JAMA ophthalmologyPub Date : 2026-09-01DOI: 10.1001/jamaophthalmol.2026.3087
Tiarnán D L Keenan, Emily Y Chew, Usha Chakravarthy
{"title":"Use of Fellow Eyes as Controls in Clinical Trials-Reply.","authors":"Tiarnán D L Keenan, Emily Y Chew, Usha Chakravarthy","doi":"10.1001/jamaophthalmol.2026.3087","DOIUrl":"10.1001/jamaophthalmol.2026.3087","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"879-880"},"PeriodicalIF":10.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761687","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}
JAMA ophthalmologyPub Date : 2026-09-01DOI: 10.1001/jamaophthalmol.2026.2767
Charles Zhang, Baltaj S Sandhur, Despoina Theotoka, Hong-Uyen Hua, Basil K Williams, Audina M Berrocal, Nicolas A Yannuzzi
{"title":"Risk of Pseudophakic Cystoid Macular Edema in Eyes With Previous Pars Plana Vitrectomy.","authors":"Charles Zhang, Baltaj S Sandhur, Despoina Theotoka, Hong-Uyen Hua, Basil K Williams, Audina M Berrocal, Nicolas A Yannuzzi","doi":"10.1001/jamaophthalmol.2026.2767","DOIUrl":"10.1001/jamaophthalmol.2026.2767","url":null,"abstract":"<p><strong>Importance: </strong>Whether prior pars plana vitrectomy (PPV) independently increases the risk of cystoid macular edema (CME) following cataract surgery remains unknown.</p><p><strong>Objective: </strong>To evaluate associations between prior PPV and incidence of CME after cataract surgery.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study was conducted using the TriNetX US Network, a multicenter federated electronic health record network from December 2005 to December 2025 including academic and community hospitals in the US. Adults aged 18 years or older who underwent cataract surgery were categorized into those with vs those without a history of PPV (≥6 months prior to cataract surgery), excluding those with preexisting CME or risk factors for CME. Data were analyzed from December 2025 through January 2026.</p><p><strong>Exposure: </strong>History of PPV performed more than 6 months prior to cataract surgery.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the incidence of CME within 30 to 90 days postoperatively, identified by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) diagnostic codes. Risk ratios (RR) were used to compare outcomes. Propensity score matching was performed for demographic and clinical covariates (age, sex, race, hypertension, hyperlipidemia, diabetes, myopia, retinal detachment [RD] history).</p><p><strong>Results: </strong>After propensity score matching with 615 983 patients undergoing cataract surgery, 7422 patients had a prior PPV. After propensity score matching, among patients with prior PPV, mean (SD) age was 62.0 (11.6) years, and 3623 patients (49.5%) were female; among the non-PPV group, mean (SD) age was 61.9 (12.2) years, and 3625 patients (49.5%) were female. Among 14 636 patients representing 7318 propensity score-matched pairs, CME occurred in 336 of 7318 patients with prior PPV (4.59%) compared with 90 of 7318 non-PPV controls (1.23%) (difference, 3.36%; 95% CI, 2.82%-3.90%; RR, 3.73; 95% CI, 2.97-4.70; P < .001). Elevated CME risk persisted in subgroup analyses evaluating prior PPV for RD (5.65% vs 1.22%; absolute difference, 4.43%; 95% CI, 3.48%-5.38%; RR, 4.62; 95% CI, 3.20-6.67; P < .001), as well as those for non-RD indications (3.99% vs 1.23%; absolute difference, 2.76%; 95% CI, 2.06%-3.48%; RR, 3.26; 95% CI, 2.36-4.50; P < .001). Furthermore, after excluding patients with intraoperative and postoperative complications of cataract surgery, the prior PPV group was still found to have a higher risk of CME (4.59% vs 1.26%; absolute difference, 3.32%; 95% CI, 2.77%-3.88%; RR, 3.63; 95% CI, 2.88-4.58; P < .001).</p><p><strong>Conclusions and relevance: </strong>Results of this cohort study suggest that eyes with vs without prior PPV have higher incidences of postoperative CME. However, numerous limitations, including dependence on coding-based diagnoses and lack of visu","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"820-826"},"PeriodicalIF":10.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148619978","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}
JAMA ophthalmologyPub Date : 2026-09-01DOI: 10.1001/jamaophthalmol.2026.3381
Voraporn Chaikitmongkol
