American Journal of Ophthalmology最新文献

{"title":"Reply to Comment on \"Pentosan Polysulfate Maculopathy: Final Outcomes From a 4-Year Prospective Study of Disease Progression After Drug Cessation\".","authors":"Brian P Hall, Sakshi Shiromani, Emily H Jung, Riley J Lyons, Judith Tribe, Nieraj Jain","doi":"10.1016/j.ajo.2025.03.015","DOIUrl":"10.1016/j.ajo.2025.03.015","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623176","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":"Dropped Lens Fragments Retrieval Using Endoscopy-Assisted Pars Plana Vitrectomy in Patients With Corneal Opacity","authors":"Amanda K. Hertel,&nbsp;Martin A. Mainster,&nbsp;Mary Champion,&nbsp;Radwan S. Ajlan","doi":"10.1016/j.ajo.2025.03.012","DOIUrl":"10.1016/j.ajo.2025.03.012","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To characterize the surgical outcomes of endoscopy-assisted pars plana vitrectomy (E-PPV) in dropped lens fragments retrieval in patients with corneal opacity.</div></div><div><h3>BACKGROUND</h3><div>Corneal opacity may delay dropped lens fragment retrieval because of limited fundus view. E-PPV permits posterior segment visualization through corneal opacity. There are limited data on E-PPV use for dropped lens fragments retrieval in the literature.</div></div><div><h3>DESIGN</h3><div>Retrospective cohort study.</div></div><div><h3>METHODS</h3><div>A retrospective chart review was performed of dropped lens fragments retrieval procedures done between 2013 and 2023 at a tertiary referral center. Data were collected on the surgical approach, visual acuity (VA), and intraocular pressure (IOP), as well as complication rates including retinal detachment (RD), cystoid macular edema (CME), and epiretinal membrane formation (ERM). Statistical analysis was performed using <em>t</em> tests and chi-square tests. Statistical significance was defined as a <em>P</em> value of .05.</div></div><div><h3>RESULTS</h3><div>There were 74 patients who met the inclusion criteria (31 patients had E-PPV, and 43 patients had standard pars plana vitrectomy [S-PPV]). Groups were balanced in age and gender. Postoperative CME rate was 25.8% after E-PPV and 25.58% after S-PPV (<em>P</em> = .95). Postoperative RD rate was 0% after E-PPV and 7% S-PPV (<em>P</em> = .13). After 1 year, there was no difference in postoperative VA, IOP, and rates of RD, CME, or ERM between groups. Interval time to dropped lens retrieval did not change the final outcome in either group.</div></div><div><h3>CONCLUSIONS</h3><div>This study showed that performing E-PPV to extract dropped lens fragments through corneal opacity had similar final outcomes compared with S-PPV, regardless of the interval time to surgery after the dropped lens fragments. Removing dropped lens fragments using E-PPV before cornea opacity clearance provided outcomes similar to those of delayed cases. Further studies are needed on the psychological benefit in patients undergoing dropped lens removal sooner than others.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"274 ","pages":"Pages 258-263"},"PeriodicalIF":4.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623175","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":"Can Sustained Suppression of VEGF be Achieved by Topical Ocular Delivery?","authors":"David Bingaman, Tejaswini Appidi, Jahnavi Pejavar, Laura M Ensign","doi":"10.1016/j.ajo.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.03.016","url":null,"abstract":"<p><strong>Purpose: </strong>Less invasive options for treating pathological blood vessel growth and leakage in the eye are an attractive option pursued by many in the commercial and academic spaces alike. However, achieving safe and effective therapeutic delivery to the posterior segment with a topical eye drop has proven very challenging. In this review, we describe past and ongoing clinical efforts to develop topical ocular therapies for the clinical management of vascular endothelial growth factor (VEGF)-dependent retinal vascular diseases. We further describe recent preclinical efforts toward the development of the next generation drug delivery strategies for biologic, tyrosine kinase inhibitor (TKI), and additional small molecule therapies to treat retinal vascular diseases. The collective knowledge gained to date can pave potential paths forward for successful regulatory approval bringing additional benefit to patients with unmet needs. Further, many of the learnings reviewed may be applicable to classes of organic molecules outside of anti-VEGF compounds for other indications.