Ophthalmology. Retina最新文献

{"title":"Associations Between Androgen Exposure, PCOS, and Transmasculine Individuals with Central Serous Chorioretinopathy.","authors":"Jonathan D Shirian, Jacqueline K Shaia, Nikhil Das, Katherine E Talcott, Rishi P Singh, Danny A Mammo","doi":"10.1016/j.oret.2024.10.026","DOIUrl":"https://doi.org/10.1016/j.oret.2024.10.026","url":null,"abstract":"<p><strong>Objective: </strong>or Purpose: The prevalence of central serous chorioretinopathy (CSCR) among transmasculine, polycystic ovary syndrome (PCOS), and androgen-exposed patients remains largely unexplored. While these groups involve patients with elevated testosterone levels, previous literature is inconclusive on the influence of testosterone on CSCR. This study aimed to determine the relationship between CSCR and cohorts with exogenous androgen exposure, female-to-male (FTM) transgender individuals, and those diagnosed with PCOS.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Subjects: </strong>Patients with CSCR, receiving exogenous androgens, FTM transgender individuals (defined as gender identity disorder (GID), endocrine disorder not otherwise specified, sex-discordant hormone therapy, and FTM surgery), and patients with PCOS.</p><p><strong>Methods: </strong>An electronic health records platform of over 100 million patients was examined for this study. Patients were identified through ICD-10 and procedural codes. Patients with prior steroid prescriptions, anxiety disorders, and fluticasone use were excluded. Prevalence and prevalence odds ratios (OR) of comorbid CSCR were calculated utilizing R Studio and 95% confidence intervals (CI) were calculated.</p><p><strong>Main outcome measures: </strong>Prevalence, prevalence ORs, and 95% CIs of CSCR.</p><p><strong>Results: </strong>Among 21,056 CSCR patients, the mean age was 61 years [SD±15], with 67.95% being male. The prevalence of CSCR was highest among those receiving exogenous androgen therapy (24.13 per 1,000 CSCR patients; OR: 5.84, 95% CI: 5.35-6.37). The FTM surgery (OR: 3.04) and sex discordant hormone therapy (OR: 5.32) cohorts also showed significant associations with CSCR (p < 0.05). PCOS patients had a more limited but still significant association (OR: 1.23, 95% CI: 1.013-1.49). GID did not show a significant relationship with CSCR (p > 0.05).</p><p><strong>Conclusions: </strong>This study which investigated the associations between FTM transgender, PCOS patients, and CSCR demonstrates that conditions linked with elevated androgens are associated with higher odds of CSCR. These findings emphasize the value of ophthalmic screenings in these populations, particularly within the transgender healthcare community.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iris Coloboma and Iris Metastatic Tumor.","authors":"Ryan Clarke, Adrian Au, Tara A McCannel","doi":"10.1016/j.oret.2024.10.003","DOIUrl":"https://doi.org/10.1016/j.oret.2024.10.003","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choroidal Folds in Checkpoint Inhibitor-Induced Vogt-Koyanagi-Harada-Like Uveitis.","authors":"Pedro Carreira, Mariana Vaz, Diogo Cabral","doi":"10.1016/j.oret.2024.10.002","DOIUrl":"https://doi.org/10.1016/j.oret.2024.10.002","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Systemic Methotrexate Therapy and Proliferative Vitreoretinopathy.","authors":"Xinyi Chen, Jeremy D Keenan, Jay M Stewart","doi":"10.1016/j.oret.2024.10.023","DOIUrl":"https://doi.org/10.1016/j.oret.2024.10.023","url":null,"abstract":"<p><strong>Objective: </strong>Proliferative vitreoretinopathy (PVR) is a major cause for failure of retinal detachment (RD) repair. We sought to determine if patients taking systemic methotrexate therapy had a lower incidence of PVR.</p><p><strong>Design: </strong>Multicenter retrospective cohort study.</p><p><strong>Participants: </strong>Patients aged 18 years or over who were documented in the Sight Outcomes Research Collaborative (SOURCE) repository to have received a diagnosis of RD and have undergone RD repair surgery between 2004 and 2024. We only included patients who had been in the SOURCE system for at least six months prior to the diagnosis date and had no prior record of RD repair surgery. We excluded patients with an unknown laterality of the primary RD repair, history of PVR, proliferative diabetic retinopathy, serous RD, retinal dialysis, or ocular trauma.