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Intra-anterior Chamber Calcium Crystals. 前房钙晶体。
IF 9.5 1区 医学
Ophthalmology Pub Date : 2025-08-05 DOI: 10.1016/j.ophtha.2025.07.004
Seitaro Komai, Hideki Fukuoka, Chie Sotozono
{"title":"Intra-anterior Chamber Calcium Crystals.","authors":"Seitaro Komai, Hideki Fukuoka, Chie Sotozono","doi":"10.1016/j.ophtha.2025.07.004","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.07.004","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789648","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}
引用次数: 0
Outpatient Oral Doxycycline versus Intravenous Penicillin for Syphilitic Uveitis. 门诊口服强力霉素与静脉注射青霉素治疗梅毒葡萄膜炎。
IF 9.5 1区 医学
Ophthalmology Pub Date : 2025-08-05 DOI: 10.1016/j.ophtha.2025.07.030
Yicheng K Bao, Jodi Hwang, Christopher Long, Kusha Davar, Nahel Kapadia, Brad Spellberg, Brandon Wong, Narsing Rao, Brian C Toy
{"title":"Outpatient Oral Doxycycline versus Intravenous Penicillin for Syphilitic Uveitis.","authors":"Yicheng K Bao, Jodi Hwang, Christopher Long, Kusha Davar, Nahel Kapadia, Brad Spellberg, Brandon Wong, Narsing Rao, Brian C Toy","doi":"10.1016/j.ophtha.2025.07.030","DOIUrl":"10.1016/j.ophtha.2025.07.030","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794949","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}
引用次数: 0
Global Prevalence of Congenital Color Vision Deficiency among Children and Adolescents, 1932-2022. 儿童和青少年先天性色觉缺陷的全球患病率,1932-2022。
IF 9.5 1区 医学
Ophthalmology Pub Date : 2025-08-05 DOI: 10.1016/j.ophtha.2025.07.031
Yi Deun Jeong, Jaehyeong Cho, Yejun Son, Yeona Jo, Yesol Yim, Tae Hyeon Kim, Soeun Kim, Hanseul Cho, Masoud Rahmati, Lee Smith, Ho Geol Woo, Ja Hye Kim, Yoon Jeon Kim, Jee Myung Yang, Dong Keon Yon
{"title":"Global Prevalence of Congenital Color Vision Deficiency among Children and Adolescents, 1932-2022.","authors":"Yi Deun Jeong, Jaehyeong Cho, Yejun Son, Yeona Jo, Yesol Yim, Tae Hyeon Kim, Soeun Kim, Hanseul Cho, Masoud Rahmati, Lee Smith, Ho Geol Woo, Ja Hye Kim, Yoon Jeon Kim, Jee Myung Yang, Dong Keon Yon","doi":"10.1016/j.ophtha.2025.07.031","DOIUrl":"10.1016/j.ophtha.2025.07.031","url":null,"abstract":"<p><strong>Purpose: </strong>To estimate the prevalence of congenital color vision deficiency (CVD), categorized by geographical region, ethnicity, type (deutan, protan, and tritan), and severity (anomalous trichromacy, dichromacy, and monochromacy).</p><p><strong>Design: </strong>Systematic review and meta-analysis of the literature.</p><p><strong>Participants: </strong>A total of 1 703 619 participants, including 31 493 patients from 56 studies across 21 countries and 5 continents, were included in our analysis.</p><p><strong>Methods: </strong>We conducted a systematic search of PubMed/MEDLINE, Embase, CINAHL, and Google Scholar databases from 1930 through August 12, 2024. We used strict inclusion criteria, limiting the analysis to studies of children and adolescents in the general population. National and regional prevalence estimates were analyzed, with additional subanalyses by ethnicity, type, and severity.</p><p><strong>Main outcome measures: </strong>Pooled estimates for the prevalence of CVD.</p><p><strong>Results: </strong>The global prevalence of CVD was estimated at 2.59% (95% confidence interval [CI], 2.20-3.03; I<sup>2</sup> = 99.37), with higher rates observed in male patients (4.38% [95% CI, 3.93%-4.88%]) compared with female patients (0.64% [95% CI, 0.46%-0.89%]). Among ancestries, individuals of European descent exhibited the highest prevalence (2.77% [95% CI, 2.10%-3.64%]), closely followed by those of African descent (2.69% [95% CI, 2.21%-3.28%]). Regionally, Oceania displayed the highest prevalence (4.37% [95% CI, 3.36%-5.68%]), followed by Africa (2.86% [95% CI, 2.36%-3.46%]). Across all CVD types and severities, male patients consistently showed higher prevalence rates than female patients. In terms of CVD types, the highest prevalence was observed for deutan in both sexes (male, 3.66% [95% CI, 3.02%-4.44%]; female, 0.46% [95% CI, 0.30%-0.69%]), followed by protan (male, 1.54% [95% CI, 1.30%-1.82%]; female, 0.30% [95% CI, 0.21%-0.43%]) and tritan (male, 0.67% [95% CI, 0.20%-2.22%]). Regarding severity, male patients showed the highest prevalence of dichromacy (1.59% [95% CI, 1.33%-1.90%]), followed by anomalous trichromacy (1.17% [95% CI, 0.89%-1.55%]) and monochromacy (0.36% [95% CI, 0.22%-0.61%]). For female patients, anomalous trichromacy showed the highest prevalence (0.38% [95% CI, 0.25%-0.56%]), followed by dichromacy (0.27% [95% CI, 0.19%-0.39%]) and monochromacy (0.10% [95% CI, 0.04%-0.21%]).