Ophthalmology science最新文献

{"title":"Cellular Determinants of Visual Outcomes in Eyes with Epiretinal Membrane: Insights from Adaptive Optics OCT","authors":"Masaharu Ishikura MD, PhD,&nbsp;Yuki Muraoka MD, PhD,&nbsp;Naomi Nishigori MD,&nbsp;Takahiro Kogo MD,&nbsp;Yuki Akiyama MD,&nbsp;Shogo Numa MD, PhD,&nbsp;Masayuki Hata MD, PhD,&nbsp;Kenji Ishihara MD, PhD,&nbsp;Sotaro Ooto MD, PhD,&nbsp;Akitaka Tsujikawa MD, PhD","doi":"10.1016/j.xops.2024.100536","DOIUrl":"10.1016/j.xops.2024.100536","url":null,"abstract":"<div><h3>Objective</h3><p>In this study, we aimed to evaluate cellular alterations in the foveal neuroglia of eyes with idiopathic epiretinal membrane (ERM) and examine their correlation with visual function. We also aimed to identify prognostic markers for visual outcomes postvitrectomy.</p></div><div><h3>Design</h3><p>A prospective longitudinal study.</p></div><div><h3>Subjects</h3><p>The study comprised 84 subjects, including 50 eyes diagnosed with idiopathic ERM and 34 healthy eyes serving as controls.</p></div><div><h3>Methods</h3><p>The foveal neuroglial changes in eyes with idiopathic ERM were determined using adaptive optics OCT (AO-OCT) by comparing them with healthy eyes. For patients with ERM, the ERM and inner limiting membrane were removed during vitrectomy in all eyes.</p></div><div><h3>Main Outcome Measures</h3><p>Foveal microstructures on AO-OCT images, best-corrected visual acuity (BCVA) and M-CHARTS scores, evaluated preoperatively and at 1, 3, and 6 months postoperatively, and associations between foveal neuroglial changes and these parameters.</p></div><div><h3>Results</h3><p>Adaptive optics OCT revealed discernible differences in the foveal cones of the eyes with ERM and their healthy counterparts. The thickness of the ellipsoid zone (EZ) band was augmented in eyes with ERM. The alignment of the Müller cells was more vertical and the density of the foveal cone cell nuclei was higher in eyes with ERM than in healthy eyes. Within the AO-OCT parameters, the higher cone nuclei count correlated with worse M-CHARTS scores, both preoperatively and 6 months postoperatively (<em>P</em> = 0.004, 0.010, respectively). Greater EZ thickness was significantly associated with poorer 6-month postoperative BCVA (<em>P</em> = 0.005).</p></div><div><h3>Conclusions</h3><p>Adaptive optics OCT can be used to precisely identify cellular alterations in eyes with ERM that are closely related to visual function impairments. These cellular insights enhance our understanding of ERM pathology and offer promising prognostic indicators of visual outcome after vitrectomy.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000721/pdfft?md5=6ebe20c52a43697fdfeed1142f227e4b&pid=1-s2.0-S2666914524000721-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140779420","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":"Special Commentary: My Perspective on Vision and Vision Rehabilitation","authors":"","doi":"10.1016/j.xops.2024.100532","DOIUrl":"10.1016/j.xops.2024.100532","url":null,"abstract":"<div><p>Vision is the most powerful sense guiding our interaction with the environment. Its process starts with the retinal image as input and results in visually guided behaviors as output. This paper summarizes insights I gained over &gt;40 years dealing with clinical ophthalmology, visual science, and vision rehabilitation, disciplines that all involve vision, but from different points of view. The retinal image contains 2-dimensional forms that have no inherent meaning. The brain matches this input to stored concepts, to create a Mental Model that is filled with 3-dimensional objects that are meaningful and linked to other senses. Ultimately this leads to the output of goal-directed visually guided behavior. The processes involved are too complex to be covered by a single practitioner. Optimal vision rehabilitation requires teamwork that includes contributions from various professions. It also requires an understanding, as well as possible, of the cerebral processes involved. The visual sciences study mostly the input-driven process from retinal image to visual percepts. Their studies deal mostly with groups and group averages and only occasionally with individual disease conditions. Clinical ophthalmology deals mostly with individuals, rather than group averages. The motto