Ophthalmology science最新文献

{"title":"Computerized Analysis of the Eye Vasculature in a Mass Dataset of Digital Fundus Images: The Example of Age, Sex, and Primary Open-Angle Glaucoma","authors":"Jonathan Fhima MSc ,&nbsp;Jan Van Eijgen MD, PhD ,&nbsp;Anat Reiner-Benaim PhD ,&nbsp;Lennert Beeckmans MSc ,&nbsp;Or Abramovich MSc ,&nbsp;Ingeborg Stalmans MD, PhD ,&nbsp;Joachim A. Behar PhD","doi":"10.1016/j.xops.2025.100778","DOIUrl":"10.1016/j.xops.2025.100778","url":null,"abstract":"<div><h3>Objective</h3><div>To develop and validate an automated end-to-end methodology for analyzing retinal vasculature in large datasets of digital fundus images (DFIs), aiming to assess the influence of demographic and clinical factors on retinal microvasculature.</div></div><div><h3>Design</h3><div>This study employs a retrospective cohort design to achieve its objectives.</div></div><div><h3>Participants</h3><div>The research utilized a substantial dataset consisting of 32 768 DFIs obtained from individuals undergoing routine eye examinations. There was no inclusion of a separate control group in this study.</div></div><div><h3>Methods</h3><div>The proposed methodology integrates multiple stages: initial image quality assessment, detection of the optic disc (OD), definition of the region of interest surrounding the OD, automated segmentation of retinal arterioles and venules, and the engineering of digital biomarkers representing vasculature characteristics. To analyze the impact of demographic variables (age, sex) and clinical factors (disc size, primary open-angle glaucoma [POAG]), statistical analyses were performed using linear mixed-effects models.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes measured were changes in the retinal vascular geometry. Special attention was given to evaluating the independent effects of age, sex, disc size, and POAG on the newly engineered microvasculature biomarkers.</div></div><div><h3>Results</h3><div>The analysis revealed significant independent similarities in the retinal vascular geometry alterations associated with both advanced age and POAG. These findings suggest a potential mechanism of accelerated vascular aging in patients with POAG.</div></div><div><h3>Conclusions</h3><div>This novel methodology allows for the comprehensive and quantitative analysis of retinal vasculature, facilitating the investigation of its correlations with specific diseases. By enabling the reproducible analysis of extensive datasets, this approach provides valuable insights into the state of retinal vascular health and its broader implications for cardiovascular and ocular health. The software developed through this research will be made publicly available upon publication, offering a critical tool for ongoing and future studies in retinal vasculature.</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 100778"},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912567","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":"Onset of End-Stage Atrophic Age-Related Macular Degeneration as an End Point—A Delphi Study: Classification of Atrophy Meetings Report 7","authors":"Zhichao Wu BAppSc(Optom), PhD ,&nbsp;Srinivas R. Sadda MD ,&nbsp;Thomas Ach MD ,&nbsp;Barbara A. Blodi MD ,&nbsp;Ferdinando Bottoni MD ,&nbsp;Usha Chakravarthy MD, PhD ,&nbsp;Emily Y. Chew MD ,&nbsp;Christine A. Curcio PhD ,&nbsp;Frederick L. Ferris III MD ,&nbsp;Monika Fleckenstein MD ,&nbsp;K. Bailey Freund MD ,&nbsp;Juan E. Grunwald MD ,&nbsp;Frank G. Holz MD ,&nbsp;Glenn J. Jaffe MD ,&nbsp;Sandra Liakopoulos MD ,&nbsp;Tock Han Lim FRCSEd ,&nbsp;Jordi M. Monés MD, PhD ,&nbsp;Sergio Pagliarini MD, FRCOphth ,&nbsp;Daniel Pauleikhoff MD ,&nbsp;Maximilian Pfau MD ,&nbsp;Robyn H. Guymer MBBS, PhD","doi":"10.1016/j.xops.2025.100777","DOIUrl":"10.1016/j.xops.2025.100777","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate whether consensus can be reached on the acceptability of end-stage atrophy onset as a clinical end point in early intervention trials of age-related macular degeneration (AMD), and the criteria for defining such an end point.</div></div><div><h3>Design</h3><div>A modified Delphi study.</div></div><div><h3>Participants</h3><div>International panel of experts in AMD, retinal imaging, and histopathology that are part of the Classification of Atrophy Meetings group.