American Journal of Ophthalmology最新文献

{"title":"Interpreting Imaging in the Era of Artificial Intelligence: Future Possibilities in Ocular Inflammatory Disease","authors":"K. MATTHEW MCKAY ,&nbsp;LEOPOLD SCHMETTERER ,&nbsp;SRINIVAS R. SADDA ,&nbsp;LUCIA SOBRIN","doi":"10.1016/j.ajo.2025.12.019","DOIUrl":"10.1016/j.ajo.2025.12.019","url":null,"abstract":"<div><h3>Purpose</h3><div>Uveitis encompasses a heterogeneous group of ocular inflammatory diseases with a high risk of permanent vision loss. Accurate diagnosis and disease monitoring are dependent on integrating disparate clinical data from patient history, examination findings and multimodal imaging, which is complex and time-consuming. The advent of artificial intelligence (AI) in the field of ophthalmology has provided new opportunities for automation of data gathering and interpretation, particularly for imaging data through deep learning algorithms. This article will review the current abilities, limitations, and future promise for the application of AI to the interpretation of multimodal imaging in the field of uveitis.</div></div><div><h3>Methods</h3><div>Review article.</div></div><div><h3>Results</h3><div>AI has provided new opportunities for automation of data gathering and interpretation in the field of uveitis, particularly for analysis of imaging data using deep learning techniques. Tools for diagnostic support, grading of intraocular inflammation, and quantification of disease features by multimodal imaging are under development.</div></div><div><h3>Conclusion</h3><div>Application of AI in the field of uveitis is in its infancy but holds promise for improving efficiency and quality of patient care.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 291-298"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822823","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: Cellular-Level Assessment of Macular Development in Patients With FEVR Using Multimodal Imaging: A Prospective Cohort Study","authors":"Gongpeng Sun ,&nbsp;Meixia Zhang","doi":"10.1016/j.ajo.2025.10.041","DOIUrl":"10.1016/j.ajo.2025.10.041","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Page 336"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145718241","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":"The Relationship Between Corneal Stiffness Distribution and Tomography in Keratoconus Patients","authors":"Nan-Ji Lu ,&nbsp;Marta Jiménez-García ,&nbsp;Ahmed Elsheikh ,&nbsp;Ahmed Makarem ,&nbsp;Carina Koppen ,&nbsp;Jos J. Rozema","doi":"10.1016/j.ajo.2025.12.011","DOIUrl":"10.1016/j.ajo.2025.12.011","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize the regional distribution of corneal stiffness in keratoconus (KC) and explore its relationship with tomographic parameters.</div></div><div><h3>Design</h3><div>Prospective, cross-sectional observational study.</div></div><div><h3>Subjects</h3><div>One hundred eleven eyes from 111 KC patients.</div></div><div><h3>Methods</h3><div>All eyes underwent Scheimpflug-based tomography and air-puff tonometry (Pentacam and Corvis). Stress-Strain Index (SSI) maps were generated to quantify overall and regional stiffness. Maximum, minimum, and mean SSI values, as well as regional values, were correlated with keratometric and pachymetric indices.</div></div><div><h3>Main Outcome Measures</h3><div>Regional SSI values and their correlations with keratometric and pachymetric parameters.</div></div><div><h3>Results</h3><div>SSI maps showed non-uniform stiffness, with the lowest values predominantly in the inferior-temporal region. The mean SSI at the thinnest pachymetry point (Pmin; 0.68 ± 0.16) was higher than at the steepest keratometry point (Kmax; 0.63 ± 0.19; <em>P</em> = .036). In overall analyses, the strongest correlation was between SSI-map minimum and Pmin (R² = 0.51), while mean SSI correlated weakly with tomography (R² = 0.11-0.19). In regional analyses, SSI correlated most strongly with Kmax in the central region (R² = 0.74), followed by the midperipheral inferior (R² = 0.38) and temporal (R² = 0.23) regions. SSI correlations with Pmin were most evident in the central (R² = 0.52), paracentral inferior (R² = 0.45), and inferior-temporal (R² = 0.31) regions.