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Dynamic realignment of extraocular muscles after inferomedial orbital wall decompression in thyroid eye disease: a 3D CT reconstruction study

2026-03-25T03:07:27Z

Title: Dynamic realignment of extraocular muscles after inferomedial orbital wall decompression in thyroid eye disease: a 3D CT reconstruction study Authors: Byeon, Hyeong Ju; Ko, JaeSang; Park, Hyun Young; Yoon, Jin Sook Abstract: Orbital wall decompression carries a risk of new-onset postoperative diplopia in patients with thyroid eye disease (TED). This study aimed to evaluate the occurrence, clinical progression, and underlying mechanisms of newonset diplopia following inferomedial orbital wall decompression over 1 year, including quantitative CT analysis of orbital structures. Inactive TED patients undergoing inferomedial orbital wall decompression were reviewed. Only patients who developed new diplopia at 1 month and completed a 1-year follow-up were included. Diplopia cases were assessed using Gorman scores and HESS tests. Orbital structures and deviated angles of the medial and inferior rectus muscles were quantified on CT images. New-onset diplopia occurred in 35% (78/204) of patients at 1 month postoperatively, with 73.2% recovering fully from diplopia by 1 year. In the recovered-diplopia group, orbital volume decreased significantly from immediate postoperative to 1 year (p = 0.038) but not in the persistent-diplopia group. Additionally, the rectus muscles, deviated immediately after surgery, showed significant straightening at 1 year in the recovered-diplopia group (p < 0.001), while no significant improvement in muscle alignment was observed in the persistent-diplopia group. New-onset diplopia after inferomedial orbital wall decompression is typically transient, resolving within 1 year. The resolution is mediated by muscle realignment driven by orbital remodeling and muscle contraction.

Demography, Clinical Characteristics and Long-Term Outcomes of Central Serous Chorioretinopathy in Women. MICRoN Report Number Fourteen

2026-04-14T07:23:14Z

Title: Demography, Clinical Characteristics and Long-Term Outcomes of Central Serous Chorioretinopathy in Women. MICRoN Report Number Fourteen Authors: Gregori, Giulia; Sahoo, Niroj Kumar; Hasan, Nasiq; Zarnegar, Arman; Lupidi, Marco; Zhang, Micheal; Wu, Lihteh; Cao, Jessica; Piccoli, Gabriele; Vujosevic, Stela; Shah, Priya; Singhanetr, Panisa; Rossin, Elizabeth; Checchin, Lisa; Pili, Lorenzo; Parodi, Maurizio Battaglia; Kim, Min; Desideri, Lorenzo Ferro; Munk, Marion R.; Chotcomwongse, Peranut; Ruamviboonsuk, Paisan; Fung, Adrian; Small, Kent; Khateb, Samer; Wang, Jay C.; Khurana, Rahul N.; Villafeurte, Carol; Yiu, Glenn; Momenaei, Bita; Garg, Sunir; Lai, Timothy; Ashfaq, Yusuf; Kroeger, Zachary; Chhablani, Jay Abstract: center dot PURPOSE: To evaluate the characteristics and longitudinal outcomes of chronic central serous chorioretinopathy (CSCR) in women compared to an age-matched cohort of men with CSCR. center dot DESIGN: Retrospective, multicenter clinical cohort study from the Macula Society CSCR Study Group. center dot PARTICIPANTS: This study included 426 eyes (213 women and 213 age-matched men) with a diagnosis of CSCR. center dot METHODS: Baseline and final best-recorded visual acuity (BRVA) and multimodal imaging parameters such as area of retinal pigment epithelium (RPE) alterations, choroidal macular thickness (CMT), sub-foveal choroidal thickness (SFCT), subretinal fluid (SRF), pigment epithelium detachment (PED), double layer sign (DLS), hyperreflective dots (HRD), as well as the presence of choroidal neovascularization (CNV) and subretinal hyperreflective material (SHRM) were assessed. Regression analysis was used to evaluate baseline predictors of final visual acuity. center dot MAIN OUTCOME MEASURES: Longitudinal changes in BRVA and imaging parameters in men and women stratified for age; factors affecting subretinal fluid (SRF) persistence, and change in BRVA. center dot RESULTS: A total of 426 eyes (213 women and 213 age-matched men) with CSCR were analyzed. Women showed better BRVA at presentation (0.25 +/- 0.24 vs 0.31 +/- 0.35 logMAR; P = .05), and exhibited smaller areas of RPE alterations (2.37 +/- 2.64 vs 1.59 +/- 1.55 disc areas; P = .003), less frequent peripapillary RPE changes (13.6% vs 7.5%; P < .001), shorter DLS (1353.9 +/- 970.2 vs 1071.6 +/- 888.7 & micro;m; P = .039), and smaller PEDs (644.9 +/- 546.4 vs 442.1 +/- 278.9 & micro;m; P = .022). During follow-up, women exhibited higher rates of complete SRF resolution ( P = .001) while persistence and the number of recurrences were significantly more common in men ( P = .006 and P = .02, respectively). Logistic regression analysis revealed that persistent SRF was independently associated with complex CSCR, male gender, baseline PROS irregularities, worse BRVA, SHRM, and CNV, while PDT was protective. center dot CONCLUSION: Women had better visual outcomes and more favorable structural evolution while men tended to present with more complex anatomical alterations and experience higher rates of persistent SRF. (Am J Ophthalmol 2026;286: 140-151. (c) 2026 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/))

