Ophthalmology science最新文献

{"title":"Diminished MYCN Dosage Endows Cavitary Transformation in Retinoblastoma","authors":"Mingpeng Xu MD ,&nbsp;Hanhan Shi MD, PhD ,&nbsp;Yongning Shen BS ,&nbsp;Ludi Yang MD ,&nbsp;Yu Luan MD ,&nbsp;Xiang Gu MD ,&nbsp;Xuyang Wen MD, PhD ,&nbsp;Chuandi Zhou MD, PhD ,&nbsp;Renbing Jia MD, PhD ,&nbsp;Xunda Ji MD, PhD ,&nbsp;Peiquan Zhao MD, PhD ,&nbsp;Minglei Han MD, PhD ,&nbsp;Jiayan Fan MD, PhD ,&nbsp;Peiwei Chai MD, PhD","doi":"10.1016/j.xops.2025.100820","DOIUrl":"10.1016/j.xops.2025.100820","url":null,"abstract":"<div><h3>Objective</h3><div>Cavitary retinoblastoma (CRB) represents a unique variant of retinoblastoma (RB) distinguished by the presence of translucent cavities, which are discernible through ophthalmoscopic examination. The present study was designed to elucidate the clinical implications and molecular signatures of CRB, thereby enhancing our understanding of this distinct subtype of RB.</div></div><div><h3>Design</h3><div>A multicentric, nested case-control, retrospective cohort study combining spatial proteomic analysis.</div></div><div><h3>Participants</h3><div>In a longitudinal study encompassing 1360 RB patients, conducted over a 13-year timeframe from June 2008 to February 2022, cavitary spaces were detected within the tumors of 48 eyes of 46 patients. A control cohort of 180 eyes from 138 age-matched patients with non-CRB was selected, maintaining a 1:3 case-control ratio. Laser-captured spatial proteomic analysis was conducted to explore the pivotal molecular changes within this specific subtype. The silencing of MYCN was achieved using adeno-associated virus (AAV) 2-mediated gene therapy in patient-derived xenograft models.</div></div><div><h3>Intervention</h3><div>Enucleation, chemotherapy, and focal therapy.</div></div><div><h3>Main Outcome Measures</h3><div>Overall survival and metastasis-free survival.</div></div><div><h3>Results</h3><div>Cavitary RB was linked to enhanced metastasis-free survival (<em>P</em> = 0.007) and overall survival (<em>P</em> = 0.03), as well as an increased proportion of well-differentiated status (<em>P</em> &lt; 0.001) and a reduced incidence of vitreous seeding (<em>P</em> = 0.02). Spatial proteomic analysis, immunofluorescence, and immunohistopathology revealed a lower MYCN expression in CRB than in non-CRB. Silencing MYCN in patient-derived xenografts using AAV recapitulated these phenotypes of CRB, including the formation of translucent cavities and the emergence of cone-like rosettes.</div></div><div><h3>Conclusions</h3><div>This study establishes a novel genetic–phenotypic association, revealing that diminished MYCN expression induces the formation of translucent cavities. This phenotype is indicative of a less aggressive, well-differentiated CRB subtype with a more favorable prognosis.</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 100820"},"PeriodicalIF":3.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222435","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":"Regional Variation in Guttae Distribution in Fuchs Endothelial Corneal Dystrophy","authors":"Yasufumi Tomioka MD, PhD ,&nbsp;Morio Ueno MD, PhD ,&nbsp;Akihisa Yamamoto PhD ,&nbsp;Koji Kitazawa MD, PhD ,&nbsp;Hideki Fukuoka MD, PhD ,&nbsp;Motomu Tanaka PhD ,&nbsp;Chie Sotozono MD, PhD ,&nbsp;Ula V. Jurkunas MD ,&nbsp;Shigeru Kinoshita MD, PhD","doi":"10.1016/j.xops.2025.100817","DOIUrl":"10.1016/j.xops.2025.100817","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate regional variations in guttae distribution in Fuchs endothelial corneal dystrophy (FECD) and evaluate its relationship with anatomical ultraviolet (UV) protection by the eyelid.</div></div><div><h3>Design</h3><div>A prospective observational study.</div></div><div><h3>Participants</h3><div>This study involved 19 eyes of 19 patients with FECD between April 2022 and June 2024 at Kyoto Prefectural University of Medicine.</div></div><div><h3>Methods</h3><div>Using slit-scanning wide-field contact specular microscopy, we analyzed guttae distribution in 5 corneal regions (central, superior, temporal, nasal, and inferior). Marginal reflex distance (MRD) was measured to assess the eyelid position. Proportion of guttae was quantified using image analysis.</div></div><div><h3>Main Outcome Measures</h3><div>Regional differences in guttae distribution and correlation with MRD measurements.