JAMA ophthalmology最新文献

{"title":"Repeated Low-Level Red Light-More Than Meets the Eye?","authors":"Jacque L Duncan","doi":"10.1001/jamaophthalmol.2025.0957","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0957","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"138 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872040","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":"Scientific Data Fabrication and AI-Pandora's Box.","authors":"Hong-Uyen Hua","doi":"10.1001/jamaophthalmol.2025.0936","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0936","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"69 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872042","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":"Human Papillomavirus and Thyroid Eye Disease","authors":"Ishita Garg, Benjamin I. Meyer, Ryan A. Gallo, Sara T. Wester, Daniel Pelaez","doi":"10.1001/jamaophthalmol.2025.0847","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0847","url":null,"abstract":"ImportanceThyroid eye disease (TED) is an autoimmune disease characterized by orbital inflammation and tissue remodeling. TED pathogenesis is poorly understood but is linked to autoantibodies to thyroid-stimulating hormone receptor (TSHR) and insulinlike growth factor-1 receptor (IGF-1R).ObjectiveTo explore the potential involvement of viral infections in TED pathogenesis.Design, Setting, and ParticipantsIn this experimental study conducted at the Bascom Palmer Eye Institute in Miami, Florida, the National Center for Biotechnology Information Basic Local Alignment Search Tool was used to search for amino acid sequence homologies between TSHR and IGF-1R proteins to various viral proteomes, including <jats:italic>Papillomaviridae</jats:italic>, <jats:italic>Paramyxoviridae</jats:italic>, <jats:italic>Herpesviridae</jats:italic>, <jats:italic>Enterovirus</jats:italic>, <jats:italic>Polyomaviridae</jats:italic>, and <jats:italic>Rhabdoviridae</jats:italic>. Participants were enrolled from December 2021 to August 2023, with the samples tested and analyzed in September 2023. Enzyme-linked immunoassays (ELISAs) were performed on orbital adipose tissue samples from 11 participants with TED undergoing orbital decompression surgery and 11 control participants undergoing blepharoplasty to quantify antiviral antibody titers. Demographic characteristics and clinical data were reviewed.Main Outcomes and MeasuresThe main outcomes were homology analysis between TSHR and IGF-1R with several viral proteins, human papillomavirus 18 (HPV18) L1 immunoglobulin G (IgG) titers in TED orbital fat samples, and clinical characteristics associated with HPV18 L1 IgG titers.ResultsAmong 22 total patients, mean (range) age was 58.6 years (37.4-74.4), and 19 patients (86.4%) were female. Homology analysis revealed conserved motifs between TSHR and IGF-1R with the HPV18 L1 capsid protein. Homologous regions of FG<jats:italic>X</jats:italic>V and I<jats:italic>X</jats:italic>E<jats:italic>X</jats:italic>T+NP were identified across all HPV serotypes and both IGF-1R and TSHR. ELISAs showed differences in the mean HPV18 L1 IgG normalized optical density levels among tissues of controls vs participants with chronic TED (mean [<jats:italic>M</jats:italic>], 0.94; mean differential, −1.37; 95% CI, −2.64 to −0.09; <jats:italic>P</jats:italic> = .03), controls vs participants with acute active TED (<jats:italic>M</jats:italic>, 0.94; mean differential, −3.15; 95% CI, −4.69 to −1.61; <jats:italic>P</jats:italic> < .001), and participants with chronic TED vs acute active TED (<jats:italic>M</jats:italic>, 2.31; mean differential, −1.78; 95% CI, −3.44 to −0.13; <jats:italic>P</jats:italic> = .03).Conclusions and RelevanceThis case-control study presents potential molecular evidence linking HPV and TED, highlighting molecular mimicry between HPV capsid protein and key autoimmunity targets in TED. This suggests an immunological link contributing to TED’s pathogenesis, opening new p","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"24 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866775","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":"Cone Density Changes After Repeated Low-Level Red Light Treatment in Children With Myopia","authors":"Xinyi Liao, Jifeng Yu, Yuzhuo Fan, Yixuan Zhang, Yan Li, Xuewei Li, Hongxin Song, Kai Wang","doi":"10.1001/jamaophthalmol.2025.0835","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0835","url":null,"abstract":"ImportanceRepeated low-level red light (RLRL) therapy has emerged as a potential intervention for controlling myopia progression in children. However, its long-term effects on retinal photoreceptors remain relatively unknown.ObjectiveTo evaluate changes associated with RLRL therapy on cone photoreceptor density in children with myopia using high-resolution adaptive optics scanning laser ophthalmoscopy (AOSLO).Design, Setting, and ParticipantsThis retrospective multicenter cohort study analyzed data collected from January to March 2024, focusing on Chinese children with myopia. All participants were recruited through questionnaires. Cone density measurements were obtained from AOSLO retinal images. Children with myopia aged 5 to 14 years recruited from the pediatric