BMC Ophthalmology[JOURNAL]
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200 papers
Impact of corneal guttata severity on visual quality in early-stage Fuchs' endothelial corneal dystrophy.
Zhang M, Li X, Liu Y … +4 more , Li F, Gao N, Shang Z, Yang R
BMC Ophthalmol · 2026 May · PMID 42185858 · Full text
BACKGROUND: To quantitatively evaluate the relationship between corneal guttata and visual quality in early-stage Fuchs' endothelial corneal dystrophy (FECD) without corneal edema. METHODS: Twenty eyes from twenty patien...
BACKGROUND: To quantitatively evaluate the relationship between corneal guttata and visual quality in early-stage Fuchs' endothelial corneal dystrophy (FECD) without corneal edema. METHODS: Twenty eyes from twenty patients with FECD were enrolled at Tianjin Medical University Eye Hospital. Guttata were classified into three grades, and objective visual quality parameters, including objective scatter index (OSI), modulation transfer function cutoff frequency (MTF cutoff), Strehl ratio, and predicted visual acuity at 100%, 20%, and 9% contrast levels (OV100%, OV20%, OV9%), were measured using Optical Quality Analysis System II (OQAS-II). Corneal densitometry, as an indicator of backward light scatter, was assessed using a corneal Scheimpflug tomography (Pentacam HR), including anterior and posterior corneal layers. Best-corrected visual acuity (BCVA) was recorded in logMAR. Differences among guttata grades were analyzed using Kruskal-Wallis tests followed by Mann-Whitney U tests with Bonferroni correction. Correlations between guttata and visual quality were analyzed using Spearman's correlation. RESULTS: Guttata severity correlated positively with OSI(0.822, P<0.001) and negatively with MTF cutoff, Strehl ratio, OV100%, and OV20%(-0.750, -0.554, 0.744, 0.567, separately, P < 0.05), while correlation with OV9% was weak(0.479, P = 0.033). No significant correlations were observed between guttata severity and either anterior or posterior corneal densitometry. BCVA showed no correlation with guttata severity or OSI but correlated moderately with MTF cutoff and Strehl ratio (-0.520, -0.551, separately, P < 0.05). CONCLUSION: In early-stage FECD, patients' visual quality begins to decline as the density and confluence of guttata increase despite the absence of visual acuity loss or corneal edema. Quantitative guttata assessment combined with objective visual quality inspection provides a more sensitive indicator for early functional impairment and may guide earlier clinical intervention.
Modified skills of trypsin-digested retinal vasculature mount preparation and string vessels observation.
Song M, Li H, Ma B … +1 more , Chen B
BMC Ophthalmol · 2026 May · PMID 42185836 · Full text
Trypsin-digested retinal vasculature mount is a key method to study vascular retinopathy. However, its failure rate and difficulty maintaining the vascular network's integrity limit its wide application. String vessels o...
Trypsin-digested retinal vasculature mount is a key method to study vascular retinopathy. However, its failure rate and difficulty maintaining the vascular network's integrity limit its wide application. String vessels occur in the vasculature of different tissues in many species. However, the definition and function of string vessels are full of controversy. This study aimed to explore the skills of preparing complete and repeatable retinal vasculature mounts and further understand the string vessel through observation. We found that the integrity of the retinal vascular network was successfully protected by using toothless micro forceps to clamp the internal limiting membrane and using glass rods to lift the vascular network from the water surface. This modification will not waste the hard-won samples. We observed the different states of the string vessels and hypothesized that they might participate in angiogenesis during vascular development or under pathological conditions.
Unilateral blindness and complete ophthalmoplegia following middle cerebral artery aneurysm clipping: a case report.
Afshar F, Majd AR, Pourazizi M … +4 more , Aghajani A, Rafiei A, Sanei P, Khalilian MS
BMC Ophthalmol · 2026 May · PMID 42185814 · Full text
BACKGROUND: Middle cerebral artery (MCA) aneurysms rarely cause ophthalmic complications due to their anatomical distance from ocular structures. We report an exceedingly rare case of acute unilateral blindness and compl...
BACKGROUND: Middle cerebral artery (MCA) aneurysms rarely cause ophthalmic complications due to their anatomical distance from ocular structures. We report an exceedingly rare case of acute unilateral blindness and complete ophthalmoplegia following MCA aneurysm clipping via a pterional/trans-sylvian approach, a complication not previously documented in the literature with concurrent optical coherence tomography (OCT) findings. CASE PRESENTATION: A 49-year-old man with a history of hypertension presented with a severe headache. Computed tomography (CT) and angiography confirmed a subarachnoid hemorrhage (SAH) secondary to a ruptured complex aneurysm of the left MCA. Preoperative MRI also revealed significant ipsilateral sinusitis. He underwent an emergent left pterional craniotomy with a trans-sylvian approach; proximal control was achieved on the M1 segment, and the aneurysm was clipped. Notably, no dissection or manipulation of the internal carotid artery (ICA) or opticocarotid cistern was performed. Twenty-four hours postoperatively, he developed no light perception (NLP) vision, complete ophthalmoplegia, ptosis, chemosis, and reduced corneal sensation in the left eye. Fundus examination revealed diffuse retinal whitening without a cherry-red spot, and optical coherence tomography (OCT) showed inner retinal edema, suggestive of probable ophthalmic artery occlusion (OAO) or orbital infarction syndrome, inconsistent with direct MCA aneurysm effects. The right eye was normal. MRI/MRA and fluorescein angiography were not feasible due to his unstable condition. Three days later, rehemorrhage prompted reoperation, but he suffered cardiopulmonary arrest and died. CONCLUSION: To our knowledge, this is the first reported case of OCT-documented inner retinal ischemia and complete ophthalmoplegia following a pterional/trans-sylvian clipping of an MCA aneurysm. It highlights the risk of rare, indirect ischemic injury to the orbital apex, potentially via retrograde microembolic or hemodynamic mechanisms, emphasizing the need for multidisciplinary awareness even in surgeries remote from the optic apparatus.