</div></div><div><h3>Results</h3><div>The superior region demonstrated a significantly lower proportion of guttae (29.4%) compared with central (69.0%), temporal (57.4%), and nasal areas (57.5%) (all <em>P</em> &lt; 0.05). The difference between superior and inferior areas (45.6%) was not significant (<em>P</em> = 0.08). Margin reflex distance measurements showed no significant correlation with superior guttae distribution (<em>P</em> = 0.40).</div></div><div><h3>Conclusions</h3><div>Our study reveals a distinct regional variation in FECD progression, with relative sparing of the superior cornea suggesting potential UV-protective mechanisms. Although not directly correlated with eyelid position, these findings indicate that environmental factors may influence disease progression. This insight suggests the potential benefit of UV protection as a preventive strategy, particularly in early-stage FECD patients.</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 5","pages":"Article 100817"},"PeriodicalIF":3.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139465","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":"Clinical Efficacy of Ex Vivo Cross-Linking on Neovascularization of the Donor Cornea Carrier Tissue for the Boston Type I Keratoprosthesis","authors":"Ana M. Roldan MD ,&nbsp;Rohan Bir Singh MD ,&nbsp;Sofia De Arrigunaga MD ,&nbsp;Elizabeth L. Gatto ,&nbsp;Alexander Melki ,&nbsp;Steven J. Staffa MS ,&nbsp;David Zurakowski MS, PhD ,&nbsp;Nikolay Boychev OD, PhD, MEd ,&nbsp;Joseph B. Ciolino MD ,&nbsp;Keratoprosthesis Cross-linking Study Group","doi":"10.1016/j.xops.2025.100816","DOIUrl":"10.1016/j.xops.2025.100816","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the effect of corneal cross-linking (CXL) on corneal neovascularization (CNV) between eyes that were randomized to receive either CXL or non-CXL donor corneas as the carrier tissue for Boston keratoprosthesis surgery.</div></div><div><h3>Design</h3><div>A retrospective masked analysis of CNV from slit lamp photographs taken at postoperative weeks 16, 24, 36, and 52.</div></div><div><h3>Subjects</h3><div>Sixty-eight donor corneas were prospectively randomized 1:1 to receive either donor corneas that underwent ex vivo CXL or were non-CXL. The images of 47 corneas that were suitable for evaluation were included in the final analysis.</div></div><div><h3>Methods</h3><div>The slit lamp photos were analyzed morphometrically using a standardized protocol on Photoshop CS5 (Adobe Systems Inc) and ImageJ software (National Institutes of Health).</div></div><div><h3>Main Outcome Measures</h3><div>The 2 primary metrics used to quantify CNV were neovascular area (NA), defined as the area of corneal vessels projected onto the plane of a photograph, and invasion area (IA), defined as the fraction of corneal area in which vessels are present.</div></div><div><h3>Results</h3><div>Based on multivariable mixed-effects linear modeling, CXL reduces the percentage of NA in the CXL group by 2.2% (<em>P</em> = 0.113). Similarly, there is an average reduction of 7.8% in the percentage of IA in the CXL group compared with the non-CXL group (<em>P</em> = 0.303).</div></div><div><h3>Conclusions</h3><div>Although not statistically significant, this study observed a trend toward a lower CNV in CXL donor corneas compared with non-CXL donor corneas, suggesting that ex vivo CXL of donor corneas may protect against CNV of the donor cornea.</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 5","pages":"Article 100816"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194768","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":"Cover","authors":"","doi":"10.1016/S2666-9145(25)00107-1","DOIUrl":"10.1016/S2666-9145(25)00107-1","url":null,"abstract":"","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 3","pages":"Article 100809"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947401","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":"The Noninvasive Measurement of Ocular Rigidity and the Pulsatile Choroidal Volume Change in Children and Young Adults","authors":"Martin Reyes ,&nbsp;Sage Smith ,&nbsp;Kelly Lam,&nbsp;Yasaman Adel,&nbsp;Nimesh B. Patel OD, PhD,&nbsp;Diane N. Sayah OD, PhD","doi":"10.1016/j.xops.2025.100814","DOIUrl":"10.1016/j.xops.2025.100814","url":null,"abstract":"<div><h3>Purpose</h3><div>Measuring ocular rigidity (OR) and the pulsatile choroidal volume change (ΔV) from childhood to adulthood would provide essential insight into the role of the sclera and choroid in axial myopia. A validated measurement method based on Beaton et al (2015) is the only noninvasive, direct, and reliable method available, yet it has never been used in children. This study aims to assess the feasibility and repeatability of noninvasive OR and ΔV measurements in children and young adults using this method.