American Journal of Ophthalmology最新文献

{"title":"Comment on: Intraocular lens power calculation-comparing big data approaches to established formulas.","authors":"Mohammad Reza Baghiyan Zarchi, Mohammad Erabi, Ali Hosseini","doi":"10.1016/j.ajo.2025.03.047","DOIUrl":"10.1016/j.ajo.2025.03.047","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778834","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":"Size Matters","authors":"Sanjay Asrani ,&nbsp;Ki Ho Park","doi":"10.1016/j.ajo.2025.03.042","DOIUrl":"10.1016/j.ajo.2025.03.042","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To describe the ideal size of a laser iridotomy and to discuss its importance.</div></div><div><h3>DESIGN</h3><div>Perspective.</div></div><div><h3>METHODS</h3><div>Articles in ophthalmology literature on this topic were reviewed, and commentary is provided based on the authors’ experiences.</div></div><div><h3>RESULTS</h3><div>An ideal laser iridotomy size is 200 µm or larger, especially in eyes with uveitis. The final size of an iridotomy must be confirmed after the effects of the pilocarpine has worn off and the pupil is not being constricted by light. A location of the iridotomy furthest from the lid margin may reduce the chances of dysphotopsias and thus allow for an adequate-sized iridotomy.</div></div><div><h3>CONCLUSIONS</h3><div>An iridotomy of an ideal size is needed to reduce the pressure differential on both sides of the iris so as to be effective in eliminating pupillary block.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 78-80"},"PeriodicalIF":4.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771007","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":"Biomechanical Properties Measured With Dynamic Scheimpflug Analyzer in Myopic Maculopathy","authors":"Kazuki Yashiro ,&nbsp;Shuichiro Aoki ,&nbsp;Kohdai Kitamoto ,&nbsp;Takahiro Arai ,&nbsp;Keiko Azuma ,&nbsp;Tatsuya Inoue ,&nbsp;Ryo Asaoka ,&nbsp;Ryo Obata","doi":"10.1016/j.ajo.2025.03.046","DOIUrl":"10.1016/j.ajo.2025.03.046","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Corneal biomechanical properties are associated with axial elongation. We aimed to characterize corneal biomechanical properties in highly myopic eyes with myopic maculopathy (MM).</div></div><div><h3>DESIGN</h3><div>Retrospective cross-sectional study.</div></div><div><h3>METHODS</h3><div>We included patients examined between June 2022 and August 2023 who underwent corneal visualization Scheimpflug technology (Corvis ST) measurements. MM in highly myopic eyes (axial length &gt;26.0 mm) was evaluated using META-PM (meta-analyses of pathologic myopia) study classification based on fundus photographs with subfoveal choroidal thickness measured via spectral domain optical coherence tomography. A linear mixed model was used to analyze the association of MM features with axial length (AL) and corneal biomechanical parameters, followed by model selection using the second-order–corrected Akaike information criterion.</div></div><div><h3>RESULTS</h3><div>We included 189 eyes from 109 participants. A significant correlation was observed between AL and biomechanical parameters that characterize maximal corneal deformation (maximal deflection amplitude and peak distance) and stiffness parameter (stress–strain index) (<em>P</em> &lt; .05). Model selection revealed that both AL and maximal deflection amplitude were independently associated with MM with category ≥2 severe, as well as with subfoveal choroidal thickness in highly myopic eyes (AL &gt;26.0 mm).</div></div><div><h3>CONCLUSIONS</h3><div>In highly myopic eyes, a greater maximal deflection amplitude was identified as a risk factor for MM. Corneal biomechanical properties may serve as biomarkers for predicting the development and progression of MM.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 92-98"},"PeriodicalIF":4.