Survey of ophthalmology最新文献

{"title":"Artificial intelligence in thyroid eye disease imaging: A systematic review.","authors":"Haiyang Zhang, Ziyuan Li, Hoi Chi Chan, Xuefei Song, Huifang Zhou, Xianqun Fan","doi":"10.1016/j.survophthal.2025.07.008","DOIUrl":"https://doi.org/10.1016/j.survophthal.2025.07.008","url":null,"abstract":"<p><p>Thyroid eye disease (TED) is a common, complex orbital disorder characterized by soft-tissue changes visible on imaging. Artificial intelligence (AI) offers promises for improving TED diagnosis and treatment; however, no systematic review has yet characterized the research landscape, key challenges, and future directions. We followed PRISMA guidelines to search multiple databases until January, 2025, for studies applying AI to computed tomography (CT), magnetic resonance imaging, and nuclear, facial or retinal imaging in TED patients. Using the APPRAISE-AI tool, we assessed study quality and included 41 studies covering various AI applications. Sample sizes ranged from 33 to 2,288 participants, predominantly East Asian. CT and facial imaging were the most common modalities, reported in 16 and 13 articles, respectively. Studies addressed clinical tasks-diagnosis, activity assessment, severity grading, and treatment prediction-and technical tasks-classification, segmentation, and image generation-with classification being the most frequent. Researchers primarily employed deep-learning models, such as residual network (ResNet) and Visual Geometry Group (VGG). Overall, the majority of the studies were of moderate quality. Image-based AI shows strong potential to improve diagnostic accuracy and guide personalized treatment strategies in TED. Future research should prioritize robust study designs, the creation of public datasets, multimodal imaging integration, and interdisciplinary collaboration to accelerate clinical translation.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relentless placoid chorioretinitis.","authors":"Claire Y Hooper, Lisia Barros Ferreira, Franzco Anagha Vaze, Daniel V Vasconcelos-Santos, Debra A Goldstein, Demi Gertig, Justine R Smith","doi":"10.1016/j.survophthal.2025.07.009","DOIUrl":"https://doi.org/10.1016/j.survophthal.2025.07.009","url":null,"abstract":"<p><p>Relentless placoid chorioretinitis (RPC) is a rare, vision-threatening posterior uveitis that predominantly affects young adults. The hallmark clinical findings are numerous scattered placoid chorioretinal lesions involving the mid-peripheral and far peripheral fundus as well as the posterior pole and a persistent or recurrent course resulting in lesions at different chronological stages, with fresh creamy placoid lesions and healing pigmented lesions being present at the same time. Although RPC is frequently described as a disease that is intermediate between acute multifocal posterior placoid epitheliopathy (APMPPE) and serpiginous choroiditis, it more closely resembles APMPPE. It is important to identify those patients with RPC who present with an APMPPE phenotype so that appropriate immunomodulatory therapy is instituted without delay, as most cases of RPC are refractory to corticosteroid monotherapy. Examination findings may help differentiate RPC and APMPPE. Multimodal imaging, including ultra-widefield imaging, and selective investigations aid in distinguishing RPC from other placoid diseases and types of posterior uveitis.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative ophthalmic posterior segment optical coherence tomography angiography and systemic conditions.","authors":"Michael Drakopoulos, Arnold Nadel, Harnaina K Bains, Jay B Bisen, Hayden Sikora, Kevin X Zhang, Alessandro Marchese, Joseph Fahey, Rukhsana G Mirza","doi":"10.1016/j.survophthal.2025.07.005","DOIUrl":"https://doi.org/10.1016/j.survophthal.2025.07.005","url":null,"abstract":"<p><p>Optical coherence tomography angiography (OCTA) non-invasively and quantitatively images the microvasculature of the eye's posterior segment in 3 dimensions. OCTA has known utility in the diagnosis and management of certain ocular conditions and is now being used to assess systemic conditions, including respiratory, cardiovascular, renal, obstetric, neurologic, rheumatologic, and genetic conditions, among others. OCTA may improve our understanding of the pathophysiology of systemic conditions and identify biomarkers useful in their diagnosis, prognosis, and management. We detail known associations between quantitative retinal, optic nerve head, and choriocapillaris OCTA findings and clinically relevant features of systemic conditions, including laboratory markers and disease severity and prognosis. We find that the breadth and depth of such correlations solidify OCTA's role in the emerging field of oculomics, which seeks to identify ocular imaging biomarkers for use in the study and management of non-ocular conditions.