</div></div><div><h3>Methods</h3><div>A modified Delphi study was undertaken to determine if there is consensus on the acceptability of the onset of end-stage atrophic AMD as a clinical end point to evaluate early interventions and the criteria for defining such an end point. Two initial rounds of online surveys were conducted. Aggregate results and anonymized comments were provided after each round, followed by a face-to-face meeting before a final survey round was completed.</div></div><div><h3>Main Outcome Measures</h3><div>Statements where consensus was reached, defined as ≥80% of responses within the 3-point bracket for agreement or disagreement based on a 9-point Likert rating scale, from a total of 33 statements included in the final round of the survey.</div></div><div><h3>Results</h3><div>Consensus was reached for the statement that the onset of end-stage atrophic AMD was an appropriate clinical end point to evaluate early interventions (82% responses in agreement). Consensus was also reached for the statement that such an end point should be defined based on anatomical changes that have been previously shown in clinical studies to be associated with marked, but not necessarily complete, functional loss (95% responses in agreement). Consensus was nearly reached for the specific criterion that ≥90% of such atrophic AMD lesions should have ≥1 test location that was ≤10 decibels on 2 microperimetry tests (77% responses in agreement).</div></div><div><h3>Conclusions</h3><div>There was expert group consensus that the onset of end-stage atrophy is an appropriate clinical end point to evaluate early interventions in AMD, and that such an end point should show evidence of marked functional loss in prior clinical studies. We believe these findings will help to define incident clinical end points that are acceptable to regulatory authorities.</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 100777"},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912566","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":"Genotypic Distribution and Clinical Correlations in Familial Exudative Vitreoretinopathy: A Single-Center Study","authors":"Brian T. Soetikno MD PhD ,&nbsp;Emily Spoth MS ,&nbsp;M. Elizabeth Hartnett MD","doi":"10.1016/j.xops.2025.100782","DOIUrl":"10.1016/j.xops.2025.100782","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the role of wide-angle imaging in detecting suspicious cases of familial exudative vitreoretinopathy (FEVR) in pediatric patients with unexplained vision loss and describe genotypic distribution and examples of phenotypes.</div></div><div><h3>Design</h3><div>A retrospective cohort study was conducted at a single tertiary referral center in the Intermountain West.</div></div><div><h3>Subjects and Participants</h3><div>Patients diagnosed with FEVR or atypical retinopathy of prematurity (ROP) between 2010 and 2021 at the University of Utah. Twenty-five families with FEVR were included, with 21 families undergoing genetic testing. Eight families with atypical ROP were included.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of patients referred with unexplained vision loss and diagnosed with FEVR at the pediatric retina center at the University of Utah from 2010 to 2021. Clinical examination and wide-angle fluorescein angiography (FA) were performed. Patients identified with abnormal peripheral retinal or intravitreal vascularization were recommended for genetic testing. Next-generation sequencing was used to identify variants in known genes associated with FEVR. The positivity rate and the proportion of each positive genetic mutation were calculated. We also include a small cohort of premature infants with atypical ROP who underwent genetic testing prior to the examination under anesthesia.</div></div><div><h3>Main Outcome Measures</h3><div>Detection rate of FEVR-associated mutations.</div></div><div><h3>Results</h3><div>Genetic variants were identified in 85.7% of families who underwent testing, exceeding previously reported detection rates. LRP5 (33.3%) and FZD4 (19%) were the most common mutations. Indeterminate results were reported in 4.8% of cases, while 9.5% had negative results for FEVR-associated mutations. Among the 8 premature infants with atypical regression of ROP, none tested positive for FEVR-associated genotypes. We described 5 illustrative cases that demonstrate unique presentations in our cohort, including those showing phenotypic variability or masquerading as other disorders.