Asia-Pacific Journal of Ophthalmology最新文献

{"title":"Corrigendum to “Evaluating photodynamic therapy as an adjuvant treatment for neovascular AMD: A comprehensive meta-analysis” [Asia-Pacific J Ophthalmol 14 (2025), 100173]","authors":"Swara M. Sarvepalli, Ishani Kapoor, Kubra Sarici, Sunir J. Garg, Majda Hadziahmetovic","doi":"10.1016/j.apjo.2026.100347","DOIUrl":"10.1016/j.apjo.2026.100347","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"15 4","pages":"Article 100347"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700752","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":"Gut-eye connection in ocular diseases: An emerging frontier","authors":"Shu Liu, Bryan C.P. Lam, Enne Hiu Ying Leung, Timothy P.H. Lin, Dennis S.C. Lam, Jost B. Jonas","doi":"10.1016/j.apjo.2026.100356","DOIUrl":"10.1016/j.apjo.2026.100356","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"15 4","pages":"Article 100356"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618278","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":"Visual preservation and surgical outcomes of phacogoniotomy in end-stage glaucoma: A multicenter study","authors":"Zefeng Yang,&nbsp;Bin Xie,&nbsp;Jiangang Xu,&nbsp;Ping Zhao,&nbsp;Xiaoyan Li,&nbsp;Nan Zhang,&nbsp;Can Wang,&nbsp;Xiaomin Zhu,&nbsp;Xiangxiang Ye,&nbsp;Tingli Wen,&nbsp;Xiaohua Pan,&nbsp;Di Wang,&nbsp;Hanying Fan,&nbsp;Hengli Zhang,&nbsp;Jing Zhu,&nbsp;Xiaohuan Zhao,&nbsp;Zhihong Zhang,&nbsp;Xin Zhang,&nbsp;Yawen Feng,&nbsp;Xiang Mo,&nbsp;Xiulan Zhang","doi":"10.1016/j.apjo.2026.100332","DOIUrl":"10.1016/j.apjo.2026.100332","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the visual preservation, safety, and surgical outcomes of phacogoniotomy (phacoemulsification combined with or without goniosynechialysis and goniotomy) in patients with end-stage glaucoma.</div></div><div><h3>Methods</h3><div>This multicenter retrospective study included 134 eyes of 128 patients (92 primary angle-closure glaucoma [PACG] and 42 primary open-angle glaucoma [POAG]) with end-stage glaucoma (defined as inability to perform perimetry or visual acuity ≤ 20/200). Patients underwent phacogoniotomy and were followed ≥ 12 months. Main outcomes included best-corrected visual acuity (BCVA), intraocular pressure (IOP), medication burden, and complications, with specific attention to the \"wipe-out\" phenomenon.</div></div><div><h3>Results</h3><div>At a mean follow-up of 19.2 ± 8.0 months, no cases of \"wipe-out\" (sudden, immediate, irreversible central vision loss) occurred. BCVA improved in 63.1% of eyes and remained stable in 30.3%. The mean IOP decreased significantly from 31.4 ± 9.7 mm Hg to 14.1 ± 3.3 mm Hg (<em>P</em> &lt; 0.001) and mean number of medications dropped from 2.2 ± 1.4–0.6 ± 1.0 (<em>P</em> &lt; 0.001). Complete success rate was 67.9% overall, with 76.1% for PACG and 50.0% for POAG (<em>P</em> = 0.005). Qualified success rate was 97.0% overall, with 96.7% for PACG and 97.6% for POAG (<em>P</em> = 0.695). The most common complications were transient hyphema (11.2%) and IOP spike (3.7%).</div></div><div><h3>Conclusions</h3><div>In end-stage glaucoma, phacogoniotomy is a safe and effective procedure that significantly lowers IOP while preserving or improving vision in &gt; 90% of cases. The procedure may reduce the risk of \"wipe-out\" associated with traditional filtration surgery and appears particularly effective in eyes with angle-closure mechanisms.