To investigate the influence of surgical timing using quantitative Hess area ratio (HAR
This study aims to evaluate the safety and efficacy of surgical treatment for small-angle (≤ 15 prism diopters [PD]) acute acquired comitant esotropia (AACE), provide preliminary dose-response estimates and explore the surgical thresholds. 25 patients with small-angle AACE(10–15 PD) underwent unilateral medial rectus (MR) recession with or without lateral rectus (LR) resection, with at least 6 months of follow-up. Causal mediation and multivariable linear regression analysis evaluated the surgical dose-response relationship. Linear modeling estimated the minimum horizontal deviation (surgical threshold) in AACE. The surgical success rate was 96
To evaluate the anatomical and functional outcomes of fluorescein angiography (FA)–guided focal subthreshold 532-nm continuous-wave green laser in patients with simple versus complex central serous chorioretinopathy (CSC). This retrospective, single-center study included 50 eyes of 50 patients with persistent CSC lasting ≥ 6 months. Patients were classified as simple or complex CSC based on multimodal imaging. All patients underwent FA-guided focal subthreshold laser, with energy titrated to avoid visible burns. Outcome measures included changes in best-corrected visual acuity (BCVA, logMAR), subretinal fluid (SRF) height, and subfoveal choroidal thickness (SFCT). Statistical comparisons were performed using paired and independent tests, with p < 0.05 considered significant. Of the included eyes, 29 (58
To evaluate the clinical and radiologic response of thyroid eye disease (TED)-associated superior ophthalmic vein periphlebitis (SOVP) to teprotumumab treatment. A retrospective chart review was performed at three institutions until June 2026. Patients with active moderate-to-severe TED with concomitant extraocular muscle (EOM) inflammation who underwent orbital magnetic resonance imaging (MRI) before teprotumumab initiation and after the 4th and 8th infusion were included. SOVP was defined as high signal intensity of the SOV wall on short tau inversion recovery (STIR) MRI. Demographic, clinical, and radiologic data were analyzed. Changes in Clinical Activity Score (CAS), Hertel exophthalmometric measurements, logMAR visual acuity, and SOV diameter were compared before and after treatment. Among 131 patients treated with teprotumumab, 7 patients (5.3
To compare optic disc morphology, visual field parameters, and OCT measurements between myopic eyes with and without peripapillary hyperreflective ovoid mass-like structures (PHOMS), and to identify factors associated with PHOMS. This retrospective case-control study included 35 myopic patients (60 eyes) with PHOMS and 23 myopic patients (46 eyes) without PHOMS. All participants underwent comprehensive ophthalmic examinations including refraction, visual field testing, fundus photography, and enhanced depth imaging OCT (EDI-OCT). PHOMS height, peripapillary RNFL thickness, and BMO-MRW were measured. Propensity score matching (1:1 on age, sex, and spherical equivalent) was performed, and generalized estimating equations (GEE) accounted for inter-eye correlation. False discovery rate (FDR) correction (q = 0.05) was applied for univariable and correlation analyses; no multiplicity adjustment was made for the multivariable logistic regression. After matching (39 eyes per group), the PHOMS group exhibited a lower optic disc ovality index (ODOI) (0.746 ± 0.072 vs. 0.803 ± 0.072, P = 0.006) and a smaller cup-to-disc ratio (CDR) (P = 0.001). Multivariable GEE logistic regression identified ODOI as the only independent factor significantly associated with the presence of PHOMS (OR = 3.332, 95
