Ophthalmology science最新文献

{"title":"A Joint Bayesian Longitudinal Model for Macular Structure–Function Correlations in Glaucoma","authors":"Erica Su PhD ,&nbsp;Kwanghyun Lee MD, PhD ,&nbsp;Abraham Liu MS ,&nbsp;Vahid Mohammadzadeh MD ,&nbsp;Sajad Besharati MD ,&nbsp;Joseph Caprioli MD ,&nbsp;Robert E. Weiss PhD ,&nbsp;Kouros Nouri-Mahdavi MD, MS","doi":"10.1016/j.xops.2025.100897","DOIUrl":"10.1016/j.xops.2025.100897","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate global longitudinal structure–function (SF) relationships between macular ganglion cell complex (GCC) thickness and central visual field (VF) mean deviation (MD) rates of change using a Bayesian joint bivariate longitudinal model.</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Participants</h3><div>One hundred seventeen eyes from 117 patients with glaucoma with central damage or moderate to advanced glaucoma were included. Eligible patients had at least 4 visits over a follow-up period of 2 years or longer.</div></div><div><h3>Methods</h3><div>Longitudinal GCC thickness was assessed using optical coherence tomography, and central VF MD was measured with 10-2 standard automated perimetry. A Bayesian joint bivariate longitudinal model was used to estimate random intercepts, slopes, and residual standard deviations (SDs) for structural and functional measures and their correlations. A simulation study compared the Bayesian model (BM)'s performance against simple linear regression (SLR) in estimating these correlations.</div></div><div><h3>Main Outcome Measures</h3><div>Correlations between GCC and MD intercepts, slopes, and residual errors.</div></div><div><h3>Results</h3><div>The mean baseline MD was −8.3 (SD: 5.2) decibels, with an average follow-up period of 5.0 (SD: 0.9) years. The mean correlation was 0.47 (95% credible interval: 0.32 to 0.61) for GCC-MD intercepts (baseline values), 0.29 (95% credible interval: 0.04 to 0.52) for GCC-MD slopes (rates of change), 0.20 (95% credible interval: −0.06 to 0.44) for GCC-MD log residual SDs, and 0.060 (95% credible interval: −0.013, 0.132) for the observation-level GCC-MD residual correlation. The BM consistently demonstrated a smaller root mean squared error than SLR in estimating GCC-MD slope correlations in all simulated scenarios where GCC-MD residual correlation differed from GCC-MD slope correlation.</div></div><div><h3>Conclusions</h3><div>The Bayesian joint model improved accuracy and reduced uncertainty in estimating SF relationships compared to SLR. Correlations between global SF rates of change were significantly positive, although weaker than random intercept correlations. This model represents a key step towards developing local longitudinal SF models to enhance glaucoma progression monitoring.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100897"},"PeriodicalIF":4.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144919805","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":"From CLMI.X to CLMIX-AI: A Machine Learning–Based Upgrade of the Cone Location and Magnitude Index Expanded to Detect Keratoconus Suspects","authors":"Bassel Hammoud MD, MS ,&nbsp;Zahi Wehbi MD ,&nbsp;Jad F. Assaf MD ,&nbsp;Cynthia J. Roberts PhD ,&nbsp;Shady T. Awwad MD","doi":"10.1016/j.xops.2025.100895","DOIUrl":"10.1016/j.xops.2025.100895","url":null,"abstract":"<div><h3>Purpose</h3><div>To enhance the CLMI.X index for detecting keratoconus suspect (KCS) cases by incorporating advanced machine learning (ML) algorithms.</div></div><div><h3>Design</h3><div>Development and validation of a ML diagnostic algorithm.