Non-infectious occlusive retinal vasculitis following switching from aflibercept 2 mg to aflibercept 8 mg in neovascular age-related macular degeneration: a case report.
Simaku E, Eddien AN, Popa M … +1 more , Shafei AE
BMC Ophthalmol · 2026 May · PMID 42177487 · Full text
BACKGROUND: Anti-vascular endothelial growth factor (anti-VEGF) therapy represents the standard of care for neovascular age-related macular degeneration (nAMD). Aflibercept 8 mg was recently introduced with extended dosi...
BACKGROUND: Anti-vascular endothelial growth factor (anti-VEGF) therapy represents the standard of care for neovascular age-related macular degeneration (nAMD). Aflibercept 8 mg was recently introduced with extended dosing intervals and favorable safety outcomes in phase III trials. Although no confirmed cases of occlusive retinal vasculitis were reported in pivotal studies, rare inflammatory vascular events may emerge during broader real-world exposure. CASE PRESENTATION: A 74-year-old pseudophakic male with active nAMD in the left eye demonstrated significant anatomical and functional improvement following intravitreal aflibercept 2 mg. After switching to aflibercept 8 mg, the patient presented 26 days later with painful visual deterioration. Fundus examination revealed mild vitritis, segmental arterial sheathing, venous narrowing, and peripheral intraretinal hemorrhages. Fluorescein angiography demonstrated capillary non-perfusion and late vascular leakage. Optical coherence tomography confirmed cystoid macular edema. Extensive infectious and autoimmune investigations were negative. Systemic and local corticosteroid therapy resulted in regression of inflammation with partial visual recovery. CONCLUSIONS: Non-infectious occlusive retinal vasculitis may rarely occur following switching to aflibercept 8 mg. Early recognition and prompt anti-inflammatory treatment are critical to minimize irreversible ischemic damage. Continued post-marketing pharmacovigilance is warranted.
Automated measurement of the minimum macular hole diameter based on optical coherence tomography images.
Xu J, Wei J, Tan R … +3 more , Shen J, Yao J, Zhou F
BMC Ophthalmol · 2026 May · PMID 42177481 · Full text
BACKGROUND: Accurate measurement of minimum macular hole (MH) diameter is essential for diagnosis and treatment. The manual measurement approach by ophthalmologists is time-consuming, poorly reproducible, and exhibits hi...
BACKGROUND: Accurate measurement of minimum macular hole (MH) diameter is essential for diagnosis and treatment. The manual measurement approach by ophthalmologists is time-consuming, poorly reproducible, and exhibits high inter-observer variability. Threshold-based methods are sensitive to image quality, and perform inadequately in low-contrast optical coherence tomography (OCT) images. Deep learning can achieve higher measurement accuracy but shows limited generalization capability. METHODS: We propose an automated measurement method comprising three sub-tasks. Specifically, a tailored MH dataset is first created by cropping publicly available OCT images to minimize interference from non-MH regions. Subsequently, an image processing pipeline, which consists of denoising, binarization, morphological operations, and edge detection, is implemented to extract the contours on both sides of MH. Finally, an automated measurement algorithm is designed to locate the closest points on the bilateral contours of MH and thereby calculate the minimum diameter. RESULTS: Extensive experiments are conducted to validate the effectiveness of this research. More concretely, on the public dataset, the [Formula: see text] metric obtained by the proposed method closely aligns with the [Formula: see text] metric. The ADE values are predominantly within 1 pixel, achieving as low as 0.00 in some cases. Simultaneously, the method demonstrates favorable performance in the RDE metric, with values ranging from 0.00% to 3.29%, most of which remain below 2.50%. Furthermore, in clinical testing, the measurement time per individual sample is approximately 4 seconds, indicating high efficiency. CONCLUSIONS: Overall, the comprehensive quantitative and qualitative experimental results confirm the method's commendable accuracy and execution efficiency in measuring the minimum MH diameter, demonstrating its potential value in assisting ophthalmologists with the diagnosis and treatment assessment of MH conditions.
Clinical analysis of 66 cases with orbital apex syndrome: a case series.
Ma Z, Jiang H, Cui S … +2 more , Peng J, Wang J
BMC Ophthalmol · 2026 May · PMID 42177480 · Full text
BACKGROUND: Orbital apex syndrome (OAS) is a rare ocular complication characterized by vision loss and ophthalmoplegia from infection, inflammation, trauma, neoplasms, and vascular causes, due to the involvement of ocula...
