Ophthalmology最新文献

{"title":"Bilateral Diffuse Uveal Melanocytic Proliferation with Oral Mucosal Pigmentation.","authors":"Mutaz Al-Nawaflh, Jill Wells","doi":"10.1016/j.ophtha.2024.07.011","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.07.011","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":"141913596","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":"Demodex in Meibum.","authors":"Nuan Zhang, Lingyi Liang","doi":"10.1016/j.ophtha.2024.07.009","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.07.009","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":"141913597","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":"Eye on Hydrochlorothiazide: Unraveling the Mystery of Choroidal-Effusion.","authors":"Rashmi Mittal, Chitralekha De","doi":"10.1016/j.ophtha.2024.07.024","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.07.024","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":"141913599","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":"The clinical utility of a glaucoma polygenic risk score in four population-based European-ancestry cohorts.","authors":"Victor A de Vries, Akiko Hanyuda, Joëlle E Vergroesen, Ron Do, David S Friedman, Peter Kraft, Constance Turman, Yuyang Leo Luo, Jessica H Tran, Bart Liefers, Sze H Wong, Rachel H Lee, Nazlee Zebardast, Caroline C W Klaver, Ayellet V Segrè, Louis R Pasquale, Janey L Wiggs, Jae H Kang, Wishal D Ramdas","doi":"10.1016/j.ophtha.2024.08.005","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.08.005","url":null,"abstract":"<p><strong>Objective: </strong>We used a polygenic risk score (PRS) to identify high-risk groups for primary open-angle glaucoma (POAG) within population-based cohorts.</p><p><strong>Design: </strong>Secondary analysis of four prospective population-based studies.</p><p><strong>Participants: </strong>We included four European-ancestry cohorts: the United States (US) based Nurses' Health Study (NHS), NHS2, and the Health Professionals Follow-up Study, and the Rotterdam Study (RS) in the Netherlands. The US cohorts included female nurses and male health professionals aged 55+ years. The RS included residents aged 45 years or older living in Rotterdam, the Netherlands.</p><p><strong>Methods: </strong>PRS weights were estimated by applying the Lassosum method on imputed genotype and phenotype data from the UK-Biobank. This resulted in 144,020 variants, single nucleotide polymorphism (SNPs) and indels, with non-zero betas that we used to calculate a PRS in the target populations. Using multivariable Cox proportional hazard models, we estimated the relationship between the standardized PRS and relative risk for POAG. Additionally, POAG prediction was tested by calculating these models' concordance (Harrell's C-statistic). Finally, we assessed the association between PRS tertiles and glaucoma-related traits.</p><p><strong>Main outcome measures: </strong>The relative risk for POAG and Harrell's C-statistic (the equivalent of an area-under-the-curve for longitudinal models).</p><p><strong>Results: </strong>Among 1,046 cases and 38,809‬ controls, the relative risk (95% confidence interval) for POAG for participants in the highest PRS quintile was 3.99 (3.08, 5.18) in the US cohorts, and 4.89 (2.93, 8.17) in the Rotterdam Study, compared with participants with median genetic risk (3^rd quintile). In restricted cubic spline analyses, the relation between continuous PRS and POAG risk increased exponentially in the US and Rotterdam cohorts (P_spline<0.05). Combining age, sex, intraocular pressure >25 mmHg, and family history resulted in a meta-analyzed concordance of 0.75 (0.73, 0.75). Adding the PRS to this model improved the concordance to 0.82 (0.80, 0.84). In a meta-analysis of all cohorts, cases in the highest tertile had a larger cup-disc ratio at diagnosis, by 0.11 (0.07, 0.15), and a 2.07-fold increased risk of requiring glaucoma surgery (1.19, 3.60).</p><p><strong>Conclusions: </strong>Incorporating a PRS into a POAG predictive model improves identification concordance from 0.75 up to 0.82, supporting its potential for guiding more cost-effective screening strategies.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":null,"pages":null},"PeriodicalIF":13.1,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917276","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: Balancing Benefits and Risks: The Case for Retinal Images to Be Considered as Nonprotected Health Information for Research Purposes.","authors":"","doi":"10.1016/j.ophtha.2024.07.031","DOIUrl":"10.1016/j.ophtha.2024.07.031","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":null,"pages":null},"PeriodicalIF":13.1,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913595","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":"Reporting Clinical Endpoints in Studies of Minimally Invasive Glaucoma Surgery.","authors":"Steven J