</p><p><strong>Conclusions: </strong>Future development of topical ocular therapies to treat retinal vascular diseases must consider several key principles that have been highlighted by efforts to date. Both the properties of the small molecule and the drug product formulation are important to enhance delivery to the posterior segment while minimizing ocular surface side effects and systemic exposure. The selection of preclinical animal models and the interpretation of observations in preclinical animal models must be done with care. Clinical trial design is of paramount importance to maximize the opportunity to demonstrate safety and efficacy. Lastly, to truly maximize patient benefit with self-administered topical therapies, remote monitoring of disease must be validated and implemented. We anticipate that a marketed topical ocular therapy for the clinical management of VEGF-dependent retinal vascular diseases is on the horizon.</p><p><strong>Table of contents statement: </strong>While a potentially attractive option for patients, achieving safe and effective therapeutic delivery to the posterior segment with a topical eye drop has proven very challenging. Herein, clinical and preclinical efforts toward the development of topical formulations for achieving sustained suppression of vascular endothelial growth factor (VEGF) for the management of VEGF- dependent retinal vascular diseases are discussed.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623174","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":"Socioeconomic Status Mediates and Modifies Racial and Ethnic Disparities in Incisional Glaucoma Surgical Outcomes","authors":"Ken Kitayama ,&nbsp;Yusuke Tsugawa ,&nbsp;Akihiro Nishi ,&nbsp;Anne L. Coleman","doi":"10.1016/j.ajo.2025.03.006","DOIUrl":"10.1016/j.ajo.2025.03.006","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To estimate the proportion of racial and ethnic disparities observed in glaucoma surgical outcomes that can be eliminated by curbing differences in socioeconomic status (SES).</div></div><div><h3>DESIGN</h3><div>Retrospective cohort study.</div></div><div><h3>SUBJECTS</h3><div>The entire population of 2016-2018 California (CA) fee-for-service Medicare beneficiaries with a claim for incisional glaucoma surgery (trabeculectomy, tube shunt, or EX-PRESS shunt).</div></div><div><h3>METHODS</h3><div>The primary exposure was race and ethnicity, stratified into: Non-Latinx White (as the reference category), Black, Latinx, Asian/Pacific Islander (PI), and Other. The SES mediator was dichotomized to low vs. nonlow based on dual-eligibility for Medicaid. Outcome (time to failure event) was defined as having a claim for a glaucoma surgery revision or reoperation event.</div></div><div><h3>MAIN OUTCOME MEASURES</h3><div>The total effect (TE) estimated the entire racial and ethnic disparity. The controlled direct effect (CDE) estimated the remaining disparity after fixing SES to nonlow for all, and the proportion eliminated (PE) estimated the proportion of the disparity eliminated after uniform SES assignment. The TE and CDE estimates are interpreted as hazards ratios given time-to-event modeling using Cox proportional hazards.</div></div><div><h3>RESULTS</h3><div>The final analytical sample included a total of 5985 unique CA beneficiaries. After uniformly fixing SES to nonlow, the racial and ethnic disparity for Black patients dissipated most (TE: 1.18, 95% CI: 0.99-1.41; CDE: 1.01, 95% CI: 0.80-1.77), followed by Latinx patients (TE: 1.23, 95% CI: 1.08-1.51; CDE: 1.10, 95% CI: 0.90-1.35), Other race and ethnicity patients (TE: 1.32, 95% CI: 1.03-1.70; CDE: 1.24, 95% CI: 0.91-1.68), and Asian/PI patients (TE: 1.18, 95% CI: 1.02-1.36; CDE: 1.21, 95% CI: 0.99-1.47). The PE estimates suggest that equalizing SES would eliminate varying levels of disparities, with a maximum of 96% for Black patients (PE: 0.96, 95% CI: −0.27 to 2.19), followed by 54% for Latinx patients (PE: 0.54, 95% CI: −0.25 to 1.33), and no significant change for Other race and ethnicity (PE: 0.24, 95% CI: −0.49 to 0.97), and Asian/PI patients (PE: −0.18, 95% CI: −1.11 to 0.75).</div></div><div><h3>CONCLUSIONS</h3><div>We found that SES mediates racial and ethnic disparities in glaucoma surgical outcomes, though by varying amounts by individual racial and ethnic group. Of note, addressing SES differences would eliminate 96% of the disparity for Black beneficiaries.