首页 > 最新文献

Ophthalmology最新文献

英文 中文
Surgical Management of a Neurofibromatosis Type 1 Associated Retinal Detachment. 神经纤维瘤病 1 型相关视网膜脱离的手术治疗。
IF 13.1 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-12-01 Epub Date: 2024-02-27 DOI: 10.1016/j.ophtha.2023.12.025
Etienne Boulanger, Georges Caputo, Thibaut Chapron
{"title":"Surgical Management of a Neurofibromatosis Type 1 Associated Retinal Detachment.","authors":"Etienne Boulanger, Georges Caputo, Thibaut Chapron","doi":"10.1016/j.ophtha.2023.12.025","DOIUrl":"10.1016/j.ophtha.2023.12.025","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":"1483"},"PeriodicalIF":13.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983444","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}
引用次数: 0
International Classification System for Ocular Complications of Anti-VEGF Agents in Clinical Trials. 临床试验中抗血管内皮生长因子药物眼部并发症的国际分类系统。
IF 13.1 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-12-01 Epub Date: 2024-06-13 DOI: 10.1016/j.ophtha.2024.06.011
Marko M Popovic, Michael Balas, SriniVas R Sadda, David Sarraf, Ryan Huang, Sophie J Bakri, Audina Berrocal, Andrew Chang, Chui Ming Gemmy Cheung, Sunir Garg, Roxane J Hillier, Frank G Holz, Mark W Johnson, Peter K Kaiser, Peter J Kertes, Timothy Y Y Lai, Jason Noble, Susanna S Park, Yannis M Paulus, Giuseppe Querques, Aleksandra Rachitskaya, Paisan Ruamviboonsuk, Shohista Saidkasimova, Maria Teresa Sandinha, David H Steel, Hiroko Terasaki, Christina Y Weng, Basil K Williams, Lihteh Wu, Rajeev H Muni

Purpose: Complications associated with intravitreal anti-VEGF therapies are reported inconsistently in the literature, thus limiting an accurate evaluation and comparison of safety between studies. This study aimed to develop a standardized classification system for anti-VEGF ocular complications using the Delphi consensus process.

Design: Systematic review and Delphi consensus process.

Participants: Twenty-five international retinal specialists participated in the Delphi consensus survey.

Methods: A systematic literature search was conducted to identify complications of intravitreal anti-VEGF agent administration based on randomized controlled trials (RCTs) of anti-VEGF therapy. A comprehensive list of complications was derived from these studies, and this list was subjected to iterative Delphi consensus surveys involving international retinal specialists who voted on inclusion, exclusion, rephrasing, and addition of complications. Furthermore, surveys determined specifiers for the selected complications. This iterative process helped to refine the final classification system.

Main outcome measures: The proportion of retinal specialists who choose to include or exclude complications associated with anti-VEGF administration.

Results: After screening 18 229 articles, 130 complications were categorized from 145 included RCTs. Participant consensus via the Delphi method resulted in the inclusion of 91 complications (70%) after 3 rounds. After incorporating further modifications made based on participant suggestions, such as rewording certain phrases and combining similar terms, 24 redundant complications were removed, leaving a total of 67 complications (52%) in the final list. A total of 14 complications (11%) met exclusion thresholds and were eliminated by participants across both rounds. All other remaining complications not meeting inclusion or exclusion thresholds also were excluded from the final classification system after the Delphi process terminated. In addition, 47 of 75 proposed complication specifiers (63%) were included based on participant agreement.

Conclusions: Using the Delphi consensus process, a comprehensive, standardized classification system consisting of 67 ocular complications and 47 unique specifiers was established for intravitreal anti-VEGF agents in clinical trials. The adoption of this system in future trials could improve consistency and quality of adverse event reporting, potentially facilitating more accurate risk-benefit analyses.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

