JAMA ophthalmology最新文献

{"title":"Photobiomodulation for Age-Related Macular Degeneration","authors":"Srinivas R. Sadda","doi":"10.1001/jamaophthalmol.2025.0077","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0077","url":null,"abstract":"This Viewpoint examines results from the LIGHTSIDE trials for photobiomodulation to treat age-related macular degeneration and raises questions regarding the trial protocols and the efficacy and safety of the therapy.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031077","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":"Red Light Therapy for Myopia—Current Regulatory Changes in China","authors":"Ya Xing Wang, Ningli Wang, Tien Yin Wong","doi":"10.1001/jamaophthalmol.2024.5977","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.5977","url":null,"abstract":"This Viewpoint discusses the ophthalmic device, red light therapy, for myopia treatment in children and adolescents in China, including its development and use, safety concerns, and implications surrounding recent regulatory changes and reclassification of this device.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"22 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021100","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":"Inflammation and Occlusive Retinal Vasculitis Post Faricimab","authors":"Will Bruening, Sean Kim, Steven Yeh, Pukhraj Rishi, Christopher D. Conrady","doi":"10.1001/jamaophthalmol.2024.5889","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.5889","url":null,"abstract":"ImportanceRandomized clinical trials have shown the safety and efficacy of faricimab as a novel vascular endothelial growth factor and angiopoietin-2 inhibitor in the treatment of neovascular age-related macular degeneration (nAMD) and macular edema of various etiologies. However, more rare adverse events may not be considered in clinical trials.ObjectiveTo describe 3 eyes that developed irreversible vision loss following initial mild intraocular inflammation (IOI) to faricimab.Design, Setting, and ParticipantsThis retrospective case series from a single academic tertiary referral center (University of Nebraska Medical Center) from October 2023 to August 2024 included 3 patients who developed occlusive retinal vasculitis (ORV) following an initial sensitization with intravitreal faricimab. Two eyes were being treated with faricimab for nAMD, and the other 2 eyes were treated for diabetic macular edema.InterventionPatients exposed to faricimab after the prior development of mild IOI.Main Outcomes and MeasuresClinical symptoms, signs, and clinical course of patients who were diagnosed with ORV following rechallenge with faricimab.ResultsMild IOI developed in 4 eyes following faricimab, and ORV developed in 3 eyes with repeated challenge. This resulted in profound, irreversible vision loss, despite treatment with topical and systemic steroids. In the eye that did not develop ORV following rechallenge, there have been no repeated adverse events despite restarting intravitreal faricimab injections.Conclusions and RelevanceGiven these observations with repeated challenge, caution is advisable when using the same biologic after the development of even mild IOI with prior injection. It appears an immunological memory response is elicited with these repeated exposures, resulting in the development of ORV.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"57 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021095","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":"Femtosecond Laser Arcuate Keratotomy vs Toric Intraocular Lens Implantation in Cataract Surgery","authors":"Yueyang Zhong, Shuying Chen, Hanle Wang, Su Li, Zhouyu Lu, Jingjie Xu, Yibo Yu, Ke Yao","doi":"10.1001/jamaophthalmol.2024.5887","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.5887","url":null,"abstract":"ImportanceAfter cataract surgery, postoperative residual astigmatism can influence a patient’s visual quality and satisfaction. Finding ways to minimize this astigmatism is important.ObjectiveTo compare the clinical outcomes of femtosecond laser arcuate keratotomy (FSAK) and toric intraocular lens (TIOL) implantation for astigmatism correction in patients undergoing femtosecond laser-assisted cataract surgery.Design, Setting, and ParticipantsThis randomized clinical trial was conducted between October 2021 and September 2023 at the Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, China. Patients