American Journal of Ophthalmology最新文献

{"title":"Home OCT and Sustained Delivery Approaches, a Perfect Marriage: Home OCT and Sustained Drug Delivery: A Perfect Marriage.","authors":"Nancy M Holekamp","doi":"10.1016/j.ajo.2024.10.031","DOIUrl":"https://doi.org/10.1016/j.ajo.2024.10.031","url":null,"abstract":"<p><strong>Purpose: </strong>To provide a perspective on the management of neovascular age-related macular degeneration (nAMD) patients using a combination of sustained drug delivery strategies and remote monitoring technology.</p><p><strong>Design: </strong>Evidence-based perspective METHODS: Review of the literature and experience of the author RESULTS: Currently there are many ongoing research efforts in the retina field directed at both safe, effective sustained drug delivery and validated remote monitoring. At present, the Port Delivery System with ranibizumab and the Home OCT are FDA approved and available for use by clinicians. A review of available data and a case example demonstrate the potential for these combined technologies to reduce both the injection burden and the monitoring burden currently experienced by nAMD patients. Other sustained drug delivery strategies such as tyrorinse kinase inhibitor delivery systems and viral vector mediated anti-VEGF intraocular bio-factory models are not yet approved for clinical use. Early experience with these technologies in clinical trials foretell the potential advantages and possible limitations of remote monitoring with a variety of sustained delivery approaches.</p><p><strong>Conclusion: </strong>The combined use of sustained drug delivery and validated remote monitoring portends a significant change in the current nAMD treatment landscape and has the potential to reduce the injection and monitoring burden faced by patients while optimizing patient outcomes.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612081","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":"Sodium-glucose cotransporter 2 inhibitors and glaucoma in patients with type 2 diabetes.","authors":"Kathleen Eng, Nazlee Zebardast, Michael V Boland, Jui-En Lo, Swarup S Swaminathan, David S Friedman, Kevin Sheng-Kai Ma","doi":"10.1016/j.ajo.2024.10.029","DOIUrl":"https://doi.org/10.1016/j.ajo.2024.10.029","url":null,"abstract":"<p><strong>Purpose: </strong>Pleiotropic cardiovascular benefits of sodium glucose co-transporter 2 inhibitors (SGLT2i) have been demonstrated in patients with type 2 diabetes mellitus due to vascular remodeling effects. It is unclear whether a similar benefit may be seen for glaucoma. The purpose of this study is to assess the effect of SGLT2i on the risk of glaucoma in patients with type 2 diabetes.</p><p><strong>Design: </strong>Target trial emulation using a population-based, propensity score-matched clinical cohort approach.</p><p><strong>Methods: </strong>Setting: Population-based, propensity score-matched clinical cohort study.</p><p><strong>Study population: </strong>Adults with type 2 diabetes in the United States who newly initiated treatment with SGLT2i, dipeptidyl peptidase 4 inhibitors (DPP4i), or glucagon-like peptide-1 receptor agonists (GLP1RA) between 2013 and 2023. After propensity score matching, 722,446 patients were included in the SGLT2i arm and the DPP4i arm, respectively. Participants were matched based on age at index, race and sex, comorbidities, and concomitant use of medications.</p><p><strong>Exposure: </strong>Treatment with SGLT2i for type 2 diabetes.</p><p><strong>Main outcome measure(s): </strong>Incidence of new-onset glaucoma and its subtypes after initiation of SGLT2i, DPP4i, or GLP1RA. Subgroup analyses were performed to demonstrate the effect of individual SGLT2i on incident glaucoma.</p><p><strong>Results: </strong>Patients on SGLT2i compared to those on DPP4 had a lower risk of glaucoma (HR: 0.815, 95% confidence interval [CI]: 0.794, 0.837), including open-angle glaucoma (HR: 0.755, 95%CI: 0.729, 0.781) and primary angle-closure glaucoma (HR: 0.592, 95%CI: 0.540, 0.650). Among all SGLT2i, ertugliflozin (HR: 0.668, 95%CI: 0.512, 0.871) was associated with the lowest risk of glaucoma, followed by empagliflozin (HR: 0.727, 95%CI: 0.696, 0.759), then dapagliflozin (HR: 0.814, 95%CI: 0.774, 0.855). The protective effect of SGLT2i on glaucoma was validated when compared with GLP1RA (HR: 0.932, 95%CI: 0.906, 0.959).</p><p><strong>Conclusions: </strong>Patients on SGLT2i, especially ertugliflozin and empagliflozin, had a significantly lower risk of incident glaucoma compared to those on DPP4i, an association that was less robust but significant in a sensitivity analysis using GLP1RA as the active comparator. SGLT2i had a protective effect for both open-angle glaucoma and angle-closure glaucoma.