American Journal of Ophthalmology最新文献

{"title":"Clinical Outcomes and Predictive Factors for Penetrating Keratoplasty Following Glue Application for Corneal Perforation and Thinning","authors":"Manokamna Agarwal ,&nbsp;Ryan S Huang ,&nbsp;Michael Mimouni ,&nbsp;David S Rootman ,&nbsp;Clara C Chan","doi":"10.1016/j.ajo.2025.08.030","DOIUrl":"10.1016/j.ajo.2025.08.030","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe the clinical outcomes and identify predictive factors associated with the need for penetrating keratoplasty (PKP) following cyanoacrylate tissue adhesive (CTA) application for corneal perforation or thinning.</div></div><div><h3>Design</h3><div>Retrospective clinical cohort study.</div></div><div><h3>Methods</h3><div>We conducted a single-center, retrospective cohort study of 189 eyes treated with CTA for corneal thinning or perforation between January 2006 and August 2024 at a tertiary care center. The primary outcome was the best-corrected visual acuity (BCVA) at final follow-up. Univariable and multivariable logistic regression models were used to identify associations between baseline and clinical characteristics with progression to PKP following CTA management.</div></div><div><h3>Results</h3><div>Of 189 eyes treated with CTA, 64 (34%) underwent subsequent PKP after CTA application. Multivariable regression identified several independent predictors of needing PKP, including central or paracentral defect location (vs peripheral, OR = 2.98, 95% CI = 1.27-6.91, <em>P</em> = .012), multiple CTA applications (vs single, OR = 2.70, 95% CI = 1.42-5.15, <em>P</em> = .003), worse baseline BCVA (logMAR &gt;2 vs logMAR &lt;1; OR = 3.10, 95% CI = 1.35-6.58, <em>P</em> = .005), and viral keratitis (OR = 3.55, 95% CI = 1.21-9.58, <em>P</em> = .020). Trauma was associated with lower odds of PKP (OR = 0.26, 95% CI = 0.08-0.80, <em>P</em> = .014). Median final BCVA following PKP was 2.0 logMAR (IQR: 1.5-2.3), with no significant difference from baseline (<em>P</em> = .585).</div></div><div><h3>Conclusion</h3><div>PKP remains an important intervention for eyes refractory to CTA; however, final visual outcomes are limited. Early identification of high-risk clinical features may help guide timely decision-making and set realistic expectations regarding prognosis.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"280 ","pages":"Pages 203-208"},"PeriodicalIF":4.2,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881838","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":"Secondary IOL Implantation Without Capsular Support","authors":"Stephanie P. Chen ,&nbsp;David F. Chang","doi":"10.1016/j.ajo.2025.08.023","DOIUrl":"10.1016/j.ajo.2025.08.023","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"280 ","pages":"Pages 230-237"},"PeriodicalIF":4.2,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881842","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":"A New Approach to Reinforce Science and Education in Ophthalmology.","authors":"Jorge L Alio","doi":"10.1016/j.ajo.2025.08.028","DOIUrl":"10.1016/j.ajo.2025.08.028","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938931","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":"SNRNP200- Associated Retinopathy: In-Depth Clinical Phenotyping and Genetic Characterization","authors":"Juan C. Romo-Aguas ,&nbsp;Yannik Laich ,&nbsp;Angelos Kalitzeos ,&nbsp;Thales A.C. de Guimarāes ,&nbsp;Anthony G. Robson ,&nbsp;Kaoru Fujinami ,&nbsp;Yu Fujinami-Yokokawa ,&nbsp;Michalis Georgiou ,&nbsp;Eduardo Di Piero ,&nbsp;Omar A. Mahroo ,&nbsp;Andrew R. Webster ,&nbsp;Michel Michaelides","doi":"10.1016/j.ajo.2025.08.015","DOIUrl":"10.1016/j.ajo.2025.08.015","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze the clinical spectrum and natural history of <em>SNRNP200</em>-associated retinopathy.</div></div><div><h3>Design</h3><div>Multicenter retrospective, observational cohort study.</div></div><div><h3>Patients</h3><div>Molecularly confirmed patients with at least 1 disease-causing variant in <em>SNRNP200.</em></div></div><div><h3>Methods</h3><div>Clinical data was extracted from the physical and electronic records, including imaging and electrophysiology. Genetic results were reviewed, and the variants assessed.