OPTICAL COHERENCE TOMOGRAPHY
Sun
200 papers
Evaluation of corneal intrastromal voriconazole injection as an adjuvant approach in recalcitrant fungal keratitis.
Said KEG, Aggour NM, Basiony AI
J Ophthalmic Inflamm Infect · 2026 Jun · PMID 42334778 · Full text
BACKGROUND: Fungal keratitis is a sight-threatening condition that accounts for approximately 30-40% of keratitis cases in developing countries. Its management remains challenging despite the availability of various anti...
BACKGROUND: Fungal keratitis is a sight-threatening condition that accounts for approximately 30-40% of keratitis cases in developing countries. Its management remains challenging despite the availability of various antifungal agents, highlighting the potential role of targeted drug delivery in recalcitrant cases. PURPOSE: To evaluate the efficacy of corneal intrastromal voriconazole (ISV) injection in the management of fungal keratitis unresponsive to conventional antifungal therapy. METHODS: This prospective interventional case series included 21 eyes of 21 patients with smear-positive fungal keratitis that failed to respond to at least two weeks of topical antifungal therapy. All patients underwent detailed ophthalmological examination and ulcer assessment using anterior segment optical coherence tomography (AS-OCT). Intrastromal voriconazole (50 µg/0.1 mL) was administered circumferentially around the ulcer. Treatment response was evaluated through serial follow-up, including assessment of ulcer size, infiltrate extent, hypopyon level, presence of satellite lesions, and best-corrected visual acuity (BCVA). RESULTS: The mean age of the patients was 57.19 ± 6.74 years, with a predominance of males (76.2%). Most patients were from rural areas (76.2%) and had a history of vegetative trauma (71.4%). The mean ulcer size was 4.64 ± 0.95 mm, and the mean infiltrate size was 6.43 ± 1.29 mm. Hypopyon was present in 57.1% of cases, and the mean ulcer depth measured by AS-OCT was 257.14 ± 68.12 μm. Aspergillus was the most isolated organism (52.4%). BCVA improved significantly from 2.71 ± 0.46 LogMAR at baseline to 1.34 ± 0.68 at 3 months (P < 0.001). Complete resolution was achieved in 19 patients (90.5%). Fourteen patients (66.7%) responded to a single injection, while five (23.8%) and two (9.5%) required two and three injections, respectively. Most cases (84.2%) resolved within 2-4 weeks. Two patients (9.5%) showed disease progression and required therapeutic penetrating keratoplasty and were excluded from the final analysis. CONCLUSION: Intrastromal voriconazole injection appears to be an effective adjunctive treatment for recalcitrant fungal keratitis, improving clinical outcomes and potentially reducing the need for therapeutic or tectonic keratoplasty.
Visual acuity is reduced with increasing central retinal thickness, but also with higher age and female sex in diabetic macular oedema.
Jeppesen SK, Bek T
Acta Ophthalmol · 2026 Jun · PMID 42334235 · Publisher ↗
INTRODUCTION: The increasing number of patients with diabetes has increased the incidence of diabetic macular oedema (DME) with the accompanying risk of developing visual loss. The purpose of the present study was to des...
INTRODUCTION: The increasing number of patients with diabetes has increased the incidence of diabetic macular oedema (DME) with the accompanying risk of developing visual loss. The purpose of the present study was to describe the contributions of increased central retinal thickness (CRT) and other risk factors to the reduction in visual acuity in patients diagnosed with treatment-requiring DME. METHODS: Best corrected visual acuity (BCVA) in the better eye was correlated with CRT at the last examination before treatment of 582 patients with DME between 2011 and 2024. Multiple linear regression was used to evaluate the contributions of CRT, sex, age, diabetes duration, body mass index (BMI) and mean arterial blood pressure (MAP) to the variation in BCVA. RESULTS: BCVA was significantly inversely correlated with CRT, with an average reduction of one ETDRS letter per 17.9 micrometres increase in CRT (p < 0.001), and CRT could explain approximately 32% of the variation in BCVA. In a multivariate model, increased CRT, higher age and female sex contributed independently to a lower BCVA, whereas diabetes duration, BMI and MAP showed no significant contribution to the variation in BCVA. The inclusion of all the variables could explain approximately 41% of the variation in BCVA. CONCLUSIONS: In DME, BCVA is on average reduced by 1 ETDRS letter for each 17.9 micrometres increase in CRT. However, BCVA in DME is also reduced by higher age and female sex.
Retinal Ischemic Perivascular Lesions in Pulmonary Hypertension: Retinal Biomarkers Informing Systemic Microvascular Dysfunction.
Bisen JB, Sikora H, Shah R … +4 more , Drakopoulos M, Zhang K, Cuttica M, Mirza RG
Transl Vis Sci Technol · 2026 Jun · PMID 42334127 · Publisher ↗
PURPOSE: Retinal ischemic perivascular lesions (RIPLs), seen on optical coherence tomography (OCT) as localized retinal changes, are markers of subclinical retinal infarcts. RIPLs are linked to systemic cardiovascular di...