目的:与玻璃体内抗血管内皮生长因子(VEGF)疗法相关的并发症在文献中的报道并不一致,因此限制了对不同研究安全性的准确评估和比较。本研究旨在通过德尔菲共识程序,为抗血管内皮生长因子眼部并发症制定一个标准化的分类系统:参与者:25 位国际视网膜专家参与了德尔菲共识调查:方法:根据抗血管内皮生长因子疗法的随机对照试验(RCT)进行系统文献检索,以确定玻璃体内使用抗血管内皮生长因子药物的并发症。从这些研究中得出了一份全面的并发症清单,并对这份清单进行了反复的德尔菲共识调查,参与调查的国际视网膜专家对并发症的纳入、排除、改写和增加进行了投票。此外,调查还确定了所选并发症的具体说明。这一反复过程有助于完善最终的分类系统:主要结果指标:选择纳入或排除抗血管内皮生长因子用药相关并发症的视网膜专家比例:结果:在筛选了 18,229 篇文章后,从 145 项纳入的 RCT 中初步分类出 130 种并发症。参与者通过德尔菲法达成共识,经过三轮筛选,最终纳入了 91 项(70%)并发症。根据参与者的建议做了进一步的修改,如重写某些短语和合并类似术语,之后删除了 24 个多余的并发症,最终共有 67 个(52%)并发症被列入最终清单。共有 14 项(11%)并发症达到了排除阈值,被两轮参与者剔除。德尔菲流程结束后,所有其他不符合纳入或排除阈值的并发症也被排除在最终分类系统之外。此外,根据参与者的一致意见,75 个建议的并发症分类指标中有 47 个(63%)被纳入:结论:通过德尔菲共识程序,为临床试验中的玻璃体内抗血管内皮生长因子药物建立了一个全面、标准化的分类系统,该系统包括 67 种眼部并发症和 47 种独特的分类标准。在未来的试验中采用该系统可提高不良事件报告的一致性和质量,从而促进更准确的风险-效益分析。
{"title":"International Classification System for Ocular Complications of Anti-VEGF Agents in Clinical Trials.","authors":"Marko M Popovic, Michael Balas, SriniVas R Sadda, David Sarraf, Ryan Huang, Sophie J Bakri, Audina Berrocal, Andrew Chang, Chui Ming Gemmy Cheung, Sunir Garg, Roxane J Hillier, Frank G Holz, Mark W Johnson, Peter K Kaiser, Peter J Kertes, Timothy Y Y Lai, Jason Noble, Susanna S Park, Yannis M Paulus, Giuseppe Querques, Aleksandra Rachitskaya, Paisan Ruamviboonsuk, Shohista Saidkasimova, Maria Teresa Sandinha, David H Steel, Hiroko Terasaki, Christina Y Weng, Basil K Williams, Lihteh Wu, Rajeev H Muni","doi":"10.1016/j.ophtha.2024.06.011","DOIUrl":"10.1016/j.ophtha.2024.06.011","url":null,"abstract":"<p><strong>Purpose: </strong>Complications associated with intravitreal anti-VEGF therapies are reported inconsistently in the literature, thus limiting an accurate evaluation and comparison of safety between studies. This study aimed to develop a standardized classification system for anti-VEGF ocular complications using the Delphi consensus process.</p><p><strong>Design: </strong>Systematic review and Delphi consensus process.</p><p><strong>Participants: </strong>Twenty-five international retinal specialists participated in the Delphi consensus survey.</p><p><strong>Methods: </strong>A systematic literature search was conducted to identify complications of intravitreal anti-VEGF agent administration based on randomized controlled trials (RCTs) of anti-VEGF therapy. A comprehensive list of complications was derived from these studies, and this list was subjected to iterative Delphi consensus surveys involving international retinal specialists who voted on inclusion, exclusion, rephrasing, and addition of complications. Furthermore, surveys determined specifiers for the selected complications. This iterative process helped to refine the final classification system.</p><p><strong>Main outcome measures: </strong>The proportion of retinal specialists who choose to include or exclude complications associated with anti-VEGF administration.</p><p><strong>Results: </strong>After screening 18 229 articles, 130 complications were categorized from 145 included RCTs. Participant consensus via the Delphi method resulted in the inclusion of 91 complications (70%) after 3 rounds. After incorporating further modifications made based on participant suggestions, such as rewording certain phrases and combining similar terms, 24 redundant complications were removed, leaving a total of 67 complications (52%) in the final list. A total of 14 complications (11%) met exclusion thresholds and were eliminated by participants across both rounds. All other remaining complications not meeting inclusion or exclusion thresholds also were excluded from the final classification system after the Delphi process terminated. In addition, 47 of 75 proposed complication specifiers (63%) were included based on participant agreement.</p><p><strong>Conclusions: </strong>Using the Delphi consensus process, a comprehensive, standardized classification system consisting of 67 ocular complications and 47 unique specifiers was established for intravitreal anti-VEGF agents in clinical trials. The adoption of this system in future trials could improve consistency and quality of adverse event reporting, potentially facilitating more accurate risk-benefit analyses.</p><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":"1457-1467"},"PeriodicalIF":13.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327729","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}
引用次数: 0
Cavernous Hemangioma of the Retina and Brain. 视网膜及脑部海绵状血管瘤。
IF 13.1 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-12-01 Epub Date: 2023-11-21 DOI: 10.1016/j.ophtha.2023.10.024
Kayo Sugiura, Ken Fukuda, Kenji Yamashiro
{"title":"Cavernous Hemangioma of the Retina and Brain.","authors":"Kayo Sugiura, Ken Fukuda, Kenji Yamashiro","doi":"10.1016/j.ophtha.2023.10.024","DOIUrl":"10.1016/j.ophtha.2023.10.024","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":"1473"},"PeriodicalIF":13.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138176971","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}
引用次数: 0
The Impact of Baseline Intraocular Pressure on Initial Treatment Response in the LiGHT Trial: Selective Laser Trabeculoplasty versus Medication. LiGHT试验中基线眼压对初始治疗反应的影响:选择性激光小梁成形术与药物治疗的比较
IF 13.1 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-02 DOI: 10.1016/j.ophtha.2024.06.022
Eamonn T Fahy, Giovanni Montesano, Anurag Garg, Victoria Vickerstaff, Evgenia Konstantakopoulou, Gus Gazzard

Purpose: The Laser in Glaucoma and Ocular Hypertension Trial demonstrated the efficacy and safety of selective laser trabeculoplasty (SLT) compared with topical hypotensive medication as first-line therapy for ocular hypertension and open-angle glaucoma. This substudy explored the impact of pretreatment (baseline) intraocular pressure (IOP) on treatment response.

Design: Post hoc analysis of randomized control trial data.

Participants: A total of 1146 eyes from 662 patients were included in this analysis: 559 eyes in the SLT group and 587 in the medication group.

Methods: Intraocular pressure reduction at 8 weeks after treatment with either SLT or prostaglandin analog (PGA) eye drops was assessed at different levels of baseline IOP, and the groups were compared. Differences in absolute and percentage IOP lowering between SLT and PGA groups were tested with a linear mixed-effects model. Differences in the probability of achieving ≥ 20% IOP lowering between SLT and PGA groups, at different levels of baseline IOP, were estimated using a logistic mixed-effects model.

Main outcome measure: Intraocular pressure-lowering response to SLT versus PGA eye drops.

Results: Mean IOP was not significantly different between the groups at baseline or 8 weeks after treatment initiation. Both treatments showed greater IOP lowering at higher baseline IOP and less IOP lowering at lower baseline IOP. Selective laser trabeculoplasty tended to achieve more IOP lowering than PGA drops at higher baseline IOP. Prostaglandin analog drops performed better at lower baseline IOP, and the difference compared with SLT, in terms of percentage IOP reduction, was significant at baseline IOP of ≤ 17 mmHg. A significant difference was found in the relationship between baseline IOP and probability of ≥ 20% IOP lowering between the two treatments (P = 0.01), with SLT being more successful than PGA at baseline IOP of more than 22.5 mmHg.

