Ophthalmology science最新文献

{"title":"Cover","authors":"","doi":"10.1016/S2666-9145(25)00161-7","DOIUrl":"10.1016/S2666-9145(25)00161-7","url":null,"abstract":"","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 4","pages":"Article 100863"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macular Thinning and Microvasculature Abnormalities in Children with Sickle Cell Disease: A Longitudinal Analysis","authors":"Sally S. Ong MD ,&nbsp;Ann Nampomba MS ,&nbsp;Sara Rahman BS ,&nbsp;Loka Thangamathesvaran MD ,&nbsp;Grace Reilly MD ,&nbsp;Jianqiao Ma ScM ,&nbsp;Jay Vaidya PhD ,&nbsp;Sophie Lanzkron MD, MHS ,&nbsp;Adrienne W. Scott MD","doi":"10.1016/j.xops.2025.100862","DOIUrl":"10.1016/j.xops.2025.100862","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess longitudinal changes in retinal thickness and vessel density (VD) in pediatric sickle cell disease (SCD).</div></div><div><h3>Design</h3><div>A prospective cohort study.</div></div><div><h3>Participants</h3><div>Children (&lt;18 years old) with HbSS and HbS variant (HbSC and HbS thalassemia) genotypes were enrolled from a university-based retina subspecialty clinic from 2017 to 2019 and followed for ≥2 years.</div></div><div><h3>Methods</h3><div>Participants received 3 × 3 and 6 × 6 mm OCT and OCT angiography scans at baseline and at each follow-up visit.</div></div><div><h3>Main Outcome Measures</h3><div>Retinal thickness, superficial capillary plexus (SCP), and deep capillary plexus (DCP) VD were compared over time.</div></div><div><h3>Results</h3><div>Children with HbSS (n = 14) and HbS variant (n = 14) genotypes with ≥1 follow-up were included in the study (total 56 eyes). For HbSS, rates of retinal thinning per year were significant in the inner retina in the nasal, inferior, and total parafovea (<em>P</em> = 0.002, 0.003, and 0.03 respectively), temporal and total perifovea (<em>P</em> = 0.01 and 0.02); in the middle retina in the superior perifovea (<em>P</em> = 0.04); and in the total retina in the superior, nasal, and total perifovea (<em>P</em> &lt; 0.001, = 0.01, and 0.009). For HbS variant, the rate of retinal thinning was significant in the inner retina in the superior parafovea (<em>P</em> = 0.002) only. Vessel density did not change in the SCP in HbSS subjects in any of the subfields studied but increased significantly in the SCP in HbS variant subjects in the nasal and inferior parafovea (<em>P</em> = 0.02 and 0.045) and superior and nasal perifovea (<em>P</em> = 0.03 and 0.004). Vessel density in the DCP increased in the HbSS group in all the subfields studied (<em>P</em> &lt; 0.05) and in the HbS variant group in the temporal parafovea (<em>P</em> = 0.02).</div></div><div><h3>Conclusions</h3><div>Progressive retinal thinning, predominantly in the inner retinal layers, was particularly notable in children with HbSS disease. This was observed in conjunction with the lack of an increase in the SCP VD in the HbSS group when compared with the HbS variant group. These findings suggest that microstructural and microvasculature abnormalities in the macula start in childhood in SCD, especially for those with HbSS disease.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100862"},"PeriodicalIF":3.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Changes in Corneal Thickness over 8 Years: Findings from the National Institute for Longevity Sciences–Longitudinal Study of Aging Population-Based Cohort Study in Japan","authors":"Hideki Fukuoka MD, PhD ,&nbsp;Chikako Tange PhD ,&nbsp;Fujiko Ando MD, PhD ,&nbsp;Hiroshi Shimokata MD, PhD ,&nbsp;Yukiko Nishita PhD ,&nbsp;Rei Otsuka PhD","doi":"10.1016/j.xops.2025.100860","DOIUrl":"10.1016/j.xops.2025.100860","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate age-related changes in central corneal thickness (CCT) and investigate its relationship with other ocular parameters in community-dwelling Japanese adults through an 8-year longitudinal analysis.