JAMA ophthalmology最新文献

{"title":"Selenium vs Control for Graves Ophthalmopathy in a Selenium-Sufficient Area: A Randomized Clinical Trial.","authors":"Hwa Young Ahn, Min Joung Lee, Kyong Yeun Jung, Hyo-Jeong Kim, Eun Hye Jung, Chae Won Chung, Kyungsik Kim, Jinsun Jang, Young Joo Park, Jeong Kyu Lee, Sun Wook Cho","doi":"10.1001/jamaophthalmol.2024.6337","DOIUrl":"10.1001/jamaophthalmol.2024.6337","url":null,"abstract":"<p><strong>Importance: </strong>Graves ophthalmopathy significantly diminishes patients' quality of life due to its immune-mediated inflammatory effects on the orbital tissues. Selenium, with its antioxidative properties, has shown potential for improving Graves ophthalmopathy progression and quality of life (QOL); however, its effectiveness in selenium-sufficient regions is not well established.</p><p><strong>Objective: </strong>To determine whether selenium supplementation improves QOL in patients with mild to moderate Graves ophthalmopathy in selenium-sufficient regions.</p><p><strong>Design, setting, and participants: </strong>The Efficacy of Selenium Supplementation for Mild-to-Moderate Graves' Ophthalmopathy in a Selenium-Sufficient Area (SeGOSS) trial was a randomized, open-label multicenter study. Eighty-four patients with mild to moderate Graves' ophthalmopathy were enrolled; 70 completed the study. Participants were selected based on Graves ophthalmopathy diagnosis and sufficient selenium levels. Data were analyzed from October 2023 to March 2024.</p><p><strong>Interventions: </strong>Participants received selenium supplementation combined with vitamin B complex for 6 months.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was improvements in Graves ophthalmopathy QOL (GO-QOL) scores at 6 months. Secondary outcomes included changes in GO-QOL scores at 3 months, the proportion of patients showing improvement based on GO-QOL scores, clinical activity score, and ophthalmic examinations at 3 months and 6 months, and changes in thyroid autoantibodies at 3 months and 6 months.</p><p><strong>Results: </strong>There was no improvement in changes in the total GO-QOL scores between the selenium group (31 female patients [83.8%] and 7 male patients [16.2%]; mean [SD] age, 40.8 [11.7] years) and control group (24 female patients [72.7%] and 9 male patients [27.3%]; mean [SD] age, 42.9 [14.2] years) for the primary outcome at 6 months (mean [SD], 12.2 [22.5] vs mean [SD], 11.2 [20.2]; difference, 0.9; 95% CI, -9.3 to 11.3; P = .85). However, at 3 months, a higher proportion of patients in the selenium group showed improved GO-QOL scores compared with the control group (78.4 vs 48.5%; difference, 0.30; 95% CI, 0.08-0.51; P = .01). The selenium group also had higher rates of improvement in proptosis reduction (49.5 vs 15.1%; difference, 0.31; 95% CI, 0.11-0.51; P = .01) at 3 months, though these effects were not sustained at 6 months.</p><p><strong>Conclusions and relevance: </strong>These results suggest that selenium supplementation did not improve QOL or clinical parameters in patients with mild to moderate GO in selenium-sufficient regions at 6 months. Some potential QOL benefits noted at 3 months supports consideration of further investigation of selenium for patients seeking treatment for Graves ophthalmopathy .</p><p><strong>Trial registration: </strong>Clinical Research Information Service Identifier KCT0004040.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515645","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":"Private Equity Acquisitions and Industry Payments in Ophthalmology.","authors":"Geronimo Bejarano, Hamid Torabzadeh, Durga Borkar, Christopher Whaley, Yashaswini Singh","doi":"10.1001/jamaophthalmol.2025.0002","DOIUrl":"10.1001/jamaophthalmol.2025.0002","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515641","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":"Slowing Geographic Atrophy-Hopeful Progress or Uncertain Benefit.","authors":"Huixun Jia, Xiaodong Sun","doi":"10.1001/jamaophthalmol.2024.6490","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.6490","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515648","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":"Selective Laser Trabeculoplasty After Medical Treatment for Glaucoma or Ocular Hypertension.","authors":"Evgenia Konstantakopoulou, Gus Gazzard, David Garway-Heath, Mariam Adeleke, Gareth Ambler, Victoria Vickerstaff, Catey Bunce, Neil Nathwani, Keith Barton","doi":"10.1001/jamaophthalmol.2024.6492","DOIUrl":"10.1001/jamaophthalmol.2024.6492","url":null,"abstract":"<p><strong>Importance: </strong>Primary selective laser trabeculoplasty (SLT) is a safe primary treatment for open-angle glaucoma (OAG) and ocular hypertension (OHT). However, there is limited evidence on its use as a secondary treatment, ie, after prior use of ocular hypotensive eye drops.