BACKGROUND: Functional home vision monitoring in macular disease yields dense, longitudinal data streams, yet analytic strategies to interpret their day-to-day variability remain underdeveloped. Time-in-Range (TIR) and T...BACKGROUND: Functional home vision monitoring in macular disease yields dense, longitudinal data streams, yet analytic strategies to interpret their day-to-day variability remain underdeveloped. Time-in-Range (TIR) and Time-in-Maintenance (TIM) represent novel longitudinal biomarkers, adapted from diabetes care, designed to quantify sustained functional stability and personalized disease control. METHODS: We conducted a retrospective cohort study of patients with macular disease undergoing anti-angiogenic therapy and smartphone-based home monitoring of hyperacuity (Alleye, Oculocare medical Inc.). TIR and TIM metrics for hyperacuity, best-corrected visual acuity (BCVA), and central subfield thickness (CST) were calculated using established (TIR) and individualized (TIM) thresholds as personalized stability metrics. Multivariable models were applied to analyze associations between TIR and TIM and injection frequency, BCVA and CST change. RESULTS: A total of 84 patients (149 eyes) were included. Greater TIR-hyperacuity was significantly associated with improvement in BCVA (β = 0.03, 95% confidence interval [CI] = 0.01-0.07, p < 0.05) and reduction in CST (β = -0.65, CI = -1.23 - -0.07, p < 0.05). In contrast, higher TIM-hyperacuity was associated with increased injection frequency (β = 0.0024, CI = 0.001-0.004, p < 0.01), but not with BCVA (β = 0.032, CI = -0.046-0.11, p = 0.42) or CST (β = -0.22, CI = -0.89-0.45, p = 0.52) changes. Sensitivity analyses confirmed the robustness of these findings across multiple threshold definitions. CONCLUSIONS: TIR and TIM serve as actionable longitudinal biomarkers, operationalized from high-frequency home monitoring, and may offer richer, patient-centric markers of disease control than traditional single-point measures.
PURPOSE: Long-term use of pentosan polysulfate sodium (PPS) for interstitial cystitis, has been associated with a sight-threatening pigmentary maculopathy. This study evaluated fluorescence lifetime imaging ophthalmoscop...PURPOSE: Long-term use of pentosan polysulfate sodium (PPS) for interstitial cystitis, has been associated with a sight-threatening pigmentary maculopathy. This study evaluated fluorescence lifetime imaging ophthalmoscopy (FLIO) in PPS maculopathy patients and correlated findings with fundus autofluorescence (FAF) and optical coherence tomography (OCT). METHODS: This prospective study included patients with confirmed PPS maculopathy at the University of California, San Diego. All patients underwent same-day multimodal imaging (FLIO, fundus photography, FAF, OCT). Disease severity was graded using updated PPS maculopathy criteria. FLIO data were compared to age-, sex- and lens-status-matched controls. RESULTS: Nineteen eyes from 10 PPS patients (mean age 71.2) and 19 eyes from 11 age-sex matched normal controls (mean age 71.5) were included. Both groups had seven pseudophakic (PP) and four phakic (P) patients. PPS maculopathy patients showed characteristic FAF changes and RPE hypertrophy. Disease severity did not significantly differ within or between phakic and pseudophakic groups. Mean FLIO lifetimes in PPS eyes were significantly longer than in controls (P: 905 ps v.s 500 ps, p<0.019), PP: 557 ps vs. 371 ps, p<0.044). Lifetimes also varied significantly with maculopathy severity (p<0.05). In 11 eyes, parafoveal foci with very short lifetimes (273-394 ps) were detected and differed significantly from central values (p=0.030). CONCLUSION: FLIO detected significant differences in fluorescence lifetimes between PPS maculopathy patients and controls. Discrete very short lifetime foci may represent early or distinct disease features. FLIO is a promising non-invasive tool for diagnosing and monitoring PPS maculopathy.
