrated reduced tear volume (2.13 ± 0.83 mm) and increased corneal staining scores (CSS) (4.63 ± 1.06). By week 4, tear secretion improved in the LE (4.38 ± 0.52 mm) and in the C. majus 1/1 (4.56 ± 0.56 mm), 1/10 (4.88 ± 0.52 mm), and 1/100 (4.56 ± 0.50 mm) groups, approaching values observed in the control group. CSS decreased markedly in the C. majus 1/10 (0.38 ± 0.52) and LE (1.13 ± 0.83) groups, whereas the DED group remained elevated (2.38 ± 0.52). Corneal sensitivity improved in the LE and C. majus 1/1 (3.44 ± 0.42 mm), 1/10 (3.75 ± 0.27 mm), and 1/100 (3.50 ± 0.46 mm) groups. Inflammatory cytokines and MMP-2/9 levels decreased significantly across treatment groups, with the most pronounced reductions observed in the C. majus 1/10 group. Histopathological analysis revealed better preservation of stromal architecture and reduced inflammatory infiltration in treated groups compared with the DED group. CONCLUSIONS: Chelidonium majus latex demonstrated significant anti-inflammatory and tissue-protective effects in this experimental model, supporting further investigation as a potential adjunctive approach in inflammatory DED.
Surgically induced necrotizing scleritis after orbital surgery with intraconal tumor excision: a case report.
Patrick S, Rashid J, Chua SW … +2 more , Juares Rizal A, Hanafi H
Int Ophthalmol · 2026 Mar · PMID 41774284 · Full text
BACKGROUND: Surgically induced necrotizing scleritis (SINS) is a blinding ocular disease characterized byinfl ammation with scleral necrosis. It occurs as early as one day after ocular surgery, although it can also occur...
BACKGROUND: Surgically induced necrotizing scleritis (SINS) is a blinding ocular disease characterized byinfl ammation with scleral necrosis. It occurs as early as one day after ocular surgery, although it can also occur years later. Commonly, it occurs after pterygium and cataract surgeries CASE PRESENTATION: Here, we report a case of a 40-year-old woman with underlying diabetes mellitus whounderwent a successful excisional biopsy via a swinging upper eyelid approach with lateral canthotomy andcantholysis, along with disinsertion of the superior and lateral rectus muscles, for an orbital cavernous venousmalformation. However, 9 weeks postoperatively, the patient developed persistent pain in the right eye (RE),especially with lateral gaze, which was not relieved with oral ibuprofen. At 16 weeks postoperative, an RE focal areaof scleral necrosis with surrounding conjunctival injection was noted at the superotemporal bulbar region. Magneticresonance imaging of the orbit and brain revealed RE focal thickening at the posterolateral sclera, posterior to thelateral rectus muscle insertion, suggesting posterior scleritis. The patient was treated with oral prednisolone (40mg/day) followed by a tapering regimen with adjunctive methotrexate (20 mg/week). After three months of oralprednisolone and six months of methotrexate, her disease resolved with no complications. CONCLUSION: SINS is a rare but potentially sight-threatening complication following orbital surgery with intraconaltumor excision. Persistent pain can be a useful clue before the clinical signs become apparent.
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