JAMA ophthalmology最新文献

{"title":"Atropine or Cyclopentolate to Diagnose Premyopia in Preschool Children.","authors":"Haotian Wu,Yanjiao Wang,Qiuying Lu,Kathryn A Rose,Ian G Morgan,Zihan Ni,Kaidi Xiang,Ziyi Qi,Bo Zhang,Jingjing Wang,Jun Chen,Xun Xu,Xiangui He","doi":"10.1001/jamaophthalmol.2025.3243","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.3243","url":null,"abstract":"ImportanceSufficient cycloplegia is essential for reliable refraction in preschool children. The choice of cycloplegic agent may affect refraction and diagnosis outcomes.ObjectiveTo evaluate the objective refraction outcomes after cycloplegia in preschool children given either atropine or cyclopentolate.Design, Setting, and ParticipantsThis was a post hoc analysis of the 2024 Preschool Children Refractive Development Pattern and Influencing Factors Study (PRDP-IFS), in which children were given atropine, and the 2013 to 2014 Elaborative Shanghai Childhood Ocular Refractive Development Study (E-SCORDS), in which children were given cyclopentolate. These were population-based studies. Eyes in each group were included via propensity score matching. Study data were analyzed from December 2024 to July 2025.ExposuresCycloplegia induced by either 1% atropine (twice daily for 4 days with an additional dose on day 5) or 1% cyclopentolate (dual administration 5 minutes apart) eye drops.Main Outcomes and MeasuresDifference between the noncycloplegic and cycloplegic spherical equivalent (DSE) and the prevalence of refractive states were compared in the atropine and cyclopentolate groups. Refractive states (moderate to high hyperopia, low hyperopia, premyopia, and myopia) were determined by cycloplegic spherical equivalent (SE) using an autorefractor.ResultsA total of 1761 children and their 3048 eyes were included in this study. There were 773 children (1524 eyes) in the atropine group (mean [SD] age, 4.62 [0.92] years; 406 male [52.5%]) and 988 children (1524 eyes) in the cyclopentolate group (mean [SD] age, 4.62 [0.93] years; 530 male [53.6%]). There were a total of 1524 eyes in each group. The mean (SD) noncycloplegic SE was 0.30 (0.92) diopters (D) and 0.31 (0.76) D in the atropine and cyclopentolate groups, respectively (mean difference, -0.01 D; 95% CI, -0.07 to 0.05 D; P = .72). Mean (SD) DSE in the atropine group was 1.56 (0.72) D and in the cyclopentolate group was 0.97 (0.70) D. The mean difference in DSE between the 2 groups was 0.59 D (95% CI, 0.54-0.64 D; P < .001). The difference in the percentages of refractive states between the atropine and cycloplegic groups was as follows: moderate to high hyperopia (7.2% vs 2.7% = 4.5%; 95% CI, 2.9%-6.0%; P < .001), low hyperopia (82.8% vs 74.0% = 8.8%; 95% CI, 6.0%-11.8%; P < .001), premyopia (8.7% vs 21.6% = -12.9%; 95% CI, -15.4% to -10.4%; P < .001), and myopia (1.3% vs 1.8% = -0.5%; 95% CI, -1.3% to 0.4%; P = .30).Conclusions and RelevanceThis study found that use of atropine for cycloplegia in preschool children was associated with less myopic refraction compared with cyclopentolate and may potentially avoid overestimation of premyopia prevalence; however, this investigation did not evaluate each cycloplegic agent in the same children.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"319 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133927","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":"Occlusive Retinal Vessels Associated With Intravitreal Aflibercept, 8.0 mg.","authors":"Reena Dail,George Bertolucci,Sumeer Thinda","doi":"10.1001/jamaophthalmol.2025.3027","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.3027","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"19 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133957","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":"Smooth Pursuit Velocity After a Season of Repetitive Head Impacts in American Football Players.","authors":"Nicholas G Murray,Madison Fenner,Brian Szekely,Kristen G Quigley,Arthur Islas,Daniel Cipriani,Marian E Berryhill,Thomas Buckley","doi":"10.1001/jamaophthalmol.2025.2935","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.2935","url":null,"abstract":"ImportanceRepetitive head impacts (RHI) are blows to the head that do not elicit clinical signs or concussion symptoms. Yet, research suggests that brain integrity and functionality can be altered following a single season of contact collision sports. These deficits are untraceable by current clinical testing.ObjectiveTo examine the association between RHI and oculomotor control across a single division I American football season.Design, Setting, and ParticipantsThis single-center cohort study took place from July 2020 to May 2022. Data were analyzed from May 2022 to December 2024. Participants included 25 division I football players (11 high-dose and 14 low-dose; mean age, 20 [SD, 3] years) and 10 controls (mean age, 22 [SD, 1] years). High-dose and low-dose groups were determined by the head impacts incurred during the season using instrumented mouthguards.ExposureA single competitive season of contact sports.Main Outcomes/MeasuresAll football players wore instrumented mouthguards throughout the 2 seasons (2021 to 2022). Each season was