JAMA ophthalmology最新文献

{"title":"Hypooleon and Hyperoleon After Retinal Detachment Repair.","authors":"Gonzalo Roig-Ferreruela,Cristina Martínez-Gil,Elena Palacios-Pozo","doi":"10.1001/jamaophthalmol.2025.0883","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0883","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"44 1","pages":"e250883"},"PeriodicalIF":8.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328954","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":"Unveiling Subconjunctival Hemorrhage in Dengue Fever-Red Alert.","authors":"Rashmi Mittal,Chitralekha De","doi":"10.1001/jamaophthalmol.2025.0882","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0882","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"45 1","pages":"e250882"},"PeriodicalIF":8.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328953","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":"Uveal Melanoma and the Lynch Syndrome Tumor Spectrum","authors":"Anaïs Le Ven, Marie-Charlotte Villy, André Bortolini Silveira, Alexandre Houy, Julien Masliah-Planchon, Mathilde Warcoin, Marine Le Mentec, Fatoumata Simaga, Antoine De Pauw, Bruno Buecher, Marion Gauthier-Villars, Thibault Verrier, Kevin Merchadou, Victor Renault, Anne Vincent-Salomon, Juliette Sauge, Sophie El Zein, Catherine Dubois d’Enghien, Sophie Piperno-Neumann, Alexandre Matet, Denis Malaise, Nathalie Cassoux, Livia Lumbroso-Le Rouic, Dominique Stoppa-Lyonnet, Marc-Henri Stern, Manuel Rodrigues, Lisa Golmard, Chrystelle Colas","doi":"10.1001/jamaophthalmol.2025.1779","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1779","url":null,"abstract":"ImportanceTo date, no environmental factors and few therapeutic options are known for uveal melanoma (UM), the most common malignant intraocular primary tumor in adults. Identification of new predisposition factors could lead to better monitoring and possibly improved treatments of patients with UM.ObjectiveTo identify new genetic alterations predisposing for UM.Design, Setting, and ParticipantsThis was a prospective cohort study conducted at Institut Curie in Paris, France, among 381 consecutive patients diagnosed with UM between July 2021 and February 2023. UM was diagnosed clinically by ophthalmologists, and a senior pathologist confirmed the diagnosis when tumor or biopsy was available. All participants received genetic counseling and consented to extended genetic testing. A panel of 122 genes predisposing to cancer were analyzed by targeted sequencing on germline DNA from these patients.Main Outcomes and MeasuresFrequency of pathogenic variants (PVs) in genes from a targeted panel, with classification of germline PVs done according to the American College of Medical Genetics and Genomics guidelines and the French Unicancer Genetics Group.ResultsA total of 79 PVs were identified in 70 participants (41 female and 29 male; mean [SD] age, 60.6 [15.3] years). Among them, 21 were found in clinically relevant genes, with an enrichment in the mismatch repair (MMR) genes, involved in Lynch syndrome, a frequent predisposition to colon and endometrial cancers. This finding suggested MMR germline PVs could also predispose to UM. One tumor was available from a participant carrying a <jats:italic>MLH1</jats:italic> germline PV. The tumor exhibited a monosomy 3 with loss of the wild-type allele of <jats:italic>MLH1</jats:italic>, located on chromosome 3. Loss of expression of <jats:italic>MLH1</jats:italic> was observed by immunohistochemistry, and MMR variant signatures SBS6, ID1, and ID2 were identified from the whole-genome sequencing of this tumor, supporting the possibility that <jats:italic>MLH1</jats:italic> contributes to the oncogenesis of this UM.Conclusions and RelevanceThis prospective germline study on patients with UM provided evidence supporting the notion that MMR germline alterations are enriched among patients with UM and may contribute to oncogenesis of UM, and that UM may therefore be a rare tumor manifestation of Lynch syndrome.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"15 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319748","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":"Recognizing Variants Prevalent in Particular Ancestries.","authors":"Omar A Mahroo,Siying Lin,Andrew R Webster","doi":"10.1001/jamaophthalmol.2025.1695","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1695","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"15 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319736","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":"Capsular Tension Ring Implantation for Intraocular Lens Position: A Systematic Review and Meta-Analysis.","authors":"Haowen Lin, Yu Zhang, Xiaohang Xie, Xuhua Tan, Ling Jin, Jiaqing Zhang, Lixia Luo, Yizhi Liu","doi":"10.1001/jamaophthalmol.2025.1623","DOIUrl":"10.1001/jamaophthalmol.2025.1623","url":null,"abstract":"<p><strong>Importance: </strong>There is currently no consensus regarding the association of capsular tension ring (CTR) on intraocular lens (IOL) position or the indications for its implantation.