American Journal of Ophthalmology最新文献

{"title":"Reading speed and visual acuity in photopic and mesopic conditions after bilateral implantation of diffractive multifocal intraocular lenses.","authors":"Jascha A Wendelstein,Kevin Vallotton,Alex Ziörjen,Maya Müller,Kamran M Riaz,Seth M Pantanelli,Achim Langenbucher,Theo G Seiler","doi":"10.1016/j.ajo.2025.09.030","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.030","url":null,"abstract":"PURPOSETo assess functional visual performance - particularly reading speed - under photopic and mesopic conditions in patients bilaterally implanted with either the AT LISA Tri 839MP or Tecnis Synergy DFR00V diffractive multifocal intraocular lenses (IOL).DESIGNProspective randomized controlled trial.METHODSThis trial included 60 patients that underwent bilateral cataract surgery with implantation of either the AT LISA Tri or Synergy IOLs. At 3 months postoperatively, distance-corrected visual acuity (VA) and distance-corrected reading speed were measured under photopic (85 cd/m²) and mesopic (3 cd/m²) conditions. Photopic defocus curves were also analyzed and compared.RESULTSMesopic VA was significantly worse than photopic VA by ∼1 ETDRS line, without inter-IOL differences. Photopic reading speeds were 143.4 ± 40.0 and 136.4 ± 27.0 wpm for the AT LISA Tri and Synergy, respectively. Mesopic reading speeds declining significantly to 38.2 ± 34.2 and 22.4 ± 29.7 wpm under mesopic conditions, respectively. Mesopic reading speed was significantly lower than in photopic conditions for both groups.CONCLUSIONSStandard VA testing may underestimate functional limitations of multifocal IOLs under mesopic conditions. The substantial loss of reading speed suggests that mesopic near vision is impaired. Low luminance reading speed is a practical, patient-relevant endpoint and should be considered in IOL evaluations.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"41 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133956","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 Edema Resistance in Retinal Vein Occlusion and the Protective Role of PAMM Subtypes.","authors":"Maria Vittoria Cicinelli,Enrico Maria Pepe,Beatrice Tombolini,Marco Romanelli,Stefano Albertini,Maria Pia de Carlo,Sebastiano Del Fabbro,Chiara Giuffré,Francesco Bandello,Rosangela Lattanzio","doi":"10.1016/j.ajo.2025.09.029","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.029","url":null,"abstract":"PURPOSETo characterize eyes without macular edema (ME) at presentation in retinal vein occlusion (RVO), evaluate incidence and predictors of ME during follow-up, and assess the prognostic significance of paracentral acute middle maculopathy (PAMM) subtypes.DESIGNRetrospective cohort study.PARTICIPANTS405 treatment-naïve RVO eyes.METHODSClinical and imaging features were compared between eyes with and without baseline ME. PAMM was classified as arteriolar, fern-like, or globular. Peripheral ischemia was quantified using ultra-widefield fluorescein angiography.MAIN OUTCOME MEASURESPredictors of ME at baseline and during follow-up identified with logistic and Cox regression. Cumulative ME risk in eyes with PAMM assessed with Kaplan-Meier and multinomial regression analyses.RESULTSAt baseline, 72 eyes (18%) were ME-free. These eyes were younger (49.8±16.6 vs. 65.8±13.6 years), more frequently had CRVO (85% vs. 50%), and had fewer systemic comorbidities. PAMM was a strong protective factor against baseline ME (OR 0.05; P<0.01). During follow-up, cumulative ME incidence reached 42% at 1 year and stabilized thereafter. Higher baseline central macular thickness (HR 2.39/100 µm; P=0.002) and ischemic index (HR 1.03/1%; P=0.03) were risk factors, while age <50 years and early anti-VEGF therapy were protective. Globular PAMM, frequently associated with a cilioretinal artery, identified the lowest ME risk profile.CONCLUSIONSYounger patients with CRVO often present without ME. Although nearly half of these eyes develop ME over time, baseline imaging-particularly presence and subtype of PAMM-helps stratify risk. Globular PAMM defines a paradoxical ischemic profile with preserved vascular integrity and minimal susceptibility to fluid accumulation.