Clinical and Experimental Ophthalmology最新文献

{"title":"Chronic Kidney Disease and Glaucoma: Is the Case Truly Closed?","authors":"Alan Y. Hsu, Yi-Ching Shao, Chun-Ju Lin, Yi-Yu Tsai","doi":"10.1111/ceo.14506","DOIUrl":"10.1111/ceo.14506","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 5","pages":"570-571"},"PeriodicalIF":4.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392581","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":"Progress in Translating Glaucoma Genetics Into the Clinic: A Review","authors":"Antonia Kolovos,&nbsp;Giorgina Maxwell,&nbsp;Emmanuelle Souzeau,&nbsp;Jamie E. Craig","doi":"10.1111/ceo.14500","DOIUrl":"10.1111/ceo.14500","url":null,"abstract":"<p>Precision medicine is paving the way for personalised risk assessment, and its translation into glaucoma clinics holds potential to change current management paradigms. Our understanding of glaucoma's genetic architecture has expanded in recent years, recognising both monogenic and polygenic contributions. Genetic testing within glaucoma populations can provide additional information for clinicians to support decision-making. Here, we review the evidence base for genetic variants strongly associated with glaucoma and outline a vision for translating these learnings into the clinic. Integrating clinical and genetic information will provide clinicians and patients with the strongest evidence to deliver personalised glaucoma management.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 3","pages":"246-259"},"PeriodicalIF":4.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ceo.14500","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eye Diseases in Chronic Kidney Disease: A Nationwide Longitudinal Case–Control Study in Sweden: Response","authors":"Pablo Ballester Dolz,&nbsp;Per Vihlborg,&nbsp;Ing-Liss Bryngelsson,&nbsp;Karim Makdoumi","doi":"10.1111/ceo.14505","DOIUrl":"10.1111/ceo.14505","url":null,"abstract":"<p>We appreciate the interest and insights shared by Hsu et al. [<span>1</span>]. regarding our recently published article in Clinical and Experimental Ophthalmology [<span>2</span>]. The points raised are important, and we are grateful for the opportunity to address these questions.</p><p>We agree that using repeated identical ICD codes, especially in combination with dialysis procedure codes, would strengthen the specificity of CKD diagnosis. It is also likely that incorporating data on glaucoma medication prescriptions would enhance the robustness of glaucoma diagnoses. However, our study used an existing database that did not include procedure codes or glaucoma medication data, as it was not designed to study these parameters. That said, as highlighted in our article, the Swedish National Patient Register provides comprehensive, high-quality, validated data commonly used in large-scale cohort studies [<span>3</span>].</p><p>The study focused on analysing the risk for different eye diseases in CKD for several conditions, including subdivisions based on age groups. Cox proportional hazards model is considered a robust method when investigating the association between two diseases over time.</p><p>We acknowledge that a more detailed approach could have provided deeper insights, particularly when analysing different stages of CKD and glaucoma subtypes. However, our study aimed to examine the overall relationship between CKD and eye diseases, rather than focusing on specific types of eye disease or CKD severity. These limitations were discussed in our article, as they arose from the constraints of the pre-existing database, which could not be modified.</p><p>It is also important to note that the incidence of glaucoma was higher in age groups II (31–45 years) and III (46–65 years), with HRs of 1.98 and 1.26, respectively, though analysis was not possible for group I due to a limited number of cases. Hence, glaucoma incidence was elevated in patients under 66 years. Differences in ethnicity between Taiwan and Sweden, such as variations in myopia prevalence [<span>4</span>] and the incidence of pseudoexfoliation syndrome (PEX), may also contribute to differences in glaucoma rates. In some regions of Sweden, PEX and open-angle glaucoma are more common, particularly in the aging population [<span>5</span>]. These factors could help explain the differences in the incidence of open-angle glaucoma between the studies and might account for some of the discrepancies in our cases and controls.</p><p>In conclusion, the differences in outcomes between those highlighted by Hsu et al. in their letter and our study are likely due to both methodological variations and population differences. Our results underscore the importance of awareness of glaucoma in CKD, and we are thankful to Hsu et al. and the Editor for the opportunity to clarify this point once again.