Ophthalmology science最新文献

{"title":"A Second-Generation (44-Channel) Suprachoroidal Retinal Prosthesis: A Single-Arm Clinical Trial of Feasibility","authors":"Matthew A. Petoe BEng (Hons), PhD ,&nbsp;Carla J. Abbott BOptom, PhD ,&nbsp;Samuel A. Titchener BEng (Hons), PhD ,&nbsp;Maria Kolic BOrth ,&nbsp;William G. Kentler BEng ,&nbsp;David A.X. Nayagam BEng (Hons), PhD ,&nbsp;Elizabeth K. Baglin BOrth ,&nbsp;Jessica Kvansakul MSc, PhD ,&nbsp;Nick Barnes PhD ,&nbsp;Janine G. Walker PhD ,&nbsp;Lewis Karapanos BBMed (Hons), MD ,&nbsp;Myra B. McGuinness MBiostat, PhD ,&nbsp;Lauren N. Ayton BOptom, PhD ,&nbsp;Chi D. Luu BOrth (Hons), PhD ,&nbsp;Penelope J. Allen MBBS, FRANZCO","doi":"10.1016/j.xops.2024.100525","DOIUrl":"10.1016/j.xops.2024.100525","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess the feasibility of a second-generation (44-channel) suprachoroidal retinal prosthesis for provision of functional vision in recipients with end-stage retinitis pigmentosa (RP) over 2.7 years.</p></div><div><h3>Design</h3><p>Prospective, single-arm, unmasked interventional clinical trial.</p></div><div><h3>Participants</h3><p>Four participants, with advanced RP and bare-light perception vision.</p></div><div><h3>Methods</h3><p>The 44-channel suprachoroidal retinal prosthesis was implanted in the worse-seeing eye. Device stability, functionality, and adverse events were investigated at approximately 12-week intervals up to 140 weeks (2.7 years) postdevice activation.</p></div><div><h3>Main Outcome Measures</h3><p>Serious adverse event (SAE) reporting, visual response outcomes, functional vision outcomes, and quality-of-life outcomes.</p></div><div><h3>Results</h3><p>All 4 participants (aged 39–66 years, 3 males) were successfully implanted in 2018, and there were no device-related SAEs over the duration of the study. A mild postoperative subretinal hemorrhage was detected in 2 recipients, which cleared spontaneously within 2 weeks. OCT confirmed device stability and position under the macula. Improvements in localization abilities were demonstrated for all 4 participants in screen-based, tabletop, and orientation and mobility tasks. In addition, 3 of 4 participants recorded improvements in motion discrimination and 2 of 4 participants recorded substantial improvements in spatial discrimination and identification of tabletop objects. Participants reported their unsupervised use of the device included exploring new environments, detecting people, and safely navigating around obstacles. A positive effect of the implant on participants’ daily lives in their local environments was confirmed by an orientation and mobility assessor and participant self-report. Emotional well-being was not impacted by device implantation or usage.</p></div><div><h3>Conclusions</h3><p>The completed clinical study demonstrates that the suprachoroidal prosthesis raises no safety concerns and provides improvements in functional vision, activities of daily living, and observer-rated quality of life.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 1","pages":"Article 100525"},"PeriodicalIF":3.2,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000617/pdfft?md5=58e184a14bc6df9fdd2eaced905fba58&pid=1-s2.0-S2666914524000617-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239711","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":"Interpretation of Clinical Retinal Images Using an Artificial Intelligence Chatbot","authors":"","doi":"10.1016/j.xops.2024.100556","DOIUrl":"10.1016/j.xops.2024.100556","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess the performance of Chat Generative Pre-Trained Transformer-4 in providing accurate diagnoses to retina teaching cases from OCTCases.</p></div><div><h3>Design</h3><p>Cross-sectional study.</p></div><div><h3>Subjects</h3><p>Retina teaching cases from OCTCases.</p></div><div><h3>Methods</h3><p>We prompted a custom chatbot with 69 retina cases containing multimodal ophthalmic images, asking it to provide the most likely diagnosis. In a sensitivity analysis, we inputted increasing amounts of clinical information pertaining to each case until the chatbot achieved a correct diagnosis. We performed multivariable logistic regressions on Stata v17.0 (StataCorp LLC) to investigate associations between the amount of text-based information inputted per prompt and the odds of the chatbot achieving a correct diagnosis, adjusting for the laterality of cases, number of ophthalmic images inputted, and imaging modalities.