JAMA ophthalmologyPub Date : 2025-04-03DOI: 10.1001/jamaophthalmol.2025.0352
Patrice M Hicks, Rithambara Ramachandran, Paula Anne Newman-Casey
{"title":"Plain Language Summaries to Bolster Team-Based Care.","authors":"Patrice M Hicks, Rithambara Ramachandran, Paula Anne Newman-Casey","doi":"10.1001/jamaophthalmol.2025.0352","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0352","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772415","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}
JAMA ophthalmologyPub Date : 2025-04-03DOI: 10.1001/jamaophthalmol.2025.0351
Prashant D Tailor, Haley S D'Souza, Clara M Castillejo Becerra, Heidi M Dahl, Neil R Patel, Tyler M Kaplan, Darrell Kohli, Erick D Bothun, Brian G Mohney, Andrea A Tooley, Keith H Baratz, Raymond Iezzi, Andrew J Barkmeier, Sophie J Bakri, Gavin W Roddy, David Hodge, Arthur J Sit, Matthew R Starr, John J Chen
{"title":"Evaluation of AI Summaries on Interdisciplinary Understanding of Ophthalmology Notes.","authors":"Prashant D Tailor, Haley S D'Souza, Clara M Castillejo Becerra, Heidi M Dahl, Neil R Patel, Tyler M Kaplan, Darrell Kohli, Erick D Bothun, Brian G Mohney, Andrea A Tooley, Keith H Baratz, Raymond Iezzi, Andrew J Barkmeier, Sophie J Bakri, Gavin W Roddy, David Hodge, Arthur J Sit, Matthew R Starr, John J Chen","doi":"10.1001/jamaophthalmol.2025.0351","DOIUrl":"10.1001/jamaophthalmol.2025.0351","url":null,"abstract":"<p><strong>Importance: </strong>Specialized ophthalmology terminology limits comprehension for nonophthalmology clinicians and professionals, hindering interdisciplinary communication and patient care. The clinical implementation of large language models (LLMs) into practice has to date been relatively unexplored.</p><p><strong>Objective: </strong>To evaluate LLM-generated plain language summaries (PLSs) integrated into standard ophthalmology notes (SONs) in improving diagnostic understanding, satisfaction, and clarity.</p><p><strong>Design, setting, and participants: </strong>Randomized quality improvement study conducted from February 1, 2024, to May 31, 2024, including data from inpatient and outpatient encounters in a single tertiary academic center. Participants were nonophthalmology clinicians and professionals and ophthalmologists. The single inclusion criterion was any encounter note generated by an ophthalmologist during the study dates. Exclusion criteria were (1) lack of established nonophthalmology clinicians and professionals for outpatient encounters and (2) procedure-only patient encounters.</p><p><strong>Intervention: </strong>Addition of LLM-generated plain language summaries to ophthalmology notes.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was survey responses from nonophthalmology clinicians and professionals assessing understanding, satisfaction, and clarity of ophthalmology notes. Secondary outcomes were survey responses from ophthalmologists evaluating PLS in terms of clinical workflow and accuracy, objective measures of semantic quality, and safety analysis.</p><p><strong>Results: </strong>A total of 362 (85%) nonophthalmology clinicians and professionals (33.0% response rate) preferred the PLS to SON. Demographic data on age, race and ethnicity, and sex were not collected. Nonophthalmology clinicians and professionals reported enhanced diagnostic understanding (percentage point increase, 9.0; 95% CI, 0.3-18.2; P = .01), increased note detail satisfaction (percentage point increase, 21.5; 95% CI, 11.4-31.5; P < .001), and improved explanation clarity (percentage point increase, 23.0; 95% CI, 12.0-33.1; P < .001) for notes containing a PLS. The addition of a PLS was associated with reduced comprehension gaps between clinicians who were comfortable and uncomfortable with ophthalmology terminology (from 26.1% [95% CI, 13.7%-38.6%; P < .001] to 14.4% [95% CI, 4.3%-24.6%; P > .06]). PLS semantic analysis found high meaning preservation (bidirectional encoder representations from transformers score mean F1 score: 0.85) with greater readability than SONs (Flesch Reading Ease: 51.8 vs 43.6; Flesch-Kincaid Grade Level: 10.7 vs 11.9). Ophthalmologists (n = 489; 84% response rate) reported high PLS accuracy (90% [320 of 