Ophthalmology science最新文献

{"title":"Retinal Vascular Fingerprints as Novel Biomarkers for Primary Angle Closure Disease Progression","authors":"Jin Wang MD ,&nbsp;Shumei Han MD ,&nbsp;Dapeng Mou MD ,&nbsp;Xin Tang MD ,&nbsp;Danli Shi PhD ,&nbsp;Mingguang He MD ,&nbsp;Chunyan Guo ,&nbsp;Ningli Wang MD, PhD ,&nbsp;Ye Zhang MD","doi":"10.1016/j.xops.2025.100848","DOIUrl":"10.1016/j.xops.2025.100848","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate retinal vascular parameters across primary angle-closure disease (PACD) stages and explore their association with glaucomatous optic neuropathy (GON).</div></div><div><h3>Design</h3><div>A cross-sectional, hospital-based study.</div></div><div><h3>Participants</h3><div>We enrolled 638 eyes from 425 participants aged ≥40 years with PACD and further classified them into primary angle closure suspect (PACS), primary angle closure (PAC), and primary angle closure glaucoma (PACG) groups.</div></div><div><h3>Methods</h3><div>Retinal vascular parameters were measured using the Retinal-based Microvascular Health Assessment System and compared between 3 groups. A multivariable logistic mixed effects model was used to identify factors associated with the presence of GON.</div></div><div><h3>Main Outcome Measures</h3><div>Vessel caliber, tortuosity, complexity, and branching angle parameters.</div></div><div><h3>Results</h3><div>No significant differences in retinal vascular parameters were found between PACS and PAC groups. Eyes in PACG showed significant vascular changes compared to PACS (<em>P</em> &lt; 0.05). Elevated intraocular pressure (odds ratio [OR] = 2.44, <em>P</em> &lt; 0.001), reduced arteriolar curve tortuosity (OR = 0.12, <em>P</em> = 0.002), arteriolar fractal dimension (OR = 0.08, <em>P</em> = 0.027), arteriolar branching angle (OR = 0.16, <em>P</em> = 0.004), and asymmetry ratio (OR = 0.10, <em>P</em> &lt; 0.001 for artery and OR = 0.25, <em>P</em> = 0.023 for vein) were significantly associated with the presence of GON.</div></div><div><h3>Conclusions</h3><div>Retinal “vascular geometric fingerprints” show significant alterations in eyes with PACG compared to PACS and are independently associated with the presence of GON. These findings offer new insights into the vascular changes in GON, and longitudinal studies are needed to determine their prognostic value and clinical utility in managing PACD.</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 100848"},"PeriodicalIF":3.2,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632091","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":"Risk Analysis of Retinal Hemangioblastomas in Nonadvanced Stages of von Hippel–Lindau Syndrome Using Ultra-widefield Imaging: The ULTRA von Hippel–Lindau Study","authors":"Sebastiano Del Fabbro MD ,&nbsp;Maria Vittoria Cicinelli MD ,&nbsp;Rosangela Lattanzio MD ,&nbsp;Soufiane Bousyf MD ,&nbsp;Lorenza Bruno MD ,&nbsp;Alessio Antropoli MD ,&nbsp;Lorenzo Bianco MD ,&nbsp;Elena Bruschi MD ,&nbsp;Alessandro Arrigo MD ,&nbsp;Giovanni Pipitone MD ,&nbsp;Francesco Cei MD ,&nbsp;Lucia Salerno MD ,&nbsp;Alessandro Larcher MD ,&nbsp;Andrea Salonia MD ,&nbsp;Francesco Bandello MD ,&nbsp;Maurizio Battaglia Parodi MD ,&nbsp;the OSR VHL Program","doi":"10.1016/j.xops.2025.100846","DOIUrl":"10.1016/j.xops.2025.100846","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the longitudinal progression, risk factors, and complications associated with retinal hemangioblastomas (RHs) in nonadvanced stages of von Hippel–Lindau (VHL) syndrome using ultra-widefield (UWF) imaging.</div></div><div><h3>Design</h3><div>Single-center longitudinal cohort study.</div></div><div><h3>Subjects</h3><div>Caucasian patients with genetically confirmed VHL syndrome.</div></div><div><h3>Methods</h3><div>Annual evaluations included dilated fundus examinations, UWF pseudocolor fundus retinal images, UWF fluorescein angiography, and OCT. Genetic analysis classified VHL mutations. Baseline RH counts and anatomical distributions were recorded as central (juxtapapillary, macular), peripheral, or both. Longitudinal follow-up tracked new RH formation and visual acuity (VA) values.</div></div><div><h3>Main Outcome Measures</h3><div>Cumulative incidence, incidence rate ratios (IRRs), and risk factors of new RHs assessed using mixed-effects negative binomial regression models. Hazard of recurrent RHs evaluated through Cox frailty models and longitudinal changes in VA.