JAMA ophthalmology最新文献

{"title":"JAMA Ophthalmology.","authors":"","doi":"10.1001/jamaophthalmol.2024.4170","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.4170","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"143 5","pages":"368"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077655","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":"Error in Figures.","authors":"","doi":"10.1001/jamaophthalmol.2025.0555","DOIUrl":"10.1001/jamaophthalmol.2025.0555","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"450"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663528","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":"Gender Differences in Case Volume Among Ophthalmology Resident Graduates, 2014-2023.","authors":"Susan M Culican,Misha F Syed,Yoon Soo Park,Sean O Hogan","doi":"10.1001/jamaophthalmol.2025.0935","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0935","url":null,"abstract":"ImportanceA previous multisite study found gender differences in cataract and total surgical volume among US residency programs. Whether that was representative of all ophthalmology residents in the US is unclear.ObjectiveTo determine whether reported surgical volume among US ophthalmology resident graduates varied by self-reported gender or by underrepresented in medicine (URiM) status.Design, Setting, and ParticipantsRetrospective observational longitudinal cohort study of deidentified Accreditation Council for Graduate Medical Education (ACGME) surgical log data for all graduates of US ophthalmology residency programs from the years 2014-2023 compared by self-reported gender or URiM status. Surgical experience was obtained from the ACGME Accreditation Data System resident case log. Data were analyzed from November 2023 to April 2024.Main Outcomes and MeasuresThe main outcome was a difference in mean reported surgical volume between comparison groups by gender or URiM status for cataract or total surgical procedures. The secondary outcomes were differences for other surgical categories by gender or URiM status.ResultsOf 4811 resident graduates, 41.6% (1999) were female and 58.4% were male (2812); 7.1% (343) self-identified as URiM. Cataract cases had a mean difference of -4.4% (-8.3 of 189.2) (95% CI, -6.4% to -2.4%; P < .001) fewer surgeries for female residents than male residents over the 10-year study, and total procedures had a mean difference of -7.4% (-43.4 of 587.3) (95% CI, -9.7% to -5.1%; P < .001) fewer surgeries for female than male residents over the 10-year study. URiM status over the same time period was not associated with a difference in cataract surgeries but was associated with a mean difference of -5.3% (-31.5 of 587.3) (95% CI, -9.8% to -0.9%; P = .02) fewer total procedures.Conclusions and RelevanceIn this study, female residents reported fewer cataract procedures than male residents from 2014-2023. Female and URiM residents reported fewer total procedures than their nonfemale or non-URiM colleagues. Future studies to assess the causes of these disparities are warranted.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"21 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143897474","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":"Cardiovascular Morbidity and Mortality After Amaurosis Fugax.","authors":"Karen M Wai, Deanne K Loube, Nathan H Pham, Chase A Ludwig, Euna Koo, Prithvi Mruthyunjaya, Ehsan Rahimy","doi":"10.1001/jamaophthalmol.2025.0249","DOIUrl":"10.1001/jamaophthalmol.2025.0249","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"446-448"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663522","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":"Errors in Figure 2.","authors":"","doi":"10.1001/jamaophthalmol.2025.1372","DOIUrl":"10.1001/jamaophthalmol.2025.1372","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"143 5","pages":"450"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077721","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":"Prevalence and Severity of Astigmatism in Children After COVID-19.","authors":"Ka Wai Kam, Erica Shing, Yuzhou Zhang, Xiu Juan Zhang, Arnold S H Chee, Mandy P H Ng, Patrick Ip, Wei Zhang, Alvin L Young, Amanda French, Ian Morgan, Kathyrn Rose, Clement C Tham, Chi Pui Pang, Li Jia Chen, Jason C Yam","doi":"10.1001/jamaophthalmol.2025.0205","DOIUrl":"10.1001/jamaophthalmol.2025.0205","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Astigmatism can cause blurred vision at near and distance. It is common among schoolchildren and associated with ametropia. Although the COVID-19 pandemic generated a surge in myopia prevalence in children, the association with child astigmatism remains unknown.