Acta Ophthalmologica最新文献

{"title":"Characterization of retinal pigment epithelium layer in healthy and diseased retinas with high-resolution adaptive optics transscleral flood illumination imaging.","authors":"Leila Sara Eppenberger, Safa Mohanna, Sohrab Ferdowsi, Sonja Simon-Zoula, Oliver Pfäffli, Christoph Amstutz, Lucas M Bachmann, Michael A Thiel, Martin K Schmid","doi":"10.1111/aos.70016","DOIUrl":"https://doi.org/10.1111/aos.70016","url":null,"abstract":"<p><strong>Purpose: </strong>The retinal pigment epithelium (RPE) is critical in the pathophysiology of retinal diseases, such as age-related macular degeneration. Adaptive optics transscleral flood illumination (AO-TFI) offers rapid, detailed morphometric characterization of the RPE layer. This study evaluated AO-TFI's efficacy and feasibility to detect clinically relevant morphological characteristics in a clinical setting.</p><p><strong>Methods: </strong>A total of 230 participants, categorized by their central retinal health, underwent comprehensive examination including SD-OCT, fundus imaging and AO-TFI using the Cellularis® prototype 2.0. Image quality control and RPE layer quantification were performed with an AO-TFI-specific automated segmentation algorithm. Density and area of hyper- and hyporeflective regions in the RPE layer plane, and, if detectable, RPE cell density, were quantified. We hypothesized that the RPE cell density would be lower in diseased retinas than in healthy retinas. Imaging results of healthy participants were statistically compared to those of diseased eyes. Additionally, generalized linear and logistic regression mixed-effect models identified associations between ocular characteristics and imaging parameters.</p><p><strong>Results: </strong>After quality evaluation, high-quality images from 200 subjects (87%) were selected and segmented. The number of hyperreflective regions and their mean surface area were significantly higher in diseased than in healthy eyes (68 ± 40/mm² vs. 51 ± 39/mm²; p < 0.001; 302 ± 196 μm² vs. 155 ± 55 μm²; p < 0.001). The RPE distinct mosaic pattern was more often visible in healthy retinas (n = 103 vs. n = 30, p < 0.0001). The mean RPE cell density was 6354 ± 695/mm², with comparable counts for healthy and diseased, 6327 ± 687/mm² vs. 6532 ± 725/mm² (p = 0.1).</p><p><strong>Conclusion: </strong>AO-TFI detected differences between healthy and diseased eyes, indicating its potential as a promising clinical modality providing quantitative and qualitative insights into RPE layer dynamics.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with the high prevalence of myopia and its decrease-A historical review.","authors":"Olavi Pärssinen","doi":"10.1111/aos.70001","DOIUrl":"https://doi.org/10.1111/aos.70001","url":null,"abstract":"<p><strong>Purpose: </strong>To review historical and recent studies on the epidemiology of myopia, identify the factors associated with its prevalence and determine how myopia has been successfully prevented.</p><p><strong>Methods: </strong>Historical and recent publications were reviewed regarding factors associated with the prevalence of myopia and the success of myopia prevention. Among the historical studies, Herman Cohn's studies in Germany and Johan Widmark's studies in Sweden were referenced and compared.</p><p><strong>Results: </strong>In the 1800s, the prevalence of myopia caused by school glasses was high in the upper grades of many schools in Germany and Sweden. In Germany, the mean prevalence of myopia in the upper grades of 24 schools was 58%, exceeding 70% in several schools. At the same time in Sweden, the corresponding average prevalence was 45%, with the highest prevalence of 65%. Germany and Sweden implemented several generally accepted reforms to reduce the educational burden of schooling. Widmark compared the prevalence of myopia in the same schools in Sweden between the periods 1822-1883 and 1904-1905. The mean myopia prevalence decreased from 22.2% to 9.8%, and from 45.3% to 17.4% in the highest grades of these schools. Widmark identified three factors to explain the decrease in myopia prevalence: (1) improved lighting due to electric lights; (2) Fraktur fonts in schools were replaced by Antiqua; and (3) the number of outdoor activities was increased. The discussion aims to find similarities between Cohn's and Widmark's studies and the current myopia boom and to describe how these historical observations might currently be used to prevent myopia.