Ophthalmology. Retina最新文献

英文中文

Fluorescein Angiography of Dark without Pressure 无压暗区荧光素血管造影。

IF 4.4 Q1 OPHTHALMOLOGY

Ophthalmology. Retina

Pub Date : 2025-01-01 DOI: 10.1016/j.oret.2024.05.013

Michael D. Yu MD, Jose S. Pulido MD, MS, Yoshihiro Yonekawa MD

引用次数: 0

Retrospective Cohort Study of Sickle Cell Disease and Large Vessel Retinal Vascular Occlusion Risk in a National United States Database 美国全国数据库中镰状细胞病与大血管视网膜血管闭塞风险的回顾性队列研究。

IF 4.4 Q1 OPHTHALMOLOGY

Ophthalmology. Retina

Pub Date : 2025-01-01 DOI: 10.1016/j.oret.2024.07.013

Gabriel T. Kaufmann MD , Matthew Russell MD , Priya Shukla BS , Rishi P. Singh MD , Katherine E. Talcott MD

Objective

To determine if differences exist in the risk of developing large vessel retinal vascular occlusions in patients with sickle cell states.

Design

Retrospective cohort study.

Participants

Patients with sickle cell disease (SCD) or trait evaluated by an ophthalmologist were compared with matched controls without SCD or sickle cell trait (SCT) also evaluated by an ophthalmologist.

Methods

This study used deidentified data from a national database (2006–2024), using International Classification of Diseases 10 codes to select for retinal vascular occlusions. Propensity score matching was performed with respect to age, sex, race, ethnicity, smoking, hypertension, diabetes, dyslipidemias, and obesity, resulting in hemoglobin SS (HbSS), hemoglobin SC (HbSC), and SCT cohorts and matched control cohorts.

Main Outcome Measures

Risk ratios (RRs) and 95% confidence intervals (CIs) of retinal vascular occlusion diagnosis, including central retinal artery occlusion (CRAO), branch retinal artery occlusion (BRAO), central retinal vein occlusion, branch retinal vein occlusion, and corneal dystrophy as a negative control, given SCD or SCT.

Results

After propensity score matching, HbSS (n = 10 802; mean age ± standard deviation, 38.6 ± 20.6 years), HbSC (n = 4296, 34.3 ± 17.8 years), and SCT (n = 15 249, 39.8 ± 23.7 years) cohorts were compared with control cohorts (n = 10 802, 38.7 ± 20.7 years; n = 4296, 34.6 ± 18.0 years; n = 15 249, 39.9 ± 23.8 years, respectively).

Patients with SCD (HbSS) had higher risk of developing any retinal vascular occlusion (RR, 2.33; 95% CI, 1.82–3.00), CRAO (RR, 2.71; 95% CI, 1.65–4.47), and BRAO (RR, 4.90; 95% CI, 2.48–9.67) than matched controls. Patients with HbSC disease had higher risk (RR, 3.14; 95% CI, 1.95–5.06) of developing any retinal vascular occlusion than matched controls without SCD. Patients with SCT did not have higher risk of developing retinal vascular occlusions (RR, 1.01; 95% CI, 0.81–1.26) than matched controls.

Conclusions

In a retrospective cohort study, patients with HbSS SCD have an increased risk of developing retinal vascular occlusions, and more specifically CRAO and BRAO, compared with patients without SCD.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

