Ophthalmology and Therapy最新文献

{"title":"Diagnostic Accuracy of Automated Diabetic Retinopathy Image Assessment Software: IDx-DR and RetCAD.","authors":"Andrzej Grzybowski, Piotr Brona, Tomasz Krzywicki, Paisan Ruamviboonsuk","doi":"10.1007/s40123-024-01049-z","DOIUrl":"10.1007/s40123-024-01049-z","url":null,"abstract":"<p><strong>Introduction: </strong>Automated diabetic retinopathy (DR) screening using artificial intelligence has the potential to improve access to eye care by enabling large-scale screening. However, little is known about differences in real-world performance between available algorithms. This study compares the diagnostic accuracy of two AI screening platforms, IDx-DR and RetCAD, for detecting referable diabetic retinopathy (RDR).</p><p><strong>Methods: </strong>Retinal images from 758 patients with diabetes were collected during screening from various clinics in Poland. Each patient was graded by three graders with 320 patients graded by Polish and 438 patients graded by Indian graders, with the majority decision serving as the reference standard. The images were evaluated independently by the IDx-DR and RetCAD algorithms. Sensitivity, specificity, positive and negative predictive values, and agreement between algorithms and human graders were calculated and statistically compared.</p><p><strong>Results: </strong>IDx-DR demonstrated higher sensitivity of 99.3% but lower specificity of 68.9% for RDR detection compared to RetCAD which had 89.4% sensitivity and 94.8% specificity. The positive predictive value was higher for RetCAD (96.4% vs 48.1% for IDx-DR) while the negative predictive value was higher for IDx-DR (99.5% vs 83.1% for RetCAD). Both algorithms achieved high sensitivity (> 95%) for sight-threatening diabetic retinopathy detection.</p><p><strong>Conclusion: </strong>In this direct comparison using the same patient cohort, the two algorithms showed differences in their operating parameters for RDR screening. IDx-DR prioritized avoiding false negatives over false positives while RetCAD maintained a more balanced trade-off. These results highlight the variable performance of current artificial intelligence screening solutions and suggest the importance of considering algorithm performance metrics when deploying automated diabetic retinopathy screening programs, based on available healthcare resources.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"73-84"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-Year Outcomes of Aflibercept in Treat-and-Extend Versus Pro Re Nata Regimens for Bevacizumab-Resistant Diabetic Macular Edema: A Real-World Study.","authors":"Zubeyir Yozgat, Mehmed Ugur Isik, Mehmet Cem Sabaner","doi":"10.1007/s40123-024-01067-x","DOIUrl":"10.1007/s40123-024-01067-x","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to compare the efficacy of the treat-and-extend (TAE) regimen versus the pro re nata (PRN) regimen in patients with bevacizumab-resistant diabetic macular edema (DME) treated with aflibercept, with or without adjunctive laser therapy.</p><p><strong>Methods: </strong>Ninety-one eyes from 91 patients who were switched to aflibercept after three consecutive intravitreal bevacizumab injections for the treatment of DME were included in this retrospective real-world study. The patients were categorized into three groups: TAE (n = 30), TAE + laser (n = 31), and PRN (n = 30). Changes in best-corrected visual acuity and central macular subfield thickness (CMST) at 12, 24, and 52 weeks were defined as the primary functional and anatomical outcomes.</p><p><strong>Results: </strong>A total of 91 eyes from 91 patients (49.5% female) with a mean age of 63.9 ± 7.1 years were included in the analysis. At 52 weeks, the mean letter gains were 8.03, 8.90, and 10.23 in the TAE, TAE + laser, and PRN groups, respectively. Anatomical improvements, as measured by CMST reduction, were 55.33 µm, 33.35 µm, and 48.96 µm in the TAE, TAE + laser, and PRN groups, respectively. The average number of injections administered was 7.7, 8.1, and 8.1, respectively. The final extension interval for the TAE group was 8.7 weeks, compared to 9.5 weeks in the TAE + laser group.</p><p><strong>Conclusions: </strong>The PRN group demonstrated the highest functional improvement while the TAE group showed the greatest anatomical improvement. Overall, both anatomical and functional outcomes in the TAE regimen were comparable to the PRN regimen in patients with bevacizumab-resistant diabetic macular edema.