</div></div><div><h3>Main outcome measures</h3><div>Molecular genetic testing and clinical findings, including best-corrected visual acuity (BCVA), qualitative and quantitative analysis of retinal imaging, and electrophysiology.</div></div><div><h3>Results</h3><div>Thirty-four patients from 4 countries were identified and assessed longitudinally. The median age was <em>36.0</em> years (IQR 27.5-43.5), with a <em>median</em> follow-up of 6.0 years (IQR 2-9.5). Median BCVA was 0.0 LogMAR (IQR 0.0-0.27) at baseline and 0.1 LogMAR (0.0-0.47) at follow-up, with an annual rate of decline of 0.021 LogMAR. The median ellipsoid zone width was 3013.5 µm (IQR 1948.7-3592.2) at baseline and 2400.1 µm (IQR 1136.75-3097.2) at follow-up, with a rate of decline of 21.9 µm/year. Detailed electrophysiology was available for 11 patients, all of whom showed a rod-cone dystrophy with largely preserved macular function in the majority of cases. Genetic analysis identified 21 variants in <em>SNRNP200</em>, including 11 novel variants.</div></div><div><h3>Conclusions</h3><div>This report represents the largest cohort of patients with <em>SNRNP200</em>-associated retinopathy, with the longest follow-up. Longitudinal analysis shows a preserved central retina until the 6th decade of life. These findings provide critical insights for patient counselling, identifying clinical endpoints, and guiding therapeutic development.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"280 ","pages":"Pages 209-220"},"PeriodicalIF":4.2,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870890","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":"Socioeconomic Deprivation Amplifies the Risk of Glaucoma From Ultrafine Particle Exposure: Evidence From the Retrospective Cohort Study","authors":"Yanlin Qu ,&nbsp;Guanran Zhang ,&nbsp;Zhenyu Wu ,&nbsp;Haoliang Zhang ,&nbsp;Jiale Zhao ,&nbsp;Zixiang Zhang ,&nbsp;Yuchen Zhang ,&nbsp;Xinyi Huang ,&nbsp;Yuxuan Li ,&nbsp;Huihuan Luo ,&nbsp;Renjie Chen ,&nbsp;Xiaodong Sun ,&nbsp;Huixun Jia","doi":"10.1016/j.ajo.2025.08.029","DOIUrl":"10.1016/j.ajo.2025.08.029","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Evidence has revealed that socioeconomic deprivation (SED) could enhance the hazard of particulate matter on health. However, the relationship between SED, ultrafine particles (UFPs), and the development of glaucoma remains uninvestigated. We aim to estimate the association between UFPs, SED, and glaucoma. Additionally, the potential modifiers of this association are also explored.</div></div><div><h3>DESIGN</h3><div>A population-based retrospective cohort study.</div></div><div><h3>PARTICIPANTS</h3><div>This study contained 379,724 participants aged exceeded 50 years without glaucoma at baseline from the UK Biobank.</div></div><div><h3>METHODS</h3><div>UFPs were estimated with the ECHAM/MESSy Atmospheric Chemistry model. SED was assessed via Townsend deprivation index (TDI), with higher scores indicating greater deprivation. Cox proportional hazards models were conducted to evaluate the association between SED, UFPs, and glaucoma. Potential effect modifiers of UFP-glaucoma association were further explored.</div></div><div><h3>MAIN OUTCOME MEASURES</h3><div>The primary outcome was the development of glaucoma.</div></div><div><h3>RESULTS</h3><div>During a median follow-up of 12.6 years, 10,950 participants were diagnosed with glaucoma. Higher UFP exposure was positively associated with glaucoma risk, and this association was significantly enhanced among individuals with higher TDI (<em>P</em>_interaction = .004). Compared with the lowest quartile, the hazard ratios (HRs) for the highest quantile were 1.16 (1.08, 1.24) in total population, 1.10 (1.00, 1.21) in the low-TDI group, and 1.21 (1.09, 1.34) in the high-TDI groups. Stratified analyses showed that only greenness exposure attenuated the hazard of UFPs on glaucoma, with a Normalized Difference Vegetation Index higher than 0.6 reversing the association to nonsignificant, especially in the high-TDI group.