</p></div><div><h3>Main Outcome Measures</h3><p>Our primary outcome was the proportion of cases for which the chatbot was able to provide a correct diagnosis. Our secondary outcome was the chatbot’s performance in relation to the amount of text-based information accompanying ophthalmic images.</p></div><div><h3>Results</h3><p>Across 69 retina cases collectively containing 139 ophthalmic images, the chatbot was able to provide a definitive, correct diagnosis for 35 (50.7%) cases. The chatbot needed variable amounts of clinical information to achieve a correct diagnosis, where the entire patient description as presented by OCTCases was required for a majority of correctly diagnosed cases (23 of 35 cases, 65.7%). Relative to when the chatbot was only prompted with a patient’s age and sex, the chatbot achieved a higher odds of a correct diagnosis when prompted with an entire patient description (odds ratio = 10.1, 95% confidence interval = 3.3–30.3, <em>P</em> &lt; 0.01). Despite providing an incorrect diagnosis for 34 (49.3%) cases, the chatbot listed the correct diagnosis within its differential diagnosis for 7 (20.6%) of these incorrectly answered cases.</p></div><div><h3>Conclusions</h3><p>This custom chatbot was able to accurately diagnose approximately half of the retina cases requiring multimodal input, albeit relying heavily on text-based contextual information that accompanied ophthalmic images. The diagnostic ability of the chatbot in interpretation of multimodal imaging without text-based information is currently limited. The appropriate use of the chatbot in this setting is of utmost importance, given bioethical concerns.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"4 6","pages":"Article 100556"},"PeriodicalIF":3.2,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000927/pdfft?md5=cbc151f11a332e61ad5ea6ce2945620c&pid=1-s2.0-S2666914524000927-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141139640","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":"Straylight of Explanted Silicone Oil Samples to Predict Emulsification","authors":"","doi":"10.1016/j.xops.2024.100558","DOIUrl":"10.1016/j.xops.2024.100558","url":null,"abstract":"","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"4 6","pages":"Article 100558"},"PeriodicalIF":3.2,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000940/pdfft?md5=0a769ed2b78f104c8537da895eef99c0&pid=1-s2.0-S2666914524000940-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141141056","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":"Demographic and Metabolic Risk Factors Associated with Development of Diabetic Macular Edema among Persons with Diabetes Mellitus","authors":"","doi":"10.1016/j.xops.2024.100557","DOIUrl":"10.1016/j.xops.2024.100557","url":null,"abstract":"<div><h3>Purpose</h3><p>Diabetic macular edema (DME), a leading cause of visual impairment, can occur regardless of diabetic retinopathy (DR) stage. Poor metabolic control is hypothesized to contribute to DME development, although large-scale studies have yet to identify such an association. This study aims to determine whether measurable markers of dysmetabolism are associated with DME development in persons with diabetes.</p></div><div><h3>Design</h3><p>Retrospective cohort study.</p></div><div><h3>Participants</h3><p>Using data from the Sight Outcomes Research Collaborative (SOURCE) repository, patients with diabetes mellitus and no preexisting DME were identified and followed over time to see what factors associated with DME development.</p></div><div><h3>Methods</h3><p>Cox proportional hazard modeling was used to assess the relationship between demographic variables, diabetes type, smoking history, baseline DR status, blood pressure (BP), lipid profile, body mass index (BMI), hemoglobin A1C (HbA1C), and new onset of DME.</p></div><div><h3>Main Outcome Measures</h3><p>Adjusted hazard ratio (HR) of developing DME with 95% confidence intervals (CIs).</p></div><div><h3>Results</h3><p>Of 47 509 eligible patients from 10 SOURCE sites (mean age 63 ± 12 years, 58% female sex, 48% White race), 3633 (7.6%) developed DME in the study period. The mean ± standard deviation time to DME was 875 ± 684 days (∼2.4 years) with those with baseline nonproliferative DR (HR 3.67, 95% CI: 3.41–3.95) and proliferative DR (HR 5.19, 95% CI: 4.61–5.85) more likely to develop DME. There was no difference in DME risk between type 1 and type 2 patients; however, Black race was associated with a 40% increase in DME risk (HR 1.40, 95% CI: 1.30–1.51). Every 1 unit increase in HbA1C had a 15% increased risk of DME (HR 1.15, 95% CI: 1.13–1.17), and each 10 mmHg increase in systolic BP was associated with a 6% increased DME risk (HR 1.06, 95% CI: 1.02–1.09). No association was identified between DME development and BMI, triglyceride levels, or high-density lipoprotein levels.