</div></div><div><h3>Conclusions</h3><div>Biomechanical weakening in KC varies regionally. Strong correlations with disease severity occurred in the central and inferior-temporal regions — especially with Kmax and Pmin, highlighting the role of regional mechanical stiffness and collagen architecture in corneal deformation.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 214-226"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784491","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":"Effect of Angle Kappa on the Refractive Prediction Accuracy in Cataract Patients After Myopic LASIK/PRK","authors":"HAORUI YUAN ,&nbsp;JIAQING ZHANG ,&nbsp;YUXING ZHENG ,&nbsp;HAOWEN LIN ,&nbsp;XIAOHANG XIE ,&nbsp;XIAOFEI HU ,&nbsp;WENLU YU ,&nbsp;XIAOZHANG QIU ,&nbsp;ZHENZHEN LIU ,&nbsp;WEIRONG CHEN ,&nbsp;LIXIA LUO ,&nbsp;XUHUA TAN","doi":"10.1016/j.ajo.2025.11.042","DOIUrl":"10.1016/j.ajo.2025.11.042","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To evaluate the impact of angle kappa on prediction accuracy in patients after myopic laser-assisted in-situ keratomileusis (LASIK)/photorefractive keratectomy (PRK).</div></div><div><h3>DESIGN</h3><div>Retrospective, consecutive interventional case-series study.</div></div><div><h3>METHODS</h3><div>This study included 127 postmyopic-LASIK/PRK cataract patients (176 eyes). Three different keratometry (K) values measured by 2 devices were assessed, including simulated keratometry (SimK) obtained by IOLMaster 700 at 2.5 mm ring centered on corneal vertex and SimK derived from Pentacam AXL in 3 mm zone centered on corneal vertex (Pentacam [CV]) and pupil center (Pentacam [PC]). The performance of the Barrett True-K formula based on vertex-centered K values (IOLMaster 700; Pentacam [CV]) and pupil-centered K values (Pentacam [PC]) was compared. Subgroup analysis was performed using angle kappa (&lt;0.4 mm; ≥0.4 mm).</div></div><div><h3>RESULT</h3><div>The hyperopic prediction error (PE) of the IOLMaster 700 and Pentacam (CV) modes increased with larger angle kappa. Both in total and in eyes with angle kappa &lt;0.4 mm, compared with other modes, the IOLMaster 700 mode showed no systematic bias and relatively lower absolute PE. For eyes with angle kappa ≥0.4 mm, IOLMaster 700 and Pentacam (CV) modes demonstrated hyperopic PE (0.43-0.46 D, <em>P</em> &lt; .05), while the Pentacam (PC) mode displayed no systematic bias, relatively lower mean absolute PE (0.70 D vs 0.90-0.96 D) and the highest percentage of eyes with PE within ±0.5 D (51.22% vs 36.59%-41.46%).</div></div><div><h3>CONCLUSION</h3><div>In postmyopic-LASIK/PRK patients, the prediction accuracy decreased with greater angle kappa when using the corneal vertex-centered K values. The pupil-centered K values were preferred for these patients with angle kappa ≥0.4 mm.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 36-44"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145613715","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":"Impact of Phacoemulsification on Vitreomacular Traction Release and Complications","authors":"Suraj Bala ,&nbsp;Nitesh Mohan ,&nbsp;Victor Bellanda ,&nbsp;Andrea Arline ,&nbsp;Gabriel Castilho S. Barbosa ,&nbsp;Matthew Schulgit ,&nbsp;Sumit Sharma ,&nbsp;Sunil K. Srivastava ,&nbsp;Danny A. Mammo ,&nbsp;Ananth Sastry","doi":"10.1016/j.ajo.2025.12.008","DOIUrl":"10.1016/j.ajo.2025.12.008","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine if phacoemulsification impacts vitreomacular traction (VMT) release and VMT-related complications.</div></div><div><h3>Design</h3><div>Single-center, comparative, retrospective clinical cohort study.</div></div><div><h3>Subjects: A total of</h3><div>310 eyes of 249 patients with a concurrent diagnosis of VMT and cataracts at the Cole Eye Institute between 2013 and 2024.</div></div><div><h3>Methods</h3><div>Eligible eyes had at least 6 months of follow-up post-VMT diagnosis or phacoemulsification. The control group included eyes that did not undergo phacoemulsification after VMT diagnosis. Clinical information was collected via manual chart review. Characteristics of VMT were recorded via review of optical coherence tomography imaging.