AJO International最新文献

{"title":"Multimodal large language models for IOL power calculation in cataract surgery: A feasibility study","authors":"Hye Won Jun ,&nbsp;Sun Young Ryu ,&nbsp;Tae Keun Yoo","doi":"10.1016/j.ajoint.2025.100205","DOIUrl":"10.1016/j.ajoint.2025.100205","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess whether multimodal large language models (MLLMs) can reproduce classical intraocular lens (IOL) power calculations and provide usable backup guidance when standard calculators are unavailable or for educational purposes.</div></div><div><h3>Design</h3><div>Methods-comparison feasibility study.</div></div><div><h3>Methods</h3><div>From a public IOLMaster 700 dataset, 180 eyes were sampled and stratified by axial length and anterior chamber depth. IOL powers were computed by device Sanders–Retzlaff–Kraff/Theoretical (SRK/T) (reference), Barrett Universal II (APACRS), and three MLLMs (ChatGPT-5, Gemini-2.5-Pro, ChatGPT-4o) using identical biometry. Agreement metrics included mean absolute error (MAE) and the proportion within ±0.25, ±0.50, and ±1.00 D versus device SRK/T.</div></div><div><h3>Results</h3><div>ChatGPT-5 and Gemini-2.5-Pro implemented SRK/T using effective lens position estimation and a vergence approach, whereas ChatGPT-4o defaulted to SRK I unless tightly constrained. ChatGPT-5 showed near-reference agreement with SRK/T (MAE 0.30 D; 78.8% within ±0.50 D vs SRK/T), while Gemini-2.5-Pro and ChatGPT-4o had larger errors. Subgroup analyses across axial length–anterior chamber depth strata showed that ChatGPT-5 did not differ significantly from SRK/T after Bonferroni correction, whereas Gemini-2.5-Pro and ChatGPT-4o exhibited significant positive biases in long and short eyes. Agreement patterns were similar when Barrett Universal II was used as the secondary comparator.</div></div><div><h3>Conclusion</h3><div>MLLMs, particularly ChatGPT-5, may provide a portable, stepwise backup for classical IOL power calculation (SRK/T). MLLMs may offer educational value and serve as a secondary check on conventional calculations but should not replace validated biometry platforms, especially in eyes with extreme biometry. Prospective, outcome-based validation and usability testing are warranted before any real-world clinical deployment.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100205"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Workforce distribution and cataract surgical rates in the eastern mediterranean (EMR) and middle east north Africa (MENA) regions","authors":"Fatma Shakarchi ,&nbsp;John Buchan ,&nbsp;Allen Foster","doi":"10.1016/j.ajoint.2025.100200","DOIUrl":"10.1016/j.ajoint.2025.100200","url":null,"abstract":"<div><h3>Purpose</h3><div>This study analyses the distribution of ophthalmic human resources in countries of the Eastern Mediterranean Region (EMR) and the Middle East North Africa (MENA), and their productivity in relation to cataract surgery.</div></div><div><h3>Design</h3><div>Cross-sectional, secondary data analysis.</div></div><div><h3>Methods</h3><div>The analysis compiled secondary data available in the public domain, on the ophthalmic workforce and Cataract Surgical Rate (CSR), defined as the number of cataract surgeries performed annually per million population, using the International Agency for the Prevention of Blindness (IAPB) Vision Atlas and the Rapid Assessment of Avoidable Blindness (RAAB) Repository. We included data from 25 countries (<em>n</em> = 25 data points), and performed a segmented linear correlation to account for the correlation between CSR and ophthalmologist density.</div></div><div><h3>Results</h3><div>The density of ophthalmologists per million population ranged from &lt;1 per million population in Somalia and South Sudan to 70 per million in Saudi Arabia. There was a positive correlation between the number of ophthalmologists per million and CSR up to approximately 20 ophthalmologists/million, after which the association was not found. On average, ophthalmologists performed &lt;1 to 22 cataract surgery per week in countries of the region. Iran and Pakistan showed the highest CSR values and CSRs per ophthalmologist/week among the countries analysed.