Asia-Pacific Journal of Ophthalmology最新文献

{"title":"Effect of 0.01%, 0.02% and 0.04% atropine eyedrops vs placebo on myopia incidence in pre-myopic children: A randomized clinical trial.","authors":"Jingjing Wang, Xueyao Jia, Guangzhuang Jing, Xiaohua Zhang, Shanxi Gao, Jun Chen, Jinliuxing Yang, Yanhui Dong, Haidong Zou, Wei Gao, Xun Xu, Xiangui He","doi":"10.1016/j.apjo.2026.100383","DOIUrl":"10.1016/j.apjo.2026.100383","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the dose-response relationship and individual efficacy of 0.01%, 0.02%, and 0.04% atropine eye drops for preventing myopia onset in pre-myopic children.</p><p><strong>Design: </strong>Twelve-month randomized, placebo-controlled, double-blind clinical trial conducted in Shanghai primary schools (March 2023-December 2024).</p><p><strong>Methods: </strong>Children aged 6-10 years with cycloplegic spherical equivalent refraction of -0.50 to + 0.75 diopters (D) were randomized 1:1:1:1 to placebo or 0.01%, 0.02%, or 0.04% atropine once daily. Primary outcome was 12-month cumulative myopia incidence (SER ≤ -0.50 D in the worse eye); secondary outcomes were changes in SER and axial length of the worse eye. Children with ocular or systemic diseases, prior orthokeratology use, or other myopia control interventions were excluded.</p><p><strong>Results: </strong>Among the 428 randomized children, 395 (92.3%) were included in the final primary analysis. Cumulative myopia incidence was 39.0%, 29.4%, 26.9%, and 25.8% in the control, 0.01%, 0.02%, and 0.04% groups, respectively (P_trend = 0.044). SER changes showed a significant dose-response relationship (P_trend < 0.001), while no significant dose-response was observed for axial length (P_trend = 0.418). Compared with control, the 0.04% atropine group showed a significantly lower mean change in SER (P < 0.001). Subgroup analyses revealed more pronounced efficacy in children aged 8-10 years, where all concentrations significantly reduced myopia incidence and SER progression. No significant differences in adverse event incidence were observed between groups.</p><p><strong>Conclusions: </strong>Low-concentration atropine demonstrated a dose-response relationship for reducing cumulative myopia incidence and slowing refractive progression in pre-myopic children, but no such relationship on axial length. This preliminary evidence suggests potential for early myopia prevention, but larger, longer-term trials are needed before recommending an optimal clinical concentration.</p>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100383"},"PeriodicalIF":7.0,"publicationDate":"2026-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The incremental diagnostic value and clinical utility of tear MMP-9 for dry eye disease: A multicentre analysis and development of a simplified screening model.","authors":"Wubi Li, Lin Kang, Yang Shen, Lyubang Zhou, Feiyue Xiao, Yuhan Wu, Yayuan Deng, Di Chen, Ying Li, Shihong Zhang, Hongbin Xie, Min Wang, Shaowei Li, Chan Zhao","doi":"10.1016/j.apjo.2026.100377","DOIUrl":"10.1016/j.apjo.2026.100377","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the incremental diagnostic value of tear matrix metalloproteinase-9 (MMP-9) in dry eye disease (DED) and validate a simplified diagnostic model suitable for primary care.</p><p><strong>Methods: </strong>This multicentre study analysed 580 participants (294 DED, 286 controls) from three Centres. Diagnostic performance was evaluated using Generalised Linear Mixed-Effects Models (GLMMs) to adjust for Centre heterogeneity. Three models were compared: (1) Traditional (Ocular Surface Disease Index [OSDI], non-invasive tear breakup time [NIBUT], Schirmer I test, and corneal fluorescein staining [CFS]), (2) Trad + MMP-9, and (3) Simplified (OSDI, Schirmer I test, and MMP-9). Performance was assessed via area under the receiver operating characteristic curve (AUC), Net Reclassification Improvement (NRI), Decision Curve Analysis (DCA), and Leave-One-Centre-Out Cross-Validation (LOCO-CV).</p><p><strong>Results: </strong>The Trad + MMP-9 model achieved the highest discrimination (AUC 0.982) and calibration. Adding MMP-9 yielded significant risk reclassification improvement (Continuous NRI 0.495, p < 0.001) over the Traditional model. A Simplified model (OSDI, Schirmer I test, MMP-9) achieved an AUC of 0.969, statistically comparable to the Traditional model, and demonstrated robust external validity in LOCO-CV. Tear MMP-9 levels correlated strongly with symptom burden (OSDI) independent of clinical signs.