</p><p><strong>Conclusion: </strong>Myopia generally begins after starting school. The younger the children are subjected to the strain caused by near work and the less time spent outdoors at school, the higher the prevalence of myopia and the higher the myopia in adulthood. To control the current myopia boom in countries where the prevalence is highest, major changes should be implemented in the education system to reduce the need for near work and increase the time children spend outdoors.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term results of conservative and surgical treatment of congenital x-linked retinoschisis: A retrospective multicentre international study.","authors":"Şengül Özdek, Hüseyin Baran Özdemir, Muna Bhende, Pramod Bhende, Parveen Sen, Dhanashree Ratra, Debarati Dasgupta, M Elizabeth Hartnett, Joseph M Simonett, Parag K Shah, Abhishek Das, Shunji Kusaka, Philip J Ferrone, Jessica Lee, Brett Rosenblatt, David Rhee, Eric Shakin, Itsuka Matsushita, Ihab Saad Othman, Anas Ahmed, Mehmet Yasin Teke, Selda Çelik Dülger, Remzi Avcı, Barbara Parolini, Wei Chi Wu, Zofia Anna Nawrocka, Zofia Nawrocka, Jerzy Nawrocki, Ehab El Rayes, Gökhan Gürelik, Nicola Ghazi","doi":"10.1111/aos.70002","DOIUrl":"https://doi.org/10.1111/aos.70002","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the demographic and clinical characteristics, treatment indications, long-term outcomes and prognostic factors in patients with congenital x-linked retinoschisis (CXLR) managed conservatively or surgically.</p><p><strong>Methods: </strong>This retrospective, international, multicentre study included data from retina specialists across 14 centres in 9 countries. Demographic information, best corrected visual acuity (BCVA), phenotype, optical coherence tomography (OCT) findings and disease management were analysed. Surgical indications, techniques and anatomical and visual outcomes were evaluated.</p><p><strong>Results: </strong>A total of 635 eyes of 318 patients were included. Median age at presentation was 9 years (range: 0-81). Observation was preferred in 73.5% of eyes, laser photocoagulation (LPC) in 9.3% and vitreoretinal surgery in 18.1%. Surgical patients presented younger (7 vs. 10 years; p = 0.002) and with worse baseline BCVA (1.50 vs. 0.50 LogMAR; p < 0.0001). Disease symmetry was lower in surgical cases (24.4%) than in conservative and LPC groups (p < 0.0001). Vitreous veils, peripheral pigmentary changes and white spiculations were predictive of surgical need, particularly in eyes with rhegmatogenous retinal detachment (RRD) and vitreous haemorrhage (VH). OCT predictors of peripheral progression included absence of ganglion cell layer cysts and presence of outer plexiform layer cysts. Single-surgery anatomical success was 68.7%, increasing to 94.7% with additional procedures. Inner-wall retinectomy significantly improved outcomes in macula-threatening retinoschisis (p = 0.026). Visual acuity improved significantly after surgery in RRD and VH cases (p = 0.003).</p><p><strong>Conclusion: </strong>CXLR shows a broad clinical spectrum requiring individualized care. Fundus and OCT features effectively predicted progression and surgical need. Surgical management achieved high success, with inner-wall retinectomy beneficial in certain cases.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring ocular fundus morphology in relation to growth in adolescents born moderate-to-late preterm.","authors":"Alexandra Lind, Sara Ali, Titus Ovik, Zoran Popovic, Eva Aring, Jovanna Dahlgren, Marita Andersson Grönlund","doi":"10.1111/aos.70011","DOIUrl":"https://doi.org/10.1111/aos.70011","url":null,"abstract":"<p><strong>Purpose: </strong>To study ocular fundus morphology and its relation to growth in adolescents born moderate-to-late preterm (MLP) and full term.</p><p><strong>Methods: </strong>This prospective and population-based cohort study included 50 MLP adolescents (26 girls, mean age 16.5 years) and 50 full-term controls (30 girls, mean age 16.7 years). Optical coherence tomography measurements were studied in relation to gestational age, auxological data, insulin-like growth factor-I (IGF-I) and IGF-binding protein 3 (IGFBP-3).