Clinical and Experimental Ophthalmology最新文献

{"title":"Glymphatic Function Abnormality and Its Association With Pathophysiology in Primary Open-Angle Glaucoma.","authors":"Yifei Sheng, Xiaojing Yang, Jianfeng Qiu, Weizhao Lu","doi":"10.1111/ceo.14574","DOIUrl":"https://doi.org/10.1111/ceo.14574","url":null,"abstract":"<p><strong>Background: </strong>Primary open-angle glaucoma (POAG) has been increasingly viewed as a neurodegenerative condition, yet whether there are changes in the brain glymphatic function in patients with POAG has remained unclear. This study aimed to investigate the changes of glymphatic function in POAG based on multi-modal magnetic resonance imaging (MRI).</p><p><strong>Methods: </strong>Thirty-eight patients with POAG and 25 age- and sex-matched healthy controls underwent structural MRI and functional MRI scans to assess abnormalities in cerebrospinal fluid circulation by choroid plexus (CP) volume and cortical glymphatic system clearance function by blood-oxygen-level-dependent signals and cerebrospinal fluid signals (BOLD-CSF) coupling. Comparisons of CP volume and BOLD-CSF coupling were conducted between the control and POAG groups. Correlation analysis was performed to assess the association between the function of the glymphatic system and clinical scales of POAG.</p><p><strong>Results: </strong>The CP volume and the ratio of CP volume to intracranial volume was significantly higher in patients with POAG compared to healthy controls (pFDR < 0.001). Additionally, the strength of BOLD-CSF coupling in the middle and posterior cortical regions were significantly weaker in POAG patients compared to controls (pFDR < 0.05). Negative correlations of glymphatic functional indicators with the thickness of the retinal nerve fibre layer (RNFL) (r from -0.427 to -0.351, p from 0.033 to 0.045) were observed, and positive correlations between BOLD-CSF of the posterior region and intraocular pressure were found (r = 0.375, p = 0.033).</p><p><strong>Conclusions: </strong>POAG patients experienced impaired glymphatic function, which may be related to the pathophysiology of the disease.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327800","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":"Minimally Invasive Glaucoma Surgery: Is It Here to Stay?","authors":"Neeranjali Jain, Jennifer C Fan Gaskin","doi":"10.1111/ceo.14571","DOIUrl":"https://doi.org/10.1111/ceo.14571","url":null,"abstract":"<p><p>The advent of minimally invasive glaucoma surgery (MIGS) has expanded the treatment options available for glaucoma by providing options for reducing intraocular pressure without the serious complication profile associated with incisional glaucoma surgery. MIGS devices aim to enhance aqueous outflow through the trabecular pathway or to bypass this pathway with drainage of fluid into the suprachoroidal or subconjunctival spaces. Having a wide range of glaucoma treatment options available helps tailor treatment to patients' individual intraocular pressure targets and aetiologies of glaucoma. This review will describe the categories and mechanisms of MIGS, comment on their relative efficacies, safety data, advantages and limitations and explore potential future changes in the glaucoma treatment paradigm in relation to MIGS.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327801","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":"Distribution of Ophthalmology Grant Opportunities and Variation Amongst Subspecialties in Australia.","authors":"Benjamin Cook, Thomas Muecke, Stephen Bacchi, Weng Onn Chan","doi":"10.1111/ceo.14568","DOIUrl":"https://doi.org/10.1111/ceo.14568","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303676","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":"Effective Interventions for Normal Tension Glaucoma in Network Meta-Analysis.","authors":"Miaomiao Wang, Liang Cao, Junqiang Lei","doi":"10.1111/ceo.14573","DOIUrl":"https://doi.org/10.1111/ceo.14573","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303677","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 Overlooked Role of Vitamin D in HLA-B27 Associated Uveitis Beyond Seasonal Variations: Response.","authors":"Priya D Samalia, James Brodie, Joanne L Sims, Rachael L Niederer","doi":"10.1111/ceo.14572","DOIUrl":"https://doi.org/10.1111/ceo.14572","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303678","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":"Waste Not: The Environmental Burden of Printed Conference Posters.","authors":"Shenal Abeysekera, Stephen Bacchi, Weng Onn Chan","doi":"10.1111/ceo.14554","DOIUrl":"https://doi.org/10.1111/ceo.14554","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303679","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":"Retinal Vessel Traits and Age-Related Eye Disease in the Canadian Longitudinal Study on Aging.","authors":"Alexis O'Neil, Roshan A Welikala, Sarah Barman, Christopher G Owen, Alicja R Rudnicka, Mohan Rakesh, Marie-Hélène Roy-Gagnon, David Maberley, Ellen E Freeman","doi":"10.1111/ceo.14566","DOIUrl":"https://doi.org/10.1111/ceo.14566","url":null,"abstract":"<p><strong>Background: </strong>To cross-sectionally and longitudinally examine whether retinal vessel traits are associated with glaucoma-related outcomes (glaucoma, cup-to-disc ratio [CDR] and intraocular pressure [IOP]) and age-related macular degeneration (AMD).</p><p><strong>Methods: </strong>Baseline and 3-year follow-up data from the 30 097 participants of the Canadian Longitudinal Study on Aging were used. The follow-up rate was 92%. QUARTZ, a deep learning algorithm, was used to extract data from retinal images including arteriolar and venular diameter, tortuosity and vertical CDR. Glaucoma and AMD were self-reported. IOP was measured. Multiple linear and logistic regression were used to adjust for demographic, lifestyle and clinical factors.