of the American Academy of Ophthalmology reminds us that the end point of patient care goes beyond “preserving sight.” It also includes “empowering lives” by creating the conditions for goal-directed interaction with the environment through visually directed behavior. Traditionally, the study of vision has mainly involved the conscious part of vision, handled mostly in the ventral stream. However, the subconscious part of vision, handled mostly in the dorsal stream must also be considered. This is further stimulated by the demands of computer vision, image processing, and artificial intelligence. Vision rehabilitation traditionally deals with the input side through better illumination and various magnification devices. This is the domain of low vision aids. Increasingly, however, it must also address the output side, and the involvement of other senses (braille, long cane, and talking books). This requires better understanding of the goal-directed higher visual processes. The supplemental material covers the development of numerical scales to quantify not only visual acuity but also visual abilities, and the use of different tests.</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":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266691452400068X/pdfft?md5=d5104c64a7e060424da850daee9e5403&pid=1-s2.0-S266691452400068X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759946","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":"Netarsudil 0.02% Alters Episcleral Venous Flowrates: A Clinical Trial Using Erythrocyte-Mediated Angiography","authors":"Sarah Kim ,&nbsp;Victoria Chen MD ,&nbsp;Jessica Pottenburgh MS, PA ,&nbsp;Marvin Cruz ,&nbsp;Gillian Cooper ,&nbsp;Catherine Sun ,&nbsp;Lily Im MD ,&nbsp;Laurence Magder MPH, PhD ,&nbsp;Osamah J. Saeedi MD, MS","doi":"10.1016/j.xops.2024.100533","DOIUrl":"10.1016/j.xops.2024.100533","url":null,"abstract":"<div><h3>Objective</h3><p>To characterize the effect of netarsudil 0.02% on episcleral blood flow in treatment-naive glaucoma suspect or ocular hypertension subjects.</p></div><div><h3>Design</h3><p>Prospective, unmasked, single-arm cohort study.</p></div><div><h3>Participants</h3><p>Ten treatment-naive patients with a diagnosis of glaucoma suspect or ocular hypertension.</p></div><div><h3>Methods</h3><p>Erythrocyte-mediated angiography (EMA) was used to measure episcleral erythrocyte velocity, vessel diameter, and blood flow at baseline before treatment, 1 hour after drop instillation (T1), 1 to 2 weeks after daily netarsudil 0.02% drop use (T2), and 1 hour after drop instillation at the 1-to-2-week time point (T3). Intraocular pressure (IOP) and blood pressure were measured at each visit.</p></div><div><h3>Main Outcome Measures</h3><p>Change in episcleral venous erythrocyte velocity, diameter, and blood flow between time points analyzed using generalized estimating equation models.</p></div><div><h3>Results</h3><p>Of the 18 eligible study eyes of 10 enrolled treatment-naive subjects, baseline IOP was 16.8 ± 3.6 mmHg (mean ± standard deviation), which significantly decreased to 13.9 ± 4.2 mmHg at T1, 12.6 ± 4.1 mmHg at T2, and 11.8 ± 4.7 mmHg at T3 (<em>P</em> &lt; 0.05 at each time point compared with baseline). Episcleral vessels averaged 61.3 ± 5.3 μm in diameter at baseline which increased significantly at all posttreatment time points (78.0 ± 6.6, 74.0 ± 5.2, 76.9 ± 6.9 μm, respectively; mean ± standard deviation, <em>P</em> &lt; 0.05 for each time point). Episcleral venous flowrates were 0.40 ± 0.22 uL/minute (mean ± standard deviation) at baseline, which increased significantly to 0.69 ± 0.45 uL/min at T1 (<em>P</em> = 0.01), did not significantly differ at T2 (0.38 ± 0.30 uL/minute), and increased significantly to 0.54 ± 0.32 uL/minute at T3 (<em>P</em> &lt; 0.05 compared with baseline and T2).</p></div><div><h3>Conclusions</h3><p>Netarsudil causes episcleral venous dilation at all time points and resulting increases in episcleral venous flowrates 1 hour after drop instillation. Increased episcleral venous flow, associated with decreased episcleral venous pressure, may result in lowered IOP.