RetinaDigest

This case report identifies outer retinal corrugations on OCT as a novel diagnostic biomarker for Schwartz-Matsuo syndrome, a rare condition combining chronic rhegmatogenous retinal detachment, anterior chamber inflammation, and elevated IOP.

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Fovea-sparing ILM peeling (FSIP) for myopic traction maculopathy resulted in a significantly higher incidence of postoperative epiretinal membrane formation (17.4%) compared to standard ILM peeling (5.0%), though most ERMs were subclinical and did not affect visual outcomes.

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In patients with vitreous hemorrhage from posterior vitreous detachment, 62% cleared spontaneously while 17% developed rhegmatogenous retinal detachment, with most detachments occurring within the first 3 weeks.

In high myopia patients undergoing posterior scleral contraction, 10.76% developed myopic maculopathy progression despite surgical improvements in visual acuity and axial length, with steeper corneal curvature and higher IOP being key risk factors.

Large IRIS Registry analysis of 4,784 eyes with intraocular foreign bodies found significant visual improvement beginning at 2 months post-removal, with worse outcomes associated with endophthalmitis, retinal detachment, hyphema, and Black/African American race.

Layer-specific OCT angiography analysis of idiopathic epiretinal membrane reveals that nerve fiber layer plexus parameters excel at diagnosis, while preoperative ganglion cell layer plexus integrity predicts postoperative visual recovery better than traditional superficial vascular complex metrics.

This systematic review and meta-analysis of 49 studies involving 3,492 individuals found that rhegmatogenous retinal detachment affects 41.9% of patients with Stickler syndrome, but prophylactic treatment reduces this risk by 92%.

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This systematic review of 33 studies involving over 100,000 participants found that sociodemographic factors significantly influence diabetic retinopathy screening adherence, with older age, higher education, higher income, and private insurance associated with better compliance.

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Subretinal balanced salt solution injection using a 40-gauge curved needle combined with vitrectomy and ILM peeling significantly improved visual acuity, macular thickness, and hard exudate resolution in diabetic macular edema patients compared to vitrectomy alone.

The DRSplus retinographer achieved >80% gradable image rates in nonmydriatic diabetic retinopathy screening, with AI demonstrating 97.3% sensitivity for detecting referable DR compared to reading center grading.

A novel metric combining OCT angiography parameters with foveal avascular zone (FAZ) enlargement significantly improves statistical models for detecting high-risk diabetic retinopathy, achieving AUCs of 0.91 for referable DR and 0.82 for proliferative DR.

Post hoc analysis of KINGFISHER study demonstrates that brolucizumab 6mg provides effective treatment for diabetic macular edema regardless of prior anti-VEGF exposure, with superior anatomical outcomes compared to aflibercept 2mg in both treatment-naive and previously treated patients.

This large retrospective cohort study of over 500,000 diabetic patients found that baseline diabetic retinopathy severity is independently associated with increased mortality risk, with proliferative DR patients having more than double the death rate compared to diabetics without retinopathy.

This 22-year retrospective cohort study of US diabetes patients reveals persistent racial disparities in diabetic retinal disease, with Hispanic patients now showing the highest prevalence rates (26.0% in 2021) and Black/African American patients consistently maintaining elevated rates compared to White patients.

Aflibercept 8 mg showed equivalent visual and anatomic outcomes compared to 2 mg in diabetic macular edema patients at 96 weeks, with efficacy maintained regardless of baseline visual acuity.

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Analysis of 386 eyes with bilateral geographic atrophy from AREDS2 found only modest correlations in enlargement rates between fellow eyes (r=0.11-0.51 depending on measurement method), challenging assumptions used in clinical trial designs.

A large retrospective cohort study of 72,074 cancer patients found that immune checkpoint inhibitor therapy was associated with a 23% reduced risk of developing non-neovascular AMD over 5 years, with no effect on neovascular AMD risk.

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Avacincaptad pegol (ACP) 2mg demonstrated sustained reduction in geographic atrophy growth over 2 years, with both monthly and every-other-month dosing showing 14% and 19% reduction respectively compared to sham treatment.

This retrospective cohort study found that levodopa exposure was associated with a 47% reduced likelihood of conversion from nonneovascular to neovascular AMD over 5 years, while other dopamine agonists showed no protective effect.