</div></div><div><h3>Conclusions</h3><div>The findings highlight the genotypic and phenotypic heterogeneity of FEVR and underscore the value of wide-angle FA to trigger obtaining genetic testing for accurate diagnosis. A high clinical suspicion for FEVR is recommended in pediatric patients with unexplained vision loss and vitreoretinal abnormalities. Future studies are needed to investigate additional genetic modifiers and refine genotype–phenotype correlations.</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 100782"},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906956","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":"Pediatric Eye-Related Emergency Department Visits and Pediatric Eye Provider Location and Density","authors":"Julius T. Oatts MD ,&nbsp;Albert Xu BS ,&nbsp;Jonathan R. Morse BA ,&nbsp;John M. Nesemann MD ,&nbsp;Kara M. Cavuoto MD ,&nbsp;Jeremy D. Keenan MD","doi":"10.1016/j.xops.2025.100776","DOIUrl":"10.1016/j.xops.2025.100776","url":null,"abstract":"<div><h3>Objective</h3><div>There is a shortage of pediatric eye specialists. Inaccessible eye care may lead parents to bring their children to the emergency department (ED) to address eye problems that could have been handled at a clinic visit. This study aimed to determine the association between childhood eye-related ED visits and the location and density of pediatric eye specialists in California.</div></div><div><h3>Design</h3><div>A population-based cross-sectional study.</div></div><div><h3>Participants</h3><div>All California ED visits between January 2012 and December 2021 for patients ≤18 years of age were identified using the California Office of Health Care Access and Information Database.</div></div><div><h3>Methods</h3><div>International Classification of Diseases diagnosis codes were used to identify eye-related ED visits. Public databases were used to identify pediatric ophthalmologist and optometrist addresses. Census data were used to determine the number of visits per 10 000 children in each zip code. Poisson regressions evaluated associations at the zip code level of eye-related ED visits and provider density with geographic sociodemographic factors.</div></div><div><h3>Main Outcome Measures</h3><div>Incidence of pediatric eye-related ED visits.</div></div><div><h3>Results</h3><div>Of the 117 363 721 ED visits in California between 2012 and 2021, 27 346 729 (23.3%) were for children, of which 391 985 (1.4%) were eye-related. Median age was 5.0 years (interquartile range: 2.0, 10.0), and 51.7% were male. The most common diagnoses were conjunctivitis (250 028; 63.8%), chalazion/blepharitis (56 389; 14.4%), and other disorders of the eye/adnexa (13 070; 3.3%). The mean number of visits per year per 10 000 children was 43 ± 12 (median 46, interquartile range: 43, 51). The estimated number of pediatric eye providers in California in 2023 was 142 (1 per 61 413 children). Zip codes with more pediatric eye providers had fewer eye-related ED visits: each additional provider per 10 000 children was associated with 2.1 fewer eye-related ED visits per 10 000 children (95% confidence interval −0.04 to −4.25; <em>P</em> = 0.046).</div></div><div><h3>Conclusions</h3><div>Most eye-related ED visits were for nonemergent eye conditions. There was a low eye provider-to-child ratio and an association between provider density and eye-related ED visit incidence. Expanding pediatric eye care could improve access and decrease ED utilization for nonemergent eye concerns.</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 100776"},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multihead Attention Deep Learning Algorithm to Detect Amblyopia Using Fixation Eye Movements","authors":"Dipak P. Upadhyaya MS ,&nbsp;Gokce Cakir MD ,&nbsp;Stefano Ramat PhD ,&nbsp;Jeffrey Albert PhD ,&nbsp;Aasef Shaikh MD, PhD ,&nbsp;Satya S. Sahoo PhD ,&nbsp;Fatema Ghasia MD","doi":"10.1016/j.xops.2025.100775","DOIUrl":"10.1016/j.xops.2025.100775","url":null,"abstract":"<div><h3>Objective</h3><div>To develop an attention-based deep learning (DL) model based on eye movements acquired during a simple visual fixation task to detect amblyopic subjects across different types and severity from controls.</div></div><div><h3>Design</h3><div>An observational study.</div></div><div><h3>Subjects</h3><div>We recruited 40 controls and 95 amblyopic subjects (anisometropic = 32; strabismic = 29; and mixed = 34) at the Cleveland Clinic from 2020 to 2024.