</div></div><div><h3>Methods</h3><div>This study included 352 eyes divided into 3 categories: normal (NL) (n = 133), KCS (n = 77), and keratoconus (KC) (n = 142). Imaging was obtained using the Galilei dual Scheimpflug–Placido system. Eleven variables, identical to those used in the original CLMI.X, were employed to train and test multiple ML models, including logistic regression (LR) and more advanced algorithms, for classification of corneas into NL, KCS, and KC. SHapley Additive exPlanations (SHAP) analysis was performed to identify influential variables for differentiating KCS from NL eyes, both for the full KCS group and a subgroup of topographically and tomographically borderline cases.</div></div><div><h3>Results</h3><div>The original CLMI.X demonstrated high sensitivity (100%) and specificity (99%) for detecting KC but low sensitivity (4%) for KCS. Training the CLMI.X-AI using LR on 3 classes improved KCS sensitivity to 68%. Incorporating advanced artificial intelligence algorithms further increased KCS sensitivity to 75%, with an overall accuracy of 89%. SHapley Additive exPlanations analysis identified the posterior axial, posterior instantaneous, and anterior axial curvature maps as the most influential variables, alongside zonal pachymetry and posterior elevation. For topographically and tomographically NL fellow eyes, SHAP analysis revealed significant influence for zonal pachymetry.</div></div><div><h3>Conclusions</h3><div>The CLMI.X-AI demonstrates substantially improved performance in detecting KCS compared with the original CLMI.X. Its ML enhanced decision-making and 3-class training make it a more clinically relevant and robust tool for early KC detection.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author has no/the authors have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100895"},"PeriodicalIF":4.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931901","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":"Characteristics of Myopic Traction Maculopathy in the Aier-SERI High Myopia Adult Cohort Study","authors":"Kai-Xiong Cheong FRCOphth ,&nbsp;Yanfeng Jiang MD ,&nbsp;Hla Myint Htoon PhD ,&nbsp;Wei Pan MS ,&nbsp;Li-Lian Foo FRCOphth ,&nbsp;Ziqi Hu ,&nbsp;Ling Chen MD ,&nbsp;Sophie Ang ,&nbsp;Ecosse L. Lamoureux PhD ,&nbsp;Quan V. Hoang PhD ,&nbsp;Seang-Mei Saw PhD ,&nbsp;Weizhong Lan PhD","doi":"10.1016/j.xops.2025.100894","DOIUrl":"10.1016/j.xops.2025.100894","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe the prevalence, clinical characteristics, associations, and visual outcomes of myopic traction maculopathy (MTM), which was defined by the presence of retinoschisis (RS), macular holes (MHs), or foveal retinal detachment (RD), in an adult high myope cohort in Changsha, China.</div></div><div><h3>Design</h3><div>A cross-sectional study.</div></div><div><h3>Participants</h3><div>Chinese adults with high myopia (defined as spherical equivalent [SE] less than or equal to −5 diopters [D]) in the Aier-Singapore Eye Research Institute High Myopia Adult Cohort Study, which is a prospective population-based study.</div></div><div><h3>Methods</h3><div>Swept-source OCT was performed to detect RS, MH, and foveal RD. Multivariable generalized estimating equation analyses were performed to assess associations of MTM and the impact of MTM on best-corrected visual acuity (BCVA).</div></div><div><h3>Main Outcome Measures</h3><div>Prevalence, clinical characteristics, associations, and visual outcomes of MTM.</div></div><div><h3>Results</h3><div>Of 437 participants (839 eyes), MTM was observed in 20 participants with a prevalence of 4.6% (by participants) or in 24 eyes (with a prevalence of 2.9%; by eyes). Overall, the whole cohort (64.7% female) had a mean age of 42.9 ± 7.2 years, an SE of −9.5 ± 4.4 D, and an axial length (AL) of 27.3 ± 1.9 mm. Retinoschisis was the most common lesion (91.7%; 22/24 eyes with MTM). In the multivariable analysis, the prevalence of MTM was associated with a more myopic SE (odds ratio [OR]: 1.09; 95% confidence interval [CI]: 1.01–1.18; <em>P</em> = 0.03), longer AL (OR: 1.30; 95% CI: 1.03–1.65; <em>P</em> = 0.03), myopic macular degeneration (MMD) (OR: 12.77; 95% CI: 3.18–51.24; <em>P</em> &lt; 0.001), and older age (OR: 1.06; 95% CI: 1.01–1.11; <em>P</em> = 0.01). In the multivariable analysis, the prevalence of MTM was also associated with poorer BCVA (beta coefficient: −0.07; 95% CI: −0.13 to −0.01; <em>P</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>The prevalence of MTM was 4.6% in an adult high myope cohort. Associations with MTM include more myopic SE, longer AL, MMD, and older age. Myopic traction maculopathy is associated with poorer vision.