Acta Ophthalmologica最新文献

{"title":"Neovascular age-related macular degeneration on three nationwide survey and register data in Finland during 2000-2017.","authors":"Petri Purola, Seppo Koskinen, Kai Kaarniranta, Hannu Uusitalo","doi":"10.1111/aos.17444","DOIUrl":"https://doi.org/10.1111/aos.17444","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate time trends in the incidence and prevalence of neovascular age-related macular degeneration (nAMD) and its treatments, associated factors, and effects on vision in Finland during 2000-2017.</p><p><strong>Methods: </strong>We used three nationwide health examination surveys representing the Finnish population aged 30 years or older. All three surveys were linked to the national care register covering nAMD diagnoses and intravitreal injections between 2000 and 2017. All three surveys included a health examination in which distance and near visual acuity (VA) were measured, as well as self-reported and register-based information on socio-demographic status and lifestyle, health care use, co-morbidities, and quality of life. The data included two cross-sectional time points in 2011 and 2017 and two 11 year longitudinal follow-ups during 2000-2011 and 2006-2017.</p><p><strong>Results: </strong>The incidence and prevalence of nAMD were two times higher in women than in men. The annual prevalence of nAMD increased from 0.51% to 0.70% and from 0.22% to 0.46% in treated nAMD between 2011 and 2017. Treated nAMD patients had an average of 4 intravitreal injections per treatment year. nAMD patients showed significantly poorer distance and near VA than persons without any AMD in 2011 and 2017 (p < 0.001). However, near VA was significantly better in 2017 than in 2011 among nAMD patients (p = 0.036). The duration of nAMD showed weak negative correlation with distance and near VA. After adjusting for age and sex, nAMD patients showed significantly higher univariable odds ratios for lower distance VA, low consumption of vegetables, living in central Finland, a higher number of hospitalisations per year, and older age compared with persons without any AMD.</p><p><strong>Conclusion: </strong>Since nAMD is an increasing burden for public health with gender discrepancy and a detrimental impact on vision, we should better find patients who have a high risk of developing nAMD and try to optimise their preventive intervention. Once nAMD is developed, we should understand treatment and follow-up demands at the personalised level. The nationwide register data help us in those challenges.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998271","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":"Societal costs of decreased visual acuity: A Finnish cohort study with 15 years of registry data follow-up.","authors":"Joonas Taipale, Petri K M Purola, Saku Väätäinen, Janika E Nättinen, Seppo V P Koskinen, Hannu M T Uusitalo","doi":"10.1111/aos.17439","DOIUrl":"https://doi.org/10.1111/aos.17439","url":null,"abstract":"<p><strong>Purpose: </strong>To examine what direct and indirect societal costs are associated with decreased visual acuity (VA).</p><p><strong>Methods: </strong>Nationally representative sample of 8028 Finnish adults aged 30 years or older with survey data and clinical examination including VA assessment was evaluated. These data were linked with multiple national registers to capture health care services utilization during 1999-2013. All direct and indirect costs were calculated using prevalence-based bottom-up approach and adjusted for age, sex, and comorbidities with generalized linear models. The results in 2019 cost level are presented according to VA groups at baseline per person, and with population estimates.</p><p><strong>Results: </strong>Total direct health care costs ranged from 1996 €/year/person for those with VA ≥1.0 to 3277 €/year/person for those with weak (0.32-0.5) VA. The increase in direct costs was notable even before the onset of visual impairment. Indirect costs showed monotonously increasing trend with decreasing VA. At the population level, the additional annual direct costs associated with decreased VA were estimated at 1.9 billion €. Only 2% or less of the additional costs are due to increased direct eye-related secondary health care usage. Estimated additional annual national indirect costs were 1.2 billion €.