</p><p><strong>Objective: </strong>To evaluate the association of CTR implantation on IOL position.</p><p><strong>Data sources: </strong>PubMed, Embase, and Cochrane Library were searched from their inception to October 18, 2024.</p><p><strong>Study selection: </strong>Randomized clinical trials (RCTs) or prospective cohorts reporting the effect or association of CTR on postoperative anterior chamber depth (ACD), IOL decentration, tilt, or rotation.</p><p><strong>Data extraction and synthesis: </strong>Data extraction was conducted by 2 reviewers and verified by another for accuracy. Mean difference (MD) was used to synthesize the effect measures, and subgroup analyses were conducted according to IOL haptic design (C-loop and plate haptic) and whether the patient had high myopia.</p><p><strong>Main outcome and measures: </strong>Postoperative ACD and IOL decentration, tilt, and rotation.</p><p><strong>Results: </strong>A total of 11 RCTs and 7 cohort studies, involving 809 eyes with CTR and 822 eyes without CTR, were included in this meta-analysis. The analysis revealed that IOL tilt (MD, -1.04°; 95% CI, -2.05° to -0.03°; P = .04) and rotation (MD, -0.82°; 95% CI, -1.27° to -0.37°; P < .001) were smaller in the CTR group compared with the control group. The subgroup analysis of ACD (I2 = 70.7%; P = .03), decentration (I2 = 66.5%, P = .08), and tilt (I2 = 76.7%, P = .01) revealed a heterogeneity between the subgroups stratified according to IOL haptic design. Additionally, subgroup analysis demonstrated that CTR group showed a deeper ACD in eyes implanted with plate haptic IOLs (MD, 0.11 mm; 95% CI, 0.02 to 0.20 mm; P = .01), and a smaller IOL tilt in highly myopic eyes (MD, -1.43°; 95% CI, -2.59° to -0.26°; P = .02) compared with the control group.</p><p><strong>Conclusions and relevance: </strong>CTR implantation was associated with enhanced stability of IOL rotation in this meta-analysis, while only reducing IOL tilt in high myopia. While the direct clinical relevance of these results could not be determined from this investigation, these findings provide evidence supporting use of CTR implantation when toric IOLs have been implanted or with high myopia, although a hyperopic refractive shift after implantation of plate haptic IOLs may require target refraction adjustment.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274874","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":"Dynamic Risk of Systemic Complement Activation With Time to Progression to Advanced Age-Related Macular Degeneration.","authors":"Anne M Lynch, Nathan C Grove, Brandie D Wagner, Alan G Palestine, V Michael Holers, Ashley A Frazer-Abel, Ramya Gnanaraj, Andres Lisker-Cervantes, Jennifer L Patnaik, Talisa E de Carlo Forest, Emily A Auer, Arden J McReynolds, Marc T Mathias, Niranjan Manoharan, Santiago Rodriquez De Cordoba, Naresh Mandava","doi":"10.1001/jamaophthalmol.2025.1608","DOIUrl":"10.1001/jamaophthalmol.2025.1608","url":null,"abstract":"<p><strong>Importance: </strong>Understanding the relationship between longitudinally measured systemic complement factors and intermediate AMD (iAMD) progression may enable the introduction of systemic therapeutics earlier in the disease course, before vision loss occurs.</p><p><strong>Objective: </strong>To determine the contribution of longitudinal measures of systemic complement factors and ratios to time to progression to advanced AMD (geographic atrophy [GA] or neovascular AMD [NVAMD]).</p><p><strong>Design, setting, and participants: </strong>This cohort study was conducted at Sue Anschutz Rodgers Eye Center, Aurora, Colorado, from 2014 to 2022. Participants were patients with iAMD and at least 1 month of follow-up. Data analysis was performed from September to December 2024.</p><p><strong>Exposures: </strong>Complement factors.</p><p><strong>Main outcomes and measures: </strong>Time to progression to advanced AMD, either GA or NVAMD. Joint models were used to estimate the relationship between the exposures and the outcomes. The hazard ratio (HR) was a measure of association.</p><p><strong>Results: </strong>Among 325 participants, the mean (SD) age was 76 (7.0) years; 212 participants (65%) were female and 113 (35%) male. During the 8-year follow-up period (mean, 3.9 years), 110 participants (34%) progressed to any advanced AMD. Sixty-four participants (20%) progressed to GA and 46 (14%) to NVAMD. Higher systemic levels of C4 (HR, 6.8; 95% credible interval [CrI], 1.7-26.2; P = .03), C4b (HR, 60.4; 95% CrI, 6.5-544; P < .001), C3a/C3 (HR, 49.4; 95% CrI, 5.2-675; P < .001), C5a/C5 (HR, 29.3; 95% CrI, 4.8-258; P < .001), sC5b-9/C5 (HR, 297; 95% CrI, 10-14 877; P = .003), and factor I (HR, 525.9; 95% CrI, 5.5-107 589; P = .02) were associated with shorter time to progression to any AMD. Levels of C3a/C3 (HR, 9.5; 95% CrI, 1.9-55.9; P = .01) and C5a/C5 (HR, 28.6; 95% CrI, 5.7-157.9; P < .001) were associated with the hazard of GA.