Ophthalmology science最新文献

{"title":"Retinal Structures in Autism Spectrum Disorder: Results from a Case-Control Study","authors":"Fateme Montazeri MD, MPH ,&nbsp;Yin Allison Liu MD, PhD ,&nbsp;Parisa Emami-Naeini MD, MPH","doi":"10.1016/j.xops.2025.100842","DOIUrl":"10.1016/j.xops.2025.100842","url":null,"abstract":"<div><h3>Objective</h3><div>To assess retinal structures in patients with autism spectrum disorder (ASD) and its correlation with cognitive impairments and brain volumes.</div></div><div><h3>Design</h3><div>A retrospective case-control study.</div></div><div><h3>Subjects</h3><div>Adults with ASD and matched neurotypical controls were identified from the UK Biobank (UKBB). The exclusion criteria included a history of neurodegenerative diseases, optic nerve pathology, retinal disorders, glaucoma surgery, high refractive error, or intraocular pressure outside the range of 6 to 21 mmHg.</div></div><div><h3>Methods</h3><div>Using OCT images, 9 distinct retinal layers were segmented: the retinal nerve fiber layer (RNFL), ganglion cell layer, inner plexiform layer, inner nuclear layer (INL), combined outer plexiform layer and outer nuclear layer, photoreceptor inner segment, photoreceptor outer segment, retinal pigment epithelium, and choroidoscleral interface. Cognitive function was evaluated using 4 standardized tests: pairs matching, prospective memory, numerical or verbal reasoning, and reaction time. Additionally, brain imaging–derived phenotypes from the UKBB were included in the analysis. Generalized linear models were used to evaluate associations.</div></div><div><h3>Main Outcome Measures</h3><div>Differences in retinal layer thickness between autistic individuals and controls, and the association with cognitive impairment and brain volumes.</div></div><div><h3>Results</h3><div>We examined 240 eyes, including 80 from autistic participants and 160 from matched neurotypical controls. Autistic participants showed significantly higher thickness in the inner retina (adjusted mean differences: 5.71 μm, 95% confidence interval [2.49–8.93], <em>P</em> = 0.001), as well as RNFL (2.52 μm [0.97–4.06], <em>P</em> = 0.001), inner plexiform layer (1.18 [0.28–2.07], <em>P</em> = 0.010), and INL (0.93 [0.22–1.66], <em>P</em> = 0.010). No significant correlation was found between inner retinal thickness and cognitive impairment. However, brain magnetic resonance imaging data indicated associations between inner retinal thickness and volumes of the total brain, corpus collosum, hippocampus, and temporal gyrus.</div></div><div><h3>Conclusions</h3><div>The inner retina may offer valuable insights into neurodevelopmental features in ASD, with observed associations with specific brain volumetric measurements. These findings could inform future research on ASD diagnostics and treatment.</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 100842"},"PeriodicalIF":4.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866827","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":"Effect of Subthreshold Nanosecond Laser on Loss of OCT Outer Retinal Bands in Age-Related Macular Degeneration: A LEAD Study Report","authors":"Robyn H. Guymer MBBS, PhD ,&nbsp;Joseph P.M. Blair PhD ,&nbsp;Sandro De Zanet PhD ,&nbsp;Stefanos Apostolopoulos PhD ,&nbsp;Carlos Ciller PhD ,&nbsp;Zhichao Wu BAppSc(Optom), PhD","doi":"10.1016/j.xops.2025.100839","DOIUrl":"10.1016/j.xops.2025.100839","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the effect of subthreshold nanosecond laser (SNL) treatment on the rate of loss of the OCT outer retinal bands in intermediate age-related macular degeneration (AMD).</div></div><div><h3>Design</h3><div>Post hoc analysis of the Laser Intervention in the Early Stages of AMD (LEAD) study.</div></div><div><h3>Participants</h3><div>A subset of 285 of 292 individuals in the LEAD study with bilateral large drusen without signs of multimodal imaging-defined late AMD at baseline, seen at 1 follow-up visit where neovascular AMD (nAMD) was absent.</div></div><div><h3>Methods</h3><div>Participants were randomized to receive SNL or sham treatment in 1 study eye at 6-monthly intervals and were reviewed for up to 36 months. OCT scans from all visits without nAMD were automatically segmented to examine between-group differences in the rate of change in external limiting membrane (ELM), ellipsoid zone (EZ), and retinal pigment epithelium (RPE) loss in the entire central 5-mm diameter region, or only nondrusen areas in this region.