Pub Date : 2025-01-30DOI: 10.1001/jamaophthalmol.2024.6181
Mahyar Etminan,Mohit Sodhi,David Maberley
{"title":"GLP-1 RAs and Nonarteritic Anterior Ischemic Optic Neuropathy-Making Sense of the Data.","authors":"Mahyar Etminan,Mohit Sodhi,David Maberley","doi":"10.1001/jamaophthalmol.2024.6181","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.6181","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"36 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-30DOI: 10.1001/jamaophthalmol.2024.6058
Bradley J. Katz, Michael S. Lee, Norah S. Lincoff, Anne S. Abel, Somya Chowdhary, Brian D. Ellis, Ahmad Najafi, John Nguyen, Meagan D. Seay, Judith E. A. Warner
ImportanceNearly 2% of the US population received a prescription for semaglutide in 2023. There has been a recent concern that this drug and other similar medications may be associated with ophthalmic complications.ObjectiveTo report ophthalmic complications associated with the use of semaglutide or tirzepatide.Design, Setting, and ParticipantsThis was a retrospective case series. All patients were initially seen in a community setting. Patients experiencing an ophthalmic complication in association with the use of semaglutide or tirzepatide were included in this analysis.ExposuresPatients described were using either semaglutide or tirzepatide.Main Outcomes and MeasuresVisual acuity and visual field defects.ResultsA total of 9 patients (mean [SD] age, 57.4 [11.6] years; age range, 37-77 years; 5 female [56%]; 4 male [44%]) were included in this study. Seven patients with nonarteritic ischemic anterior optic neuropathy, 1 patient with bilateral papillitis, and 1 patient with paracentral acute middle maculopathy were reported. Atypical features included sequential ischemic optic neuropathy, bilateral disc swelling at presentation, and progressive vision loss.Conclusions and RelevanceIn this case series study, it was not possible to determine if there is a causal link between these drugs and the ophthalmic complications reported. In some cases, it is hypothesized that rapid correction of hyperglycemia induced by these drugs, rather than a toxic effect of the drugs, could be associated with the ophthalmic complications reported.
{"title":"Ophthalmic Complications Associated With the Antidiabetic Drugs Semaglutide and Tirzepatide","authors":"Bradley J. Katz, Michael S. Lee, Norah S. Lincoff, Anne S. Abel, Somya Chowdhary, Brian D. Ellis, Ahmad Najafi, John Nguyen, Meagan D. Seay, Judith E. A. Warner","doi":"10.1001/jamaophthalmol.2024.6058","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.6058","url":null,"abstract":"ImportanceNearly 2% of the US population received a prescription for semaglutide in 2023. There has been a recent concern that this drug and other similar medications may be associated with ophthalmic complications.ObjectiveTo report ophthalmic complications associated with the use of semaglutide or tirzepatide.Design, Setting, and ParticipantsThis was a retrospective case series. All patients were initially seen in a community setting. Patients experiencing an ophthalmic complication in association with the use of semaglutide or tirzepatide were included in this analysis.ExposuresPatients described were using either semaglutide or tirzepatide.Main Outcomes and MeasuresVisual acuity and visual field defects.ResultsA total of 9 patients (mean [SD] age, 57.4 [11.6] years; age range, 37-77 years; 5 female [56%]; 4 male [44%]) were included in this study. Seven patients with nonarteritic ischemic anterior optic neuropathy, 1 patient with bilateral papillitis, and 1 patient with paracentral acute middle maculopathy were reported. Atypical features included sequential ischemic optic neuropathy, bilateral disc swelling at presentation, and progressive vision loss.Conclusions and RelevanceIn this case series study, it was not possible to determine if there is a causal link between these drugs and the ophthalmic complications reported. In some cases, it is hypothesized that rapid correction of hyperglycemia induced by these drugs, rather than a toxic effect of the drugs, could be associated with the ophthalmic complications reported.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"36 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-30DOI: 10.1001/jamaophthalmol.2024.6115
Ryan Schmidt, Dove Spector, Verian Wedeking, Annette M. Totten, Mitchell V. Brinks
This survey study describes the postprocedure conditions experienced by individuals who received eye screening from the mobile Casey Outreach Program clinics in Oregon.