Gedde, Kateki Vinod, Eileen C Bowden, Natasha N Kolomeyer, Vikas Chopra, Pratap Challa, Donald L Budenz, Michael X Repka, Flora Lum","doi":"10.1016/j.ophtha.2024.07.030","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.07.030","url":null,"abstract":"<p><p>Minimally invasive glaucoma surgery (MIGS) refers to a group of procedures generally characterized by an ab interno approach, minimal trauma to ocular tissue, moderate efficacy, an excellent safety profile, and rapid recovery. The number of MIGS procedures continues to increase, and their use has become widespread among glaucoma and cataract specialists. Standardization of the methodology and reporting of clinical endpoints in MIGS investigations enhances interpretation and comparison across different studies. The assessment of surgical interventions should not only consider statistical significance, but also whether the outcome is meaningful to patients. Minimal clinically important difference (MCID) is defined as the smallest change in a treatment outcome that is considered beneficial for an individual patient and prompts a change in their clinical management, and expert consensus is an accepted approach to determine the MCID. The American Academy of Ophthalmology's Glaucoma Preferred Practice Pattern Panel is an expert panel that develops guidelines identifying characteristics and components of quality eye care. The panel recommends that the cumulative probability of surgical success at 2 years with Kaplan-Meier survival analysis be used as the primary efficacy endpoint in MIGS studies. The panel suggests that surgical success for standalone MIGS be defined as intraocular pressure (IOP) ≤ 21 mmHg and reduced ≥ 20% from baseline without an increase in glaucoma medications, additional laser or incisional glaucoma surgery, loss of light perception vision, or hypotony. The proposed MCID for the cumulative probability of success of standalone MIGS at 2 years is 50%. The panel recommends that surgical success for MIGS combined with cataract extraction with intraocular lens implantation (CE-IOL) be defined as a decrease in glaucoma medical therapy ≥ 1 medication from baseline without an increase in IOP, or IOP ≤ 21 mmHg and reduced ≥ 20% from baseline without an increase in glaucoma medications, additional laser or incisional glaucoma surgery, loss of light perception vision, or hypotony. The suggested MCID for the cumulative probability of success for CE-IOL/MIGS at 2 years is 65%.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":null,"pages":null},"PeriodicalIF":13.1,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913602","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":"Perspectives on the incidence of Acanthamoeba Keratitis: A Systematic Review and Meta-Analysis.","authors":"Francesco Aiello, Gabriele Gallo Afflitto, Francesca Ceccarelli, Maria Vittoria Turco, Yuyi Han, Guillermo Amescua, John K Dart, Carlo Nucci","doi":"10.1016/j.ophtha.2024.08.003","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.08.003","url":null,"abstract":"<p><strong>Topic: </strong>To provide an overview on the incidence of Acanthamoeba Keratitis (AK).</p><p><strong>Clinical relevance: </strong>Although being a major and sight-threatening cause of infectious keratitis in the population, a comprehensive assessment of the incidence of this condition is lacking.</p><p><strong>Methods: </strong>Incidence of AK was computed as the number of AK eyes, per healthcare center, per year (annualized-center-incidence, or ACI). Two meta-analytical ratios were also calculated: a) the ratio of AK eyes to the count of non-viral microbial keratitis (MK) eyes; b) the ratio of AK eyes to the overall population (i.e., the total number of subjects of a nation or region, as indicated by the authors in each study). Center was defined as the healthcare facility (e.g., Hospital, Private Practice, Clinic) where the study took place. Actual and projected estimates of the number of AK eyes in years were calculated multiplying the ratio of AK to the total population and the corresponding present and projected population estimates (age range: 15 to 70), sourced from the United Nations (UN) Population Prospects.</p><p><strong>Results: </strong>Overall, 105 articles were included, published between 1987 and 2022. The total number of eyes identified was 91,951, with 5,660 affected by AK and 86,291 by non-viral MK. The median ACI was 1.9 new AK eyes per healthcare center per year (95%CI of the median: 1.5 to 2.6), with no statistically significant differences observed among continents. The ratio of AK eyes to the total number of MK eyes was 1.52% (95%CI: 1.02% to 2.24%), while the ratio of AK in relation to the entire population was estimated at 0.0002% (95%CI: 0.0001 to 0.0006), or 2.34 eyes per 1,000,000 subjects (95%CI: 0.98 to 5.55 per 1.000.000 subjects). The projected increase in the numbers of AK eyes indicates a rise of +18.5% (15,356 AK eyes) in 2053 and +25.5% (16,253 AK eyes) in 2073, compared to the baseline of 2023 (12,954 AK eyes) CONCLUSION: AK emerged as a relatively low-incident disorder, and no significant differences in terms of its incidence were found among different continents.