</div></div><div><h3>Results</h3><div>Among 78 eyes of 43 patients (mean age: 47.8 ± 13.6 years), 110 RHs were documented at baseline, with 3 (3%) centrally located, 35 (32%) peripherally, and 72 (65%) spanning both zones. von Hippel–Lindau variants were investigated in 37 patients: 19 had missense variants (51%), and 18 had presumed null alleles (49%), including nonsense (10 of 37; 27%), frameshift (1 of 37; 3%), splice site (1 of 37; 3%), and exon deletion mutations (6 of 37; 16%). Over a median follow-up of 31 months (interquartile range: 27–109), 35 (43%) eyes developed new RHs, with an incidence rate of 0.22 RHs per eye-year (95% confidence interval: 0.17–0.27). By the last available examination, 26 eyes (34%) remained disease-free, whereas17 (23%) showed no progression of existing RHs. Age reduced the IRR of new RHs by 4.2% annually (<em>P</em> = 0.003), whereas higher baseline tumor burden and vascular leakage increased the IRR significantly (<em>P</em> &lt; 0.001 and <em>P</em> = 0.03, respectively). Peripheral RHs were the strongest predictor of recurrence (hazard ratio = 16.4, <em>P</em> &lt; 0.001), whereas older age remained protective (hazard ratio = 0.96, <em>P</em> = 0.04). Visual acuity (logarithm of the minimum angle of resolution) worsened from 0.05 ± 0.2 (Snellen equivalent: 20/22) at baseline to 0.11 ± 0.3 (Snellen equivalent: 20/25) at the final visit.</div></div><div><h3>Conclusions</h3><div>Peripheral RHs and vascular leakage are significant risk factors for RH progression and recurrence in VHL syndrome. Although older age provides a protective effect, close monitoring of high-risk eyes is essential to enable timely intervention and preserve vision.</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 100846"},"PeriodicalIF":3.2,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144595924","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":"OpenAI o1 Large Language Model Outperforms GPT-4o, Gemini 1.5 Flash, and Human Test Takers on Ophthalmology Board–Style Questions","authors":"Ryan Shean BA ,&nbsp;Tathya Shah BS ,&nbsp;Sina Sobhani BS ,&nbsp;Alan Tang BS ,&nbsp;Ali Setayesh BA ,&nbsp;Kyle Bolo MD ,&nbsp;Van Nguyen MD ,&nbsp;Benjamin Xu MD, PhD","doi":"10.1016/j.xops.2025.100844","DOIUrl":"10.1016/j.xops.2025.100844","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate and compare the performance of human test takers and three artificial intelligence (AI) models—OpenAI o1, ChatGPT-4o, and Gemini 1.5 Flash—on ophthalmology board–style questions, focusing on overall accuracy and performance stratified by ophthalmic subspecialty and cognitive complexity level.</div></div><div><h3>Design</h3><div>A cross-sectional study.</div></div><div><h3>Subjects</h3><div>Five hundred questions sourced from the <em>Basic and Clinical Science Course (BCSC)</em> and <em>EyeQuiz</em> question banks.</div></div><div><h3>Methods</h3><div>Three large language models interpreted the questions using standardized prompting procedures. Subanalysis was performed, stratifying the questions by subspecialty and complexity defined by the Buckwalter taxonomic schema. Statistical analysis, including the analysis of variance and McNemar test, was conducted to assess performance differences.</div></div><div><h3>Main Outcome Measures</h3><div>Accuracy of responses for each model and human test takers, stratified by subspecialty and cognitive complexity.</div></div><div><h3>Results</h3><div>OpenAI o1 achieved the highest overall accuracy (423/500, 84.6%), significantly outperforming GPT-4o (331/500, 66.2%; <em>P</em> &lt; 0.001) and Gemini (301/500, 60.2%; <em>P</em> &lt; 0.001). o1 demonstrated superior performance on both <em>BCSC</em> (228/250, 91.2%) and <em>EyeQuiz</em> (195/250, 78.0%) questions compared with GPT-4o (<em>BCSC</em>: 183/250, 73.2%; <em>EyeQuiz</em>: 148/250, 59.2%) and Gemini (<em>BCSC</em>: 163/250, 65.2%; <em>EyeQuiz</em>: 137/250, 54.8%). On <em>BCSC</em> questions, human performance was lower (64.5%) than Gemini 1.5 Flash (65.2%), GPT-4o (73.2%), and OpenAI o1 (91.2%) (<em>P</em> &lt; 0.001). OpenAI o1 outperformed other models in each of the nine ophthalmic subfields and three cognitive complexity levels.</div></div><div><h3>Conclusions</h3><div>OpenAI o1 outperformed GPT-4o, Gemini, and human test takers in answering ophthalmology board–style questions from two question banks and across three complexity levels. These findings highlight advances in AI technology and OpenAI o1’s growing potential as an adjunct in ophthalmic education and care.