</p><p><strong>Conclusions: </strong>In addition to those with visual impairment or blindness, health care need, and societal costs are elevated even among those with adequate VA. We conclude, that focusing on prevention of VA decrease would not only help sustain the patients' quality of life but could also reduce the future societal costs.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998273","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 debate – when and how should i use idebenone for LHON?","authors":"Marcela Votruba","doi":"10.1111/aos.16902","DOIUrl":"https://doi.org/10.1111/aos.16902","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p>The International Consensus Statement on the Clinical and Therapeutic Management of Leber Hereditary Optic Neuropathy was published in 2017 based on data available in 2016. The intent was to provide expert consensus statements for the clinical and therapeutic management of LHON based on the currently available evidence. It provided the guidelines for clinical and therapeutic management of LHON. It established a number of benchmarks such as clinical staging of LHION into Asymptomatic (mutation carriers), Subacute (&lt;6 months from onset), Dynamic (6–12 months) and Chronic (&gt;12 months) stages. We can all agree on the criteria for the diagnosis of LHON, based on a careful history, evaluation of key structural and functional visual parameters, and on a molecular confirmation of a pathogenic mtDNA mutation. On management it is clearly highly important to include genetic counselling and informing the patient about potentially preventable lifestyle risk factors. The use of idebenone is more debated and much has changed. Further studies and case series have been published and issues around when to start, how long to treat for and whether to treat chronic patients have all emerged. In this debate we shall raise a number of these issues and provide a reflection of the available data, their validity and clinical relevance and debate next steps.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.16902","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116309","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":"In-situ printing of gelma-based hydrogels for cornea regeneration","authors":"Hamid Goodarzi,&nbsp;Boda Om,&nbsp;May Griffith,&nbsp;Christos Boutopoulos","doi":"10.1111/aos.16950","DOIUrl":"https://doi.org/10.1111/aos.16950","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Aims/Purpose:</b> Corneal perforation is a medical emergency that can lead to blindness. Treatment options encompass cyanoacrylate or fibrin glue, both linked to side effects, including cytotoxicity. Gelatin methacryloyl-based biomaterials offer an alternative to these adhesives [1, 2]. Achieving optical clarity and smooth surface integrity is crucial for the restoration of vision in treated corneal wounds.</p>\u0000 \u0000 <p><b>Methods:</b> Currently, the delivery of corneal biomaterials utilizes standard syringe systems, which lack the accuracy to reconstruct the cornea's shape. Therefore, the use of a laser bioprinting technology, developed in the Boutopoulos lab [3], for achieving precise <i>in-situ</i> corneal wound repair was examined. We used a photocrosslinkable ink comprising Gelatin Methacryloyl (GelMa), hydroxyethyl acrylate (HEA), and Lithium phenyl-2,4,6-trimethylbenzoylphosphinate (LAP) as a photoinitiator.</p>\u0000 \u0000 <p><b>Results:</b> Printability was optimized by generating nanoliter-volume individual droplets using 230 μJ laser energy, a flow rate 20 microliter per minute, and a temperature of 37°C. Rheology, optical characterization, and bursting pressure measurements assessed its potential to seal corneal perforations. Results indicated a hydrogel storage modulus of 1.31 ± 0.31 KPa for printed LiQD cornea and a bursting pressure of 38 ± 6 mmHg when used to seal full thickness cornea perforation in cadaveric pig eyes. Optical clarity akin to the native cornea was observed (%light transmission: 93.12 ± 1.02 printed vs 92.61 ± 1.50). The OCT results showed that the LIST technique could potentially fill the corneal wounds and reconstruct the natural curvature of the wounded cornea.</p>\u0000 \u0000 <p><b>Conclusions:</b> In conclusion, a precise printing system for delivering adhesive corneal regenerative biomaterials to wounds was developed and characterized.