Ocular Immunology and Inflammation最新文献

{"title":"Imaging Pars Plana in Acute Anterior Uveitis: Association with Inflammatory Activity.","authors":"Suchitra Biswal, Pradeep Sagar, Varsha A, Shubra Sweta, Parvathy Prabhakaran, Pradeep Bc, Sushma Raaj K, Shrinivas Shelkikar, Shimali Patle, Ravishankar Hn","doi":"10.1080/09273948.2026.2740682","DOIUrl":"https://doi.org/10.1080/09273948.2026.2740682","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the association between pars plana thickness and disease activity in acute anterior uveitis.</p><p><strong>Methods: </strong>Participants underwent anterior segment optical coherence tomography (AS-OCT) of the ciliary body using Topcon DRI-OCT Triton plus with an anterior segment adapter. Pars plana thickness was measured 3 mm posterior to the scleral spur in the nasal and temporal side. Patients received standard topical therapy and were followed longitudinally with repeat examination and AS-OCT imaging.</p><p><strong>Results: </strong>Forty nine eyes of 49 patients with anterior uveitis and 49 eyes of 49 healthy control were included in the analysis. The mean pars plana thickness was significantly greater in eyes with anterior uveitis compared to controls in both nasal (323.16 ± 81.14 µm vs 227.43 ± 56.68 µm; <i>p</i> < 0.001) and temporal side (354.48 ± 75.56 µm vs 235.31 ± 48.99 µm; <i>p</i> < 0.001). Supraciliary fluid (SCF) was detected in 59.2% of cases at baseline. Two or more than two step reduction in anterior chamber cell grade was documented in 24 eyes. It was associated with a significant decrease in nasal (313.18 ± 61.92 µm to 266.09 ± 64.95 µm; <i>p</i> < 0.001) and temporal pars plana thickness (362.39 ± 80.05 µm to 288.52 ± 74.03 µm; <i>p</i> < 0.001). Resolution of clinical activity was documented in 19 eyes. In this cohort, SCF was detected in 47.4% of eyes at baseline, declining to 10.50% at resolution.</p><p><strong>Conclusions: </strong>Pars plana thickness may serve as a novel, non-invasive imaging marker that parallels longitudinal resolution in anterior uveitis.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-7"},"PeriodicalIF":1.7,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Upadacitinib in Refractory Noninfectious Scleritis.","authors":"Qixuan Tang, Shenyu Wang, Lei Zhu, He Li, Chuandi Zhou, Wenru Su","doi":"10.1080/09273948.2026.2740684","DOIUrl":"https://doi.org/10.1080/09273948.2026.2740684","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effectiveness and safety of upadacitinib in reducing corticosteroid dependence and controlling relapse rate in patients with refractory noninfectious scleritis.</p><p><strong>Methods: </strong>A retrospective real-world study. Patients with refractory noninfectious scleritis treated with upadacitinib between January and December 2025 were included. Medical records were retrospectively reviewed. The primary outcome was sustained clinical remission, defined as absence of active scleral inflammation maintained for at least 2 consecutive visits separated by a minimum interval of 28 days. Secondary outcome is the relapse rate.</p><p><strong>Results: </strong>A total of 14 patients were included. After a median follow-up period of 8.0 months, 13 of 14 patients (92.9%) achieved absence of active scleral inflammation. The median time from upadacitinib initiation to first attainment of remission was 3.0 months (IQR, 2.0-4.0 months). A total of 3 patients (21.4%) experienced relapse. Systemic glucocorticoid use was reduced from baseline level of 14.5 mg/day to 5.0 mg/day at last follow-up. Of the 12 patients receiving systemic glucocorticoids at baseline, 4 discontinued them; 6 patients in total were glucocorticoid-free at the last follow-up. One patient developed elevated blood pressure, and no serious adverse events were observed.</p><p><strong>Conclusion: </strong>Upadacitinib provides a safe treatment option in reducing the chances of corticosteroid dependence and controlling the relapse rate in refractory noninfectious scleritis.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-7"},"PeriodicalIF":1.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Comment on Yu X, et al's \"Conjunctival Atypical Lymphoid Hyperplasia Associated with Cytomegalovirus Infection: A Case Report\".","authors":"Srinivasan Sanjay, Soon-Phaik Chee","doi":"10.1080/09273948.2026.2738015","DOIUrl":"10.1080/09273948.2026.2738015","url":null,"abstract":"<p><p>We comment on the report of bilateral conjunctival atypical lymphoid hyperplasia with cytomegalovirus (CMV) positivity by Yu et al. While the case is clinically valuable, we believe that the available findings do not establish active CMV infection or a causal relationship with lymphoid hyperplasia. We discuss the lack of tissue CMV PCR, discordant immunoglobulin heavy-chain clonality between eyes, diagnostic overlap with ocular adnexal lymphoma, and the need to consider lacrimal gland involvement and IgG4-related disease. We encourage cautious interpretation and longer clinicopathological follow-up.