Asia-Pacific Journal of Ophthalmology最新文献

{"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":"2026-09-13","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":"Factors associated with peripapillary OCTA perfusion density: separating capillary and large-vessel contributions in an Asian cohort.","authors":"Qiong Xu, Bingyao Tan, Shuhui Foo, Damon Wong, Syahidatin Rahima Binte Mohammad Naim, Rahat Husain, Tina T Wong, Tin Aung, Leopold Schmetterer, Jacqueline Chua","doi":"10.1016/j.apjo.2026.100373","DOIUrl":"10.1016/j.apjo.2026.100373","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify OCTA-derived peripapillary perfusion density in healthy adults and determine whether demographic, ocular, and systemic associations differ between capillary and large-vessel components.</p><p><strong>Methods: </strong>This cross-sectional study included 554 healthy adults (1010 eyes) aged 21-86 years, without diabetes, systemic hypertension, or ocular disease, recruited at the Singapore National Eye Centre. Optic disc-centered 6 × 6-mm OCTA scans (Cirrus HD-OCT 6000) were used to quantify peripapillary perfusion density, including total, capillary, and large-vessel components. Regression models were applied to evaluate associations with demographic, systemic, and ocular parameters.</p><p><strong>Results: </strong>Mean total, capillary, and large-vessel perfusion densities were 47.42 ± 5.80%, 32.32 ± 5.53%, and 20.14 ± 3.67%, respectively. Total (P for trend = 0.001) and capillary (P for trend = 0.010) perfusion densities were lower across older age groups, whereas large-vessel perfusion density did not differ significantly across age groups (P for trend = 0.879). Multivariable analyses demonstrated distinct associated-factor profiles across vascular compartments. Capillary perfusion density was negatively associated with age (β = -0.044, P = 0.002) and positively associated with axial length (β = 0.735, P < 0.001), retinal nerve fiber layer thickness (β = 0.122, P < 0.001), and signal strength index (β = 2.977, P < 0.001). Large-vessel perfusion density was negatively associated with axial length (β = -0.240, P = 0.014) and positively associated with intraocular pressure (β = 0.096, P = 0.017).</p><p><strong>Conclusions: </strong>Peripapillary perfusion density showed compartment-specific associated-factor profiles in healthy adults. Separating capillary and large-vessel components may improve interpretation of OCTA-derived measurements, but validation in disease cohorts is required.</p>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100373"},"PeriodicalIF":7.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944310","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":"Recognizing ocular thelaziasis: Thelazia callipaeda crawling on the ocular surface.","authors":"Satoshi Nakamura, Yumi Nakamura, Yukine Seki","doi":"10.1016/j.apjo.2026.100370","DOIUrl":"10.1016/j.apjo.2026.100370","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100370"},"PeriodicalIF":7.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787699","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":"Three-year outcomes of phacogoniotomy versus phacotrabeculectomy for advanced primary angle-closure glaucoma with cataract: A randomized controlled trial.","authors":"Fengbin Lin, Yunhe Song, Hengli Zhang, Sujie Fan, Meichun Xiao, Xiaomin Zhu, Xiaowei Yan, Xiaoyan Li, Wulian Song, Li Tang, Tingli Wen, Guangxian Tang, Huiping Yuan, Yangfan Yang, Jiangang Xu, Xin Zhan, Minwen Zhou, Xiaohuan Zhao, Fei Li, Zefeng Yang, Fengqi Zhou, Zhenyu Wang, Ling Jin, Xiaohong Liang, Weirong Chen, Dennis S C Lam, Ningli Wang, Clement C Tham, Keith Barton, Ki Ho Park, Tin Aung, Lin Xie, Lan Lu, Robert N Weinreb, Xiulan Zhang","doi":"10.1016/j.apjo.2026.100353","DOIUrl":"10.1016/j.apjo.2026.100353","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the 3-year efficacy and safety of phacogoniotomy versus phacotrabeculectomy for advanced primary angle-closure glaucoma (PACG) with cataract.</p><p><strong>Design: </strong>Multicenter, randomized controlled, open-label, non-inferiority trial.</p><p><strong>Methods: </strong>Patients were randomized 1:1 to undergo either phacogoniotomy (65 eyes) or phacotrabeculectomy (59 eyes). Three years retention was 92.3% (60/65) and 83.1% (49/59) for each group, respectively. Primary outcome was 3-year intraocular pressure (IOP) reduction (noninferiority margin: 4 mmHg). Secondary outcomes included surgical success, complications, hypotensive medications used; additional outcomes were changes in visual acuity (BCVA), visual field (VF), and corneal endothelial cell density (ECD).