Ophthalmology最新文献

{"title":"Diffuse Corneal Deposits After Long-Term Rifabutin Use.","authors":"Adam Snowden, Andrew Lima, Praneetha Thulasi","doi":"10.1016/j.ophtha.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.07.001","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Corneal Perforation After Acute Hydrops in Keratoconus.","authors":"Hideki Fukuoka, Chie Sotozono","doi":"10.1016/j.ophtha.2025.06.029","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.06.029","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Nasal Hemioptic Hypoplasia.","authors":"Anamika Dwivedi","doi":"10.1016/j.ophtha.2025.06.028","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.06.028","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"REPLY.","authors":"David M Brown, Glenn J Jaffe, Charles C Wykoff, Eser Adiguzel, Jeffrey S Heier, Arshad M Khanani","doi":"10.1016/j.ophtha.2025.06.009","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.06.009","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Brown et al.: MERLIN: Two-year results of brolucizumab in participants with neovascular age-related macular degeneration and persistent retinal fluid. (Ophthalmology. 2025;132:131-140).","authors":"Xiaoqian Liu, Guangsen Liu, Qiang Zhang","doi":"10.1016/j.ophtha.2025.06.008","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.06.008","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal Staining Responder Analysis: A Clinically Meaningful Dry Eye Outcome.","authors":"Esen K Akpek, John D Sheppard, Sonja Krösser","doi":"10.1016/j.ophtha.2025.07.015","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.07.015","url":null,"abstract":"<p><strong>Purpose: </strong>Thus far, clinical studies related to dry eye disease (DED) have focused on demonstrating a statistically significant difference in various ocular surface and tear film parameters and patient symptoms between the test arm versus comparator. However, it is largely unclear what arm differences or magnitude of improvement for a given parameter are clinically meaningful. This study aims to assess the correlations between corneal punctate erosions and patient reported symptoms and aims to define \"corneal staining responder\" as a physician measured and clinically meaningful DED outcome to be used in clinical studies and patient care.</p><p><strong>Design: </strong>Retrospective analysis of previously published studies.</p><p><strong>Participants: </strong>1704 adult patients with evaporative or aqueous deficient DED who participated in 4 large-scale randomized, controlled studies evaluating 2 different DED medications (a water-free cyclosporine 0.1 % solution and perfluorohexyloctane ophthalmic solution) or their respective comparators (vehicle and saline solution).</p><p><strong>Methods: </strong>Corneal punctate epithelial erosions were evaluated using fluorescein dye and the staining score was graded according to National Eye Institute scale (0-15). \"Corneal staining responder\" was defined as ≥ 3 grade improvement from baseline, based on published literature and expert opinion. A variety of patient symptoms were assessed using visual analogue scale (0-100).</p><p><strong>Main outcome measure: </strong>Corneal staining responders were compared to non-responders regarding improvement in symptoms via ANCOVA analysis irrespective of the treatment received.</p><p><strong>Results: </strong>In all 4 studies corneal staining responders showed numerically greater improvement in all assessed DED symptoms compared to non-responders. Overall, 36 comparisons were performed involving 14 different DED symptoms. In 75% of the comparisons the magnitude of the symptom improvement in responders was statistically significantly greater compared to non-responders. This finding was consistent across all 4 studies, irrespective of the treatment applied, patient demographics and the severity or type of DED.</p><p><strong>Conclusion: </strong>This analysis demonstrates that ≥ 3 severity grade improvement in corneal staining score is consistently associated with significant corresponding symptom improvement and may represent a clinically meaningful DED outcome measure for clinical studies and patient care.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Floating Pyramids Beneath the Flap.","authors":"Assaf Kratz, Netta Vidavsky, Tamir Regev","doi":"10.1016/j.ophtha.2025.06.026","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.06.026","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic Distribution of Access to Glaucoma Surgery: An IRIS® Registry Analysis.","authors":"Anagha Lokhande, Kanza Aziz, Asahi Fujita, Louis R Pasquale, Lucy Q Shen, David S Friedman, Michael V Boland, Alice C Lorch, Joan W Miller, Mengyu Wang, Tobias Elze, Nazlee Zebardast","doi":"10.1016/j.ophtha.2025.07.011","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.07.011","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated access to glaucoma surgical care by quantifying the geographic distribution of glaucoma surgeries across the United States.</p><p><strong>Design: </strong>Retrospective cohort study PARTICIPANTS: Using the IRIS® Registry (Intelligent Research in Sight), we extracted patient information associated with all glaucoma procedures from January 1, 2013, to December 31, 2019.</p><p><strong>Methods: </strong>Descriptive statistics were employed to evaluate physician, patient travel, and practice patterns. The United States Department of Agriculture's Rural-Urban Commuting Area Codes were utilized to define urban and non-urban zip codes. Multivariate logistic regression analyses were performed to determine which types of glaucoma surgeries were more likely to occur in urban areas. According to United States Postal Service definitions, districts were defined as aggregates of zip codes sharing the same first three digits; regions shared the same initial digit.