American Journal of Ophthalmology最新文献

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Choroidal Vascular Occlusion after Fat Injection into the Temple Area.
IF 4.1 1区 医学
American Journal of Ophthalmology Pub Date : 2025-03-29 DOI: 10.1016/j.ajo.2025.03.041
Chuanzhen Zheng, Chunxiu Li, Jie Zhong
{"title":"Choroidal Vascular Occlusion after Fat Injection into the Temple Area.","authors":"Chuanzhen Zheng, Chunxiu Li, Jie Zhong","doi":"10.1016/j.ajo.2025.03.041","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.03.041","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750044","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}
引用次数: 0
Comparison of Corneal Power Assessment Methods for True Corneal Power After Myopic Small-Incision Lenticule Extraction
IF 4.1 1区 医学
American Journal of Ophthalmology Pub Date : 2025-03-28 DOI: 10.1016/j.ajo.2025.03.026
Xiaoling Fang , Chunxia Yu , Wenwen Xue , Jinhua Tao , Wenbo Yao , Liquan Zhao , Yulan Wang
{"title":"Comparison of Corneal Power Assessment Methods for True Corneal Power After Myopic Small-Incision Lenticule Extraction","authors":"Xiaoling Fang ,&nbsp;Chunxia Yu ,&nbsp;Wenwen Xue ,&nbsp;Jinhua Tao ,&nbsp;Wenbo Yao ,&nbsp;Liquan Zhao ,&nbsp;Yulan Wang","doi":"10.1016/j.ajo.2025.03.026","DOIUrl":"10.1016/j.ajo.2025.03.026","url":null,"abstract":"<div><h3>Purpose</h3><div>We sought to compare the accuracy of different corneal curvature parameters in estimating corneal power change in eyes that underwent myopic small-incision lenticule extraction (SMILE).</div></div><div><h3>Design</h3><div>Prospective cross-sectional trial.</div></div><div><h3>Methods</h3><div>89 eyes of 48 patients who had undergone SMILE at Shanghai Eye Disease and Prevention &amp; Treatment Center were enrolled. Total corneal refractive power (TCRP) and total keratometry (TK) values, along with corrected parameters calculated using the Haigis, Shammas, Maloney, and Actual K<sub>a+p</sub> methods, were compared with data obtained using the clinical history method (CHM). We also compared the surgically induced changes in TCRP (ΔTCRP) and TK (ΔTK) to changes in the spherical equivalent on the corneal plane (ΔSEco).</div></div><div><h3>Results</h3><div>After SMILE, differences were smallest between values of TK (0.41 ± 0.48 D) and CHM. The width of the 95% limits of agreement of TK (1.88 D) was narrowest, followed by that of K<sub>a+p</sub> (1.94 D). Pearson analysis showed that each parameter had a good correlation with CHM data. The differences between ΔTK and ΔSEco was 0.42 D, when between ΔTCRP and ΔSEco was 0.62 D. The width of the 95% limits of agreement of ΔTK (1.88 D) and the correlation coefficient of ΔTK (0.964) were greater than those of ΔTCRP. A separate case of cataract surgery following SMILE confirmed the validity of the above points in our study (the absolute error was 0.005 D).</div></div><div><h3>Conclusions</h3><div>The TK parameter of the IOLMaster 700 can provide accurate and objective corneal power evaluation after SMILE.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"275 ","pages":"Pages 156-163"},"PeriodicalIF":4.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750227","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}
引用次数: 0
National Trends in Central Retinal Artery Occlusion Presentations and Stroke Workup in United States Emergency Department
IF 4.1 1区 医学
American Journal of Ophthalmology Pub Date : 2025-03-28 DOI: 10.1016/j.ajo.2025.03.040
Sinan Akosman , Sean M. Yuan , Arnold Leigh , Renxi Li , Renjie Luo , Masumi G. Asahi , Kapil Mishra
