Ophthalmology最新文献

{"title":"Issue at a Glance","authors":"","doi":"10.1016/j.ophtha.2024.07.012","DOIUrl":"10.1016/j.ophtha.2024.07.012","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":null,"pages":null},"PeriodicalIF":13.1,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011874","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":"Radiological predictors of visual outcome in myelin oligodendrocyte glycoprotein-related optic neuritis.","authors":"Armin Handzic, Jim Shenchu Xie, Nanthaya Tisavipat, Roisin Maire O'Cearbhaill, Deena A Tajfirouz, Kevin D Chodnicki, Eoin P Flanagan, John J Chen, Jonathan Micieli, Edward Margolin","doi":"10.1016/j.ophtha.2024.08.018","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.08.018","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine whether magnetic resonance imaging (MRI) biomarkers are associated with visual prognosis in myelin oligodendrocyte protein (MOG)-associated optic neuritis (MOG-ON).</p><p><strong>Design: </strong>Cross-sectional analysis.</p><p><strong>Subjects: </strong>Patients meeting 2023 international diagnostic criteria for MOG antibody-associated disease who were seen for first episodes of MOG-ON at three tertiary neuro-ophthalmology practices between January 2017 and July 2023 were enrolled. Patients who received less than 3 months of neuro-ophthalmic follow-up and did not demonstrate visual recovery (visual acuity [VA] ≥20/20 and visual field mean deviation [VFMD] >-5.0 dB) during this time were excluded.</p><p><strong>Methods: </strong>Patients received contrast-enhanced, fat-suppressed MRI of the brain and orbits within one month of symptom onset.</p><p><strong>Main outcome measures: </strong>The associations between radiological biomarkers and poor VA outcome (<20/40), incomplete VA recovery (<20/20), and poor VFMD outcome (VFMD <-5.0 dB) were assessed using multivariable logistic regression adjusting for time from symptom onset to treatment and nadir VA or VFMD. Radiological biomarkers included length of optic nerve enhancement (below vs. above 25%, 50%, and 75%); degree of orbital, canalicular, and intracranial or chiasmal optic nerve enhancement (mild vs. moderate-severe compared to the lacrimal gland); and absence vs. presence of optic nerve sheath enhancement on baseline T1-weighted MRI.</p><p><strong>Results: </strong>A total of 129 eyes of 92 patients (median [IQR] age 37.0 [20.8-51.3], 65.2% female) were included. Poor VA outcome was seen in 6.2% of cases, incomplete VA recovery in 19.4%, and poor VFMD outcome in 16.9%. Compared to eyes with moderate-severe enhancement, eyes with mild orbital optic nerve enhancement were more likely to have poor VA outcome (OR 8.57; 95% CI [1.85, 51.14], P=0.009), incomplete VA recovery (OR 7.31, 95% CI [2.42, 25.47], P=0.001), and poor VFMD outcome (adjusting for time to treatment: OR 6.81, 95% CI [1.85, 28.98], P=0.005; adjusting for nadir VFMD: OR 11.65, 95% CI [1.60, 240.09], P=0.04). Lack of optic nerve sheath enhancement was additionally associated with incomplete VA recovery (OR 3.86, 95% CI [1.19, 12.85], P=0.02) compared to the presence of enhancement. These associations remained consistent in subgroup logistic regression analysis of MRIs performed before initiation of treatment but were not seen in pairwise analysis of MRIs performed after treatment.</p><p><strong>Conclusions: </strong>In eyes with first MOG-ON episodes, milder enhancement in the orbital optic nerve is associated with poorer VA and VF recovery. Prospective and mechanistic studies are needed to confirm the prognostic utility of MRI in MOG-ON.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":null,"pages":null},"PeriodicalIF":13.1,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996286","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":"Disease activity and therapeutic response to pegcetacoplan for geographic atrophy identified by deep learning-based analysis of OCT.","authors":"Ursula Schmidt-Erfurth, Julia Mai, Gregor S Reiter, Sophie Riedl, Wolf-Dieter Vogl, Amir Sadeghipour, Alex McKeown, Emma Foos, Lukas Scheibler, Hrvoje Bogunovic","doi":"10.1016/j.ophtha.2024.08.017","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.08.017","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify morphological changes of the photoreceptors (PR) and retinal pigment epithelium (RPE) layers under pegcetacoplan therapy in geographic atrophy (GA) using deep learning-based analysis of optical coherence tomography (OCT) images.</p><p><strong>Design: </strong>Post-hoc longitudinal image analysis SUBJECTS: Patients with GA due to age-related macular degeneration from two prospective randomized phase III clinical trials (OAKS and DERBY) METHODS: Deep learning-based segmentation of RPE loss and PR degeneration, defined as loss of the ellipsoid zone (EZ) layer on OCT, over 24 months on SD-OCT images MAIN OUTCOME MEASURES: Change in the mean area of RPE loss and EZ loss over time in the pooled sham arms and the monthly (PM)/every other month (PEOM) treatment arms RESULTS: 897 eyes of 897 patients were included. There was a therapeutic reduction of RPE loss growth by 22%/20% in OAKS and 27%/21% in DERBY for PM/PEOM compared to sham, respectively, at 24 months. The reduction on the EZ level was significantly higher with 53%/46% in OAKS and 47%/46% in DERBY for PM/PEOM compared to sham at 24 months. The baseline EZ-RPE difference had an impact on disease activity and therapeutic response. The therapeutic benefit for RPE loss growth increased with larger EZ-RPE difference quartiles from 21.9%, 23.1%, 23.9% to 33.6% for PM vs. sham (all p<0.01) and from 13.6% (p=0.11), 23.8%, 23.8% to 20.0% for PEOM vs. sham (p<0.01) in quartiles 1,2,3 and 4, respectively, at 24 months. Regarding EZ layer maintenance, the therapeutic reduction of loss increased from 14.8% (p=0.09), 33.3%, 46.6% to 77.8% (p<0.0001) between PM and sham and from 15.9% (p=0.08), 33.8%, 52.0% to 64.9% (p<0.0001) between PEOM and sham for quartiles 1-4 at 24 months.