Ophthalmology science最新文献

{"title":"HORNBILL: A First-in-Human Phase I/IIa Study of the Safety, Tolerability, and Early Pharmacodynamics of BI 764524 for Diabetic Macular Ischemia","authors":"Quan Dong Nguyen MD, MSc ,&nbsp;Chirag Jhaveri MD ,&nbsp;Maged Habib MD ,&nbsp;Yasir J. Sepah MBBS ,&nbsp;Khaled Nassar MD, PhD ,&nbsp;Bartlomiej Krawczyk PhD ,&nbsp;Gudrun Simons PhD ,&nbsp;Andrea Giani MD ,&nbsp;Elizabeth Pearce PhD ,&nbsp;Martin Gliem MD ,&nbsp;Mohamed Ahmed MBBCh, MD ,&nbsp;Sobha Sivaprasad DM ,&nbsp;HORNBILL Study Group","doi":"10.1016/j.xops.2025.100781","DOIUrl":"10.1016/j.xops.2025.100781","url":null,"abstract":"<div><h3>Objective</h3><div>To report safety and early pharmacodynamic results from a first-in-human trial of intravitreal (IVT) anti-semaphorin 3A antibody in participants with diabetic macular ischemia (DMI).</div></div><div><h3>Design</h3><div>HORNBILL, a phase I/IIa study of BI 764524, comprised a nonrandomized, open-label, uncontrolled, single-rising-dose (SRD) and masked, randomized, sham-controlled, multiple-dose (MD) parts.</div></div><div><h3>Participants</h3><div>Adults with DMI and stable diabetic retinopathy (DR) treated with pan-retinal photocoagulation and without center-involving diabetic macular edema.</div></div><div><h3>Methods</h3><div>Twelve participants received single IVT doses of BI 764524 0.5 mg (n = 3), 1.0 mg (n = 3), or 2.5 mg (n = 6) in the SRD part. Thirty-one participants received 3 IVT doses of BI 764524 2.5 mg (n = 21) or sham procedures (n = 10) at 4-week intervals and were followed to week 22 in the MD part.</div></div><div><h3>Main Outcome Measures</h3><div>The primary SRD end point was the number of participants with dose-limiting events; secondary end points assessed drug-related and ocular adverse events (AEs). The primary MD end point was the number of participants with drug-related AEs; secondary end points included changes from baseline in foveal avascular zone (FAZ) area, best-corrected visual acuity (BCVA), and central subfield thickness (CST).</div></div><div><h3>Results</h3><div>No dose-limiting events or drug-related AEs were reported with SRD; the highest tested dose (2.5 mg) was selected for the MD part. In the MD part, 2 investigator-assessed drug-related AEs (vitreous floaters and increased gamma-glutamyl transferase) were reported. No intraocular inflammation or occlusive retinal vasculitis cases occurred. At week 12 (4 weeks after the final injection), the adjusted mean FAZ area change was −0.004 mm² in the BI 764524 group and +0.019 mm² with sham. At week 22 (14 weeks after the final injection), the adjusted mean FAZ area change was −0.001 mm² in the BI 764524 group and +0.010 mm² with sham. No relevant BCVA and CST changes occurred.</div></div><div><h3>Conclusions</h3><div>HORNBILL met the primary safety end points; all evaluated BI 764524 doses were well tolerated. These findings support further investigation of BI 764524 in participants with DR and retinal nonperfusion.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 5","pages":"Article 100781"},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482422","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":"Light Inhibits Lens-Induced Myopia through an Intensity-Dependent Dopaminergic Mechanism","authors":"Cindy Karouta PhD ,&nbsp;Kate Thomson PhD ,&nbsp;Ian Morgan PhD ,&nbsp;Regan Ashby PhD","doi":"10.1016/j.xops.2025.100779","DOIUrl":"10.1016/j.xops.2025.100779","url":null,"abstract":"<div><h3>Purpose</h3><div>Bright light exposure has been postulated to underlie the ability of time spent outdoors to prevent the development of myopia in humans. In support of this, bright light inhibits the development of form-deprivation myopia (FDM) in all species studied. While lens-induced myopia (LIM) is also inhibited by bright light in most species, it remains unclear whether this is brought about in an intensity-dependent manner and whether dopamine (DA) plays the same critical role in this paradigm as is seen in FDM.</div></div><div><h3>Design</h3><div>An experimental study.</div></div><div><h3>Subjects</h3><div>White Leghorn chickens (<em>Gallus gallus</em>).