</div></div><div><h3>Design</h3><div>A population-based, prospective longitudinal cohort study with baseline measurements from 1997 to 2000 and follow-up from 2006 to 2008.</div></div><div><h3>Subjects</h3><div>A total of 631 community-dwelling Japanese adults aged 40 to 79 years (mean age: 55.7 ± 9.7 years) were enrolled from the National Institute for Longevity Sciences–Longitudinal Study of Aging. We excluded participants with corneal pathologies, contact lens use, glaucoma medication, or missing endothelial cell density measurements.</div></div><div><h3>Methods</h3><div>Central corneal thickness was measured using calibrated specular microscopy (SP-2000; Topcon Corporation) at 2 time points approximately 8 years apart. Secondary measurements included corneal endothelial cell density, coefficient of variation in cell size, and corneal curvature. Mixed-effects models analyzed CCT changes, adjusting for sex, season, corneal endothelial cell density, and systemic health factors.</div></div><div><h3>Main Outcome Measures</h3><div>Age-related changes in CCT, annual rate of CCT change across different age decades, and correlations between CCT changes and ocular/systemic parameters.</div></div><div><h3>Results</h3><div>At baseline, adjusted CCT measurements were 520.2 ± 2.1 (standard error [SE]) μm, 514.1 ± 2.2 μm, 518.0 ± 2.5 μm, and 514.7 ± 3.7 μm for participants in their 40s, 50s, 60s, and 70s, respectively. Longitudinal analysis revealed a significant increase in CCT over time across all age groups (β = 0.7; SE = 0.1; <em>P</em> &lt; 0.001). The annual CCT increase showed age-dependent slowing: 0.68 ± 0.08 μm for 40s, 0.62 ± 0.08 μm for 50s, 0.46 ± 0.09 μm for 60s, and 0.20 ± 0.14 μm for 70s with a statistically significant difference between 40s and 70s groups (β = −0.5; SE = 0.2' <em>P</em> = 0.003).</div></div><div><h3>Conclusions</h3><div>This longitudinal analysis demonstrates that CCT increases over time in all age groups, with the rate of increase significantly slowing in older age groups. These findings contrast with previous cross-sectional studies suggesting CCT decreases with age, emphasizing the importance of longitudinal observations. These results have important implications for glaucoma diagnosis and refractive surgery safety evaluations in aging populations.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100860"},"PeriodicalIF":3.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Evaluation of a Computable Phenotype for Normal Tension Glaucoma","authors":"Fountane Chan MD ,&nbsp;Wei-Chun Lin MD, PhD ,&nbsp;Alan Tang ,&nbsp;Benjamin Y. Xu MD, PhD ,&nbsp;Sophia Y. Wang MD, MS ,&nbsp;Michael V. Boland MD, PhD ,&nbsp;Catherine Q. Sun MD ,&nbsp;Sally Baxter MD, MSc ,&nbsp;Brian Stagg MD, MS ,&nbsp;Michelle Hribar PhD ,&nbsp;Aiyin Chen MD","doi":"10.1016/j.xops.2025.100858","DOIUrl":"10.1016/j.xops.2025.100858","url":null,"abstract":"<div><h3>Purpose</h3><div>To develop a computable phenotype for normal tension glaucoma (NTG) to enhance disease identification from electronic health records (EHRs).</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Subjects</h3><div>Deidentified EHR data from an academic medical center identified 1851 patients aged ≥40 years, with glaucoma and available clinical notes.</div></div><div><h3>Methods</h3><div>Of these 1851 patients, 200 were randomly selected for a chart review to receive gold standard diagnoses. Four rule-based NTG computable phenotypes were developed and tested. Phenotype 1 relied on NTG International Classification of Diseases (ICD)-9 and ICD-10 codes. Phenotype 2 incorporated structured intraocular pressure (IOP) data and medication lists. Phenotype 3 used only structured IOP data. Phenotype 4 combined structured IOP and medication data natural language processing (NLP) to extract IOP values and NTG mentions from chart notes. Internal and external validation were performed.