PURPOSE: To describe the long-term clinical and imaging features of the perivascular phenotype of multifocal choroiditis with panuveitis (PV-MFCPU). METHODS: Retrospective observational case series of eight patients (14...PURPOSE: To describe the long-term clinical and imaging features of the perivascular phenotype of multifocal choroiditis with panuveitis (PV-MFCPU). METHODS: Retrospective observational case series of eight patients (14 eyes) diagnosed with PV-MFCPU at tertiary uveitis referral centers. Clinical data and multimodal imaging-including ultra-widefield color fundus photography (CFP), fundus autofluorescence (FAF), fluorescein angiography (FA), indocyanine green angiography, optical coherence tomography (OCT) and OCT angiography-were reviewed at all available visits, with analyses focused on baseline and final follow-up visits. A comprehensive systemic work-up was performed to exclude infectious, autoimmune, and neoplastic etiologies. RESULTS: Median age at presentation was 27 years (IQR, 17-51), with a median follow-up of 5.4 years (IQR, 3-10.1). Disease was bilateral in 6/8 patients (75%). Lesions demonstrated a reproducible perivascular distribution along retinal arteries and/or veins, frequently extending into the mid- and far-periphery. On CFP and FAF, lesions appeared as pigmented, hypoautofluorescent spots evolving into sharply demarcated atrophic scars. FA showed late hyperfluorescent staining without leakage. OCT revealed outer retinal and retinal pigment epithelium disruption, subretinal hyperreflective material (SHRM), vertical hyperreflective column bridging the SHRM and overlying retinal vessels, and progression to atrophy. Infectious and inflammatory evaluations were negative in all cases. Mild, transient anterior segment or vitreous inflammation was observed in a minority of eyes. Median BCVA remained stable at 20/25 (IQR, 20/32-20/20). Choroidal neovascularization occurred in 3/14 eyes (21%) and responded to anti-VEGF therapy. CONCLUSION: PV-MFCPU represents a perivascular topographic phenotype within the MFCPU spectrum. Recognition of PV-MFCPU may improve differentiation from vasculitic and inflammatory chorioretinal mimickers.
PURPOSE: This study investigated retinal microvascular alterations using optical coherence tomography angiography (OCTA) in patients with coronary microvascular dysfunction (CMD), including slow coronary flow and ectatic...PURPOSE: This study investigated retinal microvascular alterations using optical coherence tomography angiography (OCTA) in patients with coronary microvascular dysfunction (CMD), including slow coronary flow and ectatic coronary arteries. METHODS: 174 eyes from 92 patients with CMD and 82 healthy control patients were included in the study. Routine ophthalmic examination was performed, and OCTA was employed to assess both the macula and optic disc. Vascular density of vessels in the superficial capillary plexus (SCP), deep capillary plexus (DCP) of the macula, and radial peripapillary capillaries (RPC) blood supply regions and the size of the foveal avascular zone (FAZ) was detected. RESULTS: Univariate regression revealed significant differences in superficial capillary plexus (SCP), deep capillary plexus (DCP), and foveal avascular zone (FAZ) between CMD patients and healthy controls (all p<0.05). Multivariate analysis identified DCP as the sole independent predictor of CMD (OR(CI); 7.54 (2.69-21.12)). CONCLUSION: These findings align with existing literature demonstrating retinal-cardiovascular correlations and highlight DCP as a potential non-invasive biomarker for CMD, particularly in male patients. The results support OCTA's utility in cardiovascular risk stratification, with gender-specific patterns warranting further investigation in larger cohorts.
PURPOSE: The study compares refractive outcomes of secondary intraocular lens (SIOL) surgery performed by vitreoretinal, anterior segment, and both surgeons. METHODS: Eyes included in this study underwent SIOLfrom 2012-2...PURPOSE: The study compares refractive outcomes of secondary intraocular lens (SIOL) surgery performed by vitreoretinal, anterior segment, and both surgeons. METHODS: Eyes included in this study underwent SIOLfrom 2012-2024and had a final post-operative visual acuity of 20/50 or better Regression analysis compared refractive outcomes and chi squared analysis compared complications between subspecialty of SIOL surgeon. RESULTS: 94, 104, and 80 eyes were included in the retina surgeon, anterior segment surgeon, and combo surgeon cohorts respectively. There was no significant difference in error between target and final post-op spherical equivalence (SE) between retina and combo (p= 0.079), retina and anterior segment (p=0.135), or anterior segment and combo cohorts (p=0.567). There was no significant difference in number of eyes with final SE within 1 diopter of target SE between retina and combo (p=0.136), retina and anterior segment (p=0.061), or anterior segment and combo cohorts (p=0.783). The retina cohort had higher post-operative corneal edema than the combo (p=0.017) and the anterior segment cohorts (p=0.035). The combo cohort had more post-operative retinal detachment than the anterior segment cohort (p=0.046). CONCLUSION: In eyes with good visual final vision, retina and anterior segment surgeons have similar refractive outcomes following SIOL surgery.
