International Journal of Retina and Vitreous最新文献

Objectives: Age-related macular degeneration (AMD), in which oxidative stress, inflammation and metabolic imbalances play a role in its pathogenesis, is one of the leading causes of irreversible vision loss. The kynurenine (KYN) pathway, one of the principal routes of tryptophan (TRP) metabolism, constitutes an important mechanism in retinal neurodegeneration. Based on this information, our study aimed to compare the serum TRP, KYN, kynurenic acid (KYNA), 3-hydroxykynurenine (3HK), 3-hydroxyanthranilic acid (3HAA) and, quinolinic acid (QA) levels of AMD patients and to investigate the diagnostic values ​​of these biomarkers.

Methods: Serum samples were collected from AMD patients and control groups. TRP, KYN, KYNA, 3HK, 3HAA, and QA levels were measured using a commercial ELISA method. KYN pathway activity, KYN/TRP and, KYNA/3HK ratios were also assessed. Mann-Whitney U test, ROC analysis, Spearman correlation were applied for statistical comparisons.

Results: According to our results, 3HK was significantly higher in the AMD group, while TRP, KYN, QA, and KYNA/3HK ratio were higher in the control. ROC analysis revealed 3HK to be the strongest discriminatory marker. The KYNA/3HK ratio also provided significant diagnostic value. Correlation analysis revealed strong negative correlations between 3HK and KYN, QA, and especially KYNA/3HK. Conversely, strong positive correlations were found between KYN and KYNA/3HK, and between TRP, KYN, QA, and KYNA.

Conclusion: KYN pathway metabolites exhibit significant alterations in patients with AMD. 3HK levels and the reduction of the KYNA/3HK ratio suggest a disruption of the neurotoxic-neuroprotective balance and imply that KYN pathway dysfunction may play a role in the pathogenesis of AMD. Among the biomarkers examined, 3HK displayed the highest diagnostic performance, while the KYNA/3HK ratio emerged as an additional biological indicator. These findings indicate that 3HK and the KYNA/3HK ratio may serve as potential biomarker candidates for the early diagnosis and monitoring of AMD.

Background: Previous studies have established an association between age-related macular degeneration (AMD) and chronic systemic inflammation. However, the relationship between AMD and the monocyte-to-lymphocyte ratio (MLR), a novel inflammatory biomarker, remains unclear. In this study, we aimed to investigate the association between MLR and AMD using data from the 2005-2008 National Health and Nutrition Examination Survey (NHANES).

Methods: Data from three NHANES cycles (2005-2008) were analyzed to preliminarily assess the association between MLR and AMD, excluding participants with incomplete data. We utilized weighted logistic regression models, restricted cubic spline functions (RCS) and constructed receiver operating characteristic (ROC) curves to evaluate the association between MLR and AMD.

Results: A total of 4,894 participants were deemed eligible for our analysis, with 379 individuals diagnosed with AMD. The Monocyte to Lymphocyte Ratio (MLR) was significantly elevated in the AMD group compared to the non-AMD group. After adjusting for potential confounding factors, we found that elevated MLR levels were significantly associated with an increased risk of AMD, with an OR of 2.56, 95% CI: (1.17,5.58), P = 0.022. The restricted cubic spline (RCS) analysis revealed a significant nonlinear relationship between MLR and AMD, with an inflection point at 0.26 (nonlinear P < 0.05). Furthermore, the receiver operating characteristic (ROC) curve analysis demonstrated that MLR exhibited acceptable discrimination for AMD.

Conclusions: Elevated MLR is associated with an increased risk of AMD, suggesting that MLR may serve as a simple and effective clinical biomarker of AMD.

Purpose: To compare the long-term incidence of recurrent vitreous hemorrhage(VH) and neovascular glaucoma (NVG) in patients with proliferative diabetic retinopathy (PDR) undergoing pars plana vitrectomy (PPV) alone versus combined PPV and phacoemulsification (PPV&P).

Methods: This large, single-center, retrospective cohort study analyzed 548 eyes (137 PPV&P, 411 PPV-alone) with a minimum 12-month follow-up. Kaplan-Meier survival analysis and multivariable Cox proportional hazards regression models were used to compare outcomes and identify independent predictors for complications within a 2-year follow-up period. A supplementary propensity score-matched (PSM) analysis was also performed to confirm the findings.

Results: Over the entire follow-up, the overall incidence of recurrence and NVG did not differ significantly between the groups. However, multivariable Cox regression analysis for the first two years revealed that PPV-alone was a significant protective factor against recurrence (adjusted Hazard Ratio [aHR], 0.61; 95% CI, 0.40-0.92), while severe preoperative traction was a major risk factor (aHR, 2.24; 95% CI, 1.39-3.60). For NVG development within two years, the surgical approach was not a significant factor. Instead, severe preoperative traction (aHR, 5.88; 95% CI, 1.67-20.68) and older age (aHR, 1.06; 95% CI, 1.01-1.11) were the primary independent risk factors.These findings were confirmed in a 1:1 age-matched PSM cohort.

Conclusion: Combined PPV with phacoemulsification is associated with an increased risk of recurrence within the first two postoperative years but does not increase the risk of neovascular glaucoma. The severity of baseline proliferative disease, particularly the degree of traction, is a more critical determinant of postoperative complications than the surgical strategy regarding the lens. This supports tailoring the surgical approach based on individual patient cataract status and retinal pathology.

Background: To evaluate the accuracy and readability of answers to common retinitis pigmentosa (RP) questions from the popular generative artificial intelligence (AI) chatbots ChatGPT-4 and Gemini-2.0.

Methods: In March 2025, frequently asked questions about RP was entered to Google search tool, and the websites appearing on the first search page were selected for enrollment in the study. ChatGPT-4 and Gemini-2.0 were then prompted to generate responses about RP in both standard and simplified formats. To generate the simplified response, the following request was added to the prompt: 'Please provide a response suitable for the average American adult, at a sixth-grade comprehension level.' The AI chatbots' responses to 30 questions about RP, frequently asked by patients, were evaluated by two ophthalmologists using a five-point Likert scale, with scores ranging from 1-5. Additionally, 8 readability indices, including Average Reading Level Consensus Calculator (ARLC), Automated Readability Index (ARI), Flesch Reading Ease (FRE), Gunning Fog Index (GFOG), Flesch-Kincaid Grade Level (FKGL), Coleman-Liau Index (CL), Simple Measure of Gobbledygook (SMOG), and Forcast Readability Formula (FRF) were calculated using an online calculator, Readabilityformulas.com, to assess the ease of comprehension of each answer.

Results: No significant difference showed in accuracy both standard and simplified AI chatbot responses (p = 0.557, p = 0.090). In particular, almost all readability indices suggest that standard AI chatbot responses require a higher level of education for comprehension, whereas simplified responses require a lower level of education. Although Gemini-2.0 standard responses were more readable than ChatGPT-4 standard responses according to ARI, GFOG and FRF scores (p = 0.014, p = 0.040, and p = 0.001), Gemini-2.0 simplified responses were more readable than ChatGPT-4 simplified responses solely according to FRF scores (p = 0.016).

Conclusions: This study shows that ChatGPT-4 and Gemini-2.0 can provide patients with an avenue to access comprehensive and accurate information about, tailored RP to their educational level.