JAMA ophthalmology最新文献

{"title":"Flying Babies and Swept-Source OCT-An Innovative Technique to Detect Childhood Glaucoma.","authors":"Sylvia L Groth,Rachel W Kuchtey","doi":"10.1001/jamaophthalmol.2025.1375","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1375","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"68 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114164","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":"Malignant Transformation of Choroidal Indeterminate Melanocytic Tumors.","authors":"Arun D Singh,Yehonatan Weinberger,Emily C Zabor","doi":"10.1001/jamaophthalmol.2025.1262","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1262","url":null,"abstract":"ImportanceThe accuracy of the predicted risk of malignant transformation of a large choroidal nevus or indeterminate melanocytic tumor (IMT) is not known.ObjectiveTo estimate the risk of malignant transformation (predicted risk) in a cohort of patients with IMT of known outcomes (observed status; benign [large nevus] or malignant [small melanoma]).Design, Setting, and ParticipantsThis was a cohort study of patients from a single center. Patients diagnosed with IMTs that were benign (large nevus) or malignant (small melanoma) were included in the analysis. Those lesions classified as large nevus (benign; 0% risk) had documented stability over 24 or more months. IMTs classified as small melanoma (malignant; 100% risk) had quantified growth or confirmatory pathology. Data were analyzed from October to December 2024.ExposuresPrediction of malignant transformation of a large choroidal nevus or IMT.Main Outcomes and MeasuresThe primary outcome included the predicted 5-year Kaplan-Meier probability of malignant transformation using combinations of risk factors of predictive models, the Collaborative Ocular Melanoma Study (COMS) and Wills Eye Hospital (WEH) model.ResultsA total of 123 patients (median [IQR] age, 63 [56-67] years; 89 male [72%]), 62 with large nevus and 61 with small malignant melanoma, were included in this study. The mean predicted 5-year Kaplan-Meier probability of melanoma for observed melanoma was 0.39 (95% CI, 0.32-0.46) by the COMS model and 0.44 (95% CI, 0.39-0.49) by the WEH model. The difference of -0.05 (95% CI, -0.14 to 0.04) was not statistically significant. However, the mean predicted 5-year Kaplan-Meier probability of melanoma for observed nevus was 0.18 (95% CI, 0.12-0.23) by the COMS model and 0.31 (95% CI, 0.24-0.38) by the WEH model. The difference of -0.13 (95% CI, -0.22 to -0.05) was statistically significant. There was a significant difference in mean 5-year Kaplan-Meier probability of melanoma between observed melanoma and nevus of 0.21 (95% CI, 0.12-0.31) by the COMS model and 0.13 (95% CI, 0.05-0.21) by the WEH model. Optimal cut points of 0.18 and 0.34 for the COMS model and the WEH model, respectively, were identified using the Youden index. The sensitivity was lower for the COMS model than the WEH model (-15.2% difference; 95% CI, -25.6% to -4.8%), and the specificity was higher for the COMS model than the WEH model (11.7% difference; 95% CI, 2.0%-21.4%).Conclusions and RelevanceFindings of this cohort study suggest that predicted risk for malignant transformation estimated by 2 different models based on combinations of risk factors was suboptimal and may lead to overtreatment in approximately 30% of patients. These findings support pursuing other methods for prediction that should be validated before use in clinical practice.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"136 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114180","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.","authors":"Flora Lum","doi":"10.1001/jamaophthalmol.2025.1194","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1194","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"16 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114184","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":"Utility of Swept-Source Anterior-Segment OCT as an In-Office Biomarker for Early Childhood Glaucoma.","authors":"Sushmita Kaushik,Ashok Kumar Singh,Faisal Thattaruthody,Vyshak Suresh,Anchal Gera,Shivangi Yadav,Surinder Singh Pandav","doi":"10.1001/jamaophthalmol.2025.1009","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1009","url":null,"abstract":"ImportanceEarly-onset childhood glaucoma usually is diagnosed based on signs and symptoms (such as a cloudy cornea, buphthalmos, or excessive lacrimation). However, the signs and symptoms can overlap with other congenital conditions, making differentiation important. Swept-source anterior-segment optical coherence tomography (SS-ASOCT) may offer a rapid, noninvasive alternative to assess the trabecular meshwork (TM) structures, providing an additional tool to aid diagnosis.ObjectiveTo evaluate use of SS-ASOCT in diagnosing pediatric patients as having early-onset childhood glaucoma vs not having glaucoma.Design, Setting, and ParticipantsA prospective, comparative study including pediatric patients younger than 2 years of age who were referred to a tertiary care research and referral center in Northern India between June 2023 and July 2024. A diagnosis of early-onset childhood glaucoma was based on the clinical appearance of corneal clarity, intraocular pressure, buphthalmos, and optic disc evaluation.Main Outcomes and MeasuresImaging was performed using SS-ASOCT with the \"flying baby\" technique to analyze the visibility of the TM structures, the angle opening distance (500 mm or 250 mm), and the angle recess area (250 mm2 or 500 mm2). Comparisons were made using analysis of variance. The area under the receiver operating characteristic curve was used to determine the discriminators for the nonglaucomatous angles. The best discriminatory parameters studied were subsequently tested in age-matched infants (controls) with congenital cloudy corneas without glaucoma based on an eye examination using an ophthalmoscope.ResultsThe SS-ASOCT features were compared between 23 pediatric patients without and 30 pediatric patients with early-onset childhood glaucoma; the 30 patients were diagnosed as having glaucoma based on an eye examination using an ophthalmoscope. At the time of SS-ASOCT imaging, the pediatric patients without glaucoma had a mean age of 17.3 (SD, 4.4) months and the pediatric patients with glaucoma had a mean age of 18.6 (SD, 14.2) months. The TM shadow was clearly visible in 23 patients without glaucomatous eyes (100%), whereas the TM shadow was clearly visible in only 8 patients with glaucomatous eyes (26.7%) (sensitivity of 73.3% and specificity of 100%). To diagnose pediatric patients as not having early-onset childhood glaucoma, the highest area under the receiver operating characteristic curve of 0.87 (95% CI, 0.77-0.97; P < .001) was used for a clearly visible TM structure. The pediatric patients with glaucoma had greater anterior chamber angle measurement values than the pediatric patients without glaucoma. The TM structure was visualized in all young children with corneal opacity but who did not have glaucoma, and all 23 patients were correctly diagnosed as not having glaucoma using SS-ASOCT.Conclusions and RelevanceA noninvasive imaging tool, SS-ASOCT can be used to assess the anterior chamber angles in children. The findings sugg","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"31 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114182","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":"Encouraging News for Children With Aphakia.","authors":"William V Good","doi":"10.1001/jamaophthalmol.2025.1243","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1243","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"55 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991969","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":"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}