JAMA ophthalmology最新文献

{"title":"Importance of Population-Based Studies in Childhood Eye Disease-Seeing the Bigger Picture.","authors":"Jonathan R Morse, Jeremy D Keenan, Julius T Oatts","doi":"10.1001/jamaophthalmol.2025.0251","DOIUrl":"10.1001/jamaophthalmol.2025.0251","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"391-392"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663472","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":"High Myopia and Capsular Tension Rings-To Be or Not To Be?","authors":"Eubee B Koo","doi":"10.1001/jamaophthalmol.2025.0442","DOIUrl":"10.1001/jamaophthalmol.2025.0442","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"381-382"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663531","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":"Aflibercept With vs Without Reduced-Fluence Photodynamic Therapy for Polypoidal Choroidal Vasculopathy: A Randomized Clinical Trial.","authors":"Yu Jeat Chong, Kelvin Yi Chong Teo, Wendy Wong, Anna C S Tan, Xinyi Su, Noa Gilead, Hiok Hong Chan, Farah Ibrahim, Beau Fenner, Charles Ong, Christopher Sun, Shaun Sim, Caroline Chee, Usha Chakravarthy, Chui Ming Gemmy Cheung","doi":"10.1001/jamaophthalmol.2025.0250","DOIUrl":"10.1001/jamaophthalmol.2025.0250","url":null,"abstract":"<p><strong>Importance: </strong>The potential benefit of adding photodynamic therapy (PDT) to intravitreal aflibercept injection (IAI) in eyes with polypoidal choroidal vasculopathy (PCV) remains unclear.</p><p><strong>Objective: </strong>To compare the functional and anatomical benefit of combination therapy using reduced-fluence PDT (RF-PDT) plus IAI vs IAI monotherapy in participants with PCV.</p><p><strong>Design, setting, and participants: </strong>This double-masked, sham-controlled, randomized clinical trial was conducted at 2 centers in Singapore from January 2021 to June 2024 for participants aged 50 years or older with symptomatic macular PCV confirmed on indocyanine green angiography. Data were analyzed from January 2021 to June 2024.</p><p><strong>Interventions: </strong>Randomization 1:1 to RF-PDT plus 2 mg of IAI or sham-PDT plus 2 mg of IAI at week 0. Follow-up was at 4 weeks and retreatment with IAI, per protocol pro re nata regimen.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the mean change in best-corrected visual acuity (BCVA) from baseline to week 52. Secondary outcomes, not adjusted for multiple analyses, included proportion of eyes with polypoidal lesion (PL) closure at week 12 per indocyanine green angiography .</p><p><strong>Results: </strong>Only 60 (43 male [71.6%] and 17 female [28.4%]; mean [SD] age, 71.3 [5.7] years) of the planned 160 participants were enrolled between January 2021 and June 2023. Among these, 30 of 30 (100%) and 30 of 30 participants (100%) in combination and monotherapy groups, respectively, returned for the 52-week follow-up. Baseline BCVA letter score (approximate Snellen equivalent [SD]) was 62.0 (20/63 [10.6]) and 62.0 (20/63 [10.7]) in the combination and monotherapy arms, respectively. At week 52, mean gain in BCVA was 12.7 (combination) vs 11.9 (monotherapy) (difference = 0.8 letters; 95% CI, -3.0 to 6.0 letters; P = .82). At week 12, the PL closure rate occurred in 20 of 30 eyes (66.7%) vs 10 of 30 eyes (33.3%) in the combination and monotherapy arms, respectively (difference = 33.4%; 95% CI, 9.5%-57.2%; P = .02).</p><p><strong>Conclusions and relevance: </strong>With less than half of the planned sample size enrolled, no superiority in BCVA outcomes for either arm was detected and the combination arm could not be shown to be not worse (not noninferior) to the monotherapy arm. While PL closure at week 12 was greater in the combination arm, secondary outcome results, which were not adjusted for multiple analyses, should be considered hypothesis generating and not associated with a clinically relevant functional outcome in this trial.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03941587.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"393-399"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719308","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":"Cocoa Flavanol Supplementation and Risk of Age-Related Macular Degeneration: An Ancillary Study of the COSMOS Randomized Clinical Trial.","authors":"William G Christen, Pamela M Rist, M Vinayaga Moorthy, Douglas C Smith, Beth Holman, Allison Clar, Robert J Glynn, Julie A Mares, Lucia Sobrin, Aladdin H Shadyab, Matthew A Allison, Amy E Millen, JoAnn E Manson, Howard D Sesso","doi":"10.1001/jamaophthalmol.2025.0353","DOIUrl":"10.1001/jamaophthalmol.2025.0353","url":null,"abstract":"<p><strong>Importance: </strong>Abnormalities of choroidal blood flow in the eye are associated with occurrence of age-related macular degeneration (AMD). Cocoa flavanols show beneficial effects on vascular risk factors in small and short-term trials and may help reduce AMD risk.</p><p><strong>Objective: </strong>To examine whether daily supplementation with cocoa extract, a source of flavanols, prevents the development or progression of AMD.</p><p><strong>Design, setting, and participants: </strong>This was a prespecified ancillary study of the COSMOS (COcoa Supplement and Multivitamins Outcomes Study) trial, a double-blind, placebo-controlled, 2 × 2 factorial randomized clinical trial of a cocoa extract supplement and a multivitamin supplement in the prevention of cardiovascular disease and cancer among 21 442 US adults, including 12 666 women aged 65 years and older and 8776 men aged 60 years and older. The intervention phase was performed from June 2015 through December 2020; data analysis was completed in August 2024.