Ophthalmology最新文献

英文中文

Ocular Surface Fibroma: A Rare, Benign Tumor of the Conjunctiva 眼表纤维瘤：一种罕见的结膜良性肿瘤。

IF 13.1 1区医学 Q1 OPHTHALMOLOGY

Ophthalmology

Pub Date : 2025-02-01 DOI: 10.1016/j.ophtha.2024.02.020

Thomas A. Weppelmann MD, PhD , Curtis E. Margo MD, MPH , Edgar M. Espana MD

引用次数: 0

Re: Zhou et al.: Efficacy of different powers of low-level red light in children for myopia control (Ophthalmology. 2024;131:48–57) Re：Zhou et al：不同功率的低强度红光对控制儿童近视的效果（《眼科学》，2024;131:48-57）。

IF 13.1 1区医学 Q1 OPHTHALMOLOGY

Ophthalmology

Pub Date : 2025-02-01 DOI: 10.1016/j.ophtha.2024.10.005

Ameena Jennifer K DNB, Shruti Nishanth MS, Nivean Madhivanan MS

引用次数: 0

Clinico-tomographic and Histopathological Correlation of Epibulbar Schwannoma: The Key within the Whorls 上唇神经纤维瘤的临床解剖学和组织病理学相关性：漩涡中的关键。

IF 13.1 1区医学 Q1 OPHTHALMOLOGY

Ophthalmology

Pub Date : 2025-02-01 DOI: 10.1016/j.ophtha.2024.03.011

Vijitha S. Vempuluru MD , Saumya Jakati MD , Swathi Kaliki MD

引用次数: 0

Ptosis Crutches: An Eye Opening Solution 上睑下垂拐杖：大开眼界的解决方案

IF 13.1 1区医学 Q1 OPHTHALMOLOGY

Ophthalmology

Pub Date : 2025-02-01 DOI: 10.1016/j.ophtha.2024.03.009

Nkechi N. Nwabueze MD, Rachel K. Sobel MD

引用次数: 0

The Clinical Usefulness of a Glaucoma Polygenic Risk Score in 4 Population-Based European Ancestry Cohorts 青光眼多基因风险评分在四个欧洲裔人群队列中的临床实用性。

IF 13.1 1区医学 Q1 OPHTHALMOLOGY

Ophthalmology

Pub Date : 2025-02-01 DOI: 10.1016/j.ophtha.2024.08.005

Victor A. de Vries MD , Akiko Hanyuda MD, MPH , Joëlle E. Vergroesen PhD , Ron Do PhD , David S. Friedman MD, PhD , Peter Kraft PhD , Constance Turman MS , Yuyang (Leo) Luo PhD , Jessica H. Tran MD, MS , Bart Liefers PhD , Sze H. Wong MD , Rachel H. Lee MD, MPH , Nazlee Zebardast MD, MSc , Caroline C.W. Klaver MD, PhD , Ayellet V. Segrè PhD, MSc , Louis R. Pasquale MD , Janey L. Wiggs MD, PhD , Jae H. Kang PhD , Wishal D. Ramdas MD, PhD

Purpose

We used a polygenic risk score (PRS) to identify high-risk groups for primary open-angle glaucoma (POAG) within population-based cohorts.

Design

Secondary analysis of 4 prospective population-based studies.

Participants

We included four European-ancestry cohorts: the United States-based Nurses’ Health Study, Nurses’ Health Study 2, and the Health Professionals Follow-up Study and the Rotterdam Study (RS) in The Netherlands. The United States cohorts included female nurses and male health professionals ≤ 55 years of age. The RS included residents ≤ 45 years of age living in Rotterdam, The Netherlands.

Methods

Polygenic risk score weights were estimated by applying the lassosum method on imputed genotype and phenotype data from the UK Biobank. This resulted in 144 020 variants, single nucleotide polymorphism and insertions or deletions, with nonzero βs that we used to calculate a PRS in the target populations. Using multivariable Cox proportional hazard models, we estimated the relationship between the standardized PRS and relative risk for POAG. Additionally, POAG prediction was tested by calculating these models’ concordance (Harrell’s C statistic). Finally, we assessed the association between PRS tertiles and glaucoma-related traits.