</div></div><div><h3>Financial Disclosure(s)</h3><div>The authors have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100894"},"PeriodicalIF":4.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896160","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":"Retrospective OCT Analysis of Sphingosine-1-Phosphate Modulator Fingolimod in Multiple Sclerosis","authors":"Wilson X. Wang MD, MPhil ,&nbsp;Helen Rossmiller BS ,&nbsp;Henok Getahun BS ,&nbsp;Aditya Santoki BS ,&nbsp;Dana C. Perantie MPH ,&nbsp;Robert T. Naismith MD ,&nbsp;Rajendra S. Apte MD, PhD","doi":"10.1016/j.xops.2025.100893","DOIUrl":"10.1016/j.xops.2025.100893","url":null,"abstract":"<div><h3>Purpose</h3><div>Sphingosine-1-phosphate (S1P) plays a pivotal role in cells as a bioactive lipid mediator, with emerging evidence suggesting that it may play a role in retinal ganglion cell survival, axonal growth, retinal pigment epithelium (RPE) barrier function, and photoreceptor function. While previous studies have documented associated ophthalmic effects such as fingolimod-associated macular edema, the specific impact of S1P receptor modulators on inner and outer retinal layer thicknesses requires further elucidation.</div></div><div><h3>Design</h3><div>Retrospective case series.</div></div><div><h3>Subjects</h3><div>A total of 44 patients (86 eyes) with multiple sclerosis (MS) treated with fingolimod between 2011 and 2023 at the John L. Trotter Multiple Sclerosis Center at Washington University in St. Louis.</div></div><div><h3>Methods</h3><div>Eligible participants were those with baseline and follow-up OCT images conducted at or prior to S1P initiation and at the most recent visit. The peripapillary retinal nerve fiber layer (pRNFL), ganglion cell layer (GCL), central subfield thickness (CST), macular volume (MV), RPE, and photoreceptor thickness were determined through OCT segmentation. Generalized estimating equations were constructed incorporating relevant covariates.</div></div><div><h3>Main Outcome Measures</h3><div>Annualized rate of change of specified retinal layer thickness.</div></div><div><h3>Results</h3><div>The mean age was 49.4 ± 10.8 years and time between baseline and follow-up OCTs ranged from 2 months to 6.4 years with a median of 1 year, interquartile range 0.42 to 2.33. The annualized rate of change of pRNFL and CST were 0.022 [–0.363, 0.406] μm/year, and −1.37 [−3.11, 0.38] μm/year, whereas GCL and MV showed significant thinning of −0.231 [−0.430, −0.032] μm/year and −0.024 [–0.047, −0.001] mm3/year, respectively. Retinal pigment epithelium and photoreceptor layer thickness remained largely stable over time at 0.070 [−0.140, 0.280] μm/year and 0.673 [−0.218, 1.561] μm/year, respectively.</div></div><div><h3>Conclusions</h3><div>Patients with MS on S1P modulators exhibited significant GCL and MV thinning with outer retina layer thickness preservation, providing insight into the potential retinal effects of S1P modulation in the setting of MS-related neurodegeneration. Prospective studies with standardized imaging intervals and appropriate controls are needed to distinguish the specific retinal effect of S1P modulation from MS neurodegeneration and enable more precise OCT interpretation of the retina in monitoring MS disease progression.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100893"},"PeriodicalIF":4.