Ophthalmology science最新文献

{"title":"Choroidal Vascular Remodeling and Retinal Response After Aflibercept Loading in Diabetic Macular Edema","authors":"Ye Eun Han MD, PhD ,&nbsp;Leegoni Choi ,&nbsp;Dahye Jung ,&nbsp;Yulim Kim BA ,&nbsp;Soo Jin Kim PhD ,&nbsp;Yoon Jeon Kim MD, PhD ,&nbsp;Young Hee Yoon MD, PhD ,&nbsp;Junyeop Lee MD, PhD","doi":"10.1016/j.xops.2025.101025","DOIUrl":"10.1016/j.xops.2025.101025","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate choroidal changes after aflibercept treatment for diabetic macular edema (DME) and to assess their association with treatment response.</div></div><div><h3>Design</h3><div>A retrospective interventional cohort study.</div></div><div><h3>Subjects</h3><div>Thirty eyes from 30 patients who were injection-naïve for DME and received initial 5 monthly loading injections of aflibercept.</div></div><div><h3>Methods</h3><div>Choroidal and retinal changes after loading injections were analyzed using spectral-domain OCT with enhanced depth imaging (EDI-SD-OCT) and ultra-widefield indocyanine green angiography (UWF-ICGA). The correlation between choroidal and retinal changes, along with factors associated with a good treatment response, was investigated.</div></div><div><h3>Main Outcome Measures</h3><div>Changes in subfoveal choroidal thickness (sfCT), total choroidal area (TA), luminal area (LA), stromal area (SA), and choroidal vascularity index (CVI) measured by EDI-SD-OCT; choroidal vascular density (CVD) and choroidal fractal dimension (CFD) of macula and widefield assessed by UWF-ICGA; as well as treatment response, including central retinal thickness (CRT) and inflammatory hyperreflective foci (HRF) evaluated through EDI-SD-OCT.</div></div><div><h3>Results</h3><div>Aflibercept induced a significant reduction in sfCT, TA, LA, and SA (all <em>P</em> &lt; 0.001), accompanied by an increase in CVI (<em>P</em>=0.005) on EDI-SD-OCT. On UWF-ICGA, CVD showed no significant change in either macular or widefield (<em>P</em> = 0.127 and 0.517, respectively), while CFD significantly decreased in both fields (<em>P</em> = 0.033 and 0.040, respectively). Decrease in TA, especially SA, and consequent CVI increase were significant factors associated with CRT reduction (<em>P</em> = 0.017, 0.004, and 0.044) and good treatment response in univariate analysis (<em>P</em> = 0.049, 0.026, and 0.047); however, only the reduction in inflammatory HRF maintained significance in multivariable analysis (<em>P</em> = 0.021 and 0.045). The reduction in inflammatory HRF was significantly associated with the decrease in TA, LA, and SA in univariate analysis (<em>P</em> = 0.001, 0.003, and 0.002), whereas only the decrease in sfCT remained significant in multivariable analysis (<em>P</em> = 0.027).</div></div><div><h3>Conclusions</h3><div>Aflibercept treatment induces stromal-dominant choroidal thinning with a consequent increase in CVI. This choroidal remodeling may be associated with the anatomical resolution of DME through mechanisms involving reduction of inflammatory HRF.</div></div><div><h3>Financial Disclosure(s)</h3><div>The authors have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"6 2","pages":"Article 101025"},"PeriodicalIF":4.6,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripapillary Choroidal Vascularity Index for Differentiating Papilledema from Pseudopapilledema: A Deep Learning–Based Approach","authors":"Nicola Valsecchi MD ,&nbsp;Lorenzo Padovani MD ,&nbsp;Elli Davis MD ,&nbsp;Mohammed Nasar Ibrahim PhD ,&nbsp;Anna Elena Vallone MD ,&nbsp;Matilde Roda MD ,&nbsp;Maurizio Mete MD ,&nbsp;Antonio Moramarco MD ,&nbsp;Costantino Schiavi MD, PhD ,&nbsp;Kiran Kumar Vupparaboina PhD ,&nbsp;Jay Chhablani MD ,&nbsp;Luigi Fontana MD, PhD","doi":"10.1016/j.xops.2025.101024","DOIUrl":"10.1016/j.xops.2025.101024","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the peripapillary choroidal vascularity index (PPCVI) in eyes with papilledema secondary to idiopathic intracranial hypertension (IIH) and pseudopapilledema due to optic disc drusen (ODD) using a novel deep learning algorithm.</div></div><div><h3>Design</h3><div>A retrospective observational cohort study.</div></div><div><h3>Subjects</h3><div>The study included 30 eyes of 15 patients with papilledema secondary to IIH, 30 eyes of 15 patients with ODD, and 78 eyes of 39 age- and sex-matched healthy controls. All cases of IIH and ODD were confirmed with lumbar puncture and B-scan ultrasonography, respectively.