JAMA ophthalmology最新文献

英文中文

Evaluating Language Concordance in Ophthalmic Care-Equity Implications. 评估眼科护理的语言一致性-公平意义。

IF 8.1 1区医学 Q1 OPHTHALMOLOGY

JAMA ophthalmology

Pub Date : 2026-01-29 DOI: 10.1001/jamaophthalmol.2025.5982

Sajad Besharati,Vahid Mohammadzadeh,Kouros Nouri-Mahdavi

引用次数: 0

Context for Large Language Model Evaluation in Ophthalmology. 眼科学中大语言模型评估的背景。

IF 8.1 1区医学 Q1 OPHTHALMOLOGY

JAMA ophthalmology

Pub Date : 2026-01-22 DOI: 10.1001/jamaophthalmol.2025.5841

Yusuke Kameda,Yutaka Kaneko

引用次数: 0

Context for Large Language Model Evaluation in Ophthalmology. 眼科学中大语言模型评估的背景。

IF 8.1 1区医学 Q1 OPHTHALMOLOGY

JAMA ophthalmology

Pub Date : 2026-01-22 DOI: 10.1001/jamaophthalmol.2025.5844

James Doherty,Sara Lovasz

引用次数: 0

Context for Large Language Model Evaluation in Ophthalmology-Reply. 眼科学中大语言模型评价的背景——回复。

IF 8.1 1区医学 Q1 OPHTHALMOLOGY

JAMA ophthalmology

Pub Date : 2026-01-22 DOI: 10.1001/jamaophthalmol.2025.5847

Sahana Srinivasan,Qingyu Chen,Yih Chung Tham

引用次数: 0

Deep Learning-Based Prediction of Cardiopulmonary Disease in Retinal Images of Premature Infants. 基于深度学习的早产儿视网膜图像心肺疾病预测。

IF 9.2 1区医学 Q1 OPHTHALMOLOGY

JAMA ophthalmology

Pub Date : 2026-01-22 DOI: 10.1001/jamaophthalmol.2025.5814

Praveer Singh, Sourav Kumar, Riya Tyagi, Benjamin K Young, Brian K Jordan, Brian Scottoline, Patrick D Evers, Susan Ostmo, Aaron S Coyner, Wei-Chun Lin, Aarushi Gupta, Deniz Erdogmus, R V Paul Chan, Emily A McCourt, James S Barry, Cindy T McEvoy, Michael F Chiang, J Peter Campbell, Jayashree Kalpathy-Cramer

Importance: Bronchopulmonary dysplasia (BPD) and pulmonary hypertension (PH) are leading causes of morbidity and mortality in premature infants.

Objective: To determine whether images obtained as part of retinopathy of prematurity (ROP) screening might contain features associated with BPD and PH in infants and whether a multimodal model integrating imaging features with demographic risk factors might outperform a model based on demographic risk alone.

Design, setting, and participants: A deep learning model was used to study retinal images collected from patients enrolled in the multi-institutional Imaging and Informatics in Retinopathy of Prematurity (i-ROP) study. The analysis included infants at risk for ROP undergoing routine ROP screening examinations from 2012 to 2020. Infants were recruited from 7 neonatal intensive care units. Images were limited to 34 weeks' or less postmenstrual age (PMA) so as to precede the clinical diagnosis of BPD or PH. The dataset included the period from June 2015 to April 2020. Data were analyzed from April to June 2025.

Exposures: BPD was diagnosed by the presence of an oxygen requirement at 36 weeks' PMA, and PH was diagnosed by echocardiogram at 34 weeks. A support vector machine model was trained to predict BPD or PH diagnosis using (1) image features alone (extracted using ResNet18), (2) demographics alone, or (3) image features concatenated with demographics. To reduce the possibility of confounding with ROP, secondary models were trained using only images without clinical signs of ROP.

Main outcomes and measures: For both BPD and PH, performance was reported on a held-out test set and assessed by the area under receiver operating characteristic curve (AUROC).

Results: A total of 493 infants (mean [SD] gestational age, BPD, 25.7 [1.8] weeks; normal, 27.3 [1.8] weeks; 267 male [54.2%]) were included in this analysis. Performance was reported on a held-out test set (99 patients from the BPD cohort and 37 patients from the PH cohort). For BPD, the multimodal model showed higher accuracy (AUC, 0.82; 95% CI, 0.72-0.90) than demographics-only (0.72; ∆AUC, 0.1; 95% CI, -0.008 to 0.21; P = .07) or imaging-only (0.72; ∆AUC, 0.1; 95% CI, 0.04-0.16; P = .002) models. For PH, multimodal AUC was 0.91 vs the demographics-only 0.68 (∆AUC, 0.14; 95% CI, 0.006-0.27; P = .04) and imaging-only 0.91 (∆AUC, -0.09; 95% CI, -0.3 to 0.12; P = .40) models. Results persisted when trained on images lacking clinical ROP signs.

Conclusions and relevance: Results suggest that retinal images obtained during ROP screening may be used to predict the diagnosis of BPD and PH in preterm infants, which may lead to earlier diagnosis and avoid the need for invasive diagnostic testing in the future.