PURPOSE: Retinal ischemic perivascular lesions (RIPLs), seen on optical coherence tomography (OCT) as localized retinal changes, are markers of subclinical retinal infarcts. RIPLs are linked to systemic cardiovascular diseases, including hypertension and type 2 diabetes. Pulmonary hypertension (PH) stems from diverse etiologies, including cardiac, pulmonary, and thromboembolic causes. This study aimed to assess the relationship between RIPLs and PH, evaluating whether RIPL counts differ between PH and control groups and among PH subtypes. METHODS: This retrospective, cross-sectional study included patients with PH who had undergone retinal imaging within 5 years of diagnosis and controls with a coronary artery calcium score of 0. Retinal imaging was performed using macular OCT scans (Spectralis, Heidelberg Engineering, Franklin, MA). Patients with poor-quality images and significant retinal disease were excluded from the study. Statistical analyses compared clinical variables and RIPL counts among controls, pre-PH, and PH groups, and among PH subtypes. RESULTS: Among 129 patients (65 controls, 18 pre-PH, and 46 PH), pre-PH and PH groups had higher RIPL counts (control = 2.05, pre-PH = 5.78, and PH = 3.93) and prevalence (control = 48%, pPre-PH = 94%, and PH = 70%) than controls. The increased odds of elevated RIPLs in pre-PH and PH were not significant after adjustment. PH from lung disease had lower RIPL counts than other subtypes. CONCLUSIONS: Patients with pre-PH and PH have higher RIPL counts than healthy controls. Differences among PH subtypes suggest RIPLs reflect the impact of systemic vascular disease. TRANSLATIONAL RELEVANCE: RIPLs are associated with systemic microvascular dysfunction and may serve as biomarkers for early disease management and patient stratification.
Ray-Tracing-Based Intraocular Lens Power Calculation in Combined Cataract Surgery and Descemet Membrane Endothelial Keratoplasty.
Weber JO, Kaiser KP, Wendelstein JA … +3 more , Dick HB, Kohnen T, Schmack I
Clin Exp Ophthalmol · 2026 Jun · PMID 42333924 · Publisher ↗
BACKGROUND: To compare the predictive accuracy of ray tracing-based intraocular lens (IOL) power calculation formulas with the Barrett Universal II (BUII) formula in eyes with Fuchs endothelial corneal dystrophy (FECD) u...
BACKGROUND: To compare the predictive accuracy of ray tracing-based intraocular lens (IOL) power calculation formulas with the Barrett Universal II (BUII) formula in eyes with Fuchs endothelial corneal dystrophy (FECD) undergoing combined cataract surgery and Descemet membrane endothelial keratoplasty (triple DMEK). METHODS: This is a retrospective, single-centre comparative case series. Preoperative biometry was obtained using Scheimpflug tomography (Pentacam AXL) and a swept-source optical coherence tomography-based biometer (IOLMaster 700). IOL power calculations were performed using Barrett Universal II (BUII), Olsen ray-tracing and two OKULIX ray-tracing approaches (paraxial and 2.5-mm pupil). Prediction error (PE) was calculated and trueness, precision, and accuracy were evaluated using robust statistical methods (Eyetemis). A retrospective IOLup1D adjustment was additionally assessed. RESULTS: One hundred forty-nine eyes of 149 patients were enrolled. BUII demonstrated the lowest trimmed mean absolute error (0.74 ± 0.65D) and median absolute error (0.60D), with 72% of eyes within ±1.00D of the target refraction. Olsen ray-tracing showed higher errors (mean absolute error 1.06 ± 1.02D), while both OKULIX approaches performed similarly (0.91-0.92D). Only OKULIX paraxial ray-tracing showed no significant systematic bias (p = 0.450), whereas all other formulas demonstrated a significant hyperopic shift (p < 0.001). After retrospective IOLup1D adjustment, BUII and Olsen achieved comparable accuracy, with Olsen demonstrating the highest trueness. Mean keratometry values measured with the IOLMaster were 0.20 ± 0.63D steeper compared to the Pentacam. CONCLUSION: In triple DMEK eyes, ray tracing-based IOL power calculation did not offer better accuracy compared to BUII. BUII demonstrated the highest accuracy and precision overall. After IOLup1D adjustment, BUII and Olsen achieved comparable accuracy, with Olsen showing the greatest trueness.
Diagnostic Usefulness of LC-OCT in Mammary and Extramammary Paget Disease and Correlation With Vertical and Horizontal Histopathology: A Case Series.
Broggi G, Laudani F, Failla M … +4 more , Caltabiano R, Lacarrubba F, Micali G, Verzì AE
Am J Dermatopathol · 2026 Jun · PMID 42333526 · Publisher ↗
The Paget disease represents a form of adenocarcinoma arising in epidermis; it can be distinguished in mammary (when involves the nipple areolar epidermis) and extramammary Paget disease (uncommon form that involves apoc...
The Paget disease represents a form of adenocarcinoma arising in epidermis; it can be distinguished in mammary (when involves the nipple areolar epidermis) and extramammary Paget disease (uncommon form that involves apocrine gland-rich areas); they present significant diagnostic challenges because of its nonspecific clinical appearance and frequent misidentification as benign, inflammatory skin conditions. Line-field confocal optical coherence tomography (LC-OCT) is a novel, noninvasive imaging modality that enables in vivo, real-time visualization of the skin with near-histological resolution. The objective of this study was to evaluate the diagnostic performance and clinical applicability of LC-OCT as a noninvasive imaging tool for the in vivo assessment of both mammary and extramammary Paget disease, and to establish their correspondence with conventional histopathological findings. This retrospective study included 4 patients with histopathologically confirmed diagnoses of mammary and extramammary Paget disease. All lesions were imaged in vivo with LC-OCT before biopsy. In both mammary Paget disease and extramammary Paget disease, LC-OCT identified intraepidermal clusters and single hypo-reflective Paget cells correlating with histological findings. LC-OCT represents a valuable adjunct in dermatologic diagnostics, offering near-histological, real-time visualization of cutaneous architecture. It can enhance diagnostic accuracy, guide biopsy site selection, improve preoperative margin assessment, and support follow-up after nonsurgical therapy.
