American Journal of Ophthalmology最新文献

{"title":"Comparing an Advanced Monofocal With a Non-diffractive Extended Depth of Focus Intraocular Lens Using a Mini-Monovision Approach.","authors":"Johannes Zeilinger, Martin Kronschläger, Andreas Schlatter, Stefan Georgiev, Manuel Ruiss, Caroline Pilwachs, Oliver Findl","doi":"10.1016/j.ajo.2024.10.014","DOIUrl":"10.1016/j.ajo.2024.10.014","url":null,"abstract":"<p><strong>Purpose: </strong>To compare interindividual differences in visual performance of an advanced monofocal with a nondiffractive extended depth of focus intraocular lens (IOL) using a mini-monovision approach.</p><p><strong>Design: </strong>Single-center, randomized, controlled, double-masked study.</p><p><strong>Methods: </strong>In total, 48 patients (96 eyes) with bilateral age-related cataract were enrolled. One group received an advanced monofocal IOL RAO200E (RayOne EMV; Rayner) and the other group a non-diffractive extended depth of focus IOL DFT015 (Acrysof IQ Vivity; Alcon) in both eyes. Target refraction for both groups was mini-monovision. After 3 months, monocular and binocular distance corrected and uncorrected distance (CDVA/UDVA), intermediate (DCIVA/UIVA), and near visual acuity (DCNVA/UNVA); contrast sensitivity; binocular defocus curves; halometry; and Quality of Vision questionnaire scores were compared.</p><p><strong>Results: </strong>Binocular mean CDVA, DCIVA at 66 cm, and DCNVA at 40 cm were -0.10±0.10, 0.15±0.11, and 0.32±0.16 logMAR for the RAO200E and -0.10±0.10, 0.12±0.10, and 0.27±0.16 logMAR for the DFT015, respectively, with no significant difference. A significant difference could be shown for the dominant eye in monocular DCIVA and DCNVA and for the dominant and nondominant eye in monocular UNVA, with 0.28±0.14, 0.48±0.22, 0.46±0.21, and 0.41±0.20 logMAR for the RAO200E and 0.14±0.10 (P = .023), 0.35±0.16 (P = .008), 0.30±0.14 (P = .001), and 0.21±0.10 (P = .003) logMAR for the DFT015, respectively. Significantly smaller halo size in the RAO200E group and significantly better distance-corrected defocus curve at -2.5 (P = .031), -2.0 (P = .03), and -1 diopters (P = .03) of defocus in the DFT015 group could be shown.</p><p><strong>Conclusions: </strong>Distance corrected or uncorrected binocular visual acuity for far, intermediate, and near distance between the advanced monofocal IOL RAO200E and the non-diffractive extended depth of focus IOL DFT015, when compared in a mini-monovision setting, showed no significant differences.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":"86-95"},"PeriodicalIF":4.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567204","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":"Low Body Mass Index Poses Greater Risk of Primary Open-Angle Glaucoma in African Ancestry Individuals.","authors":"Isabel Di Rosa, Mina Halimitabrizi, Rebecca Salowe, Patrick Augello, Di Zhu, Yineng Chen, Prithvi Sankar, Victoria Addis, Gui-Shuang Ying, Joan O'Brien","doi":"10.1016/j.ajo.2024.10.023","DOIUrl":"10.1016/j.ajo.2024.10.023","url":null,"abstract":"<p><strong>Purpose: </strong>Investigate the relationship between body mass index (BMI) and primary open-angle glaucoma (POAG) in an African ancestry cohort from the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study.</p><p><strong>Design: </strong>Retrospective, cross-sectional \"case-control\" comparison study.</p><p><strong>Methods: </strong>A total of 6,634 POAAGG study subjects were eligible: 2,977 cases and 3,657 controls. Ocular and demographic data were collected from on-site exams, standardized interviews, and electronic medical records. BMI was calculated: weight(kg)/height(m)², and categorized as low (<18.5), moderate (18.5-24.9), high (25.0-29.9), or very high (≥30). Structural and functional POAG progression were assessed by annual rate of change in retinal nerve fiber layer thickness and visual field mean deviation, respectively, using a linear mixed-effects model. Regression analyses evaluated associations of BMI with POAG status, phenotype, and progression.