{"title":"Adverse Events in a Mobile Eye Health Outreach Program","authors":"Ryan Schmidt, Dove Spector, Verian Wedeking, Annette M. Totten, Mitchell V. Brinks","doi":"10.1001/jamaophthalmol.2024.6115","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.6115","url":null,"abstract":"This survey study describes the postprocedure conditions experienced by individuals who received eye screening from the mobile Casey Outreach Program clinics in Oregon.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"4668 1 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-24DOI: 10.1001/jamaophthalmol.2025.0077
Srinivas R. Sadda
This Viewpoint examines results from the LIGHTSIDE trials for photobiomodulation to treat age-related macular degeneration and raises questions regarding the trial protocols and the efficacy and safety of the therapy.
{"title":"Photobiomodulation for Age-Related Macular Degeneration","authors":"Srinivas R. Sadda","doi":"10.1001/jamaophthalmol.2025.0077","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.0077","url":null,"abstract":"This Viewpoint examines results from the LIGHTSIDE trials for photobiomodulation to treat age-related macular degeneration and raises questions regarding the trial protocols and the efficacy and safety of the therapy.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-23DOI: 10.1001/jamaophthalmol.2024.5977
Ya Xing Wang, Ningli Wang, Tien Yin Wong
This Viewpoint discusses the ophthalmic device, red light therapy, for myopia treatment in children and adolescents in China, including its development and use, safety concerns, and implications surrounding recent regulatory changes and reclassification of this device.
{"title":"Red Light Therapy for Myopia—Current Regulatory Changes in China","authors":"Ya Xing Wang, Ningli Wang, Tien Yin Wong","doi":"10.1001/jamaophthalmol.2024.5977","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.5977","url":null,"abstract":"This Viewpoint discusses the ophthalmic device, red light therapy, for myopia treatment in children and adolescents in China, including its development and use, safety concerns, and implications surrounding recent regulatory changes and reclassification of this device.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"22 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-23DOI: 10.1001/jamaophthalmol.2024.5889
Will Bruening, Sean Kim, Steven Yeh, Pukhraj Rishi, Christopher D. Conrady
ImportanceRandomized clinical trials have shown the safety and efficacy of faricimab as a novel vascular endothelial growth factor and angiopoietin-2 inhibitor in the treatment of neovascular age-related macular degeneration (nAMD) and macular edema of various etiologies. However, more rare adverse events may not be considered in clinical trials.ObjectiveTo describe 3 eyes that developed irreversible vision loss following initial mild intraocular inflammation (IOI) to faricimab.Design, Setting, and ParticipantsThis retrospective case series from a single academic tertiary referral center (University of Nebraska Medical Center) from October 2023 to August 2024 included 3 patients who developed occlusive retinal vasculitis (ORV) following an initial sensitization with intravitreal faricimab. Two eyes were being treated with faricimab for nAMD, and the other 2 eyes were treated for diabetic macular edema.InterventionPatients exposed to faricimab after the prior development of mild IOI.Main Outcomes and MeasuresClinical symptoms, signs, and clinical course of patients who were diagnosed with ORV following rechallenge with faricimab.ResultsMild IOI developed in 4 eyes following faricimab, and ORV developed in 3 eyes with repeated challenge. This resulted in profound, irreversible vision loss, despite treatment with topical and systemic steroids. In the eye that did not develop ORV following rechallenge, there have been no repeated adverse events despite restarting intravitreal faricimab injections.Conclusions and RelevanceGiven these observations with repeated challenge, caution is advisable when using the same biologic after the development of even mild IOI with prior injection. It appears an immunological memory response is elicited with these repeated exposures, resulting in the development of ORV.
