搜索结果：International ophthalmology

To compare canaloplasty and trabecular micro-bypass surgery outcomes in primary open-angle glaucoma (POAG). Ambispective study using data from the International Glaucoma Surgery Registry (IGSR) to evaluate mild-to-moderate POAG patients who underwent iTrack ab-interno canaloplasty (Nova Eye Medical, USA) (prospective cohort) or iStent trabecular micro-bypass implantation (Glaukos, USA) (retrospective cohort), with or without concomitant phacoemulsification, and &#x2265;12 months of follow-up. Primary outcomes were intraocular pressure (IOP), medication usage, and surgical success as defined by the American Academy of Ophthalmology (2024). The study included 339 eyes (iStent: n&#x2009;=&#x2009;115; iTrack: n&#x2009;=&#x2009;224) of which &#x2265;94% underwent concomitant phacoemulsification (iStent: n&#x2009;=&#x2009;109, iTrack: n&#x2009;=&#x2009;210). There were nonsignificant differences in baseline IOP (p&#x2009;=&#x2009;0.417) and medications (p&#x2009;=&#x2009;0.741) between groups. At last follow-up, mean IOP (mmHg) and medication usage decreased from 17.3&#x2009;&#xb1;&#x2009;4.2 and 2.0&#x2009;&#xb1;&#x2009;1.1 at baseline to 14.2&#x2009;&#xb1;&#x2009;3.5 and 1.3&#x2009;&#xb1;&#x2009;1.1 in the iStent group (p&#x2009;<&#x2009;0.001; mean follow-up: 27.2&#x2009;&#xb1;&#x2009;14.5 months), and from 16.9&#x2009;&#xb1;&#x2009;5.0 and 2.0&#x2009;&#xb1;&#x2009;1.1 at baseline to 14.3&#x2009;&#xb1;&#x2009;3.4 and 1.1&#x2009;&#xb1;&#x2009;1.3 in the iTrack group (p&#x2009;<&#x2009;0.001; mean follow-up: 20.3&#x2009;&#xb1;&#x2009;7.7 months). Both groups showed no significant differences in reduction of IOP (p&#x2009;=&#x2009;0.422) and medications (p&#x2009;=&#x2009;0.211). More eyes were medication-free in the iTrack group (42% vs 29%; p&#x2009;=&#x2009;0.029). Success was achieved in 61% of eyes in both groups (p&#x2009;=&#x2009;1.000). Postoperatively, both groups demonstrated infrequent and self-limited complications, no sight-threatening events, and low reoperation rates. In POAG, iTrack canaloplasty and iStent implantation showed no statistically significant differences in effectiveness outcomes. Both procedures had favourable safety profiles with limited additional glaucoma surgeries. More canaloplasty eyes were medication-free compared to stent eyes.

The relationship between epilepsy and neurodegeneration has recently been a subject of debate, particularly regarding whether neurodegeneration is a cause or a consequence of epilepsy. Given that the retina is an extension of the brain and closely connected to it, retinal layer thickness can serve as a biological marker of neurodegeneration. The aim of this work was to measure retinal nerve fiber layer (RNFL) thickness in patients with epilepsy in comparison to healthy controls, and to study the impact of epilepsy duration and seizure frequency on RNFL thickness in those patients. This case-control study was conducted on 53 patients matched clinical definition of epilepsy established by the International League Against Epilepsy (ILAE) 2017, and 50 healthy controls. Cognitive assessment using Montreal cognitive assessment scale (MOCA), and measurement of RNFL thickness using Spectral domain Optical Coherence Tomography (SD-OCT), were done to all included patients and controls. The peripapillary RNFL thickness (superior, inferior & average) were all significantly reduced in both eyes in epileptic patients compared to healthy controls (P-value <0.05). There was a statistically significant difference between epileptic patients and controls regarding MOCA score. There was no statistically significant impact of seizure control, history of status epilepticus, anti-epileptic drugs, seizure frequency, or disease duration on RNFL thickness. There was a statistically significant reduction of the retinal nerve fiber layer thickness in epileptic patients in comparison to healthy controls. Epileptic patients had significant impairment in cognitive functions in comparison to healthy controls.

