Pub Date : 2026-01-29DOI: 10.1001/jamaophthalmol.2025.5994
Pia Lundgren, Staffan Nilsson, Aldina Pivodic, Anders K. Nilsson, Lois E. H. Smith, Ann Hellström
This secondary analysis of a randomized clinical trial examines what risk factors for retinopathy of prematurity are influenced by supplementation with arachidonic acid and docosahexaenoic acid and their interactions with severe retinopathy of prematurity.
{"title":"Fatty Acid Supplementation and Retinopathy of Prematurity","authors":"Pia Lundgren, Staffan Nilsson, Aldina Pivodic, Anders K. Nilsson, Lois E. H. Smith, Ann Hellström","doi":"10.1001/jamaophthalmol.2025.5994","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.5994","url":null,"abstract":"This secondary analysis of a randomized clinical trial examines what risk factors for retinopathy of prematurity are influenced by supplementation with arachidonic acid and docosahexaenoic acid and their interactions with severe retinopathy of prematurity.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"15 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146071500","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 : 2026-01-29DOI: 10.1001/jamaophthalmol.2025.6002
Jintong Hou,Leon von der Emde,Souvick Mukherjee,Emily Vance,Elvira Agrón,Amitha Domalpally,Emily Y Chew,Tiarnán D L Keenan,
ImportanceExisting outcome measures for tracking geographic atrophy (GA) progression have disadvantages. As a functional measure, best-corrected visual acuity (BCVA) is associated with quality of life and recognized by regulators but is subjective and noisy (ie, with a high level of test-retest variability). As a structural measure, GA area is objective and less noisy (ie, with a low level of test-retest variability) but assumes all macular locations are equally important.ObjectiveTo derive and validate a novel outcome measure, the Geographic Atrophy Weighted-by-Acuity Index (GAWAIN). This was designed as a structural measure to align with BCVA by empirical weighting of macular pixels arranged in concentric annuli.ExposuresDerivation and validation of novel GA outcome measure.Design, Setting, and ParticipantsThis prognostic study included outcome measure development using in silico analyses. The data for the training/validation set were taken from participants in the Age-Related Eye Disease Study 2 (AREDS2) study (4313 visits, 1528 eyes), and for the external validation set, data were taken from participants in the GA Minocycline Trial (218 visits, 35 eyes). Study data were analyzed from April to October 2025.Main Outcomes and MeasuresPearson correlation between the novel GA outcome measure (0-100) and BCVA (35-85 letter score); area under receiver operating characteristic curve for clinical BCVA thresholds. The macula was divided into 60 concentric annuli; GA occupancy of each annulus was calculated. Annulus weights were derived using ridge regression, with GA involvement of each annulus and age as predictors and BCVA deficit (100 - BCVA) as outcome.ResultsTraining/validation was performed on 1120 participants (mean [SD] age, 77.1 [7.0] years; 645 female [57.6%]), and external validation was performed on 35 participants (mean [SD] age, 74.3 [7.1] years; 21 female [60.0%]). The annulus weights exhibited a decelerating decline with macular eccentricity. On internal validation, the novel GA outcome measure was correlated more strongly with BCVA deficit than GA area (Pearson r = 0.58 vs 0.32, difference = 0.27; 95% CI, 0.23-0.31; P < .001). This was also true on external validation for color fundus photograph-defined GA (Pearson r = 0.69 vs 0.58, difference = 0.12; 95% CI, 0.04-0.21; P = .005) and fundus autofluorescence-defined GA (Pearson r = 0.70 vs 0.56, difference = 0.13; 95% CI, 0.05-0.22; P = .002). On internal and external validation, the novel GA outcome measure predicted BCVA letter scores less than 36, 70, and 85 (20/200, 20/40, and 20/20, respectively) more accurately than GA area (each P < .001). Longitudinally, change in the novel GA outcome measure correlated more strongly with BCVA decline than change in GA area did (eg, Pearson r = 0.37 vs 0.28, difference = 0.09; 95% CI, 0.04-0.14; P < .001; internal validation).Conclusions and RelevanceIn this prognostic study, results suggest that the novel GA outcome measure aligned with BCVA, a