Application of subretinal injection of balanced salt solution for the management of large-diameter macular holes.
Wang X, Li X, Wu B … +2 more , Han Q, Wang Y
BMC Ophthalmol · 2026 Jun · PMID 42332604 · Full text
PURPOSE: To evaluate the efficacy and safety of subretinal injection of balanced salt solution (BSS) combined with vitrectomy and internal limiting membrane (ILM) peeling for managing large-diameter macular holes (MHs ≥ ...
PURPOSE: To evaluate the efficacy and safety of subretinal injection of balanced salt solution (BSS) combined with vitrectomy and internal limiting membrane (ILM) peeling for managing large-diameter macular holes (MHs ≥ 400 μm). METHODS: A prospective interventional study was conducted on 31 eyes of 31 patients with full-thickness MHs (including 5 refractory MHs). Patients underwent 25 G vitrectomy, ILM peeling, followed by subretinal BSS injection using a 41 G needle. Outcomes were assessed at 1 and 3 months postoperatively with optical coherence tomography (OCT), best corrected visual acuity (BCVA), and microperimetry. Metrics of the microperimetry included macular integrity index (MII) and macular threshold (MT). Ten eyes completed 6 month followup. Changes in BCVA (LogMAR), MII, and MT before and after surgery, as well as MH closure and complications were compared and analyzed. Functional outcomes were analyzed only in eyes with successful type I closure. RESULTS: At 1 month, 93.54% (29/31) achieved complete MH closure. BCVA improved from 1.34 ± 0.59 preoperatively to 0.67 ± 0.20 at 1 month and 0.48 ± 0.36 at 3 months (p < 0.001). MII improved from 98.77 ± 4.83 to 96.23 ± 11.38 (p = 0.015) and MT from 17.53 ± 5.04 to 22.54 ± 3.91 dB (p < 0.001) at 3 months. In 10 eyes with 6 month followup, BCVA further improved to 0.41 ± 0.30 and MT to 24.64 ± 2.35 dB (bothp < 0.05). The refractory subgroup (n = 5) achieved 100% complete closure. No complications were observed during the follow-up time. CONCLUSION: Combined 41 G subretinal BSS injection with PPV and ILM peeling is effective and safe for treating largediameter MHs (≥400 μm), achieving high anatomical closure rates and sustained visual functional improvement up to 6 months. Preliminary outcomes in refractory MHs are favorable; larger cohorts are needed for validation.
Impaired Rod-Mediated Vision is the Functional Hallmark of Ageing and Early and Intermediate Age-Related Macular Degeneration.
Owsley C, Curcio CA
Ophthalmic Physiol Opt · 2026 Jun · PMID 42332292 · Publisher ↗
Laboratory and patient-oriented research on photoreceptors and vision in ageing and early and intermediate age-related macular degeneration (AMD) were conducted in parallel starting in the 1990s by Christine Curcio and C...
Laboratory and patient-oriented research on photoreceptors and vision in ageing and early and intermediate age-related macular degeneration (AMD) were conducted in parallel starting in the 1990s by Christine Curcio and Cynthia Owsley, respectively. They joined forces in two longitudinal observation studies, the Alabama Study on Age-related Macular Degeneration (ALSTAR) in 2009 and in ALSTAR2 in 2019, together involving >1100 participants. These studies established rod-mediated dark adaptation (RMDA) measured close to the fovea as the first functional biomarker for incident early AMD and the progression of AMD. These studies used standardised grading of colour fundus photography and prioritised large samples for statistical power. RMDA is a global measure of dysregulated transport between the circulation and photoreceptors, involving at least seven different steps in a retinoid re-supply route especially needed by rods, and a surrogate for the delivery of other essentials across this route. The choice of functional and imaging outcome measures was informed by a model of AMD pathophysiology based on drusen biology, as discovered in the laboratory using high-quality human donor eyes. Specifically, high-risk drusen in the central retina were thought to result from large lipoproteins constitutively made by the retinal pigment epithelium and impaired in transit to circulation by ageing changes in Bruch's membrane and choriocapillaris. Imaging studies in ALSTAR/2 thus included optical coherence tomography (OCT) angiography assessments of choriocapillaris flow signal and OCT assessments of outer bands involved in intercellular transfer (interdigitation zone). Of seven vision tests utilised in ALSTAR2, only RMDA achieved a Minimum Clinically Important Difference at 3 years follow-up. This research highlights the importance of developing functionally valid structural endpoints for use in early and intermediate AMD intervention trials. Research to date supports the idea that functional changes emerge earlier than structural changes in early and intermediate AMD. Clinicaltrials.gov # NCT04112667 (registration date October 7, 2019).
Intravitreal Faricimab for Retinal Vein Occlusion: Real-World Outcomes from the Multicenter FARTURK-RVO Study in Türkiye.