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"40 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127142","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":"A Cloud-Shaped Cornea: Multipseudocystic formation following hydrops in a keratoconus patient.","authors":"Amatu Jean-Baptiste,Bastelica Paul,Baudouin Christophe","doi":"10.1016/j.ajo.2025.09.026","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.026","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"58 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127143","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":"DOUBLE RING SIGN ASSISTED REMOVAL OF RETAINED LENTICULE POST LENTICULAR EXTRACTION.","authors":"Rushad Shroff,Ritu Arora,Abhilasha Sanoria","doi":"10.1016/j.ajo.2025.09.024","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.024","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"87 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103381","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":"Longitudinal neural and microvascular changes in type 2 diabetic patients without retinopathy: a 2-year prospective cohort study.","authors":"Yiran Fan,Lingyi Li,Xinyan Wu,Yayi Yan,Pan Li,Likun Lin,Yuntong Li,Ching-Kit Tsui,Kaiqun Liu,Wenyong Huang,Xiaoling Liang,Andina Hu, ","doi":"10.1016/j.ajo.2025.09.025","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.025","url":null,"abstract":"PURPOSETo compare the 2-year longitudinal changes in macular ganglion cell-inner plexiform layer thickness (GCIPLT) and superficial capillary plexus (SCP) vessel density between patients with type 2 diabetes mellitus (T2DM) without retinopathy (non-DR) and healthy controls.DESIGNProspective observational cohort study.METHODST2DM patients without clinical retinopathy at baseline and after a 2-year follow-up, along with age- and sex-matched healthy controls, were recruited from the community in Guangzhou. Measurements of macular GCIPLT, retinal thickness (RT), and SCP vessel density were conducted at baseline and at the 2-year follow-up. Linear mixed-effects models were used to estimate absolute and relative rates of changes and to compare absolute rates between the two groups.RESULTSA total of 282 eyes (141 in the control group and 141 in the non-DR group) were included in the analysis. Significant reductions in GCIPT and GCIPLT/RT occurred only in the non-DR group, with GCIPLT decreasing by -0.229 μm/year (95% confidence interval [CI]: -0.313 to -0.144; P < 0.001) and 0.324 % (95%CI: 0.444 to 0.204; P < 0.001), approximately 5-fold faster than the control group. After adjusting for confounding factors, the longitudinal rates of RT, GCIPLT, and GCIPLT/RT were significantly accelerated in the non-DR group compared to the control group by -0.603 μm/year (95% CI: -0.939 to -0.268; P < 0.001), -0.189 μm/year (95% CI: -0.306 to -0.073; P = 0.001), and -0.073 % (95% CI: -0.118 to -0.028; P = 0.001), respectively. While, longitudinal changes in SCP vessel density did not show significant differences between the two groups (P = 0.861).CONCLUSIONSOur findings suggest that neurodegenerative changes may precede microvascular alterations in non-DR patients, indicating that monitoring of GCIPLT is crucial for patients with long-standing diabetes, even in the absence of retinopathy.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"196 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103378","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":"Comparative Risk of Glaucoma in Patients Using Sodium-glucose Cotransporter-2 Inhibitors and Metformin: A Multinational Cohort Study.","authors":"Ssu-Yu Pan,Chien-Hsiang Weng,Shang-Feng Tsai,Yi-Jing Sheen,Jun-Fu Lin,Ching-Heng Lin,I-Jong Wang,Chien-Chih Chou","doi":"10.1016/j.ajo.2025.09.027","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.027","url":null,"abstract":"OBJECTIVETo compare the impact of sodium-glucose cotransporter-2 (SGLT2) inhibitors and metformin on the risk of glaucoma-related outcomes in patients with type 2 diabetes mellitus (T2DM).DESIGNMultinational, retrospective clinical cohort study using patient data from 160 healthcare organizations across 21 countries.SUBJECTSAdults with T2DM who initiated SGLT2 inhibitors or metformin during 2013-2023 were included.INTERVENTIONPatients with T2DM prescribed SGLT2 inhibitors were compared to those prescribed metformin. We performed 1:1 propensity score matching to balance age, sex, race, glycated hemoglobin, body mass index, medications, and