Ophthalmology science最新文献

{"title":"A Multihead Attention Deep Learning Algorithm to Detect Amblyopia Using Fixation Eye Movements","authors":"Dipak P. Upadhyaya MS ,&nbsp;Gokce Cakir MD ,&nbsp;Stefano Ramat PhD ,&nbsp;Jeffrey Albert PhD ,&nbsp;Aasef Shaikh MD, PhD ,&nbsp;Satya S. Sahoo PhD ,&nbsp;Fatema Ghasia MD","doi":"10.1016/j.xops.2025.100775","DOIUrl":"10.1016/j.xops.2025.100775","url":null,"abstract":"<div><h3>Objective</h3><div>To develop an attention-based deep learning (DL) model based on eye movements acquired during a simple visual fixation task to detect amblyopic subjects across different types and severity from controls.</div></div><div><h3>Design</h3><div>An observational study.</div></div><div><h3>Subjects</h3><div>We recruited 40 controls and 95 amblyopic subjects (anisometropic = 32; strabismic = 29; and mixed = 34) at the Cleveland Clinic from 2020 to 2024.</div></div><div><h3>Methods</h3><div>Binocular horizontal and vertical eye positions were recorded using infrared video-oculography during binocular and monocular viewing. Amblyopic subjects were classified as those without nystagmus (n = 42) and those with nystagmus with fusion maldevelopment nystagmus (FMN) or nystagmus that did not meet the criteria of FMN or infantile nystagmus syndrome (n = 53). A multihead attention-based transformer encoder model was trained and cross-validated on deblinked and denoised eye position data acquired during fixation.</div></div><div><h3>Main Outcome Measures</h3><div>Detection of amblyopia across types (anisometropia, strabismus, or mixed) and severity (treated, mild, moderate, or severe) and subjects with and without nystagmus was evaluated with area under the receiver-operator characteristic curves, area under the precision–recall curve (AUPRC), and accuracy.</div></div><div><h3>Results</h3><div>Area under the receiver-operator characteristic curves for classification of subjects per type were 0.70 ± 0.16 for anisometropia (AUPRC: 0.72 ± 0.08), 0.78 ± 0.15 for strabismus (AUPRC: 0.81 ± 0.16), and 0.80 ± 0.13 for mixed (AUPRC: 0.82 ± 0.15). Area under the receiver-operator characteristic curves for classification of amblyopia subjects per severity were 0.77 ± 0.12 for treated/mild (AUPRC: 0.76 ± 0.18), and 0.78 ± 0.09 for moderate/severe (AUPRC: 0.79 ± 0.16). Th area under the receiver-operator characteristic curve for classification of subjects with nystagmus was 0.83 ± 0.11 (AUPRC: 0.81 ± 0.18), and the area under the receiver-operator characteristic curve for those without nystagmus was 0.75 ± 0.15 (AUPRC: 0.76 ± 0.09).</div></div><div><h3>Conclusions</h3><div>The multihead transformer DL model classified amblyopia subjects regardless of the type, severity, and presence of nystagmus. The model's ability to identify amblyopia using eye movements alone demonstrates the feasibility of using eye-tracking data in clinical settings to perform objective classifications and complement traditional amblyopia evaluations.</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 100775"},"PeriodicalIF":3.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143907488","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}

{"title":"Transplant of Induced Pluripotent Stem Cell–Derived Retinal Pigment Epithelium Strips for Macular Degeneration and Retinitis Pigmentosa","authors":"Daiki Sakai MD ,&nbsp;Michiko Mandai MD, PhD ,&nbsp;Yasuhiko Hirami MD, PhD ,&nbsp;Midori Yamamoto BA ,&nbsp;Shin-ichiro Ito MD, PhD ,&nbsp;Saori Igarashi MD ,&nbsp;Satoshi Yokota MD, PhD ,&nbsp;Hirofumi Uyama MD, PhD ,&nbsp;Masashi Fujihara MD, PhD ,&nbsp;Akiko Maeda MD, PhD ,&nbsp;Motoki Terada BS ,&nbsp;Mitsuhiro Nishida MS ,&nbsp;Yumiko Shibata MS ,&nbsp;Naoko Hayashi MS ,&nbsp;Kyoko Iseki MA ,&nbsp;Takuya Miura MS ,&nbsp;Keisuke Kajita MD, PhD ,&nbsp;Masaaki Ishida MD, PhD ,&nbsp;Sunao Sugita MD, PhD ,&nbsp;Tadao Maeda MD, PhD ,&nbsp;Yasuo Kurimoto MD, PhD","doi":"10.1016/j.xops.2025.100770","DOIUrl":"10.1016/j.xops.2025.100770","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the safety and efficacy of the allogeneic induced pluripotent stem cell (iPSC)–derived retinal pigment epithelium (RPE) strip transplantation for patients with RPE degeneration.</div></div><div><h3>Design</h3><div>Single-arm, open-label, interventional study.</div></div><div><h3>Participants</h3><div>Three eyes from 3 patients clinically diagnosed with RPE impairment disease; 1 patient had dry age-related macular degeneration (AMD), and remaining 2 patients had <em>MERTK</em>-associated retinitis pigmentosa.