Ophthalmology最新文献

{"title":"Risk of Depression in Persistent Blue Light Deprivation after Cataract Surgery: APopulation-BasedCohort Study.","authors":"Jihei Sara Lee, Sunyeup Kim, Chan Yun Kim, Eun Hye Jung, Hyoung Won Bae, Sung Soo Kim, Seung Won Lee, Yong Joon Kim","doi":"10.1016/j.ophtha.2025.07.019","DOIUrl":"10.1016/j.ophtha.2025.07.019","url":null,"abstract":"<p><strong>Purpose: </strong>To identify the risk of depression in individuals exposed to persistent blue light deprivation through blue light-filtering (BLF) intraocular lenses (IOLs) based on previous studies that found blue light to promote affective arousal and modulate emotional responses.</p><p><strong>Design: </strong>Population-based cohort analysis.</p><p><strong>Participants: </strong>Individuals who underwent cataract removal and IOL implantation in both eyes within 1 year between January 2012 and December 2018.</p><p><strong>Methods: </strong>Participants were categorized into either clear IOL or BLF IOL groups. The National Health Insurance Sharing Service of South Korea database was queried for new diagnoses of depressive disorders. The full observation period spanned from January 1, 2008 through December 31, 2022.</p><p><strong>Main outcome measures: </strong>Incidence rates and hazard ratios (HRs) were calculated for depressive disorders in individuals with BLF IOLs and clear IOLs using Cox proportional hazards model. Outcomes were adjusted for demographics, income, and comorbidities.</p><p><strong>Results: </strong>A total of 14 010 individuals (35.5% men; mean ± standard deviation age, 71.4 ± 9.20 years) who underwent BLF IOL implantation in both eyes within 1 year between 2012 and 2018 were age-matched and sex-matched to 14 010 individuals with clear IOLs in both eyes. The incidence rate of depressive disorders was 27.8 per 1000 person-years for the BLF IOL group compared with 24.1 per 1000 person-years for the clear IOL group. The risk of depressive disorders increased by 1.16-fold (95% confidence interval [CI], 1.09-1.23; P < 0.001) among individuals with BLF IOLs relative to those with clear IOLs after adjusting for systemic comorbidities and follow-up duration. The risk of depressive disorders was especially high for individuals with BLF IOLs between 50 and 64 years of age (HR, 1.30; 95% CI, 1.14-1.48; P < 0.001) and women (HR, 1.17; 95% CI, 1.09-1.25; P < 0.001). Similar trends were observed in the sensitivity analysis and unmatched cohort analysis.</p><p><strong>Conclusions: </strong>The risk of depressive disorders increases for individuals with BLF IOLs relative to those with clear IOLs. In the long term, persistent blue light deprivation may increase risks of depression, and particular age cohorts and women may be more vulnerable to the light deprivation than others.</p><p><strong>Financial disclosure(s): </strong>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</p>","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":"144753867","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 MD ,&nbsp;Guangsen Liu MD ,&nbsp;Qiang Zhang MD","doi":"10.1016/j.ophtha.2025.06.008","DOIUrl":"10.1016/j.ophtha.2025.06.008","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"132 10","pages":"Page e169"},"PeriodicalIF":9.5,"publicationDate":"2025-07-26","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":"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":"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":"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>A total of 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 the National Eye Institute scale (0-15). \"Corneal staining responder\" was defined as a ≥3 grade improvement from baseline, based on published literature and expert opinion. A variety of patient symptoms were assessed using a visual analogue scale (0-100).</p><p><strong>Main outcome measure: </strong>Corneal staining responders were compared with nonresponders regarding improvement in symptoms via analysis of covariance 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 with nonresponders. 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 with nonresponders. This finding was consistent across all 4 studies, irrespective of the treatment applied, the patient demographics, and the severity or type of DED.</p><p><strong>Conclusions: </strong>This analysis demonstrates that a ≥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><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found after the references.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"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 (Intelligent Research in Sight) 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":"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.