Ophthalmology science最新文献

{"title":"Reading Performances in Highly Myopic Patients and Correlation with the Topography of Atrophic Maculopathy","authors":"Matteo Mario Carlà MD ,&nbsp;Carlos Mateo MD","doi":"10.1016/j.xops.2025.100743","DOIUrl":"10.1016/j.xops.2025.100743","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate how the topography of atrophic patches influences monocular and binocular reading performances in eyes with pathologic myopia.</div></div><div><h3>Design</h3><div>Prospective single-center observational investigation.</div></div><div><h3>Participants</h3><div>Sixty-two patients (112 eyes) affected by pathologic myopia (axial length [AXL] &gt;26.5 mm). Only college graduates aged &lt;65 years were selected.</div></div><div><h3>Methods</h3><div>All patients underwent monocular and binocular reading evaluation using Colenbrander Reading Charts, taking into account the reading time and missed words/errors. Moreover, eyes underwent fundus photography and autofluorescence: the presence of chorioretinal atrophy within the central, 4 inner, and 4 outer ETDRS grid subfields was reviewed.</div></div><div><h3>Main Outcome Measures</h3><div>Reading acuity (logarithm of the reading acuity determination [logRAD]); reading speed (words per minute [wpm]); percentage of errors/missed word; correlation with ETDRS subfield atrophy localization.</div></div><div><h3>Results</h3><div>Mean AXL was 31.45 ± 2.21 mm. Monocularly, mean reading acuity was 0.37 ± 0.35 logRAD with an 8% ± 11% rate of missed or wrong words, whereas reading speed was 71.5 ± 27.8 wpm (range 25–125 wpm). Binocularly, mean reading acuity was 0.16 ± 0.16 logRAD with 5% ± 7% of missed or wrong words, whereas reading speed was 88.2 ± 18.0 wpm. Reading acuity was significantly associated with the presence of chorioretinal atrophy in the foveal central circle in univariate and multivariate analysis (<em>P</em> = 0.002). Conversely, reading speed negatively correlated with inner right subfield involvement in multivariate analysis (<em>P</em> = 0.008). Binocularly, reading acuity was associated with the presence of bilateral central atrophy (<em>P</em> = 0.001), whereas reading speed was associated with the presence of chorioretinal atrophy in the inner subfields on the horizontal plane in both eyes: bilateral inner right (<em>P</em> = 0.007) or inner left (<em>P</em> = 0.014) subfields; inner left OD (right eye)–inner right OS (left eye) (<em>P</em> = 0.002); inner right OD–inner left OS (<em>P</em> = 0.004).</div></div><div><h3>Conclusions</h3><div>In highly myopic eyes, we reported a significant relationship between the topography of patchy chorioretinal atrophy and reading performance.</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 4","pages":"Article 100743"},"PeriodicalIF":3.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bidirectional Causal Relationships between Corneal Biomechanics and Glaucoma or Intraocular Pressure","authors":"Xiaoyu Zhou MD ,&nbsp;Jiahao Xu MD ,&nbsp;Xuanchu Duan MD","doi":"10.1016/j.xops.2025.100742","DOIUrl":"10.1016/j.xops.2025.100742","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the bidirectional causal relationships between corneal biomechanics (corneal hysteresis [CH] and corneal resistance factor [CRF]) and glaucoma subtypes or intraocular pressure (IOP), and to evaluate the mediating role of IOP in these associations.</div></div><div><h3>Design</h3><div>Bidirectional univariable 2-sample Mendelian randomization (MR), multivariable MR, and mediation MR study using genome-wide association study (GWAS) summary statistics.</div></div><div><h3>Subjects</h3><div>Genetic data from large-scale GWAS cohorts of European ancestry, including individuals with measurements of CH/CRF, glaucoma subtypes (primary open-angle glaucoma [POAG], primary angle-closure glaucoma [PACG], normal-tension glaucoma [NTG], exfoliation glaucoma [XFG], juvenile open-angle glaucoma [JOAG], glaucoma suspect, neovascular glaucoma, secondary glaucoma, and other unspecified glaucoma), and glaucoma endophenotypes (IOP, retinal nerve fiber layer thickness, vertical cup-to-disc ratio).</div></div><div><h3>Methods</h3><div>Bidirectional univariable 2-sample MR analyses were performed to assess the causal effects between CH/CRF and glaucoma subtypes. Multivariable MR and mediation analysis were used to evaluate the role of IOP. Inverse-variance weighted, weighted median, MR-Egger regression, and MR-Pleiotropy RESidual Sum and Outlier were used to evaluate the causal effects, pleiotropy, and heterogeneity.