Frontiers in ophthalmology最新文献

{"title":"Editorial: The diagnoses of glaucoma in the era of artificial intelligence.","authors":"Saif Aldeen AlRyalat, Muawyah Al Bdour, Hisham M Jammal","doi":"10.3389/fopht.2024.1496533","DOIUrl":"10.3389/fopht.2024.1496533","url":null,"abstract":"","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"4 ","pages":"1496533"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916559","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":"Unexpected retinal fluid compartment responses with anti-VEGF therapy in polypoidal choroidal vasculopathy: a case report of four patients.","authors":"Noa Gilead, Yu Jeat Chong, Farah N I Ibrahim, Christopher Sun, Kelvin Y C Teo, Chui Ming Gemmy Cheung","doi":"10.3389/fopht.2024.1509065","DOIUrl":"10.3389/fopht.2024.1509065","url":null,"abstract":"<p><p>This case series describes responses to faricimab treatment in opposite directions in different fluid compartments in four patients with polypoidal choroidal vasculopathy (PCV). Despite reductions in retinal fluid (SRF) and stable visual acuity following treatment, all patients developed retinal pigment epithelium (RPE) elevation. Over a 12-15 months follow-up, three patients exhibited a gradual decrease in RPE elevation, with one case resolving completely. These findings suggest that fluid compartments in PCV may respond differently to treatment and add to the understanding of PCV by highlighting the complex interplay between different retinal fluid compartments in response to treatment.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"4 ","pages":"1509065"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916560","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":"Serum PD-1 regulation and PD-1 expression of CD4+Foxp3+ regulatory T cells in patients in thyroid eye disease associated with immunosuppression treatment.","authors":"Atsushi Sakai, Mizuki Tagami, Norihiko Misawa, Yusuke Haruna, Mami Tomita, Shigeru Honda","doi":"10.3389/fopht.2024.1491053","DOIUrl":"10.3389/fopht.2024.1491053","url":null,"abstract":"<p><strong>Purpose: </strong>Thyroid eye disease (TED) primarily occurs in hyperthyroid patients, sometimes resulting in poor visual prognosis. Although other autoimmune diseases have been reported to be associated with serum programmed cell death 1 (PD-1), the relationship with TED remains unknown. This study investigated the relationship between TED and immune checkpoint molecules.</p><p><strong>Methods: </strong>Serum immune checkpoint molecules were measured in TED and control patient blood samples. In TED patients, blood samples were compared before and 6 months after steroid pulse treatment. Cytometry analysis was additionally performed in TED and control patients to compare the expression of (PD-1) of T cells.</p><p><strong>Results: </strong>Serum concentrations of PD-1 in TED and control patients were 163.49 ± 79.01 (pg/mL) and 123.58 ± 46.61 (pg/mL) (<i>P</i> = 0.03). Serum PD-L1 concentration in TED was 157.89 ± 55.34 (pg/mL), while 152.58 ± 22.70 (pg/mL) in control patients (<i>P</i> = 0.92). For flow cytometry analysis, the mean fluorescence intensity (MFI) ratio of PD-1 in Foxp3high CD45RA- of the CD4+ T cells and CD127-CD25high of the CD4+ T cells were higher in TED versus control patients (<i>P</i> = 0.04, <i>P</i> = 0.02). There was also a higher percentage of PD-1 expressions on CD4+ T cells and Foxp3high CD45- T cells in TED patients versus that for control patients (<i>P</i> < 0.001, <i>P</i> = 0.003).</p><p><strong>Conclusions: </strong>PD-1 expression of CD4+Foxp3+ regulatory T cells appear to be associated with TED pathogenesis before and after treatment. Regulatory T cells expressed PD-1 have possibilities of clinical activity and autoimmune pathology of TED.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"4 ","pages":"1491053"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907995","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":"Infectious keratitis in Western New York: a 10-year review of patient demographics, clinical management, and treatment failure.","authors":"Caroline Maretz, Jason Atlas, Shalini Shah, Michael B Sohn, Rachel A F Wozniak","doi":"10.3389/fopht.2024.1469966","DOIUrl":"10.3389/fopht.2024.1469966","url":null,"abstract":"<p><strong>Background: </strong>Infectious keratitis (IK) is a blinding disease and an important cause of ocular morbidity. Understanding regional trends in IK are important to understand the epidemiology and clinical outcomes of this disease.