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612041","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":"PRPH2-associated Retinal Diseases: A Systematic Review of Phenotypic Findings.","authors":"Shadi M AlAshwal, Shaden H Yassin, Fritz G P Kalaw, Shyamanga Borooah","doi":"10.1016/j.ajo.2024.10.025","DOIUrl":"https://doi.org/10.1016/j.ajo.2024.10.025","url":null,"abstract":"<p><strong>Purpose: </strong>PRPH2-associated retinal diseases (PARD) result from pathogenic PRPH2 variants, primarily affecting photoreceptor outer segments and retinal pigment epithelium. The focus of this article is to review and discuss the phenotyping of PARD subtypes.</p><p><strong>Design: </strong>A systematic review METHODS: The review followed PRISMA 2020 guidelines with searches on PubMed, Medline, Web of Science, Google Scholar, and Cochrane Library. Eligible studies were those which discussed molecularly confirmed PARD or described associated diseases such as butterfly pattern dystrophy.</p><p><strong>Inclusion: </strong>cross-sectional, cohort, case-control studies, book chapters.</p><p><strong>Exclusion: </strong>non-English, conference papers, non-peer-reviewed, or non-full text articles.</p><p><strong>Results: </strong>PARD is responsible for 25% of pattern dystrophy and up to 5% of inherited retinal dystrophies. There is clear evidence of phenotypic variability between individuals carrying the same pathogenic variant. Fundus autofluorescence, fluorescein angiography, optical coherence tomography, while in research adaptive optics reveal detailed phenotypic characteristics, notably in retinal pigment epithelium changes and photoreceptor disruption. The phenotypic of PARD variability presents diagnostic challenges, with phenotypic features often overlapping with other retinal diseases including age-related macular degeneration, Stargardt disease and retinitis pigmentosa.</p><p><strong>Conclusion: </strong>This review emphasizes revising diagnostic criteria by incorporating more recent imaging techniques and confirming diagnosis with the use of genetic testing. Understanding phenotypic diversity and intrafamilial variability in PARD is crucial for developing new treatments and for patient prognosis and future research should focus on larger cohorts studying genotype-phenotype correlations.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612095","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":"Do Ophthalmology Journals Have AI Policies for Manuscript Writing?","authors":"Amr Almobayed, Taher K Eleiwa, Omar Badla, Ali Khodor, Raul E Ruiz-Lozano, Abdelrahman M Elhusseiny","doi":"10.1016/j.ajo.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.ajo.2024.11.003","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the prevalence of Artificial Intelligence (AI) usage policies in manuscript writing in PubMed-indexed ophthalmology journals and examine the relationship between adoption of these policies and journal characteristics.</p><p><strong>Design: </strong>Cross-sectional study SUBJECTS: PubMed-indexed ophthalmology journals MAIN OUTCOME MEASURES: Prevalence of policies in journal guidelines regarding the use of AI in manuscript writing.</p><p><strong>Methods: </strong>We reviewed the guidelines of 84 ophthalmology journals indexed in PubMed to determine the presence of AI-use policies for manuscript generation. We further compared journal metrics, such as CiteScore, Journal Impact Factor (JIF), Journal Citation Indicator (JCI), Source Normalized Impact per Paper (SNIP), and SCImago Journal Rank (SJR), between journals with and without AI policies. Additionally, we analyzed the association between AI policy adoption and journal characteristics, such as MEDLINE indexing and society affiliation.</p><p><strong>Results: </strong>Among the 84 journals, 53 (63.1%) had AI policies for manuscript generation, with no significant changes observed during the study period. Journals indexed in MEDLINE were significantly more likely to have AI policies (68.8%) than non-MEDLINE-indexed journals, where no AI policies were found (0%) (p = 0.0008). There was no significant difference in AI policy adoption between society-affiliated (62.7%) and unaffiliated journals (64.7%) (p = 0.8443). Journals with AI policies had significantly higher metrics, including CiteScore, SNIP, SJR, JIF, and JCI (p < 0.05).</p><p><strong>Conclusions: </strong>While many ophthalmology journals have adopted AI policies, the lack of guidelines in over one-third of journals highlights a critical need for consistent and comprehensive AI policies, particularly as the AI landscape rapidly advances.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612071","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":"Outcomes of circumferential versus hemi-gonioscopy assisted transluminal trabeculotomy for congenital glaucoma.","authors":"Shikha Gupta, Arnav Panigrahi, R Anjana, Anurag Kumar, Anand Kumar Pathak, Davinder S Grover, Viney Gupta","doi":"10.1016/j.ajo.2024.10.026","DOIUrl":"https://doi.org/10.1016/j.ajo.2024.10.026","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the efficacy of circumferential gonioscopy-assisted transluminal trabeculotomy (GATT) versus hemi-GATT in primary congenital glaucoma (PCG).