Clinical and Experimental Ophthalmology最新文献

{"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}

{"title":"Diagnostic Ability of Transverse Axial Images Obtained by Optical Coherence Tomography for Detecting Anterior Displacement of Peripapillary Tissues in Papilledema.","authors":"Gabriel Castilho S Barbosa, Rodrigo S Pegado, Fernanda N Susanna, Kenzo Hokazono, Mário Luiz R Monteiro, Leonardo Provetti Cunha","doi":"10.1111/ceo.14561","DOIUrl":"https://doi.org/10.1111/ceo.14561","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the diagnostic ability of optical coherence tomography (OCT) images to detect posterior pole deformation and anterior displacement of the optic disc (ADOD) in papilledema before and after intracranial pressure reduction with medical treatment. Additionally, we compared the analysis of these images with peripapillary retinal nerve fibre layer (pRNFL) thickness measurements in detecting papilledema.</p><p><strong>Methods: </strong>In this retrospective, observational, descriptive, and comparative study, participants underwent swept-source OCT with high-resolution imaging. Papilledema cases were analysed at baseline and 7-30 days post-treatment. Two masked examiners independently assessed images for ADOD.</p><p><strong>Results: </strong>The study included 82 eyes from 41 patients, with 50 eyes having papilledema and 32 eyes with optic disc drusen (ODD) as controls. At baseline, ADOD was observed in 50% of papilledema eyes and 32% post-treatment. A reduction in ADOD was noted in 34% of papilledema eyes. Cohen's κ coefficient indicated substantial agreement (0.799). Mean pRNFL thickness significantly decreased from baseline to post-treatment (305.4 ± 140.2 vs. 245.3 ± 94.5 μm, p < 0.001). Logistic regression demonstrated an association between mean pRNFL thickness and ADOD at baseline (OR = 1.016, p = 0.001) and post-treatment (OR = 1.012, p = 0.004).</p><p><strong>Conclusion: </strong>OCT B-scan analysis is an effective tool for detecting ADOD and posterior pole deformation in papilledema and distinguishing it from ODD. ADOD correlates with the severity of optic disc oedema and may serve as a more sensitive or specific indicator of treatment response compared to pRNFL thickness. These findings highlight the value of OCT axial imaging in diagnosing and monitoring papilledema, offering clinicians a reliable method for assessing disease progression and treatment efficacy.</p>","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":"144200898","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":"Laterality Errors and Risk Reduction Across the Entire Care Pathway at an Ambulatory Day Surgery, 2013-2023.","authors":"Stewart Lake, Carina Mathiasen, Jon Clarke","doi":"10.1111/ceo.14562","DOIUrl":"https://doi.org/10.1111/ceo.14562","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176043","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":"Typical Manifestations of the Different Corneal Deposits by In Vivo Confocal Microscopy (IVCM): A Review.","authors":"Eric Rozitis, Constantinos Petsoglou, Rajnesh Devasahayam, Scott Hau, Javier Lacorzana","doi":"10.1111/ceo.14552","DOIUrl":"https://doi.org/10.1111/ceo.14552","url":null,"abstract":"<p><p>In vivo confocal microscopy (IVCM) is a highly useful tool in ophthalmology for investigating a wide range of corneal pathologies. It provides high resolution images with minimal light scattering and is particularly useful in determining the nature of various corneal deposits. Deposits may arise within any layer of the cornea and may occur due to various reasons such as infections (e.g., crystalline deposits), metabolic bodily processes, systemic diseases, pharmacological agents and toxins. Deposits may as a general rule, be linear versus non-linear in shape or hyperreflective or hyporeflective in nature. Non-linear deposits can further be subdivided into granular, round, amorphous, or whorl-like patterns of deposits. This article will attempt to not only summarise all of the currently recognised corneal deposits but also utilise the morphology of the varying types of corneal deposits as seen in IVCM and categorise them within a table.