OPHTHALMOLOGICA

Acknowledgement to Reviewers
Patients' Perspectives on Climate Change, Health, and Sustainability in Ophthalmology
Yang-Seeger D, Schellstede A, Pauleikhoff LJB, Spitzer MS and Birtel J
Sustainability is becoming increasingly important in ophthalmology due to growing environmental, economic, and social responsibilities. Integrating sustainability into clinical practice requires not only advocacy by clinicians but also patients' collaboration and awareness. This study aimed to understand patients' perspectives on sustainability and the role attributed to ophthalmologists.
Surgical Outcomes of Epiretinal Membranes With and Without Epiretinal Proliferation: A Comparative Study
Quarta A, Toto L, Gironi M, Ruggeri ML, Aharrh-Gnama AO, Porreca A, Zeppa L, Gabriele F, Greco E, Di Nicola M and Mastropasqua R
To compare clinical findings, OCT characteristics, and postoperative outcomes in eyes with epiretinal membrane (ERM) with and without associated epiretinal proliferation (EP).
Lost to Follow-Up In Neovascular Age-Related Macular Degeneration: A Systematic Review of Global Trends, Risk Factors and Clinical Consequences
Spooner KL, Fraser-Bell S, Mehta H, Hong T, Broadhead G, Wong JG and Chang AA
Loss to follow-up (LTFU) among patients receiving anti-vascular endothelial growth factor (anti-VEGF) therapy for neovascular age-related macular degeneration (nAMD) remains a critical challenge for maintaining visual outcomes. This systematic review and meta-analysis evaluated the prevalence, risk factors, and impact on visual prognosis of LTFU across real-world studies.
Clinical Features and Outcomes of Bullous Central Serous Chorioretinopathy: A Multicentric Cohort Study
Montesel A, Sacconi R, Nicholson L, Chhablani J, Yzer S, Mohabati D, Boon CJF and Querques G
To evaluate the clinical features, systemic associations, and outcomes of the bullous variant of central serous chorioretinopathy (bvCSC) through a multicentric study.
Aflibercept 2 mg for Neovascular Age-Related Macular Degeneration: XTEND at 3 Years
Korobelnik JF, Chaudhary V, Mitchell P, Kang SW, Allmeier H, Lee J, Zhang X, Machewitz T and Bailey C
Long-term, global, data evaluating intravitreal aflibercept (IVT-AFL) 2 mg for treatment of neovascular age-related macular degeneration (nAMD) in real-world practice are needed. This study investigated the long-term, real-world effectiveness and safety of IVT-AFL 2 mg in patients with nAMD.
Technological Influence on Retina Fellows' Learning Curves: A Prospective Study of Digital versus Analog Microscopes (The BRAVE Study)
Iglicki M, Zur D, Khoury M, Muiños R, Melamud JI and Loewenstein A
The BRAVE Study (Bridging Retina Fellows' Advancement with Visualization Enhancements) aims to compare the learning curves of retina fellows performing epiretinal membrane (ERM) surgery trained using digital heads-up display (HUD) systems versus analog surgical operating microscopes (SOMs) in a prospective manner. Fellows were assigned exclusively to either HUD or SOM for all ERM surgeries during the 2-year study. There was no crossover between modalities. Posterior vitreous detachment was consistently induced by active suction under the macula. Trypan blue was routinely applied to aid in visualization of the ILM/ERM. This standardized approach was used across both groups.
Effect of Faricimab on Optical Coherence Tomography Angiography and Artificial Intelligence-Based Analysis in Resistant Choroidal Neovascularization
Morsy MS, Heinke A, Mehta NN, Nagel ID, Tran M, Cheng L, Bartsch DG and Freeman WR
Treatment-resistant choroidal neovascularization (CNV) remains a major challenge despite anti-VEGF therapy. Faricimab, with dual inhibition of VEGF-A and Ang-2, offers a novel approach. The purpose of this study was to evaluate its effect using advanced OCTA-based vascular analysis and AI-assisted anatomical assessment, providing new insights into therapeutic response in resistant CNV.
Comparative Analysis of Long-Term Outcomes of Submacular Hemorrhage in AMD: A Real-Life Study
Chirpaz N, Matagrin B, Gauthier L, Elbany S, Rocher A, Mathis T, Fenniri I, Denis P, Kodjikian L, Burillon C and Dot C
Submacular hemorrhage (SMH) is a severe complication of neovascular age-related macular degeneration (nAMD), often causing profound vision loss. The aim of this study was to assess the long-term outcomes of SMH patients managed with anti-VEGF monotherapy (MT) versus surgical displacement (SD) and to identify prognostic factors for visual acuity.
Brolucizumab for Wet Age-Related Macular Degeneration in Switch Patients: Long-Term Real-World Experience from a Tertiary Center
Scupola A, Hu L, Cusato M, Fossataro C, Michieletto M, Sammarco MG, Rizzo S and Savino G
This retrospective, single-center, observational cohort study evaluated the 3-year real-world efficacy and safety of intravitreal brolucizumab injections in patients with neovascular age-related macular degeneration (nAMD) who had previously been treated with other anti-vascular endothelial growth factor (VEGF) agents. A total of 97 eyes from 91 patients were included, all of whom completed 3 years of follow-up after switching to brolucizumab.
Impact of Intraoperative Early Positioning on Anatomical Success after Inverted Flap Technique in Large Macular Holes: A Retrospective Comparative Study
Ucar F and Kadıoğlu E
In this study, we wanted to evaluate the effect of intraoperative early positioning on anatomical success in patients with large macular holes undergoing the inverted flap (IF) technique.
Efficacy of Internal Limiting Membrane Peeling in Eyes with Proliferative Diabetic Retinopathy: A Meta-Analysis
Chung YR, Lee E, Kim H, Bodaghi B and Touhami S
We investigated the effects of internal limiting membrane (ILM) peeling on treating posterior segment complications other than macular edema in patients with proliferative diabetic retinopathy (PDR) treated with vitrectomy.
Response to "Readability of AI and Ophthalmologist Responses to Patient Surgery Queries: Comment" by Daungsupawong and Wiwanitkit
Kurapati SS, Yaghy A, Barnett DJ and Scott IU
The Seven Sins of Automated Diabetic Retinopathy Screening: Barriers for Clinical Implementation of Artificial Intelligence-Based Devices in National Screening Programs
Grauslund J and Grzybowski A
Association between Ectopic Inner Foveal Layer on Optical Coherence Tomography and Postoperative Quantitative Metamorphopsia in Patients Undergoing Epiretinal Membrane Surgery
La Franca L, Alkabes M, Muraca A, La Franca L, Rabiolo A, Fogagnolo P, Ranno S, Frerio F, Marchetti M, Wild D, Gatti V and De Cillà S
Epiretinal membrane (ERM) is a condition that can lead to visual impairment and metamorphopsia. This study aimed to examine the correlation between metamorphopsia and foveal microstructure before and after macular surgery in a cohort of patients with advanced ERM.
Indications and Outcomes of Patients Undergoing Immediate Sequential Bilateral Vitreoretinal Surgery: A Case Series
Simpson AI, Gigon A, Whitlow S, McGowan G, Burgula S, Ramsden CM, Chandra A, Keller J, Davies A, Hussain R, Steel DH and Saidkasimova S