</p><p><strong>Methods: </strong>In this 10-year retrospective review, patient characteristics including sociodemographic factors, medical history, and ocular history were collected as well as the clinical course and outcomes. This study particularly focused on these characteristics as it relates to treatment failure in IK, as defined as requiring more than 2 weeks to heal or surgical intervention, likelihood of having microbiology cultures collected, surgical intervention, and presenting disease severity.</p><p><strong>Results: </strong>935 cases of IK were identified at the University of Rochester. Age (p=0.004), history of prior corneal transplant (p=0.009), severe vision loss on presentation (p<0.001), large ulcer size (p=0.001), and fungal (p=0.001) or protozoan (p=0.009) infections were all significantly associated with treatment failure. Both ulcer size (p<0.001) and severity of vision loss (p<0.001) were associated with a higher likelihood of having microbiology cultures as well as surgical intervention. Patients' whose home address was greater than 60 miles from the University were also more likely to present with a more severe ulcer (p<0.001) and undergo a surgical intervention (p=0.05). In studying the impact of race and ethnicity, Black patients were less likely to receive corneal cultures compared to White patients (p=0.02).</p><p><strong>Conclusions: </strong>This study defined the patient characteristics and clinical course of patients with IK over 10 years at the University of Rochester providing insight into regional trends of the patient population as well as clinical outcomes.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"4 ","pages":"1469966"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901007","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":"Macular retinal nerve fiber layer thickness in retinitis pigmentosa patients with and without optic disc drusen.","authors":"Alvilda H Steensberg, Lasse Malmqvist, Mette Bertelsen, Line Kessel, Karen Grønskov, Steffen Hamann","doi":"10.3389/fopht.2024.1476911","DOIUrl":"10.3389/fopht.2024.1476911","url":null,"abstract":"<p><strong>Introduction: </strong>Retinitis pigmentosa (RP) is a group of inherited retinal dystrophies characterized by progressive photoreceptor degeneration. In a recent study, we reported co-existing optic disc drusen (ODD) at 30%, a prevalence 15 times higher than in the general population. The aims of this study were to a) assess if macular retinal nerve fiber layer thickness (RNFLt) was increased in our cohort of RP patients and b) compare RNFLt between RP patients with and without ODD.</p><p><strong>Methods: </strong>In this <i>post-hoc</i> analysis, optical coherence tomography (OCT) scans of patients with RP and healthy controls were manually delineated, and macular RNFLt measurements were obtained. The analyses were conducted both a) for RP patients without ODD compared to controls and b) for RP patients with and without ODD.</p><p><strong>Results: </strong>OCT scans of 32 patients with RP and 13 healthy controls were included. Macular RNFLt was significantly increased in RP patients compared to healthy controls and in RP patients with ODD compared to RP patients without ODD.</p><p><strong>Discussion: </strong>Further studies will explore whether increased RNFLt leads to ODD development through dystrophic calcification or, conversely, if ODD in combination with RP-associated retinal ganglion cell damage causes the increased RNFLt through retrograde axoplasmic stasis.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"4 ","pages":"1476911"},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865951","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":"Cup-to-disc ratio measured clinically and via OCT in pediatric patients being monitored as glaucoma suspects for suspicious optic discs.","authors":"Caroline Maria Zimmermann, Nur Cardakli, Courtney Lynn Kraus","doi":"10.3389/fopht.2024.1479286","DOIUrl":"10.3389/fopht.2024.1479286","url":null,"abstract":"<p><strong>Purpose: </strong>Compare cup-to-disc ratio (CDR) measured by clinical assessment and optical coherence tomography (OCT) in pediatric eyes being monitored as glaucoma suspects for suspicious optic disc appearance.</p><p><strong>Design: </strong>Retrospective cross-sectional study.</p><p><strong>Methods: </strong>An institutional study following 221 eyes from 122 unique pediatric glaucoma suspects being monitored due to increased or asymmetric appearance of CDR. Ophthalmologic findings, including visual acuity, intraocular pressure, CDR measured by clinical assessment, average retinal nerve fiber layer thickness, and average CDR measured by OCT, were recorded for each participant's initial and final examinations. CDRs measured clinically and by OCT were compared at both initial and final presentations.