</p><p><strong>Results: </strong>At 3 years, phacogoniotomy reduced mean IOP from 40.2 (10.3) to 14.1 (2.4) mmHg (-26.1 [10.4] mmHg reduction); phacotrabeculectomy, from 39.7 (9.3) to 14.4 (2.5) mmHg (-25.3 [9.2] mmHg reduction). Adjusted between-group difference in IOP change was -0.37 mmHg (95% CI, -1.32-0.58 mmHg; P = 0.44), meeting noninferiority. Complete (78.3% vs 89.8%; P = 0.13) and qualified (90.0% vs 91.8%; P > 0.999) success rates were comparable. Hypotensive medications declined in both groups (phacogoniotomy: 2.1 [1.2] to 0.2 [0.6]; phacotrabeculectomy: 2.1 [1.3] to 0.0 [0.2]; P = 0.06 for 3-year difference). BCVA improvements (0.1 vs 0.0 logMAR; P = 0.49), VF stability (MD difference:1.42 dB, P = 0.26; PSD difference: 0.22 dB, P = 0.75), and ECD loss (difference: 2%; P = 0.53) were similar. No new complications occurred in extended follow-up.</p><p><strong>Conclusions: </strong>At 3 years, phacogoniotomy remained non-inferior to phacotrabeculectomy in IOP reduction for advanced PACG with cataract.</p>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100353"},"PeriodicalIF":7.0,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590358","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":"Slowing myopia progression with a novel spectacle lens - 1-year, randomized double-masked, cross-over clinical trial.","authors":"Linlin Du, Padmaja Sankaridurg, Min Tong, Bo Zhang, Zander Hattingh, Wayne Li, Youhua Yang, Craig Woods, Nicole Liu, Arne Ohlendorf, Xun Xu, Xiangui He","doi":"10.1016/j.apjo.2026.100354","DOIUrl":"10.1016/j.apjo.2026.100354","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effectiveness of test spectacle lens in slowing myopia progression as compared to single vision (SV) spectacle (SPL).</p><p><strong>Design: </strong>Cross-over trial.</p><p><strong>Subjects: </strong>120 children aged 6-12 yrs, cycloplegic spherical equivalent (SE) of -0.75D to -5.00D.</p><p><strong>Intervention: </strong>Enrolled participants were randomly assigned to wear either SV or test SPL (n = 60 each group). The test SPL incorporates a central clear zone and four annular cylindrical rings in the paracentral zone with a mean surface power of + 4.00D. For first six months (stage I), children wore their assigned lenses and then crossed over to wear the other lens for the second six months (stage II).</p><p><strong>Outcomes: </strong>Six- monthly changes in SE and AL from baseline presented as mean and 95% confidence intervals (CIs). Differences between groups were assessed using multiple linear regression, adjusting for confounders. To determine potential rebound effect, progression with SV during stage II was compared to progression with SV in stage I.</p><p><strong>Results: </strong>Myopia progression was significantly slower with test SPL during both stages. During stage I, the difference in progression (Δ) between test SPL and SV were 0.32D (0.21, 0.43) and 0.12 mm (0.09，0.16) (P < 0.001). During stage II, myopia progressed slower by 0.25D (0.15, 0.36) and 0.11 mm (0.07, 0.14) (P < 0.001) with test SPL. Progression with SV during stage I and stage II did not differ significantly (SE: -0.42 ± 0.31D vs -0.51 ± 0.30D, p = 0.119; AL: 0.19 ± 0.11 mm vs 0.22 ± 011 mm, P = 0.182).</p><p><strong>Conclusions: </strong>Test spectacles significantly slow myopia in majority of eyes in 6 months and no statistically significant rebound signal was detected during the observation period.</p>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":" ","pages":"100354"},"PeriodicalIF":7.0,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590291","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":"2026-07-11","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":"Does lens opacity matter? The effect of cataract on deep learning based cardiovascular disease risk scores from fundus photos","authors":"Jee Eun Lee,&nbsp;Jungkyung Cho,&nbsp;Yong-Seok Lee,&nbsp;Simon Nusinovici,&nbsp;Sahil Thakur,&nbsp;Junseok Park,&nbsp;Dongjin Nam,&nbsp;Jaewon Seo,&nbsp;Wonyoung Seo,&nbsp;Yong Yu Tan,&nbsp;Zhi Da Soh,&nbsp;Can Can Xue,&nbsp;Ching-Yu Cheng,&nbsp;Sunjin Hwang","doi":"10.1016/j.apjo.2026.100333","DOIUrl":"10.1016/j.apjo.2026.100333","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the effect of cataracts on a deep learning (DL) model for cardiovascular disease (CVD) risk prediction.</div></div><div><h3>Methods</h3><div>This retrospective, dual-cohort study analyzed fundus images at baseline, 1, and 6-months post-cataract surgery from a longitudinal cohort (patients who underwent cataract surgery at Hanyang University Guri Hospital [HUGH]) and a cross-sectional replication cohort (Singapore Epidemiology of Eye Diseases [SEED] study). CVD risk scores were generated using an artificial intelligence (AI) software (Dr.Noon CVD). Longitudinal changes were evaluated using a generalized estimating equation (GEE) model. The association between CVD scores and cataract surgery was also assessed in the SEED study using multivariable linear regression. Subgroup analyses were performed based on diabetic retinopathy (DR) status.