</p></div><div><h3>Conclusions</h3><p>These findings suggest that in patients with diabetes modifiable risk factors such as elevated HbA1C and BP confer a higher risk of DME development; however, other modifiable systemic markers of dysmetabolism such as obesity and dyslipidemia did not. Further work is needed to identify the underlying contributions of race in DME.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"4 6","pages":"Article 100557"},"PeriodicalIF":3.2,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000939/pdfft?md5=15b18b21e8fd66733dff377ac4a6be36&pid=1-s2.0-S2666914524000939-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141137551","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":"Phase I Study of Tivozanib Eye Drops in Healthy Volunteers and Patients with Neovascular Age-Related Macular Degeneration","authors":"","doi":"10.1016/j.xops.2024.100553","DOIUrl":"10.1016/j.xops.2024.100553","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the safety, pharmacokinetics, and exploratory efficacy of tivozanib eye drops in healthy volunteers and patients with neovascular age-related macular degeneration (nAMD).</p></div><div><h3>Design</h3><p>This multicenter group-sequential dose escalation phase I study consisted of a placebo-controlled double-masked study of healthy volunteers (cohorts 1 and 2) and an open-label study of patients with nAMD (cohort 3).</p></div><div><h3>Participants</h3><p>Healthy volunteers: Japanese or White men aged 20 to &lt;50 years. Patients with nAMD with central subfield thickness (CST) ≥300 μm and best-corrected visual acuity score ≥23 letters in the study eye.</p></div><div><h3>Methods</h3><p>In the single-dose cohort of healthy men (cohort 1: steps 1–5), 1 or 2 tivozanib eye drops (30 μL/drop, 5-minute interval; 0.5, 1.0, and 2.0 w/v%) or placebo were administered in 1 eye once. In the multiple-dose cohort of healthy men (cohort 2: steps 1–6), 1 or 2 tivozanib eye drops (0.5, 1.0, and 2.0 w/v%) or placebo were administered 3 times daily in 1 eye for 21 days. In the multiple-dose cohort of patients with nAMD (cohort 3, steps 1–3), 1 or 2 tivozanib eye drops (0.5 and 1.0 w/v%) were administered 3 times daily in 1 affected eye for 21 days.</p></div><div><h3>Main Outcome Measures</h3><p>The safety outcome measures included adverse events (AEs). The pharmacokinetic outcome was serum tivozanib concentration. Among the exploratory efficacy outcomes, CST was evaluated.</p></div><div><h3>Results</h3><p>In total, 40, 48, and 28 participants were enrolled in cohorts 1, 2, and 3, respectively. Serious AEs did not occur in cohorts 1 to 3. The most frequent AE in multiple-dose cohorts was reversible punctate keratitis: placebo arm, 8.3% (healthy men, 1/12); tivozanib arm, 47.2% (healthy men, 17/36) and 14.3% (nAMD, 4/28). Serum tivozanib exposure increased dose-dependently and was similar in healthy men and patients with nAMD. In patients with nAMD, mean CST changes from baseline to day 22 were −27.6 ± 54.88 (0.5 w/v%; 1 drop, 3 times daily), −35.6 ± 49.64 (1.0 w/v%; 1 drop, 3 times daily), and −43.7 ± 55.19 μm (1.0 w/v%; 2 drops, 3 times daily).</p></div><div><h3>Conclusions</h3><p>Tivozanib eye drops showed a favorable safety profile in healthy Japanese and White men and Japanese patients with nAMD.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"4 6","pages":"Article 100553"},"PeriodicalIF":3.2,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000897/pdfft?md5=245002c98f6fab8a50995f2f67daf777&pid=1-s2.0-S2666914524000897-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141143992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Focal Choroidal Excavation Concurrent with Chorioretinal Disease: Evaluated by Spectral-Domain OCT","authors":"","doi":"10.1016/j.xops.2024.100554","DOIUrl":"10.1016/j.xops.2024.100554","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the risk factors for patients with focal choroidal excavation (FCE) and their correlation with chorioretinal diseases.</p></div><div><h3>Design</h3><p>Retrospective cross-sectional study.</p></div><div><h3>Subjects</h3><p>Patients with FCE were enrolled, while healthy subjects were recruited for the control group.