</p>\u0000 \u0000 <p><b>References</b></p>\u0000 \u0000 <p>1. Sharifi, S., et al., 2021. 6(11): p. 3947-3961.</p>\u0000 \u0000 <p>2. Barroso, I.A., et al., 2022. 9(2).</p>\u0000 \u0000 <p>3. Ebrahimi Orimi, H., et al., Sci Rep, 2020. 10(1): p. 9730.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.16950","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116343","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 novel artificial intelligence-based classification of highly myopic eyes based on visual function and fundus features","authors":"Jiaqi Meng,&nbsp;Yunxiao Song,&nbsp;Wenwen He,&nbsp;Zhong-Lin Lu,&nbsp;Yuxi Chen,&nbsp;Ling Wei,&nbsp;Keke Zhang,&nbsp;Jiao Qi,&nbsp;Yu Du,&nbsp;Yi Lu,&nbsp;Xiangjia Zhu","doi":"10.1111/aos.17026","DOIUrl":"https://doi.org/10.1111/aos.17026","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Aims/Purpose:</b> To develop a novel classification of highly myopic eyes using artificial intelligence (AI) and investigate its relationship with contrast sensitivity function (CSF) and fundus features.</p>\u0000 \u0000 <p><b>Methods:</b> 616 highly myopic eyes of 616 patients were enrolled. CSF was measured using the quantitative CSF method. Myopic macular degeneration (MMD) was graded according to the International META-PM Classification. Thickness of the macula and peripapillary retinal nerve fiber layer (p-RNFL) were assessed by fundus photography and optical coherence tomography, respectively. Classification was performed by combining CSF and fundus features with principal component analysis and k-means clustering.</p>\u0000 \u0000 <p><b>Results:</b> With 83.35% total variance explained, highly myopic eyes were classified into 4 categories. The percentages of categories 1 to 4 were 14.9%, 37.5%, 36.2%, and 11.4%, respectively. CSF of the eyes in category 1 were the highest, followed by those in category 2 and then category 3, while the lowest was seen in category 4. Compared to those in category 1, eyes in category 2 presented higher percentage of MMD2 and thinner temporal p-RNFL. Eyes in categories 3 and 4 presented significantly higher percentage of MMD≥3, thinner nasal macular thickness and p-RNFL (<i>p</i> &lt; 0.05). Multivariate regression showed category 4 had higher MMD grades, thinner macular and p-RNFL thickness compared to category 3.</p>\u0000 \u0000 <p><b>Conclusions:</b> We proposed an AI-based classification of highly myopic eyes by integrating features from both visual function and fundus. It might be an important tool to comprehensively evaluate highly myopic eyes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.17026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116347","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":"Gut microbial dysbiosis in age-related macular degeneration","authors":"Joëlle Vergroesen,&nbsp;Jeroen Vermeulen,&nbsp;Eric Thee,&nbsp;Bart Liefers,&nbsp;Caroline Klaver","doi":"10.1111/aos.17039","DOIUrl":"https://doi.org/10.1111/aos.17039","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Purpose:</b> The gut microbiome is highly influential in diseases with inflammatory components. Multiple studies showed a link between the gut microbiome and age-related macular degeneration (AMD). However, no consistent taxa have been reported.</p>\u0000 \u0000 <p><b>Methods:</b> We included 1372 participants from the Rotterdam Study (RS). AMD features (e.g. [reticular pseudo-]drusen, retinal pigment epithelium degeneration, and hyperpigmentation) were graded by human graders on color fundus photographs. Next, areas of these features were automatically quantified by a deep learning segmentation model. Stages were determined according to the RS classification (preliminary = 239, early-intermediate = 75, late = 6). Propensity score matching was performed on age, sex and BMI. Multivariable associations with taxonomic and functional profiles were assessed using zero-adjusted models (MaAsLin2; Compound Poisson). <i>p</i>-values were false discovery rate-adjusted (q-values). Taxa associated (q &lt; 0.25) with at least two out of seven AMD(-related) outcomes are reported.