treated as an independent observation with no individual football players included in more than 1 season. A random sample of head impacts across the season were video verified. All participants completed an eye tracking task that consisted of following a Landolt-C moving horizontally during fast (90° per second) and slow (30° per second) conditions at preseason (PRE), midseason (MID), and postseason (POST). Smooth pursuit eye movement velocity was calculated and analyzed.ResultsA total of 25 male division I American football student-athletes (RHI group; mean age, 20 [SD, 3] years; mean height, 185.72 [SD, 7.40] cm; mean weight, 104.02 [SD, 15.69] kg) and 10 healthy noncontact controls (7 recreationally active [4 female, 3 males] and 3 noncontact National Collegiate Athletic Association swimmers [all female]; mean age, 22 [SD, 1] years) participated in this cohort study. During the season, smooth pursuit eye movement velocity was PRE, 10.01 (SD, 3.16)° per second; MID, 11.48 (SD, 6.57)° per second; and POST, 11.10 (SD, 8.65)° per second for the high-dose group, while the low-dose group was PRE, 11.28 (SD, 4.10)° per second; MID, 11.50 (SD, 5.86)° per second; and POST, 15.02 (SD, 8.26)° per second, with the controls being PRE, 15.60 (SD, 4.44)° per second; MID, 17.95 (SD, 3.73)° per second, and POST, 13.44 (SD, 8.54)° per second. Specifically, at PRE, RHI high-dose players had slower smooth pursuit eye movement velocity compared with controls (difference, 4.28; 95% CI, 2.68-5.81; P = .01). At MID, both high-dose (difference, 8.49; 95% CI, 5.18-11.81; P = .01) and low-dose (difference, 9.15; 95% CI, 6.42-11.87; P = .02) groups had slower smooth pursuit eye movement velocities than controls.Conclusions and RelevanceIn this study, smooth pursuit eye movement velocity was not affected during a single season of contact sports. Group differences suggest existing deficits before the season begins, possibly due to prior c","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"49 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145078008","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":"Unilateral Iris Metastasis of Small Cell Lung Cancer.","authors":"Toshiaki Hirakata,Shintaro Nakao","doi":"10.1001/jamaophthalmol.2025.2655","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.2655","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"38 1","pages":"e252655"},"PeriodicalIF":8.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145078059","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":"Metformin and Age-Related Macular Degeneration-No Causal Evidence Yet.","authors":"Su-Hsun Liu,Naresh Mandava,Tianjing Li","doi":"10.1001/jamaophthalmol.2025.3183","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.3183","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"38 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145078006","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":"Leveraging Big Data to Improve Patient Care.","authors":"Steven Kymes","doi":"10.1001/jamaophthalmol.2025.3271","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.3271","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"7 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145078009","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":"Quality of Care in Patients With Newly Diagnosed Glaucoma.","authors":"Maryam O Ige,Dustin D French,Azraa S Chaudhury,Yang Li,Chris A Andrews,Kunal Kanwar,Xueqing Zhou,Shikha Marwah,Charlesnika T Evans,Abel N Kho,Paul J Bryar,Joshua D Stein, ","doi":"10.1001/jamaophthalmol.2025.2995","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.2995","url":null,"abstract":"ImportanceVarious communities continue to experience relatively high rates of glaucoma-related visual impairment and blindness. Identifying potential nonmedical influences on glaucoma outcomes may lead to strategies to improve glaucoma care.ObjectiveTo assess possible associations between nonmedical variables and quality of glaucoma care among patients with newly diagnosed primary open-angle glaucoma (POAG).Design, Setting, and ParticipantsThis retrospective cohort study included 1466 patients with newly diagnosed POAG receiving care at health systems in the Sight Outcomes Research Collaborative (SOURCE) Consortium from January 2010 to December 2022. Data analysis was completed from March 2024 to June 2025.ExposuresVarious nonmedical variables, including self-reported race and ethnicity, urbanicity of residence, affluence of patients' residential community, and presence of children in the household.Main Outcomes and MeasuresThe primary outcomes were odds of 15% or greater intraocular pressure (IOP) reduction at 12 to 18 months following initial POAG diagnosis and odds of loss to follow-up (LTFU).ResultsMean (SD) age of patients was 70 (12) years; among 1466 patients, 793 (54%) were female. By self-reported race and ethnicity, 39 patients (3%) were Asian American, 469 patients (32%) were Black, 95 (7%) were Latinx, and 831 (57%) were White. Among 1030 patients (70%) with 1 or more follow-up evaluations within 12 to 18 months following initial POAG diagnosis, 783 (76%) achieved 15% or higher IOP reduction in 1 or more