Ophthalmology最新文献

{"title":"Preoperative Screening Questionnaire for Common Eye Surgeries Safely Reduces the Need for Comprehensive History & Physical Examinations.","authors":"Anshuman Agrawal, Preeti Joshi, Rahul Shah, Nicole Warner, Fasika A Woreta, Oliver D Schein","doi":"10.1016/j.ophtha.2025.06.030","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.06.030","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety and utility of a brief preoperative patient questionnaire (PQ) in reducing the need for a comprehensive history and physical (H&P) in patients undergoing cataract and similar eye surgeries.</p><p><strong>Design: </strong>Observational Cohort Study PARTICIPANTS: All patients (n=7352) scheduled for anterior segment surgeries (n=11469) at an ambulatory surgical center from 6/1/2021 to 12/31/2024.</p><p><strong>Methods: </strong>The PQ was developed collaboratively by physicians with relevant content expertise. It was administered by scheduling staff, initially to a pilot cohort and then systematically, to stratify patients based on medical risk. Patients with negative responses to all the questions (\"PQ-pass\") bypassed the H&P and presented directly on the day of surgery, while others (\"PQ-fail\" and \"PQ-not-administered\") needed to obtain a preoperative H&P within 60 days of the surgery. Patient demographics, surgical scheduling details, and PQ outcomes were recorded as well as day-of-surgery cancellations and emergency department (ED) transfers. Analyses were performed using cluster-adjusted linear regression, logistic regression via generalized estimating equations (GEE) with clustering by patient, and bootstrapped quantile (median) regression.</p><p><strong>Main outcome measures: </strong>Rates of day-of-surgery cancellations for medical reasons, ED transfers, and the time from case creation to the date of surgery.</p><p><strong>Results: </strong>The PQ was administered for 4418 surgeries (2881 patients), with 81% passing it and bypassing a preoperative H&P. The cancellation rate for medical reasons was lower in the PQ-pass group (0.6%) compared with the PQ-not-administered group (1.7%, P<0.001) and the PQ-fail group (1.4%, P=0.07). ED transfer rates were almost non-existent and similar across groups. Compared to the PQ-fail group, the PQ-pass group had a significantly shorter time-to-surgery (14 days, P<0.001). Multivariate analysis identified older age, Black race, American Society of Anesthesiologists (ASA) class III or IV, and non-cataract surgeries as factors associated with failing the PQ.</p><p><strong>Conclusions: </strong>Most patients undergoing outpatient eye surgery under monitored anesthesia care can safely bypass a comprehensive preoperative H&P. These patients can be identified using a brief questionnaire. This approach is safe, has low day-of-surgery cancellation rates, quicker time-to-surgery, and substantially reduces patient, staff, and payor burden.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608971","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":"A Call to Abandon the Term Dry Eye When We Really Mean Pain.","authors":"Anat Galor, Lindsey B De Lott","doi":"10.1016/j.ophtha.2025.06.015","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.06.015","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591909","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 Acute Iris Depigmentation with a Free-Floating Pigmented Epithelial Cyst in the Anterior Chamber.","authors":"Francisco Calleja Casado, Valarmathy Vaiyavari, Mark Whiting","doi":"10.1016/j.ophtha.2025.06.001","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.06.001","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554065","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":"Orbital Apex Syndrome Associated with Hypertrophic Pachymeningitis.","authors":"Yuya Maeda, Ken Fukuda, Kenji Yamashiro","doi":"10.1016/j.ophtha.2025.06.006","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.06.006","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554067","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":"Conjunctival Mascaroma Presenting as Conjunctival Melanoma.","authors":"Shannon R Walsh, Tatyana Milman, Carol L Shields","doi":"10.1016/j.ophtha.2025.05.023","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.05.023","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554066","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":"Effects