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880260","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":"Incidence of Strabismus in Childhood Glaucoma","authors":"Kaersti L. Rickels BA ,&nbsp;Muhammad Z. Chauhan MD, MS ,&nbsp;Linda R. Dagi MD ,&nbsp;Abdulrahman Rageh MD ,&nbsp;Isdin Oke MD, MPH ,&nbsp;Paul H. Phillips MD ,&nbsp;Abdelrahman M. Elhusseiny MD, MSc","doi":"10.1016/j.xops.2025.100892","DOIUrl":"10.1016/j.xops.2025.100892","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the cumulative incidence of strabismus in childhood glaucoma and compare its risk to that in healthy controls.</div></div><div><h3>Design</h3><div>A retrospective clinical cohort study.</div></div><div><h3>Participants</h3><div>Childhood glaucoma patients aged ≤18 years from the TriNetX US Collaborative Network.</div></div><div><h3>Methods</h3><div>Patients were identified using the International Classification of Diseases Ninth and 10th Revision codes. The primary study group included childhood glaucoma patients aged ≤18 years, while the control group consisted of healthy children with no history of ocular disorders. We analyzed the cumulative incidence of strabismus in both primary and secondary glaucoma. Propensity score matching (PSM) was used to compare the risk of strabismus between glaucoma and control groups. A Cox proportional hazards model was employed to identify predictors of strabismus among children with glaucoma.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was the cumulative incidence of strabismus at 1 and 5 years after glaucoma diagnosis. The secondary outcomes included (1) comparative risk of strabismus between glaucoma and control groups, (2) evaluating the rates of strabismus surgery in the glaucoma cohort, and (3) identifying the risk factors associated with strabismus development in the glaucoma group.</div></div><div><h3>Results</h3><div>The study group included 12 637 patients, with a mean age at glaucoma diagnosis of 3.81 ± 4.44 years in the primary glaucoma group and 5.18 ± 4.40 years for the secondary glaucoma group. The cumulative incidence of strabismus in primary glaucoma was 9.19% at 1 year and 18.89% at 5 years. In secondary glaucoma, the cumulative incidence was 20.40% at 1 year and 31.39% at 5 years. After PSM, the 5-year risk of strabismus was significantly higher in the glaucoma group compared with controls (adjusted hazard ratio [aHR]: 7.95; 95% confidence interval [CI]: 5.67–11.14; <em>P</em> &lt;0.01 for primary glaucoma and aHR: 14.51; 95% CI: 12.59–16.72; <em>P</em> &lt;0.01 for secondary childhood glaucoma). Risk factors for strabismus development in the glaucoma group included younger age at secondary glaucoma diagnosis, nystagmus, and amblyopia.</div></div><div><h3>Conclusions</h3><div>Childhood glaucoma is associated with a significantly increased risk of developing strabismus compared with healthy controls. Within the glaucoma group, younger age (in secondary glaucoma), nystagmus, amblyopia, and glaucoma surgery were all associated with an increased risk of strabismus.</div></div><div><h3>Financial Disclosure(s)</h3><div>The authors have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100892"},"PeriodicalIF":4.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886115","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":"Longitudinal Assessment of Age-Related Macular Degeneration and Risk of Dementia Using Clinical Setting Data","authors":"Natan Lishinsky-Fischer ,&nbsp;Yaacov Cnaany MD ,&nbsp;Itay Nitzan MD, MPH,&nbsp;Itay Chowers MD, PhD,&nbsp;Jaime Levy MD","doi":"10.1016/j.xops.2025.100891","DOIUrl":"10.1016/j.xops.2025.100891","url":null,"abstract":"<div><h3>Objective</h3><div>To examine whether there is an association between age-related macular degeneration (AMD) and dementia using a large, multi-institutional clinical data.</div></div><div><h3>Design</h3><div>A retrospective cohort study.