</div></div><div><h3>CONCLUSIONS</h3><div>Our findings provide the first evidence that SED enhances the detrimental effect of UFPs on glaucoma risk, exacerbating health inequality. Targeted strategies aimed at increasing greenness exposure may be effective in mitigating these disparities, especially in underdeveloped regions.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"280 ","pages":"Pages 221-229"},"PeriodicalIF":4.2,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870891","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":"Controversies, Consensuses, and Guidelines on Preventing, Diagnosing and Managing Acute-onset Bacterial Endophthalmitis after Cataract Surgery by the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO), the Asia-Pacific Vitreo-retina Society (APVRS), and the Asia-Pacific Society of Ocular Inflammation and Infection (APSOII)","authors":"Namrata Sharma ,&nbsp;Aafreen Bari ,&nbsp;Srinivas K. Rao ,&nbsp;Rupesh Agrawal ,&nbsp;Penelope J. Allen ,&nbsp;John C. Buchan ,&nbsp;Andrew Chang ,&nbsp;David F. Chang ,&nbsp;Soon-Phaik Chee ,&nbsp;Weirong Chen ,&nbsp;Kuan-Jen Chen ,&nbsp;Vanissa W.S. Chow ,&nbsp;Taraprasad Das ,&nbsp;Vivek P. Dave ,&nbsp;Harry W. Flynn JR ,&nbsp;Tina Felfeli ,&nbsp;Adrian T. Fung ,&nbsp;Andrzej Grzybowski ,&nbsp;Mary Ho ,&nbsp;Wai Ching Lam ,&nbsp;Dennis S.C. Lam","doi":"10.1016/j.ajo.2025.08.031","DOIUrl":"10.1016/j.ajo.2025.08.031","url":null,"abstract":"<div><h3>Background</h3><div>Postcataract surgery endophthalmitis is a serious but largely preventable clinical entity. The implementation of uniform preoperative, intraoperative, and postoperative protocols is essential to reduce its incidence.</div></div><div><h3>Methods</h3><div>In light of emerging evidence and considerable variability in clinical practices, a panel of international experts from the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO), the Asia-Pacific Vitreo-retina Society (APVRS), and the Asia-Pacific Society of Ocular Inflammation and Infection (APSOII) convened to develop evidence-based guidelines addressing all phases of cataract surgery. This consensus manuscript is the product of a systematic review of the current literature, informed by the collective experience and expertise of the panel members. The panel engaged in structured discussions, critical evaluation of clinical data, and formal voting to establish agreement across three key domains: (1) preoperative and intraoperative prophylactic strategies, (2) diagnostic approaches for early postoperative acute bacterial endophthalmitis, and (3) standardized management protocols. Voting on each proposed statement was conducted using a 5-point Likert scale (strongly agree, agree, neutral, disagree, strongly disagree). Consensus was defined as ≥75% of experts voting either “strongly agree” or “agree.”</div></div><div><h3>Results</h3><div>A total of 45 consensus statements were evaluated, of which 21 (46.6%) achieved the predefined level of consensus.</div></div><div><h3>Conclusions</h3><div>This document aims to establish standardized guidelines to improve cataract surgery outcomes by minimizing the risk of postoperative endophthalmitis. For areas where consensus was not achieved, the panel recommends further investigation and continued research to guide future updates to clinical practice.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"280 ","pages":"Pages 436-457"},"PeriodicalIF":4.2,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870887","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 manifestations in Dengue Fever: A Systematic Review and Meta-Analysis","authors":"Alden Xavier Haslam ,&nbsp;Maria del Mar Tiffer Blandón ,&nbsp;Andrea Sarahí Rodríguez Castro","doi":"10.1016/j.ajo.2025.08.021","DOIUrl":"10.1016/j.ajo.2025.08.021","url":null,"abstract":"<div><h3>Topic</h3><div>Ocular manifestations in dengue fever remain underrecognized despite reports of vision-threatening complications. This systematic review and meta-analysis aimed to determine the pooled prevalence of ocular manifestations in dengue patients, characterizing their spectrum, frequency, and clinical significance.</div></div><div><h3>Clinical Relevance</h3><div>Dengue fever affects millions globally, predominantly in tropical regions. While systemic complications are well documented, ophthalmic involvement remains poorly defined, with variable prevalence estimates and unclear risk factors. Early recognition is crucial for timely intervention, particularly in endemic areas where clinical suspicion is low.