of Age at Surgery and Laterality of Cataract on Visual Acuity 5 years After Surgery in Infants Left Aphakic","authors":"Michael X. Repka MD MBA, Desirae R. Sutherland MPH, Sarah R. Hatt DBO, Bahram Rahmani MD, David A. Leske MS, Erick D. Bothun MD, Marielle P. Young MD, Mitchell B. Strominger MD, Susanna M. Tamkins OD, Wesley T. Beaulieu PhD, Raymond T. Kraker MSPH, Jonathan M. Holmes BM BCh, Susan A. Cotter OD MS, Pediatric Eye Disease Investigator Group","doi":"10.1016/j.ophtha.2025.06.022","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.06.022","url":null,"abstract":"To evaluate 5-year visual acuity (VA) outcomes by age at surgery and laterality among infants left aphakic at initial lensectomy.","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"2 1","pages":""},"PeriodicalIF":13.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144515866","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":"Visual Axis Opacification After Pediatric Cataract Surgery in the IRIS® Registry","authors":"Ju-Yeun Lee, Ju Hyun Jeon, Francisco Altamirano, Nadine AlMuasher, Tobias Elze, Joan W. Miller, Alice C. Lorch, Deborah K. VanderVeen, Isdin Oke, IRIS® Registry Analytic Center Consortium, Suzann Pershing MD, Leslie Hyman PhD, Julia A. Haller MD, Aaron Y. Lee MD MSCI, Cecilia S. Lee MD MS, Joan W. Miller MD, Alice C. Lorch MD MPH, Christina Thomas-Virnig PhD, Alex R. Miranda MD, Divya Srikumaran MD, Fasika A. Woreta MD MPH, Flora Lum MD","doi":"10.1016/j.ophtha.2025.06.021","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.06.021","url":null,"abstract":"In the IRIS® Registry, approximately one-third of children developed visual axis opacification within two years of cataract surgery. Children with a history of trauma or uveitis were most likely to develop visual axis opacification.","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":13.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144515870","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":"Baseline OCT Biomarkers Predicting Visual Outcomes in Neovascular Age-Related Macular Degeneration: A Meta-Analysis.","authors":"Keean Nanji, Justin Grad, Amin Hatamnejad, Tyler McKechnie, Mark Phillips, Chui Ming Gemmy Cheung, Praveen J Patel, Rosa Dolz Marco, Enrico Borrelli, David H Steel, SrinVas R Sadda, Tien Yin Wong, Sobha Sivaprasad, Robyn Guymer, Charles C Wykoff, Varun Chaudhary","doi":"10.1016/j.ophtha.2025.06.018","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.06.018","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the effect estimates and certainty of evidence for baseline optical coherence tomography (OCT) biomarkers predicting visual acuity (VA) and changes in VA from baseline at 6-, 12-, and 24-months following anti-vascular endothelial growth factor therapy for neovascular age-related macular degeneration.</p><p><strong>Clinical relevance: </strong>Understanding the prognostic utility of OCT biomarkers can improve treatment decisions.</p><p><strong>Methods: </strong>Meta-analyses were conducted using random-effects modelling. Results were reported in Early Treatment Diabetic Retinopathy Study (ETDRS) letters. GRADE guidelines for prognostic studies informed certainty of evidence assessments. Results were interpreted using a five-letter minimally important difference (MID).</p><p><strong>Results: </strong>Twenty-nine reports (8,863 eyes) evaluating 80 biomarkers were included. Two biomarkers predicted better VA at 12 months with a 'Low' certainty: the presence of an intact external limiting membrane (ELM) (+14.0; 95%CI:+3.1 to +24.8) and the presence of an intact ellipsoid zone (EZ) (+6.8; 95%CI:+2.8 to +10.8). Three biomarkers predicted worse VA at 12 months with a 'Low' certainty; the presence of intraretinal fluid (IRF) (-5.6; 95%CI:-9.7 to -1.5), the presence of IRF in the foveal center point (-7.4; 95%CI:-10.1 to -4.7), and the presence of subretinal hyperreflective material (SHRM) (-8.7; 95%CI: -19.0 to 1.6).No other biomarker predicted an effect size that crossed the MID. However, there were noteworthy results when interpreting biomarkers with statistically significant findings relative to a threshold of 0 letters and 'Moderate' certainty: the presence of a pigment epithelial detachment, geographic atrophy (GA), and both IRF and subretinal fluid (SRF) predicted reduced vision at 12 months. The presence of SRF predicted a positive change in VA at 12 months. The absence of a posterior vitreous detachment predicted a negative change in VA at 12 months. Lastly, the presence of IRF in the central 1mm, retinal pigment epithelial elevation, and GA predicted negative changes in VA at 24 months.