To characterize the clinical, demographic, and imaging features of glaucoma among adults receiving care at Kingston Public Hospital (KPH) Ophthalmology clinic, Jamaica's largest public eye care facility. We conducted a retrospective, cross-sectional chart review of adult glaucoma patients seen at the KPH Ophthalmology Clinic between January 2018 and March 2023. Included patients had documentation of at least two comprehensive ophthalmic examinations and one high-quality optical coherence tomography (OCT) scan (signal strength&#x2009;&#x2265;&#x2009;6). Extracted data included demographics, intraocular pressure (IOP), visual acuity, OCT-derived optic nerve head and retinal nerve fiber layer (RNFL) parameters, visual field (VF) metrics, glaucoma severity, comorbidities, and self-reported treatment adherence. Comparisons were performed by age group (<&#x2009;40 vs.&#x2009;&#x2265;&#x2009;40&#xa0;years) and sex. A total of 324 patients (619 eyes) were included (mean age 58.3&#x2009;&#xb1;&#x2009;12.3&#xa0;years; 66.0% female). At presentation, 51.0% had advanced-stage glaucoma, and only 17.3% reported consistent medication use. Hypertension and diabetes were common comorbidities (80.3% and 38.8%, respectively). Mean Goldmann IOP was 22.0&#xa0;mmHg, mean RNFL thickness was 75.2&#x2009;&#xb1;&#x2009;14.9&#xa0;&#x3bc;m, and mean cup-to-disc ratio was 0.73&#x2009;&#xb1;&#x2009;0.10. VF indices demonstrated moderate functional loss, with worse mean deviation among men. Longitudinal VF data were limited; only 17% of patients had more than one documented test, limiting cohort-wide assessment of functional progression. This clinic-based characterization of glaucoma in Jamaica reveals a high burden of advanced disease at presentation, low treatment adherence, and gaps in longitudinal monitoring, supporting the need for prospective studies to develop ancestry-and region-specific OCT reference data and improve equitable glaucoma care.

The study aimed to evaluate international practice patterns among oculofacial plastic surgeons regarding postoperative patching, given evolving evidence and uncertainties surrounding benefits and risks. A web-based survey was distributed to members of nine oculoplastic societies worldwide. The survey included thirty-eight questions about postoperative patching practices for oculofacial procedures. Descriptive statistics, chi-squared tests and logistic regression analyses were performed to assess practice patterns and identify demographic factors associated with patching decisions. A total of 519 surgeons completed the survey. Patching practices varied substantially by procedure: 29.1% routinely patched after eyelid surgery, 51.1% after orbital surgery, 23.9% after lacrimal surgery, and 80.3% after skin graft surgery. Logistic regression showed that surgeons practicing outside the United States were more likely to patch for eyelid (Odds Ratio (OR)&#x2009;=&#x2009;5.00, p&#x2009;<&#x2009;0.001), orbital (OR&#x2009;=&#x2009;2.94, p&#x2009;<&#x2009;0.001), and lacrimal (OR&#x2009;=&#x2009;1.96, p&#x2009;=&#x2009;0.02) surgeries. Surgeons aged&#x2009;&#x2265;&#x2009;40&#x2009;years were less likely to patch in eyelid (OR&#x2009;=&#x2009;0.64, p&#x2009;=&#x2009;0.04) and lacrimal (OR&#x2009;=&#x2009;0.51, p&#x2009;=&#x2009;0.002) surgeries. Postoperative patching practices among oculofacial plastic surgeons show significant variation, influenced by geographic location, surgeon age, and procedure focus. These findings highlight the need for further research to evaluate the impact of these practices on surgical outcomes and to develop consensus guidelines that optimize patient care.

Eyelid trauma often necessitates surgical intervention, yet remains understudied, with postoperative complications poorly described. This study aims to identify factors associated with complications following surgical treatment of traumatic eyelid injuries. A retrospective non-concurrent cohort study was conducted to analyze complications in patients undergoing surgical repair of eyelid injuries at two ophthalmology centers in Cali, Colombia, from January 2017 to December 2021. Factors associated with postoperative complications were identified using multivariable logistic regression clustered by care site. A total of 365 patients underwent surgical intervention for eyelid traumas; with a mean age of 31&#xb1;18 years. Most cases were covered by public insurance (58.1%) or employer-sponsored insurance (12.1%). Unintentional injuries comprised 60.6%; while intentional injuries accounted for 37%, primarily due to interpersonal violence (36.7%). The postoperative complication rate was 11%, including impaired healing (3.29%), tearing (3.29%), surgical site infection (2.74%), stent extrusion (1.10%), lagophthalmos (0.55%), and eyelid malposition (0.82%). Multivariable analysis showed that female sex (Odds ratio [OR]=3.00, 95% Confidence Interval [95%CI]=2.93-3.06), presence of fractures (OR=2.01, 95%CI=1.5-2.7), anterior segment damage (OR=2.29, 95%CI=1.83-2.86), and greater tissue loss (25-49%: OR=2.55, 95%CI=2.17-2.99; &#x2265;50%: OR=1.41, 95%CI=1.09-1.81) were associated withhigher odds of postoperative complications. Postoperative complication were associated with palpebral tissue loss, involvement of both upper and lower eyelid, orbital fractures, and anterior segment injuries. Future studies should use prospective designs with standardize follow-up after reconstruction.