</div></div><div><h3>Main Outcome Measures</h3><div>Between-group differences in the rate of ELM, EZ, and RPE loss.</div></div><div><h3>Results</h3><div>Overall, there was no significant between-group difference in the rate of change in the loss of all OCT outer retinal band parameters (<em>P</em> ≥ 0.206). However, there was evidence of significant treatment effect modification based on the coexistence of reticular pseudodrusen (RPD) in the study eye when evaluating the rate of RPE loss in the entire central 5-mm diameter region, and for the rate of ELM, EZ, and RPE loss when considering only nondrusen areas in this region (<em>P</em> ≤ 0.006). In eyes without coexistent RPD, there was a significant slowing of the loss of all OCT outer retinal band parameters with SNL treatment (<em>P</em> ≤ 0.038 for all), whereas there was no significant between-group difference in all parameters in eyes with coexistent RPD (<em>P</em> ≥ 0.153 for all).</div></div><div><h3>Conclusions</h3><div>Subthreshold nanosecond laser treatment slowed the progressive loss of the OCT outer retinal bands in intermediate AMD in eyes without coexistent RPD. This study also showed for the first time the responsiveness of these novel outcome measures to treatment.</div></div><div><h3>Financial Disclosure</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 100839"},"PeriodicalIF":3.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632087","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":"Multi-Comparison of Different Ocular Imaging Modality-based Deep Learning Models for Visually Significant Cataract Detection","authors":"Jocelyn Hui Lin Goh BEng ,&nbsp;Xiaofeng Lei MSc ,&nbsp;Miao-Li Chee MPH ,&nbsp;Yiming Qian PhD ,&nbsp;Marco Yu PhD ,&nbsp;Tyler Hyungtaek Rim MD, PhD ,&nbsp;Simon Nusinovici PhD ,&nbsp;David Ziyou Chen MBBS, FRCOphth ,&nbsp;Kai Hui Koh BSc ,&nbsp;Samantha Min Er Yew BSc ,&nbsp;Yibing Chen BEng ,&nbsp;Victor Teck Chang Koh MBBS, MMed ,&nbsp;Charumathi Sabanayagam MD, PhD ,&nbsp;Tien Yin Wong MD, PhD ,&nbsp;Xinxing Xu PhD ,&nbsp;Rick Siow Mong Goh PhD ,&nbsp;Yong Liu PhD ,&nbsp;Ching-Yu Cheng MD, PhD ,&nbsp;Yih-Chung Tham PhD","doi":"10.1016/j.xops.2025.100837","DOIUrl":"10.1016/j.xops.2025.100837","url":null,"abstract":"<div><h3>Purpose</h3><div>Age-related cataract is the leading cause of vision impairment. Researchers have utilized various imaging modalities, including slit beam, diffuse anterior segment, and retinal imaging, to develop deep learning (DL) algorithms for automated cataract analysis. However, the comparative performance of these algorithms across different ocular imaging modalities remains unevaluated, mainly due to the absence of standardized test sets across studies.</div></div><div><h3>Design</h3><div>Retrospective study.</div></div><div><h3>Participants</h3><div>Across all the models, the Singapore Malay Eye Study data set was used for training (N = 7093 eyes) and internal testing (N = 1649 eyes). The Singapore Indian Eye Study (SINDI; N = 5579 eyes) and the Singapore Chinese Eye Study (SCES; N = 5658 eyes) were used for external testing. A community study data set of nonmydriatic retinal photos (N = 310 eyes) was used for external testing of the retinal model.</div></div><div><h3>Methods</h3><div>We developed 3 single-modality DL models (retinal, slit beam, and diffuse anterior segment photos) and 4 ensemble models (4 different combinations of the 3 single-modality models) to detect visually significant cataract (VSC). We defined eyes with VSC as having significant cataract (based on the modified Wisconsin cataract grading system) with a best-corrected visual acuity of &lt;20/60.</div></div><div><h3>Main Outcome Measures</h3><div>Area under receiver operating characteristic curve (AUC).</div></div><div><h3>Results</h3><div>In the internal test, the retinal model had the highest AUC value (97.0%; 95% confidence interval [CI], 95.9–98.2), compared with the slit beam model (AUC, 93.4%; 95% CI, 90.1–96.7; <em>P</em>_diff = .029) and diffuse anterior segment model (AUC, 94.4; 95% CI, 92.3–96.4; <em>P</em>_diff = .002). There was no significant difference in AUC when comparing the retinal model with the ensemble models (all <em>P</em>_diff ≥ .07). These trends were consistently observed in the external test sets. In nonmydriatic eyes, the retinal model showed reasonable performance (AUC, 89.8%; 95% CI, 89.6–89.9).