</div></div><div><h3>Methods</h3><div>Binocular horizontal and vertical eye positions were recorded using infrared video-oculography during binocular and monocular viewing. Amblyopic subjects were classified as those without nystagmus (n = 42) and those with nystagmus with fusion maldevelopment nystagmus (FMN) or nystagmus that did not meet the criteria of FMN or infantile nystagmus syndrome (n = 53). A multihead attention-based transformer encoder model was trained and cross-validated on deblinked and denoised eye position data acquired during fixation.</div></div><div><h3>Main Outcome Measures</h3><div>Detection of amblyopia across types (anisometropia, strabismus, or mixed) and severity (treated, mild, moderate, or severe) and subjects with and without nystagmus was evaluated with area under the receiver-operator characteristic curves, area under the precision–recall curve (AUPRC), and accuracy.</div></div><div><h3>Results</h3><div>Area under the receiver-operator characteristic curves for classification of subjects per type were 0.70 ± 0.16 for anisometropia (AUPRC: 0.72 ± 0.08), 0.78 ± 0.15 for strabismus (AUPRC: 0.81 ± 0.16), and 0.80 ± 0.13 for mixed (AUPRC: 0.82 ± 0.15). Area under the receiver-operator characteristic curves for classification of amblyopia subjects per severity were 0.77 ± 0.12 for treated/mild (AUPRC: 0.76 ± 0.18), and 0.78 ± 0.09 for moderate/severe (AUPRC: 0.79 ± 0.16). Th area under the receiver-operator characteristic curve for classification of subjects with nystagmus was 0.83 ± 0.11 (AUPRC: 0.81 ± 0.18), and the area under the receiver-operator characteristic curve for those without nystagmus was 0.75 ± 0.15 (AUPRC: 0.76 ± 0.09).</div></div><div><h3>Conclusions</h3><div>The multihead transformer DL model classified amblyopia subjects regardless of the type, severity, and presence of nystagmus. The model's ability to identify amblyopia using eye movements alone demonstrates the feasibility of using eye-tracking data in clinical settings to perform objective classifications and complement traditional amblyopia evaluations.</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 100775"},"PeriodicalIF":3.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143907488","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":"Retinal Imaging Biomarkers and Correlation to Systemic Disease Activity in Pediatric Sickle Cell Disease","authors":"Sandra Hoyek MD ,&nbsp;Celine Chaaya MD ,&nbsp;Colin A. Lemire BS ,&nbsp;Omar Halawa MD ,&nbsp;Francisco Altamirano MD ,&nbsp;Natasha M. Archer MD ,&nbsp;Efren Gonzalez MD ,&nbsp;Nimesh A. Patel MD","doi":"10.1016/j.xops.2025.100774","DOIUrl":"10.1016/j.xops.2025.100774","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To correlate retinal imaging findings with systemic disease activity in children with sickle cell disease (SCD).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A retrospective consecutive series.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Subjects&lt;/h3&gt;&lt;div&gt;Children with SCD aged ≤18 years who had an ophthalmic examination at Boston Children's Hospital between January 1998 and August 2022 were included.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;Systemic findings included the number of hospitalizations, number of strokes, treatment with hydroxyurea, hemoglobin (Hgb), and fetal Hgb levels, and time-averaged mean velocity (TAMV) in the right middle cerebral artery (RMCA) and left middle cerebral artery (LMCA) on transcranial Doppler (TCD).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Total retinal thickness was measured on macular OCT (Spectralis OCT2, Heidelberg Engineering). Vessel density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) and superficial foveal avascular zone area were measured on 6 × 6-mm OCT angiography (OCTA) scans.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Six hundred six eyes from 303 pediatric SCD patients (53% males) were included. OCT and OCTA images were acquired on 104 (17.2%) and 60 (9.9%) eyes at presentation and on 159 (26.2%) and 100 (16.5%) eyes at the final visit, respectively. When adjusting for race and age, retinal thinning on OCT was associated with a higher frequency of hospitalizations, a higher frequency of strokes, and treatment with hydroxyurea. Retinal thickness in the inferior and temporal macula was positively correlated with TAMV in RMCA and in LMCA. Foveal retinal thickness was positively correlated with Hgb level. Similarly, reduced VD in the SCP and DCP in the inferior temporal macula correlated with a higher number of