Ophthalmology. Retina最新文献

{"title":"Intraocular Melanocytoma in a 37-Year-Old Patient","authors":"Blanca Casado-Pelaez MD , Romana García-Gil MD , Rafael Martínez-Costa MD, PhD","doi":"10.1016/j.oret.2024.09.013","DOIUrl":"10.1016/j.oret.2024.09.013","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 5","pages":"Page e47"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546609","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 MD , Mariana Vaz MD , Diogo Cabral MD","doi":"10.1016/j.oret.2024.10.002","DOIUrl":"10.1016/j.oret.2024.10.002","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 5","pages":"Page e50"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","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 MD ,&nbsp;Jeremy D. Keenan MD, MPH ,&nbsp;Jay M. Stewart MD","doi":"10.1016/j.oret.2024.10.023","DOIUrl":"10.1016/j.oret.2024.10.023","url":null,"abstract":"<div><h3>Objective</h3><div>Proliferative vitreoretinopathy (PVR) is a major cause for failure of retinal detachment (RD) repair. We sought to determine if patients taking systemic methotrexate (MTX) therapy had a lower incidence of PVR.</div></div><div><h3>Design</h3><div>Multicenter retrospective cohort study.</div></div><div><h3>Participants</h3><div>Patients aged ≥18 years 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 6 months before 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.</div></div><div><h3>Methods</h3><div>The exposure variable of interest was systemic MTX 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 MTX use and method of primary RD repair. Regression models included inverse probability weights based on propensity scores for systemic MTX use. We conducted similar analyses for other antimetabolite agents (e.g., azathioprine and mycophenolate mofetil).</div></div><div><h3>Main Outcome Measures</h3><div>Cumulative incidence of PVR and adjusted risk ratio (RR) of developing PVR within 6 months of the initial RD.</div></div><div><h3>Results</h3><div>Of the 2674 eligible patients, 48 (1.8%) were taking systemic MTX at the time of RD repair. The 6-month cumulative incidence of PVR after the primary RD was 4.2% for patients taking systemic MTX compared with 9.2% for those not taking MTX (adjusted RR, 0.58; 95% confidence interval [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).</div></div><div><h3>Conclusions</h3><div>Patients taking systemic MTX or azathioprine were significantly less likely to develop PVR within 6 months of primary RD compared with those not taking MTX or azathioprine.</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":"9 5","pages":"Pages 431-436"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","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 Anti-VEGF on Same-Day-Investigation on Safety in Retinopathy of Prematurity","authors":"Anil Babanrao Gangwe MD ,&nbsp;Anjali Agrawal MS ,&nbsp;Subhadra Jalali MS ,&nbsp;Alay Banker MS ,&nbsp;Tapas Padhi MS ,&nbsp;Parag Shah DO, DNB ,&nbsp;Renu P. Rajan MD ,&nbsp;Sucheta Kulkarni DO, DNB ,&nbsp;Shilpi Shah MS ,&nbsp;Rekha Singhal MS ,&nbsp;Pranab Das MS ,&nbsp;Ajay Kapoor MS ,&nbsp;Anand Vinekar FRCS, PhD ,&nbsp;Snehal Bavaskar MS, DNB ,&nbsp;Vasumathy Vedantham MS ,&nbsp;Gaurav Sanghi MS ,&nbsp;Shashwat Bhattacharya MD ,&nbsp;Ahan Banker MBBS ,&nbsp;Anita Gaikwad MS ,&nbsp;Shivani Shrivastava MS ,&nbsp;Raj Vardhan Azad MD","doi":"10.1016/j.oret.2024.11.004","DOIUrl":"10.1016/j.oret.2024.11.004","url":null,"abstract":"<div><h3>Purpose</h3><div>To report an incidence of procedure-related complications in preterm infants with retinopathy of prematurity (ROP) treated with intravitreal anti-VEGFs injection in both eyes on the same day.</div></div><div><h3>Design</h3><div>Retrospective, multicenter case series.</div></div><div><h3>Subjects</h3><div>Preterm infants with ROP treated with anti-VEGF bilaterally on the same day.</div></div><div><h3>Methods</h3><div>All included infants underwent intravitreal anti-VEGF injection in both eyes under aseptic precautions in an ophthalmic operation theater (OT) or neonatal intensive care unit (NICU). A postoperative examination was performed to look for procedure-related complications.