American Journal of Ophthalmology最新文献

{"title":"Risk Factors for Retinal Pigment Epithelium Tears in Patients with Neovascular Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis.","authors":"Salem Abu Al-Burak, David Sarraf, Faizan Naveed, Mohamed Ali, Vitaliy Voznyy, Mouad Elganga, Kyran Sachdeva, Faisal Ahmed, Andrew Mihalache, David Wong, Peter J Kertes, Rajeev H Muni, SriniVas R Sadda, Paolo Forte, Alessandro Feo, Marko M Popovic","doi":"10.1016/j.ajo.2026.10.007","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.10.007","url":null,"abstract":"<p><strong>Topic: </strong>To identify and synthesize clinical, imaging, and treatment-related risk factors associated with retinal pigment epithelium (RPE) tears in neovascular age-related macular degeneration (nAMD).</p><p><strong>Clinical relevance: </strong>RPE tears are a vision-threatening complication of nAMD, occurring most often in eyes with pigment epithelial detachments (PEDs) and frequently temporally associated with initiation of anti-vascular endothelial growth factor (anti-VEGF) therapy. Improved recognition of high-risk PED features may enhance counseling and risk stratification.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed PRISMA guidelines and was prospectively registered in PROSPERO (CRD420251075278). MEDLINE, Embase, and CENTRAL were searched from inception to December 15, 2025. Randomized and non-randomized studies of adults (≥50 years) with nAMD evaluating candidate predictors of RPE tear were included. Two reviewers independently screened, extracted data, and assessed risk of bias (RoB 2, ROBINS-I). Random-effects meta-analyses were performed for baseline PED height and area, with per-study weighting, standardized mean difference (SMD), and leave-one-out sensitivity analyses. Certainty was assessed using GRADE.</p><p><strong>Results: </strong>Sixteen studies comprising 4,043 eyes were included. Five studies (55 tear eyes; 370 controls; 425 eyes) showed greater baseline PED height in eyes developing tears (mean difference [MD], 212.39 µm; 95% confidence interval [CI], 133.87-290.91; I² = 24.6%; SMD, 1.09). Four studies (48 tear eyes; 1,312 controls; 1,360 eyes) showed larger baseline PED area (MD, 5.80 mm²; 95% CI, 3.48-8.12; I² = 2.7%; SMD, 0.88). Both persisted across all leave-one-out iterations; omitting the study contributing 43.5% of the area weight increased the effect (MD, 7.11 mm²). Fibrovascular PED, greater basal diameter and volume, subretinal fluid, sub-RPE clefts, radial hyperreflective lines, and occult or hemorrhagic macular neovascularization were also associated with tears. Anti-VEGF agent selection was not consistently associated. Most studies were at moderate to serious risk of bias; certainty was very low.</p><p><strong>Conclusion: </strong>Baseline PED morphology, particularly increased height, is the most consistently reported association with RPE tear in nAMD. Because the evidence is predominantly retrospective, largely unadjusted, and of very low certainty, these are associations rather than validated predictive markers. Prospective studies using standardized imaging protocols are needed.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149222947","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":"One Disease, Two Eyes, Opposite Outcomes: The Divergent History of Untreated Primary Congenital Glaucoma.","authors":"Shubham Manchanda, Sushmita Kaushik","doi":"10.1016/j.ajo.2026.10.005","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.10.005","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164011","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":"Ocular Metastasis: Clinical Course and Survival Analysis of 569 Patients (727 Eyes) Over a 40-Year Interval (1979-2018).","authors":"Adam R Leone, James J Augsburger, Zélia M Corrêa","doi":"10.1016/j.ajo.2026.10.003","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.10.003","url":null,"abstract":"<p><strong>Objective: </strong>To report the clinical course of a large series of patients with intraocular and epibulbar metastases to the eye encountered over a 40-year interval and determine whether recent systemic treatments have improved patient survival following detection compared to earlier cases.</p><p><strong>Design: </strong>Retrospective case series and trend study.</p><p><strong>Subjects: </strong>727 eyes of 569 patients diagnosed with metastasis to the eye(s).