</div></div><div><h3>Methods</h3><div>To examine the effect of light on LIM, chicks fit with lenses of −10 diopters were exposed to 500, 20 000, or 40 000 lux for 14 days (n = 6 per group). To assess the role of DA, its levels were measured 30 minutes after light exposure in previously dark-adapted animals over 6 light intensities (between dark and 40 000 lux). In a separate experiment, a D1-like (SCH-23390) or D2-like (spiperone) receptor antagonist was administered (once daily) to chicks wearing negative lenses under 40 000 lux (n = 5 to 6 per group) for a period of 5 days.</div></div><div><h3>Main Outcome Measures</h3><div>Refraction (infrared photoretinoscopy), axial length (A-scan ultrasonography), and DA levels (liquid chromatography-tandem mass spectrometry).</div></div><div><h3>Results</h3><div>Bright light inhibited LIM in an intensity-dependent manner (<em>P</em> &lt; 0.05) but did not prevent full compensation. The protection afforded by bright light was significantly reduced by administration of spiperone (D2-like, <em>P</em> &lt; 0.05), but not SCH-23390 (D1-like, <em>P</em> = 0.77). Retinal DA levels showed an intensity-dependent increase (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>As previously observed for FDM, bright light can inhibit the development of LIM in an intensity-dependent manner. This protection occurs, at least in part, via a DA-dependent mechanism. However, bright light's inability to prevent compensation to negative lenses is indicative of mechanistic differences between the 2 experimental models of myopia. These differences are most likely linked to the presence of a defocus-driven end point for growth in LIM that is not present in FDM.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 5","pages":"Article 100779"},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143911923","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":"Computerized Analysis of the Eye Vasculature in a Mass Dataset of Digital Fundus Images: The Example of Age, Sex, and Primary Open-Angle Glaucoma","authors":"Jonathan Fhima MSc ,&nbsp;Jan Van Eijgen MD, PhD ,&nbsp;Anat Reiner-Benaim PhD ,&nbsp;Lennert Beeckmans MSc ,&nbsp;Or Abramovich MSc ,&nbsp;Ingeborg Stalmans MD, PhD ,&nbsp;Joachim A. Behar PhD","doi":"10.1016/j.xops.2025.100778","DOIUrl":"10.1016/j.xops.2025.100778","url":null,"abstract":"<div><h3>Objective</h3><div>To develop and validate an automated end-to-end methodology for analyzing retinal vasculature in large datasets of digital fundus images (DFIs), aiming to assess the influence of demographic and clinical factors on retinal microvasculature.</div></div><div><h3>Design</h3><div>This study employs a retrospective cohort design to achieve its objectives.</div></div><div><h3>Participants</h3><div>The research utilized a substantial dataset consisting of 32 768 DFIs obtained from individuals undergoing routine eye examinations. There was no inclusion of a separate control group in this study.</div></div><div><h3>Methods</h3><div>The proposed methodology integrates multiple stages: initial image quality assessment, detection of the optic disc (OD), definition of the region of interest surrounding the OD, automated segmentation of retinal arterioles and venules, and the engineering of digital biomarkers representing vasculature characteristics. To analyze the impact of demographic variables (age, sex) and clinical factors (disc size, primary open-angle glaucoma [POAG]), statistical analyses were performed using linear mixed-effects models.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes measured were changes in the retinal vascular geometry. Special attention was given to evaluating the independent effects of age, sex, disc size, and POAG on the newly engineered microvasculature biomarkers.</div></div><div><h3>Results</h3><div>The analysis revealed significant independent similarities in the retinal vascular geometry alterations associated with both advanced age and POAG. These findings suggest a potential mechanism of accelerated vascular aging in patients with POAG.</div></div><div><h3>Conclusions</h3><div>This novel methodology allows for the comprehensive and quantitative analysis of retinal vasculature, facilitating the investigation of its correlations with specific diseases. By enabling the reproducible analysis of extensive datasets, this approach provides valuable insights into the state of retinal vascular health and its broader implications for cardiovascular and ocular health. The software developed through this research will be made publicly available upon publication, offering a critical tool for ongoing and future studies in retinal vasculature.