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771004","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":"Malignant Transformation of Ocular Melanocytoma to Uveal Melanoma: A Clinicopathologic Review of Three Novel Unsuspected Cases of a Likely Under-Recognized Phenomenon, With Review of the Literature and Molecular Genetic Data","authors":"Fabliha A. Mukit ,&nbsp;Nicole E. Terfloth ,&nbsp;Ivana K. Kim ,&nbsp;Frances Wu ,&nbsp;Anna M. Stagner","doi":"10.1016/j.ajo.2025.03.044","DOIUrl":"10.1016/j.ajo.2025.03.044","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To describe three cases of, and review the current knowledge regarding, malignant transformation of ocular melanocytoma (OM) to uveal melanoma (UM).</div></div><div><h3>DESIGN</h3><div>Retrospective clinicopathological case series and review of the literature.</div></div><div><h3>METHODS</h3><div>Clinical records and histopathology from three patients diagnosed with UM arising from a previously unsuspected OM were critically reviewed at a single academic institution. The patients’ demographic information, medical history, presenting clinical signs and symptoms, laboratory results, ancillary (including molecular genetic) testing, and management were collected. A literature review was conducted.</div></div><div><h3>RESULTS</h3><div>Three novel cases were identified, totaling 18 reported cases of malignant transformation of an OM to UM. The three new cases were diagnosed histopathologically on enucleation specimens for UM, without prior clinical history of OM. Where demographic information was available, ten patients were female and six male, with an average age at presentation of 45.75 years (range 15-69 years). For patients with an initial clinical diagnosis of OM, the interval to diagnosis of melanoma was between 0.25 years and 33 years, with the most common symptoms of evolution to UM being progressive vision loss, ocular pain, and elevated intraocular pressure. Six total cases did not have a previously known history of melanocytoma.</div></div><div><h3>CONCLUSION</h3><div>OM is rare; malignant transformation of OM to UM is also very uncommon. The incidental histopathological observation of darkly pigmented, polyhedral, magnocellular cells adjacent to or admixed with frank melanoma resulted in immunohistochemical confirmation of a precursor OM in three unsuspected cases, mimicking somewhat the appearance of UM with abundant admixed melanophages. OM may be a precursor to UM in more instances than previously recognized, and further data, as well as careful attention by pathologists, is needed to refine diagnosis and clinical management strategies regarding patients with known OM, especially outside of the optic nerve head.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 126-145"},"PeriodicalIF":4.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771005","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 Narrative Medicine Approach to Navigating Barriers to the Diagnosis of Pediatric Neurotrophic Keratopathy","authors":"Shadia Tannir ,&nbsp;Chilando Mulenga ,&nbsp;Khoa Tran ,&nbsp;Asim Ali ,&nbsp;Charline Boente ,&nbsp;Gregory H Borschel","doi":"10.1016/j.ajo.2025.03.043","DOIUrl":"10.1016/j.ajo.2025.03.043","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Neurotrophic keratopathy (NK) is a rare disease characterized by the loss of corneal innervation and increased vulnerability to injury. The diagnosis and treatment of NK can be challenging for pediatric patients and their caregivers. This study explores the experiences of caregivers navigating the diagnostic and treatment journey of pediatric patients with neurotrophic keratopathy.</div></div><div><h3>DESIGN</h3><div>This study is a qualitative study using semi-structured interviews.</div></div><div><h3>SUBJECTS</h3><div>Ten caregivers of pediatric patients with NK who had undergone corneal neurotization (CN) surgery.</div></div><div><h3>METHODS</h3><div>Caregivers were interviewed about their experiences related to the diagnostic process, treatment challenges, lifestyle changes, and the impact of CN surgery. Interviews were recorded, transcribed, and analyzed using an inductive-deductive approach to identify recurring themes.</div></div><div><h3>MAIN OUTCOMES</h3><div>Caregiver experiences and perceptions of diagnostic delays, information-seeking behaviors, lifestyle changes, and the effects of CN surgery on corneal health and quality of life.