Ophthalmology science最新文献

{"title":"Magnitude and Predictors of the Placebo Effects in the Dry Eye Assessment and Management Study","authors":"Katherine Han BS ,&nbsp;Aaron T. Zhao BS ,&nbsp;Yinxi Yu MS ,&nbsp;Penny Asbell MD, MBA ,&nbsp;Gui-Shuang Ying PhD ,&nbsp;The DREAM Research Group","doi":"10.1016/j.xops.2025.100730","DOIUrl":"10.1016/j.xops.2025.100730","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the magnitude and predictors of placebo effects on dry eye symptoms and signs in the Dry Eye Assessment and Management (DREAM) study.</div></div><div><h3>Design</h3><div>Secondary analysis of data from the DREAM study, a large-scale multicenter randomized clinical trial of patients with moderate to severe dry eye disease (DED).</div></div><div><h3>Participants</h3><div>One hundred sixty-four participants who were randomized to the placebo group (daily oral 1000 mg refined olive oil) and completed a 12-month follow-up in 27 United States centers.</div></div><div><h3>Methods</h3><div>At baseline, 3, 6, and 12 months, DED symptoms were evaluated using the Ocular Surface Disease Index (OSDI), and signs were assessed using conjunctival staining, corneal staining, tear break-up time (TBUT), Schirmer test, and meibomian gland dysfunction (MGD). Placebo effects were calculated as changes from baseline in DED symptoms and signs over 12 months. Univariable and multivariable models determined predictors for placebo effects.</div></div><div><h3>Main Outcome Measures</h3><div>Changes from baseline in DED symptoms and signs over 12 months after administration of the placebo.</div></div><div><h3>Results</h3><div>Among 164 participants (mean age 58 years, 82% female, 74% White) randomized to the placebo group, there were significant placebo effects that were evident by 3 months and remained until 12 months with improvement in OSDI total score (mean decline 10.4 points, <em>P</em> &lt; 0.001), conjunctival staining score (mean decrease 0.5 points, <em>P</em> &lt; 0.001), corneal staining score (mean decrease 0.9 points, <em>P</em> &lt; 0.001), TBUT (mean increase 0.7 seconds, <em>P</em> &lt; 0.001), and MGD score (mean decrease 0.3 points, <em>P</em> = 0.01). In multivariable analysis, a higher baseline OSDI total score (<em>P</em> &lt; 0.001) and absence of rheumatoid arthritis (<em>P</em> = 0.01) predicted more improvement in OSDI total score (<em>R</em>^<em>2</em> = 0.25). More severe DED in OSDI (<em>P</em> = 0.005), conjunctival staining (<em>P</em> = 0.04), and MGD (<em>P</em> &lt; 0.001) at baseline predicted more improvement in MGD score (<em>R</em>^<em>2</em> = 0.25).</div></div><div><h3>Conclusions</h3><div>The DREAM study revealed significant placebo effects on DED symptoms and signs, with more severe DED predicting larger placebo effects. Future DED trials should consider placebo effects in the trial design, statistical analysis, and result interpretation.</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 100730"},"PeriodicalIF":3.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600541","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":"COMPARISON OF FUNDUS AUTOFLUORESCENCE AND INDOCYANINE GREEN ANGIOGRAPHY IN MULTIPLE EVANESCENT WHITE DOT SYNDROME","authors":"Valentine Labattut MD ,&nbsp;Yasmine Serrar MD ,&nbsp;Armelle Cahuzac MD ,&nbsp;Pierre Gascon MD ,&nbsp;Martine Mauget-Faÿsse MD ,&nbsp;Benjamin Wolff MD ,&nbsp;Mariam Ghazaryan MD ,&nbsp;Pascal Seve MD, PhD ,&nbsp;Laurent Kodjikian MD, PhD ,&nbsp;Thibaud Mathis MD, PhD","doi":"10.1016/j.xops.2025.100731","DOIUrl":"10.1016/j.xops.2025.100731","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to compare fundus blue autofluorescence (BAF) images, indicating photoreceptor alteration, and indocyanine green angiography (ICGA), indicating retinal pigment epithelium (RPE) alteration, in multiple evanescent white dot syndrome (MEWDS) to investigate the initial damage location within the RPE-photoreceptor complex.</div></div><div><h3>Design</h3><div>Multicentric retrospective cohort study carried out across tertiary centers for retinal and inflammatory diseases in France.</div></div><div><h3>Participants</h3><div>A total of 31 eyes affected by primary MEWDS were included.