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"274 ","pages":"Pages 249-257"},"PeriodicalIF":4.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612941","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":"Genetic Distinctions Between Reticular Pseudodrusen and Drusen: A Genome-Wide Association Study","authors":"Roy Schwartz ,&nbsp;Alasdair N. Warwick ,&nbsp;Anthony P. Khawaja ,&nbsp;Robert Luben ,&nbsp;Hagar Khalid ,&nbsp;Sumita Phatak ,&nbsp;Mahima Jhingan ,&nbsp;Coen de Vente ,&nbsp;Philippe Valmaggia ,&nbsp;Sandra Liakopoulos ,&nbsp;Abraham Olvera-Barrios ,&nbsp;Clara I. Sánchez ,&nbsp;Catherine Egan ,&nbsp;Roberto Bonelli ,&nbsp;Adnan Tufail","doi":"10.1016/j.ajo.2025.03.007","DOIUrl":"10.1016/j.ajo.2025.03.007","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To identify genetic determinants specific to reticular pseudodrusen (RPD) compared with drusen.</div></div><div><h3>DESIGN</h3><div>Genome-wide association study (GWAS)</div></div><div><h3>SUBJECTS</h3><div>Participants with RPD, drusen, and controls from the UK Biobank (UKBB), a large, multisite, community-based cohort.</div></div><div><h3>METHODS</h3><div>Participants with RPD, drusen, and controls from the UK Biobank (UKBB), a large, multisite, community-based cohort, were included. A deep learning framework analyzed 169,370 optical coherence tomography (OCT) volumes to identify cases and controls within the UKBB. Five retina specialists validated the cohorts using OCT and color fundus photographs. Several GWAS were undertaken utilizing the quantity and presence of RPD and drusen. Genome-wide significance was defined as <em>P</em> &lt; 5e-8.</div></div><div><h3>MAIN OUTCOMES MEASURES</h3><div>Genetic associations were examined with the number of RPD and drusen within ‘pure’ cases, where only RPD or drusen were present in either eye. A candidate approach assessed 46 previously known AMD loci. Secondary GWAS were conducted for number of RPD and drusen in mixed cases, and binary case-control analyses for pure RPD and pure drusen.</div></div><div><h3>RESULTS</h3><div>The study included 1787 participants: 1037 controls, 361 pure drusen, 66 pure RPD, and 323 mixed cases. The primary pure RPD GWAS identified four genome-wide significant loci: rs11200630 near <em>ARMS2</em>-<em>HTRA1</em> (<em>P</em> = 1.9e-09), rs79641866 at <em>PARD3B</em> (<em>P</em> = 1.3e-08), rs143184903 near <em>ITPR1</em> (<em>P</em> = 8.1e-09), and rs76377757 near <em>SLN</em> (<em>P</em> = 4.3e-08). The latter three are uncommon variants (minor allele frequency &lt;5%). A significant association at the <em>CFH</em> locus was also observed using a candidate approach (<em>P</em> = 1.8e-04). For pure drusen, two loci reached genome-wide significance: rs10801555 at <em>CFH</em> (<em>P</em> = 6.0e-33) and rs61871744 at <em>ARMS2</em>-<em>HTRA1</em> (<em>P</em> = 4.2e-20).</div></div><div><h3>CONCLUSIONS</h3><div>The study highlights a clear association between the <em>ARMS2-HTRA1</em> locus and higher RPD load. Although the <em>CFH</em> locus association did not achieve genome-wide significance, a suggestive link was observed. Three novel associations unique to RPD were identified, albeit for uncommon genetic variants. Further studies with larger sample sizes are needed to explore these findings.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"274 ","pages":"Pages 286-295"},"PeriodicalIF":4.1,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596102","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":"Trends in the Incidence of Retinal Artery and Vein Occlusion Before and After COVID-19: A National Study in South Korea (2017-2022)","authors":"JIN CHO ,&nbsp;NANG KYEONG LEE ,&nbsp;JIN YEONG KIM ,&nbsp;CHRISTOPHER SEUNGKYU LEE ,&nbsp;SUK HO BYEON ,&nbsp;SUNG SOO KIM ,&nbsp;SEUNG WON LEE ,&nbsp;YONG JOON KIM","doi":"10.1016/j.ajo.2025.03.005","DOIUrl":"10.1016/j.ajo.2025.03.005","url":null,"abstract":"<div><h3>Purpose</h3><div>This study investigated the incidence of new retinal artery occlusion (RAO) and retinal vein occlusion (RVO) during the coronavirus disease-19 (COVID-19) pandemic compared to pre-outbreak periods in South Korea.</div></div><div><h3>Design</h3><div>Nationwide population-based retrospective cohort study.</div></div><div><h3>Participants</h3><div>Individuals diagnosed with RAO or RVO.