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Racial and Ethnic Disparities in Pediatric Ophthalmology Research. 小儿眼科研究中的种族和民族差异。
IF 7.8 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-10-01 DOI: 10.1001/jamaophthalmol.2024.3627
Megan E Collins, Adrienne W Scott
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引用次数: 0
JAMA Ophthalmology. 美国医学会眼科杂志》。
IF 7.8 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-10-01 DOI: 10.1001/jamaophthalmol.2023.4602
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引用次数: 0
Risk of Keratitis With EGFR Inhibitors Remains Controversial. 表皮生长因子受体抑制剂引发角膜炎的风险仍有争议。
IF 7.8 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-10-01 DOI: 10.1001/jamaophthalmol.2024.3348
Shiuan-Tzuen Su, James C-C Wei
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引用次数: 0
Disc Hemorrhages in Open-Angle Glaucoma-Between a Rock and a Hard Place? 开角型青光眼的椎间盘出血--两难选择?
IF 7.8 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-10-01 DOI: 10.1001/jamaophthalmol.2024.3330
Alice Verticchio Vercellin, Louis R Pasquale, Alon Harris
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引用次数: 0
METTL23 Variants and Patients With Normal-Tension Glaucoma. METTL23 变异与正常张力青光眼患者。
IF 8.1 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-09-26 DOI: 10.1001/jamaophthalmol.2024.3829
Todd E Scheetz,Mallory R Tollefson,Ben R Roos,Erin A Boese,Andrew E Pouw,Edwin M Stone,Michael J Schnieders,John H Fingert
ImportanceThis research confirms and further establishes that pathogenic variants in a fourth gene, METTL23, are associated with autosomal dominant normal-tension glaucoma (NTG).ObjectiveTo determine the frequency of glaucoma-causing pathogenic variants in the METTL23 gene in a cohort of patients with NTG from Iowa.Design, Setting, and ParticipantsThis case-control study took place at a single tertiary care center in Iowa from January 1997 to January 2024, with analysis occurring between January 2023 and January 2024. Two groups of participants were enrolled from the University of Iowa clinics: 331 patients with NTG and 362 control individuals without glaucoma. Patients with a history of trauma; steroid use; stigmata of pigment dispersion syndrome; exfoliation syndrome; or pathogenic variants in MYOC, TBK1, or OPTN were also excluded.Main Outcomes and MeasuresDetection of an enrichment of METTL23 pathogenic variants in individuals with NTG compared with control individuals without glaucoma.ResultsThe study included 331 patients with NTG (mean [SD] age, 68.0 [11.7] years; 228 [68.9%] female and 103 [31.1%] male) and 362 control individuals without glaucoma (mean [SD] age, 64.5 [12.6] years; 207 [57.2%] female and 155 [42.8%] male). There were 5 detected instances of 4 unique METTL23 pathogenic variants in patients with NTG. Three METTL23 variants-p.Ala7Val, p.Pro22Arg, and p.Arg63Trp-were judged to be likely pathogenic and were detected in 3 patients (0.91%) with NTG. However, when all detected variants were evaluated with either mutation burden analysis or logistic regression, their frequency was not statistically higher in individuals with NTG than in control individuals without glaucoma (1.5% vs 2.5%; P = .27).Conclusion and RelevanceThis investigation provides evidence that pathogenic variants in METTL23 are associated with NTG. Within an NTG cohort at a tertiary care center, pathogenic variants were associated with approximately 1% of NTG cases, a frequency similar to that of other known normal-tension glaucoma genes, including optineurin (OPTN), TANK-binding kinase 1 (TBK1), and myocilin (MYOC). The findings suggest that METTL23 pathogenic variants are likely involved in a biologic pathway that is associated with glaucoma that occurs at lower intraocular pressures.