</p><p><strong>Conclusions: </strong>This study highlights that the prevalence of CVD varies significantly by region and ethnicity.</p><p><strong>Financial disclosure(s): </strong>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794947","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}
引用次数: 0
Don’t Close Medical Libraries: That’s Where You Find Librarian Partners to Advance Medicine and Science 不要关闭医学图书馆:在那里你可以找到馆员合作伙伴来推进医学和科学。
IF 9.5 1区 医学
Ophthalmology Pub Date : 2025-07-31 DOI: 10.1016/j.ophtha.2025.07.005
Daniel Albert MD, MS, Russell N. Van Gelder MD, PhD
{"title":"Don’t Close Medical Libraries: That’s Where You Find Librarian Partners to Advance Medicine and Science","authors":"Daniel Albert MD, MS,&nbsp;Russell N. Van Gelder MD, PhD","doi":"10.1016/j.ophtha.2025.07.005","DOIUrl":"10.1016/j.ophtha.2025.07.005","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"132 10","pages":"Pages 1073-1075"},"PeriodicalIF":9.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753948","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}
引用次数: 0
Survival Outcomes of Uveal Melanoma Involving the Anterior Chamber of the Eye: A National Retrospective Cohort Study: Denmark, 1943-2022. 累及眼睛前房的葡萄膜黑色素瘤的生存结局。一项全国性回顾性队列研究:丹麦,1943-2022。
IF 9.5 1区 医学
Ophthalmology Pub Date : 2025-07-30 DOI: 10.1016/j.ophtha.2025.07.027
Kristoffer Nissen, Astrid-Helene Ravn Jørgensen, Susanne Rosthøj, Søren Thomsen, Tine Gadegaard Hindso, Carsten Faber, Mette Bagger, Steffen Heegaard, Jens Folke Kiilgaard
{"title":"Survival Outcomes of Uveal Melanoma Involving the Anterior Chamber of the Eye: A National Retrospective Cohort Study: Denmark, 1943-2022.","authors":"Kristoffer Nissen, Astrid-Helene Ravn Jørgensen, Susanne Rosthøj, Søren Thomsen, Tine Gadegaard Hindso, Carsten Faber, Mette Bagger, Steffen Heegaard, Jens Folke Kiilgaard","doi":"10.1016/j.ophtha.2025.07.027","DOIUrl":"10.1016/j.ophtha.2025.07.027","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate survival patterns of uveal melanomas involving the anterior chamber by tumor extension and primary tumor location.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Participants: </strong>Patients diagnosed with uveal melanoma in Denmark between 1943 and 2022 were identified, and cases were reviewed. Patients with tumors involving the anterior chamber were included and categorized into 4 groups based on tumor anatomic extent and configuration: (1) isolated iris melanomas, (2) iris and ciliary body tumors, (3) ring melanomas, and (4) tumors involving iris, ciliary body, and choroid.</p><p><strong>Methods: </strong>Patient data were analyzed using survival analysis techniques. Cumulative incidences of metastatic death were calculated using competing risk methods. Cause-specific hazard ratios (HRs) were estimated using Cox proportional hazards regression. Restricted mean survival time and life-years lost were calculated at the 10-year and 20-year follow-ups.</p><p><strong>Main outcome measures: </strong>Primary outcome was mortality resulting from uveal melanoma metastasis. Secondary measures included cumulative incidences, cause-specific HR, restricted mean survival time, and life-years lost at 10 and 20 years.</p><p><strong>Results: </strong>Among 3859 eligible patients, 789 patients had tumors with anterior chamber involvement, of which 786 patients were included in the analysis. The 20-year cumulative incidence of metastatic death was 0.7% for isolated iris melanomas, 10% for tumors involving the iris and ciliary body, 32% for ring melanomas, and 68% for tumors involving all 3 uveal structures. Compared with tumors involving the iris and ciliary body, the HR was 0.05 (Confidence interval [CI] 0.01-0.4) for isolated iris melanomas, 5.0 (CI, 2.5-10.3) for ring melanomas, and 15.3 (CI, 8.3-28.3) for tumors involving all uveal structures. Ring melanomas significantly worsened survival in iris melanomas (HR, 51.7, CI, 11.2- 239.3) but not in ciliary body melanomas. Among tumors involving both the iris and ciliary body, those primarily located in the ciliary body showed substantially higher mortality (HR, 19.1, CI, 2.4-149.5).