JAMA ophthalmology最新文献

{"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":"Glucagon-Like Peptide-1 Receptor Agonists and Risk of Neovascular Age-Related Macular Degeneration","authors":"Reut Shor, Andrew Mihalache, Atefeh Noori, Renana Shor, Radha P. Kohly, Marko M. Popovic, Rajeev H. Muni","doi":"10.1001/jamaophthalmol.2025.1455","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1455","url":null,"abstract":"ImportanceGlucagon-like peptide-1 receptor agonists (GLP-1 RAs) are extensively used in treating diabetes and obesity, yet little is known about the long-term ocular effects of systemic prolonged exposure.ObjectiveTo evaluate the risk of developing neovascular age-related macular degeneration (nAMD) associated with the use of GLP-1 RAs in patients with diabetes.Design, Setting, and ParticipantsThis population-based, retrospective cohort study was conducted from January 2020 to November 2023, with a follow-up period of 3 years. Data analysis was performed from August 2024 to October 2024. The investigators used comprehensive administrative health and demographic data from patients in Ontario, Canada, which were collected by the Institute for Clinical Evaluative Sciences in the context of a universal public health care system. Inclusion criteria were patients aged 66 years or older with a diagnosis of diabetes and a minimum follow-up period of 12 months following initial diabetes diagnosis. Patients with incomplete Ontario Health Insurance Plan or Ontario Drug Benefit data or patients exposed to GLP-1 RA for less than 6 months were excluded. Of 1 119 517 eligible patients, a 1:2 matched cohort of 139 002 patients was created, including 46 334 patients who were exposed to GLP-1 RAs and 92 668 unexposed matched patients. Systemic comorbidities that were associated with any kind of AMD and socioeconomic status were used to calculate propensity scores.ExposureGLP-1 RA use for 6 months or longer.Main Outcomes and MeasuresThe primary outcome was the incidence and time to event of nAMD during the follow-up period.ResultsAmong 139 002 matched patients, mean (SD) patient age was 66.2 (7.5) years, and 64 775 patients (46.6%) were women. The incidence of nAMD was higher among the exposed cohort than among the unexposed cohort. Cox proportional hazard models, both unadjusted (crude) and adjusted, estimated hazard ratios for nAMD development of greater than 2.0 among patients exposed to GLP-1 RAs (exposed, 0.2% vs unexposed, 0.1%; difference, 0.1%; crude: HR, 2.11; 95% CI, 1.58-2.82; adjusted: HR, 2.21; 95% CI, 1.65-2.96).Conclusions and RelevanceIn this cohort study, the use of GLP-1 RAs among patients with diabetes was associated with a 2-fold higher risk of incident nAMD development than among similar patients with diabetes who did not receive a GLP-1 RA. Further research is needed to elucidate the exact pathophysiological mechanisms involved and to understand the trade-offs between the benefits and risks of GLP-1 RAs.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"55 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144219491","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":"10.1001/jamaophthalmol.2025.1135","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"515-516"},"PeriodicalIF":7.8,"publicationDate":"2025-06-01","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":"Corneal Toxicity Associated With Mirvetuximab.","authors":"Marcus L Turner, Minh T Nguyen","doi":"10.1001/jamaophthalmol.2025.0884","DOIUrl":"10.1001/jamaophthalmol.2025.0884","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"143 6","pages":"e250884"},"PeriodicalIF":7.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333127","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":"Iris Ganglion Cell.","authors":"Thomas J Cummings","doi":"10.1001/jamaophthalmol.2025.0885","DOIUrl":"10.1001/jamaophthalmol.2025.0885","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"143 6","pages":"e250885"},"PeriodicalIF":7.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333128","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":"JAMA Ophthalmology.","authors":"","doi":"10.1001/jamaophthalmol.2024.4174","DOIUrl":"10.1001/jamaophthalmol.2024.4174","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"143 6","pages":"454"},"PeriodicalIF":7.