To compare the incidence and timing of postoperative complications between laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) within a national clinical registry. Retrospective registry-based clinical cohort study. 48,892 eyes of 27,372 patients who underwent refractive surgery in the IRIS&#xae; Registry (Intelligent Research in Sight). LASIK and PRK procedures were identified using Healthcare Common Procedure Coding System codes. Postoperative complications, including dry eye disease (DED), visual disturbances, and ocular pain, were identified using International Classification of Diseases codes and analyzed at the eye level. Incidence was evaluated across three postoperative intervals (1 day to 1 month, 1 to 3 months, and 3 to 12 months). Interval-specific incidence rates and incidence rate ratios (IRRs) comparing LASIK and PRK were estimated using multivariable-adjusted Poisson generalized estimating equations. Interval-specific incidence of postoperative complications and comparative IRRs between LASIK and PRK. DED was the most frequently documented postoperative complication, occurring in 16.1% of LASIK eyes and 15.6% of PRK eyes over the follow-up period. During the 1 to 3 months interval, LASIK was associated with a lower incidence of DED compared with PRK (IRR, 0.8 [95% confidence interval (CI), 0.7-0.9]). In the first postoperative month, visual disturbances occurred more frequently after PRK (IRR, 0.3 [95% CI, 0.3-0.4]), but differences between procedures were not significant at later intervals. Ocular pain was rare after both procedures, with no consistent differences in early intervals, but showed a lower incidence after LASIK in the 3 to 12 months interval (IRR, 0.5 [95% CI, 0.3-0.9]). Postoperative complication profiles following refractive surgery varied by procedure and postoperative interval. PRK was associated with a higher risk of visual disturbances in the early postoperative period and a higher incidence of DED during the 1 to 3 months interval compared with LASIK. Ocular pain was rare overall but showed a lower incidence after LASIK in the 3 to 12 months interval, whereas most other complication rates were comparable between procedures. Recognition of these temporal patterns may help guide patient counseling, optimize postoperative follow-up strategies, and guide postoperative management during different phases of corneal recovery after refractive surgery.

The real-world performance of the 2022 international consensus criteria for optic neuritis (ICON) in antibody-predominant Chinese practice is uncertain. We evaluated diagnostic yield and an antibody-stratified adjunct for settings with high antibody prevalence and timely antibody testing. We retrospectively studied 151 consecutive patients admitted with acute optic neuritis between 2020 and 2023. All cases were reclassified using strict 2022 ICON. We then evaluated an assumed-dyschromatopsia scenario in which dyschromatopsia was assumed unless normal color vision was explicitly documented. On top of that scenario, we applied an antibody-stratified adjunct using aquaporin-4 immunoglobulin G (AQP4-IgG) seropositivity or clear-positive myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG; fixed cell-based assay titer &#x2265;1:100) plus objective optic nerve evidence. Strict 2022 ICON classified 30/151 (20%) cases as Definite ON, 113/151 (75%) as Possible ON, and 8/151 (5%) as Not ON. Under the assumed-dyschromatopsia scenario, Definite ON increased to 112/151 (74%). With the antibody-stratified adjunct, Definite ON further increased to 124/151 (82%), while Not ON remained 8/151 (5%). Definite ON reached 82/82 (100%) in AQP4-IgG-positive cases, 20/21 (95%) in MOG-IgG-positive cases, 18/37 (49%) in double-seronegative cases, and 4/11 (36%) in cases with incomplete AQP4-IgG/MOG-IgG testing. In this antibody-predominant clinical sample, strict 2022 ICON yielded a low Definite ON classification rate, driven largely by incomplete bedside documentation, especially color vision assessment. Assuming complete dyschromatopsia documentation improved yield, and the antibody-stratified adjunct provided further gains without increasing the Not ON category.

