American Journal of Ophthalmology最新文献

{"title":"Quantitative evaluation of trabecular meshwork in normal tension glaucoma using trabecular meshwork analyzing software.","authors":"Teruhiko Hamanaka,Tetsuro Sakurai,Takuji Kato,Nobuo Ishida,Toshinari Funaki","doi":"10.1016/j.ajo.2025.03.049","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.03.049","url":null,"abstract":"PURPOSEThis study aimed to investigate histological changes of trabecular meshwork (TM) in normal tension glaucoma (NTG) and determine whether trabeculectomy (TRAB) specimens from NTG patients can serve as normal controls for analyzing other types of high-tension glaucoma using TM analysis software (TMAS) based on light microscopy (LM).DESIGNProspective comparative case series METHODS: TRAB specimens from 23 NTG patients (65.4±9.2 years-old), including associated clinical data, as well as 12 autopsy eyes (66±11.2 years-old, P=0.8637), were retrospectively analyzed. LM images of TRAB specimens were captured, and TM spaces, TM cellularity, and pigment granules (PG) accumulation in TM were evaluated using TMAS. TMAS1 assessed regional variations in the juxtacanalicular tissue (JCT), corneoscleral meshwork (CSM), and uveal meshwork (UVM) by dividing these regions into anterior, middle, and posterior segments, while TMAS2 measured the total areas of JCT, CSM, and UVM.MAIN OUTCOME MEASURESIntraocular pressure, outflow facility, axial length, periods of topical glaucoma medication, spaces in juxtacanalicular tissue, corneoscleral and uveal meshwork, trabecular meshwork cellularity, pigment granule accumulation RESULTS: NTG patients exhibited features such as myopia (-5.5±4.7 D), long axial length (26±2.5 mm), advanced stage of visual field defect (Aulhorn-Greve classification: stage 4.6±0.9), prolonged use of topical-glaucoma medications (13.0±5.0 Y), and subnormal outflow facility (0.24±0.09 µl/min/mmHg). TM spaces measurements showed no notable differences between TMAS1 and TMAS2 in NTG eyes. However, TMAS2 detected a significantly greater reduction in TM spaces (JCT: P=0.000, CSM: P=0.000) and a lower TM cell count (JCT: P=0.0285, UVM: P=0.0006) in NTG specimens compared to autopsy eyes.CONCLUSIONNTG should not be regarded as a normal variant, as structural abnormalities are present despite normal intraocular pressure. These abnormalities may arise from subtle irregularities in the TM, which may be less pronounced than those in high-tension primary open-angle glaucoma, prolonged use of topical glaucoma medications, or other contributing factors such as increased axial length. TMAS2 has proven to be a useful instrument for assessing not only NTG but also a potential means of identifying different types of high-tension glaucoma through the analysis of TRAB specimens.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914804","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":"Natural History of Microperimetry and Optical Coherence Tomography in USH2A-Retinopathy: A Structure-Function Association Study","authors":"Ajoy Vincent ,&nbsp;Wendi Liang ,&nbsp;Maureen G. Maguire ,&nbsp;Jacque L. Duncan ,&nbsp;Allison R. Ayala ,&nbsp;Paul S. Bernstein ,&nbsp;Joseph Carroll ,&nbsp;Janet K. Cheetham ,&nbsp;Todd A. Durham ,&nbsp;Sina Farsiu ,&nbsp;Carel B. Hoyng ,&nbsp;Rachel M. Huckfeldt ,&nbsp;Glenn J. Jaffe ,&nbsp;Jessica Loo ,&nbsp;Mark E. Pennesi ,&nbsp;José-Alain Sahel ,&nbsp;Mandeep S. Singh ,&nbsp;Zane Z. Zemborain ,&nbsp;David G. Birch ,&nbsp;Eleonora M. Lad","doi":"10.1016/j.ajo.2025.04.034","DOIUrl":"10.1016/j.ajo.2025.04.034","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To describe the natural history of optical coherence tomography (OCT) and mesopic microperimetry (MP) parameters in the Rate of Progression of <em>USH2A</em>-related Retinal Degeneration (RUSH2A) study.</div></div><div><h3>DESIGN</h3><div>Multicenter, international, prospective, longitudinal natural history study.</div></div><div><h3>METHODS</h3><div>Study Population: 105 participants with biallelic disease-causing variants in <em>USH2A</em> with a clinical diagnosis of Usher Syndrome or autosomal recessive retinitis pigmentosa who underwent annual testing over 4 years.