American Journal of Ophthalmology最新文献

{"title":"Glaucoma Surgery Comparison: SIBS Microshunt vs. Gelatin 45um Microstent vs. Trabeculectomy as Primary Surgical Interventions: Microshunt vs. Gelatin 45um Microstent vs. Trabeculectomy.","authors":"James J Armstrong,Ticiana De Francesco,Henny J Beckers,Ingeborg Stalmans,Antonio M Fea,Chelvin C A Sng,Juan F Batlle,Matthew B Schlenker,Iqbal Ike K Ahmed","doi":"10.1016/j.ajo.2025.05.011","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.05.011","url":null,"abstract":"PURPOSECompare surgical success, risk factors and post-operative course of the SIBS microshunt, gelatin 45μm microstent, and trabeculectomy with mitomycin C (MMC) as a primary surgical intervention in patients with glaucoma. We present a multicenter,12-month, retrospective, non-randomized, interventional case series.DESIGNMulticenter,12-month, retrospective, non-randomized, interventional case series.METHODSConsecutive patients with glaucoma on maximally tolerated medical therapy received either primary SIBS microshunt, gelatin 45um microstent, or trabeculectomy with MMC as a stand-alone procedure at one of six participating centers (Canada, Italy, Netherlands, Belgium, Singapore, Dominican Republic) from August 2015 to August 2020. Main outcome measures were proportion of eyes at 12-months with (1) no two consecutive IOPs > 17 mmHg or clinical hypotony (IOP < 6 mmHg with a loss of> 2 lines of vision), without (complete) or with (qualified) glaucoma medications; and (2) ≥20%reduction from baseline IOP. Secondary outcomes included IOP thresholds of 14 mmHg and 21 mmHg, median IOP, medications, risk factors, post-operative interventions, complications, and reoperations.RESULTSRecords from 577 eyes from 521 patients with SIBS microshunt (n=235), gelatin 45μm microstent (n=201) or trabeculectomy (n=141) were included. Baseline decision IOP was lower in the SIBS group and baseline number of glaucoma medications was also lower in the SIBS and trabeculectomy groups. After 12-months follow up, complete success occurred in 68.8% of patients with SIBS microshunt, 46.2% with gelatin 45μm microstent and 58.0% with trabeculectomy (p=0.0002). Qualified success occurred in 89.7%, 70.1% and 83.6% of eyes, respectively (p=0.0002). In the multivariate analysis, eyes receiving a gelatin 45μm microstent relative to SIBS microshunt (HR 2.0; 95%CI 1.5 - 2.7), trabeculectomy relative to SIBS microshunt (HR 1.6; 95%CI 1.2 - 2.2), or intra-operative MMC dose less than 0.4mg/ml (HR 1.5; 95%CI 1.1 - 2.0) was significantly associated with failure. Complications occurred in 33.6%, 42.8% and 56% of eyes (p= 0.0001); needling in 12.3%, 29.9% and 22% (p<0.0001); revisions in 10.6%, 8.5% and 8.5% (p=0.68); and reoperations in 5.5%, 13.9% and 7.8% (p<0.001) with SIBS microshunt, gelatin 45μm microstent, or trabeculectomy, respectively.CONCLUSIONOverall, patients with the SIBS microshunt achieved higher success rates compared to both trabeculectomy and the gelatin 45μm microstent group, with fewer postoperative complications, interventions, and reoperations for glaucoma.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"30 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083305","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":"Efficacy and safety of biologics in pediatric non-infectious retinal vasculitis.","authors":"Irmak Karaca,Zheng Xian Thng,Albert Bromeo,Azadeh Mobasserian,Jia-Horung Hung,Amir Akhavanrezayat,Ngoc Trong Tuong Than,Cigdem Yasar,Negin Yavari,Dalia El Feky,Osama Elaraby,Anh Ngoc Tram Tran,Xiaoyan Zhang,Aim-On Saengsirinavin,Frances Andrea Anover,Yue Bai,Jingli Guo,Chi Mong Christopher Or,Diana V Do,Quan Dong Nguyen","doi":"10.1016/j.ajo.