Ophthalmology. Retina最新文献

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Analysis of Aqueous Interleukin-6 in Diabetic Retinopathy 糖尿病视网膜病变中白介素-6的分析：328只眼的前瞻性对照试验。

IF 5.7 Q1 OPHTHALMOLOGY

Ophthalmology. Retina

Pub Date : 2026-01-01 DOI: 10.1016/j.oret.2025.06.014

Abhiram R. Manda , Lok Hin Lee PhD , Megan S. Steinkerchner MD , Jinsong Sheng MD , Lindsay Veach , Sapna Gangaputra MD, MPH , Stephen J. Kim MD

Objective

To analyze the relationship of aqueous interleukin-6 (IL-6) with diabetic retinopathy (DR) severity.

Design

Prospective, controlled trial at a tertiary academic medical center.

Subjects

Three hundred twenty-eight eyes of 164 adult type II diabetic patients with varying levels of DR.

Methods

A total of 328 eyes of 164 diabetic patients were enrolled based on DR severity: 46 eyes of 23 patients in the no DR group, 236 eyes of 118 patients in the moderate nonproliferative DR (NPDR) group, and 46 eyes of 23 patients in the proliferative DR (PDR) group. ETDRS visual acuity, spectral-domain OCT, and color fundus photographs were taken at baseline. Blood draw and aqueous sampling of each eye was performed. Blood glucose and hemoglobin A1c (HbA1c) were measured. Aqueous IL-6 was measured using a microparticle bead-based multiplex assay.

Main Outcomes Measures

Aqueous IL-6 levels, HbA1c, DR severity, Diabetic macular edema (DME).

Results

Median HbA1c differed between the 3 DR groups (P = 0.03), but there was no correlation between IL-6 and HbA1c (ρ = 0.08, P = 0.179). Baseline aqueous IL-6 levels were significantly different between DR groups. Median IL-6 and interquartile range was 5.40 pg/mL (2.99–8.77) for eyes in the no DR group, 9.25 pg/mL (5.35–22.35) for eyes in the moderate NPDR group, and 15.71 pg/mL (9.24–48.58) for eyes in the PDR group (P < 0.001). Median central subfield thickness (CST) did not differ significantly between the 3 groups (P = 0.351), but there was a significant positive correlation between IL-6 and CST (ρ = 0.18, P = 0.001). There was also a significant positive correlation between IL-6 and macular volume (ρ = 0.12, P = 0.031). Increased IL-6 was significantly associated with increased odds of having DME (odds ratio = 1.00, P = 0.015).

Conclusions

We report the largest analysis of aqueous IL-6 in diabetic eyes. We observed that IL-6 is significantly associated with DR severity and DME. Our results considerably strengthen the prevailing evidence that IL-6 is a key contributor to the pathogenesis of DR and may represent both a biomarker of disease activity and a novel therapeutic target.

Financial Disclosure(s)

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

目的：探讨白介素-6 （IL-6）与糖尿病视网膜病变（DR）严重程度的关系。设计：在三级学术医疗中心进行前瞻性对照试验。研究对象：不同程度DR的成人II型糖尿病患者164例328眼。方法：根据DR的严重程度，164例糖尿病患者共328眼入组：无DR组23例46眼，中度非增生性糖尿病视网膜病变（NPDR）组118例236眼，增生性糖尿病视网膜病变（PDR）组23例46眼。基线时拍摄ETDRS视力、光谱域光学相干断层扫描（SDOCT）和彩色眼底照片。对每只眼睛进行抽血和水采样。测量血糖和糖化血红蛋白。水相IL-6的测定采用基于微珠的多重测定法。主要结局和指标：水相IL-6水平、HbA1c、DR严重程度、糖尿病性黄斑水肿（DME）。结果：三组患者HbA1c中位数差异有统计学意义（P = 0.03），但IL-6与HbA1c无相关性（ρ = 0.08, P = 0.179）。DR组间基线水相IL-6水平有显著性差异。无DR组的中位IL-6和四分位数范围（IQR）为5.40 pg/ml(2.99 ~ 8.77)，中度NPDR组为9.25 pg/ml (5.35 ~ 22.35)， PDR组为15.71 pg/ml (9.24 ~ 48.58) （P < 0.001）。中位中心子场厚度（CST）在三组间差异无统计学意义（P = 0.351），但IL-6与CST呈正相关（ρ = 0.18, P = 0.001）。IL-6与黄斑体积也有显著正相关（ρ = 0.12, P = 0.031）。IL-6升高与DME发生率升高显著相关（OR = 1.00, P = 0.015）。结论和相关性：我们报道了糖尿病眼中最大的水相IL-6分析。我们观察到IL-6与DR严重程度和DME显著相关。我们的研究结果大大加强了当前的证据，即IL-6是DR发病机制的关键因素，可能代表疾病活性的生物标志物和新的治疗靶点。

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引用次数: 0

Characteristics and Outcomes of Patients with Neovascular Age-Related Macular Degeneration by Anti-VEGF Exposure in United States Clinical Practice 美国临床实践中抗vegf暴露对新生血管性AMD患者的特点和预后影响

IF 5.7 Q1 OPHTHALMOLOGY

Ophthalmology. Retina

Pub Date : 2026-01-01 DOI: 10.1016/j.oret.2025.06.016

Anita Barikian MD , Jaya B. Kumar MD , April J. McCullough MD , Fabiana Q. Silva MD , Steven Sherman MPH , Kathryn Tanenbaum BA , Hadi Moini PhD , Rishi P. Singh MD

Objective

To assess 1-year visual outcomes of patients in routine clinical practice treated with ≥7 anti-VEGF injections for neovascular age-related macular degeneration (nAMD), baseline characteristics associated with receiving ≥7 anti-VEGF injections, and impact of treatment exposure on visual outcomes.