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes included causal estimates (odds ratios or β-coefficients) for the associations between CH/CRF and glaucoma subtypes (POAG, PACG, NTG, XFG, JOAG, neovascular glaucoma, etc.) and the mediation effects of IOP. Secondary outcomes included relationships between glaucoma medication or surgery and CH/CRF.</div></div><div><h3>Results</h3><div>Corneal hysteresis and CRF were causally associated with increased risks of total glaucoma and most subtypes, except for the protective effect of CH against neovascular glaucoma. Both CH and CRF elevated IOP. Adjusting for IOP attenuated CH/CRF-glaucoma associations. Glaucoma inversely affected CH but positively influenced CRF. Glaucoma surgery reduced CH and CRF.</div></div><div><h3>Conclusions</h3><div>This study suggests that CH and CRF are risk factors for glaucoma and its subtypes, with IOP playing a mediating role in this relationship. These findings highlight the role of corneal biomechanics in glaucoma pathophysiology and clinical management.</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 4","pages":"Article 100742"},"PeriodicalIF":3.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Efficacy of Metformin for Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis","authors":"Matthew D. Huh BA ,&nbsp;Simon N. Le BA ,&nbsp;Kieran S. O'Brien PhD, MPH ,&nbsp;Jeremy D. Keenan MD, MPH ,&nbsp;Jay M. Stewart MD","doi":"10.1016/j.xops.2025.100741","DOIUrl":"10.1016/j.xops.2025.100741","url":null,"abstract":"<div><h3>Topic</h3><div>Metformin, a widely used diabetes medication, has shown potential for treating age-related macular degeneration (AMD) due to its antioxidative, anti-inflammatory, and antiangiogenic properties. This study aims to systematically review and analyze the efficacy of metformin in reducing AMD prevalence.</div></div><div><h3>Clinical Relevance</h3><div>Metformin's potential to serve as a treatment for AMD could significantly reduce the burden of vision loss, offering a cost-effective and widely accessible solution.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in OVID Embase, OVID MEDLINE, Cochrane Library, and Web of Science databases on May 2, 2024. Both observational and interventional studies were included if they involved oral metformin use before AMD diagnosis. Data were extracted and analyzed using a random-effects model meta-analysis, with subgroup analyses based on study design, AMD subtype, sex, and metformin dosage.</div></div><div><h3>Results</h3><div>Eighteen observational studies were identified, which together included a total of 2 683 234 individuals. Nine studies had a case–control design, 7 were retrospective cohort studies, and 2 were cross-sectional studies. The meta-analysis revealed a significant reduction in the odds of AMD among metformin users (pooled odds ratio [OR] = 0.86, 95% confidence interval = 0.79–0.93, <em>P</em> = 0.0002, I² = 90%). The association was significant in both patients with diabetes (pooled OR = 0.89) and without diabetes (pooled OR = 0.70), although only 2 studies reported nondiabetic ORs. Dose–response analysis revealed significant protective effects at low doses. Sensitivity analysis indicated that the removal of an outlier study did not alter the overall effect. Bias analysis using the Risk of Bias in Nonrandomized Studies of Interventions tool revealed significant risks of bias, particularly due to confounding.</div></div><div><h3>Conclusion</h3><div>Although the current evidence suggests a potential protective role of metformin in AMD, all studies showing an effect of metformin have been observational and thus subject to bias. Randomized clinical trials are needed to determine the effectiveness of metformin for preventing the onset of 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 4","pages":"Article 100741"},"PeriodicalIF":3.2,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance of a Handheld Electroretinography Test for Glaucoma","authors":"Anika Kumar BA ,&nbsp;Nathan Sanchez MD ,&nbsp;Alan W. Kong MD ,&nbsp;Benjamin F. Arnold PhD, MPH ,&nbsp;Yvonne Ou MD","doi":"10.1016/j.xops.2025.100739","DOIUrl":"10.1016/j.xops.2025.100739","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the diagnostic performance of a sinusoidal flicker stimulus test at various frequencies using a handheld electroretinography (ERG) device in glaucoma versus control participants.