PURPOSE: To evaluate the prevalence and characteristics of retinal ischemic perivascular lesions (RIPLs) in the clinically unaffected fellow eyes of patients with unilateral central retinal artery occlusion (CRAO) using...PURPOSE: To evaluate the prevalence and characteristics of retinal ischemic perivascular lesions (RIPLs) in the clinically unaffected fellow eyes of patients with unilateral central retinal artery occlusion (CRAO) using spectral-domain optical coherence tomography (SD-OCT). METHODS: This retrospective case-control study included 39 fellow eyes of patients with CRAO and 57 age-, sex-, and hypertension-matched healthy controls. Macular SD-OCT scans were assessed for the presence, number, and morphology of RIPLs, classified as narrow (<300 µm, peaked apex) or wide (>300 µm, flattened apex). Between-group comparisons were performed using appropriate parametric/non-parametric tests, and odds ratios (ORs) were calculated for RIPL presence. RESULTS: RIPLs were detected in 29/39 eyes (74.4%) in the CRAO fellow-eye group and 14/57 eyes (24.6%) in controls (p < 0.001). The mean number of lesions per eye was significantly higher in the CRAO group (1.36 ± 1.22) than in controls (0.35 ± 0.73; p < 0.001). Among CRAO fellow eyes with RIPLs, 5 eyes (17.2%) showed wide-type lesions, whereas all lesions in controls were narrow. The odds of RIPL presence were higher in the CRAO group (OR 8.12, 95% CI 3.20-20.57; p < 0.001). CONCLUSIONS: Increased RIPL burden in the fellow eyes of CRAO patients suggests that microstructural retinal changes may be detectable even in eyes without clinically evident arterial occlusion. Further longitudinal, multimodal studies are needed to determine the temporal course and underlying mechanisms.
PURPOSE: This scoping review examines the technique and outcomes for human amniotic membrane (hAM) grafts in macular hole (MHs) repair, an emerging alternative to conventional methods involving pars plana vitrectomy (PPV...PURPOSE: This scoping review examines the technique and outcomes for human amniotic membrane (hAM) grafts in macular hole (MHs) repair, an emerging alternative to conventional methods involving pars plana vitrectomy (PPV), internal limiting membrane (ILM) peeling, and gas endotamponade. METHODS: A literature search of three databases was conducted on December 5, 2025. RESULTS: 66 studies involving 603 eyes were included. Most hAMs were sourced from eye banks or private companies and cut into 1-4 mm grafts using punch biopsies. All participants underwent PPV with ILM peeling. Grafts were commonly placed stromal side down using forceps, viscous injectors or under fluid or perfluorocarbon liquid. Endotamponade agents included SF6, C3F8, and silicone oil. The overall MH closure rate was 96%. Fresh hAM achieved a 100% closure rate, while cryopreserved hAM achieved 95%. Visual improvement was reported in 81% of cases, with the highest gains observed in traumatic MHs. Myopic MHs with retinal detachments had the lowest closure rate (72%). Graft dislocation was the most common complication (3.6%), and no systemic or uveitic complications were reported. CONCLUSION: hAM grafting demonstrates high anatomical success and visual improvement with minimal complications, suggesting utility in MH repair, particularly in complex or refractory cases.
PURPOSE: To develop clinically practical, sex-specific prediction models for identifying TR-ROP, irrespective of fundus photography, and evaluate its generalizability, efficiency, productivity, and interpretability. METH...PURPOSE: To develop clinically practical, sex-specific prediction models for identifying TR-ROP, irrespective of fundus photography, and evaluate its generalizability, efficiency, productivity, and interpretability. METHODS: We selected premature infants who suffered risk of TR-ROP and received fundus examination between 2012 and 2022. Logistic Regression (LR) Model, Random forest-LR Model and LASSO-LR Model were constructed and the model with the best performance was chosen for predictions of the occurrence of TR-ROP. RESULTS: Among 7,235 preterm infants received ROP screening, 408 (5.63%) were TR-ROP. The median follow-up time was 24 months. Male and female shared some modifiable risk and protective factors, but they also presented independent risk factors. The sex-specific model based on birth weight, gestational age, hypoxic ischemic encephalopathy, multiple births, blood transfusion (male) and birth weight, gestational age, head circumference, cesarean delivery, blood transfusion (female) were selected by LR showed more promising results in the prediction of TR-ROP in the internal validation cohort (male: AUC 0.855-0.981, specificity 0.895; female: AUC 0.950-0.995, specificity 1.000). The performance of the above sex-specific models also demonstrated performance in the external validation cohorts (male: AUC 0.806-0.951, specificity 0.824; female: AUC 0.625-0.919, specificity 0.727). The C-index showed the sex-stratified models displayed better clinical predictive utility than the overall model. CONCLUSION: Our study provides a sex-specific clinical risk prediction tool for TR-ROP, which may help preterm infants identify their potential risk profile, reduce unnecessary fundus examination and provide guidance to prevent disease progression.