重要性：支气管肺发育不良（BPD）和肺动脉高压（PH）是早产儿发病和死亡的主要原因。目的：确定作为早产儿视网膜病变（ROP）筛查的一部分获得的图像是否可能包含与婴儿BPD和PH相关的特征，以及将影像学特征与人口统计学危险因素相结合的多模态模型是否可能优于仅基于人口统计学风险的模型。设计、设置和参与者：深度学习模型用于研究早产儿视网膜病变（i-ROP）多机构成像和信息学研究中收集的患者视网膜图像。该分析包括在2012年至2020年期间接受常规ROP筛查检查的有ROP风险的婴儿。从7个新生儿重症监护病房招募婴儿。为了提前临床诊断BPD或ph，图像被限制在月经后34周或更短的时间内。数据集包括2015年6月至2020年4月期间。数据分析时间为2025年4月至6月。暴露：BPD是在36周的PMA时通过需氧量诊断的，PH是在34周时通过超声心动图诊断的。训练一个支持向量机模型来预测BPD或PH诊断，使用(1)单独的图像特征（使用ResNet18提取），(2)单独的人口统计学，或(3)图像特征与人口统计学相结合。为了减少与ROP混淆的可能性，二级模型仅使用无ROP临床体征的图像进行训练。主要结果和测量：对于BPD和PH，在一个固定测试集上报告了性能，并通过受试者工作特征曲线下面积（AUROC）进行评估。结果：共纳入493例婴儿（平均[SD]胎龄，BPD 25.7[1.8]周；正常，27.3[1.8]周；男性267例[54.2%]）。在一个持续测试集（BPD队列99例患者和PH队列37例患者）中报告了性能。对于BPD，多模态模型的准确性（AUC, 0.82; 95% CI, 0.72-0.90）高于仅人口统计学模型(0.72;∆AUC, 0.1; 95% CI, -0.008至0.21;P =。07年)或imaging-only(0.72;∆AUC, 0.1; 95%置信区间,0.04 - -0.16;P =。002)模型。对于PH，多模态AUC为0.91，而人口统计学值仅为0.68(∆AUC, 0.14; 95% CI, 0.006-0.27; P =。04)和仅成像0.91(∆AUC, -0.09; 95% CI, -0.3至0.12;P =。40)模型。当对缺乏临床ROP征象的图像进行训练时，结果仍然存在。结论及相关性：结果提示，ROP筛查中获得的视网膜图像可用于预测早产儿BPD和PH的诊断，从而可以早期诊断，避免未来需要进行侵入性诊断检测。

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引用次数: 0

Outcome Metrics in Myopia Control Trials. 近视对照试验的结果指标。

IF 8.1 1区医学 Q1 OPHTHALMOLOGY

JAMA ophthalmology

Pub Date : 2026-01-15 DOI: 10.1001/jamaophthalmol.2025.5768

Benjamin G Jastrzembski,John Robert Mark,Nandini Gandhi

引用次数: 0

Pedunculated Palpebral Conjunctival Papilloma 带蒂眼睑结膜乳头状瘤

IF 8.1 1区医学 Q1 OPHTHALMOLOGY

JAMA ophthalmology

Pub Date : 2026-01-15 DOI: 10.1001/jamaophthalmol.2025.5767

Wisam O. Najdawi, Justin Chen, Carol L. Karp

This case report describes the diagnosis and treatment of conjunctival papilloma in a patient aged 54 years who presented with a 3-month history of a painless lower left eyelid lesion.

本病例报告描述了结膜乳头状瘤的诊断和治疗，患者年龄54岁，表现为3个月的无痛左下眼睑病变史。

引用次数: 0

Language Accessibility at Select Academic Ophthalmology Centers Across US Metropolitan Areas 在美国大都市地区选择学术眼科中心的语言可访问性

IF 8.1 1区医学 Q1 OPHTHALMOLOGY

JAMA ophthalmology

Pub Date : 2026-01-15 DOI: 10.1001/jamaophthalmol.2025.5751

Sebastian Borges, Nicholas J. DeLuca, Victoria A. Pereira, Vitalia Borges, Kara M. Cavuoto