eyes. Patients in the lowest wealth quartile had 5- to 9-fold lower odds of achieving 15% or greater IOP decrease compared with patients in higher quartiles; the odds of LTFU were 61% lower in the wealthiest patient quartile than in the least-wealthy group (odds ratio [OR], 0.39; 95% CI, 0.18-0.84; P = .02). Patients in rural communities (OR, 5.54; 95% CI, 1.13-27.08) were more likely than urban residents to experience LTFU. Patients with children in the household experienced, on average, a 4-mm Hg (95% CI, 0.99-7.13) greater IOP reduction compared with those without children in the household (P = .01).Conclusions and RelevanceIn this cohort study, patients with newly diagnosed POAG in the lowest wealth quartile were substantially less likely to achieve the US National Quality Forum's recommended IOP percentage reduction and considerably more likely to experience LTFU than those with higher wealth levels. These findings support the premise that clinicians should understand financial circumstances of patients when making management decisions and reinforce the need for clinicians and payors to find ways to ensure that patients can access IOP-lowering interventions and receive follow-up care in accordance with established guidelines.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"21 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145078064","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":"Acute Angle Closure Incidence in a Large Countywide Safety Net Teleretinal Screening Program.","authors":"Tracy Z Lang,Benjamin Y Xu,Zhiwei Li,Sreenidhi Iyengar,Carl Kesselman,Jose-Luis Ambite,Kyle Bolo,Jiun Do,Brandon Wong,Lauren P Daskivich","doi":"10.1001/jamaophthalmol.2025.3162","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.3162","url":null,"abstract":"ImportancePharmacologic pupillary dilation is vital for eye disease screening but is often avoided due to concerns about triggering acute angle closure (AAC), a sight-threatening ophthalmic emergency.ObjectiveTo assess AAC incidence after dilation and validate the use of International Classification of Diseases (ICD) codes for identifying AAC cases.Design, Setting, and ParticipantsThis retrospective cohort study used data from a primary care-based teleretinal diabetic retinopathy screening (TDRS) program. Eligible participants were Los Angeles County Department of Health Services patients who underwent teleretinal screening by dilated fundus photography between August 23, 2013, and March 1, 2024. Potential AAC cases were identified using ICD codes for angle closure, including AAC glaucoma, primary angle-closure glaucoma, and anatomical narrow angle, within 3 months of dilation. All urgent care, emergency department, and eye clinic encounters within the next calendar day after TDRS and encounters with Current Procedural Terminology codes for iridectomy/iridotomy or lens extraction within 14 calendar days of TDRS were also identified. Manual medical record review was conducted to verify AAC cases and extract clinical information. Data were analyzed from July 2024 to June 2025.ExposuresDilation with tropicamide, 1.0%, or tropicamide, 0.5%.Main Outcomes and MeasuresCumulative incidence of AAC after dilation.ResultsOf 84 008 included patients, 46 255 (55.1%) were female, and the mean (SD) age was 55.4 (10.7) years. There were a total of 168 796 dilations, with a mean (SD) of 2.01 (1.50) dilations per patient. Manual medical record review confirmed 4 AAC cases after dilation: 3 coded as AAC glaucoma and 1 as anatomical narrow angle. The AAC risk was 2.4 (95% CI, 0.05-4.69) per 100 000 dilations (0.002%) or 4.8 (95% CI, 0.10-9.43) per 100 000 patients (0.005%). All 4 AACs occurred in female patients, had narrow angles in the nonpresenting eye on gonioscopy, and presented within 1 day with AAC symptoms, including eye pain and blurry vision.Conclusions and RelevanceAAC risk was less than 1 in 40 000 per dilation in a high-volume TDRS program serving a diverse safety net population, supporting the overall safety of dilation in this setting. Further discussion about AAC risk as a contraindication to dilation is warranted.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"105 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145078003","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":"Anti-VEGF Approval and Retinal Photocoagulation for Retinopathy of Prematurity.","authors":"Masahiro Akada,Masayuki Hata,Masahiro Miyake,Hiroshi Tamura,Yoko Fukushima,Akitaka Tsujikawa","doi":"10.1001/jamaophthalmol.2025.2948","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.2948","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"77 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145078063","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":"Haab Striae and Endothelial Injury in Congenital Glaucoma.","authors":"Luca Lucchino,Sabrina Vaccaro,Vito Romano","doi":"10.1001/jamaophthalmol.2025.2657","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.2657","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"32 1","pages":"e252657"},"PeriodicalIF":8.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145078060","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}