Akkan F, Görgün E, Erden B … +25 more , Bardak YK, Şerif N, Öztürk M, Çelik E, Bölükbaşı S, İpek ŞC, Uzundede T, Karataş G, Karapapak M, Özal E, Uyar OM, Cömerter D, Alp MN, Ermiş S, Korkmaz A, Arıcı M, Karataş ME, Yenerel NM, Artunay HÖ, Önder-Tokuç E, Karabaş VL, Ünal M, Kapran Z, Özdemir H, Çakır A
Ophthalmol Ther · 2026 Jun · PMID 42332211 · Publisher ↗
INTRODUCTION: The aim of this study was to evaluate the real-world efficacy and safety of intravitreal faricimab for macular edema (ME) secondary to retinal vein occlusion (RVO) across a multicenter cohort with up to 52 ...
INTRODUCTION: The aim of this study was to evaluate the real-world efficacy and safety of intravitreal faricimab for macular edema (ME) secondary to retinal vein occlusion (RVO) across a multicenter cohort with up to 52 weeks of follow-up. METHODS: Data from 17 centers across Türkiye were retrospectively analyzed between 22 November 2024 and 1 March 2026. Patients with branch RVO (BRVO) or central RVO (CRVO) complicated by ME who received at least one intravitreal faricimab injection and had complete ophthalmic and optical coherence tomography (OCT) data with a minimum 4-week follow-up were included. Demographics, diagnosis, prior treatments, best-corrected visual acuity (BCVA; decimal converted to logMAR), central macular thickness (CMT), intraocular pressure (IOP), injection number, follow-up duration, and ocular/systemic adverse events were recorded at baseline, day 7, monthly after each of the first three injections, and at the final visit. RESULTS: A total of 70 patients (37 BRVO [52.9%], 33 CRVO [47.1%]) were included, with a mean follow-up of 23.69 ± 8.54 weeks; 44 (62.8%) were treatment-naïve and 26 (37.2%) were switch patients. When comparing baseline and final visits, treatment-naïve patients showed a mean CMT reduction of 306.9 ± 231.3 µm (from 594.1 ± 206.9 µm at baseline to 287.2 ± 89.9 µm at final visit; p < 0.001), while switch patients demonstrated a mean CMT reduction of 290.6 ± 114.3 µm (from 562.1 ± 107.3 to 271.5 ± 90.7 µm; p < 0.001). The mean logMAR BCVA gain was 0.77 (p < 0.001) in naïve and 0.38 (p < 0.001) in switch patients. IOP remained stable throughout, and no serious ocular or systemic adverse events were recorded. CONCLUSIONS: Faricimab demonstrated rapid anatomical and functional improvements in the RVO cohort, evident as early as day 7 after the initial injection. These findings support faricimab as a potent and reliable therapeutic option across both RVO subtypes in routine clinical practice.
Age, estimated basal metabolic rate, and subfoveal choroidal thickness: a cross-sectional study based on cataract patients.
Zhou D, Wang Y, Li C
Sci Rep · 2026 Jun · PMID 42332098 · Full text
To investigate the relationship between the basal metabolic rate (BMR) and subfoveal choroidal thickness (SFCT) and the statistical mediating role of the BMR in age-related changes in SFCT. This cross-sectional study inc...
To investigate the relationship between the basal metabolic rate (BMR) and subfoveal choroidal thickness (SFCT) and the statistical mediating role of the BMR in age-related changes in SFCT. This cross-sectional study included 119 cataract surgery patients. BMR was calculated by the Mifflin-St Jeor equation, and SFCT was measured via swept-source OCT and its integrated software. Covariates included metabolic indices (e.g., triglyceride-glucose index, hemoglobin level, platelet count, systolic blood pressure, and relevant comorbidities), comorbidities (hypertension, diabetes mellitus, and cardiovascular/cerebrovascular events), and ocular parameters (including intraocular pressure and axial length). Associations were evaluated using linear regression (with nested models for multicollinearity) and bootstrap mediation analysis. BMR was positively correlated with SFCT after adjusting for axial length according to both univariate and multivariate linear regression analyses (all P < 0.05), but significance was lost in the nested models including age and sex because of multicollinearity (VIF > 5). Mediation analysis revealed that age had a total effect on SFCT of -4.4641 (P < 0.01), with BMR mediating 27.71% of this effect (indirect effect: -1.2368, 95% CI: -2.0745 to -0.5340). In this cohort of cataract patients, BMR did not independently biological affect SFCT but served as a statistical mediating variable, partially elucidating the relationship between SFCT thinning and advancing age. A hypothesis was formulated that metabolic pathway regulation as a potential strategy for preserving age-related ocular health.
A combined ex vivo fundus imaging-histology protocol for clinicopathological validation of human donor eyes with limited medical history.
Vijay Singh SH, Yeap W, Too LK … +14 more , Allende A, Hall G, Hunyor A, Madigan MC, Merani R, Ortiz J, Rodriguez M, Wong J, Invernizzi A, Killingsworth M, Pye V, Mehta H, Petsoglou C, Cherepanoff S
Sci Rep · 2026 Jun · PMID 42331911 · Full text
This study evaluated a combined ex vivo fundus imaging-histology protocol to improve accuracy of diagnosis in human donor eyes with limited medical history. Fifty-one formalin-fixed eyes from 32 donors underwent a standa...
