Ophthalmology最新文献

{"title":"What Is Cerebral/Cortical Visual Impairment and Why Do We Need a New Definition?","authors":"Shefa Gordon PhD, Alicia Kerr PhD, Cheri Wiggs PhD, Michael F. Chiang MD","doi":"10.1016/j.ophtha.2024.09.011","DOIUrl":"10.1016/j.ophtha.2024.09.011","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"131 12","pages":"Pages 1357-1358"},"PeriodicalIF":13.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687766","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.2024.10.008","DOIUrl":"10.1016/j.ophtha.2024.10.008","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"131 12","pages":"Pages e1-e2"},"PeriodicalIF":13.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704159","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.2024.10.009","DOIUrl":"10.1016/j.ophtha.2024.10.009","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"131 12","pages":"Page e3"},"PeriodicalIF":13.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704259","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":"Special Commentary: Cerebral/Cortical Visual Impairment Working Definition","authors":"Melinda Y. Chang MD ,&nbsp;Lotfi B. Merabet OD, PhD","doi":"10.1016/j.ophtha.2024.09.017","DOIUrl":"10.1016/j.ophtha.2024.09.017","url":null,"abstract":"<div><div>Cerebral/cortical visual impairment (CVI), a brain-based condition, has emerged as a leading cause of pediatric visual impairment in the United States and other industrialized nations. The National Eye Institute (NEI) recognized CVI as a priority area for research as part of their 2021 NEI Vision for the Future Strategic Plan and partnered with the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Neurologic Disorders and Stroke within the National Institutes of Health (NIH) to sponsor a CVI Workshop in November 2023. A panel consisting of a group of clinicians with expertise in diagnosing CVI convened to draft a working definition for this condition. Five key elements were identified: (1) CVI encompasses a spectrum of visual impairments caused by an underlying brain abnormality that affects the development of visual processing pathways and is characterized by deficits in visual function and functional vision; (2) the visual dysfunction in CVI is greater than expected by any comorbid ocular conditions alone; (3) the visual dysfunction in CVI may manifest as lower-order or higher-order afferent visual deficits, or both, leading to characteristic behaviors in affected individuals; (4) although CVI may be comorbid with other neurodevelopmental disorders, CVI is not primarily a disorder of language, learning, or social communication; and (5) the underlying neurologic insult of the developing brain may go unrecognized or undiagnosed until later in life. Future work is needed to achieve consensus on nomenclature, diagnostic criteria, and strategies for early identification and intervention. The NIH is developing a CVI registry to collect relevant demographic and clinical data prospectively and longitudinally to help inform future research questions and to provide insight into considerations for future clinical trials in the field of CVI.</div></div>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"131 12","pages":"Pages 1359-1365"},"PeriodicalIF":13.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687764","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":"Retinopathy in Mucopolysaccharidoses.","authors":"Maha Noor, Omar Mehana, Guillermo de la Mata, Tariq Aslam, Neil Parry, Orlaith McGrath, Krishanthy Sornalingam, Arunabha Ghosh, Simon Jones, Jane Ashworth","doi":"10.1016/j.ophtha.2024.11.013","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.11.013","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the pattern(s) of onset, variation, and progression of retinopathy in patients with Mucopolysaccharidosis (MPS).</p><p><strong>Design: </strong>Prospective, longitudinal, observational study.</p><p><strong>Participants: </strong>Between November 2015 and March 2023, individuals with MPS were recruited from Ophthalmology clinics at the Manchester Royal Eye Hospital, United Kingdom.</p><p><strong>Methods: </strong>Participants underwent assessment of visual acuity, corneal clouding, intraocular pressure, along with fundoscopy, ultra-widefield (UWF) colour fundus photography, fundus autofluorescence (FAF) imaging, optical coherence tomography (OCT), and electroretinography (ERG), where feasible.</p><p><strong>Main outcome measures: </strong>Evaluation of findings from clinical examination, retinal imaging, and electroretinogram studies, to ascertain the presence and patterns of retinopathy.</p><p><strong>Results: </strong>Data was collected for 75 patients, including 45 MPS I, 9 MPS II, 13 MPS IVA, and 8 MPS VI, aged 3-58 years. Fundus photography was conducted in 65 patients, FAF in 61, OCT in 58, and electrodiagnostic studies in 36 participants. Retinopathy was defined as signs of retinal disease evident through retinal examination or fundus photography such as depigmentation, bone-spicule pigmentation, vascular tortuosity, retinal pigment epithelium (RPE) mottling/other changes, macular atrophy/puckering/epiretinal membranes, FAF findings such as a central hyperautofluorescent dot, hyperautofluorescent parafoveal ring, hypoautofluorescent lesions around fovea (double bull's eye), areas of hyper/hypoautofluorescence, and extrafoveal changes, OCT imaging features such as central external limiting membrane (ELM) thickening, RPE disturbance, photoreceptor layer loss, parafoveal retinal atrophy, and outer retinal/intrachoroidal cavities, or electroretinogram studies revealing rod-mediated retinopathy or rod-cone dystrophy. Retinopathy was confirmed in 32 patients, including 25 MPS I, 4 MPS II, 1 MPS IVA, and 2 MPS VI. Five participants were first diagnosed with retinopathy with clinical examination, while 31 participants were identified on UWF colour fundus photography supported by FAF and OCT. 21 patients exhibited ERG abnormalities consistent with retinopathy. Fifteen of the total 32 participants described symptoms of nyctalopia. The onset of retinopathy varied substantially, with initial detection between 2 and 53 years of age.