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"169-181"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preserflo MicroShunt Implantation: A Narrative Review of Its Standalone Benefits vs. Combined Use with Phacoemulsification in Managing Open-Angle Glaucoma.","authors":"Małgorzata Chilmonczyk, Kinga Gołaszewska, Emil Saeed, Joanna Konopińska","doi":"10.1007/s40123-024-01068-w","DOIUrl":"10.1007/s40123-024-01068-w","url":null,"abstract":"<p><p>Glaucoma and cataract often coexist. Patients with both conditions who qualify for surgical treatment may undergo either a combined surgical procedure or sequential treatments such as cataract surgery followed by an antiglaucoma procedure. A combined procedure with phacoemulsification is related to an increased risk of fibrosis of the filtering bleb; however, it is a rational approach for patients with high intraocular pressure and clinically significant lens opacification. Trabeculectomy has been a traditional filtration procedure for decades, effectively lowering intraocular pressure. It is highly effective; however, it may cause sight-threatening complications. The Preserflo MicroShunt, introduced less than a decade ago in the field of glaucoma surgery, has shown similar hypotensive efficacy to trabeculectomy, and is a less invasive procedure with a better safety profile. Despite their shared mechanism of action to reduce intraocular pressure, the two procedures differ in the extent of scleral incision and filtration bleb morphology, which may influence the extent of the post-surgery inflammation process. This review evaluated and compared reports on the efficacy and safety of Preserflo MicroShunt implantation as a standalone procedure versus combined with cataract removal in surgical treatment for patients with open-angle glaucoma and concomitant cataract.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"41-54"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonclinical Similarity of the Biosimilar Candidate ABP 938 with Aflibercept Reference Product.","authors":"Neungseon Seo, Scott Kuhns, Dina A Andrews, Alexander Colbert, Vincent Chow, Jennifer Liu","doi":"10.1007/s40123-024-01043-5","DOIUrl":"10.1007/s40123-024-01043-5","url":null,"abstract":"<p><strong>Introduction: </strong>ABP 938 is being developed as a biosimilar to Eylea^® (aflibercept reference product [RP]), an anti-vascular endothelial growth factor (VEGF) drug used in the management of retinal diseases. Previously, a comparative analytical similarity assessment demonstrated that ABP 938 and aflibercept RP have the same amino acid sequence and exhibit similar higher-order structure and biological activity. The nonclinical studies described here were designed to assess the in vitro pharmacology and the in vivo pharmacokinetics (PK), toxicokinetics (TK), and safety profiles of ABP 938 compared to aflibercept RP.</p><p><strong>Methods: </strong>In vitro target-binding kinetics and affinity for VEGF-A and placental growth factor (PIGF) isoforms were evaluated using surface plasmon resonance (SPR). Effector functions were assessed by cell-based assays. PK was evaluated in a nonterminal intravitreal (IVT) ocular distribution study in rabbits. Safety was assessed in a 1-month IVT study in cynomolgus monkeys.</p><p><strong>Results: </strong>SPR results demonstrated that ABP 938 is similar to aflibercept RP in binding kinetics and affinity for VEGF-A₁₁₁, VEGF-A₁₂₁, VEGF-A₁₆₅, VEGF-A₁₈₉, PlGF-1, and PlGF-2 isoforms. No antibody-dependent cellular cytotoxicity, antibody-dependent cellular phagocytosis, or complement-dependent cytotoxicity was observed with ABP 938 and aflibercept RP. Results from the nonterminal ocular distribution study in rabbits indicated that there were no meaningful differences in the distribution kinetics between intravitreally injected ABP 938 and aflibercept RP. Additionally, there was no evidence of ocular or systemic toxicity associated with IVT administration of ABP 938 in a repeat-dose, 1-month toxicology study in cynomolgus monkeys; toxicokinetic and toxicology profiles were similar to aflibercept RP.</p><p><strong>Conclusions: </strong>This integrated assessment of results from the in vitro pharmacology assessment and in vivo PK and TK/toxicology profiles formed the nonclinical portion of the totality of evidence demonstrating ABP 938 is a biosimilar to aflibercept RP.