Laser Speckle Flowgraphy (LSFG) is a non-invasive imaging technology that quantitatively evaluates retinal and choroidal blood flow by analyzing speckle patterns generated by laser light scattering. Compared with OCT-A, which provides detailed visualization of retinal and choroidal microvascular architecture, LSFG offers dynamic quantitative information on ocular blood flow. This systematic review summarizes the application of LSFG in two major vascular diseases: retinal vein occlusion (RVO), and central serous chorioretinopathy (CSCR). This second part of a PRISMA-guided systematic review evaluates LSFG in RVO and CSCR, including studies published in English retrieved throughout a comprehensive literature search (2010–2025) conducted in PubMed, Cochrane Library and EMBASE. Twenty-nine studies (966 eyes: 700 RVO, 266 CSCR) were analyzed. Across retinal vein occlusion, LSFG consistently showed that lower retinal mean blur rate (MBR) associates with higher VEGF/other cytokines, greater ischemia, and worse visual prognosis, while higher baseline or early post-injection MBR predicts better central macular thickness reduction, fewer recurrences, and superior visual recovery. total capillary resistance correlated with clinical severity and visual outcomes. In CSCR, elevated choroidal MBR during the acute phase and its reduction after photodynamic therapy highlighted choroidal hyperperfusion as a key pathogenic mechanism. LSFG captures rapid, reproducible, and non-invasive functional perfusion and vascular-resistance dynamics in RVO and CSCR, complementing OCT-A structural microvascular metrics. Despite heterogeneity and the lack of meta-analysis, LSFG integration into multimodal imaging appears clinically valuable for early diagnosis, risk stratification, treatment monitoring, and the support of individualized care pathways in retinal and choroidal vascular disorders.
To evaluate the repeatability and reproducibility of corneal endothelial parameters measured with the Topcon SP-1P specular microscope in healthy eyes, comparing single and panoramic acquisition modes. This reproducibility study included 137 eyes from 79 healthy adults. Endothelial cell density (ECD), average cell area, coefficient of variation (CV), hexagonality, and pachymetry were measured twice by two independent examiners using both single and panoramic modes. Statistical agreement was assessed using intraclass correlation coefficients (ICC), repeatability coefficients (RC), and Bland–Altman analysis. Intra-observer reproducibility for ECD, average cell area, and pachymetry was excellent in both modes (ICC ≥ 0.95). However, the panoramic mode consistently showed improved precision, with higher ICCs and lower RCs for most morphometric variables. Inter-observer agreement was also excellent for ECD (ICC 0.94) and average cell area (ICC 0.95). Significant systematic differences were found between acquisition modalities; specifically, ECD was on average 7.27
To characterize real-world adoption patterns of anti-vascular endothelial growth factor (anti-VEGF) therapies across retinal vascular diseases. This retrospective cohort study identified patients diagnosed with exudative age-related macular degeneration (AMD), diabetic macular edema (DME), or retinal vein occlusion (RVO) within TriNetX. Monthly utilization of ranibizumab, bevacizumab, aflibercept, brolucizumab, and faricimab was measured across each indication. To provide absolute treatment context, we also determined the annual number of unique patients within each disease cohort with at least one documented exposure to any evaluated anti-VEGF agent. The cohorts included 138,384 AMD patients, 322,865 DME patients, and 105,605 RVO patients. Aflibercept demonstrated sustained long-term utilization across all three indications, whereas faricimab showed rapid early uptake after its introduction. Ranibizumab utilization declined over time, while brolucizumab demonstrated limited and transient uptake. The annual number of patients receiving anti-VEGF treatment increased substantially over the observation period and reached 16,319 in AMD, 12,105 in DME, and 6,873 in RVO in 2023. Real-world adoption of anti-VEGF therapies differs markedly across retinal diseases and agents. Aflibercept demonstrated sustained long-term use, while faricimab showed rapid early uptake. Changes in agent-specific utilization occurred alongside substantial growth in the absolute number of treated patients over the study period, underscoring the importance of interpreting drug-specific trajectories in the context of overall treatment activity.