</p>\u0000 \u0000 <p><b>Results:</b> We observed no associations with alpha- or beta-diversity. Nineteen taxa were associated with AMD, of which 7 persisted after additional adjustment for dietary data. Eubacterium xylanophilum group, Lachnoclostridium, Faecalibacterium, Odoribacter splanchnicus and Parabacteroides distasonis were associated with an AMD phenotype. Parabacteroides and Akkermansia were inversely associated with an AMD phenotype. Moreover, 46 MetaCyc pathways were associated with AMD, of which 15 persisted after additional adjustment for dietary data. GLUCARDEG.PWY, PWY.5028, PWY.5347, PWY.5415, PWY.5532, PWY.5971, PWY.6969 and TCA were associated with an AMD phenotype. FOLSYN.PWY, LEU.DEG2.PWY, PANTO.PWY, PANTOSYN.PWY, PWY.6612, PWY0.1586 and PYRIDNUCSYN.PWY were inversely associated with an AMD phenotype.</p>\u0000 \u0000 <p><b>Conclusions:</b> Several gut microbiota were associated with an AMD phenotype. AMD pathophysiology might be linked to changes in gut-related metabolic pathways.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.17039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116351","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":"Conditioned media from dental pulp stem cells to counteract the age-related macular degeneration","authors":"Darin Zerti,&nbsp;Giulia Carozza,&nbsp;Fanny Pulcini,&nbsp;Loreto Lancia,&nbsp;Vincenzo Mattei,&nbsp;Simona Delle Monache,&nbsp;Rita Maccarone","doi":"10.1111/aos.16936","DOIUrl":"https://doi.org/10.1111/aos.16936","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Aims/Purpose:</b> Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly. To date, there are no effective therapies to counteract the AMD towards the most severe stages characterized by a progressive loss of photoreceptors triggered by retinal pigmented epithelium dysfunction. Given their easily source and their high proliferative potential, Dental Pulp Stem Cells (DPSCs) showed promise for regenerative medicine. The main advantage of DPSCs is related to their immunosuppressive and immunoregulatory abilities, including the capability to promote regeneration of damaged tissues. It is well known the therapeutic potential of DPSCs secretome (conditioned media, CM), including trophic factors and cytokines, as a treatment of neurogenerative diseases. We evaluated the capability of DPSCs-CM cultured in hypoxia and normoxic conditions to counteract retinal degeneration in an animal model of AMD.</p>\u0000 \u0000 <p><b>Methods:</b> DPSCs-CM were intravitreally injected the day before the exposure of albino rats to high intensity light (LD). We evaluated the retinal function, and we performed morphological and molecular analysis a week after the LD, in accordance with the well-established protocol of our light damage model.</p>\u0000 \u0000 <p><b>Results:</b> DPSCs-CM obtained from hypoxia or normoxia, were able to preserve the retinal function, to reduce microglial activation and their migration toward outer nuclear layer (ONL). Furthermore, we demonstrated that the treatment with normoxic DPSCs-CM limited the hot spot extension and preserved the ONL thickness better than the hypoxic DPSCs-CM. The different concentrations of growth factors and cytokines detected in both CM played a key role in the understanding of the greatest protective effect of the normoxic-CM compared to hypoxic-CM.</p>\u0000 \u0000 <p><b>Conclusions:</b> Taken together, our study demonstrated that normoxic DPSCs-CM represents an eligible candidate to counteract retinal degeneration and, therefore, a promising therapeutic agent for AMD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.16936","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116357","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":"Objective measurement of accommodation in patients with an accommodating intraocular lens compared to phakic, presbyopic, and pseudophakic eyes","authors":"Timo Eppig,&nbsp;Manuel Seer,&nbsp;Violetta Müller,&nbsp;Saskia Schütz,&nbsp;Michiel Rombach,&nbsp;Willem van Lawick","doi":"10.1111/aos.17278","DOIUrl":"https://doi.org/10.1111/aos.17278","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Aims/Purpose:</b> The restoration of accommodation after cataract surgery remains to be one of the biggest challenges in ophthalmology. Numerous concepts for restoration of accommodation have failed due to a lack of objective accommodation measurement. The purpose of this study was to demonstrate the dynamic pseudophakic accommodation in patients with an accommodative AIOL by means of an objective accommodation measurement and to compare the data with a young phakic, a presbyopic and a monofocal pseudophakic person.