Ophthalmology
Audio Summaries

Proton beam therapy for oropharyngeal cancer (TORPEdO): a phase 3, randomised controlled trial

The authors conducted a phase 3 trial (TORPEdO) to compare the clinical benefits of intensity-modulated proton therapy (IMPT) versus intensity-modulated radiation therapy (IMRT) in patients with locally advanced oropharyngeal squamous cell carcinoma, specifically assessing treatment-related effects on physical function and quality of life. The results indicated that both treatment modalities yielded similar outcomes regarding late physical quality of life, gastrostomy-tube dependence, disease control, and overall survival, suggesting that IMRT remains the standard of care in settings where IMPT is not routinely utilized.

Evaluation of spectacle independence with the Dutch Patient-Reported Spectacle Independence Questionnaire

The authors aimed to evaluate spectacle independence among healthy individuals and cataract patients using a Dutch version of the Patient-Reported Spectacle Independence Questionnaire (PRSIQ). Their findings revealed significant differences in rates of complete spectacle independence across various types of intraocular lenses (IOLs) and refractive targets, although the questionnaire's multidimensional nature limited its use for interval scaling. Overall, the PRSIQ-NL proved to be a useful tool for assessing spectacle independence in clinical and research settings.

Role of toric intraocular lenses in the correction of keratoconic eyes with cataract

The authors aimed to determine the most effective intraocular lens (IOL) corrections for moderate to severe keratoconus (KC) eyes with cataracts by using computer simulations to analyze image quality. They found that while IOLs alone provided modest improvements in visual quality, the combination of IOLs with toric rigid gas-permeable lenses significantly enhanced image quality. The study concluded that IOL corrections alone are inadequate for addressing the large corneal aberrations in KC, and the best results were achieved with a combination of spherical and toric IOLs to avoid overcorrection.

Short-Term Axial Length Changes Predict Progression of Myopic Maculopathy in Pediatric High Myopia

The authors aimed to determine whether short-term changes in axial length (AL) and spherical equivalent (SE) could predict long-term progression of myopic maculopathy (MM) in children and adolescents with high myopia. Their findings revealed that both baseline AL and the rate of AL change over two years were significant predictors of MM progression over an eight-year period, with nearly one-third of participants experiencing progression. This study underscores the potential for early identification of at-risk individuals through monitoring AL changes, facilitating timely interventions.

The Inherited Basis of Coronary Artery Disease

The authors investigate the genetic underpinnings of coronary artery disease (CAD) and how these insights can enhance risk prediction, prevention, and treatment strategies. They highlight the significance of both monogenic and polygenic factors in CAD, emphasizing the potential of polygenic risk scores to improve individual risk assessment. Key questions remain about the practical application, cost-effectiveness, and integration of these genetic insights into clinical practice.

Primary sclerosing cholangitis

This article investigates the clinical features, pathogenesis, and management challenges of primary sclerosing cholangitis (PSC), a rare chronic liver disease often associated with inflammatory bowel disease. The authors aim to clarify the disease's variable presentation, the role of genetic and environmental factors, including the intestinal microbiome, and the limited treatment options available. The seminar highlights the need for a deeper understanding of PSC to improve patient outcomes and management strategies.

Efficacy and safety of oral semaglutide 14 mg (flexible dose) in early-stage symptomatic Alzheimer's disease (evoke and evoke+): two phase 3, randomised, placebo-controlled trials

The evoke and evoke+ trials aimed to evaluate the efficacy and safety of oral semaglutide (14 mg) in individuals with early-stage symptomatic Alzheimer's disease. The results indicated that semaglutide did not significantly slow clinical progression compared to placebo, and while safety profiles were consistent with other indications, the treatment did not demonstrate the expected benefits in this population.

Quantifying Orbital Segmentation in Thyroid Eye Disease- Fat to Muscle Ratio correlates with Restrictive Strabismus

The authors aimed to evaluate the role of the orbital fat-to-muscle ratio (FMR) in predicting restrictive strabismus in patients with Thyroid Eye Disease (TED). Their findings indicate that a lower FMR is associated with increased risk of restrictive ocular motility and strabismus, suggesting that quantitative FMR derived from CT imaging can serve as a valuable biomarker for assessing disease severity and guiding clinical management in TED.

Prevention of urinary stones with hydration: a randomised clinical trial of an adherence intervention

This study aimed to evaluate the effectiveness of a multicomponent behavioral intervention designed to increase fluid intake in reducing symptomatic urinary stone recurrence compared to standard care. The results indicated that while the intervention modestly increased urine volume, it did not significantly reduce the rate of recurrent stone events over a two-year follow-up period. Overall, the findings suggest that enhancing fluid intake through behavioral strategies may not be sufficient to prevent urinary stones in recurrent stone formers.

Angiography-derived fractional flow reserve versus coronary angiography to guide coronary artery bypass grafting in patients undergoing surgical valve procedures with concomitant coronary artery disease in China (FAVOR IV-QVAS): a multicentre, triple-blind, randomised trial

The study aimed to determine whether a physiologically guided strategy using angiography-derived fractional flow reserve (FFR) could improve clinical outcomes compared to the traditional anatomically guided approach for coronary artery bypass grafting (CABG) in patients undergoing surgical valve procedures with concomitant coronary artery disease. Results showed that the FFR-guided CABG significantly reduced the incidence of adverse perioperative outcomes and long-term complications compared to the standard method, suggesting that physiological assessment may enhance surgical decision-making in this patient population.