</p><p><strong>Participants: </strong>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 used to evaluate physician, patient travel, and practice patterns. The US Department of Agriculture's Rural-Urban Commuting Area Codes were used to define urban and nonurban 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 US Postal Service definitions, districts were defined as aggregates of zip codes sharing the same first 3 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, 39%) and trabeculectomy (115 302 cases, 22%). Urban practice locations accounted for most surgeries (91%), with 96% of glaucoma subspecialists and 88% of nonglaucoma ophthalmologists performing surgeries exclusively in urban areas. Among 281 271 surgeries requiring inter-district travel (47%), most were performed in urban, rather than nonurban, 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 (odds ratio [OR], 1.66; confidence interval [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 approximately 10% of cases.</p><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found after the references.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"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","authors":"Yun Hsia MD, MS ,&nbsp;Chi Wang MD ,&nbsp;Chien-Chia Su MD, PhD ,&nbsp;Jehn-Yu Huang MD, MPH ,&nbsp;Tsing-Hong Wang MD, PhD ,&nbsp;Yu-Kang Tu DDS, PhD","doi":"10.1016/j.ophtha.2025.07.009","DOIUrl":"10.1016/j.ophtha.2025.07.009","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Topic&lt;/h3&gt;&lt;div&gt;To investigate the efficacy of monotherapies and combinations of glaucoma medications in reducing intraocular pressure (IOP) and drug interactions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Clinical Relevance&lt;/h3&gt;&lt;div&gt;The relative treatment efficacy and interaction of the newly introduced E-prostanoid receptor 2 (EP2) agonists, rho-kinase inhibitors (ROCKIs), and various combination therapies remain unknown.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Embase and PubMed were searched through May 20, 2025, for randomized controlled trials comparing IOP-lowering effects of topical glaucoma medications in patients with primary open-angle glaucoma or ocular hypertension. The medications evaluated included prostaglandin F2α analogs (PGFAs), nitric oxide-donating prostaglandin analogs (NO-PGA), EP2 agonists, unoprostone, α&lt;sub&gt;2&lt;/sub&gt;-adrenergic agonists (AAAs), β-adrenergic blockers (BABs), carbonic anhydrase inhibitors (CAIs), ROCKIs, and their combinations. A network meta-analysis (NMA) using contrast-based frequentist random-effects models calculated the weighted mean difference in IOP reduction, with rankings determined using &lt;em&gt;P&lt;/em&gt; scores. The risk of bias was assessed with Cochrane Risk of Bias Tool, and the certainty of evidence (COE) was evaluated using confidence in network meta-analysis. Component NMA explored interactions between different medications. The study was registered with the International Prospective Register of Systematic Reviews (identifier, CRD42024573926).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among 166 trials (36 494 participants), PGFA-based combinations demonstrated the greatest IOP reduction (range, −7.41 to −5.81 mmHg; COE: low), with PGFAs plus CAIs ranking highest. Among monotherapies, NO-PGA was most effective (−5.15 [95% confidence interval: –6.18 to –4.11 mmHg]; COE: low), followed by PGFA (–4.75 [−5.19 to −4.31]; high) and EP2 agonist (−3.50 [−4.27 to −2.73]; high). ROCKIs (−3.24 [−3.85 to −2.63]; high) were comparable with AAA (−3.36 [−3.85 to −2.86]; high) and BAB (−3.29 [−3.71 to −2.87]; high). Non-PGFA-based dual combinations (range, −5.10 to −4.82 mmHg; low to high) were comparable to PGFA, whereas non-PGFA-based triple combinations (AAA plus BAB plus CAI, −7.22 [−9.04 to −5.40]; low) were similar to the top-ranking PGFA-based combinations. Component NMA revealed antagonism between PGFA plus BAB (1.26 mmHg) and PGFA plus ROCKI (0.84), whereas synergy was observed with PGFA plus CAI (−2.05).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Non-PGFA-based triple combinations and PGFA-based combinations, especially PGFA plus CAI, were the most effective. E-prostanoid receptor 2 agonists outperformed other non-PGFA treatments but ranked below PGFA and NO-PGA. Prostaglandin F2α analog plus BAB or ROCKI showed antagonism, whereas the synergy of PGFA plus CAI suggested a promising avenue for new combinations.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Financial Disclosure(s)&lt;/h3&gt;&lt;div&gt;The author(s) have no proprietary or commercial interest in any mate","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"132 11","pages":"Pages 1304-1316"},"PeriodicalIF":9.5,"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}

{"title":"En Breve","authors":"Sandeep Ravindran PhD","doi":"10.1016/j.ophtha.2025.06.007","DOIUrl":"10.1016/j.ophtha.2025.06.007","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"132 8","pages":"Pages e1-e2"},"PeriodicalIF":13.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656461","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":"期刊一览","authors":"Sandeep Ravindran PhD","doi":"10.1016/j.ophtha.2025.06.003","DOIUrl":"10.1016/j.ophtha.2025.06.003","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"132 8","pages":"Page e3"},"PeriodicalIF":13.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656584","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}