A deep learning-based convolutional neural network successfully automated measurement of choroidal thickness and choroidal vascularity index from swept-source OCT images with high accuracy (96.9%) and excellent correlation with expert ophthalmologist measurements (ICC 0.987).

In highly myopic eyes without preexisting RPE atrophy, one-third develop MNV-related atrophy within 2 years of MNV onset, with an annual enlargement rate of 0.22 mm²/year.

A combined vitrectomy technique using subretinal tenecteplase, intravitreal conbercept, and gas tamponade achieved favorable visual outcomes in 75% of patients with submacular hemorrhage, with earlier intervention showing better results.

GLP-1 receptor agonists were associated with reduced risk of both nonneovascular and neovascular AMD development compared to other glucose- and lipid-lowering medications in this large retrospective cohort study of patients over 60 years.

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In resolved central serous chorioretinopathy eyes with perifoveal angiographic leak, longer symptom duration and complex CSCR are associated with increased risk of ellipsoid zone atrophy following resolution.

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This retrospective study of 63 patients with complex central serous chorioretinopathy identified smoking, CSCR-related changes on baseline fluorescein angiography of the fellow eye, and reduced subfoveal choroidal thickness in the affected eye as independent predictors of bilateral disease development.

Foveal-sparing (button-hole) ILM peeling demonstrated superior visual outcomes and eliminated postoperative macular hole formation compared to conventional ILM peeling in patients with retinal arterial macroaneurysm rupture.

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Systematic workup of patients with acute isolated paracentral acute middle maculopathy (iPAMM) revealed abnormal findings in 64% of cases, with particularly high yield in patients over 65 years old (87.5%).

Sleep apnea increases the risk of retinal vein occlusion by approximately 22% in adults ≤55 years, primarily through increased branch RVO risk rather than central RVO.

This OCT angiography study of 66 preeclamptic patients found that severe preeclampsia causes greater reduction in deep capillary plexus and peripapillary vessel density compared to mild disease, with slower postpartum recovery despite improvement in both groups.

In this retrospective study of 596 patients with acute retinal artery occlusion, stroke or MI occurred in only 1.51% within one week and 13.3% over long-term follow-up, with no difference in outcomes between emergency room and outpatient evaluations despite more intensive workups in the ER setting.

Anti-VEGF therapy reduces epiretinal macrophage-like cells (eMLC) in BRVO-ME patients, with greater reduction in early responders receiving three injections compared to limited responders or fewer injections.

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A 54-year-old male presented with recurrent bilateral combined branch retinal vein and artery occlusions with PAMM as the initial manifestation of lung adenocarcinoma, associated with elevated antiphospholipid antibodies that normalized after tumor resection and chemotherapy.

This multicenter case series of 10 patients demonstrates that unilateral retinal pigment epithelium dysgenesis (URPED) encompasses a broader phenotypic spectrum than previously recognized, including covert forms detectable only on indocyanine green angiography, with frequent associations with hamartomatous lesions and choroidal neovascularization.

This large cohort study of 2,196 patients with RHO-associated retinopathy reveals significant geographic variation in common variants and demonstrates that biological classification predicts disease severity, with R135W emerging as a particularly aggressive variant.

A cost-effectiveness analysis found that a hypothetical gene-agnostic therapy for retinitis pigmentosa, priced at $1.5 million for both eyes, may be cost-effective with an ICER of $158,554/QALY, particularly when initiated early at age 30.

In macular telangiectasia type 2, ellipsoid zone loss follows a sigmoid progression pattern over 30-40 years, with morphologic pattern being the strongest predictor of disease acceleration beyond 0.5 mm² of loss.

Patients with inherited macular retinal disease are significantly less likely to receive definitive genetic testing results compared to those with peripheral retinal disease, with macular patients having 58% lower odds of obtaining conclusive genetic diagnoses.

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This retrospective cohort study of 21 patients expands the phenotypic spectrum of TTLL5-associated retinal dystrophy to include cone dystrophy, cone-rod dystrophy, and rod-cone dystrophy, with high myopia being a consistent feature across all phenotypes.

Ultra-widefield imaging reveals that BEST1-related retinopathies are associated with significantly more peripheral retinal changes than controls, particularly white/dark without pressure and vascular abnormalities.