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-2"},"PeriodicalIF":1.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"JAK Inhibitors in Refractory Idiopathic Uveitis or Associated With Immune-Mediated Inflammatory Diseases: A Multicenter Case Series and Literature Review of Real-World Clinical Practice.","authors":"Nuria Barroso-García, Lara Sánchez-Bilbao, José Luis Martín-Varillas, Enrique Judez-Navarro, Marta Garijo-Bufort, Cruz Fernández-Espartero, José M Cachero, Álex Fonollosa, Leticia Del Olmo, Olga Maíz, Mar Esteban-Ortega, Ángel García-Aparicio, Vega Jovaní, José Luis Álvarez-Vega, Emma Beltrán, Raúl Veroz, Santos Castañeda, Vanesa Calvo-Río, Ricardo Blanco","doi":"10.1080/09273948.2026.2740690","DOIUrl":"https://doi.org/10.1080/09273948.2026.2740690","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the effectiveness and safety of Janus kinase inhibitors (JAKi) in patients with idiopathic or immune-mediated inflammatory diseases (IMID)-associated non-infectious uveitis (NIU) refractory to conventional therapy, and to synthesize available observational evidence.</p><p><strong>Methods: </strong>We conducted a multicenter observational study including 29 patients with refractory NIU treated with JAKi. Clinical variables assessed included best corrected visual acuity, anterior chamber cell count, and macular thickness, monitored from baseline up to 3 years. A systematic review of PubMed and Embase (inception to July 30, 2025) was performed to identify reports of JAKi in NIU.</p><p><strong>Results: </strong>Twenty-nine patients (median age 38 years) were included. Spondyloarthritis was the most frequent underlying IMID (<i>n</i> = 14). Anterior uveitis predominated (<i>n</i> = 17), with bilateral involvement (<i>n</i> = 20). Methotrexate was the most commonly immunosupressant (IS) administered (62.1%). Prior to JAKi initiation, a median of 2 biologic agents [IQR 1-3.25] had been used, mainly adalimumab and infliximab. Upadacitinib and tofacitinib were the most prescribed JAKi (<i>n</i> = 13 each). Remission was observed in 22 patients. Literature review identified 104 patients. Juvenile idiopathic arthritis and idiopathic uveitis were common. Tofacitinib was the most frequently used JAKi, with improved data. No serious adverse events were reported.</p><p><strong>Conclusions: </strong>Observational data suggests that JAKi may be a safe and effective option in clinical practice for NIU refractory to IS and biological agents.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-14"},"PeriodicalIF":1.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' Reply to Letter to the Editor in Response To: Comment on Azeem S, et al.'s \"Acute Retinal Necrosis-Associated Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis\".","authors":"Hashem Abu Serhan","doi":"10.1080/09273948.2026.2740693","DOIUrl":"10.1080/09273948.2026.2740693","url":null,"abstract":"","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-2"},"PeriodicalIF":1.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topical Insulin and Infectious Keratitis: An In Vitro Microbial Growth Study.","authors":"Salomon Merikansky, Felipe Echeverri Tribin, Heather Durkee, Alexander Alfonso, Jorge Maestre-Mesa, Juan Carlos Navia, Carolina Mercado, Alfonso L Sabater, Harry W Flynn, Guillermo Amescua, Darlene Miller","doi":"10.1080/09273948.2026.2723737","DOIUrl":"https://doi.org/10.1080/09273948.2026.2723737","url":null,"abstract":"<p><strong>Purpose: </strong>Topical insulin eye drops are used clinically to promote corneal epithelial healing in persistent epithelial defects. Given these benefits, insulin may also aid epithelial recovery in infectious keratitis. However, it remains unclear whether insulin impacts the growth of common ocular pathogens. This study aimed to evaluate the effect of insulin on microbial growth dynamics in vitro.</p><p><strong>Methods: </strong>Regular and rapid insulin were tested at 1 IU/mL and 10 IU/mL in tryptic soy broth (TSB) and lubricating eyedrops. A single clinical isolate of each organism (Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Candida albicans, Fusarium spp. and Aspergillus spp.) was included. Preparations with insulin, TSB alone, and Systane alone were inoculated in triplicate. Growth kinetics were assessed by optical density to calculate area under the curve (AUC), lag phase duration, and maximum specific growth rate (μ).</p><p><strong>Results: </strong>Insulin at either concentration in TSB did not enhance microbial growth compared to controls. No growth was observed in artificial tear groups.</p><p><strong>Conclusion: </strong>Insulin, whether regular or rapid, at 1 IU/mL or 10 IU/mL, did not increase growth of tested pathogens in vitro. These findings suggest that topical insulin unlikely promotes microbial proliferation in vitro and may be considered a potentially safe adjunct, although in vivo validation remains necessary.