American Journal of Ophthalmology最新文献

{"title":"A Nomogram Based on Ocular Hemodynamics for Predicting Ischemic Stroke","authors":"Zhuo-hua Zhou,&nbsp;Xue-ru Cheng,&nbsp;Jia-xin Guan,&nbsp;Lu Zhao,&nbsp;Yan-ling Wang,&nbsp;Jia-lin Wang","doi":"10.1016/j.ajo.2025.02.034","DOIUrl":"10.1016/j.ajo.2025.02.034","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Ischemic stroke is a cerebrovascular disease with high mortality and disability. Due to similar physiological characteristics, ocular vascular characteristics are important indicators for monitoring cerebrovascular diseases. This study aimed to develop a nomogram prediction model for ischemic stroke based on ocular hemodynamic characteristics.</div></div><div><h3>DESIGN</h3><div>Retrospective clinical cohort study.</div></div><div><h3>METHODS</h3><div>A total of 337 patients were included in this study and randomly divided into 235 training and 102 validation cohorts. The general data were collected, and the hemodynamic parameters of ophthalmic artery, central retinal artery and posterior ciliary artery were detected by ultrasound. The retinal vascular diameter was extracted from the color fundus image, and the relevant laboratory indexes of the patients were collected. Logistic regression analysis was used to determine the risk factors of ischemic stroke. A nomogram was constructed based on the identified risk factors, and the accuracy and clinical applicability of the model were analyzed using the receiver operating curve (ROC), Hosmer-Lemeshow test, and decision curve analysis (DCA).</div></div><div><h3>RESULTS</h3><div>Independent risk factors for ischemic stroke including hypertension (OR 2.17, 95% confidence interval [CI] 1.16 to 4.08; <em>P</em> = .016), hyperlipidemia (OR 2.21, 95% CI 1.18 to 4.14; <em>P</em> = .013), and resistance index of ophthalmic artery (OR 5.98, 95% CI 3.27 to 10.93; <em>P</em> &lt; .001) were identified by multivariate regression analysis. The area under the ROC curve of the training cohort was 0.790 (95% CI 0.733 to 0.847) and that of the validation cohort was 0.773 (95% CI 0.679 to 0.866), revealing the consistent ability of the nomogram to predict ischemic stroke. The mean absolute error of the training and validation cohorts were 0.020 and 0.013, respectively. In addition, the DCA curve showed good clinical benefit.</div></div><div><h3>CONCLUSIONS</h3><div>The nomogram combining traditional factors and ophthalmic artery resistance index has a preferable predictive performance for ischemic stroke. This suggests that the model combined with ocular hemodynamics can effectively promote the early diagnosis and intervention of ischemic stroke.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"274 ","pages":"Pages 91-100"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple parallel lines endotheliitis: A rare cause of transient visual loss.","authors":"Jean-Baptiste Amatu, Paul Bastelica, Christophe Baudouin","doi":"10.1016/j.ajo.2025.02.036","DOIUrl":"10.1016/j.ajo.2025.02.036","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536528","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 and Risk Factors of Primary Angle Closure Disease in an Adult Chinese American Population: The Chinese American Eye Study","authors":"Benjamin Y. Xu ,&nbsp;Grace M. Richter ,&nbsp;Bruce S. Burkemper ,&nbsp;Dandan Wang ,&nbsp;Xuejuan Jiang ,&nbsp;Mina Torres ,&nbsp;Roberta McKean-Cowdin ,&nbsp;Nathan Dhablania ,&nbsp;Rohit Varma","doi":"10.1016/j.ajo.2025.02.037","DOIUrl":"10.1016/j.ajo.2025.02.037","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To assess the prevalence and risk factors of primary angle closure disease (PACD) among adult Chinese Americans.</div></div><div><h3>DESIGN</h3><div>Cross-sectional population-based study.</div></div><div><h3>PARTICIPANTS</h3><div>Total 4582 Chinese Americans 50 years and older from 15 census tracts in Monterey Park, CA.