Visual problems are a common reason for ophthalmic evaluation in children and encompass a wide spectrum of functional visual disturbances and visual impairment. Understanding the patterns of pediatric visual disorders across different clinical care settings is important for service planning and resource allocation, particularly in tertiary referral hospitals. This retrospective descriptive study included pediatric patients aged <18 years who presented to a tertiary hospital with clinically assessed visual problems from January 1, 2015, to December 31, 2024. Patients were identified from outpatient (OPD) and inpatient (IPD) services using International Classification of Diseases, Tenth Revision (ICD-10) codes for visual disturbances (H53) and visual impairment or blindness (H54). Demographic data, laterality, clinical diagnoses, refractive status, and management indicators were collected. The distribution of visual disorders was compared between OPD and IPD settings. An exploratory multivariable logistic regression analysis was performed to identify clinical factors associated with inpatient admission. A total of 321 pediatric patients were included, comprising 196 OPD and 125 IPD cases. Amblyopia and refractive-related conditions were the most common diagnoses in OPD, whereas cataract predominated in IPD. Surgical intervention was required significantly more frequently among IPD patients than OPD patients. Refractive error was common in both settings, but occurred more frequently in IPD. ICD-10-based analysis showed that visual disturbance codes (H53) were more prevalent in OPD, while visual impairment codes (H54) were more common in IPD. In multivariable analysis, cataract and bilateral involvement were independently associated with inpatient admission. Pediatric visual disorders presenting to a tertiary hospital demonstrate distinct patterns between outpatient and inpatient settings. Outpatient encounters are dominated by amblyopia and refractive-related conditions, whereas inpatient admissions are largely driven by cataract and conditions requiring surgical management. These findings highlight the importance of differentiated service strategies to optimize the delivery of pediatric eye care and resource utilization. Children are often brought to eye clinics because of concerns about their vision. These problems can range from mild conditions, such as needing glasses, to more serious diseases that require hospital admission or surgery. Understanding the types of visual problems children present with, and how they differ between outpatient and inpatient care, can help improve planning and delivery of pediatric eye services. In this study, we reviewed medical records of children under 18 years of age who were evaluated for visual problems at a tertiary hospital between 2015 and 2024. We compared children seen in outpatient clinics with those who required hospital admission. Standardized diagnostic codes were used to classify clinically assessed visual conditions, and information on diagnoses, vision, and treatment was collected. We found clear differences between outpatient and inpatient cases. Children seen in outpatient clinics most commonly had amblyopia (reduced vision in one or both eyes) or refractive errors such as short-sightedness or astigmatism. In contrast, children admitted to hospital were more likely to have cataracts and other conditions requiring surgery. Surgery was needed much more frequently in hospitalized patients, and visual problems affecting both eyes were also more common. Overall, outpatient and inpatient services manage different types of pediatric visual disorders. Outpatient care mainly focuses on common and treatable conditions, while inpatient care is required for more severe diseases needing surgical management. Recognizing these differences can help improve resource allocation and optimize pediatric eye care in tertiary hospitals.

To screen for differentially expressed genes in retinoblastoma (RB) gene chips using GEO2R and validate them clinically. The expression profile chip data (GSE110811) was downloaded from the public gene chip database Gene Expression Omnibus (GEO). The GEO2R chip analysis platform was used to identify differentially expressed genes between RB and adjacent normal tissues. According to the International Intraocular Retinoblastoma Classification (IIRC) system, 35 children diagnosed with RB from our hospital and other hospitals were enrolled as the RB group, and 35 healthy children who underwent physical examinations in our hospital were enrolled as the control group. The relative expression levels of Sprouty RTK signaling antagonist 2 (SPRY2) and estrogen-related receptor beta (ESRRB) in the serum of patients were detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR). The diagnostic value of SPRY2 and ESRRB in RB was evaluated by receiver operating characteristic (ROC) curves. Analysis of the relationship between SPRY2/ESRRB expression and clinicopathological features, as well as its correlation with the tumor marker CA199. In the GSE110811 chip, the expression levels of two genes, 16780069 (SPRY2) and 16786783 (ESRRB), showed the most significant differences between RB and normal tissues. The relative expression levels of SPRY2 and ESRRB in the serum of children in RB group (22 males, age 1.64&#xb1;1.08y) were significantly lower (P<0.05) than those in control group (25 males, age 1.54&#xb1;0.95y). The area under the ROC curve for SPRY2 was 0.735 (95%CI: 0.616-0.854), while that for ESRRB was 0.880 (95%CI: 0.800-0.960). There were statistically significant differences in the expression of SPRY2 and ESRRB with respect to choroidal invasion, optic nerve invasion, differentiation degree, and clinical staging (P<0.05). In RB group, the expression levels of SPRY2 and ESRRB decreased gradually with increasing CA199 levels, showing a negative correlation (r SPRY2=-0.593, r ESRRB=-0.423; both P<0.05). The expression of SPRY2 and ESRRB is closely related to the occurrence and development of RB and negatively correlated with the tumor marker CA199. They have the potential to serve as diagnostic biomarkers for RB.