</div></div><div><h3>Methods</h3><div>Only primary MEWDS, with sufficiently high-quality images, were included, and their data were analyzed cross-sectionally at baseline and at the recovery phase, between 4 and 8 weeks. A standardized protocol was set up for measuring the areas affected by MEWDS on the late-phase ICGA and on BAF; this was always carried out by the same investigator. On 55° macular-centered images, both the BAF and ICGA areas were delimited and calculated in the FIJI/ImageJ Software and then compared with each other. The same process was used to compare macular areas bounded by a 6-mm diameter Early Treatment Diabetic Retinopathy Study circle centered on the fovea.</div></div><div><h3>Main Outcome Measures</h3><div>Areas in mm² affected by MEWDS on BAF and ICGA.</div></div><div><h3>Results</h3><div>The median hypofluorescent area on ICGA (93.03 mm², interquartile range [IQR: 54.08–134.00]) was significantly larger than that affected on BAF (76.22 mm² [IQR: 43.65–122.20], <em>P</em> &lt; 0.0001). The median damaged surface was 37.21% (IQR: 21.63%–53.61%) on ICGA vs. 30.49% (IQR: 17.15%–46.60%) on BAF (<em>P</em> &lt; 0.0001). Regarding only the macular area, damage was also significantly larger on ICGA than in BAF (15.16 [9.55–24.08] mm² vs. 13.48 [4.87–17.82] mm², <em>P</em> &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>Our study showed that MEWDS lesions are more extensive in ICGA than in BAF, indicating a predominant RPE dysfunction. We therefore support the hypothesis that MEWDS is a primary retinal pigment epitheliopathy, causing reversible and nondestructive dysfunction of the RPE and photoreceptors. Our results support recent analysis of modern multimodal imaging. Further studies using en face OCT are needed to analyze the outer retinal layers and corroborate the hypothesis.</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 100731"},"PeriodicalIF":3.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143806985","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":"Intravitreal Injections of Cord Blood Platelet-Rich Plasma in Dry Age-Related Macular Degeneration: Regenerative Therapy","authors":"Maria Cristina Savastano MD, PhD ,&nbsp;Claudia Fossataro MD, PhD ,&nbsp;Alessandro Berni MD ,&nbsp;Alfonso Savastano MD, PhD ,&nbsp;Valentina Cestrone OA ,&nbsp;Federico Giannuzzi MD ,&nbsp;Francesco Boselli MD ,&nbsp;Matteo Mario Carlà MD ,&nbsp;Mattia Cusato MD ,&nbsp;Francesco Mottola MD ,&nbsp;Riccardo Pirolo MD ,&nbsp;Elena D'Agostino OA ,&nbsp;Ilaria Biagini OA ,&nbsp;Sofia Marcelli OA ,&nbsp;Alessandro Gravina MD ,&nbsp;Mengxi Shen MD ,&nbsp;Clara Rizzo MD ,&nbsp;Caterina Giovanna Valentini MD ,&nbsp;Maria Bianchi MD ,&nbsp;Luciana Teofili MD ,&nbsp;Stanislao Rizzo MD","doi":"10.1016/j.xops.2025.100732","DOIUrl":"10.1016/j.xops.2025.100732","url":null,"abstract":"<div><h3>Purpose</h3><div>Intravitreal injections (IVIs) of umbilical cord blood platelet-rich plasma (CB-PRP) were investigated to assess their safety and efficacy in slowing the progression of atrophy in eyes with late-stage dry age-related macular degeneration (AMD).</div></div><div><h3>Design</h3><div>Randomized, controlled, prospective study.</div></div><div><h3>Subjects</h3><div>Patients with AMD aged &gt;65 years and diagnosed with bilateral geographic atrophy were enrolled.</div></div><div><h3>Methods</h3><div>One eye of each subject received the treatment of intravitreal CB-PRP 0.05 ml, while the fellow eye received a sham injection. Atrophic areas were identified as large choroidal hypertransmission defects (hyperTDs) on en face subretinal pigment epithelium slabs (64–400 μm beneath Bruch's membrane) obtained 0.321 from swept-source OCT angiography scans. The main outcome was the mean annualized growth rate of the square root transformed area measurements in both treated and nontreated eyes.</div></div><div><h3>Main Outcome Measures</h3><div>The mean ± standard deviation (SD) square root hyperTD area in the treated eyes was 3.30 ± 0.99 mm at baseline and 3.49 ± 0.98 mm after CB-PRP (IVI). In nontreated eyes, the mean square root hyperTD area was 2.96 ± 0.94 mm at baseline and 3.18 ± 0.94 mm after sham injections.