{"title":"National Trends in Central Retinal Artery Occlusion Presentations and Stroke Workup in United States Emergency Department","authors":"Sinan Akosman ,&nbsp;Sean M. Yuan ,&nbsp;Arnold Leigh ,&nbsp;Renxi Li ,&nbsp;Renjie Luo ,&nbsp;Masumi G. Asahi ,&nbsp;Kapil Mishra","doi":"10.1016/j.ajo.2025.03.040","DOIUrl":"10.1016/j.ajo.2025.03.040","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate trends in acute central retinal artery occlusion (CRAO) diagnostic assessments and sociodemographic characteristics of patients in the United States (US) emergency department (ED).</div></div><div><h3>Design</h3><div>Retrospective trend study.</div></div><div><h3>Subjects</h3><div>Adult patients with CRAO presenting to ED from 2016 through 2021.</div></div><div><h3>Methods</h3><div>The National Emergency Department Sample was queried with International Classification of Diseases, Tenth Revision (ICD-10) codes with a primary diagnosis of CRAO. Stroke workup modalities assessed included brain imaging (CT/computed tomography angiography and magnetic resonance imaging/magnetic resonance angiography), carotid imaging (US, computed tomography angiography, magnetic resonance angiography), cardiac diagnostics (echocardiogram/electrocardiogram), and laboratory workup (erythrocyte sedimentation rate/C-reactive protein).</div></div><div><h3>Main Outcome Measure</h3><div>Proportion of studied participants receiving stroke workup modalities.</div></div><div><h3>Results</h3><div>A total of 3736 patients were identified with mean age of 69 [13.72] years, majority were male (53.02%), and predominantly insured by Medicare (62.77%). Comorbidities included hypertension (75.45%), hyperlipidemia (44.67%), coronary artery disease (20.26%), diabetes (27.38%), and obesity (11%). CRAO incidence significantly increased over the 5-year period from 1698 to 3526 (<em>P</em> = .024). Utilization rates of all workup modalities including brain imaging, carotid imaging, heart, and laboratory tests showed a linear increase from 2016 through 2021. The proportion of patients receiving no stroke workup decreased from 66.75% to 57.87% (<em>P</em> = .259).</div></div><div><h3>Conclusions</h3><div>The US has increased the screening and stroke workup of CRAO in the ED over time, yet greater than 50% of patients continue to not receive any type of stroke workup imaging. Greater awareness of these trends and current guidelines could result in improved screening and patient outcomes.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 40-49"},"PeriodicalIF":4.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750418","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}
引用次数: 0
Incidence and Prevalence of Uveitis and Associated Ocular Complications in the United States TriNetX Database
IF 4.1 1区 医学
American Journal of Ophthalmology Pub Date : 2025-03-27 DOI: 10.1016/j.ajo.2025.03.032
NILA KIRUPAHARAN , RAYNA F. MARSHALL , MATTHEW D. SPANGLER , KAREN R. ARMBRUST , MEGHAN K. BERKENSTOCK
{"title":"Incidence and Prevalence of Uveitis and Associated Ocular Complications in the United States TriNetX Database","authors":"NILA KIRUPAHARAN ,&nbsp;RAYNA F. MARSHALL ,&nbsp;MATTHEW D. SPANGLER ,&nbsp;KAREN R. ARMBRUST ,&nbsp;MEGHAN K. BERKENSTOCK","doi":"10.1016/j.ajo.2025.03.032","DOIUrl":"10.1016/j.ajo.2025.03.032","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the demographics, immunosuppressant use, associated systemic diseases, ocular comorbidities, and incidence and prevalence of uveitis and associated low vision using the United States TriNetX database from 2013-2023.</div></div><div><h3>Design</h3><div>Retrospective cross-sectional and trend study.</div></div><div><h3>Participants</h3><div>Subjects with uveitis in the TriNetX database.</div></div><div><h3>Methods</h3><div>Subjects with uveitis were identified with International Classification for Disease codes and then divided into anatomic subtypes based on the diagnosis. Incidence and prevalence data were collected from 2013-2023. Additional data collected included demographics, use of systemic immunosuppressive medications, presence of an associated systemic disease, and associated ocular complications.