American Journal of Ophthalmology最新文献

{"title":"Risk of Cataract Surgery Complications in Patients With Prior Intravitreal Injection Therapy","authors":"CINDY S. ZHAO MD ,&nbsp;KACPER CHWIALKOWSKI PhD ,&nbsp;KAREN M. WAI MD ,&nbsp;PRITHVI MRUTHYUNJAYA MD, MHS ,&nbsp;EHSAN RAHIMY MD ,&nbsp;EUBEE B. KOO MD","doi":"10.1016/j.ajo.2025.01.004","DOIUrl":"10.1016/j.ajo.2025.01.004","url":null,"abstract":"<div><h3>Objective</h3><div>To compare cataract surgery complications in patients with and without prior intravitreal injection (IVI).</div></div><div><h3>Design</h3><div>A retrospective cohort study using the TriNetX aggregated research network.</div></div><div><h3>Subjects</h3><div>Patients with IVI therapy within twenty years of cataract surgery were compared to controls using propensity score matching (PSM) to balance for demographics, systemic, and ocular co-morbidities. Patients with lensectomy or pars plana vitrectomy (PPV) prior to cataract surgery were excluded.</div></div><div><h3>Intervention</h3><div>IVI within twenty years of cataract surgery.</div></div><div><h3>Main Outcome Measures</h3><div>Rate of retinal detachment (RD), RD repair, anterior vitrectomy, retained lens, dislocated intraocular lens (IOL), secondary lens procedure, and endophthalmitis within 14, 30, and 90 days of cataract surgery.</div></div><div><h3>Results</h3><div>Prior to PSM, 16,356 and 512,152 patients did and did not, respectively, have IVI pharmacotherapy prior to cataract surgery. After PSM, both groups had 14,240 patients. A higher rate (RR 1.34; 95% CI:1.16-1.54) of aggregate complications within 90 days of cataract surgery was found in the group with prior IVI (447/13,719 = 3.3%) relative to controls (340/13,945=2.4%). The exposure group saw an increased risk of RD repair at 30 days (RR 1.84; 95% CI:1.27-2.66) and 90 days (RR 2.05; 95% CI:1.65-2.54). IVI was only associated with higher rates of anterior vitrectomy in patients with diabetic retinopathy (DR) at 90 days (RR 1.24; 95% CI:0.85-1.79). Patients with DR and IVI exposure had more lensectomies, RD repairs, and secondary procedures.</div></div><div><h3>Conclusions</h3><div>Patients with prior IVI saw more complications following cataract surgery, primarily for RD. IVI treatment history should be considered in pre-operative planning.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"272 ","pages":"Pages 106-116"},"PeriodicalIF":4.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142991672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Ageing in the Clinical Presentation of Uveitis","authors":"PRIYA SAMALIA ,&nbsp;JOANNE SIMS ,&nbsp;RACHAEL NIEDERER","doi":"10.1016/j.ajo.2025.01.007","DOIUrl":"10.1016/j.ajo.2025.01.007","url":null,"abstract":"<div><h3>PURPOSE</h3><div>The primary aim of this study was to determine age-related patterns of uveitis entities. Secondary aims included age-related patterns of uveitic treatments and complications.</div></div><div><h3>DESIGN</h3><div>Retrospective clinical cohort study.</div></div><div><h3>METHODS</h3><div>4395 participants presenting with uveitis to a single center from January 2009 to December 2023 were included.</div></div><div><h3>RESULTS</h3><div>The median age at presentation was 45.1 years (IQR 32.2-60.3). Infections were more frequent in both younger (0-19 years) and older (≥60 years) participants. Toxoplasmosis was the most frequent cause of infectious uveitis in younger (0-19 years; 12.5%) participants and herpes zoster virus was the most prevalent cause of uveitis in adults 40+ years of age (40-59 years, 7.1%; 60-79 years, 20.5%; 80+years, 38.6%). Tumor-related uveitic masquerades demonstrated a significant association with increasing age (<em>P &lt;</em>.001). Younger individuals were more likely to require steroid-sparing immunosuppression (<em>P &lt;</em>.001) and more likely to require a switch from initial DMARD therapy (<em>P &lt;</em>.001). Older subjects were more likely to develop cystoid macular edema, raised intraocular pressure and cataract (<em>P &lt;</em>.001), while younger subjects were more likely to develop posterior synechiae (<em>P =</em>.001), papillitis (<em>P &lt;</em>.001) and choroidal neovascular membrane (<em>P =</em>.002).