</p><p><strong>Conclusion: </strong>Tear MMP-9 provides significant incremental diagnostic value, enabling a simplified, high-accuracy diagnostic strategy that omits slit-lamp examination, potentially expanding DED screening capabilities.</p>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100377"},"PeriodicalIF":7.0,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary intracranial melanoma associated with congenital ocular melanocytosis in the absence of uveal melanoma.","authors":"Antonio Bechara Ghobril, Salaam Botros, Carol L Shields","doi":"10.1016/j.apjo.2026.100375","DOIUrl":"10.1016/j.apjo.2026.100375","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100375"},"PeriodicalIF":7.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D CT reconstruction of silicone encircling band migration into corneal stroma.","authors":"Wenyi Tang, Ting Zhang, Jun Xiang","doi":"10.1016/j.apjo.2026.100376","DOIUrl":"10.1016/j.apjo.2026.100376","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100376"},"PeriodicalIF":7.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal structural changes associated with repeated low-level red-light therapy: Clinical observations and potential mechanisms.","authors":"Yu Yang, Yanxian Chen, Kyoko Ohno-Matsui, Shoji Kishi, Zhuoting Zhu, Xiaoyan Ding, Mingguang He","doi":"10.1016/j.apjo.2026.100374","DOIUrl":"10.1016/j.apjo.2026.100374","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100374"},"PeriodicalIF":7.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolving epidemiologic link between myopia and glaucoma: A narrative review on pathophysiology, progression and clinical implications.","authors":"Jong Jin Jung, Ki Ho Park","doi":"10.1016/j.apjo.2026.100371","DOIUrl":"10.1016/j.apjo.2026.100371","url":null,"abstract":"<p><p>As the prevalence of myopia and glaucoma rises worldwide, patients with both conditions are increasing simultaneously. This narrative review summarizes the evidence linking myopia and open-angle glaucoma (OAG). Population-based studies and meta-analyses consistently show that myopia is associated with OAG, and that the risk increases with dose-response as myopia worsens. This may reflect the biomechanical and microvascular vulnerability of the axially elongated optic nerve head. However, the effect of myopia on glaucoma progression has been inconsistent across studies, resulting in an epidemiologic discordance in which the progression signal appears weaker than the association with glaucoma occurrence. This discordance may arise partly because progression is harder to detect reliably in myopic eyes, diverse phenotypes are analyzed as a single unstratified cohort, and the global, rate-based endpoints used in longitudinal studies are insensitive to the topographic effects of axial elongation. We therefore distinguish the rate of progression from its pattern. Young patients with high myopia and normal-tension glaucoma (NTG) show more rapid observed structural and functional deterioration. Whether the degree of myopia accelerates loss independently of NTG and intraocular pressure has not been established: where progression has been modeled against competing risk factors, intraocular pressure and disc hemorrhage have usually dominated. The signal that appears more consistent across cohorts is instead the location of damage, though it too has not yet been attributed to myopia rather than to NTG. We propose this rate-versus-pattern distinction as a conceptual framework for recognizing and monitoring high-risk myopic phenotypes.</p>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100371"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148962985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A classification model for predicting corticosteroid and cyclosporin A responsiveness in pediatric idiopathic uveitis.","authors":"Rui Chang, Lin Chen, Jing Wang, Yuxuan Peng, Yuxian Lai, Guannan Su, Ling Chen, Peizeng Yang","doi":"10.1016/j.apjo.2026.100348","DOIUrl":"10.1016/j.apjo.2026.100348","url":null,"abstract":"<p><strong>Background: </strong>To identify serum metabolic biomarkers that distinguish corticosteroid and cyclosporin A (CS & CsA) resistant pediatric idiopathic uveitis (PIU) patients from sensitive counterparts.