</p><p><strong>Results: </strong>Lower BMI was associated with increased POAG risk (aOR[95% confidence interval], 1.02 [1.007,1.023] per kg/m² decrease in BMI, p = .0003). In cases, low BMI was associated with larger cup-to-disc ratio (p = .007) and worse visual acuity (p = .04). Fast functional POAG progressors had a significantly lower mean BMI than slow progressors (25.7 vs. 30.0 kg/m², p = .04).</p><p><strong>Conclusions: </strong>In this African ancestry cohort, low BMI was associated with increased POAG risk. POAG cases with low BMI were more likely to have larger cup-to-disc ratios, worse visual acuity, and faster functional progression, indicating more severe glaucoma.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":"119-126"},"PeriodicalIF":4.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543100","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":"Longitudinal Assessment of Retinopathy of Prematurity (LONGROP) Study: Impacts of Viewing Time and Ability to Compare on Detection of Change","authors":"TATIANA R. ROSENBLATT MD ,&nbsp;HASHEM H GHORABA MD ,&nbsp;MARCO H. JI MD ,&nbsp;CAROLINE R. BAUMAL MD ,&nbsp;AUDINA M. BERROCAL MD ,&nbsp;CAGRI G. BESIRLI MD, PhD ,&nbsp;KIMBERLY A. DRENSER MD, PhD ,&nbsp;ANNA L. ELLS MD ,&nbsp;C. ARMITAGE HARPER III MD ,&nbsp;G. BAKER HUBBARD III MD ,&nbsp;ERIC D. NUDLEMAN MD, PhD ,&nbsp;POLLY A. QUIRAM MD, PhD ,&nbsp;IRENA TSUI MD ,&nbsp;YOSHIHIRO YONEKAWA MD ,&nbsp;EDWARD H. WOOD ,&nbsp;JOCHEN KUMM ,&nbsp;DARIUS M. MOSHFEGHI","doi":"10.1016/j.ajo.2024.10.015","DOIUrl":"10.1016/j.ajo.2024.10.015","url":null,"abstract":"<div><h3>Purpose</h3><div>This study compared two imaging grading techniques to assess the utility of longitudinal image-based analysis in retinopathy of prematurity (ROP) screening: (1) time-limited without image comparison (a proxy for bedside indirect ophthalmoscopy, termed sBIO) and time-unlimited with image comparison (for telemedicine grading, termed TELE) screening. We tested two hypotheses: (1) H1: TELE was superior to sBIO for the detection of change (Tempo)—same, better, or worse and (2) H2: granular data of change (e.g., at the image and feature level) is integrated by graders to achieve the Tempo assessment.</div></div><div><h3>Design</h3><div>Prospective reliability analysis.</div></div><div><h3>Methods</h3><div>Gold standard reference (GS) was a published curated ROP image database consisting of both Tempo and granular level changes (image and components) from 40 patients in 2 sets. Graders were divided into 2 cohorts. There were two screening techniques: (1) sBIO with time limited review of 10 minutes/patient, access to prior notes and drawings and (2) TELE with unlimited review time, access to prior weeks’ images, notes and schematics. Graders switched techniques and sets after 6 weeks. H1 outcome was comparison of graders’ weekly Tempo scores to GS-Gestalt and for H2 was Tempo score compared to GS-View and GS-Component.</div></div><div><h3>Results</h3><div>H1 demonstrated no difference–accuracy of sBIO and TELE compared to GS was 51.7% and 51.9% respectively (<em>P</em> = .95). Highest agreement occurred when all exams exhibited no change (91.5% sBIO vs 93.5% TELE, <em>P</em> = .46) and worst agreement was when exams always demonstrated worsening (46.5% sBIO vs 47.1% TELE, <em>P</em> = .93). Both sets of graders did worse in weeks 7-12, irrespective of technique. H2 demonstrated that Tempo assessment did not correlate with granular data changes in the GS for View level and Component level assessments—overall agreement dropped to 31.4% for Tempo vs GS-VIEW (31.2% for sBIO, 31.5% for TELE) and 4.6% for Tempo vs GS-COMPONENT (4.9% for sBIO, 4.3% for TELE).