</div></div><div><h3>Results</h3><div>Twenty-six eyes of 13 patients were included. In treated eyes, the mean ± SD best-corrected visual acuity (BCVA) was 48.92 ± 16.33 letters at baseline and 51.46 ± 12.27 letters at last follow-up. In untreated eyes, BCVA was 67.69 ± 10.89 letters at baseline and 65.38 ± 10.34 letters at last follow-up. The mean follow-up was 258.46 ± 97.54 days. In both groups, no statistically significant difference was observed between the baseline and final BCVA. For treated eyes, the mean annualized growth rate (square root) was 0.275 mm and for nontreated eyes it was 0.321 mm. The annualized growth rate of the hyperTDs in treated eyes was 14.5% lower than that in nontreated eyes (<em>P</em> = 0.007). No adverse events were recorded.</div></div><div><h3>Conclusions</h3><div>These preliminary data suggest that intravitreal CB-PRP injections might be safe and effective in slowing the progression of atrophy in AMD. Extended follow-up and larger sample sizes are needed to confirm our findings and determine the optimal treatment regimen for this novel treatment option in late-stage dry 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 100732"},"PeriodicalIF":3.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681867","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":"Cerebral/Cortical Visual Impairment Classification and Categorization Using Eye Tracking Measures of Oculomotor Function","authors":"Melinda Y. Chang MD ,&nbsp;Mark S. Borchert MD","doi":"10.1016/j.xops.2025.100728","DOIUrl":"10.1016/j.xops.2025.100728","url":null,"abstract":"<div><h3>Purpose</h3><div>Cerebral/cortical visual impairment (CVI) is a leading cause of pediatric visual impairment and is frequently associated with abnormal ocular motility. Eye tracking has previously been used to characterize oculomotor function in CVI. The purpose of this study was to evaluate the utility of eye tracking in diagnosis, categorization, and prognostication of CVI.</div></div><div><h3>Design</h3><div>Prospective longitudinal study.</div></div><div><h3>Participants</h3><div>Thirty-nine children with CVI and 41 age-matched controls.</div></div><div><h3>Methods</h3><div>Children with CVI underwent 4 eye tracking sessions over 1 year, and age-matched controls completed 1 eye tracking session. Fixations and saccades were labeled by the eye tracking software and used to compute 9 oculomotor features. In children with CVI, unsupervised data-driven clustering analysis using these 9 features was performed to identify 3 CVI eye tracking oculomotor groups. Clinical and demographic characteristics of eye tracking oculomotor groups were compared.</div></div><div><h3>Main Outcome Measures</h3><div>(1) Area under the curve (AUC) for eye tracking oculomotor features in classifying patients with CVI and controls; (2) differences between 3 CVI eye tracking oculomotor groups on clinical and demographic characteristics; and (3) change in visual acuity (VA) over 1 year in 3 CVI eye tracking oculomotor groups.</div></div><div><h3>Results</h3><div>Six oculomotor features (fixation and saccade latency, frequency, and off-screen proportion) had an AUC ≥0.90 in classifying children with CVI and controls (<em>P</em> &lt; 0.0001). Cerebral/cortical visual impairment eye tracking oculomotor groups had significantly different VA (<em>P</em> &lt; 0.0001) and change in VA over 1 year (<em>P</em> = 0.049). Patients in group B, who had the greatest improvement in VA, were younger and had higher rates of term hypoxic ischemic encephalopathy.</div></div><div><h3>Conclusions</h3><div>Eye tracking measures of oculomotor function accurately distinguish between children with CVI and age-matched controls. Clustering analysis revealed 3 CVI eye tracking oculomotor groups with prognostic significance. Eye tracking shows promise as an objective, quantitative measure of oculomotor function in CVI that may in future be useful in both clinical practice (for longitudinal assessment, prognostication, and guiding individualized interventions) and research (as an outcome measure or method to stratify patients in clinical trials).