</p><p><strong>Methods: </strong>Serum samples were collected from 32 CS & CsA-sensitive PIU patients and 24 CS & CsA-resistant PIU patients, respectively. UHPLC-OE-MS was employed for comprehensive metabolic profiling of the serum samples. Bioinformatic analyses were performed to identify differentially expressed metabolites (DEMs) between the two patient groups. A machine learning-based classification model was constructed using the identified DEMs as predictive features. For validation purposes, an independent internal cohort of 16 CS & CsA-sensitive and 10 CS & CsA-resistant patients was recruited to evaluate the model's stability.</p><p><strong>Results: </strong>Compared with the CS & CsA-sensitive PIU patients, serum samples from CS & CsA-resistant PIU patients displayed significant metabolic reprogramming. Among the identified differential metabolites, lipids were the most prominently dysregulated class, accounting for 72.47% of all differential metabolites. A machine learning based multivariate feature selection approach including NNET, LASSO, and XGBoost identified 4 candidate metabolite biomarkers. ROC analysis showed that three of these biomarkers (MG 15:0, PI-Cer 28:0;3 O, and SPB 20:0;2 O) exhibited AUC values of 0.934, 0.953, and 0.904, respectively, and were all upregulated in CS & CsA resistant patients. In contrast, N-acetylaspartic acid showed an AUC of 0.934 and was downregulated in CS & CsA resistant patients. The combined classification model incorporating these 4 metabolites achieved an AUC of 1.0. Validation in an independent internal cohort confirmed the model's excellent performance, with AUC values of 0.971 for NNET, 0.971 for LASSO, and 0.957 for XGBoost.</p><p><strong>Conclusion: </strong>We have established a classification model capable of effectively discriminating CS & CsA-resistant from -sensitive PIU patients. The machine learning model leveraging metabolic biomarkers demonstrates exceptional classification accuracy and generalizability, offering potential for clinical subtype classification.</p>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100348"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in the clinical characteristics of geographic atrophy among Caucasians, Japanese Americans in Hawaii, and Japanese in Japan.","authors":"Satoko Fujimoto, Gregg T Kokame, Ryo Kawasaki, Chikako Hara, Jase N Omizo, Kohji Nishida","doi":"10.1016/j.apjo.2026.100372","DOIUrl":"10.1016/j.apjo.2026.100372","url":null,"abstract":"<p><strong>Purpose: </strong>To compare clinical characteristics of geographic atrophy (GA) among Caucasians in Hawaii (C-A), Japanese Americans in Hawaii (J-A), and Japanese in Japan (J-J).</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Methods: </strong>Consecutive patients with GA were recruited from single institutions in Hawaii and Japan, and GA areas within 6 × 6 mm² OCT scan area were measured on near-infrared images obtained at the latest visit. Ethnic differences in GA-related characteristics were assessed using mixed-effects models adjusted for age and sex. All values are means.</p><p><strong>Results: </strong>A total of 125 eyes from 91 patients were included: 51 eyes of 36 C-A (58% men), 36 eyes of 26 J-A (35% men), and 38 eyes of 29 J-J (69% men). Bilateral GA was more frequent in C-A (72%) than in J-J (34%, P < 0.01), while J-A (50%) did not differ from either group. The number of GA foci was greater in C-A (2.8) than in J-A (1.9, P < 0.05) and J-J (1.5, P < 0.01). GA area was significantly larger in C-A (10.3 mm²) than in J-J (6.0mm², P < 0.05), with J-A (8.8mm²) intermediate. Subfoveal choroidal thickness (SFCT) was thinner in C-A (83.3 µm) than in J-A (140.8 µm, P < 0.001) and J-J (165.3 µm, P < 0.0001).</p><p><strong>Conclusions: </strong>The number of GA foci and SFCT differed between J-J and C-A as well as between J-A and C-A, suggesting genetic differences. In contrast, significant differences in GA area and bilaterality were observed only between J-J and C-A. The intermediate values in J-A may reflect environmental influences. Further studies are warranted.</p>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100372"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148962995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multi-label deep learning system for simultaneous detection of nine fundus conditions.","authors":"Jungwoo Ha, Yeon Hee Choi, Danbi Lee, Junseo Choi, Wonyoung Seo, Geunyoung Lee, Dongjin Nam, Sahil Thakur, Tae Keun Yoo, Sunjin Hwang","doi":"10.1016/j.apjo.2026.100379","DOIUrl":"10.1016/j.apjo.2026.100379","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and validate a deep learning model for simultaneous detection of nine fundus conditions from a single color fundus photograph.