Eye Center

To study the diagnostic performance of machine learning in the diagnosis of three retinal diseases presented with subretinal fluid: central serous chorioretinopathy, polypoidal choroidal vasculopathy, and Vogt-Koyanagi-Harada disease by using optical coherence tomography (OCT) images. Optical coherence tomography scans from 259 patients presented with subretinal fluid from central serous chorioretinopathy, polypoidal choroidal vasculopathy, and Vogt-Koyanagi-Harada disease, and 108 patients with no subretinal fluid were used to train the machine learning. Three methods include using all scans from each eye, using only one-line across fovea images and using both infrared and OCT images. The result was reported in precision, recall, F-1 score, accuracy, and area under the curve. Using one-line across the fovea OCT images combined with an infrared photo achieved the best performance with an overall area under the curve score of 0.965 and an accuracy of 87.10%. The precision, recall, and F1-score were 88.43%, 87.19%, and 87.18%, respectively. The authors introduced a new aspect of developing a machine learning model to differentiate among three major retinal diseases presented with subretinal fluid from OCT images. The use of one-line across fovea OCT images combined with infrared photograph showed the highest diagnostic performance because of the possible imaging biomarkers.

Strabismus surgery may affect choroidal circulation, with potential implications for outer retinal nourishment and visual function. We conducted a systematic review and meta-analysis to quantify postoperative changes in subfoveal choroidal thickness and vascularity parameters following strabismus surgery. A systematic search was conducted in PubMed, Scopus, and Web of Science. After two-stage title/abstract and full-text screening, eligible observational studies reporting pre- and postoperative optical coherence tomography (OCT) or OCT angiography (OCTA) choroidal measures were included. Random-effects meta-analyses estimated pooled mean differences for subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI), foveal choriocapillaris vessel density (VD), and choriocapillaris flow. Subgroup analyses, meta-regression, quality assessment using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool, and evaluation of publication bias were performed. Eighteen studies met the inclusion criteria. Pooled analysis of 22 groups (14 studies) showed no significant overall change in SFCT after strabismus surgery (mean difference − 1.13 μm; 95% CI − 6.93 to 4.67; p = 0.70; I2 = 52.1%). CVI (seven groups, five studies) showed no significant change (pooled mean change 0.001; 95% CI − 0.006 to 0.008; p = 0.70; I2 = 0.04%). Foveal choriocapillaris VD and flow showed no significant pooled changes, though choriocapillaris VD exhibited substantial heterogeneity (I2 = 87.9%). Meta-regression detected no associations with follow-up duration, surgical procedure, or number of muscles. No clear publication bias was observed. Current observational evidence suggests no consistent alterations in SFCT, CVI, or choriocapillaris vascularity metrics during the intermediate postoperative period following strabismus surgeries.

PurposeTo evaluate the real-world effectiveness of MiSight 1 Day soft contact lenses for myopia control in Taiwanese children using age-, sex-, and percentile-matched axial length (AL) references.MethodsRetrospective multicenter study across 23 Universal Eye Center clinics. Children aged 6–18 years who initiated MiSight between October 2020 and July 2022 and completed ≥12 months of follow-up were included. Spherical equivalent (SE) and AL were extracted from clinical records and annualized. Observed AL change was compared with matched Taiwanese normative percentiles to estimate axial suppression. Subgroups included age, baseline AL percentile, and prior treatment history.ResultsA total of 368 eyes from 368 patients were analyzed (mean age 11.8 ± 2.3 years; 52% female; mean follow-up 19.2 ± 5.0 months). Mean SE progression was −0.41 ± 0.42 D/year. Mean AL elongation was 0.17 mm/year, corresponding to a mean AL suppression of 0.06 mm/year relative to matched Taiwanese norms. Visual performance was favorable, with 98% achieving ≥20/25. Outcomes were similar across prior treatment groups, including previous atropine or orthokeratology exposure.ConclusionIn routine Taiwanese practice, MiSight 1 Day provided meaningful myopia control and maintained good vision. AL growth was reduced by 27% versus matched normative expectations. These findings support the translational effectiveness of MiSight and emphasize the value of regional normative benchmarks for clinical interpretation.

Objective: To compare two cylindrical refinements i.e. autorefractometer and straddling by taking patients response. Method: Study protocols was approved by Ethical Review Board of College of Ophthalmology and Allied Vision Science, Lahore. A proforma based nonrandomized interventional method of study was conducted in National Eye Centre Lahore from August 2025 to September 2025. The size of obtained sample was 91 that included young healthy adults of age 18-35 having 1.00-3.00 D of astigmatism. Auto refraction, subjective refraction and then straddling was performed and then response was recorded by taking consent. Exclusion criteria for this study was individual with any ocular pathology. P-value was calculated by using Paired sample T test. Value of ˂0.05 was considered significant. Results: No statistically visible significant differences were noted in between the methods (p-value > 0.05). Although minor variations exist in axis measurements, patients' satisfaction remained constant, showing that the interchangeability of the techniques was valid. These results agree with prior studies that stressed the flexibility yet accuracy needed in refractive assessment tools. Conclusion: The straddling technique offers a reliable, time-efficient alternative to auto-refractometers for cylindrical axis refinement, ensuring comparable accuracy and patient satisfaction.