</p><p><strong>Conclusions: </strong>Survival outcomes of uveal melanomas involving the anterior chamber varies by anatomic extension. Ring melanomas resemble ciliary body melanomas in survival outcomes and drive poor prognosis in iris melanomas. Excluding ring melanomas, tumors primarily located in the iris have very low metastatic potential, even with ciliary body involvement. Tumors involving all 3 uveal structures are associated with extremely poor outcomes.</p><p><strong>Financial disclosure(s): </strong>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765123","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}
引用次数: 0
Diffuse Corneal Deposits After Long-Term Rifabutin Use. 长期使用瑞福汀后弥漫性角膜沉积。
IF 9.5 1区 医学
Ophthalmology Pub Date : 2025-07-29 DOI: 10.1016/j.ophtha.2025.07.001
Adam Snowden, Andrew Lima, Praneetha Thulasi
{"title":"Diffuse Corneal Deposits After Long-Term Rifabutin Use.","authors":"Adam Snowden, Andrew Lima, Praneetha Thulasi","doi":"10.1016/j.ophtha.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.07.001","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732504","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}
引用次数: 0
Impact of Antiviral Therapy in Cytomegalovirus-Positive Anterior Uveitis: Recurrence Risk and Corneal Endothelial Cell Protection. 抗病毒治疗对cmv阳性前葡萄膜炎的影响:复发风险和角膜内皮细胞保护。
IF 9.5 1区 医学
Ophthalmology Pub Date : 2025-07-29 DOI: 10.1016/j.ophtha.2025.07.023
Myoung Hee Park, Ji Young Lee, Soo Ji Jeon, Sung Eun Kim, Yong Sun Ahn, Su Jin Lim, Jin A Choi, Min Ho Kim
{"title":"Impact of Antiviral Therapy in Cytomegalovirus-Positive Anterior Uveitis: Recurrence Risk and Corneal Endothelial Cell Protection.","authors":"Myoung Hee Park, Ji Young Lee, Soo Ji Jeon, Sung Eun Kim, Yong Sun Ahn, Su Jin Lim, Jin A Choi, Min Ho Kim","doi":"10.1016/j.ophtha.2025.07.023","DOIUrl":"10.1016/j.ophtha.2025.07.023","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the risk of recurrence of anterior uveitis (AU) with positive polymerase chain reaction results for cytomegalovirus (CMV)-AU before and after initiation of antiviral therapy and compare the efficacy and safety of 2 treatment strategies: (1) initial oral valganciclovir followed by topical 0.15% ganciclovir and (2) continuous topical 2% ganciclovir.</p><p><strong>Design: </strong>Retrospective cohort study from a tertiary ophthalmic center and a uveitis-specialized private clinic.</p><p><strong>Participants: </strong>Patients with CMV-AU who received antiviral therapy from May 2015 to March 2024.</p><p><strong>Methods: </strong>Clinical records were analyzed retrospectively across the study period. Patients were treated with (1) a 6-week course of oral valganciclovir, followed by 0.15% ganciclovir ointment (oral to 0.15% group), or (2) continuous treatment with 2% topical ganciclovir (2% topical group). Recurrence rates were compared for the year before and after treatment initiation, expressed per person-years (PYs). Recurrence-free survival was analyzed using Kaplan-Meier analysis. A severe corneal endothelial cell (EC) loss was defined as ≥5% yearly loss from the baseline.</p><p><strong>Main outcome measures: </strong>Recurrence rate (PYs) and a severe EC loss.</p><p><strong>Results: </strong>A total of 136 patients were included, with a median follow-up of 27 months (346.8 PYs). The recurrence rate significantly decreased from 2.87 PYs before treatment to 1.16 PYs after treatment (59.6% reduction; P < 0.0001). Post-treatment recurrence occurred in 98 patients (72.0%) after treatment. The median recurrence-free survival was 5.0 months (95% confidence interval [CI], 3.4-6.6), with a 1-year recurrence-free survival rate of 31.0%. Recurrence rates were reduced by 54.3% in the oral to 0.15% group (n = 113) and by 78.8% in the 2% topical group (n = 23). No recurrences occurred during the initial 6-week oral valganciclovir phase. Severe EC loss was more frequent in the 2% topical group (70.0%) compared with the oral to 0.15% group (34.4%; P = 0.003). Multivariate logistic regression identified that 2% topical treatment, compared with the oral to 0.15% regimen, was associated with severe EC loss (Exp (B) = 3.68; P = 0.032), after adjusting for age, sex, total follow-up period, and total recurrence number.