</div></div><div><h3>Participants</h3><div>Patients with AMD, including both neovascular AMD (nvAMD) and non-neovascular AMD (non-nvAMD) types, along with matched controls who had a record of eye examination but no diagnosis of AMD.</div></div><div><h3>Methods</h3><div>Data were extracted from the 3 largest TriNetX networks (Global, United States, and Europe, Middle East, and Africa [EMEA]). Dementia diagnoses (Alzheimer disease [AD], vascular dementia, and unspecified dementia) and dementia-related medication use were compared between AMD and non-AMD groups. Diagnoses were identified using International Classification of Diseases, 10th Revision codes. Survival analyses were performed using Kaplan–Meier curves, and hazard ratios (HRs) were estimated using Cox proportional hazards models across 5-, 7-, and 10-year follow-up periods.</div></div><div><h3>Main Outcome Measures</h3><div>Hazard ratios for dementia subtypes in AMD patients versus non-AMD patients and in nvAMD patients versus non-nvAMD patients.</div></div><div><h3>Results</h3><div>No significant association between AMD and AD was observed in the global network. In the United States, AMD was associated with a reduced risk of AD at 5 and 7 years (HR = 0.79 and 0.75; <em>P</em> &lt; 0.0001), but not at 10 years. In the EMEA cohort, a protective association emerged at 7 and 10 years (HR = 0.16 and 0.33; <em>P</em> = 0.0063 and 0.0265). Vascular dementia showed no global association but was reduced in the United States at 5 and 7 years (HR = 0.73 and 0.79; <em>P</em> &lt; 0.0001 and 0.0003). Unspecified dementia was associated with increased risk globally (HR = 1.17–1.27; <em>P</em> ≤ 0.0016), while the US data indicated a protective trend at 5 and 7 years. Dementia medication use was elevated in the global network at 7 years (HR = 1.27, <em>P</em> &lt; 0.0001), but lower in the United States across all time points (<em>P</em> &lt; 0.01). The negative control outcome (appendicitis) showed no difference between groups. No significant differences in AD or vascular dementia were found between nvAMD and non-AMD patients, although unspecified dementia and dementia medication use were lower in the nvAMD group.</div></div><div><h3>Conclusions</h3><div>Age-related macular degeneration was not consistently positively associated with AD or vascular dementia across networks. Regional variation, particularly negative associations in the United States, suggests underlying health care or diagnostic differences.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100891"},"PeriodicalIF":4.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908296","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 Perfusion and Injury in Sepsis and after Major Surgery","authors":"Ella Courtie PhD ,&nbsp;Gagana Mallawaarachchi MBChB ,&nbsp;Aditya U. Kale MBChB ,&nbsp;Ahmed Gilani FRCA ,&nbsp;Nicholas Capewell ,&nbsp;Donna Holding ,&nbsp;Benjamin T.K. Hui BMBS ,&nbsp;Xiaoxuan Liu PhD ,&nbsp;Elinor Laws MBChB ,&nbsp;Ann Logan PhD ,&nbsp;Tony Whitehouse MD ,&nbsp;Alastair K. Denniston PhD ,&nbsp;Tonny Veenith PhD ,&nbsp;Richard J. Blanch PhD","doi":"10.1016/j.xops.2025.100890","DOIUrl":"10.1016/j.xops.2025.100890","url":null,"abstract":"<div><h3>Objective</h3><div>Assess retinal perfusion in sepsis, compared with uncomplicated postoperative care and healthy controls, and assess the effects of reduced perfusion on retinal structure and visual function.</div></div><div><h3>Design</h3><div>We conducted a prospective observational cohort study between March 2018 and December 2022, with follow-up measures collected 3 to 6 months after discharge.</div></div><div><h3>Subjects</h3><div>Twenty-four patients with sepsis were assessed in the intensive care unit (ICU) and 3 to 6 months later, 45 ICU control patients assessed during elective ICU admission after upper gastrointestinal cancer surgery, preoperatively, and 3 to 6 months later, and 15 healthy controls.