</div></div><div><h3>Conclusions</h3><div>Detection of ROP Tempo was independent of screening technique by expert pediatric retina graders. Both groups did significantly better in the first half of the study, indicative of a fatigue factor. This is the first study in ROP history to demonstrate that graders integrate image and retinal features in various ways that can be in contradiction of their assessment of overall disease progression.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"271 ","pages":"Pages 31-37"},"PeriodicalIF":4.1,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492880","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":"Comparison of the Photoreceptor Mosaic Before and After Macular Hole Surgery With High-Resolution Adaptive Optics Imaging","authors":"Paola L. Oquendo ,&nbsp;Thomas Wright ,&nbsp;Sumana C. Naidu ,&nbsp;Miguel Cruz Pimentel ,&nbsp;Hesham Hamli ,&nbsp;Mariam Issa ,&nbsp;Afira Faleel ,&nbsp;Flavia Nagel ,&nbsp;Peng Yan ,&nbsp;Rajeev H. Muni","doi":"10.1016/j.ajo.2024.10.018","DOIUrl":"10.1016/j.ajo.2024.10.018","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the photoreceptor mosaic in patients with idiopathic full-thickness macular hole (MH) before and after pars plana vitrectomy (PPV) with adaptive optics enhanced retinal imaging (AO).</div></div><div><h3>Design</h3><div>Prospective case series.</div></div><div><h3>Methods</h3><div>Prospective cohort study of patients who presented at the Kensington Eye Institute, Toronto, Canada with a diagnosis of MH treated with PPV. Exclusion criteria: secondary MH, high myopia (axial length &gt;26.5 mm), media opacity precluding optical coherence tomography or AO imaging, previous intraocular surgery except for cataract extraction. Imaging using an AO fundus camera (Imagine Eyes, RTX1) was performed preoperatively and 3 months following successful MH repair in both eyes. Cone density (CD), regularity, dispersion, and spacing were measured at 2° and/or 4° of eccentricity in 4 quadrants (superior, inferior, nasal, and temporal) with pre- and postoperative values compared.</div></div><div><h3>Results</h3><div>We included 18 eyes of 9 patients. At 2° there was significant reduction in CD and increase in spacing and dispersion and a nonsignificant change in regularity postoperatively. Comparison between preoperative and postoperative measurements at 2° mean (standard error) were: CD: 14,612 ± 3003 and 12,280 ± 4632 photoreceptors/mm² (95% CIs = –2413 to –702) <em>P</em> = .0004, regularity: 88% ± 7% and 84% ± 12% (95% CIs = –4.67 to 0.04) <em>P</em> = .054, dispersion: 19% ± 6% and 23% ± 10% (95% CIs = 0.5-4.24) <em>P</em> = .013, spacing: 9 ± 1 microns and 10 ± 2 microns (95% CIs = 0.40-1.27) <em>P</em> = .0002; at 4° was: CD: 13,377 ± 4339 and 12,770 ± 4391 photoreceptors/mm² (95% CIs = –1368 to 252) <em>P</em> = .176, regularity:87% ± 9% and 86% ± 12% (95% CIs = –4.65 to 0.08) <em>P</em> = .74, dispersion: 20% ± 8% and 20% ±9% (95% CIs = –2.11 to 1.5) <em>P</em> = .74, spacing:10 ± 2 microns and 10 ± 3 microns (95% CIs = –0.23 to 0.58) <em>P</em> = .39.</div></div><div><h3>Conclusions</h3><div>AO imaging allows quantitative assessment of the photoreceptor mosaic pre- and post-PPV in patients with MH. There was a significant change to the photoreceptor mosaic related to the MH at 2° pre- and postoperatively. AO imaging enables high-resolution investigation of the photoreceptor remodeling process following surgery, which may allow for a more thorough assessment of surgical outcomes.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"270 ","pages":"Pages 261-272"},"PeriodicalIF":4.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492879","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":"Multiple Factors Causing Variability of Alignment in Childhood Concomitant Strabismus","authors":"YANAN GUO ,&nbsp;YUEHAN GUAN ,&nbsp;LI LI ,&nbsp;JINGJING JIANG","doi":"10.1016/j.ajo.2024.10.013","DOIUrl":"10.1016/j.ajo.2024.10.013","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the potential factors related to variability of alignment in childhood concomitant strabismus.