American Journal of Ophthalmology最新文献

{"title":"Comment on: The Natural History of Exophoria Progression Among Young Healthy Adults.","authors":"Yasar Sakarya, Rabia Sakarya","doi":"10.1016/j.ajo.2026.02.034","DOIUrl":"10.1016/j.ajo.2026.02.034","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":"336"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147315970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Comment on: Long-term Clinical Outcomes of a Modified Yamane Technique for Intrascleral Sutureless Posterior Chamber Intraocular Lens Fixation.","authors":"Feng Xu, Hui Jiang, Jiancheng Mu, Ning Yang, Wanyue Guo, Chuhuan Sun, Bosen Peng, Ming Zhang, Wei Fan","doi":"10.1016/j.ajo.2026.03.006","DOIUrl":"10.1016/j.ajo.2026.03.006","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":"348-349"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147455185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Comment on: Effect of Capsular Tension Ring on Rotational Stability of Loop-Haptic Intraocular Lens in Highly Myopic Patients.","authors":"Hongzhe Li, Pingjun Chang, Yun-E Zhao","doi":"10.1016/j.ajo.2026.02.038","DOIUrl":"10.1016/j.ajo.2026.02.038","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":"340-341"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five-Point Star Technique for Dislocated Intraocular Implant.","authors":"Prithvi Ramtohul, Thierry David, Christina Y Weng","doi":"10.1016/j.ajo.2026.02.041","DOIUrl":"10.1016/j.ajo.2026.02.041","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":"e3-e4"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Constructed Macular Buckle for Myopic Macular Hole-Associated Retinal Detachment.","authors":"Christina Y Weng, Suzie A Gasparian, Aaron Nagiel","doi":"10.1016/j.ajo.2026.02.015","DOIUrl":"10.1016/j.ajo.2026.02.015","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":"e1-e2"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Effect of Capsular Tension Ring on Rotational Stability of Loop-Haptic Intraocular Lens in Highly Myopic Patients.","authors":"Fatih Özcura, Saadet Gültekin Irgat","doi":"10.1016/j.ajo.2026.02.040","DOIUrl":"10.1016/j.ajo.2026.02.040","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":"338-339"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Have Deprivation Amblyopia Outcomes Improved for Infants with Unilateral Cataracts?","authors":"William C Carter, R Lawrence Tychsen","doi":"10.1016/j.ajo.2026.04.029","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.04.029","url":null,"abstract":"<p><strong>Objective: </strong>An aspiration of modern medicine is for disease treatment to improve progressively. Here we examine outcomes of treatment for monocular deprivation amblyopia, caused by a congenital cataract, at an academic medical center over several decades. Have outcomes improved substantially, or have they remained stubbornly disappointing?</p><p><strong>Design: </strong>Trend study.</p><p><strong>Subjects: </strong>Patients with deprivation amblyopia due to primary monocular congenital cataract removed before one year of age.</p><p><strong>Methods: </strong>Pre-operative and outcome data were collated from sequential examinations to document corrected distance visual acuity (CDVA), binocular visuomotor behaviors, anterior segment and vitreo-retinal health, adherence to therapies, demographic variables, and the need for subsequent surgical interventions. Biometry measurements were recorded at the time of initial cataract surgery.</p><p><strong>Main outcome measures: </strong>The primary outcome measure was corrected distance visual acuity (CDVA). Additional outcomes measures were: prevalence of nystagmus, strabismus, ocular hypertension (OHT)/glaucoma and the number of ocular surgeries.</p><p><strong>Results: </strong>80 children met inclusion criteria with a median follow-up age of 12 years. Median CDVA of amblyopic eyes at last follow-up was 1.40 LogMAR or 20/500 (IQR 0.75 - CF). There were no significant differences in CDVA for patients with cataract extraction between 1990-1999, 2000-2009, and 2010-2022 (p=0.25), with medians of 1.00, 1.44, and 1.40 LogMAR respectively. Better CDVA was related systematically to earlier age at surgery but the correlation was weak (p = 0.06). 96% (77/80) of children had secondary implantation of an intraocular lens. Strabismus developed in 98% (78/80) of the children and fusion maldevelopment nystagmus in 73% (58/80). 43% (34/80) required subsequent surgery for removal of a secondary cataract, and 30% (24/80) required surgery to treat aphakic or pseudophakic OHT/glaucoma. The median number of total ophthalmic surgeries was 5 (IQR 3 - 6).