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-6"},"PeriodicalIF":1.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct Associations of Incident Choroidal Neovascularization and Focal Choroidal Excavation in Multifocal Choroiditis and Punctate Inner Choroiditis.","authors":"Luca De Simone, Riccardo Genovese, Antonio Campo, Fabrizio Gozzi, Pietro Gentile, Elena Bolletta, Chantal Adani, Marco Coassin, Luca Cimino","doi":"10.1080/09273948.2026.2737304","DOIUrl":"https://doi.org/10.1080/09273948.2026.2737304","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate associations of baseline OCT biomarkers, high myopia, and longitudinal choroidal thickness change with incident choroidal neovascularization (CNV) and focal choroidal excavation (FCE) in idiopathic multifocal choroiditis (MFC) and punctate inner choroiditis (PIC).</p><p><strong>Methods: </strong>This retrospective single-center cohort included 49 patients and 98 longitudinal eye records. Incident analyses were restricted to 71 clinically affected eyes and excluded eyes with the corresponding complication at baseline. All OCT examinations were acquired with Heidelberg Spectralis spectral-domain OCT, and Follow-Up mode was used for scan relocation. Eye-level associations were estimated using generalized estimating equations with clustering by patient.</p><p><strong>Results: </strong>Among 71 clinically affected eyes, CNV was present at baseline in 46 eyes and developed during follow-up in 12/25 affected eyes without baseline CNV (48.0%). FCE was present at baseline in 12 eyes and developed during follow-up in 40/59 affected eyes without baseline FCE (67.8%). Baseline RPE/Bruch's membrane complex disruption was associated with incident CNV (adjusted OR, 10.8; 95% CI, 1.4-81.0; <i>p</i> = 0.021), whereas OPL elevation was not (adjusted OR, 3.6; 95% CI, 0.6-21.1; <i>p</i> = 0.162). Incident FCE was associated with high myopia (adjusted OR, 12.1; 95% CI, 1.8-81.8; <i>p</i> = 0.011) and greater longitudinal choroidal thickness reduction (adjusted OR, 1.04 per 1% reduction; 95% CI, 1.001-1.081; <i>p</i> = 0.043).</p><p><strong>Conclusions: </strong>In clinically affected MFC/PIC eyes, baseline RPE/Bruch's membrane complex disruption was associated with incident CNV, while high myopia and greater longitudinal subfoveal choroidal thickness reduction were associated with incident FCE. These retrospective associations do not establish lesion-level causality or mechanism.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-8"},"PeriodicalIF":1.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uveitis as a Correlate of Systemic Manifestations in Patients Diagnosed with Behçet's Disease.","authors":"Sarthak V Shah, Karen M Wai, Prithvi Mruthyunjaya, Johannes Nowatzky, Ehsan Rahimy","doi":"10.1080/09273948.2026.2735409","DOIUrl":"https://doi.org/10.1080/09273948.2026.2735409","url":null,"abstract":"<p><strong>Purpose: </strong>Uveitis is common in Behçet's disease (BD), but risk stratification of potentially severe systemic disease by ocular involvement is still impossible. Here, we aimed to determine whether the risk for systemic manifestations of BD in Patients Diagnosed with Behçet's Disease (PDBD) depended on the presence of intra-ocular inflammation in one of the largest global health research networks.</p><p><strong>Methods: </strong>Screening > 150 million Electronic Medical Records (EMR), we compared subjects whose ICD-10 codes selected them as PDBD with or without a BD uveitis-reconcilable coding pattern. Outcomes included relative risk for systemic BD manifestations after diagnosis, likelihood of inpatient consultations, and probability of systemic manifestations over time.</p><p><strong>Results: </strong>3474 subjects met inclusion criteria, with 458 in the ocular cohort. Ocular PDBD had more than a two-fold risk of skin and vascular manifestations than non-ocular PDBD, increased risk for musculoskeletal and central nervous system manifestations, was twice as likely to receive inpatient consultations when hospitalized and showed a much shorter median time to extraocular systemic disease onset (413 days) than non-ocular PDBD (1729 days). The risk for genital lesions and the time to initial diagnosis were similar between the groups.</p><p><strong>Conclusions: </strong>Within the constraints of an EMR-based study, our results indicate a significantly higher risk for extraocular manifestations and an overall more severe disease course for PDBD with uveitis than for those without. Our findings provide rationale for confirmation in cohorts outside of big data and justify an intensified multidisciplinary clinical approach to ocular PDBD to prevent, detect, and treat the associated systemic disease.