</div></div><div><h3>Testing</h3><div>Assessments included retinal layer thickness using OCT, retinal perfusion using OCT angiography, and visual function using Humphrey visual field analysis. Organ dysfunction was assessed by Sequential Organ Failure Assessment (SOFA) scoring.</div></div><div><h3>Main Outcome Measures</h3><div>Superficial vascular plexus (SVP) retinal perfusion, OCT retinal ganglion cell layer (GCL) thickness, and mean deviation (MD) on Humphrey visual field testing were evaluated.</div></div><div><h3>Results</h3><div>Superficial vascular plexus retinal perfusion was 37.4% lower in patients with sepsis compared with ICU control patients (<em>P</em> &lt; 0.001) and 59.7% lower than in healthy controls, which returned to normal by final follow-up. Retinal perfusion correlated with the SOFA score (Pearson <em>r</em> = -0.57, <em>P</em> &lt; 0.001) and weakly correlated with C-reactive protein (<em>r</em> = -0.337, <em>P</em> = 0.01) and mean arterial pressure (<em>r</em> = 0.354, <em>P</em> = 0.006). In patients with sepsis and ICU controls, retinal perfusion in the ICU predicted subsequent GCL thickening, with every 1-unit decrease in SVP sum predicting a 1.88 μm increase in GCL thickness at follow-up (<em>P</em> = 0.003), and worsening visual field MD, with every 1-unit decrease in SVP sum predicting a 0.078 decibel lower MD (<em>P</em> = 0.023).</div></div><div><h3>Conclusions</h3><div>Retinal perfusion was impaired in patients with sepsis compared with both healthy controls and patients after major surgery. It was moderately associated with other measures of organ dysfunction assessed by SOFA. Reduced retinal perfusion in both patients with sepsis and patients after major surgery is strongly associated with subsequent GCL thickening and less strongly associated with decreased visual field MD, suggesting reduced retinal perfusion is associated with retinal damage, with consequent visual dysfunction.</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":"6 1","pages":"Article 100890"},"PeriodicalIF":4.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145097865","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":"Pointwise Structure–Function Analysis of the Ellipsoid Zone in Retinitis Pigmentosa Using an Artificial Intelligence-Assisted OCT and Microperimetry Overlay","authors":"Jesse A. Most BA ,&nbsp;An D. Le MS, PhD ,&nbsp;Melanie D. Tran BS ,&nbsp;Evan H. Walker MS ,&nbsp;Aneesh Swamy ,&nbsp;Dirk-Uwe G. Bartsch PhD ,&nbsp;William R. Freeman MD ,&nbsp;Truong Nguyen PhD ,&nbsp;Cheolhong An PhD ,&nbsp;Shyamanga Borooah MBBS, PhD","doi":"10.1016/j.xops.2025.100889","DOIUrl":"10.1016/j.xops.2025.100889","url":null,"abstract":"<div><h3>Objective</h3><div>To perform a pointwise structure–function analysis of the ellipsoid zone (EZ) in retinitis pigmentosa (RP) using an artificial intelligence–based overlay to understand EZ structure–function relationships.</div></div><div><h3>Design</h3><div>A single-center retrospective study.</div></div><div><h3>Subjects</h3><div>Patients with clinically confirmed RP.</div></div><div><h3>Methods</h3><div>Same-day spectral-domain OCT (SD-OCT) and microperimetry near-infrared images were overlaid in patients with confirmed RP. Overlay used a coarse alignment artificial intelligence model. Each locus, on a 68-point microperimetry grid spanning the central 20° of the macula, was identified on individual SD-OCT B-scans. Ellipsoid zone structure was graded at each locus on a 3-point scale: grade 0 = EZ not visible; grade 1 = EZ attenuated; grade 2 = EZ normal. Ellipsoid zone grades were correlated with microperimetry sensitivity scores recorded in decibels (dB).</div></div><div><h3>Main Outcome Measures</h3><div>Correlation of EZ integrity on SD-OCT with microperimetric retinal sensitivity.