Advances in ophthalmology practice and research最新文献

{"title":"Anterior chamber depth and vitreous zonule integrity as biomarkers for intraoperative capsule laxity in angle closure","authors":"Hui Zhang,&nbsp;Jin Wang,&nbsp;Yue Wang,&nbsp;Zijian Liu,&nbsp;Dongjun Li,&nbsp;Lin Shen,&nbsp;Chunyan Qiao,&nbsp;Ching-Yu Cheng,&nbsp;Ye Zhang","doi":"10.1016/j.aopr.2026.04.002","DOIUrl":"10.1016/j.aopr.2026.04.002","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate preoperative predictors for anterior and posterior capsule laxity during phacoemulsification combined with anti-glaucoma surgery in eyes with angle closure.</div></div><div><h3>Methods</h3><div>Cross-sectional study. Patients aged ≥40 years diagnosed with angle closure who underwent phacoemulsification combined with anti-glaucoma surgery between May 2023 and May 2025 were enrolled. Eyes were classified into four groups based on intraoperative findings: anterior capsule laxity, posterior capsule laxity, combined capsule laxity, and normal capsule. Mixed-effects logistic regression analysis was employed to determine the independent predictors of anterior and posterior capsule laxity, respectively.</div></div><div><h3>Results</h3><div>A total of 241 eyes of 203 patients were included. 36 eyes (14.9%) had anterior laxity, 51 eyes (21.2%) had posterior laxity, 73 eyes (30.3%) had combined capsule laxity, and 81 eyes (33.6%) had normal capsule. Eyes with anterior laxity had shallower anterior chamber depth (ACD) than normal capsule eyes (2.05 (1.82,2.29) mm vs. 2.33 (2.13, 2.52) mm, <em>P</em>&lt;0.001) and were more frequently acute primary angle closure (APAC) (<em>P</em>=0.001). Posterior/combined laxity eyes showed higher vitreous zonule (VZ) absence (both <em>P</em>&lt;0.001); combined laxity having thicker lens than normal eyes (5.16 ± 0.35mm vs. 4.95 ± 0.43mm, <em>P</em>=0.006). Regression analysis identified APAC diagnosis (odds ratio (OR) 3.04, 95% confidence interval (CI): 1.01–9.38, <em>P</em>=0.049) and shallower ACD (OR 0.05, 95% CI: 0.01–0.26, <em>P</em>=0.001) as independent predictors for anterior capsule laxity, while APAC diagnosis (OR 3.89, 95% CI: 1.20–13.50, <em>P</em>=0.026), VZ absence (OR 0.11, 95% CI: 0.04–0.27, <em>P</em>&lt;0.001), and increased ciliary body maximum thickness (CBMT) (OR 1.92, 95% CI: 1.22–3.17, <em>P</em>=0.007) predicted posterior capsule laxity. The anterior and posterior capsule laxity prediction models achieved AUC values of 0.817 (95% CI: 0.739–0.896) and 0.781 (95% CI: 0.690–0.872), respectively.</div></div><div><h3>Conclusions</h3><div>APAC diagnosis and shallow ACD predict anterior capsule laxity, whilst VZ absence, APAC diagnosis, and increased CBMT indicate posterior capsule laxity in eyes with angle closure. Identification of these biomarkers before surgery may help surgeons anticipate complications and optimize postoperative outcomes.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"6 3","pages":"Pages 257-265"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148730402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating large language model clinical reasoning in glaucoma using retrieval-augmented generation","authors":"Houfa Yin,&nbsp;Qi Miao,&nbsp;Wanshu Zhou,&nbsp;Chenyang Hu,&nbsp;Yongwei Guo,&nbsp;Lixia Shen,&nbsp;Haiyan Cai,&nbsp;Andrzej Grzybowski,&nbsp;Kai Jin","doi":"10.1016/j.aopr.2026.05.003","DOIUrl":"10.1016/j.aopr.2026.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Large language models (LLMs) demonstrate strong performance in knowledge-based medical tasks, yet their clinical reasoning capabilities in complex ophthalmic decision-making, particularly glaucoma management, remain insufficiently characterized. Retrieval-augmented generation (RAG) has been proposed as a strategy to improve factual grounding and safety, but its clinical value requires systematic evaluation.