</div></div><div><h3>METHODS</h3><div>Participants received complete eye exams, including gonioscopy, fundus photography, and standard automated perimetry. Primary angle closure suspect (PACS) was defined as non-visible posterior trabecular meshwork for ≥270° on gonioscopy. Primary angle closure (PAC) was defined as PACS with peripheral anterior synechiae (PAS) and/or IOP≥21 mmHg without glaucomatous neuropathy (GON). PACG was defined as PACS or PAC with GON. Suspected PACG (sPACG) was defined as GON without PACS or PAC but with evidence of prior laser iridotomy or cataract surgery with residual PAS. Multivariable logistic regression models were developed to identify risk factors for PACS, PAC, and PACG.</div></div><div><h3>Main Outcome Measures</h3><div>Prevalence and risk factors of PACS, PAC, and PACG.</div></div><div><h3>Results</h3><div>Data from 4,310 CHES participants were included in the analysis. The prevalence of PACS, PAC, and PACG were 8.1% (95% CI: 7.3%-9.0%; <em>N</em> = 351), 3.1% (95% CI: 2.6%-3.6%; <em>N</em> = 132), and 1.1% (95% CI: 0.8%-1.4%; <em>N</em> = 46), respectively. Prevalence of PACG and sPACG combined was 1.8% (95% CI: 1.4%-2.2%; <em>N</em> = 76). Older age (OR=1.06 per year), positive family history of glaucoma (OR=3.21), higher IOP (OR=1.17 per mmHg), and shorter axial length (OR=1.67 per mm) were significant risk factors (<em>P</em> &lt; .003) for PACG on multivariable analysis. 75.0% of PACG cases were previously undiagnosed. There was one case of PACG with unilateral blindness and no cases with bilateral blindness.</div></div><div><h3>Conclusion</h3><div>PACG prevalence was not substantially lower among Chinese Americans compared to mainland Chinese. Older age, higher IOP, positive family history of glaucoma, and smaller AL conferred higher risk. While the majority of PACG cases were undetected, blindness was rare. Improved access to eye care and cataract surgery appears to mitigate severe visual morbidity associated with PACG.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"274 ","pages":"Pages 32-41"},"PeriodicalIF":4.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536452","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 of Customized Photorefractive Keratectomy With Cross-Linking Versus Cross-Linking Alone in Progressive Keratoconus: A Systematic Review and Meta-Analysis","authors":"Hao Zhang ,&nbsp;Mario Cantó-Cerdán ,&nbsp;Beatriz Félix-Espinar ,&nbsp;Jorge L. Alió del Barrio","doi":"10.1016/j.ajo.2025.02.038","DOIUrl":"10.1016/j.ajo.2025.02.038","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;TOPIC&lt;/h3&gt;&lt;div&gt;This review evaluates the effectiveness and safety of combining cPRK with CXL versus CXL alone in improving visual outcomes for patients with progressive keratoconus.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;DESIGN&lt;/h3&gt;&lt;div&gt;Systematic review and meta-analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CLINICAL RELEVANCE&lt;/h3&gt;&lt;div&gt;Keratoconus leads to vision loss and affects quality of life. While CXL is the current standard for halting progression, it does not correct the visual impairment. This review explores whether adding cPRK to CXL offers better visual outcomes while maintaining the same safety, potentially refining treatment approaches.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;A systematic search of MEDLINE, PubMed, Cochrane Library and EMBASE was conducted through September 2024, following PRISMA guidelines. The initial study design aimed to include randomized controlled trials (RCTs) as well as comparative nonrandomized prospective or retrospective studies evaluating CXL+cPRK versus CXL alone, with a minimum follow-up of six months. However, only nonrandomized studies were retrieved. As a result, all included studies were assessed for the risk of bias using the ROBINS-I tool. The primary outcomes were uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA). Secondary outcomes included refraction, corneal structure, and higher-order aberrations (HOA). Meta-analysis was performed using standardized mean differences (SMD) with 95% confidence intervals (CI), and heterogeneity was assessed using a random-effects model where necessary. Sensitivity analysis was conducted using a leave-one-out approach to assess the robustness of the results. This study is registered in the PROSPERO database (CRD42024594757).