</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":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000691/pdfft?md5=2000ff2ff496c4d4e2f76b3c4d6876cb&pid=1-s2.0-S2666914524000691-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140796061","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":"Esterman Visual Field Testing Using a Virtual Reality Headset in Glaucoma","authors":"Meghan Sharma MD, MPH,&nbsp;Eleonore Savatovsky MD, PhD,&nbsp;Laura Huertas MPH,&nbsp;Robert O’Brien PhD,&nbsp;Alana Grajewski MD,&nbsp;Elena Bitrian MD","doi":"10.1016/j.xops.2024.100534","DOIUrl":"10.1016/j.xops.2024.100534","url":null,"abstract":"<div><h3>Purpose</h3><p>To test the use of a virtual reality visual field headset (VRVF) for implementation of the Esterman visual field (EVF) test as compared with standard automated perimetry (SAP) among people with glaucoma.</p></div><div><h3>Design</h3><p>Experimental design.</p></div><div><h3>Subjects</h3><p>Patients with mild to severe glaucoma ranging from 10 to 90 years who presented for follow-up at a glaucoma clinic in Miami, Florida were eligible.</p></div><div><h3>Methods</h3><p>Participants performed the EVF test on both SAP and VRVF. Five glaucoma-trained ophthalmologists were then asked to rate all anonymized SAP and RVF tests as a “pass” or “failure” based on Florida state law.</p></div><div><h3>Main Outcome Measures</h3><p>Point-by-point concordance between original VRVF EVF test results and SAP EVF test results was calculated using the Kappa statistic. Concordance between SAP and VRVF was secondarily assessed with a conditional logistic regression based on the pass-failure determinations by the glaucoma-trained ophthalmologists. Interrater agreement on test pass-failure determinations was also calculated. Finally, test results on SAP versus VRVF were compared based on Esterman efficiency score (EES), the number of correct points divided by the number of total points, and duration of testing.</p></div><div><h3>Results</h3><p>Twenty-two subjects were included in the study with ages ranging from 14 to 78 years old. Concordance between VRVF and SAP test using point-by-point analysis was poor (<em>κ</em> = 0.332, [95% confidence intervals {CI}: 0.157, 0.506]) and somewhat increased using pass-failure determinations from ophthalmologists (<em>κ</em> = 0.657, [95% CI: 0.549, 0.751]). Ophthalmologists were more likely to agree amongst themselves on pass-failure determinations for VRVF tests (<em>κ</em> = 0.890, [95% CI: 0.726, 0.964]) than for SAP (<em>κ</em> = 0.590, [95% CI: 0.372, 0.818]); however, VRVF demonstrated significantly lower EES than SAP (median EES difference: 4.5 points, <em>P</em> = 0.021).</p></div><div><h3>Conclusions</h3><p>This pilot study is the first to assess the implementation of the EVF test using a virtual reality headset. Based on the weak overall agreement between VRVF and SAP, the current VRVF EVF test is not an acceptable determinant of driver’s licensing. However, ophthalmologists were more likely to agree amongst themselves on VRVF test reports than on SAP reports. With further testing and improvement, virtual reality may eventually become a portable and convenient method for administering the EVF test.</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":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000708/pdfft?md5=2af0aa73e39d0dd321a970d4d204dc75&pid=1-s2.0-S2666914524000708-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140777154","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":"Plasma-Derived Cell-Free DNA for the Diagnosis of Ocular-Involving Histiocytosis","authors":"Jasmine H. Francis MD ,&nbsp;Maria E. Arcila MD ,&nbsp;Allison Sigler ,&nbsp;Dana F. Bossert RN ,&nbsp;David H. Abramson MD ,&nbsp;Eli L. Diamond MD","doi":"10.1016/j.xops.2024.100530","DOIUrl":"10.1016/j.xops.2024.100530","url":null,"abstract":"<div><h3>Purpose</h3><p>Circulating tumor DNA (ctDNA) is released into the plasma by many cancers and offers clinical applications including noninvasive diagnostics. Histiocytosis results from myelogenous clonal expansion of histiocytes, predominantly driven by mutations in the mitogen-activated protein kinase pathway that are potentially detectable by ctDNA-based sequencing assays. However, ocular-involving histiocytosis is often a diagnostic challenge leading to delayed diagnosis and the need for invasive biopsy of sensitive ocular structures. The purpose of this study is to determine whether sequencing of plasma-derived ctDNA can noninvasively diagnose ocular-involving histiocytosis.