American Journal of Ophthalmology最新文献

{"title":"Comparison Between Optical Coherence Tomography B-scan and En Face Imaging for the Diagnosis of Early Macular Atrophy in Age-Related Macular Degeneration","authors":"Yuxuan Cheng ,&nbsp;Monika Fleckenstein ,&nbsp;Marc Steffen Schmitz-Valckenberg ,&nbsp;Jie Lu ,&nbsp;Ziyu Liu ,&nbsp;Gissel Herrera ,&nbsp;Giovanni Gregori ,&nbsp;Ruikang K. Wang ,&nbsp;Philip J. Rosenfeld ,&nbsp;Omer Trivizki","doi":"10.1016/j.ajo.2024.10.002","DOIUrl":"10.1016/j.ajo.2024.10.002","url":null,"abstract":"<div><h3>PURPOSE</h3><div>The gradings of complete retinal pigment epithelium (RPE) and outer retinal atrophy (cRORA) and incomplete RPE and outer retinal atrophy (iRORA) on spectral domain optical coherence tomography (SD-OCT) B-scans were compared with the grading of persistent choroidal hypertransmission defects (hyperTDs) on swept-source optical coherence tomography angiography (SS-OCTA) en face images.</div></div><div><h3>DESIGN</h3><div>Comparative diagnostic analysis of prospective study data.</div></div><div><h3>METHODS</h3><div>Patients with late nonexudative age-related macular degeneration underwent same-day 6×6-mm macular scans using both SD-OCT (Spectralis Heidelberg, 512×97, automatic real-time tracking: 9) and SS-OCTA (PLEX Elite 9000, Carl Zeiss Meditec, 500×500 angio pattern) instruments. SS-OCTA and SD-OCT en face images were generated from a sub-RPE slab positioned 64 to 400 µm below Bruch's membrane. SD-OCT B-scan gradings, which included an inspection of neighboring B-scans for the diagnosis of cRORA and iRORA, were performed at the Moran Eye Center, and gradings of en face images to identify persistent choroidal hyperTDs were performed at the Bascom Palmer Eye Institute and Tel Aviv Medical Center.</div></div><div><h3>RESULTS</h3><div>There was a high degree of agreement (99.6%) between the gradings of cRORA lesions and persistent hyperTDs. However, 27.4% of iRORA lesions were found to be contained within persistent hyperTDs. This discrepancy was due to the finding that 27.5% of iRORA lesions were diagnosed as having a greatest linear horizontal dimension of &lt;250 µm on B-scans, but on en face images, these B-scan–defined iRORA lesions were found to have the greatest linear dimensions in the nonhorizontal dimension that were ≥250 µm.</div></div><div><h3>CONCLUSIONS</h3><div>This report demonstrates the benefits of using en face OCT imaging to identify cRORA lesions and highlights the need to acquire dense raster B-scans with the grading neighboring B-scans when identifying iRORA lesions to assess the full extent of the iRORA lesions in the nonhorizontal dimension. Although neighboring B-scans were inspected, 27.5% of iRORA lesions were actually part of larger cRORA lesions when graded using an en face strategy.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"270 ","pages":"Pages 252-260"},"PeriodicalIF":4.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399117","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":"Prevalence, Features, and Risk Factors of Macular Retinoschisis in High Myopic Population: The Beijing Eye Study 2011","authors":"Zhe Pan ,&nbsp;Yu Huang ,&nbsp;Zihan Li ,&nbsp;Wenqing Liu ,&nbsp;Ziyao Wang ,&nbsp;Chun Zhang ,&nbsp;Jost B. Jonas ,&nbsp;Ya Xing Wang","doi":"10.1016/j.ajo.2024.10.003","DOIUrl":"10.1016/j.ajo.2024.10.003","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To investigate the prevalence, features, and risk factors of macular retinoschisis (MRS) in highly myopic eyes and their morphological features in a Chinese population.</div></div><div><h3>DESIGN</h3><div>Population-based, cross-sectional study. From the Beijing Eye Study 2011, a total of 213 highly myopic eyes from 129 participants were included.