Yadav S, Hasan N, Sahoo N
… +33 more, Zarnegar A, Cao J, Zhou A, Saju S, Wykoff CC, Shah P, Singhanetr P, Rossin E, Desideri LF, Hertkorn F, Munk MR, Antia C, Barquet LA, Kim M, Vujosevic S, Ashfaq Y, Kroeger Z, Pili L, Checchin L, Parodi MB, Gill M, Khateb S, Zhang M, Rodriguez F, Chotcomwongse P, Ruamviboonsuk P, Fung A, Wang J, Khurana RN, Lima LH, Wu L, Chhablani J, MICRoN Study Group
PURPOSE: While central serous chorioretinopathy (CSCR) is typically associated with pachychoroid, a subset of patients presents with thin choroids. This study aims to compare the clinical features of CSCR in thin versus...PURPOSE: While central serous chorioretinopathy (CSCR) is typically associated with pachychoroid, a subset of patients presents with thin choroids. This study aims to compare the clinical features of CSCR in thin versus thick choroid eyes. METHODS: In this retrospective multicenter study, patients were categorized by subfoveal choroidal thickness (SFCT) into thin (≤250 µm) and thick (≥400 µm) groups. Multimodal imaging was used to analyze central macular thickness (CMT), SFCT, neurosensory detachment height (NSRD-h), Haller vessel thickness (HVT), and inner choroidal thickness (ICT) at baseline and final visit. RESULTS: Among 355 eyes, 52 (14.6%) had thin and 303 (85.4%) had thick choroids. Thin choroid patients were older (p<0.001) and more often female (38.5% vs. 23.1%,p=0.019). Visual acuity was similar at baseline (0.30 Log Minimum Angle of Resolution (logMAR), Snellen equivalent [20/40]) vs. 0.22 [20/33], p=0.38) and final follow-up (0.18 logMAR [Snellen equivalent [20/30] vs. 0.15 [20/28], p=0.08). CMT decreased in both groups, but SFCT, HVT, and ICT remained stable in the thin group. Spontaneous resolution and recurrence rates were similar; however, choroidal neovascularization (CNV) development was significantly higher in the thin choroid group (p=0.003). CONCLUSIONS: Thin-choroid CSCR represents a distinct clinical phenotype with older age, and female predominance. Although CNV occurred more frequently in this group compared to the thick choroid group, multivariate analysis indicates that age may be a key contributor to CNV risk.
PURPOSE: To characterize the surgical management and outcomes of large high myopic macular holes (HMMHs). METHODS: Global multicenter retrospective case series of HMMHs with minimum linear diameter (MLD) ≥ 400 μm undergo...PURPOSE: To characterize the surgical management and outcomes of large high myopic macular holes (HMMHs). METHODS: Global multicenter retrospective case series of HMMHs with minimum linear diameter (MLD) ≥ 400 μm undergoing surgery between 2013-2023 with follow up ≥ 3 months. The main outcome measure was the HMMH closure rate at postoperative month 3. RESULTS: 499 cases of 463 patients from 37 surgeons were included, with mean ± SD age 58.3 ± 12.2 years, 77.0% female, 77.4% primary, 22.6% refractory, and mean ± SD follow-up 18.8 ± 20.2 months. The mean ± SD (range) MLD was 649 ± 280 (400, 2759) µm. Surgery techniques included 127 internal limiting membrane (ILM) peels, 285 ILM flaps, 19 amniotic membrane transplantations (AMT), 36 autologous retinal transplantations (ART), and 32 others. The postoperative month 3 closure rate for all cases was 72.4%. Closure rates significantly decreased with greater CLOSE Study Group size classification for HMMHs treated with ILM peeling or ILM flap (P = 0.006) but not for HMMHs treated with AMT or ART (P > 0.05). Visual acuity (VA) significantly increased from baseline to each follow-up time point among all eyes, with final mean ± SD change in VA of -0.29 (0.55) logMAR (+14.5 ETDRS letters), which did not significantly differ by surgery type. CONCLUSION: HMMH closure rates are lower than those reported for macular holes in non-highly myopic eyes, but most eyes can still achieve anatomic closure and meaningful VA gains when treated with the appropriate technique.