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was the hazard of VMT release. Secondary outcomes included VMT-related complications, such as macular and lamellar hole formation, retinal detachment, and subsequent vitrectomy.</div></div><div><h3>Results</h3><div>VMT release occurred in 49.4% of 310 eyes, with an average follow-up period of 136.7 ± 134.4 weeks. There was no significant difference in release between the phacoemulsification and control groups (adjusted hazard ratio [aHR] = 0.861; <em>P</em> = .380). Among eyes that released, the mean time to release was 79.4 ± 68.8 weeks postsurgery in the phacoemulsification group and 76.0 ± 81.9 weeks from diagnosis in the control group (<em>P</em> = .785). In multivariate analysis, younger age at diagnosis (5-year aHR = 0.773; <em>P</em> &lt; .001) and smaller adhesion diameter (per 100 µm aHR = 0.951; <em>P</em> = .017) were significantly associated with a higher likelihood of VMT release. Black patients had a lower likelihood of VMT release compared to White patients (aHR = 0.439; <em>P</em> = .004). Eyes that developed a macular hole had a smaller baseline adhesion diameter than those that did not (439.1 ± 217.9 µm vs 685.7 ± 697.4 µm; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Phacoemulsification was not associated with increased rates or faster timing of VMT release. These findings suggest that intrinsic patient and anatomical factors play a larger role in determining the likelihood of VMT release and should be prioritized in clinical decision-making.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 176-187"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145731919","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":"Limbal Epithelial Cells Detected in Stage III Limbal Stem Cell Deficiency by Multimodal Anterior Segment Imaging","authors":"CLEMENCE BONNET ,&nbsp;MEHRNOOSH MAALHAGHFARD ,&nbsp;SOPHIE X. DENG","doi":"10.1016/j.ajo.2025.11.041","DOIUrl":"10.1016/j.ajo.2025.11.041","url":null,"abstract":"<div><h3>Purpose</h3><div>Limbal stem cell deficiency (LSCD) is a potentially blinding corneal condition with heterogeneous clinical presentations. Anterior segment imaging, in particular anterior segment optical coherence tomography (AS-OCT) and in vivo confocal microscopy (IVCM) provide objective staging of LSCD. The goal of this study was to evaluate whether the fluorescein staining test is accurate in staging LSCD.</div></div><div><h3>Design</h3><div>Diagnostic and staging validity analysis.</div></div><div><h3>Subjects</h3><div>Subjects without eye diseases and those diagnosed with LSCD based on clinical exam, AS-OCT, and IVCM.</div></div><div><h3>Methods</h3><div>The severity of LSCD was staged clinically according to the global consensus guidelines using fluorescein staining. Multimodal imaging (AS-OCT and IVCM) was performed in the central cornea and four limbal quadrants (superior, inferior, nasal, and temporal). Imaging findings were correlated with clinical stage.</div></div><div><h3>Main Outcomes Measures</h3><div>Detection of morphologically limbal epithelial cells in eyes clinically graded as stage III LSCD, and AS-OCT characteristics corresponding to these identified clusters.</div></div><div><h3>Results</h3><div>A total of 220 eyes from 156 patients were analyzed. Based on fluorescein staining, 49 eyes (22.3%) were classified as stage I, 93 eyes (42.3%) as stage II, and 75 eyes (34.1%) as stage III LSCD. In all cases of stage III LSCD, AS-OCT confirmed severe central epithelial thinning, and IVCM demonstrated significantly reduced mean basal cell density in the central cornea. Despite this, clusters of limbal epithelial cells with normal morphology were detected by IVCM in 30 eyes (40.0%), appearing in one limbal quadrant in 26 eyes (86.7%) and in two quadrants in 4 eyes (13.3%). Correlation between IVCM and AS-OCT findings at the cluster locations was variable. Absence of hyporeflective epithelial layer was observed in 20 eyes (74.1%) and presence of hyporeflective layer was detected in 7 eyes (25.9%) by AS-OCT.</div></div><div><h3>Conclusions</h3><div>Despite being graded as total stage III LSCD by clinical exam using fluorescein staining, a significant proportion of eyes retained morphologically normal limbal epithelial cells. These findings highlight the importance of multimodal anterior segment imaging to achieve LSCD diagnostic accuracy, refine disease staging, and guide future personalized management strategies.