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;Eight nonrandomized studies involving 731 eyes from 706 patients were analyzed. Compared to CXL alone, the combination of CXL+cPRK significantly improved postoperative UDVA (SMD = −0.39, 95% CI: −0.69 to −0.08, &lt;em&gt;P&lt;/em&gt; = .01) and CDVA (SMD = −0.57, 95% CI: −0.96 to −0.18, &lt;em&gt;P&lt;/em&gt; = .004), while also reducing refractive cylinder error. Additionally, CXL+cPRK led to reductions in coma, total HOA, coma-like aberrations, mean keratometry (KM), and central corneal thickness (CCT). No significant differences were observed between the groups in endothelial cell count (ECC). The rate of postoperative ectasia progression was comparable between both groups. All included studies exhibited at least one ROBINS-I domain at high risk of bias, particularly related to confounding. The heterogeneity observed in this analysis was primarily attributed to differences in surgical techniques, patient selection criteria, and study designs across the included studies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSIONS&lt;/h3&gt;&lt;div&gt;Customized PRK combined with CXL provides superior postoperative visual acuity (UDVA, CDVA) and visual quality compared to CXL alone while maintaining the same corneal stability in the management of progressive k","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"274 ","pages":"Pages 9-23"},"PeriodicalIF":4.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536466","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":"Patient Navigators Improve In-Office Eye Exam Adherence After Community Eye Screenings in a Randomized Clinical Trial: NYC-SIGHT Study","authors":"LISA A. HARK ,&nbsp;PRAKASH GORROOCHURN ,&nbsp;LAURA T. PIZZI ,&nbsp;ERIC JUTKOWITZ ,&nbsp;ANNETTE M. GOULAK ,&nbsp;STEFANIA C. MARURI ,&nbsp;NOGA HARIZMAN ,&nbsp;JASON D. HOROWITZ ,&nbsp;LISA PARK ,&nbsp;QING WANG ,&nbsp;DANIEL F. DIAMOND ,&nbsp;IVES A. VALENZUELA ,&nbsp;DESIREE R. TORRES ,&nbsp;YUJIA WANG ,&nbsp;TARUN SHARMA ,&nbsp;JEFFREY M. LIEBMANN ,&nbsp;GEORGE A. CIOFFI","doi":"10.1016/j.ajo.2025.02.030","DOIUrl":"10.1016/j.ajo.2025.02.030","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the effectiveness and cost of patient navigators in improving adherence to an initial in-office eye exam following community-based eye health screenings and referral to ophthalmology among underserved populations.</div></div><div><h3>Design</h3><div>5-year prospective, cluster-randomized clinical trial.</div></div><div><h3>Participants</h3><div>Eligible individuals aged 40 years and older were recruited from affordable housing developments and senior centers in Upper Manhattan.</div></div><div><h3>Methods</h3><div>Demographics, social determinants of health, clinical characteristics, and access to eye care were collected. Eye health screenings included visual acuity, intraocular pressure, and fundus photography. Those diagnosed with glaucoma, suspected glaucoma, retinal abnormalities, cataracts, or other ocular conditions were referred for in-office eye exams, with initial appointments scheduled by study staff. Navigator Intervention participants received appointment scheduling support for 10 months, Usual Care participants did not receive navigator assistance. T tests, chi-square tests and multivariate stepwise logistic regression analyzed factors associated with adherence. Cost-effectiveness analysis was conducted alongside the study.</div></div><div><h3>Main Outcome Measures</h3><div>Adherence to the initial in-office eye exam for those referred to ophthalmology.</div></div><div><h3>Results</h3><div>Of 468 referred participants, 47% (n = 220/468) attended the initial in-office eye exam. Adherence rates: Navigator Intervention (51.8%) versus Usual Care (38.1%). Of those who attended the in-office eye exam, mean age: 70.2 ± 11.3 years; 65.5% female; 46.8% African American, 47.3% Hispanic. Participants in the Navigator Intervention group had higher odds of adhering to the initial in-office eye exam compared to those receiving Usual Care (OR = 1.529; 95% CI (1.023, 2.285)). Participants who spoke English as their primary language also had higher odds of adhering to the initial eye exam (OR = 1.815; 95% CI (1.211, 2721)). Cost per participant in the Navigator Intervention group who attended the in-office eye exam: $24.25 vs. $33.03 per Usual Care participant.