Background The purpose of this study was to define a minimum set of outcome measures for patients affected by non-advanced age-related macular degeneration (AMD).Methods A structured Delphi consensus process was conducted by a panel of worldwide experts in treatment outcome registries, imaging, nutrition and other AMD aspects. The experts answered anonymously to a series of surveys, each followed by a face-to-face meeting to discuss the pooled results. Supporting literature was shared among the group members by a facilitator before each round. Finally, all the results were discussed and the consensus document was created based on the level of agreement between experts.Results Six rounds were conducted until a formal consensus was achieved. Five main sections were identified: demographic characteristics, health factors, functional, imaging and clinical outcomes. A minimum set of 28 outcome measures was subsequently developed and approved by all members. Based on the priority of various items, 24 fields were designated as mandatory, while the remaining were deemed optional. Five items are required only at baseline, 12 are to be assessed annually for changes and the remaining 0 1must be collected at each clinical assessment.Conclusion This newly defined minimum set of outcome measures for non-advanced AMD could be employed in future real-world data collection registries aimed at gathering comprehensive and longitudinally extensive clinical data on a global scale. This may help to elucidate the natural progression of non-advanced AMD and its response to new therapies.

Background/Objectives: To assess the acceptance of, attitudes towards, and concerns regarding allogeneic serum eye drops (Allo-SEDs) among patients treated with autologous serum eye drops (ASEDs). Methods: We conducted this investigator-initiated, cross-sectional, single-center survey at the Department of Ophthalmology, University Hospital Zurich, Switzerland. We consecutively recruited all patients using ASEDs during routine visits, who anonymously completed a 9-item questionnaire comprising eight 11-point Likert-scale items and one open numerical item on the daily application frequency. We assessed perceived ASED effectiveness, willingness to switch to Allo-SEDs under different scenarios, and concerns regarding safety, efficacy, and immunological risks. Results: Of 202 eligible patients, 107 returned the questionnaire (53.0%). The full eligible cohort had a median (IQR) age of 63.5 (49.2–75.0) years and a median ASED treatment duration of 4.0 (1.0–8.0) years. They rated ASEDs as highly effective (median 9, IQR 8.2–10.0) and applied them a median of 7 (5–10.5) times daily. Willingness to switch was low without clinical need (median 3, IQR 0–6; p = 1.0), increased when autologous production was no longer feasible (median 7, IQR 5–9; p < 0.001), and was intermediate for general openness (median 5, IQR 2–8; p = 0.7). Concerns regarding infectious disease transmission, immunological reactions, and therapeutic efficacy correlated with lower willingness to switch (all r = −0.29 to −0.46). Daily application frequency did not correlate with acceptance. Conclusions: Patients were highly satisfied with ASEDs but were reluctant to switch to Allo-SEDs unless autologous production was no longer feasible. Among the domains assessed, concerns regarding infection, immunological reactions, and efficacy were the main barriers to acceptance, supporting targeted patient education.

Abstract:PURPOSE: This retrospective study aims to evaluate the clinical outcomes of a customised "banana-shaped" anterior lamellar keratoplasty technique in the treatment of peripheral corneal ulcerative perforations in six patients treated at a tertiary care center in Switzerland over a one-year period. Abstract:METHODS: In this retrospective observational study conducted between December 2023 and December 2024 at a tertiary care center in Switzerland, six patients (5 male, aged 48 - 86 years) with peripheral corneal ulcer perforations underwent a customized crescent-shaped ("banana-shaped") anterior lamellar keratoplasty. Three patients had perforations secondary to peripheral ulcerative keratitis (PUK) of autoimmune origin, one patient presented with a perforated neurotrophic corneal ulcer, another patient had a perforation due to surgically induced necrotizing scleritis, and the last patient had a perforation secondary to gonococcal keratoconjunctivitis. The corneal grafts were tailored to the size and location of the peripheral defects while preserving the central cornea. All patients were treated with topical corticosteroids and antibiotics postoperatively, with systemic therapy adjusted to the etiology of the ulceration. Outcomes assessed included graft clarity, epithelial healing, anatomical integrity, and best spectacle corrected visual acuity (BSCVA), with follow-up ranging from 6 to 12 months. Abstract:RESULTS: Anatomical integrity of the globe was successfully restored in all six patients. All grafts remained clear, and epithelial healing was achieved within 10 days to 4 weeks. There were no cases of graft rejection or recurrent inflammation. Final BSCVA ranged from 0.7 to 0.3 logMAR. Abstract:CONCLUSION: Customised "banana-shaped" anterior lamellar keratoplasty is a safe and effective surgical approach for the management of peripheral corneal ulcerative perforations, particularly in cases of PUK. This technique allows localised structural repair while preserving the central visual axis, resulting in favorable anatomical and visual outcomes.