Clinical Characteristics and Outcomes in Subretinal Hyper-Reflective Material: MICRoN Report 6

2026-04-14T07:23:13Z

Title: Clinical Characteristics and Outcomes in Subretinal Hyper-Reflective Material: MICRoN Report 6 Authors: Sahoo, Niroj Kumar; Hasan, Nasiq; Jacob, Ninan; Cao, Jessica; Wykoff, Charles C.; Shah, Priya; Singhanetr, Panisa; Rossin, Elizabeth J.; Desideri, Lorenzo Ferro; Hertkorn, Felicia; Munk, Marion R.; Khateb, Samer; Wang, Jay; Khurana, Rahul N.; Ashfaq, Yusuf; Kroeger, Zachary; Zhang, Michael; Parodi, Maurizio Battaglia; Piccoli, Gabriele; Vujosevic, Stela; Kim, Min; Rodriguez-Fernandez, Carmen Antia; Barquet, Luis Arias; Small, Kent; Ruamviboonsuk, Paisan; Chotcomwongse, Peranut; Lima, Luiz H.; Fung, Adrian T.; Wu, Lihteh; Chhablani, Jay Abstract: center dot PURPOSE: To evaluate the clinical features and longitudinal outcomes of chronic central serous chorioretinopa thy (CSCR) presenting with subretinal hyperreflective material (SHRM). center dot DESIGN: Retrospective, multicenter clinical cohort study from the Macula Society CSCR Study Group. center dot PARTICIPANTS: This study included consecutive patients with a diagnosis of CSCR, with and without SHRM. center dot METHODS: Baseline and final best-recorded visual acuity (BRVA) and multimodal imaging parameters were compared between SHRM and non-SHRM groups. center dot MAIN OUTCOME MEASURES: Longitudinal changes in BRVA and imaging parameters in both groups; factors affecting subretinal fluid (SRF) persistence, and change in BRVA. center dot RESULTS: A total of 503 eyes (103 with SHRM and 400 eyes without SHRM) were analyzed. The SHRM group showed poorer baseline BRVA (0.4 +/- 0.3 logMAR; 20/50) compared to the non-SHRM group (0.2 +/- 0.3 logMAR; 20/30) (p = .006). SHRM eyes demonstrated greater RPE alteration (p = .04), higher neurosensory retinal detachment ( p < .001), more photoreceptor irregularities (p = .004), hyperreflective foci (p < .001), and double-layer sign (p < .001). The incidence of concurrent macular neovascularization (p = .01) and persistent subretinal fluid (p < .001) was higher in the SHRM group. Despite visual improvement in both groups, final height of neuro-sensory detachment (p < .001) remained higher in SHRM eyes. Eyes with a history of steroid exposure and ellipsoid zone (EZ) loss (post-resolution) were greater in higher SHRM grades. Logistic regression revealed non-SHRM status, and combination therapy had lower odds of SRF persistence. center dot CONCLUSION: CSCR with SHRM presented with worse initial vision. Although vision improved after treatment, persistent SRF and EZ loss (in resolved cases) remain more frequent in SHRM eyes. (c) 2026 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/))

SLEEP DEPRIVATION AND EPIRETINAL MEMBRANE RISK: Machine Learning Findings from a Nation-wide Survey

2026-06-12T08:06:52Z

Title: SLEEP DEPRIVATION AND EPIRETINAL MEMBRANE RISK: Machine Learning Findings from a Nation-wide Survey Authors: Kim, Ji Woo; Kim, Min; Lee, Christopher Seungkyu; Yeo, Jinyoung; Choi, Eun Young Abstract: Purpose: This cross-sectional study explored the association between sleep deprivation and epiretinal membrane (ERM) using machine learning applied to data from the Korean National Health and Nutrition Examination Survey 2017 to 2020. Methods: Data from 2018 to 2020 were used for training and internal validation, and from 2017 for external validation. Participants were divided into ERM and non-ERM groups, and their sociodemographic, lifestyle, and clinical characteristics were assessed. Sleep deprivation was defined as sleeping <6 hours on weekdays. Machine learning-based logistic regression was used to model the association between sleep deprivation and ERM, adjusting for confounders. The consistency of the results and importance of each feature were assessed using subgroup analyses and Shapley additive explanations. Results: Data from 15,240 participants were included, with an ERM prevalence of 9.59%. The final adjusted model achieved an area under the ROC curve of 0.763 (95% CI 0.733-0.792) in external validation. Sleep deprivation was significantly associated with increased ERM risk (adjusted odds ratio [OR], 1.247; 95% CI 1.051-1.481), particularly among non-high-risk alcohol consumers (OR 1.216; 95% CI 1.057-1.399) and individuals with diabetes mellitus (OR 1.259; 95% CI 1.069-1.481). Sleep deprivation was the fourth most influential predictor (5.3%), after age, cataract surgery, and dyslipidemia. Conclusion: Sleep deprivation was significantly associated with a 1.25-fold increase in the prevalence of ERM, especially among non-high-risk alcohol consumers and those with diabetes. Weekday sleep deprivation may be a modifiable risk factor for ERM. Prospective studies are warranted to confirm causality and explore the underlying mechanisms.