</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 100728"},"PeriodicalIF":3.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592626","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":"Annual Trend of Myopia and High Myopia in Children in Japan: A Nationwide Claims Database Study","authors":"Takuro Kamei MD ,&nbsp;Masahiro Miyake MD, PhD ,&nbsp;Ai Kido MD, PhD ,&nbsp;Saori Wada MD ,&nbsp;Shusuke Hiragi MD, PhD ,&nbsp;Masayuki Hata MD, PhD ,&nbsp;Masahiro Akada MD ,&nbsp;Koji Niimi MD ,&nbsp;Ken Ogino MD, PhD ,&nbsp;Akio Oishi MD, PhD ,&nbsp;Akihiro Nishida MD, PhD ,&nbsp;Hiroshi Tamura MD, PhD ,&nbsp;Akitaka Tsujikawa MD, PhD","doi":"10.1016/j.xops.2025.100729","DOIUrl":"10.1016/j.xops.2025.100729","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the prevalence and annual trend of the number of incident cases of myopia and high myopia in children.</div></div><div><h3>Design</h3><div>A nationwide, comprehensive claims database study.</div></div><div><h3>Participants</h3><div>Of 15 million children aged ≤14 years, those covered by the universal health insurance were included. The validation study of the claims-based definitions of myopia and high myopia was conducted using 14 654 individuals aged ≤14 years recruited from 11 diverse medical facilities.</div></div><div><h3>Methods</h3><div>This study comprises a national claims database analysis and a multicenter validation study. Data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan, which contains the nationwide health insurance claims data, were assessed. All individuals aged ≤14 years were reviewed, and children with existing and new onset of myopia or high myopia between January 2011 and December 2020 were identified. A validation study was conducted by reviewing electric medical records.</div></div><div><h3>Main Outcome Measures</h3><div>Prevalence of myopia as of October 1, 2020, and the annual number of incident cases during 2014 to 2020.</div></div><div><h3>Results</h3><div>According to the 2020 population census, there were 14 955 692 children aged ≤14 years. Among them, 5 498 764 patients had myopia on October 1, 2020, corresponding to a prevalence of 36.8%. The number of incident cases of myopia was highest at 8 years of age, increasing from 853.3 cases/person-year in 2015 to 910.7 cases/person-year in 2020. The prevalence of high myopia increased with age, peaking at 0.46% among children aged 10 to 14 years; the number of incident cases annually increased in 5- to 9-year-olds and 10- to 14-year-olds. In the year 2020, when the coronavirus disease 2019 pandemic occurred, a discontinuous increase in the number of incident cases of myopia was observed in children aged 8 to 11 years, not 12 to 14 years. The overall sensitivity and specificity of the claims-based definition for myopia were 88.5% and 79.2%, respectively, whereas the corresponding values for high myopia were 41.6% and 99.8%.</div></div><div><h3>Conclusions</h3><div>This first comprehensive nationwide study revealed the prevalence and annual incidence trends of myopia and high myopia. These findings complement the results of previous high-quality cohort studies, offering a more comprehensive understanding of myopia trends.</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 100729"},"PeriodicalIF":3.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681443","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":"Bio-interventional Uveoscleral Outflow Enhancement Surgery for Primary Open-Angle Glaucoma: 2-Year Results of Cyclodialysis with Scleral Allograft Reinforcement","authors":"Ernesto Calvo MD ,&nbsp;Ticiana De Francesco MD ,&nbsp;Lautaro Vera MD ,&nbsp;Farrell Tyson MD, FACS ,&nbsp;Robert N. Weinreb MD","doi":"10.1016/j.xops.2025.100727","DOIUrl":"10.1016/j.xops.2025.100727","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate safety and efficacy of the scleral allograft–reinforced cyclodialysis through 24 months of follow-up.</div></div><div><h3>Design</h3><div>Interventional single-center case series.</div></div><div><h3>Participants</h3><div>Thirty-one eyes with primary open-angle glaucoma and visually significant cataracts underwent bio-interventional cyclodialysis surgery with scleral allograft reinforcement combined with phacoemulsification.