</div></div><div><h3>Results</h3><div>Fifty-one eyes from thirty-one patients with RP were included in the analysis, with 60 total overlays, including follow-up studies, resulting in 3985 test loci being graded. Patients had a mean age of 39.4 (32.8–46.0) years, with 41.9% being female. Mean best-corrected visual acuity was 0.166 (0.129–0.203) logarithm of the minimum angle of resolution. The overall mean sensitivity (MS) was 9.72 (7.32–12.12) dB, whereas MS was 6.02 (4.06–7.98) dB for grade 0 loci, 18.36 (16.35–20.36) dB for grade 1 loci, and 20.90 (18.87–22.93) dB for grade 2 loci. Differences in MS were significant between graded groups (<em>P</em> &lt; 0.001). Correlation between EZ grade and sensitivity was 0.65 (0.64–0.67), whereas correlation of sensitivity with distance from the fovea was −0.41 (−0.43 to −0.39). Focusing on grade 0 loci, 57.5% had sensitivity scores &gt;0 dB, and 4% had scores ≥20 dB, suggesting that these points had function despite no observable EZ on SD-OCT.</div></div><div><h3>Conclusions</h3><div>We identified local EZ structure–function incongruencies in RP using a pointwise analysis of structure–function overlay. These loci of interest may be overlooked in analyses that average across the visual field. Preserved photoreceptor function, in the absence of visibly intact EZ, warrants further investigation.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100889"},"PeriodicalIF":4.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889380","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":"Development and Validation of a Semiautomated Tool for Measuring Periorbital Distances","authors":"Jeffrey C. Peterson MD, PhD ,&nbsp;George R. Nahass BS ,&nbsp;Claudia Lasalle BS ,&nbsp;Deanna C. Bradley BS ,&nbsp;David Wu BS ,&nbsp;Isabella Zorra MEng ,&nbsp;Alvin Nguyen BS ,&nbsp;Akriti Choudhary MBBS ,&nbsp;Kevin Heinze MD ,&nbsp;Chad A. Purnell MD ,&nbsp;Pete Setabutr MD ,&nbsp;Darvin Yi PhD ,&nbsp;Ann Q. Tran MD","doi":"10.1016/j.xops.2025.100887","DOIUrl":"10.1016/j.xops.2025.100887","url":null,"abstract":"<div><h3>Purpose</h3><div>To validate a custom FIJI (ImageJ) program for more reproducible, faster curvilinear periorbital measurements, as compared with 2 custom artificial intelligence–based tools.</div></div><div><h3>Design</h3><div>Combined technical validation and method comparison study.</div></div><div><h3>Subjects</h3><div>Front-facing photographs of 45 cleft palate syndromic patients.</div></div><div><h3>Methods</h3><div>A FIJI (ImageJ)-based macro script tool, OrbitJ (semiautomated), was developed, requiring 15 user input steps to generate 38 measurements per photo. The user outlines the irises to set image scale and then selects points along the lid margins and brow lines. Linear interpolation and fourth-degree polynomial fit lines were used to generate periorbital measurements. This tool was compared against our previously developed deep learning algorithm for periorbital measurements, OrbitMap (automated), another open-source algorithm PeriOrbitAI (automated), and against manual measurements. Four human graders measured 45 photos once both manually and with OrbitJ. Intrarater and interrater measurements were performed with 10 photos manually, 3 in triplicate manually and 5 in triplicate with OrbitJ. Fourteen manual measurements were performed: time per image, iris diameter, margin reflex distance (MRD) 1 and 2, inferior scleral show (ISS), medial, central, and lateral brow height, canthal tilt, vertical dystopia, interpupillary distance, and inner and outer canthal distance (OCD).</div></div><div><h3>Main Outcome Measures</h3><div>The mean absolute error, reliability, bias, and Pearson correlation of periorbital measurements.