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A precision risk model incorporating gestational age, postmenstrual age, and vascular severity assessment successfully predicted treatment-requiring ROP within 2 weeks, potentially reducing screening examinations by 28-39% while maintaining 100% sensitivity.

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Surgical management of optic pit maculopathy achieves significant anatomical and visual improvements in both pediatric and adult patients, with 66.7% anatomical success rate and meaningful BCVA improvement from 0.92 to 0.44 logMAR.

This cross-sectional study of 2,032 healthy Chinese children aged 7-19 years established normative ranges for wide-field retinal and choroidal thickness using OCT, finding that choroidal thickness decreases with age and myopia severity while retinal thickness remains relatively stable.

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Ultra-widefield indocyanine green angiography (UWF-ICGA) detected peripheral retinochoroidal lesions beyond the vortex veins in 71.4% of uveitis cases, with the highest detection rates in ampiginous choroiditis and vasoproliferative tumors (100%).

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Dual infection with Mycobacterium tuberculosis complex and nontuberculous mycobacteria occurred in 4.11% of tubercular uveitis patients, presenting as severe bilateral panuveitis with universal optic atrophy but responding well to standard anti-tubercular therapy.

Uveitis has been reported with 18 of 71 FDA-approved protein kinase inhibitors (PKIs), most commonly vemurafenib, with anterior uveitis being the predominant phenotype requiring interdisciplinary management to preserve vision while maintaining cancer therapy.

Exudative retinal detachment (ERD) occurs in 4.34% of acute retinal necrosis (ARN) cases and indicates severe disease with extensive quadrantic involvement and high rates of occlusive vasculitis.

OCTA revealed selective reduction in deep capillary plexus vessel density in sarcoidosis patients compared to controls, even in those without clinical ocular involvement, suggesting subclinical microvascular compromise.

VKH patients have a 27.9% cumulative incidence of cataract surgery at 5 years, with substantial visual improvement following surgery, particularly in patients receiving systemic immunomodulatory therapy.

CMV retinitis presents with distinct clinical patterns across patient populations, with pediatric patients showing more severe bilateral disease and higher retinal detachment rates compared to HIV-positive and HIV-negative adults.

In a retrospective cohort study of 1,081 uveitis patients, 36.4% had at least one no-show appointment, with younger age, Black race, Medicaid insurance, and blindness identified as significant risk factors for appointment non-attendance.

This retrospective study of 27 TINU syndrome patients found that 52% had intermediate/posterior segment involvement beyond anterior uveitis, with 50% experiencing disease relapse despite treatment, indicating most patients require long-term immunosuppressive therapy.

A retrospective study of 54 patients with syphilitic uveitis found that 37% developed chronic inflammation, with cystoid macular edema (CME) at diagnosis and longer symptom duration being significant risk factors for chronicity.

Oral valacyclovir successfully treated three cases of acute retinal pigment epithelitis (ARPE) that failed to respond to systemic steroids alone, resulting in visual improvement and outer retinal layer regeneration on OCT.

Among uveitis patients with intermittent tattoo swelling, 34.9% were diagnosed with sarcoidosis, suggesting this clinical finding should prompt sarcoidosis workup including chest CT imaging.

This case series of seven pediatric VKH patients (ages 3-17) demonstrates that cataract and glaucoma are the most common complications, with adalimumab showing promise as an effective treatment option for refractory cases.

Abstract not available — see full article for details.

This case report describes the first documented occurrence of bilateral panuveitis with occlusive retinal vasculitis in anti-synthetase syndrome, representing one of the most severe ophthalmic presentations of this rare autoimmune disorder.

Adalimumab treatment for Behçet's uveitis rebalances NK cell activating/inhibitory receptors and shifts cells toward an exhausted-like phenotype, paralleling clinical improvement and suggesting NK receptor balance as a potential biomarker for treatment response.

This large retrospective study demonstrates strong bidirectional associations between 12 immune-mediated inflammatory diseases (IMIDs) and uveitis, with ankylosing spondylitis, juvenile idiopathic arthritis, and systemic vasculitis showing the highest risk ratios.

This consensus review emphasizes the critical importance of differentiating inherited retinal diseases from noninfectious posterior uveitis to avoid inappropriate immunosuppressive therapy and prevent vision loss.