BACKGROUND: Orbital apex syndrome (OAS) is a rare ocular complication characterized by vision loss and ophthalmoplegia from infection, inflammation, trauma, neoplasms, and vascular causes, due to the involvement of ocular motor nerves in the anatomical region of the orbital apex. The epidemiological features of OAS are limited. Therefore, this study aimed to present the clinical features and determine the causes to evaluate the visual prognosis of patients with OAS. METHODS: A retrospective analysis was conducted on 126 adult patients with clinically confirmed OAS by reviewing the electronic medical records from Beijing Tongren Hospital, Capital Medical University, Beijing, China, between January 2020 and December 2024. Data on demographic information, clinical findings, medical history, laboratory results, radiological findings, diagnosis, treatment, and prognosis were collected. The final cohort comprised 66 patients with OAS (mean age: 54.95 ± 18.48 years; male: 36.36% and female 63.64%). RESULTS: All patients presented with unilateral involvement: 25 with right OAS and 41 with left OAS. However, the initial ocular presentations varied: blurred vision was reported in all patients, with 63.64% of them suffering from severe visual function impairment (best-corrected visual acuity, BCVA < 20/200), followed by ophthalmoplegia in 56 patients (84.85%), and headache/facial numbness in 40 patients (60.61%). Inflammation (54.55%) was the most frequent cause for OAS, followed by neoplasm (18.18%), trauma (15.15%), and infection (9.09%). After treatments, we found that the vision of 26 patients (39.39%) improved, the vision of 38 patients (57.58%) remained stable, and the vision of 2 patients (3.03%) worsened to blindness. The mortality in three patients was attributed to the underlying malignancies. Further subgroup analysis revealed that the proportion of patients with BCVA < 20/200 was significantly lower in the inflammatory group compared with the non-inflammatory group (27.78% vs. 66.67%, P = 0.002) after treatments. In the comparison between the inflammatory subgroup and the neoplastic subgroup, we found tha the patients in the inflammatory group were significantly younger than those in the neoplastic group (P = 0.015), the course of disease was significantly shorter (P = 0.020), and the proportion of severe visual function impairment (BCVA < 20/200) was significantly lower in the inflammatory group than in the neoplastic group (27.78% vs. 66.67%, P = 0.036). After adjusting for other confounding factors, etiology was an independent influencing factor for patient improvement (OR = 2.345, 95% CI: 1.126-4.881, P = 0.023). CONCLUSIONS: The clinical manifestations and etiologies of OAS are heterogeneous. Patients with OAS suffer from severe impairment of visual function, even after undergoing aggressive and comprehensive treatment. Our findings indicated that the inflammation was the most frequent cause of OAS and correlated with better visual outcomes. CLINICAL TRIAL NUMBER: Not applicable.
Evaluation of epithelial, stromal, and corneal thickness maps in the distinction between pellucid marginal degeneration and inferior keratoconus (pellucid-like).
Yıldırım Erdal BD, Kazancı B
BMC Ophthalmol · 2026 May · PMID 42177475 · Full text
BACKGROUND: To distinguish between these two ectasias, which can be confused with each other, using epithelial, stromal, and total corneal thickness maps in patients with pellucid marginal degeneration (PMD) and inferior...
BACKGROUND: To distinguish between these two ectasias, which can be confused with each other, using epithelial, stromal, and total corneal thickness maps in patients with pellucid marginal degeneration (PMD) and inferior keratoconus (I-KC) that have similar topographic features. METHODS: This prospective cross-sectional study included 114 eyes of 73 patients (56 eyes with PMD, 58 eyes with I-KC). All measurements were obtained using MS-39 AS-OCT. The values in the epithelial, stromal, and corneal thickness maps were recorded. RESULTS: There was no significant difference in mean age between the two groups (p = 0.061). In PMD patients, minimum epithelial, stromal, and total corneal thickness values in the inferotemporal (IT), inferior (I), inferonasal (IN), and nasal (N) zones within 6-8 mm and 8-10 mm areas were significantly thinner than in the I-KC group (p < 0.05). In the I-KC group, minimum and average epithelial thickness values in the central 2 mm area, in the IT and temporal (T) zones within 2-4 mm areas, and in the IT zone within 4-6 mm areas were significantly thinner than in the PMD group (p < 0.05). To distinguish PMD from I-KC, the IT 2-4 min./IN 8-10 min. in stromal thickness had an AUC of 0.878, with 79.5% sensitivity and 76% specificity; in epithelial thickness, the IT 2-4 min./IN 6-8 min. reached the highest diagnostic accuracy, with an AUC of 0.855, 78.6% sensitivity, and 79.7% specificity (p < 0.001). CONCLUSIONS: Patients exhibiting crab-claw patterns on the sagittal curvature map can differentiate between PMD and I-KC using pachymetric values and combinations of epithelial, stromal, and corneal thickness maps obtained with wide-field AS-OCT.
WT1-pulsed dendritic cell vaccination for neovascular age-related macular degeneration: a phase I pilot feasibility study.
Nakamura M, Koido S, Bito T … +7 more , Horiguchi H, Shimizu Y, Shimabuku M, Taguchi J, Gunji H, Sugiyama H, Nakano T
BMC Ophthalmol · 2026 May · PMID 42177462 · Full text
BACKGROUND: Neovascular age-related macular degeneration (nAMD) is a leading cause of vision loss. Although anti-VEGF therapy is effective, frequent injections carry risks and may not fully address the underlying disease...
BACKGROUND: Neovascular age-related macular degeneration (nAMD) is a leading cause of vision loss. Although anti-VEGF therapy is effective, frequent injections carry risks and may not fully address the underlying disease process. Wilms' tumor gene 1 (WT1), an upstream regulator of VEGF, is expressed in choroidal neovascular membranes and may represent a biologically relevant adjunctive target in nAMD. This pilot study evaluated the safety, tolerability, and immunogenicity of WT1-targeted dendritic cell (WT1-DC) vaccines and their effects on retinal morphology and visual function in nAMD patients, with secondary endpoints including clinical outcomes and in vitro WT1-specific T-cell responses. METHODS: Two patients initially received three monthly intravitreal injections of aflibercept (2 mg each), followed by 15 subcutaneous vaccinations with WT1-DCs. The vaccine contained both WT1-specific helper and killer peptides restricted to HLA-A*24:02. In addition, a helper peptide restricted to MHC class II and class I (HLA-A*02:01/02:06) was used. RESULTS: WT1-DC vaccination was well tolerated, and adverse events were limited. One patient maintained a stable retinal morphology and visual acuity without additional anti-VEGF therapy, whereas the other experienced recurrent subretinal fluid accumulation requiring intermittent rescue injections and a gradual decline in best-corrected visual acuity. Peripheral blood mononuclear cells from both patients exhibited functional CD4 + and CD8 + T-cell responses during vaccination and produced IFN-γ and TNF-α upon WT1 peptide stimulation in vitro. CONCLUSIONS: WT1-DC vaccination was feasible and well tolerated in these two patients who were clinically managed within the nAMD spectrum. Exploratory laboratory findings suggested WT1 peptide-responsive T-cell activity in vitro, but clinically meaningful in vivo immunogenicity was not established. Given the extremely small sample size, the confounding effect of prior anti-VEGF loading therapy, and diagnostic uncertainty regarding CNV etiology in one patient, no conclusions regarding therapeutic efficacy can be drawn. These observations support further investigations of WT1-DC vaccination in larger controlled studies. TRIAL REGISTRATION: Japan Registry of Clinical Trials (jRCTc030210068), registered May 7, 2021.
