Ophthalmology最新文献

{"title":"En Breve","authors":"Sandeep Ravindran PhD","doi":"10.1016/j.ophtha.2025.07.013","DOIUrl":"10.1016/j.ophtha.2025.07.013","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"132 10","pages":"Pages e1-e2"},"PeriodicalIF":9.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104999","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":"AAO March 2025 Audit FS Final","authors":"","doi":"10.1016/j.ophtha.2025.08.002","DOIUrl":"10.1016/j.ophtha.2025.08.002","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"132 10","pages":"Pages F1-F41"},"PeriodicalIF":9.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105000","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 association between glaucoma and dementia in a national cohort of All of Us participants.","authors":"Kenneth Pham, Rebecca Salowe, Isabel Di Rosa, Ali G Hamedani, Gui-Shuang Ying, Joan M O'Brien","doi":"10.1016/j.ophtha.2025.09.007","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.09.007","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the association between glaucoma and its subtypes and incidence of dementia and its subtypes across APOE genotypes in the National Institutes of Health (NIH) All of Us Research Program.</p><p><strong>Design: </strong>Retrospective longitudinal cohort study.</p><p><strong>Subjects: </strong>A cohort of individuals with linked electronic health record (EHR) data in the All of Us dataset, with every individual with a glaucoma diagnosis matched with four control participants. Participants diagnosed with dementia prior to glaucoma were excluded.</p><p><strong>Methods: </strong>A 1:4 cohort of participants with a glaucoma diagnosis and control participants was created using a propensity score matching design that considered age, race, ethnicity, and sex. Among participants with whole-genome sequencing data, APOE was genotyped to stratify for sub-analyses. Multivariable Cox regression model was used to adjust for residual imbalance in comorbidities: hypertension, obesity, depression, traumatic brain injury, type 2 diabetes, and hearing loss.</p><p><strong>Main outcome measure: </strong>Incidence of dementia and its subtypes.</p><p><strong>Results: </strong>Among the 393497 All of Us participants with linked EHRs, we identified 9444 individuals (2.40%) with glaucoma diagnoses (excluding participants with diagnoses of dementia before glaucoma) and 37776 matched controls without glaucoma. During the observation period (median: 6.5 years, inter-quartile range: 3.3 to 10.7 years), dementia was diagnosed in 1127 (2.39%) individuals. Glaucoma was associated with a significantly increased risk of all-cause dementia (adjusted HR (aHR): 1.23, 95% CI: 1.08-1.40), Alzheimer's disease (aHR: 1.60, 95% CI: 1.26-2.02), and vascular dementia (aHR: 1.38, 95% CI: 1.04-1.83). Among glaucoma subtypes, primary open-angle glaucoma (POAG, N=5756) and normal-tension glaucoma (NTG, N=1106) was linked to elevated risk of Alzheimer's disease (POAG: aHR: 1.48, 95% CI: 1.11-1.96; NTG: aHR: 1.87, 95% CI: 1.09-3.18), while angle-closure glaucoma (N=3150) showed no significant association (aHR=1.49, 95% CI: 0.91-2.27). Glaucoma was associated with an increased risk of all-cause dementia across the three APOE genotypes assessed, with the greatest increased risk observed in ε2ε3 (N=4965, aHR: 1.76, 95% CI: 1.11-2.79), followed by ε3ε3 (N=23667, aHR: 1.45, 95% CI: 1.19-1.75) and ε3ε4 (N=8544, aHR: 1.43, 95% CI: 1.09-1.87).</p><p><strong>Conclusions: </strong>Glaucoma was associated with a higher risk of dementia with varying associations among glaucoma and dementia subtypes across APOE genotypes.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081348","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 Cartilage Inside the Eye.","authors":"Jie Hu, Kunyi Su, Zhihao Jiang","doi":"10.1016/j.ophtha.2025.06.020","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.06.020","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145054792","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":"Pseudoexfoliation-Related Aqueous Misdirection in a Pseudophakic Eye.","authors":"Lily Farrell, Kaitlyn Brettin, Tatyana Milman","doi":"10.1016/j.ophtha.2025.08.003","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.08.003","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030192","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 Ulceration Associated with Pembrolizumab.","authors":"Meng Wang, Yong