JAMA ophthalmology最新文献

{"title":"DNA Assays to Detect and Characterize RB1 Mosaicism in Retinoblastoma.","authors":"Patricia Chévez-Barrios,Sharon E Plon,Zejuan Li","doi":"10.1001/jamaophthalmol.2025.1105","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1105","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921040","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":"Application of Artificial Intelligence to Deliver Healthcare From the Eye.","authors":"Robert N Weinreb,Aaron Y Lee,Sally L Baxter,Richard W J Lee,Theodore Leng,Michael V McConnell,Nevin W El-Nimri,David C Rhew","doi":"10.1001/jamaophthalmol.2025.0881","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0881","url":null,"abstract":"ImportanceOculomics is the science of analyzing ocular data to identify, diagnose, and manage systemic disease. This article focuses on prescreening, its use with retinal images analyzed by artificial intelligence (AI), to identify ocular or systemic disease or potential disease in asymptomatic individuals. The implementation of prescreening in a coordinated care system, defined as Healthcare From the Eye prescreening, has the potential to improve access, affordability, equity, quality, and safety of health care on a global level. Stakeholders include physicians, payers, policymakers, regulators and representatives from industry, government, and data privacy sectors.ObservationsThe combination of AI analysis of ocular data with automated technologies that capture images during routine eye examinations enables prescreening of large populations for chronic disease. Retinal images can be acquired during either a routine eye examination or in settings outside of eye care with readily accessible, safe, quick, and noninvasive retinal imaging devices. The outcome of such an examination can then be digitally communicated across relevant stakeholders in a coordinated fashion to direct a patient to screening and monitoring services. Such an approach offers the opportunity to transform health care delivery and improve early disease detection, improve access to care, enhance equity especially in rural and underserved communities, and reduce costs.Conclusions and RelevanceWith effective implementation and collaboration among key stakeholders, this approach has the potential to contribute to an equitable and effective health care system.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921039","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":"Characterization of Belantamab Mafodotin-Induced Corneal Changes in Patients With Multiple Myeloma.","authors":"Vivian Lee,Malin Hultcrantz,Stephanie Petrone,Eric W Lewis,Hussam Banna,Eben Lichtman,Praneetha Thulasi,Anjulie A Quick,Bennie H Jeng,Sarah B Sunshine,Jasmine H Francis,Julia Canestraro,Asim V Farooq,Peter Clements,Nicola Robertson,Mark Burman,Tom McKevitt,Herbert Struemper,Lucinda Weir","doi":"10.1001/jamaophthalmol.2025.1008","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1008","url":null,"abstract":"ImportanceOcular surface events are a class effect of microtubule-inhibitor payload-containing antibody-drug conjugates (ADCs); the mechanism underlying these events has not been fully elucidated.ObjectiveTo characterize corneal epithelial changes in patients with relapsed or refractory multiple myeloma (RRMM) treated with belantamab mafodotin, a maleimidocaproyl monomethyl auristatin-F (MMAF)-containing ADC.Design, Setting, and ParticipantsThis multicenter, phase 3b case series study was conducted in the US from March 26, 2020, to November 21, 2022, among adults with RRMM. Data were analyzed from May 2021 to May 2023.ExposurePrior or ongoing treatment with belantamab mafodotin.Main Outcomes and MeasuresThe primary end point included pathologic characteristics and composition of corneal epithelial changes obtained by impression cytology (IC) or superficial keratectomy (SK) in patients treated with belantamab mafodotin. Tear film and blood were collected to determine belantamab mafodotin concentrations in patients at the time of sampling.ResultsOf 16 patients screened, 9 were included in this study, with 6 evaluable corneal samples obtained from 6 patients either by IC (n = 4) or SK (n = 2). Of 9 patients included, median (range) patient age was 67.0 (57.0-81.0) years for those with samples obtained by IC and 68.0 (65.0-81.0) years