Emmetropia Verifying Optical (EVO) formula in secondary scleral fixation using the Yamane technique: a retrospective comparison of intraocular lens power calculation formulas.
Nowosielski Y, Lischke R, Rauchegger T … +8 more , Palme C, Angermann R, Zehetner C, Nowosielski M, Schmid E, Teuchner B, Rehak M, Dimmer A
BMC Ophthalmol · 2026 May · PMID 42177433 · Full text
OBJECTIVE: To compare the accuracy of Emmetropia Verifying Optical (EVO) 2.0 with Sanders-Retzlaff-Kraff/Theoretical (SRK/T), Hoffer Q and Barrett Universal II (BUII) intraocular lens power calculation formulas in eyes t...
OBJECTIVE: To compare the accuracy of Emmetropia Verifying Optical (EVO) 2.0 with Sanders-Retzlaff-Kraff/Theoretical (SRK/T), Hoffer Q and Barrett Universal II (BUII) intraocular lens power calculation formulas in eyes that have undergone scleral fixation in Yamane technique. METHODS AND ANALYSIS: In this retrospective study, patients undergoing secondary intraocular lens fixation in Yamane technique between 03/2019 - 04/2024 were included. Prediction errors for EVO 2.0, BUII, SRK/T, and Hoffer Q formulas were calculated by subtracting the actual spherical equivalent from the predicted spherical equivalent. The performance of each method was evaluated by Eyetemis, an online tool for analyzing prediction errors. The tool includes robust t-tests to compare the trimmed means of the data. RESULTS: 59 eyes met the inclusion criteria and were included in the analysis. All formulas showed myopic mean refractive prediction errors. With regard to spherical equivalent prediction error (SEQ-PE), precision of the SEQ-PE and absolute SEQ-PE, there were no significant differences between the formulas examined. The EVO 2.0 formula showed the lowest trimmed mean error with 0.62±0.58 D followed by BUII with 0.66±0.71 D. Within ± 0.50 D the EVO 2.0 formula achieved the highest accuracy with 54% whereas BUII and Hoffer Q achieved the highest accuracy within ±0.25 D with 28%. CONCLUSION: The EVO 2.0 formula represents a viable option for IOL calculation in patients undergoing scleral fixation with the Yamane technique. Although none of the formulas showed significant differences in performance, all consistently resulted in a myopic prediction error in the analyzed cohort. Therefore, when using the Yamane technique, targeting a slightly hyperopic refraction may help compensate for this myopic shift in similar patient populations.
Classification of diabetic macular edema cases based on optical coherence tomography images and evaluation of morphological features.
Temel B, Yulek F, Timur IEE … +4 more , Tunay ZO, Cakir B, Ersoy R, Ugurlu N
BMC Ophthalmol · 2026 May · PMID 42174549 · Full text
OBJECTIVES: This study aimed to classify DME morphologically using optical coherence tomography (OCT) and to assess the impact of selected OCT biomarkers on DME subtypes. METHODS: OCT images of patients with DME categori...
OBJECTIVES: This study aimed to classify DME morphologically using optical coherence tomography (OCT) and to assess the impact of selected OCT biomarkers on DME subtypes. METHODS: OCT images of patients with DME categorized into three groups as diffuse macular edema (dME), cystoid macular edema (CME) and cystoid degeneration (CD). Presence of subretinal fluid (SRF), disorganization of inner retinal layers (DRIL), ellipsoid zone (EZ) damage, external limiting membrane (ELM) damage, exudates, hyperreflective dots (HRD), epiretinal membrane (ERM) and vitreomacular traction (VMT) were evaluated. The effect of OCT findings on DME type was examined and factors affecting visual acuity were evaluated in this retrospective, cross-sectional study. RESULTS: 746 eyes of 538 patients were evaluated and 55.1% were in the CME group, 40.6% in dME and 3.8% in the CD group. It was observed that the integrity of ELM and EZ was impaired in 11.58% and 11.09%, respectively. When SRF, DRIL, HRD, exudates, VMT and ERM were examined, the rates of 16.7%, 19.23%, 28.83%, 54.40%, 2.76% and 15.8% were obtained, respectively. The CD group had the weakest visual acuity, while the dME group had the greatest (P < 0.001). While SRF, HRD, and exudates were most common in CME; DRIL, ELM and EZ damages were most common in the CD group (P < 0.001). CONCLUSION: The group with the lowest visual acuity and the most damage to the outer retinal layers is the CD group. Presence of SRF, DRIL, HRD, exudate and ERM are also among the reasons that decrease visual acuity in DME.
Preliminary clinical observation of unilateral implantation of trifocal intraocular lens.
