JAMA ophthalmology最新文献

{"title":"Ophthalmic Knowledge Assessment Program Scores and Written Qualifying Examination Performance.","authors":"Chanon Thanitcul,Sarah Schnabel,George B Bartley,Andrew G Lee,Hally Crump,Dale E Fajardo,Kathryn Peters,Beth Wilson,Divya Srikumaran","doi":"10.1001/jamaophthalmol.2025.1933","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1933","url":null,"abstract":"ImportanceThe Ophthalmic Knowledge Assessment Program (OKAP) has been widely used to determine readiness to take the high-stakes Written Qualifying Examination (WQE). However, it is unclear how well OKAP performance can predict WQE outcomes.ObjectiveTo examine the association between the OKAP and WQE nationally.Design, Setting, and ParticipantsThis was a retrospective cohort study conducted from 2017 to 2022. This national data analysis included residents from ophthalmology residency programs in the US. Study data were analyzed June 2023 to December 2024.ExposuresOKAP and WQE data.Main Outcomes and MeasuresThe national OKAP examination data and the WQE data were matched. Candidates who had complete data for the OKAP during postgraduate year (PGY) 2, 3, and 4 and completed the WQE were included in the study. Two-sample t tests, logistic regression analysis, receiver operating characteristic curves, and confusion matrix were used to examine the association of various test scores (PGY-2 OKAP, PGY-3 OKAP, PGY-4 OKAP, minimum OKAP, maximum OKAP, average OKAP) as predictors for WQE outcomes (pass or fail). Multiple logistic regression analyses were also used to assess the association of gender, time since graduation, program size, and WQE pass/fail outcomes.ResultsA total of 1597 residents (907 male [56.8%]) from 117 residency programs were included in this study. First-time pass rate of the WQE was 89% (1418 of 1597 residents). OKAP scores, particularly average OKAP, maximum OKAP, and PGY-4 OKAP scores (all had area under the curve = 0.88), were the most useful predictor of WQE outcomes. PGY-4 OKAP scores were used for the rest of the analysis for simplicity. A PGY-4 OKAP scaled score of 550 corresponded to 94% of candidates passing the WQE. Using PGY-4 OKAP scores to predict passing/failing, the WQE had 90.7% accuracy. Gender (odds ratio [OR], 1.50; 95% CI, 1.01-2.26; P = .048), program size (OR, 1.55; 95% CI, 0.98-2.41; P = .06), and time since residency graduation (OR, 1.00; 95% CI, 1.00-1.00; P = .14) were not included in the logistic regression model investigating the association of PGY-4 OKAP scores with the likelihood of passing the WQE.Conclusions and RelevanceResults suggest that OKAP examination scores were associated with passing the WQE after adjusting for program size, gender, and time since residency graduation. Further analyses may be warranted to predict failing the WQE so that potential interventions can be attempted.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"13 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversified Segmental Defocus Optimization Lenses With and Without Atropine for Myopia Prevention: A Randomized Clinical Trial.","authors":"Yuchang Lu,Xue Yang,Jingwei Zhou,Sitong Chen,Xuewei Li,Yuanqi Deng,Yixuan Zhang,Yan Li,Kai Wang","doi":"10.1001/jamaophthalmol.2025.2072","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.2072","url":null,"abstract":"ImportanceWith growing myopia prevalence worldwide, effective strategies to prevent early-onset myopia are needed.ObjectiveTo evaluate the efficacy of diversified segmental defocus optimization (DSDO) spectacle lenses with or without 0.01% atropine for myopia prevention.Design, Setting, and ParticipantsThis was 1-year randomized placebo-controlled double-masked clinical trial conducted in the Department of Ophthalmology at Peking University People's Hospital from November 2023 to December 2024. Children aged 5 to 12 years with spherical equivalent refraction (SER) of 0.00 to 1.00 diopters (D) after cycloplegia were included, excluding those with ocular diseases, systemic diseases, or previous use of optical or pharmaceutical myopia control methods.InterventionsParticipants were randomly assigned in a 1:1:1 ratio to receive DSDO spectacles with placebo eye drops (DSDO group), DSDO spectacles with 0.01% atropine eye drops (DSDOA group), or single-vision spectacles with placebo eye drops (control group).Main Outcomes and MeasuresThe primary outcomes were the cumulative incidence rate of myopia (defined as SER ≤-0.50 D) and the percentage of participants