for those with samples obtained by SK. Six patients (67%) were female. All samples demonstrated epithelial cells with eosinophilic intracytoplasmic inclusions, basophilic granular cytoplasm, or both. Five samples were positive for apoptosis, and 3 samples showed evidence of inflammation. All patients experienced complete IC or SK wound healing. ADC was detected in the tear fluid of 5 of 7 patients with tear fluid sampling, while ADC was quantifiable in 3 of 4 patients with blood samples.Conclusions and RelevanceIn this case series study, intracytoplasmic inclusions were observed by histopathology in the corneal epithelium of patients exposed to belantamab mafodotin, and the pattern of corneal changes suggests limbal vessels may be a primary pathway enabling ADC to reach the cornea. Although limited to 6 samples, this study helps us better understand corneal changes associated with certain ADCs.Trial RegistrationClinicalTrials.gov Identifier: NCT04549363.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"74 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921046","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":"Detection and Characterization of RB1 Mosaicism in Patients With Retinoblastoma Receiving cfDNA Test.","authors":"Chuan Gao,Juber Patel,Melissa Robbins,Erika Gedvilaite,Anita S Bowman,Kanika Arora,Chad Vanderbilt,A Rose Brannon,Danielle N Friedman,Jennifer Kennedy,Elise Fiala,Ozge Ceyhan-Birsoy,Ira J Dunkel,Britta Weigelt,Jasmine H Francis,Jorge S Reis-Filho,David H Abramson,Diana Mandelker","doi":"10.1001/jamaophthalmol.2025.1079","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1079","url":null,"abstract":"ImportancePlasma cell-free DNA (cfDNA) testing is increasingly used for disease diagnosis and monitoring in retinoblastoma, with RB1 allele fraction in cfDNA actively corresponding to disease status and treatment response. However, while RB1 mosaicism has been reported in retinoblastoma, its clinical implications and potential impact on cfDNA testing remain unclear.ObjectivesTo identify RB1 mosaicism using paired plasma and buffy coat (containing lymphocytes, monocytes, granulocytes, and platelets) DNA testing, and to characterize the implications of RB1 mosaicism on cfDNA testing outcomes.Design, Setting, and ParticipantsIn this cross-sectional study, participants with retinoblastoma underwent testing with MSK-ACCESS (Memorial Sloan Kettering-Analysis of Circulating cfDNA to Examine Somatic Status), a clinical assay that combines plasma cfDNA and buffy coat genomic DNA sequencing, enabling the detection and differentiation of somatic, heterozygous, and mosaic variants, between July 2020 and April 2024 at the Memorial Sloan Kettering Cancer Center. Mosaic findings from MSK-ACCESS were correlated with those from a subgroup of patients who concurrently underwent testing using the MSK-IMPACT germline assay. Data analysis was performed from April to September 2024.ExposureRB1 mosaicism in retinoblastoma.Main Outcomes and MeasuresThe RB1 variant allele fractions in cfDNA and buffy coat genomic DNA were used to detect RB1 mosaicism.ResultsA total of 136 consecutive patients with retinoblastoma (median age at diagnosis, 1.0 year [IQR, 0.4-1.7 years]; 74 [54.4%] female; 67 with bilateral disease and 69 with unilateral disease) who underwent testing with the MSK-ACCESS assay were included. RB1 mosaicism was identified in buffy coat DNA from 20 patients (14.7%), with consistent results detected in all 11 participants tested concurrently by the MSK-IMPACT (Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets) germline assay. Four participants with RB1 mosaicism previously tested negative for germline RB1 variants by external laboratories. Compared with heterozygous participants, participants with RB1 mosaicism had a lower risk of developing bilateral disease (91.7% vs 55.0%, respectively; difference, 36.7% [95% CI, 13.8%-59.6%]; P = .002). In cfDNA, the mosaicism variant was detected both before and after treatment, with variant allele fraction initially decreasing after treatment but then stabilizing at levels consistent with mosaicism, despite the absence of clinical disease.Conclusions and RelevanceThe accurate detection and quantification of RB1 mosaicism are crucial. RB1 mosaicism should be considered when RB1 variants persist in cfDNA after treatment without evidence of disease; failure to do so may lead to false-positive results and overtreatment in patients with RB1 mosaicism. Identifying RB1 mosaicism may improve patient counseling, inform treatment decisions, and enhance surveillance efforts.