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 5","pages":"Article 100778"},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Onset of End-Stage Atrophic Age-Related Macular Degeneration as an End Point—A Delphi Study: Classification of Atrophy Meetings Report 7","authors":"Zhichao Wu BAppSc(Optom), PhD ,&nbsp;Srinivas R. Sadda MD ,&nbsp;Thomas Ach MD ,&nbsp;Barbara A. Blodi MD ,&nbsp;Ferdinando Bottoni MD ,&nbsp;Usha Chakravarthy MD, PhD ,&nbsp;Emily Y. Chew MD ,&nbsp;Christine A. Curcio PhD ,&nbsp;Frederick L. Ferris III MD ,&nbsp;Monika Fleckenstein MD ,&nbsp;K. Bailey Freund MD ,&nbsp;Juan E. Grunwald MD ,&nbsp;Frank G. Holz MD ,&nbsp;Glenn J. Jaffe MD ,&nbsp;Sandra Liakopoulos MD ,&nbsp;Tock Han Lim FRCSEd ,&nbsp;Jordi M. Monés MD, PhD ,&nbsp;Sergio Pagliarini MD, FRCOphth ,&nbsp;Daniel Pauleikhoff MD ,&nbsp;Maximilian Pfau MD ,&nbsp;Robyn H. Guymer MBBS, PhD","doi":"10.1016/j.xops.2025.100777","DOIUrl":"10.1016/j.xops.2025.100777","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate whether consensus can be reached on the acceptability of end-stage atrophy onset as a clinical end point in early intervention trials of age-related macular degeneration (AMD), and the criteria for defining such an end point.</div></div><div><h3>Design</h3><div>A modified Delphi study.</div></div><div><h3>Participants</h3><div>International panel of experts in AMD, retinal imaging, and histopathology that are part of the Classification of Atrophy Meetings group.</div></div><div><h3>Methods</h3><div>A modified Delphi study was undertaken to determine if there is consensus on the acceptability of the onset of end-stage atrophic AMD as a clinical end point to evaluate early interventions and the criteria for defining such an end point. Two initial rounds of online surveys were conducted. Aggregate results and anonymized comments were provided after each round, followed by a face-to-face meeting before a final survey round was completed.</div></div><div><h3>Main Outcome Measures</h3><div>Statements where consensus was reached, defined as ≥80% of responses within the 3-point bracket for agreement or disagreement based on a 9-point Likert rating scale, from a total of 33 statements included in the final round of the survey.</div></div><div><h3>Results</h3><div>Consensus was reached for the statement that the onset of end-stage atrophic AMD was an appropriate clinical end point to evaluate early interventions (82% responses in agreement). Consensus was also reached for the statement that such an end point should be defined based on anatomical changes that have been previously shown in clinical studies to be associated with marked, but not necessarily complete, functional loss (95% responses in agreement). Consensus was nearly reached for the specific criterion that ≥90% of such atrophic AMD lesions should have ≥1 test location that was ≤10 decibels on 2 microperimetry tests (77% responses in agreement).</div></div><div><h3>Conclusions</h3><div>There was expert group consensus that the onset of end-stage atrophy is an appropriate clinical end point to evaluate early interventions in AMD, and that such an end point should show evidence of marked functional loss in prior clinical studies. We believe these findings will help to define incident clinical end points that are acceptable to regulatory authorities.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 5","pages":"Article 100777"},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genotypic Distribution and Clinical Correlations in Familial Exudative Vitreoretinopathy: A Single-Center Study","authors":"Brian T. Soetikno MD PhD ,&nbsp;Emily Spoth MS ,&nbsp;M. Elizabeth Hartnett MD","doi":"10.1016/j.xops.2025.100782","DOIUrl":"10.1016/j.xops.2025.100782","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the role of wide-angle imaging in detecting suspicious cases of familial exudative vitreoretinopathy (FEVR) in pediatric patients with unexplained vision loss and describe genotypic distribution and examples of phenotypes.</div></div><div><h3>Design</h3><div>A retrospective cohort study was conducted at a single tertiary referral center in the Intermountain West.