</div></div><div><h3>Intervention</h3><div>Allogeneic iPSC-derived RPE strip transplantation was performed by a 25-gauge pars plana vitrectomy. The RPE strips were prepared by incubating iPSC-derived RPE cells in 2-mm-wide grooves in the mold. Artificial retinal detachment was generated using a 38-gauge subretinal cannula, and the RPE strips were injected into the retinal bleb using a 31-gauge cannula with the maximum graft dose limited to 2 strips.</div></div><div><h3>Main Outcome Measures</h3><div>The reduction of RPE abnormal area by the engraftment of transplanted allogeneic iPSC-derived RPE cells, which was measured by analyzing fluorescein angiography with an automated evaluation program at pretransplantation and up to 52 weeks posttransplantation.</div></div><div><h3>Results</h3><div>The primary endpoint of reducing abnormal areas of RPE through the survival of the transplanted graft cells was achieved in all patients at 52 weeks posttransplantation. Visual function assessments confirmed significant vision-related quality of life improvement and potential retinal sensitivity restoration in 1 patient with dry AMD. The successful subretinal delivery of the iPSC-derived RPE strips was confirmed during and immediately after surgery. The engraftment of RPE cells migrated out from the strips was observed using polarization-sensitive OCT specifically and visualized as characteristic hexagonal cells via adaptive optics imaging in all patients. While no serious adverse events occurred, suspected immune reactions to graft cells and epiretinal membrane formation were observed in 1 patient each.</div></div><div><h3>Conclusions</h3><div>A decrease in the RPE abnormal area by reliable delivery of allogeneic iPSC-derived RPE strips was achieved in all 3 cases with no serious adverse events. Further long-term studies and larger cohorts with better preoperative vision are warranted to evaluate the safety and efficacy of RPE strip transplantation.</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 100770"},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838320","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":"Loss of Peripheral Retinal Vessels in Retinitis Pigmentosa","authors":"Hossein Ameri MD, PhD ,&nbsp;Alexander T. Hong BS ,&nbsp;Jason Chwa BS","doi":"10.1016/j.xops.2025.100767","DOIUrl":"10.1016/j.xops.2025.100767","url":null,"abstract":"<div><h3>Objective</h3><div>Retinitis pigmentosa (RP) is the most common inherited retinal disease and a major cause of irreversible vision loss. The purpose of this study was to assess peripheral retinal vessels in RP.</div></div><div><h3>Design</h3><div>A cross-sectional study.</div></div><div><h3>Subjects</h3><div>Patients with RP and age-matched controls.</div></div><div><h3>Methods</h3><div>Using ultra-widefield fundus images, the retina was divided into 3 zones: posterior, midperiphery, and far periphery. To evaluate vascularity of the retina, the vessels were counted at the border of posterior and midperipheral zones (Z1/2) and the border of midperipheral and far peripheral zones (Z2/3).</div></div><div><h3>Main Outcome Measures</h3><div>Vessel counts at Z1/2 and Z2/3.</div></div><div><h3>Results</h3><div>One hundred eighty-one eyes of 107 RP patients and 130 eyes of 84 controls were included. In the RP group, the median vessel counts at Z1/2 and Z2/3 were 8 and 3, respectively. These were strikingly lower than the control group with the median vessels of 42 and 43.5 at Z1/2 (<em>P</em> &lt; 0.001) and Z2/3 (<em>P</em> &lt; 0.001), respectively. Twenty-two percent of RP eyes were entirely avascular in the far periphery, and 7% were avascular in the midperiphery and far periphery. Only 5% of RP eyes had &gt;25 vessels at Z2/3. There were significantly fewer vessels in the temporal retina at both Z1/2 (<em>P</em> = 0.01) and Z2/3 (<em>P</em> &lt; 0.001) in RP eyes. Furthermore, eyes with visual acuity of 20/200 or worse had significantly fewer vessels at Z1/2 (<em>P</em> &lt; 0.001) and Z2/3 (<em>P</em> &lt; 0.001). There were no significant differences in the number of vessels at Z1/2 and 2/3 between the right and left eyes of RP patients with both eyes included in the study.</div></div><div><h3>Conclusions</h3><div>This study provides compelling evidence of substantial symmetrical peripheral retinal vascular loss in RP. This finding may aid in clinical diagnosis of the disease and have significant therapeutic implications.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 4","pages":"Article 100767"},"PeriodicalIF":3.