</div></div><div><h3>Main Outcome Measures</h3><div>Incidence of procedure-related complication (presumed endophthalmitis, intraocular inflammation, lens injury, vitreous hemorrhage, and retinal tear) in the study cohort. To study the association of indication, type of anti-VEGF, type of needle used, setting of procedure, site of injection (distance from limbus), and experience of the treating ophthalmologist with the complications.</div></div><div><h3>Results</h3><div>Nine thousand nine hundred and eighty-four eyes of 4992 infants were analyzed. The procedure was most commonly performed in ophthalmic OT (8258, 82.7%) using a 29G (4514, 45.2%) needle between 1 and 1.5 mm (9984, 100%) from limbus. Aggressive ROP was the most common indication for anti-VEGF use (4866, 48.7%), whereas Bevacizumab was the most commonly used anti-VEGF agent (8642, 86.6%). Overall, 26 eyes (0.3%) had procedure-related complications. Lens injury (15, 0.15%) and presumed endophthalmitis (7, 0.07%) were the most common complications. One eye had culture-proven endophthalmitis with <em>Pseudomonas aeruginosa</em>. No case of bilateral endophthalmitis was noted. Endophthalmitis was not associated with the setting of a procedure or type of anti-VEGF used, whereas the risk of lens injury was 7 times higher when performed in NICU and 30 times higher when performed by an ophthalmologist with &lt;1 year of experience in injecting anti-VEGF in preterm infants.</div></div><div><h3>Conclusions</h3><div>The incidence of presumed endophthalmitis after bilateral same-day anti-VEGF in infants with ROP is 0.07%. These infants can be treated in both eyes on the same day with the anti-VEGFs and needles (29–32G) evaluated in this study, with emphasis on the direction of needle parallel to the visual axis. Extra precaution is advocated if the procedure is planned in the NICU or by an ophthalmologist with limited experience.</div></div><div><h3>Financial Disclosure(s)</h3><div>The authors have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 5","pages":"Pages 484-492"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625275","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":"Clinical and Histopathologic Findings in Jalili Syndrome","authors":"Maria Franca MD, MSc ,&nbsp;Joana Providência MD, MSc ,&nbsp;Guilherme Castela MD, PhD ,&nbsp;Daniela Patrício MSc ,&nbsp;Inês Santos Sousa MSc ,&nbsp;António Francisco Ambrósio PhD ,&nbsp;Celso Henrique Alves PhD ,&nbsp;João Pedro Marques MD, PhD","doi":"10.1016/j.oret.2024.11.002","DOIUrl":"10.1016/j.oret.2024.11.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To correlate histopathologic findings in an eye with Jalili syndrome with clinical and imaging results available before enucleation.</div></div><div><h3>Design</h3><div>Case report with histopathologic analysis.</div></div><div><h3>Subjects</h3><div>Histopathologic analysis of an enucleated eye from a 63-year-old woman diagnosed with Jalili syndrome.</div></div><div><h3>Methods</h3><div>Age at diagnosis, symptoms, personal and family history, and genetic testing results and previous retinal imaging were retrieved from the patient file. The ocular specimen was dissected, retinal sections were prepared, and analysis with hematoxylin and eosin staining and fluorescent immunohistochemistry was performed. The histopathologic findings were compared with the patient’s imaging results available before enucleation.</div></div><div><h3>Results</h3><div>The ocular specimen analyzed belonged to a 63-year-old woman with Jalili syndrome, homozygous for the likely pathogenic c.971T&gt;C p.(Leu324Pro) variant in the <em>CNNM4</em> gene (NM_020184.3). This patient had no light perception bilaterally and suffered from bilateral, painful, severe dry eye, with refractory to conservative treatment for 7 years before enucleation. At 1-month follow-up after enucleation and orbital implant placement, the socket was fully recovered, and a custom ocular prosthesis was adapted. The patient experienced total pain relief, improved quality of life, and a good cosmetic result. The histopathologic analyses revealed loss of photoreceptor cells, accumulation of autofluorescent material in the subretinal space, partial preservation of the inner retinal lamination, Müller glial cell disorganization, and increased number of microglial cells in the nuclear layers.