</div></div><div><h3>Main Outcome Measures</h3><div>F1 score, sensitivities, specificities, positive predictive value (PPV), negative predictive value (NPV), and accuracy.</div></div><div><h3>Results</h3><div>Chart review identified NTG in 30% of patients, and only 7% had NTG ICD codes. Phenotype 1 had an F1 of 36.8%, sensitivity 24.1%, specificity 97%, PPV 77.8%, NPV 74.9%, and accuracy 75.1%. Compared with ICD codes, phenotypes 2 and 3 had F1 of 66.7% and 69.8%, sensitivity 77.6% and 89.7%, specificity 76.3% and 71.1%, PPV 58.4% and 57.1%, NPV 88.8% and 94.1%, and accuracy of 76.7% and 76.7%, respectively. Incorporating NLP, phenotype 4 had the best performance with an F1 of 77.4%, sensitivity 82.8%, specificity 86.7%, PPV 72.7%, NPV 92.1%, and accuracy 85.5%. Phenotypes 2 to 4 increase NTG case detection fourfold compared with phenotype 1.</div></div><div><h3>Conclusions</h3><div>Normal tension glaucoma phenotypes using NLP achieved the best overall performance, and those incorporating structured data perform better than ICD codes alone. The NTG ICD code-based phenotype is highly specific but lacks sensitivity. Insights from this study may inform the development of computable phenotypes for other disease subtypes within broader disease categories.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100858"},"PeriodicalIF":3.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144671087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Shaft Vitrectomy Probe for Vitreoretinal Diseases in Highly Myopic Eyes: A Randomized Controlled Trial","authors":"Yun Hsia MD, MS ,&nbsp;Cheng-Yung Lee MD ,&nbsp;Mei-Chi Tsui MD ,&nbsp;Shih-Wen Wang MD ,&nbsp;Chien-Jung Huang MD ,&nbsp;I-Hsin Ma MD, MS ,&nbsp;Kuo-Chi Hung MD ,&nbsp;Muh-Shy Chen MD, PhD ,&nbsp;Zih-Wei Yang MD ,&nbsp;Bo-Da Huang MD ,&nbsp;Ting-Chieh Ko MD ,&nbsp;Tzyy-Chang Ho MD","doi":"10.1016/j.xops.2025.100824","DOIUrl":"10.1016/j.xops.2025.100824","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the safety and efficacy of a long-shaft vitrectomy probe in highly myopic eyes undergoing pars plana vitrectomy.</div></div><div><h3>Design</h3><div>A randomized controlled trial.</div></div><div><h3>Subjects</h3><div>Highly myopic eyes (axial length [AL] &gt;26 mm) with epiretinal membrane (ERM), myopic tractional maculopathy, and retinal detachment.</div></div><div><h3>Methods</h3><div>The enrolled eyes were randomly assigned to a study group (UltraVit 25 Ga, 31.75 mm, Alcon) and a control group (UltraVit 25 Ga+, 27 mm, Alcon). Stratified randomization was performed to balance the proportion of eyes with AL &gt;28 mm between groups.</div></div><div><h3>Main Outcome Measures</h3><div>Trocar removal rate and core vitrectomy time were assessed as primary outcomes, and instrument bending as a secondary outcome. Anatomical and visual outcomes and complications were documented for 6 months. Subgroup analysis was performed to compare the eyes with AL &gt;28 mm to those without.