重要性这项研究证实并进一步确定了第四个基因 METTL23 的致病变体与常染色体显性正常张力性青光眼(NTG)有关。目的确定爱荷华州 NTG 患者队列中 METTL23 基因中青光眼致病变体的频率。设计、地点和参与者这项病例对照研究于 1997 年 1 月至 2024 年 1 月在爱荷华州的一家三级医疗中心进行,分析时间为 2023 年 1 月至 2024 年 1 月。爱荷华大学诊所招募了两组参与者:331 名 NTG 患者和 362 名无青光眼的对照组患者。有外伤史、类固醇使用史、色素分散综合征征兆、剥脱综合征或 MYOC、TBK1 或 OPTN 致病变异的患者也被排除在外。主要结果和测量指标与无青光眼的对照组相比,在 NTG 患者中检测到 METTL23 致病变异的富集。结果研究纳入了 331 名 NTG 患者(平均 [SD] 年龄 68.0 [11.7] 岁;228 [68.9%] 名女性和 103 [31.1%] 名男性)和 362 名无青光眼的对照组患者(平均 [SD] 年龄 64.5 [12.6] 岁;207 [57.2%] 名女性和 155 [42.8%] 名男性)。在 NTG 患者中检测到 5 例 4 个独特的 METTL23 致病变体。三个 METTL23 变异-p.Ala7Val、p.Pro22Arg 和 p.Arg63Trp-被判定为可能致病,并在 3 名 NTG 患者(0.91%)中检测到。然而,用突变负荷分析或逻辑回归评估所有检测到的变异时,它们在 NTG 患者中的频率在统计学上并不高于无青光眼的对照组(1.5% vs 2.5%;P = .27)。在一家三级医疗中心的 NTG 队列中,约有 1% 的 NTG 病例与致病变体有关,这一频率与其他已知的正常张力青光眼基因相似,包括视神经蛋白 (OPTN)、TANK 结合激酶 1 (TBK1) 和肌球蛋白 (MYOC)。研究结果表明,METTL23致病变体很可能参与了与在较低眼压下发生的青光眼有关的生物通路。
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引用次数: 0
A Competition for the Diagnosis of Myopic Maculopathy by Artificial Intelligence Algorithms. 人工智能算法诊断近视性黄斑病变竞赛。
IF 8.1 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-09-26 DOI: 10.1001/jamaophthalmol.2024.3707
Bo Qian,Bin Sheng,Hao Chen,Xiangning Wang,Tingyao Li,Yixiao Jin,Zhouyu Guan,Zehua Jiang,Yilan Wu,Jinyuan Wang,Tingli Chen,Zhengrui Guo,Xiang Chen,Dawei Yang,Junlin Hou,Rui Feng,Fan Xiao,Yihao Li,Mostafa El Habib Daho,Li Lu,Ye Ding,Di Liu,Bo Yang,Wenhui Zhu,Yalin Wang,Hyeonmin Kim,Hyeonseob Nam,Huayu Li,Wei-Chi Wu,Qiang Wu,Rongping Dai,Huating Li,Marcus Ang,Daniel Shu Wei Ting,Carol Y Cheung,Xiaofei Wang,Ching-Yu Cheng,Gavin Siew Wei Tan,Kyoko Ohno-Matsui,Jost B Jonas,Yingfeng Zheng,Yih-Chung Tham,Tien Yin Wong,Ya Xing Wang
ImportanceMyopic maculopathy (MM) is a major cause of vision impairment globally. Artificial intelligence (AI) and deep learning (DL) algorithms for detecting MM from fundus images could potentially improve diagnosis and assist screening in a variety of health care settings.ObjectivesTo evaluate DL algorithms for MM classification and segmentation and compare their performance with that of ophthalmologists.Design, Setting, and ParticipantsThe Myopic Maculopathy Analysis Challenge (MMAC) was an international competition to develop automated solutions for 3 tasks: (1) MM classification, (2) segmentation of MM plus lesions, and (3) spherical equivalent (SE) prediction. Participants were provided 3 subdatasets containing 2306, 294, and 2003 fundus images, respectively, with which to build algorithms. A group of 5 ophthalmologists evaluated the same test sets for tasks 1 and 2 to ascertain performance. Results from model ensembles, which combined outcomes from multiple algorithms submitted by MMAC participants, were compared with each individual submitted algorithm. This study was conducted from March 1, 2023, to March 30, 2024, and data were analyzed from January 15, 2024, to March 30, 2024.ExposureDL algorithms submitted as part of the MMAC competition or ophthalmologist interpretation.Main Outcomes and MeasuresMM classification was evaluated by quadratic-weighted κ (QWK), F1 score, sensitivity, and specificity. MM plus lesions segmentation was evaluated by dice similarity coefficient (DSC), and SE prediction was evaluated by R2 and mean absolute error (MAE).ResultsThe 3 tasks were completed by 7, 4, and 4 teams, respectively. MM classification algorithms achieved a QWK range of 0.866 to 0.901, an F1 score range of 0.675 to 0.781, a sensitivity range of 0.667 to 0.778, and a specificity range of 0.931 to 0.945. MM plus lesions segmentation algorithms achieved a DSC range of 0.664 to 0.687 for lacquer cracks (LC), 0.579 to 0.673 for choroidal neovascularization, and 0.768 to 0.841 for Fuchs spot (FS). SE prediction algorithms achieved an R2 range of 0.791 to 0.874 and an MAE range of 0.708 to 0.943. Model ensemble results achieved the best performance compared to each submitted algorithms, and the model ensemble outperformed ophthalmologists at MM classification in sensitivity (0.801; 95% CI, 0.764-0.840 vs 0.727; 95% CI, 0.684-0.768; P = .006) and specificity (0.946; 95% CI, 0.939-0.954 vs 0.933; 95% CI, 0.925-0.941; P = .009), LC segmentation (DSC, 0.698; 95% CI, 0.649-0.745 vs DSC, 0.570; 95% CI, 0.515-0.625; P < .001), and FS segmentation (DSC, 0.863; 95% CI, 0.831-0.888 vs DSC, 0.790; 95% CI, 0.742-0.830; P < .001).Conclusions and RelevanceIn this diagnostic study, 15 AI models for MM classification and segmentation on a public dataset made available for the MMAC competition were validated and evaluated, with some models achieving better diagnostic performance than ophthalmologists.
