RetinaDigest

In a 15-year MRI cohort study of highly myopic eyes, five distinct 3D globe remodeling patterns were identified, with focal deformation patterns—independent of axial elongation—strongly associated with MMD progression, posterior staphyloma, and myopic traction maculopathy.

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In this multicenter retrospective study of 166 eyes undergoing vitrectomy for lamellar macular hole (LMH), approximately 15% failed to achieve anatomic success—either developing unresolved LMH or postoperative full-thickness macular hole (FTMH)—both of which were associated with significantly worse visual outcomes and the absence of ILM peeling.

In this systematic review and meta-analysis of 610 eyes, vitrectomy for lamellar macular holes with epiretinal proliferation (LHEP) was associated with significant visual improvement (~1.7 lines), while observation yielded no significant visual change and comparable rates of progression to full-thickness macular hole.

En face OCT classification of supra-RPE deposits in idiopathic full-thickness macular holes into fine versus granular morphology independently predicts postoperative visual recovery, with granular deposits associated with worse visual acuity and greater outer retinal band disruption at 6 months.

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In a large propensity-matched cohort study of over 274,000 patients, atopic dermatitis (AD) was associated with nearly 5-fold increased risk of retinal detachment repair and 45% increased risk of postoperative proliferative vitreoretinopathy (PVR) compared to controls.

In this prospective study of 88 patients, aqueous humor TGF-β1 was significantly elevated in eyes with PVR secondary to RRD and demonstrated strong discriminative performance (AUC 0.92) for identifying PVR, while aqueous ACE elevation appeared to reflect general RRD-related intraocular changes rather than PVR specifically.

Primary PPV for giant retinal tear-related retinal detachment achieved high single-surgery anatomic success (88.2%) and final anatomic success (96.3%), with gas tamponade showing a trend toward better visual outcomes compared to silicone oil, particularly in macula-on eyes.

A prospective case series of 20 highly myopic eyes demonstrated 100% macular hole closure at 12 weeks using an ILM flap technique without gas tamponade, with median closure achieved at 1 week and significant visual acuity improvement sustained through 24 weeks.

This systematic review and meta-analysis of 26 studies found that AI-based models demonstrate strong predictive performance for vitreoretinal surgical outcomes, with pooled sensitivity of 0.89 and specificity of 0.87, though evidence quality remains low and external validation is lacking.

In this retrospective study of 609 primary scleral buckles, external subretinal fluid drainage did not improve single-surgery anatomical success or final visual acuity compared to non-drainage, supporting an individualized approach based on case characteristics and surgeon preference.

In Zone III open-globe injuries, PVR proliferative activity begins within 7–14 days and is associated with irreversible retinal disorganization beyond two weeks, suggesting a narrow window for early vitrectomy to preserve retinal integrity.

Following macular hole surgery with ILM peeling, the surrounding retina continues to shift asymmetrically toward the optic disc for at least one year, with temporal retinal displacement correlating inversely with basal macular hole diameter.

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This expert narrative review synthesizes advances across five biomaterial domains in retinal surgery—vitreous substitutes, retinal prostheses, RPE transplant scaffolds, sustained-release drug delivery, and gene therapy vectors—demonstrating a paradigm shift from disease stabilization toward tissue replacement and vision restoration.

Systemic eligibility criteria used in anti-VEGF clinical trials for DME exclude a substantial proportion of real-world patients—up to 59% under stringent criteria—with Black patients and other racial minorities disproportionately affected.

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In a prospective study of 164 type II diabetic patients, aqueous levels of IL-6, IL-8, IL-10, FLT-3L, and FGF-2 were significantly elevated in eyes with diabetic macular edema (DME), identifying these cytokines as key inflammatory mediators of the disease.

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In treatment-naïve DME eyes, aqueous flare did not differ from cataract controls, suggesting a milder anterior segment inflammatory profile compared to Irvine-Gass syndrome, while hyperreflective foci and ellipsoid zone disruption were more prevalent in DME and may reflect underlying inflammatory signaling.

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In this prospective RCT (COED Trial), combined dexamethasone implant plus aflibercept achieved faster DME resolution by a median of 12 weeks compared to aflibercept monotherapy, but demonstrated similar anatomic and visual outcomes at 48 weeks with a trend toward fewer injections in the combination group.

In a prospective randomized trial of 80 eyes with center-involving diabetic macular edema, combining intravitreal dexamethasone implant (Ozurdex) with navigated subthreshold micropulse yellow laser (577 nm) applied 4 weeks later yielded superior visual acuity gains, greater central subfield thickness reduction, and longer retreatment-free survival compared to dexamethasone monotherapy over 12 months.

In this retrospective case series, serial intravitreal anti-VEGF therapy achieved foveal reattachment in 75% of eyes with fovea-off tractional retinal detachment from proliferative diabetic retinopathy, with mean visual acuity improving from 20/1233 at presentation to 20/204 at last follow-up among reattached eyes.