AIMS:To compare 1-year and 2-year outcomes of eyes with persistent and non-persistent diabetic macular oedema (DME) treated with vascular endothelial growth factor (VEGF) inhibitors. METHODS:This was a cohort study using the Fight Retinal Blindness! (FRB!) international outcomes registry. Participants had treatment-naïve eyes with centre-involving DME starting intravitreal VEGF inhibitor therapy from 2014 to 2023. Eyes were grouped as those with persistent DME and those with non-persistent DME. Main outcome measures were mean visual acuity (VA) change and central subfoveal thickness change after 1 and 2 years of treatment. RESULTS:This study included 877 eyes, of which 40% had persistent DME. The mean VA change in eyes with persistent DME was less than that in eyes with non-persistent DME at 1 (+3.6 vs. +6.5 letters; p<0.001) and 2 (+3.6 vs. +6.3 letters; p<0.001) years. The persistent group had a lower mean reduction in central subfield thickness at 1 (-74 vs -111 µm; p<0.001) and 2 (-90 vs -114 µm; p<0.001) years and received more mean injections at 1 (7.6 vs 6.5; p<0.001) and 2 (11.8 vs 9.5; p<0.001) years. CONCLUSION:Eyes with persistent DME had significantly lower improvement in mean VA, lower reduction in CST and more injections 1 and 2 years after the initiation of VEGF inhibitor therapy. Eyes with persistent DME likely had a higher treatment burden because they had more aggressive disease that was more difficult to control. More effective agents would likely deliver better outcomes in this significant group of patients with DME.

PurposeTo evaluate intraocular pressure (IOP), medication burden, best-corrected visual acuity (BCVA), and safety outcomes after ab externo PRESERFLO MicroShunt (PreserFlo) implantation in routine clinical practice.MethodsThis retrospective single-center study included patients undergoing PreserFlo implantation (standalone or combined with phacoemulsification) between 2019 and 2022. IOP, BCVA, and glaucoma medications were collected preoperatively and postoperatively (day 1, week 1, month 1, year 1, and year 2). Hypotony was defined as IOP ≤ 5 mmHg. Complete success at 2 years required IOP ≤ 21 mmHg with ≥20% reduction from baseline without glaucoma medication.ResultsEighty-one eyes of 74 patients (mean age 73.2 years) were included. Mean baseline IOP was 24.0 ± 10.2 mmHg, decreasing to 12.5 ± 3.8 mmHg at year 1 (p < 0.0001) and 13.5 ± 3.4 mmHg at year 2 (p = 0.0005). Mean BCVA was 0.63 ± 0.30 at baseline, 0.70 ± 0.31 at year 1, and 0.73 ± 0.27 at year 2, indicating stable visual acuity during follow-up. Mean IOP reduction was 39.6% at year 1 and 33.8% at year 2; 75.6% and 73.3% achieved ≥20% IOP reduction at years 1 and 2, respectively. Medications decreased from 3.09 ± 1.02 to 0.44 ± 0.97 (year 1) and 0.45 ± 0.85 (year 2), and their medication-free rates were 80.5% and 73.3%, respectively. Complications occurred in 55.6% of eyes; 27.2% required postoperative interventions (needling 20.9%); 15.0% required further glaucoma surgery. Complete success rates were 60.2% (year 1) and 52.0% (year 2).ConclusionsPreserFlo implantation provided sustained mid-term IOP reduction with substantial medication sparing and stable BCVA.