with mild to moderate regular corneal astigmatism ranging from 0.75 diopters (D) to 3.00 D were recruited.InterventionsPatients were randomly assigned in a 1:1 ratio to receive FSAK or TIOL implantation.Main Outcomes and MeasuresThe primary outcome was the subjective manifest refraction assessed at 3 months postoperatively.ResultsA total of 196 patients (mean [SD] age, 68.4 [13.7] years; 124 female [63%]) were randomized to the FSAK group (98 [50%]) or TIOL group (98 [50%]), and 92 patients (94%) and 95 patients (97%), respectively, finished the 3-month follow-up. At 3 months postoperatively, there was no difference in the refractive astigmatism between the 2 groups (mean [SD], 0.64 [0.64] D vs 0.54 [0.55] D; difference, 0.11 D; 95% CI, −0.06 to 0.27 D; <jats:italic>P</jats:italic> = .21). The mean (SD) uncorrected distance visual acuity was 0.15 (0.20) logMAR (Snellen equivalent, 20/28) for the FSAK group and 0.14 (0.19) logMAR (Snellen equivalent, 20/28) for the TIOL group (difference, 0.01 D; 95% CI, −0.04 to 0.06 D; <jats:italic>P</jats:italic> = .71). Subgroup analyses showed that TIOL implantation achieved lower residual astigmatism compared with FSAK when treating astigmatism exceeding 1.5 D or against-the-rule astigmatism.Conclusions and RelevanceResults of this randomized clinical trial demonstrate that in study participants with mild to moderate astigmatism undergoing femtosecond laser-assisted cataract surgery, FSAK was not superior to TIOL implantation for astigmatism correction. However, for astigmatism exceeding 1.5 D or against-the-rule astigmatism, TIOL implantation demonstrated greater efficacy over FSAK. Future trials are needed to determine if there is greater efficacy of TIOL implantation over FSAK as suggested by subgroup analyses.Trial RegistrationChiCTR.org.cn Identifier: <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://www.chictr.org.cn/hvshowproject.html?id=99663&amp;amp;amp;v=1.0\">ChiCTR2100051066</jats:ext-link>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"13 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020892","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":"Optic Nerve Melanocytoma With Vitreous Seeding","authors":"Brian R. Coleman, Sander R. Dubovy, Basil K. Williams","doi":"10.1001/jamaophthalmol.2024.4869","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.4869","url":null,"abstract":"This case report discusses a diagnosis of optic nerve melanocytoma in a woman aged 55 years who presented with progressive painless vision loss over a 7-month period.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"41 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142986847","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":"Axial Growth and Myopia Progression After Discontinuing Soft Multifocal Contact Lens Wear.","authors":"David A Berntsen,Anita Ticak,Danielle J Orr,Amber Gaume Giannoni,Loraine T Sinnott,Donald O Mutti,Lisa A Jones-Jordan,Jeffrey J Walline,","doi":"10.1001/jamaophthalmol.2024.5885","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.5885","url":null,"abstract":"ImportanceFor myopia control to be beneficial, it would be important that the benefit of treatment (slowed eye growth) is not lost because of faster than normal growth (rebound) after discontinuing treatment.ObjectiveTo determine whether there is a loss of treatment effect (rebound) after discontinuing soft multifocal contact lenses in children with myopia.Design, Setting, and ParticipantsThe Bifocal Lenses in Nearsighted Kids 2 (BLINK2) cohort study involved children with myopia (aged 11-17 years at BLINK2 baseline) who completed the BLINK Study randomized clinical trial. Enrollment was from September 2019 through January 2021; follow-up was completed in January 2024. In the BLINK2 Study, all children wore high-add (+2.50 diopter [D]) multifocal soft contact lenses for 2 years and single-vision soft contact lenses during the third year to determine if rebound occurred.ExposureHigh-add multifocal soft contact lenses and single-vision soft contact lenses.Main Outcomes and MeasuresEye length (optical biometry) and refractive error (cycloplegic autorefraction) were measured annually.ResultsOf 248 participants enrolled in BLINK2, 235 completed the study. The median age at the baseline visit was 15 years (range, 11-17 years); 146 participants (59%) were female, and 102 (41%) were male. At