To provide consensus recommendations on the clinical use of aflibercept 8 mg in managing neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME) in the real-world setting. A modified Delphi study was undertaken, involving ophthalmologists from specialized centers in Italy, to gauge consensus on statements related to the use of aflibercept 8 mg in nAMD and DME. Two initial rounds of online surveys were conducted, followed by 2 workshops to assess the clinical feasibility of selected statements and identify the behavioral drivers and barriers to their adoption in practice. Consensus was defined as ≥ 75 What is new
To evaluate the effect of originator or biosimilar adalimumab on uveitic macular edema (UME) in refractory non-infectious uveitis. Multicenter retrospective cohort study of non-infectious uveitis patients who received either originator or biosimilar adalimumab. Serial optical coherence tomography monitored UME over 24 months. Main outcomes were time to UME resolution in eyes with baseline UME, and time to UME onset in eyes without baseline UME. The study included 94 patients (146 eyes): 56 patients (84 eyes) received originator adalimumab and 38 (62 eyes) biosimilars. Median follow-up was 24.0 (IQR 24.0, 24.0) and 12.0 (IQR 6.0, 24.0) months, respectively. Baseline UME was present in 27/84 originator (32.1
Myopia stands as a major threat to the eye health of children and adolescents, impacting their daily lives and academic performance. Early detection and implementation of targeted interventions are critical strategies to prevent myopia onset and slow its progression. Early detection and intervention help prevent and control myopia. With the development of artificial intelligence (AI), AI techniques have gradually been applied in the field of myopia prediction among children and adolescents. This article reviews the application of AI methods in myopia prediction, summarizing key areas such as refractive power prediction, myopia screening, analysis of risk factors, myopia control, pathological myopia analysis and prediction of ocular biological parameters. Furthermore, we highlight the major advancements and challenges in the field of myopia prediction for children and adolescents.
This study aimed to evaluate the association between the reticular iris pattern and cytomegalovirus (CMV) positivity detected by aqueous humour polymerase chain reaction (PCR) testing in Posner-Schlossman syndrome (PSS) and to estimate its diagnostic performance. Thirty patients with active PSS at a tertiary eye centre in Vietnam underwent aqueous humour polymerase chain reaction (PCR) testing and anterior segment assessment. Firth penalized logistic regression identified clinical signs associated with CMV positivity, and diagnostic performance metrics were calculated. CMV was detected in 46.7
To evaluate 5-year choroidal changes in eyes with unilateral neovascular age-related macular degeneration (nAMD) treated with intravitreal aflibercept (IVA) and to compare longitudinal changes among treated, fellow untreated, and control eyes using mixed-effects modeling. Sixteen patients with unilateral nAMD (16 treated and 16 fellow untreated eyes) and 20 age-matched and sex-matched control eyes were included. Best-corrected visual acuity (BCVA), central subfield thickness (CST), central choroidal thickness (CCT), and choroidal vascularity index (CVI) were assessed. Absolute and proportional CCT changes were analyzed. Annual rates of change were estimated using linear mixed-effects models. Over 5 years, control eyes showed mild age-related choroidal thinning (− 3.7 μm/year). In contrast, CCT declined significantly faster in treated eyes (− 11.5 μm/year; p < 0.01 vs. control); fellow untreated eyes also demonstrated accelerated thinning (− 8.2 μm/year; p < 0.05 vs. control). Proportional analyses showed a similar graded pattern. BCVA worsened and CST decreased in treated eyes, while remaining stable in fellow eyes. CVI increased modestly and similarly in treated and fellow eyes (approximately + 0.8
To evaluate whether age at diagnosis of strabismus or amblyopia is associated with patterns in the clinical recognition of neurodevelopmental conditions in children. This retrospective cohort study included children with a first diagnosis of strabismus or amblyopia, categorized into early (3–6 years) and late (7–12 years) diagnosis cohorts. Primary outcomes included developmental delay, learning disorders, and speech or language disorders. Hazard ratios (HRs) were estimated at 1-, 3-, and 5-year follow-up intervals. Kaplan-Meier analyses were used to evaluate event-free probability. Sensitivity analyses assessed 1-year outcomes using age-stratified control cohorts, age-matched control comparisons, and conjunctivitis comparator analyses. Children in the early-diagnosis cohort had higher detection of developmental delay (HR, 2.38; 95