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To report the prevalence of refractive astigmatism and corneal astigmatism in schoolchildren from 2015 to 2023 and explore the associations between the pandemic and astigmatism.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This population-based cross-sectional study stratified all the primary schools registered with Education Bureau in Hong Kong into 7 clustered regions used by Hospital Authority Services in Hong Kong. Participants were schoolchildren aged 6 to 8 years who underwent comprehensive ocular examinations at 2 academic medical centers in Hong Kong from 2015 to 2023. Astigmatism was measured with optical biometry and auto-refractor after cycloplegia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposure: &lt;/strong&gt;COVID-19 pandemic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The annual prevalence rates of refractive astigmatism and corneal astigmatism were the primary outcome measures. Logistic regression was used to evaluate the association of the pandemic with the risks of refractive astigmatism and corneal astigmatism. Linear regression was used to explore the association of the pandemic with the magnitudes of refractive astigmatism and corneal astigmatism.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The cohort consisted of 21 655 children: 11 464 boys (52.9%) and 10 191 girls (47.1%); their mean (SD) age was 7.31 (0.90) years. The prevalence rate of refractive astigmatism of at least 1.0 diopter (D) was 21.4% and corneal astigmatism of at least 1.0 D 59.8% in 2015 and increased to 34.7% (difference, 13.3%; 95% CI, 9.3%-17.3%) and 64.7% (difference, 4.9%; 95% CI, 0.5%-9.2%), respectively, in 2022-2023. The pandemic was associated with a 20% increase in the risk of refractive astigmatism (odd ratio [OR], 1.20; 95% CI, 1.09-1.33; P &lt; .001), 26% increase in the risk of corneal astigmatism (OR, 1.26; 95% CI, 1.15-1.38; P &lt; .001), 0.04 D in the magnitude of refractive astigmatism (95% CI, 0.02-0.07; P &lt; .001), and 0.05 D in the magnitude of corneal astigmatism (95% CI, 0.02-0.08; P &lt; .001), compared with the prepandemic period of 2015-2019 and after adjusting for sociodemographic factors, parental astigmatism, and child myopia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;This study found an increase in both the prevalence and severity of refractive astigmatism and corneal astigmatism after the COVID-19 pandemic. Corneal changes especially along the steepest meridian may explain some of the progression of corneal astigmatism. The potential impact of higher degrees of astigmatism may warrant dedicated efforts to elucidate the relationship between environmental and/or lifestyle factors, as well as the pathophysiology of astigmatism.&lt;/p","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"383-391"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663583","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":"Noninfectious Intraocular Inflammation After Intravitreal Aflibercept.","authors":"Karoline E Binder,Nathalie Bleidißel,Peter Charbel Issa,Mathias Maier,Leonard M Coulibaly","doi":"10.1001/jamaophthalmol.2025.0969","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0969","url":null,"abstract":"ImportanceAflibercept, 8 mg, is an anti-vascular endothelial growth factor (VEGF) formulation for neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). While clinical trials report a comparable safety profile as aflibercept, 2 mg, clinical practice setting (so-called real-world) data on the incidence of intraocular inflammation (IOI) should be of value.ObjectiveTo determine the clinical practice setting incidence of IOI after intravitreal injection of aflibercept, 8 mg, for nAMD and DME.Design, Setting, and ParticipantsThis retrospective case series involved a review of medical records at a single tertiary care center. Participants were all patients who received an intravitreal injection of aflibercept, 8 mg, for nAMD or DME from March 2024 to October 2024. Patients had received injections with other VEGF inhibitors before. Standard care included slitlamp examination before each injection