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 91-99"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145657309","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":"Association Between Body Composition and Risk of Primary Open-Angle Glaucoma","authors":"Jianqi Chen ,&nbsp;Yue Xiao ,&nbsp;Xiaohong Chen ,&nbsp;Yingting Zhu ,&nbsp;Zhidong Li ,&nbsp;Shitong Huang ,&nbsp;Hanyang Yu ,&nbsp;Yehong Zhuo ,&nbsp;Yunxia Leng","doi":"10.1016/j.ajo.2025.12.014","DOIUrl":"10.1016/j.ajo.2025.12.014","url":null,"abstract":"<div><h3>Purpose</h3><div>Body size has been closely linked to primary open-angle glaucoma (POAG). However, the association was inconsistent, which may be due to the fact that body size defined by body mass index does not differentiate fat from lean mass or capture body composition distribution. The impact of body composition on POAG remains largely unknown.</div></div><div><h3>Design</h3><div>Combined cross-sectional and cohort study.</div></div><div><h3>Participants</h3><div>A total of 88,123 participants and 291,983 participants from the UK Biobank for the analysis of baseline intraocular pressure (IOP) and POAG incidence, respectively.</div></div><div><h3>Methods</h3><div>Fat and muscle mass in the arm, trunk, and leg were estimated using bioimpedance analysis. Measurements were normalized for height to derive the arm fat index, trunk fat index, leg fat index (LFI), arm muscle index, trunk muscle index, and leg muscle index. Fat-to-muscle ratios for each region were also calculated as sensitivity analysis. Hazard ratios (HRs) and 95% confidence intervals (CIs) for POAG were estimated using covariate-adjusted Cox models, and associations with IOP were additionally assessed using linear regression.</div></div><div><h3>Main Outcome Measures</h3><div>Baseline IOP and POAG incidence.</div></div><div><h3>Results</h3><div>Greater leg fat was associated with a significantly reduced risk of POAG, supported by both LFI (HR, 0.85; 95% CI, 0.76-0.95; <em>P</em> = .006) and leg fat-to-muscle ratio (HR, 0.35; 95% CI, 0.16-0.73; <em>P</em> = .005). No association was observed between muscle mass and the incidence of POAG. Greater fat mass was associated with higher IOP levels, supported by arm fat index (<em>β</em>, 0.14; 95% CI, 0.07-0.22, <em>P</em> &lt; .001), LFI (<em>β</em>, 0.15; 95% CI, 0.11-0.18, <em>P</em> &lt; .001), trunk fat index (<em>β</em>, 0.07; 95% CI, 0.04-0.09, <em>P</em> &lt; .001), whereas greater muscle mass in leg (leg muscle index: <em>β</em>, –0.24; 95% CI, –0.29 to –0.20, <em>P</em> &lt; .001) and trunk (trunk muscle index: <em>β</em>, –0.05; 95% CI, –0.08 to –0.01, <em>P</em> = .005) was associated with lower IOP.</div></div><div><h3>Conclusions</h3><div>POAG risk differs according to body composition. Maintaining a healthy body composition pattern may mitigate its risk.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 256-267"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784493","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":"Pathogen-Associated Visual Outcomes Following Postprocedure Endophthalmitis","authors":"Marusha Ather ,&nbsp;Elizabeth Lyden ,&nbsp;Yue Zhan ,&nbsp;Rachana Haliyur ,&nbsp;Alina Sinha ,&nbsp;Saagar Patel ,&nbsp;Richard M. Feist Jr. ,&nbsp;Akbar Shakoor ,&nbsp;Albert T. Vitale ,&nbsp;David N. Zacks ,&nbsp;Steven Yeh ,&nbsp;Talisa E. de Carlo Forest ,&nbsp;Michael J. Huvard ,&nbsp;Christopher D. Conrady","doi":"10.1016/j.ajo.2025.11.038","DOIUrl":"10.1016/j.ajo.2025.11.038","url":null,"abstract":"<div><h3>Objective</h3><div>To report the anatomic and functional outcomes of a large, multicenter series of postprocedure acute endophthalmitis, stratified by pathogen virulence.</div></div><div><h3>Design</h3><div>Retrospective, interventional case series.</div></div><div><h3>Participants</h3><div>Two hundred forty adult patients diagnosed with postprocedural acute endophthalmitis from 2012 to 2022 at four tertiary, university-based care centers. Of these, 208 patients had adequate follow-up data for comparative analyses.