BACKGROUND/AIMS:To identify predictors of continued discontinuation of vascular endothelial growth factor (VEGF) inhibitors for retinal vein occlusion (RVO) after it has been suspended. METHODS:Eyes with RVO were identified in the Fight Retinal Blindness! registry that suspended VEGF inhibitors for ≥180 days when visual acuity (VA) was ≥35 letters, from 1 December 2011-2021. The primary outcome was not resuming therapy through 24 months which defined success. RESULTS:Half (186/362 (51%)) of the eligible 6-month suspensions successfully continued through 24 months. Successful cessation attempts began earlier (9 vs 14 months; p=0.001), after greater VA improvement (mean, +12.6 vs +8.5 letters; p=0.01) following more injections in the first 6 months (median, 5 vs 4; p<0.001) and more intensive treatment than unsuccessful attempts (176/362 (49%)). At month 6 without treatment, the mean (95% CI) changes in VA and central subfield thickness (CST) were in successful attempts +1.8 letters (+0.4 to +3.1) and -20 µm (-34 to -6); unsuccessful attempts +0.5 letters (-1.1 to 2.0) and -2 µm (-22 to +18). When therapy resumed in unsuccessful attempts (median, 9.5 months), VA and CST had deteriorated by -3.5 letters (-5.6 to -1.4) and +38 µm (+20 to +57) since suspension. These trends were more pronounced in eyes with central retinal vein occlusion. CONCLUSION:Eyes with RVO that achieve good outcomes early, following more intensive VEGF inhibition and that improve further over 6 months without therapy are likely to achieve sustained, treatment-free quiescence through 24 months.

BACKGROUND:To provide insights into the effectiveness and safety of faricimab for treatment-naïve eyes with neovascular age-related macular degeneration (nAMD). METHODS:A retrospective cohort study using a prospectively-designed registry. Treatment-naïve eyes with nAMD in Australia starting treatment with faricimab between Jan 2023-Sep 2024 were included. Controls were treatment-naïve eyes starting with aflibercept 2 mg before 2022. Visual acuity (VA), macular neovascularisation activity, time to first inactivity, number of injections, injection intervals and number of visits at 12 months were investigated. Eyes treated with faricimab versus aflibercept 2 mg were compared using overlap weighting. The main outcome measure was the 12-month VA change. RESULTS:Twenty-three practitioners treated 160 eyes with a 4-letter gain in VA (mean, 61.5-65.5 letters) and 48% attaining a dosing interval of ≥ 12 weeks, although 22% were still treated at < 8 weekly intervals. The small proportion (6.9%) of eyes switching to another agent had improved vision but were mostly active when switching off faricimab. Eyes received 7.2 injections (mean) at 7.4 visits (mean), receiving treatment at 98% of visits indicating a strongly proactive treatment regimen. Most (71%) lesions became inactive by 12 months with a mean time to inactivation of 10.3 weeks. Eyes starting faricimab had a significantly higher inactivation rate with more eyes reaching the last injection interval of ≥ 12 weeks than those starting aflibercept 2 mg. CONCLUSIONS:These findings indicate that faricimab is safe and effective for treatment-naive eyes with nAMD. Faricimab had a stronger effect on nAMD lesion activity than aflibercept 2 mg.