In treatment-naïve neovascular AMD eyes receiving anti-VEGF therapy, RNFL thickness decreased during the loading phase (likely reflecting resolution of edema) but stabilized thereafter, while GC-IPL thickness progressively declined regardless of treatment—mirroring the pattern seen in untreated fellow eyes with dry AMD.

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In this prospective cohort of 75 Asian eyes with fovea-involving submacular hemorrhage due to neovascular AMD or PCV, one-third achieved ≥20/40 vision at 12 months, with younger age, better baseline BCVA, thicker subfoveal choroid, and smaller hemorrhage size independently predicting visual outcome.

In a multicenter cohort of 195 eyes with spontaneously resolved acute CSCR, only 55% achieved ≥20/20 VA, with older age, poorer baseline VA, absent serous PED, and bilaterality independently predicting failure to reach 20/20 vision.

While a general association between cardiovascular disease (CVD) and AMD has not been established, specific high-risk cardiovascular diseases (HRCVDs) that compromise choroidal perfusion are strongly linked to subretinal drusenoid deposits (SDDs), suggesting a distinct vasculopathic pathway in AMD pathogenesis.

This systematic review of 155 studies (9,025 patients) found that while OCTA provides detailed noninvasive visualization of macular neovascularization in nAMD, significant methodological heterogeneity in devices, scan protocols, segmentation strategies, and artifact correction substantially limits cross-study comparability and reproducibility.

In a large propensity score-matched cohort of over 1.2 million patients, NSAID use was associated with a significantly reduced risk of AMD development (HR 0.58), with protective effects observed for both nonexudative and exudative subtypes across follow-up periods up to 5 years.

In patients with neovascular AMD on anti-VEGF therapy, phacoemulsification increased treatment needs in 45% of eyes, with higher preoperative choroidal vascularity index (CVI) independently predicting this risk and PCV subtype showing the greatest vulnerability.

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In a large-scale real-world analysis of over 129 million patients, retinal artery occlusions (RAO) carried significantly higher risks of ischemic stroke, ischemic heart disease, myocardial infarction, atrial fibrillation, and mortality compared to retinal vein occlusions (RVO), with CRAO posing the greatest overall systemic vascular risk.

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In this OCTA study of 92 patients with coronary microvascular dysfunction (CMD), the deep capillary plexus (DCP) emerged as the sole independent predictor of CMD (OR 7.54), suggesting retinal microvasculature—particularly the DCP—may serve as a non-invasive biomarker for systemic microvascular disease.

In patients with macular edema from retinal vein occlusion, earlier initiation of intravitreal aflibercept 2 mg yielded significantly greater visual acuity gains, while poor baseline BCVA predicted larger letter gains but lower final visual acuity regardless of treatment timing.

Fellow eyes of patients with unilateral CRAO demonstrate a significantly higher prevalence and burden of retinal ischemic perivascular lesions (RIPLs) on SD-OCT compared to healthy controls (74.4% vs. 24.6%), suggesting subclinical microstructural ischemic changes are detectable even in clinically unaffected eyes.

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The biosimilar SSGJ-601 demonstrated non-inferiority to ranibizumab in improving BCVA at 24 weeks in patients with BRVO-related macular edema, with comparable safety and immunogenicity profiles over 52 weeks.

This retrospective study of 182 Korean patients with USH2A-associated retinitis pigmentosa identified a distinct East Asian variant spectrum dominated by c.2802T>G (p.Cys934Trp) in exon 13, with Usher syndrome phenotype and higher truncating variant burden correlating with worse visual outcomes over time.

In the TEASE-1 randomized clinical trial, oral gildeuretinol acetate demonstrated a statistically significant 21.6% relative reduction in retinal atrophic lesion growth rate in Stargardt disease over 24 months, with a favorable safety profile, though clinical significance of this endpoint remains to be established.

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In 58 patients with rod-cone dystrophies, the hyperautofluorescent ring on fundus autofluorescence follows a highly predictable logarithmic (exponential decay) progression pattern, and RPGR gene therapy with Cotoretigene Toliparvovec was associated with measurable reversal of this ring alongside improvements in retinal sensitivity.

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This systematic review of 5 studies (498 eyes, 422 patients) found that ciliary neurotrophic factor (CNTF) therapy slows retinal degeneration and may preserve visual function in macular telangiectasia type 2 (MacTel), though functional benefits remain variable and long-term efficacy requires further study.

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This systematic review of 28 studies (376 patients, 673 treated eyes) found that voretigene neparvovec-rzyl consistently improves light sensitivity and visual field—particularly in pediatric patients treated before advanced degeneration—while BCVA gains are variable and modest, and perifoveal chorioretinal atrophy develops in approximately 75% of treated eyes.

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This AAO systematic review of 26 studies found no significant difference in neurodevelopmental outcomes between intravitreal anti-VEGF and laser photocoagulation as primary treatment for ROP, though evidence is limited by lack of adequately powered trials.

