Ophthalmology最新文献

{"title":"Long-term Cardiovascular, Renal, and Safety Outcomes of Teprotumumab versus Systemic Glucocorticoids in Thyroid Eye Disease: A Target Trial Emulation.","authors":"Jui-En Lo, Suzanne K Freitag, Catherine Y Liu, Giuseppe Barbesino, Kevin Sheng-Kai Ma","doi":"10.1016/j.ophtha.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.05.012","url":null,"abstract":"<p><strong>Purpose: </strong>The insulin-like growth factor-1 receptor inhibitor teprotumumab is effective for thyroid eye disease (TED), but there is limited evidence on its long-term safety. We studied the long-term cardiovascular, renal, infectious, and safety outcomes of teprotumumab compared to intravenous (IV) glucocorticoids (GCs), oral GCs, and conservative treatment in patients with TED.</p><p><strong>Design: </strong>Population-based cohort study.</p><p><strong>Participants: </strong>Patients with TED who initiated teprotumumab, GCs, or conservative treatment between January 1^st 2020 to December 1^st 2024 from 80 healthcare organizations in the United States.</p><p><strong>Methods: </strong>Propensity scores were used to match baseline covariates including demographics, comorbidities, laboratory data, and medications. Cox proportional hazard models were used to calculate hazard ratios.</p><p><strong>Main outcome measures: </strong>Outcomes included all-cause mortality and the risks of new-onset cardiovascular diseases, renal diseases, infectious outcomes, and safety outcomes, including hearing loss, within 5 years after initiating treatment.</p><p><strong>Results: </strong>Teprotumumab was associated with markedly lower all-cause mortality and reduced risks of acute myocardial infarction, cerebral infarction, peripheral vascular disease, heart failure, atrial fibrillation, acute kidney failure, emergency department visits, hospitalization, urinary tract infection, pneumonia, and severe sepsis, when compared to IV or oral GCs. There was no difference in the risks of diabetes, chronic kidney disease, inflammatory bowel disease, or complications requiring a hearing device, while there was a higher risk of hearing loss after starting teprotumumab compared to IV or oral GCs. All-cause mortality was also markedly reduced in teprotumumab users when compared to patients with conservative treatment.</p><p><strong>Conclusions: </strong>The use of teprotumumab compared to IV or oral GCs was associated with reduced risks of death, cardiovascular, renal, and infectious diseases in patients with TED. This suggests that teprotumumab may have fewer adverse outcomes than GCs for treating TED.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120540","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":"Intermediate Persistent Fetal Vasculature Syndrome.","authors":"Felicia Fong, Laurie Lau-Sickon, Matthew G J Trese","doi":"10.1016/j.ophtha.2025.04.012","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.04.012","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094341","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":"Meticulous Examination Leads to Prompt Excision of a Low-Grade Follicular Lymphoma Located in the Conjunctival Fornix.","authors":"Kelly Ann Hutchinson, Ami Wang, Rachel Curtis","doi":"10.1016/j.ophtha.2025.04.015","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.04.015","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094347","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":"Paucisymptomatic Disc Edema in Secondary Syphilis.","authors":"Angelica Hanna, Arshia Eshtiaghi, Rahul A Sharma","doi":"10.1016/j.ophtha.2025.04.016","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.04.016","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094483","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":"Jay S Pepose, Mitchell Brigell, Kostas Charizanis","doi":"10.1016/j.ophtha.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.04.003","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094485","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: Pepose et al.: Reversal of pharmacologically induced mydriasis with phentolamine ophthalmic solution (Ophthalmology. 2025;132:79-91).","authors":"Rachel Furhang, Inci Irak Dersu","doi":"10.1016/j.ophtha.