</div></div><div><h3>Methods</h3><div>OCT was performed using a 3.4 mm diameter 360° peripapillary circle scan. Choroidal segmentation was automatically performed with a deep learning ResUNet model and a volumetric smoothing algorithm. The choroidal vascularity index was quantified in each peripapillary scan. Statistical comparisons were made between groups and in IIH patients before and after resolution of papilledema. Linear mixed models were used for analysis.</div></div><div><h3>Main Outcome Measures</h3><div>Mean PPCVI, expressed as a percentage, across study groups and longitudinally in IIH eyes.</div></div><div><h3>Results</h3><div>There were no significant differences among groups regarding age, sex, visual acuity, or intraocular pressure (<em>P</em> &gt; 0.05). Mean PPCVI was significantly reduced in the papilledema group compared with the pseudopapilledema and control groups (31.7% ± 8.4% vs. 39.0% ± 8.1% and 40.7% ± 5.6%, respectively; <em>P</em> &lt; 0.001). After a mean follow-up of 36 ± 12.1 months, IIH patients with resolved papilledema showed a significant increase in PPCVI (34.8% ± 8.0% vs. 31.7% ± 8.4%, <em>P</em> = 0.033), although values remained lower compared with pseudopapilledema and control groups (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Reduced PPCVI could be a potential biomarker for differentiating papilledema from pseudopapilledema. An increase in PPCVI after resolution of papilledema supports its utility as a potential parameter for monitoring disease activity.</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":74363,"journal":{"name":"Ophthalmology science","volume":"6 2","pages":"Article 101024"},"PeriodicalIF":4.6,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalizing Personalized Medicine: The Pursuit of Optimal Thresholds in the Home OCT Artificial Intelligence Algorithm for Age-Related Macular Degeneration","authors":"Christina Y. Weng MD, MBA,&nbsp;Kevin J. Blinder MD,&nbsp;Edward F. Hall MD,&nbsp;William N. Rosenthal MD","doi":"10.1016/j.xops.2025.101017","DOIUrl":"10.1016/j.xops.2025.101017","url":null,"abstract":"","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"6 2","pages":"Article 101017"},"PeriodicalIF":4.6,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Statistical Methods for Clustered Eye Data with Skewed Distribution","authors":"Sifan Zhang ,&nbsp;Ziyi You MS ,&nbsp;Bernard Rosner PhD ,&nbsp;Gui-shuang Ying PhD","doi":"10.1016/j.xops.2025.101020","DOIUrl":"10.1016/j.xops.2025.101020","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the performance of various analysis approaches for skewed correlated eye data from 2 eyes of a subject in the same comparison group, which is common in ophthalmology and vision research.</div></div><div><h3>Design</h3><div>Simulation study and real data analysis.</div></div><div><h3>Subjects</h3><div>Simulated subjects and participants of the Dry Eye Assessment and Management (DREAM) study.</div></div><div><h3>Methods</h3><div>We simulated skewed correlated data using (skewness, kurtosis) = (27, 50) and (0.06, 5.9), intereye correlation (<em>ρ</em> = 0, 0.25, 0.50, and 0.75), sample sizes (<em>n</em> = 20, 50, 100, and 200), and mean differences between 2 groups (0 for type 1 error rate, 0.2 for statistical power). Each simulated data set was analyzed without and with applying rank-based normalization: (1) 2-sample <em>t</em> test of 2 eye data; (2) 2-sample <em>t</em> test of random eye data; (3) Wald test from generalized estimating equations (GEE Wald); (4) GEE score test (GEE score); (5) <em>F</em>-test from linear mixed effects model (LMM); (6) clustered Wilcoxon test of Rosner, Glynn, and Lee; (7) clustered Wilcoxon test of Datta and Satten; (8) Wilcoxon rank sum test of 2 eyes ignoring intereye correlation; and (9) Wilcoxon rank sum test on average of 2 eyes. We demonstrated analysis of skewed tear break-up time (TBUT) data from the DREAM study.</div></div><div><h3>Main Outcome Measures</h3><div>Type 1 error rate and statistical power.