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"15 4","pages":"Article 100332"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986274","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":"Glaucoma prevalence and prescribing trends in New Zealand: A 10-year study","authors":"Jane Shi,&nbsp;Vidit Singh,&nbsp;Brandon Nunns,&nbsp;Helen Danesh-Meyer,&nbsp;James McKelvie","doi":"10.1016/j.apjo.2026.100350","DOIUrl":"10.1016/j.apjo.2026.100350","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate dispensing trends of publicly funded glaucoma medications in New Zealand from 2012 to 2021, and to assess disparities in prescribing across demographic groups. This study provides population-level insights into real-world glaucoma care and treatment equity in a universal healthcare setting. In New Zealand, although limited information exists on prescribing practices, there has been no comprehensive analysis of national dispensing data. This distinction is critical, as dispensing data more accurately reflect medication access, patient uptake, and treatment adherence than prescribing data alone.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted using de-identified national pharmacy dispensing data from the New Zealand Ministry of Health. Dispensing trends for eleven glaucoma medications were analysed by year, medication, sex, and self-identified ethnicity. Age-adjusted per capita dispensing rates were compared using ANOVA with post-hoc analysis.</div></div><div><h3>Results</h3><div>Over 3 million glaucoma prescriptions were dispensed, representing 27.6% of all ocular medications. The number of treated individuals rose from 39,725 in 2012–50,048 in 2021 (a 25.9% increase), outpacing national population growth. The prevalence of pharmacologically treated glaucoma or ocular hypertension increased from 0.90% in 2012–0.98% in 2021. The annual incidence of newly treated glaucoma was estimated at 125 per 100,000 people per year. Latanoprost was the most frequently dispensed glaucoma medication (40%), followed by timolol (13%) and bimatoprost (11%). Disparities in dispensing patterns were evident. Europeans received 87% of glaucoma prescriptions, Māori and Pasifika peoples, who represent 17.8% and 8.9% of the population, received only 1.9% and 1.4% of glaucoma prescriptions, respectively (p &lt; 0.001), even after adjusting for age.</div></div><div><h3>Conclusion</h3><div>This nationwide study provides the most comprehensive analysis to date of glaucoma medication dispensing in Aotearoa New Zealand, capturing real-world treatment patterns across a ten-year period. It offers critical insight into the treated prevalence and incidence of pharmacologically treated glaucoma and ocular hypertension at a population level. Latanoprost has clearly emerged as the dominant first-line therapy, consistent with international clinical guidelines, followed by Timolol. However, the findings also expose significant inequities: Māori—the Indigenous people of New Zealand—and Pasifika populations remain markedly under-represented among those receiving glaucoma treatment, even after adjusting for age. Further research is needed to understand the underlying reasons for these disparities and to ensure equitable access to glaucoma care for all New Zealanders.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"15 4","pages":"Article 100350"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468665","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":"Using artificial intelligence to detect keratoconus progression based on age and anterior segment optical coherence tomography images","authors":"Takashi Miyai,&nbsp;Kazutaka Kamiya,&nbsp;Yuji Ayatsuka,&nbsp;Yudai Kato,&nbsp;Hitoha Ishii,&nbsp;Nobuyuki Shoji,&nbsp;Yosai Mori,&nbsp;Kazunori Miyata","doi":"10.1016/j.apjo.2026.100323","DOIUrl":"10.1016/j.apjo.2026.100323","url":null,"abstract":"<div><div>In this study, we aimed to establish and evaluate an index to define keratoconus progression based on map images obtained from anterior segment optical coherence tomography (AS-OCT) and age through deep learning. AS-OCT images and patient data were retrospectively retrieved from Hospital records. Classifiers for each of the six types of images were created using machine learning, and an index was established for judging keratoconus progression from the output adjusted or unadjusted for age. A total dataset of 2006 paired AS-OCT images