</div></div><div><h3>Conclusions</h3><div>Our findings highlight the severe nature of this inherited retinal degenerative disease with significant damage to the outer retinal layers, absence of synaptic terminals, and loss of photoreceptors, indicating an advanced disease stage. The presence of microglial cells in the remaining nuclear layers suggests a role in photoreceptor degeneration. This study represents the first comprehensive description of clinical, genetic, imaging, and histopathologic findings in Jalili syndrome.</div></div><div><h3>Financial Disclosure(s)</h3><div>The authors have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 5","pages":"Pages 476-483"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625277","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 MD ,&nbsp;Sara Khanji Fustek MD ,&nbsp;Honorio Barranco Gonzalez MD","doi":"10.1016/j.oret.2024.09.012","DOIUrl":"10.1016/j.oret.2024.09.012","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 5","pages":"Page e46"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","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 MD ,&nbsp;K. Bailey Freund MD","doi":"10.1016/j.oret.2024.09.015","DOIUrl":"10.1016/j.oret.2024.09.015","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 5","pages":"Page e49"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","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":"Clinical Evaluation of a Novel CRISPR-Cas12a-Based RID-MyC Assay for the Diagnosis of Fungal Endophthalmitis","authors":"Hanith Raj Deivarajan MSc ,&nbsp;Prabhakara Sethupathy R MSc ,&nbsp;Vignesh Elamurugan MBBS ,&nbsp;Akshayaa VS MSc ,&nbsp;Reega P MSc ,&nbsp;Dharani Chelliah MSc ,&nbsp;Hari Vignesh S MSc ,&nbsp;Elakkiya Nandhini GR MSc ,&nbsp;Kanmani M MSc ,&nbsp;Dharsini Nandhakumar BE ,&nbsp;Karvannan Sevugamurthi MSc ,&nbsp;Saravanan VR MBBS, DNB ,&nbsp;Anuradha K MBBS, FRCS ,&nbsp;Parag K. Shah MBBS, DNB ,&nbsp;Ram Rammohan PhD ,&nbsp;Abhishek Nair MBBS ,&nbsp;Krutin Shah MBBS ,&nbsp;Anju Jose MBBS, DNB ,&nbsp;Jaishree Pandian PhD ,&nbsp;Lalitha Prajna MBBS ,&nbsp;Siddharth Narendran MBBS","doi":"10.1016/j.oret.2024.11.003","DOIUrl":"10.1016/j.oret.2024.11.003","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluated the RID-MyC (Rapid Identification of Mycoses using clustered regularly interspaced short palindromic repeats [CRISPR]) assay, a CRISPR/Cas12a-based diagnostic tool, for its efficacy in diagnosing fungal endophthalmitis (FE) compared with panfungal polymerase chain reaction (PCR) and culture methods.</div></div><div><h3>Design</h3><div>A comparative cross-sectional study assessing the performance of the RID-MyC assay against established diagnostic modalities for FE.</div></div><div><h3>Subjects</h3><div>The study included 133 intraocular samples from 117 patients with suspected microbial endophthalmitis.</div></div><div><h3>Methods</h3><div>The study compared the sensitivity, specificity, positive predictive value, and negative predictive value of the RID-MyC assay against panfungal PCR and culture. The limit of detection for <em>Aspergillus flavus</em> and <em>Candida albicans</em> was determined for both RID-MyC and panfungal PCR across 3 different media: nuclease-free water, aqueous humor, and vitreous humor. Discrepancy analysis was conducted for discordant results, incorporating clinical outcomes and responses to antifungal treatment.</div></div><div><h3>Main Outcome Measures</h3><div>The study primarily assessed the sensitivity, specificity, positive predictive value, and negative predictive value for clinical samples. Time to diagnosis was also evaluated.