</p><p><strong>Conclusions: </strong>Cytomegalovirus AU exhibited a very high recurrence rate, which was significantly reduced by antiviral therapy. Oral valganciclovir preserved corneal EC better than 2% ganciclovir but featured increased recurrence after step-down to the 0.15% ganciclovir.</p><p><strong>Financial disclosure(s): </strong>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760669","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}
引用次数: 0
Disparities in Presentation and Anti-VEGF Therapy Initiation for Neovascular Age-Related Macular Degeneration: An Analysis of the Academy IRIS® Registry. 新生血管性AMD的表现和抗vegf治疗开始的差异:学院IRIS®注册的分析
IF 9.5 1区 医学
Ophthalmology Pub Date : 2025-07-28 DOI: 10.1016/j.ophtha.2025.07.024
Binod Acharya, Bita Momenaei, Qiang Zhang, Leslie Hyman, Julia A Haller
{"title":"Disparities in Presentation and Anti-VEGF Therapy Initiation for Neovascular Age-Related Macular Degeneration: An Analysis of the Academy IRIS® Registry.","authors":"Binod Acharya, Bita Momenaei, Qiang Zhang, Leslie Hyman, Julia A Haller","doi":"10.1016/j.ophtha.2025.07.024","DOIUrl":"10.1016/j.ophtha.2025.07.024","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate disparities in presentation and initiation of anti-VEGF therapy among patients with neovascular age-related macular degeneration (nAMD).</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Participants: </strong>Patients with nAMD newly diagnosed between October 2016 and October 2021 from the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight).</p><p><strong>Methods: </strong>Associations between demographic characteristics, presenting visual acuity (VA), and the initiation of anti-VEGF treatment were assessed using multivariable Poisson regression models.</p><p><strong>Main outcome measures: </strong>Treatment initiation with ≥ 1 anti-VEGF injections within 12 months after first presentation with nAMD.</p><p><strong>Results: </strong>Among the 918 759 patients with nAMD (61.5% female, 82.3% White), male, Black, and Hispanic patients demonstrated nAMD at younger ages (P < 0.001). Of these, 719 204 patients (78.3%) initiated anti-VEGF treatment within 1 year, with 71.1% of patients (653 340/918 759) receiving the first injection within 1 month. In multivariable regression analysis, Black patients (rate ratio [RR], 0.91; 95% confidence interval [CI], 0.89-0.93; P < 0.001) and Asian patients (RR, 0.95; CI, 0.93-0.97; P < 0.001) were less likely to initiate treatment compared with White patients. Hispanic patients were 4% less likely to initiate treatment than non-Hispanic patients (RR, 0.96; 95% CI, 0.95-0.98; P < 0.001). Patients older than 60 years (vs. those 50-59 years of age) were more likely to initiate treatment (P < 0.001 for all age group comparisons), as were patients from the West (vs. South) region (P < 0.001). Among 701 309 patients with VA data, patients with VA of worse than 20/40 to 20/200 were more likely to initiate treatment (RR, 1.14; 95% CI, 1.12-1.15) than those with 20/20 or better VA, whereas those with hand movements VA (RR, 0.72; 95% CI, 0.69-0.75) and light perception or worse VA (RR, 0.49; 95% CI, 0.44-0.54; all P < 0.001) were less likely to initiate treatment.</p><p><strong>Conclusions: </strong>Over 20% of patients with nAMD did not initiate treatment within 1 year of presentation. Results suggest that lower treatment initiation rates are associated with Black and Asian race, Hispanic ethnicity, age younger than 60 years, and low-vision status. Efforts to improve treatment uptake might prioritize groups with lower initiation rates.</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":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753947","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}