{"title":"Inflammation and Occlusive Retinal Vasculitis Post Faricimab","authors":"Will Bruening, Sean Kim, Steven Yeh, Pukhraj Rishi, Christopher D. Conrady","doi":"10.1001/jamaophthalmol.2024.5889","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.5889","url":null,"abstract":"ImportanceRandomized clinical trials have shown the safety and efficacy of faricimab as a novel vascular endothelial growth factor and angiopoietin-2 inhibitor in the treatment of neovascular age-related macular degeneration (nAMD) and macular edema of various etiologies. However, more rare adverse events may not be considered in clinical trials.ObjectiveTo describe 3 eyes that developed irreversible vision loss following initial mild intraocular inflammation (IOI) to faricimab.Design, Setting, and ParticipantsThis retrospective case series from a single academic tertiary referral center (University of Nebraska Medical Center) from October 2023 to August 2024 included 3 patients who developed occlusive retinal vasculitis (ORV) following an initial sensitization with intravitreal faricimab. Two eyes were being treated with faricimab for nAMD, and the other 2 eyes were treated for diabetic macular edema.InterventionPatients exposed to faricimab after the prior development of mild IOI.Main Outcomes and MeasuresClinical symptoms, signs, and clinical course of patients who were diagnosed with ORV following rechallenge with faricimab.ResultsMild IOI developed in 4 eyes following faricimab, and ORV developed in 3 eyes with repeated challenge. This resulted in profound, irreversible vision loss, despite treatment with topical and systemic steroids. In the eye that did not develop ORV following rechallenge, there have been no repeated adverse events despite restarting intravitreal faricimab injections.Conclusions and RelevanceGiven these observations with repeated challenge, caution is advisable when using the same biologic after the development of even mild IOI with prior injection. It appears an immunological memory response is elicited with these repeated exposures, resulting in the development of ORV.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"57 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-23DOI: 10.1001/jamaophthalmol.2024.5887
Yueyang Zhong, Shuying Chen, Hanle Wang, Su Li, Zhouyu Lu, Jingjie Xu, Yibo Yu, Ke Yao
ImportanceAfter cataract surgery, postoperative residual astigmatism can influence a patient’s visual quality and satisfaction. Finding ways to minimize this astigmatism is important.ObjectiveTo compare the clinical outcomes of femtosecond laser arcuate keratotomy (FSAK) and toric intraocular lens (TIOL) implantation for astigmatism correction in patients undergoing femtosecond laser-assisted cataract surgery.Design, Setting, and ParticipantsThis randomized clinical trial was conducted between October 2021 and September 2023 at the Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, China. Patients with mild to moderate regular corneal astigmatism ranging from 0.75 diopters (D) to 3.00 D were recruited.InterventionsPatients were randomly assigned in a 1:1 ratio to receive FSAK or TIOL implantation.Main Outcomes and MeasuresThe primary outcome was the subjective manifest refraction assessed at 3 months postoperatively.ResultsA total of 196 patients (mean [SD] age, 68.4 [13.7] years; 124 female [63%]) were randomized to the FSAK group (98 [50%]) or TIOL group (98 [50%]), and 92 patients (94%) and 95 patients (97%), respectively, finished the 3-month follow-up. At 3 months postoperatively, there was no difference in the refractive astigmatism between the 2 groups (mean [SD], 0.64 [0.64] D vs 0.54 [0.55] D; difference, 0.11 D; 95% CI, −0.06 to 0.27 D; P = .21). The mean (SD) uncorrected distance visual acuity was 0.15 (0.20) logMAR (Snellen equivalent, 20/28) for the FSAK group and 0.14 (0.19) logMAR (Snellen equivalent, 20/28) for the TIOL group (difference, 0.01 D; 95% CI, −0.04 to 0.06 D; P = .71). Subgroup analyses showed that TIOL implantation achieved lower residual astigmatism compared with FSAK when treating astigmatism exceeding 1.5 D or against-the-rule astigmatism.Conclusions and RelevanceResults of this randomized clinical trial demonstrate that in study participants with mild to moderate astigmatism undergoing femtosecond laser-assisted cataract surgery, FSAK was not superior to TIOL implantation for astigmatism correction. However, for astigmatism exceeding 1.5 D or against-the-rule astigmatism, TIOL implantation demonstrated greater efficacy over FSAK. Future trials are needed to determine if there is greater efficacy of TIOL implantation over FSAK as suggested by subgroup analyses.Trial RegistrationChiCTR.org.cn Identifier: ChiCTR2100051066