</p>\u0000 \u0000 <p><b>Methods:</b> We included 3 patients in the study who had a Lumina AIOL implanted in both eyes. All patients had completed at least the 6 month follow-up. In addition, we included both eyes of 3 comparative persons with different status of the lens (phakic, presbyopic and pseudophakic). We used a binocular open-field videorefractor (PowerRef 3, Plusoptix GmbH, Germany) to measure the change of refraction, pupil diameter and ocular convergence while patients were asked to focus on an ETDRS chart. The ETDRS chart was then continuously moved from 6m distance to 33 cm distance while the patients were asked to focus on a single letter. The resulting curves were then compared to demonstrate the objective change in refraction.</p>\u0000 \u0000 <p><b>Results:</b> The data exhibit a continuous change of binocular refraction which follows the pupil constriction and decrease of pupil distance (convergence) in the young phakic person and the AIOL patients. The maximum accommodative change was up to 2.5 D in the AIOL patients and up to 3 D in the young phakic person for a stimulus distance of 33 cm. The presbyopic patient and the monofocal pseudophakic patient showed pupil constriction and convergence but the accommodative range was less pronounced with a maximum change of 1 D.</p>\u0000 \u0000 <p><b>Conclusions:</b> The PowerRef 3 allows for an objective proof of pseudophakic accommodation in patients with an AIOL. AIOL eyes show defined change of refractive power that can be maintained constant for the time of fixation to a near target compared to presbyopic and monofocal pseudophakic eyes that show only little modulation, which can be attributed to pseudo-accommodative effects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.17278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116369","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":"Orthokeratology and myopia control: A comprehensive meta-analysis of axial growth in children and adolescents","authors":"António Queirós,&nbsp;Inês Mota-Silva,&nbsp;Ana Filipa Pereira-da-Mota","doi":"10.1111/aos.17279","DOIUrl":"https://doi.org/10.1111/aos.17279","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Aims/Purpose:</b> The aim of this study was to evaluate the longitudinal effect on axial eye length in myopic children and adolescents treated with orthokeratology (OK) lenses compared to spectacles (GL), through a systematic review and meta-analysis</p>\u0000 \u0000 <p><b>Methods:</b> We conducted a systematic search of PubMed and Google Scholar databases for randomized controlled trials and cohort studies investigated the effects of longitudinal axial length difference, using the keyword “Axial Length” AND “orthokeratology” AND “spectacles”. From the initial 91 studies, we excluded 13 review studies, 10 meta-analysis studies, 7 systematic reviews and 37 studies that did not meet the inclusion criteria. Of the 24 selected studies, detailed information was available at 24, 18, 12, 6, 3 and 1 month, with 10, 8, 19, 17, 2 and 3 studies respectively, allowing for the comparison between 2172 eyes treated with orthokeratology and 2095 eyes with glasses.</p>\u0000 \u0000 <p><b>Results:</b> The analysis of the 24 studies (which included 59 comparisons from 1 month to 24 months) showed no statistically significant differences in initial axial length [AL(GL) = 24.39 ± 0.34 mm; AL(OK) = 24.44 ± 0.38 mm] and initial refractive error [M(GL) = -2.59 ± 0.70 D; M(OK) = -2.53 ± 0.44 D] between the two treatment groups (<i>p</i> &gt; 0.565, independent samples t-test) and for the evolution time intervals (<i>p</i> &gt; 0.591, ANOVA). This analysis encompassed 4267 eyes with a mean age of 10.23 ± 1.21 years. Forest plot provided in an overall effect size of myopic defocus AL = -0.16 com IC 95% -0.19 a -0.14, <i>Z</i> = 12.71 <i>p</i> &lt; 0.001. A random effects model was used considering the heterogeneity observed (<i>I</i>² = 97%; <i>p</i> &lt; 0.001, df = 58). There was a greater myopia control effect at 24 months (AL = -0.26, 95% IC -0.29 to -0.22, <i>Z</i> = 13.71 <i>p</i> &lt; 0.001; <i>I</i>² = 0%; <i>p</i> = 0.95) than to treatments of less than 3 months (AL = -0.04, 95% IC -0.06 to -0.01, <i>Z</i> = 2.60 <i>p</i> = &lt; 0.009; <i>I</i>² = 86%; <i>p</i> &lt; 0.001).