Main Outcome Measures

The relative risk for POAG and Harrell’s C statistic.

Results

Among 1046 patients and 38 809‬ control participants, the relative risk (95% confidence interval) for POAG for participants in the highest PRS quintile was 3.99 (3.08–5.18) times higher in the United States cohorts and 4.89 (2.93–8.17) times higher in the RS, compared with participants with median genetic risk (third quintile). Combining age, sex, intraocular pressure of more than 25 mmHg, and family history resulted in a meta-analyzed concordance of 0.75 (95% CI, 0.73–0.75). Adding the PRS to this model improved the concordance to 0.82 (95% CI, 0.80–0.84). In a meta-analysis of all cohorts, patients in the highest tertile showed a larger cup-to-disc ratio at diagnosis, by 0.10 (95% CI, 0.06–0.14), and a 2.07-fold increased risk of requiring glaucoma surgery (95% CI, 1.19–3.60).

Conclusions

Incorporating a PRS into a POAG predictive model improves identification concordance from 0.75 up to 0.82, supporting its potential for guiding more cost-effective screening strategies.

Financial Disclosure(s)

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

目的：我们使用多基因风险评分（PRS）在人群队列中识别原发性开角型青光眼（POAG）的高风险群体：我们使用多基因风险评分（PRS）在基于人群的队列中识别原发性开角型青光眼（POAG）的高风险人群：设计：对四项前瞻性人群研究进行二次分析：我们纳入了四项欧洲人群队列研究：基于美国的护士健康研究（NHS）、NHS2、卫生专业人员随访研究以及荷兰的鹿特丹研究（RS）。美国队列包括 55 岁以上的女护士和男性保健专业人员。RS 包括居住在荷兰鹿特丹的 45 岁或以上的居民：PRS权重是通过对来自英国生物库（UK-Biobank）的估算基因型和表型数据应用Lassosum方法进行估算的。这样就得到了 144,020 个变体，包括单核苷酸多态性（SNP）和嵌合体，我们用这些变体计算目标人群的 PRS，其 Betas 均不为零。我们使用多变量 Cox 比例危险模型估算了标准化 PRS 与 POAG 相对风险之间的关系。此外，我们还通过计算这些模型的一致性（Harrell's C 统计量）对 POAG 预测进行了检验。最后，我们评估了 PRS tertiles 与青光眼相关特征之间的关联：POAG 的相对风险和 Harrell 的 C 统计量（相当于纵向模型的曲线下面积）：在 1,046 例病例和 38,809 例对照中，与遗传风险中位数（第 3 个五分位数）的参与者相比，PRS 最高五分位数参与者的 POAG 相对风险（95% 置信区间）在美国队列中为 3.99（3.08，5.18），在鹿特丹研究中为 4.89（2.93，8.17）。在限制性立方样条分析中，连续 PRS 与 POAG 风险之间的关系在美国和鹿特丹队列中呈指数增长（Pspline25 mmHg），家族史导致荟萃分析的一致性为 0.75（0.73，0.75）。将 PRS 加入该模型后，一致性提高到 0.82（0.80，0.84）。在对所有队列进行的荟萃分析中，最高三分位数的病例在确诊时杯盘比值较大，增加了 0.11 (0.07, 0.15)，需要进行青光眼手术的风险增加了 2.07 倍 (1.19, 3.60)：将 PRS 纳入 POAG 预测模型可将识别一致性从 0.75 提高到 0.82，从而支持其在指导更具成本效益的筛查策略方面的潜力。