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes were the incidence and prevalence of uveitis (annual and cumulative) with additional analysis by anatomic subtype. Secondary outcomes were the incidence and prevalence of low vision (annual and cumulative).</div></div><div><h3>Results</h3><div>Out of the 109,026,851 subjects in the database, 278,333 (0.26%) had a diagnosis of uveitis. The mean age was 56 years (Standard Deviation = 21, 95% Confidence Interval (CI) 55.9-56.1), and the majority were female (n = 149,186; 53.6%, 95% CI 53.4%-53.8%) and white (n = 150,578; 54.1%, 95% CI 53.9%-54.3%). Anterior uveitis was the most common subtype (n = 209,073, 75.1%). Oral prednisone (n = 62,834; 22.6%, 95% CI 22.5%-22.8%) was the most used immunosuppressant and methotrexate (n = 15,817; 5.7%, 95% CI 5.6%-5.8%) was the most prevalent corticosteroid-sparing immunosuppressive agent. Inflammatory spondyloarthropathies (n = 18,372; 6.6%, 95% CI 6.5%-6.7%) were the most frequently associated systemic disease. The cumulative incidence and prevalence of uveitis from 2013-2023 were 212.5 and 260.8 per 100,000 persons, respectively.</div></div><div><h3>Conclusions</h3><div>This study represents one of the largest uveitis populations analyzed in the United States, revealing a rising incidence of all uveitis subtypes and an increase in low vision among affected patients over the past decade in the database. Prospective studies are needed to identify the factors driving these trends and to develop strategies to prevent vision loss and ocular complications in uveitis patients.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 30-39"},"PeriodicalIF":4.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741755","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}
引用次数: 0
Ocular Features of VEXAS Syndrome: A Systematic Review and Meta-analysis
IF 4.1 1区 医学
American Journal of Ophthalmology Pub Date : 2025-03-27 DOI: 10.1016/j.ajo.2025.03.036
Clare Quigley , James Pietris , Terence Ang , Lina Zgaga , Dinesh Selva
{"title":"Ocular Features of VEXAS Syndrome: A Systematic Review and Meta-analysis","authors":"Clare Quigley ,&nbsp;James Pietris ,&nbsp;Terence Ang ,&nbsp;Lina Zgaga ,&nbsp;Dinesh Selva","doi":"10.1016/j.ajo.2025.03.036","DOIUrl":"10.1016/j.ajo.2025.03.036","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To identify and analyze ocular features seen in Vacuoles, E1-ligase, X-linked Auto-inflammatory, Somatic (VEXAS) syndrome.</div></div><div><h3>DESIGN</h3><div>A systematic literature review was performed following PRISMA guidelines (PROSPERO registration number: ID 566167).</div></div><div><h3>METHODS</h3><div>Article inclusion criteria comprised genetic confirmation VEXAS syndrome that included eye involvement. Exclusion criteria included lack of genetic testing, or ocular feature reporting. A systematic search of the PubMed/MEDLINE, Embase, and CENTRAL databases was performed from January 2020 to September 2024. Data were collected and risk of bias assessed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. For the meta-analysis, specific <em>UBA1</em> mutation and systemic feature data were also included. An association between severity of ocular features, presence of specific ophthalmic or systemic features, with age or causative mutation was investigated using Kruskal-Wallis rank sum testing and Fisher exact test, respectively, using R.