Zhong","doi":"10.1016/j.ophtha.2025.07.034","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.07.034","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030134","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":"Bayesian Analysis of Valacyclovir Treatment Effect in the Zoster Eye Disease Study.","authors":"Bennie H Jeng, Ting-Fang Lee, Andrea B Troxel, Ying Lu, Elisabeth J Cohen, Jiyu Kim, Judith S Hochman","doi":"10.1016/j.ophtha.2025.09.002","DOIUrl":"10.1016/j.ophtha.2025.09.002","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145054789","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":"Global gender disparities in access to refractive error services: A systematic review and meta-analysis.","authors":"Sonia Mavi, Noelle Whitestone, Ving Fai Chan, Nathan Congdon, Jacqueline Ramke, Mapa Prabhath Piyasena, Iris Gordon, Jennifer L Patnaik, David H Cherwek, Habtamu Negash, Dongfeng Li, Julie-Anne Little, Gianni Virgili","doi":"10.1016/j.ophtha.2025.08.031","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.08.031","url":null,"abstract":"<p><strong>Topic: </strong>Summarize existing evidence on global gender disparities in access to refractive error (RE) correction, among adults and children.</p><p><strong>Clinical relevance: </strong>Uncorrected refractive error, remains the leading cause of vision impairment worldwide. Women and girls experience disproportionate levels of vision impairment, but gender disparities in access to RE correction are not well understood. Lower coverage among females may lead to prolonged vision impairment and functional limitations, impacting education, employment and quality of life.</p><p><strong>Methods: </strong>We searched MEDLINE (Ovid), Embase (Ovid), Global Health and grey literature sources from inception to 15 February 2024 for population-based, observational studies reporting effective or overall refractive error coverage (REC), stratified by sex. There were no restrictions on language, publication date or location. Titles and abstracts were independently reviewed. Quality appraisal was performed in duplicate using the Joanne Briggs Institute tool. Random effects models were made of the age-adjusted female:male odds ratio of REC, stratifying for age (0-17, >18 years), geographic setting and super-region. The protocol was registered on The International Prospective Register of Systematic Reviews (identifier, CRD42021271297).</p><p><strong>Results: </strong>Across 43 studies in 18 countries, 33,534 (36.7%) of 91,487 adults and 23,008 (2.91%) of 790,145 children had refractive needs. The certainty of evidence for gender disparities in REC was rated as moderate for adults and very low for children using the GRADE approach. Females had lower refractive error coverage than males (OR: 0.86; 95% CI: 0.78-0.96; p = 0.01). Urban, but not rural, females were significantly less likely than males to access RE correction (OR: 0.70; 95% CI: 0.60-0.83; p < 0.01). Gender disparities were most evident in Southeast Asia, East Asia and Oceania, where females were significantly less likely than males to access RE correction (OR: 0.75; 95% CI: 0.62-0.91; p < 0.01). Globally, adult women were less likely to access RE correction than men (OR: 0.85, 95% CI: 0.75-0.96; p = 0.01), but no significant sex differences were observed among children (OR: 0.86, 95% CI: 0.68-1.10; p = 0.24).</p><p><strong>Conclusion: </strong>Targeted interventions are needed to address barriers to refractive services among women and girls, with a particular focus on urban settings, adult women and low-income regions.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040933","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":"Health-Related Quality-of-Life Outcomes for Upper Blepharoplasty and Blepharoptosis Surgery: A Report by the American Academy of Ophthalmology.","authors":"M Reza Vagefi, Vinay K Aakalu, Jill A Foster, Lora R Dagi Glass, Seanna R Grob, Timothy J McCulley, Jeremiah P Tao, Michael T Yen, Michael K Yoon, Stephen J Kim, Edward J Wladis","doi":"10.1016/j.ophtha.2025.07.014","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.07.014","url":null,"abstract":"<p><strong>Purpose: </strong>To review the literature and identify the health-related quality-of-life (HRQL) outcomes that used a validated instrument in the assessment of upper blepharoplasty, blepharoptosis surgery, or combination surgery.