</div></div><div><h3>Conclusions</h3><div>There are wide variations in the availability and productivity of ophthalmic personnel in terms of cataract surgeries/ophthalmologist/week between countries in the region. These findings highlight the need to strengthen efficiency, equitable access, and data quality across eye care systems in the region. Wider adoption of newer indicators, particularly the effective cataract surgical coverage (eCSC), would provide additional information on equity and quality of cataract services.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100200"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating changes in pro- and anti-inflammatory mediators in keratoconus following corneal collagen cross-linking: A systematic review","authors":"Ryan S. Huang ,&nbsp;Andrew Mihalache ,&nbsp;Marko M. Popovic ,&nbsp;Clara C. Chan","doi":"10.1016/j.ajoint.2025.100185","DOIUrl":"10.1016/j.ajoint.2025.100185","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the changes in pro- and anti-inflammatory mediators following corneal collagen cross-linking (CXL) in patients with keratoconus (KC).</div></div><div><h3>Design</h3><div>Systematic review.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted using Ovid MEDLINE, Embase, and the Cochrane Library from inception to September 2024. Eligibility criteria included English studies reporting pre- and post-CXL changes in cytokine, chemokine, matrix metalloproteinase (MMP), and growth factor concentrations in adult patients with KC. The primary endpoint was the change in pro- and anti-inflammatory mediator concentrations following CXL. The secondary endpoint focused on correlations between post-CXL changes in inflammatory mediators and corneal tomography measurements. Descriptive statistics were used to report findings.</div></div><div><h3>Results</h3><div>Six prospective cohort studies were included, encompassing 173 eyes from 168 patients diagnosed with progressive KC. The mean age of participants was 25.3 years, and 69 % were male. Three studies reported on cytokine and chemokine levels, demonstrating a significant increase in interleukin-6 (IL-6) concentrations up to three months post-CXL, followed by a decline to levels below pre-CXL at 12 months. Additionally, MMP-9 levels and growth factors, such as nerve growth factor (NGF) and epidermal growth factor (EGF), significantly decreased 12 months post-CXL in two studies, respectively. Significant positive correlations were observed between changes in cytokine levels and tomographic parameters, including keratometry (Ks and Kf) and corneal thickness.</div></div><div><h3>Conclusion</h3><div>IL-6 levels may rise within the first three months post-CXL, followed by a decline to below baseline levels by 12 months. In contrast, MMP-13 concentrations may decrease within days of treatment, and MMP-9 levels may decline after one year. Similarly, both EGF and NGF may show post-CXL reductions, with NGF levels potentially reflecting underlying KC severity. Altogether, these patterns suggest an initial acute inflammatory response, followed by subsequent changes likely associated with the promotion of corneal healing. However, interpretation may be limited by the relatively small number of included studies and heterogeneity in patient severity, sample sizes, sampling methods, assays, and follow-up timepoints. Further research is required to elucidate their role in monitoring treatment response in patients with KC undergoing CXL.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100185"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145320621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender differences in faculty rank and salary among ophthalmology subspecialists at U.S. public medical schools","authors":"Emily Sun ,&nbsp;Chen Dun ,&nbsp;Susan K. Burden ,&nbsp;Ambar Faridi ,&nbsp;Laura K. Green ,&nbsp;Andrea L. Kossler ,&nbsp;Christina R. Prescott ,&nbsp;Jamie B. Rosenberg ,&nbsp;Erin M. Shriver ,&nbsp;Grace Sun ,&nbsp;Christina Y. Weng ,&nbsp;Kimberly M. Winges ,&nbsp;Maria A. Woodward ,&nbsp;Fasika A. Woreta","doi":"10.1016/j.ajoint.2025.100173","DOIUrl":"10.1016/j.ajoint.2025.100173","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine gender differences in faculty rank and salary among ophthalmology subspecialists at U.S. medical schools.