重要性变性黄斑病变(MM)是全球视力损伤的主要原因。从眼底图像中检测 MM 的人工智能(AI)和深度学习(DL)算法有可能改善诊断并帮助各种医疗机构进行筛查。目的评估用于 MM 分类和分割的 DL 算法,并将其性能与眼科医生的性能进行比较。参赛者获得了 3 个子数据集,分别包含 2306、294 和 2003 张眼底图像,并以此为基础建立算法。由 5 位眼科医生组成的小组对任务 1 和任务 2 的相同测试集进行了评估,以确定性能。模型集合(将 MMAC 参与者提交的多个算法的结果合并在一起)的结果与每个单独提交的算法进行了比较。本研究于 2023 年 3 月 1 日至 2024 年 3 月 30 日进行,数据分析于 2024 年 1 月 15 日至 2024 年 3 月 30 日进行。主要结果和测量MM分类通过二次加权κ(QWK)、F1 分数、灵敏度和特异性进行评估。通过骰子相似系数(DSC)评估 MM 加病变分割,通过 R2 和平均绝对误差(MAE)评估 SE 预测。MM 分类算法的 QWK 值范围为 0.866 至 0.901,F1 分数范围为 0.675 至 0.781,灵敏度范围为 0.667 至 0.778,特异性范围为 0.931 至 0.945。MM 加病变分割算法对漆裂(LC)的 DSC 值为 0.664 至 0.687,对脉络膜新生血管的 DSC 值为 0.579 至 0.673,对福克斯斑(FS)的 DSC 值为 0.768 至 0.841。SE 预测算法的 R2 范围为 0.791 至 0.874,MAE 范围为 0.708 至 0.943。与提交的每种算法相比,模型集合结果的性能最佳,模型集合在 MM 分类的灵敏度方面优于眼科医生(0.801; 95% CI, 0.764-0.840 vs 0.727; 95% CI, 0.684-0.768; P = .006)和特异性(0.946; 95% CI, 0.939-0.954 vs 0.933; 95% CI, 0.925-0.941; P = .009)、LC分割(DSC, 0.698; 95% CI, 0.649-0.745 vs DSC, 0.结论和相关性在这项诊断研究中,对为 MMAC 竞赛提供的公共数据集上用于 MM 分类和分割的 15 个人工智能模型进行了验证和评估,其中一些模型的诊断性能优于眼科医生。
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引用次数: 0
Crowdsourcing for Artificial Intelligence Models in Ophthalmology. 眼科人工智能模型的众包。
IF 8.1 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-09-26 DOI: 10.1001/jamaophthalmol.2024.3778
Shahin Hallaj,Niloofar Radgoudarzi,Sally L Baxter
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引用次数: 0
Biallelic Loss-of-Function Variants in UBAP1L and Nonsyndromic Retinal Dystrophies. UBAP1L 和非综合征性视网膜营养不良症中的双拷贝功能缺失变异。
IF 8.1 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-09-26 DOI: 10.1001/jamaophthalmol.2024.3836
Ehsan Ullah,Siying Lin,Jiaxiong Lu,Chelsea Bender,Andrew R Webster,Samantha Malka,Savita Madhusudhan,Emma Rees,Denise Williams,Aime R Agather,Catherine A Cukras,Robert B Hufnagel,Rui Chen,Laryssa A Huryn,Gavin Arno,Bin Guan
ImportanceInherited retinal dystrophies (IRDs) present a challenge in clinical diagnostics due to their pronounced genetic heterogeneity. Despite advances in next-generation sequencing (NGS) technologies, a substantial portion of the genetic basis underlying IRDs remains elusive. Addressing this gap seems important for gaining insights into the genetic landscape of IRDs, which may help improve diagnosis and prognosis and develop targeted therapies in the future.ObjectiveTo provide a clinical and molecular characterization of 6 patients with IRDs with biallelic disease-causing variants in a novel candidate IRD disease gene.Design, Setting, and ParticipantsThis multicenter case series study included 6 patients with IRDs from 4 tertiary hospitals (in the US: National Eye Institute, National Institutes of Health Clinical Center; in the UK: Moorfields Eye Hospital, Royal Liverpool University Hospital, Birmingham Women's and Children's).ExposuresBiallelic disease-causing variants in the novel candidate IRD disease gene, UBAP1L.Main Outcome and