Journal of VitreoRetinal Diseases最新文献

{"title":"Initial Impact of Loss of Copay Assistance From a National Nonprofit Fund on Outcomes of Retinal Disease.","authors":"Victor Bellanda, Suraj Bala, Gabriel Castilho S Barbosa, Nitesh Mohan, Matthew J Schulgit, Amy S Babiuch, Alex Yuan, Ananth Sastry, Katherine E Talcott, Diana McOwen, Frances Igrec, Sunil K Srivastava, Sumit Sharma, Andrew P Schachat, Danny A Mammo","doi":"10.1177/24741264261477369","DOIUrl":"10.1177/24741264261477369","url":null,"abstract":"<p><strong>Purpose: </strong>Many patients with neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), or retinal vein occlusion who have lost copay assistance from the DBA Good Days national charity fund have been forced to switch treatment from branded intravitreal antivascular endothelial growth factor (anti-VEGF) therapy to bevacizumab. This study sought to characterize the short-term impact of these changes on clinical outcomes.</p><p><strong>Methods: </strong>This retrospective study included 89 eyes of 69 patients with nAMD, DME, or retinal vein occlusion who transitioned from receiving branded anti-VEGF therapy (aflibercept 2.0 mg or 8.0 mg; faricimab) to bevacizumab. The primary endpoint was changes from baseline in central subfield thickness (CST) after 1, 2, and 3 injections. Secondary endpoints included changes in best-corrected visual acuity (BCVA), intraocular pressure, intraretinal fluid, subretinal fluid, pigment epithelial detachment, injection intervals, predictors of poor outcome (BCVA loss of ≥15 Early Treatment Diabetic Retinopathy Study letters or CST increase of ≥50 µm), and switchback to branded therapy.</p><p><strong>Results: </strong>From baseline to after the third bevacizumab injection, the CST increased from a mean (±SD) 228.7 ± 52.3 µm to 271.3 ± 40.0 µm in the overall cohort (<i>P</i> = .004), and from 224.1 ± 50.6 µm to 268.6 ± 38.5 µm among nAMD eyes (<i>P</i> = .007). The injection interval decreased from a median 8.6 weeks (interquartile range [IQR], 7.0-10.9 weeks) preswitch to 7.5 weeks (IQR, 5.3-9.5 weeks) after 3 injections (<i>P</i> < .001). Fourteen eyes (15.7%) met the criteria for poor outcome, and 15 (16.9%) were switched back to branded therapy. Worsening intraretinal fluid was an early indicator of suboptimal response, and shorter preswitch injection intervals were a predictor of switching back to branded therapy.</p><p><strong>Conclusions: </strong>Switching from branded anti-VEGF therapy to bevacizumab was associated with anatomic worsening and shorter injection intervals. Shorter preswitch intervals and early postswitch intraretinal fluid changes may help identify patients at risk for poor outcomes.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264261477369"},"PeriodicalIF":1.3,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of Ultrasound Biomicroscopy in Pachyphakia, Microcornea, and Angle Closure.","authors":"Prashanth G Iyer, Teresa Horan, Astrid C Werner, Audina M Berrocal, Caroline R Baumal","doi":"10.1177/24741264261474158","DOIUrl":"10.1177/24741264261474158","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the case of a young adult patient with a history of laser treatment for threshold retinopathy of prematurity, presenting with pachyphakia, microcornea, and acute angle-closure glaucoma.</p><p><strong>Methods: </strong>A single case was observed.</p><p><strong>Results: </strong>The patient presented with reduced vision secondary to acute angle closure, with an intraocular pressure (IOP) of 60 mm Hg in the left eye. A surgical iridectomy resulted in immediate deepening of the anterior chamber and IOP normalization, though the anterior chamber remained shallow. Postoperatively, visual acuity returned to baseline, and IOP remained in the normal range. Ultrasound biomicroscopy after iridectomy demonstrated a persistently shallow anterior chamber secondary to pachyphakia. Phacoemulsification was performed 1 year later. Postoperative ultrasound biomicroscopy revealed normalization of anterior chamber anatomy.</p><p><strong>Conclusions: </strong>Patients with pachyphakia, microcornea, and acute angle-closure glaucoma are at risk for both acute and chronic angle-closure glaucoma and must be monitored closely. Ultrasound biomicroscopy can be used to supplement clinical examination of angle closure.