</p><p><strong>Results: </strong>The MLP group showed an increased central macular retinal thickness (MRT) compared with controls in right eye (RE) (249.7 ± 21.0 vs. 239.9 ± 16.4 μm, p = 0.019). Moreover, the MLP group showed a thinner total peripapillary retinal nerve fibre layer (ppRNFL) thickness in RE (104.3 ± 8.5 vs. 109.1 ± 8.3, p = 0.0011). Nasal ppRNFL thickness was thinner in both RE (79.4 ± 13.2 vs. 85.0 ± 10.8, p = 0.0012) and left eye (LE) (77.0 ± 13.8 vs. 81.7 ± 13.4, p = 0.025) compared with controls. A weak association between total ppRNFL thickness and IGF-I levels was found (RE, r = 0.28, p = 0.032; LE, r = 0.27, p = 0.048), as well as between central MRT and a ratio between IGF-I and IGFBP-3 levels (RE, r = 0.30, p = 0.022). Additionally, there was a correlation between optic cup/disc area ratio and birth weight (RE: r = -0.44, p = 0.0006; LE: r = -0.30, p = 0.026).</p><p><strong>Conclusion: </strong>The present study suggests that growth and MLP birth may impact ocular fundus morphology. The MLP adolescents were shown to have thinner ppRNFL thickness and greater MRT, compared with full-term controls. Furthermore, a weak association between these structures and growth factors was found. In addition, the current study proposes that birth weight may impact optic disc parameters.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The longitudinal associations of reading, writing and screen time with myopia at age 9 years among children from the GUSTO birth cohort.","authors":"Fan Wu, Chen-Hsin Sun, Hla Myint Htoon, Jonathan Y Bernard, Fabian Yap, Yih-Chung Tham, Charumathi Sabanayagam, Seang-Mei Saw","doi":"10.1111/aos.70009","DOIUrl":"https://doi.org/10.1111/aos.70009","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the associations between paper-based reading and writing time, screen-based time at ages 2, 3, 6 and 9 years and myopia at age 9 in the GUSTO birth cohort.</p><p><strong>Methods: </strong>The GUSTO study recruited pregnant women from two Singapore public maternity hospitals between 2009 and 2010. Parent-reported reading and writing time, screen time and outdoor time were collected at ages 2, 3, 6 and 9 years. Cycloplegic autorefraction and axial length were measured at age 9. Myopia was defined as a spherical equivalent ≤-0.5 D. Associations between near work exposures and myopia were examined using multivariable regression with generalised estimating equations.</p><p><strong>Results: </strong>Among 471 children (942 eyes), 37.3% were myopic at age 9 years. Greater reading and writing time at ages 6 and 9 were associated with higher odds of myopia at age 9 (OR [95% CI] = 1.20 [1.02-1.42] and 1.11 [1.02-1.22] per h/day, respectively). Children spending >3 h/day reading and writing at age 9 had 76% higher odds of myopia than those spending ≤3 h/day (OR = 1.76, 95% CI: 1.08-2.85). Reading and writing time at ages 2 and 3 years, and screen time at all age groups showed no significant association with myopia at age 9.</p><p><strong>Conclusions: </strong>Traditional paper-based reading and writing, but not screen time, were associated with myopia in Singaporean children. Future studies with larger samples and objective screen time measures are needed to evaluate the distinct role of screen time in myopia.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topiramate-induced acute angle closure with suprachoroidal effusion: Insights from a novel ultra-wide-field OCT device.","authors":"Michael Hafner, Nicolas Pensel, Nicolas C D Scherer, Marc J Mackert, Siegfried G Priglinger, Leonie F Keidel, Maximilian J Gerhardt","doi":"10.1111/aos.70012","DOIUrl":"https://doi.org/10.1111/aos.70012","url":null,"abstract":"","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145204963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining laissez-faire treatment of periocular tumour defects by exploring the impact of defect localization and geometry on the healing process.","authors":"Jens Nääv Ottosson, Adrianna Opalko, Johanna Berggren, Kajsa Tenland, John Albinsson, Aboma Merdasa, Elin Bohman, Malin Malmsjö","doi":"10.1111/aos.70019","DOIUrl":"https://doi.org/10.1111/aos.70019","url":null,"abstract":"<p><strong>Background: </strong>Large lower eyelid defects resulting from tumour removal are frequently reconstructed using a tarsoconjunctival flap from the upper eyelid together with an overlying free skin graft, the so-called Hughes