{"title":"The Clinical Usefulness of a Glaucoma Polygenic Risk Score in 4 Population-Based European Ancestry Cohorts","authors":"Victor A. de Vries MD , Akiko Hanyuda MD, MPH , Joëlle E. Vergroesen PhD , Ron Do PhD , David S. Friedman MD, PhD , Peter Kraft PhD , Constance Turman MS , Yuyang (Leo) Luo PhD , Jessica H. Tran MD, MS , Bart Liefers PhD , Sze H. Wong MD , Rachel H. Lee MD, MPH , Nazlee Zebardast MD, MSc , Caroline C.W. Klaver MD, PhD , Ayellet V. Segrè PhD, MSc , Louis R. Pasquale MD , Janey L. Wiggs MD, PhD , Jae H. Kang PhD , Wishal D. Ramdas MD, PhD","doi":"10.1016/j.ophtha.2024.08.005","DOIUrl":"10.1016/j.ophtha.2024.08.005","url":null,"abstract":"<div><h3>Purpose</h3><div>We used a polygenic risk score (PRS) to identify high-risk groups for primary open-angle glaucoma (POAG) within population-based cohorts.</div></div><div><h3>Design</h3><div>Secondary analysis of 4 prospective population-based studies.</div></div><div><h3>Participants</h3><div>We included four European-ancestry cohorts: the United States-based Nurses’ Health Study, Nurses’ Health Study 2, and the Health Professionals Follow-up Study and the Rotterdam Study (RS) in The Netherlands. The United States cohorts included female nurses and male health professionals ≤ 55 years of age. The RS included residents ≤ 45 years of age living in Rotterdam, The Netherlands.</div></div><div><h3>Methods</h3><div>Polygenic risk score weights were estimated by applying the lassosum method on imputed genotype and phenotype data from the UK Biobank. This resulted in 144 020 variants, single nucleotide polymorphism and insertions or deletions, with nonzero βs that we used to calculate a PRS in the target populations. Using multivariable Cox proportional hazard models, we estimated the relationship between the standardized PRS and relative risk for POAG. Additionally, POAG prediction was tested by calculating these models’ concordance (Harrell’s C statistic). Finally, we assessed the association between PRS tertiles and glaucoma-related traits.</div></div><div><h3>Main Outcome Measures</h3><div>The relative risk for POAG and Harrell’s C statistic.</div></div><div><h3>Results</h3><div>Among 1046 patients and 38 809‬ control participants, the relative risk (95% confidence interval) for POAG for participants in the highest PRS quintile was 3.99 (3.08–5.18) times higher in the United States cohorts and 4.89 (2.93–8.17) times higher in the RS, compared with participants with median genetic risk (third quintile). Combining age, sex, intraocular pressure of more than 25 mmHg, and family history resulted in a meta-analyzed concordance of 0.75 (95% CI, 0.73–0.75). Adding the PRS to this model improved the concordance to 0.82 (95% CI, 0.80–0.84). In a meta-analysis of all cohorts, patients in the highest tertile showed a larger cup-to-disc ratio at diagnosis, by 0.10 (95% CI, 0.06–0.14), and a 2.07-fold increased risk of requiring glaucoma surgery (95% CI, 1.19–3.60).</div></div><div><h3>Conclusions</h3><div>Incorporating a PRS into a POAG predictive model improves identification concordance from 0.75 up to 0.82, supporting its potential for guiding more cost-effective screening strategies.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"132 2","pages":"Pages 228-237"},"PeriodicalIF":13.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Demographic and Ocular Comorbidities in Elderly Individuals with Corneal Ulcers 患有角膜溃疡的老年人的人口统计学和眼部并发症。

IF 13.1 1区医学 Q1 OPHTHALMOLOGY

Ophthalmology

Pub Date : 2025-02-01 DOI: 10.1016/j.ophtha.2024.10.035

Jihwan Hwang BA , Gavin Li BS , Arvind Sommi BS , Janek Klawe MA , Esen Akpek MD , Sumayya Ahmad MD

引用次数: 0

Special Commentary: Reporting Clinical Endpoints in Studies of Minimally Invasive Glaucoma Surgery 在微创青光眼手术研究中报告临床终点。

IF 13.1 1区医学 Q1 OPHTHALMOLOGY

Ophthalmology

Pub Date : 2025-02-01 DOI: 10.1016/j.ophtha.2024.07.030

Steven J. Gedde MD , Kateki Vinod MD , Eileen C. Bowden MD , Natasha N. Kolomeyer MD , Vikas Chopra MD , Pratap Challa MD , Donald L. Budenz MD, MPH , Michael X. Repka MD, MBA , Flora Lum MD

