American Journal of Ophthalmology最新文献

{"title":"Avascular islands in retinopathy of prematurity with regression after intravitreal anti-VEGF injection.","authors":"Ethan K Sobol,Joshua M Barnett","doi":"10.1016/j.ajo.2025.04.035","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.04.035","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"77 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932419","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":"Primary Merkel cell carcinoma of the eyelid.","authors":"Jing Li,Tingting Ren,Jianmin Ma","doi":"10.1016/j.ajo.2025.04.027","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.04.027","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"18 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932463","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":"Global Burden of Eye Injuries in Children and Adolescents, 1990 to 2021: A Systematic Analysis From the Global Burden of Disease Study","authors":"Gongpeng Sun ,&nbsp;Hong Luo ,&nbsp;Qibo Ran ,&nbsp;Ye Wei ,&nbsp;Yi Zhang ,&nbsp;Xi Huang ,&nbsp;Meixia Zhang","doi":"10.1016/j.ajo.2025.04.043","DOIUrl":"10.1016/j.ajo.2025.04.043","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Eye injuries are a leading cause of monocular vision impairment and disability in children and adolescents. Unlike adults, eye injuries in children exhibit significant age specificity, with worse visual outcomes due to immature vision, the risk of long-term damage, and amblyopia. However, research on the global distribution and trends of eye injury burdens in this population is limited.</div></div><div><h3>DESIGN</h3><div>Retrospective population-based trend study.</div></div><div><h3>METHODS</h3><div>This study analyzes the burden of eye injuries among children and adolescents aged 0 to 19 years globally, regionally, and nationally, using data from the 2021 Global Burden of Disease study. We evaluated the epidemiological characteristics of eye injuries by calculating incidence, years lived with disability (YLD), age-standardized incidence rates (ASIR), and age-standardized YLD rates (ASYR). Temporal trends in ASIR and ASYR from 1990 to 2021 were assessed using joinpoint regression analysis, expressed as average annual percentage changes. The analysis was further stratified by sex, age, and sociodemographic index (SDI) to explore trends in different subgroups.</div></div><div><h3>RESULTS</h3><div>In 2021, the global ASIR and ASYR for children and adolescents were 434.24 per 100,000 (95% confidence interval [CI], 305.17-603.22) and 3.19 per 100,000 (95% CI, 0.96-6.99), respectively, indicating a decline since 1990. Regions with high SDI showed the highest incidence of eye injuries. Australasia, Southern Latin America, and Western Europe had the highest ASIRs and ASYRs in both 1990 and 2021. From 1990 to 2021, Afghanistan, Yemen, Libya, the Central African Republic, and Chile experienced the most significant increases in pediatric eye injuries. Global data show that boys have an eye injury incidence rate approximately 1.8 times higher than that of girls. In 2021, the incidence of eye injuries among children and adolescents increased with age. The primary causes include foreign bodies, exposure to mechanical forces, and falls.</div></div><div><h3>CONCLUSIONS</h3><div>Despite observed declines in incidence and YLD, the burden of eye injuries in children and adolescents remains substantial. These findings underscore the urgent need for the development and implementation of targeted preventive education initiatives and ocular protection protocols on a global scale.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 374-385"},"PeriodicalIF":4.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932464","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, Stability, and Influence Factors of Femtosecond Laser-Assisted Arcuate Keratotomy in Cataract Surgery: A Systematic Review and Meta-Analysis","authors":"Baoxian Zhuo ,&nbsp;Wenqian Shen ,&nbsp;Lei Cai ,&nbsp;Shuang Ni ,&nbsp;Jiying Shen ,&nbsp;Jin Yang","doi":"10.1016/j.ajo.2025.04.037","DOIUrl":"10.1016/j.ajo.2025.04.037","url":null,"abstract":"<div><h3>PURPOSE</h3><div>This study aimed to evaluate the effectiveness, stability, and influencing factors of femtosecond laser-assisted arcuate keratotomy (FSAK) performed during cataract surgery for correcting corneal astigmatism (CA).