American Journal of Ophthalmology最新文献

{"title":"Using Real-World Data to Assess the Association of Retinal Detachment With Topical Pilocarpine Use","authors":"ABDELRAHMAN M. ELHUSSEINY ,&nbsp;MUHAMMAD Z. CHAUHAN ,&nbsp;SAYENA JABBEHDARI ,&nbsp;NAYEF ALSHAMMARI ,&nbsp;SARAH JONG ,&nbsp;PAUL H. PHILLIPS ,&nbsp;AHMED B. SALLAM","doi":"10.1016/j.ajo.2024.10.035","DOIUrl":"10.1016/j.ajo.2024.10.035","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine the association between topical pilocarpine and the risk of new-onset rhegmatogenous retinal detachment (RRD).</div></div><div><h3>Design</h3><div>Retrospective clinical cohort study.</div></div><div><h3>Methods</h3><div>We used an aggregated electronic health records research network, TriNetX, to examine the risk of RRD (ICD-10: H33.0x) following the initiation of pilocarpine. The primary study group included adult patients over 40 years who received topical pilocarpine (1.25% or any dose with the exclusion of other indications) for the first time. Our control group consisted of patients with presbyopia who were started on artificial tears and had no history of topical pilocarpine use during the study period. We matched both cohorts using propensity score matching (PSM) based on demographics, systemic comorbidities, and known risk factors for RRD.</div></div><div><h3>Results</h3><div>After matching, the three-month risk of RRD was significantly higher in the pilocarpine group (0.53%) compared to the control (0.25%) (RR: 2.18, 95% CI: 1.07-4.45, <em>P</em> = .03). The 6-month risk of RRD remained elevated at 0.60% in the study group versus 0.31% in the control group (RR: 1.93, 95% CI: 1.01-3.67, <em>P</em> = .04). At one year, the risk increased to 0.78% in the pilocarpine group and 0.33% in the control group (RR: 2.33, 95% CI: 1.28-4.27, <em>P = .</em>005). A Cox proportional hazards model indicated that pilocarpine use was associated with a 3.14-fold increased risk of RRD (95% CI: 1.66-5.93, <em>P &lt; .</em>001) compared to controls after adjusting for demographics and comorbidities. Additional risk factors for RRD included male sex (aHR: 2.36, <em>P = .</em>001), myopia (aHR: 2.36, <em>P = .</em>001), vitreous degeneration (aHR: 2.22, <em>P = .</em>020), lattice degeneration (aHR: 3.71, <em>P = .</em>010), and pseudophakia (aHR: 3.48, <em>P &lt; .</em>001).</div></div><div><h3>Conclusions</h3><div>Our study quantified the increased risk of RRD associated with topical pilocarpine use.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"271 ","pages":"Pages 1-6"},"PeriodicalIF":4.1,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602557","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":"PRPH2-ASSOCIATED RETINAL DISEASES: A SYSTEMATIC REVIEW OF PHENOTYPIC FINDINGS","authors":"Shadi M. AlAshwal,&nbsp;Shaden H. Yassin,&nbsp;Fritz Gerald P. Kalaw,&nbsp;Shyamanga Borooah","doi":"10.1016/j.ajo.2024.10.025","DOIUrl":"10.1016/j.ajo.2024.10.025","url":null,"abstract":"<div><h3>Purpose</h3><div><em>PRPH2</em>-associated retinal diseases (PARD) result from pathogenic <em>PRPH2</em> variants, primarily affecting photoreceptor outer segments and retinal pigment epithelium. The focus of this article is to review and discuss the phenotyping of PARD subtypes.</div></div><div><h3>Design</h3><div>A systematic review.</div></div><div><h3>Methods</h3><div>The review followed PRISMA 2020 guidelines with searches on PubMed, Medline, Web of Science, Google Scholar, and Cochrane Library. Eligible studies were those which discussed molecularly confirmed PARD or described associated diseases such as butterfly pattern dystrophy. Inclusion: cross-sectional, cohort, case-control studies, book chapters. Exclusion: non-English, conference papers, non-peer-reviewed, or non-full text articles.</div></div><div><h3>Results</h3><div>PARD is responsible for 25% of pattern dystrophy and up to 5% of inherited retinal dystrophies. There is clear evidence of phenotypic variability between individuals carrying the same pathogenic variant. Fundus autofluorescence, fluorescein angiography, optical coherence tomography, while in research adaptive optics reveal detailed phenotypic characteristics, notably in retinal pigment epithelium changes and photoreceptor disruption. The phenotypic of PARD variability presents diagnostic challenges, with phenotypic features often overlapping with other retinal diseases including age-related macular degeneration, Stargardt disease, and retinitis pigmentosa.</div></div><div><h3>Conclusions</h3><div>This review emphasizes revising diagnostic criteria by incorporating more recent imaging techniques and confirming diagnosis with the use of genetic testing. Understanding phenotypic diversity and intrafamilial variability in PARD is crucial for developing new treatments and for patient prognosis and future research should focus on larger cohorts studying genotype-phenotype correlations.