</p><p><strong>Results: </strong>Having wider arterioles was associated with a lower odds of glaucoma (OR = 0.36, 95% CI: 0.20, 0.65) at baseline but there was no association using longitudinal data. Instead, glaucoma at baseline was strongly associated with 3-year change in arteriolar diameter (β = -0.21, 95% CI: -0.37, -0.05) indicating that the cross-sectional association may have been due to reverse causality. Using longitudinal data, greater venular tortuosity was associated with a reduced 3-year development of glaucoma (OR = 0.52, 95% CI: 0.31, 0.87) and a 3-year reduction in the CDR (β = -0.006, 95% CI: -0.010, -0.002). Wider venular diameter was associated with a higher odds of AMD at baseline (OR = 2.77, 95% CI: 1.50, 5.15) and a higher odds of the 3-year development of AMD (OR = 4.15, 95% CI: 1.95, 8.82).</p><p><strong>Conclusions: </strong>Understanding the temporal relationship of changes in the retinal microvasculature and the development of eye disease may lead to better treatment and prevention strategies.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295410","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":"Barriers and Enablers Influencing the Implementation of Artificial Intelligence for Diabetic Retinopathy Screening in Clinical Practice: A Scoping Review.","authors":"Jenny Tran, Jose J Estevez, Natasha J Howard, Saravana Kumar","doi":"10.1111/ceo.14567","DOIUrl":"https://doi.org/10.1111/ceo.14567","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy is a leading cause of preventable blindness worldwide. Meanwhile, artificial intelligence is rapidly growing in clinical utility within medicine. This scoping review aims to identify and summarise existing literature on the barriers and enablers of clinical applications of artificial intelligence systems for the screening of diabetic retinopathy.</p><p><strong>Methods: </strong>Utilising a systematic approach and the PRISMA-ScR protocol for conducting scoping reviews, searches were performed in MEDLINE, Embase, Emcare, Cochrane, CINAHL, ProQuest, Scopus and grey literature (Australian Indigenous Health InfoNet). Two reviewers independently reviewed the records. A third reviewer provided consensus. Data extraction and synthesis in narrative form ensued.</p><p><strong>Results: </strong>A total of 3844 articles were screened, of which 18 were selected. Published between 2018 and 2023, the selected studies varied in study design and were conducted across 10 countries. Several barriers and enablers were identified and categorised into four domains: healthcare system, healthcare professional, healthcare user and information technology. Within the healthcare system, clinical efficiency was reported on most frequently. Concerning the healthcare professional, education was most frequently discussed. Within healthcare user, studies most frequently identified factors pertaining to patient outcomes, while diagnostic performance was most frequently explored under the information technology domain.</p><p><strong>Conclusions: </strong>As evidence for the efficacy of artificial intelligence for diabetic retinopathy screening grows, barriers to and enablers for its uptake in clinical practice are paramount considerations. Translating the knowledge of systems, provider, consumer and technological factors informs clinical strategies, ultimately facilitating the sustainable and effective implementation of this novel technology for screening practices.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295409","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":"Development and Validation of a Deep Learning System for the Provision of a District-Wide Diabetes Retinal Screening Service.","authors":"Jason R Daley, Xingdi Wang, Natalie Ngo, Chee L Khoo, Peter Heydon, Gerald Liew, Vallimayil Vallayutham, Tobias Kongbrailatpam, Uchechukwu L Osuagwu, Marko Andric, Wei Xuan, David Simmons, Shweta Kaushik","doi":"10.1111/ceo.14560","DOIUrl":"https://doi.org/10.1111/ceo.14560","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) enhanced retinal screening could reduce the impact of diabetic retinopathy (DR), the leading cause of preventable blindness in Australia. This study assessed the performance and validity of a dual-modality, deep learning system for detection of vision-threatening diabetic retinopathy (vtDR) in a multi-ethnic community.</p><p><strong>Methods: </strong>Cross-sectional (algorithm-validation) study with the deep learning system assessing fundus photographs for gradability and severity of DR, and optical coherence tomography (OCT) scans for diabetic macular oedema (DMO). Internal validation of each algorithm was performed using a computer-randomised 80:20 split. External validation was by comparison to standard grading provided by two ophthalmologists in 748 prospectively recruited persons with diabetes (age ≥ 10) from hospital diabetes clinics and a general practice. Main outcome measures included sensitivity, specificity and the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>Internal validation revealed robust test characteristics. When compared to ophthalmologists, the system achieved an AUC of 0.92 (95% CI 0.90-0.94) for fundus photograph gradeability, 0.91 (95% CI 0.85-0.94) for the diagnosis of severe non-proliferative DR/proliferative DR and 0.90 (95% CI 0.87-0.96) for DMO detection from OCT scans. It demonstrated real-world applicability with an AUC of 0.94 (95% CI 0.91-0.97), sensitivity of 92.7% and specificity of 95.5% for detection of vtDR. Ungradable images occurred in 55 participants (7.4%).</p><p><strong>Conclusions: </strong>The dual-modality, deep learning system can diagnose vtDR from fundus photographs and OCT scans with high levels of accuracy and specificity. This could support a novel model of care for DR screening in our community.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259427","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 Overlooked Role of Vitamin D in HLA-B27 Associated Uveitis Beyond Seasonal Variations.","authors":"Sıdıka Gerçeker Demircan","doi":"10.1111/ceo.14563","DOIUrl":"https://doi.org/10.1111/ceo.14563","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200899","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}