</div></div><div><h3>METHODS</h3><div>A systematic literature review was conducted to identify clinical trials adopting a pre-post study design. Data sources included electronic databases such as PubMed, Scopus, Web of Science, and Embase. Corneal astigmatism was assessed preoperatively and at multiple postoperative intervals: 1 month, 3 months, 6 months, and 1 year. Comparative analyses were conducted to determine the efficacy and stability over time. Subgroup analyses of CA reduction and absolute angle of error were performed based on potential influence factors including the type, depth, diameter, and platform of FSAK, magnitude and type of preoperative CA, and area of the study. Statistical analyses were performed using Review Manager 5.4.</div></div><div><h3>DESIGN</h3><div>Systematic review and meta-analysis.</div></div><div><h3>RESULTS</h3><div>Of the 40 articles initially identified, 20 met the final inclusion criteria. Follow-up durations ranged from 1 month to 2 years. Significant reduction in CA postoperative were observed at 1 month, 3 months, 6 months, and 1 year after surgery (mean difference [MD] = −0.55 D, −0.66 D, −0.43 D, and −0.67 D, respectively; all <em>P</em> &lt; .02). CA between different postoperative time points were not significant (all <em>P</em> &gt; .20). Subgroup analysis did not address the high heterogeneity. However, differences of CA reduction between subgroups based on type, depth, diameter, and platform of FSAK were significant. Penetrating FSAK, deeper incision, optical diameter at 8.5 mm were shown to introduce higher CA reduction (<em>P</em> = .005, .02, &lt; .001, respectively). The effect achieved by different laser platforms were significantly different (<em>P</em> = .0002).</div></div><div><h3>CONCLUSIONS</h3><div>FSAK performed during cataract surgery effectively reduces corneal astigmatism, with stability observed from 1 month to 1 year postoperatively. The corrective performance is closely related to type, depth, diameter, and platform of FSAK.</div><div>This study was supported by the <span>National Natural Science Foundation of China</span> (Grant No. <span><span>82171039</span></span> and No. <span><span>82301191</span></span>). Registration number: PROSPERO CRD 42024504481).</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"277 ","pages":"Pages 33-44"},"PeriodicalIF":4.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932462","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":"Fluids aspiration for refractory PED in polypoidal choroidal vasculopathy.","authors":"Ruyi Han,Min Wang,Gezhi Xu","doi":"10.1016/j.ajo.2025.04.028","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.04.028","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"12 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932461","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":"Reply to Comment on: \" Epithelial Mapping Efficacy for Subclinical Keratoconus Identification \".","authors":"Barbara A L Dutra,Bassel Hammoud,Bianca N Susanna,Giuliano Scarcelli,William J Dupps,J Bradley Randleman","doi":"10.1016/j.ajo.2025.04.030","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.04.030","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"24 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Polypropylene Scleral Suture Fixation of Intraocular Lens in Pediatric Nontraumatic Ectopia Lentis: A Real-World Study","authors":"Siyuan Liu ,&nbsp;Xinyu Zhang ,&nbsp;Zhenzhen Liu ,&nbsp;Charlotte Young ,&nbsp;Zhangkai Lian ,&nbsp;Danying Zheng ,&nbsp;Guangming Jin","doi":"10.1016/j.ajo.2025.04.036","DOIUrl":"10.1016/j.ajo.2025.04.036","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To report the efficacy and safety of scleral-suture fixation of intraocular lens (SFIOL) in children with nontraumatic ectopia lentis (EL) in a real-world setting.</div></div><div><h3>DESIGN</h3><div>Retrospective case series.</div></div><div><h3>METHODS</h3><div>The retrospective study included 220 eyes of 123 children with nontraumatic EL completing a minimum of 3 years of postoperative follow-up, and was conducted at the Zhongshan Ophthalmic Center, Sun Yat-sen University (Guangzhou, China). Lens extraction with primary SFIOL was performed in all eyes. The efficacy outcome was postoperative corrected distance visual acuity (CDVA). The safety outcomes were postoperative complications and the rate of additional surgery. The secondary outcomes were change in refraction and IOL centration.