</p><p><strong>Intervention: </strong>Cocoa extract supplement (500 mg/day cocoa flavanols, including 80 mg (-)-epicatechin) or placebo.</p><p><strong>Main outcomes and measures: </strong>The primary end point was a composite of incident cases of AMD plus cases of progression to advanced AMD (geographic atrophy, neovascular membrane, retinal pigment epithelium detachment, or disciform scar) among participants with AMD at baseline, based on self-report confirmed by medical record review.</p><p><strong>Results: </strong>Mean (SD) participant age was 72.1 (6.6) years, and 12 666 participants (59.1%) were female. During a median (IQR) period of 3.6 (3.2-4.2) years of treatment and follow-up, 344 participants (1.6%) experienced a confirmed AMD event (316 incident AMD, 28 progression to advanced AMD). For the primary composite end point, there were 159 cases (1.5%) in the cocoa extract group and 185 cases (1.7%) in the placebo group (hazard ratio [HR], 0.87; 95% CI, 0.71-1.08; P = .21). Separate Cox models fitted because of evidence of nonproportional hazards (P = .048) indicated a 23% decreased risk in the cocoa extract group during the first 2 years of treatment (HR, 0.77; 95% CI, 0.59-1.01), with no added benefit for treatment beyond 2 years (HR, 1.06; 95% CI, 0.76-1.50). Similar time-dependent findings were observed for the secondary trial outcomes of incident visually significant AMD and advanced AMD.</p><p><strong>Conclusions and relevance: </strong>In this ancillary study of the COSMOS randomized clinical trial, cocoa extract supplementation for a median period of 3.6 years among older women and men had no effect overall on occurrence of AMD. However, a possible modest treatment effect early in the trial could not be ruled out, which warrants further investigation to clarify whether cocoa extract may help reduce AMD risk.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03205202.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"429-437"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719310","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":"JAMA Ophthalmology-The Year in Review 2024: The Power of the JAMA Network.","authors":"Neil M Bressler","doi":"10.1001/jamaophthalmol.2025.0547","DOIUrl":"10.1001/jamaophthalmol.2025.0547","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"371-372"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663582","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":"Conflicting Results-Need for More Transparent and Reproducible Research.","authors":"Cindy X Cai, Michelle Hribar, Akihiko Nishimura","doi":"10.1001/jamaophthalmol.2025.0350","DOIUrl":"10.1001/jamaophthalmol.2025.0350","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"408-409"},"PeriodicalIF":7.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719313","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":"Repeated Low-Level Red Light-More Than Meets the Eye?","authors":"Jacque L Duncan","doi":"10.1001/jamaophthalmol.2025.0957","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0957","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"138 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872040","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":"Scientific Data Fabrication and AI-Pandora's Box.","authors":"Hong-Uyen Hua","doi":"10.1001/jamaophthalmol.2025.0936","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0936","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"69 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872042","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":"Human Papillomavirus and Thyroid Eye Disease","authors":"Ishita Garg, Benjamin I. Meyer, Ryan A. Gallo, Sara T. Wester, Daniel Pelaez","doi":"10.1001/jamaophthalmol.2025.0847","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0847","url":null,"abstract":"ImportanceThyroid eye disease (TED) is an autoimmune disease characterized by orbital inflammation and tissue remodeling. TED pathogenesis is poorly understood but is linked to autoantibodies to thyroid-stimulating hormone receptor (TSHR) and insulinlike growth factor-1 receptor (IGF-1R).ObjectiveTo explore the potential involvement of viral infections in TED pathogenesis.Design, Setting, and ParticipantsIn this experimental study conducted at the Bascom Palmer Eye Institute in Miami, Florida, the National Center for Biotechnology Information Basic Local Alignment Search Tool was used to search for amino acid sequence homologies between TSHR and IGF-1R proteins to various viral proteomes, including &lt;jats:italic&gt;Papillomaviridae&lt;/jats:italic&gt;, &lt;jats:italic&gt;Paramyxoviridae&lt;/jats:italic&gt;, &lt;jats:italic&gt;Herpesviridae&lt;/jats:italic&gt;, &lt;jats:italic&gt;Enterovirus&lt;/jats:italic&gt;, &lt;jats:italic&gt;Polyomaviridae&lt;/jats:italic&gt;, and &lt;jats:italic&gt;Rhabdoviridae&lt;/jats:italic&gt;. Participants were enrolled from December 2021 to August 2023, with the samples tested and analyzed in September 2023. Enzyme-linked immunoassays (ELISAs) were performed on orbital adipose tissue samples from 11 participants with TED undergoing