</p><p><strong>Methods: </strong>Retrospective chart review and statistical analysis with SPSS (including descriptive statistics, cross-tabulations, statistical comparison of distributions, actuarial event rate curves using both Kaplan-Meier and life table methods, and comparison of survival curves using the log rank test).</p><p><strong>Main outcome measures: </strong>Sex and age of patients, source cancer and metastatic history, symptoms, laterality and focality of eye metastases, ocular sites of involvement, largest basal diameter and thickness of metastases, ocular biopsies, systemic and ophthalmic treatment, symptomatic and tumor response to treatment, cause of death, and median, 5-year, 10-year, and comparative overall survival among various categorical subgroups.</p><p><strong>Results: </strong>We identified dates of death for 98.1% of 569 patients. The median overall survival was 8.2 months, the 5-year overall survival was 8.2%, and the 10-year overall survival was 2.8%. Patients encountered in the second half of the study interval did not have significantly better survival compared to those in the first half. Breast cancer was the most common primary cancer. Lung cancer follows as the second most common primary, with affected patients having far worse survival outcomes. Treatment was administered in 435 worse or only affected eyes, and of the 313 of those for which we have follow-up visual acuity data, visual acuity improved or remained stable in 62.6%. Of the 286 of those for which we have a follow-up fundus examination, 85.7% demonstrated initial complete or partial regression. One hundred fifty-seven of 569 total patients (27.6%) ultimately had bilateral ocular involvement.</p><p><strong>Conclusions: </strong>Survival for patients with cancer metastatic to the eye, which remains extremely poor, did not improve significantly from 1979 to 2018. Breast and lung cancer remain the predominant primary cancers and are followed by gastrointestinal, hematologic, and genitourinary cancers. Based on available but incomplete data, treatment improves or maintains vision and shrinks metastases in most patients.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147246","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":"My Dinner With Jack (Mustardé).","authors":"George B Bartley","doi":"10.1016/j.ajo.2026.10.006","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.10.006","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147181","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: Ocular Response Analyzer versus Goldmann Applanation Tonometry in a Population-based Sample: The Thessaloniki Eye Study.","authors":"Yasar Sakarya, Rabia Sakarya","doi":"10.1016/j.ajo.2026.09.038","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.09.038","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147318","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":"Interpretable Machine Learning for Course Prediction in Central Serous Chorioretinopathy Using Baseline OCT from a Multicenter Cohort.","authors":"Lorenzo Ferro Desideri, Nina Eldridge, Lieselotte E Berger, Andreas Ebneter, Margarita Todorova, Hung-Da Chou, Nan-Kai Wang, Christoph Spartalis, Oliver Findl, Reem Mohsen, Sherif N Embabi, Ozge Yanik, Sibel Demirel, Yousif Subhi, Paolo Forte, Jennifer Cattaneo, Eva Cristina de Oliveira Figueiredo, Chiara Eandi, Helena M A Feenstra, Camiel J F Boon, Elon H C van Dijk, Martin S Zinkernagel, Rodrigo Anguita","doi":"10.1016/j.ajo.2026.10.002","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.10.002","url":null,"abstract":"<p><strong>Purpose: </strong>To predict disease clinical course in central serous chorioretinopathy (CSC) using an interpretable machine learning model applied to baseline artificial intelligence (AI)-derived optical coherence tomography (OCT) biomarkers acquired at first presentation.</p><p><strong>Design: </strong>Multicenter, retrospective cohort study.</p><p><strong>Participants: </strong>Overall, 329 treatment-naïve CSC eyes recruited across eight international centers in Europe, the Middle East, Asia, and North Africa.