</div></div><div><h3>Design</h3><div>Prospective interexaminer (test-retest) reliability analysis.</div></div><div><h3>Methods</h3><div>In total, 197 children with concomitant strabismus (57 esotropia, 140 exotropia) underwent repeat prism and alternate cover test (PACT) by two orthoptists who were certified by the study, and sensory tests were all performed once. We defined the alignment measurement as stable if the absolute value of the measurement difference between two orthoptists was within 10 prism diopters (PD), and unstable if the difference was 10 PD or greater. We analyzed the relationship between the measurement variability and sensory results, patient age, and angle of deviations.</div></div><div><h3>Results</h3><div>The mean age of the esotropia and exotropia patients was 68.5 ± 26.3 months (range, 36-164 months) and 96.0 ± 33.7 months (range, 22-200 months), respectively, and there was a significant difference in suppression related variability of alignment, both at distance (<em>P</em> = .004) and at near (<em>P</em> = .046). Anisometropia also showed a significant difference at distance (<em>P</em> = .035) for variability of alignment, and there was no significant statistical effect of age on measurement variability in our study. Variability of alignment is positively associated with the angle of deviation, especially at distance (<em>P</em> = .021 for exotropia, <em>P</em> = .002 for esotropia) with more variability between observers with larger angles of misalignment.</div></div><div><h3>Conclusion</h3><div>Suppression is an important factor for variability of alignment in childhood concomitant strabismus. Other factors, such as anisometropia and a large angle of strabismus should be taken into account when evaluating binocular alignment.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"270 ","pages":"Pages 77-82"},"PeriodicalIF":4.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490305","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":"Submacular Hemorrhage Rates Following Anti-Vascular Endothelial Growth Factor Injections for Exudative Age-Related Macular Degeneration","authors":"Gabriel T. Kaufmann ,&nbsp;Nicholas Boucher ,&nbsp;Chakshu Sharma ,&nbsp;Nitika Aggarwal ,&nbsp;Matthew R. Starr","doi":"10.1016/j.ajo.2024.10.017","DOIUrl":"10.1016/j.ajo.2024.10.017","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine rates of submacular hemorrhage in patients undergoing anti-vascular endothelial growth factor (VEGF) injections, comparing rates between specific anti-VEGF agents.</div></div><div><h3>Design</h3><div>Retrospective clinical cohort study.</div></div><div><h3>Methods</h3><div>All patients in the database from January 2015 to November 2023 with a diagnosis of neovascular age-related macular degeneration and accompanying submacular hemorrhage (SMH). SMH prevalence and associated anti-VEGF injection type were analyzed in 140,915 eyes (of which 9107 had SMH) in a nationwide aggregated electronic health care database using chi-square test of proportion. Visual acuity (VA) data was assessed using 2-sample independent t-tests. The primary outcome was rate of SMH per injection type. Secondary datapoints examined were time between SMH diagnosis and last anti-VEGF injection, number of injections before SMH, treatment interval at time of SMH, VA before and at 12 months after SMH, eyes undergoing pars plana vitrectomy (PPV) within 30 days of SMH, and VA before PPV and at 12 months after PPV.