orbital decompression surgery and 11 control participants undergoing blepharoplasty to quantify antiviral antibody titers. Demographic characteristics and clinical data were reviewed.Main Outcomes and MeasuresThe main outcomes were homology analysis between TSHR and IGF-1R with several viral proteins, human papillomavirus 18 (HPV18) L1 immunoglobulin G (IgG) titers in TED orbital fat samples, and clinical characteristics associated with HPV18 L1 IgG titers.ResultsAmong 22 total patients, mean (range) age was 58.6 years (37.4-74.4), and 19 patients (86.4%) were female. Homology analysis revealed conserved motifs between TSHR and IGF-1R with the HPV18 L1 capsid protein. Homologous regions of FG&lt;jats:italic&gt;X&lt;/jats:italic&gt;V and I&lt;jats:italic&gt;X&lt;/jats:italic&gt;E&lt;jats:italic&gt;X&lt;/jats:italic&gt;T+NP were identified across all HPV serotypes and both IGF-1R and TSHR. ELISAs showed differences in the mean HPV18 L1 IgG normalized optical density levels among tissues of controls vs participants with chronic TED (mean [&lt;jats:italic&gt;M&lt;/jats:italic&gt;], 0.94; mean differential, −1.37; 95% CI, −2.64 to −0.09; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .03), controls vs participants with acute active TED (&lt;jats:italic&gt;M&lt;/jats:italic&gt;, 0.94; mean differential, −3.15; 95% CI, −4.69 to −1.61; &lt;jats:italic&gt;P&lt;/jats:italic&gt; &amp;amp;lt; .001), and participants with chronic TED vs acute active TED (&lt;jats:italic&gt;M&lt;/jats:italic&gt;, 2.31; mean differential, −1.78; 95% CI, −3.44 to −0.13; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .03).Conclusions and RelevanceThis case-control study presents potential molecular evidence linking HPV and TED, highlighting molecular mimicry between HPV capsid protein and key autoimmunity targets in TED. This suggests an immunological link contributing to TED’s pathogenesis, opening new p","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"24 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866775","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":"Cone Density Changes After Repeated Low-Level Red Light Treatment in Children With Myopia","authors":"Xinyi Liao, Jifeng Yu, Yuzhuo Fan, Yixuan Zhang, Yan Li, Xuewei Li, Hongxin Song, Kai Wang","doi":"10.1001/jamaophthalmol.2025.0835","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0835","url":null,"abstract":"ImportanceRepeated low-level red light (RLRL) therapy has emerged as a potential intervention for controlling myopia progression in children. However, its long-term effects on retinal photoreceptors remain relatively unknown.ObjectiveTo evaluate changes associated with RLRL therapy on cone photoreceptor density in children with myopia using high-resolution adaptive optics scanning laser ophthalmoscopy (AOSLO).Design, Setting, and ParticipantsThis retrospective multicenter cohort study analyzed data collected from January to March 2024, focusing on Chinese children with myopia. All participants were recruited through questionnaires. Cone density measurements were obtained from AOSLO retinal images. Children with myopia aged 5 to 14 years recruited from the pediatric ophthalmology clinic during routine eye examinations were included in the study and assigned to the RLRL group or the control group. Inclusion criteria were spherical equivalent refraction below −6.00 diopters (D) and best-corrected visual acuity ≥20/20.ExposuresCone density measurement with AOSLO retinal images.Main Outcomes and MeasuresCone photoreceptor density was measured along 4 retinal meridians from central fovea to 4° eccentricity on AOSLO. Fundus abnormalities were assessed using AOSLO, optical coherence tomography (OCT), and fundus photography. Image evaluators were masked to group allocation.ResultsA total of 99 children with myopia were included in this analysis: 52 (97 eyes; mean [SD] age, 10.3 [1.9] years; 27 female [51.9%]) in the RLRL group and 47 (74 eyes; mean [SD] age, 9.8 [2.1] years; 25 male [53.2%]) in the control group. RLRL users showed decreased cone density within 0.5-mm eccentricity from the foveal center, most notably in the temporal region. At 0.3-mm temporal eccentricity, the RLRL group showed a mean difference of −2.1 × 10<jats:sup>3</jats:sup> cells/mm<jats:sup>2</jats:sup> compared with controls (95% CI, −3.68 to −0.59 × 10<jats:sup>3</jats:sup> cells/mm<jats:sup>2</jats:sup>; <jats:italic>P</jats:italic> = .003). A total of 11 eyes exhibited abnormal low-frequency, high-brightness signals near the fovea. The odds ratio of abnormal signals in RLRL users compared with nonusers was 7.23 (95% CI, 1.15-303.45; Fisher exact test, <jats:italic>P</jats:italic> = .02). One participant had relatively small cystoid abnormalities on OCT in the ganglion cell layer, which resolved 3 months after discontinuing RLRL therapy.Conclusions and RelevanceResults of this cohort study suggest that RLRL therapy for at least 1 year was associated with reduced cone density in the paracentral fovea and other subtle retinal abnormalities in some children receiving this therapy for myopia control. These findings support the need for further research to evaluate longer-term safety of RLRL therapy in similar individuals.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"23 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866771","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}