JAMA ophthalmology最新文献

{"title":"Drusen Regression After Macular Hole Surgery.","authors":"Shannan Berzack,Prashant K Parekh","doi":"10.1001/jamaophthalmol.2025.0444","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0444","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"23 1","pages":"e250444"},"PeriodicalIF":8.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991962","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":"Growing Congenital Simple Hamartoma of the Retinal Pigment Epithelium.","authors":"Giorgio Gaspari,Gaspare Monaco,Giuseppe Casalino","doi":"10.1001/jamaophthalmol.2025.0527","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0527","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"57 1","pages":"e250527"},"PeriodicalIF":8.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991970","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":"Child With Ruptured Soemmering Ring and Visual Axis Reopacification.","authors":"Jiaxing Wang,Ramsey Yusuf,Ta Chen Chang","doi":"10.1001/jamaophthalmol.2025.0443","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0443","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"53 1","pages":"e250443"},"PeriodicalIF":8.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991963","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":"Visual Acuity and Complications at Age 7 Years Following Bilateral Secondary Intraocular Lens Implantation at 2 to Younger Than 6 Years for Pediatric Aphakia.","authors":"Kun Hu,Yu Zhang,Wan Chen,Hui Chen,Qiwei Wang,Anqi He,Tingfeng Qin,Xin Li,Ling Xia,Yizhi Liu,Weirong Chen","doi":"10.1001/jamaophthalmol.2025.1080","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1080","url":null,"abstract":"ImportanceThe optimal timing for secondary intraocular lens (IOL) implantation in children with bilateral aphakia remains uncertain, with important implications for long-term visual outcomes and the risk of complications such as glaucoma. Determining when to implant to achieve the best visual outcomes while minimizing complications is critical for improving clinical decision-making in pediatric cataract management.ObjectiveTo report the visual acuity (VA) and complications in children with bilateral aphakia after lensectomy for pediatric cataracts, undergoing secondary IOL implantation at different ages.Design, Setting, and ParticipantsThis single-center prospective observational cohort study, conducted from 2014 to 2023, is a 7-year follow-up study. A total of 251 children met the inclusion criteria. After exclusion, 158 children were enrolled in this study. These 158 children (316 eyes) underwent lensectomy before the age of 2 years, followed by secondary IOL implantation between the ages of 2 and younger than 6 years in bilateral pediatric cataracts.ExposureStudy participants were categorized into 4 groups based on the timing of secondary IOL implantation (2 to <3 years, 3 to <4 years, 4 to <5 years, and 5 to <6 years).Main Outcome and MeasureBest-corrected VA (BCVA) outcomes at age 7 years after secondary IOL implantation in children with bilateral pediatric cataracts.ResultsAmong the 158 children included in the study, 103 (65.2%) were male. At age 7 years, the mean (SD) BCVA for children who underwent secondary IOL implantation was 0.49 (0.35) logMAR (Snellen equivalent, 20/62) at 2 to younger than 3 years, 0.59 (0.36) logMAR (Snellen equivalent, 20/78) at 3 to younger than 4 years, 0.60 (0.30) logMAR (Snellen equivalent, 20/80) at 4 to younger than 5 years, and 0.65 (0.34) logMAR (Snellen equivalent, 20/89) at 5 to younger than 6 years (P = .20). Glaucoma-related adverse events occurred in 47 eyes in total: 6 eyes (8.8%), 7 eyes (9.0%), 10 eyes (15.6%), and 24 eyes (22.6%) across the groups, respectively, with a statistical difference among the groups (P = .03).Conclusions and RelevanceThese findings suggest that secondary IOL implantation performed between the ages of 2 and younger than 6 years following bilateral pediatric cataract lensectomy can achieve comparable visual outcomes; however, the risk of glaucoma increases with older implantation age.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"33 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991967","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":"Bilateral Paracentral Corneal Opacity in a Man Aged 22 Years.","authors":"Keli Mao,Zixiang Zhao,Man Yu","doi":"10.1001/jamaophthalmol.2025.0528","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0528","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"40 1","pages":"e250528"},"PeriodicalIF":8.