</div></div><div><h3>Design</h3><div>This is a cross-sectional study.</div></div><div><h3>Subjects</h3><div>Children and young adults aged 6 to 26 years.</div></div><div><h3>Methods</h3><div>OCT videos were acquired using enhanced depth imaging mode. A neural network (NN) approach was used to extract the choroid segmentation from OCT videos, which was then used to measure choroidal filling as described by Beaton et al. Ocular rigidity was computed from the ΔV and the ocular pulse amplitude using Friedenwald equation. Intrasession repeatability was assessed for subjects with 2 consecutive measurements of OR.</div></div><div><h3>Main Outcome Measures</h3><div>Ocular rigidity, pulsatile choroidal volume change, and the method's yield.</div></div><div><h3>Results</h3><div>Sixty-seven subjects (67 eyes, 27 males) aged 13 ± 6 years were enrolled, and 62 subjects completed the study. ΔV and OR were computed. Out of the 62 videos, 98% (61) of the OCT videos were successfully segmented using the NN approach, with heart rate detectable in 79% (48) of the videos. Average OR and ΔV were 0.027 ± 0.022 μL⁻¹ and 5.7 ± 2.8 μL, respectively (n = 48). The mean submacular choroidal thickness (CT) and pulsatile CT change were 283.6 ± 40.4 μm and 8.36 ± 4.4 μm, respectively. Intrasession repeatability for OR and ΔV was assessed in 31 eyes and was determined to be excellent based on a single measure intraclass correlation coefficient of 0.912, 95% confidence interval (CI) (0.825, 0.956) and 0.941, 95% CI (0.879, 0.972), respectively and a within-subject standard deviation of 0.0037 μL⁻¹ and 1.14 μL, respectively.</div></div><div><h3>Conclusions</h3><div>Measures of OR and ΔV are achievable in children and young adults and have good repeatability. This noninvasive method can be used to establish structural biomechanical changes of the sclera and choroid with myopic axial elongation in childhood and beyond.</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 100814"},"PeriodicalIF":3.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166800","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":"Scleral Thickness in Eyes with Pachychoroid Pigment Epitheliopathy Accompanied by Keratoconus","authors":"Paolo Forte MD ,&nbsp;Alessandro Feo MD ,&nbsp;Hideki Koizumi MD, PhD ,&nbsp;Enrico Borrelli MD, PhD ,&nbsp;Riccardo Manocchio MD ,&nbsp;Luca Di Cello MD, PhD ,&nbsp;Francesco Biagini MD ,&nbsp;Francesco Macocco MD ,&nbsp;Gabriele Drago MD ,&nbsp;Giovanni Forte MD ,&nbsp;Aldo Vagge MD, PhD ,&nbsp;Christian Gianoglio PhD ,&nbsp;Vincenzo Fontana PhD ,&nbsp;Michele Iester MD, PhD ,&nbsp;Massimo Nicolò MD, PhD ,&nbsp;Mario R. Romano MD, PhD ,&nbsp;Chiara Bonzano MD, PhD","doi":"10.1016/j.xops.2025.100808","DOIUrl":"10.1016/j.xops.2025.100808","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the prevalence of pachychoroid pigment epitheliopathy (PPE) in eyes with keratoconus (KC) and investigate its correlation with corneal, choroidal, and scleral indices with multimodal imaging.</div></div><div><h3>Design</h3><div>An exploratory, cross-sectional, cohort study.</div></div><div><h3>Subjects</h3><div>One hundred consecutive patients affected with KC.</div></div><div><h3>Main Outcome Measures</h3><div>Scleral stromal thickness, PPE prevalence, and their associations with corneal and choroidal parameters.</div></div><div><h3>Methods</h3><div>Demographic data, corneal collagen cross-linking, anamnestic records, and clinical findings were collected. Imaging protocol included OCT (Spectralis HRA+OCT; Heidelberg Engineering), corneal topography (TMS-4N, Tomey), corneal pachymetry (RTVue-XR Avanti, Optovue), and axial length (AXL) measurement (OA-2000, Tomey). Anterior scleral stromal thickness was measured in the horizontal gaze positions 6 mm posteriorly to the scleral spur (Spectralis HRA+OCT; linear 20° scan, 1024 A-scan per second). Odds ratios (ORs) and corresponding 95% confidence limits (95% CLs) were estimated through logistic regression analysis to evaluate the association between each study parameter and PPE. To accommodate for the potential clustering effect due to within-patient correlated eye data, a generalized estimating equation procedure was applied to regression analysis. Additionally, a decision tree machine learning model with K-fold cross-validation was employed to predict PPE.