Minimally invasive glaucoma surgery (MIGS) refers to a group of procedures generally characterized by an ab interno approach, minimal trauma to ocular tissue, moderate efficacy, an excellent safety profile, and rapid recovery. The number of MIGS procedures continues to increase, and their use has become widespread among glaucoma and cataract specialists. Standardization of the methodology and reporting of clinical endpoints in MIGS investigations enhances interpretation and comparison across different studies. The assessment of surgical interventions not only should consider statistical significance, but also whether the outcome is meaningful to patients. Minimal clinically important difference (MCID) is defined as the smallest change in a treatment outcome that is considered beneficial for an individual patient and prompts a change in their clinical management. Expert consensus is an accepted approach to determine the MCID. The American Academy of Ophthalmology’s Glaucoma Preferred Practice Pattern® Committee is an expert panel that develops guidelines identifying characteristics and components of quality eye care. The Committee recommends that the cumulative probability of surgical success at 2 years with Kaplan–Meier survival analysis be used as the primary efficacy endpoint in MIGS studies. The Committee suggests that surgical success for standalone MIGS be defined as intraocular pressure (IOP) of 21 mmHg or less and reduced by 20% or more from baseline without an increase in glaucoma medications, additional laser or incisional glaucoma surgery, loss of light perception vision, or hypotony. The proposed MCID for the cumulative probability of success of standalone MIGS at 2 years is 50%. The panel recommends that surgical success for MIGS combined with cataract extraction with intraocular lens implantation (CE-IOL) be defined as a decrease in glaucoma medical therapy of 1 medication or more from baseline without an increase in IOP or IOP of 21 mmHg or less and reduced by 20% or more from baseline without an increase in glaucoma medications, additional laser or incisional glaucoma surgery, loss of light perception vision, or hypotony. The suggested MCID for the cumulative probability of success for MIGS combined with CE-IOL at 2 years is 65%.

Financial Disclosure(s)

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

微创青光眼手术（MIGS）指的是一组手术，其一般特点是采用室内方法，对眼部组织的创伤最小，疗效适中，安全性高，恢复迅速。MIGS 手术的数量不断增加，在青光眼和白内障专科医生中已得到广泛应用。MIGS 研究方法和临床终点报告的标准化有助于不同研究之间的解释和比较。手术干预的评估不仅要考虑统计意义，还要考虑结果是否对患者有意义。最小临床意义差异（MCID）被定义为治疗结果中对个体患者有益并促使其改变临床管理的最小变化，专家共识是确定 MCID 的公认方法。美国眼科学会青光眼首选实践模式小组是一个专家小组，负责制定指导方针，确定优质眼科护理的特征和组成部分。该小组建议，在 MIGS 研究中，使用 Kaplan-Meier 生存分析法将 2 年后手术成功的累积概率作为主要疗效终点。专家小组建议，独立 MIGS 的手术成功定义为眼压 (IOP) ≤ 21 mmHg 且比基线降低≥ 20%，且未增加青光眼药物、未进行额外的激光或切口青光眼手术、未丧失光感视力或眼睑下垂。建议独立 MIGS 2 年的累积成功概率 MCID 为 50%。专家小组建议，MIGS 联合白内障摘除术与眼内人工晶体植入术（CE-IOL）的手术成功定义为：青光眼药物治疗比基线减少≥ 1 种药物且眼压未增加，或眼压≤ 21 mmHg 且比基线减少≥ 20%，且未增加青光眼药物、额外的激光或切口青光眼手术、光感视力丧失或眼压过低。CE-IOL/MIGS 2 年的累积成功概率的建议 MCID 为 65%。

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引用次数: 0

Ocular Neovascular Conversion and Systemic Bleeding Complications in Patients with Age-Related Macular Degeneration on Anticoagulants 使用 DOACs 或华法林的老年性视网膜病变患者眼部新生血管转换和全身出血并发症的风险。

IF 13.1 1区医学 Q1 OPHTHALMOLOGY

Ophthalmology

Pub Date : 2025-02-01 DOI: 10.1016/j.ophtha.2024.07.034

Amer F. Alsoudi MD , Euna Koo MD , Karen Wai MD , Prithvi Mruthyunjaya MD, MHS , Ehsan Rahimy MD

Purpose

Conversion to neovascular disease in patients with non-neovascular age-related macular degeneration (AMD) initiated on direct oral anticoagulants (DOACs) compared with matched patients treated with warfarin.