{"title":"Femtosecond Laser Arcuate Keratotomy vs Toric Intraocular Lens Implantation in Cataract Surgery","authors":"Yueyang Zhong, Shuying Chen, Hanle Wang, Su Li, Zhouyu Lu, Jingjie Xu, Yibo Yu, Ke Yao","doi":"10.1001/jamaophthalmol.2024.5887","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.5887","url":null,"abstract":"ImportanceAfter cataract surgery, postoperative residual astigmatism can influence a patient’s visual quality and satisfaction. Finding ways to minimize this astigmatism is important.ObjectiveTo compare the clinical outcomes of femtosecond laser arcuate keratotomy (FSAK) and toric intraocular lens (TIOL) implantation for astigmatism correction in patients undergoing femtosecond laser-assisted cataract surgery.Design, Setting, and ParticipantsThis randomized clinical trial was conducted between October 2021 and September 2023 at the Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, China. Patients with mild to moderate regular corneal astigmatism ranging from 0.75 diopters (D) to 3.00 D were recruited.InterventionsPatients were randomly assigned in a 1:1 ratio to receive FSAK or TIOL implantation.Main Outcomes and MeasuresThe primary outcome was the subjective manifest refraction assessed at 3 months postoperatively.ResultsA total of 196 patients (mean [SD] age, 68.4 [13.7] years; 124 female [63%]) were randomized to the FSAK group (98 [50%]) or TIOL group (98 [50%]), and 92 patients (94%) and 95 patients (97%), respectively, finished the 3-month follow-up. At 3 months postoperatively, there was no difference in the refractive astigmatism between the 2 groups (mean [SD], 0.64 [0.64] D vs 0.54 [0.55] D; difference, 0.11 D; 95% CI, −0.06 to 0.27 D; <jats:italic>P</jats:italic> = .21). The mean (SD) uncorrected distance visual acuity was 0.15 (0.20) logMAR (Snellen equivalent, 20/28) for the FSAK group and 0.14 (0.19) logMAR (Snellen equivalent, 20/28) for the TIOL group (difference, 0.01 D; 95% CI, −0.04 to 0.06 D; <jats:italic>P</jats:italic> = .71). Subgroup analyses showed that TIOL implantation achieved lower residual astigmatism compared with FSAK when treating astigmatism exceeding 1.5 D or against-the-rule astigmatism.Conclusions and RelevanceResults of this randomized clinical trial demonstrate that in study participants with mild to moderate astigmatism undergoing femtosecond laser-assisted cataract surgery, FSAK was not superior to TIOL implantation for astigmatism correction. However, for astigmatism exceeding 1.5 D or against-the-rule astigmatism, TIOL implantation demonstrated greater efficacy over FSAK. Future trials are needed to determine if there is greater efficacy of TIOL implantation over FSAK as suggested by subgroup analyses.Trial RegistrationChiCTR.org.cn Identifier: <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://www.chictr.org.cn/hvshowproject.html?id=99663&amp;amp;v=1.0\">ChiCTR2100051066</jats:ext-link>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"13 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-16DOI: 10.1001/jamaophthalmol.2024.4869
Brian R. Coleman, Sander R. Dubovy, Basil K. Williams
This case report discusses a diagnosis of optic nerve melanocytoma in a woman aged 55 years who presented with progressive painless vision loss over a 7-month period.
本病例报告讨论了视神经黑素细胞瘤的诊断在55岁的妇女谁提出了渐进无痛性视力丧失超过7个月的时间。
{"title":"Optic Nerve Melanocytoma With Vitreous Seeding","authors":"Brian R. Coleman, Sander R. Dubovy, Basil K. Williams","doi":"10.1001/jamaophthalmol.2024.4869","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.4869","url":null,"abstract":"This case report discusses a diagnosis of optic nerve melanocytoma in a woman aged 55 years who presented with progressive painless vision loss over a 7-month period.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"41 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142986847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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