现有的追踪地理萎缩（GA）进展的结果测量方法有缺点。作为一种功能测量，最佳矫正视力（BCVA）与生活质量相关，并得到监管机构的认可，但它是主观的和嘈杂的（即，具有高水平的测试-重测试变异性）。作为一种结构测量，遗传面积是客观的，噪声较小（即，具有低水平的测试-重测试变异性），但假设所有黄斑位置都同样重要。目的推导并验证一种新的预后指标——地理萎缩加权视力指数（GAWAIN）。这是一种结构性措施，通过对排列在同心环空中的黄斑像素进行经验加权来与BCVA对齐。新的遗传算法结果测量的推导和验证。设计、环境和参与者本预后研究包括使用计算机分析的结果测量开发。训练/验证集的数据来自年龄相关眼病研究2 （AREDS2）研究的参与者（4313次就诊，1528只眼睛），外部验证集的数据来自GA米诺环素试验的参与者（218次就诊，35只眼睛）。研究数据分析时间为2025年4月至10月。新型GA结局指标（0-100）与BCVA（35-85字母评分）的相关性；临床BCVA阈值的受试者工作特征曲线下面积。黄斑分为60个同心环空；计算每个环的GA占用率。使用脊回归计算环的重量，以每个环的GA累及和年龄为预测因子，以BCVA缺陷（100 - BCVA）为结果。结果对1120名参与者（平均[SD]年龄77.1[7.0]岁，女性645名[57.6%]）进行了筛选/验证，对35名参与者（平均[SD]年龄74.3[7.1]岁，女性21名[60.0%]）进行了外部验证。随着黄斑偏心率的增加，黄斑环重呈减速下降趋势。在内部验证中，与GA面积相比，新的GA结果测量与BCVA缺陷的相关性更强（Pearson r = 0.58 vs 0.32，差异= 0.27;95% CI, 0.23-0.31; P < 0.001）。彩色眼底照片定义GA的外部验证也是如此(皮尔逊r = 0.69 vs 0.58，差异= 0.12;95% CI, 0.04-0.21; P =。005)和眼底自身荧光定义的GA （Pearson r = 0.70 vs 0.56，差异= 0.13;95% CI, 0.05-0.22; P = 0.002）。在内部和外部验证中，新的GA结果测量预测BCVA字母得分小于36、70和85（分别为20/200、20/40和20/20）比GA面积更准确（P < 0.001）。纵向上，与GA面积变化相比，新型GA结果测量值的变化与BCVA下降的相关性更强（例如，Pearson r = 0.37 vs 0.28，差异= 0.09;95% CI, 0.04-0.14; P < 0.001；内部验证）。结论和相关性在这项预后研究中，结果表明，通过同心环空的经验加权，新的GA结局指标与BCVA一致，BCVA是一个关键的功能结局指标。这为客观地跟踪预测功能下降提供了替代措施，比GA面积更有意义。
{"title":"Proposal, Derivation, and External Validation of a Novel Geographic Atrophy Outcome Measure.","authors":"Jintong Hou,Leon von der Emde,Souvick Mukherjee,Emily Vance,Elvira Agrón,Amitha Domalpally,Emily Y Chew,Tiarnán D L Keenan, ","doi":"10.1001/jamaophthalmol.2025.6002","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.6002","url":null,"abstract":"ImportanceExisting outcome measures for tracking geographic atrophy (GA) progression have disadvantages. As a functional measure, best-corrected visual acuity (BCVA) is associated with quality of life and recognized by regulators but is subjective and noisy (ie, with a high level of test-retest variability). As a structural measure, GA area is objective and less noisy (ie, with a low level of test-retest variability) but assumes all macular locations are equally important.ObjectiveTo derive and validate a novel outcome measure, the Geographic Atrophy Weighted-by-Acuity Index (GAWAIN). This was designed as a structural measure to align with BCVA by empirical weighting of macular pixels arranged in concentric annuli.ExposuresDerivation and validation of novel GA outcome measure.Design, Setting, and ParticipantsThis prognostic study included outcome measure development using in silico analyses. The data for the training/validation set were taken from participants in the Age-Related Eye Disease Study 2 (AREDS2) study (4313 visits, 1528 eyes), and for the external validation set, data were taken from participants in the GA Minocycline Trial (218 visits, 35 eyes). Study data were analyzed from April to October 2025.Main Outcomes and MeasuresPearson correlation between the novel GA outcome measure (0-100) and BCVA (35-85 letter score); area under receiver operating characteristic curve for clinical BCVA thresholds. The macula was divided into 60 concentric annuli; GA occupancy of each annulus was calculated. Annulus weights were derived using ridge regression, with GA involvement of each annulus and age as predictors and BCVA deficit (100 - BCVA) as outcome.ResultsTraining/validation was performed on 1120 participants (mean [SD] age, 77.1 [7.0] years; 645 female [57.6%]), and external validation was performed on 35 participants (mean [SD] age, 74.3 [7.1] years; 21 female [60.0%]). The annulus weights exhibited a decelerating decline with macular eccentricity. On internal validation, the novel GA outcome measure was correlated more strongly with BCVA deficit than GA area (Pearson r = 0.58 vs 0.32, difference = 0.27; 95% CI, 0.23-0.31; P < .001). This was also true on external validation for color fundus photograph-defined GA (Pearson r = 0.69 vs 0.58, difference = 0.12; 95% CI, 0.04-0.21; P = .005) and fundus autofluorescence-defined GA (Pearson r = 0.70 vs 0.56, difference = 0.13; 95% CI, 0.05-0.22; P = .002). On internal and external validation, the novel GA outcome measure predicted BCVA letter scores less than 36, 70, and 85 (20/200, 20/40, and 20/20, respectively) more accurately than GA area (each P < .001). Longitudinally, change in the novel GA outcome measure correlated more strongly with BCVA decline than change in GA area did (eg, Pearson r = 0.37 vs 0.28, difference = 0.09; 95% CI, 0.04-0.14; P < .001; internal validation).Conclusions and RelevanceIn this prognostic study, results suggest that the novel GA outcome measure aligned with BCVA, a","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"93 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073075","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 : 2026-01-22DOI: 10.1001/jamaophthalmol.2025.5841