</div></div><div><h3>METHODS</h3><div>All participants underwent spectral-domain optical coherence tomography with a macula cube scan of 30°×30°centered in the fovea. High myopia was defined as a refractive error ≤–6 diopters or an axial length ≥26.0 mm. MRS presence and its subtypes were assessed based on location, and affected retinal layers were evaluated. Prevalence, features, and associated factors of MRS and its subtypes in highly myopic population were assessed.</div></div><div><h3>RESULTS</h3><div>Of 213 highly myopic eyes (129 participants), MRS was observed in 48 eyes, with a prevalence of 22.5% (95% CI, 16.9-28.6) per eye, or 36 participants with 27.9% (95% CI, 20.5-35.7) per subject. In addition to well-documented factors such as older age and higher myopia, the prevalence of MRS was found to be related with a higher intraocular pressure (<em>P = .</em>013, odds ratio [OR], 1.25; 95% CI, 1.05-1.48), a thinner subfoveal choroidal thickness (<em>P = .</em>006, OR, 0.86; 95% CI, 0.77-0.96), a wider Gamma zone (<em>P = .</em>003, OR, 1.99; 95% CI, 1.05-3.11), the presence of glaucoma (<em>P = .</em>010, OR, 3.37; 95% CI, 1.34-8.48), and the presence of epiretinal membrane (<em>P = .</em>023, OR, 3.13; 95% CI, 1.17-8.36) after multivariate analysis. Eyes with advanced high myopia (<em>P = .</em>021) and wider gamma zone (<em>P = .</em>005) were more likely to develop foveal MRS. Eyes with glaucoma tended to have a higher prevalence of outer retinal MRS compared with inner retinal MRS (60.9% vs 36.0%), although the difference was not statistically significant (<em>P = .</em>06). MRS located in the foveal region or affecting the outer retina was related with a significantly worse best-corrected visual acuity (BCVA) compared with MRS that was perifoveally located or affected other regions (<em>P</em> &lt; .05).</div></div><div><h3>CONCLUSIONS</h3><div>The prevalence of MRS was 27.9% among the elderly highly myopic population. MRS occurring in the foveal region or involving the outer retina demands increased vigilance due to its significant impact on BCVA. The findings contribute to a deeper understanding of MRS, offering insights into its mechanisms and vision prognosis.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"270 ","pages":"Pages 227-236"},"PeriodicalIF":4.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399118","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":"Myopic Maculopathy Progression: Insights Into Posterior Staphyloma and Macular Involvement","authors":"Ignacio Flores-Moreno ,&nbsp;Mariluz Puertas ,&nbsp;Marina Fernández-Jiménez ,&nbsp;Luis Celestino Franco ,&nbsp;María Terrón-Vilalta ,&nbsp;Blanca Eslava ,&nbsp;Elena Almazán-Alonso ,&nbsp;Jorge Ruiz-Medrano ,&nbsp;Bachar Kudsieh ,&nbsp;María García-Zamora ,&nbsp;José M. Ruiz-Moreno","doi":"10.1016/j.ajo.2024.09.035","DOIUrl":"10.1016/j.ajo.2024.09.035","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To analyze myopic maculopathy's progression pattern.</div></div><div><h3>DESIGN</h3><div>Retrospective, observational case series.</div></div><div><h3>METHODS</h3><div>A total of 824 highly myopic eyes (axial length ≥26 mm) of 430 patients examined at Puerta de Hierro-Majadahonda University Hospital (Madrid, Spain) with a minimum follow-up of 2 years. All patients underwent complete ophthalmologic examination, including multimodal imaging. Progression of myopic maculopathy was assessed according to ATN classification system at baseline and throughout the follow-up, as well as associated clinical features.</div></div><div><h3>RESULTS</h3><div>Progression of myopic maculopathy was described in 42% of eyes over a mean follow-up of 4.10 ± 1.28 (range, 2.00-6.23) years. Compared with nonprogressing eyes, myopic maculopathy progression correlated with worse best-corrected visual acuity (BCVA) at follow-up (<em>P &lt; .</em>05) and greater BCVA loss (<em>P &lt; .</em>01). There were no significant differences between groups in axial length, gender, and age (<em>P &gt; .</em>05). Eyes with posterior staphyloma (PS) and, particularly, those with macular PS showed significantly greater myopic maculopathy progression (<em>P &lt; .