Design

Retrospective cohort study.

Participants

The study included 20 300 patients and 13 387 patients with non-neovascular AMD initiated on DOACs or warfarin, respectively, before propensity score matching (PSM).

Methods

TriNetX was used to identify patients diagnosed with non-neovascular AMD stratified by treatment with DOACs or warfarin with at least 6 months of follow-up. Propensity score matching was performed to control for baseline demographics and medical comorbidities.

Main Outcome Measures

Relative risk (RR) of developing neovascular AMD, macular hemorrhage (MH), vitreous hemorrhage (VH), and requiring an ocular intervention (intravitreal anti-VEGF therapy or pars plana vitrectomy [PPV]) within 6 months and 1 year. Patients with chronic atrial fibrillation (AF) on anticoagulation were separately evaluated for the same measures within 5 years after initiating therapy.

Results

Treatment with warfarin was associated with a higher risk of developing neovascular AMD at 6 months (RR, 1.24, 95% confidence interval [CI], 1.12–1.39; P < 0.001) and 1 year (RR, 1.26, 95% CI, 1.14–1.40; P < 0.001) when compared with matched patients treated with DOACs. There was an increased risk of requiring intravitreal anti-VEGF therapy (6 months: RR, 1.30; 95% CI, 1.13–1.49; P < 0.001; 1 year: RR, 1.31, 95% CI, 0.72–2.05; P < 0.001) and PPV (6 months: RR, 2.13; 95% CI, 1.16–3.94; P = 0.01; 1 year: RR, 2.29, 95% CI, 1.30–4.05; P = 0.003). Among patients with AMD and AF treated with warfarin, there was an increased risk of ocular complications (neovascular AMD: RR, 1.25; 95% CI, 1.14–1.38; P < 0.001; MH: RR, 1.86; 95% CI, 1.47–2.35; P < 0.001; VH: RR, 2.22; 95% CI, 1.51–3.26; P < 0.001) and need for intravitreal anti-VEGF therapy (RR, 1.34; 95% CI, 1.18–1.52; P < 0.001) over an extended 5-year period. There was no significant difference in the development of major systemic hemorrhagic events between the 2 cohorts over 5 years.

Conclusions

Patients with non-neovascular AMD treated with warfarin were more likely to develop neovascular disease and require ocular intervention for hemorrhagic complications when compared with matched patients initiated on DOACs.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found after the references.

目的：与接受华法林治疗的匹配患者相比，接受直接口服抗凝剂（DOAC）治疗的非新生血管性老年性黄斑变性（AMD）患者转为新生血管性疾病的情况：研究对象、参与者和/或对照组：该研究纳入了20300名患者和13387名患者，他们都是在倾向评分匹配（PSM）前开始使用DOAC或华法林治疗的非新血管性AMD患者：采用 TriNetX（美国马萨诸塞州剑桥市）来识别诊断为非血管性 AMD 的患者，并按照使用 DOACs 或华法林治疗且随访至少 6 个月进行分层。进行倾向评分匹配以控制基线人口统计学和医疗合并症：主要结局指标：6个月和1年内发生新生血管性AMD、黄斑出血（MH）、玻璃体出血（VH）以及需要眼部干预（玻璃体内抗血管内皮生长因子（VEGF）治疗或玻璃体旁切除术（PPV））的相对风险（RR）。对接受抗凝治疗的慢性心房颤动（房颤）患者在开始治疗后5年内的相同指标进行了单独评估：结果：接受华法林治疗的患者在六个月内罹患新生血管性黄斑变性的风险较高（RR,1.24, 95% CI, 1.12 - 1.39; PC结论：接受华法林治疗的非新生血管性黄斑变性患者在六个月内罹患新生血管性黄斑变性的风险较高：与接受 DOACs 治疗的匹配患者相比，接受华法林治疗的非新生血管性 AMD 患者更有可能罹患新生血管性疾病，并需要对出血性并发症进行眼科干预。

