The ocular surface最新文献

{"title":"Infectious Keratitis and Endophthalmitis Following Boston Type I Keratoprosthesis: Incidence, Risk Factors, and Long-Term Outcomes.","authors":"Maria Soledad Cortina, Li-Yi Chiu, Jose De La Cruz, Raul E Ruiz-Lozano","doi":"10.1016/j.jtos.2026.09.002","DOIUrl":"https://doi.org/10.1016/j.jtos.2026.09.002","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the incidence, clinical characteristics, and risk factors for infectious keratitis and endophthalmitis following Boston Type I keratoprosthesis (KPro) implantation.</p><p><strong>Methods: </strong>We retrospectively reviewed 153 eyes (141 patients) that underwent KPro implantation at the University of Illinois Chicago between 2005 and 2023. Demographic, clinical, microbiologic, and surgical data were analyzed. Incidence rates were calculated per eye-year at risk, and Cox proportional hazards models were used to assess risk factors.</p><p><strong>Results: </strong>Among 153 eyes from 141 patients, 30 developed at least one infection: 12 developed endophthalmitis alone, 5 developed infectious keratitis alone, and 13 developed both. The incidence rates of endophthalmitis and infectious keratitis were 2.77 and 1.97 cases per 100 eye-years at risk, respectively. In univariable Cox analysis, immune-mediated ocular disease (HR, 3.05; 95% CI, 1.04-8.95; P = .043) was associated with endophthalmitis, and preexisting eyelid/adnexal abnormality was associated with infectious keratitis (HR, 5.67; 95% CI, 2.02-15.95; P = .001). In the model adjusted for age, immune-mediated ocular disease, and prior herpes simplex virus (HSV) keratitis, immune-mediated ocular disease was associated with endophthalmitis (adjusted HR, 3.62; 95% CI, 1.19-11.04; P = .024), whereas prior HSV keratitis showed a borderline association (adjusted HR, 3.05; 95% CI, 1.00-9.26; P = .050). The proportional hazards assumption was not met for immune-mediated ocular disease or preexisting eyelid/adnexal abnormality; the corresponding HRs represent average associations over follow-up. No multivariable model was fitted for infectious keratitis.</p><p><strong>Conclusions: </strong>Infectious keratitis and endophthalmitis remain serious complications after Boston Type I KPro. Endophthalmitis occurred most often in the first postoperative year but continued during long-term follow-up. Immune-mediated ocular disease was associated with endophthalmitis in the adjusted model, whereas prior HSV keratitis showed a borderline adjusted association. Preexisting eyelid/adnexal abnormality was associated with infectious keratitis in univariable analysis; this finding is exploratory. Long-term surveillance and careful management of the ocular surface and eyelids remain central to postoperative care.</p>","PeriodicalId":94247,"journal":{"name":"The ocular surface","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mtROS-Stat1 Axis Defines an Acinar Dysfunctional State Linking Metabolic Stress to Immune Activation in Cigarette Smoking-Associated Dry Eye Disease.","authors":"Zedu Cui, Lihong Liang, Wenfeng Huang, Yufan Jiang, Chenxu Wang, Zengzefang Zheng, Zihan Liu, Zhichong Wang, Bingjie Chen, Xiaoran Wang, Bowen Wang","doi":"10.1016/j.jtos.2026.10.002","DOIUrl":"https://doi.org/10.1016/j.jtos.2026.10.002","url":null,"abstract":"<p><strong>Purpose: </strong>Dry eye disease (DED) is a prevalent ocular disorder in which environmental factors, particularly cigarette smoking (CS), are increasingly implicated. However, the underlying mechanisms remain poorly defined.</p><p><strong>Methods: </strong>We integrated cross-sectional data from the UK Biobank with a chronic CS-exposure mouse model and single-nucleus RNA sequencing of the lacrimal gland (LG) tissue. Histological and functional assays were used to characterize ocular surface and LG phenotypes. Transcriptomic analyses were conducted to resolve acinar cell states, define metabolic and inflammatory pathways, and infer cell-cell interactions. Pharmacological interventions targeting mitochondrial reactive oxygen species (mtROS) and Stat1 signaling were applied to assess therapeutic potential.