</div></div><div><h3>Design</h3><div>Retrospective cross-sectional</div></div><div><h3>Methods</h3><div>Gender and academic rank for faculty where state laws mandate public salary disclosure for university employees were collected from department websites. Annual salary was collected from GovSalaries.com. Differences in rank and salary, by gender, were analyzed using Student’s <em>t</em>-test.</div></div><div><h3>Results</h3><div>Salaries were available from 28/122 departments (23 %) from 17 states (538 ophthalmologists, 41.1 % women). A smaller proportion of women were full professors compared to men (25.8 % vs. 46.7 %). A larger proportion were assistant professors (47.1 % vs. 30.1 %) or associate professors (27.1 % vs. 22.7 %). Medical retina, neuro-ophthalmology, and comprehensive ophthalmology had the largest gender disparity among full professors between men and women (15.4 % vs. 61.5 %; 31.3 % vs. 69.0 %; 5.9 % vs. 42.1 % respectively).</div><div>Women had lower salaries compared to men across all subspecialties ($281,718 vs. $364,017, <em>p</em> &lt; 0.0001), including assistant professors ($229,389 vs. $265,974, <em>p</em> = 0.03). There were no significant differences among associate ($280,704 vs. $324,434, <em>p</em> = 0.15) or full professors ($378,264 vs. $447,531, <em>p</em> = 0.08). Among assistant professors, women had lower salaries in comprehensive ophthalmology ($224,755 vs. $441,742 <em>p</em> &lt; 0.0001), cornea ($181,284 vs. $276,121, <em>p</em> = 0.05), and medical retina ($204,057 vs. $393,616, <em>p</em> = 0.03). Overall, women earned significantly less after controlling for subspecialty, VA status, rank, and region ($278,751 vs. $308,629, <em>p</em> = 0.015), and earned significantly less in comprehensive ophthalmology ($230,837 vs. $355,782, <em>p</em> = 0.038) and cornea ($289,211 vs. $360,546, <em>p</em> = 0.018).</div></div><div><h3>Conclusions</h3><div>Significant gender differences in rank and salary exist in several subspecialties. Further research is needed to identify effective strategies for these disparities.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100173"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geospatial analysis of accessibility to oculofacial plastic surgery in the United States: Driving distance and sociodemographic disparities","authors":"Anne X. Nguyen ,&nbsp;Daniel R. Chow ,&nbsp;Mélanie Hébert ,&nbsp;Edsel Ing ,&nbsp;Georges Nassrallah ,&nbsp;Navdeep Nijhawan","doi":"10.1016/j.ajoint.2025.100192","DOIUrl":"10.1016/j.ajoint.2025.100192","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify disparities in access to complex oculofacial plastic care by mapping American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) members’ service coverage areas (SCAs) in the United States (US).</div></div><div><h3>Design</h3><div>Cross-sectional analysis</div></div><div><h3>Methods</h3><div>We analyzed US-based ASOPRS members’ practice locations in ArcGIS Pro (Esri) to define SCAs as regions within a 60-minute drive. With American Community Survey data and chi-square tests, we compared social determinants of health within and outside SCAs.</div></div><div><h3>Results</h3><div>Of the 322,561,852 Americans, 260,154,031 (80.7 %) lived within a 60-minute driving time from one of the 635 ASOPRS members. The population outside 60-minute SCAs was significantly more likely to be White, Non-Hispanic, without university education, receiving social security income, residing in a household below federal poverty level, and lacking health insurance, compared to the population inside SCAs (each <em>P</em> &lt; 0.001). States with the most ASOPRS members were California (<em>n</em> = 95, 2.4 per million residents), Texas (<em>n</em> = 47, 1.5/million) and Florida (<em>n</em> = 45, 2.0/million), while none practiced in Montana, North Dakota, South Dakota, New Mexico and Wyoming.</div></div><div><h3>Conclusions</h3><div>Inequitable geographic distribution of ASOPRS members disproportionately affects patients in rural areas and those with lower socio-economic status. Recognizing these geographic-social obstacles can inform policies to reduce barriers to complex oculofacial plastic care access.