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264261474158"},"PeriodicalIF":1.3,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapidly Progressive Hydroxychloroquine Retinal Toxicity Presenting With Cystoid Macular Edema and Retinal Vasculopathy: A Novel Phenotype With 6-Year Follow-Up.","authors":"Irmak Karaca, Rebecca Kellner, Patrick Hughes, Barry Chaiken, Robert Spiera, Talia R Kaden, Kenneth Wald, Yasha S Modi","doi":"10.1177/24741264261479196","DOIUrl":"10.1177/24741264261479196","url":null,"abstract":"<p><strong>Purpose: </strong>To report a unique case of hydroxychloroquine-associated retinal toxicity presenting with cystoid macular edema (CME) and retinal vasculopathy and to discuss its potential pathophysiology.</p><p><strong>Methods: </strong>A single case was reviewed.</p><p><strong>Case report: </strong>A 65-year-old woman with a history of hydroxychloroquine use for approximately 5.5 years presented with bilateral CME and parafoveal ellipsoid zone disruption with outer retinal loss on optical coherence tomography. Multimodal imaging demonstrated central bull's-eye maculopathy and peripheral pigmentary changes on fundus autofluorescence and peripheral vascular leakage on fluorescein angiography. The uveitis workup, anti-retinal antibody testing, and genetic testing were negative. As retinal findings were normal at the first hydroxychloroquine screening, the patient was diagnosed with advanced hydroxychloroquine toxicity.</p><p><strong>Conclusions: </strong>This case expands the phenotypic spectrum of hydroxychloroquine retinal toxicity to include CME associated with retinal vasculopathy. Annual retinal examination should begin promptly in patients receiving hydroxychloroquine at doses exceeding 5 mg/kg/day.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264261479196"},"PeriodicalIF":1.3,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ability of Large Language Models to Answer Patients' Questions and Generate Educational Materials for Uncommon Retinal Conditions.","authors":"Samuel A Cohen, Prashant D Tailor, Adrian Au, Jennifer Vu, Alejandro I Marin, Pradeep S Prasad, Julie Kwon, Hamid Hosseini, Jayanth Sridhar","doi":"10.1177/24741264261469005","DOIUrl":"https://doi.org/10.1177/24741264261469005","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the ability of large language models to accurately and comprehensively respond to frequently asked questions and generate patient education materials related to uncommon retinal conditions.</p><p><strong>Methods: </strong>A total of 50 frequently asked questions related to 10 uncommon retinal conditions were input into 3 large language models: ChatGPT-4o1, Google Gemini 2.0 Flash, and Microsoft Copilot (updated January 7, 2025). The accuracy and completeness of responses to frequently asked questions were evaluated by retina specialists using a Likert scale ranging from 1 (very inaccurate/not at all complete) to 5 (very accurate/completely complete), while readability was assessed using validated indices. The large language models were also instructed to generate patient education materials at specific reading levels, which were again evaluated for accuracy, completeness, and readability.</p><p><strong>Results: </strong>Responses to patient frequently asked questions were written at mean grade levels of 15.3 ± 1.4 (ChatGPT), 15.7 ± 1.9 (Gemini), and 14.6 ± 1.3 (Copilot), respectively (<i>P =</i> .02). Mean accuracy scores were 4.02 ± 0.7, 4.16 ± 0.7, and 3.81 ± 0.8. Accuracy scores for large language models-generated patient education materials were 4.70 ± 0.7 (ChatGPT), 4.85 ± 0.4 (Gemini), and 4.30 ± 0.8 (Copilot). When instructed to revise educational materials to improve understandability, all large language models significantly reduced reading levels by 4.8 (ChatGPT), 6.9 (Gemini), and 3.8 (Copilot) grade levels (<i>P</i> < .001) without compromising accuracy.</p><p><strong>Conclusions: </strong>Large language models can accurately respond to patients' frequently asked questions related to uncommon retinal conditions. Furthermore, large language models can effectively improve the readability of existing education materials for patients with varying levels of health literacy. A deeper understanding of large language model applications may facilitate their integration into clinical practice.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264261469005"},"PeriodicalIF":1.