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.05.002","url":null,"abstract":"PURPOSETo assess the efficacy and safety of adalimumab (ADA) injections (Group 1), infliximab (IFX) (Group 2), and tocilizumab (TCZ) (Group 3) infusions in pediatric non-infectious retinal vasculitis (RV).DESIGNRetrospective interventional case series.METHODSPediatric patients who were diagnosed with non-infectious RV and treated with biologics (ADA, IFX, TCZ) for ≥6 months were included. Chart review of 11 patients (18 eyes), 17 patients (30 eyes), and 7 patients (11 eyes) in Group 1, 2 and 3, respectively, was performed to assess clinical characteristics, central subfield thickness (CST), and fluorescein angiography (FA) score using the Angiographic Scoring for the Uveitis Working Group (ASUWOG) system.RESULTSMean age was 13.5±4.3 years in Group 1, 11.8±2.5 years in Group 2, and 13.9±4.1 years in Group 3 (p=0.332). Eight patients (72.7%, 13 eyes) in Group 1, and 14 patients (82.4%, 24 eyes) in Group 2 were biologic-naïve, whereas in Group 3 all patients were treated with ADA and/or IFX prior to TCZ. Mean FA scores were significantly reduced from 6.8±2.6, 13.4±4.8, and 12.8±4.0 at baseline to 0.9±2.3, 3.6±4.6, and 4.4±3.9 at final visit in Group 1, 2, and 3, respectively (p<0.05). Complete RV resolution was observed in 12 (66.7%), 13 (43.3%), and 1 (9.1%) eyes; mean time to complete resolution was 11.0±5.0, 13.3±5.8, and 23 months in Group 1, 2, and 3, respectively. No significant adverse events were observed in any group, except hair loss in one patient which led to discontinuation of IFX infusions after 20 cycles of therapy.CONCLUSIONADA, IFZ, and TCZ are effective and safe treatment options for pediatric non-infectious RV as objectively shown by FA scoring. TCZ appears as an effective therapy for patients with JIA-associated RV or those who failed TNF-α inhibitors.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"121 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065793","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":"OPHTHALMOLOGICAL AND GENETIC PROFILE IN KNOBLOCH SYNDROME: Ocular and Genetic Features of Knobloch Syndrome.","authors":"Sengul Ozdek,Ece Ozdemir Zeydanli,Gulsum Kayhan,Ebru Yalcin,H Baran Ozdemir,M Ali Ergun,Kenan Sonmez,Arif O Khan,Nicola G Ghazi","doi":"10.1016/j.ajo.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.05.003","url":null,"abstract":"PURPOSETo analyze the clinical and genetic characteristics of Knobloch syndrome in a large cohort, with a focus on retinal detachment (RD) characteristics, surgical outcomes, and variants in the COL18A1 gene.DESIGNRetrospective, multicenter interventional/observational case series.SUBJECTSThirty-four patients (68 eyes) with clinically and genetically confirmed Knobloch syndrome were included.METHODS, INTERVENTION, OR TESTINGData were collected from three institutions, including demographics, clinical findings, surgical techniques and outcomes, and genetic testing results. Surgical success was defined as retinal reattachment after silicone oil removal. Genetic testing was performed for the COL18A1 gene to identify pathogenic variants.MAIN OUTCOME MEASURESThe primary outcomes included the prevalence and characteristics of RD, surgical success rates, and the identification of pathogenic variants in COL18A1.RESULTSThe median age at diagnosis was 24 months, with consanguinity noted in 76% of cases. RD occurred in 50% of eyes, with a median onset of 2.5 years. Macular hole (MH)-related RD accounted for 57% of cases and presented early (median age: 11 months). Surgical success after the first procedure was 54%, improving to 69% after reoperation. The use of Tenon's capsule or amniotic membrane grafts in 69% of MH-RD cases doubles the reattachment rate (82% vs. 40%). Genetic testing identified 14 COL18A1 variants, including nine novel variants.CONCLUSIONSKnobloch syndrome presents significant diagnostic and surgical challenges: early-onset RD, small flap-shaped MHs that are easily overlooked, and an abnormally adherent vitreoretinal interface. Early recognition of MH-RD and the use of grafts during surgery can improve anatomical outcomes. While the ocular phenotype is often pathognomonic, genetic testing aids in confirming the diagnosis and guiding counseling. Understanding these clinical and surgical challenges may improve outcomes in patients with this rare disorder.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"24 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065794","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":"Barriers and Facilitators of Implementing a Community and Faith-Based Intervention to Increase Eye Care Utilization in Black Americans.","authors":"Dominique A Alexis,Olivia L Johnson,Charles E Williams,Paula Anne Newman-Casey,Gretchen A Piatt,Angela R Elam","doi":"10.1016/j.ajo.