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100192"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between diabetic retinopathy and neurodegenerative diseases in the All of Us research program","authors":"Ha-Neul Yu ,&nbsp;Jocelyn He ,&nbsp;Benjamin Kim ,&nbsp;Gui-Shuang Ying","doi":"10.1016/j.ajoint.2025.100190","DOIUrl":"10.1016/j.ajoint.2025.100190","url":null,"abstract":"<div><h3>Purpose</h3><div>While diabetic retinopathy (DR) has previously been linked to neurodegenerative diseases, it remains unclear whether DR independently reflects neurodegenerative diseases beyond those attributable to diabetes itself. In this study, we leveraged data from the All of Us Research Program to assess whether DR serves as an independent marker of neurodegenerative disease among individuals with diabetes.</div></div><div><h3>Methods</h3><div>A matched case-control, cross-sectional study was conducted using data from the All of Us Research Program (US-based EHR database). Three groups (exactly matched by age, sex, and race) were created and compared: individuals with both DR and DM (DR+DM, <em>n</em> = 7629), individuals with DM but no DR (DM-only, <em>n</em> = 22,887), and individuals without DM (<em>n</em> = 22,887). Outcomes included dementia, Alzheimer’s disease (AD), Parkinson’s disease (PD), and multiple sclerosis (MS). Univariate and multivariate logistic regression analyses were performed, adjusting for demographics, comorbidities and diabetes-related mediators.</div></div><div><h3>Results</h3><div>In multivariable analysis, DM-only was associated with increased odds of dementia (adjusted odds ratio [aOR] 1.28, 95 % CI: 1.08–1.51; <em>p</em> = 0.004). However, DR in the setting of DM (DM+DR vs. DM-only) was not associated with further increased odds of neurodegenerative disease outcome in multivariate models (aOR for dementia 1.18, 95 % CI: 0.94–1.49). No significant associations were identified for AD, PD, or MS (all <em>p</em> ≥ 0.10).</div></div><div><h3>Conclusion</h3><div>Diabetic retinopathy was not associated with increased rates of neurodegenerative diseases beyond that conferred by diabetes itself, and the relationship may be mediated by diabetes severity and related comorbidities.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100190"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Xen45 gel stent versus trabeculectomy for glaucoma: A systematic review and meta-analysis of efficacy and safety","authors":"Jumanah Qedair ,&nbsp;Konrad Schargel ,&nbsp;Sami AlShahwan ,&nbsp;Ibrahim AlObaida","doi":"10.1016/j.ajoint.2025.100202","DOIUrl":"10.1016/j.ajoint.2025.100202","url":null,"abstract":"<div><h3>Purpose</h3><div>Although trabeculectomy is invasive, it remains the gold standard for refractory glaucoma. The XEN45 Gel Stent provides a minimally-invasive alternative; however, comprehensive data comparing its efficacy and safety to trabeculectomy remain limited. This meta-analysis evaluates outcomes between XEN45 and trabeculectomy.</div></div><div><h3>Design</h3><div>We conducted a systematic review and meta-analysis, following PRISMA guidelines.</div></div><div><h3>Methods</h3><div>We searched PubMed, Web of Science, and CENTRAL from inception to July 2025. We pooled weighted mean differences (WMDs), proportions, and odds ratios (ORs), using random-effects maximum likelihood models. Primary outcomes included intraocular pressure (IOP) reduction; complete success, qualified success, and failure rates; and risk of hyphema and hypotony.</div></div><div><h3>Results</h3><div>Twelve studies (2,381 eyes [XEN45: 1,106; trabeculectomy: 1,275]) were included. Open-angle glaucoma was the predominant diagnosis (XEN45: 78.7 %; trabeculectomy: 74.7 %). Trabeculectomy showed greater IOP reduction rates (WMD: 11.9 mmHg [95 % CI: 10.2–13.7]) compared to the XEN45 Gel Stent (WMD: 9.1 mmHg [95 % CI: 7.4–10.8], p=0.02). Trabeculectomy achieved higher complete success rates (63.0 % [95 % CI: 56.0–70.0]) than XEN45 (47.0 % [95 % CI: 40.0–55.0], p=0.004), with no significant difference in qualified success (67.0 % vs. 58.0 %, p=0.44). Failure rates were significantly lower in the trabeculectomy group (10.0 % vs. 25.0 %, p=0.002). XEN45 demonstrated a superior safety profile, with significantly reduced risks of hyphema (OR: 0.34, p=0.04), hypotony (OR: 0.31, p=0.01), bleb fibrosis (OR: 0.68, p=0.01), and bleb leak (OR: 0.16, p&lt;0.01).