</em>01). The likelihood of myopic maculopathy's progression was 3.94 times higher (odds ratio, 3.94 ± 1.22, <em>P &lt; .</em>01) in eyes with PS compared with those without PS. Atrophic progression occurred in 21.9% of eyes, with diffuse to patchy atrophy being the most common pattern (54.17%). Tractional progression was observed in 22.8% of eyes, predominantly from nontraction to inner/outer foveoschisis (40%). Neovascular progression affected 11.4% of the eyes, most of them from no neovascular component to macular lacquer cracks (40%).</div></div><div><h3>CONCLUSIONS</h3><div>This study highlights significant myopic maculopathy progression over the natural course of the disease, compromising the BCVA as macular complications progress. Myopic maculopathy progression was significantly associated with PS, especially in those with macular involvement.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"270 ","pages":"Pages 164-171"},"PeriodicalIF":4.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142405809","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":"Assessing Private Equity Involvement in Ophthalmology: Parallels With the Past, Concerns for the Future","authors":"Jonathan D. Groothoff ,&nbsp;David J. Browning","doi":"10.1016/j.ajo.2024.09.026","DOIUrl":"10.1016/j.ajo.2024.09.026","url":null,"abstract":"<div><h3>Purpose</h3><div>To discuss the history and current state of private equity in ophthalmology, and to explore potential implications for ophthalmology practices, physicians, and patients.</div></div><div><h3>Design</h3><div>Perspective.</div></div><div><h3>Methods</h3><div>Selected articles in ophthalmology and non-ophthalmology medical literature were reviewed, and commentary is provided based on the authors’ experiences.</div></div><div><h3>Results</h3><div>Investment in ophthalmology appeals to private equity firms because of high procedural volumes, fragmented private practices, opportunities for real estate ownership, and an aging population in need of eye care. As a result, acquisition of private practices by large private equity companies has swelled since 2015. Metropolitan areas and practices that possess ambulatory surgical centers or a high proportion of retina surgeons receive the greatest investment. However, little objective data exist regarding the benefits of this trend. Initial research suggests that private equity ownership may have a negative impact on patient care through greater costs, shorter appointments, and fewer Medicare/Medicaid patients seen. Skeptics of private equity also highlight concerns that include financial risk falling primarily on the acquired practice itself, a short-term business approach that rewards profit maximization, and the erosion of physician autonomy. Furthermore, young ophthalmologists express reservations about working for private equity firms. In all, 78% of trainees indicated that they would not consider employment by a private equity–owned practice, and 81.4% of vitreoretinal fellows voiced concerns about autonomy and job security. Proposed legislation aimed at limiting private equity acquisitions is currently under review at the statewide level, adding additional uncertainty to the future of private equity involvement in ophthalmology.</div></div><div><h3>Conclusions</h3><div>Although investment by private equity offers potential financial rewards and operational improvements for practices, it also raises significant concerns reminiscent of those experienced by physician practice management companies in the 1990s<em>.</em> Non-anecdotal data are needed to assess the benefits and future of private equity involvement in ophthalmology.