</p><p><strong>Conclusions: </strong>Visual acuity outcomes for monocular deprivation amblyopia remain disappointing. Adherence to patching therapy and contact lens wear is burdensome and often unachieved. Children with the condition require an average of four subsequent surgeries in the first decade of life for intraocular lens implantation, removal of a secondary cataract, strabismus, or glaucoma.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genotype-phenotype correlations in RPGRIP1-associated retinal dystrophy in a nationwide Japanese cohort.","authors":"Kei Mizobuchi, Taiga Inooka, Takuya Aoki, Hazuki Anzai, Kaoruko Torii, Kazuki Hashimoto, Akiko Suga, Ryo Ando, Miki Hiraoka, Taro Kominami, Shigeru Sato, Motokazu Tsujikawa, Kohji Nishida, Yusuke Murakami, Toru Nakazawa, Akiko Maeda, Kazuki Kuniyoshi, Yasuhiro Ikeda, Hiroyuki Kondo, Mineo Kondo, Koji M Nishiguchi, Akira Murakami, Maki Fukami, Sachiko Nishina, Takeshi Iwata, Hirotomo Saitsu, Kazushige Tsunoda, Shinji Ueno, Yoshihiro Hotta, Tadashi Nakano, Takaaki Hayashi","doi":"10.1016/j.ajo.2026.05.002","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.05.002","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate genotype-phenotype correlations in a nationwide Japanese cohort of patients with RPGRIP1-associated retinal dystrophy.</p><p><strong>Design: </strong>Retrospective, multicenter cohort study.</p><p><strong>Methods: </strong>Japanese patients with biallelic pathogenic RPGRIP1 variants diagnosed with Leber congenital amaurosis (LCA) or achromatopsia (ACHM) were recruited from university hospitals throughout Japan. Genetic analyses included polymerase chain reaction for detection of the exon 18 deletion variant (exon 18-DEL), whole-exome sequencing, and whole-genome sequencing. Ophthalmic evaluations comprised best-corrected visual acuity (BCVA), visual field testing, full-field electroretinography (ERG), and multimodal retinal imaging.</p><p><strong>Results: </strong>Thirty-four patients from 26 families [23 (18 families) with ACHM and 11 (8 families) with LCA] were included. Fourteen distinct RPGRIP1 variants were identified, with exon 18-DEL being the most prevalent (43 of 68 alleles, 63.2%). In ACHM, variants were predominantly clustered around exon 18, whereas LCA showed more diverse variant combinations. BCVA was significantly worse in LCA than in ACHM, although the rate of BCVA decline did not differ between phenotypes. Multimodal imaging demonstrated relatively preserved macular structure even in older patients with LCA, while ACHM showed age-dependent progressive outer retinal degeneration. ERG revealed near-complete loss of rod and cone function in early infancy in LCA, whereas rod function was initially preserved in ACHM but gradually deteriorated.</p><p><strong>Conclusions: </strong>RPGRIP1 variants cause two distinct clinical phenotypes, LCA and ACHM, with clear genotype-phenotype correlations. The exon 18-DEL, observed in both phenotypes, likely represents a founder variant in the Japanese population. These findings expand the clinical spectrum of RPGRIP1-associated retinal dystrophy and have implications for molecular diagnosis, prognostic counseling, and future therapeutic development.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of non-infectious uveitis associated with disease-modifying therapies for multiple sclerosis.","authors":"Anthony J Cordisco, Fangming Jin, Ali G Hamedani, Brian L VanderBeek","doi":"10.1016/j.ajo.2026.04.032","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.04.032","url":null,"abstract":"<p><strong>Purpose: </strong>Multiple sclerosis (MS) is associated with an increased risk of non-infectious uveitis (NIU). Whether disease-modifying therapies (DMTs) for MS alter this risk is unknown. Our objective was to determine the comparative risk of NIU after DMT initiation for MS.</p><p><strong>Design: </strong>Retrospective clinical cohort study using Optum's de-identified Clinformatics™ Data Mart database, which is comprised of medical claims for patients enrolled in commercial and Medicare Advantage insurance plans from January 1, 2000 - June 30, 2022.</p><p><strong>Participants: </strong>Adults with MS, defined by ≥3 diagnosis codes on separate dates, who received ≥1 DMT prescription and had ≥2 years of prior enrollment. Participants could contribute multiple treatment episodes if they switched therapies.</p><p><strong>Methods: </strong>Users of interferons, fumarates, nucleic acid synthesis inhibitors/sphingosine-1-phosphate (S1P) modulators, natalizumab, and anti-CD20 monoclonal antibodies were compared to glatiramer acetate as the reference.