</div></div><div><h3>Conclusion</h3><div>Trabeculectomy demonstrates superior IOP control and higher complete success rates, but at the expense of a higher complication profile. XEN45 offers a relatively safer but less effective alternative. A patient-tailored approach is essential when selecting the optimal surgical intervention.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100202"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of ocular pathology among homeless and housed adults visiting a safety-net hospital","authors":"Hongan Chen ,&nbsp;Jintong Liu ,&nbsp;Jennifer L Patnaik ,&nbsp;Cristos Ifantides","doi":"10.1016/j.ajoint.2025.100182","DOIUrl":"10.1016/j.ajoint.2025.100182","url":null,"abstract":"<div><h3>Purpose</h3><div>People experiencing homelessness have a higher risk for chronic illness and mortality compared to the general population. Furthermore, visual impairment is an independent risk-factor for mortality. We sought to characterize the prevalence of ophthalmic conditions and visual impairment among homeless individuals.</div></div><div><h3>Methods</h3><div>A retrospective chart review between January 1, 2018, to February 9, 2022 conducted at Denver Health and Hospital Authority in Denver, CO, USA. Adults 18 years of age or older identified as homeless in the electronic medical record system and randomly selected controls among all eye clinic patients seen during the same period were included for analysis. Visual acuity was recorded as best-corrected or pinhole occluder visual acuity when available, or otherwise presenting visual acuity (with or without correction).</div></div><div><h3>Results</h3><div>A total of 718 homeless and 240 control patients were identified within the specified time frame. Compared to the housed controls, homeless patients had a higher prevalence of trauma-related injuries (25.2% versus 2.7%, p&lt;0.001) and worse best-reported visual acuities. The most common ocular diagnoses among the homeless cohort were refractive error (43.5%), trauma-related injury (25.2%), and cataract (24.2%).</div></div><div><h3>Conclusions</h3><div>To our knowledge, this is the largest clinic-based retrospective cohort study of ocular pathology among individuals experiencing homelessness. Our study reinforces the importance of providing access to ophthalmic care to the homeless population while highlighting specific priorities distinct from the general patient population, namely management of higher rates of ocular trauma.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100182"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology, risk factors, clinical outcomes, and prognostic factors of infectious keratitis: A tertiary center experience in Qatar","authors":"M. Basil Marchi ,&nbsp;Adeya Al Harami ,&nbsp;Ahmed Maher ,&nbsp;Omar Al-Qahtani ,&nbsp;Joenie Datingaling Anilao ,&nbsp;Javed Iqbal ,&nbsp;Hashem Abu Serhan","doi":"10.1016/j.ajoint.2025.100191","DOIUrl":"10.1016/j.ajoint.2025.100191","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the infectious keratitis profile, causative agents, underlying risk factors, and clinical outcomes reported over 5 years in Qatar.</div></div><div><h3>Design</h3><div>A retrospective cohort study.</div></div><div><h3>Methods</h3><div>A retrospective analysis of all patients who received treatment for infectious keratitis at Hamad Medical Corporation, Qatar, between January 2019 and December 2023 was performed. Data regarding culture results, risk factors for infectious keratitis, visual acuity at the time of presentation, and the clinical course were obtained from medical records and microbiological reports.</div></div><div><h3>Results</h3><div>A total of 143 patients with microbial keratitis were included. The median age was 38 years (30–47.5). 93 (65 %) of patients were male. The mean follow-up duration was 18 ± 3 months. 