Importance Language concordance between patients and physicians may improve health outcomes; the extent to which academic ophthalmology centers meet the needs of limited English proficiency populations remains unclear. Objective To evaluate alignment between ophthalmologists language skills at US academic ophthalmology centers and linguistic needs of surrounding limited English proficiency populations. Design, Setting, and Participants This cross-sectional study included ophthalmologists affiliated with 32 ophthalmology programs across 28 metropolitan areas, identified from overlap of 2024-2025 US News &amp; World Report “Best Hospitals for Ophthalmology” rankings and 2024 Blue Ridge Institute for Medical Research data on National Institutes of Health funding. Language and training data were collected from institutional websites and public sources. Exposures Ophthalmologist language offerings and local limited English proficiency (LEP) language composition derived from institutional websites and US Census Bureau American Community Survey data. Main Outcomes and Measures Language coverage (proportion of limited English proficiency languages represented by ophthalmologists), adjusted ratios (proportion of ophthalmologists speaking a language relative to the limited English proficiency population speaking it), and ophthalmologist availability (number of ophthalmologists per 10 000 limited English proficiency patients). Regional differences were tested using χ 2 and ANOVA tests. Results A mean of 330 (range, 314-367) ophthalmologists were evaluated per region. Across regions, total coverage was 45 of 82 ophthalmologists (54.9%) in the Northeast, 31 of 59 (52.5%) in the South, 29 of 72 (40.3%) in the West, and 24 of 74 (32.4%) in the Midwest. Coverage in the Midwest was lower than in the Northeast (difference, −0.22; 95% CI, −0.42 to −0.02; P = .03). Across 49 identified languages, only Spanish (mean adjusted ratio, 0.64 [95% CI, 0.28-1.00]) and Vietnamese (mean adjusted ratio, 0.86 [95% CI, 0.05-1.67]) were present in every region with consistent underrepresentation. Ophthalmologist availability was lowest for Spanish (mean adjusted ratio, 4.97 [95% CI, −4.49 to 14.43] per 10 000 limited English proficiency patients overall; &lt;3.0 in 3 regions) and Chinese (mean adjusted ratio, 33.25 [95% CI, −33.26 to 99.76] per 10 000). Conclusions and Relevance In this cross-sectional study, academic ophthalmology centers demonstrated substantial gaps in language concordance, with Spanish-speaking patients disproportionately affected despite representing the largest limited English proficiency population nationally. These findings extend prior evidence of patient-level disparities by identifying potential workforce-level contributors to inequities in ophthalmic care and support targeted recruitment, training, and reporting strategies to expand Spa

患者和医生之间的语言一致性可以改善健康结果；学术眼科中心在多大程度上满足英语水平有限的人群的需求仍不清楚。目的评估美国眼科学术中心眼科医生的语言技能与周边有限英语熟练人群的语言需求之间的一致性。设计、环境和参与者本横断面研究包括28个大都市地区32个眼科项目的眼科医生，从2024-2025年US News的重叠部分确定。世界报告“最佳眼科医院”排名和2024年蓝岭医学研究所的数据由美国国立卫生研究院资助。语言和培训数据收集自机构网站和公共资源。来自机构网站和美国人口普查局美国社区调查数据的眼科医生语言产品和当地有限英语水平（LEP）语言组成。语言覆盖率（眼科医生所代表的有限英语熟练语言的比例）、调整比率（说一种语言的眼科医生相对于说这种语言的有限英语熟练人群的比例）和眼科医生可获得性（每1万名有限英语熟练患者的眼科医生人数）。采用χ 2和方差分析检验区域差异。结果每个地区平均有330名眼科医生（范围314-367）接受评估。从地区来看，东北地区82名眼科医生中有45名（54.9%），南部地区59名眼科医生中有31名（52.5%），西部地区72名眼科医生中有29名（40.3%），中西部地区74名眼科医生中有24名（32.4%）。中西部地区的覆盖率低于东北部（差异为- 0.22;95% CI, - 0.42至- 0.02;P = .03）。在49种确定的语言中，只有西班牙语（平均校正比，0.64 [95% CI, 0.28-1.00]）和越南语（平均校正比，0.86 [95% CI, 0.05-1.67]）在每个地区都存在一致的代表性不足。西班牙语（平均校正比为4.97 [95% CI, - 4.49至14.43]/ 1万名有限英语水平患者；3个地区为3.0）和汉语（平均校正比为33.25 [95% CI, - 33.26至99.76]/ 1万名）眼科医生的可用性最低。在这项横断面研究中，学术眼科中心显示了语言一致性的巨大差距，西班牙语患者受到的影响不成比例，尽管他们代表了全国最大的有限英语熟练人群。这些发现通过确定眼科护理不平等的潜在劳动力水平因素，扩展了先前患者水平差异的证据，并支持有针对性的招聘、培训和报告策略，以扩大西班牙语能力并解决特定地区的短缺问题。

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Outcome Metrics in Myopia Control Trials-Reply. 近视控制试验的结果指标-回复。

IF 8.1 1区医学 Q1 OPHTHALMOLOGY

JAMA ophthalmology

Pub Date : 2026-01-15 DOI: 10.1001/jamaophthalmol.2025.5771

Jianfeng Zhu,Hannan Xu,Xun Xu

引用次数: 0

Pediatric Orbital MALT Lymphoma Masquerading as a Pyogenic Granuloma 儿童眼眶MALT淋巴瘤伪装成化脓性肉芽肿

IF 8.1 1区医学 Q1 OPHTHALMOLOGY

JAMA ophthalmology

Pub Date : 2026-01-08 DOI: 10.1001/jamaophthalmol.2025.5067

Marie Callet, Marc Putterman, Augustin Lecler

This case report discusses a diagnosis of B-cell lymphoma mucosa-associated lymphoid tissue (MALT) in the conjunctiva of a young boy who presented with a painless, enlarging conjunctival mass.

本病例报告讨论的诊断b细胞淋巴瘤粘膜相关淋巴组织（MALT）在结膜的一个年轻的男孩谁提出了无痛，扩大结膜肿块。

引用次数: 0

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