</p></div><div><h3>Methods</h3><p>The study collected demographic information, clinical features, and multimodal images. Parameters of FCE identified using spectral-domain OCT (SD-OCT) were manually measured using built-in software and subsequently analyzed statistically.</p></div><div><h3>Main Outcome Measures</h3><p>Subfoveal choroidal thickness (SFCT), subexcavation choroidal thickness (SECT), and the greatest depth and width of each excavation were manually measured using built-in calipers in OCT software.</p></div><div><h3>Results</h3><p>Twenty-one patients (13/8, male/female) with FCE were included in this study. The average age was 45.2 years, and their best-corrected visual acuity (BCVA) was 0.4 logarithm of the minimum angle of resolution (Snellen equivalent, 20/50). Focal choroidal excavation was present in 28 eyes of 21 patients, including isolated FCE (12 eyes) and complicated FCE (16 eyes) with choroidal neovascularization (sCNV), central serous chorioretinopathy, and other conditions. Patients with complicated FCE were significantly older than those isolated FCE (<em>P</em> = 0.015). The SFCT of the healthy subjects was significantly less than that of the fellow eyes of the patients with FCE (<em>P</em> &lt; 0.01), as was that of the eyes with isolated FCE (<em>P</em> &lt; 0.001) and complicated FCE (<em>P</em> &lt; 0.001). The width of excavation was wider in eyes with complicated FCE than in those with isolated FCE (<em>P</em> = 0.001). Hypertransmission defect (HD) was found beneath 15 excavations and was more prevalent in the complicated FCE group than the isolated FCE group (<em>P</em> = 0.023).</p></div><div><h3>Conclusions</h3><p>Focal choroidal excavation appears to be closely related to chorioretinal disorders, and the width of the excavation is a significant indicator for evaluating the risk of chorioretinal diseases.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"4 6","pages":"Article 100554"},"PeriodicalIF":3.2,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000903/pdfft?md5=27fb013ae91e9a344485e78b09c090d8&pid=1-s2.0-S2666914524000903-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141137479","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":"Comparative Analysis of Vision Transformers and Conventional Convolutional Neural Networks in Detecting Referable Diabetic Retinopathy","authors":"","doi":"10.1016/j.xops.2024.100552","DOIUrl":"10.1016/j.xops.2024.100552","url":null,"abstract":"<div><h3>Objective</h3><p>Vision transformers (ViTs) have shown promising performance in various classification tasks previously dominated by convolutional neural networks (CNNs). However, the performance of ViTs in referable diabetic retinopathy (DR) detection is relatively underexplored. In this study, using retinal photographs, we evaluated the comparative performances of ViTs and CNNs on detection of referable DR.</p></div><div><h3>Design</h3><p>Retrospective study.</p></div><div><h3>Participants</h3><p>A total of 48 269 retinal images from the open-source Kaggle DR detection dataset, the Messidor-1 dataset and the Singapore Epidemiology of Eye Diseases (SEED) study were included.</p></div><div><h3>Methods</h3><p>Using 41 614 retinal photographs from the Kaggle dataset, we developed 5 CNN (Visual Geometry Group 19, ResNet50, InceptionV3, DenseNet201, and EfficientNetV2S) and 4 ViTs models (VAN_small, CrossViT_small, ViT_small, and Hierarchical Vision transformer using Shifted Windows [SWIN]_tiny) for the detection of referable DR. We defined the presence of referable DR as eyes with moderate or worse DR. The comparative performance of all 9 models was evaluated in the Kaggle internal test dataset (with 1045 study eyes), and in 2 external test sets, the SEED study (5455 study eyes) and the Messidor-1 (1200 study eyes).</p></div><div><h3>Main Outcome Measures</h3><p>Area under operating characteristics curve (AUC), specificity, and sensitivity.</p></div><div><h3>Results</h3><p>Among all models, the SWIN transformer displayed the highest AUC of 95.7% on the internal test set, significantly outperforming the CNN models (all <em>P</em> &lt; 0.001). The same observation was confirmed in the external test sets, with the SWIN transformer achieving AUC of 97.3% in SEED and 96.3% in Messidor-1. When specificity level was fixed at 80% for the internal test, the SWIN transformer achieved the highest sensitivity of 94.4%, significantly better than all the CNN models (sensitivity levels ranging between 76.3% and 83.8%; all <em>P</em> &lt; 0.001). This trend was also consistently observed in both external test sets.