Chu Z, Chen H, Song J … +3 more , Shao Z, Bi H, Liu D
BMC Ophthalmol · 2026 May · PMID 42174536 · Full text
BACKGROUND: Evidence on unilateral trifocal IOL implantation is limited. This study evaluates the clinical outcomes of unilateral implantation of the AcrySof IQ PanOptix TFNT00 trifocal intraocular lens (IOL) in cataract...
BACKGROUND: Evidence on unilateral trifocal IOL implantation is limited. This study evaluates the clinical outcomes of unilateral implantation of the AcrySof IQ PanOptix TFNT00 trifocal intraocular lens (IOL) in cataract patients. METHODS: This study included 55 eyes of 55 cataract patients who underwent unilateral TFNT00 trifocal IOL implantation. Comprehensive evaluations were performed preoperatively and postoperatively at 1, 3, 6, and 12 months. Outcome measures included uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), and corrected distance visual acuity (CDVA); defocus curve analysis; objective optical quality parameters, including Strehl ratio (SR) and modulation transfer function area ratio (MTF-AR); reading performance; and dysphotopsia. Subjective visual function was quantified using the VF-14 Cataract Visual Function Questionnaire at 1 and 12 months postoperatively. RESULTS: At 12 months postoperatively, 76.4% of eyes achieved UDVA of 20/20 or better and 87.3% achieved a CDVA of 20/20 or better (≤ 0.0 logMAR). All eyes achieved UIVA and UNVA of 20/40 or better (≤ 0.3 logMAR). Refractive outcomes were stable and accurate, with 74.5% of eyes within ± 0.50 D of target spherical equivalent and a mean residual astigmatism of 0.25 ± 0.25 D at 12 months. Defocus curves demonstrated a bimodal profile with peaks at 0.00 to -0.50 D and - 2.00 to -2.50 D. Significant improvements were observed in objective optical quality parameters, Strehl ratio (SR) improved from 0.008 ± 0.007 preoperatively to 0.093 ± 0.023 at 12 months (P < 0.001), and modulation transfer function area ratio (MTF-AR) increased from 0.169 ± 0.060 to 0.413 ± 0.077 (P < 0.001). Reading performance showed marked enhancement in both reading acuity and speed (both P < 0.001). VF-14 questionnaire scores exceeded 3 points for all items. Glare or halos were reported by 3 eyes (5.5%) at 12 months; severity was not formally graded. CONCLUSION: Unilateral implantation of the TFNT00 trifocal IOL effectively restores distance, intermediate, and near vision in cataract patients, with favorable objective optical quality and a low incidence of photic phenomena. Patients reported satisfactory subjective visual function across a wide range of daily activities, suggesting effective neuroadaptation despite monocular correction. These preliminary findings support unilateral trifocal IOL implantation as a viable option for patients in whom bilateral surgery is not feasible or desired. However, given the exploratory nature of this study, further comparative research with larger cohorts is warranted to confirm these outcomes.
Long-term clinical course and recurrence pattern of orbital Kimura's disease: a retrospective case series.
Yang R, Ren T, Liu R … +4 more , Wang N, Xu L, Ma J, Li J
BMC Ophthalmol · 2026 May · PMID 42174535 · Full text
BACKGROUND: Kimura's disease (KD) is a rare chronic inflammatory disorder that predominantly affects young Asian males and typically involves the head and neck region. Orbital involvement is uncommon and remains insuffic...
BACKGROUND: Kimura's disease (KD) is a rare chronic inflammatory disorder that predominantly affects young Asian males and typically involves the head and neck region. Orbital involvement is uncommon and remains insufficiently characterized, particularly with respect to long-term outcomes. This study aimed to investigate the clinical features, imaging characteristics, treatment strategies, and long-term prognosis of orbital KD. METHODS: We conducted a retrospective case series of patients with histopathologically confirmed KD involving the orbit at a single tertiary referral center between January 2010 and December 2025. Demographic characteristics, clinical manifestations, imaging findings, pathological features, treatment modalities, and follow-up outcomes were reviewed. For suspected recurrence, recurrent clinical manifestations were first identified during follow-up, and orbital imaging was used to confirm lesion recurrence and assess lesion extent when indicated. Pathological confirmation was obtained only when repeat surgery or biopsy was performed. RESULTS: Eight male patients were included, with a mean age of 21.25 ± 17.20 years (range, 6-47 years). Painless eyelid swelling was the most common presenting symptom (62.5%). The eyelid and lacrimal gland were the most frequently involved structures. Histopathological examination revealed dense eosinophilic infiltration and lymphoid follicular hyperplasia in all cases. Surgery combined with systemic glucocorticoid therapy was the primary treatment modality (87.5%). Among the seven patients with available follow-up data, the mean follow-up duration was 87.57 ± 55.42 months. Recurrence occurred in two of the seven patients with available follow-up data (28.6%; 25.0% of the entire cohort), both presenting as local orbital/periorbital recurrence. No distant disease progression, metastasis, or disease-related mortality was observed. CONCLUSIONS: Orbital KD predominantly affects young males and most commonly involves the eyelid and lacrimal gland. Although local recurrence may occur, the long-term prognosis appears favorable. Structured follow-up remains important for detecting recurrence and guiding subsequent management.
Risk factors for ocular complications in HIV/AIDS patients: a retrospective analysis of ophthalmology consultations in a tertiary hospital in Central China.
Zhang R, Zheng T, Chen X … +3 more , Yang L, Zeng W, Ke M
BMC Ophthalmol · 2026 May · PMID 42174527 · Full text
BACKGROUND: Acquired immunodeficiency syndrome (AIDS) affects 39.9 million people worldwide. Despite antiretroviral therapy, sight-threatening ocular complications, such as cytomegalovirus retinitis (CMVR), remain common...