</div></div><div><h3>RESULTS</h3><div>Fifty-two articles were included, amounting to 204 individuals (1 female). Mean age of VEXAS symptom onset was 67 ± 5 years (range: 46-87). Orbital inflammation was the most common ocular manifestation, comprising periorbital edema (n = 83, 40.7%), orbital myositis (n = 14, 6.9%), dacryoadenitis (n = 6, 2.9%), and orbital compartment syndrome (n = 1, 0.5%). Other features included episcleritis (n = 28, 13.7%), scleritis (n = 28, 13.7%), uveitis (n = 25, 12.3%), and retinal vasculitis (n = 2, 1%), among others. Visual acuity reporting was limited (n = 4, 2%). Meta-analysis was conducted on 32 articles (n = 48) with genotype and ocular feature data. The most commonly reported <em>UBA1</em> mutation was the missense mutation p.Met41Thr (n = 24, 50%), followed by p.Met41Val (n = 17, 35%), p.Met41Leu (n = 4, 8%), and splice site mutations or deletions (n = 3, 6%). There was an association for more severe ophthalmic features in the splice site mutation group vs methionine 41 missense mutations (<em>P</em> = .04). The most commonly associated systemic features included dermatologic manifestations (n = 41, 85%), recurrent fever (n = 38, 79%), and pulmonary involvement (n = 30, 63).</div></div><div><h3>CONCLUSION</h3><div>There is notable variation in the ophthalmic features of VEXAS. Ophthalmic review is advised for VEXAS patients who develop eye symptoms, given the risk of sight-threatening disease.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 50-63"},"PeriodicalIF":4.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741825","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}
引用次数: 0
Characterization of Visual Field Loss Over 4 Years in the Rate of Progression in USH2A-Related Retinal Degeneration (RUSH2A) Study
IF 4.1 1区 医学
American Journal of Ophthalmology Pub Date : 2025-03-27 DOI: 10.1016/j.ajo.2025.03.039
Jacque L. Duncan , Maureen G. Maguire , Lee S. McDaniel , Nicole R. Doucet , Isabelle Audo , Allison R. Ayala , Janet K. Cheetham , Peiyao Cheng , Todd A. Durham , Rachel M. Huckfeldt , Robert B. Hufnagel , K. Thiran Jayasundera , Naheed Khan , Brett Malbin , Ramiro S. Maldonado , Michel Michaelides , Mark E. Pennesi , Christina Y. Weng , Alex Zmejkoski , Shobana Aravind , David G. Birch
{"title":"Characterization of Visual Field Loss Over 4 Years in the Rate of Progression in USH2A-Related Retinal Degeneration (RUSH2A) Study","authors":"Jacque L. Duncan ,&nbsp;Maureen G. Maguire ,&nbsp;Lee S. McDaniel ,&nbsp;Nicole R. Doucet ,&nbsp;Isabelle Audo ,&nbsp;Allison R. Ayala ,&nbsp;Janet K. Cheetham ,&nbsp;Peiyao Cheng ,&nbsp;Todd A. Durham ,&nbsp;Rachel M. Huckfeldt ,&nbsp;Robert B. Hufnagel ,&nbsp;K. Thiran Jayasundera ,&nbsp;Naheed Khan ,&nbsp;Brett Malbin ,&nbsp;Ramiro S. Maldonado ,&nbsp;Michel Michaelides ,&nbsp;Mark E. Pennesi ,&nbsp;Christina Y. Weng ,&nbsp;Alex Zmejkoski ,&nbsp;Shobana Aravind ,&nbsp;David G. Birch","doi":"10.1016/j.ajo.2025.03.039","DOIUrl":"10.1016/j.ajo.2025.03.039","url":null,"abstract":"<div><h3>Purpose</h3><div>To report visual field loss using static perimetry (SP) and kinetic perimetry (KP) over 4 years in the Rate of Progression of <em>USH2A-</em>related Retinal Degeneration (RUSH2A) study.</div></div><div><h3>Design</h3><div>Prospective, observational cohort study.</div></div><div><h3>Subjects, Participants, and/or Controls</h3><div>Participants had <em>USH2A-</em>related rod-cone degeneration, visual acuity ≥20/80, and KP III4e ≥10° at baseline in the study eye. Preserved cohorts with baseline visual fields sufficient to detect progression were identified.</div></div><div><h3>Methods</h3><div>Participants were examined annually through 4 years. Mixed-effects models were used to estimate the annual, standardized rate, and percentage rates of change.</div></div><div><h3>Main Outcome Measures</h3><div>SP measures included hill of vision (total: V<sub>TOT</sub>, central 30°: V<sub>30</sub>, and peripheral: V<sub>PERIPH</sub>) and centrally weighted mean sensitivity (MScw). Percentages with 4-year progression exceeding the coefficient of repeatability (CoR) and with change meeting Food and Drug Administration (FDA)-recommended criteria were estimated. KP seeing area (dB-steradian (sr)/degree) for I4e, III4e, and V4e isopters was calculated.