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":null,"pages":null},"PeriodicalIF":13.1,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913601","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":"Confluent Drusen in a Young Woman with Bannayan-Riley-Ruvalcaba Syndrome.","authors":"Bruna Depieri Michels, Ana Bárbara Dias Lopes Urzedo, Kenzo Hokazono","doi":"10.1016/j.ophtha.2024.07.007","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.07.007","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":null,"pages":null},"PeriodicalIF":13.1,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902521","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":"Immune Checkpoint Inhibitor Therapy for Periocular Merkel Cell Carcinoma.","authors":"Joshua Hohlbein, Janet Fan, Hila Goldberg, Tracy Lu, Anastasios Maniakas, Michael Wong, Bita Esmaeli","doi":"10.1016/j.ophtha.2024.08.004","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.08.004","url":null,"abstract":"<p><p>We herein report four patients with periocular Merkel cell carcinoma treated with immune checkpoint inhibitors who experienced a dramatic response and, therefore, had less morbid surgery and/or avoided radiation therapy with its inherent ocular toxicity.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":null,"pages":null},"PeriodicalIF":13.1,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913600","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 ocular neovascular conversion and systemic bleeding complications in patients with AMD on DOACs or Warfarin.","authors":"Amer F Alsoudi, Euna Koo, Karen Wai, Prithvi Mruthyunjaya, Ehsan Rahimy","doi":"10.1016/j.ophtha.2024.07.034","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.07.034","url":null,"abstract":"<p><strong>Purpose: </strong>Conversion to neovascular disease in patients with non-neovascular age-related macular degeneration (AMD) initiated on direct oral anticoagulants (DOAC) compared to matched patients treated with warfarin.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Subjects, participants, and/or controls: </strong>The study included 20,300 patients and 13,387 patients with non-neovascular AMD initiated on DOACs or warfarin, respectively, before propensity score matching (PSM).</p><p><strong>Methods, intervention, or testing: </strong>TriNetX (Cambridge, MA, USA), was used to identify patients diagnosed with non-neovascular AMD stratified by treatment with DOACs or warfarin with at least six months of follow-up. Propensity score matching was performed to control for baseline demographics and medical comorbidities.</p><p><strong>Main outcome measures: </strong>Relative risk (RR) of developing neovascular AMD, macular hemorrhage (MH), vitreous hemorrhage (VH), and requiring an ocular intervention (intravitreal anti-vascular endothelial growth factor (VEGF) therapy or pars plana vitrectomy (PPV)) within six months and one year. Patients with chronic atrial fibrillation (AF) on anticoagulation were separately evaluated for the same measures within 5 years after initiating therapy.</p><p><strong>Results: </strong>Treatment with warfarin was associated with higher risk of developing neovascular AMD at six months (RR,1.24, 95% CI, 1.12 - 1.39; P<.001) and one year (RR, 1.26, 95% CI, 1.14 - 1.40; P<.001) when compared to matched patients treated with DOACs. There was an increased risk of requiring intravitreal anti-VEGF therapy (6 months: RR, 1.30; 95% CI, 1.13-1.49; P<.001; 1 year: RR, 1.31, 95% CI, 0.72 - 2.05; P<.001) and PPV (6 months: RR, 1.16; 95% CI, 1.16-3.94; P = .01; 1 year: RR, 2.29, 95% CI, 1.30 - 4.05; P=.003). Among patients with AMD and AF treated with warfarin, there was an increased risk of ocular complications (neovascular AMD: RR, 1.25; 95% CI, 1.14-1.38; P<.001; MH: RR, 1.86; 95% CI, 1.47-2.35; P<.001; VH: RR, 2.22; 95% CI, 1.51-3.26; P<.001) and need for intravitreal anti-VEGF therapy (RR, 1.34; 95% CI, 1.18-1.52; P<.001) over an extended 5-year period. There was no significant difference in the development of major systemic hemorrhagic events between the two cohorts over five years.</p><p><strong>Conclusions: </strong>Patients with non-neovascular AMD treated with warfarin were more likely to develop neovascular disease and require ocular intervention for hemorrhagic complications when compared to matched patients initiated on DOACs.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":null,"pages":null},"PeriodicalIF":13.1,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907263","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}