目的：确定镰状细胞患者发生大血管视网膜血管闭塞的风险是否存在差异：确定镰状细胞患者发生大血管视网膜血管闭塞的风险是否存在差异：设计：回顾性队列研究：由眼科医生评估的镰状细胞疾病或特质患者与同样由眼科医生评估的无镰状细胞疾病或特质的匹配对照组进行比较：这项研究使用了国家数据库（2006-2024 年）中的去身份化数据，使用国际疾病分类 10 代码来选择视网膜血管闭塞患者。对年龄、性别、种族、民族、吸烟、高血压、糖尿病、血脂异常和肥胖等因素进行倾向得分匹配，得出 HbSS、HbSC 和镰状细胞特质（SCT）队列和匹配的对照队列：视网膜血管闭塞诊断的风险比和 95% 置信区间 (CI)，包括视网膜中央动脉闭塞 (CRAO)、视网膜分支动脉闭塞 (BRAO)、视网膜中央静脉闭塞 (CRVO)、视网膜分支静脉闭塞 (BRVO)，以及作为阴性对照的角膜营养不良：经过倾向评分匹配后，HbSS（人数=10802，平均±标准差年龄为 38.6 ± 20.6 岁）、HbSC（人数=4296，34.3 ± 17.8 岁）和 SCT（人数=15249，39.8±23.7岁）队列与对照队列（分别为10,802人，38.7±20.7岁；4,296人，34.6±18.0岁；15,249人，39.9±23.8岁）进行了比较。与匹配的对照组相比，镰状细胞病（HbSS）患者发生任何视网膜血管闭塞（RR 2.33；95% CI 1.82-3.00）、CRAO（RR 2.71；95% CI 1.65-4.47）和BRAO（RR 4.90；95% CI 2.48-9.67）的风险较高。与无镰状细胞病的匹配对照组相比，HbSC 患者发生视网膜血管闭塞的风险更高（RR 3.14；95% CI 1.95-5.06）。镰状细胞性状患者发生视网膜血管闭塞的风险（RR 1.01；95% CI 0.81-1.26）并不比匹配对照组高：在一项回顾性队列研究中，与非镰状细胞病患者相比，HbSS 型镰状细胞病患者发生视网膜血管闭塞的风险更高，尤其是 CRAO 和 BRAO。

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引用次数: 0

Using Multimodal Imaging to Refine the Phenotype of PRPH2-associated Retinal Degeneration 利用多模态成像完善 PRPH2 相关视网膜变性的表型。

IF 4.4 Q1 OPHTHALMOLOGY

Ophthalmology. Retina

Pub Date : 2025-01-01 DOI: 10.1016/j.oret.2024.07.016

Fritz Gerald P. Kalaw MD , Naomi E. Wagner MS , Thiago Barros de Oliveira MD , Lesley A. Everett MD, PhD , Paul Yang MD, PhD , Mark E. Pennesi MD, PhD , Shyamanga Borooah MBBS, PhD

Objective

To refine retinal peripherin-2 (PRPH2)-associated retinal degeneration (PARD) phenotypes using multimodal imaging.

Design

Retrospective review of clinical records and multimodal imaging.

Subjects

Patients who visited the inherited retinal degeneration (IRD) clinic at 2 tertiary referral eye centers with molecularly confirmed IRD due to PRPH2 variants.

Methods

Retinal imaging was reviewed using ultrawidefield (UWF) pseudocolor, UWF fundus autofluorescence, and spectral-domain OCT. Phenotypes were identified in the macular or peripheral region. A combined phenotype was considered if any phenotypes were present in both macular and peripheral regions. Mixed phenotypes in the macula or peripheral retina were considered if there were 2 distinct phenotypes identified in the same eye. The presence or absence of atrophy in the macular or peripheral area was also noted.

Main Outcome Measure

Grading of multimodal imaging by phenotype and atrophy.

Results

A total of 144 eyes of 72 patients were included in this study. The majority of the eyes had combined macular and peripheral phenotypes (89/144, 61.8%), whereas 44 (30.6%) eyes had isolated macular findings, and 11 (7.6%) had isolated peripheral findings. Twenty-five eyes were classified with mixed macular phenotypes, whereas fundus flavimaculatus dystrophy type was the most common combined macular and peripheral phenotype (54/144, 37.5%): n = 10 with macular dystrophy and macular flavimaculatus dystrophy (MFD), and n = 15 with butterfly pattern dystrophy and MFD. Nearly half of the eyes (71/144, 49.3%) were identified to have concomitant outer retinal atrophy. Fundus flavimaculatus type dystrophy was also associated with the highest proportion of concomitant atrophy (57/71, 80.3%).