Circadian rhythms affect cardiovascular function, and the timing and severity of stroke and myocardial infarction (commonly known as a heart attack). Afternoon cardiac surgery may improve outcomes by reducing ischaemia-reperfusion injury (i.e. reducing tissue damage caused when blood supply returns to tissue (reperfusion) after a period of oxygen deprivation (ischaemia)). However, the evidence is conflicting. This systematic review assessed the impact of surgical timing on clinical outcomes after cardiac surgery. To assess the effects of early versus late surgical start times for on-pump cardiac surgery on mortality, cardiac outcomes, and quality of life. We searched CENTRAL, MEDLINE, Embase, and Web of Science Conference Proceedings Citation Index - Science, along with ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform trials registers. We also conducted reference checking, citation searching, and contacted study authors to identify studies for inclusion. The latest search date was 26 January 2025. We included randomised controlled trials (RCTs) in adults undergoing cardiac surgery comparing late with early surgical start times. We excluded non-randomised studies and studies in children. Our critical outcomes were short-term mortality (&#x2264; 30 days postoperative), long-term mortality (> 30 days postoperative), and perioperative myocardial infarction. Other important outcomes were perioperative myocardial injury, postoperative atrial fibrillation, left ventricular ejection fraction, lengths of intensive care unit (ICU) and hospital stays, and quality of life. We used the Cochrane Risk of Bias 2 tool to assess bias in the included RCTs. As only one study met the inclusion criteria, we did not perform meta-analysis. We synthesised results descriptively, and used GRADE to assess the certainty of the evidence for specified outcomes. We included one study with 88 participants. The included study was conducted in France, and reported on differences in outcomes between morning and afternoon on-pump elective aortic valve replacement in adults. Critical outcomes No study reported short-term or long-term mortality data for early versus late surgical start times for on-pump cardiac surgery. In the included study, there was no evidence of a difference regarding in-hospital mortality between groups, with no deaths in both groups (risk ratio (RR) and 95% confidence interval (CI) not estimable; 1 study, 88 participants). The evidence is very uncertain about the effect of early versus late surgery on perioperative myocardial infarction (RR 0.29, 95% CI 0.06 to 1.30; 1 study, 88 participants, very low-certainty evidence). Important outcomes There was evidence of lower perioperative myocardial injury as measured by cumulative troponin release over 72 hours in those undergoing late surgery compared to early surgery (MD -46 ng/L &#xd7; 72 h, 95% CI -79 to -13; 1 study, 88 participants). In the included study, there was no evidence of a difference in new-onset postoperative atrial fibrillation during hospital stay between groups (RR 0.75, 95% CI 0.40 to 1.40; 1 study, 88 participants). No study reported differences in left ventricular ejection fraction at discharge as a continuous variable for early versus late surgical start times for on-pump cardiac surgery. In the included study, there was no evidence of a difference in left ventricular ejection fraction < 45% at discharge between groups (RR 0.40, 95% CI 0.08 to 1.95; 1 study, 88 participants). No study reported differences in length of ICU admission for early versus late surgical start times for on-pump cardiac surgery. There was no evidence of a difference in need for inotropic support between groups in the included study (RR 0.25, 95% CI 0.03 to 2.15; 1 study, 88 participants). The evidence is very uncertain about the effect of late surgery on length of hospital stay (MD 0.00, 95% CI -1.48 to 1.48; 1 study, 88 participants, very low-certainty evidence). No study reported on the outcome of quality of life. The evidence is very uncertain about the effects of early versus late surgical start time for the outcomes of perioperative myocardial infarction and length of hospital stay. We found no data for the outcomes of short-term or long-term mortality, left ventricular ejection fraction, length of ICU stay, or quality of life. Late surgical start time could reduce the risk of perioperative myocardial injury as estimated by cumulative troponin release over 72 hours. More research is needed to determine whether scheduling heart surgery later in the day improves patient outcomes. This Cochrane review had no dedicated funding. Protocol (2022) DOI: 10.1002/14651858.CD014901.

To evaluate the success of surgical management for rhegmatogenous retinal detachment (RRD) secondary to acute retinal necrosis (ARN). PubMed, Embase, ClinicalTrials, the Cochrane Library, and grey literature (2000-present) were searched for case series, interventional, and cohort studies reporting surgical repair of ARN-related RRD. Interventions included pars plana vitrectomy (PPV), scleral buckle (SB), and tamponade agents. Outcomes were final anatomical reattachment, visual acuity (VA), complications, and re-detachment. Study quality was assessed using the Newcastle-Ottawa Scale. A single-arm random-effects meta-analysis with subgroup analysis by surgical technique was performed using R. Twenty-three studies including 770 eyes of 680 patients were analyzed. The pooled anatomical success rate was 88% (95% CI: 79-95%), highest with PPV&#x2009;+&#x2009;SB (91%, 95% CI: 45-100%), followed by PPV&#x2009;+&#x2009;silicone oil (83%, 95% CI: 59-99%). The pooled final VA was 1.36 logMAR (95% CI: 1.18-1.54). PPV&#x2009;+&#x2009;SB achieved the best visual outcomes (0.87 logMAR, 95% CI: 0.47-1.27), while PPV&#x2009;+&#x2009;gas tamponade had the poorest (1.75 logMAR, 95% CI: -0.73-4.23); surgical technique significantly affected final VA (p&#x2009;=&#x2009;0.028). Common complications included proliferative vitreoretinopathy (65%), optic atrophy (53%), retinal re-detachment (25%), and cataract (38%). Poorer preoperative VA was significantly associated with worse postoperative VA (p&#x2009;=&#x2009;0.026). Surgical repair of ARN-related RRD yields high anatomical success, but visual recovery remains limited and technique-dependent. Combined PPV&#x2009;+&#x2009;SB provides the most favorable structural and functional outcomes without increased complication risk, supporting its preferential use.