</div></div><div><h3>Conclusions</h3><div>Patient navigators improved adherence to in-office eye exams following community-based eye health screenings and referral to ophthalmology among an underserved population. The Navigator Intervention resulted in cost savings with an incremental cost-effectiveness difference of $8.78 less per participant randomized to the Navigator Intervention group.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"274 ","pages":"Pages 54-66"},"PeriodicalIF":4.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522449","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":"Racial and Ethnic Disparities at Enrollment in DRCRnet Clinical Trials for Diabetic Macular Edema","authors":"MELISSA LI,&nbsp;JOCELYN HE,&nbsp;BRIAN L. VANDERBEEK,&nbsp;GUI-SHUANG YING","doi":"10.1016/j.ajo.2025.02.029","DOIUrl":"10.1016/j.ajo.2025.02.029","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess racial/ethnic disparities and association with diabetic macular edema (DME) characteristics at enrollment in DRCR Retina Network (DRCRnet) DME clinical trials.</div></div><div><h3>Design</h3><div>Retrospective, cross-sectional analysis of data from DRCRnet clinical trials.</div></div><div><h3>Subjects</h3><div>5468 participants in 17 DRCRnet DME trials (2003-2020).</div></div><div><h3>Methods</h3><div>The racial and ethnic distribution of DRCRnet DME trial participants was compared to United States census data and DME prevalence data in the CDC's Vision and Eye Health Surveillance System (VEHSS). Generalized linear models were used for comparing demographics, HgbA1c, diabetic retinopathy (DR) severity, and visual acuity (VA) among racial/ethnic groups, and for determining factors associated with VA.</div></div><div><h3>Main Outcome Measures</h3><div>Racial and ethnic distribution of DME trial participants; patient and ocular characteristics at enrollment.</div></div><div><h3>Results</h3><div>Compared to VEHSS (64% White, 16% Black, 4% Asian, 14% Hispanic) and the 2020 U.S. census (62% White, 12% Black, 6% Asian, 19% Hispanic), White (76%) participants were over-represented, and Asians (2%) and Hispanics (12%) were under-represented (<em>P</em> &lt; .001) in DME trials. HgbA1c was higher in Black and Hispanic (8.3) than in White (7.7) and Asian (7.6) participants (<em>P</em> &lt; .001). More Asian (20%) and Hispanic (23%) participants had proliferative DR than White (19%) and Black (15%) participants (<em>P</em> &lt; .001). Hispanic ethnicity, female gender, older age at diabetes diagnosis, and severe DR were independently associated with worse VA (all <em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Hispanic participants, while under-represented, had higher HgbA1c, more severe DR, and worse VA than other groups, emphasizing the need for diverse recruitment in DME trials.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"273 ","pages":"Pages 231-239"},"PeriodicalIF":4.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cefuroxime-Induced Outer Retinopathy After Scleral-Fixated IOL Implant.","authors":"Andrea Trinco, Francesco Romano, Anna Paola Salvetti","doi":"10.1016/j.ajo.2025.02.039","DOIUrl":"10.1016/j.ajo.2025.02.039","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530887","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":"The 1-Step Versus 2-Step Subretinal Injection Trial (1,2-SIT)—A Randomized Controlled Trial to Compare Drug Reflux Following Subretinal Injection","authors":"Matthew P. Simunovic ,&nbsp;Zak J. Prime ,&nbsp;Rhuen Chiou Chow ,&nbsp;Emily Han Shao ,&nbsp;Zeid Madanat ,&nbsp;Perach Osaadon ,&nbsp;Tun Hang Yeo ,&nbsp;Khin Thida Oo ,&nbsp;Lay Khoon Too","doi":"10.1016/j.ajo.2025.02.018","DOIUrl":"10.1016/j.ajo.2025.02.018","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To estimate in humans, in vivo, drug retention in the subretinal space following either 1- or 2-step subretinal injection (SRI).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A single-masked, randomized, controlled trial.