</div></div><div><h3>Results</h3><div>We included 86 patients with a mean age of 60.7 ± 9.6 years and an AL of 29.15 ± 2.14 mm. Two groups had comparable core vitrectomy times (−0.5 minutes, <em>P</em> = 0.172). The study group had a lower trocar removal rate (5% vs. 67%, <em>P</em> &lt; 0.001) but a higher instrument bending rate (36% vs. 14%, <em>P</em> = 0.036), particularly in eyes with AL &gt;28 mm. In eyes with AL &gt;28 mm, the standard vitrectomy probe faced a significantly greater difficulty in cortical vitreous removal, internal limiting membrane (ILM) trimming, or posterior vitreous detachment induction compared with the long-shaft vitrectomy (<em>P</em> &lt; 0.001). At 6 months, significant visual improvement (logarithm of the minimum angle of resolution) and anatomical success were achieved (study: −0.22, 95%; control: −0.24, 88%). Eyes with ERM in the study group, not the controls, had significant visual improvement (−0.21, <em>P</em> = 0.02 vs. −0.09, <em>P</em> = 0.34).</div></div><div><h3>Conclusions</h3><div>The long-shaft vitrectomy probe is safe and efficient, especially in highly myopic eyes with AL &gt;28 mm, despite a higher instrument bending rate. It provides improved access to the posterior pole, allowing for delicate removal of adherent cortical vitreous and trimming of ILM flaps. Addressing increased instrument bending due to the sleeveless design is important for future design.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 5","pages":"Article 100824"},"PeriodicalIF":3.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal Blood Flow Decreases after Treatment with Bevacizumab for Retinopathy of Prematurity","authors":"Joyce Wang BS ,&nbsp;Shaiza Mansoor BS ,&nbsp;Jeong-Yoon Wu BS ,&nbsp;Christina Kilby BS ,&nbsp;He Forbes MS ,&nbsp;Ria Kapoor BS ,&nbsp;Sarah Ward ,&nbsp;Jason Zhou BS ,&nbsp;Kristin Williams RN ,&nbsp;Moran Roni Levin MD ,&nbsp;Sripriya Sundararajan MD ,&nbsp;Larry Magder PhD ,&nbsp;Avigyan Sinha PhD ,&nbsp;Abhishek Rege PhD ,&nbsp;Janet L. Alexander MD, MS","doi":"10.1016/j.xops.2025.100857","DOIUrl":"10.1016/j.xops.2025.100857","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare total retinal blood flow (TRBF) rates before and after retinopathy of prematurity (ROP) treatment with intravitreal bevacizumab using laser speckle contrast imaging (LSCI).</div></div><div><h3>Design</h3><div>A prospective cohort study.</div></div><div><h3>Participants</h3><div>Twenty-five eyes from 14 premature infants in the neonatal intensive care unit receiving intravitreal bevacizumab for treatment-requiring ROP.</div></div><div><h3>Methods</h3><div>Total retinal blood flow was measured using LSCI longitudinally before and after bevacizumab treatment. Subject characteristics and clinical ROP features, including the need for ROP retreatment, were included in regression analysis using generalized estimating equations to account for 2 eyes per subject and longitudinal measures over time.</div></div><div><h3>Main Outcome Measures</h3><div>The main outcome measure was TRBF, which includes components of peak, mean, and dip over the cardiac cycle.</div></div><div><h3>Results</h3><div>Before ROP treatment, subjects had a peak TRBF of 11.1 ± 2.9 a.u. compared to 8.6 ± 1.8 a.u. after treatment (mean difference = 2.5 a.u., <em>P</em> &lt; 0.0001). Among eyes that required ROP retreatment earlier (&lt;10 weeks) after initial treatment, the posttreatment peak TRBF was 9.0 ± 1.5 a.u., compared to 7.3 ± 2.2 a.u. for eyes that did not require retreatment in the first 10 weeks after initial bevacizumab injection (mean difference = 1.7 a.u., <em>P</em> = 0.01). Peak TRBF decreased over time after bevacizumab treatment (β = −0.1 a.u./week, <em>P</em> = 0.004).</div></div><div><h3>Conclusions</h3><div>We observed lower TRBF after treatment with intravitreal bevacizumab.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100857"},"PeriodicalIF":3.