MeasuresParticipants underwent comprehensive clinical ophthalmic assessments to characterize the features of retinal dystrophy. Exome and genome sequencing revealed candidate variants in the UBAP1L gene; no other plausible disease variants in known IRD genes were identified. A minigene assay provided functional insights for a noncanonical splice variant, and a knockout mouse model was used for in vivo functional elucidation.ResultsFour homozygous UBAP1L variants were identified in the affected individuals from 6 families, including 2 frameshift variants (c.710del and c.634_644del), 1 canonical splice variant (c.121-2A>C), and 1 noncanonical splice variant (c.910-7G>A), which was shown to cause aberrant splicing and frameshift in a minigene assay. Participants presented with retinal dystrophy including maculopathy, cone dystrophy, and cone-rod dystrophy. Single-cell RNA sequencing of the retina showed that human UBAP1L is highly expressed in both cones and retinal pigment epithelium, whereas mouse Ubap1l is highly expressed in cone cells only. Mice with truncation of the C-terminal SOUBA domain did not manifest retinal degeneration up to 15 months of age.Conclusions and RelevanceStudy results reveal clinical and genetic evidence that loss of UBAP1L function was associated with inherited retinopathy in humans. These findings hold promise for improved clinical diagnostics, prognosis, and the potential development of targeted therapies for individuals affected by IRDs.
重要性遗传性视网膜营养不良症(IRDs)由于其明显的遗传异质性,给临床诊断带来了挑战。尽管下一代测序(NGS)技术在不断进步,但IRDs的遗传基础仍有很大一部分难以捉摸。解决这一空白似乎对深入了解 IRD 的遗传情况非常重要,这可能有助于改善诊断和预后,并在未来开发出靶向治疗方法。目的对 6 例在新型 IRD 候选疾病基因中存在双倍拷贝致病变异的 IRD 患者进行临床和分子特征描述:美国:国立眼科研究所、国立卫生研究院临床中心;英国:摩尔菲尔德眼科医院、皇家利兹大学眼科中心;美国:国立眼科研究所、国立卫生研究院临床中心:主要结果和测量参与者接受了全面的临床眼科评估,以确定视网膜营养不良症的特征。外显子组和基因组测序发现了 UBAP1L 基因的候选变异;在已知的 IRD 基因中未发现其他可能的疾病变异。一个微型基因测定为一个非典型剪接变体提供了功能性见解,一个基因敲除小鼠模型被用于体内功能阐释。del 和 c.634_644del)、1 个规范剪接变体(c.121-2A>C)和 1 个非规范剪接变体(c.910-7G>A)。参与者患有视网膜营养不良症,包括黄斑病变、视锥营养不良症和视锥-视杆细胞营养不良症。视网膜单细胞 RNA 测序显示,人的 UBAP1L 在视锥和视网膜色素上皮细胞中均高表达,而小鼠的 Ubap1l 仅在视锥细胞中高表达。截断了 C 端 SOUBA 结构域的小鼠在 15 个月大时没有表现出视网膜变性。研究结果揭示了 UBAP1L 功能缺失与人类遗传性视网膜病变相关的临床和遗传学证据。这些发现有望改善临床诊断和预后,并为受 IRD 影响的个体开发潜在的靶向疗法。
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引用次数: 0
Federally Qualified Health Centers to Reduce Disparities in Ophthalmology. 联邦合格保健中心,以减少眼科方面的差距。
IF 7.8 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-09-19 DOI: 10.1001/jamaophthalmol.2024.3837
Roomasa Channa, Fasika Woreta
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引用次数: 0
Untreated Vision Loss as a Modifiable Dementia Risk Factor. 未经治疗的视力丧失是一种可改变的痴呆症风险因素。
IF 7.8 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-09-19 DOI: 10.1001/jamaophthalmol.2024.3991
Joshua R Ehrlich
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引用次数: 0
期刊
JAMA ophthalmology
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