</p><p><strong>Methods: </strong>The exposure variable of interest was systemic methotrexate use, as documented from the medication list. The outcome of interest was the presence of new-onset PVR within 6 months of surgery. Incident PVR was modeled in log binomial regression models that included terms for systemic methotrexate use and method of primary RD repair. Regression models included inverse probability weights based on propensity scores for systemic methotrexate use. We conducted similar analyses for other antimetabolite agents (e.g., azathioprine, mycophenolate mofetil).</p><p><strong>Main outcome measures: </strong>Cumulative incidence of PVR and adjusted risk ratio (RR) of developing PVR within 6 months of the initial RD.</p><p><strong>Results: </strong>Of the 2674 eligible patients, 48 (1.8%) were taking systemic methotrexate at the time of RD repair. The 6-month cumulative incidence of PVR following the primary RD was 4.2% for patients taking systemic methotrexate compared with 9.2% for those not taking methotrexate (adjusted RR 0.58, 95% CI 0.47-0.71). Similar results were found for azathioprine (adjusted RR 0.28, 95% CI 0.22-0.37) but not mycophenolate mofetil (adjusted RR 0.93, 95% CI 0.77-1.11).</p><p><strong>Conclusions: </strong>Patients taking systemic methotrexate or azathioprine were significantly less likely to develop PVR within six months of primary RD compared with those not taking methotrexate or azathioprine.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Exudative Retinal Detachments due to Primary Hyperoxaluria in a Child.","authors":"Blanca Casado-Pelaez, Sara Khanji Fustek, Honorio Barranco Gonzalez","doi":"10.1016/j.oret.2024.09.012","DOIUrl":"https://doi.org/10.1016/j.oret.2024.09.012","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myopic Tractional Maculopathy and Retinoschisis with Telangiectasia.","authors":"Livia Faes, K Bailey Freund","doi":"10.1016/j.oret.2024.09.015","DOIUrl":"https://doi.org/10.1016/j.oret.2024.09.015","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electron Microscopy to Confirm Rhegmatogenous Cause of Retinal Detachments.","authors":"Shivesh Varma, Chris Van Vliet, Chandrakumar Balaratnasingam","doi":"10.1016/j.oret.2024.09.014","DOIUrl":"https://doi.org/10.1016/j.oret.2024.09.014","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Treatment Patterns for Endophthalmitis after Cataract Surgery Follow the Endophthalmitis Vitrectomy Study Recommendations?","authors":"Maurizio Tomaiuolo PhD ,&nbsp;Jordan Deaner MD ,&nbsp;Brian L. VanderBeek MD ,&nbsp;Binod Acharya MS ,&nbsp;Zeba A. Syed MD ,&nbsp;Qiang Zhang MD, PhD ,&nbsp;Joel S. Schuman MD ,&nbsp;Leslie Hyman PhD","doi":"10.1016/j.oret.2024.07.014","DOIUrl":"10.1016/j.oret.2024.07.014","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate whether treatment patterns for endophthalmitis after cataract surgery in American Academy of Ophthalmology IRIS® (Intelligent Research in Sight) Registry patients are in line with evidence-based guidelines established by the 1995 Endophthalmitis Vitrectomy Study (EVS), which showed that patients who present with light perception (LP) vision have better visual outcomes with immediate vitrectomy (VIT) compared with vitreous tap with antibiotic injection (TAP).</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Subjects</h3><div>Intelligent Research in Sight Registry patients undergoing cataract surgery between 2014 and 2022 (identified by Current Procedural Terminology codes), presenting with endophthalmitis (identified by International Classification of Diseases 10 codes) within 42 days postcataract surgery, and having a record of being treated with VIT or TAP on the same or 1 day after endophthalmitis diagnosis were identified.</div></div><div><h3>Methods</h3><div>Potential covariates of age, sex, race, ethnicity, geographic region, insurance status, and visual acuity on the day of endophthalmitis diagnosis were evaluated using multivariable logistic regression.</div></div><div><h3>Main Outcome Measures</h3><div>Treatment with VIT or TAP.