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 5","pages":"572-573"},"PeriodicalIF":4.9,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ceo.14505","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detecting Glaucoma in Highly Myopic Eyes From Fundus Photographs Using Deep Convolutional Neural Networks","authors":"Xiaohong Chen,&nbsp;Chen Zhou,&nbsp;Yingting Zhu,&nbsp;Man Luo,&nbsp;Lingjing Hu,&nbsp;Wenjing Han,&nbsp;Chengguo Zuo,&nbsp;Zhidong Li,&nbsp;Hui Xiao,&nbsp;Shaofen Huang,&nbsp;Xuhao Chen,&nbsp;Xiujuan Zhao,&nbsp;Lin Lu,&nbsp;Yizhou Wang,&nbsp;Yehong Zhuo","doi":"10.1111/ceo.14498","DOIUrl":"10.1111/ceo.14498","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>High myopia (HM) is a major risk factor for glaucoma. However, glaucomatous optic neuropathy is often undiagnosed owing to atypical structural alterations with axial elongation. Moreover, an algorithm to detect glaucoma in highly myopic eyes has not yet been reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We recruited 2643 colour fundus photographs to train a ResNet-50 network for discriminating eyes with highly myopic glaucoma (HMG) from HM or glaucoma alone. We employed a 10-fold cross-validation strategy to evaluate the model's performance and applicability across diverse patient groups. Multiple metrics were computed to gauge the model's diagnostic process. The diagnostic ability of the model was then juxtaposed with those made by ophthalmologists to determine concordance. The gradient-weighted class activation maps were used for visual explanations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our model demonstrated an overall accuracy of 97.7% with an area under the curve of 98.6% (sensitivity, 91.2%; specificity, 98.0%) for the differential diagnosis among HM, glaucoma, HMG and normal controls. These metrics notably outperformed the diagnostic performances of two attending ophthalmologists, who achieved accuracies of 64.7% and 69.9%. The activation maps derived from the model suggested that the most discriminative lesions for diagnosing HMG were predominantly in the disc, peripapillary area and inferior region of the disc, which are often displayed with a tessellated fundus. These results were slightly different from the understanding of the attending ophthalmologists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our proposed model demonstrates high efficacy and suggests specific features for distinguishing eyes with HMG, enabling potential clinical value in assisting the intricate diagnosis of this vision-threatening disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 5","pages":"502-515"},"PeriodicalIF":4.9,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ceo.14498","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seasonal Variation in HLA-B27 Associated Uveitis","authors":"Priya D. Samalia,&nbsp;James Brodie,&nbsp;Joanne L. Sims,&nbsp;Rachael L. Niederer","doi":"10.1111/ceo.14503","DOIUrl":"10.1111/ceo.14503","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To examine if there was a monthly variation in HLA-B27-associated uveitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective review of all individuals presenting to a single centre with HLA-B27-associated uveitis from 2009 to 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>577 participants with HLA-B27-associated uveitis were included. The median age at presentation was 40.4 years (IQR 31.1–51.4) and 356 (61.7%) were male. 141 (24.4%) participants were diagnosed with ankylosing spondylitis. The incidence of HLA-B27 uveitis was greatest in August (winter) and lowest in March (autumn). On univariate analysis, there was an inverse relationship between HLA-B27-associated uveitis incidence and mean air temperature (β−2.704, <i>p</i> &lt; 0.001) and sunlight hours (β−0.221, <i>p</i> = 0.003), and a positive relationship between uveitis incidence and rainfall (β 0.324, <i>p</i> = 0.006) and humidity (β 1.741, <i>p</i> = 0.006). On multivariate analysis, there was an inverse relationship with temperature (β−4.846, <i>p</i> = 0.002) and a positive association with humidity (β 2.033, <i>p</i> = 0.008). On multivariate analysis, the impact of rainfall shifted to negative (β−0.446, <i>p</i> = 0.017) and sunlight hours lost significance. The monthly effect was more pronounced for non-Caucasian ethnicities and for those without ankylosing spondylitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In New Zealand, HLA-B27-associated uveitis episodes are influenced by monthly changes with higher incidence in winter months.