hospitalizations and strokes. A higher VD of the DCP in the inferior-temporal macula positively correlated with TAMV in RMCA (ρ = 0.328, &lt;em&gt;P&lt;/em&gt; = 0.3) and in LMCA (ρ = 0.342, &lt;em&gt;P&lt;/em&gt; = 0.029). A higher Hgb level correlated with a higher prevalence (ρ = 0.237, &lt;em&gt;P&lt;/em&gt; = 0.037) and severity (ρ = 0.299, &lt;em&gt;P&lt;/em&gt; = 0.008) of peripheral retinopathy in HbSC, while it correlated with lower prevalence (ρ = −0.183, &lt;em&gt;P&lt;/em&gt; = 0.004) and severity (ρ = −0.185, &lt;em&gt;P&lt;/em&gt; = 0.004) of peripheral retinopathy in HbSS genotypes. Visual acuity did not correlate with TCD velocity, Hgb level, or number of hospitalizations in HbSS or HbSC genotypes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;OCT and OCTA findings are correlated with the severity of systemic disease in children with SCD. Imaging parameters were better correlated with key outcomes such as stroke and hospitalizations than visual acuity. The results suggest that quantitative measures on retinal imaging could be used as biomarkers to predict systemic disease risk and activity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Financial Disclosure(s)&lt;/h3&gt;&lt;div&gt;Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at t","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 5","pages":"Article 100774"},"PeriodicalIF":3.2,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906955","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 Myopic Defocus on the Retina and Choroid and Its Interaction with Defocus Regions, Diurnal Rhythm, and Accommodation","authors":"Yingying Huang MD ,&nbsp;Jiali Zhang MD ,&nbsp;Xue Li PhD,&nbsp;Hao Chen MD, OD,&nbsp;Jinhua Bao PhD","doi":"10.1016/j.xops.2025.100773","DOIUrl":"10.1016/j.xops.2025.100773","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the effect of defocus region and amount, diurnal rhythm, and accommodation on myopic defocus-induced changes in the retina and choroid.</div></div><div><h3>Design</h3><div>Four test lenses were used: single-vision soft contact lens (SVCL), bifocal spectacle lens (BSL) with +3.50 diopters (D) addition in the inferior visual field, defocus incorporated multiple segments lens (DIMS), and dual-focus contact lens (DFCL) with +2.00 D addition.</div></div><div><h3>Participants</h3><div>Twenty-one adults aged between 18 and 30 years, myopia between −1.00 D and −6.00 D, were included.</div></div><div><h3>Methods</h3><div>Four lenses were used in random order at 4 separate days for each participant. Participants underwent OCT and OCT angiography examinations after distance-viewing (4 m) and near-viewing (20 cm) for 20 minutes with 4 test lenses at both 10 <span>am</span> and 5 <span>pm</span>.</div></div><div><h3>Main Outcome Measures</h3><div>Retinal and choroidal thicknesses (RT and ChT) and vessel density were assessed.</div></div><div><h3>Results</h3><div>The changes in RT, retinal and choroidal vessel density were not significantly different between lenses or times (all <em>P</em> &gt; 0.05). Choroidal thickness changes differed between lenses after near-viewing in both the morning and evening and after distance-viewing in the morning (all <em>P</em> &lt; 0.05). Compared with SVCL, BSL, DIMS, and DFCL achieved lower ChT reductions (all <em>P</em> &lt; 0.05), and BSL showed least reduction. No lenses completely inhibited ChT thinning after near-viewing.</div></div><div><h3>Conclusions</h3><div>Myopic defocus inhibited choroid thinning more effectively in the morning, and provided sufficient defocus in the superior retina was more effective. The amount of lens defocus in this study (+3.50 D) was insufficient to inhibit choroidal thinning with 5 D accommodation completely.</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 100773"},"PeriodicalIF":3.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886747","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":"Pivotal Trial Validating Usability and Visualization Performance of Home OCT in Neovascular Age-Related Macular Degeneration: Report 1","authors":"Jeffrey S. Heier MD ,&nbsp;Nancy M. Holekamp MD ,&nbsp;Miguel A. Busquets MD ,&nbsp;Michael J. Elman MD ,&nbsp;Sidney A. Schechet MD ,&nbsp;Byron S. Ladd MD ,&nbsp;Kapil G. Kapoor MD ,&nbsp;Eric W. Schneider MD ,&nbsp;Ella H. Leung MD ,&nbsp;Ron P. Danis MD ,&nbsp;Kester Nahen PhD ,&nbsp;Nishant Mohan PhD ,&nbsp;Gidi Benyamini MBA","doi":"10.1016/j.xops.2025.100772","DOIUrl":"10.1016/j.xops.2025.100772","url":null,"abstract":"<div><h3>Purpose</h3><div>To validate the usability and visualization performance of the index test of the home OCT system (HOCT) during a pivotal study toward de novo US Food and Drug Administration marketing authorization.