Translational Vision Science & Technology最新文献

{"title":"The Observation of Peripapillary Hyperreflective Ovoid Mass-Like Structures in Adolescents by Swept-Source Optical Coherence Tomography Angiography.","authors":"Di Xiao, Dihao Hua, Lhamo Tsering, Fangyuan Zhou, Yilin Yuan, Changzheng Chen, Yishuang Xu","doi":"10.1167/tvst.14.8.34","DOIUrl":"https://doi.org/10.1167/tvst.14.8.34","url":null,"abstract":"<p><strong>Purpose: </strong>To present the swept-source optical coherence tomography angiography (SS-OCTA) characteristics of peripapillary hyperreflective ovoid mass-like structures (PHOMS) in healthy adolescents and evaluate the effects of PHOMS on peripapillary structural and microvascular parameters.</p><p><strong>Methods: </strong>A total of 218 eyes of 117 healthy adolescents were included. SS-OCTA images centered on the optic nerve head (ONH) were captured on eyes included. Structural characteristics of the ONH were compared between adolescents with or without PHOMS. After a propensity score matching was conducted, the alterations of peripapillary structures and capillaries in adolescents with PHOMS were analyzed.</p><p><strong>Results: </strong>PHOMS were found in 33.5% of the adolescent eyes. OCTA showed blood flow signals within all PHOMS. Large ONH tilt angle and small cup-to-disc ratio were independent risk factors for PHOMS (P < 0.001), and they were closely related to the size of PHOMS (P < 0.01). Thickened peripapillary retinal nerve fiber layer and elevated radial peripapillary capillary vessel density were observed in adolescents with PHOMS, especially in those with large PHOMS (all P < 0.05).</p><p><strong>Conclusions: </strong>PHOMS, complex structures containing nerve fibers and vascular networks, were common in adolescents. The presence of PHOMS in healthy individuals was closely related to the structural features of ONH. PHOMS were usually accompanied by congested and dilated nerve fibers and radial peripapillary capillaries.</p><p><strong>Translational relevance: </strong>This study provides new insights into the composition of PHOMS and their effects on peripapillary structures and capillaries.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 8","pages":"34"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970503","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":"Short-Term Outcomes of Pediatric Patients With Mild Autosomal Recessive RPE65-Associated Retinal Dystrophy Treated With Voretigene Neparvovec.","authors":"David A Merle, Leen Hertens, Spyridon Dimopoulos, Susanne Kohl, Manon Van Haute, Elfride De Baere, Marieke De Bruyne, Barbara Janssens, Klaus Rüther, Cord Huchzermeyer, Pascale Mazzola, Fanny Nerinckx, Tobias Haack, Lasse Wolfram, Melanie Kempf, Laura Kühlewein, Krunoslav Stingl, Bart P Leroy, Katarina Stingl","doi":"10.1167/tvst.14.8.8","DOIUrl":"10.1167/tvst.14.8.8","url":null,"abstract":"<p><strong>Purpose: </strong>Voretigene neparvovec is approved for RPE65-associated inherited retinal degeneration (RPE65-IRD) in the United States and the European Union. According to current knowledge, early treatment benefits efficacy. However, consensus on treating mild cases is lacking due to ambiguity in balancing clinical benefits with potential side effects. Therefore, we present short-term outcomes of four pediatric patients with milder types of RPE65-IRD.</p><p><strong>Methods: </strong>Two unrelated pediatric patients were unilaterally treated at the University Eye Hospital in Tübingen, Germany. Another two unrelated pediatric patients were bilaterally treated at Ghent University Hospital, Belgium. Examinations were performed before and until at least 6 months after treatment, including best-corrected visual acuity, slit-lamp examination, fundus photography, short-wavelength fundus autofluorescence, optical coherence tomography, 90° kinetic perimetry, dark-adapted chromatic perimetry, and full-field stimulus threshold measurements.</p><p><strong>Results: </strong>Despite surgical challenges, treatment with voretigene neparvovec was successful in all four patients. All patients showed rod functional rescue with stable best-corrected visual acuity. Three patients suffered chorioretinal atrophy at the retinotomy site but none developed signs of fast-growing CRA. One case developed limited CRA in the bleb area, potentially related to inflammation in the subretinal space.</p><p><strong>Conclusions: </strong>Treatment with voretigene neparvovec was safe and effective in patients with mild RPE65-IRD. Early treatment showed good functional outcomes. Also, treatment at stages without profound retinal degeneration might lower the risk of fast-growing CRA.</p><p><strong>Translational relevance: </strong>This study aids clinical decision-making in unclear cases by demonstrating that early treatment with voretigene neparvovec in mild RPE65-IRD provides functional benefits while minimizing the risk of fast-growing chorioretinal atrophy.