</p><p><strong>Objective: </strong>To evaluate outcomes following SLT after using hypotensive eye drops for at least 3 years.</p><p><strong>Design, setting, and participants: </strong>This is a post hoc exploratory analysis of data from a multicenter randomized clinical trial conducted within the UK National Health Service. Participants were patients with OAG or OHT who participated in the LiGHT trial. Data were analyzed from February 2021 to December 2024.</p><p><strong>Intervention: </strong>Participants were initially randomized to either primary SLT or primary hypotensive eye drops and remained on the allocated treatment pathway for 3 years. Participants using eye drops were then allowed to have secondary SLT as a treatment switch (to reduce their medication load) or as a treatment escalation (if more intense treatment was needed). Participants were treated and monitored according to a predefined protocol.</p><p><strong>Main outcomes and measures: </strong>The outcomes of interest were rates of incisional glaucoma surgery, medication use, and intraocular pressure.</p><p><strong>Results: </strong>In total, 633 participants entered the extension of the LiGHT trial, and 524 participants (82.8%) completed the extension (72 months). Of 320 participants receiving primary hypotensive eye drops, 112 (35.0%) received SLT: 70 participants switched to SLT, 29 participants had SLT as a treatment escalation, and 13 participants had SLT as a treatment escalation in 1 eye and as a treatment switch in the other eye. Switching to SLT was associated with a reduction in the number of medications (mean [SD], 1.38 [0.62] to 0.59 [0.92] active ingredients; mean difference, 0.79 [95% CI 0.66 to 0.93] active ingredients; P < .001). At 72 months, 69 eyes that switched to SLT (60.5%) needed no medical or surgical treatment, and 62 eyes receiving 1 drug before switching (83.8%) needed no medical treatment. Escalating to SLT was associated with a mean intraocular pressure reduction of 4.6 mm Hg (21.8%), and 30 eyes (62.5%) reached target intraocular pressure at 72 months without the need for surgery; 9 eyes (18.7%) needed a trabeculectomy.</p><p><strong>Conclusions and relevance: </strong>This secondary analysis of a randomized clinical trial found that secondary SLT was associated with a reduction in the medication load for stable, medically treated eyes. For medically uncontrolled eyes, there is evidence that SLT could provide additional intraocular pressure control, but the need for trabeculectomy was not eliminated.</p><p><strong>Trial registration: </strong>isrctn.org Identifier: ISRCTN32038223.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458117","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":"Semaglutide and Risk of NAION-Additional Insights.","authors":"Joseph F Rizzo, Jimena Tatiana Hathaway","doi":"10.1001/jamaophthalmol.2025.0005","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0005","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458119","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":"Semaglutide and Nonarteritic Anterior Ischemic Optic Neuropathy.","authors":"Cindy X Cai, Michelle Hribar, Sally Baxter, Kerry Goetz, Swarup S Swaminathan, Alexis Flowers, Eric N Brown, Brian Toy, Benjamin Xu, John Chen, Aiyin Chen, Sophia Wang, Cecilia Lee, Theodore Leng, Joshua R Ehrlich, Andrew Barkmeier, Karen R Armbrust, Michael V Boland, David Dorr, Danielle Boyce, Thamir Alshammari, Joel Swerdel, Marc A Suchard, Martijn Schuemie, Fan Bu, Anthony G Sena, George Hripcsak, Akihiko Nishimura, Paul Nagy, Thomas Falconer, Scott L DuVall, Michael Matheny, Benjamin Viernes, William O'Brien, Linying Zhang, Benjamin Martin, Erik Westlund, Nestoras Mathioudakis, Ruochong Fan, Adam Wilcox, Albert Lai, Jacqueline C Stocking, Sahar Takkouche, Lok Hin Lee, Yangyiran Xie, Izabelle Humes, David B McCoy, Mohammad Adibuzzaman, Raymond G Areaux, William Rojas-Carabali, James Brash, David A Lee, Nicole G Weiskopf, Louise Mawn, Rupesh Agrawal, Hannah Morgan-Cooper, Priya Desai, Patrick B Ryan","doi":"10.1001/jamaophthalmol.2024.6555","DOIUrl":"10.1001/jamaophthalmol.2024.6555","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Semaglutide, a glucagonlike peptide-1 receptor agonist (GLP-1RA), has recently been implicated in cases of nonarteritic anterior ischemic optic neuropathy (NAION), raising safety concerns in the treatment of type 2 diabetes (T2D).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the potential association between semaglutide and NAION in the Observational Health Data Sciences and Informatics (OHDSI) network.