</div></div><div><h3>RESULTS</h3><div>Five key themes emerged from the analysis: (1) Delays in diagnosis due to insufficient specialist knowledge; (2) Caregivers' proactive efforts in seeking information; (3) Substantial lifestyle changes required by NK; (4) The impact of CN surgery on corneal health and quality of life; and (5) Variability in healthcare experiences, highlighting the need for effective communication. Caregivers expressed frustration with diagnostic delays and highlighted their reliance on external support networks.</div></div><div><h3>CONCLUSIONS</h3><div>This study illustrates the need for enhanced awareness among clinicians about NK and the benefits of narrative medicine in fostering caregiver-provider relationships. The challenges reported by families navigating NK inform strategies that may improve diagnosis and treatment of NK.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 109-116"},"PeriodicalIF":4.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771077","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":"Choroidal Vascular Occlusion After Fat Injection Into the Temple Area.","authors":"Chuanzhen Zheng, Chunxiu Li, Jie Zhong","doi":"10.1016/j.ajo.2025.03.041","DOIUrl":"10.1016/j.ajo.2025.03.041","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750044","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":"Comparison of Corneal Power Assessment Methods for True Corneal Power After Myopic Small-Incision Lenticule Extraction","authors":"Xiaoling Fang ,&nbsp;Chunxia Yu ,&nbsp;Wenwen Xue ,&nbsp;Jinhua Tao ,&nbsp;Wenbo Yao ,&nbsp;Liquan Zhao ,&nbsp;Yulan Wang","doi":"10.1016/j.ajo.2025.03.026","DOIUrl":"10.1016/j.ajo.2025.03.026","url":null,"abstract":"<div><h3>Purpose</h3><div>We sought to compare the accuracy of different corneal curvature parameters in estimating corneal power change in eyes that underwent myopic small-incision lenticule extraction (SMILE).</div></div><div><h3>Design</h3><div>Prospective cross-sectional trial.</div></div><div><h3>Methods</h3><div>89 eyes of 48 patients who had undergone SMILE at Shanghai Eye Disease and Prevention &amp; Treatment Center were enrolled. Total corneal refractive power (TCRP) and total keratometry (TK) values, along with corrected parameters calculated using the Haigis, Shammas, Maloney, and Actual K_a+p methods, were compared with data obtained using the clinical history method (CHM). We also compared the surgically induced changes in TCRP (ΔTCRP) and TK (ΔTK) to changes in the spherical equivalent on the corneal plane (ΔSEco).</div></div><div><h3>Results</h3><div>After SMILE, differences were smallest between values of TK (0.41 ± 0.48 D) and CHM. The width of the 95% limits of agreement of TK (1.88 D) was narrowest, followed by that of K_a+p (1.94 D). Pearson analysis showed that each parameter had a good correlation with CHM data. The differences between ΔTK and ΔSEco was 0.42 D, when between ΔTCRP and ΔSEco was 0.62 D. The width of the 95% limits of agreement of ΔTK (1.88 D) and the correlation coefficient of ΔTK (0.964) were greater than those of ΔTCRP. A separate case of cataract surgery following SMILE confirmed the validity of the above points in our study (the absolute error was 0.005 D).</div></div><div><h3>Conclusions</h3><div>The TK parameter of the IOLMaster 700 can provide accurate and objective corneal power evaluation after SMILE.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"275 ","pages":"Pages 156-163"},"PeriodicalIF":4.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750227","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":"National Trends in Central Retinal Artery Occlusion Presentations and Stroke Workup in United States Emergency Department","authors":"Sinan Akosman ,&nbsp;Sean M. Yuan ,&nbsp;Arnold Leigh ,&nbsp;Renxi Li ,&nbsp;Renjie Luo ,&nbsp;Masumi G. Asahi ,&nbsp;Kapil Mishra","doi":"10.1016/j.ajo.2025.03.040","DOIUrl":"10.1016/j.ajo.2025.03.040","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate trends in acute central retinal artery occlusion (CRAO) diagnostic assessments and sociodemographic characteristics of patients in the United States (US) emergency department (ED).