</div></div><div><h3>Methods</h3><div>We evaluated data from 326 154 patients diagnosed with RAO (<em>n</em> = 32 028), RVO (<em>n</em> = 304 405), or both (<em>n</em> = 10 279) from January 1, 2017 to December 31, 2022. We calculated the incidence rate ratios (IRR) of RAO and RVO using 2019 as the reference year, making comparisons across the total population and within age and sex subgroups. We examined correlations between the number of new RVO patients and COVID-19 infected or vaccinated persons. Additionally, we compared the systemic characteristics of individuals with RAO and RVO, adjusting for multiple comparisons with Bonferroni correction.</div></div><div><h3>Main Outcome Measures</h3><div>Annual IRRs of RAO and RVO.</div></div><div><h3>Results</h3><div>The IRR for RAO showed no significant increase across all age and sex subgroups. Contrastingly, RVO exhibited a consistent IRR in 2020; however, significant increases were observed in 2021 and 2022 among those aged 20-39 years (adjusted IRR in 2021, 1.22, 95% CI, 1.15-1.29; adjusted IRR in 2022, 1.12, 95% CI, 1.06-1.18) as well as those aged 40-64 years (adjusted IRR in 2021, 1.11; 95% CI, 1.09-1.13; adjusted IRR in 2022, 1.11, 95% CI, 1.08-1.12). No correlations were found between the monthly number of patients with RVO and the number of individuals infected with or vaccinated against COVID-19. Additionally, a higher proportion of patients with RVO having hypertension, diabetes, dyslipidemia, and chronic liver disease were seen in 2021 and 2022, as analyzed by ANOVA with Bonferroni correction.</div></div><div><h3>Conclusions</h3><div>The incidence of RAO did not increase during the COVID-19 outbreak. However, the incidence of RVO increased during the pandemic, especially in 2021 and 2022, with the highest rates observed in the 40-64 years age group, likely linked to increases in metabolic diseases rather than COVID-19 infection and vaccination. Further research is warranted to confirm these findings.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"274 ","pages":"Pages 101-111"},"PeriodicalIF":4.1,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584374","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 Visceral Fat Metabolism Score and Cataract Risk in US Adults: National Health and Nutrition Examination Survey 1999 to 2008","authors":"Wen Guo ,&nbsp;Hongfei Xue ,&nbsp;Qing Li ,&nbsp;Zimu Wen ,&nbsp;Zhihuan Zhou ,&nbsp;Yujun Dong ,&nbsp;Meiqin He ,&nbsp;Yankai Li ,&nbsp;Fangfei Li ,&nbsp;Yi Tong","doi":"10.1016/j.ajo.2025.03.010","DOIUrl":"10.1016/j.ajo.2025.03.010","url":null,"abstract":"<div><h3>PURPOSE</h3><div>The present work focused on investigating the relation of visceral fat metabolic score (METS-VF) with cataract prevalence among the American adults.</div></div><div><h3>DESIGN</h3><div>A cross-sectional study.</div></div><div><h3>METHODS</h3><div>This cross-sectional study, based on the U.S. population, used data from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2008. For assessing the association of METS-VF with cataract, we employed multivariable logistic regression analysis, subgroup analyses, and restricted cubic splines (RCS) analysis for exploring their relation. Additionally, receiver operating characteristic (ROC) curve analysis was conducted to compare the cataract diagnostic abilities of METS-VF, body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR).</div></div><div><h3>RESULTS</h3><div>There were altogether 2,730 participants included, of whom 290 had cataract.METS-VF was significantly related to cataract (<em>P</em> &lt; .001). As METS-VF quartiles increased, cataract prevalence also increased (Q1: 1.90%, Q2: 6.74%, Q3: 10.25%, Q4: 23.61%). After adjusting for all variables, METS-VF still showed positive relation to cataract prevalence (odds ratio (OR) = 3.14, 95% confidence interval (CI): 1.67, 5.93). Subgroup analysis revealed a consistent relationship between METS-VF and cataracts across different groups. The RCS results showed that there was no significant nonlinear relationship between METS-VF and cataracts (<em>P−non−linear</em> = 0.209). ROC curve analysis showed that METS-VF outperformed BMI, WC, and WHtR in cataract prediction.</div></div><div><h3>CONCLUSION</h3><div>METS-VF is significantly positively related to a higher cataract prevalence, and this relationship remains robust across various subgroups. Additionally, METS-VF demonstrates a stronger predictive ability for cataract than BMI, WC, and WHtR.