</div></div><div><h3>CONCLUSIONS</h3><div>Age appears to be a key factor influencing the underlying etiology and clinical course of uveitis. Investigations should be tailored to the clinical presentation and consideration of the individuals presenting age may provide clues as to the underlying cause of disease and to guide treatment.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"272 ","pages":"Pages 58-66"},"PeriodicalIF":4.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142991676","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: Subretinal Gene Therapy for Treatment of Retinal and Choroidal Vascular Diseases.","authors":"Arshad M Khanani, Aamir A Aziz, Zoha A Khanani, Hannah Khan, Ohidul Mojumder, Humza Sulahria, Ibrahim Khanani, Huma Khan, Greggory M Gahn, Kapil Mishra","doi":"10.1016/j.ajo.2025.01.009","DOIUrl":"10.1016/j.ajo.2025.01.009","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998550","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, \"Associations Between Contrast Sensitivity, OCT Features, and Progression From Intermediate to Late AMD\".","authors":"Víctor Manuel Asensio-Sánchez","doi":"10.1016/j.ajo.2024.12.031","DOIUrl":"10.1016/j.ajo.2024.12.031","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998546","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: Subretinal Gene Therapy for Treatment of Retinal and Choroidal Vascular Diseases.","authors":"Gary D Novack","doi":"10.1016/j.ajo.2024.12.032","DOIUrl":"https://doi.org/10.1016/j.ajo.2024.12.032","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"98 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988592","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 Accuracy of Toric Intraocular Lens Formulas With Measured Posterior Corneal Astigmatism of Different Orientations.","authors":"Stephen Stewart, Tun Kuan Yeo, Salissou Moutari, Richard McNeely, Jonathan E Moore","doi":"10.1016/j.ajo.2025.01.010","DOIUrl":"10.1016/j.ajo.2025.01.010","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998549","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":"Validation of a Visual Field Prediction Tool for Glaucoma: A Multicenter Study Involving Patients With Glaucoma in the United Kingdom","authors":"Arlen Dean ,&nbsp;Dun Jack Fu ,&nbsp;Mohammad Zhalechian ,&nbsp;Mark P. Van Oyen ,&nbsp;Mariel S. Lavieri ,&nbsp;Anthony P. Khawaja ,&nbsp;Joshua D. Stein","doi":"10.1016/j.ajo.2025.01.006","DOIUrl":"10.1016/j.ajo.2025.01.006","url":null,"abstract":"<div><h3>PURPOSE</h3><div>A previously developed machine-learning approach with Kalman filtering technology accurately predicted the disease trajectory for patients with various glaucoma types and severities using clinical trial data. This study assesses performance of the KF approach with real-world data.</div></div><div><h3>DESIGN</h3><div>Retrospective cohort study.</div></div><div><h3>METHODS</h3><div>We tested the performance of a previously validated KF model (PKF) initially trained using data from the African Descent and Glaucoma Evaluation Study and the Diagnostic Innovations in Glaucoma Study in patients with different types and severities of glaucoma receiving care in the United Kingdom (UK), comparing the predictive accuracy to 2 conventional linear regression (LR) models and a newly developed KF trained on UK patients (UK-KF).</div></div><div><h3>RESULTS</h3><div>A total of 3116 patients with open-angle glaucoma or suspects were divided into training (n=1584) and testing (n=1532) sets. The predictive accuracy for MD within 2.5 dB of the observed value at 60 months’ follow-up for PKF (75.7%) was substantially better than those for the LR models (<em>P</em> &lt; .01 for both) and similar to that for UK-KF (75.2%, <em>P</em> = .70). The proportion of MD predictions in the 95% repeatability intervals at 60 months’ follow-up for PKF (67.9%) was higher than those for the LR models (40.2%, 40.9%) and similar to that for UK-KF (71.4%).