</div></div><div><h3>Results</h3><div>Of the 2425 patients who met the inclusion criteria, 14% (345) underwent VIT and 86% (2080) underwent TAP. Notably, 80% of patients (1946) presented with endophthalmitis within 14 days from cataract surgery (median = 6 days). Notably, 66% (173/263) of the patients presenting with LP vision underwent TAP instead of VIT. In a multivariable logistic regression model, receiving VIT instead of TAP was positively associated with poor vision at endophthalmitis presentation (LP – odds ratio [OR] = 5.4; confidence interval [CI], 2.9–10.6; counting fingers, hand motions – OR = 1.9; CI, 1.1–3.6) versus (20/20–20/40) vision; Asian versus White race (OR = 2.6; CI, 1.3–5.2); Hispanic versus non-Hispanic ethnicity (OR = 1.9; CI, 1.1–3.2); living in the West (OR = 1.6; CI, 1.1–2.2) and Midwest (OR = 1.5; CI, 1.1–2.0) (vs. South), but not with age, sex, and insurance coverage (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>In the IRIS Registry, treatment patterns for postcataract surgery endophthalmitis did not match evidence-based recommendations of the EVS, a randomized controlled clinical trial. More work is needed to evaluate whether the current treatment patterns are optimal for patients with postcataract surgery endophthalmitis.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"8 11","pages":"Pages 1035-1043"},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitreous Veils in a Patient with Marfan Syndrome","authors":"","doi":"10.1016/j.oret.2024.04.001","DOIUrl":"10.1016/j.oret.2024.04.001","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"8 11","pages":"Page e41"},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screen Failures in Clinical Trials in Retina","authors":"","doi":"10.1016/j.oret.2024.05.014","DOIUrl":"10.1016/j.oret.2024.05.014","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Disparities in clinical trials are a major problem because of significant underrepresentation of certain gender, racial, and ethnic groups. Several factors including stringent eligibility criteria and recruitment strategies hinder our understanding of retinal disease. Thus, we aimed to study the various reasons of screen failures and specific patient and study characteristics among screen failures.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;This is a cross-sectional retrospective study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Screening data of 87 trials from 6 centers were analyzed. Study characteristics (disease studied, phase of trial, and route of drug administration) and patient demographics (age, gender, race, ethnicity, and employment status) were compared among different causes of screen failures. Screen failures were broadly classified into 6 categories: exclusion because of vision-based criteria, exclusion because of imaging findings, exclusion because of other factors, patient-related criteria, physician-related criteria, and miscellaneous. Descriptive statistics, Pearson chi-square test, and analysis of variance were used for statistical analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;Prevalence of various reasons for screen failures in multiple trials and its trend among different study and patient characteristics.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among 87 trials and 962 patients, 465 (48.2%) patients were successfully randomized and 497 (51.8%) patients were classified as screen failures. The trials were conducted for various retinal diseases. Mean age was 76.50 ± 10.45 years and 59.4% were females. Predominantly White patients (93.4%) and unemployed/retired patients (66.6%) were screened. Of the 497 screen failures, most were because of patients not meeting inclusion criteria of imaging findings (n = 221 [44.5%]) followed by inclusion of vision-based criteria (n = 73 [14.7%]), exclusion because of other factors (n = 75 [15.1%]), patient-related (n = 34 [6.8%]), physician-related (n = 28 [5.6%]), and miscellaneous reasons (n = 39 [7.8%]). Reason for screen failure was not available for 27 (5.4%) patients. A higher proportion of patients screened for surgical trials (15%) declined to participate in the study compared with noninvasive trials involving topical drugs and photobiomodulation (0%) (&lt;em&gt;P&lt;/em&gt; = 0.02).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Patients not meeting the imaging and vision-cased criteria were the most common reasons for screen failures. White patients and unemployed patients predominantly participated in clinical trials. Patients are more inclined to continue participation in noninvasive clinical trials compared with surgical trials. Better recruitment strategies and careful consideration of study criteria can aid in decreasing the rate of screen failures.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Financial Disclosure(s)&lt;/h3&gt;&lt;div&gt;Proprietary or commercial disclosure may be found after the references i","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"8 11","pages":"Pages 1093-1099"},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}