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13486393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional and Anatomic Outcomes at 12 Months After Switching to Faricimab in Treatment-Recalcitrant Neovascular Age-Related Macular Degeneration.","authors":"S Saeed Mohammadi, Hayden Sikora, Jay Bisen, Helena Kim, Michael Drakopoulos, Arnold Nadel, Nikoo Hamzeh, Harnaina Bains, Alice T Lyon, Rukhsana G Mirza","doi":"10.1177/24741264261472089","DOIUrl":"https://doi.org/10.1177/24741264261472089","url":null,"abstract":"<p><p><b>Purpose:</b> To evaluate functional and anatomic outcomes over 12 months in patients with recalcitrant neovascular age-related macular degeneration (nAMD) whose treatment was transitioned to faricimab. <b>Methods:</b> This retrospective observational study included 36 patients (41 eyes) with treatment-recalcitrant nAMD previously treated with bevacizumab, ranibizumab, or aflibercept. Patients received 4 monthly intravitreal faricimab injections followed by individualized treatment intervals. Best-corrected visual acuity (BCVA), optical coherence tomography (OCT) images, and swept-source OCT angiography images were assessed at baseline, 6 months, and 12 months. Anatomic features evaluated included intraretinal fluid (IRF), subretinal fluid (SRF), pigment epithelial detachment (PED), macular neovascularization (MNV), and geographic atrophy (GA). <b>Results:</b> Mean (±SD) BCVA remained stable over the 12-month period (baseline, 0.289 ± 0.350 logMAR; 12 months, 0.306 ± 0.394 logMAR; <i>P</i> = .41). Treatment intervals increased from a mean of 5.29 weeks prior to the switch to faricimab to 7.58 weeks afterward. Anatomically, the proportion of eyes without IRF or SRF improved from 34.14% at baseline to 74.68% at 12 months. A significant reduction in PED maximum height was observed at 6 months, along with decreases in mean PED height and volume. MNV metrics demonstrated a significant decline in vessel area density at 6 months (<i>P</i> = .031), although no sustained significant changes were observed at 12 months. GA size increased by a mean of 0.41 mm²/year over the study period (<i>P</i> = .026). <b>Conclusions:</b> Switching to faricimab in treatment-recalcitrant nAMD maintained visual acuity, improved anatomic outcomes, and significantly extended injection intervals. These findings underscore faricimab's efficacy in managing refractory nAMD cases.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264261472089"},"PeriodicalIF":1.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13486384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequential Application of Transpupillary Thermal Therapy and Cryotherapy in the Management of Small Choroidal Melanoma: A Pilot Evaluation of Efficacy and Safety.","authors":"Jessica Henry, Thomas M Aaberg","doi":"10.1177/24741264261474157","DOIUrl":"https://doi.org/10.1177/24741264261474157","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether transpupillary thermal therapy and cryotherapy could improve control of small choroidal melanoma and reduce scleral extension risk.</p><p><strong>Methods: </strong>A retrospective review identified 30 patients with clinically diagnosed unilateral choroidal melanoma treated sequentially with transpupillary thermal therapy and cryotherapy between 2001 and 2025. Data collected included demographics, tumor characteristics, treatment response, complications, visual acuity, metastasis, and mortality. Treatment failure was defined as the need for brachytherapy or enucleation. An exploratory comparison with a 2008 study of transpupillary thermal monotherapy was performed.</p><p><strong>Results: </strong>All tumors (100%) showed growth prior to treatment. Mean tumor thickness was 1.63 mm (range, 0.50-2.80 mm), and maximum basal linear diameter was 7.80 mm (range, 5.00-12.00 mm). The mean follow-up was 5.80 years. Tumor regression was achieved posttreatment in 97% of cases; 1 patient required brachytherapy. All-cause mortality was 10%, with 1 patient experiencing death from metastatic melanoma. Compared with the 2008 transpupillary thermal monotherapy study (24% treatment failure rate, 32% complication rate, 8% extraocular extension), the current series demonstrated a 3% treatment failure rate, 53% complication rate, and no intrascleral or extrascleral extension. Macular pucker was the most common complication, occurring in 53%.</p><p><strong>Conclusions: </strong>Sequential transpupillary thermal therapy and cryotherapy may provide effective tumor control for small choroidal melanoma. Sequential transpupillary thermal therapy with cryotherapy was associated with low rates of treatment failure and scleral extension. However, the cohort also had relatively high complication rates for conditions such as macular pucker, vascular occlusion, and refractory cystoid macular edema. Further investigations with larger sample sizes and longer follow-up are warranted to assess the safety and efficacy of sequential transpupillary thermal therapy with cryotherapy.