procedure. One disadvantage of this technique is that the tarsoconjunctival flap occludes the eye during the revascularization of the graft, which is particularly troublesome for patients with poor vision in the other eye. Another alternative method for reconstructing large lower eyelid defects is the use of a free bilamellar eyelid graft with the advantage that it is a single-stage procedure and that the vision is not occluded during the healing process. However, both these methods require extensive surgery, which is time-consuming and might be too much effort for the frail and elderly. In these specific cases, where one wishes to avoid extensive surgery, laissez-faire treatment, so-called self-healing, might be an alternative.</p><p><strong>Methods: </strong>46 patients undergoing laissez-faire treatment for periocular tumour defects were included. Surgical defects were in the medial canthal area (n = 10) and the lower eyelid (n = 28), with the latter classified as proportional (n = 21) or disproportional (n = 7) based on the anterior to posterior lamellae ratio. Cases requiring repeated surgical excisions due to tumour-positive margins (n = 8) were analysed separately. Wound contraction was assessed through serial photography after 1 week, 3 weeks, 6-8 weeks, and 5 months to 2 years. Defect size was standardized using corneal area measurements.</p><p><strong>Results: </strong>Proportional lower eyelid defects exhibited predictable healing, with rapid wound contraction the first 6-8 weeks and minimal complications. Disproportional defects showed uneven healing, resulting in ectropion or significant tissue loss in 6 of 7 cases. Medial canthal defects generally healed well, but larger defects (>50% of corneal area) took longer to contract and were associated with traction-related complications in isolated cases. Repeated surgical excisions were associated with a higher prevalence of complications, including ectropion, entropion, and residual defects.</p><p><strong>Conclusions: </strong>Defect geometry is crucial in the healing process and clinical outcomes of periocular defects treated with laissez-faire. Medial canthal defects and proportional lower eyelid defects heal more reliably, while disproportional and large medial canthal defects, as well as cases requiring repeated surgical excisions, pose a higher risk of complications. These findings emphasize the importance of careful patient selection and defect analysis to optimize outcomes.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of efficacy and safety between partial and complete gonioscopy-assisted transluminal trabeculotomy for open-angle glaucoma.","authors":"Murat Gunay, Adem Turk, Irem Berfu Bozat, Busra Mor, Busra Kose, Dilek Uzlu","doi":"10.1111/aos.70017","DOIUrl":"https://doi.org/10.1111/aos.70017","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the surgical efficacy and safety of partial and complete gonioscopy-assisted transluminal trabeculotomy (GATT) in open-angle glaucoma.</p><p><strong>Methods: </strong>This retrospective comparative study included 206 eyes with primary open-angle glaucoma (POAG) or pseudoexfoliation glaucoma (PEXG) who underwent partial GATT (superior 180°, inferior 180°, or 270°) or complete GATT (360°) at a tertiary centre with at least 12 months of follow-up. Surgical success (qualified and complete) was defined across three intraocular pressure (IOP) criteria: A (<18 mmHg), B (<15 mmHg), and C (<12 mmHg), each requiring a ≥30% reduction from baseline. Additional outcomes included best-corrected visual acuity (BCVA), number of anti-glaucoma medications (AGMs), extent of episcleral venous fluid wave (EVFW) and postoperative complications.</p><p><strong>Results: </strong>Mean follow-up was 19.7 ± 9.6 months. Baseline demographics, glaucoma type and surgical indications were comparable between groups. At final follow-up, all GATT variants resulted in significant IOP and AGM reductions (p < 0.001), with no statistically significant differences in IOP, BCVA, success rates, or complications among the four groups (p > 0.05). EVFW extent and safety profiles were similar across groups.</p><p><strong>Conclusion: </strong>Partial GATT (superior 180°, inferior 180°, or 270°) provides similar surgical outcomes and safety as complete 360° GATT. Hemi-GATT may serve as a time-efficient and effective alternative to circumferential GATT in appropriate patients.