</div></div><div><h3>Design</h3><div>Retrospective trend study.</div></div><div><h3>Subjects</h3><div>Adult patients with CRAO presenting to ED from 2016 through 2021.</div></div><div><h3>Methods</h3><div>The National Emergency Department Sample was queried with International Classification of Diseases, Tenth Revision (ICD-10) codes with a primary diagnosis of CRAO. Stroke workup modalities assessed included brain imaging (CT/computed tomography angiography and magnetic resonance imaging/magnetic resonance angiography), carotid imaging (US, computed tomography angiography, magnetic resonance angiography), cardiac diagnostics (echocardiogram/electrocardiogram), and laboratory workup (erythrocyte sedimentation rate/C-reactive protein).</div></div><div><h3>Main Outcome Measure</h3><div>Proportion of studied participants receiving stroke workup modalities.</div></div><div><h3>Results</h3><div>A total of 3736 patients were identified with mean age of 69 [13.72] years, majority were male (53.02%), and predominantly insured by Medicare (62.77%). Comorbidities included hypertension (75.45%), hyperlipidemia (44.67%), coronary artery disease (20.26%), diabetes (27.38%), and obesity (11%). CRAO incidence significantly increased over the 5-year period from 1698 to 3526 (<em>P</em> = .024). Utilization rates of all workup modalities including brain imaging, carotid imaging, heart, and laboratory tests showed a linear increase from 2016 through 2021. The proportion of patients receiving no stroke workup decreased from 66.75% to 57.87% (<em>P</em> = .259).</div></div><div><h3>Conclusions</h3><div>The US has increased the screening and stroke workup of CRAO in the ED over time, yet greater than 50% of patients continue to not receive any type of stroke workup imaging. Greater awareness of these trends and current guidelines could result in improved screening and patient outcomes.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 40-49"},"PeriodicalIF":4.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750418","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":"Incidence and Prevalence of Uveitis and Associated Ocular Complications in the United States TriNetX Database","authors":"NILA KIRUPAHARAN ,&nbsp;RAYNA F. MARSHALL ,&nbsp;MATTHEW D. SPANGLER ,&nbsp;KAREN R. ARMBRUST ,&nbsp;MEGHAN K. BERKENSTOCK","doi":"10.1016/j.ajo.2025.03.032","DOIUrl":"10.1016/j.ajo.2025.03.032","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the demographics, immunosuppressant use, associated systemic diseases, ocular comorbidities, and incidence and prevalence of uveitis and associated low vision using the United States TriNetX database from 2013-2023.</div></div><div><h3>Design</h3><div>Retrospective cross-sectional and trend study.</div></div><div><h3>Participants</h3><div>Subjects with uveitis in the TriNetX database.</div></div><div><h3>Methods</h3><div>Subjects with uveitis were identified with International Classification for Disease codes and then divided into anatomic subtypes based on the diagnosis. Incidence and prevalence data were collected from 2013-2023. Additional data collected included demographics, use of systemic immunosuppressive medications, presence of an associated systemic disease, and associated ocular complications.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes were the incidence and prevalence of uveitis (annual and cumulative) with additional analysis by anatomic subtype. Secondary outcomes were the incidence and prevalence of low vision (annual and cumulative).