</div></div><div><h3>Results</h3><div>The average decline with SP (95% CI) was 1.94 (1.62, 2.25) dB-sr/y for V<sub>TOT</sub>, 0.54 (0.45, 0.62) dB-sr/y for V<sub>30</sub>, 1.37 (1.11, 1.63) dB-sr/y for V<sub>PERIPH,</sub> and 0.56 (0.48, 0.64) dB/y for MS<sub>cw</sub>. Average percentage decline per year was 8.6% (7.2, 10.0) for V<sub>TOT</sub>, 6.4% (5.3, 7.5) for V<sub>30</sub>, 13.6% (10.4, 16.7) for V<sub>PERIPH</sub>, and 5.6% (4.7, 6.4) for MS<sub>cw</sub>. The standardized rate of change was greatest at −1.35 for MS<sub>cw</sub>. Rates were higher in the preserved cohorts. Progression exceeding the CoR was 18% (11, 28) for V<sub>TOT</sub>, 21% (13, 31) for V<sub>30</sub>, 21% (13, 31) for V<sub>PERIPH</sub> and 17% (10, 27) for MS<sub>cw</sub>. Progression exceeding an FDA-recommended threshold was 5% (2%, 12%) for all SP points and 45% (35%, 55%) for functional transition points. Average KP annual percentage decline was 13.1% (7.5, 18.5) for I4e, 12.1% (8.1,15.9) for III4e, and 9.2% (6.3,12.0) for V4e.</div></div><div><h3>Conclusions</h3><div>All quantitative perimetry measures declined over 4 years. Progression was greater than the CoR in a relatively low percentage of eyes (17%-21%); 45% exceeded the FDA-recommended threshold when only functional transition points were considered. Standardized rate of change was greatest for MS<sub>cw</sub>. These measures are useful characterizations of vision loss in <em>USH2A-</em>related retinal degeneration.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 9-21"},"PeriodicalIF":4.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741749","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}
引用次数: 0
Correlation Between Length of Interdigitation Zone With Severity and Progression of Diabetic Retinopathy
IF 4.1 1区 医学
American Journal of Ophthalmology Pub Date : 2025-03-27 DOI: 10.1016/j.ajo.2025.03.034
Feiyan Liang, Shuya Tao, Yimeng Zhang, Siyuan Liu, Wenyong Huang, Chang He, Shuxin Fan, Xialin Liu
{"title":"Correlation Between Length of Interdigitation Zone With Severity and Progression of Diabetic Retinopathy","authors":"Feiyan Liang,&nbsp;Shuya Tao,&nbsp;Yimeng Zhang,&nbsp;Siyuan Liu,&nbsp;Wenyong Huang,&nbsp;Chang He,&nbsp;Shuxin Fan,&nbsp;Xialin Liu","doi":"10.1016/j.ajo.2025.03.034","DOIUrl":"10.1016/j.ajo.2025.03.034","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To objectively evaluate the alteration of interdigitation zone (IZ) length in diabetic patients and to determine its relationship with diabetic retinopathy (DR) progression.</div></div><div><h3>DESIGN</h3><div>Prospective cohort study.</div></div><div><h3>METHOD</h3><div>Two hundred and thirty-one diabetic patients (231 eyes) were included. DR was graded according to the modified Airlie House classification system. The high-resolution spectral-domain optical coherence tomography (SD-OCT) images were obtained to calculate the length of IZ using Image-Pro Plus. Linear regression analysis and logistic regression analysis were performed to determine the associations between IZ length with DR severity and DR progression.</div></div><div><h3>RESULTS</h3><div>IZ length was significantly reduced in DR patients compared to that in diabetic patients without DR (NDR) (3.758 ± 1.653 mm vs 5.722 ± 0.865 mm, <em>P</em> &lt; .001). After adjusting for confounding factors, IZ length showed a negative association with DR severity, and longer IZ length correlated with better best corrected visual acuity (BCVA) (ß −0.021, 95% CI −0.030 to −0.011, <em>P</em> &lt; .001). Forty eyes (21.98%) developed DR progression over 3-year follow-up. Notably, longer IZ length at baseline was associated with lower risk of DR progression over 3-year follow-up (OR 0.039, 95% CI 0.011-0.139, <em>P</em> &lt; .001). The logistic regression models predicted DR progression with area under the curve (AUC) of 0.917 (95% CI 0.872-0.962) and 0.953 (95% CI 0.917-0.989) respectively based only on IZ length and IZ length combined with established risk factors.