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Patients presenting with submacular hemorrhage secondary to age-related macular degeneration were randomly allocated to receive subretinal tissue plasminogen activator (50 µg in 0.1 mL) with sodium fluorescein (10 µg in 0.1 mL) as an optical label either as a 1-step (&lt;em&gt;n&lt;/em&gt; = 6) procedure, in which the drug defines the subretinal space, or as a 2-step (&lt;em&gt;n&lt;/em&gt; = 6) procedure, in which balanced salt solution is first used to define the subretinal space, following pars plana vitrectomy. All patients underwent air-for-fluid exchange at the completion of surgery with subsequent 20% sulfahexafluoride gas and bevacizumab injection. Reflux of subretinally injected drug was calculated by performing fluorophotometry on the fluid collected at the end of air-for-fluid exchange. Patients received intravitreal anti-VEGF at 4-weekly intervals to the final follow-up at 12 weeks. The primary outcome measure was the proportion of drug reflux. Secondary outcomes included duration of surgery, change in visual acuity (VA), final VA, final foveal thickness, and change in foveal thickness. To determine our fluorophotometric technique's applicability to gene and cell therapy, real-time quantitative polymerase chain reaction was employed to determine adeno-associated viral (AAV) yields following exposure to 0.1 mg/mL sodium fluorescein and its effects on retinal progenitor cells (RPCs) was assessed using a cell viability assay.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Mean reflux was 4.8% ± 3.1% (mean ± SEM, range 0.4%-19.5%) for 1-step SRI and 3.9% ± 0.9% (range 1.7%-5.3%) for 2-step SRI (no significant difference in means; &lt;em&gt;P&lt;/em&gt; = .0155 for the difference in variance). There was no significant difference in the duration of surgery (26.8 ± 1.2 minutes vs 30 ± 2.7 minutes), final VA (1.1 ± 0.26 [Snellen 20/252] vs 1.1 ± 0.32 [Snellen 20/252] logMAR), change in BCVA (−0.45 ± 0.27 vs −0.27 ± 0.23 logMAR) or foveal thickness (139.2 ± 33.2 µm vs 129.8 ± 21.1 µm). Quantitative polymerase chain reaction confirmed that AAV titers are not affected by 0.1 mg/mL sodium fluorescein in vitro, and viability assays suggest that it does not adversely affect RPC viability.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This study demonstrates that drug loss following SRI ranged from 0.4% to 19.8% (mean 4.3%). There is no significant difference between 1-step and 2-step SRI in the mean proportion of drug reflux, duration of surgery, change in neural retinal thickness, or change in BCVA. However, there is a significantly greater variability in reflux for 1-step injection compared to 2-step injection. AAV yields are not affected by 0.1 mg/mL sodium fluorescein, nor is RPC viability. These data suggest that sodium flu","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"274 ","pages":"Pages 149-162"},"PeriodicalIF":4.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital X-Linked Retinoschisis in an Indian Population: A Single Center Study in 70 Eyes","authors":"Abhishek Das,&nbsp;Parag K. Shah,&nbsp;Veerappan R. Saravanan,&nbsp;Prema Subramaniam,&nbsp;Narendran Venkatapathy","doi":"10.1016/j.ajo.2025.02.031","DOIUrl":"10.1016/j.ajo.2025.02.031","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To study and analyze the demographics, clinical features, and surgical indications in congenital X-linked retinoschisis (CXLRS) in an Indian population.</div></div><div><h3>DESIGN</h3><div>Retrospective case series.</div></div><div><h3>METHODS</h3><div>This was a retrospective case series in 70 eyes, which included all the patients diagnosed with CXLRS. A data set including demographic characteristics, phenotype, frequency of follow-up/surgery, surgical techniques and details, pre- and postoperative visual acuity, and complications of CXLRS patients followed up were obtained and analyzed.