BACKGROUND: Acquired immunodeficiency syndrome (AIDS) affects 39.9 million people worldwide. Despite antiretroviral therapy, sight-threatening ocular complications, such as cytomegalovirus retinitis (CMVR), remain common, yet contemporary incidence data from Asian populations are scarce. PURPOSE: To quantify the incidence of fundus lesions and identify independent predictors of ocular lesions among HIV-positive inpatients referred for ophthalmologic evaluation at a tertiary center in Central China. METHODS: All consecutive HIV-1-positive inpatients aged ≥ 18 years who underwent standardized ophthalmic screening from 19 November 2019 to 9 June 2023 were included. Data on demographic, systemic, and ocular characteristics were collected. Binary logistic regression models were used to identify factors associated with fundus lesions. RESULTS: Of 345 eligible individuals, 117 had fundus lesions, classified into three main types. The distribution was 35.9% for opportunistic infections, 59.8% for HIV-related microangiopathy, and 4.3% for syphilis-related uveitis. The opportunistic infections group was common among the youngest age group [median age: 41.5 years, IQR: 32-54 years], with 38.1% reporting blurred vision. Patients in the microangiopathy group had the lowest CD4 T cell count [median count: 18.5 cells/µL, IQR: 5-40.25 cells/µL] and the shortest duration of HIV/AIDS [median month: 0.7 months, IQR: 0-6.5 months]. The syphilis-related uveitis group had the longest duration of HIV/AIDS [median month: 24 months, IQR: 8.125-54 months], the highest CD4 T cell count [median count: 166 cells/µL, IQR: 41-224.5 cells/µL], and the most frequent complaint of blurred vision (80%). CONCLUSION: In this contemporary Central-Chinese cohort, CMVR remains the leading ocular sequela despite widespread HAART. Age, nadir CD4 < 50 cells/µL, and symptomatic visual loss are independent red flags. We propose routine dilated fundus examinations every 3 months for patients with any of these predictors and immediate ophthalmic referral at the onset of visual symptoms.
Nasolacrimal balloon dacryoplasty versus nasolacrimal bi-canalicular intubation for the management of congenital nasolacrimal duct obstruction with a previous failed probing or intubation: a retrospective study.
Salem L, El Sada M, Hosny R … +1 more , El-Essawy RA
BMC Ophthalmol · 2026 May · PMID 42174514 · Full text
PURPOSE: To compare the results and complications of nasolacrimal duct intubation and balloon dacryoplasty (BDCP) for the treatment of cases with recurrent epiphora following previous probing or intubation. METHODS: A re...
PURPOSE: To compare the results and complications of nasolacrimal duct intubation and balloon dacryoplasty (BDCP) for the treatment of cases with recurrent epiphora following previous probing or intubation. METHODS: A retrospective study including patients with recurrent nasolacrimal duct obstruction following previous probing or intubation whether retreated with balloon dacryoplasty or bi-canalicular intubation. All procedures were performed by the same surgeon. The results were evaluated and compared using a Modified Munk classification. RESULTS: The study included 103 eyes of 77 patients; 53 eyes (51.5%) underwent BDCP and 50 eyes (48.5%) underwent bi-canalicular intubation. Mean age was 4.03 ± 2.71 years (range 9 months to 12 years). Most eyes (85.5%) had severe pre-operative disease (Modified Munk grades 4 and 5). Post-operative, all patients showed improvement in terms of grading according to MMC; the collective success rate of both procedures in both groups was 51.5%, 69.7%, 86.7% and 88.9% at 1 week, 1-, 3- and 6-months post-op. respectively. Subgroup analysis revealed earlier successful outcome in group B compared to group A (p-value = 0.002), yet this relationship is reversed with Group A (BDCP) having 96% success at 6 months follow-up compared to 80% in Group B (Bi-canalicular intubation) (p-value = 0.021). Baseline demographic and clinical characteristics were comparable between the two groups, with no statistically significant differences in age, sex distribution, type of previous intervention (p-value = 0.95), or pre-operative Modified Munk grades. Complications were minimal and insignificant in both groups. CONCLUSION: Balloon dacryoplasty showed a 96% success rate compared to 80% success rate of intubation after 6 months follow up. Higher success rates of treatment of recurrent CNLDO epiphora is seen when the previous procedure was a simple probing.
Influence of type 2 diabetes mellitus on functional progression of primary open-angle glaucoma.
Kostianeva-Zhelinska SS, Konareva-Kostianeva MI
BMC Ophthalmol · 2026 May · PMID 42174496 · Full text
PURPOSE: To assess the effect of diabetes mellitus (DM) type 2 on the functional progression of primary open-angle glaucoma (POAG) by comparing the rate of progression (RoP) of POAG in eyes with and without diabetes. MET...
PURPOSE: To assess the effect of diabetes mellitus (DM) type 2 on the functional progression of primary open-angle glaucoma (POAG) by comparing the rate of progression (RoP) of POAG in eyes with and without diabetes. METHODS: In a retrospective observasional study from our practice were included 32 followed-up POAG patients with accompanying disease DM type 2 (60 eyes) (group I, POAG + DM) and 32 patients with POAG without DM (58 eyes) (group II, POAG-DM). The groups were matched by age and gender but not by stage of POAG iat the start of investigation. The mean period of disease tracking was 6.0 ± 3.4 years (from 2 to14 years) for POAG + DM group and 5.4 ± 2.3 years (from 2 to 10 years) for POAG -DM group. Visual field (VF) changes were determined by standard automatic perimetry, Humphrey analyzer, program 30 - 2. For each eye the slope of MD (Mean deviation) changes over time was calculated and the RoP was established. RESULTS: A significant difference was observed for initial MD values in eyes of both groups: -5.52dB in groupI vs. -10.66 dB in group II. The number and percentage of eyes with initially severe VF losses was three times higher in group II: 21 eyes (36.2%) vs. 7 eyes (11.7%). A real progression in one or both eyes was established in 21 patients of POAG + DM group and in 25 patients of POAG-DM group. During the follow-up period the progressing eyes were 34 eyes (56.7%) in POAG + DM group and in 38 eyes (65.5%) in POAG-DM group. The difference between both groups was not significant (P > 0.05) about progressing eyes. The mean value of RoP in the progressing eyes was - 0.98 ± 1.12/year in POAG + DM group and - 0.78 ± 0.66/year in POAG-DM group. Although RoP was larger in progressing POAG + DM, no significant difference was found in both groups (Z - 0.017, Sig 0.986, Mann-Whitney Test). CONCLUSIONS: The real influence of DM on functional progression of POAG was not established in this comparative study. The rate of progression in POAG eyes with DM type 2 was slightly higher but without statistical significance. It was due to the significantly greater percentage of eyes with severe visual field changes in POAG patients without DM. The severity of POAG influences the assessment of the functional progression in eyes with and without DM.