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, scenario-based comparative evaluation using 40 real-world glaucoma cases spanning primary, secondary, postoperative, and end-stage disease. Six model conditions (GPT, Gemini, and Grok, each with and without RAG) were assessed using a guideline-grounded framework covering medical accuracy, key point coverage, logical completeness, and a separate qualitative safety audit. Model outputs were compared with written responses from four practicing ophthalmologists. All responses were independently scored by two masked glaucoma specialists using a prespecified ordinal rubric, and formal inter-rater reliability and paired sensitivity analyses were performed.</div></div><div><h3>Results</h3><div>RAG-enhanced models consistently outperformed their matched non-RAG counterparts across evaluation domains. In human-rating sensitivity analyses, the composite RAG advantage remained significant for GPT (mean difference=0.119, 95% CI: 0.068–0.173), Gemini (mean difference=0.095, 95% CI: 0.030–0.161), and Grok (mean difference=0.110, 95% CI: 0.033–0.194). Inter-rater agreement of the ordinal rubric was limited, supporting consensus adjudication and cautious interpretation of artificial intelligence-human comparisons.</div></div><div><h3>Conclusions</h3><div>Retrieval augmentation was associated with more accurate, more complete, and more safety-aware glaucoma reasoning under this scenario-based evaluation. These findings support the potential value of RAG-enhanced LLMs as supervised clinical decision-support tools, but they do not establish standalone clinical use. Safety was evaluated as a separate audit layer rather than as part of the weighted composite score.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"6 3","pages":"Pages 291-298"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148770817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A practical starting guide to tear fluid biobanking","authors":"Jente Schmeetz,&nbsp;Suzanne Hagan,&nbsp;Nienke van de Sande,&nbsp;Nikolay Boychev,&nbsp;Karima Kessal,&nbsp;Marlies Gijs","doi":"10.1016/j.aopr.2026.04.001","DOIUrl":"10.1016/j.aopr.2026.04.001","url":null,"abstract":"<div><h3>Background</h3><div>Tear fluid is increasingly recognized as a minimally invasive source of biomarkers in various diseases with broad potential for diagnostics and disease monitoring. Biobanking tear fluid samples provides valuable access to high-quality biological samples while reducing the need for new collection efforts. Ensuring appropriate collection and storage conditions is critical for maintaining sample integrity. However, standardized guidelines and operating protocols for tear fluid biobanking are still lacking.</div></div><div><h3>Main text</h3><div>This review synthesizes existing literature on tear fluid biobanking, complemented by additional sources such as reports and online guidelines on biobanking standards and recommendations. Together, these insights provide a practical guide for researchers and institutions aiming to establish a tear fluid biobank or integrate tear fluid samples into existing biobanking infrastructures. This guide outlines key aspects including (i) governance, regulatory, and ethical considerations, (ii) biosafety, infrastructure, and logistics, (iii) collection methods and materials, and (iv) data harmonization through the developed and proposed Tear Fluid-Common Data Elements, which emphasize on the collection, storage, processing, and analysis of biobanked samples.</div></div><div><h3>Conclusions</h3><div>By providing clear and practical guidance, this review supports the standardization of tear fluid biobanking, thereby enhancing the value of these samples for future research and clinical applications.