from longitudinal examinations (positive: 883, negative: 1123), comprising a learning dataset of 1678 pairs (positive: 741, negative: 937) and a validation dataset of 328 pairs (positive: 142, negative: 186), was used. The final numerical value (index) was obtained from the output results and age. The index was subsequently evaluated using the validation dataset to determine its accuracy, sensitivity, specificity, goodness of fit, and area under the receiver operating characteristic curve (AUC). The average value of the keratoconus progression index significantly differed between the age-adjusted and unadjusted algorithms (p &lt; 0.001). Adjusting for age improved the keratoconus progression index (accuracy, 0.655 vs. 0.909; sensitivity, 0.915 vs. 0.937; specificity, 0.457 vs. 0.887; precision, 0.563 vs. 0.864; F-value, 0.697 vs. 0.899; and AUC 0.727 vs. 0.935). Using machine learning on six types of AS-OCT images adjusted for age, we developed an index with a better predictive value of keratoconus progression than previously reported. This index accurately predicts keratoconus progression, which is useful for determining indications for corneal cross-linking using initial AS-OCT imaging.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"15 4","pages":"Article 100323"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760661","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":"Grades of pinhole pupilloplasty (PPP)","authors":"Amar Agarwal,&nbsp;Priya Narang,&nbsp;Dhivya Ashok Kumar,&nbsp;Soundari Sivangnanam","doi":"10.1016/j.apjo.2026.100351","DOIUrl":"10.1016/j.apjo.2026.100351","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"15 4","pages":"Article 100351"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468663","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":"Benchmarking and fine-tuning vision-language models on a visual question answering dataset for myopic maculopathy","authors":"Tsun Hei Yip,&nbsp;Pusheng Xu,&nbsp;Zirong Liu,&nbsp;Ebenezer Zaabaar,&nbsp;Angie H.C. Fong,&nbsp;Yatu Guo,&nbsp;Ziming Xu,&nbsp;Wei Zhang,&nbsp;Yau Kei Chan,&nbsp;Dennis S.C. Lam,&nbsp;Kendrick C. Shih,&nbsp;Christopher K.S. Leung,&nbsp;Xiu Juan Zhang","doi":"10.1016/j.apjo.2026.100345","DOIUrl":"10.1016/j.apjo.2026.100345","url":null,"abstract":"<div><h3>Purpose</h3><div>To build a visual question answering (VQA) dataset for fine-tuning and evaluating vision-language models (VLMs) in myopic maculopathy (MM).</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>Colour fundus photographs (CFPs) from two publicly available datasets were graded using META-PM classification system. GPT–5 was used to generate clinical captions, true/false [TFQ] and open-ended [OEQ] question-answer pairs, all of which were manually verified. InternVL3‐8B was fine-tuned on this dataset and evaluated against Gemini 3 Pro, Claude Sonnet 4.5, Qwen3-VL-30B-A3B-Instruct, and pre-trained InternVL3‐8B. OEQ responses was evaluated by GPT–5 using a three-level scoring system (0, completely incorrect; 0.5, partially correct; 1, fully correct) and summarized as weighted accuracy. Overall accuracy was defined as the arithmetic mean of the TFQ and OEQ accuracies.</div></div><div><h3>Results</h3><div>MM-VQA comprises 2591 CFPs and 19,648 question-answer pairs. Fine-tuned InternVL3-8B model achieved an overall accuracy of 0.746, surpassing Claude Sonnet 4.5 (0.596), Qwen3-VL-30B-A3B-Instruct (0.566), and pre-trained InternVL3-8B (0.428) (all <em>P</em> &lt; 0.001), while showing no significant difference compared with Gemini 3 Pro (0.724, <em>P</em> = 0.642). For TFQ, the fine-tuned model reached an accuracy of 0.919, outperforming Gemini 3 Pro (0.881), Qwen3-VL-30B-A3B-Instruct (0.834), Claude Sonnet 4.5 (0.796), and the pre-trained model (0.696) (all <em>P</em> &lt; 0.001). On OEQ, it also ranked highest (0.572), outperforming Gemini 3 Pro (0.567, <em>P</em> = 0.044), Claude Sonnet 4.5 (0.395, <em>P</em> &lt; 0.001), Qwen3-VL-30B-A3B-Instruct (0.297, <em>P</em> &lt; 0.001) and the pre-trained model (0.160, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>This study provides a valuable VQA dataset for MM, supporting the development of disease-specialised VLMs in ophthalmology.