</p><p><strong>Results: </strong>CS was identified as an independent, dose-dependent risk factor for DED and induces progressive LG dysfunction characterized by corneal damage and impaired tear secretion. Single-cell profiling revealed a damage-associated acinar cell (DAAC) state marked by loss of secretory identity and acquisition of an immunogenic phenotype. Mechanistically, we show that mitochondrial oxidative phosphorylation suppression eventually activates Stat1 signaling, which functions as a stress-responsive metabolic checkpoint driving the transition of acinar cells into the DAAC state. Functionally, DAACs exhibited enhanced antigen presentation and actively engage immune cells, supporting an epithelial-driven inflammatory model of DED. Targeting either mtROS or Stat1 ameliorated acinar dysfunction, suppress immune activation, and restored tear secretion.</p><p><strong>Conclusion: </strong>These findings define a mtROS-Stat1-DAAC axis that links metabolic stress to epithelial dysfunction and immune activation in CS-associated DED. This work provides a mechanistic framework connecting environmental exposure to tissue pathology and highlights potential therapeutic strategies for intervention.</p>","PeriodicalId":94247,"journal":{"name":"The ocular surface","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Single-Cell Atlas of Diabetes-Associated Remodeling in the Human Corneal Limbus.","authors":"Daxian Zha, Yizhou Wang, Ruchi Shah, Shaghaiegh M Ebrahimi, Adam J Poe, Cynthia Amador, Jake Inzalaco, Andrew Fealy, Onkar B Sawant, Andrei A Kramerov, Zhiping P Wang, Alexander V Ljubimov, Mehrnoosh Saghizadeh","doi":"10.1016/j.jtos.2026.10.003","DOIUrl":"https://doi.org/10.1016/j.jtos.2026.10.003","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetes mellitus (DM) disrupts epithelial integrity, sensory function, basement membrane composition, wound healing, and stem cell function. Corneal epithelial homeostasis and wound healing involve the complex coordination of various sub-populations of limbal cells. However, the transcriptomic changes at the single-cell level in these cell populations associated with diabetes have never been addressed. This study aims to generate a high-resolution single-cell transcriptomic atlas of human DM corneal limbal tissue to advance our conceptual understanding of human diabetes-associated changes in cell types and composition, transcriptional states, cellular trajectories, and intercellular communication.</p><p><strong>Methods: </strong>Single-cell sequencing (scRNA-seq) was performed on isolated corneolimbal epithelial tissues from a total of six age-matched human donors, including three non-diabetic (N) and three DM donors using 10X Genomics. Selected transcriptomic findings were assessed at the protein level by immunofluorescence staining of corneal sections.</p><p><strong>Results: </strong>Thirteen distinct cell clusters were identified based on the top expressed gene markers in both N and DM samples. Analyses of differentially expressed genes (DEGs), biological pathways, pseudotime trajectories, and subclustering identified DM-associated transcriptional changes, cell-cycle differences, and altered inferred intercellular signaling patterns. Pathway analysis highlighted extracellular matrix organization, adhesion, inflammation, and ligand-receptor interactions that may be associated with diabetes-impaired corneal homeostasis. Immunofluorescence showed corresponding differences in protein staining patterns for selected markers, including decreased IFITM3, MMP-1, periostin, LGI4, and eNOS, and increased ADAMTS-4.</p><p><strong>Conclusions: </strong>We provide the first high-resolution single-cell transcriptome atlas of DM-associated alterations in the human corneolimbal niche and identify molecular pathways and cellular populations that may contribute to compromised corneal homeostasis and regenerative capacity in DM.