JAMA ophthalmology最新文献

{"title":"Safety and Effects of Gildeuretinol Acetate on Retinal Atrophic Lesions in Stargardt Disease: The TEASE-1 Randomized Clinical Trial.","authors":"Christine N Kay, Leonide Saad, Gabrielle DeBartolomeo, Neil Bressler, Stephen H Tsang, Kimberly Stepien, Paul Bernstein, Byron L Lam, Ilyas Washington, Michael B Gorin","doi":"10.1001/jamaophthalmol.2026.3662","DOIUrl":"10.1001/jamaophthalmol.2026.3662","url":null,"abstract":"<p><strong>Importance: </strong>Stargardt disease (STGD) is the most common macular dystrophy, resulting in profound loss of vision. There is no approved treatment.</p><p><strong>Objective: </strong>To evaluate the safety and effects of oral gildeuretinol acetate on the growth of retinal atrophic lesions in individuals with STGD.</p><p><strong>Design, setting, and participants: </strong>TEASE-1 was a 2-year, multicenter, double-masked, placebo-controlled randomized clinical trial incorporating a crossover group and additional natural history (NH) cases selected prior to drafting the statistical analysis plan. The trial was conducted at 7 outpatient clinics in the US. Participants were aged 12 years or older, clinically diagnosed with STGD, with well-demarcated area(s) of significantly reduced autofluorescence, and supported with at least 1 ABCA4 disease-causing or likely disease-causing variant. The study was conducted between August 2015 and October 2019; data were analyzed between July and December 2020.</p><p><strong>Interventions: </strong>Participants were randomized 1.5:1.5:1:1 to daily oral gildeuretinol acetate, 14 mg; gildeuretinol acetate, 24 mg; or placebo for 24 months; or placebo for 12 months followed by gildeuretinol for 12 months.</p><p><strong>Main outcomes and measures: </strong>The primary efficacy end point was the growth rate of well-delineated and homogeneous areas of retinal atrophic lesions over 24 months of treatment on fundus autofluorescence imaging. Safety end points included treatment-emergent adverse events (AEs), serious AEs, and clinical laboratory assessments.</p><p><strong>Results: </strong>A total of 50 participants were randomized, and 54 NH cases included. The mean (range) age of randomized participants was 44.3 (18-60) years. Overall, 58 of 104 participants or cases (55.8%) were female. The growth rate of retinal atrophic lesions was 0.182 mm/y with gildeuretinol and 0.232 mm/y in the untreated group (placebo and NH), representing a mean difference of -0.050 mm/y (95% CI, -0.072 to -0.027; P < .001) and a 21.6% relative reduction. In a prespecified sensitivity analysis restricted to randomized participants, the growth rate was 0.206 mm/y with gildeuretinol and 0.242 mm/y with placebo, representing a mean difference of -0.036 mm/y (95% CI, -0.062 to -0.009; P = .008) and a 14.9% relative reduction. The majority of AEs were mild or moderate and equally distributed between groups. No treatment-related serious AEs, clinically significant liver function abnormalities, or participant-reported night blindness or dark adaption difficulties occurred.</p><p><strong>Conclusions and relevance: </strong>In the TEASE-1 randomized clinical trial, the primary efficacy end point of retinal atrophic lesion growth from 6 to 24 months was 0.05 mm/y greater on average in the untreated group (placebo and NH) than the gildeuretinol acetate group. Further research is needed to determine the clinical relevance of this end point.</p><","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"944-952"},"PeriodicalIF":10.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887293","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":"Acetazolamide for Retinoschisis in Branchio-Oculo-Facial Syndrome","authors":"Mihaela Chitoroaga, Daniela Gallo Castro, Aude Ambresin","doi":"10.1001/jamaophthalmol.2026.4207","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.4207","url":null,"abstract":"This case report discusses a patient with branchio-oculo-facial syndrome and bilateral optic nerve coloboma, with progressive retinoschisis disproportionate to coloboma extent and showing marked improvement after oral acetazolamide.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"66 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083864","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":"Artificial Intelligence for Diabetic Retinopathy.","authors":"Jennifer I Lim, Theodore Leng","doi":"10.1001/jamaophthalmol.2026.3479","DOIUrl":"10.1001/jamaophthalmol.2026.3479","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"887-888"},"PeriodicalIF":10.