baseline for BLINK2, mean (SD) axial length and spherical equivalent refractive error were 25.2 (0.9) mm and -3.40 (1.40) D, respectively. After participants switched from multifocal to single-vision contact lenses, axial elongation increased by 0.03 mm per year (95% CI, 0.01 to 0.05) regardless of their original BLINK treatment assignment (P = .81). There was also an increase in myopia progression after switching to single-vision lenses of -0.17 D per year (95% CI, -0.22 to -0.12) that did not depend on the original BLINK treatment assignment (P = .57). There continued to be a difference in axial length and refractive error throughout BLINK2 based on the BLINK Study treatment assignment with the original high-add group having shorter eyes and less myopia than the original medium-add (+1.50 D) and single-vision groups.Conclusions and RelevanceThe BLINK2 Study found no evidence of a loss of treatment effect after discontinuing multifocal contact lenses in older teenagers. These data suggest eye growth and myopia progression returned to faster but age-expected rates and support continuing multifocal lenses until cessation of elongation and progression.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"30 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988586","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":"Representation Quotients to Examine Diversity in Ophthalmology Residency Applicants and Matriculants","authors":"Saba S. Paracha, Shani A. Williams, Alizeh Shamshad, Elijah M. Persad-Paisley, Michael E. Migliori","doi":"10.1001/jamaophthalmol.2024.5863","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.5863","url":null,"abstract":"ImportanceA diverse ophthalmic workforce is key to equitable care, and identifying areas of underrepresentation is important in tackling vision care disparities.ObjectiveTo evaluate the diversity of applicants and matriculants in ophthalmology residency programs relative to medical school graduates and analyze the intersection of race and gender within this pathway.Design, Setting, and ParticipantsThis retrospective cross-sectional study conducted from 2022 to 2024 used representation quotients (RQs) using reports from the Association of University Professors of Ophthalmology and San Francisco Match, along with demographic data from the Association of American Medical Colleges from 2008 to 2021. RQs measure equity by dividing a racial, ethnic, or gender group’s proportion in a specific population by its proportion in a larger reference population. Individuals who graduated from US medical schools from 2008 to 2021 or who applied to or matriculated into US ophthalmology residency programs from 2015 to 2021 and from 2008 to 2021, respectively, were eligible for inclusion.ExposureApplying to or matriculating into ophthalmology residency.Main Outcomes and MeasuresThe primary outcome was median RQs and trends among racial, ethnic, and gender groups for ophthalmology applicants (RQ&lt;jats:sub&gt;app&lt;/jats:sub&gt;) and matriculants (RQ&lt;jats:sub&gt;mat&lt;/jats:sub&gt;), with RQ differences evaluated using Mann-Whitney &lt;jats:italic&gt;U&lt;/jats:italic&gt; tests.ResultsAmong total applicants (n = 5304) and matriculants (n = 6139), 36% and 42% of applicants and matriculants, respectively, were female (applicants: 28% Asian, 4% Black, 7% Hispanic, and 47% White; matriculants: 31% Asian, 3% Black, 5% Hispanic, and 57% White). Self-identified Black individuals had the lowest median (IQR) RQs (RQ&lt;jats:sub&gt;app&lt;/jats:sub&gt;, 0.604 [0.437-0.771]; RQ&lt;jats:sub&gt;mat&lt;/jats:sub&gt;, 0.469 [0.341-0.597]). Regression analysis revealed increased representation for male applicants (slope, 0.036; 95% CI, 0.015-0.057; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .007) and matriculants (slope, 0.009; 95% CI, 0.002-0.016; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .02), but decreased representation for female applicants (slope, –0.031; 95% CI, –0.010 to –0.102; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .01) and matriculants (slope, –0.009; 95% CI, –0.016 to –0.002; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .02). Black (RQ&lt;jats:sub&gt;app&lt;/jats:sub&gt;, 0.604 vs RQ&lt;jats:sub&gt;mat&lt;/jats:sub&gt;, 0.469; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .047) and Hispanic (RQ&lt;jats:sub&gt;app&lt;/jats:sub&gt;, 1.46 vs RQ&lt;jats:sub&gt;mat&lt;/jats:sub&gt;, 