Pub Date : 2024-10-23DOI: 10.1016/j.ophtha.2024.09.004
Nieraj Jain, Maureen G Maguire, Christina J Flaxel, Stephen J Kim, Shriji Patel, Justine R Smith, Christina Y Weng, Leo A Kim, Steven Yeh
Purpose: To review the evidence on the effectiveness of dietary supplementation for retinitis pigmentosa (RP).
Methods: A literature search of the PubMed database was last conducted in January 2024 to identify published English-language original research on dietary supplementation for RP. Eligible compounds included products ingested orally containing nutrients intended to supplement the diet. Studies meeting eligibility criteria were assigned a level of evidence rating by the panel methodologist.
Results: The search identified 283 citations, 15 of which met the assessment criteria. Two studies were rated level I, 11 studies were rated level II, and 2 studies were rated level III. All were single-center studies and were published between 1993 and 2022. The products evaluated included vitamin A, docosahexaenoic acid (DHA), lutein, vitamin E, goji berry (Lycium barbarum fruit) extract, and chlorogenic acid. Primary outcome measures were most commonly based on electroretinography (n = 7) or perimetry (n = 2) testing. Numerous studies highlighted data suggestive of possible efficacy for vitamin A, DHA, and lutein, yet these findings typically derived from secondary outcomes, evaluations of participant subsets, post hoc analyses, problematic interpretations of the data, or a combination thereof. Additionally, it was often unclear if the study findings represented clinically meaningful outcomes. No prominent safety concerns were reported in any study.
Conclusions: No high-quality evidence was found to support the effectiveness of any form of dietary supplementation for RP. The findings underscore the challenges of studying this rare and slowly progressive retinal disease. Future studies should leverage the enhanced recruitment abilities from collaborative research networks to refine eligibility criteria while using novel, clinically meaningful endpoints.
Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
目的：回顾膳食补充剂对视网膜色素变性（RP）有效性的证据：最后一次对PubMed数据库进行文献检索是在2024年1月，目的是确定已发表的有关视网膜色素变性膳食补充剂的英语原创研究。符合条件的化合物包括口服产品，其中含有旨在补充饮食的营养物质。符合资格标准的研究由专家组方法论专家进行证据等级评定：检索发现了 283 篇引文，其中 15 篇符合评估标准。2 项研究被评为 I 级，11 项研究被评为 II 级，2 项研究被评为 III 级。所有研究均为单中心研究，发表于 1993 年至 2022 年之间。接受评估的产品包括维生素 A、二十二碳六烯酸 (DHA)、叶黄素、维生素 E、枸杞子提取物和绿原酸。主要结果测量通常基于视网膜电图（7 项）或视周计（2 项）测试。许多研究强调了表明维生素 A、DHA 和叶黄素可能具有疗效的数据，但这些研究结果通常来自次要结果、对参与者子集的评估、事后分析、对数据的错误解释或上述因素的综合。此外，研究结果是否代表有临床意义的结果也往往不明确。所有研究均未报告突出的安全性问题：没有发现高质量的证据支持任何形式的膳食补充剂对 RP 有效。研究结果凸显了研究这种罕见且缓慢进展的视网膜疾病所面临的挑战。未来的研究应利用合作研究网络增强的招募能力来完善资格标准，同时采用新颖的、有临床意义的终点：专利或商业信息披露见本文末尾的 "脚注和披露"。
{"title":"Dietary Supplementation for Retinitis Pigmentosa: A Report by the American Academy of Ophthalmology.","authors":"Nieraj Jain, Maureen G Maguire, Christina J Flaxel, Stephen J Kim, Shriji Patel, Justine R Smith, Christina Y Weng, Leo A Kim, Steven Yeh","doi":"10.1016/j.ophtha.2024.09.004","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.09.004","url":null,"abstract":"<p><strong>Purpose: </strong>To review the evidence on the effectiveness of dietary supplementation for retinitis pigmentosa (RP).</p><p><strong>Methods: </strong>A literature search of the PubMed database was last conducted in January 2024 to identify published English-language original research on dietary supplementation for RP. Eligible compounds included products ingested orally containing nutrients intended to supplement the diet. Studies meeting eligibility criteria were assigned a level of evidence rating by the panel methodologist.</p><p><strong>Results: </strong>The search identified 283 citations, 15 of which met the assessment criteria. Two studies were rated level I, 11 studies were rated level II, and 2 studies were rated level III. All were single-center studies and were published between 1993 and 2022. The products evaluated included vitamin A, docosahexaenoic acid (DHA), lutein, vitamin E, goji berry (Lycium barbarum fruit) extract, and chlorogenic acid. Primary outcome measures were most commonly based on electroretinography (n = 7) or perimetry (n = 2) testing. Numerous studies highlighted data suggestive of possible efficacy for vitamin A, DHA, and lutein, yet these findings typically derived from secondary outcomes, evaluations of participant subsets, post hoc analyses, problematic interpretations of the data, or a combination thereof. Additionally, it was often unclear if the study findings represented clinically meaningful outcomes. No prominent safety concerns were reported in any study.</p><p><strong>Conclusions: </strong>No high-quality evidence was found to support the effectiveness of any form of dietary supplementation for RP. The findings underscore the challenges of studying this rare and slowly progressive retinal disease. Future studies should leverage the enhanced recruitment abilities from collaborative research networks to refine eligibility criteria while using novel, clinically meaningful endpoints.</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":""},"PeriodicalIF":13.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505260","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}