</p><p><strong>Conclusions: </strong>MPS patients as young as 2 may develop retinopathy, diagnosed through fundus examination, ophthalmic imaging, or ERG. Emerging treatments, including gene therapy, may prevent or stabilise retinopathy. Phenotypic data and natural history of MPS-related retinopathy are thus of paramount importance.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639464","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":"Associations between School-Based Vision Program Outcomes and School Characteristics in 410 Schools.","authors":"Medha Kallem, Xinxing Guo, Xi Dai, Christina Ambrosino, Andrew Nguyen, David S Friedman, Michael X Repka, Nick Kourgialis, Megan Collins","doi":"10.1016/j.ophtha.2024.11.012","DOIUrl":"10.1016/j.ophtha.2024.11.012","url":null,"abstract":"<p><strong>Objective: </strong>School-based vision programs (SBVPs) deliver vision care services directly to students at school, helping address disparities in access to pediatric vision care. We aim to evaluate the associations between SBVP outcomes and school-level characteristics.</p><p><strong>Design: </strong>Retrospective cross-sectional data analysis PARTICIPANTS: Public schools with at least 50 SBVP-enrolled students 5 to 22 years old with complete demographic data. Schools with fewer than 60% of total grade levels served by the SBVP were excluded, resulting in a sample of 410 schools.</p><p><strong>Methods: </strong>Vision screening and eye exam data were extracted from Helen Keller International's United States Vision Program dataset from 2016 through 2022. Individual student data were aggregated to characterize each school's SBVP outcomes and analyzed with schools' publicly available socioeconomic and demographic data (student body race and ethnicity composition, proportion of students qualifying for free and reduced-price meals [FARM%], and proportion of English Language Learners). Descriptive statistics summarized SBVP outcomes. Fractional regression models were utilized to understand associations between SBVP outcomes and school characteristics.</p><p><strong>Main outcome measures: </strong>SBVP outcomes were rates of vision screening failure, eyeglasses prescription, and community eye care referral among each school's SBVP-enrolled students.</p><p><strong>Results: </strong>We evaluated 151 (36.8%) elementary, 155 (37.8%) middle, and 104 (25.4%) high schools, with a median FARM% of 87.4% and a plurality of Hispanic students in 61.0% of schools. Overall median rates of vision screening failure, eyeglasses prescription, and referral were 38.4%, 25.2%, and 5.4%, respectively. High schools were associated with increased screening failure and eyeglasses prescription rates and a decrease in referral rate, compared with elementary schools. In multivariate analysis, each 10% increase in FARM% was associated with a 2.6% (95% confidence interval [CI]: 1.54-3.65), 1.8% (CI: 0.87-2.74), and 0.86% (CI: 0.36-1.36) increase in screening failure, eyeglasses prescription, and referral rates, respectively.</p><p><strong>Conclusions: </strong>There is significant vision care demand among public schools, especially those with student populations from lower socioeconomic backgrounds. SBVPs are important in bridging the gap in pediatric vision care access in such populations. Our findings demonstrated opportunities to allocate program staffing and equipment resources according to schools' anticipated needs, thus maximizing SBVPs' impact in delivering pediatric vision care.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625073","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 uveitis among E-Cigarette Users: a multi-institutional TriNetX study.","authors":"Alan Y Hsu, Yu-Hsun Wang, Ning-Yi Hsia, Chun-Ting Lai, Hou-Ting Kuo, Bing-Qi Wu, Chun-Ju Lin, Chun-Chi Chiang, Yi-Ching Shao, Huan-Sheng Chen, Yi-Yu Tsai, James Cheng-Chung Wei","doi":"10.1016/j.ophtha.2024.11.008","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.11.008","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the risk of uveitis among e-cigarette users METHODS: The TriNetX database was used to recruit adult patients with and without a history of e-cigarette usage. The primary outcome was the incidence of new-onset uveitis.</p><p><strong>Results: </strong>E-cigarette users were associated with an increased risk for uveitis compared to non-users (HR: 2.53, CI: 2.33-2.76). Subgroup analysis revealed an increased risk of uveitis among e-cigarette users aged 18-39 years (HR: 2.59, CI: 2.11-3.17), 40-64 years (HR: 2.20, CI: 1.95-2.48) and ≥65 years (HR: 3.15, CI: 2.72-3.64).</p><p><strong>Conclusions: </strong>An increased risk for uveitis was seen among e-cigarette users compared to non-users.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625153","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 Imaging of Nanophthalmos with Choroidal Congestion.","authors":"Xiaojun Li, Yonghao Gu, Kai Zhu","doi":"10.1016/j.ophtha.2024.10.016","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.10.016","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625154","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":"Intravitreal Melphalan for Vitreous Metastases from Cutaneous Melanoma.","authors":"Rachel E Cain, Yu-Bai Chou, Carol L Shields","doi":"10.1016/j.ophtha.2024.10.015","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.10.015","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625117","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":"Michael X Lin, Esen K Akpek","doi":"10.1016/j.ophtha.2024.10.014","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.10.014","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625104","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}