1.04; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .03) groups experienced a decrease between applicant and matriculants.Conclusions and RelevanceThis cross-sectional retrospective study found persistent underrepresentation of Black and female individuals in ophthalmology residency programs, with increases in Black and Hispanic applicants failing to translate into higher matriculation rates. Barriers that female or Black medical students face when applying or matricula","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"8 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142986886","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":"Addressing Representation in Ophthalmology Training.","authors":"Khalid El-Jack, Dolly Ann Padovani-Claudio, Basil K Williams","doi":"10.1001/jamaophthalmol.2024.6086","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.6086","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005412","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 Vasculitis Associated With Castleman Disease","authors":"Yujing Qian, Meifen Zhang","doi":"10.1001/jamaophthalmol.2024.5152","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.5152","url":null,"abstract":"This case report describes a diagnosis of retinal vasculitis associated with Castleman disease in a man who presented with 6 months of progressive floaters bilaterally and no change in visual acuity.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"205 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142986917","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":"Temperature Excursion of Intravitreal Anti-VEGF Agents During Home Storage","authors":"Inès Ben Ghezala, Laure-Anne Steinberg, Maxime Sibert, Aline Lazzarotti, Aude Ambresin, Pierre-Henry Gabrielle, Catherine Creuzot-Garcher","doi":"10.1001/jamaophthalmol.2024.5884","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.5884","url":null,"abstract":"ImportanceSome patients worldwide are asked to acquire an anti–vascular endothelial growth factor (anti-VEGF) agent from a pharmacy, store it, and then bring it to a physician for intravitreal injection (IVT). Anti-VEGF agents must be stored in the refrigerator to avoid bacterial contamination or denaturation. Some cases of severe intraocular inflammation have been reported following IVT of more recently approved anti-VEGF agents, which might be explained by thermal instability.ObjectiveTo investigate whether patients followed the storage temperature guidelines for intravitreal anti-VEGF agents in daily clinical practice.Design, Setting, and ParticipantsThis quality improvement study, performed between May 27 and June 7, 2024, at the Ophthalmology Department of Dijon University Hospital in Dijon, France, included all consecutive patients with new or renewed prescriptions for intravitreal anti-VEGF agents for any macular disease.Main Outcomes and MeasuresAll participants were given a time-temperature indicator that changed color according to brief (2-12 hours), moderate (12-48 hours), and prolonged (≥48 hours) exposure over 8 °C. The indicator was activated at the time of the anti-VEGF agent delivery to the participant in community pharmacies.ResultsDuring the study period, 50 participants were prescribed intravitreal anti-VEGF agents and were given a time-temperature indicator. A total of 38 participants (24 [63.2%] female; median age, 79.3 [IQR, 74.3-86.3] years) returned for their IVT with an analyzable indicator. Of the 38 analyzable indicators, all showed temperature excursions above the threshold of 8 °C, including 26 (68.4%) for 12 to 48 hours and 11 (28.9%) for 48 hours or longer. Following anti-VEGF agent IVT, no participant experienced any ocular adverse effect that might be associated with severe intraocular inflammation.Conclusions and RelevanceIn this quality improvement study, temperature excursions of anti-VEGF agents above 8 °C for 48 hours or longer were recorded for 28.9% of participants during home storage. While it is unknown how these 38 participants relate to other patients worldwide who are required to obtain their own anti-VEGF agents, these findings suggest that patients need education about the importance of rigorous maintenance of cold storage of their anti-VEGF agents.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"43 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142986887","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}