</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 100844"},"PeriodicalIF":3.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144569780","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":"Retinograd-AI: An Open-Source Automated Fundus Autofluorescence Retinal Image Gradability Assessment for Inherited Retinal Diseases","authors":"Gunjan Naik PhD ,&nbsp;Saoud Al-Khuzaei MD, PhD ,&nbsp;Ismail Moghul PhD ,&nbsp;Thales A.C. de Guimaraes PhD, MD ,&nbsp;Sagnik Sen MD ,&nbsp;Malena Daich Varela MD, PhD ,&nbsp;Yichen Liu MSci ,&nbsp;Pallavi Bagga PhD ,&nbsp;Vincent Rocco PGCERT ,&nbsp;Dun Jack Fu MD, PhD ,&nbsp;Mariya Moosajee MD, PhD ,&nbsp;Savita Madhusudhan MD ,&nbsp;Andrew R. Webster MD ,&nbsp;Samantha De Silva MD, PhD ,&nbsp;Praveen J. Patel MD ,&nbsp;Omar A. Mahroo MD, PhD ,&nbsp;Susan M. Downes MD ,&nbsp;Michel Michaelides MD ,&nbsp;Konstantinos Balaskas MD ,&nbsp;Nikolas Pontikos PhD ,&nbsp;William Woof A. PhD","doi":"10.1016/j.xops.2025.100845","DOIUrl":"10.1016/j.xops.2025.100845","url":null,"abstract":"<div><h3>Purpose</h3><div>To develop an automated system for assessing the quality of fundus autofluorescence (FAF) images in patients with inherited retinal diseases (IRDs).</div></div><div><h3>Design</h3><div>A retrospective study of imaging data.</div></div><div><h3>Participants</h3><div>Patients with a confirmed molecular diagnosis of IRD who have undergone FAF imaging at Moorfields Eye Hospital.</div></div><div><h3>Methods</h3><div>A dataset of 2445 FAF images from patients with IRD was marked by 3 expert graders as either gradable (acceptable quality) or ungradable (poor quality), following a strict grading protocol. This dataset was used to train an artificial intelligence (AI) algorithm, Retinograd-AI, which was then applied to predict the gradability label of our entire dataset of 136 631 FAF images.</div></div><div><h3>Main Outcome Measures</h3><div>Fundus autofluorescence gradability of FAF images as predicted and validated against human assessment.</div></div><div><h3>Results</h3><div>Retinograd-AI achieves 91% accuracy on our held-out dataset of 133 images with an area under the receiver operator characteristic curve of 0.94, indicating high performance in distinguishing between gradable and ungradable images. Applying Retinograd-AI to our entire dataset, a small but significant positive association of gradability with age was found (ß = 0.002, <em>P</em> &lt; 0.001). Excluding X-linked conditions, 77.1% of images were rated as gradable in men and 82.3% in women (odds ratio = 1.43, <em>P</em> &lt; 0.001). By genotype, from the 30 most common genetic diagnoses in our dataset, the highest proportion of gradable images was in patients with disease-causing variants in <em>PRPH2</em> (93.1%), while the lowest was in <em>RDH12</em> (27.1%). Applying Retinograd-AI to filter images improved the accuracy of a gene prediction classifier from 33.8% to 68.9%. Retinograd-AI is open-sourced and available at <span><span>https://github.com/Eye2Gene/retinograd-ai</span><svg><path></path></svg></span>.</div></div><div><h3>Conclusions</h3><div>Retinograd-AI is an open-source AI model for automated retinal image quality assessment of FAF images in IRDs. Automated gradability assessment through Retinograd-AI enables large-scale analysis of retinal images and the development of robust analysis pipelines. Quality assessment is essential for the deployment of AI algorithms, such as Eye2Gene, into clinical settings. Due to the diverse nature of IRD pathologies, Retinograd-AI will be extended to other conditions, either in its current form or through transfer learning and fine-tuning.</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 100845"},"PeriodicalIF":3.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687389","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":"Re: Patel et al: Oral Antithrombotic Medication Is Associated with Improved Visual Acuity Outcomes in Eyes with Neovascular Age-Related Macular Degeneration","authors":"Pierre-Henry Gabrielle MD, PhD,&nbsp;Catherine Creuzot-Garcher MD, PhD","doi":"10.1016/j.xops.2025.100840","DOIUrl":"10.1016/j.xops.2025.100840","url":null,"abstract":"","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100840"},"PeriodicalIF":3.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144569781","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":"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}