This study evaluated a combined ex vivo fundus imaging-histology protocol to improve accuracy of diagnosis in human donor eyes with limited medical history. Fifty-one formalin-fixed eyes from 32 donors underwent a standardised workflow comprising ex vivo fundus photography, selective spectral-domain optical coherence tomography (SD-OCT), and comprehensive histological examination. Medical/surgical retinal ophthalmologists independently reviewed imaging, while ophthalmic pathologists performed masked histological assessment. Diagnostic metrics were calculated using histology as the reference standard. Ex vivo imaging identified definitive pathology in 10 of 51 eyes (19.6%) and possible abnormalities in 4 eyes (7.8%). Histological analysis, however, revealed definitive pathology in 20 eyes (39.2%), detecting a broader range of diseases, including early age-related macular degeneration, hypertensive vasculopathy, and a rare choroidal tumour. Concordance was observed in 27 eyes (52.9%), mainly where no pathology was present. Significant discordance occurred in 24 eyes (47.1%), comprising 13 false negatives and 11 false positives (including misclassified pathology). Consequently, the sensitivity and specificity of ex vivo imaging for detecting pathology were 18.8% and 68.6%, respectively. While ex vivo imaging is a practical screening tool, imaging alone may miss or misclassify pathology due to postmortem artefacts and a lack of validated interpretive criteria. A combined imaging-histology approach validates the limited tissue available from eye-bank programs and maximises research value.
Microstructural and neural impairment of the ocular surface induced by HER2-targeted ADCs: a prospective longitudinal study with ultrastructural insights.
Yang L, Cui M, Huang S … +5 more , Li X, Li F, Shang Z, Zhao S, Yang R
Br J Ophthalmol · 2026 Jun · PMID 42331364 · Publisher ↗
AIMS: To characterise the clinical and morphological features of ocular surface toxicity induced by human epidermal growth factor receptor 2 (HER2)-targeted antibody-drug conjugates (ADCs) in patients with HER2-positive...
AIMS: To characterise the clinical and morphological features of ocular surface toxicity induced by human epidermal growth factor receptor 2 (HER2)-targeted antibody-drug conjugates (ADCs) in patients with HER2-positive breast cancer, guiding clinical intervention. METHODS: 21 HER2-positive breast cancer patients receiving HER2-ADC therapy were enrolled. Assessments included best corrected visual acuity, the Ocular Surface Disease Index, conjunctival lissamine green staining, tear break-up time, tear meniscus height, Meibomian Gland Score, Strip Meniscometry Tube (SMTube strips), corneal sensitivity (Cochet-Bonnet esthesiometry), anterior segment optical coherence tomography and in vivo confocal microscopy (IVCM) to evaluate morphology, corneal nerve fibre density and length, and endothelial cell density. Transmission electron microscopy (TEM) was performed in selected cases. All parameters were compared from baseline to follow-up. RESULTS: Ocular surface toxicity occurred in 85.7% (18/21) of patients after HER2-ADC therapy, with a mean onset at 28.0±8.4 days. Vortex-like keratopathy progressed from inferior subepithelial microcysts to linear deposits and a vortex pattern. IVCM revealed severe subepithelial nerve fibre fragmentation and loss. TEM revealed epithelial extracellular matrix fibrosis, mitochondrial damage (swelling, disordered cristae, vacuolisation), nuclear alterations (chromatin dispersion, electron-dense deposits) and suspected endocytic vesicles. Lesions appeared dose- and time-dependent and showed partial reversibility. After 12 cycles, corneal structure and transparency showed restoration trends. CONCLUSION: HER2-ADC-induced ocular surface toxicity presents as vision loss, dry eye and selective damage to corneal epithelium (vortex-like keratopathy) and nerves (nerve fibre loss and reduced sensitivity), which is dose- and time-dependent and partially reversible.
Clinical experience with gene therapy for autosomal recessive RPE65-related retinal dystrophy in the Arabian Gulf.
Khan Z, Ghazi NG, Hay S … +1 more , Khan AO
Ophthalmol Retina · 2026 Jun · PMID 42331100 · Publisher ↗
PURPOSE: To report a single-center experience of subretinal voretigene neparvovec-rzyl (VN) gene therapy for Arabian Gulf patients with autosomal recessive RPE65-related inherited retinal dystrophy. DESIGN: Retrospective...
PURPOSE: To report a single-center experience of subretinal voretigene neparvovec-rzyl (VN) gene therapy for Arabian Gulf patients with autosomal recessive RPE65-related inherited retinal dystrophy. DESIGN: Retrospective case series. PARTICIPANTS: Nine patients (6 families; 3 males) with RPE65-related retinal dystrophy who underwent VN gene therapy (pars plana vitrectomy and subretinal injection) at Cleveland Clinic Abu Dhabi between 2020-2024. TESTING: Pre and post operative best corrected visual acuity (BCVA), ophthalmic examination, full-field stimulus threshold (FST), and multimodal retinal imaging (photography, optical coherence tomography, short-wave autofluorescence). MAIN OUTCOME MEASURES: BCVA, clinical findings, FST, multimodal imaging. RESULTS: Eight patients were Emirati and one was Bahraini. All were treated bilaterally. Age at first eye treatment ranged from 11 to 56 years (mean 24.2) and second eye treatment was 7-11 days later. No intraoperative surgical complications occurred. Follow up after treatment ranged from 13 to 71 months (mean 38.8 months). Postoperative systemic steroid withdrawal-related effects and transient intraocular pressure elevation were observed in one patient each. Two patients developed lens opacities that were not visually significant. All eyes of all patients developed postoperative CRA. At last follow-up, BCVA improved in five patients (55.6%), remained stable in two (22.2%), and reduced in two (22.2%) who had progressive central CRA. FST improved in all but the two oldest at treatment (41 and 56 years old), who showed some decline. CONCLUSIONS: VN treatment improved scotopic vision (FST) in all patients treated before 40 years old and often improved BCVA. Postoperative CRA was universal; ethnicity and sunny climate may have been contributing factors. The possibility of postoperative BCVA loss related to central CRA is an important preoperative counseling point, particularly when preoperative BCVA is functionally useful.