</div></div><div><h3>MAIN OUTCOME MEASURE(S)</h3><div>Ellipsoid zone (EZ) area and central sub-field thickness (CST) on OCT. Mean sensitivity (MS) and mean pointwise sensitivity at predefined functional transition points (MS_FTP) on MP.</div></div><div><h3>RESULTS</h3><div>A total of 101 and 94 participants met criteria for OCT and MP analysis, respectively. The average EZ area was 3.9 ± 5.3 mm² at baseline which decreased to 3.3 ± 4.1 mm² at 4 years (rate of change [ROC] [−0.18 mm²/year]). The average CST decreased from 249.7 ± 35.6 to 244.1 ± 39.3 microns over 4 years (−2.14 microns/year). The average MP MS declined from 6.0 ± 5.1 dB (baseline) to 4.5 ± 4.2 (4 years) (−0.39 dB/year). The MS_FTP significantly decreased over time (17.9 dB [baseline] to 10.8 dB [4 years]). Notably, at 4 years, there was a meaningful decrease (≥ 7dB) in MS_FTP in 46% of study eyes.</div></div><div><h3>CONCLUSIONS</h3><div>This study establishes the natural history of key structural and functional parameters in <em>USH2A</em>-retinopathy. The MS_FTP is a novel, robust parameter that showed clinically meaningful change over time and is a promising tool to monitor treatment efficacy in clinical trials.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 336-349"},"PeriodicalIF":4.1,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914817","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: \"Epithelial Mapping Efficacy for Subclinical Keratoconus Identification\".","authors":"Ibrahim Toprak, Osman Parca","doi":"10.1016/j.ajo.2025.04.029","DOIUrl":"10.1016/j.ajo.2025.04.029","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953442","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":"Erratum to \"Disparities Between Clinical Trial Recruitment and Real-World Demographics in Macular Edema Secondary to Retinal Vein Occlusion,\" Am J Ophthalmol 2025; 269:429-434.","authors":"Theodore Bowe,Collin J Richards,Hana A Mansour,Ferhina S Ali,Jayanth Sridhar,Basil K Williams,Yoshihiro Yonekawa,Michael N Cohen,David Xu,Jordan D Deaner,Meera Sivalingam,Anton Orlin,Shriji Patel,Ajay E Kuriyan","doi":"10.1016/j.ajo.2025.04.015","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.04.015","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"24 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903071","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":"Erratum to \"An Analysis of Solicitations From Predatory Journals in Ophthalmology,\" Am J Ophthalmol 2024; 264:216-223.","authors":"Grant A Justin,Charles Huang,Michael K Nguyen,Jessica Lee,Ian Seddon,Treven A Wesley,Sophie J Bakri,J Peter Campbell,Kara Cavuoto,Megan Collins,Steven J Gedde,Andrea L Kossler,Tatyana Milman,Aakriti Shukla,Jayanth Sridhar,Zeba A Syed,Basil K Williams,Fasika A Woreta,Samir N Patel,Yoshihiro Yonekawa","doi":"10.1016/j.ajo.2025.04.014","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.04.014","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"11 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903072","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 \"Dropped Lens Fragments Retrieval Using Endoscopy-Assisted Pars Plana Vitrectomy in Patients With Corneal Opacity\".","authors":"Radwan S Ajlan,Martin A Mainster,Amanda K Hertel,Mary Champion","doi":"10.1016/j.ajo.2025.04.021","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.04.021","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"36 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143897476","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":"Clinical Characteristics of Patients With Less Common Causes of Leber Congenital Amaurosis/Early-Onset Severe Retinal Dystrophy","authors":"Vishanna Balbirsingh ,&nbsp;Malena Daich Varela ,&nbsp;Michel Michaelides","doi":"10.1016/j.ajo.2025.04.019","DOIUrl":"10.1016/j.ajo.2025.04.019","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze the clinical characteristics, natural history, and genetics of Leber congenital amaurosis (LCA) early-onset severe retinal dystrophy (EOSRD) associated with uncommon genes.