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 8","pages":"8"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776266","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":"Machine Learning Models for Predicting Treatment-Requiring Retinopathy of Prematurity in the e-ROP Study.","authors":"Dinglun He, Xinwei Luo, Bowen Ying, Graham E Quinn, Agnieshka Baumritter, Yong Chen, Gui-Shuang Ying, Lifang He","doi":"10.1167/tvst.14.8.14","DOIUrl":"10.1167/tvst.14.8.14","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate machine learning (ML) models for predicting treatment-requiring retinopathy of prematurity (TR-ROP) using image findings at 32 to 34 weeks of postmenstrual age, along with demographic and clinical characteristics.</p><p><strong>Methods: </strong>This secondary analysis included 771 infants with a birth weight of less than 1251 g who had at least one imaging session by 34 weeks postmenstrual age and at least one subsequent ROP examination for determining TR-ROP by ophthalmologists in the Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) Study. Six ML models (K-nearest neighbors, support vector machine, random forest, extreme gradient boosting, deep neural network [DNN], and transformer) were evaluated for predicting TR-ROP. Prediction performance was evaluated using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity.</p><p><strong>Results: </strong>Using image findings and demographic and clinical data, ML models achieved AUCs ranging from 0.777 (K-nearest neighbors) to 0.853 (DNN), sensitivity ranging from 0.765 (extreme gradient boosting) to 0.929 (DNN), and specificity ranging from 0.644 (DNN) to 0.698 (transformer). Using image findings alone, the DNN performed best with an AUC of 0.787, sensitivity of 0.729, and specificity of 0.725.</p><p><strong>Conclusions: </strong>ML models using image findings, demographics and clinical characteristics moderately predict TR-ROP, with DNN achieving the highest AUC and sensitivity. Although ML models may provide tools for the early identification of high-risk infants for close monitoring and timely treatment of TR-ROP, future research is needed to improve their performance.</p><p><strong>Translational relevance: </strong>ML has the potential to predict TR-ROP risk based on early image findings, demographics, and clinical characteristics.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 8","pages":"14"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817492","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":"Psychometric Evaluation and Computerized Adaptive Testing Simulations of Myopic Refractive Intervention Quality of Life Item Banks.","authors":"Ryan E K Man, Eva K Fenwick, Kodi J L Goh, Phyllis R T Teo, Marcus Ang, Quan V Hoang, Chee Wai Wong, Mohamad Rosman, Seang-Mei Saw, Ecosse L Lamoureux","doi":"10.1167/tvst.14.8.4","DOIUrl":"10.1167/tvst.14.8.4","url":null,"abstract":"<p><strong>Purpose: </strong>To optimize the psychometric properties of myopia refractive intervention quality of life (QoL) item banks (IBs), and evaluate their performance using computerized adaptive testing (CAT) simulations.</p><p><strong>Methods: </strong>In this clinical study, adults utilizing myopic refractive intervention modalities answered 204 items within seven IBs: Activity Limitation (AL); Comfort (CM); Concerns (CN); Convenience (CV); Emotional (EM); Mobility (MB); and Work (WK), referred to collectively as \"MyoRICAT\". The psychometric properties of each IB were assessed with Rasch analysis, and CAT simulations with 1000 respondents determined the average number of items needed to achieve moderate (standard error of measurement [SEM] = 0.387) and high (SEM = 0.30) precision levels.</p><p><strong>Results: </strong>Of the 291 participants (mean age 34.02 ± 11.04 years; 65.64% female), 61 (20.96%) wore spectacles only, 123 (42.27%) used both spectacles and contact lenses, and 107 (36.76%) underwent laser refractive surgery. AL, CM, CN, CV, and EM showed satisfactory psychometric properties after minor amendments. WK lacked measurement precision owing to certain items being applicable only to specific subsets of refractive modalities. This IB was therefore retained as a fixed length rather than a CAT operationalized scale. Conversely, MB demonstrated such poor targeting that it was not considered further. In CAT simulations, the mean number of items required per IB ranged from 10 (CV) to 12 (AL) for moderate, and 15 (CV) to 19 (AL) for high measurement precision.</p><p><strong>Conclusions: </strong>Five IBs demonstrated strong psychometric properties and potential CAT efficiency.</p><p><strong>Translational relevance: </strong>MyoRICAT can provide a comprehensive measurement of the QoL impact of myopic refractive intervention modalities.