</div></div><div><h3>CONCLUSIONS</h3><div>This study validates the performance of our previously developed KF model on a real-world, multicenter patient population. Our model substantially outperforms the current clinical standard (LR) and forecasts well for patients with different glaucoma types and severities. This study supports the generalizability of PKF performance and supports prospective study of implementation into clinical practice.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"272 ","pages":"Pages 87-97"},"PeriodicalIF":4.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988593","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":"Using a Deep Learning Model to Predict Postoperative Visual Outcomes of Idiopathic Epiretinal Membrane Surgery","authors":"HSIN-LE LIN ,&nbsp;PO-CHEN TSENG ,&nbsp;MIN-HUEI HSU ,&nbsp;SYU-JYUN PENG","doi":"10.1016/j.ajo.2025.01.003","DOIUrl":"10.1016/j.ajo.2025.01.003","url":null,"abstract":"<div><h3>Purpose</h3><div>This study assessed the performance of various deep learning models in predicting the postoperative outcomes of idiopathic epiretinal membrane (ERM) surgery based on preoperative optical coherence tomography (OCT) images.</div></div><div><h3>Design</h3><div>Validation of algorithms to predict the outcomes of ERM surgery based on OCT data.</div></div><div><h3>Methods</h3><div>Internal training and validation were performed using 1,392 OCT images from 696 eyes. External testing was performed using 152 OCT images from 76 eyes. This study assessed three deep learning models, including Inception-v3, ResNet-101, and VGG-19. Grad-CAM was employed for hotspot analysis. The dataset was split into a training set (80%) and a validation set (20%). Subjects presenting an improvement of ≥2 lines on the Snellen chart at 1-year postsurgery were classified as <em>pronounced visual improvement</em>, whereas those presenting an improvement of &lt;2 lines were classified as <em>limited visual improvement</em>. Using an external test dataset, we compared assessments by seven ophthalmologists with the prediction of deep learning model. The main outcome measures were recall, specificity, precision, F1 score, accuracy, and area under the receiver operating characteristic curve (AUROC).</div></div><div><h3>Results</h3><div>ResNet-101 achieved the best overall performance, as evidenced by the following metrics: recall (0.90), specificity (0.90), precision (0.91), F1-score (0.90), accuracy (0.90), and AUROC (0.97). In Grad-CAM heatmap analysis, the logic of ResNet-101 closely resembled that of clinical physicians. Overall, the performance of this deep learning model was significantly better than that of general ophthalmologists and non-retina specialists and was slightly superior to that of retina specialists.</div></div><div><h3>Conclusions</h3><div>Deep learning based on preoperative OCT images proved highly effective in predicting the outcomes of ERM surgery and elucidating the structural mechanisms underlying the phenomena observed in OCT images.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"272 ","pages":"Pages 67-78"},"PeriodicalIF":4.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988595","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":"Reply to Comment on: \"Associations Between Contrast Sensitivity, OCT Features, and Progression From Intermediate to Late AMD\".","authors":"Francesco Romano,Cade Bennett,Xinyi Ding,John B Miller","doi":"10.1016/j.ajo.2025.01.005","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.01.005","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"5 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988594","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":"Vortex Vein Varix changes with digital pressure: Ultra-Wide-Field imaging and Peripheral OCT report.","authors":"Giovanni Rubegni, Tommaso Bacci, Gianmarco Tosi","doi":"10.1016/j.ajo.2024.12.030","DOIUrl":"10.1016/j.ajo.2024.12.030","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977201","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}