Diabetic patients require long-term polypharmacy, yet the causal effects of these medications on ocular complications-specifically diabetic retinopathy (DR), diabetic maculopathy (DMac), and glaucoma-remain unclear due to confounding in observational studies. We performed a Mendelian randomization (MR) study using GWAS summary statistics for 23 common medication classes and five diabetic eye diseases. Multivariable MR (MVMR) was employed to adjust for key comorbidities (e.g., hypertension, type 2 diabetes), while enrichment analyses explored biological mechanisms. In the univariable MR (UVMR) analysis, drugs used in diabetes, agents acting on the renin-angiotensin system, and several other medication classes showed significant associations with increased risks of diabetic eye diseases. Crucially, MVMR confirmed robust causal links after adjusting for key comorbidities. Specifically, drugs used in diabetes remained associated with DMac (OR&#x2009;=&#x2009;1.44, p = 1.31 &#xd7; 10-11), DR (OR&#x2009;=&#x2009;1.23, p = 1.26 &#xd7; 10-8), neovascular glaucoma (OR&#x2009;=&#x2009;1.19, p = 0.003), and senile cataract (OR&#x2009;=&#x2009;1.10, p = 9.25 &#xd7; 10-12) independent of type 2 diabetes liability. Similarly, thyroid preparations retained significance for DMac (OR&#x2009;=&#x2009;1.26, p = 4.35 &#xd7; 10-10), DR (OR&#x2009;=&#x2009;1.17, p = 9.53 &#xd7; 10-10), and senile cataract (OR&#x2009;=&#x2009;1.04, p = 0.004) after adjusting for hypothyroidism. Additionally, adrenergic inhalants were independently linked to senile cataract (OR&#x2009;=&#x2009;1.07, p = 0.008) after adjusting for asthma. Pathway analysis highlighted hormone transport and MAPK signaling as potential mechanisms. Our findings provide genetic evidence supporting potential comorbidity-independent causal links between specific systemic medications-particularly diabetes and thyroid drugs-and ocular complications, suggesting the importance of ophthalmological monitoring in these patients.

To evaluate real-world efficacy of Diversified Segmental Defocus Optimization (DSDO) lenses in controlling axial length (AL) growth in children and adolescents with or without myopia, compared with Defocus Incorporated Multiple Segments (DIMS) lenses and no optical correction, respectively. Prospective, multicenter, real-world study. Individuals were recruited from eight Aier Eye Hospital Group centers in China and wore using DSDO lenses, DIMS lenses, or no optical correction. AL was measured at baseline, 6 months, and 12 months. Propensity score matching (PSM) was applied to balance baseline characteristics. AL changes were compared between DSDO and DIMS lenses in myopia cohort, and between DSDO lenses and untreated controls in non-myopia cohort. Change in AL over 6- and 12-month follow-up periods. A total of 1541 participants were included (myopic: 654 DSDO, 661 DIMS; non-myopic: 85 DSDO, 141 controls). After PSM, baseline age, sex, SE, and AL were well-balanced. In myopic cohort, AL elongation was 0.07 &#xb1; 0.12 mm with DSDO lenses and 0.09 &#xb1; 0.10 mm with DIMS lenses at 6 months (P = 0.026), and 0.17 &#xb1; 0.18 mm versus 0.19 &#xb1; 0.16 mm at 12 months (P = 0.019). In non-myopic cohort, AL growth was 0.18 &#xb1; 0.14 mm with DSDO lenses and 0.29 &#xb1; 0.14 mm in untreated controls at 12 months (P = 0.01), greater in hyperopic/emmetropic subgroup (0.00 < SE &#x2264;1.50 D; P = 0.004). The most pronounced effect was observed within the first 6 months. In myopic cohort, subgroup analyses revealed greater efficacy in children aged &#x2264; 10 years (P = 0.022) and in low-myopia subgroup (P = 0.001). Age and intervention type independently predicted AL changes, whereas sex was not. Notably, baseline AL was significant determinant of subsequent AL changes in myopia cohort. DSDO lenses provide greater control of axial elongation compared with DIMS lenses in specific myopic subgroups and effectively suppress physiological axial growth in non-myopic children and adolescents. The greatest advantage occurs during the first 6 months and among younger children with low baseline refractive error, highlighting the importance of early, individualized optical intervention for effective myopia prevention and control. The author(s) have no proprietary or commercial interest in any materials discussed in this article.