</div></div><div><h3>Subjects and Participants</h3><div>Patients diagnosed with FEVR or atypical retinopathy of prematurity (ROP) between 2010 and 2021 at the University of Utah. Twenty-five families with FEVR were included, with 21 families undergoing genetic testing. Eight families with atypical ROP were included.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of patients referred with unexplained vision loss and diagnosed with FEVR at the pediatric retina center at the University of Utah from 2010 to 2021. Clinical examination and wide-angle fluorescein angiography (FA) were performed. Patients identified with abnormal peripheral retinal or intravitreal vascularization were recommended for genetic testing. Next-generation sequencing was used to identify variants in known genes associated with FEVR. The positivity rate and the proportion of each positive genetic mutation were calculated. We also include a small cohort of premature infants with atypical ROP who underwent genetic testing prior to the examination under anesthesia.</div></div><div><h3>Main Outcome Measures</h3><div>Detection rate of FEVR-associated mutations.</div></div><div><h3>Results</h3><div>Genetic variants were identified in 85.7% of families who underwent testing, exceeding previously reported detection rates. LRP5 (33.3%) and FZD4 (19%) were the most common mutations. Indeterminate results were reported in 4.8% of cases, while 9.5% had negative results for FEVR-associated mutations. Among the 8 premature infants with atypical regression of ROP, none tested positive for FEVR-associated genotypes. We described 5 illustrative cases that demonstrate unique presentations in our cohort, including those showing phenotypic variability or masquerading as other disorders.</div></div><div><h3>Conclusions</h3><div>The findings highlight the genotypic and phenotypic heterogeneity of FEVR and underscore the value of wide-angle FA to trigger obtaining genetic testing for accurate diagnosis. A high clinical suspicion for FEVR is recommended in pediatric patients with unexplained vision loss and vitreoretinal abnormalities. Future studies are needed to investigate additional genetic modifiers and refine genotype–phenotype correlations.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 5","pages":"Article 100782"},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Eye-Related Emergency Department Visits and Pediatric Eye Provider Location and Density","authors":"Julius T. Oatts MD ,&nbsp;Albert Xu BS ,&nbsp;Jonathan R. Morse BA ,&nbsp;John M. Nesemann MD ,&nbsp;Kara M. Cavuoto MD ,&nbsp;Jeremy D. Keenan MD","doi":"10.1016/j.xops.2025.100776","DOIUrl":"10.1016/j.xops.2025.100776","url":null,"abstract":"<div><h3>Objective</h3><div>There is a shortage of pediatric eye specialists. Inaccessible eye care may lead parents to bring their children to the emergency department (ED) to address eye problems that could have been handled at a clinic visit. This study aimed to determine the association between childhood eye-related ED visits and the location and density of pediatric eye specialists in California.</div></div><div><h3>Design</h3><div>A population-based cross-sectional study.</div></div><div><h3>Participants</h3><div>All California ED visits between January 2012 and December 2021 for patients ≤18 years of age were identified using the California Office of Health Care Access and Information Database.</div></div><div><h3>Methods</h3><div>International Classification of Diseases diagnosis codes were used to identify eye-related ED visits. Public databases were used to identify pediatric ophthalmologist and optometrist addresses. Census data were used to determine the number of visits per 10 000 children in each zip code. Poisson regressions evaluated associations at the zip code level of eye-related ED visits and provider density with geographic sociodemographic factors.</div></div><div><h3>Main Outcome Measures</h3><div>Incidence of pediatric eye-related ED visits.