</div></div><div><h3>Results</h3><div>Eighty-five Caucasian patients were eligible for analysis (mean age: 34.2 years, standard deviation: 8.7). The prevalence of PPE was 10.5% (95% CL: 4.9/19.1%; 9/85 patients; 11/170 eyes; 2 bilateral cases). Significant predictors for PPE according to logistic regression were choroidal thickness (OR: 4.51; 95% CL: 1.50/13.6 for 50 μm increments; <em>P</em> = 0.007), age (OR: 4.61; 95% CL: 1.30/16.4 for 10-year increments; <em>P</em> = 0.018), and scleral stromal thickness (OR: 7.48: 95% CL: 1.69/33.1 for 25 μm increments; <em>P</em> = 0.008). Sex, AXL, corneal curvature, and astigmatism parameters did not show significant discriminant ability (<em>P</em> &gt; 0.05). Collagen cross-linking treatment was performed in a comparable proportion between the 2 groups (73.6% vs. 63.4% in PPE and non-PPE, respectively).</div></div><div><h3>Conclusions</h3><div>Our study identifies increased scleral thickness as the key predictor of PPE in KC patients, followed by choroidal thickening and increased age. These findings provide new insights into the role of scleral biomechanics in KC eyes with PPE.</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 100808"},"PeriodicalIF":3.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222434","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":"Double-Masked, Dose-Response, Vehicle-Controlled Study of VVN461 Ophthalmic Solution in Postoperative Ocular Inflammation","authors":"James H. Peace MD ,&nbsp;Kevin Y. Jong MD ,&nbsp;Jason Bacharach MD ,&nbsp;Xiao-Yan Li MD ,&nbsp;Wang Shen PhD ,&nbsp;Caroline Lu MS ,&nbsp;Gary D. Novack PhD ,&nbsp;VVN461-CS201 Study Group","doi":"10.1016/j.xops.2025.100806","DOIUrl":"10.1016/j.xops.2025.100806","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the safety and ocular efficacy of VVN461, a Janus kinase kinase inhibitor, for treatment of postoperative inflammation.</div></div><div><h3>Design</h3><div>This was a phase II, multicenter, double-masked, randomized, vehicle-controlled, parallel-comparison study in subjects who underwent routine unilateral cataract extraction and lens replacement surgery via phacoemulsification without surgical complication.</div></div><div><h3>Participants</h3><div>Ninety-one subjects at 9 private practice US ophthalmology offices.</div></div><div><h3>Intervention</h3><div>VVN61 0.5% and 1.0% topical ophthalmic solution or vehicle, 4 times daily.</div></div><div><h3>Main Outcome Measures</h3><div>The proportion of subjects with anterior chamber cell (ACC) grade 0 in the study eye at day 14.</div></div><div><h3>Results</h3><div>The proportion of subjects with ACC grade 0 in the study eye at day 14 was 60.0% (18/30), 53.3% (16/30), and 19.4% (6/31) in the VVN461, 1.0%, VVN461, 0.5%, and vehicle groups, respectively (<em>P</em> = 0.0012 and 0.0057). Treatment effects in favor of VVN461 were also seen in the need for rescue medication and reduction of anterior chamber flare. There were relatively few adverse events in either VVN461 treatment group (10%, 3/30, or less), and they were judged of mild severity.</div></div><div><h3>Conclusions</h3><div>In this double-masked, vehicle-controlled study, clinically and statistically significant anti-inflammatory efficacy was seen with few safety issues.</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 5","pages":"Article 100806"},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139464","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":"Explainable Artificial Intelligence–Assisted Exploration of Clinically Significant Diabetic Retinal Neurodegeneration on OCT Images","authors":"Miyo Yoshida MD,&nbsp;Tomoaki Murakami MD, PhD,&nbsp;Kenji Ishihara MD, PhD,&nbsp;Yuki Mori MD, PhD,&nbsp;Akitaka Tsujikawa MD, PhD","doi":"10.1016/j.xops.2025.100804","DOIUrl":"10.1016/j.xops.2025.100804","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore clinically significant diabetic retinal neurodegeneration in OCT images using explainable artificial intelligence (XAI) and subsequent evaluation by retinal specialists.</div></div><div><h3>Design</h3><div>A single-center, retrospective, consecutive case series.