</p><p><strong>Methods: </strong>A literature search was last conducted in the PubMed database in January 2025 to identify all studies in the English language investigating HRQL outcomes that used a validated instrument in the assessment of upper blepharoplasty, blepharoptosis surgery, or combination surgery. The literature search yielded 773 citations, and 20 studies met the inclusion criteria. All studies included a validated instrument to assess HRQL. A panel methodologist then assigned a level of evidence rating for each study that met the inclusion criteria.</p><p><strong>Results: </strong>Three studies were rated level I, 8 studies were rated level II, and 9 studies were rated level III. The surgeries performed in the studies included upper blepharoplasty, blepharoptosis correction, or both. Some studies also included the addition of brow ptosis repair. Seven studies focused on the effect of the upper eyelid interventions on dry eye symptoms, 5 of which observed no subjective worsening and 1 of which demonstrated symptoms that were transient. The remaining studies focused on aspects of visual function, patient satisfaction, self-consciousness of appearance, benefit in daily life, ocular symptoms, headache symptoms, or a combination thereof and found a benefit of surgery in these various domains. Three studies that examined the long-term HRQL benefit of blepharoptosis correction noted continued improvement at mean follow-up intervals ranging from 1.5 years to 3.6 years after surgery.</p><p><strong>Conclusions: </strong>Most HRQL studies examining the effects of upper blepharoplasty, blepharoptosis correction, or both on dry eye symptoms found no significant worsening of subjective metrics. Other studies demonstrated that surgery could provide improved HRQL outcomes that persist for several years.</p><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006435","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":"Rose Bengal Electromagnetic Activation with Green Light for Infection Reduction Study: A Randomized Controlled Trial.","authors":"N Venkatesh Prajna, Prajna S Lalitha, Revathi Rajaraman, Sankalp Sharma, Josephine Christy, Naveen Radhakrishnan, Kunal Mandlik, Ana Luisa Höfling-Lima, Denise de Freitas, Camila Kase, Aileen Miwa Tabuse, Talita Trevizani Rocchetti, Srinivas Sai Suma Maalika Kanchugantla, Nicole E Varnado, Sarah Abdelrahman, Benjamin F Arnold, Thomas Leitman, Jennifer Rose-Nussbaumer","doi":"10.1016/j.ophtha.2025.08.027","DOIUrl":"10.1016/j.ophtha.2025.08.027","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the effect of adjunctive rose bengal (RB) photodynamic therapy (PDT) in the treatment of fungal, Acanthamoeba, and smear- or culture-negative infectious keratitis.</p><p><strong>Design: </strong>International, randomized, double-masked, sham-controlled clinical trial.</p><p><strong>Participants: </strong>Patients with corneal ulcers randomized in a 1:1 fashion to 1 of 2 treatment arms: (1) topical antimicrobial therapy plus sham RB PDT or (2) topical antimicrobial therapy plus RB PDT.</p><p><strong>Main outcome measures: </strong>The primary outcome was best spectacle-corrected visual acuity (BSCVA) at 6 months. Secondary outcomes included BSCVA at 3 weeks and 3 months; infiltrate, scar size, or both at 3 weeks, 3 months, and 6 months; and corneal perforation (CP), the rate of therapeutic penetrating keratoplasty (TPK), or both; and microbiological cure rate.</p><p><strong>Results: </strong>Three hundred thirty patients were enrolled. Isolated organisms included filamentous fungus (n = 301 [91%]), Acanthamoeba (n = 10 [3%]), and negative culture or smear findings (n = 19 [6%]). No evidence was found of a benefit of RB PDT versus sham for BSCVA at 6 months (-0.0004; 95% confidence interval [CI], -0.13 to 0.13; P = 0.62). Evidence was found of a statistically significant interaction between treatment arm and fungal organism with regard to BSCVA (P = 0.02). Rose bengal PDT improved BSCVA among eyes with Fusarium infections (difference, -0.17 logarithm of the minimum angle of resolution [logMAR]; 95% CI, -0.37 to 0.03 logMAR), but worsened BSCVA among eyes with Aspergillus infections (difference, 0.39 logMAR; 95% CI, -0.03 to 0.80 logMAR). Scar size was 0.45 mm smaller in the RB PDT group at 3 weeks (95% CI, -0.76 to -0.15 mm; P = 0.004), but this finding was no longer statistically significant at 3 and 6 months. No difference between groups was found in rates of CP, TPK, or microbiological cure.</p><p><strong>Conclusions: </strong>We were unable to find a benefit of adjuvant RB PDT overall. Future directions may include trying alternative photosensitizers or other treatment algorithms.</p><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001033","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}