</p>","PeriodicalId":94247,"journal":{"name":"The ocular surface","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pipeline: Olympic medals and analyzing therapeutic trials in ocular surface disease.","authors":"Gary D Novack","doi":"10.1016/j.jtos.2026.09.007","DOIUrl":"10.1016/j.jtos.2026.09.007","url":null,"abstract":"","PeriodicalId":94247,"journal":{"name":"The ocular surface","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular surface damage and blink dynamics associated with high-intensity smartphone use.","authors":"Zhiqing Chen, Zihan Cheng, Han Wen, Dan Jiang, Yinan Zhou, Qixin Li, Anpeng Pan, Ruilin Hu, Hanlu Xu, Yuyang Zou, JianPeng Wang, Xiaoyu Cao, Jinyang Li, Wei Chen","doi":"10.1016/j.jtos.2026.08.004","DOIUrl":"10.1016/j.jtos.2026.08.004","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effects of 2 h of intensive smartphone use on the ocular surface and evaluate contributing factors, including task type, viewing distance, exposure duration, and blinking dynamics.</p><p><strong>Methods: </strong>A within-subject interventional study was conducted in 21 healthy adults. Participants performed video viewing and gaming tasks at viewing distances of 20, 30, and 40 cm for two consecutive hours under controlled environmental conditions. Blink behavior was recorded using front-facing camera and Visual Analog Scale (VAS) were collected every 30 min. Comprehensive assessments including computer vision syndrome questionnaire, functional visual acuity, accommodative function, tear meniscus height, non-invasive tear breakup time, bulbar redness, fluorescein breakup time, and corneal fluorescein staining, were performed at baseline and immediately after screen exposure.</p><p><strong>Results: </strong>Intensive smartphone use exacerbated subjective symptoms, reduced visual function, and impaired tear film stability. Game task and near-distance viewing were associated with greater symptom aggravation, visual impairment and tear film instability within the same participants (P < 0.001). During gaming, blink frequency remained persistently reduced, while incomplete blink rate (IBR) increased to approximately 60%. IBR rose progressively and correlated positively with corneal fluorescein staining (OR = 1.19, P = 0.01). A digital eye strain prediction model based on VAS scores demonstrated a strong fit (R² = 0.854).</p><p><strong>Conclusions: </strong>Two hours of intensive smartphone use, particularly during gaming tasks, significantly alters blinking behavior, including reduced blink frequency and increased IBR, which may contribute to ocular surface damage. These changes may reflect a failure of compensatory blinking under high visual load.</p>","PeriodicalId":94247,"journal":{"name":"The ocular surface","volume":" ","pages":"184-191"},"PeriodicalIF":5.6,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Male predominance and pubertal resolution in vernal Keratoconjunctivitis: Exploring associations with ocular surface sex steroid intracrinology.","authors":"Shweta Agarwal, Sindhu Maran, Patra Sutanu, Srividya Gurumurthy, M Bharathselvi, R Chitradevi, Varsha Bhambhani, R Mugundhan, Andrea Leonardi, N Angayarkanni","doi":"10.1016/j.jtos.2026.08.003","DOIUrl":"10.1016/j.jtos.2026.08.003","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the role of sex steroid hormones in influencing the sex- and age-related predilection of vernal Keratoconjunctivitis (VKC).</p><p><strong>Methods: </strong>Prospective case-control study of 84 VKC patients, stratified by sex and age (≤16/>16 years) and 96 age and sex-matched controls. Conjunctival imprint cytology and peripheral blood samples were collected during active and quiet disease stages. Gene expression of sex steroid-metabolizing enzymes (CYP19A1, STS, SRD5A2, UGT2B), estrogen and progesterone receptors (ESR1, ESR2, NR3C3) was quantified by qPCR. Plasma DHEA-S, estradiol, testosterone, and progesterone levels were measured by ELISA in a subset.