</p><p><strong>Conclusion: </strong>With 'Low' certainty evidence, the baseline presence of an intact ELM and EZ predicted better VA at 12 months, and the presence of IRF, IRF in the foveal center point, and SHRM predicted worse VA at 12 months. Improved standardization in biomarker classification and control of confounding variables are needed.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507320","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":"Surgical outcomes and risk factors for failure in childhood glaucoma: Analysis of the IRIS® Registry.","authors":"Asahi Fujita, Daniel M Vu, Adam L Rothman, David S Friedman, Nazlee Zebardast, Ta Chen Chang","doi":"10.1016/j.ophtha.2025.06.017","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.06.017","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the surgical outcomes and risk factors for failure in surgeries for childhood glaucoma.</p><p><strong>Design: </strong>Retrospective cohort study SUBJECTS: Patients under 18 years of age who underwent glaucoma-related procedure between January 1, 2013, and December 31, 2019, in the IRIS® Registry (Intelligent Research in Sight).</p><p><strong>Methods: </strong>Patient demographic information and clinical characteristics were extracted. Failure was defined as having any of the following: intraocular pressure (IOP) greater than 21 mmHg, IOP reduction < 20% of baseline, IOP < 5 mmHg, any additional IOP-lowering procedure, loss of light perception, removal of eye or chemodenervation, or diagnosis of phthisis bulbi.</p><p><strong>Main outcome measures: </strong>Our primary outcome was the proportion of eyes that failed for glaucoma-related surgical procedures. Secondary outcomes included the factors associated with failure.</p><p><strong>Results: </strong>Among 2380 eyes, failure was recorded in 1081 eyes (45.4%) at a mean of 9.1 (10.4) months. Factors associated with a higher likelihood of failure were younger age (hazard ratio (HR): 1.12, 95% confidence interval (CI): 1.06-1.18, per 5 years), higher IOP on the index date (HR: 1.10, 95% CI: 1.08-1.12, per 3mmHg), worse visual acuity on the index date (HR: 1.33, 95% CI: 1.23-1.44, per 1 unit higher logMAR), concurrent uveitis (HR: 1.41, CI: 1.16-1.71), more glaucoma medications on the index date (HR: 1.18, CI: 1.14-1.22, per 1 medication), systemic IOP-lowering medication (HR: 1.71, CI: 1.44-2.03), and complication of hyphema (HR: 13.5, CI: 5.03-36.46). Compared to ab interno angle incision surgery, iris-based surgery (HR: 2.26, CI: 1.64 -3.12), iris-based laser (HR: 1.94, CI: 1.50-2.50), and trabecular/angle-based implants (HR: 3.83, CI: 2.00-7.33) were associated with higher failure rates. One or more re-operations were required in almost 18% of the eyes. Three-year failure rates of angle surgery were 34.5% and 39.2% for PCG and JOAG, respectively. A higher proportion of eyes with poor vision eyes were aphakic, used more intense medication, and had ocular comorbidities.</p><p><strong>Conclusions: </strong>Surgical failure was common in nearly half of all cases. Younger age, higher IOP and worse visual acuity at index, concurrent uveitis, and more intense preceding medication were predictors for failure.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507332","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":"Association between nucleoside and nucleotide reverse transcriptase inhibitor use and primary open-angle glaucoma risk in All of Us","authors":"Kenneth Pham BA, Fangming Jin MS, Roy Lee MS, Isabel Di Rosa AB, Rebecca Salowe MSE, Gui-Shuang Ying PhD, Joan M. O’Brien MD","doi":"10.1016/j.ophtha.2025.06.014","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.06.014","url":null,"abstract":"To assess the association between the systemic use of nucleoside and nucleotide reverse transcriptase inhibitors (NRTIs) and primary open-angle glaucoma (POAG).","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"175 1","pages":""},"PeriodicalIF":13.7,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337745","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}