</p><p><strong>Design: </strong>Prospective randomized controlled trial METHODS: This study included children with PCG having corneal diameters <14mm and relatively clear cornea. Based on randomisation, the eyes included, underwent either circumferential GATT (360-GATT) or hemi-GATT (180-GATT). The intra-ocular pressure (IOP) reduction, requirement for glaucoma medications after surgery, need for repeat surgery and the incidence and type of complications in each group were analysed. Surgical success was defined as absolute when IOP ≤18 (criterion A) and ≤15mmHg (criterion B) was achieved without medications and qualified when the same was achieved with pressure-lowering medications. Eyes with an IOP ≥18mmHg on maximum medications, those with IOP <6 mmHg or need for further intervention for IOP control were considered failures.</p><p><strong>Results: </strong>Fifty-two eyes of children with PCG were randomized into either the 360-GATT group (22 eyes) or the 180-GATT group (30 eyes) and followed up for at least 1 year. The median follow-up duration was 22.5 months (range: 12-30 months). IOP fell by 49% and 20.5% with 360-GATT and 180-GATT respectively, final IOP being significantly lower in the former group (p=0.0003). For absolute success the cumulative survival was superior with 360-GATT for both criterion A and B at 1 year (p=0.009). Average cup disc ratio, corneal diameter and axial length reversal were significant in the 360-GATT group but not in the hemi-GATT group.</p><p><strong>Conclusions: </strong>This study reinforces the superior efficacy of circumferential GATT for IOP control in eyes with congenital glaucoma.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612090","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":"Multiple Factors Causing Variability of Alignment in Childhood Concomitant Strabismus","authors":"YANAN GUO ,&nbsp;YUEHAN GUAN ,&nbsp;LI LI ,&nbsp;JINGJING JIANG","doi":"10.1016/j.ajo.2024.10.013","DOIUrl":"10.1016/j.ajo.2024.10.013","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the potential factors related to variability of alignment in childhood concomitant strabismus.</div></div><div><h3>Design</h3><div>Prospective interexaminer (test-retest) reliability analysis.</div></div><div><h3>Methods</h3><div>In total, 197 children with concomitant strabismus (57 esotropia, 140 exotropia) underwent repeat prism and alternate cover test (PACT) by two orthoptists who were certified by the study, and sensory tests were all performed once. We defined the alignment measurement as stable if the absolute value of the measurement difference between two orthoptists was within 10 prism diopters (PD), and unstable if the difference was 10 PD or greater. We analyzed the relationship between the measurement variability and sensory results, patient age, and angle of deviations.</div></div><div><h3>Results</h3><div>The mean age of the esotropia and exotropia patients was 68.5 ± 26.3 months (range, 36-164 months) and 96.0 ± 33.7 months (range, 22-200 months), respectively, and there was a significant difference in suppression related variability of alignment, both at distance (<em>P</em> = .004) and at near (<em>P</em> = .046). Anisometropia also showed a significant difference at distance (<em>P</em> = .035) for variability of alignment, and there was no significant statistical effect of age on measurement variability in our study. Variability of alignment is positively associated with the angle of deviation, especially at distance (<em>P</em> = .021 for exotropia, <em>P</em> = .002 for esotropia) with more variability between observers with larger angles of misalignment.</div></div><div><h3>Conclusion</h3><div>Suppression is an important factor for variability of alignment in childhood concomitant strabismus. Other factors, such as anisometropia and a large angle of strabismus should be taken into account when evaluating binocular alignment.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cornea Endothelial Cell Loss Before and After Explantation of Artisan and Artiflex Iris-Fixated Phakic Intraocular Lenses","authors":"Hye yeon Yoon MD. ,&nbsp;Yong-Soo Byun MD., PhD. ,&nbsp;Hyun Seung Kim MD., PhD. ,&nbsp;So-Hyang Chung MD., PhD.","doi":"10.1016/j.ajo.2024.10.010","DOIUrl":"10.1016/j.ajo.2024.10.010","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To investigate the risk factors for corneal endothelial cell density (ECD) loss of 2 types of iris-fixated phakic intraocular lenses (pIOL) and indicate the cutoff values for preventing irreversible ECD loss after explantation.