</div></div><div><h3>Design</h3><div>Single tertiary referral center, retrospective case series.</div></div><div><h3>Methods</h3><div>Review of clinical notes, ophthalmic images, and genetic testing results of 19 patients with disease-causing variants in genes that represent an unknown or &lt;1% of all LCA/EOSRD cases: <em>ALMS1, CABP4, KCNJ13,</em> and <em>OTX2</em>.</div></div><div><h3>Results</h3><div>Six patients were included with <em>ALMS1</em>-LCA, 7 patients with <em>CABP4</em>, and 3 patients with <em>OTX2</em> and <em>KCNJ13,</em> respectively. Nine previously unreported variants were identified. Disease and symptom onset were during early infancy in all patients, photophobia was seen in patients with <em>ALMS1</em> and <em>CABP4</em>, and nyctalopia was observed in <em>KCNJ13</em> and <em>OTX2.</em> Across all groups, using the World Health Organization visual impairment criteria, most patients (68%) were severely sight impaired at presentation and progressed to blindness during follow-up. Poorer vision was seen earliest in patients with <em>ALMS1</em> and <em>KCNJ13</em>, with mean visual acuities of 2.2 and 2.8 logMAR in the second decade of life. Macular atrophy was present in all patients with <em>KCNJ13</em> variants, and peripheral retinal pigment deposits were also densest in <em>KCNJ13</em>, followed by <em>OTX2</em>. Patients with <em>ALMS1</em> and <em>CABP4</em> had minimal retinal deposits, and adult patients with <em>CABP4</em> had a foveal hyporeflective zone combined with generalized retinal involvement.</div></div><div><h3>Conclusions</h3><div>The detailed genetic and phenotypic characteristics of patients with LCA due to four rare genes are described. Cross-sectional and longitudinal analysis contribute to our understanding of these rare diseases, aiming at improving patient diagnosis, prognostication, and management.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 297-306"},"PeriodicalIF":4.1,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889248","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 \"COVID-19 Vaccination and Ocular Adverse Events: A Self-Controlled Case Series Study From the Entire South Korean Population\".","authors":"Sungsoon Hwang,Se Woong Kang","doi":"10.1016/j.ajo.2025.04.026","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.04.026","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"135 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889249","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":"Ocular Adverse Events Associated with Pegcetacoplan and Avacincaptad Pegol for Geographic Atrophy: A Population-Based Pharmacovigilance Study","authors":"Zeena Kailani ,&nbsp;Andrew Mihalache ,&nbsp;Marko M. Popovic ,&nbsp;Peter J. Kertes ,&nbsp;Rajeev H. Muni","doi":"10.1016/j.ajo.2025.04.022","DOIUrl":"10.1016/j.ajo.2025.04.022","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the postmarketing ocular adverse events (AEs) reported for avacincaptad pegol and pegcetacoplan, the only Food and Drug Administration (FDA)–approved treatments for geographic atrophy (GA).</div></div><div><h3>Design</h3><div>Retrospective pharmacovigilance analysis.</div></div><div><h3>Subjects</h3><div>Ocular AE reports in the FDA Adverse Event Reporting System (FAERS) in which pegcetacoplan or avacincaptad pegol was identified as the primary suspect drug were analyzed.</div></div><div><h3>Methods</h3><div>Using the OpenVigil 2.1 data mining software, we conducted a retrospective pharmacovigilance analysis of the FAERS database from inception to December 2024. We conducted disproportionality analyses to assess reporting odds ratios (RORs) for specific drug-AE combinations compared with all other drugs in the database.</div></div><div><h3>Main Outcome Measures</h3><div>Ocular AEs were evaluated.