comorbidities between the SGLT2 inhibitor and metformin groups.MAIN OUTCOME MEASUREThe occurrence of ocular hypertension, primary open-angle glaucoma (POAG), and the need for glaucoma medications.RESULTSOur final analysis included 32,634 patients prescribed SGLT2 inhibitors and 32,634 prescribed metformin. Compared to metformin, SGLT2 inhibitors are associated with significantly lower risks of ocular hypertension (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.60-0.89), POAG (HR, 0.64; 95% CI, 0.51-0.81), and the need for glaucoma medications (HR, 0.76; 95% CI, 0.69-0.84) in 5 years. These associations remain consistent in patients aged ≥60 years, females, males, Whites, and those prescribed empagliflozin.CONCLUSIONSAmong patients with T2DM, treatment with SGLT2 inhibitors may be associated with lower risks of ocular hypertension, POAG, and the need for glaucoma medications compared to metformin.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"235 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103379","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 comorbidities of psoriasis: A systematic review and meta-analysis of observational studies.","authors":"Ching-Ya Wang,Tzu-Yi Lin,Tzu- Yu Wang,Ching-Chi Chi","doi":"10.1016/j.ajo.2025.09.020","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.020","url":null,"abstract":"TOPICOcular comorbidities of psoriasis: A systematic review and meta-analysis of observational studies.DESIGNSystematic review and meta-analysis.CLINICAL RELEVANCEOcular comorbidities of psoriasis have been raised with growing evidence. Certain eye diseases require prompt diagnosis and appropriate interventions, otherwise irreversible blindness may occur.METHODSWe searched PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) databases from their respective inception to August 15th, 2025. Observational studies providing data on risk estimates for eye diseases, such as cataract, uveitis, dry eye disease, glaucoma, retinal vein occlusion, conjunctivitis, meibomian gland dysfunction and blepharitis, between patients with psoriasis and without psoriasis were included. Newcastle-Ottawa scale was utilized to evaluate the risk of bias. A random-effects model meta-analysis was conducted. Our primary outcomes were the risk estimates of ocular comorbidities in patients with psoriasis. This study is registered in the Open Science Framework (https://osf.io/tkn92).RESULTSWe included 34 studies involving 10,045,036 subjects. Patients with psoriasis showed increased risk of cataract (hazard ratio (HR) 1.78, 95% confidence interval (CI) 1.53-2.07), uveitis (HR 1.65, 95% CI 1.35-2.01 (cohort studies); odds ratio [OR] 2.56, 95% CI 1.60-4.10 (case-control studies)), dry eye disease (OR 5.01, 95% CI 2.31-10.86), glaucoma (HR 1.40, 95% CI 1.05-1.88), retinal vein occlusion (HR 1.58, 95% CI, 1.23-2.03), conjunctivitis (OR 3.76, 95% CI 1.33-10.63), meibomian gland dysfunction (OR 4.45, 95% CI 1.9-10.40), and blepharitis (OR 2.28, 95% CI 1.24-4.19).CONCLUSIONSThe current evidence reveals associations of psoriasis with cataract, uveitis, dry eye disease, glaucoma, retinal vein occlusion, conjunctivitis, meibomian gland dysfunction and blepharitis. Ophthalmic consultation should be sought for psoriasis patients presenting ocular symptoms for prompt diagnosis and appropriate intervention.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"128 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Outdoor Daylight Exposure Duration and Primary Open-Angle Glaucoma.","authors":"Jianqi Chen,Shaofen Huang,Xiaohua Zhuo,Xuhao Chen,Rui Xie,Ruiyu Luo,Xinyue Shen,Yue Xiao,Jingying Liang,Yingting Zhu,Jingfeng Mu,Hongmei Tan,Yehong Zhuo","doi":"10.1016/j.ajo.2025.09.022","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.022","url":null,"abstract":"PURPOSEAs a crucial environmental factor, outdoor daylight exposure has become an increasing focus in ophthalmic research. Although exploratory studies have indicated a potential connection between daylight exposure and primary open-angle glaucoma (POAG), a detailed association remains largely unknown. This study aimed to examine the association using data from the UK Biobank.DESIGNCombined cross-sectional and cohort study.PARTICIPANTSFollowing the application of exclusion criteria, 67,558 and 71,480 participants were included in the