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of time-driven activity-based costing in ophthalmology: A scoping review.","authors":"Howard Y Zhang, Aden W Smith, Heather E Laferriere, Avni P Finn, Sean T Berkowitz","doi":"10.1016/j.survophthal.2025.07.007","DOIUrl":"https://doi.org/10.1016/j.survophthal.2025.07.007","url":null,"abstract":"<p><p>In healthcare economics, time-driven activity-based costing (TDABC) and activity-based costing (ABC) are increasingly utilized, yet their applications within ophthalmology remain undefined and non-standardized. A literature search was performed using the standards of Preferred Reporting Items for Systemic Reviews and Meta-Analyses extension for Scoping Reviews (PRIMSA-ScR). Studies were subjected to 3 rounds of screening, with 3 separate data extractions to summarize study characteristics, TDABC-specific parameters, and secondary or sensitivity analysis. Out of the 27 included articles, 11 utilized ABC, 12 utilized TDABC, and four were micro-costing studies with activity-based elements. The 2 most common ophthalmologic processes being studied were surgery only (41%), and clinical services only (19%). Process flow was delineated through direct observation and interviews (22%), a mix of direct observation and electronic health record (her) (15%), EHR only (11%), direct observation only (11%), interviews only (3.7%) and often unspecified (37.2%). Estimated average capacity cost rates (CCR) found in TDABC articles for operating room (OR) spaces, non-OR spaces, surgeons, anesthesia, registered nurses, and other staff were reported. We observed an increase in publications utilizing activity-based costing, particularly the use of TDABC over the preceding two decades, with heterogenous methodologies. Standardized approaches with more detailed reporting of data sources and additional analyses are needed to increase the accessibility of TDABC in ophthalmology.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal artificial intelligence in ophthalmology: Applications, challenges, and future directions.","authors":"Kai Jin, Tao Yu, Andrzej Grzybowski","doi":"10.1016/j.survophthal.2025.07.003","DOIUrl":"https://doi.org/10.1016/j.survophthal.2025.07.003","url":null,"abstract":"<p><p>With the rapid development of artificial intelligence (AI) technology, multimodal AI that integrates multiple data modalities has shown tremendous potential in the field of ophthalmology. We systematically evaluate the current applications, technical characteristics, and clinical value of multimodal AI in ophthalmology. This study was conducted as a systematic review following the PRISMA guidelines. We searched relevant literature published from 2018 to 2025 in PubMed, Web of Science, Scopus, and Google Scholar databases. A total of 10 studies were included in the final analysis. The main applications of multimodal AI in ophthalmology include glaucoma, age-related macular degeneration, corneal diseases, ophthalmic emergency triage, cognitive impairment screening, diabetes complication screening, and chatbot-based ophthalmic consultation. Multimodal systems showed superior performance compared to unimodal systems across various application areas, with AUC improvements of 4-5% and accuracy improvements of 2-7%. Multimodal AI demonstrates broad application prospects in ophthalmology, providing more comprehensive and accurate diagnostic information. Future research should focus on clinical validation, novel fusion methods, interpretability, and lightweight models to promote the clinical translation of multimodal AI in ophthalmology.