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in PubMed, CINAHL, and LILACS. Eligible studies included observational studies reporting the prevalence of ocular manifestations in dengue patients. Risk of bias was assessed using Hoy et al.’s tool for prevalence studies. Pooled prevalence estimates were calculated using a random-effects model, and heterogeneity was assessed using I² statistics.</div></div><div><h3>Results</h3><div>A total of 32 studies, including 11,426 patients, were included. The pooled prevalence of ocular manifestations, calculated from 16 studies, was 0.32 (95% CI: 0.22–0.45, I² = 91.8%). Retro-ocular pain had a pooled prevalence of 0.20 (95% CI: 0.10–0.37, I² = 99.6%), while blurred vision was reported in 0.11 (95% CI: 0.05–0.23, I² = 92.8%). Among structural manifestations, subconjunctival hemorrhage had a prevalence of 0.18 (95% CI: 0.10–0.30, I² = 94.1%), retinal hemorrhage 0.08 (95% CI: 0.05–0.12, I² = 77.8%), maculopathy 0.04 (95% CI: 0.02–0.08, I² = 91.6%), and uveitis 0.05 (95% CI: 0.01–0.24, I² = 97.4%). Significant heterogeneity was observed across studies, likely due to differences in diagnostic criteria, study populations, and disease severity.</div></div><div><h3>Conclusion</h3><div>This study highlights a substantial prevalence of ocular manifestations in dengue patients, emphasizing the need for increased clinical awareness, particularly in endemic regions. Given the heterogeneity in reported prevalence, future research should focus on prospective, standardized ophthalmologic assessments to improve early diagnosis and management.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"280 ","pages":"Pages 308-325"},"PeriodicalIF":4.2,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870888","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":"Sleep Disturbance as a Risk Factor for Retinal Neurodegeneration and Subsequent Glaucoma","authors":"MASAHIRO AKADA ,&nbsp;YUTA NAKANISHI ,&nbsp;MIDORI IDEYAMA ,&nbsp;YUKI MORI ,&nbsp;KAZUYA MORINO ,&nbsp;ERI NAKANO ,&nbsp;SHOGO NUMA ,&nbsp;TADAO NAGASAKI ,&nbsp;TAKESHI MATSUMOTO ,&nbsp;HIRONOBU SUNADOME ,&nbsp;SATOSHI HAMADA ,&nbsp;NAOMI TAKAHASHI ,&nbsp;TOYOHIRO HIRAI ,&nbsp;NAOKO KOMENAMI ,&nbsp;KAZUO CHIN ,&nbsp;KIMIHIKO MURASE ,&nbsp;SUSUMU SATO ,&nbsp;YASUHARU TABARA ,&nbsp;FUMIHIKO MATSUDA ,&nbsp;HIROSHI TAMURA ,&nbsp;MASAYUKI HATA","doi":"10.1016/j.ajo.2025.08.019","DOIUrl":"10.1016/j.ajo.2025.08.019","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine whether insufficient sleep, insomnia, and sleep-apnea syndrome (SAS) are associated with retinal nerve fiber layer (RNFL) thinning and incident glaucoma in adults.</div></div><div><h3>Design</h3><div>Community-based cross-sectional analysis and nationwide population-based retrospective cohort study.</div></div><div><h3>Participants</h3><div>The regional cohort included 5958 adults aged 40-80 years who underwent wrist actigraphy and optical coherence tomography. The nationwide cohort, comprised adults aged ≥40 years, totaling 985,136 patients with insomnia and 72,075 with sleep apnea syndrome, along with respective control groups without these disorders.</div></div><div><h3>Methods</h3><div>In the regional cohort, we conducted a cross-sectional analysis to assess the association between objectively measured sleep parameters and retinal nerve fiber layer (RNFL) thickness, using multivariable linear models. In the nationwide cohort, we performed a longitudinal analysis with up to 7.5 years of follow-up, estimating adjusted hazard ratios (aHR) for incident glaucoma using Cox proportional hazards models.</div></div><div><h3>Results</h3><div>In the regional cohort, RNFL thickness peaked at 6-7 h of actual sleep and declined with shorter duration; sleeping &lt;6 h remained independently associated with thinner RNFL after adjustment for age, sex, intraocular pressure, and systemic factors. In the nationwide cohort, glaucoma risk was higher in patients with insomnia (aHR 1.30, 95% CI 1.28-1.32) and SAS (aHR 1.43, 95% CI 1.35-1.51) compared with controls.