</div></div><div><h3>RESULTS</h3><div>The mean age at surgery of the cohort was 7.62 ± 3.41 years, and the median follow-up duration was 4.04 (interquartile range [IQR] = 3.41-5.17) years. In all, 87.2% eyes had CDVA greater than or equal to 0.5 at final follow-up. The postoperative complications included suture exposure in 19 eyes (8.6%), IOL dislocation in 17 eyes (7.7%), IOL pupillary capture in 7 eyes (3.2%), persistent high intraocular pressure in 4 eyes (1.8%), retinal detachment in 3 eyes (1.3%), and endophthalmitis in 2 eyes (0.9%). The additional surgery rate was 7.7%, including retinal detachment in 3 eyes and IOL dislocation in 14 eyes. The postoperative refraction showed a tendency toward myopia. The mean IOL tilt and decentration were 8.6 ± 5.7° and 0.75 ± 0.38 mm, respectively.</div></div><div><h3>CONCLUSIONS</h3><div>SFIOL is an effective method for managing children with nontraumatic EL, but with a certain incidence of complications. Suture exposure and IOL dislocation are the most common complications and may occur over time. Strengthening the postoperative long-term follow-up is crucial for children with nontraumatic EL.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 386-394"},"PeriodicalIF":4.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926442","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":"Differential Impact of Central and Global Visual Field Progression on Quality of Life in Glaucoma","authors":"Gopikasree Gunasegaran ,&nbsp;Sasan Moghimi ,&nbsp;Evan Walker ,&nbsp;Takashi Nishida ,&nbsp;Jeffrey M. Liebmann ,&nbsp;Massimo A. Fazio ,&nbsp;Christopher A. Girkin ,&nbsp;Linda M. Zangwill ,&nbsp;Robert N. Weinreb","doi":"10.1016/j.ajo.2025.04.031","DOIUrl":"10.1016/j.ajo.2025.04.031","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the impact of progression of central visual field (VF) and global VF on vision-related quality of life (VRQOL).</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>This study included 364 eyes of 235 primary open-angle glaucoma participants who had at least five 24-2 VF tests over a minimum of 2-year follow-up. The slopes of global mean deviation (MD) and central mean total deviation (MTD₁₀) (12 test points within the central 10° of 24-2) were calculated. Analyses were conducted using different slope thresholds to define VF-based progression, and mean composite National Eye Institute Visual Function Questionnaire Rasch-calibrated scores associated with these progression thresholds were quantified using linear mixed-effects models.</div></div><div><h3>Results</h3><div>The baseline 24-2 VF MD of all participants was –5.6 (95% CI –6.4, –4.9) decibels (dB). At baseline, eyes with MTD₁₀ progression had significantly worse 24-2 VF MD compared to those without MTD₁₀ progression. When fast progression was defined as MTD₁₀ slope &lt;–0.50 dB/y, fast progressors had a mean baseline 24-2 MD of –9.71 dB (95% CI –11.89, –7.53) compared to –5.24 dB (95% CI –6.02, –4.46) in slow progressors (<em>P</em> &lt; .001). Eyes exhibiting MTD₁₀ progression consistently displayed worse mean composite VRQOL scores across various thresholds compared to global MD. Notably, a similar level of VRQOL impairment was observed at a lower threshold for MTD₁₀ compared to MD, consistent across all glaucoma severity groups. In the overall cohort, eyes progressing at a rate of –0.5 dB/y or faster for MTD₁₀ had a mean composite VRQOL score comparable to those progressing at –1.0 dB/y or faster for global MD.</div></div><div><h3>Conclusions</h3><div>Central VF change had a greater impact on VRQOL compared to global VF change. Conventional assessments based on global MD may underestimate the effect of central VF changes. Refining progression detection strategies to include central VF is necessary to better reflect changes in patient-centered outcomes like VRQOL.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 327-335"},"PeriodicalIF":4.