American Journal of Ophthalmology最新文献

{"title":"Measuring the costs of strabismus surgery: a time-driven activity-based costing analysis.","authors":"David S Portney,David F Skanchy,Jeremy N Shapiro,Alexander D Valentine,Christopher Gappy,Pamela E Williams","doi":"10.1016/j.ajo.2025.09.055","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.055","url":null,"abstract":"OBJECTIVETo determine the costs and cost drivers of strabismus surgery, specifically examining which factors influence the final costs of surgery in relation to their relative reimbursement.DESIGNThis study was an economic analysis of strabismus surgery at a single academic institution using time-driven activity-based costing (TDABC).SUBJECTSStrabismus surgeries, both adult and pediatric, at the University of Michigan during the calendar year 2022 were included for analysis.METHODSSurgical characteristics, time inputs, and supplies expenses were obtained via the electronic health record. Resource cost rates were obtained via internal financial reporting systems and from prior literature. Day of surgery costs were calculated using TDABC. Multivariate regression was completed to estimate surgical factor impact of surgery time and costs.MAIN OUTCOME MEASURESMain outcome measures included surgery time (in minutes) and day-of-surgery costs.RESULTSA total of 690 strabismus surgeries were included, 324 (47%) were pediatric. The average day-of-surgery costs were $4420. There were no significant differences in the TDABC costs between pediatric and adult strabismus surgeries (p = .339) or unilateral versus bilateral surgery (p = .547), though the surgery time was lower for pediatric cases (50.7 minutes versus 56.9 minutes, p < .001). With multivariate regression, individual surgical factors that lowered costs were location at an ambulatory surgery center (-$813) and fellow second surgeon (-$512). Each additional horizontal muscle added $768, vertical muscle $976, and inferior oblique muscle $498. Adjustable suture use added $1023 and reoperations added $823.CONCLUSIONSTDABC analysis identified the average costs of strabismus surgery and allowed for a cost estimate based on various surgical factors. Moreover, the ability to assess individual surgical cost drivers allows for a comparison to Medicare reimbursement, which highlights multiple areas where Medicare reimbursement does not cover the incremental costs of surgery. With growing concerns over the future of pediatric ophthalmology and adult strabismus surgery, ensuring adequate access to care requires a proper understanding of the economics of strabismus surgery.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"81 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235662","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":"Exogenous Testosterone Use Increases the Risk of Central Serous Chorioretinopathy.","authors":"Emilio M Roig,Leo Arnal,Anish Salvi,Yeabsira Mesfin,Karen M Wai,Eubee Koo,Andrea Kossler,Euna Koo,Ehsan Rahimy,Prithvi Mruthyunjaya,Chase A Ludwig,Hong-Uyen Hua","doi":"10.1016/j.ajo.2025.09.044","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.044","url":null,"abstract":"OBJECTIVETo evaluate the association between exogenous testosterone (ExoT) use and central serous chorioretinopathy (CSCR).DESIGNRetrospective observational cohort study using large-scale electronic health record (EHR) data.SUBJECTS/PARTICIPANTSPatients receiving exogenous testosterone therapy, identified from the MarketScan and STARR databases.METHODSData were accessed from two sources: Merative™ MarketScan® Commercial Database, and Stanford's Clinical Data Warehouse (STARR), which aggregates de-identified patient records from Stanford Health Care. Patients on testosterone therapy were included and categorized by CSCR status. Demographic factors such as sex (administrative field), race, and ethnicity were assessed. Laboratory values (testosterone, hematocrit, RBC count, cortisol) were compared in STARR, with limited availability in MarketScan. Logistic regression analyses were performed in MarketScan adjusting for age and sex. A sensitivity analysis restricted to patients exposed to ExoT prior to CSCR diagnosis was also performed.MAIN OUTCOME MEASURESThe primary outcomes were CSCR prevalence and adjusted odds ratios (AOR) for CSCR risk in patients on exogenous testosterone. Secondary outcomes included differences in laboratory values and treatment requirements (photodynamic therapy [PDT] and intravitreal injections).RESULTSIn STARR, individuals with CSCR on exogenous testosterone had significantly higher mean testosterone levels (p=0.001), hematocrit (p=0.022), and RBC counts (p=0.005) compared to those without CSCR. In MarketScan, laboratory values trended in the same direction but were not statistically significant, likely reflecting limited sample sizes. Logistic regression in MarketScan showed that exogenous testosterone was significantly associated with increased CSCR risk (AOR: 8.05; 99% CI: 6.04-10.73). In both datasets, there were no significant differences in treatment rates (PDT or intravitreal injections) between ExoT and non-ExoT users. In a sensitivity analysis restricted to patients who received ExoT prior to CSCR diagnosis, no significant laboratory differences were observed.CONCLUSIONSThis study demonstrates a significant association between exogenous testosterone use and increased CSCR risk, highlighting the importance of monitoring patients on testosterone therapy for potential ocular symptoms, especially among high-risk demographic groups.