</div></div><div><h3>Results</h3><div><em>T</em> test and Wilcoxon test on 2 eye data without accounting for intereye correlation inflated type 1 error rate up to 0.13, and GEE Wald inflated type 1 error rate to 0.08 when sample size is small, whereas all other tests maintained type 1 error rate close to 0.05. For skewed data without normalization, <em>t</em> test of random eye, GEE Wald, GEE score, and LMM had substantially lower power than clustered Wilcoxon methods. After normalization, GEE score and LMM achieved similar or slightly higher power than clustered Wilcoxon methods. Results from analysis of TBUT are consistent with simulation findings.</div></div><div><h3>Conclusions</h3><div>When comparing skewed correlated eye measures between 2 groups of subjects with their 2 eyes in the same comparison group, clustered Wilcoxon methods can be used. Alternatively, skewed data can be normalized before applying GEE score or LMM, which may achieve slightly higher statistical power than clustered Wilcoxon methods and offers flexibility to adjust for other covariates.</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":74363,"journal":{"name":"Ophthalmology science","volume":"6 2","pages":"Article 101020"},"PeriodicalIF":4.6,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Randomizing Either One Eye or Both Eyes in Clinical Trials for Stargardt Disease Type 1","authors":"Jeroen A.A.H. Pas MD ,&nbsp;Patty P.A. Dhooge MD, PhD ,&nbsp;Catherina H.Z. Li MD ,&nbsp;Rob W.J. Collin PhD ,&nbsp;Carel B. Hoyng MD, PhD ,&nbsp;Joanna IntHout PhD","doi":"10.1016/j.xops.2025.101021","DOIUrl":"10.1016/j.xops.2025.101021","url":null,"abstract":"<div><h3>Objective</h3><div>Designing a clinical trial for rare diseases such as Stargardt disease type 1 is challenging due to the limited patient population. In traditional clinical trial designs for inherited retinal diseases, often only 1 eye of each patient is used as the treated eye or the sham, disregarding half of the available eyes.</div><div>This study explores a trial design in which both eyes are included, with the fellow eye serving as the control, maximizing the use of available data and enhancing statistical power.</div></div><div><h3>Design</h3><div>Retrospective analysis of natural history data to conduct sample size calculations.</div></div><div><h3>Participants</h3><div>Patients with genetically solved Stargardt disease type 1 who had at least 2 fundus autofluorescence measurements obtained within 5 years of each other. Retrospective data of 164 patients were included for analysis.</div></div><div><h3>Methods</h3><div>The required sample sizes for 1-eye and paired-eye study designs were calculated using retrospective natural history data on the progression of definitely decreased autofluorescence quantified from fundus autofluorescence imaging.</div></div><div><h3>Main Outcome Measures</h3><div>Required sample size for a clinical trial.</div></div><div><h3>Results</h3><div>Sample size calculations showed that 170 patients are needed for a 2-year clinical trial with a 1-eye design, decreasing to 99 patients for a 5-year trial. When using a paired-eye design, 64 patients are needed in a 2-year trial, decreasing to 28 patients in a 5-year trial. When using a paired-eye design and requiring definitely decreased autofluorescence atrophy in both eyes at inclusion, 37 patients were needed in a 2-year trial, decreasing to 16 patients in a 5-year trial.</div></div><div><h3>Conclusions</h3><div>Using a paired-eye design for a clinical trial in Stargardt disease type 1, with definitely decreased autofluorescence atrophy growth rate as the primary end point, is more efficient than a 1-eye design. Implementing additional inclusion criteria, such as requiring definitely decreased autofluorescence atrophy in both eyes at baseline, further reduces the number of patients needed to achieve sufficient statistical power. This approach enhances the feasibility for trials in Stargardt disease type 1 where patient availability is limited.</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":74363,"journal":{"name":"Ophthalmology science","volume":"6 2","pages":"Article 101021"},"PeriodicalIF":4.6,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Analysis of Instrument Motion Paths in Cataract Surgery across a Resident’s Training","authors":"David Mikhail MD(C), MSc ,&nbsp;Shuting Xie MSc ,&nbsp;Michael Balas MD ,&nbsp;Jason M. Kwok MD ,&nbsp;Ana Miguel MD, PhD ,&nbsp;Amrit Rai MD ,&nbsp;Amandeep Rai MD ,&nbsp;Peter J. Kertes MD ,&nbsp;Iqbal Ike K. Ahmed MD ,&nbsp;Matthew B. Schlenker MD, MSc","doi":"10.1016/j.xops.2025.101014","DOIUrl":"10.1016/j.xops.2025.101014","url":null,"abstract":"<div><h3>Purpose</h3><div>To objectively quantify the motion paths of surgical instruments during cataract surgery across a resident’s training, identifying patterns of skill acquisition and proficiency development.