引用次数: 0
Peripheral Corneal Perforation After Acute Hydrops in Keratoconus. 急性圆锥角膜积液后角膜周围穿孔。
IF 9.5 1区 医学
Ophthalmology Pub Date : 2025-07-28 DOI: 10.1016/j.ophtha.2025.06.029
Hideki Fukuoka, Chie Sotozono
{"title":"Peripheral Corneal Perforation After Acute Hydrops in Keratoconus.","authors":"Hideki Fukuoka, Chie Sotozono","doi":"10.1016/j.ophtha.2025.06.029","DOIUrl":"https://doi.org/10.1016/j.ophtha.2025.06.029","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732505","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}
引用次数: 0
Peripapillary Hyperreflective Ovoid Mass-like Structures before and after Intracranial Decompression: A Longitudinal Cohort Study. 颅内减压前后乳头周围高反射卵形肿块样结构:一项纵向队列研究。
IF 9.5 1区 医学
Ophthalmology Pub Date : 2025-07-28 DOI: 10.1016/j.ophtha.2025.07.025
Yoon-Hee Chang, Ryan Gise, Tais Estrela, David Zurakowski, Steven J Staffa, Jacqueline Jeon-Chapman, Linda R Dagi
{"title":"Peripapillary Hyperreflective Ovoid Mass-like Structures before and after Intracranial Decompression: A Longitudinal Cohort Study.","authors":"Yoon-Hee Chang, Ryan Gise, Tais Estrela, David Zurakowski, Steven J Staffa, Jacqueline Jeon-Chapman, Linda R Dagi","doi":"10.1016/j.ophtha.2025.07.025","DOIUrl":"10.1016/j.ophtha.2025.07.025","url":null,"abstract":"<p><strong>Purpose: </strong>To appraise the association of peripapillary hyperreflective ovoid mass-like structures (PHOMS) with the need for intracranial pressure (ICP) decompression surgery and to study the impact of decompression surgery on the persistence of PHOMS.</p><p><strong>Design: </strong>Retrospective, longitudinal cohort study.</p><p><strong>Participants: </strong>Patients with syndromic craniosynostosis evaluated at Boston Children's Hospital (2010-2023) who had a minimum of 2 consecutive optic nerve volume scans.</p><p><strong>Methods: </strong>Consecutive OCT volume scans were reviewed by 2 neuro-ophthalmologists to determine the presence of PHOMS. Demographic and ophthalmic features and history of elevated ICP, ICP decompression procedures, presence of Chiari malformation, and obstructive sleep apnea were noted for each patient.</p><p><strong>Main outcome measures: </strong>Primary outcomes were sensitivity, specificity, positive and negative predictive values, and odds of needing a subsequent ICP decompression procedure given the presence of PHOMS. Secondary outcome was the impact of ICP decompression procedures on persistence of PHOMS.</p><p><strong>Results: </strong>Median age of 34 patients at first scan was 7.7 years (interquartile range [IQR], 5.1-11.2), and 59% were female. Diagnoses were Apert (n = 7); Crouzon (n = 10); Muenke (n = 3); Pfeiffer (n = 3); and Saethre-Chotzen (n = 11). Median duration of follow-up was 4.2 years (IQR, 1.4-7.7). Sensitivity and specificity of PHOMS as a predictor of having ICP decompression procedure were 85.7% and 70.4%, respectively. The positive predictive value was 42.9%, and negative predictive value was 95.0%. By using logistic regression, the odds ratio of having subsequent ICP decompression surgery was 14.3:1 (95% confidence interval, 1.47-138.3; P = 0.022) in the presence versus the absence of PHOMS. Resolution of PHOMS during the study period was more common in patients who had ICP decompression than in patients who did not (83.3% vs. 0%, P = 0.003). Kaplan-Meier curves comparing those treated and not treated with ICP decompression surgery demonstrated a faster rate of PHOMS resolution with ICP decompression procedure (log-rank test = 7.87, P = 0.005).</p><p><strong>Conclusions: </strong>Presence of PHOMS was significantly associated with the need for a subsequent ICP decompression procedure. If PHOMS were absent, it was highly unlikely that ICP decompression was indicated. Resolution of PHOMS was highly associated with ICP decompression surgery and might prove to be a convenient noninvasive measure of success.</p><p><strong>Financial disclosure(s): </strong>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753949","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}
引用次数: 0
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