JAMA ophthalmology最新文献

{"title":"Event-Based Progression Detection Among OCT, OCT Angiography, and Visual Field in Glaucoma","authors":"Melika Hashemi, Takashi Nishida, Sasan Moghimi, Ghazaleh Soltani, Amelia de Oliveira Pereira, Gizem Dogan Gokce, Mauro Gobira, Linda M. Zangwill, Robert N. Weinreb","doi":"10.1001/jamaophthalmol.2026.3545","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.3545","url":null,"abstract":"Importance Early detection of glaucoma progression is essential. Optical coherence tomography angiography (OCTA) vascular metrics may identify progression before structural OCT or visual field changes. Objective To evaluate timing and agreement of event-based progression detection among OCT, OCTA, and visual field testing in glaucoma. Design, Setting, and Participants This was a retrospective cohort study designed in August 2024. Included were patients from the Diagnostic Innovations in Glaucoma Study (DIGS) who underwent OCT and OCTA imaging and visual field testing from January 2015 to April 2023. Inclusion required 2 or more years of follow-up and 4 or more visits with each modality. Exposures OCT, OCTA, and visual field testing. Main Outcomes and Measures OCT and OCTA progression were defined as change exceeding test-retest variability thresholds at 2 consecutive visits; visual field progression was assessed with guided progression analysis. Progression rates and lead times were compared. Results A total of 180 eyes (111 perimetric, 69 preperimetric) from 116 patients (mean [SD] age, 67.6 [13.7] years; 61 female [52.6%]) were included in this analysis. During mean (SD) follow-up of 5.1 (1.4) years, 107 eyes (59.4%) had progression detected by at least 1 modality as follows: 58 eyes (32.2%) by OCTA vessel density, 45 eyes (25.0%) by OCT circumpapillary retinal nerve fiber layer (CPRNFL) thickness, and 59 eyes (32.8%) by visual field testing. Among eyes with progression, the earliest detection occurred with OCTA vessel density in 40 eyes (37.4%), OCT CPRNFL thickness in 32 eyes (29.9%), and visual field testing in 26 eyes (24.3%). Among 45 stable eyes, specificity was 75.6% for OCT CPRNFL thickness and 68.9% for OCTA vessel density. Mean lead times were 2.3 years for OCTA vessel density before visual field progression (95% CI, 1.3-3.2 years), 1.5 years for OCT CPRNFL thickness before visual field progression (95% CI, 0.6-2.4 years), and 0.2 years for OCT CPRNFL thickness vs OCTA vessel density (95% CI, −0.6 to 0.9 years). Conclusions and Relevance Results of this cohort study suggest that OCTA vessel density may detect event-based glaucoma progression earlier than OCT or visual field testing at the cost of a slight decrease in specificity compared with OCT. These findings support a potential complementary role for OCTA in glaucoma monitoring, although the cost-benefit of additional testing requires further evaluation.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"23 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148884003","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":"Deuterated Vitamin A for Stargardt Disease in TEASE-1 Trial.","authors":"Rachel M Huckfeldt, Jason I Comander","doi":"10.1001/jamaophthalmol.2026.3926","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.3926","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887378","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":"Beyond Axial Length-3-Dimensional Remodeling in Pathologic Myopia.","authors":"Kyoko Ohno-Matsui","doi":"10.1001/jamaophthalmol.2026.3777","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.3777","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887368","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":"Lipemia Retinalis Reversal in Familial Partial Lipodystrophy","authors":"Benjamin Blackburn, Mohamed Dembele, M. Dominik Fischer","doi":"10.1001/jamaophthalmol.2026.3568","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.3568","url":null,"abstract":"This case report describes a diagnosis of lipemia retinalis in a woman aged 27 years with creamy discoloration of the retinal vessels on fundus examination and markedly elevated serum triglyceride levels.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"17 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883656","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":"Longitudinal Trajectories of 3-Dimensional Eye Shape and Pathological Sequelae in High Myopia","authors":"Shida Chen, Yunqian Li, Meng Xuan, Ruilin Xiong, Shaoying Tan, Wei Wang","doi":"10.1001/jamaophthalmol.2026.3684","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.3684","url":null,"abstract":"Importance The highly myopic eye remodels in 3 dimensions, but the longitudinal trajectories of globe shape and their associations with sight-threatening outcomes remain poorly defined. Objective To characterize 15-year 3-dimensional (3D) remodeling trajectories of highly myopic globes and examine their associations with baseline features and ocular outcomes. Design, Setting, and Participants This 15-year 3D magnetic resonance imaging (MRI) cohort substudy was nested within the Zhongshan High Myopia Cohort. Thirty participants (60 eyes) with bilateral high myopia (spherical equivalent refraction, −6.00 D or worse) randomly drawn from 95 participants imaged in September 2011 were rescanned in September 2025. Exposures Orbital 3D MRI reconstructions were classified into 6 globe-shape categories. Paired classifications, global enlargement, and staphyloma status defined 5 remodeling patterns: quiescence, proportional expansion, focal emergence, focal progression, and shape transition. Main Outcomes and Measures Distribution of remodeling patterns and their associations with myopic macular degeneration (MMD), myopic traction maculopathy (MTM), posterior staphyloma (PS), visual acuity, and visual field indices. Results Among the 30 included participants, the mean (SD) age was 37.30 (15.89) years, and 16 (53.3%) participants were women. The 60 eyes were classified as quiescent (21 [35.0%]), proportional expansion (12 [20.0%]), focal emergence (14 [23.3%]), focal progression (6 [10.0%]), or shape transition (7 [11.7%]). No deformed eye reverted to spheroidal. Pattern distribution was associated with baseline age and contour: 10 of 12 eyes (83.3%) of individuals younger than 20 years underwent proportional expansion, whereas 13 of 24 eyes (54.2%) of individuals aged 40 years and older followed focal progression or shape transition. Eyes with focal emergence had the largest best-corrected visual acuity decline (0.26 logMAR) and mean deviation worsening (−3.50 dB), and eyes with shape transition had the largest pattern standard deviation increasing (1.95 dB). At similar axial elongation, eyes developing focal deformation had higher frequencies of MMD progression (91.7%; 95% CI, 74.2-97.7 vs 58.8%; 95% CI, 36.0-78.4; <jats:italic toggle=\"yes\">P</jats:italic> = .02), incident or progressive PS (91.7%; 95% CI, 74.2-97.7 vs 17.6%; 95% CI, 6.2-41.0; <jats:italic toggle=\"yes\">P</jats:italic> &amp;amp;lt; .001), and MTM (58.3%; 95% CI, 38.8-75.5 vs 11.8%; 95% CI, 3.3-34.3; <jats:italic toggle=\"yes\">P</jats:italic> = .003). Conclusions and Relevance Highly myopic globes followed age- and geometry-associated trajectories linked to outcomes beyond axial elongation. These 2–time-point findings potentially support 3D shape analysis as a candidate framework for individualized surveillance, pending prospective validation.