Conclusions

Peripherin-2-associated retinal degeneration demonstrates a wide array of phenotypes using multimodal imaging. We report that combinations of classically described phenotypes were often seen. Additionally, macular and peripheral atrophy were often associated with PARD phenotypes. Refinement of PARD phenotypes using newer multimodal imaging techniques will likely assist diagnosis and future clinical trials.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

目的利用多模态成像完善视网膜PRPH2相关视网膜变性（PARD）表型：设计：回顾性审查临床记录和多模态成像：在两家三级眼科转诊中心的遗传性视网膜变性（IRD）门诊就诊并经分子证实因PRPH2变体导致IRD的患者：方法：使用超宽场（UWF）伪彩色成像、UWF眼底自动荧光（FAF）和光谱域光学相干断层扫描（SD-OCT）对视网膜成像进行检查。表型在黄斑或周边区域被识别。如果黄斑区和周边区均存在表型，则视为综合表型。如果在同一只眼睛中发现两种不同的表型，则认为黄斑或周边视网膜存在混合表型。主要结果指标：根据表型和萎缩程度对多模态成像进行分级：本研究共纳入 72 名患者的 144 只眼睛。大多数患者的表型为黄斑和周边联合表型（89/14，61.8%），44 眼（30.6%）的表型为孤立的黄斑，11 眼（7.6%）的表型为孤立的周边。25只眼睛被归类为混合黄斑表型，而眼底黄斑营养不良型是最常见的黄斑和周边综合表型（54/144，37.5%）：黄斑营养不良型和黄斑黄斑营养不良型各10只，蝴蝶型营养不良型和黄斑黄斑营养不良型各15只。近一半的眼睛（71/144，49.3%）被确认同时患有视网膜外层萎缩。眼底黄斑营养不良症同时伴有视网膜萎缩的比例也最高（57/71，80.3%）：结论：通过多模态成像，PARD 表现出多种表型。结论：通过多模态成像，PARD 表现出多种表型。此外，黄斑和周边萎缩通常与 PARD 表型相关。使用较新的多模态成像技术完善 PARD 表型可能有助于诊断和未来的临床试验。

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引用次数: 0

Exploding Stink Bomb Causing Intraocular Foreign Body 爆炸的臭弹导致眼内异物。

IF 4.4 Q1 OPHTHALMOLOGY

Ophthalmology. Retina

Pub Date : 2025-01-01 DOI: 10.1016/j.oret.2024.06.008

Boon Lin Teh FRCOphth, Daniela Vaideanu-Collins FRCOphth

引用次数: 0

Multimodal Imaging of Bilateral Retinal Pigment Epithelial Immunoglobulin Light Chain Deposition in Patients with Systemic Immunoglobulin Light Chain Deposition 全身性免疫球蛋白轻链沉积患者双侧视网膜色素上皮免疫球蛋白轻链沉积的多模式成像。

IF 4.4 Q1 OPHTHALMOLOGY

Ophthalmology. Retina

Pub Date : 2025-01-01 DOI: 10.1016/j.oret.2024.07.011

Ke Zhu MD , Yao Zhou MD , Boya Lei MD , Jing Li MD , Ziyan Shen MD , Nuo Tang MD , Xinyi Weng MD , Qing Chang PhD , Gezhi Xu PhD , Min Wang PhD

Objective

To describe multimodal imaging of peculiar bilateral globular subretinal deposits and acquired serous retinal detachment in patients with systemic immunoglobulin light chain deposition.

Design

A retrospective observational case series.

Participants

We examined 6 eyes in 3 patients (1 with multiple myeloma, 1 with membranous nephropathy, and 1 with immunoglobulin A nephropathy) at the Eye and ENT Hospital of Fudan University. The patients presented with peculiar globular subretinal deposits along the retinal pigment epithelium (RPE)‒Bruch’s membrane complex and acquired serous retinal detachment.