34 (21.1 %) were culture-positive, and 107 (79.9 %) were culture-negative. Pseudomonas aeruginosa and Staphylococci spp. were the most common pathogens in culture-positive patients (<em>N</em> = 18, 53 %). Most patients (<em>N</em> = 104, 72.7 %) had at least one risk factor. Of these, 25 (17.5 %) had two risk factors, and 14 (9.8 %) had three or more. Ocular trauma was the most common risk factor (<em>N</em> = 45, 31.5 %), followed by contact lens use (<em>N</em> = 34, 23.8 %) and ocular surface disease (<em>N</em> = 24, 16.8 %). 133 (93 %) of patients improved with medical treatment alone, while 10 (7 %) required surgical interventions. The mean CDVA (logMAR) improved from 0.78 at presentation to 0.48 at the final follow-up (<em>p</em> &lt; 0.001). Multivariable regression analysis showed that culture positivity was significantly associated with poorer corneal healing (OR 1.91; 95 % CI 1.49–2.33). While this indicates a robust association, causal inference cannot be established due to the observational study design.</div></div><div><h3>Conclusions</h3><div>Ocular trauma is the major risk factor for infectious keratitis in Qatar. Pseudomonas aeruginosa and Staphylococci spp. were the most common organisms isolated. Awareness campaigns about occupational hazards and ocular safety equipment could help decrease the burden of trauma-related keratitis in the country.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100191"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammation and increased intraocular pressure associated with intravitreal aflibercept 8 mg: A systematic review and meta-analysis","authors":"Nikoline Skindhøj Rebsdorf ,&nbsp;Marie Martine Michaelsen ,&nbsp;Natasja Kærmose Ølholm ,&nbsp;Suffía Olsen ,&nbsp;Celine Lee ,&nbsp;Yousif Subhi ,&nbsp;Marie Ørskov ,&nbsp;Henrik Vorum ,&nbsp;Lasse Jørgensen Cehofski","doi":"10.1016/j.ajoint.2025.100179","DOIUrl":"10.1016/j.ajoint.2025.100179","url":null,"abstract":"<div><h3>Topic</h3><div>Aflibercept 8 mg was recently approved for the treatment of neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). The increased intravitreal injection volume and higher drug concentration has raised concerns regarding the potential risks of adverse events. The purpose of this review was to evaluate the current evidence on intraocular inflammation (IOI) and intraocular pressure (IOP) associated with aflibercept 8 mg.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted in the PubMed and Embase databases on the 13th of July 2025. Four authors conducted the screening of the titles and abstracts followed by a full text review of the remaining studies for potential eligibility. For data extraction and risk of bias assessment, two independent evaluations of each study were performed.</div></div><div><h3>Results</h3><div>A total of 16 studies were identified, comprising 2019 eyes treated with 9481 injections of aflibercept 8 mg in total. Twenty-eight incidences of IOI were reported out of 8834 injections (0.32 %), in which the incidence rates differed between clinical trials (0.15 %) and real-world studies (0.93 %). IOP elevation was observed in 28 out of 8889 injections (0.31 %), including three events of IOP <span><math><mo>≥</mo></math></span> 35 mmHg pre- or post-injection. No real-world studies reported any IOP elevation. Six studies comprising of a total of 1897 injections, reported on long term pre-injection IOP and three studies with a total of 206 injections investigated short-term post-injection IOP.</div></div><div><h3>Conclusion</h3><div>A fairly low incidence of IOP-related adverse events was observed following administration of aflibercept 8 mg, despite the increased injection volume and higher concentration. The incidence of IOI was generally low, but a higher incidence of IOI was identified in real-world studies, highlighting the need for monitoring potential high-risk patients in daily clinical practice. Further insights related to the safety profile of aflibercept 8 mg may be gained through generation of real-world evidence and standardized reporting of adverse events.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100179"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}