Impact of Wearing a Face Mask on the Reliability of Standard Automated Perimetry in Glaucoma Patients and Suspects: a Retrospective Longitudinal Study.
Keye P, Martin J, Evers C … +3 more , Böhringer D, Reinhard T, Luebke J
Klin Monbl Augenheilkd · 2026 Jun · PMID 42331014 · Publisher ↗
ABSTRACT: PURPOSE: To assess the reliability of standard automated perimetry in a real-life cohort of glaucoma patients and suspects wearing face masks due to the COVID-19 pandemic in a large German eye hospital. ABSTRAC...
ABSTRACT: PURPOSE: To assess the reliability of standard automated perimetry in a real-life cohort of glaucoma patients and suspects wearing face masks due to the COVID-19 pandemic in a large German eye hospital. ABSTRACT: METHODS: Data of 160 eyes of 83 glaucoma patients and suspects who received at least one visual field examination and optical coherence tomography for glaucoma monitoring in 2018, 2019 and 2020 were included. Mean visual field defect and the rates of false-positive and false-negative responses between tests without (2019) and tests with a face mask (2020) were compared. Mean retinal nerve fibre layer thickness and the minimum rim width of Bruch's membrane opening served as a control for glaucoma progression. ABSTRACT: RESULTS: No statistically significant difference between visual fields without a face mask, and examinations with a face mask could be detected for mean defect (p = 0.075), rate of false-positives (p = 0.7) and rate of false-negatives (p = 0.16). ABSTRACT: CONCLUSION: Our data suggest that protective face mask wear does not impair the quality and reliability of standard automated perimetry in a real-life cohort of glaucoma patients and glaucoma suspects.
Insights into the clinical presentation, imaging, and management of infiltrative keratitis following accelerated corneal collagen cross-linking.
Bari A, Sushma N, Agarwal T … +4 more , Shakkarwal C, Maharana PK, Dada T, Sharma N
Indian J Ophthalmol · 2026 Jun · PMID 42330205 · Publisher ↗
PURPOSE: To analyze the risk factors, clinical features, visual outcomes, and in-vivo imaging characteristics in cases of keratoconus developing keratitis following accelerated collagen cross-linking (CXL). METHODS: A re...
PURPOSE: To analyze the risk factors, clinical features, visual outcomes, and in-vivo imaging characteristics in cases of keratoconus developing keratitis following accelerated collagen cross-linking (CXL). METHODS: A retrospective observational case series at a tertiary eye center in India evaluating eyes that underwent accelerated CXL from January 2021 to July 2024. RESULTS: Of 723 eyes undergoing CXL, 14 eyes developed infiltrative keratitis (1.93%). The majority belonged to the upper middle socioeconomic class and presented in summer and rainy seasons. The relative risk of developing infiltrates in cases ≤16 years was 2.38, and in cases with history of vernal keratoconjunctivitis, it was 0.7. The median area of epithelial defect was 12 mm 2 , and the average resolution time was 18.4 ± 12.9 days. The most common organism that was isolated was coagulase-negative Staphylococcus. The majority of the cases on anterior segment optical coherence tomography showed involvement anterior to the demarcation line. Scheimpflug imaging showed three keratometric patterns: flattening and thinning, flattening and thinning with transient steepening, and minimal to no change. CONCLUSION: Infiltrative keratitis following accelerated CXL is a rare clinical entity. Early presentation and timely management including use of topical steroids are associated with good visual outcomes.
Mid-Phase Hyperfluorescent Plaques as a biomarker of disease activity in Central Serous Chorioretinopathy: Clinical Course and Treatment Response - MICRoN report number Ten.
Gregori G, Sahoo NK, Hasan N … +7 more , Lupidi M, Saju S, Zhou A, Wykoff CC, Wu L, Chhablani J, Macula Society International CSCR Research Network (MICRoN)
Retina · 2026 Jun · PMID 42328888 · Publisher ↗
PURPOSE: To investigate the association between mid-phase hyperfluorescent plaques (MPHP) with subretinal fluid (SRF) dynamics in central serous chorioretinopathy (CSCR) and to assess response across different therapeuti...