</div></div><div><h3>Results</h3><div>Of the 117 363 721 ED visits in California between 2012 and 2021, 27 346 729 (23.3%) were for children, of which 391 985 (1.4%) were eye-related. Median age was 5.0 years (interquartile range: 2.0, 10.0), and 51.7% were male. The most common diagnoses were conjunctivitis (250 028; 63.8%), chalazion/blepharitis (56 389; 14.4%), and other disorders of the eye/adnexa (13 070; 3.3%). The mean number of visits per year per 10 000 children was 43 ± 12 (median 46, interquartile range: 43, 51). The estimated number of pediatric eye providers in California in 2023 was 142 (1 per 61 413 children). Zip codes with more pediatric eye providers had fewer eye-related ED visits: each additional provider per 10 000 children was associated with 2.1 fewer eye-related ED visits per 10 000 children (95% confidence interval −0.04 to −4.25; <em>P</em> = 0.046).</div></div><div><h3>Conclusions</h3><div>Most eye-related ED visits were for nonemergent eye conditions. There was a low eye provider-to-child ratio and an association between provider density and eye-related ED visit incidence. Expanding pediatric eye care could improve access and decrease ED utilization for nonemergent eye concerns.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 5","pages":"Article 100776"},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal Imaging Biomarkers and Correlation to Systemic Disease Activity in Pediatric Sickle Cell Disease","authors":"Sandra Hoyek MD ,&nbsp;Celine Chaaya MD ,&nbsp;Colin A. Lemire BS ,&nbsp;Omar Halawa MD ,&nbsp;Francisco Altamirano MD ,&nbsp;Natasha M. Archer MD ,&nbsp;Efren Gonzalez MD ,&nbsp;Nimesh A. Patel MD","doi":"10.1016/j.xops.2025.100774","DOIUrl":"10.1016/j.xops.2025.100774","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To correlate retinal imaging findings with systemic disease activity in children with sickle cell disease (SCD).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A retrospective consecutive series.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Subjects&lt;/h3&gt;&lt;div&gt;Children with SCD aged ≤18 years who had an ophthalmic examination at Boston Children's Hospital between January 1998 and August 2022 were included.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;Systemic findings included the number of hospitalizations, number of strokes, treatment with hydroxyurea, hemoglobin (Hgb), and fetal Hgb levels, and time-averaged mean velocity (TAMV) in the right middle cerebral artery (RMCA) and left middle cerebral artery (LMCA) on transcranial Doppler (TCD).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Total retinal thickness was measured on macular OCT (Spectralis OCT2, Heidelberg Engineering). Vessel density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) and superficial foveal avascular zone area were measured on 6 × 6-mm OCT angiography (OCTA) scans.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Six hundred six eyes from 303 pediatric SCD patients (53% males) were included. OCT and OCTA images were acquired on 104 (17.2%) and 60 (9.9%) eyes at presentation and on 159 (26.2%) and 100 (16.5%) eyes at the final visit, respectively. When adjusting for race and age, retinal thinning on OCT was associated with a higher frequency of hospitalizations, a higher frequency of strokes, and treatment with hydroxyurea. Retinal thickness in the inferior and temporal macula was positively correlated with TAMV in RMCA and in LMCA. Foveal retinal thickness was positively correlated with Hgb level. Similarly, reduced VD in the SCP and DCP in the inferior temporal macula correlated with a higher number of hospitalizations and strokes. A higher VD of the DCP in the inferior-temporal macula positively correlated with TAMV in RMCA (ρ = 0.328, &lt;em&gt;P&lt;/em&gt; = 0.3) and in LMCA (ρ = 0.342, &lt;em&gt;P&lt;/em&gt; = 0.029). A higher Hgb level correlated with a higher prevalence (ρ = 0.237, &lt;em&gt;P&lt;/em&gt; = 0.037) and severity (ρ = 0.299, &lt;em&gt;P&lt;/em&gt; = 0.008) of peripheral retinopathy in HbSC, while it correlated with lower prevalence (ρ = −0.183, &lt;em&gt;P&lt;/em&gt; = 0.004) and severity (ρ = −0.185, &lt;em&gt;P&lt;/em&gt; = 0.004) of peripheral retinopathy in HbSS genotypes. Visual acuity did not correlate with TCD velocity, Hgb level, or number of hospitalizations in HbSS or HbSC genotypes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;OCT and OCTA findings are correlated with the severity of systemic disease in children with SCD. Imaging parameters were better correlated with key outcomes such as stroke and hospitalizations than visual acuity. The results suggest that quantitative measures on