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"85-101"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Large Language Models in Cataract Care Information Provision: A Quantitative Comparison.","authors":"Zichang Su, Kai Jin, Hongkang Wu, Ziyao Luo, Andrzej Grzybowski, Juan Ye","doi":"10.1007/s40123-024-01066-y","DOIUrl":"10.1007/s40123-024-01066-y","url":null,"abstract":"<p><strong>Introduction: </strong>Cataracts are a significant cause of blindness. While individuals frequently turn to the Internet for medical advice, distinguishing reliable information can be challenging. Large language models (LLMs) have attracted attention for generating accurate, human-like responses that may be used for medical consultation. However, a comprehensive assessment of LLMs' accuracy within specific medical domains is still lacking.</p><p><strong>Methods: </strong>We compiled 46 commonly inquired questions related to cataract care, categorized into six domains. Each question was presented to the LLMs, and three consultant-level ophthalmologists independently assessed the accuracy of their responses on a three-point scale (poor, borderline, good) and their comprehensiveness on a five-point scale. A majority consensus approach established the final rating for each response. Responses rated as 'Poor' were prompted for self-correction and reassessed.</p><p><strong>Results: </strong>For accuracy, ChatGPT-4o and Google Bard both achieved average sum scores of 8.7 (out of 9), followed by ChatGPT-3.5, Bing Chat, Llama 2, and Wenxin Yiyan. In consensus-based ratings, ChatGPT-4o outperformed Google Bard in the 'Good' rating. For completeness, ChatGPT-4o had the highest average sum score of 13.22 (out of 15), followed by Google Bard, ChatGPT-3.5, Llama 2, Bing Chat, and Wenxin Yiyan. Detailed performance data reveal nuanced differences in model capabilities. In the 'Prevention' domain, apart from Wenxin Yiyan, all other models were rated as 'Good'. All models showed improvement in self-correction. Bard and Bing improved 1/1 from 'Poor' to better, Llama improved 3/4, and Wenxin Yiyan improved 4/5.</p><p><strong>Conclusions: </strong>Our findings emphasize the potential of LLMs, particularly ChatGPT-4o, to deliver accurate and comprehensive responses to cataract-related queries, especially in prevention, indicating potential for medical consultation. Continuous efforts to enhance LLMs' accuracy through ongoing strategies and evaluations are essential.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"103-116"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-Year Comparison of Efficacy and Safety of PreserFlo MicroShunt with Mitomycin C Applied by Sub-Tenon Injection Versus Sponge.","authors":"Nora Majtanova, Adriana Takacova, Veronika Kurilova, Libor Hejsek, Juraj Majtan, Petr Kolar","doi":"10.1007/s40123-024-01074-y","DOIUrl":"10.1007/s40123-024-01074-y","url":null,"abstract":"<p><strong>Introduction: </strong>This study was performed to compare the efficacy and safety of PreserFlo MicroShunt (PMS) implantation with mitomycin C (MMC) applied by sub-tenon injection versus conventional application by MMC-soaked sponges.</p><p><strong>Methods: </strong>This retrospective, 1-year cohort study included 100 eyes of 100 patients with glaucoma who underwent PMS implantation with MMC (0.4 mg/ml) delivered either by sub-tenon injection (50 eyes) or via soaked sponges (50 eyes). The primary outcome measure at 1 year was intraocular pressure (IOP) reduction, with complete success defined as an IOP reduction of ≥ 20% and achieving a target IOP of ≤ 21 or 18 mmHg without the use of medication. Secondary outcomes, including corneal endothelial cell density (CECD) loss, the number of medications, and complications, were assessed and compared between the groups.</p><p><strong>Results: </strong>Sustained reductions in mean IOP were observed in both groups over the 1-year follow-up, with no significant differences between the groups. The complete success rate, with a target IOP of ≤ 21 mmHg after 1 year, was 19.3% in the sponge group and 26.4% in the injection group. The qualified success rate was 59.0% and 87.4% in the sponge and injection groups, respectively. A longer survival rate was observed in the injection group than in the sponge group when IOP was below 21 mmHg. The mean CECD significantly decreased (P < 0.01) from baseline to each postoperative follow-up time point in both groups. At 1 year postoperatively, the percentage of total CECD loss was 8.1% in the sponge group and 8.0% in the injection group. However, no significant differences in mean CECD values, the number of medications, or adverse events were found between the groups.