ophthalmology clinic during routine eye examinations were included in the study and assigned to the RLRL group or the control group. Inclusion criteria were spherical equivalent refraction below −6.00 diopters (D) and best-corrected visual acuity ≥20/20.ExposuresCone density measurement with AOSLO retinal images.Main Outcomes and MeasuresCone photoreceptor density was measured along 4 retinal meridians from central fovea to 4° eccentricity on AOSLO. Fundus abnormalities were assessed using AOSLO, optical coherence tomography (OCT), and fundus photography. Image evaluators were masked to group allocation.ResultsA total of 99 children with myopia were included in this analysis: 52 (97 eyes; mean [SD] age, 10.3 [1.9] years; 27 female [51.9%]) in the RLRL group and 47 (74 eyes; mean [SD] age, 9.8 [2.1] years; 25 male [53.2%]) in the control group. RLRL users showed decreased cone density within 0.5-mm eccentricity from the foveal center, most notably in the temporal region. At 0.3-mm temporal eccentricity, the RLRL group showed a mean difference of −2.1 × 10<jats:sup>3</jats:sup> cells/mm<jats:sup>2</jats:sup> compared with controls (95% CI, −3.68 to −0.59 × 10<jats:sup>3</jats:sup> cells/mm<jats:sup>2</jats:sup>; <jats:italic>P</jats:italic> = .003). A total of 11 eyes exhibited abnormal low-frequency, high-brightness signals near the fovea. The odds ratio of abnormal signals in RLRL users compared with nonusers was 7.23 (95% CI, 1.15-303.45; Fisher exact test, <jats:italic>P</jats:italic> = .02). One participant had relatively small cystoid abnormalities on OCT in the ganglion cell layer, which resolved 3 months after discontinuing RLRL therapy.Conclusions and RelevanceResults of this cohort study suggest that RLRL therapy for at least 1 year was associated with reduced cone density in the paracentral fovea and other subtle retinal abnormalities in some children receiving this therapy for myopia control. These findings support the need for further research to evaluate longer-term safety of RLRL therapy in similar individuals.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"23 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866771","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":"Exploring Detection Methods for Synthetic Medical Datasets Created With a Large Language Model","authors":"Andrea Taloni, Giulia Coco, Marco Pellegrini, Matthias Wjst, Niccolò Salgari, Giovanna Carnovale-Scalzo, Vincenzo Scorcia, Massimo Busin, Giuseppe Giannaccare","doi":"10.1001/jamaophthalmol.2025.0834","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0834","url":null,"abstract":"ImportanceRecently, it was proved that the large language model Generative Pre-trained Transformer 4 (GPT-4; OpenAI) can fabricate synthetic medical datasets designed to support false scientific evidence.ObjectiveTo uncover statistical patterns that may suggest fabrication in datasets produced by large language models and to improve these synthetic datasets by attempting to remove detectable marks of nonauthenticity, investigating the limits of generative artificial intelligence.Design, Setting, and ParticipantsIn this quality improvement study, synthetic datasets were produced for 3 fictional clinical studies designed to compare the outcomes of 2 alternative treatments for specific ocular diseases. Synthetic datasets were produced using the default GPT-4o model and a custom GPT. Data fabrication was conducted in November 2024.ExposurePrompts were submitted to GPT-4o to produce 12 “unrefined” datasets, which underwent forensic examination. Based on the outcomes of this analysis, the custom GPT Synthetic Data Creator was built with detailed instructions to generate 12 “refined” datasets designed to evade authenticity checks. Then, forensic analysis was repeated on these enhanced datasets.Main Outcomes and MeasuresForensic analysis was performed to identify statistical anomalies in demographic data, distribution uniformity, and repetitive patterns of last digits, as well as linear correlations, distribution shape, and outliers of study variables. Datasets were also qualitatively assessed for the presence of unrealistic clinical records.ResultsForensic analysis identified 103 fabrication marks among 304 tests (33.9%) in unrefined datasets. Notable flaws included mismatch between patient names and gender (n = 12), baseline visits occurring during weekends (n = 12), age calculation errors (n = 9), lack of uniformity (n = 4), and repetitive numerical patterns in last digits (n = 7). Very weak correlations (<jats:italic>r</jats:italic> &amp;amp;lt; 0.1) were observed between study variables (n = 12). In addition, variables showed a suspicious distribution shape (n = 6). Compared with unrefined datasets, refined ones showed 29.3% (95% CI, 23.5%-35.1%) fewer signs of fabrication (14 of 304 statistical tests performed [4.6%]). Four refined datasets passed forensic analysis as authentic; however, suspicious distribution shape or other issues were found in others.Conclusions and RelevanceSufficiently sophisticated custom GPTs can perform complex statistical tasks and may be abused to fabricate synthetic datasets that can pass forensic analysis as authentic.