</div></div><div><h3>CONCLUSIONS</h3><div>IZ length decreased with DR severity and significantly correlated with DR progression, potentially serving as a new predictor for disease progression.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"275 ","pages":"Pages 135-144"},"PeriodicalIF":4.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741751","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}
引用次数: 0
Visual and topographic outcomes after Corneal Allogeneic Intrastromal Ring Segments (CAIRS) for keratoconus: a systematic review and meta-analysis.
IF 4.1 1区 医学
American Journal of Ophthalmology Pub Date : 2025-03-27 DOI: 10.1016/j.ajo.2025.03.028
Maximilian Friedrich, Gerd Uwe Auffarth, Uri Soiberman, Victor Aristide Augustin, Ramin Khoramnia, Hyeck-Soo Son
{"title":"Visual and topographic outcomes after Corneal Allogeneic Intrastromal Ring Segments (CAIRS) for keratoconus: a systematic review and meta-analysis.","authors":"Maximilian Friedrich, Gerd Uwe Auffarth, Uri Soiberman, Victor Aristide Augustin, Ramin Khoramnia, Hyeck-Soo Son","doi":"10.1016/j.ajo.2025.03.028","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.03.028","url":null,"abstract":"<p><p>Purpose Corneal allogeneic intrastromal ring segments (CAIRS) are a novel therapeutic approach to treat ectatic diseases such as keratoconus and improve visual acuity as well as corneal topography. This analysis aimed to evaluate the visual outcomes and corneal topography changes after CAIRS implantation for keratoconus. Design Systematic Review and Meta-Analysis Methods In this systematic literature review and meta-analysis (ID: CRD42024612508) original peer-reviewed clinical studies on the effect of CAIRS in eyes with keratoconus were included. Exclusion criteria were pre-implanted ring segments, ectatic diseases other than keratoconus, as well as no reported pre- or postoperative outcome parameters. Cochrane, Embase, PubMed and Web of Science libraries were screened in November 2024 by two researchers independently. The risk of bias was assessed using the Evidence Project risk of bias tool. The primary effect measure was the difference in corrected distance visual acuity (CDVA) before and after CAIRS. Additionally, changes in uncorrected distance visual acuity (UDVA), spherical equivalent (SE), cylinder, flat keratometry, steep keratometry, maximum keratometry (Kmax), mean keratometry, thinnest corneal thickness, and higher order aberrations (HOAs) due to CAIRS were analyzed and compared using a random effects model. In addition, postoperative complications were documented. Results In total, fourteen clinical studies with a total of 442 eyes were included in the meta-analysis. The mean improvement in CDVA was 0.37 logMAR (95% CI: 0.28, 0.46; 14 studies; n = 442 eyes). UDVA improved by 0.43 logMAR (95% CI: 0.34, 0.55; 11 studies; n = 427 eyes). SE was improved by 4.59 D (95% CI: 3.35, 5.84; 12 studies; n = 430 eyes). Kmax was reduced by -4.49 D (95% CI: -6.05, -2.92; 13 studies; n = 439 eyes) and total HOAs decreased by -0.33 µm (95% CI: -0.62, -0.03; 6 studies; n = 171 eyes). One severe adverse event (0.2%) reported was an acute rejection, which necessitated explantation. Conclusions This meta-analysis demonstrates that CAIRS implantation is an effective procedure that can significantly improve UDVA, CDVA, and topographic outcomes in keratoconus eyes with low complication rates.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741936","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}
引用次数: 0
Giant Conjunctival Melanoma.