To investigate the correlation between postoperative visual recovery and subjective visual satisfaction in cataract patients with varying degrees of corneal astigmatism, and to identify factors influencing patient-reported outcomes following modern cataract surgery. This retrospective cohort study analyzed 682 eyes of cataract patients who underwent phacoemulsification with standard monofocal non-toric intraocular lens (IOL) implantation targeting emmetropia between January 2022 and December 2022. Patients were stratified into four groups based on preoperative corneal astigmatism: Group 1 (<&#x2009;0.75 D, n&#x2009;=&#x2009;250), Group 2 (0.75-1.50 D, n&#x2009;=&#x2009;245), Group 3 (1.51-2.50 D, n&#x2009;=&#x2009;121), and Group 4 (>&#x2009;2.50 D, n&#x2009;=&#x2009;66). Primary outcomes included best-corrected visual acuity (BCVA), uncorrected distance visual acuity (UDVA), and patient satisfaction scores measured using the modified NEI VFQ-25 questionnaire. Secondary outcomes encompassed visual symptoms and spectacle independence for distance vision. Mean postoperative UDVA improved significantly across all groups (p&#x2009;<&#x2009;0.001), with Group 1 achieving 0.12&#x2009;&#xb1;&#x2009;0.08 logMAR compared to 0.36&#x2009;&#xb1;&#x2009;0.14 logMAR in Group 4. Postoperative BCVA was&#x2009;&#x2265;&#x2009;20/30 in 97.1% of all eyes, confirming good visual potential across groups. Patient satisfaction composite scores decreased progressively with increasing astigmatism magnitude (Group 1: 88.4&#x2009;&#xb1;&#x2009;9.2 vs. Group 4: 67.1&#x2009;&#xb1;&#x2009;15.8; p&#x2009;<&#x2009;0.001). Spectacle independence for distance vision was achieved in 92.5% of Group 1 patients versus 45.5% in Group 4. Multiple regression analysis revealed that postoperative UDVA (&#x3b2;&#x2009;=&#x2009;&#x2009;-&#x2009;0.42, p&#x2009;<&#x2009;0.001), residual astigmatism (&#x3b2;&#x2009;=&#x2009;&#x2009;-&#x2009;0.38, p&#x2009;<&#x2009;0.001), and severity of glare symptoms (&#x3b2;&#x2009;=&#x2009;&#x2009;-&#x2009;0.21, p&#x2009;=&#x2009;0.003) were significant independent predictors of reduced satisfaction (adjusted R2&#x2009;=&#x2009;0.57). Higher degrees of preoperative corneal astigmatism are associated with reduced postoperative visual satisfaction despite good BCVA outcomes. These findings support a low threshold for astigmatism management and highlight the importance of comprehensive patient counseling regarding expected visual outcomes based on preoperative astigmatism magnitude.

Bietti crystalline corneoretinal dystrophy (BCD), a rare autosomal recessive retinal degenerative disease caused by cytochrome P450 family 4 subfamily V member 2 (CYP4V2) mutations, leads to progressive vision loss and blindness and exhibits a high prevalence in East Asia. Adeno-associated virus (AAV)-mediated gene replacement therapy has emerged as the most promising therapeutic strategy for BCD, considering its success in monogenic retinal diseases and unique advantages for retinal delivery. This review provides valuable insights into the translational journey of BCD gene therapy to accelerate research progress, facilitate the sharing of resources and expertise, and overcome the complex challenges associated with the development of therapies for rare diseases. It also offers a comprehensive overview of the current progress and future prospects of ZVS101e and provides a valuable resource to researchers, clinicians, and patients interested in the development of gene therapy for inherited retinal diseases. Additionally, it highlights the translational potential of AAV-based therapy in addressing unmet medical needs, such as BCD, and emphasizes the crucial role of industry-university-research collaboration in driving innovative therapies from the laboratory to clinical practice. Potential use of suprachoroidal space injection to deliver the gene materials in treating BCD is also discussed.