{"title":"Ocular Neovascular Conversion and Systemic Bleeding Complications in Patients with Age-Related Macular Degeneration on Anticoagulants","authors":"Amer F. Alsoudi MD , Euna Koo MD , Karen Wai MD , Prithvi Mruthyunjaya MD, MHS , Ehsan Rahimy MD","doi":"10.1016/j.ophtha.2024.07.034","DOIUrl":"10.1016/j.ophtha.2024.07.034","url":null,"abstract":"<div><h3>Purpose</h3><div>Conversion to neovascular disease in patients with non-neovascular age-related macular degeneration (AMD) initiated on direct oral anticoagulants (DOACs) compared with matched patients treated with warfarin.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Participants</h3><div>The study included 20 300 patients and 13 387 patients with non-neovascular AMD initiated on DOACs or warfarin, respectively, before propensity score matching (PSM).</div></div><div><h3>Methods</h3><div>TriNetX was used to identify patients diagnosed with non-neovascular AMD stratified by treatment with DOACs or warfarin with at least 6 months of follow-up. Propensity score matching was performed to control for baseline demographics and medical comorbidities.</div></div><div><h3>Main Outcome Measures</h3><div>Relative risk (RR) of developing neovascular AMD, macular hemorrhage (MH), vitreous hemorrhage (VH), and requiring an ocular intervention (intravitreal anti-VEGF therapy or pars plana vitrectomy [PPV]) within 6 months and 1 year. Patients with chronic atrial fibrillation (AF) on anticoagulation were separately evaluated for the same measures within 5 years after initiating therapy.</div></div><div><h3>Results</h3><div>Treatment with warfarin was associated with a higher risk of developing neovascular AMD at 6 months (RR, 1.24, 95% confidence interval [CI], 1.12–1.39; <em>P <</em> 0.001) and 1 year (RR, 1.26, 95% CI, 1.14–1.40; <em>P <</em> 0.001) when compared with matched patients treated with DOACs. There was an increased risk of requiring intravitreal anti-VEGF therapy (6 months: RR, 1.30; 95% CI, 1.13–1.49; <em>P <</em> 0.001; 1 year: RR, 1.31, 95% CI, 0.72–2.05; <em>P <</em> 0.001) and PPV (6 months: RR, 2.13; 95% CI, 1.16–3.94; <em>P</em> = 0.01; 1 year: RR, 2.29, 95% CI, 1.30–4.05; <em>P</em> = 0.003). Among patients with AMD and AF treated with warfarin, there was an increased risk of ocular complications (neovascular AMD: RR, 1.25; 95% CI, 1.14–1.38; <em>P <</em> 0.001; MH: RR, 1.86; 95% CI, 1.47–2.35; <em>P <</em> 0.001; VH: RR, 2.22; 95% CI, 1.51–3.26; <em>P <</em> 0.001) and need for intravitreal anti-VEGF therapy (RR, 1.34; 95% CI, 1.18–1.52; <em>P <</em> 0.001) over an extended 5-year period. There was no significant difference in the development of major systemic hemorrhagic events between the 2 cohorts over 5 years.</div></div><div><h3>Conclusions</h3><div>Patients with non-neovascular AMD treated with warfarin were more likely to develop neovascular disease and require ocular intervention for hemorrhagic complications when compared with matched patients initiated on DOACs.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found after the references.</div></div>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"132 2","pages":"Pages 219-227"},"PeriodicalIF":13.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907263","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

Eyelid Metastatic Renal Clear Cell Carcinoma Mimics Sebaceous Carcinoma 眼睑转移性肾透明细胞癌与皮脂腺癌相似

IF 13.1 1区医学 Q1 OPHTHALMOLOGY

Ophthalmology

Pub Date : 2025-02-01 DOI: 10.1016/j.ophtha.2024.02.010

Mingpeng Xu MD , Chuandi Zhou MD, PhD , Jiang Li MD, PhD

引用次数: 0

Perspectives on the Incidence of Acanthamoeba Keratitis 关于棘阿米巴角膜炎发病率的观点：系统回顾与元分析》。

IF 13.1 1区医学 Q1 OPHTHALMOLOGY

Ophthalmology

Pub Date : 2025-02-01 DOI: 10.1016/j.ophtha.2024.08.003

Francesco Aiello MD, PhD , Gabriele Gallo Afflitto MD , Francesca Ceccarelli MD , Maria Vittoria Turco MD , Yuyi Han MD , Guillermo Amescua MD , John K. Dart MD , Carlo Nucci MD, PhD

Topic

To provide an overview on the incidence of Acanthamoeba keratitis (AK).