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"270 ","pages":"Pages 245-251"},"PeriodicalIF":4.1,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379897","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":"Outer Retinal Thinning is Associated With Brain Atrophy in Early Age-Related Macular Degeneration","authors":"Yu Jiang ,&nbsp;Thomas Swain ,&nbsp;Nayoon Gim ,&nbsp;Marian Blazes ,&nbsp;Christine Mac Donald ,&nbsp;Ariel Rokem ,&nbsp;Julia P. Owen ,&nbsp;Niranjan Balu ,&nbsp;Mark E. Clark ,&nbsp;Lukas Goerdt ,&nbsp;Gerald McGwin ,&nbsp;David Hunt ,&nbsp;Christine A. Curcio ,&nbsp;Swati Rane Levendovszky ,&nbsp;Emily H. Trittschuh ,&nbsp;Cynthia Owsley ,&nbsp;Cecilia S. Lee","doi":"10.1016/j.ajo.2024.09.033","DOIUrl":"10.1016/j.ajo.2024.09.033","url":null,"abstract":"<div><h3>Purpose</h3><div>Both retinal changes and age-related macular degeneration (AMD) have been shown to be associated with Alzheimer's disease and related dementias (ADRD). In AMD, the outer retina is impacted significantly and early, but little is known about its association with cognition or changes in brain morphometry. This study investigates the relationship between retinal and brain morphometry in older adults with early and intermediate AMD.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>Adults ≥70 years with normal, early, and intermediate AMD were recruited from Callahan Eye Hospital Clinics at the University of Alabama at Birmingham. Participants underwent cognitive testing, optical coherence tomography, and magnetic resonance imaging. Associations of retinal layer thickness with brain volume and thickness of specific brain regions were evaluated utilizing multivariable linear regression. The relevance of retinal thickness variables in brain volumetrics was quantified using least absolute shrinkage and selection operator regression models. Correlations between demographic variables, cognitive scores, and brain morphometry were evaluated.</div></div><div><h3>Results</h3><div>Participants with thinner outer retina had significantly smaller hippocampus (<span><math><mi>β</mi></math></span> = 0.019, <em>P</em> = .022), lower occipital cortex regions of interest (occipital ROIs) thickness (<span><math><mi>β</mi></math></span> = 5.68, <em>P</em> = .020), and lower cortical thickness in ADRD-related brain regions (<span><math><mi>β</mi></math></span> = 7.72, <em>P</em> = .006). People with thinner total retina had significantly lower occipital ROIs (<span><math><mi>β</mi></math></span> = 3.19, <em>P</em> = .009) and ADRD-related brain region (<span><math><mi>β</mi></math></span> = 3.94, <em>P</em> = .005) thickness. Outer retinal thickness in the outer Early Treatment of Diabetic Retinopathy Study ring was the most frequently reported retinal variable associated with brain morphometry on least absolute shrinkage and selection operator regression. Total gray matter volume showed positive correlations with education (Pearson's <em>r</em> = 0.30, <em>P</em> = .022).</div></div><div><h3>Conclusions</h3><div>In older adults with normal retinal aging and early and intermediate AMD, thinner outer retina had specific associations with brain regions primarily involved in vision and cognition, such as lower hippocampal volume and lower thickness of the occipital ROIs and brain regions known to show early structural changes in dementia.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"269 ","pages":"Pages 457-465"},"PeriodicalIF":4.1,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379899","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":"Disparities Between Clinical Trial Recruitment and Real-World Demographics in Macular Edema Secondary to Retinal Vein Occlusion","authors":"Theodore Bowe ,&nbsp;Collin J. Richards ,&nbsp;Hana A. Mansour ,&nbsp;Ferhina S. Ali ,&nbsp;Jayanth Sridhar ,&nbsp;Jr Basil K. Williams ,&nbsp;Yoshi Yonekawa ,&nbsp;Michael N. Cohen ,&nbsp;David Xu ,&nbsp;Jordan D. Deaner ,&nbsp;Meera Sivalingam ,&nbsp;Anton Orlin ,&nbsp;Shriji Patel ,&nbsp;Ajay E. Kuriyan","doi":"10.1016/j.ajo.2024.09.031","DOIUrl":"10.1016/j.ajo.2024.09.031","url":null,"abstract":"<div><h3>Purpose</h3><div>Clinical trial cohorts frequently differ demographically from the overall population receiving treatment for the condition under study. Our study describes the racial, ethnic, and gender composition of the cohorts of retinal vein occlusion (RVO) macular edema (ME) clinical trials and compares this to the racial, ethnic, and gender composition of patients undergoing treatment for ME secondary to RVO from the (Intelligent Research in Sight) IRIS Registry.