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333129","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":"Short-Term Ocular Biometric Changes as Predictors of Long-Term Angle Closure Progression","authors":"Kendra L. Hong, Benjamin Y. Xu, Wei Wang, Austin Cho, Natalie M. Kistler, Paul J. Foster, Yuzhen Jiang, Tin Aung, David S. Friedman, Mingguang He","doi":"10.1001/jamaophthalmol.2025.1007","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1007","url":null,"abstract":"ImportanceBaseline ocular biometrics of the anterior segment forecast progression from primary angle closure suspect (PACS) to primary angle closure (PAC). As ocular biometrics change with aging, it is also important to understand the progression risk associated with these longitudinal anatomical changes.ObjectiveTo assess 18-month ocular biometric changes as risk factors for progression from PACS to PAC between 36 and 72 months.Design, Setting, and ParticipantsThis retrospective cohort study analyzed data from the prospective Zhongshan Angle Closure Prevention (ZAP) Trial, which was a randomized clinical trial conducted from September 2008 to November 2018. Participants were aged 50 to 70 years and had bilateral PACS, defined as inability to visualize pigmented trabecular meshwork in 2 or more quadrants on gonioscopy. Participants were evaluated at baseline, at 2 weeks, and at 6, 18, 36, 54, and 72 months for progression to PAC, defined as development of intraocular pressure greater than 24 mm Hg, peripheral anterior synechiae, or acute angle closure. Untreated eyes without progression at or before 18 months were eligible. Cox regression models assessed risk factors for progression. Data were analyzed from November 2023 to June 2024.Main Outcome and MeasureProgression from PACS to PAC between 36 and 72 months.ResultsA total of 785 untreated eyes (759 without progression, 26 with progression) of 785 participants were analyzed (mean [SD] age, 58.7 [5.0] years; 651 females [82.9%], 134 males [17.1%]). In univariable Cox models, baseline trabecular-iris space area at 500 μm (TISA500) and 18-month change in lens vault (ΔLV) and TISA at 750 μm (ΔTISA750) were associated with progression. In age-adjusted multivariable Cox models, baseline TISA500 (hazard ratio [HR], 1.28 per −0.01 mm&lt;jats:sup&gt;2&lt;/jats:sup&gt;; 95% CI, 1.09-1.50; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .006) and ΔLV (HR, 1.22 per 0.1 mm; 95% CI, 1.07-1.41; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .008) (concordance index, 0.73) or baseline TISA500 (HR, 1.31 per −0.01 mm&lt;jats:sup&gt;2&lt;/jats:sup&gt;; 95% CI, 1.11-1.54; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .003) and ΔTISA750 (HR, 1.06 per −0.01 mm&lt;jats:sup&gt;2&lt;/jats:sup&gt;; 95% CI, 1.02-1.10; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .009) (concordance index, 0.73) were more predictive than baseline TISA500 alone (HR, 1.27 per −0.01 mm&lt;jats:sup&gt;2&lt;/jats:sup&gt;; 95% CI, 1.09-1.49; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .007) (concordance index, 0.69). A multivariable model with categorical TISA500 in the lowest quartile (&amp;amp;lt;0.031 mm&lt;jats:sup&gt;2&lt;/jats:sup&gt;; HR, 2.65; 95% CI, 1.20-5.86; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .03) and ΔLV in the highest quartile (&amp;amp;gt;0.663 mm; HR, 2.70, 95% CI, 1.23-5.93; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .02) independently conferred greater risk of progression (concordance index, 0.69).Conclusions and RelevanceShort-term (18-month) changes in LV and TISA750 were associated with long-term (36-72 month) angle closure progression in untreated PACS eyes, suggesting th","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"98 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144165670","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 Central Retinal Artery Occlusion After Paclitaxel in Breast Cancer","authors":"Harsh H. Jain, Rabia Naaz, Tanya Sagar, Akshay Kothari, Aditya Kelkar, Sabyasachi Sengupta","doi":"10.1001/jamaophthalmol.2025.1379","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1379","url":null,"abstract":"This case report discusses development of central retinal artery occlusion in a patient undergoing chemotherapy for biopsy-proven stage 3 breast cancer with paclitaxel.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"49 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144165665","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-Based Detection of Diabetic Retinopathy-Reply.","authors":"Shreya A Shah,Prithvi Mruthyunjaya,Ravi Parikh","doi":"10.1001/jamaophthalmol.2025.1197","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1197","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"97 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114163","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":"A New Vision for Site-Neutral Policy.","authors":"Taylor Hall,Brian J Miller,Fasika A Woreta,Catherine L Chen","doi":"10.1001/jamaophthalmol.2025.1278","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1278","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"19 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114162","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}