Design

Retrospective analysis.

Participants

Treatment-naive eyes with baseline best-corrected visual acuity (BCVA) ≥20/400, from patients aged ≥55 years with nAMD diagnosed from January 1, 2013 to December 31, 2019.

Methods

This analysis included eyes from the American Academy of Ophthalmology IRIS Registry® (Intelligent Research in Sight). Visual outcomes were evaluated by treatment exposure (≥7 or <7 intravitreal anti-VEGF injections) through year 1. Baseline factors associated with ≥7 anti-VEGF injections and impact of treatment exposure on visual outcomes were evaluated by logistic regression.

Main Outcome Measures

Best-corrected visual acuity change from baseline by treatment exposure, association between baseline factors and treatment exposure, and magnitude of BCVA change by baseline factors and treatment exposure at year 1.

Results

Of 295 561 eligible eyes, 184 258 actively treated were analyzed (≥7 anti-VEGF injections: 109 696 eyes [59.5%]; <7 injections: 74 562 eyes [40.5%]). At year 1, eyes receiving ≥7 injections achieved greater BCVA gains versus those receiving <7 injections (least squares mean change [95% confidence interval]: +3.4 [3.3–3.5] vs. −0.2 [−0.3 to 0.0] letters). Asian or Black race (vs. White); Hispanic ethnicity (vs. non-Hispanic or Latino); Medicaid insurance (vs. Medicare); and treatment by a nonretina specialist were associated with lower odds of receiving ≥7 injections. For both treatment exposure groups, BCVA <20/200 to 20/400 (vs. 20/100–20/200) was associated with greater visual gains, whereas BCVA >20/80, age ≥85 years (vs. 75–84 years), treatment by a nonretina specialist, and Medicaid insurance were associated with lower BCVA gains.

Conclusions

Over one-third of newly diagnosed eyes with nAMD received <7 anti-VEGF injections and experienced worse visual outcomes at year 1 versus eyes receiving ≥7 injections. Race, insurance type, and physician specialty impacted treatment exposure in nAMD management, whereas age, baseline BCVA, and insurance type impacted visual outcomes regardless of treatment exposure.

Financial Disclosure(s)

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

目的：评估常规临床实践中接受≥7次抗vegf注射治疗的新生血管性年龄相关性黄斑变性（nAMD）患者的1年视力结果，接受≥7次抗vegf注射的基线特征，以及治疗暴露对视力结果的影响。设计：回顾性分析。参与者：基线最佳矫正视力(BCVA)≥20/400的未接受治疗的眼睛，来自2013年1月1日至2019年12月31日诊断为nAMD的年龄≥55岁的患者。方法：本分析纳入了美国眼科智能研究学会（AAO） IRIS®注册中心的眼睛。通过第一年的治疗暴露（≥7或< 7次玻璃体内抗vegf注射）来评估视力结果。通过logistic回归评估与≥7次抗vegf注射相关的基线因素以及治疗暴露对视力结果的影响。主要结局指标：治疗暴露后BCVA从基线变化，基线因素与治疗暴露之间的相关性，以及第1年基线因素与治疗暴露后BCVA变化幅度。结果：在295,561只符合条件的眼睛中，分析了184,258只积极治疗的眼睛(≥7次抗vegf注射：109,696只眼睛[59.5%]；< 7针：74,562眼[40.5%])。在第一年，接受≥7次注射的眼睛比接受< 7次注射的眼睛获得了更大的BCVA增益(最小二乘平均变化[95%置信区间；CI: 3.4 +(3.3 - 3.5)和-0.2(-0.3 - 0.0)字母)。亚洲或黑人种族（相对于白人）；西班牙裔（相对于非西班牙裔或拉丁裔）；医疗补助保险（vs.医疗保险）；由非视网膜专科医生治疗与接受≥7次注射的几率较低相关。对于两个治疗暴露组，BCVA < 20/200 -20/400 （vs. 20/100-20/200）与更大的视力增益相关，而BCVA bbb20 /80、年龄≥85岁（vs. 75-84岁）、非视网膜专科医生治疗和医疗补助保险与较低的BCVA增益相关。结论：超过三分之一的新诊断患有nAMD的眼睛接受了< 7次抗vegf注射，与接受≥7次注射的眼睛相比，第一年的视力结果更差。种族、保险类型和医生专业影响nAMD管理的治疗暴露，而年龄、基线BCVA和保险类型影响视力结果，无论治疗暴露如何。

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IF 5.7 Q1 OPHTHALMOLOGY

Ophthalmology. Retina

Pub Date : 2026-01-01

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Ophthalmology. Retina

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Ophthalmology. Retina

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IF 5.7 Q1 OPHTHALMOLOGY

Ophthalmology. Retina

Pub Date : 2026-01-01

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IF 5.7 Q1 OPHTHALMOLOGY

Ophthalmology. Retina

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Ophthalmology. Retina

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Bilateral Macular Ectopia and Folds in X-Linked Retinoschisis x连锁视网膜裂的双侧黄斑异位和皱褶。

IF 5.7 Q1 OPHTHALMOLOGY

Ophthalmology. Retina

Pub Date : 2026-01-01 DOI: 10.1016/j.oret.2025.05.003

Zhenlong Ran MD , Jiayue Wang MD , Dongyan Pan MD

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Retinal Starfold Induced by Lyophilized Human Amniotic Membrane Wrinkling 冻干人羊膜起皱诱导视网膜星折。

IF 5.7 Q1 OPHTHALMOLOGY

Ophthalmology. Retina

Pub Date : 2026-01-01 DOI: 10.1016/j.oret.2025.05.018

Federica Fossataro MD , Salvatore Parrulli MD , Matteo Giuseppe Cereda MD

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