PurposeTo evaluate the long-term efficacy of the bimatoprost sustained-release (SR) implant focusing on time to additional intraocular pressure (IOP) lowering intervention and changes in medication burden and IOP, with subgroup analyses by lens status and prior trabecular meshwork (TM) procedures.Patients and MethodsThis retrospective study included patients who received a single bimatoprost SR implant between September 2020 and June 2022 at a single center. Data was obtained from electronic medical records. The primary outcomes were time to failure defined as addition of IOP-lowering medications, procedures, or surgery, changes in topical medication use, and IOP over time. Kaplan-Meier survival analysis and linear mixed-effects models were used to assess overall outcomes and within subgroups.ResultsThe study included 223 eyes from 134 patients. At 6-, 12-, and 24-months post-implantation, 67.3%, 38.5%, and 20.5% of eyes, respectively, remained free of additional IOP-lowering treatment. The rates of survival were not statistically significant when stratified by lens status or history of TM procedures. The mean number of topical medications was 1.8 ± 1.3 at baseline and was significantly reduced beginning at 1 month and through 18 months (p < 0.001). There was not a significant IOP decrease post implantation. Subgroup analysis showed no significant differences in IOP and a borderline significant difference in medication use (p = 0.051) between phakic and pseudophakic eyes. Eyes with a history of TM procedures had higher IOP compared to those without prior intervention (p = 0.042), and medication use was not significantly different between groups.ConclusionIn this retrospective, single-center study the bimatoprost SR implant provided significant reduction in topical medication burden for 18 months. The implant provided six months of freedom from additional IOP lowering interventions in more than half of the eyes with an expected decline. A small group continued to be free from additional IOP lowering intervention for up to 24 months.

Abstract This prospective, multicenter, real-world evidence study evaluates the 12-month safety and effectiveness of standalone cyclodialysis with AlloFlo™ cleft reinforcement for intraocular pressure (IOP) reduction in open-angle glaucoma (OAG). AlloFlo represents the world’s first acellular, allogenic scleral tissue implant, and data from this CREST Study cohort ( NCT05506423 ) contribute critical long-term safety and effectiveness knowledge to the field of extracellular matrix biomaterials research, in addition to describing a novel procedure for surgical management of OAG. Eyes with investigator-confirmed inadequately controlled OAG were treated with standalone cyclodialysis using a microsurgical cannula (CycloPen™), followed by uveoscleral cleft reinforcement with AlloFlo. Eyes were followed prospectively for 12 months. Key outcomes included changes in medicated IOP, number of glaucoma medications, adverse events, and progression to subsequent glaucoma procedures. Forty-one eyes of 38 patients were included. Most eyes (66%) were considered treatment-refractory, defined as having any of: failed ≥ 1 incisional surgery or cilioablative procedure; condition in which incisional surgery would be more likely to fail than in eyes with uncomplicated OAG. At 12 months, mean IOP decreased 31% to 14.7 ± 6.9 mmHg (within the normal IOP range of 10-20 mmHg, p &lt; 0.001); mean number of glaucoma medications decreased 32% to 1.9 ± 1.6 (p &lt; 0.001). Seventy-one percent of eyes achieved ≥ 20% IOP reduction (a clinically meaningful benchmark set by the FDA). More than half of eyes (53%) achieved ≥ 20% IOP reduction without increasing medication. Three eyes (7.2%) progressed to incisional glaucoma surgery. Postoperative IOP elevations ≥ 10 mmHg occurred in 17% of eyes, most of which resolved within 30 days of the procedure. No persistent inflammation, implant rejection, clinically significant hyphema, or scaffold migration occurred. These findings suggest that uveoscleral outflow enhancement with AlloFlo provides a safe, conjunctiva-sparing option for IOP reduction in OAG, including eyes with prior surgical interventions.

To compare the posterior keratometry (PK) values obtained with three instruments based on optical coherence tomography (Anterion [Heidelberg Engineering], IOLMaster 700 [Carl Zeiss Meditec AG], and MS-39 [CSO]), and one Scheimpflug camera biometer (Pentacam AXL Wave; Oculus Optikgeräte GmbH). The average keratometry (Kave), total corneal power (TCP), anterior-to-posterior ratio (A/P ratio), and posterior corneal astigmatism (PCA) were also compared. Measurements by the four instruments, expressed in diopters (D), were compared using repeated measures analysis of variance, when they were normally distributed, or Friedman's test, when they were not. One hundred eyes (100 consecutive patients) scheduled to undergo cataract surgery were prospectively enrolled. Statistically significant differences among the Anterion, IOLMaster 700, MS-39, and Pentacam AXL Wave were detected for PK: Anterion: -6.08 ± 0.23 D, IOLMaster 700: -5.77 ± 0.23 D, MS-39: -6.15 ± 0.26 D, and Pentacam AXL Wave: -6.26 ± 0.26 D (P < .0001); for Kave: Anterion: 43.19 ± 1.50 D, IOLMaster 700: 43.35 ± 1.49 D, MS-39: 43.36 ± 1.53 D, and Pentacam AXL Wave: 43.22 ± 1.55 D (P < .0001); for the A/P ratio: Anterion: 1.19 ± 0.02, IOLMaster 700: 1.12 ± 0.02, MS-39: 1.20 ± 0.03, Pentacam AXL Wave: 1.22 ± 0.03 (P < .0001); and for TCP: Anterion: 42.69 ± 1.51 D, IOLMaster 700: 43.36 ± 1.49 D, MS-39: 42.92 ± 1.52 D, and Pentacam AXL Wave: 42.35 ± 1.55 D (P < .0001). PCA revealed significant differences for the KP(45) and KP(0) vectors (P < .0001). The four instruments showed different PK values. The largest difference was observed with the IOL-Master 700, which provided the flattest PK and the lowest A/P ratio. The measurements cannot be considered interchangeable, and this should be considered when entering PK values into calculators using this parameter for IOL power.