</div></div><div><h3>Methods</h3><div>Medical records were reviewed for demographics, microbiology, treatment, and visual outcomes of patients that developed endophthalmitis following any intraocular procedure. Organisms were categorized into surface commensals (coagulase-negative <em>Staphylococcus</em> sp.) and nonsurface commensals (eg, <em>Streptococcus, Enterococcus</em> sp.) as a proxy for virulence. Visual acuity (VA) outcomes and complication rates were compared across groups using Fisher’s exact test and regression models adjusting for age, sex (male or female), comorbidities, and treatment modality for postinjection endophthalmitis.</div></div><div><h3>Main Outcome Measures</h3><div>Final VA, number of interventions, and rates of vision-threatening complications, including phthisis, retinal detachment, enucleation/evisceration.</div></div><div><h3>Results</h3><div>Among culture-positive cases, patients infected with nonsurface commensal organisms had significantly worse final VA than those with coagulase-negative <em>Staphylococcus</em> (mean logMAR 2.14 vs 0.77, <em>P</em> &lt; .0001), as well as higher rates of third interventions (27.5% vs 10.1%, <em>P</em> = .017), phthisis (15.4% vs 1.1%, <em>P</em> = .0032), and enucleation/evisceration (12.8% vs 0%, <em>P</em> = .0022). In multivariable regression of postinjection endophthalmitis, virulent, nonsurface commensal organisms remained independently associated with poorer visual outcomes (<em>P</em> = .0005). Complication patterns were consistent whether culture-negative cases were included or not in the nonvirulent group. Most patients were initially treated with intravitreal injections (92.1%). An initial vitrectomy was uncommon and not significantly associated with better outcomes when performed.</div></div><div><h3>Conclusions</h3><div>Infections with virulent, nonsurface commensal organisms such as <em>Streptococcus</em> and <em>Enterococcus</em> are associated with significantly worse outcomes in postprocedure endophthalmitis, independent of presenting vision or treatment delay. These findings support a shift toward pathogen-informed management and underscore the need for timely identification of virulent organisms in postprocedural acute endophthalmitis.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 72-80"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145611708","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":"Autosomal Recessive Bestrophinopathy—Phenotypic Variability, Natural History, and Genotype-Phenotype Correlations","authors":"Lorenzo Bianco ,&nbsp;Alessio Antropoli ,&nbsp;Elise Boulanger-Scemama ,&nbsp;Marco Nassisi ,&nbsp;Amine Benadji ,&nbsp;Grégoire Mésa ,&nbsp;Louise O’Toole ,&nbsp;Aline Antonio ,&nbsp;Christel Condroyer ,&nbsp;Camille Andrieu ,&nbsp;José-Alain Sahel ,&nbsp;Christina Zeitz ,&nbsp;Isabelle Audo","doi":"10.1016/j.ajo.2025.12.012","DOIUrl":"10.1016/j.ajo.2025.12.012","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the clinical characteristics, natural history, and genotype-phenotype correlations of autosomal recessive bestrophinopathy (ARB).</div></div><div><h3>Design</h3><div>Retrospective cohort study including data collected for clinical practice.</div></div><div><h3>Participants</h3><div>Thirty-four consecutive patients (68 eyes) affected by ARB who had a molecularly confirmed diagnosis followed at a single referral center for inherited retinal diseases (REFERET, Quinze-Vingts Hospital, Paris, France).</div></div><div><h3>Methods</h3><div>We collected data from medical records, including genetic data, ophthalmologic history, clinical examinations, retinal imaging, and full-field electroretinograms (ERG). Disease severity graded on short-wavelength autofluorescence (SW-AF), and the presence of primary angle closure (PAC) was evaluated as candidate risk factors for clinical outcomes. Longitudinal outcome analysis was performed using mixed-effects linear modeling and Kaplan–Meier survival curves.</div></div><div><h3>Main Outcomes Measures</h3><div>ERG amplitudes; best-corrected visual acuity and degree of visual impairment according to World Health Organization criteria; central subfield thickness measured on optical coherence tomography.