IF 4.1 1区 医学
American Journal of Ophthalmology Pub Date : 2025-03-27 DOI: 10.1016/j.ajo.2025.03.033
Chunxiao Wang, Jianjun Gu
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引用次数: 0
Association of Age With Glaucoma and Visual Acuity Outcomes 10.5 Years After Unilateral Congenital Cataract Surgery
IF 4.1 1区 医学
American Journal of Ophthalmology Pub Date : 2025-03-26 DOI: 10.1016/j.ajo.2025.03.035
Claudia K. Wong , He Forbes , Taylor Kolosky , Urjita Das , Euna Cho , Shaiza Mansoor , Sera Chase , Madi Kore , Moran Roni Levin , Larry Magder , Carolyn Drews-Botsch , Scott R. Lambert , Janet L. Alexander
{"title":"Association of Age With Glaucoma and Visual Acuity Outcomes 10.5 Years After Unilateral Congenital Cataract Surgery","authors":"Claudia K. Wong ,&nbsp;He Forbes ,&nbsp;Taylor Kolosky ,&nbsp;Urjita Das ,&nbsp;Euna Cho ,&nbsp;Shaiza Mansoor ,&nbsp;Sera Chase ,&nbsp;Madi Kore ,&nbsp;Moran Roni Levin ,&nbsp;Larry Magder ,&nbsp;Carolyn Drews-Botsch ,&nbsp;Scott R. Lambert ,&nbsp;Janet L. Alexander","doi":"10.1016/j.ajo.2025.03.035","DOIUrl":"10.1016/j.ajo.2025.03.035","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To determine the association among age, gestational age, glaucoma-related adverse events, and visual acuity following unilateral cataract surgery.</div></div><div><h3>DESIGN</h3><div>Post hoc follow-up of a multicenter randomized clinical trial.</div></div><div><h3>METHODS</h3><div>An analysis of 112 infants who had unilateral congenital cataract surgery between 1-6 months of chronological age. Data on long-term glaucoma-related status and visual acuity were collected when children were 10.5 years old. Intergroup comparison and correlation tests were performed, and associations of adjusted and chronological age with glaucoma and visual acuity at 10.5 years of age were assessed by logistic regression.</div></div><div><h3>RESULTS</h3><div>Chronological and adjusted age were highly correlated (Pearson correlation, <em>r</em> = 0.98, <em>P</em> &lt; .001). Gestational age was not significantly associated with glaucoma (<em>P</em> = .08) nor visual acuity (<em>P</em> = .6). Younger adjusted age had a significant association with glaucoma (<em>P</em> = .04) and with better visual acuity (<em>P</em> = .03). Younger chronological age was not significantly associated with glaucoma (<em>P</em> = .06) but had a significant association with better visual acuity (<em>P</em> = .02).</div></div><div><h3>CONCLUSIONS</h3><div>Age adjusted for gestation and chronological age are important risk factors for glaucoma and visual acuity in patients who have undergone cataract removal in infancy. Among the IATS participants, age adjusted for gestation significantly predicted glaucoma-related adverse events at 10.5 years. Conversely, chronological age was significantly associated with visual acuity at 10.5 years. Adjusted age should be considered in addition to chronological age when determining age of cataract surgery to minimize the risk of glaucoma and maximize visual acuity.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 22-29"},"PeriodicalIF":4.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741738","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}
引用次数: 0
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