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"271 ","pages":"Pages 7-30"},"PeriodicalIF":4.1,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612095","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":"Initial Results of the Paul Ahmed Comparison (PAC) Study in Refractory Childhood Glaucoma","authors":"ABDELRAHMAN M. ELHUSSEINY ,&nbsp;OMAR M. KHALED ,&nbsp;MUHAMMAD Z. CHAUHAN ,&nbsp;MOHAMED S. SAYED ,&nbsp;TAREK SHAARAWY","doi":"10.1016/j.ajo.2024.10.024","DOIUrl":"10.1016/j.ajo.2024.10.024","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the effectiveness and safety of the Paul glaucoma implant (PGI) to the Ahmed glaucoma valve (AGV) in managing refractory childhood glaucoma.</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Setting</h3><div>Two clinical centers.</div></div><div><h3>Methods</h3><div>An ongoing randomized controlled trial including patients ≤ 18 years with refractory childhood glaucoma in whom glaucoma drainage implant surgery was planned. Patients were randomized to receive either PGI or AGV. The primary outcome was the intraocular pressure (IOP) reduction. Secondary outcomes included glaucoma medication reduction, success rate, and complications rate. The success rate was defined as achieving a postoperative IOP between 6-21 mmHg without or with glaucoma medications (up to three topical glaucoma medications), without the need for additional glaucoma surgeries, and without the occurrence of vision-threatening complications or evidence of disease progression. The use of oral glaucoma medications, such as acetazolamide, was considered a failure.</div></div><div><h3>Results</h3><div>The current report included 44 patients (44 eyes) who completed the one-year postoperative follow-up (25 in the PGI group versus 19 in the AGV group). The mean age at the time of surgery was 96.9 ± 59.1 months (90.5 ± 60.04 months in the PGI group and 105.4 ± 58.5 months in the AGV group). Preoperatively, the mean IOP was 32.6 ± 6.1 mmHg with a mean of 3.6 ± 0.6 glaucoma medications in the PGI group, compared with 29.8 ± 6.1 mmHg (<em>P</em> = .1) with a mean of 3.4 ± 0.7 glaucoma medications (<em>P</em> = .35) in the AGV group. At one year, there were no statistically significant differences in the mean IOP (14.9 ± 4.1 mmHg in the PGI group versus 15.5 ± 3.5 in the AGV group, <em>P</em> = .6) and number of glaucoma medications (1.1 ± 1 in the PGI group versus 1.6 ± 1.03 in the AGV group, <em>P</em> = .1). The success rate of PGI was 80% versus 73.6% in the AGV (<em>P</em> = .2). The postoperative complications rate was comparable in both groups (three eyes in each group).</div></div><div><h3>Conclusion/Relevance</h3><div>At one year postoperatively, the IOP reduction, reduction of glaucoma medications, success rates, and rate of complications were comparable between both groups.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"271 ","pages":"Pages 71-78"},"PeriodicalIF":4.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602555","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":"Postoperative Pain in Vitreoretinal Surgery With Combined Regional-General Anesthesia Versus General Anesthesia: A Systematic Review and Meta-Analysis","authors":"Yu-Chen Su ,&nbsp;Yu-Chi Su ,&nbsp;Sheng-Min Hsu","doi":"10.1016/j.ajo.2024.10.032","DOIUrl":"10.1016/j.ajo.2024.10.032","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate postoperative pain variations in vitreoretinal surgeries conducted with combined regional-general anesthesia or general anesthesia.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>A systematic search of the PubMed, Embase, and Cochrane Library databases was conducted to identify relevant randomized controlled trials published before December 26, 2023. Studies comparing vitreoretinal surgeries conducted under combined anesthesia to general anesthesia were included, while studies using only regional anesthesia were excluded. The quality of the studies was assessed using the Cochrane Collaboration risk of bias tool, and the results are presented as odds ratios or standardized mean differences (SMDs) with 95% confidence intervals (CIs). <em>I</em>² statistic was calculated to assess heterogeneity. The primary outcomes in our study included the proportions of patients needing as-needed postoperative analgesics, dosage of as-needed postoperative analgesia medications, and time to the first demand for as-needed postoperative analgesia. The secondary outcomes included postoperative pain scores at 0.5, 1, 2, 4, 6, 12, 24 hours (h), duration of surgery and anesthesia, and percentage of patients experiencing postoperative nausea and vomiting.