Conclusions: We confirm previous reports of greater IOP lowering with higher baseline IOP for both SLT and PGA drops. In treatment-naïve eyes, at higher baseline IOP, SLT was more successful at achieving ≥ 20% IOP lowering than PGA drops. At lower baseline IOP, a statistically greater percentage, but not absolute, IOP lowering was seen with PGA drops compared with SLT, although the clinical significance of this is uncertain.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

目的:青光眼和眼压过高症激光治疗(LiGHT)试验表明,选择性激光小梁成形术(SLT)与局部降压药物相比,作为眼压过高症和开角型青光眼的一线疗法,具有良好的疗效和安全性。本子研究探讨了治疗前(基线)眼压(IOP)对选择性激光小梁成形术和药物治疗反应的影响:设计:随机对照试验数据的事后分析:本分析包括 662 名患者的 1146 只眼睛:SLT 组 559 只,药物组 587 只:方法:在不同的基线眼压水平下,对开始使用SLT或前列腺素类似物(PGA)滴眼液治疗8周后的眼压降低情况进行评估,并对两组进行比较。采用线性混合效应模型检验了 SLT 和 PGA 药物在降低眼压的绝对值和百分比方面的差异。使用逻辑混合效应模型估算了在不同基线眼压水平下,SLT 和 PGA 药物降低眼压≥20% 的概率差异。主要结果指标:SLT 与 PGA 滴眼液的降眼压反应:结果:无论是基线还是开始治疗后 8 周,两组的平均眼压均无明显差异。基线眼压较高时,两种疗法的降眼压效果均较好,而基线眼压较低时,降眼压效果较差。在基线眼压较高时,SLT 的降眼压效果往往优于 PGA 滴眼液。在基线眼压较低时,PGA滴眼液的效果更好,与SLT相比,在基线眼压≤17 mmHg时,PGA滴眼液在降低眼压百分比方面的差异显著。两种治疗方法的基线眼压与眼压降低≥20%的概率之间存在显著差异(p = 0.01),在基线眼压> 22.51 mmHg时,SLT比PGA更成功:这些数据证实了之前的报道,即 SLT 和局部降压药的基线眼压越高,降眼压效果越好。在未接受过治疗的眼睛中,当基线眼压较高时,SLT 比 PGA 更能成功地降低≥20% 的眼压。在基线眼压较低的情况下,PGA滴眼液与SLT相比,在统计学上降低眼压的百分比(而非绝对值)更高,但其临床意义尚不确定。
{"title":"The Impact of Baseline Intraocular Pressure on Initial Treatment Response in the LiGHT Trial: Selective Laser Trabeculoplasty versus Medication.","authors":"Eamonn T Fahy, Giovanni Montesano, Anurag Garg, Victoria Vickerstaff, Evgenia Konstantakopoulou, Gus Gazzard","doi":"10.1016/j.ophtha.2024.06.022","DOIUrl":"10.1016/j.ophtha.2024.06.022","url":null,"abstract":"<p><strong>Purpose: </strong>The Laser in Glaucoma and Ocular Hypertension Trial demonstrated the efficacy and safety of selective laser trabeculoplasty (SLT) compared with topical hypotensive medication as first-line therapy for ocular hypertension and open-angle glaucoma. This substudy explored the impact of pretreatment (baseline) intraocular pressure (IOP) on treatment response.</p><p><strong>Design: </strong>Post hoc analysis of randomized control trial data.</p><p><strong>Participants: </strong>A total of 1146 eyes from 662 patients were included in this analysis: 559 eyes in the SLT group and 587 in the medication group.</p><p><strong>Methods: </strong>Intraocular pressure reduction at 8 weeks after treatment with either SLT or prostaglandin analog (PGA) eye drops was assessed at different levels of baseline IOP, and the groups were compared. Differences in absolute and percentage IOP lowering between SLT and PGA groups were tested with a linear mixed-effects model. Differences in the probability of achieving ≥ 20% IOP lowering between SLT and PGA groups, at different levels of baseline IOP, were estimated using a logistic mixed-effects model.</p><p><strong>Main outcome measure: </strong>Intraocular pressure-lowering response to SLT versus PGA eye drops.</p><p><strong>Results: </strong>Mean IOP was not significantly different between the groups at baseline or 8 weeks after treatment initiation. Both treatments showed greater IOP lowering at higher baseline IOP and less IOP lowering at lower baseline IOP. Selective laser trabeculoplasty tended to achieve more IOP lowering than PGA drops at higher baseline IOP. Prostaglandin analog drops performed better at lower baseline IOP, and the difference compared with SLT, in terms of percentage IOP reduction, was significant at baseline IOP of ≤ 17 mmHg. A significant difference was found in the relationship between baseline IOP and probability of ≥ 20% IOP lowering between the two treatments (P = 0.01), with SLT being more successful than PGA at baseline IOP of more than 22.5 mmHg.</p><p><strong>Conclusions: </strong>We confirm previous reports of greater IOP lowering with higher baseline IOP for both SLT and PGA drops. In treatment-naïve eyes, at higher baseline IOP, SLT was more successful at achieving ≥ 20% IOP lowering than PGA drops. At lower baseline IOP, a statistically greater percentage, but not absolute, IOP lowering was seen with PGA drops compared with SLT, although the clinical significance of this is uncertain.</p><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":"1366-1376"},"PeriodicalIF":13.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535003","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}
引用次数: 0
Reply. 答复
IF 13.1 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-12-01 Epub Date: 2024-10-03 DOI: 10.1016/j.ophtha.2024.08.034
Esen K Akpek, Ian J Saldanha
{"title":"Reply.","authors":"Esen K Akpek, Ian J Saldanha","doi":"10.1016/j.ophtha.2024.08.034","DOIUrl":"10.1016/j.ophtha.2024.08.034","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":"e48"},"PeriodicalIF":13.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372464","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}
引用次数: 0
Concordance between Self-Reported Visual Difficulty and Objective Visual Impairment: The National Health and Aging Trends Study. 自述视力困难与客观视力损伤之间的一致性:全国健康与老龄化趋势研究》。
IF 13.1 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-12-01 Epub Date: 2024-06-12 DOI: 10.1016/j.ophtha.2024.06.009
Taylor Potter, Louay Almidani, Mariah Diaz, Varshini Varadaraj, Aleksandra Mihailovic, Pradeep Y Ramulu

Purpose: To examine the performance of self-reported visual difficulty (VD) in predicting objective visual impairment (VI) in older adults and explore factors that influence discordance.

Design: Cross-sectional analysis of the National Health and Aging Trends Study (2022).

Methods: Participants reporting blindness or difficulties with distance or near vision were characterized as having VD. Presenting binocular distance visual acuity (VA), near VA, and contrast sensitivity (CS) were assessed. Objective VI was defined as having VI in distance VA (worse than 20/40), near VA (worse than 20/40), or CS (worse than 1.55 logCS). Receiver operating characteristic analysis was used to compare performance of VD in predicting VI. To investigate factors that influence discordance, we limited our sample to adults with VI and used a multivariable logistic regression model to identify factors associated with not reporting VD. Similar analyses were performed to explore factors associated with reporting VD in adults without VI.

Main outcome measures: Discordance factors.