Abstract:PURPOSE: Toxoplasmosis is the most common cause of infectious uveitis of the posterior segment. Current literature regarding this parasitic ocular infection in children is sparse. In this study, we focused on localisation of retinal infiltration and visual outcome in children and adolescents. Abstract:MATERIAL AND METHODS: Single-centre, retrospective study from 2012 to 2021. Patients were divided into three subgroups depending on foveal involvement: (1) direct foveal infiltrate, (2) with extrafoveal infiltrate, either with or (3) without fovea-involving inflammation. The primary outcome was visual acuity (VA) improvement (Snellen, decimal). The secondary outcome was the VA outcome depending on foveal involvement. Wilcoxon signed rank test (SPSS Statistics 26) was used for statistical analysis. Abstract:RESULTS: Data of 144 paediatric uveitis cases were identified, with active ocular toxoplasmosis in 21 (14.5%) patients. Data analysis was permitted in 20/21 patients. Oral antibiotic and prednisone therapy and additional topical steroids were initiated if deemed necessary. Overall, VA improved from first presentation (mean 0.5, range hand motion to 1.0) to last follow-up (mean 0.7, range counting fingers to 1.0; p = 0.001). Focusing on the subgroups, the most substantial VA improvement was reported in group 1 (0.042 to 0.30; p = 0.028) and in group 2 (0.62 to 0.9; p = 0.078). Abstract:CONCLUSION: In children in adolescence, VA improves the symptoms of in children of fovea involving ocular toxoplasmosis. Direct foveal infiltrate is associated with the lowest visual acuity outcome but also with the most substantial VA improvement.

PURPOSE:To evaluate visual outcomes observed across visit gaps in patients with neovascular age-related macular degeneration (nAMD) treated with anti-VEGF therapy in routine clinical practice. DESIGN:Retrospective data analysis from a prospectively designed observational outcomes registry: the Fight Retinal Blindness!. PARTICIPANTS:Treatment-naïve nAMD eyes receiving intravitreal anti-VEGF therapy (≥1 injection), monitored at least quarterly during the first treatment year, and experiencing a visit gap of ≥6 to 12 months, with subsequent follow-up over the next 9 months (≥3 visits). METHODS:Visual outcomes were assessed using a segmented linear mixed-effect model. Cumulative incidence and risk factors for visit gaps were evaluated using Aalen-Johansen estimators and Cox regression models. MAIN OUTCOME MEASURES:The main outcome was the mean estimated change in visual acuity (VA) immediately after the visit gap. Secondary outcomes included the cumulative incidence and associated risk factors of visit gaps. RESULTS:From 3694 eligible eyes for the survival analysis, we tracked 262 (7.1%) eligible eyes experiencing a visit gap for the visual outcome analysis. Neovascular age-related macular degeneration-treated eyes experiencing a 6- to 12-month visit gap had a significant drop in vision immediately after the visit gap, with a mean (95% confidence interval) estimated change in VA of -4.9 letters (-6.0 to -3.7; P < 0.001). Eyes with active choroidal neovascularization (CNV) lesions (difference -3.9 [-7.1 to -0.3] letters vs. inactive CNV) and without subfoveal macular atrophy (MA) (difference 3.4 [-0.3 to 7.0] letters vs. subfoveal MA) at the last visit before the gap experienced a greater decline in VA after the visit gap. A quarter of the eyes experienced a 6- to 12-month visit gap at 6.5 years. Neovascular age-related macular degeneration eyes with a longer time interval since last injection were more likely to experience a visit gap, whereas eyes with better VA and that had active CNV with subretinal fluid only at follow-up visits were less likely. CONCLUSIONS:Visit gaps were common and associated with a significant visual decline across the visit gap in nAMD eyes treated with anti-VEGF therapy in routine clinical practice. FINANCIAL DISCLOSURE(S):Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