</div></div><div><h3>Design</h3><div>An <em>n</em> = 1 panel study.</div></div><div><h3>Subjects</h3><div>One ophthalmology resident performing cataract surgery.</div></div><div><h3>Methods</h3><div>One hundred cataract surgery videos performed by a single resident from their sixth to 760th case were collected. Advanced motion tracking software (Computer Vision Annotation Tool) was utilized to annotate and track the trajectories of 11 surgical instruments on a frame-by-frame basis. Monotonic trends were assessed using the Mann–Kendall test and Theil–Sen slope estimation, with Spearman correlation measuring the association between case number and performance metric values. Pettitt change-point analysis identified significant transitions in the resident’s skill progression.</div></div><div><h3>Main Outcome Measures</h3><div>Six key motion parameters, including total path length, average velocity, average acceleration, root mean square jerk, average angular change, and workspace coverage, were extracted for each instrument in each video.</div></div><div><h3>Results</h3><div>All 11 instruments demonstrated statistically significant reductions in ≥1 motion parameter. Path length consistently decreased across training, with the largest reductions seen in the cannula (–11.8%; 95% confidence interval [CI], –17.4% to –6.8%; <em>P</em> &lt; 0.001), phacoemulsification handpiece (–11.5%; 95% CI, –14.1% to –8.7%; <em>P</em> &lt; 0.001), and cystotome (–8.9%; 95% CI, –11.8% to –5.9%; <em>P</em> &lt; 0.001). The intraocular lens inserter showed the greatest reduction in average angular change of 3.0% (–1.70°) (95% CI, –3.9% to –2.0%; <em>P</em> &lt; 0.001). Pettitt analysis demonstrated significant shifts in surgical efficiency at around case 300 for most instruments, although improvements in certain advanced tasks (e.g., lens implantation) emerged later.</div></div><div><h3>Conclusions</h3><div>This large-scale, frame-by-frame motion tracking study revealed distinct instrument- and task-specific learning curves in cataract surgery, highlighting progressive changes in motion metrics over time. A significant shift at approximately case 300 marked a milestone in the resident’s instrument use patterns. These findings underscore the potential of objective, video-based motion tracking analytics to provide data-driven resident feedback, guiding targeted instruction and standardizing cataract surgery training.</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":74363,"journal":{"name":"Ophthalmology science","volume":"6 2","pages":"Article 101014"},"PeriodicalIF":4.6,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Vision-Related Quality of Life before and after Geographic Atrophy Development in Age-Related Eye Disease Study Participants","authors":"Minali Prasad BA,&nbsp;Susan Vitale PhD,&nbsp;Elvira Agrón MA,&nbsp;Thilaka Arunachalam MD,&nbsp;Emily Y. Chew MD","doi":"10.1016/j.xops.2025.101022","DOIUrl":"10.1016/j.xops.2025.101022","url":null,"abstract":"<div><h3>Objective</h3><div>To examine for change in vision-related quality of life before and after geographic atrophy (GA) development.</div></div><div><h3>Design</h3><div>A post hoc analysis of a prospective randomized clinical trial.</div></div><div><h3>Participants</h3><div>Age-Related Eye Disease Study (AREDS) participants with ≥2 study visits 1 year apart at which they completed the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) and age-related macular degeneration (AMD) severity gradings available at the VFQ visits.</div></div><div><h3>Methods</h3><div>A masked reading center assessed AMD severity using annual color fundus photographs. Regression spline models with random effects for time and eye-within-participant (SAS 9.4) were used to compare the rate of change in quality of life (difference in slope for each of the 4 quality of life measures) before and after development of GA (with separate models for GA subtypes: central GA [CGA], noncentral GA [NCGA], and any GA). Models were adjusted for age and visual acuity. If neovascular AMD developed after a GA outcome, we censored the subsequent observations.