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848530","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":"Loss of OCT Outer Retinal Bands as Potential Clinical Trial Endpoints in Intermediate Age-Related Macular Degeneration","authors":"Zhichao Wu BAppSc(Optom), PhD ,&nbsp;Sandro De Zanet PhD ,&nbsp;Joseph P.M. Blair PhD ,&nbsp;Robyn H. Guymer MBBS, PhD","doi":"10.1016/j.xops.2025.100769","DOIUrl":"10.1016/j.xops.2025.100769","url":null,"abstract":"<div><h3>Purpose</h3><div>To understand the potential utility of evaluating loss of the outer retinal bands on OCT B-scans as outcome measures for early interventional trials in age-related macular degeneration (AMD).</div></div><div><h3>Design</h3><div>An observational study.</div></div><div><h3>Participants</h3><div>Two hundred eighty eyes from 140 participants with bilateral large drusen.</div></div><div><h3>Methods</h3><div>All participants underwent OCT imaging, color fundus photography, and microperimetry testing at 6-monthly intervals up to 36 months. The extent of loss of the external limiting membrane (ELM), ellipsoid zone (EZ), and retinal pigment epithelium (RPE) bands on OCT was derived in the central 5-mm diameter, and within 5 equiareal sectors in the central 3.6-mm diameter where microperimetry testing was performed.</div></div><div><h3>Main Outcome Measures</h3><div>The potential utility of the OCT outer retinal bands was examined based on their performance at capturing longitudinal changes according to the coefficient of variation (CoV; lower values indicating better performance) and their association with visual sensitivity loss.</div></div><div><h3>Results</h3><div>Overall, the extent of loss of all 3 OCT bands increased significantly over time (<em>P</em> &lt; 0.001), with a significant change from baseline first detected at 12 months for ELM and EZ loss and at 24 months for RPE loss (<em>P</em> ≤ 0.005 for all). Changes in the ELM, EZ, and RPE loss were all individually associated with change in mean sensitivity, percentage of locations showing a ≥7 decibels loss from baseline, and change in percentage of deep visual sensitivity defects at each corresponding sector tested on microperimetry (≤10 dB; <em>P</em> &lt; 0.001 for all). The CoV of the rate of ELM and EZ loss was lower than RPE loss (<em>P</em> &lt; 0.001 for both), and lower for EZ compared with ELM loss (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The extent of loss of the outer retinal bands on OCT increased significantly over time in a cohort with intermediate AMD that was associated with changes in visual sensitivity, and measurements of EZ loss had the highest performance for capturing longitudinal changes. These findings highlight the potential utility of these parameters for evaluating interventions in the early stages of AMD.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 4","pages":"Article 100769"},"PeriodicalIF":3.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143858781","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":"Profiles of Choroidal Vortex Vein Drainage System Using Ultra-Widefield OCT Angiography in a Chinese Population","authors":"Zhonghua Luo MD ,&nbsp;Zhenping Li MD ,&nbsp;Yuefeng Yu MD ,&nbsp;Yan Lu MD, PhD ,&nbsp;Yangyang Du MMed ,&nbsp;Xiaolan Xiang MMed ,&nbsp;Caijuan Lin MMed ,&nbsp;Kun Xu MMed ,&nbsp;Yue Xu MD, PhD ,&nbsp;Jingjing Huang MD, PhD ,&nbsp;Shanshan Yu MD ,&nbsp;Yuqing Lan MD, PhD ,&nbsp;Xiaoling Liang MD, PhD","doi":"10.1016/j.xops.2025.100768","DOIUrl":"10.1016/j.xops.2025.100768","url":null,"abstract":"<div><h3>Purpose</h3><div>To develop a normative profile for choroidal vortex vein systems based on ultra-widefield OCT angiography (UWF-OCTA) in a healthy Chinese population.</div></div><div><h3>Design</h3><div>A cross-sectional, multicenter study.</div></div><div><h3>Participants</h3><div>A total of 515 eyes of 515 Chinese adults (515 healthy eyes) aged ≥20 years were recruited from the Choroidal Vortex Vein System Study.</div></div><div><h3>Methods</h3><div>All participants underwent comprehensive ophthalmic examinations. The 2-dimensional and 3-dimensional choroidal parameters of the vortex vein system were measured in each vortex vein drainage quadrant (24 × 20 mm² scan mode; central, superotemporal [ST], superonasal [SN], inferonasal [IN], and inferotemporal [IT] quadrants) using a UWF-OCTA device. The normative profile examined the choroidal parameters' fifth and 95th percentile values. The associations of ocular and systemic factors with choroidal parameters were investigated using multivariable linear regression to account for the correlation.