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.05.006","url":null,"abstract":"Purpose To identify the determinants to successfully implement a community-based intervention to increase eye care utilization in individuals at high-risk for glaucoma. Design Qualitative study with semi-structured interviews Methods Semi-structured qualitative interviews were conducted with community members in Detroit, Michigan at a trusted community site. Participants were Black Americans at least 40 years of age. A codebook of themes was developed through an iterative process and analyzed using Dedoose. Results Narrative themes emerged under two overarching categories: barriers and facilitators. The number of themes identified were 15 and 14 for barriers and facilitators, respectively. All perceived barriers and facilitators fell into one or more domains of the social determinants of health model. Conclusion Identifying facilitators and eliminating barriers to eye care in Black and low-income communities is essential to successful implementation of interventions to increase eye care utilization. Understanding how these determinants align with social determinants of health may be helpful in designing community-based interventions. Community-based participatory research methods are critical to achieving equity in eye care.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"53 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065788","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":"Fern-Like Retinal Vasculopathy in Intermediate Uveitis: Pathogenesis, Natural History, and Clinical Implications.","authors":"Maria Vittoria Cicinelli,Costanza Barresi,Makan Ziafati,Lorenzo Bianco,Prithvi Ramtohul,Francesco Bandello,Elisabetta Miserocchi","doi":"10.1016/j.ajo.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.05.008","url":null,"abstract":"PURPOSETo investigate peripheral vascular changes and their progression in intermediate uveitis characterized by a fern-like leakage pattern and examine their relationship with macular vascular changes to elucidate their pathogenesis, natural history, and clinical implications.DESIGNRetrospective, observational case series with healthy-eyes comparison.PARTICIPANTS43 eyes (28 patients) with intermediate uveitis (mean age 31±16 years, 58% female) followed for an average of 18 months, compared with 41 healthy control eyes.METHODSUltra-widefield fluorescein angiography (UWF-FA) images were analyzed. Vessel Length Density (VLD), Fractal Dimension (FD), and Branchpoints Density (BPD) were compared across different leakage extents (posterior pole/diffuse[Zone 1], mid-periphery[Zone 2], and far periphery[Zone 3]) and control eyes using linear mixed-effects models. The foveal avascular zone (FAZ) was manually traced.MEAN OUTCOME MEASURESQualitative retinal changes and quantitative measures of VLD, FD, and BPD across three concentric temporal retina sectors.RESULTSEarly-phase UWF-FA revealed substantial alterations in study eyes, including dilated capillary channels, reduced capillary branching, delayed venous filling, and telangiectatic post-capillary dilations, primarily in non-perfused regions. Eyes with intermediate uveitis showed significantly lower VLD, FD, and BPD than controls, particularly in the far peripheral retina, with the most pronounced reductions in eyes with diffuse leakage [Zone 1](interaction p-values: 0.04 for VLD, 0.007 for FD, and 0.045 for BPD). Negative correlations were observed between these vascular metrics and enlarged FAZ areas, suggesting a potential association between peripheral and macular perfusion (all p < 0.05). Fern-like leakage persisted with reduced intensity despite immunosuppression; some vascular changes progressed, while others, such as non-perfusion and neovascularization, showed possible reversibility.CONCLUSIONThis study identifies \"Fern-Like Retinal Vasculopathy\" as a distinctive vascular pattern observed in at least some forms of intermediate uveitis, characterized by chronic vascular remodeling. Recognizing these peripheral vascular changes is clinically important, as emphasizing such patterns in practice may refine treatment strategies, reduce unnecessary long-term immunosuppression, and improve the management of young adults affected by this condition.