Primary angle-closure glaucoma (PACG) is a major cause of irreversible blindness worldwide, with the highest burden in Asia. Its pathogenesis involves the interplay of multiple mechanisms, including pupillary block, plateau iris configuration, lens-related crowding, and dynamic choroidal expansion. Traditional surgical management has relied on trabeculectomy, lens extraction, or transscleral cyclophotocoagulation, which often achieve substantial intraocular pressure (IOP) control but carry significant risks and require prolonged recovery. Minimally invasive glaucoma surgery (MIGS) expands treatment options for PACG once angle access is restored. It offers safer, earlier, and targeted interventions tailored to the underlying mechanisms. Techniques range from trabecular meshwork (TM) and Schlemm's canal-based procedures to subconjunctival stents and ciliary body approaches. Combined with lens extraction, these methods deepen the anterior chamber, release peripheral anterior synechiae, and restore physiological outflow, with clinical evidence showing 20-50% IOP reductions and reduced medication burden. This paper reviews anatomical, physiological, and clinical evidence for the use of MIGS in PACG, discussing how these procedures can complement, or in selected cases replace, invasive filtration surgery, potentially enabling earlier intervention while maintaining a favorable safety profile. Future advancements will hinge on device refinements for narrow-angle eyes, imaging-guided precision, biologic modulation, and strategies to enhance cost-effectiveness and accessibility, ultimately enabling individualized, mechanism-based treatment pathways.

Spaceflight presents several unique challenges for the diagnosis and management of in-flight ocular trauma. Constrained medical resources, microgravity, and delayed access to advanced medical care require novel and unique approaches to ocular trauma. The Ocular Trauma Score (OTS), an evidence-based clinical tool, aids in establishing a prognosis for ocular injuries and offers a method of informed triage and management. As governmental space agencies and private space companies (e.g., SpaceX, Blue Origin, and Virgin Galactic) rapidly increase the number and length of human spaceflight missions, the development of increasingly autonomous medical decision-making will be critical for astronaut safety and mission success. This paper aims to evaluate the practical utility of the OTS during spaceflight and highlight potential protocols to optimize triage and management of spaceflight related ocular trauma (SROT) effectively during future missions.

Demodex blepharitis is a chronic inflammatory ocular condition caused by Demodex mite infestation of the eyelid that can negatively impact quality of life. Currently, lotilaner ophthalmic solution 0.25% is the only FDA-approved treatment for Demodex blepharitis. The Demodex Expert Panel on Treatment and Eyelid Health has established consensus that lotilaner ophthalmic solution 0.25% should be considered the preferred first-line treatment for Demodex blepharitis. We report a patient who presented with collarettes, the pathognomonic sign of Demodex blepharitis, meibomian gland dysfunction, and poor visual acuity. The patient also had a history of neovascular age-related macular degeneration. Consistent with the Demodex Expert Panel on Treatment and Eyelid Health consensus recommendations, the patient was treated with lotilaner ophthalmic solution 0.25%, lid scrubs, and warm compresses. At the 2-month follow-up, collarettes had resolved, and signs of meibomian gland dysfunction had improved. This case supports the Demodex Expert Panel on Treatment and Eyelid Health recommendation that lotilaner ophthalmic solution 0.25% should be considered the preferred first-line treatment for Demodex blepharitis.

To evaluate the efficacy and safety of transscleral diode laser cyclophotocoagulation (TSCPC) in patients with refractory glaucoma using real-world clinical data from a tertiary referral center. This retrospective study reviewed the medical records of 143 patients who underwent primary TSCPC for refractory glaucoma between December 2022 and January 2024. Data regarding intraocular pressure (IOP), best-corrected visual acuity (BCVA), number of IOP-lowering medications, repeat treatments, and postoperative complications were collected. Surgical success was defined as achieving an IOP between 6 and 21&#xa0;mmHg with at least a 20% reduction from baseline, with (qualified success) or without (complete success) adjunctive medical therapy, in the absence of glaucoma-related phthisis bulbi, loss of light perception, or the need for additional glaucoma surgery other than repeat TSCPC. A total of 143 eyes from 143 patients (57.0% male) with a mean age of 62.0&#x2009;&#xb1;&#x2009;15.7&#xa0;years were included. Neovascular glaucoma was the most common diagnosis (62.0%). Mean IOP decreased significantly from 35.9&#x2009;&#xb1;&#x2009;11.0&#xa0;mmHg preoperatively to 16.2&#x2009;&#xb1;&#x2009;8.3&#xa0;mmHg at the 12-month follow-up (p&#x2009;<&#x2009;0.001). Overall surgical success was achieved in 65.8% of eyes, including 16.8% complete success and 49.0% qualified success. The mean number of antiglaucoma medications decreased from 2.8&#x2009;&#xb1;&#x2009;1.0 to 1.5&#x2009;&#xb1;&#x2009;1.1 (p&#x2009;<&#x2009;0.001). Postoperative complications occurred in 10.9% of eyes and were predominantly mild and transient. No cases of persistent hypotony or phthisis bulbi were observed. In a real-world tertiary care setting, TSCPC was associated with significant IOP reduction and an acceptable safety profile over 12&#xa0;months in patients with refractory glaucoma. Despite the high proportion of neovascular glaucoma cases, no sight-threatening complications such as persistent hypotony or phthisis bulbi were observed during follow-up. However, longer-term studies are needed to confirm the durability and long-term safety of these outcomes.