</div></div><div><h3>DESIGN</h3><div>The retrospective, comparative, clinical cohort study.</div></div><div><h3>METHODS</h3><div>Total 114 eyes of 61 patients were included in this study. Fifty-five eyes with Artisan pIOL and 59 eyes with Artiflex pIOL had undergone explantation of pIOLs due to continuous ECD loss. Correlation analysis was performed to assess the ocular parameters associated with ECD loss. Receiver operating characteristic (ROC) curve was performed to set cutoff values of ocular parameters to prevent ECD loss after explantation.</div></div><div><h3>RESULTS</h3><div>The mean ECD before explantation was 1637 cells/mm² in Artisan group and 1769 cells/mm² in Artiflex group. The distance of cornea endothelium to IOL center and edges were all significantly higher in Artisan group (<em>P</em> &lt; .05). The risk factor of decreased ECD in Artisan group were small anterior chamber angle (ACA), and distance of nasal edge of IOL to endothelium and iris fixation to nasal limbus distance, and differences of fixation length. In Artiflex group, ACA, distance of nasal edge of IOL to endothelium, both limbus to IOL fixation length, fixation length, iris pigmentation grading were the risk factors. At 1 year after the pIOL removal, the population demonstrating ΔECD &gt;10% were significantly higher in Artisan group than Artiflex group (<em>P</em> &lt; .05). In ROC curve analysis, the cutoff value of preoperative ECD to prevent significant postexplantation ECD loss was 1683.5 cells/mm² in Artisan group and 1648 cells/mm² in Artiflex group.</div></div><div><h3>CONCLUSIONS</h3><div>This study examined the existing explantation guidelines for these lenses. In analyzing the longterm prognosis of cornea ECD with Iris-fixated phakic intraocular lens, it is important to identify the relevant anatomical factors. Small ACA, and short distances from IOL to endothelium and from limbus to iris fixation especially in the nasal region were significant risk factors to continuous ECD loss in both lenses. To minimize irreversible ECD loss after explantation, it is important to determine the optimal period of explantation by observing both ECD and structural changes.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451408","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":"Macular Buckling for Myopic Traction Maculopathy: A Comprehensive Systematic Review and Meta-Analysis","authors":"Hashem Abu Serhan ,&nbsp;Abdullah Ahmed ,&nbsp;Mahrukh Chaudhry ,&nbsp;Zain Ali Nadeem ,&nbsp;Fakiha Ahmed ,&nbsp;Usama Hussain Kamal ,&nbsp;Ameen Alkhateeb ,&nbsp;Ayman G. Elnahry","doi":"10.1016/j.ajo.2024.10.008","DOIUrl":"10.1016/j.ajo.2024.10.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Myopic traction maculopathy (MTM) is a major cause of visual impairment and blindness, particularly in Asian populations. With the global burden of myopia on the rise, understanding effective treatment options is crucial. This systematic review and meta-analysis evaluate the efficacy of macular buckling in the management of MTM.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Cochrane Library, and EMBASE databases were searched for relevant studies up to July 2024. Inclusion criteria encompassed studies reporting outcomes of macular buckling for MTM. Primary outcomes included changes in best-corrected visual acuity and axial length, retinal reattachment rate, and macular hole closure rate. Random-effect models were used for statistical analysis, with heterogeneity assessed using the <em>I</em>² statistic. The pooled results were reported as mean difference or proportion with corresponding 95% confidence intervals (CIs) for each outcome.</div></div><div><h3>Results</h3><div>Thirteen studies (482 eyes) met the inclusion criteria. Significant improvements in best-corrected visual acuity were observed across all follow-up periods, with the most substantial improvement in long-term outcomes (mean difference: 0.38 logarithm of the minimum angle of resolution; 95% CI: 0.28-0.47). Axial length showed consistent reductions, with a mean long-term reduction of 2.88 mm (95% CI: 2.54-3.21). The pooled long-term retinal reattachment rate was 94% (95% CI: 86%-97%), while the long-term full thickness macular hole closure rate was 72% (95% CI: 55%-85%). Heterogeneity varied across outcomes and follow-up periods, ranging from low to high.</div></div><div><h3>Conclusions</h3><div>Macular buckling demonstrates promising outcomes for MTM, including improved visual acuity, reduced axial length, high retinal reattachment rates, and favorable macular hole closure rates. These findings support the efficacy of macular buckling as a treatment option for MTM. However, further standardized, long-term studies are needed to confirm these results and explore potential combination therapies.