and follow-up examination within 4 days after every injection.ExposureIOI adverse events (AEs) after injections.Main Outcomes and MeasuresIncidence of IOI after intravitreal injection of aflibercept, 8 mg. Secondary outcomes included the time point of IOI and best-corrected visual acuity (BCVA) during and after recovery of IOI.ResultsForty-one patients were treated with intravitreal aflibercept, 8 mg, injections: 23 with nAMD (56%) and 18 with DME (44%). Twenty-seven patients (66%) were male and 14 patients female (34%). A total of 136 intravitreal injections of aflibercept, 8 mg, were administered during the observation period. Five patients of 41 developed mild sterile IOI within 1 to 3 days after the intervention (incidence per injection, 3.7%; 95% CI, 1.6%-8.3%; incidence per patient, 12%; 95% CI, 5.3%-25.5%). Four patients had prior exposure to aflibercept, 8 mg, before the inflammation occurred; only 1 patient developed inflammation after the first dose. All patients were treated with local anti-inflammatory therapy (topical or subconjunctival corticosteroids), and 2 patients received additional systemic oral corticosteroids. No reduction of BCVA was observed after IOI-associated AEs receded.Conclusions and RelevanceThis analysis in a clinical practice setting revealed a more frequent occurrence of IOI-associated AEs compared with previous clinical trials. All observed cases showed a mild IOI, which resolved under anti-inflammatory therapy without loss of BCVA.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"13 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143897473","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":"Training Inequities in Ophthalmology-Insights From Educators.","authors":"Fasika Woreta,Laura K Green,Grace Sun","doi":"10.1001/jamaophthalmol.2025.1112","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.1112","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143897475","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":"Evaluation of AI Summaries on Interdisciplinary Understanding of Ophthalmology Notes.","authors":"Prashant D Tailor, Haley S D'Souza, Clara M Castillejo Becerra, Heidi M Dahl, Neil R Patel, Tyler M Kaplan, Darrell Kohli, Erick D Bothun, Brian G Mohney, Andrea A Tooley, Keith H Baratz, Raymond Iezzi, Andrew J Barkmeier, Sophie J Bakri, Gavin W Roddy, David Hodge, Arthur J Sit, Matthew R Starr, John J Chen","doi":"10.1001/jamaophthalmol.2025.0351","DOIUrl":"10.1001/jamaophthalmol.2025.0351","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Specialized ophthalmology terminology limits comprehension for nonophthalmology clinicians and professionals, hindering interdisciplinary communication and patient care. The clinical implementation of large language models (LLMs) into practice has to date been relatively unexplored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate LLM-generated plain language summaries (PLSs) integrated into standard ophthalmology notes (SONs) in improving diagnostic understanding, satisfaction, and clarity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;Randomized quality improvement study conducted from February 1, 2024, to May 31, 2024, including data from inpatient and outpatient encounters in a single tertiary academic center. Participants were nonophthalmology clinicians and professionals and ophthalmologists. The single inclusion criterion was any encounter note generated by an ophthalmologist during the study dates. Exclusion criteria were (1) lack of established nonophthalmology clinicians and professionals for outpatient encounters and (2) procedure-only patient encounters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;Addition of LLM-generated plain language summaries to ophthalmology notes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The primary outcome was survey responses from nonophthalmology clinicians and professionals assessing understanding, satisfaction, and clarity of ophthalmology notes. Secondary outcomes were survey responses from ophthalmologists evaluating PLS in terms of clinical workflow and accuracy, objective measures of semantic quality, and safety analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 362 (85%) nonophthalmology clinicians and professionals (33.0% response rate) preferred the PLS to SON. Demographic data on age, race and ethnicity, and sex were not collected. Nonophthalmology clinicians and