</p><p><strong>Methods: </strong>Treatment-naïve CSC patients were retrospectively included and classified, based on follow-up, as acute or chronic CSC according to subretinal fluid (SRF) resolution. Baseline OCT biomarkers were extracted using an AI-based platform (Discovery OCT Biomarker Detector; RetinAI AG, Switzerland), which quantified retinal layer thicknesses, including the outer nuclear layer (ONL) and photoreceptor-retinal pigment epithelium (PR+RPE) complex, fluid volumes (SRF and RPE detachment [PED]), and biomarker probabilities, across central, parafoveal, and perifoveal ETDRS regions. These features used to develop an interpretable machine learning model predicting future CSC chronicity.</p><p><strong>Main outcome measures: </strong>Classification of eyes as acute or chronic CSC, determined by SRF resolution on follow-up; discriminative performance of the Random Forest classifier, assessed by area under the receiver operating characteristic curve (AUC); and biomarker importance, evaluated using SHapley Additive exPlanations (SHAP) values.</p><p><strong>Results: </strong>Of 329 eyes (291 patients), 92 (28.0%) were classified as acute and 237 (72.0%) as chronic CSC; mean follow-up was 4.2 ± 1.6 years. Chronic CSC patients were significantly older (51.7 ± 12.6 vs. 43.2 ± 9.6 years, p<0.001) with worse baseline visual acuity (0.25 ± 0.21 vs. 0.16 ± 0.15 logMAR, p=0.029). Among baseline OCT biomarkers, parafoveal ONL thickness showed the strongest association with disease chronicity (q<0.0001; r=-0.414). The Random Forest classifier achieved an AUC of 0.852 (95% CI: 0.748-0.940). SHAP analysis identified parafoveal ONL thickness, perifoveal PR+RPE thickness, and central SRF volume as the strongest predictors of acute CSC, whereas greater RNFL thickness, PED volume, FLAT PED probability, and HF probability were the most influential predictors of chronic disease.</p><p><strong>Conclusions: </strong>Automatically detected OCT biomarkers can predict CSC chronicity at initial presentation with good discriminatory performance. Quantitative markers of outer retinal integrity, fluid configuration, and RPE dysfunction may improve prognostication, facilitate patient counseling, and help identify individuals at increased risk of persistent CSC.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134823","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: Ocular Response Analyzer versus Goldmann Applanation Tonometry in a Population-based Sample: The Thessaloniki Eye Study.","authors":"Rodanthi Christina Bartzoulianou, Anne L Coleman, M Roy Wilson, Alon Harris, Dimitrios A Giannoulis, Georgios Bontzos, Anna-Bettina Haidich, Fei Yu, Vassileios Kilintzis, Iordanis Vagiakis, Eleftherios Anastasopoulos, Dimitrios Mikropoulos, Anastasia Raptou, Grigoria Tzoanou, Fotis Topouzis","doi":"10.1016/j.ajo.2026.10.004","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.10.004","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134806","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":"Subbasal Nerve Plexus Alterations Following Ocular Proton Therapy in Uveal Melanoma Assessed by Corneal Confocal Microscopy","authors":"Carlos Knappe,Claudia Prystupa,Zohreh Jami,Lynn S. Zur Bonsen,Nathalie Biniaminov,Jens Heufelder,Tina Dietrich-Ntoukas,Oliver Zeitz,Antonia M. Joussen,Anna-Karina B. Maier","doi":"10.1016/j.ajo.2026.09.031","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.09.031","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"25 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088255","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":"Corrigendum to “Evaluation of the Impact of Gamma-Aminobutyric Acid on Diabetic Retinopathy in a Large US Population-Based Cohort”. Am J Ophthalmol. 2026;291:63–72","authors":"Sonia B. Kim,Melody Y. Zhou,Kevin C. Allan,David C. Kaelber,Amy S. Babiuch,Rishi P. Singh,Katherine E. Talcott","doi":"10.1016/j.ajo.2026.09.013","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.09.013","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088260","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":"Multimodal Characterization of Mid-phase Hyperfluorescent Plaques on Indocyanine Green Angiography in Central Serous Chorioretinopathy- MICRoN report number 27","authors":"Diana Flores-Peña,Niroj Kumar Sahoo,Giulia Gregori,Nasiq Hasan,Oscar Matteo Gagliardi,Elham Sadeghi,Marco Lupidi,Elodie Bousquet,Lihteh Wu,Jay Chhablani","doi":"10.1016/j.ajo.2026.09.030","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.09.030","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"75 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088259","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}