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Risk and OCT-Based Phenotypic Associations in Age-Related Macular Degeneration","authors":"Shlomit Jaskoll ,&nbsp;Yahel Shwartz MSc ,&nbsp;Adi Kramer MSc ,&nbsp;Sarah Elbaz-Hayoun PhD ,&nbsp;Batya Rinsky PhD ,&nbsp;Michelle Grunin PhD ,&nbsp;Liran Tiosano MD ,&nbsp;Jaime Levy MD ,&nbsp;Brice Nguedia Vofo MD, MBA ,&nbsp;Itay Chowers MD","doi":"10.1016/j.xops.2025.100853","DOIUrl":"10.1016/j.xops.2025.100853","url":null,"abstract":"<div><h3>Purpose</h3><div>The risk for developing age-related macular degeneration (AMD) is associated with multiple genetic variants. We aim to evaluate the association of AMD genetic risk variants with specific features of the disease detected by OCT.</div></div><div><h3>Design</h3><div>A retrospective cross-sectional study.</div></div><div><h3>Participants</h3><div>Subjects diagnosed with AMD and healthy controls (&gt;50 years of age) from a single tertiary referral center.</div></div><div><h3>Methods</h3><div>Genotyping of 52 single nucleotide polymorphisms associated with AMD was analyzed in 578 patients. Weighted genetic risk scores (WGRSs) were calculated for variants in genes encoding proteins involved in the complement cascade, lipid metabolism, and other pathways, respectively. A global WGRS was calculated for all 52 variants. OCT images were annotated for the presence of typical drusen, subretinal drusenoid deposits, hyperreflective foci (HRF), complete retinal pigmented epithelium and outer retinal atrophy (cRORA), and macular neovascularization.</div></div><div><h3>Main Outcome Measures</h3><div>Association of WGRS and individual genetic risk variants with specific disease features detected by OCT.</div></div><div><h3>Results</h3><div>A positive correlation between the presence of drusen and the lipid WGRS was detected (<em>r</em> = 0.09, <em>P</em> = 0.02). Logistic regression analysis indicated associations between cRORA and the complement score (odds ratio [OR] = 1.25, 95% confidence interval [CI] 1.05–1.50; <em>P</em> = 0.01), as well as the global score (OR = 1.29, 95% CI 1.13–1.46; <em>P</em> &lt; 0.001). Regression also showed an association of HRF with the age-related maculopathy susceptibility 2/high-temperature requirement A serine peptidase 1 variant (OR = 1.53, 95% CI 1.03–2.27; <em>P</em> = 0.03), the other pathways score (OR = 1.94, 95% CI 1.20–3.12; <em>P</em> = 0.007), and the global score (OR = 1.16, 95% CI 1.00–1.35; <em>P</em> = 0.04).</div></div><div><h3>Conclusions</h3><div>Weighted genetic risk scores based on risk variants for AMD are associated with specific disease features. Tighter association of the global WGRS compared to pathway-specific scores suggests that several pathways are involved in the development of specific disease features such as cRORA, drusen, and HRF.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100853"},"PeriodicalIF":3.2,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Machine Learning to Identify Ophthalmology Subspecialty Care and Advance Workforce Research with the IRIS® Registry (Intelligent Research in Sight)","authors":"Ju Hyun Jeon MS ,&nbsp;Ju-Yeun Lee MD, PhD ,&nbsp;Tobias Elze PhD ,&nbsp;Joan W. Miller MD ,&nbsp;Alice C. Lorch MD, MPH ,&nbsp;Mei-Sing Ong PhD ,&nbsp;Ann Chen Wu MD, MPH ,&nbsp;David G. Hunter MD, PhD ,&nbsp;Isdin Oke MD, MPH","doi":"10.1016/j.xops.2025.100855","DOIUrl":"10.1016/j.xops.2025.100855","url":null,"abstract":"<div><h3>Purpose</h3><div>To develop machine-learning models to identify ophthalmology subspecialists using deidentified patient data from a large database.</div></div><div><h3>Design</h3><div>Cross-sectional.</div></div><div><h3>Participants</h3><div>All ophthalmologists participating in the American Academy of Ophthalmology's IRIS® Registry (Intelligent Research in Sight) from 2013 to 2023 were classified under one of the following general or subspecialty categories: comprehensive, cataract, cornea, glaucoma, retina, oculofacial, pediatric, or neuro-ophthalmology.