{"title":"Progression of Pachychoroid Disease-Who Is At Risk?","authors":"Voraporn Chaikitmongkol","doi":"10.1001/jamaophthalmol.2026.3381","DOIUrl":"10.1001/jamaophthalmol.2026.3381","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"861-862"},"PeriodicalIF":10.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758396","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}
JAMA ophthalmologyPub Date : 2026-09-01DOI: 10.1001/jamaophthalmol.2026.3084
Maureen G Maguire
{"title":"Use of Fellow Eyes as Controls in Clinical Trials.","authors":"Maureen G Maguire","doi":"10.1001/jamaophthalmol.2026.3084","DOIUrl":"10.1001/jamaophthalmol.2026.3084","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"878-879"},"PeriodicalIF":10.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764525","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}
JAMA ophthalmologyPub Date : 2026-09-01DOI: 10.1001/jamaophthalmol.2026.3202
David B Warner, Ting-Fang Lee, Andrea B Troxel, Christina Prescott, Elisabeth J Cohen, Bennie H Jeng
{"title":"Time-Varying Effects of Valacyclovir Prophylaxis in the Zoster Eye Disease Study: A Post Hoc Exploratory Analysis of a Randomized Clinical Trial.","authors":"David B Warner, Ting-Fang Lee, Andrea B Troxel, Christina Prescott, Elisabeth J Cohen, Bennie H Jeng","doi":"10.1001/jamaophthalmol.2026.3202","DOIUrl":"10.1001/jamaophthalmol.2026.3202","url":null,"abstract":"<p><strong>Importance: </strong>The Zoster Eye Disease Study (ZEDS) supports consideration of suppressive valacyclovir for 1 year to reduce risk of recurrent keratitis or iritis in patients with herpes zoster ophthalmicus (HZO). Although the primary outcome did not show benefit of suppressive valacyclovir treatment, secondary study outcomes showed treatment superiority at the 18-month end point and reduced number of multiple episodes of keratitis or iritis at both 12 and 18 months; however, it is unknown if these possible protective effects vary over time.</p><p><strong>Objective: </strong>To assess for temporal patterns of potential benefit of suppressive valacyclovir treatment to reduce risk of new or worsening stromal keratitis (SK), endothelial keratitis (EK), iritis (IR), or dendriform epithelial keratitis (DEK).</p><p><strong>Design, setting, and participants: </strong>This is a post hoc exploratory analysis of a multicenter, double-masked, placebo-controlled randomized clinical trial conducted in 95 centers from November 2017 to January 2023. Immunocompetent, nonpregnant adults with history of HZO rash, documented active keratitis or IR within 1 year, and estimated glomerular filtration rate of 45 mL/min/1.73 m2 or greater were eligible. Data were analyzed from September 2025 through December 2025.</p><p><strong>Intervention: </strong>Twelve months of double-masked daily valacyclovir, 1000 mg, or placebo, with 6 months of observational follow-up.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the time from randomization to first occurrence of new or worsening SK, EK, IR, or DEK.</p><p><strong>Results: </strong>A total of 651 participants consented and 527 were randomized (stratified by age at onset and chronicity), while 490 participants completed 12 months and 460 completed 18 months. Median (IQR) participant age was 60 years (50-68), and 266 of 527 patients (50.5%) were female. Cox proportional hazards and restricted mean survival time analyses of ZEDS data suggested greater benefit of valacyclovir over placebo in early treatment and observational periods. Time-varying Cox analyses showed lower hazards for valacyclovir during the treatment interval (hazard ratio [HR], 0.77; 95% CI, 0.56-1.05; P = .09) for 0 to 12 months and the observation interval (HR, 0.57; 95% CI, 0.27-1.18; P = .12) for more than 12 to 18 months, with lower hazard from 0 to 6 months (HR, 0.71; 95% CI, 0.49-1.01; P = .06) than from more than 6 to 12 months (HR, 0.99; 95% CI, 0.52-1.86; P = .97).</p><p><strong>Conclusions and relevance: </strong>In this post hoc exploratory analysis of the ZEDS randomized clinical trial, prophylactic valacyclovir decreased probability of subsequent zoster-related keratitis and IR, although statistical significance was not reached. Protective effects of valacyclovir prophylaxis were localized to early treatment and observation periods, supporting previously published recommendation of 1 year of prophylaxis.</","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"863-866"},"PeriodicalIF":10.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759896","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}
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