</p></div><div><h3>Design</h3><p>Single tertiary cancer referral center.</p></div><div><h3>Participants</h3><p>Twenty-four adult patients with ocular-involving histiocytosis and ctDNA sequencing.</p></div><div><h3>Methods</h3><p>Circulating tumor DNA was analyzed (via digital droplet polymerase chain reaction for BRAF V600E, and/or next-generation sequencing) and variant allele frequency was measured at initial presentation to our center. Patient demographics, clinical characteristics, and oncogenic mutations identified from tumor-based sequencing were recorded.</p></div><div><h3>Main Outcome Measures</h3><p>Plasma-derived ctDNA detectability of pertinent driver mutations of histiocytosis.</p></div><div><h3>Results</h3><p>At the initial presentation of 14 patients with ocular-involving histiocytosis, sequencing of plasma-derived ctDNA detected driver mutations for histiocytosis (BRAF V600E [10], KRAS [2], ARAF [1], and concurrent MAP2K1/KRAS [1]). Mutations found in circulating cell-free DNA were 100% concordant in 11 of 11 patients with mutations identified by solid tumor sequencing. Of 10 patients without driver mutation detected in ctDNA, 3 patients had alterations (CBL mutation or kinase fusion) not captured in the ctDNA sequencing assay, 3 were wildtype even by tumor sequencing; in 4 patients, tumor-based sequencing identified mutations (BRAF [2], MAP2K1 [2]) not detected in ctDNA. Detectable mutations in ctDNA were significantly more likely in patients with uveal infiltration (<em>P</em> = 0.036).</p></div><div><h3>Conclusions</h3><p>In this cohort, plasma-derived ctDNA was detectable and diagnostic in the majority of patients with ocular-involving histiocytosis. This suggests that if ocular histiocytosis is suspected (particularly if involving the uvea), noninvasive plasma-derived ctDNA analysis is a helpful diagnostic tool that may obviate the need to invasively biopsy sensitive ocular structures.</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":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000666/pdfft?md5=f38ee0925503fa490ba6b3d024f64d39&pid=1-s2.0-S2666914524000666-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140773933","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":"Generative Artificial Intelligence Enhancements for Reducing Image-based Training Data Requirements","authors":"Dake Chen PhD ,&nbsp;Ying Han MD, PhD ,&nbsp;Jacque Duncan MD ,&nbsp;Lin Jia PhD ,&nbsp;Jing Shan MD, PhD","doi":"10.1016/j.xops.2024.100531","DOIUrl":"10.1016/j.xops.2024.100531","url":null,"abstract":"<div><h3>Objective</h3><p>Training data fuel and shape the development of artificial intelligence (AI) models. Intensive data requirements are a major bottleneck limiting the success of AI tools in sectors with inherently scarce data. In health care, training data are difficult to curate, triggering growing concerns that the current lack of access to health care by under-privileged social groups will translate into future bias in health care AIs. In this report, we developed an autoencoder to grow and enhance inherently scarce datasets to alleviate our dependence on big data.</p></div><div><h3>Design</h3><p>Computational study with open-source data.</p></div><div><h3>Subjects</h3><p>The data were obtained from 6 open-source datasets comprising patients aged 40–80 years in Singapore, China, India, and Spain.</p></div><div><h3>Methods</h3><p>The reported framework generates synthetic images based on real-world patient imaging data. As a test case, we used autoencoder to expand publicly available training sets of optic disc photos, and evaluated the ability of the resultant datasets to train AI models in the detection of glaucomatous optic neuropathy.</p></div><div><h3>Main Outcome Measures</h3><p>Area under the receiver operating characteristic curve (AUC) were used to evaluate the performance of the glaucoma detector. A higher AUC indicates better detection performance.</p></div><div><h3>Results</h3><p>Results show that enhancing datasets with synthetic images generated by autoencoder led to superior training sets that improved the performance of AI models.</p></div><div><h3>Conclusions</h3><p>Our findings here help address the increasingly untenable data volume and quality requirements for AI model development and have implications beyond health care, toward empowering AI adoption for all similarly data-challenged fields.