</div></div><div><h3>Results</h3><div>A total of 19 randomized controlled trials involving 1314 patients were analyzed. Combined anesthesia was associated with lower proportions of patients needing as-needed postoperative analgesics (odds ratio, 0.218 95% CI, 0.114-0.418, <em>I</em>² = 55.2%), reduced dosage of as-needed postoperative analgesia medications (SMD, –1.429, 95% CI, –2.395 to –0.462, <em>I</em>² = 90.4%), and longer time to the first demand for as-needed postoperative analgesia compared with general anesthesia alone (SMD, 2.650, 95% CI, 1.169-4.132, <em>I</em>² = 96.5%). The effect of additional regional anesthesia lasted for 6 h (0.5 h SMD, –1.471, 95% CI, –2.498 to –0.444, <em>I</em>² = 90.5%; 1 h, –1.507, –2.309 to –0.705, 92.7%; 2 h –1.487, –2.300 to –0.674, 93.2%; 4 h –1.052, –1.708 to –0.396, 89.5%; 6 h –1.053, –1.932 to –0.174, 93.4%; 12 h –0.286, –0.648 to 0.076, 57.1%; 24 h –0.297, –0.624 to 0.029, 64.0%). Combined anesthesia decreased postoperative nausea and vomiting risk without affecting the surgical or anesthesia duration.</div></div><div><h3>Conclusions</h3><div>Combined anesthesia demonstrated additional postoperative analgesic effects versus general anesthesia only. Further research is needed to validate the results of our study and to identify vision-threatening complications.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"271 ","pages":"Pages 60-70"},"PeriodicalIF":4.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602556","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":"Spontaneous Rupture of Anterior Lenticonus in a Patient With Alport Syndrome.","authors":"John M Nesemann, Madi Sachs, Alejandra G de Alba Campomanes","doi":"10.1016/j.ajo.2024.10.022","DOIUrl":"10.1016/j.ajo.2024.10.022","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567235","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":"Pure Intraorbital Arteriovenous Fistula.","authors":"Clément Péchiné, Emilie Agard, Quentin Holay","doi":"10.1016/j.ajo.2024.10.020","DOIUrl":"10.1016/j.ajo.2024.10.020","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567233","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":"Response to: \"Comment on: Association between Glucagon-Like Peptide 1 Receptor Agonists Exposure and Intraocular Pressure Change\".","authors":"Shahin Hallaj, William Halfpenny, Benton G Chuter, Robert N Weinreb, Sally L Baxter, Qi N Cui","doi":"10.1016/j.ajo.2024.10.021","DOIUrl":"10.1016/j.ajo.2024.10.021","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563751","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: Association Between Glucagon-Like Peptide 1 Receptor Agonists Exposure and Intraocular Pressure Change.","authors":"Wei-Zhen Tang, Hao-Wen Chen, Tai-Hang Liu","doi":"10.1016/j.ajo.2024.09.038","DOIUrl":"10.1016/j.ajo.2024.09.038","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142556903","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":"Early Versus Delayed Vitrectomy for Vitreous Hemorrhage Secondary to Proliferative Diabetic Retinopathy","authors":"Rodrigo Anguita ,&nbsp;Lorenzo Ferro Desideri ,&nbsp;Philipp Schwember ,&nbsp;Neil Shah ,&nbsp;Syed Ahmed ,&nbsp;Antony Raharja ,&nbsp;Janice Roth ,&nbsp;Sobha Sivaprasad ,&nbsp;Louisa Wickham","doi":"10.1016/j.ajo.2024.10.019","DOIUrl":"10.1016/j.ajo.2024.10.019","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the clinical outcomes of early pars plana vitrectomy (PPV) versus delayed PPV in patients with first episode of vitreous hemorrhage (VH) secondary to proliferative diabetic retinopathy (PDR).</div></div><div><h3>Design</h3><div>Retrospective, comparative, interventional study.</div></div><div><h3>Subjects, Participants, and/or Controls</h3><div>Consecutive patients with type 1 or II diabetes diagnosed with new onset VH secondary to PDR who underwent PPV at Moorfields Eye Hospital between December 2014 and December 2016. Exclusions were prior vitrectomy, iris neovascularization, neovascular glaucoma, macular edema, or presence of tractional/rhegmatogenous retinal detachment.</div></div><div><h3>Methods, Intervention, or Testing</h3><div>Patients were divided into two groups based on the timing of their surgery: early PPV (≤6 weeks) and delayed PPV (&gt;6 weeks). Demographic and clinical features, including best-corrected visual acuity (BCVA), expressed in logMAR at baseline and 12 months were collected. Statistical analyses, including propensity score matching, were performed using Python 3.10, Scikit-learn, Pandas, and GraphPad Prism 10.</div></div><div><h3>Main Outcome Measures</h3><div>BCVA at 12 months postoperatively, reoperation rates, and severity of complications.