</p></div><div><h3>Conclusions</h3><p>Our findings demonstrate that ViTs provide superior performance over CNNs in detecting referable DR from retinal photographs. These results point to the potential of utilizing ViT models to improve and optimize retinal photo-based deep learning for referable DR detection.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"4 6","pages":"Article 100552"},"PeriodicalIF":3.2,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000885/pdfft?md5=e825a283c219c78d58998007371e0532&pid=1-s2.0-S2666914524000885-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141029822","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":"Reticular Pseudodrusen","authors":"","doi":"10.1016/j.xops.2024.100551","DOIUrl":"10.1016/j.xops.2024.100551","url":null,"abstract":"<div><h3>Purpose</h3><p>To understand the spatial relationship between local rod-mediated visual function and reticular pseudodrusen (RPD) in eyes with large drusen.</p></div><div><h3>Design</h3><p>Retrospective cross-sectional study.</p></div><div><h3>Participants</h3><p>One eye with large drusen (&gt;125 μm) each from 91 individuals with intermediate age-related macular degeneration, with and without RPD.</p></div><div><h3>Methods</h3><p>All participants underwent dark adaptation testing using a dark-adapted chromatic perimeter, where visual sensitivities were measured over 30 minutes of dark adaptation after photobleach. The rod intercept time (RIT; a measure of dynamic rod function) and pointwise sensitivity difference (PWSD; a relative measure of rod- compared with cone-mediated function) was determined at multiple retinal locations, and their association with the overall (central 20° × 20° region) and local (2° diameter region centered on the location tested) extent of RPD and drusen (quantified using multimodal imaging) was examined.</p></div><div><h3>Main Outcome Measures</h3><p>Association between overall and local extent of RPD and drusen with RIT and PWSD at each retinal location tested.</p></div><div><h3>Results</h3><p>In a multivariable analysis, delayed RIT was associated with an increasing overall (<em>P</em> &lt; 0.001), but not local (<em>P</em> = 0.884), extent of RPD. In contrast, the increasing local (<em>P</em> &lt; 0.001), but not overall (<em>P</em> = 0.475), extent of drusen was associated with delayed RIT. Furthermore, only an increasing overall extent of RPD (<em>P</em> &lt; 0.001) was associated with reduced PWSD (or worse rod compared with cone function), but not the local extent of RPD and drusen, or overall extent of drusen (<em>P</em> ≥ 0.344).</p></div><div><h3>Conclusions</h3><p>Local rod-mediated function was associated with the overall, rather than local, extent of RPD in eyes with large drusen, suggesting that there may be widespread pathologic changes in eyes with RPD that account for this.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"4 6","pages":"Article 100551"},"PeriodicalIF":3.2,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000873/pdfft?md5=8a890207b878b9a7e353a3f0042e4544&pid=1-s2.0-S2666914524000873-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141030948","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":"Circulating VEGF-A Levels in Relation to Retinopathy of Prematurity and Treatment Effects: A Systematic Review and Meta-Analysis","authors":"","doi":"10.1016/j.xops.2024.100548","DOIUrl":"10.1016/j.xops.2024.100548","url":null,"abstract":"<div><h3>Topic</h3><p>Retinopathy of prematurity (ROP) is a severe retinal vascular disorder affecting preterm infants, potentially leading to retinal detachment and blindness. This review aims to elucidate the relationship between systemic VEGF levels and ROP.</p></div><div><h3>Clinical Relevance</h3><p>This systematic review aims to consolidate evidence from available studies to guide future research and inform clinical practice. In particular, the role of circulating VEGF-A levels in predicting ROP onset and progression, and evaluating the impact of anti-VEGF therapy on these levels, is crucial in ensuring efficacy and safety in patient care.</p></div><div><h3>Methods</h3><p>Scopus and PubMed were searched to identify studies investigating circulating VEGF-gene products in ROP patients using immunologic assays. Two authors independently screened the literature and extracted data, employing a random-effects meta-analysis to compare VEGF levels as the ratio of means between ROP patients and controls before and after treatment, heterogeneity was reported by I²-statistics. Risks of bias and publication bias were assessed using Quality Assessment of Diagnostic Accuracy Studies-2 and funnel plots/Egger’s tests, respectively.