This article synthesizes the major conceptual and therapeutic transformations in myopia management from the early twentieth century to the present era of designed defocus and multimodal care, examining how myopia evolved from a simple refractive inconvenience into a measurable disorder of ocular growth and a global public-health concern. This article presents a conceptual synthesis of the historical evolution of myopia management using PubMed and Scopus (through 14 February 2026), supplemented by selected historical ophthalmology texts. The search included combinations of the terms “myopia”, “axial elongation”, “atropine”, “orthokeratology”, “defocus lenses”, “myopia control”, and “epidemiology”. Priority was given to landmark trials, historical publications, and studies representing conceptual or methodological advances. Evidence was selected based on methodological rigor and historical or conceptual impact. The identified literature was synthesized into six interpretative phases reflecting progressive shifts in theoretical models, outcome measurement, and clinical objectives. Six major conceptual phases were identified, marking a transition from optical compensation (1900–1950) to early therapeutic experimentation (1950–1980), biometric and experimental consolidation (1980–2000), conceptual paradigm shift (2000–2010), evidence-based myopia control (2010–2020), and the current era of designed defocus and multimodal strategies (2020–present). The introduction of axial length as a structural endpoint, together with large-scale epidemiology and randomized controlled trials, reframed myopia as a dynamic growth disorder. Pharmacologic modulation with low-dose atropine, corneal reshaping techniques, multifocal and dual-focus contact lenses, and defocus-incorporated spectacle designs have consistently demonstrated reductions in axial elongation. Even modest annual slowing of eye growth may translate into substantial reductions in lifetime risk of myopia-related complications. While interventions are primarily applied in childhood, their ultimate objective is the reduction of adult myopia-related morbidity. Over the past century, myopia management has shifted from an optical correction to a careful control of axial elongation. The convergence of structural measurement, experimental evidence, and rigorous clinical trials has redefined therapeutic goals, aligning individual patient care with population-level risk reduction. This evolution highlights current preventive and personalized strategies and predicts further advances toward anticipatory modulation of ocular growth.
To evaluate the utility of specific enzyme-linked immunosorbent assays (ELISAs) for identifying vascular endothelial growth factor (VEGF)-A isoforms in the context of ophthalmic diseases, using proliferative diabetic retinopathy (PDR) as a representative model. This was a single-institute, retrospective cohort study of patients with epiretinal membrane (ERM), rhegmatogenous retinal detachment (RRD), or PDR who underwent pars plana vitrectomy at Kagoshima University Hospital between January 2016 and August 2023. We measured vitreous VEGF-A121 and VEGF-A165 concentrations using a VEGF-A isoform-specific ELISA and compared them among the ERM, RRD, and PDR groups. The study included 48 patients (48 eyes): 12 with ERM, 26 with RRD, and 10 with PDR. The concentration of VEGF-A121 was significantly greater in eyes affected by PDR (vs. ERM, P = 2.0 × 10− 4; vs. RRD, P = 2.9 × 10− 5). A similar trend was observed for the concentration of VEGF-A165 (vs. ERM, P = 1.0 × 10− 4; vs. RRD, P = 1.0 × 10-4 ). The levels of VEGF-A121 and VEGF-A165 did not differ significantly between RRD and ERM (P = 0.855 and P = 0.136, respectively). After adjusting for age and sex, the VEGF-A165 levels in eyes with PDR were negatively associated with the patient’s eGFR (β = -3.5; P = 0.040) and the HbA1c level (β = -84.6; P = 0.020). These findings demonstrate this isoform-specific ELISA enables the measurement of VEGF-A isoforms in the vitreous. Quantification of vitreous VEGF-A isoforms may provide as crucial biomarkers for PDR.