In anti-VEGF-treated Type 1 ROP eyes, retinal vascular extension was significantly greater in both nasal and temporal hemispheres compared to controls, but treated eyes exhibited notable nasal-temporal asymmetry, suggesting uneven anti-VEGF drug distribution within the infant vitreous.

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The MUV Taskforce developed consensus-based multimodal imaging guidelines for ocular toxoplasmosis, concluding that typical active OT remains a clinical diagnosis requiring only color fundus photography, while OCT and FAF are valuable adjuncts for disease monitoring and atypical presentations.

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In demyelinating disease-associated uveitis, 68.8% of clinically inactive eyes demonstrated ongoing peripheral vascular leakage on ultrawidefield fluorescein angiography (UWF-FA), highlighting a significant discordance between standard clinical examination and angiographic disease activity.

In this large propensity score-matched cohort study, melanoma patients receiving immune checkpoint inhibitors (ICIs) had a 6-fold higher risk of noninfectious uveitis compared to lung cancer patients, with elevated risk persisting even after excluding ipilimumab/nivolumab, suggesting an intrinsic disease-specific component to ICI-associated uveitis.

In inactive MFCPU/PIC lesions, Bruch's membrane disruption (94.7%) and inner nuclear layer herniation into focal choroidal excavation (57.9%) are highly characteristic OCT features that strongly differentiate these lesions from atrophic scars caused by infectious and inflammatory mimickers.

In chronic central serous chorioretinopathy treated with verteporfin PDT, symptom duration predicts anatomical resolution of subretinal fluid, while baseline photoreceptor integrity—graded via a novel 6-stage SD-OCT classification—is the primary determinant of visual acuity recovery after treatment.

Inner choroidal fibrosis (ICF) in chronic central serous chorioretinopathy (CSC) is associated with persistent subretinal fluid, poor treatment response, and progressive enlargement over time, with Type 2 ICF (well-demarcated accumulations) carrying worse visual outcomes than Type 1.

En face OCT using minimum intensity projection (MIP) demonstrated high sensitivity (0.82) for detecting fluorescein angiography-defined inflammatory retinal vascular changes in uveitis, substantially outperforming retinal thickness maps and offering a promising noninvasive adjunct for uveitic disease monitoring.

Structural en face OCT using a customized outer plexiform layer-outer nuclear layer slab demonstrated high sensitivity (0.94) but limited specificity (0.38) for detecting FA-defined inflammatory retinal vascular activity in uveitis, supporting its use as a noninvasive adjunctive screening tool rather than a standalone diagnostic.

Multimodal imaging reveals fundamentally distinct anatomic and immunopathogenic mechanisms among the six classically grouped 'white dot syndromes,' challenging the validity of this umbrella terminology and supporting a shift toward disease-specific classification.

This retrospective case series characterizes a distinct perivascular phenotype of multifocal choroiditis with panuveitis (MCP), demonstrating reproducible lesion distribution along retinal vessels with generally preserved visual acuity and a 21% rate of choroidal neovascularization responsive to anti-VEGF therapy.

Thin-choroid CSC (subfoveal choroidal thickness ≤250 µm) represents a distinct clinical phenotype affecting older, predominantly female patients, with a significantly higher rate of choroidal neovascularization compared to classic thick-choroid CSC, though age may be the primary driver of CNV risk.

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In a landmark series of 4,000 eyes with posterior uveal melanoma treated with plaque radiotherapy, significant visual acuity loss (≥15 letters) occurred in 30% at 1 year and 82% at 10 years, with greater tumor thickness, proximity to the foveola, higher radiation dose to the foveola and lens, and diabetes mellitus as key predictive risk factors.

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This systematic review and meta-analysis of over 787,000 intravitreal anti-VEGF injections found a pooled rhegmatogenous retinal detachment risk of 0.012% per injection (1 in 8,675 injections) and 0.08% per eye (1 in 1,250 eyes), providing clinicians with quantified risk estimates for informed consent discussions.

In a large 5-year retrospective series of 138,216 intravitreal injections at Bascom Palmer, the cumulative endophthalmitis incidence was 0.0072%, with no significant difference in rates between agents and a trend toward zero cases in 2025.

In this large IRIS Registry analysis of over 17 million ophthalmic procedures, endophthalmitis rates varied significantly by procedure type, with open-globe repair carrying the highest risk in both adults (0.94%) and pediatrics (0.87%), and pediatric patients facing a significantly higher endophthalmitis risk after cataract surgery compared to adults.

This systematic review and meta-analysis of nearly 2 million vitrectomies found an overall postvitrectomy endophthalmitis incidence of 0.14%, with nonfluid intraocular tamponade significantly reducing infection risk, while subconjunctival antibiotics, small-gauge instrumentation, and combined phacovitrectomy did not significantly alter endophthalmitis rates.

Adjunctive 0.025% povidone-iodine irrigation during pars plana vitrectomy for infectious endophthalmitis was associated with significantly better visual outcomes at 3 and 6 months compared to standard irrigation, without observed ocular toxicity.