</div></div><div><h3>Main Outcome Measures</h3><div>Outcomes included the VFQ composite score calculated as an average score of nonmissing answered items. The method of successive dichotomizations was used to estimate person measures for the overall NEI VFQ-25 and for 2 derived subscales: visual functioning and social-emotional functioning.</div></div><div><h3>Results</h3><div>Among AREDS participants with NEI VFQ-25 data available, 358 eyes (298 participants) developed any GA. None of the quality of life measures differed significantly pre- and post-CGA. Rasch-calibrated subscale score for visual function and composite scores declined more quickly after NCGA (difference in slope [post minus pre]: –0.10 logit/yr [95% confidence interval: –0.18, –0.01], <em>P</em> = 0.03; –0.78 points/yr [95% confidence interval: –1.47, –0.08], <em>P</em> = 0.03, respectively) and after any GA (–0.09 logit/yr [95% confidence interval: –0.16, –0.01], <em>P</em> = 0.02; –0.68 points/yr [95% confidence interval: –1.29, –0.07], <em>P</em> = 0.03, respectively).</div></div><div><h3>Conclusions</h3><div>We observed worsening quality of life after development of NCGA and any GA in AREDS participants across several quality of life measures. Development of CGA was not associated with any significant changes in the quality of life measures, possibly due to the smaller sample size and limited power. Our findings highlight the importance of examining the relationship between GA subtypes and different indices of quality of life.</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":74363,"journal":{"name":"Ophthalmology science","volume":"6 2","pages":"Article 101022"},"PeriodicalIF":4.6,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomy- versus Sensitivity-Based Loci Preselection in Detecting USH2A-Retinopathy Microperimetric Progression","authors":"Jason Charng PhD ,&nbsp;David Alonso-Caneiro PhD ,&nbsp;Tina M. Lamey PhD ,&nbsp;Jennifer A. Thompson PhD ,&nbsp;Jeremiah K.H. Lim PhD ,&nbsp;Elaine Ong MD ,&nbsp;Terri L. McLaren BS ,&nbsp;Fred K. Chen PhD, FRANZCO","doi":"10.1016/j.xops.2025.101018","DOIUrl":"10.1016/j.xops.2025.101018","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare microperimetry progression rate in <em>USH2A-</em>retinopathy using prespecified points based on fundus autofluorescence coregistration with loci preselected based on retinal sensitivity profile.</div></div><div><h3>Design</h3><div>Cohort longitudinal study.</div></div><div><h3>Subjects</h3><div>Seventeen eyes from 17 patients with biallelic pathogenic variants in <em>USH2A</em> gene.</div></div><div><h3>Methods</h3><div>Microperimetry was recorded using 10-2 grid. The grid was partitioned into 68 2° × 2° nonoverlapping squares, representing the retinal coverage of each locus. Four metrics were defined at baseline: (1) mean macular sensitivity (MMS): average sensitivity of all loci; (2) edge of scotoma sensitivity (ESS): average sensitivity of all loci adjacent to a scotomatous loci at baseline; (3) modified Rate of Progression in <em>USH2A</em>-related Retinal Degeneration study-defined functional transitional point (mFTP): selection based on ranking of the proportion peripheral adjacent loci that showed ≥7 decibel (dB) decrease; and (4) hyperautofluorescent ring sensitivity (HRS): average sensitivity of stimulus squares which the hyperautofluorescent ring boundary transects into. Trend-based progression rates (gradient from linear regression) were compared between these metrics, and event-based analysis of the US Food and Drug Administration-defined clinically significant change in visual field (mean change of ≥7 dB across ≥5 prespecified loci).</div></div><div><h3>Main Outcome Measures</h3><div>Trend- and event-based measures in MMS, ESS, mFTP, and HRS.</div></div><div><h3>Results</h3><div>Seventeen patients (median age 37.0 years) had mean baseline values of 9.7 dB, 9.2 dB, 17.9 dB, and 13.1 dB for MMS, ESS, mFTP, and HRS, respectively. Using all longitudinal data (mean follow-up 4.0 years), trend analysis showed mFTP progression rate (–1.53 ± 1.37 dB/year) was significantly faster than MMS (–0.51 ± 0.63 dB/year) and ESS (–1.11 ± 1.23 dB/year) but similar to HRS (–1.29 ± 1.41 dB/year). Edge of scotoma sensitivity was more prone to floor effect and had lower baseline sensitivity than mFTP and HRS. In event-based analysis, the proportion of eyes that demonstrated clinically significant mean change was similar between ESS (2-year 36.4%, overall 45.5%), mFTP (2-year 33.3%, overall 43.8%), and HRS (2-year 28.5%, overall 42.9%) but noticeable less in MMS (2-year 13.3%, overall 12.5%).