Influence of the use of an intraoperative image-guided alignment system on the refractive outcomes in subjects with preoperative astigmatism: a large comparative retrospective study.
Rebenitsch L, Singh IP, Schallhorn JM
BMC Ophthalmol · 2026 May · PMID 42174491 · Full text
BACKGROUND: The aim of this study is to compare the refractive outcomes in a large cohort with preoperative corneal astigmatism who underwent cataract surgery with toric intraocular lens (IOL) implantation assisted (stud...
BACKGROUND: The aim of this study is to compare the refractive outcomes in a large cohort with preoperative corneal astigmatism who underwent cataract surgery with toric intraocular lens (IOL) implantation assisted (study group) or no (control group) with an intraoperative image-guided cataract planning system (Callisto, Carl Zeiss Meditec, Jena, Germany). METHODS: In this retrospective comparative database study, mean and centroid postoperative cylinder, mean absolute error (MAE) and the proportion of eyes with a prediction error (PE) within ± 0.25 D, ± 0.50 D and ± 1.00 D (both in cylinder and spherical equivalent (SE)) were compared between both groups. These endpoints were also compared depending on the type of preoperative astigmatism, i.e. against the rule (ATR), oblique or with-the-rule (WTR) astigmatism. RESULTS: In total, 31,176 cases were analyzed in this study. Mean (± standard deviation (SD)) postoperative cylinder was found to be significantly lower in the study group (0.419 ± 0.432 D) compared with the control group (0.443 ± 0.453 D, p < 0.001). This statistical difference was observed in eyes with ATR and oblique astigmatism when looking at subgroups. Postoperative centroid cylinder (mean @angle ± SD) was 0.042 @97° ± 0.600 D in the study group and 0.043 @100° ± 0.633 D in the control group. MAE in cylinder was significantly lower in the study group compared to the control group. A slight but significantly higher percentages (up to 3%) of eyes with a PE in cylinder within ± 0.25 D, ± 0.50 D and 1.00 D were observed in the study group compared to the control group. CONCLUSIONS: Results of this study showed that the use of CALLISTO surgical planning system can improve refractive outcomes after cataract surgery and toric IOL implantation in patients with preoperative corneal astigmatism, especially in terms of cylinder for ATR and oblique astigmatism.
Quantitative analysis of anterior and posterior chamber parameters of primary angle-closure glaucoma based on Level set method.
Wang X, Yao Y, Liu X … +1 more , You X
BMC Ophthalmol · 2026 May · PMID 42174485 · Full text
PURPOSE: The study aimed to accurately measure anterior and posterior chamber parameters in ultrasound biomicroscopy (UBM) images and to quantify their relationship with intraocular pressure (IOP), axial length (AL) and...
PURPOSE: The study aimed to accurately measure anterior and posterior chamber parameters in ultrasound biomicroscopy (UBM) images and to quantify their relationship with intraocular pressure (IOP), axial length (AL) and lens thickness (LT), enhancing the understanding of primary angle-closure disease. METHODS: UBM images of 135 patients with primary angle-closure glaucoma(PACG) and 30 healthy individuals were analyzed. The Level set method was used to measure anterior chamber depth (ACD) and posterior chamber area (PCA). Relative error and intraclass correlation coefficient (ICC) were used to assess the accuracy and consistency of these measurements compared to the ground truth. IOP, AL and LT were also measured, and the relationships between ACD, PCA, IOP, AL and LT were explored using Spearman correlation analysis. RESULTS: The Level set method yielded highly accurate measurements of ACD and PCA with low Relative errors and high ICC values. Spearman correlation analysis revealed that PCA was significantly positively correlated with both AL (R = 0.398, p = 0.002) and LT (R = 0.255, p = 0.006). In contrast, no statistically or clinically significant associations were found for the remaining parameter pairs (e.g., ACD-IOP, PCA-IOP), all of which showed |R|<0.2 and P > 0.05. CONCLUSION: The Level set method proves to be a highly accurate and consistent technique for UBM image analysis, boosting measurement efficiency and reproducibility. The significant correlations of PCA with AL and LT offer new insights into the anatomical complexity of angle-closure disease, emphasizing the posterior chamber as a critical dimension for further exploration.
Patient with longstanding mpox keratitis successfully treated with topical Cidofovir 0.5% eye drops: a case report.
Otiti-Sengeri J, Mugisha D, Ngoma DB … +3 more , Lusobya RC, Atukunda I, Colebunders R
BMC Ophthalmol · 2026 May · PMID 42168928 · Full text
BACKGROUND: Mpox-associated ocular disease, including keratitis, is an emerging, vision-threatening complication. Management is challenging because no anti-viral therapy has yet been approved to prevent permanent corneal...