</div></div><div><h3>Conclusions</h3><div>Our findings highlight the retinal model as a promising tool for detecting VSC, outperforming slit beam and diffuse anterior segment models. Because retinal photography is routine in diabetic retinopathy screening, this approach could enable opportunistic cataract screening with minimal add-on cost.</div></div><div><h3>Financial Disclosure</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 100837"},"PeriodicalIF":4.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144739216","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":"Treatment Cessation in Patients with Diabetic Maculopathy under Intravitreal Anti-VEGF Therapy Following a Treat-and-Extend Protocol","authors":"Lucia Saucedo PhD ,&nbsp;Isabel B. Pfister PhD ,&nbsp;Christin Schild PhD ,&nbsp;Justus G. Garweg MD, PhD","doi":"10.1016/j.xops.2025.100838","DOIUrl":"10.1016/j.xops.2025.100838","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the outcomes of treatment cessation due to disease stability in eyes with diabetic macular edema (DME).</div></div><div><h3>Design</h3><div>A single-center, retrospective, consecutive case series.</div></div><div><h3>Subjects</h3><div>Patients with DME who had received their first anti-VEGF treatment between 2012 and 2021, a Snellen best-corrected visual acuity (VA) ≥0.1, and a follow-up of ≥24 months.</div></div><div><h3>Methods</h3><div>Baseline characteristics, best-corrected VA, OCT biomarkers over time, and injection details were collected from patients' medical records. Treatment interruption was defined as a treatment-free interval of ≥25 weeks after the last injection for any reason. An active decision for treatment interruption due to a stable retinal situation was defined as treatment cessation. Data are presented as mean ± standard deviation.</div></div><div><h3>Main Outcome Measures</h3><div>Percentage of patients experiencing treatment cessation, time to treatment cessation and to reuptake, and change in best-corrected VA and central retinal thickness.</div></div><div><h3>Results</h3><div>Beyond 109 eyes treated over ≥24 months, 81 eyes (62 patients) met the inclusion criteria. During a follow-up of 5.5 ± 2.3 (median 5) years, patients received 22.6 ± 14.9 (median 20) intravitreal injections, 7.7 ± 3.0 (8.0) of these in the first year. Fifty-seven eyes (70.4%) experienced ≥1 planned treatment cessation of ≥25 weeks, while 4 eyes experienced an unplanned treatment interruption. Treatment cessation was documented in 53 eyes (65.4%) 65.2 ± 52.4 (median 42) weeks after treatment initiation for 106.2 ± 110.4 (median 54) weeks. The reason for treatment cessation was patient-driven in 1 eye (1.9%; the patient wished to stop treatment against medical advice), physician-driven in 38 eyes (71.7%; stable VA, despite persisting residual retinal fluid in OCT), and OCT-driven in 14 eyes (26.4%; no retinal fluid in OCT). Baseline parameters were comparable between eyes experiencing treatment cessation and those which did not.</div></div><div><h3>Conclusions</h3><div>Treatment cessation was achieved in 70% of eyes with DME after intensive treatment during the first year. This calls for a discussion about a possible systematic assessment of disease stability by omitting a single injection in eyes with stable residual retinal fluid.</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 100838"},"PeriodicalIF":3.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144569062","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":"Serological Influences on Dry Eye: Insights from the Sjögren's International Collaborative Clinical Alliance","authors":"Chloe Shields BS ,&nbsp;Pragnya Rao Donthineni MD ,&nbsp;Rohit Muralidhar BS ,&nbsp;Shreya Bhatt MS ,&nbsp;Ema V. Karakoleva BS ,&nbsp;Alan Baer MD ,&nbsp;Robert Fox MD ,&nbsp;Sara S. McCoy MD, PhD ,&nbsp;Anat Galor MD, MSPH","doi":"10.1016/j.xops.2025.100843","DOIUrl":"10.1016/j.xops.2025.100843","url":null,"abstract":"<div><h3>Purpose</h3><div>To define associations between serologies, specifically Sjögren syndrome–related antigen A (SSA) antibody and immunoglobulin (Ig) levels, on ocular profiles in patients enrolled in the Sjögren's International Collaborative Clinical Alliance (SICCA) cohort.