</div></div><div><h3>Results</h3><div>The last injection type in eyes with SMH was bevacizumab in 3430 (37.8%) eyes, brolucizumab-dbll in 46 (0.51%) eyes, aflibercept in 3221 (35.4%) eyes. Ranibizumab in 2246 (24.7%) eyes, and faricimab-svoa in 155 (1.7%) eyes. Rates of SMH were significantly higher (<em>P</em> ≤ .001) for last injection with bevacizumab compared to every other injection type. Rates of SMH were significantly lower (<em>P</em> = .0004) for last injection with faricimab-svoa or ranibizumab injections each had significantly shorter (mean and standard deviation 48.9 (27.9), <em>P</em> &lt; .02; mean and standard deviation 59.6 (38.2), <em>P</em> = .003, respectively) mean time between SMH diagnosis and last injection than did patients undergoing any other injection. Mean VA before SMH and at 12 months after SMH did not significantly differ by injection type among all patients. The number of patients who underwent PPV were 52 (1.51%) for bevacizumab, 4 (8.7%) for brolucizumab-dbll, 58 (1.8%) for aflibercept, 41 (1.8%) for ranibizumab, and 3 (1.9%) for faricimab-svoa. Mean VA before SMH and at 12 months after SMH did not significantly differ by injection type in patients undergoing PPV.</div></div><div><h3>Conclusions</h3><div>Faricimab may be more protective than other anti-VEGF injections against SMH in patients with neovascular age-related macular degeneration.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"270 ","pages":"Pages 172-182"},"PeriodicalIF":4.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492881","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":"Cornea Endothelial Cell Loss Before and After Explantation of Artisan and Artiflex Iris-Fixated Phakic Intraocular Lenses","authors":"Hye yeon Yoon MD. ,&nbsp;Yong-Soo Byun MD., PhD. ,&nbsp;Hyun Seung Kim MD., PhD. ,&nbsp;So-Hyang Chung MD., PhD.","doi":"10.1016/j.ajo.2024.10.010","DOIUrl":"10.1016/j.ajo.2024.10.010","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To investigate the risk factors for corneal endothelial cell density (ECD) loss of 2 types of iris-fixated phakic intraocular lenses (pIOL) and indicate the cutoff values for preventing irreversible ECD loss after explantation.</div></div><div><h3>DESIGN</h3><div>The retrospective, comparative, clinical cohort study.</div></div><div><h3>METHODS</h3><div>Total 114 eyes of 61 patients were included in this study. Fifty-five eyes with Artisan pIOL and 59 eyes with Artiflex pIOL had undergone explantation of pIOLs due to continuous ECD loss. Correlation analysis was performed to assess the ocular parameters associated with ECD loss. Receiver operating characteristic (ROC) curve was performed to set cutoff values of ocular parameters to prevent ECD loss after explantation.</div></div><div><h3>RESULTS</h3><div>The mean ECD before explantation was 1637 cells/mm² in Artisan group and 1769 cells/mm² in Artiflex group. The distance of cornea endothelium to IOL center and edges were all significantly higher in Artisan group (<em>P</em> &lt; .05). The risk factor of decreased ECD in Artisan group were small anterior chamber angle (ACA), and distance of nasal edge of IOL to endothelium and iris fixation to nasal limbus distance, and differences of fixation length. In Artiflex group, ACA, distance of nasal edge of IOL to endothelium, both limbus to IOL fixation length, fixation length, iris pigmentation grading were the risk factors. At 1 year after the pIOL removal, the population demonstrating ΔECD &gt;10% were significantly higher in Artisan group than Artiflex group (<em>P</em> &lt; .05). In ROC curve analysis, the cutoff value of preoperative ECD to prevent significant postexplantation ECD loss was 1683.5 cells/mm² in Artisan group and 1648 cells/mm² in Artiflex group.</div></div><div><h3>CONCLUSIONS</h3><div>This study examined the existing explantation guidelines for these lenses. In analyzing the longterm prognosis of cornea ECD with Iris-fixated phakic intraocular lens, it is important to identify the relevant anatomical factors. Small ACA, and short distances from IOL to endothelium and from limbus to iris fixation especially in the nasal region were significant risk factors to continuous ECD loss in both lenses. To minimize irreversible ECD loss after explantation, it is important to determine the optimal period of explantation by observing both ECD and structural changes.