</div></div><div><h3>Results</h3><div>In the longitudinal cohort, Dr. Noon CVD scores significantly increased from baseline after cataract surgery at 1 month (β = +2.14; 95% CI, 1.28–3.01; <em>P</em> &lt; 0.001) and 6 months (β = +1.69; 95% CI, 0.82–2.56; <em>P</em> &lt; 0.001). A significant interaction with DR was observed, showing substantially larger score increases at 1 month (interaction β = +3.02; 95% CI, 1.20–4.85; <em>P</em> = 0.001) and 6 months (interaction β = +4.78; 95% CI, 2.99–6.56, <em>P</em> &lt; 0.001). These findings were partially replicated in the SEED cohort, where pseudophakia was significantly associated with a higher CVD score compared to phakic eyes (β = +2.60; 95% CI, 1.71–3.49, <em>P</em> &lt; 0.001); however, the interaction between cataract surgery and DR status was not formally significant in SEED (<em>P</em> = 0.451).</div></div><div><h3>Conclusions</h3><div>Cataract-induced media opacity is associated with significant attenuation of DL-derived CVD risk scores, particularly in eyes with DR. This score shift following improvement in optical clarity highlights the critical need to account for lens status when interpreting fundus-based AI prediction models.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"15 4","pages":"Article 100333"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-advanced age-related macular degeneration: Current concepts and future perspectives","authors":"Mariano Cozzi,&nbsp;Sandrine A. Zweifel,&nbsp;Kimberly Spooner,&nbsp;Francesco Romano,&nbsp;Robyn Guymer,&nbsp;SriniVas R. Sadda,&nbsp;Giovanni Staurenghi,&nbsp;Alessandro Invernizzi","doi":"10.1016/j.apjo.2026.100346","DOIUrl":"10.1016/j.apjo.2026.100346","url":null,"abstract":"<div><div>Non-advanced age-related macular degeneration (AMD), encompassing early and intermediate stages, represents a critical therapeutic window before irreversible central vision loss. Traditionally defined by drusen size and pigmentary abnormalities on color fundus photography, disease characterization has evolved substantially with the integration of multimodal imaging biomarkers. Contemporary imaging enables detailed structural phenotyping, including reticular pseudodrusen (also known as subretinal drusenoid deposits), hyperreflective foci, and incomplete retinal pigment epithelium and outer retinal atrophy, which refine risk stratification and provide insight into progression toward advanced disease. Functional assessment has expanded beyond best-corrected visual acuity to include low-luminance visual acuity, contrast sensitivity, dark adaptation, and microperimetry, many of which are more sensitive to early dysfunction. However, standardization and regulatory approval of these endpoints remain ongoing challenges. Non-advanced AMD arises from complex interactions among genetic susceptibility, aging, environmental exposures, and systemic metabolic factors. Smoking remains the strongest modifiable risk factor, while Mediterranean dietary patterns appear protective. Currently, no pharmacologic therapies are approved for non-advanced AMD. The Age-Related Eye Disease Study formulations remain the only interventions proven to reduce progression in high-risk individuals. Emerging approaches, including subthreshold laser therapy and photobiomodulation, show preliminary promise but require validation in robust and adequately powered randomized clinical trials. Recent consensus efforts emphasize biomarker-driven classification and highlight the heterogeneity of AMD phenotypes across populations. Future research priorities include validation of quantitative imaging and functional endpoints, integration of artificial intelligence–based predictive models, and development of targeted therapies to delay progression. These endevours will be essential to advance precision prevention strategies.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"15 4","pages":"Article 100346"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal assessment of cone structure and lesion remodeling in laser-induced retinopathy","authors":"Dong Fang,&nbsp;Xiangqing Hei,&nbsp;Lu Chen,&nbsp;Jia Liang,&nbsp;Changfeng Pan,&nbsp;Pan Xiao,&nbsp;Han Wang,&nbsp;Yingying Diao,&nbsp;Huiyan Zheng,&nbsp;Renxue Liang,&nbsp;Jie Zhang,&nbsp;Shaochong Zhang,&nbsp;Wei Chi","doi":"10.1016/j.apjo.2026.100325","DOIUrl":"10.1016/j.apjo.2026.100325","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess photoreceptor structural changes and lesion remodeling during spontaneous recovery of laser-induced retinopathy (LIR), and to evaluate accompanying alterations in localized retinal function.