</p><p><strong>Conclusion: </strong>OCT-based AI analysis objectively identifies and quantifies PR and RPE degeneration in GA. Reductions in further PR degeneration consistent with EZ loss on OCT are even higher than the effect on RPE loss in phase 3 trials of pegcetacoplan treatment. The EZ-RPE difference has a strong impact on disease progression and therapeutic response. Identification of patients with higher EZ-RPE loss difference may become an important criterion for the management of GA secondary to AMD.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":null,"pages":null},"PeriodicalIF":13.1,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996241","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 1-Year-Old Child with Peripheral T-cell Lymphoma of the Orbit.","authors":"Jiaqi Guan, Ye Jiang, Huasheng Yang","doi":"10.1016/j.ophtha.2024.07.017","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.07.017","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":null,"pages":null},"PeriodicalIF":13.1,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976288","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":"Facedown Positioning in Macular Hole Surgery: A Systematic Review and Individual Participant Data Meta-Analysis.","authors":"Raffaele Raimondi, Nikolaos Tzoumas, Steven Toh, Gurkaran S Sarohia, Mark R Phillips, Varun Chaudhary, David H Steel","doi":"10.1016/j.ophtha.2024.08.012","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.08.012","url":null,"abstract":"<p><strong>Topic: </strong>To assess the anatomical and visual effects of facedown positioning (FDP) advice in patients undergoing vitrectomy with gas tamponade for idiopathic full-thickness macular holes (FTMHs), and to explore differential treatment effects by macular hole size and FDP duration.</p><p><strong>Clinical relevance: </strong>The necessity and duration of FDP for FTMH closure remain contentious, with no consensus guidelines.</p><p><strong>Methods: </strong>Prospectively registered systematic review and individual patient data (IPD) meta-analysis of randomised controlled trials comparing FDP to no FDP (nFDP) across the MEDLINE, Embase, and Cochrane Library databases and clinical trial registries from January 2000 to March 2023 (CRD42023395152). All adults with idiopathic FTMHs undergoing vitrectomy with gas tamponade were included. The main outcomes were primary macular hole closure and post-operative visual acuity at 6 months or nearest time point.</p><p><strong>Results: </strong>Of 8 eligible trials, 5 contributed IPD for 379 eyes and were included in our analysis. The adjusted odds ratio (OR) for primary closure with FDP versus nFDP was 2.41 (95% CI 0.98 to 5.93, P = 0.06) [GRADE: Low], translating to a relative risk (RR) of 1.08 (1.00 to 1.11) and a number needed to treat (NNT) of 15. The FDP group exhibited a mean improvement in post-operative visual acuity of -0.08 logMAR (-0.13 to -0.02, P = 0.006) [GRADE: Low] compared to the nFDP group. Benefits were more certain in participants with larger holes of minimum linear diameter ≥ 400 μm: adjusted OR for closure ranged from 1.13 to 10.12 (P = 0.030) (NNT 12), with a mean visual acuity improvement of -0.18 to -0.01 logMAR (P = 0.022). Each additional day of FDP was associated with improved odds of anatomical success (adjusted OR 1.02 to 1.41, RR 1.00 to 1.02, P = 0.026) and visual acuity improvement (-0.02 logMAR, -0.03 to -0.01, P = 0.002), possibly plateauing at 3 days.</p><p><strong>Conclusion: </strong>This study provides low certainty evidence that FDP improves the anatomical and visual outcomes of macular hole surgery modestly and indicate that the effect may be more substantial for macular holes exceeding 400 μm. The findings support recommending FDP for patients with macular holes exceeding 400 μm pending further investigation.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":null,"pages":null},"PeriodicalIF":13.1,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988426","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":"Ultrawidefield Swept-Source OCT Angiography of Retinopathy of Prematurity.","authors":"Ioanna Ploumi, Nimesh A Patel, John B Miller","doi":"10.1016/j.ophtha.2024.07.023","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.07.023","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":null,"pages":null},"PeriodicalIF":13.1,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976292","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":"Evolution of Vitreous Separation following Prophylactic Buckle in Stickler Syndrome.","authors":"Harrison W Pratt, Austen N Knapp, Darius M Moshfeghi","doi":"10.1016/j.ophtha.2024.07.019","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.07.019","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":null,"pages":null},"PeriodicalIF":13.1,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976290","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":"Evaluation of a Normal Tension Glaucoma Suspect with Visual Field Changes.","authors":"Abdulrahman Mamoon Allaf, Ta Chen Chang","doi":"10.1016/j.ophtha.2024.07.022","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.07.022","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":null,"pages":null},"PeriodicalIF":13.1,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976289","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":"Transient Bilateral Ophthalmoplegia and Ptosis following Peribulbar Anesthesia.","authors":"Aswen Sriranganathan, Ahmed Almeer, Rahul A Sharma","doi":"10.1016/j.ophtha.2024.07.016","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.07.016","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":null,"pages":null},"PeriodicalIF":13.1,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976291","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":"Double Circulation Pattern in Amelanotic Choroidal Melanoma.","authors":"Zhihao Jiang, Xintong Jiang, Jie Hu","doi":"10.1016/j.ophtha.2024.07.015","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.07.015","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":null,"pages":null},"PeriodicalIF":13.1,"publicationDate":"2024-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913598","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}