Methods

Fundus appearance was documented with multimodal imaging, which included fundus photography, fundus autofluorescence, spectral domain OCT, swept-source OCT (SS-OCT), en face OCT, and SS-OCT angiography. Additional evaluations included serum protein electrophoreses, positron emission tomography computed tomography, and renal and bone biopsies to assess the primary diseases.

Main Outcome Measures

Multimodal imaging, course, and prognosis of bilateral RPE immunoglobulin light chain deposition in patients with systemic immunoglobulin light chain deposition.

Results

Bilateral, multiple, speckled, or patchy RPE changes in the posterior fundus that corresponded to striking multifocal hyperautofluorescence on fundus autofluorescence and lumpy, globular hyperreflective deposits along the RPE‒Bruch’s membrane complex were identified as characteristic features of bilateral RPE light chain deposition. These features may be accompanied by dense light chain deposits in the choriocapillaris and choroid vessels, diffuse choroidal thickening, and “angiographically silent” serous retinal detachment in patients with systemic immunoglobulin light chain deposition.

Conclusions

We have documented the characteristic features, clinical course, and prognosis of bilateral RPE immunoglobulin light chain deposition in patients with systemic immunoglobulin light chain deposition. Appropriate evaluations, including serum protein electrophoresis and hematologic consultation, are recommended to manage patients with this fundus abnormality.

Financial Disclosure(s)

The authors have no proprietary or commercial interest in any materials discussed in this article.

目的描述全身性免疫球蛋白轻链沉积患者特殊双侧球状视网膜下沉积物和获得性浆液性视网膜脱离的多模态成像：设计：回顾性观察病例系列：我们对复旦大学附属眼耳鼻喉科医院的三名患者（一名多发性骨髓瘤患者、一名膜性肾病患者和一名免疫球蛋白A肾病患者）的六只眼睛进行了检查。患者表现为沿视网膜色素上皮（RPE）-布氏膜复合体的特殊球状视网膜下沉积物和获得性浆液性视网膜脱离：通过多模态成像记录眼底外观，包括眼底照相、眼底自动荧光、光谱域光学相干断层扫描（OCT）、扫源OCT（SS-OCT）、面内OCT和SS-OCT血管造影。其他评估包括血清蛋白电泳、正电子发射计算机断层扫描、肾活检和骨活检，以评估主要疾病：主要结果指标：全身性免疫球蛋白轻链沉积患者双侧RPE免疫球蛋白轻链沉积的多模态成像、病程和预后：后眼底双侧、多发、斑点状或斑片状RPE改变，与眼底自发荧光中显著的多灶性高自荧光和沿RPE-布鲁赫膜复合体的块状、球状高反射沉积物相对应，被确定为双侧RPE轻链沉积的特征。在全身性免疫球蛋白轻链沉积的患者中，这些特征可能伴随着绒毛膜和脉络膜血管中致密的轻链沉积、弥漫性脉络膜增厚以及 "血管造影无声 "的浆液性视网膜脱离：我们记录了全身性免疫球蛋白轻链沉积症患者双侧 RPE 免疫球蛋白轻链沉积的特征、临床过程和预后。建议对眼底异常患者进行适当的评估，包括血清蛋白电泳和血液学会诊。

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引用次数: 0

Longitudinal Changes in Diabetic Retinopathy Severity: Learnings from PANORAMA 糖尿病视网膜病变严重程度的纵向变化：从 PANORAMA 中学习（78/80 个字符，包括空格）。

IF 4.4 Q1 OPHTHALMOLOGY

Ophthalmology. Retina

Pub Date : 2025-01-01 DOI: 10.1016/j.oret.2024.10.007

Charles C. Wykoff MD, PhD , Diana V. Do MD , W. Lloyd Clark MD , David S. Boyer MD , Dilsher S. Dhoot MD , Dennis M. Marcus MD , Robert Vitti MD , Alyson J. Berliner MD, PhD , Kimberly Reed OD, FAAO , Yenchieh Cheng PhD , Hadi Moini PhD , David M. Brown MD

引用次数: 0

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IF 4.4 Q1 OPHTHALMOLOGY

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IF 4.4 Q1 OPHTHALMOLOGY

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