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921047","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":"Sustained Suppression of VEGF for Treatment of Retinal and Choroidal Vascular Diseases","authors":"Peter A. Campochiaro","doi":"10.1016/j.ajo.2025.04.032","DOIUrl":"10.1016/j.ajo.2025.04.032","url":null,"abstract":"<div><div>Clinical trials have demonstrated remarkable benefits from intravitreal injections of anti–vascular endothelial growth factor (anti-VEGF) agents in patients with retinal or choroidal vascular diseases, but observational studies have shown poor outcomes in the same patient populations treated in clinical practice, and this is associated with less frequent injections. Current treatment strategies in clinical practice are designed to minimize injection frequency, which involves imprecise estimates of when recurrent exudation might occur. An alternative strategy is to use treatments that provide sustained suppression of VEGF, but many retina specialists are concerned that such treatments may damage the macula and cause atrophy, particularly in patients with neovascular age-related macular degeneration (nAMD). Evidence regarding the potential benefits and risks of sustained suppression of VEGF is provided along with an overview of treatments aimed at achieving it, one that is currently available to treat patients with nAMD and diabetic macular edema and others that are in development. The overview of these various treatment strategies is an introduction to other articles in this special issue that provide detailed background and currently available data. We are entering a new era in the treatment of retinal and choroidal vascular diseases and this issue is designed to provide a guidebook of what is here and what is about to come.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"277 ","pages":"Pages 1-6"},"PeriodicalIF":4.1,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961614","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":"Is There a Safe Glycemic Threshold for Cataract Surgery?","authors":"ZAIN S. HUSSAIN ,&nbsp;AHMED F. SHAKARCHI ,&nbsp;MUHAMMAD Z. CHAUHAN ,&nbsp;DANE A. JESTER ,&nbsp;MOHAMED K. SOLIMAN ,&nbsp;AHMED B. SALLAM","doi":"10.1016/j.ajo.2025.04.033","DOIUrl":"10.1016/j.ajo.2025.04.033","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the relationship between cataract surgery and the 30-day incidence of post-operative endophthalmitis (POE) (analysis 1) and serious systemic adverse events (analysis 2) in diabetic patients with varying preoperative hemoglobin A1c (HbA1c) levels.</div></div><div><h3>Design</h3><div>Retrospective, longitudinal cohort study; multicenter study using a global federated database of electronic health records.</div></div><div><h3>Subjects and Controls</h3><div>Adults (≥18 years) with type 1 or type 2 diabetes mellitus who underwent phacoemulsification cataract surgery. Control groups in analysis 1 were patients without diabetes who underwent cataract surgery. Control groups in analysis 2 were diabetic patients with similar HbA1c who had a routine eye examination without cataract surgery.</div></div><div><h3>Intervention</h3><div>Cataract surgery.</div></div><div><h3>Main Outcomes Measures</h3><div>The primary outcomes were 30-day incidence of: (1) POE, defined by ICD-10 codes; and (2) serious systemic adverse events, including mortality, stroke/transient ischemic attack, major cardiovascular events, and a composite outcome of these events. Hazard ratios (HRs) and 95% CIs were calculated using Cox proportional hazards models.</div></div><div><h3>Results</h3><div>In analysis 1, the risk of POE within 30 days post-cataract surgery did not differ significantly across HbA1c levels compared to non-diabetic controls. The HRs were 0.62 (95% CI, 0.30-1.27) for good HbA1c level (&lt;7%), 1.08 (95% CI, 0.44-2.66) for moderate (7%-8.4%), 1.36 (95% CI, 0.43-4.28) for poor (8.5%-11.3%), and 2.85 (95% CI, 0.29-27.44) for very poor HbA1c (&gt;11.3%). In analysis 2, the HRs for the 30-day composite outcome of any systemic events were not significantly different across HbA1c levels compared to controls. The 90-day analyses showed similar results for systemic events.</div></div><div><h3>Conclusions</h3><div>Cataract surgery does not appear to increase the risk of POE or serious systemic adverse events in diabetic patients across all HbA1c levels. These findings suggest that HbA1c alone should not be a reason to defer cataract surgery and highlight the need for individualized risk assessments to determine surgical fitness.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"277 ","pages":"Pages 17-25"},"PeriodicalIF":4.1,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914805","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}