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"27 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229131","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 of ROSAH syndrome caused by different mutations of the ALPK1 gene.","authors":"Zixi Sun,Xing Wei,Xiaoxu Han,Huixin Liu,Xuan Zou,Hui Li,Ruifang Sui","doi":"10.1016/j.ajo.2025.09.049","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.049","url":null,"abstract":"PURPOSEThis study aims to elucidate the ocular manifestations and disease progression of ROSAH syndrome, which is attributed to different mutations of the ALPK1 gene.DESIGNObservational case series.METHODSA cohort of five patients from four distinct families diagnosed with ROSAH syndrome was recruited for this investigation. Comprehensive ophthalmic assessments were conducted, including best corrected visual acuity (BCVA), fundus photography (FP), B-ultrasound imaging, electroretinography (ERG), optical coherence tomography (OCT), visual field (VF) testing, and fundus autofluorescence (FAF). Additionally, systemic evaluations including abdominal ultrasonography and blood tests were performed. Whole exome sequencing (WES) was utilized to identify pathogenic variants, and in silico algorithms were employed to assess their pathogenicity. The patients were followed up for one to five years to evaluate the progression of the disease.RESULTSThe age of the patients varied from 5 to 33 years, with visual acuity ranging from hand motion to 0.6. All patients exhibited optic disc edema and significant, persistent vitreous inflammatory opacities as observed in B-scan imaging. Each patient presented with retinal dystrophy, characterized by varying degrees of patchy pigment alterations on FP, differing extents of hypo-fluorescence on FAF, concentric reductions in VF, and varying degrees of ellipsoid zone (EZ) signal loss on OCT. ERG results indicated substantial retinal dysfunction, with rod photoreceptor function typically more reduced than that of cone photoreceptors. Three patients were found to carry the recurrent T237M variant of the ALPK1 gene, while two patients from a single family exhibited a novel T237A variant. Notably, individuals with the T237A variant displayed solely ocular manifestations, with no/mild systemic symptoms.CONCLUSIONSROSAH syndrome is characterized by ocular manifestations that include persistent optic disc edema and a gradually progressive retinal degeneration, resembling retinitis pigmentosa (RP). Ocular symptoms may serve as the initial presentation or the exclusive manifestation in patients with ROSAH syndrome. Furthermore, we have identified a novel mutation in the ALPK1 gene that correlates with a relatively mild phenotype of ROSAH syndrome.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226639","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":"Management of retinopathy of prematurity in the anti-VEGF era: Consensus and recommendations from the Taiwan Pediatric Retina (TPR) Group.","authors":"Tso-Ting Lai,Yen-Chih Chen,Sheng-Chu Chi,Margaret Ming-Chih Ho,Ning-Yi Hsia,San-Ni Chen,Yi-Hao Chen,Yu-Bai Chou,Yu-Hung Lai,Hui-Ju Lin,Hsiang-Ling Tsai,Tzu-Hsun Tsai,Po-Ting Yeh,Wei-Chi Wu","doi":"10.1016/j.ajo.2025.09.050","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.050","url":null,"abstract":"OBJECTIVERetinopathy of prematurity (ROP) is the leading cause of childhood blindness, particularly in preterm infants. In Taiwan, the absence of national guidelines and the variability in clinical practice have highlighted the need for locally adapted consensus recommendations.METHODSAn expert panel of eleven ophthalmologists from eight tertiary centers in Taiwan convened to develop a consensus on ROP management. Through a structured process that included key question formulation, systematic literature review, iterative discussion, and voting, the panel established consensus statements. Agreement was defined as ≥75% of panelists voting \"agree\" or \"strongly agree\" using a five-point Likert scale.RESULTSConsensus recommendations were developed across three major domains: screening, treatment, and follow-up. For screening, the panel endorsed criteria commonly used