</p><p><strong>Main outcome measures: </strong>Marginal Cox models with robust sandwich covariance matrix estimation were used to calculate adjusted hazard ratios (aHR) for incident NIU, defined as a new ICD code for NIU with a 2^nd confirmatory diagnosis within 120 days. A sensitivity analysis varied this definition to require a new concurrent corticosteroid prescription or ocular injection within 120 days of diagnosis. DMT-specific propensity score models were constructed using multivariable logistic regression with generalized estimating equations (GEE) to calculate overlap weights for adjustment. Participants were censored if they switched treatments, underwent intraocular surgery, or disenrolled.</p><p><strong>Results: </strong>Across 48,221 treatment episodes for 43,501 patients, median follow-up ranged from 562-703 days. Compared to glatiramer acetate, the NIU incidence was lower for nucleic acid synthesis inhibitors/S1P modulators (aHR 0.14, 95% CI: 0.07-0.29), fumarates (aHR 0.51, 95% CI: 0.36-0.74), anti-CD20 (aHR 0.66, 95% CI, 0.51-0.85), and interferons (aHR 0.67, 95% CI: 0.50-0.91), but not natalizumab (aHR 0.87, 95% CI: 0.61-1.24). Sensitivity analysis confirmed findings for fumarates (aHR 0.56, 95% CI: 0.38-0.82) and nucleic acid synthesis inhibitors/S1P modulators (aHR 0.16, 95% CI: 0.08-0.33).</p><p><strong>Conclusions: </strong>Certain DMT classes are associated with a protective effect for NIU in MS. If confirmed, these medications could be targeted for personalized MS treatment and potentially repurposed to treat NIU in other patient populations.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tubercular Retinitis: Clinical Spectrum and Multimodal Imaging Features of an Insufficiently Characterized Entity.","authors":"Atul Arora, Manu Sharma, Pietro Gentile, Aniruddha Agarwal, Mohit Dogra, Aman Sharma, Vishali Gupta","doi":"10.1016/j.ajo.2026.04.031","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.04.031","url":null,"abstract":"<p><strong>Purpose: </strong>Ocular tuberculosis (OTB) affecting the posterior segment commonly presents with choroiditis lesions. However, tubercular retinitis (TBR) is a rare and poorly characterized phenotype. This study aims to define the clinical spectrum, multimodal imaging characteristics, natural course of TBR lesions, and differentiate it from similar appearing chorioretinal lesions in OTB.</p><p><strong>Design: </strong>Single-center, retrospective case series.</p><p><strong>Methods: </strong>The study included patients presenting with lesions clinically suggestive of retinitis. Clinical data, fundus findings, and multimodal imaging (ultra-widefield fundus photography, fluorescein and indocyanine green angiography (FFA and ICGA), and optical coherence tomography (OCT)) were analyzed. The diagnosis of OTB was established based on the Collaborative Ocular Tuberculosis Study (COTS) criteria, that includes supportive immunological and radiological evidence (positive Mantoux test or interferon-gamma release assay, and chest imaging). All patients received standard four-drug antitubercular therapy (ATT) with adjunctive corticosteroids and were followed for anatomical and functional outcomes.</p><p><strong>Results: </strong>Eight patients (six males; age range: 21-54 years) were included. A total of 37 lesions were identified in 12 eyes (median: 2 lesions per eye). Twenty-five lesions (67.6%) were purely retinal with no choroidal involvement, and were classified as tubercular retinitis (TBR). Twelve lesions (32.4%) showed involvement of the choroid, retinal pigment epithelium(RPE), and outer retina, and were classified as tubercular retinochoroiditis(TBRC). All the eyes demonstrated occlusive retinal vasculitis. FFA of TBR lesions demonstrated early central hypofluorescence with circumferential perilesional hyperfluorescence ('moat sign'). On OCT, TBR lesions were intraretinal and characterized by full-thickness hyper-reflectivity and disruption of inner retinal architecture with no choroidal/RPE changes. TBRC lesions showed outer retinal disruption, RPE irregularity with focal defects, and choroidal shadowing. ICGA showed focal hypofluorescence in TBRC lesions, but was unremarkable in TBR. Following ATT, TBR lesions healed without pigmentation or scarring, whereas TBRC lesions resolved with discrete pigmented scars with retinal thinning and RPE disruption on OCT (32.4%) (p=0.028).</p><p><strong>Conclusion: </strong>The spectrum of posterior segment involvement in OTB includes intraretinal inflammation that can present as TBR and TBRC. These lesions are typically present in eyes with occlusive retinal vasculitis. Features on clinical examination and multimodal imaging help identify the tubercular etiology and differentiate between TBR and TBRC lesions.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}