with fast myopic shift (defined as a spherical equivalent myopic shift ≥0.50 D) over 1 year. Secondary outcomes included changes in SER, axial length, and subfoveal choroidal thickness.ResultsOf the 450 children initially randomized (DSDO group: mean [SD] age, 7.05 [0.12] years; 77 [51.3%] male; DSDOA group: mean [SD] age, 7.02 [0.14] years; 73 [48.7%] male; control group: mean [SD] age, 7.01 [0.11] years; 78 [52.0%] male), 370 (82.2%) completed the study, including 121 in the DSDO group, 125 in the DSDOA group, and 124 in the control group. The 1-year cumulative incidence rates of myopia in the DSDO, DSDOA, and control groups were 5.8% (7/121), 4.8% (6/125), and 15.3% (19/124), respectively, and the percentages of participants with fast myopic shift after 1 year were 15.7% (19/121), 9.6% (12/125), and 42.7% (53/124). Both DSDO and DSDOA groups showed significantly lower 1-year cumulative myopia incidence (DSDO: difference, 9.5%; 95% CI, 1.9-17.5; P = .02; DSDOA: difference, 10.5%; 95% CI, 3.3-18.4; P = .006) and the percentage of patients with fast myopic shift (DSDO: difference, 27.0%; 95% CI, 16.1-37.3; P < .001; DSDOA: difference, 33.1%; 95% CI, 23.1-42.8; P < .001) vs control. No significant differences were observed between DSDO and DSDOA groups.Conclusions and RelevanceThese data suggest that daily use of DSDO spectacles delays the onset of myopia among children without myopia, supporting DSDO spectacles without atropine as an alternative preventive method for children without myopia if supported with longer follow-up and replication by others.Trial RegistrationChinese Clinical Trial Registry: ChiCTR2300077307.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"43 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Declaration of a Pandemic, 5 Years Later-Lessons Learned.","authors":"Ann-Margret Ervin,Allen O Eghrari,Sheila K West","doi":"10.1001/jamaophthalmol.2025.2180","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.2180","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"13 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of COVID-19 Pandemic and Ocular Surgery-Reply.","authors":"Mariam Samuel,Raziyeh Mahmoudzadeh,Jessica D Randolph","doi":"10.1001/jamaophthalmol.2025.2010","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.2010","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"35 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preflight Myopia and Visual Acuity Changes in Long-Duration Astronauts.","authors":"Jay C Buckey,Michael E Zegans,Mimi Lan","doi":"10.1001/jamaophthalmol.2025.1935","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1935","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Cannabis Use and Risk of Postoperative Proliferative Vitreoretinopathy.","authors":"Ahmed M Alshaikhsalama,Amer F Alsoudi,Ali Mukhtar,Karen Wai,Euna Koo,Andrea Kossler,Chase Ludwig,Prithvi Mruthyunjaya,Ehsan Rahimy","doi":"10.1001/jamaophthalmol.2025.1851","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1851","url":null,"abstract":"ImportanceProliferative vitreoretinopathy (PVR) is a major cause of retinal detachment (RD) repair failure, resulting in poor visual outcomes. Cannabis use continues to increase globally and may affect PVR development through its anti-inflammatory and neuroprotective properties, although this association remains unclear.ObjectiveTo assess the risk of developing PVR among patients with concomitant cannabis use who underwent primary RD repair.Design, Setting, and ParticipantsThis retrospective cohort study examined data from electronic health records for a multicenter research network extracted for the period February 1, 2005, to February 1, 2025. Participants were patients who underwent initial RD repair with pars plana vitrectomy (PPV) with or without scleral buckle (SB), primary SB, or pneumatic retinopexy. The records were used to identify patients diagnosed with concomitant cannabis-related disorder together with confirmatory testing of cannabis in urine or blood compared with a control group without documented use. Exclusion criteria were a history proliferative diabetic retinopathy or less than 6 months of follow-up.ExposuresPrimary RD repair and cannabis-related disorder.Main Outcome MeasuresRelative risk (RR) of developing PVR and requiring a subsequent complex RD repair at 6 months and 1 year of follow-up.ResultsAfter propensity score matching, each cohort had 1193 patients. The mean (SD) age was 53.2 (16.1) years; 1662 were male (69.7%), 641 