</p><p><strong>Methods: </strong>A development dataset of 236,242 color fundus images was assembled from 17 heterogeneous sources and partitioned at the patient level into training (70%), tuning (10%), and internal validation (20%) sets; 5-fold cross-validation was applied on the training set. Nine target conditions were labeled using standardized or photographic criteria: diabetic retinopathy (DR), age-related macular degeneration (AMD), myopic macular degeneration (MMD), glaucoma suspect (GS), epiretinal membrane (ERM), retinal vascular occlusion (VO), media opacity, retinal hemorrhages, and any retinal disorder (composite). A multitask ConvNeXt architecture was trained end-to-end, with operating thresholds pre-specified via Youden's index on the tuning set. External validation was performed on an independent cohort of 4055 images from an East Asian health-screening center, excluded from model development.</p><p><strong>Results: </strong>On internal validation (N = 47,229), AUROCs ranged from 0.943 (AMD) to 0.989 (VO), with sensitivity of 88.1%-97.1% and NPV ≥ 98.8% for eight of nine conditions. On independent external validation (N = 4055), AUROCs ranged from 0.894 (retinal disorder) to 0.983 (MMD), with NPV ≥ 95.6% for eight of nine conditions, including 99.3% for DR, 99.9% for VO, and 99.8% for MMD.</p><p><strong>Conclusions: </strong>This study presents a validated, criteria-anchored multi-label fundus triage framework capable of simultaneously screening for nine conditions from a single fundus photograph, with performance maintained on external validation at a source-excluded health-screening site within the same national health-screening system.</p>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100379"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors of primary angle-closure glaucoma: An exposome-wide association study in the China Kadoorie Biobank.","authors":"Zilun Shao, Shuo Gong, Charles Li, Canqing Yu, Pei Pei, Ling Yang, Yiping Chen, Enzhong Jin, Ting Shen, Jie Yu, Bin Wang, Zhi Chen, Ruoyan Wei, Jian Wang, Xiaoming Yang, Junshi Chen, Zhengming Chen, Xingtao Zhou, Yongyue Wei, Jun Lv, Liming Li, Huaidong Du, Dianjianyi Sun","doi":"10.1016/j.apjo.2026.100378","DOIUrl":"10.1016/j.apjo.2026.100378","url":null,"abstract":"<p><strong>Purpose: </strong>Primary angle-closure glaucoma (PACG) is a leading cause of irreversible blindness in Asia. Although traditionally considered an anatomical ocular disorder, the contribution of systemic metabolic, vascular, and lifestyle factors to PACG development remains unclear.</p><p><strong>Methods: </strong>Using data from the China Kadoorie Biobank (CKB), involving 499,102 participants aged 30-79 years at baseline, we explored associations of 117 exposures, including socio-demographics, lifestyle patterns, medical history, and physical measurements, with probable PACG (prob PACG) incidence. Elastic-Net, XGboost, and Cox regression methods were employed.</p><p><strong>Results: </strong>Over a median follow-up of 15.7 years, 3266 incident prob PACG cases were ascertained. After correcting for multiple testing, 26 factors were independently associated with prob PACG. Age, female sex, and postmenopausal status showed the strongest positive associations with pro PACG. Notably, several markers of metabolic and vascular ageing-including diabetes, higher random plasma glucose, larger waist circumference, and elevated pulse pressure-were independently associated with higher risk, whereas BMI was inversely associated (all P < 0.01). In addition, daily intake of dairy products and daily preserved vegetables, and peptic ulcer were associated with a higher risk, while higher physical activity and weekly tea consumption were associated with lower risk. No significant associations were found for hypertension, SBP, or DBP with prob PACG.</p><p><strong>Conclusions: </strong>Our findings suggest that PACG may be influenced not only by anatomical susceptibility but also by broader metabolic, vascular, and lifestyle factors. The clustering of several strong associations around markers of metabolic and vascular ageing provides new insights into PACG aetiology and may help identify priorities for future studies of risk stratification and prevention.</p>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100378"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}