</div></div><div><h3>RESULTS</h3><div>A total of 70 eyes of 35 patients were included. Mean age at presentation was 6.9 ± 3.8 years. Mean follow-up time was 65.2 ± 30.4 months. Most common phenotype was type 3 (77.1%) which is foveal schisis on clinical examination and optical coherence tomography (OCT), as well as lamellar schisis on OCT, plus peripheral schisis on ophthalmoscopy. Five eyes underwent vitreo-retinal surgery (VR), and 2 eyes underwent laser therapy. Mean central foveal thickness was 532 ± 223.1 µm. Median best-corrected visual acuity of patients undergoing VR surgery (logMAR) was 1.8 (1.1-2). Rhegmatogenous retinal detachment (RRD) was the most common cause of surgery in patients with CXLR. Median best-corrected final visual acuity (logMAR) was 0.6 (0.2-2.0). The most frequent VR procedure was pars plana vitrectomy, and most common tamponade used was silicone oil (100%).</div></div><div><h3>CONCLUSIONS</h3><div>Family history and screening is important. RRD is a vision-threatening complication of CXLRS, and surgical intervention in the form of vitrectomy or scleral buckle can be performed. Multi-modal imaging such as OCT can be an assistive tool.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"274 ","pages":"Pages 142-148"},"PeriodicalIF":4.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522436","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":"The Effect of Semaglutide and GLP-1 RAs on Risk of Nonarteritic Anterior Ischemic Optic Neuropathy","authors":"Nadia J. Abbass ,&nbsp;Raya Nahlawi ,&nbsp;Jacqueline K. Shaia ,&nbsp;Kevin C. Allan ,&nbsp;David C Kaelber ,&nbsp;Katherine E. Talcott ,&nbsp;Rishi P. Singh","doi":"10.1016/j.ajo.2025.02.025","DOIUrl":"10.1016/j.ajo.2025.02.025","url":null,"abstract":"<div><h3>PURPOSE</h3><div>The association between GLP-1 receptor agonists (GLP-1RA) and nonarteritic anterior ischemic optic neuropathy (NAION) remains unclear. Given the debilitating sequelae of NAION and rapid increase of GLP-1RA use, further research is essential to investigate this potential relationship. This study seeks to determine the risk of NAION and ischemic optic neuropathy (ION) in patients prescribed GLP-1RAs.</div></div><div><h3>DESIGN</h3><div>Retrospective matched cohort study.</div></div><div><h3>SETTING</h3><div>TriNetX United States collaborative network.</div></div><div><h3>PARTICIPANTS</h3><div>Patients ≥12 years old with type 2 diabetes (T2DM) and considered overweight or obese (high BMI), with at least one ophthalmology or neurology visit. Among T2DM patients, approximately 120,000 patients with a semaglutide prescription and 220,000 prescribed any GLP-1RA were compared to matched T2DM controls. Among high BMI patients, approximately 58,000 on semaglutide and 66,000 on any GLP-1RA were compared to matched controls.</div></div><div><h3>METHODS</h3><div>Patients prescribed semaglutide or any GLP-1RA were compared with those on non-GLP-1RA medications. Populations were propensity matched (1:1) on various demographic and risk factors to balance baseline cohorts.</div></div><div><h3>MAIN OUTCOMES AND MEASURES</h3><div>Cumulative incidence and risk of NAION and ION. Risk ratios (RR) with 95% confidence intervals (CI) were reported, with significance defined as CI &lt;0.9 or &gt; 1.1.</div></div><div><h3>RESULTS</h3><div>In T2DM patients prescribed semaglutide, the risk of NAION (RR = 0.7, 95% CI: 0.523-0.937) and ION (RR = 0.788, 95% CI: 0.609-1.102) after 5 years was not significantly increased compared to matched T2DM controls. Similarly, T2DM patients on any GLP-1RA demonstrated no significant difference in the risk of NAION (RR = 0.887, 95% CI: 0.735-1.071) or ION (RR = 0.969, 95% CI: 0.813-1.154) compared to controls. Furthermore, no increased risk of either outcome was found in the high BMI groups prescribed semaglutide or any GLP-1RA. The cumulative 5-year risk of NAION and ION in T2DM patients on semaglutide was 0.065% and 0.08%, respectively. In those with high BMI prescribed semaglutide, the risk of NAION and ION after 2 years was 0.038% and 0.404%, respectively.</div></div><div><h3>CONCLUSIONS</h3><div>There was no significant increase in risk of NAION or ION in patients taking semaglutide or GLP-1RAs compared to T2DM or high BMI controls.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"274 ","pages":"Pages 24-31"},"PeriodicalIF":4.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}