</p><p><strong>Results: </strong>Conjunctival NR3C3 gene expression and the Estrogen receptor (ESR1/ESR2) were upregulated in all VKC cases compared to control irrespective of age; sex and disease activity. During active disease, CYP19A1, SRD5A2 and UGT2B expression were higher than in the quiet stage. Age-stratified analysis showed upregulation of SRD5A2, STS, UGT2B and ESR2 in age >16 years, whereas age ≤16 years and males exhibited downregulation of SRD5A2, STS, and UGT2B with persistent CYP19A1 upregulation. Females showed higher UGT2B expression. Multiple linear regression analysis revealed age and disease activity as significant contributors to gene expression in VKC (p = 0.007; p = 0.01 respectively). Plasma DHEA-S was significantly reduced in VKC patients with quiet disease and in males ≤16years.</p><p><strong>Conclusion: </strong>Altered ocular surface intracrinology with enhanced local estrogenic signaling, particularly in males and pre-pubertal individuals may be associated with the sex and age-related predilection of vernal keratoconjunctivitis.</p>","PeriodicalId":94247,"journal":{"name":"The ocular surface","volume":" ","pages":"176-183"},"PeriodicalIF":5.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pipeline: Eugene Garfield, Ph.D. and bibliometrics.","authors":"Gary D Novack","doi":"10.1016/j.jtos.2026.07.003","DOIUrl":"10.1016/j.jtos.2026.07.003","url":null,"abstract":"","PeriodicalId":94247,"journal":{"name":"The ocular surface","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective consecutive case series of patients with neurotrophic keratopathy associated with unilateral total limbal stem cell deficiency caused by severe ocular surface burns.","authors":"Gustavo S Figueiredo, Teodor Stefanache, Oliver J Baylis, Hardeep-Singh Mudhar, Majlinda Lako, Francisco C Figueiredo","doi":"10.1016/j.jtos.2025.07.002","DOIUrl":"10.1016/j.jtos.2025.07.002","url":null,"abstract":"<p><strong>Introduction: </strong>Limbal stem cell deficiency (LSCD) is commonly caused by ocular surface burns. Corneal nerve damage, often due to infection, inflammation, trauma, leads to neurotrophic keratopathy (NK). This study investigates corneal sensation and nerve damage in patients with unilateral total LSCD before and after autologous cultivated limbal epithelial transplantation (Auto-CLET).</p><p><strong>Methods: </strong>This prospective, single-centre case series included patients with unilateral total LSCD due to severe burns treated at Royal Victoria Infirmary, UK, between June 2012 and January 2018. Corneal sensation was assessed using Cochet-Bonnet aesthesiometry at baseline and 6 months post-Auto-CLET, and in vivo confocal microscopy (IVCM) was used to examine nerve regeneration.</p><p><strong>Results: </strong>Twenty-three patients (19 males, 4 females) received Auto-CLET. Successful restoration of the ocular surface was achieved in all patients, confirmed by slit lamp examination, impression cytology, and IVCM at follow-ups up to 36 months. Baseline best corrected visual acuity was 1.67 logMAR in the affected eye compared to a mean of -0.08 in the healthy eye. Corneal aesthesiometry in LSCD eyes averaged 9.13 mm at baseline, increasing to 12.0 mm at 6 months post-Auto-CLET, though this change was not statistically significant (p = 0.26). IVCM revealed no regeneration of corneal nerves at any follow-up intervals, indicating persistent nerve damage.</p><p><strong>Conclusions: </strong>Despite successful ocular surface restoration, corneal nerve damage persisted, leaving patients at risk of persistent NK. To address this, we strongly suggest continuous topical treatment with blood derived products, such as serum eye drops, but also newly developed therapies such as IGF and rhNGF class of drugs.</p>","PeriodicalId":94247,"journal":{"name":"The ocular surface","volume":" ","pages":"195-202"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tear lymphotoxin-alpha deficiency is associated with conjunctival epitheliopathy in patients with dry eye disease.","authors":"Yun Yang, Tong Lin, Lan Gong","doi":"10.1016/j.jtos.2025.07.009","DOIUrl":"10.1016/j.jtos.2025.07.009","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates the association between lymphotoxin-alpha (LTA) concentration in tear fluid and dry eye disease severity, particularly in relation to the conjunctival microenvironment, and evaluates the clinical utility of measuring LTA to guide treatment with diquafosol sodium eye drops.