</div></div><div><h3>Methods</h3><div>This prospective longitudinal observational study included thirteen patients (15 eyes) with LIR. Baseline and 6-month follow-up examinations included adaptive optics scanning laser ophthalmoscopy (AO-SLO), optical coherence tomography (OCT), and microperimetry. Outcome measures were AO-SLO–based lesion area and cone metrics, OCT-derived ellipsoid zone (EZ) disruption, and retinal sensitivity.</div></div><div><h3>Results</h3><div>LIR lesions on AO-SLO appeared as irregular localized dark areas containing scattered cones with weak reflectivity. OCT images showed focal outer retinal disruptions involving the EZ and interdigitation zones. Over 6 months, lesion area significantly decreased (97,128 ± 107,478 µm² to 27,560 ± 26,901 µm²; <em>P</em> = 0.031), perilesional cone density increased (27,942 ± 6970 to 36,700 ± 9257 cones/mm²; <em>P</em> = 0.010), and cone spacing decreased (4.71 ± 0.57 µm to 4.25 ± 0.57 µm; <em>P</em> = 0.040). EZ disruption length remained stable (203 ± 181 µm to 195 ± 173 µm; <em>P</em> = 0.64). Lesion-specific retinal sensitivity improved significantly (19.25 ± 4.37 dB to 26.43 ± 1.56 dB; <em>P</em> &lt; 0.001), whereas mean macular sensitivity and best-corrected visual acuity showed no significant change.</div></div><div><h3>Conclusions</h3><div>AO-SLO revealed lesion contraction and perilesional cone reorganization during spontaneous recovery from LIR. These findings suggest that the human retina shows microstructural plasticity after laser injury and highlight AO-SLO’s superiority in detecting early cellular-level changes in LIR.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"15 4","pages":"Article 100325"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal foundation model assistance for differentiating primary open-angle glaucoma in highly myopic eyes","authors":"Houfa Yin,&nbsp;Kaikai Zhao,&nbsp;Qi Miao,&nbsp;Wanshu Zhou,&nbsp;Chenyang Hu,&nbsp;Yongwei Guo,&nbsp;Dongmei Shi,&nbsp;Qiaoli Yang,&nbsp;Luoluo Mei,&nbsp;Yi Chen,&nbsp;Yelei Song,&nbsp;Andrzej Grzybowski,&nbsp;Kai Jin","doi":"10.1016/j.apjo.2026.100352","DOIUrl":"10.1016/j.apjo.2026.100352","url":null,"abstract":"<div><h3>Purpose</h3><div>To develop and evaluate a multimodal foundation-model-assisted system for differentiating primary open-angle glaucoma (POAG) from non-glaucoma in highly myopic eyes and assessing whether artificial intelligence (AI) assistance changes ophthalmologist diagnostic performance.</div></div><div><h3>Design</h3><div>Retrospective diagnostic model-development study with internal validation and paired sequential multi-reader evaluation.</div></div><div><h3>Participants</h3><div>Model development used 603 eye-level cases (502 POAG, 101 non-glaucoma); a fixed 150-case set from 149 patients was used for internal test reporting and the paired reader evaluation.</div></div><div><h3>Methods</h3><div>A RETFound-based multimodal classifier used color fundus photographs, optical coherence tomography (OCT) images, and 24 structured OCT/retinal nerve fiber layer (RNFL) variables. Six ophthalmologists reviewed each case without and then with AI assistance after a washout interval.</div></div><div><h3>Main Outcome Measures</h3><div>Model area under the receiver operating characteristic curve (AUC); reader sensitivity, specificity, accuracy, F1 score, confidence, reading time, diagnostic switching, and inter-reader agreement.</div></div><div><h3>Results</h3><div>The final multimodal model achieved an AUC of 0.911 (95% confidence interval [CI], 0.862–0.950) on the fixed 150-case set. In the sequential paired evaluation, unaided versus AI-assisted mean sensitivity was 68.0% versus 75.3%, accuracy was 74.2% versus 79.6%, F1 score was 0.790 versus 0.844, and mean specificity was 91.3% in both phases; Fleiss kappa was 0.583 versus 0.709. Reader-level diagnostic differences were not significant after multiplicity adjustment and were exploratory.</div></div><div><h3>Conclusions</h3><div>In this internal retrospective study, the AI-assisted phase showed numerically higher mean sensitivity, accuracy, confidence, and inter-reader agreement than the unaided phase, with unchanged mean specificity. Reader-level diagnostic differences were not statistically significant after multiplicity adjustment and should be considered exploratory. Prospective multicenter validation is required before clinical deployment.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"15 4","pages":"Article 100352"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}