Results: Four thousand nine hundred ninety-nine adults were included in the 2022 cohort. Visual difficulty achieved an area under the curve (AUC) of 56.0 (95% confidence interval [CI], 55.2-56.9) in predicting VI, with a sensitivity of 15.8 (95% CI, 14.2-17.5) and specificity of 96.3 (95% CI, 95.5-96.9). Characteristics associated with not reporting VD in adults with VI included female gender (odds ratio [OR], 0.64 [95% CI, 0.42-0.99]), Hispanic ethnicity (OR, 0.49 [95% CI, 0.31-0.78), higher income (≥75 000, OR, 1.99 [95% CI, 1.14-3.45]), ≥4 comorbidities (OR, 0.46 [95% CI, 0.29-0.72]), and depressive symptoms (OR, 0.49 [95% CI, 0.25-0.93]). Factors associated with self-reporting VD in the absence of VI included Hispanic ethnicity (OR, 2.11 [95% CI, 1.15-3.86]), higher income (≥$75 000, OR, 0.27 [95% CI, 0.12-0.63]), and anxiety symptoms (OR, 3.05 [95% CI, 1.56-5.97]).

Conclusions: Self-reported VD is a distinct measure assessing disability and has limited ability in predicting objective VI. Caution is advised when using self-reported VD as a surrogate measure for objective VI in epidemiological studies, although it may still be an effective way to capture risk of current or future disability.

Financial disclosure(s): Proprietary or commercial disclosure may be found after the references.

目的研究自我报告的视觉困难(VD)在预测老年人客观视觉损伤(VI)方面的表现,并探讨影响这些分类不一致的因素:方法:对全国健康与老龄化趋势研究(2022 年)进行横断面分析:方法:将报告失明或远近视力有困难的参与者定性为视力障碍者。对参与者的双眼远视力 (VA)、近视力 (VA) 和对比敏感度 (CS) 进行评估。客观视力障碍的定义是远视力(低于 20/40)、近视力(低于 20/40)或对比敏感度(低于 1.55 logCS)均为视力障碍。接收者操作特征分析用于比较 VD 在预测客观 VI 方面的性能。为了研究影响不一致的因素,我们将样本限定为具有客观视力障碍的成年人,并采用多变量逻辑回归模型来确定与未报告 VD 相关的因素。我们还进行了类似的分析,以探讨与没有客观VI的成年人报告VD相关的因素:2022 年的队列中有 4999 名成人。VD预测客观VI的曲线下面积(AUC)为56.0(95% CI:55.2,56.9),灵敏度为15.8(95% CI:14.2,17.5),特异性为96.3(95% CI:95.5,96.9)。与客观 VI 成人未报告 VD 相关的特征包括:女性(几率比 [OR]:0.64 [95% CI:0.42, 0.99])、西班牙裔(OR:0.49 [95% CI:0.31,0.78)、收入较高(≥75k,OR:1.99 [95% CI:1.14,3.45])、合并症≥4 种(OR:0.46 [95% CI:0.29,0.72])和有抑郁症状(OR:0.49 [95% CI:0.25,0.93])。同时,在没有客观视力障碍的情况下,与自我报告视力障碍相关的因素包括西班牙裔(OR:2.11 [95% CI:1.15, 3.86])、高收入(≥75k,OR:0.27 [95% CI:0.12, 0.63])和焦虑症状(OR:3.05 [95% CI:1.56, 5.97]):自我报告的视觉困难是评估残疾的一种独特方法,在预测客观 VI 方面能力有限。在流行病学研究中,将自我报告的视觉困难作为客观VI的替代测量指标时应谨慎,尽管它仍可能是捕捉当前或未来残疾风险的有效方法。
{"title":"Concordance between Self-Reported Visual Difficulty and Objective Visual Impairment: The National Health and Aging Trends Study.","authors":"Taylor Potter, Louay Almidani, Mariah Diaz, Varshini Varadaraj, Aleksandra Mihailovic, Pradeep Y Ramulu","doi":"10.1016/j.ophtha.2024.06.009","DOIUrl":"10.1016/j.ophtha.2024.06.009","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the performance of self-reported visual difficulty (VD) in predicting objective visual impairment (VI) in older adults and explore factors that influence discordance.</p><p><strong>Design: </strong>Cross-sectional analysis of the National Health and Aging Trends Study (2022).</p><p><strong>Methods: </strong>Participants reporting blindness or difficulties with distance or near vision were characterized as having VD. Presenting binocular distance visual acuity (VA), near VA, and contrast sensitivity (CS) were assessed. Objective VI was defined as having VI in distance VA (worse than 20/40), near VA (worse than 20/40), or CS (worse than 1.55 logCS). Receiver operating characteristic analysis was used to compare performance of VD in predicting VI. To investigate factors that influence discordance, we limited our sample to adults with VI and used a multivariable logistic regression model to identify factors associated with not reporting VD. Similar analyses were performed to explore factors associated with reporting VD in adults without VI.</p><p><strong>Main outcome measures: </strong>Discordance factors.</p><p><strong>Results: </strong>Four thousand nine hundred ninety-nine adults were included in the 2022 cohort. Visual difficulty achieved an area under the curve (AUC) of 56.0 (95% confidence interval [CI], 55.2-56.9) in predicting VI, with a sensitivity of 15.8 (95% CI, 14.2-17.5) and specificity of 96.3 (95% CI, 95.5-96.9). Characteristics associated with not reporting VD in adults with VI included female gender (odds ratio [OR], 0.64 [95% CI, 0.42-0.99]), Hispanic ethnicity (OR, 0.49 [95% CI, 0.31-0.78), higher income (≥75 000, OR, 1.99 [95% CI, 1.14-3.45]), ≥4 comorbidities (OR, 0.46 [95% CI, 0.29-0.72]), and depressive symptoms (OR, 0.49 [95% CI, 0.25-0.93]). Factors associated with self-reporting VD in the absence of VI included Hispanic ethnicity (OR, 2.11 [95% CI, 1.15-3.86]), higher income (≥$75 000, OR, 0.27 [95% CI, 0.12-0.63]), and anxiety symptoms (OR, 3.05 [95% CI, 1.56-5.97]).</p><p><strong>Conclusions: </strong>Self-reported VD is a distinct measure assessing disability and has limited ability in predicting objective VI. Caution is advised when using self-reported VD as a surrogate measure for objective VI in epidemiological studies, although it may still be an effective way to capture risk of current or future disability.</p><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found after the references.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":"1447-1456"},"PeriodicalIF":13.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317901","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}
引用次数: 0
Retinal Tear and Retinal Detachment after Cataract Surgery in Eyes with a Previous History of Treated Phakic Retinal Tears. 白内障手术后出现视网膜撕裂和视网膜脱离,且曾接受过法光性视网膜撕裂治疗。
IF 13.1 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-02 DOI: 10.1016/j.ophtha.2024.06.021
Bita Momenaei, Andrew Zhou, Adina S Kazan, Taku Wakabayashi, Anthony Obeid, Michael Morano, M Ali Khan, David Xu, Ajay E Kuriyan, Yoshihiro Yonekawa, Jason Hsu, Allen C Ho

Purpose: To investigate the incidence and outcomes of retinal tear (RT) and retinal detachment (RD) after cataract extraction in patients with a history of previous phakic RT.