retinal imaging could be used as biomarkers to predict systemic disease risk and activity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Financial Disclosure(s)&lt;/h3&gt;&lt;div&gt;Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at t","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 5","pages":"Article 100774"},"PeriodicalIF":3.2,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Myopic Defocus on the Retina and Choroid and Its Interaction with Defocus Regions, Diurnal Rhythm, and Accommodation","authors":"Yingying Huang MD ,&nbsp;Jiali Zhang MD ,&nbsp;Xue Li PhD,&nbsp;Hao Chen MD, OD,&nbsp;Jinhua Bao PhD","doi":"10.1016/j.xops.2025.100773","DOIUrl":"10.1016/j.xops.2025.100773","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the effect of defocus region and amount, diurnal rhythm, and accommodation on myopic defocus-induced changes in the retina and choroid.</div></div><div><h3>Design</h3><div>Four test lenses were used: single-vision soft contact lens (SVCL), bifocal spectacle lens (BSL) with +3.50 diopters (D) addition in the inferior visual field, defocus incorporated multiple segments lens (DIMS), and dual-focus contact lens (DFCL) with +2.00 D addition.</div></div><div><h3>Participants</h3><div>Twenty-one adults aged between 18 and 30 years, myopia between −1.00 D and −6.00 D, were included.</div></div><div><h3>Methods</h3><div>Four lenses were used in random order at 4 separate days for each participant. Participants underwent OCT and OCT angiography examinations after distance-viewing (4 m) and near-viewing (20 cm) for 20 minutes with 4 test lenses at both 10 <span>am</span> and 5 <span>pm</span>.</div></div><div><h3>Main Outcome Measures</h3><div>Retinal and choroidal thicknesses (RT and ChT) and vessel density were assessed.</div></div><div><h3>Results</h3><div>The changes in RT, retinal and choroidal vessel density were not significantly different between lenses or times (all <em>P</em> &gt; 0.05). Choroidal thickness changes differed between lenses after near-viewing in both the morning and evening and after distance-viewing in the morning (all <em>P</em> &lt; 0.05). Compared with SVCL, BSL, DIMS, and DFCL achieved lower ChT reductions (all <em>P</em> &lt; 0.05), and BSL showed least reduction. No lenses completely inhibited ChT thinning after near-viewing.</div></div><div><h3>Conclusions</h3><div>Myopic defocus inhibited choroid thinning more effectively in the morning, and provided sufficient defocus in the superior retina was more effective. The amount of lens defocus in this study (+3.50 D) was insufficient to inhibit choroidal thinning with 5 D accommodation completely.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 5","pages":"Article 100773"},"PeriodicalIF":3.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pivotal Trial Validating Usability and Visualization Performance of Home OCT in Neovascular Age-Related Macular Degeneration: Report 1","authors":"Jeffrey S. Heier MD ,&nbsp;Nancy M. Holekamp MD ,&nbsp;Miguel A. Busquets MD ,&nbsp;Michael J. Elman MD ,&nbsp;Sidney A. Schechet MD ,&nbsp;Byron S. Ladd MD ,&nbsp;Kapil G. Kapoor MD ,&nbsp;Eric W. Schneider MD ,&nbsp;Ella H. Leung MD ,&nbsp;Ron P. Danis MD ,&nbsp;Kester Nahen PhD ,&nbsp;Nishant Mohan PhD ,&nbsp;Gidi Benyamini MBA","doi":"10.1016/j.xops.2025.100772","DOIUrl":"10.1016/j.xops.2025.100772","url":null,"abstract":"<div><h3>Purpose</h3><div>To validate the usability and visualization performance of the index test of the home OCT system (HOCT) during a pivotal study toward de novo US Food and Drug Administration marketing authorization.</div></div><div><h3>Design</h3><div>A prospective, 5-week longitudinal, at-home visualization multicenter study with preplanned office visits at week 1 and week 5 and as-needed interim visits.</div></div><div><h3>Participants</h3><div>The study enrolled adults aged ≥55 years diagnosed with neovascular age-related macular degeneration (nAMD) on anti-VEGF therapy in at least 1 eligible eye and best-corrected visual acuity of 20/320 or better.</div></div><div><h3>Methods</h3><div>Participants self-installed and imaged daily with the HOCT at home for 5 weeks with 2 or 3 interspersed office visits at 1 and 5 weeks with interim reading center (RC)-triggered visits including a comparator in-office OCT (IO-OCT). Scans with an acceptable quality signal index were independently graded by the RC in a masked manner.