</div></div><div><h3>Results</h3><div>The RID-MyC assay demonstrated a sensitivity of 88.24% (95% confidence interval [CI], 63.56%–98.54%) and specificity of 93.1% (95% CI, 86.86%–96.98%), with positive predictive value and negative predictive value of 65.22% (95% CI, 48.45%–78.91%) and 98.18% (95% CI, 93.62%–99.50%), respectively. Discrepancy analysis enhanced sensitivity to 90.48% (95% CI, 69.62%–98.83%) and specificity to 96.43% (95% CI, 91.11%–99.02%). The RID-MyC assay was 10- to 1000-fold more sensitive than panfungal PCR in detecting <em>A. flavus</em> and <em>C. albicans</em> in intraocular specimens. The time to diagnosis with the RID-MyC assay was consistently &lt;2 hours.</div></div><div><h3>Conclusions</h3><div>The RID-MyC assay may advance the rapid and precise diagnosis of FE, with possible relevance to other invasive fungal conditions.</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":"9 5","pages":"Pages 444-452"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625279","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":"Assessing Macular Function: Should We Move Beyond Pragmatic Measures of Visual Acuity?","authors":"Marion R. Munk MD, PhD,&nbsp;Eleonora M. Lad MD, PhD,&nbsp;Usha Chakravarthy MD, PhD","doi":"10.1016/j.oret.2025.01.006","DOIUrl":"10.1016/j.oret.2025.01.006","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 5","pages":"Pages 409-411"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143888258","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":"Diagnostic Accuracy of B-Scan Ultrasonography in Detecting Vitreoretinal Pathology after Open-Globe Injury","authors":"Mahsaw Mansoor MD,&nbsp;Matthew S. Hunt MD,&nbsp;Elaine M. Binkley MD,&nbsp;Timothy M. Boyce MD,&nbsp;Ian C. Han MD,&nbsp;Elliott H. Sohn MD,&nbsp;Stephen R. Russell MD,&nbsp;H. Culver Boldt MD,&nbsp;Jonathan F. Russell MD, PhD","doi":"10.1016/j.oret.2024.10.028","DOIUrl":"10.1016/j.oret.2024.10.028","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the diagnostic accuracy of B-scan ultrasonography (echography) after open-globe injury (OGI) repair in detecting vitreoretinal pathology, as confirmed by intraoperative inspection during subsequent pars plana vitrectomy (PPV).</div></div><div><h3>Design</h3><div>Retrospective, single-center, consecutive case series.</div></div><div><h3>Participants</h3><div>Patients with OGI treated at the University of Iowa Hospitals and Clinics from February 2018 through December 2023 who underwent OGI repair and had at least 1 B-scan performed postrepair but before subsequent PPV.</div></div><div><h3>Methods</h3><div>B-scans were performed by an experienced echographer and reviewed by the managing vitreoretinal surgeon for the presence of vitreous hemorrhage (VH), retinal tear (RT), retinal detachment (RD), choroidal detachment, and vitreoretinal incarceration. B-scan findings were compared with findings on direct inspection during PPV, which served as the gold standard.</div></div><div><h3>Main Outcome Measures</h3><div>Sensitivity, specificity, and positive/negative predictive value of B-scan findings.</div></div><div><h3>Results</h3><div>The study included 62 eyes of 61 patients, predominantly with severe OGIs (mean presenting logarithm of the minimum angle of resolution visual acuity of 2.52 ± 0.41; 75% with an Ocular Trauma Score of 1 or 2). B-scan had excellent diagnostic accuracy for VH, but, for every other type of vitreoretinal pathology, there were significant false positives, false negatives, or both. B-scan sensitivity was particularly low for vitreoretinal incarceration (11%), RT (32%), and RD (78%).</div></div><div><h3>Conclusions</h3><div>This study identified much lower diagnostic accuracy of B-scan ultrasonography after OGI for all vitreoretinal pathologies except VH compared with previous, smaller studies that reported perfect accuracy (100% sensitivity and specificity). Ultrasonography provides useful clinical information but should not be solely relied upon to diagnose or rule out severe vitreoretinal pathology that may prompt vitreoretinal referral or PPV after OGI.</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":"9 5","pages":"Pages 453-459"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625281","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}