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-8"},"PeriodicalIF":1.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Results of Primary Trabeculectomy with Mitomycin C in Fuchs Uveitis Syndrome-Associated Glaucoma.","authors":"Damla Erdas, Cigdem Altan, Berru Yargi Ozkocak, Nese Alagoz, Burcu Kemer Atik, Berna Basarir, Banu Solmaz, Tekin Yasar","doi":"10.1080/09273948.2026.2735416","DOIUrl":"https://doi.org/10.1080/09273948.2026.2735416","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and safety of mitomycin C (MMC)-augmented trabeculectomy in patients with Fuchs uveitis syndrome (FUS)-associated glaucoma.</p><p><strong>Methods: </strong>This retrospective study included FUS-associated glaucoma patients with ≥1-year follow-up after trabeculectomy (MMC 0.2 mg/mL, 2 min) for uncontrolled glaucoma despite maximum tolerated medical therapy. Preoperative and postoperative data were collected, including best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of antiglaucoma medications, intraoperative and postoperative complications, and required additional surgical interventions. Postoperative assessments included bleb morphology and the need for reoperation. Success criteria (5 < IOP ≤ 21 mmHg) were categorized as \"complete\" (without medication/reoperation) or \"qualified\" (with medication).</p><p><strong>Results: </strong>Fifty-seven eyes of 56 patients (mean age 45.4 ± 11.8 years; 61.4% pseudophakic) were enrolled. At a median follow-up of 41 (18-73) months, mean IOP decreased from 31.2 ± 9.2 mmHg to 14.8 ± 5.2 mmHg at the 24-month follow-up (<i>p</i> < 0.001). Medications were reduced from 2.8 ± 0.6 to 1.4 ± 1.5 (<i>p</i> < 0.001). At the 2-year follow-up, complete and qualified success rates were 42.1% and 22.8%, respectively. Reoperation was required in 20 eyes (35%) at a mean of 25.7 ± 26.2 months. Complications included transient hypotony in 8 eyes, with choroidal detachment in 2 eyes. Bleb needling was performed in 22 eyes (38%) at a mean of 16.7 months. The number of preoperative antiglaucoma medications was significantly associated with total surgical success (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>MMC-augmented trabeculectomy provides effective long-term IOP control and significantly reduces the medication burden in patients with FUS-associated glaucoma. Although postoperative complications and reoperations are not uncommon, favourable surgical outcomes can be achieved.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance of Deep Learning Models for Ocular Toxoplasmosis Using Fundus Photography: A Systematic Review and Meta-Analysis.","authors":"Seyed Mohammad Mousavi, Masoud Rezayi, Majid Fasihi Harandi, Iraj Sharifi, Elham Akhlaghi, Saeedeh Shamsaddini, Mitra Sharbatkhori","doi":"10.1080/09273948.2026.2736177","DOIUrl":"https://doi.org/10.1080/09273948.2026.2736177","url":null,"abstract":"<p><strong>Background: </strong>Ocular toxoplasmosis (OT) is the leading infectious cause of posterior uveitis worldwide, yet diagnosis remains challenging without a universal gold standard. Although deep learning (DL) shows significant promise for automated image analysis, a rigorous synthesis of its diagnostic accuracy across heterogeneous architectures and datasets is lacking.</p><p><strong>Methods: </strong>Following PRISMA-DTA and CLAIM-AI guidelines, we searched major databases through January 2026 for studies evaluating DL models for OT detection using fundus photography. Methodological quality was appraised using QUADAS-2. A bivariate random-effects model (MetaDTA v2.1.3) was applied to pool sensitivity and specificity, generating hierarchical summary receiver operating characteristic (HSROC) curves to visualize discriminatory performance.</p><p><strong>Results: </strong>Sixteen primary studies (38 model configurations) met qualitative synthesis criteria; nine studies evaluating 24 unique architectures provided sufficient 2×2 contingency data for meta-analysis. Pooled sensitivity was 0.965 (95% CI: 0.944-0.978) and pooled specificity was 0.955 (95% CI: 0.929-0.972). The diagnostic odds ratio reached 594.1 (95% CI: 263.3-1340.4), with positive and negative likelihood ratios of 21.6 and 0.036. Substantial between-study heterogeneity was observed (I^2 = 87.9%). Critically, 81.2% of included studies relied exclusively on a single Paraguayan dataset (OTFID), raising concerns regarding phenotypic bias and limited global generalizability.</p><p><strong>Conclusion: </strong>DL models demonstrate excellent diagnostic accuracy for OT on fundus photography, comparable to established ophthalmic AI benchmarks. However, clinical translation is constrained by geographic data homogeneity and the absence of multicentric external validation. Future research must prioritize diverse international cohorts, explainable AI, and federated learning frameworks.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}