</div></div><div><h3>Main Outcome Measures</h3><div>Ability to self-image at home, positive and negative percent agreement (NPA) in visualization of total hyporeflective spaces (TRO) on HOCT and on IO-OCT.</div></div><div><h3>Results</h3><div>At home, self-imaging success rate was 96.1% (95% confidence interval [CI]: 92.2%–98.4%). One hundred eighty participants self-imaged the primary and secondary eyes 5426 and 4012 times with a mean (standard deviation) manufacturer signal quality index of 4.40 (1.26) and 4.58 (1.28), respectively. Positive percent agreement was 86.6% (95% CI: 80.4%–92.8%) and NPA was 86.1% (95% CI: 80.4%–91.8%), with nearly all disagreements being minimal.</div></div><div><h3>Conclusions</h3><div>The target population successfully self-installed and self-imaged at home with image quality comparable to IO-OCT. The findings of the visualization study support the intended use of the system as a tool to monitor TRO at home between routine clinical visits during the management of nAMD.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 5","pages":"Article 100772"},"PeriodicalIF":3.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Age-Related Macular Degeneration with Cholelithiasis","authors":"Kevin R. Zhang MD, PhD ,&nbsp;Rohini M. Nair PhD ,&nbsp;Yineng Chen MS ,&nbsp;Fangming Jin MS ,&nbsp;Joshua Dunaief MD, PhD ,&nbsp;Brian L. VanderBeek MD, MPH","doi":"10.1016/j.xops.2025.100771","DOIUrl":"10.1016/j.xops.2025.100771","url":null,"abstract":"<div><h3>Purpose</h3><div>Dysregulated lipid metabolism likely contributes to the pathogenesis of age-related macular degeneration (AMD). There is an overlap in risk factors between AMD and diseases of lipid metabolism, such as cholelithiasis, suggesting that an association between these diseases could provide insight into AMD pathogenesis. This study sought to determine if there is an association between cholelithiasis and AMD.</div></div><div><h3>Design</h3><div>A cohort study was conducted using patients in the Optum deidentified Clinformatics Data Mart database from January 1, 2000, to June 30, 2022.</div></div><div><h3>Participants</h3><div>Patients over the age of 55 with ≥2 years of data and no prior history of AMD were included. The exposed cohort included patients who had a history of cholelithiasis, cholecystitis, or cholecystectomy. The control cohort included patients with gastroesophageal reflux disease (GERD), matched for age ±3 years, sex, race, and year of index date.</div></div><div><h3>Methods</h3><div>Propensity scores were created using multivariable logistic regression and applied to inverse probability of treatment weighting (IPTW). Cox proportional hazard regression modeling with IPTW was used to compare progression to AMD in each cohort.</div></div><div><h3>Main Outcome Measures</h3><div>Progression to AMD for patients with cholelithiasis, cholecystitis, or a history of cholecystectomy.</div></div><div><h3>Results</h3><div>A total of 332 536 patients with cholelithiasis and 776 591 matched GERD controls were analyzed. After IPTW, the mean age (±standard deviation) was 66.6 ± 9.4 years in the cholelithiasis cohort and 67.5 (±10.3) years in the GERD cohort. Women comprised 58% of the cholelithiasis cohort and 57% of the GERD cohort. In the cholelithiasis cohort, 3511.7 (1.14%) were diagnosed with AMD, compared with 23 367.1 (2.92%) in the GERD cohort and corresponding to a significantly decreased hazard of AMD (adjusted hazard ratio [aHR] = 0.72, 95% confidence interval [CI]: 0.69–0.75, <em>P</em> &lt; 0.0001). In the subanalysis, before IPTW weighting, AMD developed in 3809 of 275 897 (1.4%) patients with only cholelithiasis (aHR = 0.76, 95% CI: 0.73–0.80, <em>P</em> &lt; 0.0001), 335 of 47 166 (0.71%) patients with cholecystitis (aHR = 0.54, 95% CI: 0.47–0.61, <em>P</em> &lt; 0.0001), and 114 of 9473 (1.20%) patients who underwent cholecystectomy (aHR = 0.50, 95% CI: 0.41–0.63, <em>P</em> &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>Cholelithiasis was associated with a 28% hazard reduction in AMD. More severe gallbladder disease conferred greater protection.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 4","pages":"Article 100771"},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}