</div></div><div><h3>Participants</h3><div>Three hundred ninety-seven eyes from 397 diabetic retinopathy patients for XAI-based screening and 244 fellow eyes for subjective human evaluation.</div></div><div><h3>Methods</h3><div>We acquired 30° horizontal OCT images centered on the fovea. An artificial intelligence (AI) model was developed to infer visual acuity (VA) reduction using fine-tuned RETFound-OCT. Attention maps highlighting regions contributing to VA inference were generated using layer-wise relevance propagation. Retinal specialists assessed OCT findings based on salient regions indicated by XAI. Two newly described findings, a needle-like appearance of the ganglion cell layer (GCL)/inner plexiform layer (IPL) (“ice-pick sign”) and dot-like alterations in the outer nuclear layer (ONL) (“salt-and-pepper sign”), were evaluated alongside 2 established findings: EZ disruption and choroidal hypertransmission.</div></div><div><h3>Main Outcome Measures</h3><div>Identification of clinically significant OCT findings associated with diabetic retinal neurodegeneration.</div></div><div><h3>Results</h3><div>The AI model effectively discriminated eyes with poor vision (decimal VA ≤0.5) from those with good vision (VA ≥1.0) (area under the receiver operating characteristic curve of 0.947). Explainable artificial intelligence–based attention maps highlighted salient regions in the GCL/IPL (65.2% or 70.0%), ONL (52.2% or 28.3%), EZ (39.1% or 21.7%), and choroid (26.1% or 5.00%) in eyes with poor or good vision, respectively. Subjective evaluation by retinal specialists revealed the frequencies of these 4 findings as follows: ice-pick sign (32.4%), EZ disruption (25.0%), salt-and-pepper sign (16.0%), and choroidal hypertransmission (13.5%). Eyes with decimal VA ≤0.9 had these findings more frequently than those with VA ≥1.0 (<em>P</em> &lt; 0.001 for all comparisons). Salt-and-pepper sign and choroidal hypertransmission exhibited high specificity for identifying eyes with poor vision. Statistical analyses demonstrated more significant associations between EZ disruption, salt-and-pepper sign, and hypertransmission compared with their relationships with the ice-pick sign.</div></div><div><h3>Conclusions</h3><div>Artificial intelligence–assisted exploration of OCT findings identified 2 established lesions and 2 novel OCT biomarkers indicative of clinically significant diabetic retinal neurodegeneration.</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 100804"},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154504","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":"Impact of Social Vulnerability Index and Distance to Tertiary Ocular Emergency Department in Patients Presenting with Open Globe Injury","authors":"Davina A. Malek MD ,&nbsp;Jason A. Greenfield BS ,&nbsp;Timothy Norris PhD ,&nbsp;Swarup S. Swaminathan MD ,&nbsp;Kara M. Cavuoto MD","doi":"10.1016/j.xops.2025.100802","DOIUrl":"10.1016/j.xops.2025.100802","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the impact of Social Vulnerability Index (SVI) and the distance to a tertiary eye emergency department (ED) on presenting visual acuity (VA), final VA, and rates of VA change over time in patients presenting with open globe injury (OGI).</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Participants</h3><div>Patients with OGI from 2018 to 2021 were identified from the electronic health records using the International Classification of Diseases coding system.</div></div><div><h3>Methods</h3><div>Data collected included demographics, insurance status, follow-up visits, and VA measurements. Social Vulnerability Index scores were calculated using a US Census Geocoder and stratified into quartiles, and distances to the eye ED were calculated. Simple logistic regression models evaluated the associations of presenting and final VAs with SVI, distance, baseline characteristics, and time from injury to presentation, adjusting for potential confounders. Univariable and multivariable linear regression models analyzed the associations between VA rates of change over time and SVI, distance to ED, demographics, insurance, and presenting VA.</div></div><div><h3>Main Outcome Measures</h3><div>The relationship between SVI and distance on presenting VA, final VA, and rates of longitudinal VA change over time.