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This was a retrospective study across 14 databases (6 administrative claims and 8 electronic health records). Included were adults with T2D taking semaglutide, other GLP-1RA (dulaglutide, exenatide), or non-GLP-1RA medications (empagliflozin, sitagliptin, glipizide) from December 1, 2017, to December 31, 2023. The incidence proportion and rate of NAION were calculated. Association between semaglutide and NAION was assessed using 2 approaches: an active-comparator cohort design comparing new users of semaglutide with those taking other GLP-1RAs and non-GLP-1RA drugs, and a self-controlled case-series (SCCS) analysis to compare individuals' risks during exposure and nonexposure periods for each drug. The cohort design used propensity score-adjusted Cox proportional hazards models to estimate hazard ratios (HRs). The SCCS used conditional Poisson regression models to estimate incidence rate ratios (IRRs). Network-wide HR and IRR estimates were generated using a random-effects meta-analysis model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposures: &lt;/strong&gt;GLP-1RA and non-GLP-1RAs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;NAION under 2 alternative definitions based on diagnosis codes: one more inclusive and sensitive, the other more restrictive and specific.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study included 37.1 million individuals with T2D, including 810 390 new semaglutide users. Of the 43 620 new users of semaglutide in the Optum's deidentified Clinformatics Data Mart Database, 24 473 (56%) were aged 50 to 69 years, and 26 699 (61%) were female. The incidence rate of NAION was 14.5 per 100 000 person-years among semaglutide users. The HR for NAION among new users of semaglutide was not different compared with that of the non-GLP-1RAs using the sensitive NAION definition-empagliflozin (HR, 1.44; 95% CI, 0.78-2.68; P = .12), sitagliptin (HR, 1.30; 95% CI, 0.56-3.01; P = .27), and glipizide (HR, 1.23; 95% CI, 0.66-2.28; P = .25). The risk was higher only compared with patients taking empagliflozin (HR, 2.27; 95% CI, 1.16-4.46; P = .02) using the specific definition. SCCS analysis of semaglutide exposure showed an increased risk of NAION (meta-analysis IRR, 1.32; 95% CI, 1.14-1.54; P &lt; .001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;Results of this study suggest a modest increase in the risk of NAION among individuals with T2D associated with semaglutide use, smaller than that previously reported, and warranting further investigation into the clinical implications o","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458118","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":"Shedding LiGHT on Selective Laser Trabeculoplasty.","authors":"Harry A Quigley","doi":"10.1001/jamaophthalmol.2025.0004","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0004","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458121","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":"Sexual Harassment in Ophthalmology.","authors":"Olivia J Killeen, Leona Ding, Laura Enyedi, Grace Sun, Michelle T Cabrera","doi":"10.1001/jamaophthalmol.2024.6489","DOIUrl":"10.1001/jamaophthalmol.2024.6489","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;High rates of sexual harassment were reported among ophthalmologists who responded to a survey in 2018. A comparison with the rates in 2023 seems warranted following increased initiatives to combat sexual harassment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To compare the rates and characteristics of sexual harassment in ophthalmology from survey respondents in 2018 and 2023 and to investigate rates of gender discrimination among the 2023 respondents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;In this cross-sectional, observational survey study, the survey was administered anonymously using Google Forms through the Women in Ophthalmology email blast list from August 25 to September 25, 2023. Primarily female ophthalmologists or ophthalmology trainees were surveyed in the United States and Canada. The study was determined to be exempt by the University of Washington institutional review board because it involved an anonymous, low-risk survey of adults. Participants provided consent electronically.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Rates of sexual harassment in ophthalmology, number of occurrences in the past 5 years, and gender discrimination. Rates were compared between the 2018 and 2023 surveys.