JAMA ophthalmology最新文献

{"title":"Variables Associated With Faricimab Treatment Durability in Neovascular Age-Related Macular Degeneration","authors":"Colin S. Tan, Benjamin Bakall, Adrian Hock Chuan Koh, Priya Vakharia, Deepak Sambhara, Mathias Maier, Quresh Mohamed, Ming Yang, Philippe Margaron, Shriji Patel, Eric H. Souied","doi":"10.1001/jamaophthalmol.2026.4385","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.4385","url":null,"abstract":"This post hoc analysis of 2 randomized clinical trials evaluates baseline and early treatment response factors associated with longer faricimab dosing intervals in patients with neovascular age-related macular degeneration.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"14 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187868","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":"Sclerochoroidal Calcification and Choroidal Neovascularization","authors":"Salaam Botros, Antonio Bechara Ghobril, Carol L. Shields","doi":"10.1001/jamaophthalmol.2026.4398","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.4398","url":null,"abstract":"This case report discusses subretinal hemorrhage as a complication of sclerochoroidal calcification found in a man aged 71 years who was referred for evaluation of a hemorrhagic choroidal lesion of the left eye.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"409 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187867","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":"Cytopathology and Prognostic Accuracy of 15-GEP/PRAME","authors":"Anne Marie Lane, Amy C. Schefler, Zelia M. Correa, Miguel A. Materin, Alison H. Skalet, Kisha D. Piggott, Thomas M. Aaberg, Basil K. Williams, Prithvi Mruthyunjaya, Scott C. N. Oliver, Devron Char, Scott D. Walter, Antonio Capone, Shilpa Desai, Tony Tsai, Dan S. Gombos, Jill R. Wells, Hakan Demirci, Michael Cusick, Timothy Fuller, Peter Hovland, Cameron Javid, Michael M. Altaweel, Ezekiel Weis, David A. Reichstein, John Mason, J. William Harbour, Ivana K. Kim","doi":"10.1001/jamaophthalmol.2026.4378","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.4378","url":null,"abstract":"Importance Gene expression profiling (GEP) reliably predicts metastatic uveal melanoma risk and is used to manage uveal melanoma (UM) in patients with this diagnosis. Efforts to refine molecular prognostication continue. Objective To determine if confirmatory cytopathology findings influence the prognostic accuracy of a commercially available GEP/Preferentially Expressed Antigen in Melanoma (PRAME) assay. Design, Setting, and Participants The Collaborative Ocular Oncology Group 2 study, a prospective cohort study, was conducted from 2017 to 2020 with follow-up recorded at 6-month intervals. This was a multicenter study that included patients with choroidal and/or ciliary body melanoma and results from a 15-GEP and PRAME RNA expression (15-GEP/PRAME) assay. Patients with iris tumors or less than 6 months’ follow-up were excluded. Study data were analyzed from April 2025 to July 2026. Exposures 15-GEP/PRAME, cytopathology, and next-generation sequencing (NGS). Main Outcomes and Measures Metastatic uveal melanoma rates in patients who had 15-GEP/PRAME and confirmatory cytopathology (CCP) results confirming or suspicious for UM (GEP+CCP) were compared with those who had 15-GEP/PRAME and no cytopathology performed, or unknown or nondiagnostic cytopathology results (GEP only). UM-associated variants identified by NGS were also evaluated. Results Of 1537 patients (mean [SD] age, 62.0 [13.4] years; 787 male [51.2%]), 727 (47.3%) had CCP results, and 810 (52.7%) had nondiagnostic cytopathology results or no cytopathology performed. Class 2/PRAME+ tumors were more common (136 of 727 [18.7%]) in the GEP+CCP group than in the GEP-only group (72 of 810 [8.9%]; 9.8% difference; 95% CI, 6.4-13.3; <jats:italic toggle=\"yes\">P</jats:italic> <.001), whereas class 1/PRAME– tumors were less common (330 of 727 [45.4%] vs 495 of 810 [61.1%]; 15.7% difference; 95% CI, 10.8-20.6; <jats:italic toggle=\"yes\">P</jats:italic> <.001). In patients with GEP+CCP, 22.7% (n = 165) developed metastasis vs 15.4% (n = 125) in patients with GEP only (7.3% difference, 95% CI, 3.3-11.2; <jats:italic toggle=\"yes\">P</jats:italic> < .001). Adjusting for 15-GEP/PRAME status, there were no differences in metastasis rates between CCP groups. Of 1327 patients with successful NGS, 94.1% (605 of 643) in the GEP+CCP group and 71.9% (492 of 684) in the GEP-only group had a UM-associated variant (22.2% difference, 95% CI, 18.3-26.0; <jats:italic toggle=\"yes\">P</jats:italic> < .001). Conclusions and Relevance Results of this cohort study reveal that no differences in metastasis outcomes were observed between