PURPOSE: To identify predictors of sequential bilateral rhegmatogenous retinal detachment (RD) and quantify patient-level risk of fellow-eye involvement following unilateral RD. METHODS: Adults undergoing RD repair at a...PURPOSE: To identify predictors of sequential bilateral rhegmatogenous retinal detachment (RD) and quantify patient-level risk of fellow-eye involvement following unilateral RD. METHODS: Adults undergoing RD repair at a tertiary center from 2010 to 2023 were included. Demographic and clinical characteristics were compared between unilateral and bilateral cases, and multivariable logistic regression was used to identify predictors of fellow-eye detachment. Predicted probabilities of sequential bilateral RD were generated across combinations of axial length, age, and sex. RESULTS: Among 1,480 patients, 185 (12.5%) developed RD in the fellow eye. Patients with sequential RD were younger, more often male, and had longer axial length. Axial length was the strongest predictor of bilateral RD, with each millimeter increase associated with a 17% increase in odds (OR 1.17, 95% CI 1.07-1.27). Younger age and male sex showed smaller independent associations. Although fellow-eye detachments presented earlier and with slightly better visual acuity, more than one third were still macula-off at presentation. CONCLUSIONS: Approximately one in eight patients with rhegmatogenous RD develops detachment in the fellow eye. Risk is strongly influenced by axial length and is concentrated in younger, highly myopic patients. These findings support risk-stratified surveillance after unilateral RD using simple clinical measurements available at routine examination.
PURPOSE: To assess whether external drainage of subretinal fluid (SRF) improves anatomical or visual outcomes in scleral buckle surgery for rhegmatogenous retinal detachment (RRD). METHODS: Retrospective review of 609 pr...PURPOSE: To assess whether external drainage of subretinal fluid (SRF) improves anatomical or visual outcomes in scleral buckle surgery for rhegmatogenous retinal detachment (RRD). METHODS: Retrospective review of 609 primary scleral buckles performed at Manchester Royal Eye Hospital (2008-2023). Pre/intra-operative characteristics, drainage use, best-corrected visual acuity (BCVA) and single-surgery anatomical success (SSAS) were analysed. RESULTS: 428 patients without SRF drainage and 181 with drainage were included. Groups were similar for age (p=0.33), preoperative BCVA (p=0.47), RRD type (dialysis vs. retinal hole, p=0.17), high myopia (p=0.52) and trauma (p=0.06). Drainage group had more macula-off RRDs (48 % vs 39 %, p=0.05) and were more often operated on by consultants (p<0.01). SSAS rates were 86.7 % with drainage and 83.6 % without (p=0.67). Final BCVA also showed no difference in all (p=0.47); macula-on (p=1.00); and macula-off eyes (p=0.17). After adjusting for age, high myopia, trauma, type of RRD, macula status, surgeon grade, external SRF drainage was not independently associated with either SSAS (OR=1.39, 95% CI 0.81-2.36, p=0.23) or postoperative BCVA (B= -0.023, 95% CI -0.093 to 0.048, p=0.532). Drainage caused subretinal haemorrhage in 34 eyes (18.8 %), almost all (32) small and localised to the drainage site; no endophthalmitis, retinal incarceration or vitreous loss occurred. CONCLUSIONS: External SRF drainage during scleral buckling is safe but did not improve SSAS or BCVA. Its use should remain individualized based on RRD characteristics and surgeon preference.