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 5","pages":"516-522"},"PeriodicalIF":4.9,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ceo.14503","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Potential of Retina-Based Biological Age in Assessing Chronic Obstructive Pulmonary Disease Risk","authors":"Qingsheng Peng,&nbsp;Tyler Hyungtaek Rim,&nbsp;Zhi Da Soh,&nbsp;Miao Li Chee,&nbsp;Yih-Chung Tham,&nbsp;Zhuoting Zhu,&nbsp;Simon Nusinovici,&nbsp;Charumathi Sabanayagam,&nbsp;Ah. Young Leem,&nbsp;Chan Joo Lee,&nbsp;Byoung Kwon Lee,&nbsp;Sungha Park,&nbsp;Sung Soo Kim,&nbsp;Hyeon Chang Kim,&nbsp;Marco Chak Yan Yu,&nbsp;Tien Yin Wong,&nbsp;Ching-Yu Cheng","doi":"10.1111/ceo.14501","DOIUrl":"10.1111/ceo.14501","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previously, based on retinal photographs, we developed a deep-learning algorithm to predict biological age (termed, RetiAGE) that was associated with future risks of morbidity and mortality. This study specifically aimed to evaluate the performance of RetiAGE in predicting future risks of chronic obstructive pulmonary disease (COPD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>RetiAGE scores were generated from retinal images in the UK Biobank and stratified into tertiles. We used Cox proportional hazards models to evaluate the longitudinal association between RetiAGE and incident COPD, adjusting for calendar age, gender, smoking, asthma history, and socio-economic status. In addition, we performed a cross-sectional analysis using generalised linear models to examine the association between RetiAGE and baseline respiratory function, specifically the forced expiratory volume in 1 s to forced vital capacity ratio (FEV1/FVC) and peak expiratory flow (PEF), adjusting for the same confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 45 438 UK Biobank participants without a history of COPD at baseline, 448 (0.9%) developed COPD over a mean follow-up period of 9.8 ± 0.7 years. Participants in the moderate-risk and high-risk tertiles of RetiAGE had significantly lower baseline respiratory function (all <i>p</i> &lt; 0.05) and a higher risk of incident COPD (HR = 1.60; 95% CI, 1.18–2.19) compared to the low-risk tertile, after adjusting for confounders. Adding RetiAGE to the multivariable risk model improved predictive performance, as demonstrated by significant enhancements in C-statistics (<i>p</i> &lt; 0.001) and likelihood ratio tests (<i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our deep-learning-based retinal aging biomarker, RetiAGE, can potentially stratify the risk of developing COPD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 4","pages":"402-408"},"PeriodicalIF":4.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366761","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.14476","DOIUrl":"https://doi.org/10.1111/ceo.14476","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 1","pages":"105-108"},"PeriodicalIF":4.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111411","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":"Treat and Extend Anti-VEGF Treatment Regimens for Neovascular Age-Related Macular Degeneration: To Stop or Not to Stop?","authors":"Praveen J. Patel","doi":"10.1111/ceo.14495","DOIUrl":"https://doi.org/10.1111/ceo.14495","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 1","pages":"8-10"},"PeriodicalIF":4.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111410","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":"Seeking best outcomes for patients living with vitreoretinal lymphoma","authors":"Justine R. Smith FRANZCO, PhD","doi":"10.1111/ceo.14473","DOIUrl":"https://doi.org/10.1111/ceo.14473","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 1","pages":"5-7"},"PeriodicalIF":4.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143110271","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":"Leber Hereditary Optic Neuropathy: Support, Genetic Prediction and Accurate Genetic Counselling Enhance Family Planning Choices","authors":"Lisa S. Kearns,&nbsp;Sandra E. Staffieri,&nbsp;David A. Mackey","doi":"10.1111/ceo.14493","DOIUrl":"10.1111/ceo.14493","url":null,"abstract":"<p>With the increased availability of genetic testing and the addition of mitochondrial genetic variants on disease panels, accurate genetic counselling for individuals and families affected by, or at risk of, Leber hereditary optic neuropathy (LHON) is becoming increasingly relevant. Challenges in providing genetic counselling for LHON include its mitochondrial inheritance pattern, different haplogroups, incomplete penetrance and that it predominantly affects males. Accurate genetic counselling aims to avoid incorrect disease-risk assessment and delays in either diagnosis or implementation of psychosocial support. Families are also empowered to make autonomous health decisions regarding potential trigger factors for LHON vision loss and informed reproductive choices. Using clinical vignettes, this review demonstrates that an increased awareness of LHON amongst eye care, general and genetic health professionals can address challenges and misconceptions.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 3","pages":"292-301"},"PeriodicalIF":4.9,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ceo.14493","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}