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"270 ","pages":"Pages 52-60"},"PeriodicalIF":4.1,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451408","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":"Macular Buckling for Myopic Traction Maculopathy: A Comprehensive Systematic Review and Meta-Analysis","authors":"Hashem Abu Serhan ,&nbsp;Abdullah Ahmed ,&nbsp;Mahrukh Chaudhry ,&nbsp;Zain Ali Nadeem ,&nbsp;Fakiha Ahmed ,&nbsp;Usama Hussain Kamal ,&nbsp;Ameen Alkhateeb ,&nbsp;Ayman G. Elnahry","doi":"10.1016/j.ajo.2024.10.008","DOIUrl":"10.1016/j.ajo.2024.10.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Myopic traction maculopathy (MTM) is a major cause of visual impairment and blindness, particularly in Asian populations. With the global burden of myopia on the rise, understanding effective treatment options is crucial. This systematic review and meta-analysis evaluate the efficacy of macular buckling in the management of MTM.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Cochrane Library, and EMBASE databases were searched for relevant studies up to July 2024. Inclusion criteria encompassed studies reporting outcomes of macular buckling for MTM. Primary outcomes included changes in best-corrected visual acuity and axial length, retinal reattachment rate, and macular hole closure rate. Random-effect models were used for statistical analysis, with heterogeneity assessed using the <em>I</em>² statistic. The pooled results were reported as mean difference or proportion with corresponding 95% confidence intervals (CIs) for each outcome.</div></div><div><h3>Results</h3><div>Thirteen studies (482 eyes) met the inclusion criteria. Significant improvements in best-corrected visual acuity were observed across all follow-up periods, with the most substantial improvement in long-term outcomes (mean difference: 0.38 logarithm of the minimum angle of resolution; 95% CI: 0.28-0.47). Axial length showed consistent reductions, with a mean long-term reduction of 2.88 mm (95% CI: 2.54-3.21). The pooled long-term retinal reattachment rate was 94% (95% CI: 86%-97%), while the long-term full thickness macular hole closure rate was 72% (95% CI: 55%-85%). Heterogeneity varied across outcomes and follow-up periods, ranging from low to high.</div></div><div><h3>Conclusions</h3><div>Macular buckling demonstrates promising outcomes for MTM, including improved visual acuity, reduced axial length, high retinal reattachment rates, and favorable macular hole closure rates. These findings support the efficacy of macular buckling as a treatment option for MTM. However, further standardized, long-term studies are needed to confirm these results and explore potential combination therapies.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"270 ","pages":"Pages 25-34"},"PeriodicalIF":4.1,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451402","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":"Combination of Pretarsal and Preseptal Botulinum Toxin Injections in the Treatment of Blepharospasm: A Prospective Nonrandomized Clinical Trial","authors":"JUNHAO HU ,&nbsp;QINYING MU ,&nbsp;FUHAO MA ,&nbsp;HAO WANG ,&nbsp;LIYI CHI ,&nbsp;MING SHI","doi":"10.1016/j.ajo.2024.10.007","DOIUrl":"10.1016/j.ajo.2024.10.007","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the efficacy of two botulinum toxin (BoNT) injection methods, pretarsal (PT) combined with preseptal (PS) injection (PT-PS) and conventional PT injection, in the treatment of benign essential blepharospasm (BEB).</div></div><div><h3>Design</h3><div>Prospective nonrandomized clinical trial.</div></div><div><h3>Methods</h3><div>From January 2023 to April 2024, 95 BoNT injections into orbicularis oculi were performed in 45 BEB patients, including 52 PT-PS injections s and 43 PT injections. Jankovic Rating Scale (JRS) and Blepharospasm Disability Index (BSDI) were used to assess motor symptoms. The efficacy of two injection methods for BEB was compared in terms of latency to response (LTR), latency to the peak response (LPR), duration of peak response (DPR), duration of response (DOR), satisfaction degree, and possible complications.