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991968","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":"Corneal Changes From Antibody-Drug Conjugates.","authors":"Lauren A Dalvin, Meghan K Berkenstock, Neel D Pasricha","doi":"10.1001/jamaophthalmol.2025.1135","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1135","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005596","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":"DNA Assays to Detect and Characterize RB1 Mosaicism in Retinoblastoma.","authors":"Patricia Chévez-Barrios,Sharon E Plon,Zejuan Li","doi":"10.1001/jamaophthalmol.2025.1105","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1105","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921040","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":"Application of Artificial Intelligence to Deliver Healthcare From the Eye.","authors":"Robert N Weinreb,Aaron Y Lee,Sally L Baxter,Richard W J Lee,Theodore Leng,Michael V McConnell,Nevin W El-Nimri,David C Rhew","doi":"10.1001/jamaophthalmol.2025.0881","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0881","url":null,"abstract":"ImportanceOculomics is the science of analyzing ocular data to identify, diagnose, and manage systemic disease. This article focuses on prescreening, its use with retinal images analyzed by artificial intelligence (AI), to identify ocular or systemic disease or potential disease in asymptomatic individuals. The implementation of prescreening in a coordinated care system, defined as Healthcare From the Eye prescreening, has the potential to improve access, affordability, equity, quality, and safety of health care on a global level. Stakeholders include physicians, payers, policymakers, regulators and representatives from industry, government, and data privacy sectors.ObservationsThe combination of AI analysis of ocular data with automated technologies that capture images during routine eye examinations enables prescreening of large populations for chronic disease. Retinal images can be acquired during either a routine eye examination or in settings outside of eye care with readily accessible, safe, quick, and noninvasive retinal imaging devices. The outcome of such an examination can then be digitally communicated across relevant stakeholders in a coordinated fashion to direct a patient to screening and monitoring services. Such an approach offers the opportunity to transform health care delivery and improve early disease detection, improve access to care, enhance equity especially in rural and underserved communities, and reduce costs.Conclusions and RelevanceWith effective implementation and collaboration among key stakeholders, this approach has the potential to contribute to an equitable and effective health care system.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921039","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":"Characterization of Belantamab Mafodotin-Induced Corneal Changes in Patients With Multiple Myeloma.","authors":"Vivian Lee,Malin Hultcrantz,Stephanie Petrone,Eric W Lewis,Hussam Banna,Eben Lichtman,Praneetha Thulasi,Anjulie A Quick,Bennie H Jeng,Sarah B Sunshine,Jasmine H Francis,Julia Canestraro,Asim V Farooq,Peter Clements,Nicola Robertson,Mark Burman,Tom McKevitt,Herbert Struemper,Lucinda Weir","doi":"10.1001/jamaophthalmol.2025.1008","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1008","url":null,"abstract":"ImportanceOcular surface events are a class effect of microtubule-inhibitor payload-containing antibody-drug conjugates (ADCs); the mechanism underlying these events has not been fully elucidated.ObjectiveTo characterize corneal epithelial changes in patients with relapsed or refractory multiple myeloma (RRMM) treated with belantamab mafodotin, a maleimidocaproyl monomethyl auristatin-F (MMAF)-containing ADC.Design, Setting, and ParticipantsThis multicenter, phase 3b case series study was conducted in the US from March 26, 2020, to November 21, 2022, among adults with RRMM. Data were analyzed from May 2021 to May 2023.ExposurePrior or ongoing treatment with belantamab mafodotin.Main Outcomes and MeasuresThe primary end point included pathologic characteristics and composition of corneal epithelial changes obtained by impression cytology (IC) or superficial keratectomy (SK) in patients treated with belantamab mafodotin. Tear film and blood were collected to determine belantamab mafodotin concentrations in patients at the time of sampling.ResultsOf 16 patients screened, 9 were included in this study, with 6 evaluable corneal samples obtained from 6 patients either by IC (n = 4) or SK (n = 2). Of 9 patients included, median (range) patient age was 67.0 (57.0-81.0) years for those with samples obtained by IC and 68.0 (65.0-81.0) years for those with samples obtained by SK. Six patients (67%) were female. All samples demonstrated epithelial cells with eosinophilic intracytoplasmic inclusions, basophilic granular cytoplasm, or both. Five samples were positive for apoptosis, and 3 samples showed evidence of inflammation. All patients experienced complete IC or SK wound healing. ADC was detected in the tear fluid of 5 of 7 patients with tear fluid sampling, while ADC was quantifiable in 3 of 4 patients with blood samples.Conclusions and RelevanceIn this case series study, intracytoplasmic inclusions were observed by histopathology in the corneal epithelium of patients exposed to belantamab mafodotin, and the pattern of corneal changes suggests limbal vessels may be a primary pathway enabling ADC to reach the cornea. Although limited to 6 samples, this study helps us better understand corneal changes associated with certain ADCs.Trial RegistrationClinicalTrials.gov Identifier: NCT04549363.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"74 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921046","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":"Detection and Characterization of RB1 Mosaicism in Patients With Retinoblastoma Receiving cfDNA Test.","authors":"Chuan Gao,Juber Patel,Melissa Robbins,Erika Gedvilaite,Anita S Bowman,Kanika Arora,Chad Vanderbilt,A Rose Brannon,Danielle N Friedman,Jennifer Kennedy,Elise Fiala,Ozge Ceyhan-Birsoy,Ira J Dunkel,Britta Weigelt,Jasmine H Francis,Jorge S Reis-Filho,David H Abramson,Diana Mandelker","doi":"10.1001/jamaophthalmol.2025.1079","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1079","url":null,"abstract":"ImportancePlasma cell-free DNA (cfDNA) testing is increasingly used for disease diagnosis and monitoring in retinoblastoma, with RB1 allele fraction in cfDNA actively corresponding to disease status and treatment response. However, while RB1 mosaicism has been reported in retinoblastoma, its clinical implications and potential impact on cfDNA testing remain unclear.ObjectivesTo identify RB1 mosaicism using paired plasma and buffy coat (containing lymphocytes, monocytes, granulocytes, and platelets) DNA testing, and to characterize the implications of RB1 mosaicism on cfDNA testing outcomes.Design, Setting, and ParticipantsIn this cross-sectional study, participants with retinoblastoma underwent testing with MSK-ACCESS (Memorial Sloan Kettering-Analysis of Circulating cfDNA to Examine Somatic Status), a clinical assay that combines plasma cfDNA and buffy coat genomic DNA sequencing, enabling the detection and differentiation of somatic, heterozygous, and mosaic variants, between July 2020 and April 2024 at the Memorial Sloan Kettering Cancer Center. Mosaic findings from MSK-ACCESS were correlated with those from a subgroup of patients who concurrently underwent testing using the MSK-IMPACT germline assay. Data analysis was performed from April to September 2024.ExposureRB1 mosaicism in retinoblastoma.Main Outcomes and MeasuresThe RB1 variant allele fractions in cfDNA and buffy coat genomic DNA were used to detect RB1 mosaicism.ResultsA total of 136 consecutive patients with retinoblastoma (median age at diagnosis, 1.0 year [IQR, 0.4-1.7 years]; 74 [54.4%] female; 67 with bilateral disease and 69 with unilateral disease) who underwent testing with the MSK-ACCESS assay were included. RB1 mosaicism was identified in buffy coat DNA from 20 patients (14.7%), with consistent results detected in all 11 participants tested concurrently by the MSK-IMPACT (Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets) germline assay. Four participants with RB1 mosaicism previously tested negative for germline RB1 variants by external laboratories. Compared with heterozygous participants, participants with RB1 mosaicism had a lower risk of developing bilateral disease (91.7% vs 55.0%, respectively; difference, 36.7% [95% CI, 13.8%-59.6%]; P = .002). In cfDNA, the mosaicism variant was detected both before and after treatment, with variant allele fraction initially decreasing after treatment but then stabilizing at levels consistent with mosaicism, despite the absence of clinical disease.Conclusions and RelevanceThe accurate detection and quantification of RB1 mosaicism are crucial. RB1 mosaicism should be considered when RB1 variants persist in cfDNA after treatment without evidence of disease; failure to do so may lead to false-positive results and overtreatment in patients with RB1 mosaicism. Identifying RB1 mosaicism may improve patient counseling, inform treatment decisions, and enhance surveillance efforts.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"13 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921045","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}