</p></div><div><h3>Financial Disclosure(s)</h3><p>The authors have no proprietary or commercial interest in any materials discussed in this article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000678/pdfft?md5=c185f42a34115a97df571fc008ff4be2&pid=1-s2.0-S2666914524000678-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794453","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":"Prediction of Functional and Anatomic Progression in Lamellar Macular Holes","authors":"","doi":"10.1016/j.xops.2024.100529","DOIUrl":"10.1016/j.xops.2024.100529","url":null,"abstract":"<div><h3>Purpose</h3><p>To use artificial intelligence to identify imaging biomarkers for anatomic and functional progression of lamellar macular hole (LMH) and elaborate a deep learning (DL) model based on OCT and OCT angiography (OCTA) for prediction of visual acuity (VA) loss in untreated LMHs.</p></div><div><h3>Design</h3><p>Multicentric retrospective observational study.</p></div><div><h3>Participants</h3><p>Patients aged &gt;18 years diagnosed with idiopathic LMHs with availability of good quality OCT and OCTA acquisitions at baseline and a follow-up &gt;2 years were recruited.</p></div><div><h3>Methods</h3><p>A DL model based on soft voting of 2 separate models (OCT and OCTA-based respectively) was trained for identification of cases with VA loss &gt;5 ETDRS letters (attributable to LMH progression only) during a 2-year follow-up. Biomarkers of anatomic and functional progression of LMH were evaluated with regression analysis, feature learning (support vector machine [SVM] model), and visualization maps.</p></div><div><h3>Main Outcome Measures</h3><p>Ellipsoid zone (EZ) damage, volumetric tissue loss (TL), vitreopapillary adhesion (VPA), epiretinal proliferation, central macular thickness (CMT), parafoveal vessel density (VD) and vessel length density (VLD) of retinal capillary plexuses, choriocapillaris (CC), and flow deficit density (FDD).</p></div><div><h3>Results</h3><p>Functionally progressing LMHs (VA-PROG group, 41/139 eyes [29.5%]) showed higher prevalence of EZ damage, higher volumetric TL, higher prevalence of VPA, lower superficial capillary plexus (SCP), VD and VLD, and higher CC FDD compared with functionally stable LMHs (VA-STABLE group, 98/139 eyes [70.5%]). The DL and SVM models showed 92.5% and 90.5% accuracy, respectively. The best-performing features in the SVM were EZ damage, TL, CC FDD, and parafoveal SCP VD. Epiretinal proliferation and lower CMT were risk factors for anatomic progression only.</p></div><div><h3>Conclusions</h3><p>Deep learning can accurately predict functional progression of untreated LMHs over 2 years. The use of AI might improve our understanding of the natural course of retinal diseases. The integrity of CC and SCP might play an important role in the progression of LMHs.</p></div><div><h3>Financial Disclosure(s)</h3><p>The authors have no proprietary or commercial interest in any materials discussed in this article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000654/pdfft?md5=c2b312975bed4d456349b36dd1a9dbad&pid=1-s2.0-S2666914524000654-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140768489","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":"Clinical Characteristics and Progression of Pachychoroid and Conventional Geographic Atrophy","authors":"Yukiko Sato MD ,&nbsp;Naoko Ueda-Arakawa MD, PhD ,&nbsp;Ayako Takahashi MD, PhD ,&nbsp;Masahiro Miyake MD, PhD ,&nbsp;Yuki Mori MD, PhD ,&nbsp;Yasunori Miyara MD ,&nbsp;Chikako Hara MD, PhD ,&nbsp;Yoko Kitajima MD ,&nbsp;Ruka Maruko MD, PhD ,&nbsp;Moeko Kawai MD ,&nbsp;Hajime Takahashi MD, PhD ,&nbsp;Hideki Koizumi MD, PhD ,&nbsp;Maiko Maruyama-Inoue MD, PhD ,&nbsp;Yasuo Yanagi MD, PhD ,&nbsp;Tomohiro Iida MD, PhD ,&nbsp;Kanji Takahashi MD, PhD ,&nbsp;Taiji Sakamoto MD, PhD ,&nbsp;Akitaka Tsujikawa MD, PhD","doi":"10.1016/j.xops.2024.100528","DOIUrl":"10.1016/j.xops.2024.100528","url":null,"abstract":"<div><h3>Purpose</h3><p>To elucidate the clinical characteristics and progression rates of pachychoroid and conventional geographic atrophy (GA).</p></div><div><h3>Design</h3><p>Retrospective, multicenter, observational study.