Pub Date : 2024-10-22DOI: 10.1016/j.ophtha.2024.09.023
Brice Dille
{"title":"Re: Singh: Transactional care and the looming glaucoma public health crisis (Ophthalmology 2024;131:877-879).","authors":"Brice Dille","doi":"10.1016/j.ophtha.2024.09.023","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.09.023","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505263","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}
Pub Date : 2024-10-22DOI: 10.1016/j.ophtha.2024.09.029
Muhammad Hanif, Muhammad Saad, Mujjaddad Rehman
{"title":"Double Crystalline Lens in a 3-Year-Old Child.","authors":"Muhammad Hanif, Muhammad Saad, Mujjaddad Rehman","doi":"10.1016/j.ophtha.2024.09.029","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.09.029","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505261","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}
Pub Date : 2024-10-22DOI: 10.1016/j.ophtha.2024.09.018
Yating Zhou, Fei Xue
{"title":"Re: Potter et al.: Concordance between self-reported visual difficulty and objective visual impairment: The National Health and Aging Trends Study (Ophthalmology. 2024 Jun 12:S0161-6420(24)00363-4.doi: 10.1016/j.ophtha.2024.06.009. Online ahead of print.).","authors":"Yating Zhou, Fei Xue","doi":"10.1016/j.ophtha.2024.09.018","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.09.018","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505262","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}
Pub Date : 2024-10-22DOI: 10.1016/j.ophtha.2024.09.003
Leo A Kim, Maureen G Maguire, Christina Y Weng, Justine R Smith, Nieraj Jain, Christina J Flaxel, Shriji Patel, Stephen J Kim, Steven Yeh
<p><strong>Purpose: </strong>To assess the safety and efficacy of the multiple therapeutic modalities for the treatment of central serous chorioretinopathy (CSCR).</p><p><strong>Methods: </strong>A literature search of English-language studies in the PubMed database with no date restrictions was last conducted in May 2024. The combined searches yielded 612 citations, 31 of which were selected for full-text review and for inclusion in this assessment. The panel methodologist assigned a level of evidence rating to each study. Six were assigned a level I rating, 23 were assigned a level II rating, and 2 were assigned a level III rating. Studies were categorized based on treatment modalities: laser-based therapy, intravitreal therapy, laser-based therapy versus intravitreal therapy, and systemic therapies. Within those categories, they were separated based on treatments for acute versus chronic CSCR.</p><p><strong>Results: </strong>One level I study showed that photodynamic therapy (PDT) using half-dose verteporfin for acute CSCR led to a significant decrease in subretinal fluid (SRF) with 95% of treated patients having no SRF at 12 months compared with 58% of untreated eyes with acute CSCR (P = 0.001). Anatomically, the mean CFT at 1 year was significantly lower in the treated group (161 ± 65 μm) versus the observation group (278 ± 92 μm) (P = 0.001). A second level I study compared half-dose verteporfin PDT versus 30%-dose verteporfin PDT and found that 94.6% in the half-dose PDT group had no SRF at 12 months compared with 75.4% in the 30%-dose PDT group (P = 0.004). The noninferiority of the 30%-dose PDT compared with half-dose PDT was not demonstrated. The VICI trial was a level I study that found no benefit with the use of mineralocorticoid antagonism with eplerenone for the treatment of chronic CSCR. With respect to the primary outcome of visual acuity (VA), the VICI trial found no significant difference at 12 months: 79.5 letters in the placebo group and 80.4 letters in the eplerenone group (P = 0.24). In general, the results from the other evaluated studies were inconsistent and thus inconclusive. There were no level I studies that supported the role of intravitreal anti-VEGF injections or systemic beta-blockers for patients with CSCR. A small level I study showed potential efficacy of Helicobacter pylori therapy for CSCR.</p><p><strong>Conclusions: </strong>There is evidence to support half-dose PDT for the treatment of acute CSCR regarding anatomic improvement, but less robust evidence supports improvement in VA or sustained anatomic benefit beyond 12 months. Intravitreal anti-VEGF injections and oral beta-blockers demonstrate inconsistent anatomic and visual benefits in patients with CSCR. The mineralocorticoid antagonist eplerenone has not been demonstrated as efficacious for treatment of chronic CSCR. The treatment of H. pylori infection may have some anatomic and visual benefit in the treatment of either acute or chronic CSCR. Acute CSC