</div></div><div><h3>Design</h3><div>A retrospective cohort study.</div></div><div><h3>Subjects</h3><div>Individuals from the SICCA cohort (n = 3514).</div></div><div><h3>Methods</h3><div>A retrospective analysis to examine relationships between dry eye (DE) symptoms and signs and serologic status, including SSA (SSA+ Sjögren disease [SjD], SSA− SjD, non-SjD) and Ig (G, A, M) levels (low, normal, and high).</div></div><div><h3>Main Outcome Measures</h3><div>Univariate analyses using analysis of variance and chi-square tests examined differences in ocular profiles by serologies. Multivariable analyses were then performed to account for potential confounding variables, including other serological measures.</div></div><div><h3>Results</h3><div>The mean age of the SICCA cohort was 53 ± 13 years, with the majority identifying as female (91%, n = 3185) and White (54%, n = 1894). The presence of SSA impacted ocular profiles, with the SSA+ SjD group reporting less severe symptoms compared with the SSA− SjD and non-SjD groups (spontaneous pain: 2.61 ± 2.83 vs. 3.39 ± 3.01 vs. 3.52 ± 3.09, <em>P</em> &lt; 0.001), but more frequently having ocular signs (low tear production: 57% vs. 52% vs. 28%, <em>P</em> &lt; 0.001; ocular surface staining [OSS]: 83% vs. 69% vs. 35%, <em>P</em> &lt; 0.001). Immunoglobulin levels showed a similar pattern, with the high IgG level group reporting less severe ocular symptoms in the SjD (spontaneous pain: 2.41 ± 2.82 vs. 3.10 ± 2.91 vs. 3.40 ± 2.96; <em>P</em> &lt; 0.001 and <em>P</em> &lt; 0.05) and non-SjD (spontaneous pain: 2.09 ± 2.35 vs. 3.58 ± 3.11 vs. 3.85 ± 3.11; <em>P</em> &lt; 0.001) groups but more severe signs (SjD group: low tear production: 60% vs. 53% vs. 49%; OSS: 88% vs. 72% vs. 70%; <em>P</em> &lt; 0.001) compared with the normal and low-level groups. A similar pattern was noted for IgA levels. Most associations remained significant when considered concomitantly.</div></div><div><h3>Conclusions</h3><div>Ocular manifestations of DE are influenced by serological factors. Specifically, SSA+ and high IgG and IgA status align with a disease picture of clinical signs of DE disease out of proportion to pain symptoms, while SSA− and low and normal IgG and IgA status align with a DE disease picture of symptoms that outweigh signs.</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 100843"},"PeriodicalIF":3.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588389","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":"Genotype Prediction from Retinal Fundus Images Using Deep Learning in Eyes with Age-Related Macular Degeneration","authors":"Avishai Halev PhD ,&nbsp;Denis Huang MD ,&nbsp;Shahbaz Rezaei PhD ,&nbsp;Sean Banks BS ,&nbsp;John D. McPherson PhD ,&nbsp;Suma P. Shankar MD, PhD ,&nbsp;Xin Liu PhD ,&nbsp;Glenn Yiu MD, PhD","doi":"10.1016/j.xops.2025.100836","DOIUrl":"10.1016/j.xops.2025.100836","url":null,"abstract":"<div><h3>Purpose</h3><div>To employ deep learning models to predict high-risk genetic variants associated with age-related macular degeneration (AMD) from retinal fundus photographs of patients with this condition.</div></div><div><h3>Design</h3><div>Deep learning algorithm development to classify single-nucleotide polymorphism in the complement factor H (CFH) and age-related maculopathy susceptibility 2 (ARMS2) genes using retinal fundus images.</div></div><div><h3>Participants</h3><div>Thirty-one thousand two hundred seventy-one retinal color fundus photographs of 1754 participants from the Age-Related Eye Disease Study.</div></div><div><h3>Methods</h3><div>We trained deep learning models including convolution neural networks and vision transformers (ViTs) to classify patients into high-risk (homozygous high-risk alleles) or low-risk (heterozygous or homozygous low-risk alleles) genotypes for CFH or ARMS2, then evaluated algorithm performance on an independent test set. The complexity of genotype predictions was compared with AMD severity or gender classification tasks using V-usable information. Attribution mapping was performed to identify fundus regions used to predict genotype from phenotype.