American Journal of Ophthalmology最新文献

{"title":"Importance of Screening for Contrast Sensitivity, Falls, and Mobility Limitations in Older Adults With Maculopathy","authors":"CATHERINE P. AGATHOS,&nbsp;NATELA M. SHANIDZE,&nbsp;DONALD C. FLETCHER","doi":"10.1016/j.ajo.2025.08.051","DOIUrl":"10.1016/j.ajo.2025.08.051","url":null,"abstract":"<div><h3>Objective</h3><div>Assess the potential value of adding questions on falls/balance difficulties due to vision loss and testing contrast sensitivity (CS) in patients with maculopathy (mainly age-related macular degeneration, AMD) to help guide referral for mobility rehabilitation.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Participants</h3><div>A total of 125 patients over 55 years old with binocular maculopathy and intact peripheral vision presenting for a low vision rehabilitation consultation.</div></div><div><h3>Methods</h3><div>Patients were asked questions regarding difficulties with their balance and mobility, including the 9-item Glaucoma Activity Limitation questionnaire (GAL-9). For analysis, patients were grouped by visual impairment severity using better-eye visual acuity (VA) and binocular CS.</div></div><div><h3>Main Outcome Measures</h3><div>Visual function, self-reported balance and mobility difficulties, falls history, and rehabilitation referrals were examined across visual impairment severity groups.</div></div><div><h3>Results</h3><div>Total 52% of patients reported balance or gait difficulties and 36% attributed mobility limitations to vision loss. Increasing vision deficit severity related to greater mobility concerns (&gt;50% of patients in the severe categories rated difficulty as 3/5 or higher) and higher referral rates. Scores on the GAL-9 increased with greater vision loss and were predicted by CS, female sex, larger relative scotomata and falls history (R² = 0.45, <em>P</em> &lt; .0001). CS was a better predictor of mobility difficulties than VA. Based on reported concerns, 31.2% of patients were referred to orientation and mobility training and/or physical therapy (&gt;50% in the severe groups).</div></div><div><h3>Conclusions</h3><div>Mobility limitations and falls affect a substantial proportion of AMD patients yet may go undiscussed in eye clinics. Incorporating screening questions and explicit discussion of mobility difficulties in clinical practice in maculopathy can help elucidate patient mobility limitations. Realization of these limitations is the prerequisite to initiate appropriate referrals to low vision and mobility specialists to improve mobility and manage falls risk. Clinical practice may also benefit from assessment of CS as this is a better indicator of difficulties in daily living. Our results, along with prior literature, underscore the need to recognize the role of central vision loss, and vision loss more broadly, in mobility decline. Thus, a central vision loss-specific mobility questionnaire may be needed to facilitate patient screening in the future.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"280 ","pages":"Pages 481-492"},"PeriodicalIF":4.2,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Scoping Review of Ergonomics in Ophthalmology: Working Smarter.","authors":"Jim Shenchu Xie, Hargun Kaur, Adrien Lusterio, Haoran Charles Li, Taranah Adli, Omar Taboun, Amy Basilious, Allison Angold-Stephens, Samuel Masket, Rookaya Mather","doi":"10.1016/j.ajo.2025.08.053","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.08.053","url":null,"abstract":"<p><strong>Topic: </strong>Work-related musculoskeletal disorders (WMSDs) are prevalent among ophthalmologists due to maladaptive working postures. This review summarizes published ergonomic optimization strategies to mitigate WMSD risk in ophthalmology.</p><p><strong>Clinical relevance: </strong>WMSDs can lead to career-interrupting or career-ending disabilities in ophthalmologists. There is a need for summative research on ophthalmology-specific strategies to reduce WMSD risk such as: utilizing ergonomically designed microscopes, workflows and workspaces, adopting ergonomic best practices, and engaging in injury prevention training. This scoping review aims to consolidate all ophthalmology-specific WMSD prevention strategies published in the literature to provide a practical resource for ophthalmologists and foundation for future research.</p><p><strong>Methods: </strong>A systematic search was conducted in Medline (Ovid), Embase (Ovid), CENTRAL, Scopus, CINAHL, and Web of Science from inception to June 2023. Primary and secondary research articles, as well as conference abstracts, were included if they assessed at least one ergonomics-related outcome in ophthalmology. Reference lists of included studies were hand-searched for additional relevant literature.</p><p><strong>Results: </strong>Of 3,596 retrieved articles, 33 epidemiologic studies, 36 interventional studies, and 25 secondary research articles met inclusion criteria. Factors associated with reduced WMSD risk included system and individual factors such as ergonomic equipment design and workspace ergonomics, optimizing personal working postures, and individual physical endurance.