analysis of POAG incidence and prevalence, respectively. Additionally, 69,441 and 28,029 participants were included in the analysis of intraocular pressure (IOP) and ganglion cell complex (GCC) thickness, which are traits related to POAG.METHODSThe initial assessment of outdoor daylight exposure duration was conducted using a standardized touchscreen questionnaire and measured in hours per day. Cox proportional hazard models were employed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for each additional hour of exposure per day. Additionally, logistic regression models and linear regression models were utilized to investigate the association with POAG prevalence and POAG-related traits, with adjustments made for multiple covariates.MAIN OUTCOME MEASURESPOAG incidence, prevalence, and related traits.RESULTSAfter adjusting for all covariates, annual average daylight exposure duration (HR, 1.10; 95% CI, 1.02-1.18; P = 0.009) and summer daylight exposure duration (HR, 1.08; 95% CI, 1.02-1.14; P = 0.009) were associated with an increased incidence of POAG, and stronger associations were observed for males. Participants with elevated outdoor exposure duration had higher IOP levels across annual exposure (β, 0.04, 95% CI, 0.03-0.06, P<0.001), summer exposure (β, 0.04, 95% CI, 0.03-0.05, P<0.001), and winter exposure (β = 0.02, 95% CI, 0.01-0.04, P=0.007). No association was found between outdoor daylight exposure and the prevalence of POAG or GCC thickness.CONCLUSIONSProlonged daylight exposure, particularly during the summer, is associated with an elevated risk of POAG incidence, possibly due to increased IOP. These findings highlight the need for protective strategies against excessive daylight exposure.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"316 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Ocular Magnification Correction on Measurements of Macula Ganglion Cell Complex in Myopic Children.","authors":"Rachel S Chong,Bryan Sim,Hla Myint Htoon,Audrey Chia","doi":"10.1016/j.ajo.2025.09.019","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.09.019","url":null,"abstract":"PURPOSEOptical Coherence Tomography (OCT) imaging in myopic eyes may be influenced by measurement error from axial length-induced magnification effects. We studied the effects of magnification correction on ganglion cell complex (GCL++) thickness in myopic children.DESIGNClinical cohort SUBJECTS: Children aged 7-16 years in a myopic clinic METHODS: Data collected included age, gender, race, cycloplegic refraction, axial length (AL), keratometry (K), intraocular pressure (IOP), cup-to-disc ratio (CDR), optic disc tilt, peripapillary atrophy (PPA) and OCT macula scans from the right eye. GCL++ thickness in the central, inner and outer superior, inferior, nasal and temporal quadrants was measured with or without adjustments for ocular magnification using the Littmann-Bennett formula.RESULTS492 subjects, comprising 46.7% male and 91.8% Chinese with an average age of 10.3±1.6 years were included in the study. Mean spherical equivalent (SE) was -4.43±2.24D, and AL was 25.04±1.05 mm. Multivariate analysis showed unadjusted and adjusted GCL++ thickening in older age; in the central and inner quadrants in males; and in the outer temporal quadrant in Chinese children. Central unadjusted and adjusted GCL++ were also thicker with decreased SE, flatter K and increased AL. In other quadrants, unadjusted GCL++ was thinner with decreasing SE and increasing AL in all but the nasal quadrant. Adjusted values were thicker with decreased SE, flatter K, and increasing AL (p≤0.001 for all). IOP, CDR, optic disc tilt, PPA and myopia treatment had no effect on GCL++.DISCUSSIONOcular magnification correction of OCT-measured retinal layer thickness using adjustments for axial length suggests increasing myopia is associated with thickening of the ganglion cell complex in children.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"38 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: The Relationship of Hydroxychloroquine Retinopathy Progression to Stage at Cessation of Therapy.","authors":"Michael F Marmor","doi":"10.1016/j.ajo.2025.08.056","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.08.056","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102572","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}