</p></div><div><h3>Results</h3><p>Out of 941 papers, 54 were included, with 26 providing posttreatment data and 31 providing biomarker data. Findings show a significant decrease in VEGF-A levels in the first week after ROP treatment (ratio of means [95% confidence interval] 0.34 [0.25–0.45], I² = 97%, 17 publications). Anti-VEGF therapy showed a significantly more pronounced decrease (0.31 [0.25–0.38], I² = 40%, 7 publications) than laser treatment in the first week after treatment (0.77 [0.61–0.97], I² = 42%, 2 publications, subgroup difference, <em>P</em> &lt; 0.01), among studies with a low risk of bias. Serum samples demonstrated a more marked decrease in VEGF-A than plasma (subgroup difference <em>P</em> &lt; 0.01). However, the use of blood VEGF-A concentration as a biomarker for ROP prediction has shown inconsistent trends. The risk of bias mainly stems from unclear patient selection and lack of sample timing or analytical method details.</p></div><div><h3>Conclusion</h3><p>While anti-VEGF treatment significantly reduced blood VEGF-A levels in the first week post-ROP treatment, blood VEGF-A levels did not consistently predict ROP development. Heterogeneity in the results underscores the need for optimized analytical methods and emphasizes the importance of considering individual variation in VEGF-A concentrations independent of ROP diagnosis.</p></div><div><h3>Financial Disclosure(s)</h3><p>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"4 6","pages":"Article 100548"},"PeriodicalIF":3.2,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000848/pdfft?md5=9979f6a65422d836abb69dbbe7d86ed8&pid=1-s2.0-S2666914524000848-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141034498","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":"Systemic Oxidative Stress Level as a Pathological and Prognostic Factor in Myopic Choroidal Neovascularization","authors":"","doi":"10.1016/j.xops.2024.100550","DOIUrl":"10.1016/j.xops.2024.100550","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the association of systemic oxidative stress level with myopic choroidal neovascularization (mCNV) and its clinical outcomes.</p></div><div><h3>Design</h3><p>Retrospective case-control study.</p></div><div><h3>Participants</h3><p>This retrospective study included 52 eyes of 52 healthy participants (mean age: 62.5 years), 30 eyes of 30 patients (mean age: 59.6 years) with high myopia (HM) but without mCNV, and 23 eyes of 23 patients (mean age: 61.8 years) with HM and mCNV who received intravitreal anti-VEGF antibody injections (IVIs) using a pro re nata regimen during the 6-month follow-up after the first IVI.</p></div><div><h3>Methods</h3><p>Clinical findings, including oxidative stress parameters, such as diacron reactive oxygen metabolites (dROMs), biological antioxidant potential (BAP), and the BAP/dROM ratio (B/d ratio), were analyzed.</p></div><div><h3>Main Outcome Measures</h3><p>Clinical features and oxidative stress parameters.</p></div><div><h3>Results</h3><p>Both BAP and the B/d ratio were significantly lower in the HM/mCNV group than in the HM/no mCNV group (<em>P</em> = 0.002 and <em>P</em> = 0.012, respectively) and than in the control group (<em>P</em> = 0.001 and <em>P</em> = 0.026, respectively). In a multiple logistic regression analysis, axial length (odds ratio 1.878, <em>P</em> = 0.042) and the B/d ratio (odds ratio 0.470, <em>P</em> = 0.026) were significantly associated with mCNV. Dividing the patients into high and low B/d ratio groups (with a cutoff of 5.2) showed that subfoveal choroidal thickness (SFCT) was lower (<em>P</em> = 0.002) and the number of IVI treatments was higher (<em>P</em> = 0.029) in the low B/d ratio group than in the high B/d ratio group. In multiple regression analyses, only the B/d ratio was significantly associated with SFCT (β = 0.684, <em>P</em> = 0.006).</p></div><div><h3>Conclusions</h3><p>The oxidative stress level in eyes with HM differed according to mCNV, SFCT, and the number of IVI treatments. Measuring oxidative stress parameters might be useful in eyes with HM both for assessing the risk of developing mCNV and determining disease activity.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"4 6","pages":"Article 100550"},"PeriodicalIF":3.2,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000861/pdfft?md5=7d68f9ea9ab1c4d8e07ae6e4223a0ce1&pid=1-s2.0-S2666914524000861-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141035674","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}