Design: Retrospective case series.

Participants: Patients with phakic eyes with RT that were treated successfully with laser photocoagulation or cryotherapy and subsequently underwent cataract surgery.

Methods: A retrospective review of data between April 1, 2012, and May 31, 2023, was performed. Exclusions included prior vitreoretinal surgery before cataract removal and follow-up of less than 6 months after cataract surgery.

Main outcome measures: The incidence of RTs and RDs after cataract surgery, along with visual and anatomic outcomes.

Results: Of 12 109 phakic eyes treated for RTs, 1039 eyes (8.6%) underwent cataract surgery. After exclusions, 713 eyes of 660 patients were studied. The mean ± standard deviation follow-up period after cataract surgery was 34.8 ± 24.6 months, with a median of 239 and 246 days to a new RT or RD development, respectively. The overall incidence of RT and RD diagnosis after cataract surgery was 7.3% (52/713; 2.9% and 4.3%, respectively), with a 1-year incidence of 5.6% (2.2% and 3.4%, respectively). Multivariable regression analysis identified a higher risk of RT and RD among younger individuals (odds ratio [OR], 1.034; P = 0.028), male patients (OR, 2.058; P = 0.022), and those with a shorter interval between laser treatment and cataract surgery (OR, 1.001; P = 0.011). Single-surgery anatomic success for the RD repair was achieved in 25 eyes (80.6%) at 3 months, with a 100% final reattachment rate. The median final visual acuity was 0.10 logarithm of the minimum angle of resolution (logMAR; Snellen equivalent, 20/25) for RT, showing no significant change from after cataract surgery, and 0.18 logMAR (Snellen equivalent, 20/30) for RD, a significant worsening from after cataract surgery.

Conclusions: One year after cataract surgery, the rate of diagnosed RT and RD in patients with previously treated RTs was relatively high, occurring in nearly 1 in 18 eyes. Higher risk was noted among younger individuals, male patients, and patients with a shorter interval between initial treatment for RT and cataract surgery. Retinal detachment repair achieved good anatomic results, but vision declined.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

目的研究既往有法球RT史的白内障摘除术后视网膜撕裂(RT)和视网膜脱离(RD)的发生率和结局:设计:回顾性病例系列:方法:回顾性病例系列:方法:对 2012 年 4 月 1 日至 2023 年 5 月 31 日期间接受 RT 治疗的法眼进行回顾性研究。排除因素包括白内障摘除术前曾接受玻璃体视网膜手术,以及白内障手术后随访不足 6 个月:主要结果指标:白内障手术后RT和RD的发生率,以及视觉和解剖结果:在12109只接受RT治疗的人工晶体眼中,有1039只(8.6%)接受了白内障手术。经排除后,对 660 名患者的 713 只眼睛进行了研究。白内障手术后的平均(标准差,SD)随访时间为 34.8(24.6)个月,出现新的 RT 或 RD 的中位时间分别为 239 天和 246 天。白内障手术后 RT 和 RD 的总发病率为 7.3%(52/713)(分别为 2.9% 和 4.3%),一年的发病率为 5.6%(分别为 2.2% 和 3.4%)。多变量回归分析发现,年龄较小的患者(几率比 [OR] 1.034;95% 置信区间 [CI] 1.004-1.065,P=0.028)、男性(OR 2.058;95% CI 1.110-3.816,P=0.022)和激光治疗与白内障手术间隔时间较短的患者(OR 1.001;95% CI 1.001-1.001,P=0.011)发生 RT/RD 的风险较高。25 只眼睛(80.6%)在 3 个月时进行了 RD 修复,单次手术解剖成功,最终重新接合率为 100%。RT的最终logMAR视力中位数为0.10(20/25),与白内障手术后相比无明显变化;RD的最终logMAR视力中位数为0.18(20/30),与白内障手术后相比明显恶化:结论:白内障手术后一年,曾接受过RT治疗的患者确诊RT和RD的比例相对较高,几乎每18只眼睛中就有1只。年轻人、男性和 RT 初次治疗与白内障手术间隔时间较短的患者的风险更高。RD修复术取得了良好的解剖效果,但视力有所下降。
{"title":"Retinal Tear and Retinal Detachment after Cataract Surgery in Eyes with a Previous History of Treated Phakic Retinal Tears.","authors":"Bita Momenaei, Andrew Zhou, Adina S Kazan, Taku Wakabayashi, Anthony Obeid, Michael Morano, M Ali Khan, David Xu, Ajay E Kuriyan, Yoshihiro Yonekawa, Jason Hsu, Allen C Ho","doi":"10.1016/j.ophtha.2024.06.021","DOIUrl":"10.1016/j.ophtha.2024.06.021","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the incidence and outcomes of retinal tear (RT) and retinal detachment (RD) after cataract extraction in patients with a history of previous phakic RT.</p><p><strong>Design: </strong>Retrospective case series.</p><p><strong>Participants: </strong>Patients with phakic eyes with RT that were treated successfully with laser photocoagulation or cryotherapy and subsequently underwent cataract surgery.</p><p><strong>Methods: </strong>A retrospective review of data between April 1, 2012, and May 31, 2023, was performed. Exclusions included prior vitreoretinal surgery before cataract removal and follow-up of less than 6 months after cataract surgery.</p><p><strong>Main outcome measures: </strong>The incidence of RTs and RDs after cataract surgery, along with visual and anatomic outcomes.</p><p><strong>Results: </strong>Of 12 109 phakic eyes treated for RTs, 1039 eyes (8.6%) underwent cataract surgery. After exclusions, 713 eyes of 660 patients were studied. The mean ± standard deviation follow-up period after cataract surgery was 34.8 ± 24.6 months, with a median of 239 and 246 days to a new RT or RD development, respectively. The overall incidence of RT and RD diagnosis after cataract surgery was 7.3% (52/713; 2.9% and 4.3%, respectively), with a 1-year incidence of 5.6% (2.2% and 3.4%, respectively). Multivariable regression analysis identified a higher risk of RT and RD among younger individuals (odds ratio [OR], 1.034; P = 0.028), male patients (OR, 2.058; P = 0.022), and those with a shorter interval between laser treatment and cataract surgery (OR, 1.001; P = 0.011). Single-surgery anatomic success for the RD repair was achieved in 25 eyes (80.6%) at 3 months, with a 100% final reattachment rate. The median final visual acuity was 0.10 logarithm of the minimum angle of resolution (logMAR; Snellen equivalent, 20/25) for RT, showing no significant change from after cataract surgery, and 0.18 logMAR (Snellen equivalent, 20/30) for RD, a significant worsening from after cataract surgery.</p><p><strong>Conclusions: </strong>One year after cataract surgery, the rate of diagnosed RT and RD in patients with previously treated RTs was relatively high, occurring in nearly 1 in 18 eyes. Higher risk was noted among younger individuals, male patients, and patients with a shorter interval between initial treatment for RT and cataract surgery. Retinal detachment repair achieved good anatomic results, but vision declined.</p><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":"1416-1426"},"PeriodicalIF":13.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498573","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}
引用次数: 0
Retinal Vasculature Changes Herald the Presence of Carotid-Cavernous Fistula. 颈动脉-海绵瘘导致的视网膜血管变化
IF 13.1 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-12-01 Epub Date: 2023-12-20 DOI: 10.1016/j.ophtha.2023.11.020
Yi-Wen Su, An-Guor Wang, Hui-Chen Cheng
{"title":"Retinal Vasculature Changes Herald the Presence of Carotid-Cavernous Fistula.","authors":"Yi-Wen Su, An-Guor Wang, Hui-Chen Cheng","doi":"10.1016/j.ophtha.2023.11.020","DOIUrl":"10.1016/j.ophtha.2023.11.020","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":"1477"},"PeriodicalIF":13.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138830837","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}
引用次数: 0
Assessment of the Predictive Ability of Theranostics for Corneal Cross-linking in Treating Keratoconus: A Randomized Clinical Trial. 角膜交联疗法治疗角膜炎的疗效预测能力评估:随机临床试验。
IF 13.1 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-12-01 Epub Date: 2024-06-20 DOI: 10.1016/j.ophtha.2024.06.012
Anna Maria Roszkowska, Vincenzo Scorcia, Rita Mencucci, Giuseppe Giannaccare, Giuseppe Lombardo, Danilo Alunni Fegatelli, Annarita Vestri, Luca Bifezzi, Giuseppe Massimo Bernava, Sebastiano Serrao, Marco Lombardo

