Ophthalmology science最新文献

{"title":"Exploring Effects of Age at the Onset of Myopia on Multiple Diseases Using Electronic Health Records","authors":"Xiayin Zhang PhD ,&nbsp;Shan Wang MD ,&nbsp;Yu Huang PhD ,&nbsp;Yanjie Xie PhD ,&nbsp;Ishith Seth MD ,&nbsp;Gabriella Bulloch MD ,&nbsp;Chunran Lai MD ,&nbsp;Yijun Hu PhD ,&nbsp;Xianwen Shang PhD ,&nbsp;Mingguang He PhD ,&nbsp;Zhuoting Zhu PhD ,&nbsp;Honghua Yu PhD","doi":"10.1016/j.xops.2025.100819","DOIUrl":"10.1016/j.xops.2025.100819","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine whether genetic predisposition to age at the onset of myopia is associated with the development of future diseases.</div></div><div><h3>Design</h3><div>Mendelian randomization phenome-wide association study (MR-PheWAS) from the UK Biobank.</div></div><div><h3>Participants</h3><div>A polygenic risk score (PRS) for age at the onset of myopia was constructed using 80 variants selected from a genome-wide association study. Participants were eligible if they had available genetic information during recruitment between March 13, 2006, and October 1, 2010. Disease outcomes were mapped to phenotype codes (phecodes) based on hospital episode statistics and causes of death up to April 29, 2021.</div></div><div><h3>Methods</h3><div>The analysis of phenome-wide association studies (PheWAS) identified possible associations between the age of myopia-onset PRS and a range of disease outcomes. Cox proportional hazards analysis and 2-sample Mendelian randomization (MR) further confirmed associations between PRS and diseases passing Bonferroni correction. The disease-trajectory analysis explored the sequential patterns in childhood-onset and adult-onset groups.</div></div><div><h3>Main Outcome Measures</h3><div>Disease outcomes related to age at the onset of myopia.</div></div><div><h3>Results</h3><div>Our study population comprised 315 568 UK Biobank participants, and 1000 unique phecodes from 17 different disease categories were included for analysis. After Bonferroni correction, PheWAS identified younger age at myopia-onset PRS was associated with hospital-diagnosed myopia and 13 other outcomes when using the Bonferroni threshold (all <em>P</em> &lt; 5.0 × 10⁻⁵). Eleven distinct disease associations with dose-response effects were confirmed using Cox proportional hazards analysis with stratified PRS. Two-sample MR analyses provided further support for the effects of younger age at myopia on higher risks of retinal detachments, cataracts, disorders of the vitreous body, and hypothyroidism, whereas older age of the onset of myopia conferred a higher risk of primary angle-closure glaucoma. Temporal analyses indicated myopia preceded the above disorders in both the childhood-onset and adult-onset groups.</div></div><div><h3>Conclusions</h3><div>This data-driven MR-PheWAS identified a range of ocular disorders and hypothyroidism that were related to age at the onset of myopia. Our results highlight the importance of treating younger-onset myopia and the management of myopia-related comorbidities.</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 100819"},"PeriodicalIF":3.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241834","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":"Age-Related Scattered Hypofluorescent Spots as an Adverse Prognostic Factor for Polypoidal Choroidal Vasculopathy","authors":"Seo Hee Kim MD ,&nbsp;Kai Tzu-iunn Ong ,&nbsp;Seonghee Choi MD ,&nbsp;Eun Jee Chung MD, PhD ,&nbsp;Min Kim MD, PhD ,&nbsp;Christopher Seungkyu Lee MD, PhD ,&nbsp;Jinyoung Yeo PhD ,&nbsp;Eun Young Choi MD, PhD","doi":"10.1016/j.xops.2025.100818","DOIUrl":"10.1016/j.xops.2025.100818","url":null,"abstract":"<div><h3>Purpose</h3><div>Polypoidal choroidal vasculopathy (PCV) demonstrates significant prognostic variability, and the impact of age-related scattered hypofluorescent spots observed in late-phase indocyanine green angiography (ASHS-LIA) on the prognosis of PCV remains under-researched. This study aims to investigate the association between ASHS-LIA in PCV and prognosis using the AdaBoost machine learning model.</div></div><div><h3>Design</h3><div>A cross-sectional study.</div></div><div><h3>Participants</h3><div>The study included patients diagnosed with PCV and treated with anti-VEGF therapy at 2 medical institutions between 2012 and 2021.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of the clinical characteristics, anti-VEGF treatment history, and outcomes of the participants, classifying them based on the presence or absence of ASHS-LIA. An AdaBoost meta-estimator was applied to predict prognosis, including disease stability, injection frequency, and time to first remission, utilizing features selected through principal component analysis.</div></div><div><h3>Main Outcome Measures</h3><div>The prognostic significance of ASHS-LIA was assessed by feature importance, with the mean decrease in impurity serving as the evaluation metric.</div></div><div><h3>Results</h3><div>Of 57 eyes with PCV, 31 exhibited ASHS-LIA and 26 did not. Compared with the non-ASHS-LIA group, the ASHS-LIA group had fewer patients who achieved a super-stable status without recurrence for &gt;18 months postremission (<em>P =</em> 0.03), required a longer time to reach first remission (<em>P</em> = 0.04), and needed more injections (<em>P</em> &lt; 0.001). AdaBoost models confirmed the importance of ASHS-LIA for predicting disease stability, injection demand, and time to first remission, ranking it as the third, seventh, and eighth top contributory factor, respectively.</div></div><div><h3>Conclusions</h3><div>Machine learning analysis identified ASHS-LIA as a negative prognostic factor in PCV, correlating with reduced disease stability, higher recurrence rates, and increased treatment requirements. These findings suggest that ASHS-LIA could serve as a valuable marker for assessing prognosis and guiding treatment strategies in PCV management.</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 100818"},"PeriodicalIF":3.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240211","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}