</p><p><strong>Conclusions: </strong>PMS implantation with sub-tenon injection of MMC was comparable in terms of efficacy and safety to traditional MMC delivery via soaked sponges. However, the injection group demonstrated a significantly higher success rate than the sponge group.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"153-167"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Device for Vergence Exercises: Testing Automatic Dual Rotational Risley Prisms on Asymptomatic Adults and Patients with Convergence Insufficiency.","authors":"Ya-Yu Chen, Yun-Shao Hu, Shuan-Yu Huang, Tzu-Hsun Tsai","doi":"10.1007/s40123-024-01055-1","DOIUrl":"10.1007/s40123-024-01055-1","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigated the effects of automatic dual rotational Risley prisms (ADRRPs), a mobile phone application-operated device, on vergence abilities in young adults.</p><p><strong>Methods: </strong>Fifty-six participants aged 20-24 performed vergence exercises. The test group used prisms with power changes from 30Δ base-out to 10Δ base-in, while the control group used plano lenses for 10 min. Ophthalmic examinations included lateral heterophoria, near point of convergence (NPC), vergence facility (VF), negative fusional vergence (NFV), and positive fusional vergence (PFV), all measured before and after the vergence exercises. Pre- and post-test results were analyzed using a paired sample t test. Additionally, three cases with convergence insufficiency (CI) performed similar exercises for 12 weeks.</p><p><strong>Results: </strong>Participants were divided into the test group (n = 39; age 21.82 ± 1.10 years) and control group (n = 17; age 20.53 ± 0.51 years). In the test group, NPC improved from 6.11 ± 2.52 cm to 5.77 ± 2.30 cm (p = 0.023). VF increased from 13.75 ± 4.10 cpm to 16.50 ± 4.42 cpm (p = 0.007). PFV at 6 m and 0.4 m increased from 19.49 ± 6.77∆ to 22.19 ± 6.64∆ (p < 0.001) and 20.51 ± 7.05∆ to 22.69 ± 6.44∆ (p = 0.012), respectively. After 12 weeks, convergence insufficiency symptom survey scores for cases with CI decreased significantly, with NPC improving from 7.0 to 0 cm, 6.0 to 5.8 cm, and 6.0 to 4.7 cm. PFV increased from 10 to 25∆, 20 to 30∆, and 25 to 50∆.</p><p><strong>Conclusion: </strong>This preliminary study showed the effect of ADRRPs on improving vergence abilities. Further studies are needed to investigate the long-term sustainability and effects in a larger population of individuals with CI of this approach.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3189-3201"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geometry of Modern Presbyopia-Correcting Intraocular Lenses and Changes in Haptic-Capsular Bag Behavior According to Compression and Different Well Diameters: A Bench Study Using Computed Tomography.","authors":"Andreas F Borkenstein, Eva-Maria Borkenstein","doi":"10.1007/s40123-024-01046-2","DOIUrl":"10.1007/s40123-024-01046-2","url":null,"abstract":"<p><strong>Introduction: </strong>The geometry of an intraocular lens (IOL), the design of the haptics, and the optic-haptic junction play a role in initial and long-term visual outcome after cataract surgery. Knowledge of the behavior of an implant in the capsular bag and under compression is of major importance. Our laboratory experiment analyzed in-depth the geometry of acrylic, single-piece, premium, presbyopia-correcting intraocular lenses and changes in haptic-capsular bag relationships according to capsular bag size using a range of compression well diameters.</p><p><strong>Methods: </strong>One hydrophilic (RayOne Trifocal^® RAO603F) and three hydrophobic intraocular lenses (AcrySof IQ PanOptix^®, Synergy DFR00V™, and AT ELANA 841P^®) were scanned with computed tomography (CT) in a dry, uncompressed state for quantitative analyses of haptic and optic-haptic junction (OHJ) dimensions and qualitative assessment of geometry. In the second part of the experiment, CT was performed after sample placement into a series of compression wells (9.0, 10.0, 11.0, 11.5 mm) for analyses of length of contact (LoC) between the haptics and the wells. Axial alignment and haptic-capsular bag relationships were assessed.