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"6 3","pages":"Pages 281-290"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148770820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing the non-pigmented retinitis pigmentosa in a Chinese cohort: Insights into phenotype, genotype, and disease progression","authors":"Hong-Li Liu,&nbsp;Ping Xu,&nbsp;Sheng-Hai Zhang,&nbsp;Wei Liu,&nbsp;Ji-Hong Wu","doi":"10.1016/j.aopr.2026.02.005","DOIUrl":"10.1016/j.aopr.2026.02.005","url":null,"abstract":"<div><h3>Purpose<em>s</em></h3><div>To characterize the comprehensive clinical and genetic spectrum of non-pigmented presentation of retinitis pigmentosa in a large Chinese cohort, addressing a significant knowledge gap in non-Caucasian populations.</div></div><div><h3>Methods</h3><div>This retrospective, cross-sectional study identified and characterized 80 patients with an absence of typical pigmentation from a cohort of 1063 individuals with retinitis pigmentosa at a single tertiary center.</div></div><div><h3>Results</h3><div>A proportion of 7.5% of the retinitis pigmentosa patients in our clinic-based cohort presented with the non-pigmented phenotype. This subgroup was characterized by a myopic shift (median spherical power: −1.00 D) and a distinct superior-to-inferior gradient of visual field defect. Survival analysis identified a critical window of accelerated functional decline between ages 34.5 and 52. Visual acuity decline was biphasic, with rates peaking within the first 5 years (0.044 logMAR/year) and after 40 years of disease (0.079 logMAR/year). Age significantly amplified the detrimental effect of disease duration on vision (<em>β</em> = 0.015 vs. 0.008 logMAR/year in older vs. younger patients). Structurally, horizontal ellipsoid zone width was a key biomarker. A definitive genetic diagnosis was achieved in 41.3% (33/80) of patients, most frequently <em>EYS</em> and <em>USH2A</em>. Genotype-phenotype correlations revealed that large structural deletions and truncating variants were significantly associated with ultra-early onset and more severe visual impairment, respectively.</div></div><div><h3>Conclusions</h3><div>This study characterizes the non-pigmented presentation within the retinitis pigmentosa disease spectrum, detailing its phenotypic characteristics and natural history. The identified clinical, structural, and genetic biomarkers enable refined prognosis and inform stratified therapeutic trials.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"6 3","pages":"Pages 299-307"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148770819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A meta-analysis of clinical outcomes in diabetic macular edema","authors":"Christina N. Bobrek,&nbsp;Ishani Kapoor,&nbsp;Swara M. Sarvepalli,&nbsp;Elise Timtim,&nbsp;Majda Hadziahmetovic","doi":"10.1016/j.aopr.2026.06.001","DOIUrl":"10.1016/j.aopr.2026.06.001","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the efficacy of intravitreal anti-vascular endothelial growth factor (anti-VEGF), steroid, and laser on best-corrected visual acuity (BCVA), central retinal thickness (CRT), and treatment frequency in patients with diabetic macular edema.</div></div><div><h3>Methods</h3><div>PubMed, EMBASE, and Web of Science were systematically searched from inception to August 2024. Mean change from baseline in BCVA (mcBCVA), mean change from baseline in CRT (mcCRT), and treatment frequency were collected using PRISMA guidelines. Statistical analysis was done on 20 studies using Review Manager 5.4.1.</div></div><div><h3>Results</h3><div>mcBCVA (mean difference (MD) = 0.14 logMAR, 95% confidence interval (CI): 0.05 to 0.23, <em>P</em> = 0.002) and mcCRT (MD = 38.73 μm, 95% CI: 13.39 to 64.08, <em>P</em> = 0.003) were significantly improved in the anti-VEGF group compared to laser. mcCRT (MD = −61.17 μm, 95% CI: −106.07 to −16.27, <em>P</em> = 0.008) was significantly greater in the steroid group compared to anti-VEGF. Mean number of treatments per year was significantly lower in the steroid treatment group compared to anti-VEGF (MD = −4.29, 95% CI: −4.5 to −4.09, <em>P</em> &lt; 0.00001). In the anti-VEGF subgroup, mcCRT was significantly greater in the aflibercept group (MD = −37.52 μm, 95% CI: −62.97 to −12.07, <em>P</em> = 0.004) when compared to bevacizumab.