</div></div><div><h3>Intervention</h3><div>Uveoscleral outflow enhancement surgery comprised of cyclodialysis with sequential bio-reinforcement with a scleral allograft combined with phacoemulsification.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was the proportion of eyes achieving ≥20% intraocular pressure (IOP) reduction with same or fewer medications compared with baseline. Secondary outcomes included the mean change in medicated IOP and mean number of IOP-lowering medications compared with baseline. Adverse events were also recorded and evaluated throughout the study.</div></div><div><h3>Results</h3><div>The primary outcome was achieved in 74% of the eyes, and there was a mean IOP reduction of 34% compared with baseline. Baseline mean medicated IOP was 21.9 ± 4.92 mmHg on 1.22 ± 1.29 IOP-lowering medications. At 12 months postoperation, mean IOP was 12.62 ± 2.63 on 0.55 ± 0.52 glaucoma medications. The procedure was well tolerated, and there were no serious ocular adverse events.</div></div><div><h3>Conclusions</h3><div>Uveoscleral outflow enhancement can be successfully achieved at the time of cataract surgery through bio-interventional cyclodialysis and scleral allograft reinforcement to lower IOP in patients with primary open-angle glaucoma.</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 100727"},"PeriodicalIF":3.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725555","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":"The Role of Menopause and Its Association with the Apolipoprotein E4 Allele for Age at Diagnosis of Glaucoma in Women","authors":"Yan Shi MD, PhD ,&nbsp;William Liu ,&nbsp;Junming Hu PhD ,&nbsp;Wei Qiao Qiu MD, PhD ,&nbsp;Xinyue He MD, PhD ,&nbsp;Yan Gao MD ,&nbsp;Xiaoling Zhang MD, PhD ,&nbsp;Zhigang Fan MD, PhD","doi":"10.1016/j.xops.2025.100726","DOIUrl":"10.1016/j.xops.2025.100726","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the impact of menopause for age at diagnosis (AAD) of glaucoma in women and illustrate its interaction with the apolipoprotein E (<em>APOE</em>) E4 allele.</div></div><div><h3>Design</h3><div>A retrospective, case-only analysis using the UK Biobank participants with complete data (2006–2010) for analysis.</div></div><div><h3>Participants</h3><div>One thousand three hundred fifty-eight female glaucoma patients.</div></div><div><h3>Methods</h3><div>Multivariable-adjusted associations of AAD of glaucoma, <em>APOE</em> E4 allele, age of menopause, and hormone replacement therapy (HRT) were analyzed by linear mixed model (LMM) analyses across groups stratified by whether glaucoma developed before or after menopause and whether or not HRT was used.</div></div><div><h3>Main Outcome Measures</h3><div>Age at diagnosis of glaucoma, age of menopause, <em>APOE</em> E4 allele, and HRT information.</div></div><div><h3>Results</h3><div>The age-adjusted univariate LMM showed that later menopause was significantly associated with an older AAD of glaucoma in both the overall cohort and subgroups where glaucoma developed before or after menopause (model 1, all <em>P</em> &lt; 0.05). The age-adjusted multivariate LMM found that carrying the <em>APOE</em> E4 allele combined with later menopause significantly increased the AAD of glaucoma in patients diagnosed before menopause (model 3: β_{age of menopause} = 0.711 ± 0.074, <em>P</em> &lt; 0.001; β_e4 = 1.406 ± 0.596, <em>P</em> = 0.019; model 1 vs. model 3: <em>P</em> = 0.018). No similar association was observed in patients diagnosed after menopause (<em>P</em> &gt; 0.05). Additionally, the age-adjusted univariate LMM showed that HRT was associated with an older AAD of glaucoma (model 4: β_HRT = 1.239 ± 0.368, <em>P</em> = 0.001), with this effect being more pronounced in patients with later menopause (model 5: β_HRT = 1.625 ± 0.356, <em>P</em> &lt; 0.001; β_{age of menopause} = 0.301 ± 0.033, <em>P</em> &lt; 0.001; model 4 vs. model 5: <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Later menopause was associated with an older AAD of glaucoma, with the <em>APOE</em> E4 allele providing increased protection against glaucoma in those diagnosed before, but not after, menopause. The protective effect of later menopause was also enhanced by HRT use after menopause. These findings underscore the interaction of hormonal status and <em>APOE</em> genotype in glaucoma onset, potentially guiding the prevention or management of glaucoma and other age-related health conditions in women.