We evaluated 24-month real-world outcomes of intravitreal aflibercept 2 mg for diabetic macular edema (DME) in treatment-naive eyes and eyes previously treated with macular thermal laser photocoagulation. This retrospective observational cohort study analyzed data from a prospectively designed treatment outcomes registry. We described outcomes separately in treatment-naive eyes and eyes previously treated with macular thermal laser photocoagulation, all of which received intravitreal aflibercept 2 mg for DME in routine clinical practice. Given the small number of eyes with prior macular laser, findings in this subgroup were considered descriptive and exploratory. The main functional outcome was change in visual acuity (VA) from baseline at 6, 12, and 24 months. The main anatomical outcome was change in central subfield thickness (CST) from baseline at the same time points. Secondary outcomes were injection and visit burden, changes in center-involving clinically significant macular edema activity, time to additional macular laser treatment, and ocular adverse events. The cohort included 122 eyes from 78 patients: 110 treatment-naive eyes and 12 eyes with prior macular laser. In treatment-naive eyes, mean VA improved from baseline by 5.5, 5.0, and 5.5 letters at 6, 12, and 24 months, respectively. Mean CST decreased by 105.9 µm, 90.4 µm, and 97.1 µm, respectively. In eyes with prior macular laser, changes in VA were not statistically significant at any follow-up point. CST decreased significantly at 6 months (−36.5 µm) and 12 months (−37.5 µm), but not at 24 months (−26.1 µm). By month 24, the median number of injections was 12 in treatment-naive eyes and 11 in eyes with prior macular laser. Additional macular laser was rarely needed, and ocular adverse events were rare. In routine clinical care, intravitreal aflibercept 2 mg for DME was associated with sustained anatomical improvement and modest, largely stable visual gains over 24 months, particularly in treatment-naive eyes. These findings support favorable real-world outcomes with aflibercept, although subgroup findings in eyes with prior macular laser should be interpreted cautiously.

To evaluate the epidemiology of herpetic keratitis over a 15-year period at a tertiary care center in Switzerland, focusing on the relative incidence of herpes simplex virus (HSV)-1, HSV-2, and varicella zoster virus (VZV), gender distribution, and co-infections, we conducted a retrospective single-center analysis of polymerase chain reaction (PCR) assays from corneal and conjunctival scrapings of suspected herpetic keratitis at a tertiary referral hospital. Patient demographics, viral spectra, and microbiological co-infections were assessed. Between 2010 and 2025, we identified 9954 PCR assays from 2892 patients, with 482 samples testing positive for herpesvirus. HSV-1 was the most frequent pathogen (328 of 3358, 9.8%), followed by VZV (143 of 3112, 4.6%), HSV-2 (9 of 3290, 0.27%), and CMV (2 of 194, 1.0%). Triplet testing (simultaneous HSV-1, HSV-2, and VZV-PCR) enabled direct comparisons of relative incidence rates. We found 2913 triplet testing results, with a relative distribution in positive results of 65.4% for HSV-1, 32.5% for VZV, and 2.1% for HSV-2. HSV-1 keratitis had a statistically significant higher incidence in men (58.9%, p = 0.0044), while no sex difference was detected for VZV (47.9%, p = 0.6683), HSV-2 (33.3%, p = 0.5078), or CMV (100%, p = 0.500). Bilateral infections were present in two patients, and co-infections were detected as follows: 8 cases of HSV-1/VZV co-detection, 3 cases of Acanthamoeba, and 15 of fungi. HSV-1 was the overwhelmingly dominant cause of herpetic keratitis at our institution, occurring more than twice as frequently as VZV and vastly outnumbering HSV-2. The statistically significant higher incidence in men in HSV-1 keratitis suggests possible biological or sociodemographic influences, whereas co-infections highlight the complexity of corneal pathology in a referral setting. These findings underscore the importance of multiplex PCR testing for accurate pathogen detection and provide insights into the epidemiologic landscape of herpetic keratitis.

Gonococcal and chlamydial conjunctivitis and keratoconjunctivitis are potentially sight-threatening ocular manifestations of sexually transmitted infections. Recent epidemiological data indicate rising rates of gonorrhoea and chlamydia infections worldwide, raising concerns about a possible increase in associated ocular infections. This retrospective single-center study analyzed the frequency and temporal trends of laboratory-confirmed gonococcal and chlamydial ocular infections in adults treated at the University Hospital Zurich between January 2005 and July 2025. Clinical characteristics, treatment, complications, and outcomes were additionally assessed for gonococcal cases. We identified 17 gonococcal and 121 chlamydial conjunctivitis or keratoconjunctivitis cases over the past approximately 20.5 years. A marked increase in gonococcal cases was observed between 2021 and 2025 (p < 0.0001), during which 70.6% of all cases were diagnosed. Complications occurred in 41.1% of gonococcal infections, including one corneal perforation requiring keratoplasty. Although gonococcal conjunctivitis and keratoconjunctivitis remain rare, their recent increase and risk of severe ocular complications highlight the importance of early recognition and prompt treatment. In contrast, chlamydial conjunctivitis was more common, affected a younger population, and showed a significant declining trend, with an average annual decrease of 5% (p = 0.0015).