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 1051 emails sent, 692 (65.8%) were opened, and of those opened, 289 of 692 eligible participants (41.8%) responded, so that the respondents represented 289 (27.5%) of the 1051 emails sent. Among the 288 survey participants who provided gender data, there were 282 women (97.9%), 3 men (1.0%), 1 nonbinary or third gender participant (0.3%), and 2 other participants (ie, they preferred not to say or preferred to self-describe) (0.6%), with 113 (39.2%) aged 31 to 40 years. Of the 289 survey respondents in 2023, 172 (59.5%) experienced sexual harassment in ophthalmology compared with 265 of 447 (59.3%) surveyed in 2018 (difference, 0.2%; 95% CI, -7.0% to 7.5%; P = .95). Also, of the 172 respondents in 2023 who reported experiencing sexual harassment, 107 (62.2%) experienced it within the past 5 years compared with 125 of 265 respondents (47.2%) who reported experiencing it in 2018 (difference, 15.0%; 95% CI, 5.5%-24.2%; P &lt; .001). In 2023, 41 of 170 respondents (24.1%) reported their most severe experience to an authority compared with 40 of 265 (15.1%) in 2018 (difference, 9.0%; 95% CI, 1.3%-16.8%; P = .02). Of 287 survey respondents in 2023, 244 (85.0%) experienced gender discrimination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In this survey study, the rates of sexual harassment among respondents remained high 5 years after a survey on sexual harassment in ophthalmology, with higher frequency of recent experiences and continued low reporting rates. With other forms of gender discrimination also highly prevalent among respondents, these results support pursuit of validated strategies to foster a culture of zero tolerance toward harassment and discrimination","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458120","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":"#MeToo in Ophthalmology.","authors":"Julia A Haller","doi":"10.1001/jamaophthalmol.2024.6491","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.6491","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458105","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":"Federally Qualified Health Centers as a Model to Improve Vision Health: A Systematic Review.","authors":"Patricia Bai, Spencer S Burt, Maria A Woodward, Scott Haber, Paula Anne Newman-Casey, Jeffrey D Henderer, R V Paul Chan, Aiyin Chen","doi":"10.1001/jamaophthalmol.2024.6264","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.6264","url":null,"abstract":"<p><strong>Importance: </strong>Disparities in eye health are associated with lower-income and minoritized populations, many of whom seek care at federally qualified health centers (FQHCs).</p><p><strong>Objective: </strong>To examine the literature addressing vision and eye health care provided at FQHCs, identify barriers to providing care at FQHCs, and highlight recommendations on how FQHCs can decrease disparities in eye health.</p><p><strong>Evidence review: </strong>A systematic review of Embase, SCOPUS, and PubMed was performed, and articles regarding eye and vision health at FQHCs within the US published between January 1, 1965, and July 14, 2023, were included. This review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Structured data and case studies were extracted and collated using an a priori method to reduce bias.</p><p><strong>Findings: </strong>The systematic review yielded 423 unique articles, with 43 meeting inclusion criteria. Only 18.3% to 29% of FQHCs reported on-site vision services with the remainder relying on external referrals to vision specialists. Primary eye conditions evaluated included diabetic retinopathy (26 studies), general eye health (11 studies), and glaucoma (6 studies). Telehealth vision initiatives were an important method to expand access (18 studies). Other topics included economic analysis (5 studies) and policy suggestions (3 studies) to increase vision services at FQHCs. Systemic barriers to accessing care at FQHCs were the lack of eye clinicians available to provide services, the cost of resources, and limited reimbursement to implement screening programs. Patient barriers to accessing care included financial constraints for specialist care, limited awareness of the importance of eye examinations, and difficulty navigating the insurance system.</p><p><strong>Conclusions and relevance: </strong>Findings of this systematic review suggest that FQHCs are well positioned to increase vision services and thus improve vision health equity, serving populations who are at a higher risk for vision disorders. Results find systemic and patient-level barriers to vision health that may need to be addressed. Policy leaders could leverage existing gaps for purposeful advocacy, set standards and metrics for vision health at FQHCs, promote novel models of care, and encourage collaboration of eye clinicians with partnering FQHCs.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407735","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}