</p><p><strong>Results: </strong>Average age at presentation was 9.0 years old (95% CI: 8.0-9.9), and mean length of follow-up was 5.0 years (95% CI: 5.4-4.5). At initial presentation, 53 eyes had CDRs recorded by both clinical assessment and OCT, and at final presentation, 93 eyes had CDRs measured by both modalities. CDR measured by OCT was significantly larger than CDR measured clinically on initial and final presentation (p=0.002, p<0.001).</p><p><strong>Conclusions: </strong>Measurements of CDR by clinician assessment were significantly smaller than measurements obtained via OCT imaging. However, the average difference between CDR measured clinically and by OCT was <0.1. Thus, OCT may be a suitable way to measure CDR in pediatric glaucoma suspects, especially when clinical exam proves difficult. Further research is needed to assess CDR in glaucoma suspects using OCT longitudinally and in the context of other optic disc measurements, such as disc area.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"4 ","pages":"1479286"},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866716","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":"Influence of zonular tension on molecular transport in the porcine ocular lens.","authors":"Morgan Crews, Wade Rich, Matthew A Reilly","doi":"10.3389/fopht.2024.1508779","DOIUrl":"10.3389/fopht.2024.1508779","url":null,"abstract":"<p><strong>Introduction: </strong>Accommodation is the process of changing the ocular lens' refractive power and focal distance. This process involves application of biomechanical forces on the lens by the surrounding musculature. Previous studies have demonstrated that the lens epithelium demonstrates mechanotransduction and that tension influences its chemical activity. It is not yet known how these forces affect the structure and permeability of the lens. This study aimed to identify the influence of tension on molecular transport of dyes through the lens.</p><p><strong>Methods: </strong>Paired porcine eyes were incubated in each of four dyes for three time periods with no stretch (null), static, or cyclic stretching using a bespoke mechanical lens stretcher. After incubation, the lenses were frozen and cryosectioned sagittally through the optic axis. Photographs of the stretched and unstretched lenses were compared and qualitatively assessed.</p><p><strong>Results: </strong>None of the four dyes showed drastic stretch-induced differences in dye penetration depth. However, the dye neutral red showed dramatic stretch-induced changes in the dye uptake color behind lens anterior surfaces, with unstretched lenses appearing far more orange than their stretched counterparts. Three of four dyes showed notable differences between anterior and posterior diffusion patterns. One dye, methylene blue, demonstrated unexpected intensity in the lens nucleus compared to the lower intensity shown in the cortex, suggesting active transport rather than a linearly graded passive diffusion regardless of stretching condition.</p><p><strong>Discussion: </strong>All this taken together suggests that lens transport is more complex than simple passive diffusion and that active transport of some molecules may be affected by stretching. Future work should assess the mechanisms of transport for the various dyes and attempt to explain the dye permeation patterns observed here, including the effects of stretching.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"4 ","pages":"1508779"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840450","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":"Rasch analysis and targeting assessment of the teach-CVI survey tool in a cohort of CVI patients.","authors":"Jem Martin, Chris Bradley, Barry S Kran, Nicole C Ross","doi":"10.3389/fopht.2024.1495000","DOIUrl":"10.3389/fopht.2024.1495000","url":null,"abstract":"<p><strong>Purpose: </strong>Cerebral Visual Impairment (CVI) is the leading cause of pediatric visual impairment. Given the diversity of clinical presentations of CVI, we are interested in whether questionnaires appropriately target the spectrum CVI cases, specifically the Teach-CVI Screening Tool. Rasch analysis is a standard psychometric technique for assessing the targeting of questionnaire items, however this analysis technique has not yet been applied to this questionnaire.</p><p><strong>Methods: </strong>We performed a retrospective review of clinical CVI cases from the NECO Center for Eye Care at Perkins School for the Blind from January 2016 to December 2022. Electronic medical records were reviewed to identify patients with an ICD-9 or ICD-10 code of CVI or other neurological visual impairment. Age, gender, diagnoses, visual acuity, contrast sensitivity, visual fields, ocular alignment, and Teach-CVI responses were collected. We applied the method of successive dichotomizations, a polytomous Rasch model, to estimate item measures and person measures from the survey. Targeting of questionnaire items to the sample population was explored by comparing estimated item measures to person measures. Multiple linear regression was used to determine which factors influence patient visual ability (i.e., Teach-CVI person measure).