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"6 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866772","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":"Bilateral Fundus Hypopigmentation in a Patient With Glaucoma.","authors":"Zhonghua Luo,Shanshan Yu,Jingjing Huang","doi":"10.1001/jamaophthalmol.2025.0216","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0216","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"17 1","pages":"e250216"},"PeriodicalIF":8.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846308","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":"Two-Year Outcomes of Phacogoniotomy vs Phacotrabeculectomy for Advanced Primary Angle-Closure Glaucoma With Cataract: A Noninferiority Randomized Clinical Trial.","authors":"Yunhe Song,Sujie Fan,Li Tang,Fengbin Lin,Fei Li,Aiguo Lv,Xiaoyan Li,Tingli Wen,Lan Lu,Meichun Xiao,Lin Xie,Xiaomin Zhu,Guangxian Tang,Hengli Zhang,Xiaowei Yan,Huiping Yuan,Wulian Song,Yangfan Yang,Jiangang Xu,Fengqi Zhou,Zhenyu Wang,Ling Jin,Xiaohong Liang,Minwen Zhou,Xiaohuan Zhao,Weirong Chen,Ki-Ho Park,Keith Barton,Tin Aung,Clement C Tham,Dennis S C Lam,Robert N Weinreb,Ningli Wang,Xiulan Zhang,","doi":"10.1001/jamaophthalmol.2025.0685","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0685","url":null,"abstract":"ImportanceIntraocular pressure (IOP) reduction with phacogoniotomy (phacoemulsification plus goniosynechialysis plus goniotomy) was not less than that of phacotrabeculectomy for advanced primary angle-closure glaucoma (PACG) with cataract at 1-year follow-up, but longer-term outcomes are needed.ObjectiveTo investigate if phacogoniotomy is noninferior to phacotrabeculectomy for advanced PACG with cataract at 2 years.Design, Setting, and ParticipantsThis multicenter, noninferiority, randomized clinical trial took place in 7 ophthalmology centers in China. The trial started May 31, 2021, and 2-year follow-up ended May 31, 2024. Included in this analysis were patients with advanced PACG and cataract. Study data were analyzed from September 2024 to January 2025.InterventionsRandom assignment (1:1) to phacogoniotomy or phacotrabeculectomy.Main Outcomes and MeasuresThe primary outcome measure was reduction in IOP from baseline to the 2-year visit with a noninferiority margin of 4 mm Hg.ResultsA total of 124 participants (124 eyes) were randomized (mean [SD] age, 66.4 [8.6] years; 67 female [54.0%]), 65 (52.4%) to the phacogoniotomy group and 59 (47.6%) to the phacotrabeculectomy group. A total of 59 patients (90.7%) in the phacogoniotomy group and 52 patients (88.1%) in the phacotrabeculectomy group completed 2-year visits. All participants were Chinese. Mean (SD) IOP reduction was -25.6 (10.2) mm Hg and -24.7 (9.4) mm Hg in the phacogoniotomy and phacotrabeculectomy groups, respectively, and the upper boundary of the CI for difference in change between groups was lower than the 4-mm Hg noninferiority margin (mean difference, -0.5 mm Hg; 97.5% CI, -1.7 mm Hg to 0.8 mm Hg; P = .42). The mean difference for complete success for phacogoniotomy vs phacotrabeculectomy was -6.7% (95% CI, -21.4% to 8.8%; P = .47) and for qualified success was 1.4% (95% CI, -11.0% to 14.3%, P = .30). Median (IQR) number of antiglaucomatous medication was 0 (0) vs 0 (0; Hodges-Lehmann estimate of location shift, 0; 95% CI, 0; P =.12) with phacogoniotomy vs phacotrabeculectomy, respectively (mean difference, 0.13; 95% CI, -0.36 to 0.63; P = .60).Conclusions and RelevanceMean IOP reduction with phacogoniotomy was noninferior to phacotrabeculectomy for advanced PACG and cataract at 2-year follow-up with no differences detected in complete or qualified success or mean number of antiglaucomatous medications. These findings support phacogoniotomy as an alternative to phacotrabeculectomy for patients with advanced PACG and cataract.Trial registrationClinicalTrials.gov Identifier: NCT04878458.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"88 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846354","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":"Is Phacogoniotomy the Best Surgery for PACG and Cataract?","authors":"David S Friedman,Gus Gazzard,Paul J Foster","doi":"10.1001/jamaophthalmol.2025.0958","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0958","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"108 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846348","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":"Retinal Proliferative Membrane Caused by Picosecond Laser.","authors":"Jingyuan Yang,Shan Wu,Youxin Chen","doi":"10.1001/jamaophthalmol.2024.6512","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.6512","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"88 1","pages":"e246512"},"PeriodicalIF":8.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846322","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":"Golden Eye on Diabetic Retinopathy Screening.","authors":"Jason A W Giger,Maximilian Pfau,Hanna Zuche","doi":"10.1001/jamaophthalmol.2024.6513","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.6513","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"29 1","pages":"e246513"},"PeriodicalIF":8.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846307","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}