</div></div><div><h3>Results</h3><div>Out of the 109,026,851 subjects in the database, 278,333 (0.26%) had a diagnosis of uveitis. The mean age was 56 years (Standard Deviation = 21, 95% Confidence Interval (CI) 55.9-56.1), and the majority were female (n = 149,186; 53.6%, 95% CI 53.4%-53.8%) and white (n = 150,578; 54.1%, 95% CI 53.9%-54.3%). Anterior uveitis was the most common subtype (n = 209,073, 75.1%). Oral prednisone (n = 62,834; 22.6%, 95% CI 22.5%-22.8%) was the most used immunosuppressant and methotrexate (n = 15,817; 5.7%, 95% CI 5.6%-5.8%) was the most prevalent corticosteroid-sparing immunosuppressive agent. Inflammatory spondyloarthropathies (n = 18,372; 6.6%, 95% CI 6.5%-6.7%) were the most frequently associated systemic disease. The cumulative incidence and prevalence of uveitis from 2013-2023 were 212.5 and 260.8 per 100,000 persons, respectively.</div></div><div><h3>Conclusions</h3><div>This study represents one of the largest uveitis populations analyzed in the United States, revealing a rising incidence of all uveitis subtypes and an increase in low vision among affected patients over the past decade in the database. Prospective studies are needed to identify the factors driving these trends and to develop strategies to prevent vision loss and ocular complications in uveitis patients.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 30-39"},"PeriodicalIF":4.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741755","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 Features of VEXAS Syndrome: A Systematic Review and Meta-analysis","authors":"Clare Quigley ,&nbsp;James Pietris ,&nbsp;Terence Ang ,&nbsp;Lina Zgaga ,&nbsp;Dinesh Selva","doi":"10.1016/j.ajo.2025.03.036","DOIUrl":"10.1016/j.ajo.2025.03.036","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To identify and analyze ocular features seen in Vacuoles, E1-ligase, X-linked Auto-inflammatory, Somatic (VEXAS) syndrome.</div></div><div><h3>DESIGN</h3><div>A systematic literature review was performed following PRISMA guidelines (PROSPERO registration number: ID 566167).</div></div><div><h3>METHODS</h3><div>Article inclusion criteria comprised genetic confirmation VEXAS syndrome that included eye involvement. Exclusion criteria included lack of genetic testing, or ocular feature reporting. A systematic search of the PubMed/MEDLINE, Embase, and CENTRAL databases was performed from January 2020 to September 2024. Data were collected and risk of bias assessed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. For the meta-analysis, specific <em>UBA1</em> mutation and systemic feature data were also included. An association between severity of ocular features, presence of specific ophthalmic or systemic features, with age or causative mutation was investigated using Kruskal-Wallis rank sum testing and Fisher exact test, respectively, using R.</div></div><div><h3>RESULTS</h3><div>Fifty-two articles were included, amounting to 204 individuals (1 female). Mean age of VEXAS symptom onset was 67 ± 5 years (range: 46-87). Orbital inflammation was the most common ocular manifestation, comprising periorbital edema (n = 83, 40.7%), orbital myositis (n = 14, 6.9%), dacryoadenitis (n = 6, 2.9%), and orbital compartment syndrome (n = 1, 0.5%). Other features included episcleritis (n = 28, 13.7%), scleritis (n = 28, 13.7%), uveitis (n = 25, 12.3%), and retinal vasculitis (n = 2, 1%), among others. Visual acuity reporting was limited (n = 4, 2%). Meta-analysis was conducted on 32 articles (n = 48) with genotype and ocular feature data. The most commonly reported <em>UBA1</em> mutation was the missense mutation p.Met41Thr (n = 24, 50%), followed by p.Met41Val (n = 17, 35%), p.Met41Leu (n = 4, 8%), and splice site mutations or deletions (n = 3, 6%). There was an association for more severe ophthalmic features in the splice site mutation group vs methionine 41 missense mutations (<em>P</em> = .04). The most commonly associated systemic features included dermatologic manifestations (n = 41, 85%), recurrent fever (n = 38, 79%), and pulmonary involvement (n = 30, 63).</div></div><div><h3>CONCLUSION</h3><div>There is notable variation in the ophthalmic features of VEXAS. Ophthalmic review is advised for VEXAS patients who develop eye symptoms, given the risk of sight-threatening disease.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"276 ","pages":"Pages 50-63"},"PeriodicalIF":4.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741825","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}