</p><p><strong>Conclusions and relevance: </strong>Continued dysregulation of complement pathways appears to increase the hazard of iAMD progression. This supports the possibility of identifying a high-risk group of patients with iAMD for personalized ophthalmic care and targeted treatments to attenuate the risk of iAMD progression.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274875","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":"Appreciating the Role of Mental Health in Glaucoma Diagnosis and Care.","authors":"Gerald McGwin, Cynthia Owsley","doi":"10.1001/jamaophthalmol.2025.1600","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1600","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225455","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":"Fundus Refraction Offset as an Individualized Myopia Biomarker","authors":"Fabian Yii, Ian J. C. MacCormick, Niall Strang, Miguel O. Bernabeu, Tom MacGillivray","doi":"10.1001/jamaophthalmol.2025.1513","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1513","url":null,"abstract":"ImportanceAs on-axis metrics, spherical equivalent refraction (SER) and axial length (AL) are limited in capturing individual-level differences in posterior segment anatomy.ObjectiveTo propose a fundus-level metric—fundus refraction offset (FRO)—and investigate its association with ocular parameters derived from optical coherence tomography (OCT).Design, Setting, and ParticipantsThis cross-sectional, population-based study used data from 45 180 healthy eyes in the UK Biobank (2009-2010). Fundus photographs from a random subset (70%) were used to train a deep learning model to predict SER, with the goal of developing a model that learned to capture the nonpathological variations in fundus appearance from −15.50 D to 9.25 D. The trained model was applied to the remaining subset (internal unseen set) to derive FRO for each eye. FRO was also computed for an external dataset (the Caledonian cohort, 2023-2024) with enhanced depth imaging OCT and AL data for 152 right eyes. Data were analyzed from July to November 2024.ExposureFRO, defined as the error in fundus-predicted SER. A more negative FRO indicated a more myopic-looking fundus than typical for an eye with the same SER.Main Outcomes and MeasuresThe association between FRO and macular thickness (MT) was tested using linear mixed-effects regression in the internal unseen set, controlling for SER, age, sex, and race. In the external dataset, the associations of FRO with choroidal area, choroidal vascularity index (CVI), and MT were examined using linear fixed-effects regression, controlling for SER (and subsequently AL) and other aforementioned covariates.ResultsHigh-quality OCT data were available from 9524 eyes in the internal unseen set and 152 eyes in the external dataset among individuals with a mean (SD) age of 54.5 (8.2) years and 19.3 (3.8) years, respectively. In the internal unseen set, a more negative FRO was independently associated with lower MT (β, 0.64; 95% CI, 0.37-0.90; <jats:italic>P</jats:italic> &amp;amp;lt; .001). A similar association was observed in the external dataset—whether adjusted for SER (β, 2.45; 95% CI, 0.64-4.26; <jats:italic>P</jats:italic> = .008) or AL (β, 2.09; 95% CI, 0.28-3.91; <jats:italic>P</jats:italic> = .02). Additionally, CVI decreased as FRO became more negative—both in the SER-adjusted (β, 0.01; 95% CI, 0.01-0.02; <jats:italic>P</jats:italic> &amp;amp;lt; .001) and AL-adjusted (β, 0.01, 95% CI, 0.004-0.02; <jats:italic>P</jats:italic> = .001) analyses.Conclusion and RelevanceIn this study, FRO reflected the individual-level mismatch between SER (or AL) and the anatomical severity of ametropia. This may have prognostic relevance for personalized risk prediction of myopia and its complications.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"35 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144219488","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 Spherical Equivalent and Axial Length in Myopia.","authors":"Xiu Juan Zhang, Connie H Y Lai, Kendrick Co Shih","doi":"10.1001/jamaophthalmol.2025.1622","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1622","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225456","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":"Should We Be Concerned About Glucagon-Like Peptide-1 Receptor Agonists?","authors":"Brian L VanderBeek","doi":"10.1001/jamaophthalmol.2025.1599","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1599","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225458","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}