</div></div><div><h3>Design</h3><div>A prospective, 5-week longitudinal, at-home visualization multicenter study with preplanned office visits at week 1 and week 5 and as-needed interim visits.</div></div><div><h3>Participants</h3><div>The study enrolled adults aged ≥55 years diagnosed with neovascular age-related macular degeneration (nAMD) on anti-VEGF therapy in at least 1 eligible eye and best-corrected visual acuity of 20/320 or better.</div></div><div><h3>Methods</h3><div>Participants self-installed and imaged daily with the HOCT at home for 5 weeks with 2 or 3 interspersed office visits at 1 and 5 weeks with interim reading center (RC)-triggered visits including a comparator in-office OCT (IO-OCT). Scans with an acceptable quality signal index were independently graded by the RC in a masked manner.</div></div><div><h3>Main Outcome Measures</h3><div>Ability to self-image at home, positive and negative percent agreement (NPA) in visualization of total hyporeflective spaces (TRO) on HOCT and on IO-OCT.</div></div><div><h3>Results</h3><div>At home, self-imaging success rate was 96.1% (95% confidence interval [CI]: 92.2%–98.4%). One hundred eighty participants self-imaged the primary and secondary eyes 5426 and 4012 times with a mean (standard deviation) manufacturer signal quality index of 4.40 (1.26) and 4.58 (1.28), respectively. Positive percent agreement was 86.6% (95% CI: 80.4%–92.8%) and NPA was 86.1% (95% CI: 80.4%–91.8%), with nearly all disagreements being minimal.</div></div><div><h3>Conclusions</h3><div>The target population successfully self-installed and self-imaged at home with image quality comparable to IO-OCT. The findings of the visualization study support the intended use of the system as a tool to monitor TRO at home between routine clinical visits during the management of nAMD.</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 100772"},"PeriodicalIF":3.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906957","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":"Association of Age-Related Macular Degeneration with Cholelithiasis","authors":"Kevin R. Zhang MD, PhD ,&nbsp;Rohini M. Nair PhD ,&nbsp;Yineng Chen MS ,&nbsp;Fangming Jin MS ,&nbsp;Joshua Dunaief MD, PhD ,&nbsp;Brian L. VanderBeek MD, MPH","doi":"10.1016/j.xops.2025.100771","DOIUrl":"10.1016/j.xops.2025.100771","url":null,"abstract":"<div><h3>Purpose</h3><div>Dysregulated lipid metabolism likely contributes to the pathogenesis of age-related macular degeneration (AMD). There is an overlap in risk factors between AMD and diseases of lipid metabolism, such as cholelithiasis, suggesting that an association between these diseases could provide insight into AMD pathogenesis. This study sought to determine if there is an association between cholelithiasis and AMD.</div></div><div><h3>Design</h3><div>A cohort study was conducted using patients in the Optum deidentified Clinformatics Data Mart database from January 1, 2000, to June 30, 2022.</div></div><div><h3>Participants</h3><div>Patients over the age of 55 with ≥2 years of data and no prior history of AMD were included. The exposed cohort included patients who had a history of cholelithiasis, cholecystitis, or cholecystectomy. The control cohort included patients with gastroesophageal reflux disease (GERD), matched for age ±3 years, sex, race, and year of index date.</div></div><div><h3>Methods</h3><div>Propensity scores were created using multivariable logistic regression and applied to inverse probability of treatment weighting (IPTW). Cox proportional hazard regression modeling with IPTW was used to compare progression to AMD in each cohort.</div></div><div><h3>Main Outcome Measures</h3><div>Progression to AMD for patients with cholelithiasis, cholecystitis, or a history of cholecystectomy.