Clinical Relevance

Although being a sight-threatening cause of infectious keratitis, a comprehensive assessment of the incidence of AK is lacking.

Methods

Incidence of AK was computed as the number of eyes with AK per health care center, per year (annualized center incidence [ACI]). Two meta-analytical ratios also were calculated: (1) the ratio of eyes with AK to the count of eyes with nonviral microbial keratitis (MK) and (2) the ratio of eyes with AK to the overall population (i.e., the total number of people in a nation or region, as indicated by the authors in each study). Center was defined as the health care facility where the study took place. Actual and projected estimates of the number of eyes with AK in years were calculated multiplying the ratio of eyes with AK to the total population and the corresponding population estimates, sourced from the United Nations Population Prospects.

Results

Overall, 105 articles were included, published between 1987 and 2022. The total number of eyes identified was 91 951, with 5660 eyes affected by AK and 86 291 eyes affected by nonviral MK. The median ACI was 1.9 eyes with AK per health care center per year (95% confidence interval [CI], 1.5–2.6 eyes), with no statistically significant differences among continents. The ratio of eyes with AK to the total number of eyes with MK was 1.52% (95% CI, 1.03%–2.22%), whereas the ratio of eyes with AK in relationship to the entire population was estimated at 2.34 eyes per 1 000 000 people (95% CI, 0.98–5.55 per 1 000 000 people). The projected increase in the numbers of eyes with AK indicated an increase of 18.5% (n = 15 355 eyes with AK) in 2053 and 25.5% (n = 16 253 eyes with AK) in 2073, compared with the baseline of 2023 (n = 12 953 eyes with AK).

Discussion

Acanthamoeba keratitis emerged as a relatively low-incident disorder, and no significant differences in terms of its incidence were found among different continents.

Financial Disclosure(s)

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

主题概述阿卡阿米巴角膜炎（AK）的发病率：临床相关性：尽管阿卡阿米巴角膜炎是导致人群感染性角膜炎的主要原因之一，并对视力构成威胁，但目前尚缺乏对其发病率的全面评估：方法：AK的发病率按每个医疗中心每年的AK眼数计算（年化中心发病率，或ACI）。此外，还计算了两个元分析比率：a）AK 眼数与非病毒性微生物角膜炎（MK）眼数之比；b）AK 眼数与总人口（即每个研究中作者标明的一个国家或地区的受试者总数）之比。中心是指进行研究的医疗机构（如医院、私人诊所、诊所）。实际和预测的 AK 眼年估计数是根据联合国（UN）《人口展望》中提供的 AK 占总人口的比例，乘以相应的目前和预测人口估计数（年龄范围：15 至 70 岁）计算得出的：总共纳入了 105 篇发表于 1987 年至 2022 年的文章。确定的眼球总数为 91,951 只，其中 5,660 只受 AK 影响，86,291 只受非病毒性 MK 影响。每个医疗中心的 ACI 中位数为每年新增 1.9 只 AK 眼（中位数的 95%CI 为 1.5 至 2.6），各大洲之间无显著统计学差异。AK 眼与 MK 眼总数的比率为 1.52%（95%CI：1.02% 至 2.24%），而 AK 与整个人口的比率估计为 0.0002%（95%CI：0.0001 至 0.0006），即每 100 万受试者中有 2.34 只眼（95%CI：每 100 万受试者中有 0.98 至 5.55 只眼）。与 2023 年的基线（12,954 只 AK 眼）相比，预计 AK 眼数在 2053 年和 2073 年将分别增加 18.5%（15,356 只 AK 眼）和 25.5%（16,253 只 AK 眼）。

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