</p>\u0000 \u0000 <p><b>Conclusions:</b> While the treatment at 24 months shows an homogeneous behaviour among studies, shorter follow-up times renders a larger heterogeneity and for that reason, longer follow-up periods should be preferred to estimate a more solid effect size. Orthokeratology treatment has been shown to be effective in myopia control progression for short or longer longitudinal treatments in children and young people with spectacles comparison.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.17279","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116370","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":"Genetic polymorphisms and uveitis","authors":"Stéphane Abramowicz","doi":"10.1111/aos.16886","DOIUrl":"https://doi.org/10.1111/aos.16886","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;p&gt;Uveitis is a multifactorial disease, originating from the interplay between our genes, the environment and stochastic factors.&lt;sup&gt;1&lt;/sup&gt; In contrast, only a handful of exceptional uveitic entities are monogenic.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;To understand the immunogenetics of uveitis, one must understand the concept of multifactorial disease. These diseases are characterized by multigenic involvement, with any one variant allele being neither necessary nor sufficient for disease initiation. Rather, it is the combination of multiple variants in multiple genes, which all increase the susceptibility of an individual to develop a particular disease. The second concept is that of the environmental trigger, such as an infection or exposure to a drug, which triggers the disease in genetically susceptible individuals. Stochastic factors may also play a role in disease genesis.&lt;sup&gt;2&lt;/sup&gt;&lt;/p&gt;\u0000 \u0000 &lt;p&gt;In the context of uveitis, genetic polymorphisms in genes of the class I major histocompatibility complex (MHC), such as &lt;i&gt;HLA-A&lt;/i&gt;, or &lt;i&gt;HLA-B&lt;/i&gt;, are associated with common non-infectious uveitides (NIU) like HLA-B27-associated acute anterior uveitis (AAU), Behçet's disease, and Birdshot retinochoroiditis (BRC).&lt;sup&gt;3&lt;/sup&gt;&lt;/p&gt;\u0000 \u0000 &lt;p&gt;Specifically, HLA-B27 carrier frequency in the Caucasian US population is around 7%, while it is present in approximately 50% of patients who develop AAU, and 90% of patients who develop ankylosing spondylitis (AS). This represents a relative risk (RR) for carriers of HLA-B27 of around 8 for developing AAU,&lt;sup&gt;4&lt;/sup&gt; and around 50 to 100 for developing AS.&lt;sup&gt;5&lt;/sup&gt;&lt;/p&gt;\u0000 \u0000 &lt;p&gt;HLA-B51 carrier frequency in populations along the Silk Road is around 10-30%,&lt;sup&gt;6&lt;/sup&gt; compared to 50-80% in Behçet's disease patients, conferring a RR of 5-10 to develop the disease.&lt;sup&gt;7&lt;/sup&gt;&lt;/p&gt;\u0000 \u0000 &lt;p&gt;The third major HLA polymorphism associated with uveitis is HLA-A29, whose carrier frequency in the Western European population is reported to be 5-10%,&lt;sup&gt;8&lt;/sup&gt; compared to the 97.5% in BRC patients,&lt;sup&gt;3,9&lt;/sup&gt; conferring an astronomically high RR of 50-224 for developing BRC in carriers of HLA-A29 versus non-carriers.&lt;sup&gt;4,9&lt;/sup&gt; BRC is actually the immunological disease with the strongest HLA association ever described.&lt;sup&gt;4&lt;/sup&gt;&lt;/p&gt;\u0000 \u0000 &lt;p&gt;Some weaker HLA associations have been reported with other NIU entities, such as HLA-DR4/&lt;i&gt;HLA-DRB1*04&lt;/i&gt; with Vogt-Koyanagi-Harada disease,&lt;sup&gt;10,11&lt;/sup&gt; &lt;i&gt;HLA-DRB1*04:05&lt;/i&gt;, &lt;i&gt;HLA-DQB1*04:01&lt;/i&gt;, and the &lt;i&gt;DRB1*04:05-DQB1*04:01&lt;/i&gt; haplotype with sympathetic ophthalmia,&lt;sup&gt;12&lt;/sup&gt; or &lt;i&gt;HLA-DRB1*15:01&lt;/i&gt; and the &lt;i&gt;IL2-RA&lt;/i&gt; gene polymorphism rs2104286 A&gt;G with multiple sclerosis-associated uveitis.&lt;sup&gt;13&lt;/sup&gt;&lt;/p&gt;\u0000 \u0000 &lt;p&gt;In addition to HLA typing and polymorphisms, there has been m","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.16886","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143116491","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}