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"42 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982430","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":"IOL power calculation project: accuracy of 36 formulas.","authors":"Oleksiy V Voytsekhivskyy,Kenneth J Hoffer,David L Cooke,Giacomo Savini","doi":"10.1016/j.ajo.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.05.004","url":null,"abstract":"PURPOSETo ascertain the refractive accuracy of 36 intraocular lens (IOL) power calculation formulas in unoperated eyes.DESIGNRetrospective accuracy and validity analysis.PARTICIPANTSSix hundred fifty-five patients undergoing phacoemulsification and implantation of the Tecnis 1 ZCB00 IOL (Johnson & Johnson Vision, Jacksonville, FL, USA).METHODSThirty-six formulas were evaluated including some that have never been tested, such as 3C 2.0, Eom, Hoffer H, Hoffer H-5, Fam adjusted methods, Norrby Regression Formula (Norrby RF), Norrby thin lens paraxial Ray-Tracing (Norrby RT), and VRF Cooke modified axial length (VRF CMAL). Optical biometry with the IOLMaster 700 (Carl Zeiss Meditec AG) was performed preoperatively. All descriptive statistics and the percentage of eyes within prediction error thresholds were evaluated with optimized lens constants.MAIN OUTCOME MEASURESThe Formula Performance Index (FPI) and Formula Performance Index for subgroup (FPI sub) were used as the primary formula outcomes.RESULTSThe highest FPI indexes were yielded by the VRF-G (0.590), Hoffer QST (0.575), VRF CMAL (0.574), Eom (0.572), EVO 2.0 (0.569), and Kane (0.568) formulas. The heteroscedastic test revealed statistically significant differences (P < 0.05) among formulas. The standard deviation (SD) of VRF-G (0.353 D), EVO 2.0 (0.362 D), Kane (0.366 D), Hoffer QST (0.371 D), and Eom (0.372 D) were lower than other methods (P < 0.05). The highest percentage of eyes with a PE within ±0.50 D was achieved by VRF-G (87.48%), Kane (86.41%), Hoffer QST (86.26%), and PEARL-DGS (86.26%).CONCLUSIONContemporary IOL power calculation formulas (Eom, EVO 2.0, Hoffer QST, VRF CMAL, and VRF-G) improved accuracy in all axial length ranges compared to traditional and updated methods. The CMAL method raised the accuracy of the VRF formula.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"148 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982429","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":"Intraocular Pressure Monitoring Using An Implantable Sensor Detects Structural Glaucoma Progression in the EYEMATE-IO Trial.","authors":"Eleonora Micheletti,Harsha Rao,Robert N Weinreb,Kaweh Mansouri,","doi":"10.1016/j.ajo.2025.05.010","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.05.010","url":null,"abstract":"OBJECTIVE AND PURPOSETo evaluate the association between intraocular pressure (IOP) measurements and concurrent rates of retinal nerve fiber layer (RNFL) thinning in primary open-angle glaucoma (POAG) eyes previously implanted with a sulcus-based IOP sensor.DESIGNThis case series is part of the prospective, open-label, multicenter interventional EYEMATE-SC trial.SUBJECTS, PARTICIPANTS, AND/OR CONTROLSPatients implanted with the EYEMATE-IO sensor system (Implandata, Hanover, Germany) were enrolled in the 3 years' ARGOS-03 follow-up study.METHODS, INTERVENTION, OR TESTINGAll patients enrolled had at least five optical coherence tomography (OCT) examinations six-months apart with minimum two years follow-up. A minimum of 4 IOP measurements daily at different times of the day were obtained with the EYEMATE-IO.MAIN OUTCOME MEASURESMean IOP, peak IOP, and fluctuation of IOP measured by EYEMATE-IO sensor during the period between two consecutive OCT examinations were calculated and the relationship with OCT RNFL thinning was analyzed using mixed effects models. The relationship of mean IOP measured by Goldmann applanation tonometry (GAT) on the day of OCT visit with RNFL thinning was also analyzed.RESULTSEight