</div></div><div><h3>Conclusions</h3><div>These data suggest anti-VEGF treatment is more effective than laser at improving BCVA and CRT, whereas steroid treatment is more effective than anti-VEGF at improving CRT outcomes. Steroid therapy, while not currently allotted a first-line therapy in the United States, may have a more significant role in reducing treatment burden and improving macular morphology.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"6 3","pages":"Pages 266-272"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148770818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fifteen-year follow-up of implantable collamer lens surgery in high myopia: Complications, cataract surgery outcomes, and ultrastructural analysis","authors":"Yinjie Jiang,&nbsp;Guanghan Xu,&nbsp;I-Chun Lin,&nbsp;Mingrui Cheng,&nbsp;Boliang Li,&nbsp;Yadi Lei,&nbsp;Mingwei Li,&nbsp;Zhiwei Mao,&nbsp;Rui Ning,&nbsp;Xun Chen,&nbsp;Xiaoying Wang","doi":"10.1016/j.aopr.2026.02.001","DOIUrl":"10.1016/j.aopr.2026.02.001","url":null,"abstract":"<div><h3>Purposes</h3><div>This study reports 15-year outcomes of implantable collamer lens (ICL) surgery in patients with high myopia, analyzing complications, efficacy of cataract surgical, and ultrastructural mechanisms of anterior subcapsular cataract (ASC).</div></div><div><h3>Methods</h3><div>This retrospective study included 1208 eyes (ICL V4) and 6258 eyes (ICL V4c) from Eye &amp; ENT Hospital of Fudan University, Shanghai, China. Follow-ups occurred preoperatively, at 1/3/6 months, annually post-ICL, and 1 month post-cataract surgery. Lens opacity, ASC rates, and complications were evaluated. Anterior capsule ultrastructure was assessed using scanning/transmission electron microscopy (SEM/TEM).</div></div><div><h3>Results</h3><div>The ICL V4 group (follow-up: 23.12 ± 32.06 months) exhibited higher complication rates than V4c (8.95 ± 17.40 months): lens opacity (6.46% vs. 0.16%), ASC (2.32% vs. 0.10%), and bilensectomy (3.89% vs. 0.16%). Bilensectomy improved corrected distance visual acuity from 0.56 ± 0.39 to 0.34 ± 0.51 logMAR (<em>P</em> = 0.006), restoring pre-ICL levels (<em>P</em> = 0.310), with safety/efficacy indices of 1.08 ± 0.11 and 0.99 ± 0.08. Myopia-related complications included myopic macular atrophy (0.38%), choroidal neovascularization (0.24%), and retinal detachment (0.04%). SEM/TEM revealed lens epithelial cell proliferation, fibronectin or collagen deposition, and mitochondrial abnormalities (thickened cristae, perinuclear vacuolization) in ASC cases.</div></div><div><h3>Conclusions</h3><div>Super high myopia, shallow anterior chamber depth, and older age are key risk factors for post-ICL cataract. While bilensectomy restores vision, high myopia-related complications persist. ASC pathogenesis involves mechanical damage and metabolic dysfunction, evidenced by ultrastructural changes. These findings underscore the need for long-term monitoring in ICL patients with high myopia.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"6 3","pages":"Pages 308-318"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148951069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating micronutrients as protective factors for the retinal structure and vasculature: Mendelian randomization analyses","authors":"Linxin Wei,&nbsp;Meiqian He,&nbsp;Qing Zhao,&nbsp;Xinyu Zhao,&nbsp;Youxin Chen","doi":"10.1016/j.aopr.2026.03.002","DOIUrl":"10.1016/j.aopr.2026.03.002","url":null,"abstract":"<div><h3>Background</h3><div>Epidemiological data and clinical trials have suggested that micronutrients may preserve retinal integrity by mitigating neurodegenerative alterations and microvascular damage. To strengthen the genetic evidence, we investigated the causal effects of various circulating micronutrients (CMs) on retinal imaging parameters using Mendelian randomization (MR) analyses.