355] a great deal) with minimal review time burden (94.9% [464 of 489] ≤1 minute). PLS error rate on ophthalmologist review was 26% (126 of 489). A total of 83.9% (104 of 126) of errors wer","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772403","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":"Risk of Developing Pediatric Uveitis Among Patients With Early-Onset Atopic Dermatitis.","authors":"Yung-Yu Chu, Cheng-Hao Sung, Yu-Shiuan Lin, Chung-Han Ho, Yi-Chen Chen, Wan-Ju Annabelle Lee, Shu-Chun Kuo","doi":"10.1001/jamaophthalmol.2025.0366","DOIUrl":"10.1001/jamaophthalmol.2025.0366","url":null,"abstract":"<p><strong>Importance: </strong>The relationship between atopic dermatitis (AD) and pediatric uveitis may be underexplored, warranting large-scale, multicenter studies.</p><p><strong>Objective: </strong>To evaluate the risk of pediatric uveitis among children with early-onset AD compared with a matched control population.</p><p><strong>Design, setting, and participants: </strong>This cohort study used aggregated electronic health records of US patients with early-onset AD and matched controls from January 1, 2004, through December 14, 2024, sourced from health care organizations in the collaborative research network TriNetX. Patients with early-onset AD and matched controls without AD were included in the analysis; those with uveitis prior to AD diagnosis were excluded. Propensity score matching was applied to balance baseline characteristics. The analyses were conducted on December 14, 2024.</p><p><strong>Exposure: </strong>International Classification of Diseases, 10th Revision (ICD-10) diagnosis code for AD.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the hazard ratio (HR) for developing pediatric uveitis in the AD cohort compared with the matched controls. Cox proportional hazards models were applied to assess the risk.</p><p><strong>Results: </strong>A total of 114 889 patients were identified in the AD cohort (mean [SD] follow-up, 6.0 [3.3] years; mean [SD] age, 0.5 [0.7] years; 64 817 male [56.4%]) and the control cohort (mean [SD] follow-up, 6.6 [3.7] years; mean [SD] age, 0.6 [0.8] years; 65 377 male [56.9%]) after matching. The AD cohort demonstrated a higher risk of developing pediatric uveitis compared with controls (94 [0.08%] vs 58 [0.05%]; HR, 1.92 [95% CI, 1.38-2.66]). Sensitivity analyses among patients without dupilumab use (89 of 113 284 [0.08%] vs 59 of 113 284 [0.05%]; HR, 1.77 [95% CI, 1.27-2.46]) and those without autoimmune conditions (80 of 114 425 [0.07%] vs 61 of 114 425 [0.05%]; HR, 1.52 [95% CI, 1.09-2.12]) similarly indicated an increased risk in the AD cohort. Additionally, patients with severe AD had a higher risk of developing pediatric uveitis compared with those with nonsevere AD (12 of 3004 [0.40%] vs 97 of 126 482 [0.08%]; HR, 3.64 [95% CI, 2.00-6.66]).</p><p><strong>Conclusions and relevance: </strong>This cohort study of children with early-onset AD found an elevated risk of pediatric uveitis compared with matched controls, independent of autoimmune conditions or dupilumab use. These findings support the potential need to consider ophthalmologic monitoring in children with early-onset AD to try to detect and subsequently manage uveitis if it develops.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772417","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}
JAMA ophthalmologyPub Date : 2025-03-27DOI: 10.1001/jamaophthalmol.2025.0399
Michelle R Hribar, Cindy X Cai, Kerry E Goetz, George Hripcsak
{"title":"The OHDSI Network in Ophthalmology-The Promise of Observational Health Data.","authors":"Michelle R Hribar, Cindy X Cai, Kerry E Goetz, George Hripcsak","doi":"10.1001/jamaophthalmol.2025.0399","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0399","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719323","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}
JAMA ophthalmologyPub Date : 2025-03-27DOI: 10.1001/jamaophthalmol.2025.0400
Tyler Bahr, Jenna Krivit, Diva R Salomao, Keith H Baratz, Lauren A Dalvin