</p><p><strong>Conclusions: </strong>WMSDs in ophthalmologists are primarily linked to forward head posture at the slit lamp and operating microscope. Published injury prevention strategies include: the use of ergonomically designed digital operating microscopes that do not require forward head posture, injury prevention education for ophthalmologists, maintenance of individual physical fitness and the adoption of ergonomic recommendations suggested by many authors. Gaps in the literature include: evidence on the efficacy of these strategies, formal ergonomic best practice guidelines and subspecialty-specific ergonomic recommendations. Based on the literature reviewed, the authors propose an evidence-informed framework for improving ergonomics and reducing WMSDs for ophthalmologists, trainees, and institutions.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938929","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":"Visual and Patient-Reported Outcomes of a Novel Full Visual Range Intraocular Lens Versus a Monofocal Intraocular Lens: A Randomized Multicenter US Trial","authors":"MITCHELL C. SHULTZ ,&nbsp;WILLIAM F. WILEY ,&nbsp;EVA LIANG ,&nbsp;ALICE T. EPITROPOULOS ,&nbsp;JEFFREY WHITMAN","doi":"10.1016/j.ajo.2025.08.050","DOIUrl":"10.1016/j.ajo.2025.08.050","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the visual, refractive, and patient-reported outcomes following bilateral implantation of a novel full visual range (FVR) intraocular lens (IOL) and a monofocal IOL in subjects undergoing cataract surgery.</div></div><div><h3>Design</h3><div>Prospective, masked, multicenter, controlled pivotal trial.</div></div><div><h3>Methods</h3><div>Subjects scheduled to undergo cataract surgery were randomized to bilateral implantation of a novel FVR IOL (enVista Envy MX60EF, Bausch + Lomb; N = 332) or enVista monofocal IOL (MX60E; N = 169). Primary effectiveness endpoints were monocular corrected distance visual acuity (CDVA, 4 m), distance-corrected intermediate (DCIVA, 66 cm), and near (DCNVA, 40 cm) visual acuity, and secondary effectiveness endpoints were binocular DCIVA, DCNVA, uncorrected intermediate (UIVA), and near visual acuity (UNVA), at postoperative days 120 to 180.</div></div><div><h3>Results</h3><div>The noninferiority of the FVR IOL group for monocular CDVA and statistical superiority for monocular DCIVA and DCNVA over the monofocal group were established. Binocular UIVA, DCIVA, UNVA, and DCNVA were also better in the FVR group compared to the monofocal group (all <em>P</em> &lt; .0001). Mean postoperative MRSE was −0.14 ± 0.39 D (FVR) and −0.14 ± 0.40 D (monofocal group). The FVR group showed consistent visual acuity of ∼0.1 logMAR from −1.50 to −2.50 D. The difference in mesopic contrast sensitivity (without glare) between the 2 groups at 1.5, 3, and 12 cpds was less than the minimum detectable difference of 0.15 logCS.</div></div><div><h3>Conclusions</h3><div>Compared to the monofocal group, the FVR IOL group exhibited superior monocular DCNVA and DCIVA, with comparable CDVA. Binocular visual acuity was 0.09 logMAR or better (∼20/25) from distance to near (−0.5 D to −2.5 D).</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"280 ","pages":"Pages 493-507"},"PeriodicalIF":4.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939047","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":"Corrigendum to Evidence and Consensus-Based Imaging Guidelines in Multifocal Choroiditis With Panuveitis and Punctate Inner Choroiditis-Multimodal Imaging in Uveitis (MUV) Taskforce Report 5. Am J Ophthalmol. 2025;276:272-285.","authors":"Sapna Gangaputra, Aniruddha Agarwal, Jeannette Ossewaarde-Van Norel, Edmund Tsui, Jennifer E Thorne, Alejandra de-la-Torre, Michael Altaweel, Jyotirmay Biswas, Srinivas Sadda, Alessandro Invernizzi, Rupesh Agrawal, Jessica G Shantha, Massimo Accorinti, Amani Fawzi, Douglas A Jabs, David Sarraf, Vishali Gupta","doi":"10.1016/j.ajo.2025.08.027","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.08.027","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938927","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":"Antidepressant Use and Incidence and Progression of Age-Related Macular Degeneration in a National United States Database","authors":"RAZIYEH MAHMOUDZADEH ,&nbsp;MICHELLE ZAICHIK ,&nbsp;KEAN FARHANI ,&nbsp;MIRATAOLLAH SALABATI ,&nbsp;JESSICA RANDOLPH","doi":"10.1016/j.ajo.2025.08.052","DOIUrl":"10.1016/j.ajo.2025.08.052","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the association between antidepressant use and the risk of developing nonexudative and exudative age-related macular degeneration (AMD), as well as the progression from nonexudative to exudative AMD, in patients using selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), or tricyclic antidepressants (TCAs).</div></div><div><h3>Design</h3><div>Retrospective clinical cohort study.</div></div><div><h3>Subjects</h3><div>Patients aged ≥40 years identified from the TriNetX database (October 2004-October 2023). Individuals were grouped based on exclusive use of SSRIs, SNRIs, or TCAs and compared to a control group without antidepressant use. Patients using multiple antidepressant classes were excluded.</div></div><div><h3>Methods</h3><div>Propensity score matching (PSM) was applied to adjust for 17 confounders, including age, sex, smoking status, hypertension, and cardiovascular disease. The primary outcomes were the incidence of nonexudative AMD, exudative AMD, and progression from nonexudative to exudative AMD.</div></div><div><h3>Main Outcome Measures</h3><div>Risk ratios (RRs) comparing the incidence of nonexudative AMD, exudative AMD, and AMD progression in each antidepressant group versus matched controls.