PURPOSE: To investigate the association between mid-phase hyperfluorescent plaques (MPHP) with subretinal fluid (SRF) dynamics in central serous chorioretinopathy (CSCR) and to assess response across different therapeutic modalities using a validated quantitative approach. METHODS: This was a retrospective, multicenter study in patients with CSCR. All patients underwent baseline and follow-up indocyanine green angiography (ICG-A) and enhanced depth imaging optical coherence tomography (EDI-OCT). MPHP were measured on mid-phase ICG-A images, and changes in MPHP number and area were correlated with various imaging parameters. Response of MPHP to different treatment modalities were also evaluated. RESULTS: The study included 96 eyes of 60 patients, 50 males (83.33%) and 10 females (16.67%) with CSCR. Over a median follow-up of 31 months, significant reductions were observed in central macular thickness (p = 0.003), SRF height (p = 0.02), SFCT (p = 0.001), and MPHP area (p = 0.02), while MPHP number and BRVA remained stable. PDT and laser induced greater SRF reduction (-125.0 ± 143.2 µm and -123.8 ± 139.5 µm) and MPHP area decrease (-4.14 ± 6.13 mm2 and -1.75 ± 2.98 mm2, respectively) compared with eplerenone and observation (p < 0.01). Multivariable analysis confirmed PDT as the strongest independent predictor of MPHP area regression (p ≤ 0.001), while baseline SRF height and symptom duration predicted final SRF height (p ≤ 0.02). CONCLUSION: MPHP represent a frequent and dynamic angiographic feature in CSCR, closely associated with disease activity. PDT significantly reduced MPHP area and promoted SRF resolution, supporting its role as an effective treatment.
Cancer-Associated Retinopathy Worsening After Tumor Resection: Case Report and Review of the Literature.
Warne MM, Bhatnagar P, Habib MM
Retin Cases Brief Rep · 2026 Jun · PMID 42328857 · Publisher ↗
PURPOSE: To report an unusual presentation of cancer associated retinopathy and review the current literature for diagnostic consensus and recommended management. METHODS: A single case report of a patient with cancer as...
PURPOSE: To report an unusual presentation of cancer associated retinopathy and review the current literature for diagnostic consensus and recommended management. METHODS: A single case report of a patient with cancer associated retinopathy that presented as bilateral severe anterior and intermediate uveitis that initially improved with high-dose steroids and IVIG. The patient was assessed via serum laboratory testing, optical coherence tomography, fundus auto-fluorescence, magnetic resonance imaging, lumbar puncture, computed tomography, and Humphrey visual field testing. A targeted literature review was conducted to evaluate visual outcomes in cancer-associated retinopathy (CAR) following tumor-directed therapy by searching Google Scholar from 2022 through April 2026. Studies reporting visual outcomes after tumor resection were included. RESULTS: The patient initially greatly improved after initiation of IV methylprednisolone and IVIG and was stable for four months, but after the patient stopped IVIG due to insurance issues and was tapered off steroids, her vision acutely worsened after undergoing extensive resection of her pelvic mass. CONCLUSION: Though tumor resection is paramount to patient survival, it may negatively impact the course of cancer-associated retinopathy, particularly in the setting of withdrawal of immunosuppressive therapy. A review of the literature demonstrates heterogeneous visual outcomes following tumor removal, emphasizing the need for careful perioperative management.
Spontaneous Branch Retinal Artery Occlusion Secondary to Aneurysmal Fibrosis in an Adult with Coats Disease: A Case Report.
Ahmad NS, Barak A, Nudleman E … +1 more , Zur D
Retin Cases Brief Rep · 2026 Jun · PMID 42328839 · Publisher ↗
PURPOSE: To describe a case of branch retinal artery occlusion (BRAO) in an adult with Coats disease, documented using ultra-widefield fluorescein angiography (UW-FA). METHODS: Observational case report with longitudinal...
PURPOSE: To describe a case of branch retinal artery occlusion (BRAO) in an adult with Coats disease, documented using ultra-widefield fluorescein angiography (UW-FA). METHODS: Observational case report with longitudinal evaluation using optical coherence tomography (OCT) and ultra-widefield fluorescein angiography. RESULTS: A 21-year-old male with a childhood diagnosis of Coats disease presented with recalcitrant macular edema and best-corrected visual acuity (BCVA) of 6/40 in the right eye. Baseline UW-FA demonstrated multiple microaneurysms and a patent, tortuous temporal arteriole with focal aneurysmal distention. At a 10-month follow-up, the patient's BCVA remained entirely unchanged. However, repeated UW-FA revealed a new extensive area of retinal nonperfusion extending from the temporal macula to the periphery. Comparison with baseline imaging identified that the previously patent arteriole had become completely occluded at the site of the proximal aneurysm. The absence of prior laser application at this specific site confirms that the subsequent fibrotic closure and arterial occlusion were entirely spontaneous. CONCLUSION: Sudden arterial occlusion may occur in adult Coats disease due to spontaneous aneurysmal fibrosis. This highlights a vascular remodeling pathway distinct from classic exudative progression. Ultra-widefield imaging may aid in detecting and monitoring these ischemic changes.
Spontaneous Closure of a Macular Hole Secondary to Paracentral Acute Middle Maculopathy After Vitrectomy for Retinal Detachment.
Hepokur M, Arslan N
Retin Cases Brief Rep · 2026 Jun · PMID 42328835 · Publisher ↗
PURPOSE: To report a case of spontaneous closure of a macular hole secondary to paracentral acute middle maculopathy (PAMM) following vitrectomy for retinal detachment. METHODS: Case report. RESULTS: A 67-year-old female...