</div></div><div><h3>Design</h3><div>Retrospective observational case series Subjects: Participants in RVO-ME clinical trials that met the following inclusion criteria: conducted in the United States of America, Phase III completed, data reported between January 1, 2000, and January 1, 2020, and demographic information reported with results.</div></div><div><h3>Methods</h3><div>This study identified clinical trials by searching PubMed with the following search terms; “retinal vein occlusion” and “clinical trial” and by searching ClinicalTrials.gov with the search term “retinal vein occlusion.”</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was the enrollment fraction defined as the number of trial enrollees divided by the reference sample size of RVO patients undergoing treatment for ME from published IRIS Registry (Intelligent Research in Sight) data. Enrollment fraction was compared between different races, ethnicities, and genders.</div></div><div><h3>Results</h3><div>Eight clinical trials met our inclusion criteria. Compared to the enrollment fraction of 7.69% among Whites, lower enrollment fractions were found in Black patients (4.32%, odds ratio [OR] 0.541, confidence interval [CI] 0.468-0.626, <em>P</em> &lt; .001) and Hispanic patients (3.38%, OR 0.420, CI 0.351-0.503, <em>P</em> &lt; .001), and higher enrollment fraction in Asian patients (10.68%, OR 1.436, CI 1.207-1.708, <em>P</em> &lt; .001). Men were more likely to enroll in the clinical trials compared to women (enrollment fraction, 7.69% vs 5.77%, respectively, OR 1.364, CI 1.273-1.462, <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>RVO-ME clinical trials have a higher relative proportion of Asian, White and male subjects when compared to the population undergoing treatment for ME secondary to RVO. Further efforts should encourage clinical trial recruitment that is reflective of the RVO population undergoing treatment for ME to ensure generalizability of clinical trial results.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"269 ","pages":"Pages 429-434"},"PeriodicalIF":4.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379898","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":"Outcomes of Hyperbaric Oxygen Treatment for Central Retinal Artery Occlusion: A Single Center Experience","authors":"BOYOUNG M. KIM ,&nbsp;KENNY Y. WANG ,&nbsp;TIMOTHY T. XU ,&nbsp;SARA J. HOOSHMAND ,&nbsp;GARY N. TOUPS ,&nbsp;MARTHA P. MILLMAN ,&nbsp;LAWRENCE W. STEINKRAUS ,&nbsp;ANDREA A. TOOLEY ,&nbsp;ANDREW J. BARKMEIER ,&nbsp;JOHN J. CHEN","doi":"10.1016/j.ajo.2024.09.027","DOIUrl":"10.1016/j.ajo.2024.09.027","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe the outcomes of hyperbaric oxygen therapy (HBOT) for patients with central retinal artery occlusion (CRAO) at a single tertiary care center.</div></div><div><h3>Design</h3><div>Retrospective clinical cohort study.</div></div><div><h3>Methods</h3><div>Medical records of all patients diagnosed with CRAO who received HBOT at Mayo Clinic in Rochester, Minnesota from January 1, 2009 to December 31, 2020 were reviewed to confirm diagnosis, time from onset to presentation, exam findings, treatments, and follow-up data. Main outcome measures included final visual acuity (VA) and number of lines of improvement.</div></div><div><h3>Results</h3><div>There were 41 patients diagnosed with CRAO who received HBOT during the 12-year study period. Median time from symptom onset to HBOT treatment was 9.5 h (interquartile range [IQR] 6.5, 14.0 h), and patients received a median of 4 HBOT sessions (IQR 2.5, 6.0 sessions). There were 20 patients who received HBOT within 9 h, 14 (70%) of which had clinically meaningful improvement in VA of ≥0.3 logMAR. In comparison, of the 21 patients treated after 9 h, 6 (28.6%) had VA improvement of ≥0.3 logMAR (<em>P</em> = .008). For all patients, the median logMAR VA at presentation was 2.00 (IQR 1.70, 2.30) and the median logMAR VA at follow-up was 1.94 (IQR 1.00, 2.00) (<em>P</em> &lt; .001), with median lines of improvement of 3.0 (IQR 0.0, 7.0). For patients treated within 9 h, the median logMAR VA at presentation was 2.00 (IQR 1.93, 2.30) and the median logMAR VA at follow-up was 1.70 (IQR 0.54, 2.00). Patients treated within 9 h had statistically significant greater median lines of VA improvement than cases that were treated after &gt;9 h from symptom onset at 5.9 (IQR 3.0, 10.0) and 0.0 (IQR 0.0, 3.0), respectively (<em>P</em> &lt; .001). There was no difference in VA recovery associated with specific retinal exam findings such as cherry-red spot (<em>P</em> = .22) and cilioretinal artery perfusion (<em>P</em> = .36) compared to patients without those findings.</div></div><div><h3>Conclusion</h3><div>There was a statistically significant improvement in VA after HBOT treatment in CRAO patients among patients that received early HBOT, with patients receiving the most benefit when receiving treatment within 9 h. Randomized control trials in patients with CRAO are required to confirm the efficacy of HBOT.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"269 ","pages":"Pages 393-401"},"PeriodicalIF":4.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379003","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":"Risk Factors for the Development of Ocular Complications in Herpes Zoster Ophthalmicus and Zoster Vaccine Utilization in a Large, Urban Health System","authors":"Ann-Marie Lobo-Chan,&nbsp;Amy Song,&nbsp;Arya Kadakia,&nbsp;Supriya D. Mehta","doi":"10.1016/j.ajo.2024.09.028","DOIUrl":"10.1016/j.ajo.2024.09.028","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize the epidemiology of herpes zoster (HZ) and herpes zoster ophthalmicus (HZO) in an urban hospital system and determine risk factors associated with developing ocular complications in HZO. To report the frequency of shingles vaccination and HZ reactivation following shingles vaccination in this population.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on patients seen at the University of Illinois Hospital system from January 1, 2010 to December 1, 2021 with HZ and HZO identified by diagnosis code. Charts of HZO patients seen within 1 year of diagnosis were abstracted. Multivariable logistic regression analysis identified factors associated with the development of ocular complications in HZO.</div></div><div><h3>Results</h3><div>During the study period, 3283 patients had HZ; mean age of onset was 52.3 years, 61.6% were female, and 37% were Black. HZO with ocular involvement was seen in 110 (3.4%) patients. Ocular complications developed in 40 (36.4%) patients; the most common complication was corneal scarring (70%). Age (odds ratio [OR] 1.04, 95%CI 1.0-1.1), female gender (OR 2.86, 95%CI 1.0-8.1), steroids at initial visit (4.46, 95%CI 1.4-14.6), and stromal keratitis (OR 3.45, 95% CI 1.2, 9.8) were associated with developing ocular complications. Of eligible populations, 5333 (1.5%) received shingles vaccination; 43 patients developed reactivation of HZ following vaccination.</div></div><div><h3>Conclusions</h3><div>In HZO, age, female gender, steroids at initial visit, and stromal keratitis are strongly associated with developing ocular complications. Shingles vaccination rates were low in this study population. Understanding potential for complications in HZ/HZO and vaccination uptake can help identify at risk populations to prevent disease. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"269 ","pages":"Pages 435-449"},"PeriodicalIF":4.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370682","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 “COVID-19 Morbidity and Severity in Patients With Age-Related Macular Degeneration: A Korean Nationwide Cohort Study,” American Journal of Ophthalmology, 239C, 159-169","authors":"Jee Myung Yang ,&nbsp;Sung Yong Moon ,&nbsp;Joo Yong Lee ,&nbsp;Dritan Agalliu ,&nbsp;Dong Keon Yon ,&nbsp;Seung Won Lee","doi":"10.1016/j.ajo.2024.09.004","DOIUrl":"10.1016/j.ajo.2024.09.004","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"268 ","pages":"Page 421"},"PeriodicalIF":4.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142363970","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":"Temporary Keratoprosthesis and Primary Corneal Graft for Ocular Trauma: A Systematic Review and Meta-Analysis","authors":"DAVID MCMASTER ,&nbsp;SOPHIA HALLIDAY ,&nbsp;JAMES BAPTY ,&nbsp;SCOTT F MCCLELLAN ,&nbsp;SARAH C MILLER ,&nbsp;GRANT A JUSTIN ,&nbsp;RUPESH AGRAWAL ,&nbsp;ANNETTE K HOSKIN ,&nbsp;KARA CAVUOTO ,&nbsp;JAMES LEONG ,&nbsp;ANDRÉS ROUSSELOT ASCARZA ,&nbsp;FASIKA A WORETA ,&nbsp;JOHN CASON ,&nbsp;KYLE E MILLER ,&nbsp;MATTHEW C CALDWELL ,&nbsp;WILLIAM G GENSHEIMER ,&nbsp;TOM H WILLIAMSON ,&nbsp;FELIPE DHAWAHIR-SCALA ,&nbsp;PETER SHAH ,&nbsp;ANDREW COOMBES ,&nbsp;RICHARD J BLANCH","doi":"10.1016/j.ajo.2024.09.025","DOIUrl":"10.1016/j.ajo.2024.09.025","url":null,"abstract":"<div><h3>Purpose</h3><div>When severe retinal and corneal injury occur together, a temporary keratoprosthesis (TKP) is often a last resort to allow posterior segment visualization to enable vitreoretinal surgery, followed by a penetrating keratoplasty (PKP) which can restore corneal clarity in a single operation. We aimed to assess visual outcomes following combined PKP and vitreoretinal surgery with the use of a TKP for cases of ocular trauma.</div></div><div><h3>Design</h3><div>A systematic literature review was performed following PRISMA guidelines (PROSPERO registration number: CRD42023423518).</div></div><div><h3>Methods</h3><div>CENTRAL, MEDLINE, Embase, ISRCTN registry, and ClinicalTrials.gov were searched from inception to 27 April 2023. Randomized and nonrandomized studies assessing visual outcomes after combined vitreoretinal surgery and PKP with the use of a TKP after ocular trauma were eligible for inclusion. Outcomes included change in best corrected visual acuity, corneal graft survival and retinal reattachment at final follow up. Proportional meta-analysis was used to estimate the overall rate of the primary outcomes. Risk of bias for nonrandomized studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist for case series.</div></div><div><h3>Results</h3><div>A total of 19 studies met inclusion criteria reporting a total of 352 eyes. All studies were retrospective and nonrandomized with follow up times ranging from 6 to 91 months, with at least 79% of outcomes reported after 6 months. After combined surgery the rate of corneal graft survival was 52% (95% CI 0.41-0.62; I² 60%) successful retinal attachment was 79% (95% CI 0.73-0.84; I² 0%). and improved visual acuity, when compared to no change or decrease in visual acuity, was 45% (95% CI 0.32-0.59; I² 66%).</div></div><div><h3>Conclusion</h3><div>Patients with severe injury affecting the anterior and posterior segments have very limited treatment options. This systematic review found that when combined vitreoretinal surgery and PKP with a TKP are performed, approximately half of corneal grafts survive, anatomically successful retinal reattachment is likely, and a similar proportion of patients benefit in terms of improved visual acuity, compared to their preoperative function. This systematic review of the available literature may help inform surgeons of the benefits of using a TKP for cases of ocular trauma.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"268 ","pages":"Pages 378-387"},"PeriodicalIF":4.1,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339172","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}