Yusuke Kameda,Yutaka Kaneko
{"title":"Context for Large Language Model Evaluation in Ophthalmology.","authors":"Yusuke Kameda,Yutaka Kaneko","doi":"10.1001/jamaophthalmol.2025.5841","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.5841","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"4 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015135","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 : 2026-01-22DOI: 10.1001/jamaophthalmol.2025.5844
James Doherty,Sara Lovasz
{"title":"Context for Large Language Model Evaluation in Ophthalmology.","authors":"James Doherty,Sara Lovasz","doi":"10.1001/jamaophthalmol.2025.5844","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.5844","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"92 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015419","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 : 2026-01-22DOI: 10.1001/jamaophthalmol.2025.5847
Sahana Srinivasan,Qingyu Chen,Yih Chung Tham
{"title":"Context for Large Language Model Evaluation in Ophthalmology-Reply.","authors":"Sahana Srinivasan,Qingyu Chen,Yih Chung Tham","doi":"10.1001/jamaophthalmol.2025.5847","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.5847","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"7 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015123","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 : 2026-01-15DOI: 10.1001/jamaophthalmol.2025.5768
Benjamin G Jastrzembski,John Robert Mark,Nandini Gandhi
{"title":"Outcome Metrics in Myopia Control Trials.","authors":"Benjamin G Jastrzembski,John Robert Mark,Nandini Gandhi","doi":"10.1001/jamaophthalmol.2025.5768","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.5768","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"5 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986453","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 : 2026-01-15DOI: 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。
{"title":"Pedunculated Palpebral Conjunctival Papilloma","authors":"Wisam O. Najdawi, Justin Chen, Carol L. Karp","doi":"10.1001/jamaophthalmol.2025.5767","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.5767","url":null,"abstract":"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.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"8 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972251","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 : 2026-01-15DOI: 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 <jats:italic toggle="yes">US News &amp; World Report</jats:italic> “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 <jats:sup>2</jats:sup> 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; <jats:italic toggle="yes">P</jats:italic> = .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
{"title":"Language Accessibility at Select Academic Ophthalmology Centers Across US Metropolitan Areas","authors":"Sebastian Borges, Nicholas J. DeLuca, Victoria A. Pereira, Vitalia Borges, Kara M. Cavuoto","doi":"10.1001/jamaophthalmol.2025.5751","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2025.5751","url":null,"abstract":"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 <jats:italic toggle=\"yes\">US News &amp;amp; World Report</jats:italic> “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 <jats:sup>2</jats:sup> 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; <jats:italic toggle=\"yes\">P</jats:italic> = .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; &amp;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","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"18 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972252","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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