</div></div><div><h3>Methods</h3><div>Two-sample MR analyses utilized genetic variants as instrumental variables to investigate the effects of 14 CMs on retinal structural parameters including ganglion cell inner plexiform layer (GCIPL) thickness, outer nuclear layer thickness, and retinal nerve fiber layer thickness, as well as retinal vascular parameters comprising vascular density (VD) and fractal dimension (FD). Inverse variance weighted model was employed as the primary analytical method, with 5 sensitivity methods supplemented to confirm the results' robustness.</div></div><div><h3>Results</h3><div>Genetic predisposition to higher circulating folate levels was robustly associated with increased macular GCIPL thickness (<em>β</em>=0.94, 95% confidence interval (CI): 0.17–1.70, <em>P</em>=0.017), which remained significant (<em>P</em>=0.039) after MRlap correction. While nominal associations were observed between circulating vitamin B12 and vitamin E levels with both VD (vitamin B12: <em>β</em>=0.33, 95% CI: 0.09–0.56, <em>P</em>=0.007; vitamin E: <em>β</em>=0.19, 95% CI: 0.04–0.34, <em>P</em>=0.016) and FD (vitamin B12: <em>β</em>=0.24, 95% CI: 0.05−0.42, <em>P</em>=0.012; vitamin E: <em>β</em>=0.18, 95% CI: 0.04−0.33, <em>P</em>=0.016), these findings warranted a cautious interpretation due to inconsistencies across sensitivity analyses.</div></div><div><h3>Conclusions</h3><div>Our MR analyses evaluate the complex relationship between CMs and retinal imaging features, suggesting the protective and thus potentially therapeutic effects of folate in maintaining GCIPL thickness. Conversely, the potential associations observed for other micronutrients remain tentative and warrant cautious interpretation and further empirical validation.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"6 3","pages":"Pages 237-246"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148690253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of brain-computer interface technology in ophthalmology: Current status, challenges and future directions","authors":"Jie Zhou,&nbsp;Dongyu Hu,&nbsp;Meichen Wu,&nbsp;Zichao Hong,&nbsp;Rong li,&nbsp;Qianyin Chen,&nbsp;Xuesong Mi,&nbsp;Jinglin Zhang","doi":"10.1016/j.aopr.2026.03.005","DOIUrl":"10.1016/j.aopr.2026.03.005","url":null,"abstract":"<div><h3>Background</h3><div>Visual impairment is a major global public health issue. Irreversible blindness caused by end-stage outer retinal diseases, optic nerve injuries, and other conditions remains refractory to conventional therapies. Brain-Computer Interface (BCI) technology, which establishes a direct communication pathway between the brain and external devices, has emerged as a promising interdisciplinary strategy for ophthalmic diagnosis, functional assessment, and artificial visual restoration.</div></div><div><h3>Main text</h3><div>This review summarizes recent advances in BCI technology for ophthalmic applications. In diagnosis and assessment, BCIs provide objective and quantitative measures for evaluating visual disorders and the integrity of the visual pathway through neural signals, using modalities such as steady-state visual evoked potentials, functional near-infrared spectroscopy, and functional magnetic resonance imaging. In treatment, implantable visual prostheses, particularly retinal and cortical prostheses, have shown substantial progress in partial visual reconstruction, while noninvasive BCI-related approaches are being increasingly explored for rehabilitation. However, major barriers remain, including difficulties in signal acquisition, immature encoding and decoding algorithms, limited electrode array performance, inefficient wireless transmission, implantation-related complications, high device costs, and insufficient evidence for some noninvasive interventions. Legal, regulatory, and ethical concerns also constrain large-scale clinical implementation.