eyes of 8 patients with the EYEMATE-IO sensor were included in the analysis. The mean number of self-measurements of IOP per patient was 7283 ± 5562 (range 1478 to 17247), with a mean follow-up time of 2.88 ± 0.19 years (range 2.43 to 3.01). The mean number of OCT examinations per patient was 6.38 ± 0.74 (range 5 to 7). Overall, the mean rate of RNFL thinning during the follow-up was -0.62 ± 1.06 um/year (P=0.274). In the linear mixed-effects model analysis, both peak IOP and IOP fluctuations measured using the EYEMATE-IO sensor were significantly associated with RNFL thinning (coefficient [95%CI]: -0.11 [-0.19;-0.34], P=0.005 and -0.76 [-1.31;-0.20], P=0.007, respectively), whereas no association was found for in-office mean IOP measured by GAT (coefficient 95%CI]: 0.04 [-0.12;0.20], P=0.616).CONCLUSIONSPeak IOP and IOP fluctuations in glaucoma patients derived from measurements with the EYEMATE-IO sensor were associated with progression of the disease, whereas GAT measurements were not. These findings suggest that self-measurements of IOP throughout the day with an implantable IOP sensor can predict glaucoma progression.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"76 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982445","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":"Utility of Screening Examination for CMV Retinitis among Patients with CMV Viremia.","authors":"Chloe Y Li,Andrew Massa,Maria Krisch,Neha Gupta,Nilesh Raval,Tavish Nanda,James Lin,Mark P Breazzano,Srilaxmi Bearelly","doi":"10.1016/j.ajo.2025.04.039","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.04.039","url":null,"abstract":"PURPOSETo determine utility of cytomegalovirus retinitis (CMVR) screening among patients with CMV bloodstream infection (viremia) in the context of multiple and recently implemented state-wide policies in heightening congenital screening.DESIGNRetrospective diagnostic testing evaluation.STUDY POPULATION- All patients with CMV viremia and ophthalmologic examination during the study period between 2010 and 2023 were included.METHODS- Patients with CMV viremia were identified via International Classification of Diseases (ICD)-10 code. Information regarding their demographics and clinical course were collected from respective electronic health records.MAIN OUTCOME MEASURE(S)- Immunocompromising conditions, CMV testing modality, CMV plasma titer, ophthalmic findings, CD4 count, CMVR diagnosis (presumed or confirmed based on direct ocular tissue confirmation), and visual acuity.RESULTS234 patients with CMV viremia and underwent a screening dilated fundus examination during inpatient hospitalization between 2010 and 2019 were identified. 18 (7.7%) patients with CMV viremia were found to have CMVR. Among 49 pediatric patients, 2 (4.1%) had CMVR; zero neonates with congenital infection had CMVR. Five CMVR patients had confirmed ocular CMV infection by aqueous humor testing, while remaining 13 did not and were classified as presumed CMVR cases. Among all CMVR cases, 14 (78%) were symptomatic, while 2 (11%) were asymptomatic and 2 (11%) were unable to report symptoms. Factors associated with increased risk of CMVR diagnosis included: HIV/AIDS infection (unadjusted OR [uOR]: 4.83, 95% CI: 1.76-12.35) and presence of ocular symptoms (uOR: 14.3, 95% CI: 3.6 to 64.4). After adjusting for race, HIV/AIDS infection status, and presence of ocular symptoms, HIV/AIDS infection (adjusted OR [aOR]: 4.12, 95%CI: 1.33 to 14.22) and ocular symptoms (aOR: 14.88, 95% CI: 3.82 to 99.2) remained significantly associated with increased risk of CMVR.CONCLUSIONPatients with CMV viremia and HIV/AIDS infection or visual symptoms are at significantly elevated risk of CMVR and should undergo ophthalmic examination. Meanwhile, the utility of DFE in neonates with congenital CMV infection but no clinically observable sequelae of infection is debatable, given the rarity of CMVR while undergoing concurrent systemic treatment in this population. Although larger, prospective studies would be informative, retinal screening in neonates with congenital CMV infection without other clinical signs of infection does not appear supported by these and other recent data.