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"274 ","pages":"Pages 184-195"},"PeriodicalIF":4.1,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584337","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":"Evaluating Practical Approaches for Including MYOC Variants Alongside Common Variants for Genetics-Based Risk Stratification for Glaucoma","authors":"Ngoc-Quynh Le ,&nbsp;Weixiong He ,&nbsp;Matthew H. Law ,&nbsp;Sarah E. Medland ,&nbsp;David A. Mackey ,&nbsp;Alex W. Hewitt ,&nbsp;Puya Gharahkhani ,&nbsp;Stuart MacGregor","doi":"10.1016/j.ajo.2025.03.011","DOIUrl":"10.1016/j.ajo.2025.03.011","url":null,"abstract":"<div><h3>Objective</h3><div>Rare variants in the <em>MYOC</em> gene are associated with glaucoma risk, with p.Gln368Ter the most common pathogenic variant in Europeans. Genetics-based risk stratification may aid with early diagnosis for glaucoma but it is unclear how best to combine the p.Gln368Ter status with polygenic risk scores (PRS). Our study aimed to examine approaches for identifying p. Gln368Ter carriers using genotyping array data and the utility of integrating p.Gln368Ter status into glaucoma PRS.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>We identified p.Gln368Ter carriers using directly genotyped and imputed data. Results were confirmed in a subset with sequencing data. We evaluated the combined effects of p.Gln368Ter status and PRS in stratified analyses by considering them as two separate factors and as an aggregate score.</div></div><div><h3>Participants</h3><div>A total of 58,452 participants from the Genetics of Glaucoma, the QSkin Sun and Health Study (QSKIN), and CARTaGENE projects, including 6015 with sequencing data.</div></div><div><h3>Main Outcomes and Measures</h3><div>The concordance of direct genotyping, compared with imputation and sequencing for p.Gln368Ter identification.</div></div><div><h3>Results</h3><div>Without appropriate quality control, substantial mis-calling may occur. Nevertheless, the p.Gln368Ter variant could be accurately genotyped in most cases by filtering individuals for call rate and heterozygosity. In 6015 individuals with sequencing data, direct genotyping exhibited perfect concordance with sequencing results. Filtered direct genotyping results showed high agreement with imputed results, with only 16 discrepancies among 57,468 individuals. When quality control is not possible (eg, heterozygosity filtering for an individual), we recommend comparing genotyped and imputed results to ensure accuracy. Incorporating p.Gln368Ter into PRS had additional effects on stratifying high–risk individuals, but did not improve risk prediction for the general population given the variant's rarity. The <em>MYOC</em>-enhanced PRS increased the proportion of p.Gln368Ter carriers classified as high risk from 32.31% to 75.38% in QSKIN and from 38.24% to 79.41% in CARTaGENE.</div></div><div><h3>Conclusions</h3><div>The p.Gln368Ter variant can be genotyped with high accuracy using array data, provided careful quality control measures are implemented. Incorporating p.Gln368Ter into glaucoma PRS improved risk stratification for carriers.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"274 ","pages":"Pages 232-240"},"PeriodicalIF":4.1,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596100","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":"Illness Uncertainty, Burden, and Capacity Among Caregivers of Children With Chronic Uveitis: A Stress and Coping Theory Perspective","authors":"Jiali Huang ,&nbsp;Ruru Liu ,&nbsp;Xi Huang ,&nbsp;Jingyao Dai ,&nbsp;Yijie Chen ,&nbsp;Xiaoxian Zhang ,&nbsp;Yuqin Wang ,&nbsp;Yanyan Chen","doi":"10.1016/j.ajo.2025.03.008","DOIUrl":"10.1016/j.ajo.2025.03.008","url":null,"abstract":"<div><h3>PURPOSE</h3><div>The aim was to determine the relationships among illness uncertainty and caregiver burden and capacity in caregivers of children with chronic uveitis and to determine whether caregiver burden plays a mediating role in the relationship between illness uncertainty and caregiver capacity.</div></div><div><h3>DESIGN</h3><div>This was a cross-sectional study.</div></div><div><h3>METHODS</h3><div>The sample included 134 caregivers of children with chronic uveitis. All paper questionnaires were collected at a tertiary-level eye hospital in Wenzhou Province, China. Demographic and clinical characteristics and the Parents’ Perception of Uncertainty Scale (PPUS), Zarit Burden Interview (ZBI) and Family Caregiver Task Inventory (FCTI) scores were determined. IBM SPSS 26.0, AMOS 26.0 and GraphPad Prism 9.0.0 were used for figure preparation and statistical analyses.