{"title":"Conjunctival Melanoma With Invasion of a LASIK Flap Interface.","authors":"Tyler Bahr, Jenna Krivit, Diva R Salomao, Keith H Baratz, Lauren A Dalvin","doi":"10.1001/jamaophthalmol.2025.0400","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0400","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719316","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}
JAMA ophthalmologyPub Date : 2025-03-27DOI: 10.1001/jamaophthalmol.2025.0349
Alan Y Hsu, Hou-Ting Kuo, Yu-Hsun Wang, Chun-Ju Lin, Yi-Ching Shao, Chun-Chi Chiang, Ning-Yi Hsia, Chun-Ting Lai, Hsin Tseng, Bing-Qi Wu, Huan-Sheng Chen, Yi-Yu Tsai, Min-Yen Hsu, James Cheng-Chung Wei
{"title":"Semaglutide and Nonarteritic Anterior Ischemic Optic Neuropathy Risk Among Patients With Diabetes.","authors":"Alan Y Hsu, Hou-Ting Kuo, Yu-Hsun Wang, Chun-Ju Lin, Yi-Ching Shao, Chun-Chi Chiang, Ning-Yi Hsia, Chun-Ting Lai, Hsin Tseng, Bing-Qi Wu, Huan-Sheng Chen, Yi-Yu Tsai, Min-Yen Hsu, James Cheng-Chung Wei","doi":"10.1001/jamaophthalmol.2025.0349","DOIUrl":"10.1001/jamaophthalmol.2025.0349","url":null,"abstract":"<p><strong>Importance: </strong>Recent studies have suggested an association between nonarteritic anterior ischemic optic neuropathy (NAION) with semaglutide usage. However, the limitations of those analyses warrant further investigation, given the frequency of use of these medications in people with and without diabetes.</p><p><strong>Objective: </strong>To investigate the association between semaglutide use and the risk of NAION among patients with diabetes.</p><p><strong>Design, setting, and participants: </strong>This cohort study used data from the TriNetX database between October 1, 2019, and December 31, 2023, to identify patients with diabetes with no history of NAION who were prescribed semaglutide. The semaglutide cohort was compared with a control group of randomly selected patients with diabetes who were prescribed non-glucagonlike peptide 1 (non-GLP-1) receptor agonist (RA) antidiabetic medications. The data analysis for this study was performed on September 1, 2024.</p><p><strong>Exposures: </strong>Semaglutide history, identified using diagnostic codes.</p><p><strong>Main outcomes and measures: </strong>Cumulative incidence and (HR) hazard ratio of NAION.</p><p><strong>Results: </strong>A total of 3 344 205 patients with diabetes were included in this study. Regarding the diabetes cohort, a total of 174 584 patients with diabetes who received semaglutide (mean [SD] age, 58.3 [12.5] years; 90 427 female [51.8%]; 71 739 male [41.1%]) and 174 584 patients with diabetes who received non-GLP-1 RA medications (mean [SD] age, 58.2 [14.3] years; 90 475 female [51.82%]; 71 989 male [41.24%]) were recruited. Patients with diabetes taking semaglutide exhibited an absence of NAION risk at the 1-month (HR, 2.99; 95% CI, 0.31-28.75), 3-month (HR, 1.33; 95% CI, 0.30-5.93), 6-month (HR, 1.79; 95% CI, 0.60-5.35), and 1-year (HR, 1.94; 95% CI: 0.93-4.02) time points after the index date. However, those taking semaglutide were found to have an increased risk for NAION at the 2-year (HR, 2.39; 95% CI, 1.37-4.18), 3-year (HR, 2.44; 95% CI, 1.44-4.12), and 4-year (HR, 2.05; 95% CI, 1.26-3.34) time points from the index date. Increased risk for NAION was also noted in patients with diabetes and concomitant hypertension who were taking semaglutide (HR, 2.42; 95% CI, 1.19-4.92). An increased NAION risk was also observed among patients with diabetes who had a history of Ozempic (Novo Nordisk) use or stand-alone Ozempic (Novo Nordisk) prescription history.</p><p><strong>Conclusions and relevance: </strong>Results of this cohort study suggest that semaglutide use was associated with an increased risk of NAION in patients with diabetes. However, the study's retrospective design presents limitations, as it can only infer associations rather than establish causality; further studies are needed.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719320","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}
JAMA ophthalmologyPub Date : 2025-03-27DOI: 10.1001/jamaophthalmol.2025.0250
Yu Jeat Chong, Kelvin Yi Chong Teo, Wendy Wong, Anna C S Tan, Xinyi Su, Noa Gilead, Hiok Hong Chan, Farah Ibrahim, Beau Fenner, Charles Ong, Christopher Sun, Shaun Sim, Caroline Chee, Usha Chakravarthy, Chui Ming Gemmy Cheung