</p><p><strong>Results: </strong>The qualitative and quantitative evaluations highlighted differences in haptic and OHJ geometry and dimensions across the samples. The mid-zone of the optic was thickest in the hydrophilic sample (RayOne Trifocal^® RAO603F) with a maximum of 0.880 mm compared to the thinnest hydrophobic sample (AT ELANA 841P^®) with 0.564 mm. The AT ELANA 841P^® showed the largest OHJ surface area (3.86 mm²) and OHJ volume (0.60 mm³) of the hydrophobic samples. The TECNIS Synergy DFR00V™ showed the thickest OHJ (0.51 mm), while the AcrySof IQ PanOptix^® showed the thinnest OHJ (0.21 mm). The LoC values decreased with increasing well size for all tested samples. The AT ELANA 841P^® showed the largest LoC and largest contact zones of hydrophobic samples in all wells.</p><p><strong>Conclusion: </strong>The laboratory experiments highlight differences in the haptics, the OHJ geometric characteristics, and behavior of samples in different well diameters. The results support the idea that specific IOL designs may have advantages or disadvantages depending on anatomical dimensions. We cannot make any classification or rating (good versus bad) for clinical practice on the basis these experimental results, as many other factors play a role. However, knowledge of IOL geometry seems important to select the best option in each individual case.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3059-3077"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Correlation Between Retinal Arteriolar Bifurcation Parameters and Coronary Atherosclerosis.","authors":"Guangzheng Dai, Geng Wang, Sile Yu, Weinan Fu, Shenming Hu, Yue Huang, Xinze Luan, Xue Cao, Xiaoting Wang, Hairu Yan, Xinying Liu, Xingru He","doi":"10.1007/s40123-024-01038-2","DOIUrl":"10.1007/s40123-024-01038-2","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to examine the relationship between the morphological parameters of retinal arteriolar bifurcations and coronary artery disease (CAD).</p><p><strong>Methods: </strong>In this cross-sectional observational study, fundus photography was conducted on 444 participants to capture retinal arteriolar bifurcations. A total of 731 fundus photographs yielded 9625 measurable bifurcations. Analyzed bifurcation parameters included the diameters of the parent vessel (d₀), the larger branch (d₁), and the smaller branch (d₂), as well as the angles (θ₁) and (θ₂) representing the orientation of each branch in relation to the parent vessel, respectively. Additionally, theoretical optimal angles ( <math><msubsup><mi>θ</mi> <mrow><mn>1</mn></mrow> <mo>'</mo></msubsup> </math> ) and ( <math><msubsup><mi>θ</mi> <mrow><mn>2</mn></mrow> <mo>'</mo></msubsup> </math> ), calculated from the measured parameters, provided a benchmark for ideal bifurcation geometry. The study assessed the variation in these parameters across different levels of coronary atherosclerosis severity.</p><p><strong>Results: </strong>After adjusting for anatomical characteristics including the asymmetry ratio, area ratio, and distance to the optic disc, we observed that patients with severe coronary artery stenosis had significant deviations from the theoretical optimal bifurcation angles, with a decrease in ( <math><msubsup><mi>θ</mi> <mrow><mn>1</mn></mrow> <mo>'</mo></msubsup> </math> ) and an increase in ( <math><msubsup><mi>θ</mi> <mrow><mn>2</mn></mrow> <mo>'</mo></msubsup> </math> ) compared to those with moderate stenosis.</p><p><strong>Conclusion: </strong>The findings suggest a clear alteration in retinal arteriolar bifurcation morphology among patients with severe CAD, which could potentially serve as an indicator of disease severity.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3079-3093"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is Occluding Our Understanding of Retinal Vein Occlusion?","authors":"Christiana Dinah, Andrew Chang, Junyeop Lee, William W Li, Rishi Singh, Lihteh Wu, David Wong, Insaf Saffar","doi":"10.1007/s40123-024-01042-6","DOIUrl":"10.1007/s40123-024-01042-6","url":null,"abstract":"","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3025-3034"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}