in Taiwan-gestational age <32 weeks or birth weight <1500 g-but emphasized the need for population-based validation. Both anti-vascular endothelial growth factor (VEGF) agents and laser photocoagulation were recognized as acceptable first-line treatments for type 1 ROP, with individualized treatment decisions based on disease characteristics, anesthesia risk, and follow-up capacity. Guidelines were also established for the management of ROP reactivation, procedural protocols, and agent selection. For follow-up, the panel recommended extended surveillance after anti-VEGF therapy and outlined the criteria for identifying and monitoring persistent avascular retina. Follow-up schedules were proposed to detect long-term ocular and neurodevelopmental complications.CONCLUSIONSThis consensus provides updated evidence-based guidance for ROP care in Taiwan, addressing both traditional and emerging clinical challenges. These recommendations aim to standardize care practices while remaining adaptable to future research and evolving clinical needs.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"483 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215551","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":"Simultaneous Type 1 and Type 2 Big-Bubble Deep Anterior Lamellar Keratoplasty (DALK) for Macular Corneal Dystrophy.","authors":"Nilay Kandemir Besek,Gizem Taskin","doi":"10.1016/j.ajo.2025.09.046","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.046","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"105 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215723","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":"Clinical Characteristics and Long-term Visual Prognosis of Familial Exudative Vitreoretinopathy.","authors":"Ratima Chokchaitanasin,Kanruthai Trerayapiwat,Wadakarn Wuthisiri,Duangnate Rojanaporn,Tharikarn Sujirakul,Thitiporn Thongborisuth,Boontip Tipsuriyaporn","doi":"10.1016/j.ajo.2025.09.041","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.041","url":null,"abstract":"OBJECTIVETo investigate the clinical characteristics and long-term visual outcomes of familial exudative vitreoretinopathy (FEVR).DESIGNRetrospective case series.SUBJECTSPatients diagnosed with FEVR and treated at Ramathibodi Hospital, Bangkok, Thailand, between January 2007 and February 2024.METHODSMedical records were reviewed for demographic data, clinical features, management, and visual outcomes. Logistic regression was used to identify predictors of visual outcomes.MAIN OUTCOME MEASURESClinical characteristics, treatment modalities, surgical success, and visual outcomes.RESULTSNinety-two eyes of 46 patients were included. The median (interquartile range) age of onset was 6.4 (2.0-24.0) months. FEVR stages 1, 2, 3, 4, and 5 were observed in 38.0%, 13.0%, 5.5%, 26.9%, and 16.3% of eyes, respectively. Retinal vessel abnormalities (55.4%) were the most common posterior finding. Overall, 62.0% of eyes required no treatment, 34.8% underwent laser photocoagulation, and 7.6% received surgery (pneumatic retinopexy [PR], pars plana vitrectomy with silicone oil [PPV+SO], or scleral buckling). The surgical success rate was 42.9%. Peripheral avascular retina <9 clock-hours was associated with better visual outcomes (odds ratio [OR], 3.61; 95% confidence interval [CI], 1.06-12.32). Disc dragging, macular dragging, and retinal detachment were associated with worse outcomes, with ORs (95% CI) of 0.12 (0.04-0.36), 0.04 (0.01-0.15), and 0.03 (0.01-0.12), respectively. Stage 4 disease independently predicted poor outcome (adjusted OR, 0.05; 95% CI, 0.00-0.82; p = 0.036).CONCLUSIONSMost patients with FEVR presented with mild disease requiring no treatment, Despite successful treatment, advanced stages (≥4) were significantly associated with poor vision. When appropriately selected, PPV+SO and PR have potential benefits, particularly in achieving anatomical attachment.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"199 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188789","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":"Effectiveness and safety of cross-linking in keratoconus patients with corneal thickness <400μm: A systematic review and meta-analysis.","authors":"Farzaneh Mohammadi,Myra B McGuinness,Mohammad Zuhair Mustafa,Elaine W Chong,Mark Daniell Franzco","doi":"10.1016/j.ajo.2025.09.039","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.039","url":null,"abstract":"TOPICIn this systematic review and meta-analysis, we aimed to investigate the effectiveness and safety of corneal cross-linking (CXL) in patients with keratoconus and thin corneas (corneal thickness <400μm).CLINICAL RELEVANCEGuidelines for the conventional (Dresden) CXL protocol to treat keratoconus recommend patients have a minimum stromal thickness of ≥400μm to avoid endothelial damage. Newer CXL methods have