</p></div><div><h3>Participants</h3><p>A total of 173 eyes from 173 patients (38 eyes with pachychoroid GA and 135 with conventional GA) from 6 university hospitals in Japan were included. All patients were Japanese, aged ≥50 years and with fundus autofluorescence images having analyzable image quality. A total of 101 eyes (22 with pachychoroid GA and 79 with conventional GA) were included in the follow-up group.</p></div><div><h3>Methods</h3><p>The studied eyes were classified as having pachychoroid or conventional GA; the former was diagnosed if the eye had features of pachychoroid and no drusen. The GA area was semiautomatically measured on fundus autofluorescence images, and the GA progression rate was calculated for the follow-up group. Multivariable linear regression analysis was used to determine whether the rate of GA progression was associated with GA subtype.</p></div><div><h3>Main Outcome Measures</h3><p>Clinical characteristics and progression rates of pachychoroid and conventional GA.</p></div><div><h3>Results</h3><p>The pachychoroid GA group was significantly younger (70.3 vs. 78.7 years; <em>P</em> &lt; 0.001), more male-dominant (89.5 vs. 55.6%; <em>P</em> &lt; 0.001), and had better best-corrected visual acuity (0.15 vs. 0.40 in logarithm of the minimum angle of resolution; <em>P</em> = 0.002), thicker choroid (312.4 vs. 161.6 μm; <em>P</em> &lt; 0.001), higher rate of unifocal GA type (94.7 vs. 49.6%; <em>P</em> &lt; 0.001), and smaller GA area (0.59 vs. 3.76 mm²^; <em>P</em> &lt; 0.001) than the conventional GA group. In the follow-up group, the mean GA progression rate (square-root transformation) was significantly lower in the pachychoroid GA group than in the conventional GA group (0.11 vs. 0.27 mm/year; <em>P</em> &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>Demographic and ocular characteristics differed between GA subtypes. The progression rate of pachychoroid GA, adjusted for age and baseline GA area, was significantly lower than that of conventional GA. Japanese patients with conventional GA showed characteristics and progression rates similar to those in White populations. Some characteristics of GA in Japanese population differ from those in Waucasian populations, which may be due to the inclusion of pachychoroid GA.</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":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000642/pdfft?md5=4f58345dd5be031501cd659ca7700e4f&pid=1-s2.0-S2666914524000642-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140770545","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 DAVIO Trial: EYP-1901 Bioerodible, Sustained-Delivery Vorolanib Insert in Patients With Wet Age-Related Macular Degeneration","authors":"Sunil Patel MD, PhD ,&nbsp;Philip P. Storey MD ,&nbsp;Mark R. Barakat MD ,&nbsp;Vrinda Hershberger MD ,&nbsp;William Z. Bridges Jr. MD ,&nbsp;David A. Eichenbaum MD ,&nbsp;David R. Lally MD, PhD ,&nbsp;David S. Boyer MD ,&nbsp;Sophie J. Bakri MD ,&nbsp;Monica Roy OD, MPH ,&nbsp;Dario A. Paggiarino MD","doi":"10.1016/j.xops.2024.100527","DOIUrl":"10.1016/j.xops.2024.100527","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate safety and tolerability of EYP-1901, an intravitreal insert containing vorolanib, a pan–VEGF receptor inhibitor packaged in a bioerodible delivery technology (Durasert E™) for sustained delivery, in patients with wet age-related macular degeneration (wAMD) previously treated with anti-VEGF therapy.</p></div><div><h3>Design</h3><p>Phase I, multicenter, prospective, open-label, dose-escalation trial.</p></div><div><h3>Participants</h3><p>Patients with wAMD and evidence of prior anti-VEGF therapy response.</p></div><div><h3>Methods</h3><p>Patients received a single intravitreal injection of EYP-1901.</p></div><div><h3>Main Outcome Measures</h3><p>The primary objective was to evaluate safety and tolerability of EYP-1901. Secondary objectives assessed biologic activity of EYP-1901 including best-corrected visual acuity (BCVA) and central subfield thickness (CST). Exploratory analyses included reduction in anti-VEGF treatment burden and supplemental injection-free rates.