Purpose: To validate the ability of theranostic imaging biomarkers in assessing corneal cross-linking (CXL) efficacy in flattening the maximum keratometry (Kmax) index.

Design: Prospective, randomized, multicenter, masked clinical trial (ClinicalTrails.gov identifier, NCT05457647).

Participants: Fifty patients with progressive keratoconus.

Intervention: Participants were stratified to undergo epithelium-off (25 eyes) and epithelium-on (25 eyes) CXL protocols using an ultraviolet A (UV-A) medical device with theranostic software. The device controlled UV-A light both for performing CXL and assessing the corneal riboflavin concentration (riboflavin score) and treatment effect (theranostic score). A 0.22% riboflavin formulation was applied onto the cornea for 15 minutes and 20 minutes in epithelium-off and epithelium-on protocols, respectively. All eyes underwent 9 minutes of UV-A irradiance at 10 mW/cm2.

Main outcome measures: The primary outcome measure was validation of the combined use of theranostic imaging biomarkers through measurement of their accuracy (proportion of correctly classified eyes) and precision (positive predictive value) to classify eyes correctly and predict a Kmax flattening at 1 year after CXL. Other outcome measures included change in Kmax, endothelial cell density, uncorrected and corrected distance visual acuity, manifest spherical equivalent refraction and central corneal thickness 1 year after CXL.

Results: Accuracy and precision of the theranostic imaging biomarkers in predicting eyes that had >0.1 diopter (D) of Kmax flattening at 1 year were 91% and 95%, respectively. The Kmax value significantly flattened by a median of -1.3 D (IQR, -2.11 to -0.49 D; P < 0.001); both the uncorrected and corrected distance visual acuity improved by a median of -0.1 logarithm of the minimum angle of resolution (logMAR; IQR, -0.3 to 0.0 logMAR [P < 0.001] and -0.2 to 0.0 logMAR [P < 0.001], respectively). No significant changes in endothelial cell density (P = 0.33) or central corneal thickness (P = 0.07) were noted 1 year after surgery.

Conclusions: The study demonstrated the efficacy of integrating theranostics in a UV-A medical device for the precise and predictive treatment of keratoconus with epithelium-off and epithelium-on CXL protocols. Concentration of riboflavin and its UV-A light mediated photoactivation in the cornea are the primary factors determining CXL efficacy.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