{"title":"Aflibercept With vs Without Reduced-Fluence Photodynamic Therapy for Polypoidal Choroidal Vasculopathy: A Randomized Clinical Trial.","authors":"Yu Jeat Chong, Kelvin Yi Chong Teo, Wendy Wong, Anna C S Tan, Xinyi Su, Noa Gilead, Hiok Hong Chan, Farah Ibrahim, Beau Fenner, Charles Ong, Christopher Sun, Shaun Sim, Caroline Chee, Usha Chakravarthy, Chui Ming Gemmy Cheung","doi":"10.1001/jamaophthalmol.2025.0250","DOIUrl":"10.1001/jamaophthalmol.2025.0250","url":null,"abstract":"<p><strong>Importance: </strong>The potential benefit of adding photodynamic therapy (PDT) to intravitreal aflibercept injection (IAI) in eyes with polypoidal choroidal vasculopathy (PCV) remains unclear.</p><p><strong>Objective: </strong>To compare the functional and anatomical benefit of combination therapy using reduced-fluence PDT (RF-PDT) plus IAI vs IAI monotherapy in participants with PCV.</p><p><strong>Design, setting, and participants: </strong>This double-masked, sham-controlled, randomized clinical trial was conducted at 2 centers in Singapore from January 2021 to June 2024 for participants aged 50 years or older with symptomatic macular PCV confirmed on indocyanine green angiography. Data were analyzed from January 2021 to June 2024.</p><p><strong>Interventions: </strong>Randomization 1:1 to RF-PDT plus 2 mg of IAI or sham-PDT plus 2 mg of IAI at week 0. Follow-up was at 4 weeks and retreatment with IAI, per protocol pro re nata regimen.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the mean change in best-corrected visual acuity (BCVA) from baseline to week 52. Secondary outcomes, not adjusted for multiple analyses, included proportion of eyes with polypoidal lesion (PL) closure at week 12 per indocyanine green angiography .</p><p><strong>Results: </strong>Only 60 (43 male [71.6%] and 17 female [28.4%]; mean [SD] age, 71.3 [5.7] years) of the planned 160 participants were enrolled between January 2021 and June 2023. Among these, 30 of 30 (100%) and 30 of 30 participants (100%) in combination and monotherapy groups, respectively, returned for the 52-week follow-up. Baseline BCVA letter score (approximate Snellen equivalent [SD]) was 62.0 (20/63 [10.6]) and 62.0 (20/63 [10.7]) in the combination and monotherapy arms, respectively. At week 52, mean gain in BCVA was 12.7 (combination) vs 11.9 (monotherapy) (difference = 0.8 letters; 95% CI, -3.0 to 6.0 letters; P = .82). At week 12, the PL closure rate occurred in 20 of 30 eyes (66.7%) vs 10 of 30 eyes (33.3%) in the combination and monotherapy arms, respectively (difference = 33.4%; 95% CI, 9.5%-57.2%; P = .02).</p><p><strong>Conclusions and relevance: </strong>With less than half of the planned sample size enrolled, no superiority in BCVA outcomes for either arm was detected and the combination arm could not be shown to be not worse (not noninferior) to the monotherapy arm. While PL closure at week 12 was greater in the combination arm, secondary outcome results, which were not adjusted for multiple analyses, should be considered hypothesis generating and not associated with a clinically relevant functional outcome in this trial.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03941587.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719308","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}
JAMA ophthalmologyPub Date : 2025-03-27DOI: 10.1001/jamaophthalmol.2025.0353
William G Christen, Pamela M Rist, M Vinayaga Moorthy, Douglas C Smith, Beth Holman, Allison Clar, Robert J Glynn, Julie A Mares, Lucia Sobrin, Aladdin H Shadyab, Matthew A Allison, Amy E Millen, JoAnn E Manson, Howard D Sesso