</p><p><strong>Main outcome measures: </strong>The primary outcomes were the likelihood of each procedure type occurring in urban areas. The secondary outcomes were procedure characteristics (e.g., type, location) and the proportion of procedures requiring inter-region or inter-district travel.</p><p><strong>Results: </strong>The most performed glaucoma procedures were trabecular microbypass (iStent and Hydrus) (207,451 cases, 34%) and trabeculectomy (64,931 cases, 23%). Urban practice locations accounted for most surgeries (91%), with 96% of glaucoma subspecialists and 88% of non-glaucoma ophthalmologists performing surgeries exclusively in urban areas. Among 281,271 surgeries requiring inter-district travel (47%), most were performed in urban, rather than non-urban, practices (93%). A smaller subset of 42,667 surgeries involved inter-region travel (8% across all procedure types). Trabeculectomy (11%) and glaucoma drainage device (GDD) implantation (10%) were the procedures with their highest proportion of cases involving inter-region travel. We found higher odds of nearly all types of glaucoma surgeries occurring in urban practice locations: goniotomy/canaloplasty (OR=1.66, CI:1.59 - 1.74), XEN ab interno (OR=1.54, CI:1.38 - 1.72), endocyclophotocoagulation (OR=1.46, CI=1.39 - 1.53), GDD (OR= 1.70, CI:1.62 - 1.77), and trabeculectomy (OR=1.24, CI:1.17 - 1.32). Only trabecular microbypass was less likely to be performed in urban areas (OR=0.49, CI:0.47 - 0.51).</p><p><strong>Conclusions: </strong>Patients are more likely to receive most types of glaucoma surgeries in urban practice locations. Trabeculectomy or GDD implantation involved inter-regional travel in about 10% of cases.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Drug Interactions of Glaucoma Medications: A Systematic Review and Component Network Meta-Analysis.","authors":"Yun Hsia, Chi Wang, Chien-Chia Su, Jehn-Yu Huang, Tsing-Hong Wang, Yu-Kang Tu","doi":"10.1016/j.ophtha.2025.07.009","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.07.009","url":null,"abstract":"<p><strong>Topic: </strong>To investigate the efficacy of monotherapies and combinations of glaucoma medications in reducing intraocular pressure(IOP) and the drug interactions among different categories of medications.</p><p><strong>Clinical relevance: </strong>The treatment efficacy of the newly-introduced E-prostanoid receptor agonists(EP2), rho kinase inhibitors(ROCKI), and various combination therapies, has not been evaluated among all available glaucoma treatments. The synergistic or antagonistic effects of these combination therapies remain unknown.</p><p><strong>Methods: </strong>Embase and PubMed were searched until 5/20/2025 for randomized controlled trials comparing IOP-lowering effects of topical glaucoma monotherapies and combinations in patients with primary open angle glaucoma or ocular hypertension. The medications evaluated included F-prostanoid receptor agonists prostaglandin analogs(PG), nitric oxide-donating prostaglandin analogs(PGN), EP2, alpha-2 adrenergic agonists(A), beta-adrenergic blockers(B), carbonic anhydrase inhibitors(C), ROCKI, and their combinations. A network meta-analysis(NMA) was performed using contrast-based frequentist random-effects models to calculate the weighted mean difference in IOP reduction among treatments. Efficacy rankings were determined using P-scores. The risk of bias was assessed with RoB2, and the certainty of evidence(COE) was evaluated using Confidence in Network Meta-Analysis(CINeMA). Component NMA(cNMA) was employed to explore interactions between different medications. The study was registered with PROSPERO (CRD42024573926).</p><p><strong>Results: </strong>A total of 166 trials (36,494 participants) were included. PG-based combinations demonstrated the greatest IOP reduction (-7.41∼-5.81 mmHg,low COE), with PG+C ranking highest. Among monotherapies, PGN was most effective (-5.15[-6.18∼-4.11] mmHg,low COE), followed by PG (-4.75[-5.19∼-4.31] mmHg,high COE) and EP2 (-3.50[-4.27∼-2.73]mmHg,high COE). ROCKI (-3.24[-3.85∼-2.63]mmHg,high COE) was comparable to A (-3.36[-3.85∼-2.86] mmHg,high COE) and B (-3.29[-3.71∼-2.87]mmHg,high COE). Non-PG-based dual combinations (-5.10∼-4.82 mmHg,low to high COE) showed efficacy comparable to PG monotherapies, while non-PG-based triple combinations (A+B+C, -7.22[-9.04∼-5.40]mmHg,low COE) showed efficacy similar to the top-ranking PG-based combinations. cNMA revealed antagonism between PG+B(1.26mmHg) and PG+ROCKI(0.84mmHg), while a synergy was observed with PG+C(-2.05mmHg). Seventy-two percent of mixed comparisons had moderate to high COE, whereas all indirect comparisons had low to very low COE.</p><p><strong>Conclusion: </strong>PG-based combinations, especially PG+C, were the most effective, comparable to non-PG-based triple combinations. EP2 outperformed other non-PG treatments but ranked below PG and PGN. PG+B and PG+ROCKI showed antagonism, whereas the synergy of PG+C suggested a promising avenue for new combinations.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"This Issue at a Glance","authors":"Sandeep Ravindran PhD","doi":"10.1016/j.ophtha.2025.06.004","DOIUrl":"10.1016/j.ophtha.2025.06.004","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"132 8","pages":"Page 853"},"PeriodicalIF":13.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}