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887285","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":"Ten-Year Update of a Global Survey of Corneal Transplant and Eye Banking.","authors":"Oliver Dorado Cortez, Sylvain Poinard, Philippe Gain, Vito Romano, Serge Resnikoff, Gilles Thuret","doi":"10.1001/jamaophthalmol.2026.4147","DOIUrl":"10.1001/jamaophthalmol.2026.4147","url":null,"abstract":"<p><strong>Importance: </strong>Corneal transplant (CT) is the most frequent type of tissue transplant worldwide. A decade after the first global survey quantified a severe supply-demand imbalance, an updated analysis is needed to test whether progress has been equitable.</p><p><strong>Objective: </strong>To describe global CT and corneal procurement (CP) activity in 2022, compare findings with 2012, and characterize supply and demand by country income group.</p><p><strong>Design, setting, and participants: </strong>This global cross-sectional epidemiological study was conducted from December 2023 to December 2024. Data were obtained from a systematic literature review covering January 2018 to December 2024 and national or international eye banking registries. The 7-category supply-demand classification used in the 2012 survey was reapplied, with additional stratification by World Bank fiscal year 2023 country income group.</p><p><strong>Main outcomes and measures: </strong>The primary outcomes were country-level numbers and rates per million population of CTs and CPs, country income group distributions, and prevalence-based supply-demand ratios.</p><p><strong>Results: </strong>This study included 122 countries representing 89.5% of the world population. A total of 214 299 CTs were performed in 122 countries in 2022, a 16.1% increase from 184 576 in 2012. A total of 312 349 corneas were procured in 70 countries, a 10.2% increase outpaced by approximately 12% population growth, yielding a declining per capita procurement rate. The median (IQR) CT rate was 13.8 (5.0-43.4) per million; median (IQR) CP rate across procuring countries was 23.3 (7.2-69.4) per million. Median (IQR) CT rates were 43.1 (21.4-66.3) per million in high-income countries, 11.2 (6.0-22.6) per million in upper-middle-income countries, 4.4 (1.8-14.0) per million in lower-middle-income countries, and 0.4 (0.3-3.4) per million in low-income countries. Countries at or above the 2012 global median CT rate performed 89.7% of 2022 global CT activity while accounting for 44.1% of the cohort population. The prevalence-based supply-demand ratio was approximately 1:26 for bilateral corneal vision impairment and 1:55 when unilateral cases were included.</p><p><strong>Conclusions and relevance: </strong>In this global cross-sectional epidemiological study, despite a moderate increase in CT volume from 2012 to 2022, the supply-demand gap remains severe, and inequity has not narrowed. Coordinated investment in eye banking infrastructure in middle-income countries is needed alongside alternative therapies.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037775","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":"Patient-Reported Exposure to Potentially Bogus Ophthalmic Treatments.","authors":"Lee Jones, Nikki Heinze, Mariya Moosajee","doi":"10.1001/jamaophthalmol.2026.4121","DOIUrl":"10.1001/jamaophthalmol.2026.4121","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038762","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":"Smartphone-Based 3D Ocular Reconstruction for Automated Quantitative Blepharoptosis Evaluation.","authors":"Yahan Yang, Yuxuan Han, Ruixin Wang, Sinting Ling, Junfeng Lyu, Chengkai Li, Lanqin Zhao, Qianni Wu, Jingyi Wen, Tingxin Cui, You Li, Yunxi Lai, Danqi Zeng, Xinwei Chen, Yongxin Zhang, Lin Ye, Weihua Yang, Xiuyun Gao, Jianmin Hu, Can Gong, Jiemin Zou, Jie Meng, Xingyi Li, Xuanwei Liang, Danping Huang, Patrick Yu-Wai-Man, Feng Xu, Haotian Lin","doi":"10.1001/jamaophthalmol.2026.4120","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.4120","url":null,"abstract":"<p><strong>Importance: </strong>External ocular examination is central to ptosis evaluation, yet it often relies on manual, experience-dependent measurements with variable accuracy and reproducibility.