BACKGROUND: Mpox-associated ocular disease, including keratitis, is an emerging, vision-threatening complication. Management is challenging because no anti-viral therapy has yet been approved to prevent permanent corneal scaring or blindness. CASE PRESENTATION: We describe a 43-year-old female Ugandan health worker who acquired a Clade Ib mpox infection following occupational exposure during clinical examination of a patient with confirmed mpox attending a health facility in Kampala, Uganda. She developed severe ulcerative keratitis, with persistent epithelial defects and progressive stromal involvement despite standard-of-care treatment, including topical trifluridine and supportive therapy. Diagnostic confirmation of mpox was made by real-time polymerase chain reaction (PCR) from lesion swabs, and Clade Ib was identified. The keratitis remained active and vision-threatening for more than four months after symptom onset. Because of ongoing deterioration and high risk of irreversible vision loss, the treating team initiated topical cidofovir 0.5% ophthalmic drops under emergency compassionate use. Subsequent improvement included epithelial closure, decreased stromal inflammation, and visual recovery after 8 weeks of treatment and has since remained stable for to date. CONCLUSIONS: Topical cidofovir 0.5% may provide therapeutic benefit in severe, refractory mpox keratitis when trifluridine fails, and when no other effective, approved alternative exists. Controlled clinical evaluation and structured compassionate-use frameworks for cidofovir are urgently warranted given the risk of permanent blindness in mpox keratitis.
Impaired pupillary sensitivity in diabetic patients and correlation with visual outcome in cataract surgery.
Li Y, Xu Y, Ren Q … +3 more , Pan Z, Shi F, Wan P
BMC Ophthalmol · 2026 May · PMID 42168924 · Full text
PURPOSE: To investigate the relationship between pupillary response and diabetic characteristics in cataract patients and explore whether impaired pupillary function may impact cataract surgical outcomes and visual recov...
PURPOSE: To investigate the relationship between pupillary response and diabetic characteristics in cataract patients and explore whether impaired pupillary function may impact cataract surgical outcomes and visual recovery in diabetic patients. METHODS: This prospective study included 362 participants (133 diabetic patients and 229 controls) who underwent cataract surgery. Diabetic patients were stratified by disease duration (≤ 1 year, 1-10 years, > 10 years). Pupil parameters and Visual quality metrics including higher-order aberrations (HOA), Strehl ratio (SR), and area ratio (AR) were evaluated using the OPD-Scan III aberrometer preoperatively and at 1 day, 1 week, and 1 month postoperatively. RESULTS: Scotopic pupil diameter (PD) demonstrated a progressive decline with increasing diabetes duration. Patients with duration > 10 years showed significantly smaller scotopic pupils compared to controls (p < 0.0001) and shorter-duration subgroups (p < 0.01). PD difference deteriorated progressively in patients with duration > 1 year (p < 0.0001). Linear regression revealed that each 1% increase in HbA1c was associated with a 0.10 mm decrease in PD difference (β=-0.103, p < 0.001) and reduced scotopic PD (β=-0.112, p = 0.025). Postoperative visual quality parameters (HOA, SR, AR) showed comparable improvement between diabetic and control groups at all time points (p > 0.05), with diabetes duration showing minimal influence on outcomes. CONCLUSION: Diabetic patients exhibit reduced pupillary sensitivity, particularly affecting scotopic pupil dilation, significantly associated with elevated HbA1c levels and longer diabetes duration. Postoperative improvements in visual quality of diabetic patients are comparable to those of non-diabetic patients, supporting use of functional intraocular lenses.
Safety and pharmacokinetics of intravitreally repeatedly injected panitumumab in non-human primates - a study performed under good laboratory practice.
Wang YX, Holz FG, Coenen M … +5 more , Sun X, Xie W, Panda-Jonas S, Dong L, Jonas JB
BMC Ophthalmol · 2026 May · PMID 42168916 · Full text
BACKGROUND: Epidermal growth factor (EGF) has been suggested to play a role in myopic axial elongation, and EGF receptor blockade may be of potential therapeutic benefit. Here we examined the ocular and systemic toxicity...
BACKGROUND: Epidermal growth factor (EGF) has been suggested to play a role in myopic axial elongation, and EGF receptor blockade may be of potential therapeutic benefit. Here we examined the ocular and systemic toxicity of panitumumab, a clinically used EGF receptor blocker in oncology, when repeatedly administered intravitreally in non-human primates. METHODS: The experimental study included six non-human cynomolgus primates (3 males) which underwent five (n = 1 animal) or three (n = 5 animals) 4-weekly intravitreal injections of panitumumab (dose: 0.78 mg (78µL)) or of phosphate buffered solution (PBS) (78µL). RESULTS: The study group with panitumumab injections consisted of 7 eyes and the control group with PBS injections of 5 eyes. Two animals of the study group developed on Day 59 (two days after the third injection) signs of a slight intraocular inflammation (cells in anterior chamber and vitreous) and reduction of intraocular pressure, with most of the signs having resolved at study end (Day 86). Panitumumab reached the serum peak concentration at 24 h after the first dose (C 18.3 to 946ng/mL; serum exposure 2120 to 37300 h*ng/mL). Four weeks after the third injection (Day 86), panitumumab concentrations in aqueous humor ranged from 12.8 ng/mL to 65.0 ng/mL, and in the vitreous from 1.74 ng/mL to 531 ng/mL, with a panitumumab accumulation factor between 0.891 and 0.012. TUNEL staining did not reveal pathological results. CONCLUSIONS: Except for mild and reversible intraocular inflammation in some eyes, repeated intravitreal application of 0.78 mg panitumumab did not result in ophthalmological or systemic adverse effects in non-human primates.
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