目的:验证治疗成像生物标志物在评估角膜交联术(CXL)平滑最大角膜指数(Kmax)方面的能力:前瞻性、随机、多中心、掩蔽临床试验(NCT05457647):干预:对参与者进行分层,分别采用上皮-关闭(epi-off;25 眼)和上皮-开启(epi-on;25 眼)CXL 方案,使用包含治疗软件模块的 UV-A 医疗设备。该设备使用受控紫外线-A 光进行 CXL,并实时估算角膜核黄素浓度(核黄素评分)和评估治疗效果(治疗评分)。在外延-关闭和外延-开启方案中,将 0.22% 核黄素制剂分别涂在角膜上 15 分钟和 20 分钟。所有眼睛均接受 9 分钟 10 mW/cm2 的紫外线-A 照射:主要结果指标是通过测量治疗成像生物标志物的准确性(正确分类眼睛的比例)和精确性(阳性预测值)来验证治疗成像生物标志物的综合使用,以正确分类眼睛并积极预测 CXL 后 1 年的 Kmax 平整度。其他结果测量指标包括 CXL 一年后 Kmax、内皮细胞密度、未矫正和矫正远视力、显性球面等效屈光度和中央角膜厚度的变化:结果:联合使用治疗成像生物标志物预测 1 年后 Kmax 值变平超过 0.1 屈光度 (D) 的眼睛的准确率和精确率分别为 91% 和 95%。Kmax值明显变平,中位数为-1.3 D(IQR:-2.11, -0.49 D;P <0.001);未矫正和矫正远视力均提高,中位数为-0.1 LogMAR(IQR:-0.3, 0.0 LogMAR;P <0.001,IQR:-0.2, 0.0 LogMAR;P <0.001)。术后一年,内皮细胞密度(P = 0.33)和角膜中央厚度(P = 0.07)无明显变化:该研究证明了将治疗技术整合到 UV-A 医疗设备中,通过外延-关闭和外延-开启 CXL 方案对角膜病进行精确和预测性治疗的有效性。角膜中核黄素的浓度及其紫外线-A 光介导的光激活作用是决定 CXL 治疗效果的主要因素。
{"title":"Assessment of the Predictive Ability of Theranostics for Corneal Cross-linking in Treating Keratoconus: A Randomized Clinical Trial.","authors":"Anna Maria Roszkowska, Vincenzo Scorcia, Rita Mencucci, Giuseppe Giannaccare, Giuseppe Lombardo, Danilo Alunni Fegatelli, Annarita Vestri, Luca Bifezzi, Giuseppe Massimo Bernava, Sebastiano Serrao, Marco Lombardo","doi":"10.1016/j.ophtha.2024.06.012","DOIUrl":"10.1016/j.ophtha.2024.06.012","url":null,"abstract":"<p><strong>Purpose: </strong>To validate the ability of theranostic imaging biomarkers in assessing corneal cross-linking (CXL) efficacy in flattening the maximum keratometry (K<sub>max</sub>) index.</p><p><strong>Design: </strong>Prospective, randomized, multicenter, masked clinical trial (ClinicalTrails.gov identifier, NCT05457647).</p><p><strong>Participants: </strong>Fifty patients with progressive keratoconus.</p><p><strong>Intervention: </strong>Participants were stratified to undergo epithelium-off (25 eyes) and epithelium-on (25 eyes) CXL protocols using an ultraviolet A (UV-A) medical device with theranostic software. The device controlled UV-A light both for performing CXL and assessing the corneal riboflavin concentration (riboflavin score) and treatment effect (theranostic score). A 0.22% riboflavin formulation was applied onto the cornea for 15 minutes and 20 minutes in epithelium-off and epithelium-on protocols, respectively. All eyes underwent 9 minutes of UV-A irradiance at 10 mW/cm<sup>2</sup>.</p><p><strong>Main outcome measures: </strong>The primary outcome measure was validation of the combined use of theranostic imaging biomarkers through measurement of their accuracy (proportion of correctly classified eyes) and precision (positive predictive value) to classify eyes correctly and predict a K<sub>max</sub> flattening at 1 year after CXL. Other outcome measures included change in K<sub>max</sub>, endothelial cell density, uncorrected and corrected distance visual acuity, manifest spherical equivalent refraction and central corneal thickness 1 year after CXL.</p><p><strong>Results: </strong>Accuracy and precision of the theranostic imaging biomarkers in predicting eyes that had >0.1 diopter (D) of K<sub>max</sub> flattening at 1 year were 91% and 95%, respectively. The K<sub>max</sub> value significantly flattened by a median of -1.3 D (IQR, -2.11 to -0.49 D; P < 0.001); both the uncorrected and corrected distance visual acuity improved by a median of -0.1 logarithm of the minimum angle of resolution (logMAR; IQR, -0.3 to 0.0 logMAR [P < 0.001] and -0.2 to 0.0 logMAR [P < 0.001], respectively). No significant changes in endothelial cell density (P = 0.33) or central corneal thickness (P = 0.07) were noted 1 year after surgery.</p><p><strong>Conclusions: </strong>The study demonstrated the efficacy of integrating theranostics in a UV-A medical device for the precise and predictive treatment of keratoconus with epithelium-off and epithelium-on CXL protocols. Concentration of riboflavin and its UV-A light mediated photoactivation in the cornea are the primary factors determining CXL efficacy.</p><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":"1403-1415"},"PeriodicalIF":13.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440702","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}
引用次数: 0
Phase 1 Study of JNJ-81201887 Gene Therapy in Geographic Atrophy Secondary to Age-Related Macular Degeneration. JNJ-81201887 基因疗法治疗继发于老年性黄斑变性的地理萎缩的 1 期研究。
IF 13.1 1区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-12-01 Epub Date: 2024-06-22 DOI: 10.1016/j.ophtha.2024.06.013
Jeffrey S Heier, Michael N Cohen, Daniel L Chao, Anthony Pepio, Yoko Shiraga, George Capuano, Adam Rogers, Jessica Ackert, H Nida Sen, Karl Csaky

Purpose: To evaluate the safety and tolerability of a single intravitreal injection of JNJ-81201887 (JNJ-1887) in patients with geographic atrophy (GA) secondary to advanced dry age-related macular degeneration (AMD).

Design: Phase 1, open-label, single-center, first-in-human clinical study.

Participants: Adult patients (≥50 years of age) with GA secondary to AMD in the study-treated eye (treated eye) with Snellen best-corrected visual acuity of 20/200 or worse in the treated eye (20/80 or worse after the first 3 patients), a total GA lesion size between 5 and 20 mm2 (2-8 disc area), and best-corrected visual acuity of 20/800 or better in fellow, nontreated eye were included.

Methods: Patients (n = 17) were enrolled sequentially into low-dose (3.56 × 1010 viral genome/eye; n = 3), intermediate-dose (1.07 × 1011 viral genome/eye; n = 3), and high-dose (3.56 × 1011 viral genome/eye; n = 11) cohorts without steroid prophylaxis and assessed for safety and tolerability over 24 months.

Main outcome measures: Safety and tolerability outcomes included assessment of ocular and nonocular treatment-emergent adverse events (AEs) over 24 months. Secondary outcomes included GA lesion size and growth rate.