</div></div><div><h3>Design</h3><div>A cross-sectional study conducted between June 2019 and October 2022 at the University of California, San Francisco.</div></div><div><h3>Participants</h3><div>Participants with glaucoma were recruited from glaucoma clinics if they had a diagnosis of open-angle glaucoma, as demonstrated by optic nerve damage or reproducible visual field defects. Control participants had normal optic nerves and intraocular pressures of ≤21 mmHg and were recruited from optometry clinics.</div></div><div><h3>Methods</h3><div>The RETeval device (LKC Technologies), a handheld ERG recording system, was used to administer a sinusoidal flicker stimulus modulated at 14 frequencies from 1 to 50 Hz, and the first harmonic frequency response amplitudes were collected. Logistic regression models with glaucoma diagnosis as the outcome were trained using data from 67% of participants; models were then tested on the remaining 33%.</div></div><div><h3>Main Outcome Measures</h3><div>Receiver operating characteristic curves demonstrating model performance on the testing set were generated, and area under the receiver operating characteristic curve (AUC) was calculated. The improved DeLong algorithm was used to compare diagnostic performance of the models and differences in performance in dilated versus nondilated eyes.</div></div><div><h3>Results</h3><div>The study included 117 eyes from 72 participants (18 control, 54 glaucoma; mean age [standard deviation {SD}] = 70.4 [12.2] years; 51.4% female). Among glaucomatous eyes, average (SD) mean deviation was −4.61 (5.55) decibels. In a model assessing the combined effects of amplitude responses across all frequencies, the AUC was 0.57 (95% confidence interval [CI]: 0.37–0.78). However, in a model focusing on frequencies of ≥30 Hz, where the OFF pathway may be more affected, the AUC improved to 0.81 (95% CI: 0.66–0.97). In this higher frequency model, sensitivity was 80% and specificity was 74% at the Youden J cutoff.</div></div><div><h3>Conclusions</h3><div>These findings provide evidence of the potential use of handheld ERG in diagnosing glaucoma by assessing retinal amplitude responses to sinusoidal flicker stimuli at frequencies between 30 and 50 Hz. This supports the hypothesis that the OFF pathway may be more vulnerable in glaucoma.</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 4","pages":"Article 100739"},"PeriodicalIF":3.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OCT-Based Retinal Vasculature Analysis: Age, Sex, and Body Mass Index Associations in the Nagahama Study, a Large Japanese Cohort","authors":"Ran Xiang MD ,&nbsp;Yuki Muraoka MD, PhD ,&nbsp;Takahiro Kogo MD ,&nbsp;Yuki Mori MD, PhD ,&nbsp;Masahiro Miyake MD, PhD ,&nbsp;Yu Hidaka PhD ,&nbsp;Satoshi Morita PhD ,&nbsp;Yasuharu Tabara PhD ,&nbsp;Fumihiko Matsuda PhD ,&nbsp;Akitaka Tsujikawa MD, PhD","doi":"10.1016/j.xops.2025.100740","DOIUrl":"10.1016/j.xops.2025.100740","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate retinal vessel structure using OCT, which enables high-resolution imaging for detailed vascular assessment. We investigated how age, sex, and body mass index (BMI) influence the OCT-measured parameters, including outer and inner diameters (ODs and IDs, respectively), wall thickness, and wall reflectivity—parameters that are challenging to assess using color fundus photography.</div></div><div><h3>Design</h3><div>A cross-sectional retrospective study.</div></div><div><h3>Participants</h3><div>The study included 6981 participants in the Nagahama Study, with 6981 eyes being assessed.</div></div><div><h3>Methods</h3><div>OCT B-scan images centered on the optic disc were obtained. For each participant, mean values of the ODs and IDs, wall thickness, and wall reflectivity of the 4 largest arteries and veins were measured.</div></div><div><h3>Main Outcome Measures</h3><div>Associations of retinal vessel parameters with age, sex, and BMI were evaluated. The reliability of OCT-measured parameters was assessed using intraclass correlation coefficients. Multivariable linear regression adjusted for intraocular pressure and axial length was used to investigate the associations with demographic and anthropometric factors.