{"title":"Therapies for Central Serous Chorioretinopathy: A Report by the American Academy of Ophthalmology.","authors":"Leo A Kim, Maureen G Maguire, Christina Y Weng, Justine R Smith, Nieraj Jain, Christina J Flaxel, Shriji Patel, Stephen J Kim, Steven Yeh","doi":"10.1016/j.ophtha.2024.09.003","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.09.003","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the safety and efficacy of the multiple therapeutic modalities for the treatment of central serous chorioretinopathy (CSCR).</p><p><strong>Methods: </strong>A literature search of English-language studies in the PubMed database with no date restrictions was last conducted in May 2024. The combined searches yielded 612 citations, 31 of which were selected for full-text review and for inclusion in this assessment. The panel methodologist assigned a level of evidence rating to each study. Six were assigned a level I rating, 23 were assigned a level II rating, and 2 were assigned a level III rating. Studies were categorized based on treatment modalities: laser-based therapy, intravitreal therapy, laser-based therapy versus intravitreal therapy, and systemic therapies. Within those categories, they were separated based on treatments for acute versus chronic CSCR.</p><p><strong>Results: </strong>One level I study showed that photodynamic therapy (PDT) using half-dose verteporfin for acute CSCR led to a significant decrease in subretinal fluid (SRF) with 95% of treated patients having no SRF at 12 months compared with 58% of untreated eyes with acute CSCR (P = 0.001). Anatomically, the mean CFT at 1 year was significantly lower in the treated group (161 ± 65 μm) versus the observation group (278 ± 92 μm) (P = 0.001). A second level I study compared half-dose verteporfin PDT versus 30%-dose verteporfin PDT and found that 94.6% in the half-dose PDT group had no SRF at 12 months compared with 75.4% in the 30%-dose PDT group (P = 0.004). The noninferiority of the 30%-dose PDT compared with half-dose PDT was not demonstrated. The VICI trial was a level I study that found no benefit with the use of mineralocorticoid antagonism with eplerenone for the treatment of chronic CSCR. With respect to the primary outcome of visual acuity (VA), the VICI trial found no significant difference at 12 months: 79.5 letters in the placebo group and 80.4 letters in the eplerenone group (P = 0.24). In general, the results from the other evaluated studies were inconsistent and thus inconclusive. There were no level I studies that supported the role of intravitreal anti-VEGF injections or systemic beta-blockers for patients with CSCR. A small level I study showed potential efficacy of Helicobacter pylori therapy for CSCR.</p><p><strong>Conclusions: </strong>There is evidence to support half-dose PDT for the treatment of acute CSCR regarding anatomic improvement, but less robust evidence supports improvement in VA or sustained anatomic benefit beyond 12 months. Intravitreal anti-VEGF injections and oral beta-blockers demonstrate inconsistent anatomic and visual benefits in patients with CSCR. The mineralocorticoid antagonist eplerenone has not been demonstrated as efficacious for treatment of chronic CSCR. The treatment of H. pylori infection may have some anatomic and visual benefit in the treatment of either acute or chronic CSCR. Acute CSC","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505266","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}
Pub Date : 2024-10-21DOI: 10.1016/j.ophtha.2024.09.016
Yaoming Liu, Rong Lu
{"title":"Microphthalmia with Orbital Cyst.","authors":"Yaoming Liu, Rong Lu","doi":"10.1016/j.ophtha.2024.09.016","DOIUrl":"https://doi.org/10.1016/j.ophtha.2024.09.016","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471545","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}
Pub Date : 2024-10-21DOI: 10.1016/j.ophtha.2024.08.027
Sandeep Ravindran PhD
{"title":"This Issue at a Glance","authors":"Sandeep Ravindran PhD","doi":"10.1016/j.ophtha.2024.08.027","DOIUrl":"10.1016/j.ophtha.2024.08.027","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"131 11","pages":"Page 1247"},"PeriodicalIF":13.1,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532436","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号