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"13 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921045","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":"The OHDSI Network in Ophthalmology-The Promise of Observational Health Data.","authors":"Michelle R Hribar, Cindy X Cai, Kerry E Goetz, George Hripcsak","doi":"10.1001/jamaophthalmol.2025.0399","DOIUrl":"10.1001/jamaophthalmol.2025.0399","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"369-370"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719323","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":"Capsular Tension Ring Implantation for Intraocular Lens Power Calculation in Highly Myopic Eyes: Secondary Analysis of a Randomized Clinical Trial.","authors":"Haowen Lin, Jiaqing Zhang, Aixia Jin, Yifan Zhang, Yu Zhang, Ling Jin, Yifan Xu, Xiaohang Xie, Xiaozhang Qiu, Boyufei Dai, Xuhua Tan, Lixia Luo, Yizhi Liu","doi":"10.1001/jamaophthalmol.2025.0110","DOIUrl":"10.1001/jamaophthalmol.2025.0110","url":null,"abstract":"<p><strong>Importance: </strong>Capsular tension ring (CTR) implantation has been shown to reduce intraocular lens (IOL) decentration and tilt in high myopia. However, the effect of CTR implantation in highly myopic eyes on IOL power calculation remains unclear, particularly in new-generation formulas.</p><p><strong>Objective: </strong>To evaluate the influence of CTR implantation on IOL power calculation in highly myopic eyes.</p><p><strong>Design, setting, and participants: </strong>This is a prespecified secondary analysis of outcomes of a randomized clinical trial conducted between November 2021 and September 2023 at the Zhongshan Ophthalmic Center in Guangzhou, China. Cataract patients with an axial length (AL) of 26 mm or longer were enrolled and stratified into 3 strata based on AL (stratum 1: AL 26-<28 mm; stratum 2: AL 28-<30 mm; stratum 3: AL ≥30 mm).</p><p><strong>Interventions: </strong>Participants were stratified based on AL and randomized to the CTR group (a C-loop IOL combined with a CTR) or the control group (only a C-loop IOL) within each stratum.</p><p><strong>Main outcomes and measures: </strong>Predictive outcomes of 6 new-generation formulas and 4 traditional formulas were evaluated. The arithmetic and absolute prediction error (PE) and the percentages of eyes within ±0.25 diopter (D), ±0.50 D, ±0.75 D, and ±1.00 D of PE were analyzed.</p><p><strong>Results: </strong>A total of 186 eyes of 186 participants were randomized into the CTR group (93 eyes [50%]) or control group (93 eyes [50%]). Excluding a withdrawal case and 24 eyes with best-corrected visual acuity less than 20/40, 80 eyes in the CTR group (86.0%) and 81 eyes in the control group (87.1%) were analyzed. Of 161 participants analyzed, overall mean (SD) participant age was 56.7 (10.5) years, and 100 participants (62.1%) were female. No differences were observed in arithmetic PE between the CTR and control groups in any strata. The CTR group showed smaller absolute PE in all new-generation formulas and higher percentage of PE within ±0.50 D in the Emmetropia Verifying Optical 2.0, Hoffer QST, LISA, and Pearl-DGS formulas only for eyes with an AL of 30 mm or longer compared with the control group. In traditional formulas, no differences were observed between the 2 groups in any strata.</p><p><strong>Conclusions and relevance: </strong>In this secondary analysis, CTR implantation in highly myopic eyes did not affect the target refraction and can improve the prediction accuracy of new-generation IOL calculation formulas in eyes with AL of 30 mm or longer. These findings support use of CTR implantation in eyes with an AL of 30 mm or longer.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05161520.