PURPOSE: To evaluate the risk of retinal vein occlusion (RVO) in patients 55 years old or younger with a history of migraine compared to a control group without migraine. METHODS: Using the TriNetX platform, a retrospect...PURPOSE: To evaluate the risk of retinal vein occlusion (RVO) in patients 55 years old or younger with a history of migraine compared to a control group without migraine. METHODS: Using the TriNetX platform, a retrospective cohort analysis was conducted comparing patients 55 or younger with a diagnosis of migraine to non-migraine patients undergoing routine health exams. The study period comprised 20 years from March 2006 through March 2026. 1:1 nearest-neighbor propensity score matching without replacement was used to balance baseline demographics, BMI, and comorbidities between cohorts. RVO incidence was the primary outcome measure, including central (CRVO) and branch (BRVO) subtypes, defined by ICD-10 codes. RESULTS: After propensity score matching, the combined matched sample comprised 3,482,652 individuals (1,741,326 per cohort). RVO (composite): 462 events in the migraine cohort vs 325 events in the control cohort (RR = 1.422, 95% CI: 1.234-1.638; p < 0.001; HR = 1.331, 95% CI: 1.155-1.534; log-rank χ2 = 15.655; p < 0.001). CRVO: 303 vs 206 events (RR = 1.471, 95% CI: 1.232-1.756; p < 0.001; HR = 1.375, 95% CI: 1.152-1.641; log-rank χ2 = 12.511; p < 0.001). BRVO: 221 vs 154 events (RR = 1.435, 95% CI: 1.168-1.763; p = 0.001; HR = 1.340, 95% CI: 1.090-1.646; log-rank χ2 = 7.798; p = 0.005). CONCLUSION: Patients ≤55 years old with a history of migraine have an increased risk of developing retinal vein occlusion compared to controls without migraines.
PURPOSE: To characterize multimodal imaging features and potential mechanisms of microcystoid macular edema (MME) in epiretinal membrane (ERM), and explore postoperative heterogeneity in retinal structure and visual reco...PURPOSE: To characterize multimodal imaging features and potential mechanisms of microcystoid macular edema (MME) in epiretinal membrane (ERM), and explore postoperative heterogeneity in retinal structure and visual recovery. METHODS: This pilot study included patients with idiopathic ERM postoperatively. Patients were categorized into MME and non-MME (NMME) groups based on postoperative SS-OCT findings. Postoperative multimodal retinal imaging features were detected using adaptive optics scanning laser ophthalmoscopy (AO-SLO) and swept-source optical coherence tomography (SS-OCT) and compared between the two groups. RESULTS: A total of 40 eyes of 40 patients were enrolled in the current study. There was no significant difference in baseline characteristics between the two group (All P > 0.050). AO-SLO revealed microcysts, waxy membranes, hyperreflective foci, hyporeflective zones, and microfolds. Dissociated optic nerve fiber layer was observed in 29 eyes (72.5%), comprising 17 eyes in the NMME group and 12 eyes in the MME group (P = 0.279). Compared with the NMME group, the MME group showed increased central retinal thickness (P = 0.016), inner nuclear layer thickness (P = 0.016), and vessel density in the deep vascular complex (P = 0.029), along with thinner retinal nerve fiber layer (P = 0.019). CONCLUSIONS: Postoperative MME in ERM may be associated with ERM-induced traction, Müller cell dysfunction, and remodeling of retinal structure and microcirculation. In this pilot study, the presence of postoperative MME may reflect a distinct pattern of biological injury and recovery in ERM. AO-SLO and SS-OCT provide insights into biological heterogeneity, aiding personalized postoperative evaluation.
PURPOSE: To characterize chronological clinicopathological changes in the inner wound tract of Zone III open-globe injuries (OGIs) and clarify the early evolution of proliferative vitreoretinopathy (PVR). METHODS: Patien...PURPOSE: To characterize chronological clinicopathological changes in the inner wound tract of Zone III open-globe injuries (OGIs) and clarify the early evolution of proliferative vitreoretinopathy (PVR). METHODS: Patients with Zone III OGIs who underwent initial pars plana vitrectomy (PPV) were enrolled from the multicenter prospective Eye Injury Vitrectomy Study (EIVS). Tissue from the inner wound tract was collected during surgery for H&E and PAS staining. PVR progression was further confirmed retrospectively from intraoperative videos. RESULTS: Thirty-seven eyes were analyzed. Histopathology demonstrated a sequential course: initial inflammation and exudation, followed by fibroblast migration and fibrous membrane formation. Hemorrhagic clots progressively organized, replaced by fibrous tissue, and eventually evolved into scar tissue with declining cellularity. Retinal structures remained largely preserved within 14 days. Beyond this stage, thinning of the nuclear layer and vacuolar degeneration of the nerve fiber layer were evident. Thereafter, nuclear loss, disorganization, and loosening were observed in the retina, with compressed nuclei in regions adjacent to epimembranes. Clinically, proliferative activity appeared by 7 ∼ 14 days and intensified after two weeks, coinciding with irreversible retinal remodeling. CONCLUSIONS: PVR develops rapidly after OGIs, with proliferative activity detectable within the first week and significant retinal disorganization after two weeks. Early PPV may preserve retinal integrity and limit progression, but acute-phase surgery faced technical risks, underscoring the need for individualized timing of intervention.