</div></div><div><h3>Results</h3><div>Both injection methods significantly improved JRS and BSDI scores in patients with BEB. However, PT-PS injections showed a shorter LTR ([4.00 (3.00, 6.00] vs 5.00 [4.00, 7.00] days, <em>P</em> = .024) and LPR (23.50 [16.00, 26.00] vs 26.00 [20.00, 30.00] days, <em>P</em> = .040), a longer DPR (88.00 [80.50, 104.75] vs 75.00 [65.00, 92.00] days, <em>P</em> = .003) and DOR (135.00 [118.50, 153.75] vs 121.00 [107.00, 135.00] days, <em>P</em> = .003) than PT injections. Patients with PT-PS injections were more satisfied than those with PT injections (9.50 [8.50, 10.00] vs 8.00 [7.50, 9.00], <em>P</em> &lt; .001), and around 2/3 of patients were more willing to receive the combined injection method later. Among patients receiving PT-PS injections, only one case experienced ptosis, and there were no significant differences in other complications such as lacrimation, dry eyes, and blurred vision between the two injection methods.</div></div><div><h3>Conclusions</h3><div>PT-PS injections of BoNT showed more advantages in the treatment of BEB than PT injections in terms of both their efficacy and patients’ satisfactions.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"270 ","pages":"Pages 19-24"},"PeriodicalIF":4.1,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451409","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":"Associations Between Dry Eye Disease and Mental Health Conditions in the All of Us Research Program","authors":"AARON T. ZHAO ,&nbsp;JOCELYN HE ,&nbsp;YUQING LEI ,&nbsp;YONG CHEN ,&nbsp;GUI-SHUANG YING","doi":"10.1016/j.ajo.2024.10.009","DOIUrl":"10.1016/j.ajo.2024.10.009","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the association between dry eye disease (DED) and mental health conditions in a sociodemographically diverse nationwide population of Americans.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>We used the National Institute of Health's All of Us Research Program database to identify 18257 participants with DED who were propensity score matched in a 1:3 ratio to participants without DED. Univariate and multivariable logistic regression models were used to assess associations between DED and mental health conditions (i.e., depressive disorders, anxiety, bipolar disorder, and schizophrenic spectrum disorder).</div></div><div><h3>Results</h3><div>Participants with DED had a significantly higher prevalence of depressive disorders (31.6% vs. 10.7%; <em>P</em> &lt; .001), anxiety disorders (34.8% vs. 14.7%; <em>P</em> &lt; .001), bipolar disorder (5.5% vs. 2.3%; <em>P</em> &lt; .001), and schizophrenia spectrum disorders (2.3% vs. 0.9%; <em>P</em> &lt; .001) than controls. Adjusted for medical comorbidities (i.e., hypothyroidism, Sjögren's syndrome, systemic lupus erythematosus), participants with DED had higher odds than controls in having a depressive disorder (odds ratio [OR]: 3.47; 95% CI: 3.32-3.62), anxiety (OR: 2.74; 95% CI: 2.63-2.85), bipolar disorder (OR: 2.23; 95% CI: 2.04-2.44), and schizophrenia spectrum disorder (OR: 2.48; 95% CI: 2.17-2.84). The association between DED and mental health conditions was stronger in Black participants than White participants (OR: 3.68 vs. 3.09, <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Participants with DED were significantly more likely to have mental health conditions than matched participants without DED; this association was stronger in Black participants than White participants. Greater efforts should be undertaken to screen DED patients for mental health conditions, particularly in historically medically underserved populations.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"270 ","pages":"Pages 61-66"},"PeriodicalIF":4.1,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451412","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}