</div></div><div><h3>Results</h3><div>Intraclass correlation coefficients for retinal vessel parameters demonstrated good-to-excellent reliability (0.767–0.957, <em>P</em> &lt; 0.001). Compared with those of veins, arterial diameters were smaller, and arterial wall thickness and reflectivity were greater. Multivariable analysis revealed a U-shaped association between age and arterial diameter. Participants aged ≥60 years had significantly larger diameters than those aged 30 to 40 years and those in their 50s. Venous diameter decreased linearly with age. The arterial wall thickness and reflectivity increased with age. Women exhibited larger arterial diameters than men. Body mass index was negatively associated with the arterial diameter and positively associated with the venous diameter and arterial wall thickness.</div></div><div><h3>Conclusions</h3><div>OCT enabled detailed evaluation of retinal vessel structure, allowing for the measurement of parameters that are challenging to assess by fundus photography, such as IDs and ODs, wall thickness, and wall reflectivity. This study, conducted in a large Japanese cohort, demonstrated significant associations between these OCT-measured retinal vascular parameters and age, sex, and BMI. These findings support the potential of OCT as a valuable tool for objective, in-depth assessment of retinal vascular health and its relationships with demographic and anthropometric factors.</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 4","pages":"Article 100740"},"PeriodicalIF":3.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal Imaging Findings in Patients with Maturity-Onset Diabetes of the Young","authors":"Matthew Lin BA ,&nbsp;Jaffer Shah BS ,&nbsp;Laura Alonso MD ,&nbsp;Szilard Kiss MD ,&nbsp;Kyle Kovacs MD","doi":"10.1016/j.xops.2025.100737","DOIUrl":"10.1016/j.xops.2025.100737","url":null,"abstract":"","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 3","pages":"Article 100737"},"PeriodicalIF":3.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143570499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized Rehabilitation for Residual Deficits: Tailoring Perceptual Learning for Improved Visual Function in Meridional Amblyopia","authors":"Yunsi He MD,&nbsp;Zixuan Xu MD,&nbsp;Lei Feng BM,&nbsp;Qingqing Ye BM,&nbsp;Yusong Zhou MD,&nbsp;Ying Yao MD,&nbsp;Yangfei Pang MM,&nbsp;Wentong Yu MM,&nbsp;Yudan Zhong MM,&nbsp;Junpeng Yuan BS,&nbsp;Jing Liu MD, PhD,&nbsp;Jinrong Li MD, PhD","doi":"10.1016/j.xops.2025.100736","DOIUrl":"10.1016/j.xops.2025.100736","url":null,"abstract":"<div><h3>Purpose</h3><div>This study explored the efficacy and predictors of success for a novel monocular fine orientation discrimination perceptual learning (fine-PL) approach in addressing perceptual deficits in meridional amblyopia (MA).</div></div><div><h3>Design</h3><div>Prospective, longitudinal study.</div></div><div><h3>Participants</h3><div>Fifty-three children with persistent MA participated in this study.</div></div><div><h3>Methods</h3><div>Twenty-one participants underwent a 14-day regimen of monocular fine-PL focused on grating orientation discrimination exercise (±5°) aligned with the vertical or horizontal meridian near each individual's threshold spatial frequencies. Nineteen participants underwent coarse orientation discrimination perceptual learning (coarse-PL), and 13 participants received optical correction alone.</div></div><div><h3>Main Outcome Measures</h3><div>Measurements included both the best-corrected and uncorrected visual acuity (VA), contrast sensitivity function (CSF), and stereoacuity, with daily VA assessments during the training.</div></div><div><h3>Results</h3><div>Significant improvements were observed in uncorrected VA (increased by 1.3 lines, <em>P</em> &lt; 0.001) and best-corrected VA (increased by 0.3 lines, <em>P</em> = 0.002) in the fine-PL group. Posttraining assessments showed enhancements in all measured CSF metrics, both with and without correction (all <em>P</em> &lt; 0.05), and in both distance and near stereopsis (all <em>P</em> &lt; 0.05). Compared with coarse-PL, fine-PL more effectively addressed residual deficits in uncorrected vision. Early changes in VA correlated significantly with final VA outcomes. A 6-month follow-up confirmed the retention of these gains.</div></div><div><h3>Conclusions</h3><div>Fine-PL offers targeted rehabilitation for perceptual distortions in MA, with early responses during training serving as potential predictors of success. This personalized approach effectively addresses residual deficits beyond optical correction, offering a promising noninvasive option for visual function improvement.