</div></div><div><h3>Main Outcome Measures</h3><div>Area under the receiver operating characteristic curve (AUROC), balanced accuracy, and average precision for predicting high-risk genotypes.</div></div><div><h3>Results</h3><div>Our trained ViT models predicted high-risk genotypes in CFH and ARMS2 with an AUROC of 0.719 and 0.741 across all eyes, respectively. For genotype predictions for ARMS2, model performance is improved in eyes with advanced AMD (AUROC 0.867), choroidal neovascularization (AUROC 0.833), and geographic atrophy (AUROC 0.957). Genotype predictions from fundus images appear more difficult than AMD severity or gender classification tasks, although saliency mapping supports biological plausibility by demonstrating attention to the central macula for genotype predictions.</div></div><div><h3>Conclusions</h3><div>Deep learning can predict high-risk genotypes in CFH and ARMS2 from retinal fundus images of patients with AMD. Our findings provide proof of principle for inferring genotype from noninvasive eye imaging and reveal insights into genotype-phenotype relationships in AMD.</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 100836"},"PeriodicalIF":3.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588388","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":"Time-in-Range Analysis of Responses after Intravitreal Dexamethasone Therapy in Eyes with Diabetic Macular Edema","authors":"Igor Kozak MD, PhD ,&nbsp;Diana V. Do MD ,&nbsp;Hongxin Lai PhD ,&nbsp;Miller J. Ogidigben PhD ,&nbsp;Francisco J. López MD, PhD","doi":"10.1016/j.xops.2025.100833","DOIUrl":"10.1016/j.xops.2025.100833","url":null,"abstract":"<div><h3>Purpose</h3><div>Time in range (TIR) is a novel end point that assesses the time during which an outcome remains within a predetermined range. Because the range includes normal parameters, it is indicative of clinically meaningful benefit. The MEAD trial comprised two 3-year randomized, multicenter, sham-controlled, phase III clinical studies that evaluated the efficacy and safety of dexamethasone intravitreal implant (DEX-I) in patients with diabetic macular edema. Dexamethasone intravitreal implant significantly improved best-corrected visual acuity (BCVA) and central retinal thickness (CRT) compared with sham treatment. We present a post hoc analysis of the MEAD trial to investigate TIR benefit across various thresholds of BCVA and CRT with DEX-I versus sham.</div></div><div><h3>Design</h3><div>Post hoc analysis of results from the randomized, multicenter, sham-controlled, phase III MEAD trial (NCT00168337 and NCT00168389).</div></div><div><h3>Participants</h3><div>Adults with type 1 or 2 diabetes mellitus and fovea-involved macular edema associated with diabetic retinopathy.</div></div><div><h3>Intervention</h3><div>Intravitreal injection of DEX-I 0.7 mg or sham procedure.</div></div><div><h3>Main Outcome Measures</h3><div>Time in range during year 1 was evaluated using BCVA thresholds of ≥69, ≥51, ≥59, and ≥64 letters, and CRT thresholds of &lt;300, &lt;353, &lt;446, and &lt;551 μm (the latter cutoffs being quartile [Q] 1, Q2, and Q3 of pooled baseline BCVA and CRT, respectively).</div></div><div><h3>Results</h3><div>Dexamethasone intravitreal implant 0.7 mg was associated with a statistically significant longer TIR versus sham at the BCVA ≥69-letter threshold (15.0 vs. 9.1 weeks, respectively; <em>P &lt;</em> 0.001) and the CRT &lt;300 μm threshold (18.5 vs. 8.3 weeks, respectively; <em>P &lt;</em> 0.001). Dexamethasone intravitreal implant was also associated with longer TIR versus sham at thresholds of BCVA ≥59 (greater than or equal to Q2) and ≥64 letters (greater than or equal to Q3) and CRT &lt;353 μm (less than Q1), &lt;446 μm (less than Q2), and &lt;551 μm (less than Q3) (all <em>P &lt;</em> 0.001).</div></div><div><h3>Conclusions</h3><div>Patients receiving intravitreal DEX-I 0.7 mg had a longer time with BCVA above the driving threshold and below the normal limit of CRT during year 1 of the MEAD trial versus those who received sham. These results suggest that patients treated with dexamethasone experience a longer time with clinically meaningful outcomes than with sham, such as being able to drive or regaining normal structural retinal features.</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 100833"},"PeriodicalIF":3.