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy as a risk factor for central serous chorioretinopathy: A systematic review and meta-analysis.","authors":"Nathalie Skovgaard Eriksen, Zainab Fakhril-Din, Riccardo Fasana, Rodrigo Anguita, Elon H C van Dijk, Lorenzo Ferro Desideri, Jakob Grauslund, Michael Stormly Hansen, Oliver Niels Klefter, Armin Motaabbed, Line Petersen, Prithvi Ramtohul, Mehmet Cem Sabaner, Osman Savran, Miklos Schneider, Yousif Subhi","doi":"10.1111/aos.70013","DOIUrl":"https://doi.org/10.1111/aos.70013","url":null,"abstract":"<p><strong>Purpose: </strong>Pregnancy induces significant changes in the body, including increased peripheral and choroidal blood perfusion and an increased systemic corticosteroid level. Here, we systematically reviewed the evidence on pregnancy as a risk factor for developing central serous chorioretinopathy (CSC) and conducted a meta-analysis to obtain a summary estimate.</p><p><strong>Methods: </strong>We searched 12 literature databases on 16 February 2025 for epidemiological studies, which evaluated the potential association between pregnancy and CSC. All eligible studies were included for a qualitative review and a meta-analysis. The meta-analysis was made using the random-effects model on the odds ratio (OR) of the association between pregnancy and CSC.</p><p><strong>Results: </strong>Four studies were eligible for our review. Of the 2766 individuals (1345 patients with CSC, 1391 controls) in these studies, females constituted 26%-64% of study populations in individual studies. The calculated summary estimate of pregnancy as a risk factor for CSC was OR 5.51 (95% CI: 2.12-14.30, p = 0.00046). Heterogeneity statistics suggested minimal to no heterogeneity (Cochran's Q = 0.72; I² = 0%), the funnel plot was symmetrical and the sensitivity analysis suggested robustness of the estimates.</p><p><strong>Conclusion: </strong>Pregnancy appears to be a significant risk factor for CSC.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External limiting membrane defects in age-related macular degeneration. The Beijing Eye Study.","authors":"Jost B Jonas, Songhomitra Panda-Jonas, Jie Xu, Rahul A Jonas, Ya Xing Wang","doi":"10.1111/aos.70015","DOIUrl":"https://doi.org/10.1111/aos.70015","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the prevalence and associations of external limiting membrane (ELM) defects on optical coherence tomographic (OCT) images in a general population, affected by age-related macular degeneration (AMD) or free of any retinal disease.</p><p><strong>Methods: </strong>Using OCT images, we assessed the ELM defect presence in participants of the population-based Beijing Eye Study.</p><p><strong>Results: </strong>The study population consisted of 712 (44.2%) eyes with early AMD, 295 (18.3%) eyes with intermediate AMD, 12 (0.7%) eyes with geographic atrophy and 592 (36.7%) eyes without signs of AMD. ELM defect prevalence increased from 6/592 (1.0%; 95% CI: 0.0, 2.0) in the normal group to 57/712 (8.0%; 95% CI: 6.0, 10.0), 117/295 (39.7%; 95% CI: 34.2, 45.2) and 11/12 (91.7%; 95% CI: 73.7, 100) in the group with early AMD stage, intermediate AMD and late AMD stage, respectively. Higher ELM defect prevalence was spatially associated with higher prevalence of ellipsoid zone (EZ) defects (OR: 929; 95% CI: 291-2964; p < 0.001). In multivariable analysis, higher ELM defect prevalence correlated with higher AMD stage (OR: 2.22; 95% CI: 1.33, 3.71; p = 0.002), higher prevalence of intraretinal hyperreflective foci (iHRFs) superior to the EZ/ELM (OR: 29.7; 95% CI: 8.69-102; p < 0.001), lower prevalence of iHRFs beneath the EZ/ELM (OR: 0.11; 95% CI: 0.04, 0.35; p < 0.001) and higher prevalence of localized interdigitation zone thinnings (IZTs) (OR: 5.66; 95% CI: 3.14, 10.2; p < 0.001).</p><p><strong>Conclusions: </strong>The spatial correlation between ELM defects and EZ defects, the associations of both defect types with a higher occurrence of iHRFs superior to the ELM, the association between an absence of ELM defects and a higher prevalence of iHRFs located inferior to the ELM, and the association between a higher ELM defect prevalence and higher IZT prevalence may suggest the ELM/EZ may act as a barrier for RPE cells migrating into the retina.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}