</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 4","pages":"Article 100736"},"PeriodicalIF":3.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vision Loss and Blindness in the United States: An Age-Adjusted Comparison by Sex and Associated Disease Category","authors":"Victoria A. Bugg MD ,&nbsp;Kaleb Eppich MS ,&nbsp;Macey S. Blakley BA ,&nbsp;Flora Lum MD ,&nbsp;Tom Greene PhD ,&nbsp;M. Elizabeth Hartnett MD","doi":"10.1016/j.xops.2025.100735","DOIUrl":"10.1016/j.xops.2025.100735","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To evaluate differences in vision loss and blindness by disease category between men and women in the the United States (US).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Retrospective observational study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Patients (14 549 105) &gt;50 years old with eye examination data recorded in the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) between January 1, 2018, and December 31, 2018.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Patients were assigned to the vision loss cohort and categorized (mild, moderate, severe, blindness) based on the best-corrected visual acuity in the better-seeing eye. The cause of vision loss was assumed using the International Classification of Diseases, 10th Revision codes for cataract, diabetic retinopathy, age-related macular degeneration (AMD), glaucoma, retinal detachment, retinal vein occlusion, corneal opacity, or amblyopia documented in the electronic health record. The no vision loss cohort was created by subtracting the vision loss cohort from the 2018 total IRIS Registry database.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;Primary analyses provided age-adjusted prevalence ratios (PRs) for vision loss conditions for women and men within the vision loss cohort relative to the 2018 US census. Secondary analyses computed age-adjusted PRs for women and men for the same conditions relative to the IRIS Registry.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The age-adjusted PR of vision loss in women versus men when comparing our vision loss cohort relative to the US census was 1.28 (95% confidence interval, 1.27, 1.29) for mild vision loss, 1.29 (1.28, 1.30) for moderate vision loss, 1.35 (1.32, 1.38) for severe vision loss, and 1.54 (1.49, 1.59) for blindness. However, these differences were attenuated when age-adjusted prevalences were computed relative to those who were seen in 2018 in the IRIS Registry database. In women, the prevalence of vision loss associated with cataract and AMD was increased in both analyses, while men had a higher prevalence of vision loss associated with retinal detachment in both analyses.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Women in the US are more likely to be diagnosed with vision loss at an IRIS Registry practice compared with men, based on clinical presentations relative to the US census. However, this finding is partly driven by the higher rates at which women presented to ophthalmic practices in both the vision loss cohort and no vision loss cohort. The age-adjusted prevalence for vision loss associated with cataract and AMD was higher in women when utilizing both the US census and the 2018 IRIS Registry database as the denominator, which suggests that a true difference in prevalence is present. The same is true for an increase in the age-adjusted relative risk for vision loss associated with retinal detachment in men. These findings warrant further study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Financial Disclosure","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 4","pages":"Article 100735"},"PeriodicalIF":3.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epiretinal Membrane Is Associated with Diabetic Retinopathy Severity and Cumulative Anti-VEGF Injections","authors":"Shinji Kakihara MD, PhD,&nbsp;Mohamed AbdelSalam,&nbsp;Kallista Zhuang BS,&nbsp;Amani A. Fawzi MD","doi":"10.1016/j.xops.2025.100733","DOIUrl":"10.1016/j.xops.2025.100733","url":null,"abstract":"<div><h3>Objective</h3><div>To identify and assess the risk factors for epiretinal membrane (ERM) formation in patients with diabetes mellitus (DM).</div></div><div><h3>Design</h3><div>A cross-sectional observational study.