</div></div><div><h3>Methods</h3><div>We collected the diagnosis, procedure, and prescription codes linked to each ophthalmologist. We performed binary subspecialty classification using random forest models with fivefold cross validation and multispecialty classification using 4 approaches (diagnosis only, procedure only, prescription only, and combined).</div></div><div><h3>Main Outcome Measures</h3><div>Model performance was assessed using area under the receiver operating characteristic curve (AUROC), F1 scores, and Matthews correlation coefficient.</div></div><div><h3>Results</h3><div>The study included 9032 ophthalmologists. Classification accuracy differed by subspecialty (AUROC, retina: 0.981; oculofacial: 0.975; pediatric: 0.972; glaucoma: 0.937; cornea: 0.932; neuro: 0.912; cataract: 0.861; and comprehensive: 0.760). The procedure-only random forest model had better performance (AUROC, 0.903) than the diagnosis-only (0.880) and prescription-only (0.835) model.</div></div><div><h3>Conclusions</h3><div>Machine learning models leveraging the IRIS Registry can provide a near real-time assessment of the landscape of ophthalmic subspecialty care. Identifying subspecialty physicians through practice patterns may provide valuable insights into the future trends of eye care delivery with implications for workforce research and policy interventions.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100855"},"PeriodicalIF":3.2,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated Intraocular Pressure Immediately after Cataract Surgery and Future Risk of Primary Open-Angle Glaucoma in the IRIS® Registry (Intelligent Research in Sight)","authors":"Nayoon Gim BS ,&nbsp;Yu Jiang PhD ,&nbsp;Yelena Bagdasarova PhD ,&nbsp;Alina Ferguson BS ,&nbsp;Marian Blazes MD ,&nbsp;Aaron Y. Lee MD, MSCI ,&nbsp;Andrew Chen MD ,&nbsp;Cecilia S. Lee MD, MS ,&nbsp;Parisa Taravati MD ,&nbsp;IRIS® Registry Analytic Center Consortium","doi":"10.1016/j.xops.2025.100851","DOIUrl":"10.1016/j.xops.2025.100851","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluated associations between postoperative intraocular pressure (IOP) after cataract surgery and the future risk of developing primary open-angle glaucoma (POAG) in patients without prior glaucoma, glaucoma suspect, or ocular hypertension diagnoses.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Subjects</h3><div>1 912 101 individuals without prior glaucoma, glaucoma suspect, or ocular hypertension diagnoses who underwent their first cataract surgery in the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight).</div></div><div><h3>Methods</h3><div>The highest IOP recorded on postoperative days 0 to 2 was used for analysis. For Kaplan–Meier survival estimates and Cox proportional hazards model analysis, IOP was dichotomized into normal (≤21 mmHg) and high (&gt;21 mmHg) and assessed for associations with POAG. The stratified Cox model quantified the associations between IOP and the risk of POAG across different demographic groups. Additionally, postoperative IOP was divided into decile categories, and hazard ratios (HRs) of the risk of POAG were estimated for each, with the 40% to 60% IOP range as the reference, adjusting for demographic factors.</div></div><div><h3>Main Outcome Measures</h3><div>Cumulative probability of POAG diagnosis and HRs for POAG development.</div></div><div><h3>Results</h3><div>The median time to development of POAG was 682 days (interquartile range 191–1467 days). Kaplan–Meier estimates showed that the 4000-day cumulative probability of POAG diagnosis for the high IOP group was nearly double the normal group (3.4% vs. 1.7%, <em>P</em> &lt; 0.0001). The Cox proportional hazards model identified high postoperative IOP, older age, male sex, and Asian, Black, Native Hawaiian, and Other Pacific Islander races, as well as Hispanic ethnicity, as risk factors for POAG. In the stratified Cox analysis, high postoperative IOP was consistently associated with increased risk of POAG across demographic subgroups. The highest IOP decile was associated with increased risk of POAG (HR 2.42; 95% confidence intervals [CI] 2.26–2.58), while the lowest decile was not (HR 0.88, 95% CI 0.81–0.95). Similar trends were observed with risks of other types of glaucoma.