Stressed retinal pigment epithelium (RPE) cells upregulate the transcription factor FoxP3 and inflammatory cytokines, then rapidly re-establish immune privilege through FoxP3-mediated mechanisms similar to regulatory T cells.

En face OCT and OCTA provide disease-specific imaging signatures that enhance diagnostic accuracy and management of inflammatory macular diseases by revealing layer-specific structural and vascular alterations.

Multimodal imaging analysis of 10 autoimmune retinopathy patients identified three distinct phenotypic clusters that may help characterize the heterogeneity of this condition.

A novel highly multiplexed pan-ocular-pathogen panel (OcuPan) assay demonstrated 50.9% sensitivity and 100% specificity for diagnosing infectious uveitis, with excellent agreement with PCR and ability to detect 46 ocular pathogens in a single 12-hour test.

Abstract not available — see full article for details.

Male patients and those using topical corticosteroids for active uveitis are significantly more likely to exhibit recurrent no-show patterns at a tertiary ocular immunology clinic, suggesting targeted interventions may improve adherence in these high-risk groups.

A national study of 2,911 non-infectious uveitis patients found significant disparities in biologic therapy access, with uninsured patients having 77% lower odds of receiving treatment and insurance status being the strongest predictor of biologic use.

This case report documents the first detection of interleukin-16 (IL-16) in vitreous fluid of a patient with vitreoretinal lymphoma, suggesting it may serve as an additional biomarker alongside IL-10 for diagnosis and monitoring treatment response.

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A case report demonstrates that vitreoretinal lymphoma can present with placoid hyperautofluorescent macular lesions mimicking autoimmune retinopathy, with CSF molecular analysis providing crucial diagnostic confirmation when vitreous biopsy is negative.

OCTA detected early subclinical microvascular changes following Ru-106 plaque brachytherapy for uveal melanoma, with radial peripapillary capillary density loss correlating strongly with optic nerve radiation dose and visual decline.

Secondary tumor-associated neovascularization (STN) developed in 12 eyes of retinoblastoma patients, primarily after intra-arterial chemotherapy, with intravitreal anti-VEGF injections achieving neovascularization control in most cases despite significant complications.

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Geographic location significantly influences retinoblastoma treatment patterns and modifies ethnoracial and socioeconomic disparities in care, with metropolitan patients having lower odds of receiving enucleation and chemotherapy.

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A novel OCT finding termed the "bucket handle sign" was identified in 8.2% of post-endophthalmitis patients, representing bullous internal limiting lamina separation with characteristic hyper-reflective band morphology.

Ultrasound biomicroscopy analysis of 22 sutureless intrascleral haptic-fixated IOLs (SIS-IOLs) showed they position more posteriorly than standard posterior chamber IOLs and demonstrate increased iris mobility over time.

A 5-year retrospective study of endogenous endophthalmitis identified swollen eyelids and ocular pain as critical red flags for poor prognosis, with Klebsiella pneumoniae infection being the strongest predictor of both visual loss and globe loss.

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This systematic review and meta-analysis of over 5.8 million intravitreal injections found that topical antibiotic prophylaxis does not reduce endophthalmitis risk and may actually increase risk in patients receiving anti-VEGF injections.

The 2025 AAO revision updates hydroxychloroquine retinopathy screening recommendations, emphasizing OCT and fundus autofluorescence as primary screening tools with baseline examination recommended soon after HCQ initiation.

This global pharmacovigilance study analyzing 30,761 FAERS reports revealed distinct ocular safety profiles for different anti-VEGF agents: aflibercept 8mg showed highest risk for intraocular inflammation and endophthalmitis, faricimab for injection-related inflammatory events, and aflibercept 2mg for structural complications.

Abstract not available — see full article for details.

This systematic review and meta-analysis of over 3 million intravitreal injections found no significant reduction in endophthalmitis rates with topical antibiotic prophylaxis compared to no prophylaxis, leading authors to recommend against routine antibiotic use.

This nationwide South Korean cohort study of 98,246 paclitaxel users found a 1.4% cumulative incidence of macular edema and/or cystic maculopathy, with a 4-fold increased risk compared to pre-treatment periods.

Early pars plana vitrectomy within 24 hours of diagnosis achieved significant visual improvement and 100% anatomical success in 15 cases of delayed-onset endophthalmitis following glaucoma surgery over a 10-year period.