</div></div><div><h3>Participants</h3><div>Diabetes mellitus subjects with varying severities of diabetic retinopathy (DR).</div></div><div><h3>Methods</h3><div>Epiretinal membrane severity was graded using OCT macular volumetric scans. After comparing the features of eyes with and without ERM, a logistic regression model was employed to investigate risk factors for the presence of ERM formation, with explanatory variables that were statistically significant between 2 groups.</div></div><div><h3>Main Outcome Measures</h3><div>The risk factors for ERM formation and their odds ratios.</div></div><div><h3>Results</h3><div>The study analyzed 207 eyes of 207 patients without center-involving diabetic macular edema, including 44 with DM but no DR, 23 with mild DR, 42 with moderate DR, 28 with severe nonproliferative DR, and 70 with proliferative DR. Among these, 49 eyes had ERM. Eyes with ERM demonstrated significantly higher DR severity, more frequent history of cataract surgery, a greater number of anti-VEGF injections, less frequent hypertension, and higher geometric perfusion deficits in the deep capillary plexus, as calculated by OCT angiography, compared to eyes without ERM. After adjusting for explanatory variables, the logistic regression model identified DR severity and the number of injections as significant risk factors for ERM formation. The adjusted odds ratios were 2.388 (95% confidence interval [CI]: 1.694–3.566, <em>P</em> &lt; 0.0001) for DR severity and 1.196 (95% CI: 1.013–1.444, <em>P</em> = 0.0449) for the number of injections, respectively.</div></div><div><h3>Conclusions</h3><div>In this cross-sectional study, DR severity as well as the number of anti-VEGF injections were identified as significant risk factors for ERM formation.</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 3","pages":"Article 100733"},"PeriodicalIF":3.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Retinal Vein Occlusion between Glucagon-Like Peptide-1 Receptor Agonists and Dipeptidyl Peptidase-4 Inhibitors in Type 2 Diabetes","authors":"Ssu-Yu Pan MD ,&nbsp;Chien-Hsiang Weng MD, MPH ,&nbsp;Shang-Feng Tsai MD, PhD ,&nbsp;Yi-Jing Sheen MD, PhD ,&nbsp;Hui-Ju Lin MD, PhD ,&nbsp;Peng-Tai Tien MD, PhD ,&nbsp;Jun-Fu Lin MS ,&nbsp;Ching-Heng Lin PhD ,&nbsp;I-Jong Wang MD, PhD ,&nbsp;Chien-Chih Chou MD, PhD","doi":"10.1016/j.xops.2025.100734","DOIUrl":"10.1016/j.xops.2025.100734","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate whether glucagon-like peptide-1 receptor agonists (GLP-1RAs) are associated with reduced retinal vein occlusion (RVO) risk compared with dipeptidyl peptidase-4 (DPP-4) inhibitors in patients with type 2 diabetes mellitus (T2DM).</div></div><div><h3>Design</h3><div>A multinational, retrospective cohort study.</div></div><div><h3>Participants</h3><div>Adults with T2DM newly prescribed GLP-1RAs or DPP-4 inhibitors between 2006 and 2023 were included in our analysis.</div></div><div><h3>Methods</h3><div>This study leveraged data from populations across 21 countries. Propensity score matching at a 1:1 ratio balanced age, sex, race, glycated hemoglobin (HbA1c), body mass index (BMI), estimated glomerular filtration rate, medications, and comorbidities between GLP-1RA and DPP4 inhibitor users.</div></div><div><h3>Main Outcomes Measures</h3><div>We observed the occurrence of incident RVO and branch RVO (BRVO) in the overall population and in subpopulations stratified by age, sex, race, GLP-1RA type, baseline HbA1c, BMI, and diabetes duration.</div></div><div><h3>Results</h3><div>Among 79 486 matched participants, GLP-1RA use is associated with a lower risk of RVO (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.54–0.98) and BRVO (HR, 0.62; 95% CI, 0.41–0.95) over 5 years compared with DPP-4 inhibitor use. This association is consistent among patients aged ≥50 years, Blacks, those prescribed human-analog GLP-1RAs, and those with baseline HbA1c ≥8%, BMI ≥30 kg/m², and diabetes duration ≥3 years.</div></div><div><h3>Conclusions</h3><div>Glucagon-like peptide-1 receptor agonist use was linked to reduced RVO and BRVO risks in patients with T2DM when compared with DPP-4 inhibitor use, particularly in high-risk populations, suggesting potential benefits of GLP-1RAs over DPP-4 inhibitors in managing ocular complications in T2DM.</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 4","pages":"Article 100734"},"PeriodicalIF":3.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}