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264261474157"},"PeriodicalIF":1.3,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Recovery of 15-Letter Loss of Visual Acuity in Patients With Neovascular Age-Related Macular Degeneration on Antivascular Endothelial Growth Factor Therapy.","authors":"Calvin X Taylor, Hayden Reed, Katherine E Talcott, Rishi P Singh","doi":"10.1177/24741264261472092","DOIUrl":"https://doi.org/10.1177/24741264261472092","url":null,"abstract":"<p><strong>Purpose: </strong>To describe how 15-letter loss of visual acuity (VA) in patients with neovascular age-related macular degeneration (nAMD) results in transient fluctuations in vision. In addition, to compare recoverability of letter loss in patients treated with antivascular endothelial growth factor (anti-VEGF) with untreated patients.</p><p><strong>Methods: </strong>Patients with previously untreated nAMD in the Comparisons of AMD Treatments Trials were assigned to transient and nontransient groups based on recovery of baseline best-corrected VA within 8 weeks. Magnitude of recoverable letter loss was modeled via linear regression.</p><p><strong>Results: </strong>Two hundred fifty-three of 1018 patients (25%) experienced 15-letter loss: 68 transient (7%) and 185 nontransient (18%). Two-year outcomes were better without 15-letter loss (+12 letters, 95% CI, 11-13, n = 772) compared with transient 15-letter loss (+0.4 letters, 95% CI, -4 to 5) and nontransient 15-letter loss (-14 letters, 95% CI, -17 to -12). Nontransient losses up to -2.5 letters were expected to be recoverable (95% CI, -6.0 to 1.0). Fifteen-letter loss was associated with smoking (<i>P</i> = .02) and poor nontransient outcomes with higher blood pressure (<i>P</i> = .04).</p><p><strong>Conclusions: </strong>Patients experiencing transient and nontransient 15-letter loss differed significantly in outcomes. Nontransient losses were not expected to be recoverable. These findings may help guide the selection of measures in clinical trial design.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264261472092"},"PeriodicalIF":1.3,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitreoretinal Lymphoma: A Comprehensive Clinical Review and Current Standards in Management.","authors":"Aditya Maitray, Pukhraj Rishi, Christopher D Conrady, Elaine Binkley, Basil K Williams, Steven Yeh, Maura Di Nicola, Paul T Finger","doi":"10.1177/24741264261474159","DOIUrl":"https://doi.org/10.1177/24741264261474159","url":null,"abstract":"<p><strong>Purpose: </strong>To summarize current evidence on clinical features, multimodal imaging findings, diagnostic techniques, and management strategies for vitreoretinal lymphoma.</p><p><strong>Methods: </strong>A literature review was performed to provide updated information on available treatment options for vitreoretinal lymphoma.</p><p><strong>Results: </strong>Diagnosis of vitreoretinal lymphoma requires vitreous biopsy, with or without retinal/subretinal tissue, for cytology and immunohistochemistry, along with ancillary tests such as flow cytometry, cytokine profiling (interleukin-10/interleukin-6 ratio >1), immunoglobulin heavy chain gene rearrangement analysis, and detection of the MYD88 L265P mutation. Optical coherence tomography and other multimodal imaging techniques have become increasingly useful in raising suspicion, guiding biopsy, and monitoring treatment response. No standardized treatment protocol exists for isolated vitreoretinal lymphoma. Management options include intravitreal chemotherapy (methotrexate and/or rituximab), radiation therapy, and systemic chemotherapy, often showing a good initial response, but relapse and subsequent central nervous system (CNS) involvement are common, resulting in poor overall prognosis and survival. For vitreoretinal lymphoma with CNS disease, current strategies favor high-dose methotrexate-based systemic chemotherapy, with or without intrathecal chemotherapy; whole-brain radiation is generally reserved as rescue therapy. Emerging directions for earlier diagnosis include metagenomic deep sequencing, and chimeric antigen receptor T-cell (CAR-T) therapy has shown promise for treatment of selected relapsed/refractory cases of primary CNS lymphoma with a potential to prolong survival.</p><p><strong>Conclusions: </strong>Treatment of vitreoretinal lymphoma requires a multidisciplinary, individualized approach that integrates multimodal imaging, cytologic and molecular diagnostics, CNS evaluation, and tailored local or systemic therapy. Prospective multicenter studies are needed to refine diagnostic algorithms and standardize management.