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518277","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":"Incidence and Clinical Practice of Myopic Macular Neovascularization: A Nationwide Population-Based Cohort Study","authors":"Masahiro Akada MD ,&nbsp;Masahiro Miyake PhD, MPH ,&nbsp;Masayuki Hata MD, PhD ,&nbsp;Ai Kido MD, PhD ,&nbsp;Wakako Okayama MD ,&nbsp;Ai Nakata MD ,&nbsp;Shinya Nakao MD ,&nbsp;Kazuya Morino MD ,&nbsp;Shota Yasukura MD ,&nbsp;Yuki Mori MD, PhD ,&nbsp;Hiroshi Tamura PhD, ScM ,&nbsp;Akitaka Tsujikawa MD, PhD","doi":"10.1016/j.xops.2025.100834","DOIUrl":"10.1016/j.xops.2025.100834","url":null,"abstract":"<div><h3>Purpose</h3><div>To elucidate the epidemiological background of myopic macular neovascularization (mMNV), including its incidence and treatment patterns.</div></div><div><h3>Design</h3><div>A population-based cohort study using a nationwide claims database.</div></div><div><h3>Participants</h3><div>Individuals covered by the Japanese National Health Insurance System between 2016 and 2022.</div></div><div><h3>Methods</h3><div>This study utilized data from the national claims database managed by the Japan Ministry of Health, Labour and Welfare. The database covers over 95% of health care claims in Japan under the universal health coverage system. We identified individuals with new-onset mMNV between January 2016 and December 2022. We also calculated incidence rates based on age and sex stratification for each year. We also assessed the initial treatment patterns for mMNV, focusing on the use of anti-VEGF therapy.</div></div><div><h3>Main Outcome Measures</h3><div>Incidence rates and treatment patterns of mMNV.</div></div><div><h3>Results</h3><div>During the 7-year period, we identified 45 671 cases of mMNV, with 70.7% occurring in women. The crude incidence rate (per 100 000 person-years) in the general population was 5.17 (95% confidence interval [CI], 5.13–5.22), with 3.12 (95% CI, 3.07–3.18) in men and 7.12 (95% CI, 7.04–7.19) in women. The mean age of onset was lower in men (59.3 ± 16.7 years) than in women (63.5 ± 16.2 years). In total, 52.6% of newly diagnosed patients with mMNV received anti-VEGF treatment, with 43.5% receiving ranibizumab and 56.5% receiving aflibercept. The number of injections in the first (0–12 months), second (13–24 months), and third (25–36 months) years after the initial injection was 2.45 ± 1.83, 0.62 ± 1.42, and 0.46 ± 1.27, respectively.</div></div><div><h3>Conclusions</h3><div>This study provides the largest population-based evidence on the detailed epidemiology of mMNV following the implementation of anti-VEGF therapy under the Japanese National Insurance System. We examined how the incidence varied over time and analyzed the usage rates of each anti-VEGF agent, as well as the number of injections, offering valuable insights into the medical and social implications of mMNV following the widespread implementation of anti-VEGF therapy. These findings enhance understanding of the medical and social features of mMNV.</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 100834"},"PeriodicalIF":3.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588497","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":"Dark Adaptometry Kinetics Differentiates Age-Related Macular Degeneration from Central Serous Chorioretinopathy","authors":"Ashwin P. Verghese BE ,&nbsp;Claudia C. Lasalle BA ,&nbsp;David J. Ramsey MD, PhD","doi":"10.1016/j.xops.2025.100835","DOIUrl":"10.1016/j.xops.2025.100835","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the diagnostic utility of dark adaptometry (DA) rod intercept time (RIT) to differentiate age-related macular degeneration (AMD) from central serous chorioretinopathy (CSCR).</div></div><div><h3>Design</h3><div>Retrospective consecutive case series.</div></div><div><h3>Participants</h3><div>Consecutive patients with a clinical diagnosis of AMD or CSCR who were ≥50 years of age.</div></div><div><h3>Methods</h3><div>The study included patients who had completed a DA study in ≥1 eye measured at 5° superior to the fovea on the retina. All patients underwent a comprehensive retina examination, including OCT assessment of the macula.</div></div><div><h3>Main Outcome Measures</h3><div>Patients were classified based on their RIT, with an RIT &gt;6.50 minutes considered a delay.