</p></div><div><h3>Results</h3><p>Seventeen patients enrolled in the 440 μg (3 patients), 1030 μg (1 patient), 2060 μg (8 patients), and 3090 μg (5 patients) dose cohorts. No dose-limiting toxicity, ocular serious adverse events (AEs), or systemic AEs related to EYP-1901 were observed. There was no evidence of ocular or systemic toxicity related to vorolanib or the delivery technology. Moderate ocular treatment-emergent AEs (TEAEs) included reduced visual acuity (2/17) and retinal exudates (3/17). One patient with reduced BCVA had 3 separate reductions of 17, 18, and 16 letters, and another had a single drop of 25 letters. One severe TEAE, neovascular AMD (i.e., worsening/progressive disease activity), was reported in 1 of 17 study eyes but deemed unrelated to treatment. Mean change from baseline in BCVA was −1.8 letters and −5.4 letters at 6 and 12 months. Mean change from baseline in CST was +1.7 μm and +2.4 μm at 6 and 12 months. Reduction in treatment burden was 74% and 71% at 6 and 12 months. Of 16 study eyes, 13, 8, and 5 were injection-free up to 3, 6, and 12 months.</p></div><div><h3>Conclusion</h3><p>In the DAVIO trial (<span>ClinicalTrials.gov</span><svg><path></path></svg> identifier, NCT04747197), EYP-1901 had a favorable safety profile and was well tolerated in previously treated eyes with wAMD. Measures of biologic activity remained relatively stable following a single EYP-1901 injection. These preliminary data support ongoing phase II and planned phase III trials to assess efficacy and safety.</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":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000630/pdfft?md5=9d462f7351a608ab1ac261afc7321547&pid=1-s2.0-S2666914524000630-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140776026","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":"Visual Function Measurements in Eyes With Diabetic Retinopathy: An Expert Opinion on Available Measures","authors":"Adam R. Glassman MS ,&nbsp;Mohamed Ashraf Elmasry MD, PhD ,&nbsp;Darrell E. Baskin MD ,&nbsp;Mitchell Brigell PhD ,&nbsp;Victor Chong MD ,&nbsp;Quentin Davis PhD ,&nbsp;Luis Lesmes PhD ,&nbsp;Leonard A. Levin MD, PhD ,&nbsp;Ted Maddess PhD, FNAI ,&nbsp;Laura J. Taylor BSc(Hons) ,&nbsp;Andreas Wenzel PhD","doi":"10.1016/j.xops.2024.100519","DOIUrl":"10.1016/j.xops.2024.100519","url":null,"abstract":"<div><h3>Clinical Relevance</h3><p>Visual function impairment from diabetic retinopathy can have a considerable impact on patient’s quality of life. Best-corrected visual acuity (BCVA) is most commonly used to assess visual function and guide clinical trials. However, BCVA is affected late in the disease process, is not affected in early disease, and does not capture some of the visual disturbances described by patients with diabetes. The goal of this report is to evaluate the relationship between diabetic retinal disease (DRD) and visual function parameters to determine which if any of them may be used in a future DRD staging system.</p></div><div><h3>Methods</h3><p>The visual functions working group was 1 of 6 areas of DRD studied as part of the DRD staging system update, a project of the Mary Tyler Moore Vision Initiative. The working group identified 12 variables of possible interest, 7 of which were judged to have sufficient preliminary data to suggest an association with DR to warrant further review: microperimetry, static automated perimetry, electroretinogram (ERG) oscillatory potentials, flicker ERG, low luminance visual acuity (LLVA), contrast sensitivity (CS), and BCVA. The objective field analyzer (OFA) was added after subsequent in-person workshops.</p></div><div><h3>Results</h3><p>Currently, the only visual function test available for immediate use is BCVA; the remaining tests are either promising (within 5 years) or have potential (&gt;5 years) use. Besides BCVA, most visual function tests had a limited role in current clinical care; however, LLVA, CS, flicker ERG, and OFA demonstrated potential for screening and research purposes.</p></div><div><h3>Conclusions</h3><p>Although current visual function tests are promising, future prospective studies involving patients with early and more advanced retinopathy are necessary to determine if these tests can be used clinically or as endpoints for clinical studies.</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":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000551/pdfft?md5=3217947b683f5b6968fe29909225a468&pid=1-s2.0-S2666914524000551-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788441","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}