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination of Pretarsal and Preseptal Botulinum Toxin Injections in the Treatment of Blepharospasm: A Prospective Nonrandomized Clinical Trial","authors":"JUNHAO HU ,&nbsp;QINYING MU ,&nbsp;FUHAO MA ,&nbsp;HAO WANG ,&nbsp;LIYI CHI ,&nbsp;MING SHI","doi":"10.1016/j.ajo.2024.10.007","DOIUrl":"10.1016/j.ajo.2024.10.007","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the efficacy of two botulinum toxin (BoNT) injection methods, pretarsal (PT) combined with preseptal (PS) injection (PT-PS) and conventional PT injection, in the treatment of benign essential blepharospasm (BEB).</div></div><div><h3>Design</h3><div>Prospective nonrandomized clinical trial.</div></div><div><h3>Methods</h3><div>From January 2023 to April 2024, 95 BoNT injections into orbicularis oculi were performed in 45 BEB patients, including 52 PT-PS injections s and 43 PT injections. Jankovic Rating Scale (JRS) and Blepharospasm Disability Index (BSDI) were used to assess motor symptoms. The efficacy of two injection methods for BEB was compared in terms of latency to response (LTR), latency to the peak response (LPR), duration of peak response (DPR), duration of response (DOR), satisfaction degree, and possible complications.</div></div><div><h3>Results</h3><div>Both injection methods significantly improved JRS and BSDI scores in patients with BEB. However, PT-PS injections showed a shorter LTR ([4.00 (3.00, 6.00] vs 5.00 [4.00, 7.00] days, <em>P</em> = .024) and LPR (23.50 [16.00, 26.00] vs 26.00 [20.00, 30.00] days, <em>P</em> = .040), a longer DPR (88.00 [80.50, 104.75] vs 75.00 [65.00, 92.00] days, <em>P</em> = .003) and DOR (135.00 [118.50, 153.75] vs 121.00 [107.00, 135.00] days, <em>P</em> = .003) than PT injections. Patients with PT-PS injections were more satisfied than those with PT injections (9.50 [8.50, 10.00] vs 8.00 [7.50, 9.00], <em>P</em> &lt; .001), and around 2/3 of patients were more willing to receive the combined injection method later. Among patients receiving PT-PS injections, only one case experienced ptosis, and there were no significant differences in other complications such as lacrimation, dry eyes, and blurred vision between the two injection methods.</div></div><div><h3>Conclusions</h3><div>PT-PS injections of BoNT showed more advantages in the treatment of BEB than PT injections in terms of both their efficacy and patients’ satisfactions.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451409","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":"Associations Between Dry Eye Disease and Mental Health Conditions in the All of Us Research Program","authors":"AARON T. ZHAO ,&nbsp;JOCELYN HE ,&nbsp;YUQING LEI ,&nbsp;YONG CHEN ,&nbsp;GUI-SHUANG YING","doi":"10.1016/j.ajo.2024.10.009","DOIUrl":"10.1016/j.ajo.2024.10.009","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the association between dry eye disease (DED) and mental health conditions in a sociodemographically diverse nationwide population of Americans.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>We used the National Institute of Health's All of Us Research Program database to identify 18257 participants with DED who were propensity score matched in a 1:3 ratio to participants without DED. Univariate and multivariable logistic regression models were used to assess associations between DED and mental health conditions (i.e., depressive disorders, anxiety, bipolar disorder, and schizophrenic spectrum disorder).</div></div><div><h3>Results</h3><div>Participants with DED had a significantly higher prevalence of depressive disorders (31.6% vs. 10.7%; <em>P</em> &lt; .001), anxiety disorders (34.8% vs. 14.7%; <em>P</em> &lt; .001), bipolar disorder (5.5% vs. 2.3%; <em>P</em> &lt; .001), and schizophrenia spectrum disorders (2.3% vs. 0.9%; <em>P</em> &lt; .001) than controls. Adjusted for medical comorbidities (i.e., hypothyroidism, Sjögren's syndrome, systemic lupus erythematosus), participants with DED had higher odds than controls in having a depressive disorder (odds ratio [OR]: 3.47; 95% CI: 3.32-3.62), anxiety (OR: 2.74; 95% CI: 2.63-2.85), bipolar disorder (OR: 2.23; 95% CI: 2.04-2.44), and schizophrenia spectrum disorder (OR: 2.48; 95% CI: 2.17-2.84). The association between DED and mental health conditions was stronger in Black participants than White participants (OR: 3.68 vs. 3.09, <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Participants with DED were significantly more likely to have mental health conditions than matched participants without DED; this association was stronger in Black participants than White participants. Greater efforts should be undertaken to screen DED patients for mental health conditions, particularly in historically medically underserved populations.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451412","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}