</div></div><div><h3>Results</h3><div>After PSM, the analysis included 633 535 SSRI users, 826 404 SNRI users, and 501 873 TCA users. Compared to controls, antidepressant use was associated with a significantly reduced risk of nonexudative AMD (RR 0.606 for SSRIs; 0.141 for SNRIs; 0.234 for TCAs), exudative AMD (RR 0.733 for SSRIs; 0.161 for SNRIs; 0.267 for TCAs), and progression to exudative AMD (RR 0.701 for SSRIs; 0.665 for SNRIs; 0.676 for TCAs).</div></div><div><h3>Conclusions</h3><div>Use of SSRIs, SNRIs, or TCAs was associated with a lower risk of AMD onset and progression. Potential mechanisms include reduced inflammation, decreased oxidative stress, and neuroprotection via upregulation of brain-derived neurotrophic factors and suppression of proinflammatory cytokines. These findings are exploratory and hypothesis-generating, and further prospective and mechanistic studies are needed to better understand the relationship between antidepressant use and AMD pathophysiology.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"280 ","pages":"Pages 458-471"},"PeriodicalIF":4.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938921","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":"Corrigendum to Silk-Derived Protein-4 Versus Vehicle Control in Treating Patients With Moderate to Severe Dry Eye Disease: A Randomized Clinical Trial. Am J Ophthalmol. 2025;269:315-326.","authors":"Brian D Lawrence, Paul M Karpecki, David W Infanger, Brian Levy","doi":"10.1016/j.ajo.2025.08.026","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.08.026","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938936","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":"Surgical Dosing for Correction of Consecutive Exotropia","authors":"Qingyu Meng ,&nbsp;Emanuil Parunakian ,&nbsp;Veronika Yehezkeli ,&nbsp;Joseph L. Demer","doi":"10.1016/j.ajo.2025.08.025","DOIUrl":"10.1016/j.ajo.2025.08.025","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Because surgical tables have not previously been available for consecutive exotropia, this study aimed to determine the appropriate surgical dosing for medial rectus (MR) advancement in this condition.</div></div><div><h3>DESIGN</h3><div>Retrospective case series.</div></div><div><h3>METHODS</h3><div>Data were reviewed for patients with consecutive exotropia who underwent MR advancement with or without lateral rectus (LR) recession.</div></div><div><h3>RESULTS</h3><div>A total of 44 patients were included averaging 35 ± 20 (stamdard deviation ) years of age. Mean preoperative exotropia was 29 ± 15∆ at distance and 33 ± 19∆ at near. Thirty-four patients underwent unilateral or bilateral MR advancement, and 10 patients underwent MR advancement combined with LR recession. For the MR advancement group, mean advancement was 4.9 ± 1.4 mm. At the last follow-up visit, exotropia at distance was reduced from 26 ± 12∆ to 7 ± 11∆. For the MR advancement + LR recession group, mean MR advancement was 6.2 ± 2.0 mm, and the mean total surgical dose, including LR recession, was 14.6 ± 4.7 mm. Overall, distance exotropia at last follow-up was surgically reduced from 39 ± 18∆ to 9 ± 14∆. Exodrift from initial to final follow-up was 6.6∆ for MR advancement alone and 7.5∆ for MR advancement + LR recession. Regression analysis of surgical dose-response suggests that each MR advancement should be augmented by 2 mm more than Parks' general surgical recommendation for treating exotropia by MR resection.</div></div><div><h3>CONCLUSIONS</h3><div>Augmentation of MR advancement may improve the correction of consecutive exotropia and is effective while affording opportunity to explore the MR muscle.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"280 ","pages":"Pages 176-181"},"PeriodicalIF":4.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938989","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":"Accuracy of the O Formula Based on OCT and Ray-Tracing for Intraocular Lens Power Prediction","authors":"Yosai Mori, So Goto, Naoyuki Maeda, Kazuhiko Ohnuma, Tjundewo Lawu, Toru Noda, Kazunori Miyata","doi":"10.1016/j.ajo.2025.08.049","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.08.049","url":null,"abstract":"To evaluate the predictive accuracy of the O formula, based on the ray-tracing method, compared with the latest formulas included in the ESCRS website.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"41 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144924033","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: Underlying Disease in Atypical Retinopathy of Prematurity","authors":"Ece Ozdemir Zeydanli, Sengul Ozdek","doi":"10.1016/j.ajo.2025.07.042","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.07.042","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"30 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144924036","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 “Underlying Disease in Atypical Retinopathy of Prematurity”","authors":"Natasha F.S. da Cruz MD PhD, Julia L. Hudson MD, Jesse D. Sengillo MD, Serena M. Shah BS, Francisco Lopez-Font MHA, Catherin I. Negron MBA, Michel E. Farah MD PhD, Audina M. Berrocal MD","doi":"10.1016/j.ajo.2025.08.047","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.08.047","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"57 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144924067","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}