been developed for thinner corneas. Evaluation of clinical outcomes is required to inform surgical decisions and maximize the number of people who can safely benefit from CXL.METHODSMEDLINE Ovid, Embase Ovid, and Scopus were searched in July 2024 for studies published in peer-reviewed journals in English. Prospective and retrospective case series, cohort studies, and randomized clinical trials of people with corneal thickness of <400μm (with or without epithelium) who underwent CXL for keratoconus were eligible, regardless of CXL approach. Key outcomes included maximum and mean corneal curvature (Kmax and Kmean) corrected and uncorrected distance visual acuity, refractive error, corneal thickness, and endothelial cell density at 3, 6, 12, and 24 months. Random effects meta-analysis was used to pool average change from preoperative values across CXL protocols. Study quality was assessed using the JBI Critical Appraisal Checklist for Case Series. PROSPERO registration: CRD42023403190.RESULTSTwenty-nine records published between 2011 and 2024 were included with a total of 470 eyes. Most studies were retrospective case series with substantial potential for bias. Substantial heterogeneity was observed between studies in terms of patients, CXL approach and observed outcomes. At 12 months, flattening of the maximum corneal curvature (mean change in Kmax: -1.4D, 95% CI [-2.0, -0.9], n=17/402 studies/eyes, I2 =93%) and improvement in corrected distance visual acuity (mean change -0.09 log MAR units, 95% CI [-0.13, -0.06], n = 19/443 studies/eyes, I2 = 68%) were observed relative to baseline. No study reported major complications and there were minimal reductions in corneal thickness and endothelial cell density.CONCLUSIONSVisual and keratometric parameters improved following CXL without major complications, suggesting CXL may be suitable for patients with stromal thicknesses of <400μm, providing adequate modifications have been applied. Prospective comparative studies are required to guide the choice of approach.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"8 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182589","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 of polygenic scores for glaucoma with measures of retinal ganglion cell integrity in young and older adults.","authors":"Samantha Sze-Yee Lee,Santiago Diaz Torres,Gareth Lingham,Seyhan Yazar,Michael Hunter,Jamie E Craig,Alex W Hewitt,Stuart MacGregor,Puya Gharahkhani,David A Mackey","doi":"10.1016/j.ajo.2025.09.042","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.042","url":null,"abstract":"PURPOSEPolygenic scores (PGS) for glaucoma is predictive of the disease in older adults. This study tested the hypothesis that multitrait PGS for primary open-angle glaucoma (POAG) and its associated traits are associated with glaucoma endophenotypes from a young age, but with larger effects in older adults.DESIGNCross-sectional and cohort analyses PARTICIPANTS: Young (<30 years; n=1,400) and older (45+ years; n∼ 3,500) community-based adults.METHODSParticipants underwent ocular tonometry, optical coherence tomography imaging, and genotyping. Their PGS for POAG, IOP, and vertical cup-to-disc ratio (VCDR) were generated. A subset of young participants (n∼614) had follow-up measurements 8 years later. Cross-sectional associations in both cohorts and the 8-year change in the young cohort were analysed against each PGS.MAIN OUTCOME MEASURESIntraocular pressure (IOP), peripapillary retinal nerve fibre layer (pRNFL) thickness, and Bruch's membrane opening minimum rim width (BMO-MRW).RESULTSIOP-PGS explained 4 and 8% of the variance in IOP (p≤0.001) in the young and older cohorts. Weak associations between pRNFL thickness and all 3 PGS were observed in the older group (all p<0.017), but none were significant in the young participants. All 3 PGS were significantly associated with BMO-MRW, explaining 0.3-14.5% and 0.1-12.8% of the phenotypic variance in the older and younger cohorts, respectively. None of the PGS were associated with longitudinal IOP or pRNFL change in the young cohort.CONCLUSIONSAssociations between PGS and optic disc measures were present from young adulthood, but the effect sizes were greater in older adults. This, coupled with the lack of associations in the 8-year change in the young adults, suggests that glaucoma-related genetic effects on the optic nerve are not apparent until older age.