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163936","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":"Optimising the Evaluation of Optic Neuritis YouTube Videos: A Call for Multimedia-Specific Tools and Audience-Oriented Approaches-Response.","authors":"Bedia Kesimal, Sıdıka Gerçeker Demircan, Sücattin İlker Kocamış","doi":"10.1111/ceo.14555","DOIUrl":"https://doi.org/10.1111/ceo.14555","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136532","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":"Real-World 10-Year Outcomes of Anti-VEGF Therapy for Neovascular Age-Related Macular Degeneration: A Meta-Analysis.","authors":"Kimberly Spooner, Geoffrey Broadhead, Samantha Fraser-Bell, Thomas Hong, James G Wong, Andrew A Chang","doi":"10.1111/ceo.14559","DOIUrl":"https://doi.org/10.1111/ceo.14559","url":null,"abstract":"<p><strong>Background: </strong>This study examines the long-term effectiveness of anti-VEGF therapy in managing neovascular age-related macular degeneration (nAMD). Despite the well-established short-term improvements of anti-VEGF therapy, there is limited data on its continued efficacy over extended periods. This meta-analysis synthesises real-world data to evaluate anti-VEGF therapy's long-term outcomes systematically.</p><p><strong>Methods: </strong>We conducted a comprehensive literature review across PubMed, EMBASE and Cochrane databases, focusing on studies that reported outcomes of anti-VEGF treatment for nAMD over a decade. The analysis included pooling baseline patient characteristics, study designs, sample sizes and changes in visual acuity (VA) over 10 years.</p><p><strong>Results: </strong>Our search produced 12 observational studies encompassing 7509 eyes, with 1274 completing 10-years of follow-up. The most substantial improvement in VA was observed in the first year following the initiation of anti-VEGF therapy. On average, there was a decline of 8.11 letters in VA after 10 years from baseline (95% CI -10.83 to -5.39, p < 0.01). In some cases, VA reverted to baseline levels after 10 years; in others, it declined significantly below baseline. Meta-regression showed that mean VA change was greater in those with a lower baseline VA and those treated with a higher number of injections over 10-years(p < 0.01).</p><p><strong>Conclusion: </strong>Our findings suggest that the mean visual acuity of eyes treated for nAMD deteriorates progressively over the long-term from two years after starting treatment. Regular injections appear crucial for preserving maximum vision. While our analysis did not identify an increased incidence of serious ocular adverse events, the long-term impact of anti-VEGF therapy on geographic atrophy remains unclear and warrants further investigation.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136579","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":"Normative Values on Stromal Curvature, Power and Corneal-Stromal Curvature Ratios From a Hybrid AS-OCT.","authors":"Jascha A Wendelstein, Arianna Grendele, Achim Langenbucher, Alice Galzignato, Catarina Praefke Coutinho, Seth Pantanelli, Kamran M Riaz, Giacomo Savini","doi":"10.1111/ceo.14556","DOIUrl":"https://doi.org/10.1111/ceo.14556","url":null,"abstract":"<p><strong>Background: </strong>To establish normative values for stromal curvature and its relationships to anterior and posterior curvature.</p><p><strong>Methods: </strong>Retrospective observational study. Data were obtained from 75 eyes of cataract surgery patients using a high-resolution anterior segment optical coherence tomograph (AS-OCT; MS-39, CSO). Data analysis included anterior, stromal, and posterior curvature across multiple zones (1.0-5.0 mm), and derived curvature ratios.</p><p><strong>Results: </strong>The anterior-to-stromal curvature ratio (ASR) remained stable (1.016-1.007), while the stromal-to-posterior (SPR) and anterior-to-posterior (APR) ratios exhibited trends of slight change (SPR: 1.149-1.167; APR: 1.167-1.175). The refractive power analysis revealed incremental effects across one, two, and three refractive surface models, emphasising the importance of integrating posterior and stromal curvature data into optical assessments.</p><p><strong>Conclusion: </strong>This study provides the first normative values for stromal curvature and its ratios with anterior and posterior curvature. These findings may have implications for corneal- and lens-based surgeries and diagnostics.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121394","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":"Continuing Professional Development","authors":"","doi":"10.1111/ceo.14541","DOIUrl":"10.1111/ceo.14541","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 4","pages":"446-448"},"PeriodicalIF":4.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103179","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":"Real World Data to Improve Outcomes in Retinal Vein Occlusion","authors":"Rachael C. Heath Jeffery,&nbsp;Ian L. McAllister,&nbsp;Fred K. Chen","doi":"10.1111/ceo.14547","DOIUrl":"10.1111/ceo.14547","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 4","pages":"342-343"},"PeriodicalIF":4.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103186","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}