Hydroxychloroquine (HCQ) is a frequently used drug for a variety of rheumatological conditions. One significant adverse effect is HCQ retinopathy, which irreversibly affects the photoreceptor layer and retinal pigment epithelium, causing paracentral scotomas and potential visual loss. Retinal impairment is irreversible, even after termination of therapy. This study investigates the progression of the retinal destruction after drug cessation. The study was performed at the Departments of Ophthalmology at Zurich University Hospital and Tel Aviv Sourasky Medical Center from January 2012 – December 2020. In a multicenter retrospective observational design, we analyzed 25 lesions in 18 eyes of 11 patients with HCQ retinopathy. Patients were examined for retinal alterations using spectral-domain (SD) optical coherence tomography (OCT) scans (Heidelberg Engineering, Heidelberg Germany) at first diagnosis of HCQ retinopathy and at least one follow-up (minimum follow up 2 months duration, maximum follow up 5.5 years). Demographics and clinical aspects including age, ethnicity, therapy duration, indication, cumulative dosage, and follow-up interval were recorded. The lengths of the structural damage including ellipsoid zone defect and photoreceptor alterations were analyzed on OCT images. Demographically, the average patient age was 53.0 years at time of enrollment. All patients were female. The cohort consisted of 54.5

Background: Autologous serum eye drops (ASEDs) are produced without preservatives and need to be stored at 2–8 °C while in use. This study aims to analyze the behavior of specific bacteria and fungi in the case of contamination during the usage of single-day use ophtioles containing ASED. Methods: This is a prospective experimental study conducted at the Department of Ophthalmology, University Hospital of Zurich (USZ), and a regulatory-licensed, independent, external laboratory. The laboratory performed microbial testing on the ASEDs with 11 microorganisms in 100% concentration or 50% diluted using the original 2.5 mL ASED ophtioles provided by the Eye Bank of the Department of Ophthalmology, USZ. Storage took place at 2–8 °C and 20–25 °C. The acceptance criterion was the absence of microbial growth between opening (T0), 24 h afterwards (T24), and 48 h afterwards (T48). Results: The acceptance criteria were met for all microorganisms for 2–8 °C. For seven microorganisms, the acceptance criteria were met for 2–8 °C and 20–25 °C. For four microorganisms, the acceptance criteria were only met for 2–8 °C. Conclusions: No relevant growth was observed in any of the test strains from T0 to T24 and T48 at 2–8 °C, demonstrating the microbiological safety of reclosable single-day use ophtioles containing unpreserved ASEDs when stored at 2–8 °C.

Background To evaluate risk behaviors for infectious keratitis among contact lens (CL) wearers in Switzerland, focusing on survey-based, observational subgroup analyses by contact lens type. Methods This investigator-initiated, cross-sectional, survey-based, observational, multi-center study was conducted across five eye care institutions in Switzerland. Between August 2023 and August 2024, we interviewed participants wearing CLs using a structured questionnaire. We assigned four subgroups, which included daily disposable soft contact lenses (SCL), reusable SCL, rigid corneal contact lenses (RCL), and rigid scleral contact lenses (ScCL). The survey collected data on demographics, CL type and indication, self-assessed CL knowledge, and risk behaviors related to infectious keratitis. We classified risk behaviors into three main categories, including hand hygiene, wearing behavior, and exposure to water or saliva. Results 156 participants were included in the final analysis. Regarding the subgroup allocation, 38 of 156 (24.4%) wore daily disposable SCLs, 48 (30.8%) reusable SCLs, 40 (25.6%) RCLs, and 30 (19.2%) ScCLs. Overall, participants wearing rigid CLs felt better informed about CL care and demonstrated fewer risk behaviors than SCL users. However, risk behaviors were observed across all subgroups, including applying or removing lenses with potentially contaminated hands, extended CL wear, sleeping with CLs, and exposure to water or saliva. Conclusion This study revealed variations in hygiene practices, wearing behavior, exposure to water or saliva, and risk perception across different CL types. Nevertheless, risk factors for infectious keratitis were present among all subgroups, underscoring the need for lens-specific patient education under professional supervision to improve compliance and mitigate complications.