</div></div><div><h3>Main Outcome Measures</h3><div>Choroidal thickness, choroidal vascularity index (CVI), choroidal vascular volume (CVV), and choroidal stromal volume (CSV).</div></div><div><h3>Results</h3><div>The fifth and 95th percentile values of the choroidal parameter dataset for the peripheral choroidal vortex vein system were set. The mean values of the peripheral choroidal vortex vein system parameters (choroidal thickness, CVI, CVV, and CSV) decreased with age, with a significant decline after 50 years. An association was observed between an increased axial length elongation and a thinner choroid layer in the macular region and the ST drainage system (all <em>P</em> &lt; 0.01). The CVI was significantly correlated with gender in the ST vortex vein drainage system (coefficient: −1.02, <em>P</em> = 0.04).</div></div><div><h3>Conclusions</h3><div>We report a normative choroidal parameter dataset for the peripheral choroidal vortex vein system in a large Chinese cohort. Choroidal vessels and stroma in vortex vein drainage systems decrease with age, more remarkably after the age of 50 years.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 4","pages":"Article 100768"},"PeriodicalIF":3.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838318","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":"Myopia Control Efficacy of Spectacle Lenses with Dual-Index Aspherical Lenslets: A 1-Year Randomized Clinical Trial","authors":"Yee Ling Wong PhD ,&nbsp;Andrew Tan BBus ,&nbsp;Ee Woon Lim ,&nbsp;Hua Ren Chua ,&nbsp;Liang Shen PhD ,&nbsp;Matthieu Guillot MSc ,&nbsp;Björn Drobe PhD","doi":"10.1016/j.xops.2025.100766","DOIUrl":"10.1016/j.xops.2025.100766","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the myopia control efficacy, in terms of axial elongation, of a new myopia control spectacle lenses with Dual-Index Aspherical Lenslets (DIAL) embedded within the lens, compared with single-vision spectacle lenses (SVLs) over a 1-year period.</div></div><div><h3>Design</h3><div>A prospective, randomized, double-masked clinical trial.</div></div><div><h3>Participants</h3><div>Eighty children aged 8 to 13 years with myopia (spherical equivalent refraction [SER] between −0.75 and −4.75 diopters [D]) were recruited.</div></div><div><h3>Intervention</h3><div>Participants were randomized to either the DIAL or SVL spectacle lenses group (1:1 ratio).</div></div><div><h3>Main Outcome Measures</h3><div>Axial length (AL), noncycloplegic subjective refraction, and best-corrected visual acuity (BCVA) were measured at baseline and 6-month intervals. Questionnaires on adaptation and compliance were administered during all visits.</div></div><div><h3>Results</h3><div>A total of 76 (N = 38 in each group) participants (mean [standard deviation] age, 10.8 [1.6] years) completed the 1-year visit. Mean (± standard error) 1-year AL change in the DIAL and SVL groups was 0.04 ± 0.02 and 0.22 ± 0.04 mm, respectively. A mean difference of −0.18 mm (95% confidence interval [CI], −0.26 to −0.10 mm; <em>P</em> &lt; 0.001) was found. Mean 1-year SER change in the DIAL and SVL groups was −0.13 ± 0.06 and −0.39 ± 0.08 D, respectively, with a mean difference of 0.26 D (95% CI, 0.06–0.46 D; <em>P</em> = 0.01). Compared with SVL, younger children (8 to &lt;11 years) and older children (11–13 years) in the DIAL group had significantly less axial elongation (−0.29 mm less for younger children and −0.09 mm less for older children), with greater myopia control effect of DIAL spectacle lenses among the younger group than among the older group (<em>P</em> = 0.004 for interaction). No significant differences between the lens groups were found for distance BCVA (<em>P</em> = 0.36). All participants adapted within 3 to 4 days regardless of lens group. No significant differences in mean daily wearing time were seen between the DIAL and SVL groups (<em>P</em> = 0.53).</div></div><div><h3>Conclusions</h3><div>Dual-Index Aspherical Lenslets spectacle lenses showed good myopia control efficacy, in terms of axial elongation, compared with SVL, among children aged 8 to 13 years in Singapore.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosures 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 100766"},"PeriodicalIF":3.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886012","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}