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"373-381"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663517","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":"Semaglutide and Nonarteritic Anterior Ischemic Optic Neuropathy Risk Among Patients With Diabetes.","authors":"Alan Y Hsu, Hou-Ting Kuo, Yu-Hsun Wang, Chun-Ju Lin, Yi-Ching Shao, Chun-Chi Chiang, Ning-Yi Hsia, Chun-Ting Lai, Hsin Tseng, Bing-Qi Wu, Huan-Sheng Chen, Yi-Yu Tsai, Min-Yen Hsu, James Cheng-Chung Wei","doi":"10.1001/jamaophthalmol.2025.0349","DOIUrl":"10.1001/jamaophthalmol.2025.0349","url":null,"abstract":"<p><strong>Importance: </strong>Recent studies have suggested an association between nonarteritic anterior ischemic optic neuropathy (NAION) with semaglutide usage. However, the limitations of those analyses warrant further investigation, given the frequency of use of these medications in people with and without diabetes.</p><p><strong>Objective: </strong>To investigate the association between semaglutide use and the risk of NAION among patients with diabetes.</p><p><strong>Design, setting, and participants: </strong>This cohort study used data from the TriNetX database between October 1, 2019, and December 31, 2023, to identify patients with diabetes with no history of NAION who were prescribed semaglutide. The semaglutide cohort was compared with a control group of randomly selected patients with diabetes who were prescribed non-glucagonlike peptide 1 (non-GLP-1) receptor agonist (RA) antidiabetic medications. The data analysis for this study was performed on September 1, 2024.</p><p><strong>Exposures: </strong>Semaglutide history, identified using diagnostic codes.</p><p><strong>Main outcomes and measures: </strong>Cumulative incidence and (HR) hazard ratio of NAION.</p><p><strong>Results: </strong>A total of 3 344 205 patients with diabetes were included in this study. Regarding the diabetes cohort, a total of 174 584 patients with diabetes who received semaglutide (mean [SD] age, 58.3 [12.5] years; 90 427 female [51.8%]; 71 739 male [41.1%]) and 174 584 patients with diabetes who received non-GLP-1 RA medications (mean [SD] age, 58.2 [14.3] years; 90 475 female [51.82%]; 71 989 male [41.24%]) were recruited. Patients with diabetes taking semaglutide exhibited an absence of NAION risk at the 1-month (HR, 2.99; 95% CI, 0.31-28.75), 3-month (HR, 1.33; 95% CI, 0.30-5.93), 6-month (HR, 1.79; 95% CI, 0.60-5.35), and 1-year (HR, 1.94; 95% CI: 0.93-4.02) time points after the index date. However, those taking semaglutide were found to have an increased risk for NAION at the 2-year (HR, 2.39; 95% CI, 1.37-4.18), 3-year (HR, 2.44; 95% CI, 1.44-4.12), and 4-year (HR, 2.05; 95% CI, 1.26-3.34) time points from the index date. Increased risk for NAION was also noted in patients with diabetes and concomitant hypertension who were taking semaglutide (HR, 2.42; 95% CI, 1.19-4.92). An increased NAION risk was also observed among patients with diabetes who had a history of Ozempic (Novo Nordisk) use or stand-alone Ozempic (Novo Nordisk) prescription history.</p><p><strong>Conclusions and relevance: </strong>Results of this cohort study suggest that semaglutide use was associated with an increased risk of NAION in patients with diabetes. However, the study's retrospective design presents limitations, as it can only infer associations rather than establish causality; further studies are needed.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"400-407"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719320","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":"Conjunctival Melanoma With Invasion of a LASIK Flap Interface.","authors":"Tyler Bahr, Jenna Krivit, Diva R Salomao, Keith H Baratz, Lauren A Dalvin","doi":"10.1001/jamaophthalmol.2025.0400","DOIUrl":"10.1001/jamaophthalmol.2025.0400","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"448-450"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719316","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 Peer Reviewers in 2024.","authors":"","doi":"10.1001/jamaophthalmol.2025.0394","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0394","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"143 5","pages":"e250394"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077654","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":"Plain Language Summaries to Bolster Team-Based Care.","authors":"Patrice M Hicks, Rithambara Ramachandran, Paula Anne Newman-Casey","doi":"10.1001/jamaophthalmol.2025.0352","DOIUrl":"10.1001/jamaophthalmol.2025.0352","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"419-420"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772415","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}