Results: Baseline patient characteristics were consistent with the disease under study, and all enrolled patients demonstrated foveal center-involved GA. JNJ-81201887 was well-tolerated across all cohorts, with no dose-limiting AEs. No serious or systemic AEs related to study intervention occurred. Overall, 5 of 17 patients (29%) experienced 5 events of mild ocular inflammation related to study treatment; examination findings in all resolved, and AEs resolved in 4 of 5 patients after topical steroids or observation. One unresolved vitritis event, managed with observation, occurred in a patient with an unrelated fatal AE. No endophthalmitis or new-onset choroidal neovascularization was reported. Geographic atrophy lesion growth rate was similar among all cohorts over 24 months. For treated eyes in the high-dose cohort, GA lesion growth rate showed continued decline through 24 months, with a reduction in mean square root lesion growth from 0.211 mm at months 0 through 6 to 0.056 mm at months 18 through 24.

Conclusions: All 3 studied doses of JNJ-1887 showed a manageable safety profile through 24 months of follow-up. Further investigation of JNJ-1887 for the treatment of GA is warranted.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

目的评估晚期干性年龄相关性黄斑变性(AMD)继发地理萎缩(GA)患者单次玻璃体内注射 JNJ-81201887 (JNJ-1887)的安全性和耐受性:设计:1期、开放标签、单中心、首次人体临床研究:受试者:年龄≥50 岁,研究对象治疗眼(治疗眼)继发于 AMD 的成人 GA 患者,治疗眼的最佳矫正视力(BCVA)斯奈伦等效视力为 20/200 或更差(前 3 位患者为 20/80 或更差),GA 病变总面积在 5 至 20 平方毫米(2-8 圆盘面积)之间,同侧非治疗眼的 BCVA 为 20/800 或更佳:将患者(17 人)依次纳入低剂量组(3.56×1010 病毒基因组 [vg]/眼;3 人)、中剂量组(1.07×1011 vg/眼;3 人)和高剂量组(3.56×1011 vg/眼;11 人),不使用类固醇预防,并在 24 个月内对安全性和耐受性进行评估:安全性和耐受性结果包括对 24 个月内眼部和非眼部治疗引发的不良事件(AEs)进行评估。次要结果包括GA病变大小和生长率:结果:患者的基线特征与研究中的疾病一致,所有入组患者都患有眼窝中心受累的GA。所有组群对 JNJ-1887 的耐受性良好,没有出现剂量限制性 AE。没有出现与研究干预相关的严重或全身性 AE。总体而言,5/17(29%)名患者经历了 6 次与研究治疗相关的轻度眼部炎症事件;所有患者的检查结果均已缓解,5 名患者中有 4 名患者在使用局部类固醇或观察后,AEs 均已缓解。一名患者的玻璃体炎症未得到缓解,但通过观察得到了控制,该患者还出现了与此无关的致命性 AE。没有眼内炎或新发脉络膜新生血管的报道。在 24 个月内,所有组别中的 GA 病变增长率相似。对于高剂量队列中接受治疗的眼睛,GA病变增长率在24个月内持续下降,平均平方根病变增长率从0-6个月的0.211毫米降至18-24个月的0.056毫米:结论:所研究的三种剂量的 JNJ-1887 在 24 个月的随访期间都具有可控的安全性。有必要进一步研究 JNJ-1887 治疗 GA 的效果。
{"title":"Phase 1 Study of JNJ-81201887 Gene Therapy in Geographic Atrophy Secondary to Age-Related Macular Degeneration.","authors":"Jeffrey S Heier, Michael N Cohen, Daniel L Chao, Anthony Pepio, Yoko Shiraga, George Capuano, Adam Rogers, Jessica Ackert, H Nida Sen, Karl Csaky","doi":"10.1016/j.ophtha.2024.06.013","DOIUrl":"10.1016/j.ophtha.2024.06.013","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety and tolerability of a single intravitreal injection of JNJ-81201887 (JNJ-1887) in patients with geographic atrophy (GA) secondary to advanced dry age-related macular degeneration (AMD).</p><p><strong>Design: </strong>Phase 1, open-label, single-center, first-in-human clinical study.</p><p><strong>Participants: </strong>Adult patients (≥50 years of age) with GA secondary to AMD in the study-treated eye (treated eye) with Snellen best-corrected visual acuity of 20/200 or worse in the treated eye (20/80 or worse after the first 3 patients), a total GA lesion size between 5 and 20 mm<sup>2</sup> (2-8 disc area), and best-corrected visual acuity of 20/800 or better in fellow, nontreated eye were included.</p><p><strong>Methods: </strong>Patients (n = 17) were enrolled sequentially into low-dose (3.56 × 10<sup>10</sup> viral genome/eye; n = 3), intermediate-dose (1.07 × 10<sup>11</sup> viral genome/eye; n = 3), and high-dose (3.56 × 10<sup>11</sup> viral genome/eye; n = 11) cohorts without steroid prophylaxis and assessed for safety and tolerability over 24 months.</p><p><strong>Main outcome measures: </strong>Safety and tolerability outcomes included assessment of ocular and nonocular treatment-emergent adverse events (AEs) over 24 months. Secondary outcomes included GA lesion size and growth rate.</p><p><strong>Results: </strong>Baseline patient characteristics were consistent with the disease under study, and all enrolled patients demonstrated foveal center-involved GA. JNJ-81201887 was well-tolerated across all cohorts, with no dose-limiting AEs. No serious or systemic AEs related to study intervention occurred. Overall, 5 of 17 patients (29%) experienced 5 events of mild ocular inflammation related to study treatment; examination findings in all resolved, and AEs resolved in 4 of 5 patients after topical steroids or observation. One unresolved vitritis event, managed with observation, occurred in a patient with an unrelated fatal AE. No endophthalmitis or new-onset choroidal neovascularization was reported. Geographic atrophy lesion growth rate was similar among all cohorts over 24 months. For treated eyes in the high-dose cohort, GA lesion growth rate showed continued decline through 24 months, with a reduction in mean square root lesion growth from 0.211 mm at months 0 through 6 to 0.056 mm at months 18 through 24.</p><p><strong>Conclusions: </strong>All 3 studied doses of JNJ-1887 showed a manageable safety profile through 24 months of follow-up. Further investigation of JNJ-1887 for the treatment of GA is warranted.</p><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":"1377-1388"},"PeriodicalIF":13.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443137","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}
引用次数: 0
期刊
Ophthalmology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1