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chorioretinal folds: A review and update of new and old etiologies.","authors":"John Yu Cheng, David Hsu, Alessandro Feo, Vicki Liu, Mostafa Mafi, David Sarraf","doi":"10.1016/j.survophthal.2025.07.004","DOIUrl":"10.1016/j.survophthal.2025.07.004","url":null,"abstract":"<p><p>Chorioretinal or choroidal folds are wrinkles or undulations involving contiguous tissues including the anterior choroid, Bruch membrane, the retinal pigment epithelium, and in some cases the overlying neurosensory retina. These folds consist of alternating light and dark lines that may radiate from the optic disc or can be isolated to the macula or periphery. Chorioretinal folds can be the result of primary or secondary etiologies. Primary chorioretinal folds are due to hyperopia or idiopathic causes. Secondary folds are the result of secondary processes, such as mass compression, traction, or hypotony. Visual and anatomic outcomes and management strategies depend on the etiology of the folds. Multimodal imaging including color fundus photography, fundus autofluorescence, optical coherence tomography , fluorescein angiogram, and B-scan ultrasonography are integral to the diagnosis of chorioretinal folds and determination of the etiology. We summarize the principal mechanisms leading to chorioretinal folds and will review the diverse spectrum of etiologies, new and old. Choroidal folds-related maculopathy will also be described, a sequela of chorioretinal folds that can lead to vision loss.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular trauma in microgravity: In-flight diagnostics and extraterrestrial strategies for management.","authors":"Alex Suh, Jonathan J Szeto, Joshua Ong, Grayson W Armstrong, C Robert Gibson, Thomas H Mader, William Lipsky, Ethan Waisberg, John Berdahl, David M Hinkle, Andrew G Lee","doi":"10.1016/j.survophthal.2025.07.006","DOIUrl":"10.1016/j.survophthal.2025.07.006","url":null,"abstract":"<p><p>Long-duration spaceflight missions (including the International Space Station [ISS]) are in one of the most remote and harsh environments humans live and work in. Medical emergencies in space are even more complicated in an already high-risk environment. Despite training, ISS crewmembers face many challenges in diagnosing and managing disease with limited diagnostic capability and equipment on the ISS, restricted medication availability, delayed access to medical professionals; and the latency of space missions. Ocular trauma (e.g., cabin contact with equipment, chemical exposure, and foreign body entry) has been well-documented in previous ISS missions, highlighting the vulnerability of crewmembers' vision. While no serious vision loss has yet occurred, the risk of ocular injuries during future commercial and lunar missions remains significant. We review the utilization of onboard diagnostic tools and potential management modalities with current ISS resources for mitigating long-term effects of ocular trauma in the unique microgravity environment of spaceflight. We aim to assess the overall medical preparedness for future space exploration to ensure the well-being and ocular health of crewmembers during extended missions to the Moon, Mars, and beyond.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of scleral buckle on choroidal architecture: An unexplored link with the spectrum of acquired overload choroidopathy?","authors":"Matteo Mario Carlà, Aude Couturier, Francesco Mottola, Mattia Cusato, Gianmarco Oreste, Giorgia Campaniello, Carlos Mateo, Stanislao Rizzo","doi":"10.1016/j.survophthal.2025.07.002","DOIUrl":"10.1016/j.survophthal.2025.07.002","url":null,"abstract":"<p><p>Scleral buckling (SB) has been a cornerstone in the surgical management of rhegmatogenous retinal detachment for decades, achieving success rates above 85 %; however, its impact on choroidal architecture and hemodynamics has been less thoroughly explored until recent advancements in ocular imaging techniques. We synthesize current evidence on the effects of SB surgery on choroidal structure and circulation, examining its implications for postoperative complications and exploring a potential link with the newly described spectrum of acquired venous overload choroidopathy (AVOC). Various imaging modalities including indocyanine green angiography, optical coherence tomography (OCT), and OCT angiography have demonstrated that SB induces both transient and sometimes persistent alterations in choroidal thickness, blood flow patterns, and vascular morphology, with encircling buckles showing more pronounced and enduring effects than segmental