</div></div><div><h3>Results</h3><div>The median age at baseline was 32 years (interquartile range, 18.3-46.9), and 29% (10/34) of patients had PAC. On SW-AF, 21% (7/34) had isolated macular lesions (grade 1), 44% (15/34) had multifocal lesions or diffuse alterations at the posterior pole with zonal sparing (grade 2), and 35% (12/34) had panretinal alterations (grade 3). Marked attenuation of ERG amplitudes was found only in patients with grade 3 disease. Of 32 unique BEST1 variants, 11 (34%) were novel, and the p.(Thr363Pro) occurred only in grade 1 disease. The median age at onset of severe visual impairment was lower in patients with PAC (47 years) compared with those without (68 years; <em>P</em> = .01), whereas no such association was observed with SW-AF grade. No significant linear annual change in best-corrected visual acuity could be demonstrated over a median follow-up of 3 years.</div></div><div><h3>Conclusions</h3><div>ARB encompasses a wide phenotypic spectrum, ranging from mild, isolated macular involvement to severe panretinal degeneration with abnormal ERG. However, the risk of visual impairment appears to be driven primarily by the presence of PAC rather than by the severity of fundus lesions, representing an important confounding factor for future clinical trials. The very slow rate of visual acuity decline further underscores the need for more sensitive functional outcome measures in bestrophinopathies.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 188-198"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784497","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":"Potential Eye Disorders in People With and Without Type 2 Diabetes Mellitus Exposed to GLP-1 Receptor Agonists: An Examination of the FAERS (FDA Adverse Event Reporting System) Database","authors":"Mya Murray ,&nbsp;Fabrizio Schifano ,&nbsp;Stefania Chiappini ,&nbsp;John Martin Corkery ,&nbsp;Amira Guirguis","doi":"10.1016/j.ajo.2025.12.015","DOIUrl":"10.1016/j.ajo.2025.12.015","url":null,"abstract":"<div><h3>Purpose</h3><div>As use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) for Type 2 diabetes (T2DM) and weight management increases, emerging research identifies various adverse drug reactions. This study aimed to expand this research base, focusing on eye disorders in people with and without T2DM, a novel consideration.</div></div><div><h3>Design</h3><div>A retrospective clinical cohort disproportionality analysis of reports made to the Food and Drug Administration Adverse Event Reporting System (FAERS).</div></div><div><h3>Methods</h3><div>FAERS was queried regarding selected GLP-1RAs. Python 3.11 was adopted to develop a program, quantifying reported cases between January 2017 - September 2025 (January 2022-September 2025 for tirzepatide) meeting the criteria for cases with and without T2DM. Main outcome measures Reporting Odds Ratios (RORs) &gt;4.000 and 95% confidence intervals were calculated, with metformin and orlistat as controls.</div></div><div><h3>Results</h3><div>Compared to metformin, semaglutide showed increased reporting of optic ischemic neuropathy (ROR: 12.269 [0.915-1.967]), cataract (ROR: 31.879 [2.463-4.461]) and retinopathy (ROR: 5.185 [0.556-2.736]) in T2DM patients, and retinopathy (ROR: 9.424 [1.081-3.406]) and retinal hemorrhage (ROR: 10.253 [0.319-4.336]) in non-T2DM patients. Tirzepatide showed increased reporting of optic ischemic neuropathy (ROR: 4.619 [0.726-2.335]) and macular degeneration (ROR: 15.579 [0.554-4.938]) in T2DM patients and eye swelling (ROR: 6.475 [0.407-3.329]) in non-T2DM patients. Liraglutide showed increased reporting of cataract (ROR: 53.866 [2.945-5.028]), diabetic retinopathy (ROR: 18.162 [1.753-4.045]) and macular degeneration (ROR: 26.261 [1.076-5.460]) in T2DM patients and cataract (ROR: 9.628 [1.387-3.142]) and macular degeneration (ROR: 9.557 [0.110-4.405]) in non-T2DM patients.</div></div><div><h3>Conclusions</h3><div>These results provide a signal of increased reporting of various eye disorders with GLP-1RA use compared to metformin across T2DM and non-T2DM patient cases. Further research is required to support these findings and confirm a biological causation.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 279-290"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145796071","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}