To systematically compare the accuracy of commonly used intraocular lens (IOL) power calculation formulas in eyes undergoing the Yamane technique. PubMed, Scopus, Web of Science, and Cochrane Library databases were searched for studies published between January 2014 and January 2026. Comparative clinical studies involving patients undergoing the Yamane technique were included if they reported mean absolute error (MAE), median absolute error (MedAE) and percentage of eyes with a prediction error (PE) within ± 0.50 or ± 1.00 diopters (D). Network meta-analysis was performed using R software. The protocol was registered in PROSPERO (CRD420261343495). 9 studies were included, involving 399 eyes and 7 calculation formulas. In pairwise analyses and the network meta-analysis, the Barrett Universal II (BUII) formula showed higher proportions of eyes with PE within ± 0.50 and ± 1.00 D, although these differences were not statistically significant. Surface under the cumulative ranking area (SUCRA) showed the BUII formula ranked first (79.1
To evaluate Schlemm’s canal (SC) axial dimensions using anterior segment optical coherence tomography (AS-OCT) in children with juvenile idiopathic arthritis–associated uveitis (JIA-U) and to investigate its relationship with uveitis-related prognostic factors. This cross-sectional study included 60 eyes of 30 children with JIA-U and 33 eyes of 33 healthy pediatric controls. Comprehensive ophthalmic examination, biometric measurements, anterior chamber angle (ACA) assessment, and Schlemm’s canal axial length (SCAL) measurements were performed using AS-OCT at nasal and temporal locations with right nasal SCAL used for the between-group comparison. Inter-eye, inter-location, and group comparisons were conducted. Subgroup and correlation analyses evaluated associations between SCAL and JIA-U-related clinical prognostic factors. No significant differences were observed between right and left eyes or between nasal and temporal SCAL measurements in the JIA-U group. SCAL and ACA parameters did not differ significantly between the JIA-U and control groups (p > 0.05 for all). Correlation analysis revealed a location-specific significant negative association between uveitis duration and temporal SCAL in the right eye (r = − 0.489, p = 0.01). In JIA-U children with well-controlled inflammation and intraocular pressure, SC axial dimensions appear to be largely preserved. A location-specific, exploratory inverse association was observed between uveitis duration and right temporal SCAL. These results warrant confirmation in larger, prospective studies before any conclusions regarding the impact of disease duration on aqueous outflow structures can be drawn.
Diabetic Retinopathy (DR) is a vision-threatening complication in diabetic patients. It harms retinal vessels and may lead to blindness. Detection at an early stage and its classification can prevent the risk of vision loss. However, fundus image-based manual screening of DR is a time-consuming and complex process. In recent years, many automated techniques for DR detection have been developed to screen and diagnose the disease condition at an early stage. These techniques are explored using the keywords diabetic retinopathy, fundus image, ophthalmology with machine learning (ML), and deep learning (DL). Search engines such as Google Scholar, PubMed, Medline, IEEE Explore, and Science Direct are utilised and explored to gather existing research papers. This review systematically examines several techniques for DR detection and classification, using ML, DL, and hybrid approaches. This study analyses methodologies, datasets, pre-processing steps, performance evaluation metrics of existing techniques, and challenges associated with overfitting, model complexity, class imbalance, and deep feature extraction. Recent advancements in ensemble learning, transformer-based techniques, and attention mechanisms are also discussed for DR detection and classification. The review explored and discussed the challenges of existing DR detection and classification methods. This paper suggests future research directions to improve the accuracy and robustness of DR detection systems.
To evaluate the demographic and clinical characteristics, surgical techniques, and postoperative outcomes in patients with exotropic Duane retraction syndrome (DRS) at a tertiary referral strabismus center. This retrospective study included 109 patients with exotropic DRS (Type 1, n = 78; Type 2, n = 20; Type 3, n = 11) evaluated between 1995 and 2023. Surgical indications were exotropia ≥ 20 prism diopters (PD) in primary position or abnormal head posture (AHP) ≥ 10°. Procedures included lateral rectus (LR) recession (3–7 mm), Y-splitting of the LR, vertical rectus transposition, and adjunctive techniques. Botulinum toxin type A (BTX-A) was administered in selected cases. The cohort comprised 79 females (72.5