were female (26.9%), and for 83 patients (3.5%), the sex was unknown. At 6 months, patients with concomitant cannabis use with RD repaired by any method had a reduced risk of developing subsequent PVR (25 events [2.10%] vs 52 events [4.36%]; RR, 0.48; 95% CI, 0.30-0.77; P = .002) and requiring complex RD repair (37 [3.10%] vs 60 [5.03%]; RR, 0.62; 95% CI, 0.41-0.92; P = .02) when compared with controls. Similar results were observed at 1 year for both outcomes.Conclusions and RelevancePatients who underwent initial repair for RD with concomitant cannabis use were less likely to develop PVR and require subsequent complex RD repair compared with matched patients without documented cannabis exposure; however, the absolute difference in rates was small. While this protective association noted with cannabis use could be due to the population using it rather than an effect of the cannabis itself, the findings suggest that cannabis use might have a role in reducing PVR development. Intervention trials would be needed to try to control for confounding factors.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabis Use and Proliferative Vitreoretinopathy Risk Reduction.","authors":"Jonathan D Groothoff,Sally S Ong","doi":"10.1001/jamaophthalmol.2025.1977","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1977","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"70 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of COVID-19 Pandemic and Ocular Surgery.","authors":"Naira Ikram,Owais Fazal,Isdin Oke","doi":"10.1001/jamaophthalmol.2025.2007","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.2007","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"20 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transparency in Ophthalmology Markets.","authors":"Sean T Berkowitz, Sumit Sharma, Katherine E Talcott","doi":"10.1001/jamaophthalmol.2025.2024","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.2024","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commercial Price Variation in Ophthalmology.","authors":"Alexander P Philips, Christopher Whaley","doi":"10.1001/jamaophthalmol.2025.1693","DOIUrl":"10.1001/jamaophthalmol.2025.1693","url":null,"abstract":"<p><strong>Objective: </strong>To assess the variation in commercial insurance payment rates for common ophthalmology procedures across major national insurers and identify patterns in professional and facility fees.</p><p><strong>Design, setting, and participants: </strong>This cross-sectional study used January 2025 Transparency in Coverage data, payment rates negotiated between insurers and health care professionals from 4 large national insurers (Blue Cross Blue Shield, United Healthcare, Cigna, and Aetna) for 10 common ophthalmology procedures. Data included approximately 684 506 professional fee price points from 15 788 physicians and 55 930 facility fee price points from 4697 facilities. Data were analyzed January through March 2025.</p><p><strong>Main outcomes and measures: </strong>The primary outcomes were the distribution of negotiated prices (mean, median, percentiles), coefficients of variation, and volume-weighted price indices by payer for professional and facility payments by commercial insurers. Geographic variation in pricing was also assessed.</p><p><strong>Results: </strong>Negotiated facility fees showed substantially greater price variation than professional fees across all ophthalmology procedures, with facility coefficients of variation exceeding professional coefficients by factors of 2 to 4. Blue Cross Blue Shield maintained consistently higher payments (14% above market average for professional fees; 13% above for facility fees), while Aetna demonstrated dramatic variation with professional fees 54% below average but facility fees 45% above average. Geographic analysis revealed substantial state-level variability, with facility prices for standard cataract surgeries showing up to 5-fold differences between upper and lower bounds across states.</p><p><strong>Conclusions and relevance: </strong>This study reveals substantial variability in commercial insurance payment rates for ophthalmology procedures, particularly in facility fees. These findings indicate that market dynamics, insurer-health care professional negotiations, and geographic factors substantially influence price variation, which has important implications for health care affordability and access to ophthalmologic care.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}