</p><p><strong>Results: </strong>119 patient records were included, 54% of which were male. The mean age was 8.9 years (SD = 6.12) with a range of 0 to 33 years of age. Mean visual acuity was 0.46 logMAR (SD = 0.40), or 20/57. The majority of patients in the sample had a co-occurring visual disorder in addition to CVI (84%), the most frequent being strabismus (69.9%) or visual field loss (25.3%). Item measures ranged from -2.67 to 1.77 logits (SD = 0.76), with a mean of 0 logit by convention. Estimated person measures ranged from -2.19 to 3.08 logits (SD = 1.10) with a mean of -0.03 logit. The range of item measures covered 93.3% of the person measures, and all person measures, except one, were within one logit of an item measure. Visual measures were not statistically significantly associated with Teach-CVI person measures.</p><p><strong>Conclusion: </strong>The findings from this study suggest that the Teach-CVI survey is well targeted and an appropriate patient reported outcome measure for CVI.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"4 ","pages":"1495000"},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830284","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":"Case report: HLA-B35-associated optic neuritis.","authors":"Florian H Guillot, Andrew R Carey","doi":"10.3389/fopht.2024.1483937","DOIUrl":"10.3389/fopht.2024.1483937","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a unique presentation of optic neuritis associated with positive HLA-B35.</p><p><strong>Observations: </strong>A woman presented with unilateral retro-orbital pain, mildly decreased vision, and optic disc edema with new-onset aphthous ulcers. Color vision was preserved, and no visual field deficits were noted. Diagnostic imaging demonstrated retrobulbar optic nerve enhancement, with genetic testing revealing HLA-B35 positivity. Treatment with high-dose oral steroids for 3 days resolved all symptoms, and the patient remained stable for at least 2 months.</p><p><strong>Conclusions and importance: </strong>In addition to rheumatic conditions and oral lesions, HLA-B35 can be linked to optic neuritis. This relationship highlights the need to further explore genetic risk factors associated with optic neuritis and the potential need for human leukocyte antigen (HLA) testing in unusual cases of optic neuritis.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"4 ","pages":"1483937"},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11617506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786909","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":"Intraoperative optical coherence tomography imaging for assessment of anterior chamber gas fill.","authors":"Michael Tseng, Avrey Thau, Carla Berkowitz, Abhijit Ramaprasad, Surendra Basti","doi":"10.3389/fopht.2024.1488764","DOIUrl":"10.3389/fopht.2024.1488764","url":null,"abstract":"<p><strong>Introduction: </strong>During endothelial keratoplasty, anterior chamber gas is titrated to a desired fill, which is difficult to optimize by visualization alone. This study evaluates how an anterior chamber gas fill correlates with intraocular pressure (IOP) and iris-angle configuration as identified by optical coherence tomography (OCT).</p><p><strong>Methods: </strong>Eleven cadaveric eyes were studied in three configurations: baseline, air-fill just spanning limbus-to-limbus (\"full-fill\"), and air-fill maximally filling the anterior chamber (\"overfill\"). At each configuration, IOP was measured by Tonopen and iris-angle was determined by analyzing OCT images.</p><p><strong>Results: </strong>No differences in IOP or irisangles were identified between baseline and full-fill configurations (p=0.113 and p=0.152, respectively). When compared to overfill configuration, differences in IOP and iris-angles were identified for baseline (p<0.001 and p=0.001, respectively) and full-fill configuration (p=0.001 and p=0.039, respectively).</p><p><strong>Discussion: </strong>These findings highlight that en-face visualization of full-fill may not be indicative of IOP elevation. A significant difference in IOP and iris-angle exists between full-fill and overfill configurations. Intraoperative OCT can serve as a useful surrogate to identify the extent of fill.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"4 ","pages":"1488764"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752408","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}