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 8","pages":"4"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761455","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":"Photoreceptor Disease at Ambiguous Transition Zones in Inherited Retinal Degenerations.","authors":"Alexander Sumaroka, Malgorzata Swider, Tomas S Aleman, Artur V Cideciyan","doi":"10.1167/tvst.14.8.11","DOIUrl":"10.1167/tvst.14.8.11","url":null,"abstract":"<p><strong>Purpose: </strong>Key outcome measures for inherited retinal degenerations (IRDs) are derived from the termination point of the inner and outer segment junction (IS/OS, or ellipsoid zone (EZ)) signal on optical coherence tomography (OCT), which demarcates the emergence of photoreceptor outer segment (OS) abnormalities. However, the termination point is not always abrupt and can be ambiguous. This study aimed to characterize OS disease at each retinal location.</p><p><strong>Methods: </strong>Widefield OCTs from two ABCA4-associated and fifteen RHO-associated IRD patients were recorded over ∼2 years. Data from a neighborhood of each sample were fed into a two-level artificial intelligence architecture, which achieved 95% accuracy for classifying outer retinal disease into definitely present OS (DPOS), definitely absent OS (DAOS), or questionably absent OS (QAOS).</p><p><strong>Results: </strong>DPOS and DAOS regions were always separated by QAOS regions; wider QAOS regions corresponded to an extended transition from OS disease to health. Point-by-point comparison of OS maps with serial widefield imaging showed that, on average, 94% of the samples remained stable, with the remainder showing progression. The best predictor of progression was the distance to the nearest locus with greater OS disease: DPOS and QAOS pixels within 2° and 5.5°, respectively, of a nearby location with greater disease had as much as 10-fold higher likelihood of progression.</p><p><strong>Conclusions: </strong>The assumption of an abrupt transition in EZ-based outcomes may not reflect the underlying pathophysiology of IRDs.</p><p><strong>Translational relevance: </strong>Ambiguous transition zones and their immediate neighborhoods may demarcate retinal regions having high likelihood for progression and act as efficient endpoints for clinical trials.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 8","pages":"11"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12338365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785424","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":"Analysis of Total Antioxidant Capacity and Ascorbic Acid Levels in the Aqueous Humor of Patients With Diabetic Retinopathy.","authors":"Yen-Ning Chen, Yi-Jen Hsueh, Chao-Kai Chang, Po-Yi Wu, Yu-Ting Tsao, Yi-Hsing Chen, Eugene Yu-Chuan Kang, Chao-Min Cheng, Wei-Chi Wu, Yih-Shiou Hwang, Hung-Chi Chen","doi":"10.1167/tvst.14.8.31","DOIUrl":"https://doi.org/10.1167/tvst.14.8.31","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to investigate aqueous humor total antioxidant capacity (TAC) and ascorbic acid (AA) levels of patients with diabetic retinopathy (DR), and their correlation with serum glycated hemoglobin (HbA1c) levels.</p><p><strong>Methods: </strong>This case-control study enrolled 177 eyes from 177 patients that underwent cataract surgery between April 2019 and November 2022 in Chang Gung Memorial Hospital. Group 1 comprised 103 eyes from patients without diabetes; group 2 comprised 40 eyes from patients with diabetes but without DR; and group 3 comprised 34 eyes from patients with DR. Aqueous humor samples were collected and analyzed for TAC and AA levels using the ferric reducing/antioxidant AA assay.</p><p><strong>Results: </strong>Aqueous humor TAC and AA levels were decreased in group 3 compared with group 2 and group 1 (P < 0.001 and P < 0.001). Aqueous humor TAC and AA levels were independent protective factors against DR in the diabetes population, with adjusted odds ratios of 0.109 (95% confidence interval [CI] = 0.017-0.719, P = 0.021) and 0.095 (95% CI = 0.012-0.726, P = 0.023), respectively. Aqueous humor TAC and AA concentrations were weakly negatively correlated with serum HbA1c levels, with Pearson's correlation coefficients of -0.339 (P = 0.013) and -0.341 (P = 0.012), respectively.</p><p><strong>Conclusions: </strong>TAC and AA had protective effects against DR. Decreased aqueous humor TAC and AA levels may serve as potential biomarkers for DR among the diabetes population.</p><p><strong>Translational relevance: </strong>This study highlights the role of antioxidants in DR and provides foundation for future research on AA supplementation's potential for the prophylaxis and treatment of DR.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 8","pages":"31"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970422","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":"OBM1701 Alleviates Choroidal Neovascularization in Experimental Animals Via Suppressing the Expression of HIF-1α in Retinal Pigment Epithelial Cells.","authors":"Shu-I Yeh, Tsung-Chuan Ho, Ting-Wen Chu, Show-Li Chen, Ruchong Ou, Yeou-Ping Tsao","doi":"10.1167/tvst.14.8.21","DOIUrl":"10.1167/tvst.14.8.21","url":null,"abstract":"<p><strong>Purpose: </strong>OBM1701, a pigment epithelium-derived factor-derived short peptide, can eliminate corneal neovascularization by blocking endothelial cell angiogenesis. Activation of hypoxia-inducible factor (HIF)-1α in the retinal pigment epithelium (RPE) is critical for the pathogenesis of choroidal neovascularization (CNV), the hallmark of neovascular age-related macular degeneration (nAMD). Here, the potential inhibitory effect of OBM1701 on laser-induced CNV in animals was investigated.