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"57 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883657","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":"Patient With Bilateral Corneal Opacities","authors":"John Placide, Daniel J. Lee, Afshan A. Nanji","doi":"10.1001/jamaophthalmol.2026.3540","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.3540","url":null,"abstract":"A 31-year-old woman from Guam with no known medical history was referred by an ophthalmologist to a US cornea clinic for bilateral progressive blurred vision and corneal opacities. What would you do next?","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"12 1 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883655","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":"Safety and Effects of Gildeuretinol Acetate on Retinal Atrophic Lesions in Stargardt Disease: The TEASE-1 Randomized Clinical Trial.","authors":"Christine N Kay, Leonide Saad, Gabrielle DeBartolomeo, Neil Bressler, Stephen H Tsang, Kimberly Stepien, Paul Bernstein, Byron L Lam, Ilyas Washington, Michael B Gorin","doi":"10.1001/jamaophthalmol.2026.3662","DOIUrl":"10.1001/jamaophthalmol.2026.3662","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Stargardt disease (STGD) is the most common macular dystrophy, resulting in profound loss of vision. There is no approved treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the safety and effects of oral gildeuretinol acetate on the growth of retinal atrophic lesions in individuals with STGD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;TEASE-1 was a 2-year, multicenter, double-masked, placebo-controlled randomized clinical trial incorporating a crossover group and additional natural history (NH) cases selected prior to drafting the statistical analysis plan. The trial was conducted at 7 outpatient clinics in the US. Participants were aged 12 years or older, clinically diagnosed with STGD, with well-demarcated area(s) of significantly reduced autofluorescence, and supported with at least 1 ABCA4 disease-causing or likely disease-causing variant. The study was conducted between August 2015 and October 2019; data were analyzed between July and December 2020.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interventions: &lt;/strong&gt;Participants were randomized 1.5:1.5:1:1 to daily oral gildeuretinol acetate, 14 mg; gildeuretinol acetate, 24 mg; or placebo for 24 months; or placebo for 12 months followed by gildeuretinol for 12 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The primary efficacy end point was the growth rate of well-delineated and homogeneous areas of retinal atrophic lesions over 24 months of treatment on fundus autofluorescence imaging. Safety end points included treatment-emergent adverse events (AEs), serious AEs, and clinical laboratory assessments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 50 participants were randomized, and 54 NH cases included. The mean (range) age of randomized participants was 44.3 (18-60) years. Overall, 58 of 104 participants or cases (55.8%) were female. The growth rate of retinal atrophic lesions was 0.182 mm/y with gildeuretinol and 0.232 mm/y in the untreated group (placebo and NH), representing a mean difference of -0.050 mm/y (95% CI, -0.072 to -0.027; P &lt; .001) and a 21.6% relative reduction. In a prespecified sensitivity analysis restricted to randomized participants, the growth rate was 0.206 mm/y with gildeuretinol and 0.242 mm/y with placebo, representing a mean difference of -0.036 mm/y (95% CI, -0.062 to -0.009; P = .008) and a 14.9% relative reduction. The majority of AEs were mild or moderate and equally distributed between groups. No treatment-related serious AEs, clinically significant liver function abnormalities, or participant-reported night blindness or dark adaption difficulties occurred.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In the TEASE-1 randomized clinical trial, the primary efficacy end point of retinal atrophic lesion growth from 6 to 24 months was 0.05 mm/y greater on average in the untreated group (placebo and NH) than the gildeuretinol acetate group. Further research is needed to determine the clinical relevance of this end point.&lt;/p&gt;&lt;","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887293","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}

{"title":"Artificial Intelligence for Diabetic Retinopathy.","authors":"Jennifer I Lim, Theodore Leng","doi":"10.1001/jamaophthalmol.2026.3479","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.3479","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887285","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":"High-Resolution Imaging of RPE Cellular Mosaic Over Drusen","authors":"Marco Lombardo, Raffaella Cascella, Andrea Cusumano","doi":"10.1001/jamaophthalmol.2026.3332","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.3332","url":null,"abstract":"This case report of a patient aged 37 years with asymptomatic bilateral drusen discusses how adaptive optics transscleral flood illumination imaging enabled in vivo has the potential to detect subtle retinal pigment epithelial (RPE) changes in patients with drusen.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"38 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148836185","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":"Data and Temporal Risk Concerns of Semaglutide and NAION-Reply.","authors":"Kent R Heberer, Adam P Bress, Jennifer S Lee","doi":"10.1001/jamaophthalmol.2026.3442","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.3442","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840020","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}