Introduction: Bilateral vision threatening vitreoretinal disease requiring urgent surgery such as proliferative diabetic retinopathy, vitreous haemorrhage and retinal detachment are not uncommon presentations. Accepted practice has been to address each eye in separate, staged procedures. However, there are specific circumstances in which operating on both eyes in the same anaesthetic sitting may be preferable. Immediate sequential bilateral vitreoretinal surgery (ISBVS) has rarely been described in the literature. We present a series of cases and discuss the indications, risks and relative merits of this approach.

The Impact of the COVID-19 Pandemic on Ophthalmology Conferences
Schmuter G, Kolomeyer NN, Nijm LM, Tao J, Subramanian PS, Al-Mohtaseb Z, Kim T, Rachitskaya AV, Law JC and Tooley AA

Introduction: The COVID-19 pandemic prompted ophthalmology conferences to transition to virtual platforms. The impact of these changes on attendance and research productivity remains underexplored. The objective of this study was to evaluate the effects of virtual platforms on attendance and research inclusion at ophthalmology conferences during the COVID-19 pandemic.

Safety Profile of Intravitreal Dexamethasone Implant to Manage Diabetic Macular Edema: A Systematic Review of Real-World Studies
Querques G, Figus M, De Bernardo M, Toro MD, Gharbiya M, Gallinaro V, Strina E, Cacace V and Nicolò M
With increasing experience using intravitreal dexamethasone implant (DEX-i), it has become a first-line therapy in patients with diabetic macular edema (DME), due mainly to its good efficacy profile. However, this treatment is not devoid of adverse events (AEs), which are predominantly transient and should be considered when administering it.
Limited Progression of Nuclear Sclerosis after Lens-Sparing Vitrectomy in Proliferative Diabetic Retinopathy Eyes: A Real-World Investigation with Scheimpflug Lens Densitometry
Mautone L, Fisel P, Druchkiv V, Kounatidou NE, Schindler P, Spitzer MS and Skevas C
The objective of this study was to objectively investigate the progression of lens nuclear sclerosis after lens spearing pars plana vitrectomy (PPV) in patients with proliferative diabetic retinopathy (PDR).
The British-Israeli Project for Algorithm-Based Management of Age-Related Macular Degeneration: Deep Learning Integration for Real-World Data Management and Analysis
Zur D, Wright DM, Shahar Gonen M, Shor R, Wen Q, Benyamini G, Havilio M, Ben-Nun M, Look S, Dor O, Chakravarthy U, Loewenstein A and Peto T
The aim of this study was to describe the development of an integrative dataset, combining clinical and optical coherence tomography (OCT) imaging data by applying a deep learning (DL) algorithm for automated, objective, and comprehensive quantification of OCT scans in two large real-world datasets of eyes with neovascular age-related macular degeneration (nAMD). We further report baseline characteristics of the study population, focusing on demographics, clinical parameters, and quantitative retinal morphological features.
Comparison of Rescue Approach with Gore-Tex Suture Scleral Fixation and Lens Explantation Combined with Standardized Flanged Intrascleral Fixation
Giancipoli E, Besozzi G, Nitti G, Costa MC, Niro A, Boscia G, Viggiano P, Addabbo G, Boscia F, Giannaccare G, Savastano A, Pignatelli F and Iaculli C
The aim of this study was to evaluate the safety and effectiveness of fixing dislocated intraocular lenses (IOLs) with Gore-Tex suture scleral fixation, compared to IOL explantation combined with a secondary implant using a standardized flanged intrascleral fixation (Yamane technique).