PURPOSE: To report a case of spontaneous closure of a macular hole secondary to paracentral acute middle maculopathy (PAMM) following vitrectomy for retinal detachment. METHODS: Case report. RESULTS: A 67-year-old female patient with a history of rheumatoid arthritis, hypertension, and peripheral vascular occlusive disease underwent pars plana vitrectomy for retinal detachment. Following surgery, a parafoveal grayish lesion was observed on color fundus photography, and optical coherence tomography revealed a band-like hyperreflective lesion in the inner nuclear layer. A macular hole secondary to PAMM also developed in the patient and was closed spontaneously. CONCLUSION: This report describes spontaneous closure of a macular hole secondary to PAMM following vitrectomy for retinal detachment. The possibility of this complication should be considered, especially in patients presenting with systemic risk factors.
Case Report: Perifoveal exudative vascular anomalous complex with secondary fundus hemorrhage.
Liu Z, Zhang X, Du X … +5 more , Niu C, Sha F, Wen B, Gao Y, Wen Y
Front Med (Lausanne) · 2026 · PMID 42328590 · Full text
BACKGROUND: Perifoveal exudative vascular anomalous complex (PEVAC) is a rare macular disorder characterized by isolated, circular aneurysmal lesions surrounding the fovea centralis, typically occurring in otherwise heal...
BACKGROUND: Perifoveal exudative vascular anomalous complex (PEVAC) is a rare macular disorder characterized by isolated, circular aneurysmal lesions surrounding the fovea centralis, typically occurring in otherwise healthy patients without retinal inflammation or vascular abnormalities. This study aimed to highlight a rare case of PEVAC with secondary fundus hemorrhage. CASE PRESENTATION: This study reports the case of a 44-year-old Chinese woman with PEVAC complicated by secondary fundus hemorrhage. The PEVAC diagnosis was confirmed through fundus fluorescein angiography, indocyanine green angiography, optical coherence tomography, and optical coherence tomography angiography. After intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment, the patient experienced marked improvement in visual acuity, reaching 20/20. CONCLUSION: The case presented in this study underscores that PEVAC may lead to the rupture and hemorrhage of secondary lesions. Gradual improvement in the patient's vision was achieved through intravitreal anti-VEGF injections. This study found that the menstrual cycle in women may influence disease progression. However, the relationship between the menstrual cycle and disease progression remains unclear.
Real-World Functional and Anatomical Outcomes of Intravitreal Faricimab in Suboptimal Responders With Neovascular Age-Related Macular Degeneration: A 24-Month Clinical Audit.
Sukumaran D, Benjamin D, Abdul Karim MN … +6 more , Amankwah R, Maharajan P, Mubashar M, Sarmad A, Sharma P, Dhar-Munshi S
Cureus · 2026 Jun · PMID 42328256 · Full text
INTRODUCTION: Neovascular age-related macular degeneration (nAMD) is a chronic sight-threatening disease requiring repeated intravitreal antivascular endothelial growth factor (anti-VEGF) injections. Although established...
INTRODUCTION: Neovascular age-related macular degeneration (nAMD) is a chronic sight-threatening disease requiring repeated intravitreal antivascular endothelial growth factor (anti-VEGF) injections. Although established anti-VEGF agents have transformed the prognosis of nAMD, a proportion of patients demonstrate persistent exudation, limited durability, or inability to extend beyond short treatment intervals. Faricimab is a bispecific intravitreal antibody targeting both vascular endothelial growth factor A and angiopoietin-2, designed to improve vascular stability, reduce exudation, and increase treatment durability. This clinical audit evaluates 24-month real-world outcomes following switching to faricimab in suboptimal responders with nAMD in an NHS medical retina service. METHODS: A retrospective clinical audit was conducted of 274 eyes with nAMD switched to faricimab at Sherwood Forest Hospitals NHS Foundation Trust between January 2023 and January 2025. All eyes had previously received at least one anti-VEGF agent and were switched because of persistent disease activity, inadequate anatomical response, or high treatment burden. Data were extracted from the Medisight electronic patient record and cross-checked against pharmacy records. Primary outcomes were best corrected visual acuity (BCVA) in Early Treatment Diabetic Retinopathy Study letters and central macular thickness (CMT) on optical coherence tomography. Secondary outcomes included injection interval extension, number of injections, and safety events. RESULTS: Baseline mean BCVA was 58.1 letters. Mean BCVA improved to 59.7 letters at less than six months, representing a gain of +1.6 letters. At 12 months, mean BCVA was 56.9 letters, a change of -1.2 letters from baseline. At 24 months, mean BCVA was 54.4 letters, a change of -3.7 letters from baseline. Anatomical response was more consistent, with mean CMT reductions of -29.1 µm at less than six months, -34.7 µm at 12 months, and -45.7 µm at 24 months. The mean injection interval increased from 7.88 weeks before switching to 10.67 weeks after switching, representing an extension of +2.79 weeks. No cases of intraocular inflammation, retinal vasculitis, or endophthalmitis were recorded. CONCLUSION: In this real-world NHS audit, faricimab achieved meaningful anatomical improvement and reduced treatment burden in treatment-experienced nAMD eyes switched because of suboptimal response or limited durability on previous anti-VEGF therapy. Visual acuity improved modestly during early follow-up but declined slightly over 24 months, despite progressive anatomical drying. This functional-anatomical dissociation likely reflects the chronicity of disease and irreversible macular damage in a switch population. Faricimab appears to be a safe and effective second-line option for reducing exudation and extending treatment intervals, although expectations regarding long-term visual gain should be realistic.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe