American Journal of Ophthalmology最新文献

{"title":"Clinical Assessment of a Highly Multiplexed Panel Assay for the Diagnosis of Infectious Uveitis","authors":"Paulo J.M. Bispo ,&nbsp;Nicole L. Belanger ,&nbsp;Renee Liu ,&nbsp;Eduardo Ferracioli-Oda ,&nbsp;Tatiana Tanaka ,&nbsp;Joyce Hisae Yamamoto ,&nbsp;Lucia Sobrin","doi":"10.1016/j.ajo.2025.12.024","DOIUrl":"10.1016/j.ajo.2025.12.024","url":null,"abstract":"<div><h3>Purpose</h3><div>Current diagnostic workup for infectious uveitis relies on the use of various immunoassays and polymerase chain reaction (PCR) tests on ocular fluids that are time consuming and not comprehensive, requiring large sample volumes to probe for all causes. To streamline the diagnostic process, improve turnaround time, and target inclusivity, we developed a highly multiplexed pan-ocular-pathogen panel (OcuPan) that can be used for broad-range pathogen detection in only 1 assay, with PCR-level sensitivity and in a timely fashion (12 hours). Here, we assessed the clinical usefulness and performance of this innovative assay as a novel tool for rapid and accurate laboratory diagnosis of infectious uveitis.</div></div><div><h3>Design</h3><div>Laboratory evaluation of a novel diagnostic test and technology</div></div><div><h3>Participants and Controls</h3><div>A total of 109 patients from 2 centers were included, including 78 infectious uveitis cases and 31 controls.</div></div><div><h3>Methods</h3><div>Intraocular samples (n = 108 from patients and 43 from controls) were processed by PCR and the OcuPan diagnostic assay that detects 46 ocular pathogens plus 2 resistance/virulence markers.</div></div><div><h3>Main Outcome Measures</h3><div>Clinical sensitivity and specificity, quantification capabilities, and agreement between PCR and the OcuPan assay.</div></div><div><h3>Results</h3><div>The clinical sensitivity and specificity of the OcuPan assay were 50.9% (95% CI, 41.3-60.5) and 100% (95% CI 89.7%-100%), respectively. Sensitivity varied according to the sample matrix tested, with undiluted vitreous having the highest positivity rates (72.4%, 95% CI 55.1-89.7), followed by dilute vitreous (53.3%, 95% CI 34.4-72.3) and aqueous (36.7%, 95% CI 22.7-50.7). There was excellent overall agreement (93.5%) between the OcuPan assay and PCR (kappa of 0.870 ± 0.047; <em>P</em> &lt; .001) with positive (PPA) and negative (NPA) percentage agreements &gt;92% for all targets. PPA was 100% for herpesviruses and <em>Treponema pallidum</em>, whereas the NPA values ranged from 96.6% to 100% for these pathogens. For <em>Toxoplasma gondii</em>, the PPA was 75% and NPA 100%. We also found significant correlation (Spearman ρ = –0.7506, <em>P</em> &lt; .0001) between the quantitative metric for the OcuPan assay and the real-time PCR cycle threshold values.</div></div><div><h3>Conclusions</h3><div>The OcuPan assay offers an all-in-one highly multiplexed detection system for rapid, comprehensive, quantitative, and accurate diagnosis of infectious uveitis.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"284 ","pages":"Pages 15-29"},"PeriodicalIF":4.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145891881","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":"Academic Freedom Under Threat","authors":"HESTER BIJL","doi":"10.1016/j.ajo.2025.12.022","DOIUrl":"10.1016/j.ajo.2025.12.022","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"284 ","pages":"Pages 12-14"},"PeriodicalIF":4.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893647","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":"Efficacy and Safety of SJP-0132 in Patients With Dry Eye Disease: A Phase 2b Randomized, Double-Masked, Dose-Finding Study","authors":"Yuichi Hori ,&nbsp;Tomoyuki Wada ,&nbsp;Kazunori Omatsu","doi":"10.1016/j.ajo.2025.11.036","DOIUrl":"10.1016/j.ajo.2025.11.036","url":null,"abstract":"<div><h3>Objective</h3><div>Evaluate the efficacy, safety, and optimal dose of the TRPV1 antagonist SJP-0132 ophthalmic suspension in patients with dry eye disease.</div></div><div><h3>Design</h3><div>Randomized, double-masked, multicenter, placebo-controlled, Phase 2b dose-response study in Japan.</div></div><div><h3>Participants</h3><div>Outpatients aged ≥20 years with dry eye-related subjective symptoms (eye dryness visual analog scale score ≥40; 5-item Dry Eye Questionnaire score ≥6), and objective signs (mean tear-breakup time ≤5 seconds in both eyes; corneal fluorescein staining [CFS] score using Baylor criteria: 2 to 4 for central zone of at least one eye, total score 4 to 20 for all zones, and ≥1 for at least one of the four peripheral corneal regions).</div></div><div><h3>Methods</h3><div>After a 2-week placebo run-in period, patients were randomized 1:1:1:1 to receive SJP-0132 ophthalmic suspension 0.1%, 0.3%, or 1.0%, or placebo, administered as 1 drop in each eye four times daily for 4 weeks.</div></div><div><h3>Main Outcome Measures</h3><div>The primary endpoint was the change from baseline to week 4 in CFS score for all zones with SJP-0132 0.3% vs placebo (primary analysis) and SJP-0132 0.1% or 1.0% vs placebo (secondary analysis).</div></div><div><h3>Results</h3><div>Total 344 patients were randomized and received at least one dose of SJP-0132 0.1% (<em>n</em> = 87), SJP-0132 0.3% (<em>n</em> = 87), SJP-0132 1.0% (<em>n</em> = 85), or placebo (<em>n</em> = 85). For the primary endpoint, there were no statistically significant differences between the SJP-0132 0.3% and placebo groups (between-group difference −0.8; 95% CI −1.7, 0.2; <em>P</em> = .1181), or between the SJP-0132 0.1% (−0.7; 95% CI −1.8, 0.4; <em>P</em> = .1990) or SJP-0132 1.0% (−0.1; 95% CI −1.3, 1.0; <em>P</em> = .8276) and placebo groups. Secondary endpoints showed generally dose-dependent efficacy and safety of SJP-0132. Improvements in subjective symptoms of dry eye, quality of life, and objective signs were observed after 1 week of SJP-0132 administration and maintained through to week 4, with statistically significant differences to placebo observed at some endpoints. Subgroup analyses suggested greater treatment benefits with SJP-0132 0.3% in subgroups based on baseline ocular characteristics. SJP-0132 was generally well tolerated across the dose groups.</div></div><div><h3>Conclusions</h3><div>SJP-0132 showed generally dose-dependent efficacy and safety. Based on safety and treatment benefits with SJP-0132 0.3% in the overall population and in subgroups, this dose was considered optimal for further development.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 163-175"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688968","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":"Interpreting Imaging in the Era of Artificial Intelligence: Future Possibilities in Ocular Inflammatory Disease","authors":"K. MATTHEW MCKAY ,&nbsp;LEOPOLD SCHMETTERER ,&nbsp;SRINIVAS R. SADDA ,&nbsp;LUCIA SOBRIN","doi":"10.1016/j.ajo.2025.12.019","DOIUrl":"10.1016/j.ajo.2025.12.019","url":null,"abstract":"<div><h3>Purpose</h3><div>Uveitis encompasses a heterogeneous group of ocular inflammatory diseases with a high risk of permanent vision loss. Accurate diagnosis and disease monitoring are dependent on integrating disparate clinical data from patient history, examination findings and multimodal imaging, which is complex and time-consuming. The advent of artificial intelligence (AI) in the field of ophthalmology has provided new opportunities for automation of data gathering and interpretation, particularly for imaging data through deep learning algorithms. This article will review the current abilities, limitations, and future promise for the application of AI to the interpretation of multimodal imaging in the field of uveitis.</div></div><div><h3>Methods</h3><div>Review article.</div></div><div><h3>Results</h3><div>AI has provided new opportunities for automation of data gathering and interpretation in the field of uveitis, particularly for analysis of imaging data using deep learning techniques. Tools for diagnostic support, grading of intraocular inflammation, and quantification of disease features by multimodal imaging are under development.</div></div><div><h3>Conclusion</h3><div>Application of AI in the field of uveitis is in its infancy but holds promise for improving efficiency and quality of patient care.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 291-298"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822823","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: Cellular-Level Assessment of Macular Development in Patients With FEVR Using Multimodal Imaging: A Prospective Cohort Study","authors":"Gongpeng Sun ,&nbsp;Meixia Zhang","doi":"10.1016/j.ajo.2025.10.041","DOIUrl":"10.1016/j.ajo.2025.10.041","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Page 336"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145718241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Corneal Stiffness Distribution and Tomography in Keratoconus Patients","authors":"Nan-Ji Lu ,&nbsp;Marta Jiménez-García ,&nbsp;Ahmed Elsheikh ,&nbsp;Ahmed Makarem ,&nbsp;Carina Koppen ,&nbsp;Jos J. Rozema","doi":"10.1016/j.ajo.2025.12.011","DOIUrl":"10.1016/j.ajo.2025.12.011","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize the regional distribution of corneal stiffness in keratoconus (KC) and explore its relationship with tomographic parameters.</div></div><div><h3>Design</h3><div>Prospective, cross-sectional observational study.</div></div><div><h3>Subjects</h3><div>One hundred eleven eyes from 111 KC patients.</div></div><div><h3>Methods</h3><div>All eyes underwent Scheimpflug-based tomography and air-puff tonometry (Pentacam and Corvis). Stress-Strain Index (SSI) maps were generated to quantify overall and regional stiffness. Maximum, minimum, and mean SSI values, as well as regional values, were correlated with keratometric and pachymetric indices.</div></div><div><h3>Main Outcome Measures</h3><div>Regional SSI values and their correlations with keratometric and pachymetric parameters.</div></div><div><h3>Results</h3><div>SSI maps showed non-uniform stiffness, with the lowest values predominantly in the inferior-temporal region. The mean SSI at the thinnest pachymetry point (Pmin; 0.68 ± 0.16) was higher than at the steepest keratometry point (Kmax; 0.63 ± 0.19; <em>P</em> = .036). In overall analyses, the strongest correlation was between SSI-map minimum and Pmin (R² = 0.51), while mean SSI correlated weakly with tomography (R² = 0.11-0.19). In regional analyses, SSI correlated most strongly with Kmax in the central region (R² = 0.74), followed by the midperipheral inferior (R² = 0.38) and temporal (R² = 0.23) regions. SSI correlations with Pmin were most evident in the central (R² = 0.52), paracentral inferior (R² = 0.45), and inferior-temporal (R² = 0.31) regions.</div></div><div><h3>Conclusions</h3><div>Biomechanical weakening in KC varies regionally. Strong correlations with disease severity occurred in the central and inferior-temporal regions — especially with Kmax and Pmin, highlighting the role of regional mechanical stiffness and collagen architecture in corneal deformation.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 214-226"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784491","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":"Effect of Angle Kappa on the Refractive Prediction Accuracy in Cataract Patients After Myopic LASIK/PRK","authors":"HAORUI YUAN ,&nbsp;JIAQING ZHANG ,&nbsp;YUXING ZHENG ,&nbsp;HAOWEN LIN ,&nbsp;XIAOHANG XIE ,&nbsp;XIAOFEI HU ,&nbsp;WENLU YU ,&nbsp;XIAOZHANG QIU ,&nbsp;ZHENZHEN LIU ,&nbsp;WEIRONG CHEN ,&nbsp;LIXIA LUO ,&nbsp;XUHUA TAN","doi":"10.1016/j.ajo.2025.11.042","DOIUrl":"10.1016/j.ajo.2025.11.042","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To evaluate the impact of angle kappa on prediction accuracy in patients after myopic laser-assisted in-situ keratomileusis (LASIK)/photorefractive keratectomy (PRK).</div></div><div><h3>DESIGN</h3><div>Retrospective, consecutive interventional case-series study.</div></div><div><h3>METHODS</h3><div>This study included 127 postmyopic-LASIK/PRK cataract patients (176 eyes). Three different keratometry (K) values measured by 2 devices were assessed, including simulated keratometry (SimK) obtained by IOLMaster 700 at 2.5 mm ring centered on corneal vertex and SimK derived from Pentacam AXL in 3 mm zone centered on corneal vertex (Pentacam [CV]) and pupil center (Pentacam [PC]). The performance of the Barrett True-K formula based on vertex-centered K values (IOLMaster 700; Pentacam [CV]) and pupil-centered K values (Pentacam [PC]) was compared. Subgroup analysis was performed using angle kappa (&lt;0.4 mm; ≥0.4 mm).</div></div><div><h3>RESULT</h3><div>The hyperopic prediction error (PE) of the IOLMaster 700 and Pentacam (CV) modes increased with larger angle kappa. Both in total and in eyes with angle kappa &lt;0.4 mm, compared with other modes, the IOLMaster 700 mode showed no systematic bias and relatively lower absolute PE. For eyes with angle kappa ≥0.4 mm, IOLMaster 700 and Pentacam (CV) modes demonstrated hyperopic PE (0.43-0.46 D, <em>P</em> &lt; .05), while the Pentacam (PC) mode displayed no systematic bias, relatively lower mean absolute PE (0.70 D vs 0.90-0.96 D) and the highest percentage of eyes with PE within ±0.5 D (51.22% vs 36.59%-41.46%).</div></div><div><h3>CONCLUSION</h3><div>In postmyopic-LASIK/PRK patients, the prediction accuracy decreased with greater angle kappa when using the corneal vertex-centered K values. The pupil-centered K values were preferred for these patients with angle kappa ≥0.4 mm.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 36-44"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145613715","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":"Impact of Phacoemulsification on Vitreomacular Traction Release and Complications","authors":"Suraj Bala ,&nbsp;Nitesh Mohan ,&nbsp;Victor Bellanda ,&nbsp;Andrea Arline ,&nbsp;Gabriel Castilho S. Barbosa ,&nbsp;Matthew Schulgit ,&nbsp;Sumit Sharma ,&nbsp;Sunil K. Srivastava ,&nbsp;Danny A. Mammo ,&nbsp;Ananth Sastry","doi":"10.1016/j.ajo.2025.12.008","DOIUrl":"10.1016/j.ajo.2025.12.008","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine if phacoemulsification impacts vitreomacular traction (VMT) release and VMT-related complications.</div></div><div><h3>Design</h3><div>Single-center, comparative, retrospective clinical cohort study.</div></div><div><h3>Subjects: A total of</h3><div>310 eyes of 249 patients with a concurrent diagnosis of VMT and cataracts at the Cole Eye Institute between 2013 and 2024.</div></div><div><h3>Methods</h3><div>Eligible eyes had at least 6 months of follow-up post-VMT diagnosis or phacoemulsification. The control group included eyes that did not undergo phacoemulsification after VMT diagnosis. Clinical information was collected via manual chart review. Characteristics of VMT were recorded via review of optical coherence tomography imaging.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was the hazard of VMT release. Secondary outcomes included VMT-related complications, such as macular and lamellar hole formation, retinal detachment, and subsequent vitrectomy.</div></div><div><h3>Results</h3><div>VMT release occurred in 49.4% of 310 eyes, with an average follow-up period of 136.7 ± 134.4 weeks. There was no significant difference in release between the phacoemulsification and control groups (adjusted hazard ratio [aHR] = 0.861; <em>P</em> = .380). Among eyes that released, the mean time to release was 79.4 ± 68.8 weeks postsurgery in the phacoemulsification group and 76.0 ± 81.9 weeks from diagnosis in the control group (<em>P</em> = .785). In multivariate analysis, younger age at diagnosis (5-year aHR = 0.773; <em>P</em> &lt; .001) and smaller adhesion diameter (per 100 µm aHR = 0.951; <em>P</em> = .017) were significantly associated with a higher likelihood of VMT release. Black patients had a lower likelihood of VMT release compared to White patients (aHR = 0.439; <em>P</em> = .004). Eyes that developed a macular hole had a smaller baseline adhesion diameter than those that did not (439.1 ± 217.9 µm vs 685.7 ± 697.4 µm; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Phacoemulsification was not associated with increased rates or faster timing of VMT release. These findings suggest that intrinsic patient and anatomical factors play a larger role in determining the likelihood of VMT release and should be prioritized in clinical decision-making.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 176-187"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145731919","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":"Limbal Epithelial Cells Detected in Stage III Limbal Stem Cell Deficiency by Multimodal Anterior Segment Imaging","authors":"CLEMENCE BONNET ,&nbsp;MEHRNOOSH MAALHAGHFARD ,&nbsp;SOPHIE X. DENG","doi":"10.1016/j.ajo.2025.11.041","DOIUrl":"10.1016/j.ajo.2025.11.041","url":null,"abstract":"<div><h3>Purpose</h3><div>Limbal stem cell deficiency (LSCD) is a potentially blinding corneal condition with heterogeneous clinical presentations. Anterior segment imaging, in particular anterior segment optical coherence tomography (AS-OCT) and in vivo confocal microscopy (IVCM) provide objective staging of LSCD. The goal of this study was to evaluate whether the fluorescein staining test is accurate in staging LSCD.</div></div><div><h3>Design</h3><div>Diagnostic and staging validity analysis.</div></div><div><h3>Subjects</h3><div>Subjects without eye diseases and those diagnosed with LSCD based on clinical exam, AS-OCT, and IVCM.</div></div><div><h3>Methods</h3><div>The severity of LSCD was staged clinically according to the global consensus guidelines using fluorescein staining. Multimodal imaging (AS-OCT and IVCM) was performed in the central cornea and four limbal quadrants (superior, inferior, nasal, and temporal). Imaging findings were correlated with clinical stage.</div></div><div><h3>Main Outcomes Measures</h3><div>Detection of morphologically limbal epithelial cells in eyes clinically graded as stage III LSCD, and AS-OCT characteristics corresponding to these identified clusters.</div></div><div><h3>Results</h3><div>A total of 220 eyes from 156 patients were analyzed. Based on fluorescein staining, 49 eyes (22.3%) were classified as stage I, 93 eyes (42.3%) as stage II, and 75 eyes (34.1%) as stage III LSCD. In all cases of stage III LSCD, AS-OCT confirmed severe central epithelial thinning, and IVCM demonstrated significantly reduced mean basal cell density in the central cornea. Despite this, clusters of limbal epithelial cells with normal morphology were detected by IVCM in 30 eyes (40.0%), appearing in one limbal quadrant in 26 eyes (86.7%) and in two quadrants in 4 eyes (13.3%). Correlation between IVCM and AS-OCT findings at the cluster locations was variable. Absence of hyporeflective epithelial layer was observed in 20 eyes (74.1%) and presence of hyporeflective layer was detected in 7 eyes (25.9%) by AS-OCT.</div></div><div><h3>Conclusions</h3><div>Despite being graded as total stage III LSCD by clinical exam using fluorescein staining, a significant proportion of eyes retained morphologically normal limbal epithelial cells. These findings highlight the importance of multimodal anterior segment imaging to achieve LSCD diagnostic accuracy, refine disease staging, and guide future personalized management strategies.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 91-99"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145657309","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":"Association Between Body Composition and Risk of Primary Open-Angle Glaucoma","authors":"Jianqi Chen ,&nbsp;Yue Xiao ,&nbsp;Xiaohong Chen ,&nbsp;Yingting Zhu ,&nbsp;Zhidong Li ,&nbsp;Shitong Huang ,&nbsp;Hanyang Yu ,&nbsp;Yehong Zhuo ,&nbsp;Yunxia Leng","doi":"10.1016/j.ajo.2025.12.014","DOIUrl":"10.1016/j.ajo.2025.12.014","url":null,"abstract":"<div><h3>Purpose</h3><div>Body size has been closely linked to primary open-angle glaucoma (POAG). However, the association was inconsistent, which may be due to the fact that body size defined by body mass index does not differentiate fat from lean mass or capture body composition distribution. The impact of body composition on POAG remains largely unknown.</div></div><div><h3>Design</h3><div>Combined cross-sectional and cohort study.</div></div><div><h3>Participants</h3><div>A total of 88,123 participants and 291,983 participants from the UK Biobank for the analysis of baseline intraocular pressure (IOP) and POAG incidence, respectively.</div></div><div><h3>Methods</h3><div>Fat and muscle mass in the arm, trunk, and leg were estimated using bioimpedance analysis. Measurements were normalized for height to derive the arm fat index, trunk fat index, leg fat index (LFI), arm muscle index, trunk muscle index, and leg muscle index. Fat-to-muscle ratios for each region were also calculated as sensitivity analysis. Hazard ratios (HRs) and 95% confidence intervals (CIs) for POAG were estimated using covariate-adjusted Cox models, and associations with IOP were additionally assessed using linear regression.</div></div><div><h3>Main Outcome Measures</h3><div>Baseline IOP and POAG incidence.</div></div><div><h3>Results</h3><div>Greater leg fat was associated with a significantly reduced risk of POAG, supported by both LFI (HR, 0.85; 95% CI, 0.76-0.95; <em>P</em> = .006) and leg fat-to-muscle ratio (HR, 0.35; 95% CI, 0.16-0.73; <em>P</em> = .005). No association was observed between muscle mass and the incidence of POAG. Greater fat mass was associated with higher IOP levels, supported by arm fat index (<em>β</em>, 0.14; 95% CI, 0.07-0.22, <em>P</em> &lt; .001), LFI (<em>β</em>, 0.15; 95% CI, 0.11-0.18, <em>P</em> &lt; .001), trunk fat index (<em>β</em>, 0.07; 95% CI, 0.04-0.09, <em>P</em> &lt; .001), whereas greater muscle mass in leg (leg muscle index: <em>β</em>, –0.24; 95% CI, –0.29 to –0.20, <em>P</em> &lt; .001) and trunk (trunk muscle index: <em>β</em>, –0.05; 95% CI, –0.08 to –0.01, <em>P</em> = .005) was associated with lower IOP.</div></div><div><h3>Conclusions</h3><div>POAG risk differs according to body composition. Maintaining a healthy body composition pattern may mitigate its risk.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 256-267"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784493","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}