OBJECTIVES:This work describes the design and methodological framework of the I-SCREEN project, which aims to develop an artificial intelligence (AI)-based infrastructure utilising optical coherence tomography (OCT) for early detection of AMD and assessment of progression risk. METHODS:The pan-European project is conducted across clinics and optometry/optician practices in six European countries. I-SCREEN encompasses seven work packages covering community-based AMD identification, clinical follow-up, AI development and project dissemination. Three interconnected clinical studies are carried out by optometry/optician practices (PYRENEES) and ophthalmology clinics (SUDETES and APENNINES). RESULTS:The PYRENEES study is a prospective, cross-sectional study evaluating the feasibility of detecting subclinical AMD in optometry/optician practices under ophthalmologist supervision via telemedicine. A robust screening network comprising 28 community-based optometry/optician practices and 7 ophthalmology clinics has been established. Patients with suspected non-neovascular AMD are referred to partnered clinics. In the hospital setting, patients with early or intermediate AMD are followed in the longitudinal SUDETES study, while patients with non-foveal geographic atrophy are invited to take part in the APENNINES study. Data obtained inform AI development for community-based AMD detection and monitoring. Predictive modelling will further enable personalised risk assessments. CONCLUSIONS:I-SCREEN brings together multidisciplinary experts across Europe to establish an AI-driven shared care model for AMD detection and monitoring. By combining high-quality OCT imaging from community practices with longitudinal clinical studies, the initiative provides novel insights into early AMD progression and  establishes a foundation for innovative AI-based detection and prediction throughout the real-world population.

Abstract:PURPOSE: To present infectious keratitis associated with overnight orthokeratology lenses. Abstract:METHODS: This investigator-initiated, dual-centre, retrospective study reviewed patients with orthokeratology-associated infectious keratitis between 2021 and 2024. Abstract:RESULTS: We identified seven cases of infectious keratitis in orthokeratology lens wearers. The first was an 18-year-old female with bilateral severe keratitis. Corneal scrapings revealed Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus caprae/capitis, Cutibacterium acnes in the right eye, Staphylococcus aureus in the left, and Acinetobacter baumannii complex on both lenses. Despite intensive inpatient treatment, she discontinued care prematurely. The second was an 18-year-old female with unilateral Acanthamoeba keratitis confirmed by PCR and in vivo confocal microscopy. The anti-amoebic treatment resulted in clinical improvement. The third, a 20-year-old female, showed unilateral infectious keratitis without pathogens, improving under empirical antibiotics. The fourth, a 20-year-old male, presented with unilateral peripheral corneal infiltrates, neovascularisation, and corneal ulceration, improving without corneal scrapings. The fifth, a 34-year-old male, had severe unilateral keratitis with corneal ulceration and hypopyon. Corneal scrapings revealed Streptococcus dysgalacticae by culture and HSV-1 by PCR, which responded to intensive antiviral and antibiotic treatment. The sixth, a 34-year-old male, initially diagnosed with herpetic keratitis, was later PCR-confirmed for Acanthamoeba and required penetrating keratoplasty after prolonged anti-amoebic therapy. The seventh, a 17-year-old female, had PCR-confirmed Acanthamoeba keratitis and recovered to a corrected visual acuity of 1.2 after six months of anti-amoebic treatment. Abstract:DISCUSSION: Overnight orthokeratology lens use can be associated with severe, sight-threatening infectious keratitis of various microbial origins. Enhanced patient education and strict lens hygiene practices are critical to reducing such complications.