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.04.002","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094484","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":"Risk of Giant Cell Arteritis Among Patients Presenting With Undifferentiated Non-Infectious Uveitis.","authors":"Muhammad Z Chauhan, Jawad Muayad, J Anthony Chacko, Asad Loya, Zain S Hussain, Chaow Charoenkijkajorn, Paul H Phillips, Joseph G Chacko, Ahmed B Sallam","doi":"10.1016/j.ophtha.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.05.005","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086231","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":"Stephen J Kim, Jennifer I Lim, Steven T Bailey, Jaclyn L Kovach, G Atma Vemulakonda, Gui-Shuang Ying, Christina J Flaxel","doi":"10.1016/j.ophtha.2025.03.027","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.03.027","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079360","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: Kim et al.: Idiopathic Macular Hole Preferred Practice Pattern (Ophthalmology. 2025;132:P234-P269).","authors":"Colin A McCannel","doi":"10.1016/j.ophtha.2025.03.026","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.03.026","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079359","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":"Randomized Non-Inferiority Trial of Direct Selective Laser Trabeculoplasty in Open-Angle Glaucoma and Ocular Hypertension: GLAUrious.","authors":"Gus Gazzard, Nathan Congdon, Augusto Azuara-Blanco, Eytan Z Blumenthal, Ketevan Gomelauri, Monika Zaliniyan, Carlo E Traverso, Zohar Bracha, Ana Dvalishvili, Yoram Solberg, Michael Belkin, Thomas W Samuelson","doi":"10.1016/j.ophtha.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.05.004","url":null,"abstract":"<p><strong>Objective: </strong>Effective glaucoma treatment is limited by non-adherence to topical medications and suboptimal access to selective laser trabeculoplasty (SLT). GLAUrious compared direct selective laser trabeculoplasty (DSLT), an automated, gonioscopy-free, non-contact, image-guided procedure to reduce intraocular pressure (IOP), with conventional SLT in open-angle glaucoma (OAG) and ocular hypertension (OHT).</p><p><strong>Design: </strong>Prospective, multicenter, randomized, controlled, evaluator-masked non-inferiority trial.</p><p><strong>Participants: </strong>Participants aged ≥40 years with OAG or OHT, on 0-3 hypotensive medications at screening, and washout IOP 22-35 mmHg were treated at 14 centers.</p><p><strong>Methods: </strong>Following washout, 192 participants randomized 1:1 were treated with DSLT (n=99) or SLT (n=93). IOP was assessed at pre-treatment and follow-up visits through 12-months post-procedure, with washout IOP measured at baseline and 6 months. Ocular adverse events (AEs) were assessed in both groups.</p><p><strong>Main outcome measures: </strong>Difference between DSLT and SLT in mean IOP change from baseline to 6 months (non-inferiority margin -1.95 mmHg). Exploratory efficacy and safety outcomes were assessed over 12 months.</p><p><strong>Results: </strong>Of 156 (81.3%) participants without major protocol deviations analyzed at 6 months, mean (± SE) washout IOP reduction from baseline was 5.5 (± 0.5) mmHg (-20.6%) following DSLT and 6.2 (± 0.5) mmHg (-23.6%) following SLT. The between-group difference (SLT-DSLT) in mean IOP reduction was -0.7 mmHg (95% CI: -2.2, 0.8; P=0.09 [NS] for non-inferiority). Of 161 (83.9%) participants without major protocol deviations analyzed at 12 months, mean (±SE) non-washout IOP reduction from screening was 3.2 (± 0.4) mmHg (-12.2%) following DSLT and 3.2 (± 0.4) mmHg (-9.4%) following SLT. The between-group difference in mean IOP reduction was 0.01 mmHg (95% CI: -1.1, 1.1; P<0.001 for non-inferiority). Safety profiles were similar between groups, although clinically non-significant punctate subconjunctival hemorrhage was more frequent in the DSLT group. Ocular AEs were generally mild and resolved without intervention.</p><p><strong>Conclusions: </strong>The 6-month primary endpoint did not achieve statistical noninferiority compared to conventional SLT. Nonetheless, DSLT was well tolerated and provided an effective reduction in IOP that was sustained for 12 months. Failure to demonstrate noninferiority does not prove inferiority: DSLT remains an effective option in the early treatment paradigm and can considered as a first-line treatment when SLT is not readily accessible.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997386","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}