</div></div><div><h3>Results</h3><div>A total of 446 patients presented with an OGI. Of these patients, 337 (75.0%) with complete SVI data were included in the final analysis. Social Vulnerability Index was associated with nearly a fourfold increased risk of worse presenting VA in populations with higher vulnerability compared with those with lower overall vulnerability (odds ratio [OR] = 3.85; 95% confidence interval [CI]: 1.34–11.05; <em>P</em> = 0.012). Greater distance from the eye ED was also a contributing factor to higher risk of poorer presenting VA (OR = 2.55; 95% CI: 1.42–4.60; <em>P</em> = 0.002). On multivariable analyses, longitudinal VA change over time was not impacted by SVI (<em>P</em> &gt; 0.05 for all groups), and final visual outcome was not associated with either SVI or distance to the eye ED.</div></div><div><h3>Conclusions</h3><div>Greater distances from the eye ED and social vulnerability were associated with a higher risk of worse VA at presentation. However, no significant impact of SVI or distance was observed on long-term VA changes and final visual outcome on the multivariable analyses.</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 100802"},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139463","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":"A Hybrid Deep Learning–Based Approach for Visual Field Test Forecasting","authors":"Ashkan Abbasi PhD ,&nbsp;Sowjanya Gowrisankaran PhD ,&nbsp;Wei-Chun Lin MD, PhD ,&nbsp;Xubo Song PhD ,&nbsp;Bhavna Josephine Antony PhD ,&nbsp;Gadi Wollstein MD ,&nbsp;Joel S. Schuman MD ,&nbsp;Hiroshi Ishikawa MD","doi":"10.1016/j.xops.2025.100803","DOIUrl":"10.1016/j.xops.2025.100803","url":null,"abstract":"<div><h3>Objective</h3><div>Longitudinal assessment of visual field (VF) testing is essential in glaucoma management. Conventional VF forecasting methods require numerous prior tests, while deep learning techniques have shown promising results with fewer tests. This study introduces a hybrid deep learning framework to enhance flexibility and accuracy in VF test forecasting.</div></div><div><h3>Design</h3><div>A retrospective longitudinal study using deep learning–based VF forecasting models.</div></div><div><h3>Subjects and Controls</h3><div>A total of 1750 subjects (healthy and glaucoma patients) with 19 437 Humphrey VF (24-2 Swedish Interactive Threshold Algorithm) tests collected from longitudinal glaucoma cohorts at the University of Pittsburgh and New York University.</div></div><div><h3>Methods</h3><div>Three deep learning models were trained for pointwise forecasting of VF test data: (1) a recurrent neural network (RNN), (2) CascadeNet-5, a convolutional neural network (CNN), and (3) Hybrid-VF-Net, our proposed method that combines an RNN with a CNN equipped with depthwise transformers for both spatial and temporal modeling. The results were analyzed from multiple perspectives, including the impact of varying the amount of prior input data and how data reliability and disease severity influence VF forecasting performance.</div></div><div><h3>Main Outcome Measures</h3><div>Mean absolute error between predicted and actual VF test results was evaluated using five-fold cross-validation.</div></div><div><h3>Results</h3><div>We found that specific VF locations benefited more from either local or temporal modeling, and our proposed methods outperformed the compared approaches using a hybrid strategy. Hybrid-VF-Net exhibited greater resilience to data reliability issues, particularly in managing high false-negative rates often seen in moderate-to-severe glaucoma cases due to increased test–retest variability. Additionally, it demonstrated improved performance with fewer prior VF tests, thus reducing the waiting time needed for progression analysis.</div></div><div><h3>Conclusions</h3><div>The proposed Hybrid-VF-Net method outperformed the existing deep learning VF methods in terms of performance and robustness. Our findings highlight the influence of disease severity, data quality, and time displacement on forecasting performance, with certain VF locations benefiting more from either local or temporal modeling. Low reliability in data from moderate to advanced glaucoma cases continues to pose a challenge. Therefore, future research could refine temporal modeling and leverage larger datasets to further enhance predictive performance.</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 5","pages":"Article 100803"},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166802","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}