</div></div><div><h3>Results</h3><div>A total of 752 and 80 patients with AEs secondary to pegcetacoplan and avacincaptad pegol, respectively, were identified. Ocular AEs disproportionately overreported for pegcetacoplan included anterior segment (iris) hemorrhage (ROR 1767, 95% CI 538-5803), iris neovascularization (ROR 1248, 95% CI 502-3099), choroidal neovascularization (ROR 1328, 95% CI 956-1845), intraocular injection complication (ROR 2552, 95% CI 1607-4053), hemorrhagic occlusive retinal vasculitis (ROR 4606, 95% CI 2000-10,611), retinal occlusive vasculitis (ROR 2352, 95% CI 1313-4212), and bacterial endophthalmitis (ROR 1260, 95% CI 613-2589). Ocular AEs disproportionately overreported for avacincaptad pegol included choroidal neovascularization (ROR 1169, 95% CI 426-3205), vitritis (ROR 782, 95% CI 316-1936), dry age-related macular degeneration (ROR 684, 95% CI 316-1936), and cystoid macular edema (ROR 445, 95% CI 140-1412).</div></div><div><h3>Conclusions</h3><div>Current prescribing patterns indicate that a broader spectrum of ocular AEs were reported for pegcetacoplan than avacincaptad pegol. These findings aim to enhance clinicians’ understanding of the safety profiles of these agents, enabling informed patient care and heightened vigilance of these novel GA treatments.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 252-260"},"PeriodicalIF":4.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885461","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":"Evidence and Consensus-Based Imaging Guidelines in Multifocal Choroiditis With Panuveitis and Punctate Inner Choroiditis—Multimodal Imaging in Uveitis (MUV) Taskforce Report 5","authors":"Sapna Gangaputra ,&nbsp;Aniruddha Agarwal ,&nbsp;Jeannette Ossewaarde-van Norel ,&nbsp;Edmund Tsui ,&nbsp;Jennifer E. Thorne ,&nbsp;Alejandra de-la-Torre ,&nbsp;Michael Altaweel ,&nbsp;Jyotirmay Biswas ,&nbsp;Srinivas Sadda ,&nbsp;Alessandro Invernizzi ,&nbsp;Rupesh Agrawal ,&nbsp;Jessica G. Shantha ,&nbsp;Massimo Accorinti ,&nbsp;Amani Fawzi ,&nbsp;Douglas A. Jabs ,&nbsp;David Sarraf ,&nbsp;Vishali Gupta","doi":"10.1016/j.ajo.2025.04.018","DOIUrl":"10.1016/j.ajo.2025.04.018","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To develop imaging and consensus-based guidelines on the application of multimodal imaging in noninfectious multifocal choroiditis and panuveitis (MFCPU) and punctate inner choroiditis (PIC).</div></div><div><h3>DESIGN</h3><div>Consensus agreement guided by the review of literature and an expert committee using nominal group technique (NGT).</div></div><div><h3>METHODS</h3><div>An expert committee applied a timed structured nominal group technique (NGT) to achieve consensus-based recommendations on specific disease characteristics, biomarkers of activity, and complications for MFCPU and PIC. Representative cases with noninfectious active and inactive MFCPU and PIC with color fundus photographs (CFP), optical coherence tomography (OCT), fundus fluorescein angiography (FFA), OCT angiography (OCTA), indocyanine angiography (ICGA), and fundus autofluorescence images (FAF) were reviewed. These recommendations were voted upon by the entire task force.</div></div><div><h3>RESULTS</h3><div>The experts agreed that lesions of MFCPU and PIC can be well characterized using CFP. OCT is the preferred modality for detecting active lesions. Both FAF and OCT are effective for monitoring disease recurrence. Late-phase ICGA is most valuable in recurrent disease when the lesions are not visible on FAF and CFP. While OCTA and ICGA can successfully identify lesions and complications such as choroidal neovascularization, no imaging biomarkers were found to reliably distinguish between active and inactive lesions on these two modalities.</div></div><div><h3>CONCLUSIONS</h3><div>Incorporating imaging findings, particularly OCT, into the Standardization of Uveitis Nomenclature (SUN) classification criteria for MFCPU and PIC enables more precise assessment of disease activity. These consensus-based guidelines provide a framework for selecting optimal imaging modalities for diagnosis, monitoring and identification of complications of MFCPU and PIC.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 272-285"},"PeriodicalIF":4.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885483","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}