</div></div><div><h3>Conclusions</h3><div>BCI technology holds considerable promise in ophthalmology, but significant technical and translational challenges remain. Future advances in artificial intelligence, flexible electronics, virtual reality, wireless systems, and closed-loop strategies are expected to improve precision, safety, adaptability, and accessibility, thereby enabling more effective diagnostic and visual rehabilitation solutions for patients with severe visual impairment.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"6 3","pages":"Pages 247-256"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal effect of gastroesophageal reflux disease on cataracts: A mendelian randomization study","authors":"Yichu Chen,&nbsp;Xinrui Wu,&nbsp;Junyong Ou,&nbsp;Wenbo Zhuang,&nbsp;Chenxi Yan,&nbsp;Yu Wu,&nbsp;Li Fang,&nbsp;Xianqun Fan,&nbsp;Tao Guo,&nbsp;Yun Su","doi":"10.1016/j.aopr.2026.03.003","DOIUrl":"10.1016/j.aopr.2026.03.003","url":null,"abstract":"<div><h3>Background</h3><div>Cataracts, the leading cause of blindness globally, have been linked to genetic variants in regions also implicated in gastroesophageal reflux disease (GERD), suggesting potential pleiotropic effects. While observational studies have hinted at a possible association, the direction and causality of this link remain unclear. To date, no studies have systematically evaluated whether GERD causally contributes to cataract development.</div></div><div><h3>Methods</h3><div>We applied univariable Mendelian randomization (UVMR) and multivariable Mendelian randomization (MVMR) to evaluate the causal effect of GERD on cataracts, using publicly available GWAS summary data from European-ancestry populations, including the GWAS Catalog and the FinnGen consortium. Genetic instruments for GERD were selected from a GWAS meta-analysis involving 602604 individuals, using genome-wide significance (<em>P</em> &lt; 5 × 10⁻⁸) and linkage disequilibrium pruning (<em>r</em>² &lt; 0.001). To explore potential mediating pathways, we additionally performed two-step Mendelian randomization (MR) analysis to quantify indirect effects through coronary heart disease and diabetes.</div></div><div><h3>Results</h3><div>UVMR analysis showed a significant association between GERD and increased cataract risk (OR: 1.13, <em>P</em> = 4.01 × 10⁻⁶ from the GWAS Catalog Consortium; OR: 1.12, <em>P</em> = 2.43 × 10⁻² from the FinnGen consortium). MVMR analysis indicated that GERD independently increased the odds of cataracts, even after adjusting for factors like Barrett's esophagus (OR: 1.13, <em>P</em> = 9.39 × 10⁻⁶; OR: 1.10, <em>P</em> = 4.53 × 10⁻²) and coronary heart disease (OR: 1.11, <em>P</em> = 4.64 × 10⁻⁴; OR: 1.10, <em>P</em> = 5.61 × 10⁻²) in the GWAS Catalog Consortium and FinnGen consortium. Sensitivity analyses confirmed these findings. A meta-analysis across both GWAS datasets reinforced the association (OR: 1.11, <em>P</em> = 2.58 × 10⁻⁷). Coronary heart disease (15.23%) and diabetes (16.03%) were identified as key mediators.</div></div><div><h3>Conclusions</h3><div>This MR study provides genetic evidence supporting a causal effect of GERD on cataract risk. Furthermore, coronary heart disease and diabetes were found to partially mediate this relationship. These findings highlight the potential importance of managing systemic comorbidities in patients with GERD as a supportive strategy to reduce the risk of cataract development and warrant further research into underlying mechanisms.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"6 3","pages":"Pages 273-280"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148770761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TOC","authors":"","doi":"10.1016/S2667-3762(26)00064-8","DOIUrl":"10.1016/S2667-3762(26)00064-8","url":null,"abstract":"","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"6 3","pages":"Pages iii-v"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149050732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}