approaches. Notably, persistent subretinal fluid (PSF), a known complication following SB surgery, appears associated with alterations in choroidal architecture, particularly in eyes with preexisting pachychoroid features, suggesting potential overlap with the AVOC spectrum characterized by impaired venous outflow from the choroid. The mechanical indentation of the sclera by the buckle may compress vortex veins, disrupt the Starling resistor mechanism regulating choroidal fluid dynamics, and contribute to venous congestion, with implications for long-term visual outcomes. While vascular adaptations often mitigate these effects through the development of collateral circulation, in some cases, particularly with encircling bands, persistent choroidal alterations may contribute to complications like PSF. Further research is needed to establish a definitive link between SB-induced choroidal changes and the AVOC spectrum, which could significantly influence patient selection, surgical technique, and postoperative management strategies for RRD.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trabecular meshwork: A pivotal target for evolving glaucoma treatments.","authors":"Yue Wan, Xinzheng Guo, Ningli Wang","doi":"10.1016/j.survophthal.2025.07.001","DOIUrl":"10.1016/j.survophthal.2025.07.001","url":null,"abstract":"<p><p>The trabecular meshwork (TM) is a key regulator of intraocular pressure (IOP) through its role in facilitating aqueous humor outflow. Pathological alterations in the TM-such as reduced cellularity, impaired extracellular matrix turnover, and increased biomechanical stiffness-raise outflow resistance, leading to elevated IOP and contributing to glaucoma pathogenesis. We summarize the TM's anatomical structure, cellular heterogeneity, and biomechanical properties, emphasizing its central role in maintaining IOP homeostasis. It also outlines TM alterations across different glaucoma subtypes and highlights key molecular mechanisms underlying TM dysfunction, including dysregulation of Rho GTPase signaling, nitric oxide (NO) pathways, TGF-β2-induced fibrosis, lipid signaling, and endoplasmic reticulum stress. Advancements in TM-targeted therapies include pharmacologic interventions (e.g., Rho kinase inhibitors, NO donors), non-invasive approaches (e.g., laser trabeculoplasty, ultrasound, sonic therapies), and minimally invasive glaucoma surgeries. Emerging gene therapies that target TM outflow pathway show promise for long-lasting IOP control. Additionally, cell-based therapies aiming to restore TM cellularity and function represent a novel regenerative strategy. Despite significant progress, challenges remain in optimizing delivery methods, sustaining therapeutic efficacy, and ensuring safety. We highlight the evolving landscape of TM-targeted interventions and underscore the importance of continued innovation in glaucoma management.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-related changes in optical coherence tomography glaucoma-related parameters: A systematic review.","authors":"Rodrigo Vilares-Morgado, Kamiel Verbruggen, Ingeborg Stalmans, João Barbosa-Breda","doi":"10.1016/j.survophthal.2025.06.008","DOIUrl":"10.1016/j.survophthal.2025.06.008","url":null,"abstract":"<p><p>The specificity of optical coherence tomography (OCT) to detect glaucoma progression can be compromised by the non-adjustment to the healthy aging of OCT glaucoma-related parameters. We summarize the age-related changes of glaucoma-related parameters on OCT in the healthy population. Fifty-one longitudinal studies met our inclusion criteria. Retinal nerve fiber layer (RNFL) thickness change was -0.47 ± 0.27 μm/year for Spectralis® OCT, -0.44 ± 0.17 μm/year for Cirrus® OCT and -0.25 ± 0.21 μm/year for Optovue® OCT. Ganglion cell-inner plexiform layer change was -0.24 ± 0.08 μm/year on Cirrus® OCT. Ganglion cell complex change was -0.40 ± 0.26 μm/year on Optovue® OCT. Bruch membrane opening-minimum rim width change was -1.61 ± 0.14 μm/year on Spectralis® OCT. Vessel density change was -0.33 ± 0.50 %/year on OCTA, measured with Optovue® OCT. Aging in the healthy population leads to a progressive decrease of glaucoma-related parameters. This needs to be considered when assessing glaucoma patients for possible progression measured through OCT or OCT-angiography.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}