</div></div><div><h3>Results</h3><div>A total of 178 eyes were analyzed (48 early PPV, 130 delayed PPV). The mean (SD) number of weeks before surgery was 3.36 (SD 1.6) for the early PPV group and 22.56 (SD 17.23) for the delayed PPV group (<em>P</em> &lt; .0001). Baseline BCVA prior to PPV was similar between groups (<em>P</em> = .08). At 12 months, the early PPV group had significantly better BCVA (0.40 logMAR vs 0.67 logMAR; <em>P</em> = .02). Patients without evidence of posterior vitreous detachment on ultrasound or OCT showed more pronounced differences (0.3 logMAR vs 0.7 logMAR; <em>P</em> = .001). The early PPV group had fewer sight-threatening complications (<em>P</em> = .005). Multivariable logistic regression identified initial BCVA, early PPV, and absence of preoperative panretinal photocoagulation as significant predictors of better visual outcomes.</div></div><div><h3>Conclusions</h3><div>Early PPV significantly improves visual outcomes and reduces severe complications in patients with VH secondary to PDR. These findings support the benefits of early surgical intervention to enhance long-term visual prognosis in these patients. However, a randomized clinical trial is warranted.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"270 ","pages":"Pages 237-244"},"PeriodicalIF":4.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543099","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":"Expanded Field OCT Angiography Biomarkers for Predicting Clinically Significant Outcomes in Non-Proliferative Diabetic Retinopathy","authors":"Xinyi Ding ,&nbsp;Francesco Romano ,&nbsp;Itika Garg ,&nbsp;Jenny Gan ,&nbsp;Filippos Vingopoulos ,&nbsp;Mauricio D. Garcia ,&nbsp;Katherine M. Overbey ,&nbsp;Ying Cui ,&nbsp;Ying Zhu ,&nbsp;Cade F. Bennett ,&nbsp;Isabella Stettler ,&nbsp;Mridula Shan ,&nbsp;Matthew J. Finn ,&nbsp;Demetrios G. Vavvas ,&nbsp;Deeba Husain ,&nbsp;Nimesh A. Patel ,&nbsp;Leo A. Kim ,&nbsp;John B. Miller","doi":"10.1016/j.ajo.2024.10.016","DOIUrl":"10.1016/j.ajo.2024.10.016","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the utility of extended field swept-source Optical Coherence Tomography Angiography (SS-OCTA) imaging biomarkers in predicting the occurrence of clinically significant outcomes in eyes with Non-Proliferative Diabetic Retinopathy (NPDR).</div></div><div><h3>Design</h3><div>Retrospective clinical case-control study.</div></div><div><h3>Methods</h3><div>Single-center clinical study. Eighty-eight eyes with NPDR from 57 participants (median age: 64.0 years; mean duration of diabetes: 15.8 years) with at least 2 consecutive SS-OCTA scans over a follow-up period of at least 6 months were included. The presence of intraretinal microvascular abnormalities (IRMAs) at baseline and the stability of IRMAs during follow-up period on 12 × 12-mm angiograms were evaluated. Baseline nonperfusion ischemia index (ISI) and other SS-OCTA metrics were calculated on FIJI and ARI Network. Significant clinical outcomes were defined as occurrence of one or more of the following events at the last available clinical visit:1. significant DR progression (2-step DR progression or progression to proliferative DR (PDR)); 2) development of new center-involving diabetic macular edema (CI-DME); and 3) initiation of treatment with PRP or anti-VEGF injections during the follow-up period. Mixed-effects Cox regression models was used to explore these outcomes.</div></div><div><h3>Results</h3><div>Following a clinical follow-up period lasting 25.1 ± 10.8 months, we observed significant clinical outcomes in 17 eyes (19.3%). Among these, 7 eyes (8.0%) experienced significant progression and 4 eyes (4.5%) developed CI-DME. Anti-VEGF injections were initiated in 15 eyes (17.0%), while PRP was initiated in 2 eyes (2.3%). Upon adjusting for age, the duration of DM, and prior Anti-VEGF treatments, our analysis revealed that non-stable IRMAs during the follow-up periods and a higher ischemia index at baseline were significantly associated with the occurrence of significant clinical outcomes with HRs of 3.88 (95% CI: 1.56-9.64; <em>p</em> = .004) and 1.05 (95% CI: 1.02-1.09; <em>p</em> = .004), respectively.</div></div><div><h3>Conclusions</h3><div>In conclusion, NPDR eyes with non-stable IRMAs over time and more ischemia at baseline are in higher risk of developing significant clinical outcomes. Our findings suggest that expanded field SS-OCTA may offer additional prognostic benefits for clinical DR staging and predicting high-risk patients.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"270 ","pages":"Pages 216-226"},"PeriodicalIF":4.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567208","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}