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264261474159"},"PeriodicalIF":1.3,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aging-Related Choroidal Heterogeneity and Loss: An Investigative Global Human Choroidal Thickness Review (ARCHLIGHT Study).","authors":"Abbie Lai, Mariam Issa, Ahmad Ali, Austin Pereira, Alaa Al Ali, Jay Chhablani, Peng Yan","doi":"10.1177/24741264261457969","DOIUrl":"https://doi.org/10.1177/24741264261457969","url":null,"abstract":"<p><strong>Purpose: </strong>To synthesize current evidence on the pathophysiology, clinical relevance, and implications for age-related choroidal thinning.</p><p><strong>Methods: </strong>A systematic literature search of relevant publications was conducted across MEDLINE, Embase, and Cochrane Library, up to and including May 2024. Identified studies reported choroidal thickness changes with aging. Data on subfoveal choroidal thickness, choroidal vascularity index, and associated factors (ethnicity, systemic disease, axial length) were analyzed (PROSPERO ID: CRD420251041101).</p><p><strong>Results: </strong>Choroidal thickness declines with age, with ethnicity-specific rates ranging from -0.93 µm/year in Spanish cohorts to -4.00 µm/year in Chinese populations. Age-related choroidal thinning correlates with retinal and neurodegenerative pathologies, including glaucoma (nasal choroidal thinning >250 µm in older adult patients), myopic maculopathy (subfoveal choroidal thickness <100 µm in high myopia), and Alzheimer disease (subfoveal choroidal thickness 169 µm vs 253 µm in control patients). Enhanced depth imaging optical coherence tomography (OCT) and swept-source OCT reveal preferential vascular loss (choroidal vascularity index <30%) and stromal atrophy. Systemic risks, such as hypertension or smoking, accelerate choroidal thinning.</p><p><strong>Conclusions: </strong>Age-related choroidal thinning exists on a continuum between physiologic aging and pathology, with implications for retinal and systemic health. Future prospective studies will help determine diagnostic thresholds (subfoveal choroidal thickness <200 µm in nonmyopic adults >60 years or rapid thinning beyond ethnic normative values), management recommendations for high-risk cohorts (glaucoma, age-related macular degeneration, high myopia), and therapeutic considerations for monitoring of choroidal thickness changes from moderate- to low-certainty evidence.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264261457969"},"PeriodicalIF":1.3,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of Hydroxychloroquine Whole Blood Levels With Real and Ideal Body Weight Dosing and Development of Retinal Toxicity.","authors":"Alexis Kaiser, Joseph Colcombe, Lucy Cobbs, Emily Gutowski, Jill Buyon, Howard Belmont, Peter Izmirly, Amit Saxena, Yasha Modi","doi":"10.1177/24741264261467190","DOIUrl":"10.1177/24741264261467190","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the correlation between hydroxychloroquine levels with real body weight and ideal body weight dose and identify patient characteristics at risk for subtherapeutic or supratherapeutic dosing.</p><p><strong>Methods: </strong>A retrospective chart review of 181 patients with lupus (429 unique hydroxychloroquine whole blood levels) was performed. Hydroxychloroquine levels <100 (indicating medication noncompliance) were excluded (n = 26). Summary statistics, linear regression of hydroxychloroquine level and real body weight/ideal body weight, and odds ratios (ORs) for factors associated with supratherapeutic (>2000 ng/mL) or subtherapeutic (<750 ng/mL) hydroxychloroquine levels were calculated.</p><p><strong>Results: </strong>The correlation of real body weight and hydroxychloroquine level was r = 0.124. Ideal body weight and hydroxychloroquine level had a correlation of r = 0.324. The OR of body mass index (BMI) >30 kg/m² and supratherapeutic hydroxychloroquine level was 4.95 (95% CI, 1.98-12.39). The OR of BMI <20 kg/m² and subtherapeutic hydroxychloroquine level was 2.90 (95% CI, 1.58-5.37). Three of 71 patients screened for toxicity had hydroxychloroquine maculopathy. These subjects had mean hydroxychloroquine levels of 1314 ng/mL (range, 1101-1553 ng/mL), 2402 ng/mL (range, 1754-3050 ng/mL), and 1223.8 ng/mL, and BMIs of 20.8 kg/m², 29.7 kg/m², and 19.8 kg/m², respectively.</p><p><strong>Conclusions: </strong>All dosing schedules show variability in hydroxychloroquine levels. Ideal body weight may correlate more strongly with hydroxychloroquine level than real body weight. Under real body weight-based guidelines, obesity may increase the risk for supratherapeutic hydroxychloroquine levels, and low weight may increase the risk for subtherapeutic levels.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264261467190"},"PeriodicalIF":1.3,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}