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"15 4","pages":"Article 100345"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148337520","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":"Goniotomy and phacogoniotomy in open and angle-closure glaucoma","authors":"Xiulan Zhang","doi":"10.1016/j.apjo.2026.100349","DOIUrl":"10.1016/j.apjo.2026.100349","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"15 4","pages":"Article 100349"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468732","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":"A symphony of color and connection – charity cataract projects in Xizang","authors":"Alyssa C.Y. Lam,&nbsp;Bryan C.P. Lam,&nbsp;Tenden Yangkyi,&nbsp;Nellie Fong,&nbsp;Mingzhi Zhang,&nbsp;Dennis S.C. Lam","doi":"10.1016/j.apjo.2026.100355","DOIUrl":"10.1016/j.apjo.2026.100355","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"15 4","pages":"Article 100355"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618347","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":"International consensuses and guidelines on clinical management of highly myopic cataracts: A two-round modified e-Delphi study by the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO) and the Asia-Pacific Myopia Society (APMS)","authors":"Yu Du ,&nbsp;Jiaqi Meng ,&nbsp;Jorge L. Alió ,&nbsp;Yi Lu ,&nbsp;Giacomo Savini ,&nbsp;Kevin M. Miller ,&nbsp;Hong Yan ,&nbsp;Marcus Ang ,&nbsp;Haike Guo ,&nbsp;H. Burkhard Dick ,&nbsp;Damien Gatinel ,&nbsp;Jiangyue Zhao ,&nbsp;Mayank A. Nanavaty ,&nbsp;Noel Alpins ,&nbsp;Priya Narang ,&nbsp;Anubha Rathi ,&nbsp;Vanissa W.S. Chow ,&nbsp;Vishal Jhanji ,&nbsp;Hun Lee ,&nbsp;Hiu Ying Enne Leung ,&nbsp;Xiangjia Zhu","doi":"10.1016/j.apjo.2026.100322","DOIUrl":"10.1016/j.apjo.2026.100322","url":null,"abstract":"<div><h3>Purpose</h3><div>As the prevalence of high myopia increases around the world, the incidence of highly myopic cataract (HMC) would increase and present clinicians with unique management challenges. This modified Delphi consensus study aimed to establish practical recommendations for HMC diagnosis and treatment, addressing key controversies in preoperative evaluation, surgical considerations, and postoperative care.</div></div><div><h3>Methods</h3><div>An international panel of 30 cataract experts from 14 countries/territories participated in this two-round e-Delphi study. Consensus was defined as ≥ 75% agreement on 5-point Likert-scale statements covering disease characterization, preoperative evaluation, intraoperative precautions, and postoperative care.</div></div><div><h3>Results</h3><div>A formal consensus was reached by a broad majority of the panel (86.67%) to endorse HMC as a separate disease category, typically manifesting 10–20 years earlier than age-related cataracts. Key consensus included: use of combined IOL formula calculations (96.67% agreement), preference for hydrophobic acrylic intraocular lens (96.67%), and mandatory 3-month postoperative retinal exams (96.67%). Controversies persisted regarding immediate sequential bilateral surgery, prophylactic routine implantation of a capsular tension ring, and postoperative steroid regime.</div></div><div><h3>Conclusions</h3><div>We present commonly agreed recommendations for the clinical management of HMC, which include tailored surgical approaches and vigilant postoperative monitoring to address this growing public health challenge.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"15 3","pages":"Article 100322"},"PeriodicalIF":4.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760653","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}