</div></div><div><h3>Results</h3><div>The study included 67 patients with AMD and 25 with CSCR. Patients with AMD tended to be older (73.8 ± 8.9 years vs. 65.0 ± 7.2 years, <em>P</em> &lt; 0.001) and were more likely female (53.7% vs. 28.0%, <em>P</em> = 0.049) compared with their CSCR counterparts. Additionally, patients with AMD tended to exhibit poorer vision in both their better-seeing (logarithm of the minimum angle of resolution 0.14 ± 0.13 vs. 0.08 ± 0.13, <em>P</em> = 0.057) and worse-seeing (logarithm of the minimum angle of resolution 0.48 ± 0.47 vs. 0.26 ± 0.25, <em>P</em> = 0.028) eyes. Rod intercept times were slower in patients with AMD compared with CSCR, both in the faster-adapting (12.44 ± 6.96 minutes vs. 4.01 ± 1.28 minutes, <em>P</em> &lt; 0.001) and slower-adapting (13.06 ± 6.67 minutes vs. 4.95 ± 1.78 minutes, <em>P</em> &lt; 0.001) eyes. Using a delayed RIT in the faster-adapting eye to classify patients with AMD versus CSCR showed excellent performance with a sensitivity of 79.1% (95% confidence interval [CI]: 67.4%–88.1%) and perfect specificity of 100.0% (95% CI: 86.3%–100.0%), yielding an accuracy of 97.4% (95% CI: 91.7%–99.6%). After adjusting for age, sex, and visual acuity, RIT in the faster-adapting eye remained an independent predictor of AMD versus CSCR.</div></div><div><h3>Conclusions</h3><div>Prolonged dark adaptation, indicated by a longer RIT, is capable of distinguishing individuals with AMD from CSCR, 2 conditions that share similar fundus features. Future investigations are warranted to assess the effectiveness of this noninvasive technique for AMD screening.</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 100835"},"PeriodicalIF":3.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549441","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 Association between Myopia and Anxiety: a bidirectional two-sample Mendelian randomization study","authors":"Waihang Wong ,&nbsp;Yimin Qin ,&nbsp;Chi Liu ,&nbsp;Shiran Zhang ,&nbsp;Yu Jiang ,&nbsp;Yangfa Zeng ,&nbsp;Decai Wang ,&nbsp;Lingyi Liang ,&nbsp;Xiaotong Han","doi":"10.1016/j.xops.2025.100832","DOIUrl":"10.1016/j.xops.2025.100832","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate whether there is a causal relationship between generalized anxiety disorder (GAD) and myopia.</div></div><div><h3>Design</h3><div>A bidirectional 2-sample Mendelian randomization (MR) analysis.</div></div><div><h3>Subjects</h3><div>For the forward MR, 11 single nucleotide polymorphisms (SNPs) associated with GAD were obtained from the FinnGen Research (5280 cases and 368 054 controls; European). For reverse MR, 253 SNPs associated with mean spherical equivalent (MSE) were derived from the UK Biobank (95 619 participants; European).</div></div><div><h3>Methods</h3><div>Summary-level data from the 2 genome-wide association studies were used to conduct bidirectional MR analyses. Four MR methodologies—inverse variance weighted (IVW), MR-Egger regression, weighted median, and weighted mode—were employed, with IVW serving as the primary analysis. Sensitivity analyses, including MR-Egger intercept and heterogeneity Q test, were performed.</div></div><div><h3>Main Outcome Measures</h3><div>The outcomes of the forward and reverse MR analyses were MSE and GAD, respectively.</div></div><div><h3>Results</h3><div>This study demonstrated a significant causal effect of GAD and myopia, suggesting individuals with GAD are at an elevated risk of more myopic MSE (IVW: β = −0.138; 95% confidence interval [CI] −0.221 to −0.056, <em>P</em> = 0.001). Conversely, we did not find evidence to support a causal effect of myopia on GAD (IVW: β = −0.017; 95% CI −0. 051 to −0.016, <em>P</em> = 0.308). Sensitivity analyses revealed no evidence of genetic confounding to bias the estimate of causal effect.</div></div><div><h3>Conclusions</h3><div>Our study demonstrates a significant causal relationship between GAD and a more myopic MSE, though the effect size was relatively small. These findings could be taken into consideration while implementing mental health interventions in children.</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 100832"},"PeriodicalIF":3.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338965","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}