</p><p><strong>Objective: </strong>To develop and prospectively evaluate the Digital Rulers of Ptosis (DRP), a smartphone-based 3-dimensional (3D) reconstruction system for automated quantitative external ocular assessment in blepharoptosis, including marginal reflex distance 1 (MRD1) and levator muscle function (LF), and clinical classification.</p><p><strong>Design, setting, and participants: </strong>This diagnostic/prognostic study was conducted prospectively across 5 hospitals in 2025. Participants 3 years and older underwent smartphone video capture and same-day oculoplastic specialist assessment as the reference standard. Participants undergoing surgery received repeat specialist measurements of MRD1 and LF at 3 months postoperatively to assess recurrence.</p><p><strong>Exposure: </strong>DRP uses a 10-second smartphone video for 3D reconstruction with metric unit conversion and real-time quality control.</p><p><strong>Main outcomes and measures: </strong>Agreement between DRP and specialist measurements was assessed by mean absolute error (MAE) and intraclass correlation coefficient. Diagnostic performance was assessed by area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive predictive value, negative predictive value. For patients who underwent surgery, 3-month postoperative recurrence was assessed.</p><p><strong>Results: </strong>Among 952 participants (1904 eyes), the mean age was 27.9 years (range, 3-86 years); 493 participants were female (51.8%) and 459 were male (48.2%). A total of 1862 eyes were included in MRD1 analysis and 1830 eyes in LF analysis after quality control. DRP demonstrated high agreement with specialist measurements for MRD1 (MAE, 0.52 mm; 95% CI, 0.50-0.54 mm) and LF (MAE, 0.95 mm; 95% CI, 0.91-0.98 mm). For diagnosing ptosis, DRP achieved an AUC of 0.97 (95% CI, 0.96-0.97). For identifying surgical approach, DRP achieved an AUC of 0.98 (95% CI, 0.97-0.98). Performance remained consistent across sex, age, and geographic region. Among 206 surgical participants (248 eyes), the 3-month postoperative recurrence rate was 7.3% (95% CI, 4.4%-11.2%; 18/248 eyes), within the lower range of previously reported rates.</p><p><strong>Conclusions and relevance: </strong>This study found that accurate, standardized quantitative blepharoptosis assessment might be supported by commercially available smartphones, demonstrating the potential of smartphone-based 3D reconstruction for external ocular assessment and clinical decision-making. Further studies are needed to evaluate its clinical impact.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038791","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 Conjunctival Cysts.","authors":"Whitney Stuard Sambhariya, Ashley Behrens, Laura Di Meglio","doi":"10.1001/jamaophthalmol.2026.4101","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.4101","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038825","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":"Macular Hole Following Nd:YAG Laser Vitreolysis for Floaters.","authors":"Ran Zhang, Qing Chang, Yingqin Ni","doi":"10.1001/jamaophthalmol.2026.4097","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.4097","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038757","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 Eyes Refractory to Corticosteroids","authors":"Brenda Zhou, J. William Harbour, Ilyse Kornblau","doi":"10.1001/jamaophthalmol.2026.3933","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.3933","url":null,"abstract":"A 57-year-old man with bilateral red eyes and irritation refractory to topical corticosteroids presents with symmetric yellow conjunctival lesions and progressive systemic nodules and joint pain. What would you do next?","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"6 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148985110","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":"CNV and Angioid Streaks in Pseudoxanthoma Elasticum","authors":"Yi Xuan, Wei Liu","doi":"10.1001/jamaophthalmol.2026.3913","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2026.3913","url":null,"abstract":"This case report discusses a diagnosis of pseudoxanthoma elasticum in a woman aged 47 years who presented with bilateral blurry vision and a history of intravitreal treatment for choroidal neovascularization (CNV).","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"249 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148985108","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}