{"title":"Cocoa Flavanol Supplementation and Risk of Age-Related Macular Degeneration: An Ancillary Study of the COSMOS Randomized Clinical Trial.","authors":"William G Christen, Pamela M Rist, M Vinayaga Moorthy, Douglas C Smith, Beth Holman, Allison Clar, Robert J Glynn, Julie A Mares, Lucia Sobrin, Aladdin H Shadyab, Matthew A Allison, Amy E Millen, JoAnn E Manson, Howard D Sesso","doi":"10.1001/jamaophthalmol.2025.0353","DOIUrl":"10.1001/jamaophthalmol.2025.0353","url":null,"abstract":"<p><strong>Importance: </strong>Abnormalities of choroidal blood flow in the eye are associated with occurrence of age-related macular degeneration (AMD). Cocoa flavanols show beneficial effects on vascular risk factors in small and short-term trials and may help reduce AMD risk.</p><p><strong>Objective: </strong>To examine whether daily supplementation with cocoa extract, a source of flavanols, prevents the development or progression of AMD.</p><p><strong>Design, setting, and participants: </strong>This was a prespecified ancillary study of the COSMOS (COcoa Supplement and Multivitamins Outcomes Study) trial, a double-blind, placebo-controlled, 2 × 2 factorial randomized clinical trial of a cocoa extract supplement and a multivitamin supplement in the prevention of cardiovascular disease and cancer among 21 442 US adults, including 12 666 women aged 65 years and older and 8776 men aged 60 years and older. The intervention phase was performed from June 2015 through December 2020; data analysis was completed in August 2024.</p><p><strong>Intervention: </strong>Cocoa extract supplement (500 mg/day cocoa flavanols, including 80 mg (-)-epicatechin) or placebo.</p><p><strong>Main outcomes and measures: </strong>The primary end point was a composite of incident cases of AMD plus cases of progression to advanced AMD (geographic atrophy, neovascular membrane, retinal pigment epithelium detachment, or disciform scar) among participants with AMD at baseline, based on self-report confirmed by medical record review.</p><p><strong>Results: </strong>Mean (SD) participant age was 72.1 (6.6) years, and 12 666 participants (59.1%) were female. During a median (IQR) period of 3.6 (3.2-4.2) years of treatment and follow-up, 344 participants (1.6%) experienced a confirmed AMD event (316 incident AMD, 28 progression to advanced AMD). For the primary composite end point, there were 159 cases (1.5%) in the cocoa extract group and 185 cases (1.7%) in the placebo group (hazard ratio [HR], 0.87; 95% CI, 0.71-1.08; P = .21). Separate Cox models fitted because of evidence of nonproportional hazards (P = .048) indicated a 23% decreased risk in the cocoa extract group during the first 2 years of treatment (HR, 0.77; 95% CI, 0.59-1.01), with no added benefit for treatment beyond 2 years (HR, 1.06; 95% CI, 0.76-1.50). Similar time-dependent findings were observed for the secondary trial outcomes of incident visually significant AMD and advanced AMD.</p><p><strong>Conclusions and relevance: </strong>In this ancillary study of the COSMOS randomized clinical trial, cocoa extract supplementation for a median period of 3.6 years among older women and men had no effect overall on occurrence of AMD. However, a possible modest treatment effect early in the trial could not be ruled out, which warrants further investigation to clarify whether cocoa extract may help reduce AMD risk.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03205202.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719310","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}
JAMA ophthalmologyPub Date : 2025-03-27DOI: 10.1001/jamaophthalmol.2025.0350
Cindy X Cai, Michelle Hribar, Akihiko Nishimura
{"title":"Conflicting Results-Need for More Transparent and Reproducible Research.","authors":"Cindy X Cai, Michelle Hribar, Akihiko Nishimura","doi":"10.1001/jamaophthalmol.2025.0350","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0350","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719313","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}
JAMA ophthalmologyPub Date : 2025-03-20DOI: 10.1001/jamaophthalmol.2024.5708
Kundian Guo, Chunxia Jiang, Zhen Hong
{"title":"Intraventricular Silicone Oil After Retinal Detachment Repair","authors":"Kundian Guo, Chunxia Jiang, Zhen Hong","doi":"10.1001/jamaophthalmol.2024.5708","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.5708","url":null,"abstract":"This case report discusses a diagnosis of intraventricular silicone oil discovered 2 years after silicone oil tamponade was performed for retinal detachment repair for proliferative diabetic retinopathy in a woman aged 54 years.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"29 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143661356","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}