</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 100726"},"PeriodicalIF":3.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681923","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":"Autonomous Screening for Diabetic Macular Edema Using Deep Learning Processing of Retinal Images","authors":"Idan Bressler ,&nbsp;Rachelle Aviv ,&nbsp;Danny Margalit ,&nbsp;Gal Yaakov Cohen MD ,&nbsp;Tsontcho Ianchulev MD, MPH ,&nbsp;Shravan V. Savant MD ,&nbsp;David J. Ramsey MD, PhD ,&nbsp;Zack Dvey-Aharon PhD","doi":"10.1016/j.xops.2025.100722","DOIUrl":"10.1016/j.xops.2025.100722","url":null,"abstract":"<div><h3>Objective</h3><div>To develop and validate a deep learning model for diabetic macular edema (DME) detection using color fundus imaging, which is applicable in a diverse, multidevice clinical setting.</div></div><div><h3>Design</h3><div>Evaluation of diagnostic test or technology.</div></div><div><h3>Subjects</h3><div>A deep learning model was trained for DME detection using the EyePACS dataset, consisting of 32 049 images from 15 892 patients. The average age was 55.02%, and 51% of the patients were women.</div></div><div><h3>Methods</h3><div>Data were randomly assigned, by participant, into development (n = 14 246) and validation (n = 1583) sets. Analysis was conducted on the single image, eye, and patient levels. Model performance was evaluated using sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC). Independent validation was further performed on the Indian Diabetic Retinopathy Image Dataset, as well as on new data.</div></div><div><h3>Main Outcome Measures</h3><div>Sensitivity, specificity, and AUC.</div></div><div><h3>Results</h3><div>At the image level, a sensitivity of 0.889 (95% confidence interval [CI]: 0.878, 0.900), a specificity of 0.889 (95% CI: 0.877, 0.900), and an AUC of 0.954 (95% CI: 0.949, 0.959) were achieved. At the eye level, a sensitivity of 0.905 (95% CI: 0.890, 0.920), a specificity of 0.902 (95% CI: 0.890, 0.913), and an AUC of 0.964 (95% CI: 0.958, 0.969) were achieved. At the patient level, a sensitivity of 0.900 (95% CI: 0.879, 0.917), a specificity of 0.900 (95% CI: 0.883, 0.911), and an AUC of 0.962 (95% CI: 0.955, 0.968) were achieved.</div></div><div><h3>Conclusions</h3><div>Diabetic macular edema can be detected from color fundus imaging with high performance on all analysis metrics. Automatic DME detection may simplify screening, leading to more encompassing screening for diabetic patients. Further prospective studies are necessary.</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 100722"},"PeriodicalIF":3.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681924","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":"Long-Term Monitoring of Corneal Grafts Via Anterior Segment OCT Pachymetry Maps","authors":"Anastasia Neokleous MD, MSc ,&nbsp;Neofytos Michail MD ,&nbsp;Fedonas Herodotou MD ,&nbsp;Aikaterini Athanasiadou MSc ,&nbsp;Stylianos Christodoulou MD, MSc ,&nbsp;Dimitris Kola MD ,&nbsp;Klea Panayidou PhD ,&nbsp;Georgina Hadjilouka MD, PhD ,&nbsp;Sotiria Palioura MD, PhD","doi":"10.1016/j.xops.2025.100724","DOIUrl":"10.1016/j.xops.2025.100724","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the efficacy of anterior segment OCT (AS-OCT) in the long-term monitoring of corneal grafts and its integration into a hybrid remote care model for early detection and management of graft rejection or failure.</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Participants</h3><div>Seventy-four patients (93 eyes) who underwent corneal transplantation from October 2021 to December 2023, with a follow-up period of ≥6 months.