</div></div><div><h3>Conclusions</h3><div>Elevated postoperative IOP after cataract surgery is a risk factor for future POAG development, independent of age, sex, race, and ethnicity.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100851"},"PeriodicalIF":3.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144654562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploiting Microperimetry as a Functional End Point in Healthy Aging and Different Stages of Age-Related Macular Degeneration","authors":"Johannes Schrittwieser MD ,&nbsp;Klaudia Birner MD ,&nbsp;Leonard M. Coulibaly MD ,&nbsp;Ursula Schmidt-Erfurth MD ,&nbsp;Gregor S. Reiter MD, PhD","doi":"10.1016/j.xops.2025.100850","DOIUrl":"10.1016/j.xops.2025.100850","url":null,"abstract":"<div><h3>Objective</h3><div>To compare functional parameters between healthy aged eyes and different stages of age-related macular degeneration (AMD) based on functional parameters in microperimetry (MP) in 2 commonly used MP devices.</div></div><div><h3>Design</h3><div>A prospective, cross-sectional study.</div></div><div><h3>Subjects</h3><div>From 80 eyes from 80 subjects, 14 400 stimuli points were included.</div></div><div><h3>Methods</h3><div>Subjects classified as healthy, intermediate AMD, neovascular AMD (nAMD), or geographic atrophy (GA) secondary to AMD were imaged with Spectralis HRA+OCT (Heidelberg Engineering) and underwent 2 consecutive examinations each, using the MP-3 (NIDEK) under photopic conditions and the MAIA (Centervue) under mesopic conditions. Pointwise sensitivity (PWS), mean sensitivity, range between highest and lowest PWS, fixation stability, and examination duration were compared between all 4 groups in both devices. Group comparison was performed using linear mixed-effects models and a discriminant analysis to find the parameters that best discriminated the respective AMD stage.</div></div><div><h3>Main Outcome Measures</h3><div>Pointwise sensitivity, range of the PWS, fixation metrics, and durations of the examinations.</div></div><div><h3>Results</h3><div>The groups exhibited significant differences in PWS (<em>P</em> &lt; 0.001) and mean sensitivity (<em>P</em> &lt; 0.001), with healthy eyes showing the highest and late stages of AMD showing the lowest sensitivity values. In addition, GA showed significantly greater fixation stability compared with nAMD in the MP-3 at 2° and 4° (<em>P</em> = 0.014 and <em>P</em> = 0.008, respectively). The examination duration in healthy patients was significantly shorter compared with patients with GA (<em>P</em> = 0.041) in MP-3. No significant differences in fixation stability and duration between groups were observed with the MAIA device. The range between the highest and lowest PWS was the most effective parameter for discrimination, with a classification accuracy of 52.5% and 50.6% in the MP-3 and MAIA, respectively.</div></div><div><h3>Conclusions</h3><div>Retinal sensitivity declines with disease progression in AMD in both mesopic and photopic background illumination. The lowest retinal sensitivity was observed in patients with GA. Background illumination should be considered when selecting an MP device for a clinical trial.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100850"},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}