</p><p><strong>Methods: </strong>In this study, 75 DED patients and 35 non-DED participants were assessed at baseline and DED patients were assessed at one month after treatment with diquafosol sodium eye drops. Clinical assessments included the OSDI, LTA concentration, TBUT, CFS, CLGS, IC, Schirmer test, and MMP-9 and MUC5Ac measurement.</p><p><strong>Results: </strong>Among 110 participants, concordance between LTA diagnostics and clinical diagnosis reached 80.90 %. There was a strong inverse correlation between tear LTA concentration and both CLGS score (R = -0.716, p < 0.001) and IC Nelson grade (R = -0.571, p < 0.001), a positive correlation with conjunctival goblet cell count (R = 0.520, p < 0.001) and TBUT (R = 0.387, p < 0.001). DED patients were subsequently divided into two groups, based on the IC Nelson grade reflecting the degree of damages in conjunctiva. ROC curve analysis identified an optimum threshold LTA concentration of 0.11 ng/mL to distinguish between mild and severe DED. Patients in the low LTA group had higher MMP-9 and lower Muc5ac concentrations compared to the high LTA group. After one month of diquafosol treatment, patients with LTA < 0.11 ng/mL showed more significant improvements compared to those with LTA ≥ 0.11 ng/mL.</p><p><strong>Conclusion: </strong>Tear fluid LTA concentration is strongly correlated with conjunctival damage severity. Measuring LTA concentration offers a noninvasive method for evaluating the conjunctival microenvironment and guiding DED treatment.</p>","PeriodicalId":94247,"journal":{"name":"The ocular surface","volume":" ","pages":"209-218"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning-based classification of fungal and Acanthamoeba keratitis using confocal microscopy.","authors":"Rohith Erukulla, Kosar Esmaili, Amir Rahdar, Mehdi Aminizade, Kasra Cheraqpour, Seyed Ali Tabatabaei, Zahra Bibak-Bejandi, Seyed Farzad Mohammadi, Siamak Yousefi, Mohammad Soleimani","doi":"10.1016/j.jtos.2025.07.012","DOIUrl":"10.1016/j.jtos.2025.07.012","url":null,"abstract":"<p><strong>Introduction: </strong>Fungal and Acanthamoeba keratitis carry the worst prognoses among microbial keratitis (IK), owing to challenges in diagnosis and treatment. This study assesses the feasibility of deep learning (DL) to classify types of IK-fungal keratitis (FK), Acanthamoeba keratitis (AK), and nonspecific keratitis (NSK) (any other corneal inflammation)-and subtyping of FK using in vivo confocal microscopy.</p><p><strong>Methods: </strong>In this study, we employed transfer learning with a ResNet50 architecture to classify culture-confirmed keratitis types in a dataset of 1975 images (1137 FK, 457 AK, and 381 NSK) obtained from the Heidelberg Retinal Tomograph 3 (HRT 3). The dataset was split into training and testing sets. Data augmentation (e.g., rotation, zooming) was applied to the training subset to address class imbalance, and class weighting was used (5x for AK, 30x for NSK). Both models were trained for 150 epochs using the Adam optimizer with 5-fold cross-validation. Model 1 performed multi-class classification (FK, AK, NSK). Model 2 classified FK cases as either filamentous or non-filamentous.</p><p><strong>Results: </strong>Model 1 achieved a macro average accuracy of 87 % and a weighted average accuracy of 89 %. Precision and recall were high for AK (93 %, 96 %) and FK (90 %, 92 %), while NSK showed lower performance (78 %, 71 %). Model 2 demonstrated an accuracy of 85 % in subtyping FK, with an F1-score of 0.81 for filamentous and 0.85 for non-filamentous, an ROC AUC of 0.94, and a PR AUC of 0.95.</p><p><strong>Conclusion: </strong>DL models can accurately classify IK and subtype FK, enhancing diagnostic accuracy and informing targeted treatment strategies.</p>","PeriodicalId":94247,"journal":{"name":"The ocular surface","volume":" ","pages":"203-208"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}