</div></div><div><h3>Methods</h3><div>Serial AS-OCT pachymetry maps and cross-sectional scans were performed at fixed postoperative intervals, and the findings were correlated with clinical signs of graft rejection or failure on slit lamp examination for thickness changes &gt;50 μm. A hybrid remote AS-OCT screening protocol was initiated 1 week postoperatively.</div></div><div><h3>Main Outcome Measures</h3><div>Diagnostic accuracy of AS-OCT, measured by specificity and sensitivity, in detecting graft rejection or failure through changes in corneal and graft thickness.</div></div><div><h3>Results</h3><div>Anterior segment OCT demonstrated high diagnostic accuracy with a specificity of 97.6% and a sensitivity of 88.9% in detecting graft rejection or failure. The mean central corneal thickness increase in cases resulting in graft rejection or failure was 82.7 ± 21.5 μm, a thickness change that is not discernible by slit lamp examination alone. The utility of AS-OCT in a hybrid remote monitoring model was demonstrated through 3 detailed case studies, highlighting improved clinical workflow and patient convenience without compromising postoperative outcomes.</div></div><div><h3>Conclusions</h3><div>Serial AS-OCT imaging serves as a robust, objective, and quantitative tool for postoperative surveillance of corneal grafts, significantly benefiting patient outcomes by allowing timely interventions. Integration of AS-OCT into a hybrid remote screening protocol supports comprehensive monitoring, complementing direct clinical evaluations and optimizing postoperative care.</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 100724"},"PeriodicalIF":3.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681445","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":"Population-Based Normative Reference for Retinal Microvascular Atlas","authors":"Mayinuer Yusufu MTI ,&nbsp;Algis J. Vingrys PhD ,&nbsp;Xianwen Shang PhD ,&nbsp;Lei Zhang PhD ,&nbsp;Danli Shi PhD, MD ,&nbsp;Nathan Congdon PhD, MD ,&nbsp;Mingguang He PhD, MD","doi":"10.1016/j.xops.2025.100723","DOIUrl":"10.1016/j.xops.2025.100723","url":null,"abstract":"<div><h3>Objective</h3><div>To establish the normative range of a comprehensive set of retinal vascular measurements to better understand their value as biomarkers for assessing ocular and systemic health.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Participants</h3><div>The study included 10 151 healthy participants from the UK Biobank.</div></div><div><h3>Methods</h3><div>Retina-based Microvascular Health Assessment System software was used to extract retinal vascular measurements, including caliber, complexity, density, branching angle, and tortuosity, differentiating between arteries and veins and between the macula and retinal periphery. In addition, we explored relationships between those measurements and health metrics, including age, systolic blood pressure (SBP), body mass index, glycated hemoglobin, and intraocular pressure.</div></div><div><h3>Main Outcome Measures</h3><div>We reported the population normative range for 114 retinal vascular measurements, further stratified by sex and age.</div></div><div><h3>Results</h3><div>The mean values of central retinal artery equivalent and central retinal vein equivalent (CRVE) were 152 (standard deviation = 14.9) μm and 233 (21.5) μm, respectively. The mean value of fractal dimension (FD) was 1.77 (0.032), with arterial FD 1.53 (0.039) and venular FD 1.56 (0.025). Age and SBP showed the strongest associations with most retinal parameters among health metrics. Central retinal artery equivalent, CRVE, density, and complexity decreased with increasing age and SBP. Changes in arterial measurements with age and SBP were generally greater than those in venous measurements. Generalized additive models further revealed that observed associations were mainly linear.</div></div><div><h3>Conclusions</h3><div>By establishing population normative data for a comprehensive set of retinal vascular measurements, our study enables quantifiable approaches to better understand retinal vascular changes.</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 100723"},"PeriodicalIF":3.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592718","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}