</p><p><strong>Methods: </strong>Two days after the laser injury, topical OBM1701 eye drops were applied once daily for 12 days. Subsequently, CNV vascular leakage and CNV area were measured by fluorescein angiography and isolectin GS-IB4 staining on choroidal/RPE flatmounts, respectively. Immunostaining was used to detect the expression of HIF-1α and vascular endothelial growth factor A (VEGFA) in CNV lesions. In vitro, ARPE-19 cells and primary porcine RPE were exposed to hypoxia mimetic condition by adding dimethyloxalylglycine and oxygen deprivation in cultures, respectively. Then the gene and protein expression of HIF-1α and VEGFA were evaluated by real-time PCR and Western blotting.</p><p><strong>Results: </strong>OBM1701 effectively reduced vascular leakage and CNV formation. Meanwhile, OBM1701 treatment blocked the overexpression of HIF-1α and VEGFA in RPE cells located within CNV lesions. In culture, OBM1701 pretreatment suppressed hypoxia-induced HIF-1α and VEGFA expressions.</p><p><strong>Conclusions: </strong>Through animal studies, we demonstrate that OBM1701 has the potential to treat CNV. We also suggest RPE as a drug target for OBM1701 to treat CNV, by attenuating the hypoxia-induced HIF-1α/VEGFA signaling.</p><p><strong>Translational relevance: </strong>OBM1701 in ophthalmic drop shows the potential to be developed into a novel therapy for the treatment of nAMD.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 8","pages":"21"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875408","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":"Enhancing the Readability of Online Pediatric Cataract Education Materials: A Comparative Study of Large Language Models.","authors":"Xinyi Qiu, Chaokun Luo, Qingruo Zhang, Ka Yi Chung, Weirong Chen, Hui Chen","doi":"10.1167/tvst.14.8.19","DOIUrl":"10.1167/tvst.14.8.19","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess large language models (LLMs) for enhancing the readability of online patient education materials (PEMs) on pediatric cataracts through multilingual adaptation, content retrieval, and prompt engineering.</p><p><strong>Methods: </strong>This study included 103 PEMs presented in different languages and retrieved from diverse resources. Three LLMs (ChatGPT-4o, Gemini 2.0, and DeepSeek-R1) were used for content improvement. Readability was assessed for both the original and converted PEMs with multiple formulas. Different prompt engineering strategies for LLMs were also tested in this study.</p><p><strong>Results: </strong>The PEMs directly generated by LLMs exceeded a 10th grade reading level. Compared to a traditional Google search, LLMs' web browsing feature provided online PEMs with better characteristics and a higher reading level. Original PEMs from Google showed significantly improved readability after LLM conversion, with DeepSeek-R1 achieving the greatest reduction in reading level from 10.59 ± 2.20 to 7.01 ± 0.91 (P < 0.001). Prompt engineering also showed statistically significant results in their effects on LLM conversion, and Zero-shot-Cot (APE) successfully achieving target readability below the sixth grade reading level. Besides, the LLMs' simplified Chinese conversion, as well as the LLMs conversion of other original Chinese PEMs, both showed that they meet the recommended standards for reading levels in multiple dimensions.</p><p><strong>Conclusions: </strong>LLMs can significantly enhance the readability of multilingual online PEMs on pediatric cataract. Combining it with web browsing and prompt engineering can further optimize outcomes and advance patient education.</p><p><strong>Translational relevance: </strong>This study links LLMs with patient education and demonstrates their potential to significantly improve the readability of online PEMs.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 8","pages":"19"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875406","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 Deep Learning Model for Detecting the Eyes Receiving Glaucoma Medications Using Anterior Segment Images.","authors":"Shogo Arimura, Ryohei Komori, Kentaro Iwasaki, Marie Suzuki, Yusuke Orii, Masaru Inatani","doi":"10.1167/tvst.14.8.28","DOIUrl":"https://doi.org/10.1167/tvst.14.8.28","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to investigate whether a deep learning model can detect eyes receiving glaucoma medications from anterior segment images and to visualize the anatomical areas prioritized during classification.