professionals reported enhanced diagnostic understanding (percentage point increase, 9.0; 95% CI, 0.3-18.2; P = .01), increased note detail satisfaction (percentage point increase, 21.5; 95% CI, 11.4-31.5; P &lt; .001), and improved explanation clarity (percentage point increase, 23.0; 95% CI, 12.0-33.1; P &lt; .001) for notes containing a PLS. The addition of a PLS was associated with reduced comprehension gaps between clinicians who were comfortable and uncomfortable with ophthalmology terminology (from 26.1% [95% CI, 13.7%-38.6%; P &lt; .001] to 14.4% [95% CI, 4.3%-24.6%; P &gt; .06]). PLS semantic analysis found high meaning preservation (bidirectional encoder representations from transformers score mean F1 score: 0.85) with greater readability than SONs (Flesch Reading Ease: 51.8 vs 43.6; Flesch-Kincaid Grade Level: 10.7 vs 11.9). Ophthalmologists (n = 489; 84% response rate) reported high PLS accuracy (90% [320 of 355] a great deal) with minimal review time burden (94.9% [464 of 489] ≤1 minute). PLS error rate on ophthalmologist review was 26% (126 of 489). A total of 83.9% (104 of 126) of errors wer","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"410-419"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772403","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":"Risk of Developing Pediatric Uveitis Among Patients With Early-Onset Atopic Dermatitis.","authors":"Yung-Yu Chu, Cheng-Hao Sung, Yu-Shiuan Lin, Chung-Han Ho, Yi-Chen Chen, Wan-Ju Annabelle Lee, Shu-Chun Kuo","doi":"10.1001/jamaophthalmol.2025.0366","DOIUrl":"10.1001/jamaophthalmol.2025.0366","url":null,"abstract":"<p><strong>Importance: </strong>The relationship between atopic dermatitis (AD) and pediatric uveitis may be underexplored, warranting large-scale, multicenter studies.</p><p><strong>Objective: </strong>To evaluate the risk of pediatric uveitis among children with early-onset AD compared with a matched control population.</p><p><strong>Design, setting, and participants: </strong>This cohort study used aggregated electronic health records of US patients with early-onset AD and matched controls from January 1, 2004, through December 14, 2024, sourced from health care organizations in the collaborative research network TriNetX. Patients with early-onset AD and matched controls without AD were included in the analysis; those with uveitis prior to AD diagnosis were excluded. Propensity score matching was applied to balance baseline characteristics. The analyses were conducted on December 14, 2024.</p><p><strong>Exposure: </strong>International Classification of Diseases, 10th Revision (ICD-10) diagnosis code for AD.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the hazard ratio (HR) for developing pediatric uveitis in the AD cohort compared with the matched controls. Cox proportional hazards models were applied to assess the risk.</p><p><strong>Results: </strong>A total of 114 889 patients were identified in the AD cohort (mean [SD] follow-up, 6.0 [3.3] years; mean [SD] age, 0.5 [0.7] years; 64 817 male [56.4%]) and the control cohort (mean [SD] follow-up, 6.6 [3.7] years; mean [SD] age, 0.6 [0.8] years; 65 377 male [56.9%]) after matching. The AD cohort demonstrated a higher risk of developing pediatric uveitis compared with controls (94 [0.08%] vs 58 [0.05%]; HR, 1.92 [95% CI, 1.38-2.66]). Sensitivity analyses among patients without dupilumab use (89 of 113 284 [0.08%] vs 59 of 113 284 [0.05%]; HR, 1.77 [95% CI, 1.27-2.46]) and those without autoimmune conditions (80 of 114 425 [0.07%] vs 61 of 114 425 [0.05%]; HR, 1.52 [95% CI, 1.09-2.12]) similarly indicated an increased risk in the AD cohort. Additionally, patients with severe AD had a higher risk of developing pediatric uveitis compared with those with nonsevere AD (12 of 3004 [0.40%] vs 97 of 126 482 [0.08%]; HR, 3.64 [95% CI, 2.00-6.66]).</p><p><strong>Conclusions and relevance: </strong>This cohort study of children with early-onset AD found an elevated risk of pediatric uveitis compared with matched controls, independent of autoimmune conditions or dupilumab use. These findings support the potential need to consider ophthalmologic monitoring in children with early-onset AD to try to detect and subsequently manage uveitis if it develops.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"421-428"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772417","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}