PURPOSE: To evaluate comparative aspiration flow rates and core vitrectomy times of a reengineered 27-gauge (G) 20,000 cuts per minute (CPM) dual action cutting (two-dimensional cutting [TDC]) vitrectomy probe (TDC Veloc...PURPOSE: To evaluate comparative aspiration flow rates and core vitrectomy times of a reengineered 27-gauge (G) 20,000 cuts per minute (CPM) dual action cutting (two-dimensional cutting [TDC]) vitrectomy probe (TDC Veloce; DORC International B.V.) versus a standard 27-G 16,000 CPM TDC probe (DORC). METHODS: In vitro investigations assessed comparative aspiration flow rates in Newtonian and non-Newtonian fluids using EVA Nexus system (DORC). In an accompanying single surgeon randomized controlled clinical study, core vitrectomy duration in patients undergoing 27-G vitrectomy using either a TDC Veloce or regular TDC probe, both in combination with EVA Nexus (n = 42), were compared. RESULTS: Significantly higher aspiration flow rates were achieved with the 27-G TDC Veloce probe compared with a 27-G TDC probe. The overall percentage increase in flow for TDC Veloce probe versus TDC probe was 31%, 69%, and 37% in water, artificial vitreous solution and porcine vitreous, respectively ( P < 0.001). Higher flow rates stabilized at cut speeds greater than 16,000 CPM. Mean (SD) core vitrectomy time (seconds) was 59.5 (6.1), 58.2 (3.3) and 98.6 (7.9) for the TDC Veloce 20,000 CPM, TDC Veloce 16,000 CPM, and TDC 16,000 CPM groups, respectively. The mean difference between the TDC Veloce 20,000 CPM and TDC 16,000 CPM groups was -39.1 seconds (95% CI: -44.57 to -33.63, P < 0.0001). CONCLUSION: Increased flow with the 27-G TDC Veloce probe resulted in a significantly shorter core vitrectomy time compared with a standard 27-G TDC probe, suggesting greater procedural efficiency during vitrectomy with the modified vitrectome.
PURPOSE: To evaluate the impact of cataract surgery on disease activity in neovascular age-related macular degeneration (nAMD) and determine whether choroidal biomarkers and macular neovascularization (MNV) subtypes pred...PURPOSE: To evaluate the impact of cataract surgery on disease activity in neovascular age-related macular degeneration (nAMD) and determine whether choroidal biomarkers and macular neovascularization (MNV) subtypes predict increased postoperative treatment requirements. METHODS: This retrospective study included 84 eyes from 84 patients with nAMD who underwent phacoemulsification while receiving intravitreal anti-VEGF therapy. Increased treatment need was defined as a shortened injection interval or occurrence of submacular hemorrhage. Pre-and postoperative choroidal vascularity index (CVI), subfoveal choroidal thickness (SFCT), and central subfield thickness (CST) were analyzed using EDI-OCT within 1 month before and after surgery. MNV subtypes were classified as type 1, type 2, retinal angiomatous proliferation (RAP), and polypoidal choroidal vasculopathy (PCV). RESULTS: Best-corrected visual acuity remained stable after cataract surgery (from 0.39 ± 0.27 [20/50] to 0.38 ± 0.28 logMAR [20/50]; p = 0.907), with no significant differences among MNV subtypes. Increased treatment need occurred in 45.2% of eyes. Both CVI and SFCT increased significantly postoperatively (p < 0.001). Eyes with increased treatment need showed significantly higher preoperative and postoperative CVI (p = 0.003 and p = 0.032, respectively). The PCV subtype demonstrated the highest rates of increased treatment need and the shortest injection intervals. Higher preoperative CVI independently predicted increased postoperative treatment need (OR = 1.13; p = 0.019). CONCLUSIONS: Cataract surgery may affect disease activity in a subset of patients with nAMD, particularly those with PCV and increased CVI. Preoperative choroidal characteristics such as CVI and SFCT may provide valuable insights for risk stratification and postoperative management.