patients with and without CCP within any GEP/PRAME categories. UM-associated variants were found less frequently in the GEP-only group than in the GEP+CCP group. In this cohort, 15-GEP/PRAME classification without CCP retained prognostic validity, supporting its clinical consideration in guiding metastatic surveillance in cases in which cytopathology is","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"33 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187904","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":"Diabetes Severity in Cornea Donors and 1-Year Outcomes in Recipients in the Diabetes Endothelial Keratoplasty Study: A Secondary Analysis of a Randomized Clinical Trial.","authors":"Mark A Greiner, Vincent M Monnier, Baha M Arafah, Loretta B Szczotka-Flynn, Beth Ann Benetz, Ryan J Bailey, Robin L Gal, Craig Kollman, Keith H Baratz, James M Huffman, Ula V Jurkunas, Christopher S Ketcherside, Francis W Price, Gregory A Schmidt, Evan D Schoenberg, Mark C Soper, Lawrence R Tenkman, David D Verdier, Deepitha Nelson, David R Sell, Roy W Beck, Marianne O Price, Jonathan H Lass","doi":"10.1001/jamaophthalmol.2026.4253","DOIUrl":"10.1001/jamaophthalmol.2026.4253","url":null,"abstract":"<p><strong>Importance: </strong>The effect of cornea donor diabetes severity on graft success, endothelial cell density (ECD), and morphometry after Descemet membrane endothelial keratoplasty (DMEK) is not known.</p><p><strong>Objective: </strong>To determine whether graft success, corneal endothelial cell loss (ECL), and morphometric changes 1 year after DMEK are associated with cornea donor diabetes severity measured by severity score, donor's postmortem level of hemoglobin A1c (HbA1c), and postmortem advanced glycation end products (AGEs) or advanced oxidation end products (AOPs).</p><p><strong>Design, setting, and participants: </strong>This was a secondary analysis of a multicenter, double-masked, randomized clinical trial at 28 clinical sites (46 surgeons) and 13 eye banks in the US among individuals undergoing low- to moderate-risk DMEK. AGE and AOP measurements were collected from a subset of donors. Data analysis was conducted from September 1, 2025, through April 30, 2026.</p><p><strong>Intervention: </strong>DMEK performed with a cornea from a donor without or with diabetes, assigned using a minimization procedure (comparable to randomization) to achieve an approximate 2:1 distribution, respectively.</p><p><strong>Main outcomes and measures: </strong>Graft success, ECL, coefficient of variation (CV) of cell area, and percentage of hexagonal cells (HEX) at 1 year from eye bank and postoperative specular central endothelial images.</p><p><strong>Results: </strong>A total of 1097 individuals (1421 study eyes; median [IQR] age, 71 [66-76] years; 631 [57.5%] female) undergoing low- to moderate-risk DMEK (1044 [95.2%] for Fuchs endothelial corneal dystrophy) were included. AGE and AOP measurements were collected from a subset of 472 donors (542 study donor corneas). Among 968 eyes with a postmortem donor HbA1c level lower than 6.5%, the 1-year graft success rate was 97.1% (95% CI, 95.4%-98.4%), compared with 97.4% (95% CI, 93.9%-100.0%), 93.0% (95% CI, 83.3%-98.8%), and 95.8% (95% CI, 87.3%-100.0%) among eyes with a donor HbA1c level of 6.5% to less than 7.5% (n = 194), 7.5% to less than 9.0% (n = 86), and 9.0% or higher (n = 48), respectively (P = .72). There was no significant difference in mean ECD across donor HbA1c groups. Donor diabetes severity measured with severity score, donor HbA1c level, and AGE and AOP metrics was not associated with 1-year graft failure, ECD, CV in cell area, or HEX percentage.</p><p><strong>Conclusions and relevance: </strong>This secondary analysis of a randomized clinical trial found that ECL and morphometry 1 year after DMEK were not affected by cornea donor diabetes severity. Comparable 1-year graft success, ECL, and cell morphometrics with tissue from donors with and without diabetes, regardless of the diabetes severity biomarker values observed, support the use of corneas from donors with diabetes for endothelial keratoplasty procedures without additional preoperative testing or risk stratification based","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136579","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":"Trends in Spending on Corrective Lenses","authors":"Santiago Lopez Zuluaga, Brandy Lipton, Melissa McInerney, Michel Boudreaux","doi":"10.1001/jamaophthalmol.2026.4314","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.4314","url":null,"abstract":"Importance About 50% of the population has a refractive error, but corrective lenses can impose cost barriers on patients given the lack of widespread vision insurance. Objective