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"68 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945124","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":"Translation from ophthalmic research to ophthalmic products.","authors":"Gary D Novack,William J Brock,Audrey R Schupp","doi":"10.1016/j.ajo.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.05.001","url":null,"abstract":"PURPOSETo provide guidance primarily for the academic researcher for the translation from research of novel ophthalmic drugs for improved patient treatment to early stage development including clinical trials METHODS: Based upon available guidelines and the authors' extensive experience in developing novel products, the authors present the requirements for chemistry (both drug substance and formulated drug product), nonclinical (pharmacology, pharmacokinetics, and toxicology), clinical and regulatory development.CONCLUSIONDevelopment of successful novel ophthalmic products is a structured, sequential and interactive scientific process.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"27 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932829","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":"Lawnmower-Related Eye Injuries in the U.S. 2004-2023.","authors":"Nicholas R Stange,Charles A Jennissen","doi":"10.1016/j.ajo.2025.04.038","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.04.038","url":null,"abstract":"OBJECTIVETo determine the epidemiology, mechanisms, and trends of lawnmower-related eye injuries in the U.S., focusing on national estimates, injury types, and high-risk populations.DESIGNA retrospective trend study.PARTICIPANTSIndividuals presenting to National Electronic Injury Surveillance System (NEISS) emergency departments.METHODSLawnmower-related eye injuries from 2004-2023 were identified using the NEISS. The database narratives were coded to classify the mechanism of injury and other variables. Periorbital injuries were not included. Descriptive and comparative analyses (chi-square and Fisher's exact test) were performed of national estimates derived using statistical weights.MAIN OUTCOME MEASURESInjury mechanisms, demographics, diagnoses, and trends over time.RESULTSAn estimated 120,613 lawnmower-related eye injuries occurred in the U.S. from 2004-2023 (N=2,467 NEISS cases). Those injured were 82% males, 95% adults and 82% non-Hispanic Whites. Ninety-nine percent of injuries occurred at home. Most injuries (77%) were from projectiles (predominately grass, dirt and rocks), 12% non-projectile injuries during mowing, 8% maintenance/repair-related and 2% from chemical exposures (primarily gasoline). Common diagnoses included eye abrasions/contusions (55%) and foreign bodies (27%). Severe injuries included retinal detachment, iris sphincter tear, corneal erosion, lens dislocation, and open globes. Only 2% of projectile injuries were documented in narratives as using eye protection including eyeglasses. The average annual estimate for lawnmower-related eye injuries was 33% lower when comparing 2018-2023 to 2004-2017 (4,502 vs. 6,686, p<0.001). Injuries decreased more in males than in females (35% vs. 23%, p<0.001), and in adults aged 18-65 (35%) as compared to youth <18 yrs (26%) and adults >65 yrs (23%), p<0.001. Whereas injuries decreased in non-Hispanic White individuals (41%), they increased in Black individuals (18%) and other racial/ethnic groups including Hispanic (42%), p<0.001. Youth <18 years were a higher proportion of bystander (50%) versus operator (5%) injuries, p<0.001. Bystanders, as compared to operators, had higher rates of severe injuries requiring hospital admission, p=0.002.CONCLUSIONSLawnmower-related eye injuries remain a serious risk, especially from projectiles. Interventions designed to increase the use of safety glasses both while operating mowers and when performing maintenance/repair such as sharpening blades and prevent bystander presence, especially children, are needed to significantly reduce risk of injury.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"2 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932830","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}