</p><p><strong>Methods: </strong>The training dataset was comprised of 20,000 augmented images of eyes receiving or not receiving glaucoma medications. The test dataset was comprised of 100 images each of eyes receiving and not receiving glaucoma medications. Diagnostic performance of the model was evaluated using the area under the receiver operating characteristic curve (AROC) and compared with human recognition. Subgroup analyses were performed based on conjunctival hyperemia, prostaglandin analog use, and illumination conditions. Gradient-Weighted Class Activation Mapping (Grad-CAM) was applied to explore anatomical areas prioritized by the model.</p><p><strong>Results: </strong>The deep learning model detected the eyes receiving glaucoma medications with significantly higher accuracy than human recognition (AROC, 0.90 vs. 0.75; P < 0.01). No significant AROC differences were observed in the presence or absence of conjunctival hyperemia, prostaglandin analog use, or under varying illumination. Grad-CAM analysis revealed the periocular area was significantly more frequently highlighted in eyes receiving glaucoma medication than in those not receiving medication (P < 0.01).</p><p><strong>Conclusions: </strong>The deep learning model objectively detected glaucoma medication use based on anterior segment images. Saliency mapping suggests that the model can identify subtle periocular changes induced by treatment.</p><p><strong>Translational relevance: </strong>The deep learning model will contribute to assessing the severity of side-effects of glaucoma medications and facilitate the development of eye drops with improved tolerability.</p>","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 8","pages":"28"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970571","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":"Economic Evaluation of Intraocular Lens Targeting Cataract Patients: A Review and Future Directions.","authors":"Ziwei Wu, Feng Cheng, Junfang Xu","doi":"10.1167/tvst.14.8.30","DOIUrl":"https://doi.org/10.1167/tvst.14.8.30","url":null,"abstract":"<p><strong>Purpose: </strong>Cataracts remain the leading global cause of blindness, disproportionately affecting aging populations and imposing substantial economic burdens. With the widespread adoption of intraocular lens (IOLs) implantation in cataract surgery, rigorous health economic evaluations are imperative to inform clinical decision making and resource allocation across diverse healthcare systems.</p><p><strong>Methods: </strong>A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, encompassing PubMed, Web of Science, CNKI, and other databases, alongside reports from international health technology assessment agencies (May 2024). Fourteen studies (2001-2022) across 12 countries were included after screening 436 records. Data extraction adhered to the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist, with methodological quality assessed via the Drummond tool. Analyses focused on cost-effectiveness analysis (CEA), cost-utility analysis (CUA), and incremental cost-effectiveness ratios (ICERs), incorporating Markov models and sensitivity analyses.</p><p><strong>Results: </strong>Multifocal IOLs demonstrated superior cost-effectiveness compared to monofocal IOLs, with ICERs well below established thresholds (e.g. $4805/quality-adjusted life years (QALY) in the United States vs. $50,000/QALY). Lifetime societal costs for multifocal IOLs ranged from $5780.79 to $15,944.76, yielding QALY gains of 0.16 to 0.71 and spectacle-independence rates of 86.0% to 90.9% versus 8.5% to 31.8% for monofocal IOLs. Hydrophobic acrylic lenses outperformed other materials (Nd:YAG laser intervention rates = 7.1% vs. 31.1% for hydrophilic acrylic), whereas scleral-fixated IOLs justified higher costs by preserving endothelial cells (ICER = €3.72/cell). Toric IOLs showed regional variability, with long-term cost savings in the United States ($349/QALY) but limited viability in the Netherlands (1-15% probability at €20,000/QALY). Heterogeneity arose from methodological differences, short-term utility assumptions, and contextual factors (e.g. reimbursement policies).</p><p><strong>Conclusions: </strong>Advanced IOLs, particularly multifocal and hydrophobic acrylic variants, are cost-effective for patients prioritizing spectacle independence and long-term visual outcomes. However, economic viability is context-dependent, necessitating region-specific analyses that integrate real-world data, patient preferences, and indirect costs (e.g. productivity loss). Future research should prioritize lifecycle assessments, equity-focused models, and low- and middle-income countries' (LMIC) perspectives to bridge existing evidence gaps and guide sustainable policy decisions.</p><p><strong>Translational relevance: </strong>This review bridges health economics and clinical practice by evaluating the cost-effectiveness of advanced IOLs across different healthcare systems, offeri","PeriodicalId":23322,"journal":{"name":"Translational Vision Science & Technology","volume":"14 8","pages":"30"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970439","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}