</div></div><div><h3>Results</h3><div>A total of 332 536 patients with cholelithiasis and 776 591 matched GERD controls were analyzed. After IPTW, the mean age (±standard deviation) was 66.6 ± 9.4 years in the cholelithiasis cohort and 67.5 (±10.3) years in the GERD cohort. Women comprised 58% of the cholelithiasis cohort and 57% of the GERD cohort. In the cholelithiasis cohort, 3511.7 (1.14%) were diagnosed with AMD, compared with 23 367.1 (2.92%) in the GERD cohort and corresponding to a significantly decreased hazard of AMD (adjusted hazard ratio [aHR] = 0.72, 95% confidence interval [CI]: 0.69–0.75, <em>P</em> &lt; 0.0001). In the subanalysis, before IPTW weighting, AMD developed in 3809 of 275 897 (1.4%) patients with only cholelithiasis (aHR = 0.76, 95% CI: 0.73–0.80, <em>P</em> &lt; 0.0001), 335 of 47 166 (0.71%) patients with cholecystitis (aHR = 0.54, 95% CI: 0.47–0.61, <em>P</em> &lt; 0.0001), and 114 of 9473 (1.20%) patients who underwent cholecystectomy (aHR = 0.50, 95% CI: 0.41–0.63, <em>P</em> &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>Cholelithiasis was associated with a 28% hazard reduction in AMD. More severe gallbladder disease conferred greater protection.</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 100771"},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828659","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":"Transplant of Induced Pluripotent Stem Cell–Derived Retinal Pigment Epithelium Strips for Macular Degeneration and Retinitis Pigmentosa","authors":"Daiki Sakai MD ,&nbsp;Michiko Mandai MD, PhD ,&nbsp;Yasuhiko Hirami MD, PhD ,&nbsp;Midori Yamamoto BA ,&nbsp;Shin-ichiro Ito MD, PhD ,&nbsp;Saori Igarashi MD ,&nbsp;Satoshi Yokota MD, PhD ,&nbsp;Hirofumi Uyama MD, PhD ,&nbsp;Masashi Fujihara MD, PhD ,&nbsp;Akiko Maeda MD, PhD ,&nbsp;Motoki Terada BS ,&nbsp;Mitsuhiro Nishida MS ,&nbsp;Yumiko Shibata MS ,&nbsp;Naoko Hayashi MS ,&nbsp;Kyoko Iseki MA ,&nbsp;Takuya Miura MS ,&nbsp;Keisuke Kajita MD, PhD ,&nbsp;Masaaki Ishida MD, PhD ,&nbsp;Sunao Sugita MD, PhD ,&nbsp;Tadao Maeda MD, PhD ,&nbsp;Yasuo Kurimoto MD, PhD","doi":"10.1016/j.xops.2025.100770","DOIUrl":"10.1016/j.xops.2025.100770","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the safety and efficacy of the allogeneic induced pluripotent stem cell (iPSC)–derived retinal pigment epithelium (RPE) strip transplantation for patients with RPE degeneration.</div></div><div><h3>Design</h3><div>Single-arm, open-label, interventional study.</div></div><div><h3>Participants</h3><div>Three eyes from 3 patients clinically diagnosed with RPE impairment disease; 1 patient had dry age-related macular degeneration (AMD), and remaining 2 patients had <em>MERTK</em>-associated retinitis pigmentosa.</div></div><div><h3>Intervention</h3><div>Allogeneic iPSC-derived RPE strip transplantation was performed by a 25-gauge pars plana vitrectomy. The RPE strips were prepared by incubating iPSC-derived RPE cells in 2-mm-wide grooves in the mold. Artificial retinal detachment was generated using a 38-gauge subretinal cannula, and the RPE strips were injected into the retinal bleb using a 31-gauge cannula with the maximum graft dose limited to 2 strips.</div></div><div><h3>Main Outcome Measures</h3><div>The reduction of RPE abnormal area by the engraftment of transplanted allogeneic iPSC-derived RPE cells, which was measured by analyzing fluorescein angiography with an automated evaluation program at pretransplantation and up to 52 weeks posttransplantation.</div></div><div><h3>Results</h3><div>The primary endpoint of reducing abnormal areas of RPE through the survival of the transplanted graft cells was achieved in all patients at 52 weeks posttransplantation. Visual function assessments confirmed significant vision-related quality of life improvement and potential retinal sensitivity restoration in 1 patient with dry AMD. The successful subretinal delivery of the iPSC-derived RPE strips was confirmed during and immediately after surgery. The engraftment of RPE cells migrated out from the strips was observed using polarization-sensitive OCT specifically and visualized as characteristic hexagonal cells via adaptive optics imaging in all patients. While no serious adverse events occurred, suspected immune reactions to graft cells and epiretinal membrane formation were observed in 1 patient each.</div></div><div><h3>Conclusions</h3><div>A decrease in the RPE abnormal area by reliable delivery of allogeneic iPSC-derived RPE strips was achieved in all 3 cases with no serious adverse events. Further long-term studies and larger cohorts with better preoperative vision are warranted to evaluate the safety and efficacy of RPE strip transplantation.</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 100770"},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838320","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}