</div></div><div><h3>Results</h3><div>Analysis was successful in all 45 images for all methods except PeriOrbitAI, which failed on 6 images. For manual and semiautomated intra- and interrater measurements, reliability was considered moderate or better (intraclass correlation coefficient [ICC] &gt;0.5) for all measurements excluding elapsed time. Manual interrater mean absolute error was &lt;1 mm all measures except OCD. Reliability and correlation were high (ICC, Pearson correlation coefficient &gt;0.8) between all OrbitJ and manual measurements. Comparing OrbitMap to manual measurements, ICC and Pearson correlation coefficient were &gt;0.5 except for ISS, borderline for OCD (ICC = 0.51). Reliability between PeriOrbitAI and manual measurements was low (ICC &lt;0.5) except for MRD2 and OCD, and correlation was moderate (Pearson correlation coefficient = 0.49–0.75). The mean analysis time per image was 13.4 ± 4 minutes (manual measurements), 5.4 ± 1.9 minutes (semiautomated OrbitJ), 10.71 ± 1.65 seconds (automated PeriOrbitAI), and 1.45 ± 0.15 seconds (automated OrbitMap) (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Compared with manual measurements, all semiautomated OrbitJ measurements and most automated OrbitMap measurements were reliable. Notably, only 2 PeriOrbitAI measurements were reliab","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100887"},"PeriodicalIF":4.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908295","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":"Evaluation of Retinal Edema in Nonproliferative Diabetic Retinopathy Using Widefield Swept-Source OCT","authors":"Yoshiaki Chiku MD,&nbsp;Takao Hirano MD, PhD,&nbsp;Ken Hoshiyama MD,&nbsp;Toshinori Murata MD, PhD","doi":"10.1016/j.xops.2025.100888","DOIUrl":"10.1016/j.xops.2025.100888","url":null,"abstract":"<div><h3>Purpose</h3><div>This study evaluates retinal volume in the macula and peripheral retina in patients with nonproliferative diabetic retinopathy (NPDR), with and without diabetic macular edema (DME), using widefield swept-source OCT (SS-OCT).</div></div><div><h3>Design</h3><div>Retrospective observational study.</div></div><div><h3>Participants</h3><div>A total of 98 eyes were included: 30 from patients with NPDR without DME (DME−), 38 from patients with NPDR with DME (DME+), and 30 from age- and sex-matched healthy controls.</div></div><div><h3>Methods</h3><div>OCT examinations used SS-OCT (Xephilio OCT-S1; Canon) to capture 23 × 20 mm (1024 × 128 A-scans) cube images. Retinal volume was calculated for each sector in a 9-sector grid defined by concentric circles (1 mm, 6 mm, and 20 mm in diameter) centered on the fovea and divided into four quadrants: superior, inferior, nasal, and temporal. The macular region was defined within a 6-mm diameter, whereas the peripheral retina spanned 6 mm to 20 mm.</div></div><div><h3>Main Outcome Measures</h3><div>Macular and peripheral retinal volumes measured from SS-OCT images in each group.</div></div><div><h3>Results</h3><div>A total of 98 eyes were analyzed (control: 30; DME−: 30; DME+: 38). Macular retinal volume was 8.46 ± 0.49 mm³ in the control group, 8.79 ± 0.55 mm³ in the DME−group, and significantly higher at 10.53 ± 1.81 mm³ in the DME + group (<em>P</em> &lt; 0.0001). Peripheral retinal volume was 64.5 ± 3.1 mm³ in the control group, 62.2 ± 3.7 mm³ in the DME−group, and significantly higher at 68.7 ± 10.4 mm³ in the DME + group (<em>P</em> &lt; 0.001). In DME+, severe NPDR showed greater volumes (macula: 11.2 ± 1.9 mm³; periphery: 71.9 ± 13.0 mm³) than mild-to-moderate NPDR (macula: 9.67 ± 1.14 mm³; periphery: 65.1 ± 4.6 mm³; <em>P</em> &lt; 0.01 and <em>P</em> &lt; 0.05, respectively).</div></div><div><h3>Conclusions</h3><div>Our findings indicate that retinal volume increases in both macular and peripheral regions in DME, particularly as NPDR severity progresses.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author has no/the authors have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100888"},"PeriodicalIF":4.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144919804","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}