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"79 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182609","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":"Prediction of Risk, Severity, and Progression of Primary Open-Angle Glaucoma in a Taiwanese Population Based on Polygenic Risk Scores.","authors":"Yu-Chuen Huang,Wen-Ling Liao,Hui-Ju Lin,Yu-Te Huang,Ya-Wen Chang,Jai-Sing Yang,Hsuan-Chung Chou,Angel L Weng,Fuu-Jen Tsai","doi":"10.1016/j.ajo.2025.09.040","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.040","url":null,"abstract":"OBJECTIVEPrimary open-angle glaucoma (POAG) is the most common type of glaucoma worldwide and a leading cause of irreversible blindness. While polygenic risk scores (PRS) have shown promise for predicting POAG risk in European populations, their applicability in East Asian populations remains underexplored. We aimed to develop PRSs to predict the risk of developing POAG and evaluate their association with disease severity and progression in the Taiwanese population.DESIGNPopulation-based retrospective cohort study SUBJECTS: A total of 3,064 patients with POAG and 8,247 participants aged > 70 years without a glaucoma diagnosis were included.METHODSGenotypic and demographic data were collected from all participants. The PRS for POAG was constructed using summary statistics from a genome-wide association study. Associations between PRS and POAG risk were assessed using multivariate logistic regression to estimate odds ratios. Additional outcomes-medication burden, visual field performance, and longitudinal changes in retinal nerve fiber layer (RNFL) thickness-were analyzed to assess PRS correlation with disease severity and progression.MAIN OUTCOME MEASURESPRS, number of topical glaucoma medication classes used, visual field test results, and annual RNFL thinning rate.RESULTSIndividuals in the top 10% of the PRS had a 1.64-fold increased risk of developing POAG (95% CI: 1.02-2.63; p = 0.042) compared with those in the lowest quartile. Among the patients with POAG, a higher mean PRS was significantly associated with the use of more than two classes of topical medications (p=0.024). Additionally, those in the top 50% of the PRS had an average annual decline of 1.79% in visual field index (β=-1.79; 95% CI: -0.14 to -0.01; p=0.048) compared with those in the bottom 50%.CONCLUSIONThe PRS developed in this study effectively predicted POAG risk and was associated with increased disease severity and rapid progression in a Taiwanese population. These findings highlight the potential of PRS as a clinical tool for early risk stratification, personalized treatment planning, and the optimization of follow-up intervals in glaucoma care.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"27 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182586","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":"Prevalence of Intravitreal Silicone Oil Following Intravitreal Injections: A Meta-Analysis: Silicone Oil Droplets After Intravitreal Injections.","authors":"Matheus Pedrotti Chavez,Tiago Nelson de Oliveira Rassi,Camilo Moreno Yate,Dillan Cunha Amaral,Larissa Matioski Brasil,Thaine Garcia Carvalho Vasconcelos,Geoffrey Guy Emerson,Maurício Maia,Gustavo Barreto Melo","doi":"10.1016/j.ajo.2025.09.043","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.043","url":null,"abstract":"TOPICIntravitreal injections (IVIs) are used for retinal diseases, but concerns emerged regarding silicone oil (SiO) contamination, which may cause floaters and inflammation. This meta-analysis evaluated the prevalence of intravitreal SiO following IVIs, its association with floaters, and contributing factors.CLINICAL RELEVANCESiO contamination may compromise visual quality, lead to inflammation, and patient dissatisfaction.METHODSWe systematically searched PubMed, Embase, and Cochrane for studies reporting SiO prevalence after IVIs. We conducted a single-arm meta-analysis with subgroup analyses by syringe and needle types. We applied meta-regression to test whether SiO prevalence correlated with the number of injections per eye. We used a generalized linear mixed model to pool data and assessed heterogeneity with I².RESULTSWe included ten studies, comprising 1,583 eyes. The prevalence of intravitreal SiO following IVIs was 57.56% (95% CI: 40.45-73.03; I²=96%; very low certainty), and floaters occurred in 27.85% (95% CI: 14.59-46.58; I²=1%; very low certainty) of eyes. Staked-in needles showed higher SiO prevalence than attachable needles (72.33% vs 17.14%; p<0.01; very low certainty). SiO prevalence did not correlate with the number of injections (p=0.41). Post hoc analysis showed SiO-free syringes had significantly lower contamination rates than siliconized syringes (OR 0.05; 95% CI 0.02-0.12; I²=0%; p<0.01; moderate certainty).CONCLUSIONSIVIs are frequently associated with intravitreal SiO and floaters. Siliconized syringes and staked-in needles may increase contamination risk. Utilizing SiO-free syringes and attachable needles may reduce SiO-related complications. Randomized controlled trials should confirm these preventive strategies.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"194 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182610","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}