</div></div><div><h3>Conclusions</h3><div>Objective sleep insufficiency and clinically diagnosed sleep disorders correlate with retinal neurodegeneration and confer a higher risk of developing glaucoma. Integrating sleep evaluation and management into ophthalmic care may aid glaucoma prevention.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"280 ","pages":"Pages 193-202"},"PeriodicalIF":4.2,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870889","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 \"Is There a Safe Glycemic Threshold for Cataract Surgery?\"","authors":"Raimo Tuuminen,Idan Hecht,Piotr Kanclerz","doi":"10.1016/j.ajo.2025.06.052","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.06.052","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"12 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860095","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":"Real-World Outcomes in Eyes With Neovascular AMD Switched From Brolucizumab to Faricimab: A TRUCKEE Study Analysis","authors":"CEREN SOYLU ,&nbsp;GIULIA CORRADETTI ,&nbsp;MAI ALHELALY ,&nbsp;HANNAH KHAN ,&nbsp;AAMIR A. AZIZ ,&nbsp;HUMA KHAN ,&nbsp;HAAZIQ ALI ,&nbsp;HUMZA SULAHRIA ,&nbsp;ARSHAD M. KHANANI ,&nbsp;SRINIVAS SADDA","doi":"10.1016/j.ajo.2025.08.018","DOIUrl":"10.1016/j.ajo.2025.08.018","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate anatomical and functional outcomes in a subset of eyes with neovascular age-related macular degeneration (nAMD) switched from brolucizumab to faricimab in the real-world TRUCKEE study.</div></div><div><h3>Design</h3><div>Retrospective, multicentric clinical cohort study.</div></div><div><h3>Subjects and Participants</h3><div>134 eyes of 108 patients were switched from brolucizumab to faricimab. This study included 56 eyes (49 patients) with complete data after 1 injection of faricimab and 40 eyes (34 patients) with complete data after 3 injections of faricimab.</div></div><div><h3>Methods</h3><div>A multicenter, retrospective chart review was conducted on real-world participants enrolled in the TRUCKEE study switched from brolucizumab to faricimab for the treatment of nAMD. Participants were considered eligible for this post-hoc analysis if they had documented anatomical and functional outcome data following 1 and 3 injections of faricimab after being switched from brolucizumab. A comparative analysis was performed using the Wilcoxon signed-rank test.</div></div><div><h3>Main Outcome Measures</h3><div>Change in best corrected visual acuity (BCVA) measured in Early Treatment of Diabetic Retinopathy Study (ETDRS) letters, durability – defined as time interval between treatments in days, and central subfield thickness (CST), following 1 and 3 injections of faricimab.</div></div><div><h3>Results</h3><div>The mean age of patients who had complete data after 1 injection of faricimab was 81.1 ± 7.1 years, and 25 were males. After 1 injection of faricimab following the switch, (mean treatment interval of 57.0 ± 32.9 days) a significant reduction in CST was observed (mean -5.25 µm, <em>P = .</em>048). Changes in BCVA and durability were not statistically significant after 1 injection. The mean age of patients who had data after 3 injections was 80.4±7.7 years, and 16 were males. The mean CST reduction measured -11.28 µm, when comparing post-faricimab with post-brolucizumab values (<em>P = .</em>086). Additionally, after 3 injections of faricimab, a numerical increase in retreatment interval (+5.0 days, <em>P = .</em>769) and improvement in visual acuity (BCVA +1.63 letters, <em>P = .</em>174) were observed, though these were not statistically significant.</div></div><div><h3>Conclusions</h3><div>Switching from brolucizumab to faricimab was associated with numerical improvements in BCVA, CST, and retreatment interval. The apparent benefit in patients already on maximum VEGF suppression with brolucizumab, may suggest the relevance of angiopoetin-2 suppression with faricimab.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"280 ","pages":"Pages 169-175"},"PeriodicalIF":4.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857708","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}