</div></div><div><h3>RESULTS</h3><div>Both the PPUS score (<em>r</em> = 0.725, <em>P</em> &lt; .001) and ZBI score (<em>r</em> = 0.756, <em>P</em> &lt; .001) were positively correlated with the FCTI score, indicating that higher levels of illness uncertainty and caregiver burden was significantly correlated with lower caregiver capacity. Illness uncertainty and caregiver burden (both <em>P</em> &lt; .001) were found to be influencing factors of caregiver capacity. Furthermore, the effect of illness uncertainty on caregiver capacity was partly mediated by caregiver burden. The indirect effect was 0.366 (<em>P</em> = .012; 95% CI: 0.102, 0.879), accounting for 40.13% of the total effect.</div></div><div><h3>CONCLUSIONS</h3><div>Our findings revealed that both illness uncertainty and caregiver burden may reduce caregiver capacity among caregivers of children with chronic uveitis. Caregiver burden mediated the relationship between illness uncertainty and caregiver capacity in this population. Therefore, this study alerts health care providers to pay attention to illness uncertainty and caregiver burden, as these factors can help in developing effective interventions to improve caregiver capacity in clinical practice.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"274 ","pages":"Pages 221-231"},"PeriodicalIF":4.1,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584369","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":"Associations Between Ambient Air Pollution and Five Common Vision-Threatening Ocular Diseases in Middle-Aged and Older Adults: A Large Prospective Cohort Study","authors":"Zhanying Wang ,&nbsp;Yanze Yu ,&nbsp;Yuhao Ye ,&nbsp;Liyin Wang ,&nbsp;Yongle Bao ,&nbsp;Xiaoying Wang ,&nbsp;Xingtao Zhou ,&nbsp;Jing Zhao","doi":"10.1016/j.ajo.2025.03.009","DOIUrl":"10.1016/j.ajo.2025.03.009","url":null,"abstract":"<div><h3>Purpose</h3><div>Ambient air pollution may exacerbate ocular conditions; however, comprehensive research on the effects of various pollutants remains limited. This study aims to evaluate the association between multiple air pollutants and the incidence of five common vision-threatening ocular diseases: cataracts, glaucoma, macular degeneration, diabetic retinopathy, and retinal detachment.</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Methods</h3><div>We included 114,930 participants with refractometry at baseline in this prospective cohort study based on data from the UK Biobank. Annual average concentrations of nitrogen oxides (NO<em>_x</em>), nitrogen dioxide (NO₂), and particulate matter (PM) with diameters &lt;2.5 µm (PM_2.5) and &lt;10 µm (PM₁₀) were assessed using land use regression models. Restricted cubic spline models and Cox proportional hazards regression were used to estimate the association between air pollution exposure and ocular disease incidence, with stratified analyses based on myopia status.</div></div><div><h3>Results</h3><div>An interquartile range increase in PM₁₀ and NO<em>_x</em> was significantly associated with a higher risk of diabetic retinopathy among participants with myopia, with hazard ratios of 1.11 (95% confidence interval: 1.01-1.23) and 1.22 (95% confidence interval: 1.02-1.45), respectively. PM₁₀ was linked to a 9% increase in retinal detachment incidence in the myopic population, and PM_2.5 was linked to an 8% increase in glaucoma incidence in the nonmyopic population. High PM₁₀ exposure was associated with a 61% higher risk of diabetic retinopathy in the myopic group. Further stratified analysis revealed that the impact of PM₁₀ on diabetic retinopathy was more pronounced in individuals with low-to-moderate myopia than in those with high myopia. High PM₁₀ exposure also correlated with a 67% higher risk of retinal detachment and a 44% higher risk of macular degeneration in the low-to-moderate myopic population.</div></div><div><h3>Conclusions</h3><div>Exposure to high levels of PM₁₀ was associated with an increased risk of diabetic retinopathy and retinal detachment, highlighting the importance of addressing air pollutants as an intervention for vision-threatening ocular diseases.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"274 ","pages":"Pages 276-285"},"PeriodicalIF":4.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584338","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}