</div></div><div><h3>Conclusions</h3><div>Hyperautofluorescent ring sensitivity and mFTP showed comparable performance in both trend- and event-based analyses, superior to that of MMS and ESS. Additional advantage of mFTP is inclusion of patients without the autofluorescent ring.</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":74363,"journal":{"name":"Ophthalmology science","volume":"6 2","pages":"Article 101018"},"PeriodicalIF":4.6,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-Widefield Fundus Autofluorescence Findings as an Indicator of Duration in Rhegmatogenous Retinal Detachment","authors":"David L. Zhang MD,&nbsp;Isaac Bakis BS,&nbsp;Russel H. Dinh MD,&nbsp;Megan S. Steinkerchner MD,&nbsp;Avni P. Finn MD, MBA","doi":"10.1016/j.xops.2025.101016","DOIUrl":"10.1016/j.xops.2025.101016","url":null,"abstract":"<div><h3>Objective</h3><div>To describe and compare characteristics of rhegmatogenous retinal detachments (RRDs) on ultra-widefield (UWF) color fundus photography versus UWF fundus autofluorescence (FAF).</div></div><div><h3>Design</h3><div>A retrospective observational study.</div></div><div><h3>Participants</h3><div>Patients presenting with RRDs at 1 tertiary medical center from 2022 to 2025. Patients without UWF color and FAF imaging at initial presentation and those with total retinal detachments or poor image quality were excluded.</div></div><div><h3>Methods</h3><div>Rhegmatogenous retinal detachments were graded for the following characteristics: clock hours of detachment, quadrants involved, number of breaks, and macular involvement and compared between UWF fundus photography and FAF. Rhegmatogenous retinal detachment duration was determined by patient-reported symptom onset and categorized as acute (&lt;2 weeks) or chronic (&gt;2 weeks). Color photographs were further assessed for bullous appearance. Fundus autofluorescence images were also assessed for the presence of hyperautofluorescent dots and presence of a hyperautofluorescent leading edge of the detachment.</div></div><div><h3>Main Outcome Measures</h3><div>(1) Differences in detachment grading as assessed by UWF color photography versus autofluorescence and (2) association of hyperautofluorescent dots and leading edge with detachment duration.</div></div><div><h3>Results</h3><div>Ninety-three eyes of 92 patients with RRDs were included. Ultra-widefield color fundus photography and FAF were equivalent when evaluating clock hours, quadrants involved, and macular or foveal involvement (<em>P</em> &gt; 0.05). Bullous detachments were associated with a corrugated appearance on color photographs (<em>P</em> &lt; 0.001) and were associated with more acute detachments (<em>P</em> = 0.005) and uniform hypoautofluorescence over the area of detachment (<em>P</em> = 0.03). A hyperautofluorescent leading edge was significantly associated with symptom duration &lt;2 weeks (<em>P</em> = 0.01). In contrast, hyperautofluorescent dots on the area of detachment were associated with detachment duration &gt;2 weeks (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Fundus autofluorescence may be helpful in determining the duration of RRDs and aid in surgical planning. A hyperautofluorescent leading edge on FAF was associated with detachments of shorter duration, while hyperautofluorescent dots were associated with detachments of longer duration. These findings may be useful adjuncts in determining chronicity and be validated in future studies as a biomarker for pathophysiologic changes occurring with increased duration of retinal detachment.</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":74363,"journal":{"name":"Ophthalmology science","volume":"6 2","pages":"Article 101016"},"PeriodicalIF":4.6,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Randomized Study of Intravitreal Autologous CD34+ Stem Cells in Central Retinal Vein Occlusion (Treatment of Retinal vein occlusion Using STem cells [TRUST] Report 1): Safety and Feasibility. Ophthalmol Sci. 2026;6:100905”","authors":"","doi":"10.1016/j.xops.2025.101019","DOIUrl":"10.1016/j.xops.2025.101019","url":null,"abstract":"","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"6 2","pages":"Article 101019"},"PeriodicalIF":4.6,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}