To describe temporal trends and sociodemographic variation in corrective lens spending and payment source (third party vs out-of-pocket). Design, Setting, and Participants This survey-based study used data from respondents to the 2010 through 2023 Medical Expenditure Panel Survey (N = 155 928). Annual response rates varied between 26.1% to 53.5%. These data were analyzed from March 2025 to July 2026. Exposures Temporal trends and sociodemographic variation. Main Outcomes and Measures The prevalence of any corrective lens spending, average spending among those with positive amounts, and the percent of those with positive spending that financed all purchases completely out-of-pocket. Results In 2023, 19.94% (95% CI, 19.06-20.83) of the population had positive spending on corrective lenses and the mean (SD) expenditure was $439.59 ($390.22). About half of people with positive spending (48.14%; 95% CI, 45.75%-50.53%) financed all purchases out-of-pocket. There was an increase in the percentage of people with any spending (2.62; 95% CI, 1.67-3.57) in mean spending amounts ($32.07; 95% CI, $12.49-$51.64), and a decline in 100% out-of-pocket burden (−10.38; 95% CI, −13.55 to −7.20) between 2010 and 2017, but not between 2018 and 2023. On an adjusted basis in the 2018 to 2023 period, spending outcomes increased with age; 65- to 74-year olds were 12.27 percentage points (95% CI, 11.40-13.14) more likely to have any spending and they had higher mean spending by $129.34 (95% CI, $87.37-$171.31), and were 18.78 percentage points (95% CI, 16.10-21.47) more likely to finance all spending out-of-pocket, compared with respondents who were 20 years and younger. The uninsured were 34.6 percentage points (95% CI, 31.52-37.70) more likely to be 100% out-of-pocket compared with those with private health insurance. Conclusions and Relevance These findings suggest that corrective lens spending can be substantial. Since many individuals completely pay for these purchases out of-pocket, costs might impede access and produce financial burdens. These results might inform policy discussions regarding coverage of routine vision services in public programs (eg, Medicaid and Medicare) and increased regulation of the vision insurance and eyewear markets.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"21 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149124118","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":"Pseudoprogression After Cemiplimab in Ocular Surface Squamous Neoplasia.","authors":"Sara-Maude Desforges, Minh Tri Le, Erika Massicotte, Alexandre Odashiro, Alexandre Pellan Cheng, Kanchan Ramesh Sainani, Antoine Desilets","doi":"10.1001/jamaophthalmol.2026.4254","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.4254","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136588","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":"Graft Survival With Donor Corneal Tissue From Individuals With Diabetes.","authors":"N Venkatesh Prajna, Naveen Radhakrishnan","doi":"10.1001/jamaophthalmol.2026.4430","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.4430","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136582","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":"Port-Associated Candida tropicalis Endogenous Endophthalmitis","authors":"David S. Wu, Nancy Faux, Jennifer I. Lim","doi":"10.1001/jamaophthalmol.2026.4250","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.4250","url":null,"abstract":"A patient with colon cancer and an indwelling central venous port developed endogenous endophthalmitis despite negative blood culture results. What would you do next?","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"29 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149124119","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":"Glasses Are Expensive, But They Do Not Have to Be.","authors":"David B Rein, John S Wittenborn","doi":"10.1001/jamaophthalmol.2026.4431","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.4431","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136635","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":"Elevated Retinal Neovascularization in Diabetic Retinopathy","authors":"An-Lun Wu, Yali Jia, Thomas S. Hwang","doi":"10.1001/jamaophthalmol.2026.4305","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.4305","url":null,"abstract":"This case report discusses the use of single-shot widefield swept-source optical coherence tomography angiography to delineate elevated retinal neovascularization in a patient with proliferative diabetic retinopathy.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"12 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149124117","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}