Ophthalmology science最新文献

{"title":"Age-Related Associations of Blood Pressure and Arterial Stiffness with Retinal Arterial Structure","authors":"Ran Xiang MD ,&nbsp;Yuki Muraoka MD, PhD ,&nbsp;Takahiro Kogo MD ,&nbsp;Yu Hidaka PhD ,&nbsp;Yuki Mori MD, PhD ,&nbsp;Masayuki Hata MD, PhD ,&nbsp;Masahiro Miyake MD, PhD ,&nbsp;Satoshi Morita PhD ,&nbsp;Yasuharu Tabara PhD ,&nbsp;Fumihiko Matsuda PhD ,&nbsp;Akitaka Tsujikawa MD, PhD","doi":"10.1016/j.xops.2025.100957","DOIUrl":"10.1016/j.xops.2025.100957","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the associations of systolic blood pressure (SBP) and arterial stiffness, measured via the cardio-ankle vascular index (CAVI), with retinal arterial structure assessed by OCT, and examine age-related differences.</div></div><div><h3>Design</h3><div>A cross-sectional analysis of a community-based Japanese cohort.</div></div><div><h3>Participants</h3><div>A total of 6969 adults (mean age, 57.6 years; 69.6% women) who underwent OCT imaging between 2012 and 2016.</div></div><div><h3>Methods</h3><div>Peripapillary circular OCT B-scans were used to assess the 4 largest retinal arteries. OCT-derived parameters included outer diameter (OD), inner diameter (ID), wall thickness, and wall reflectivity. Multivariable linear regression adjusted for demographic, ocular, and systemic covariates. Interaction analyses evaluated age modification, followed by analyses stratified by age (&lt;65 vs. ≥65 years).</div></div><div><h3>Main Outcome Measures</h3><div>OCT-based measurements of OD, ID, wall thickness, and wall reflectivity.</div></div><div><h3>Results</h3><div>Higher SBP was associated with smaller OD (β = –0.136, 95% confidence interval [CI]: –0.151 to –0.120) and ID (β = –0.136, 95% CI: –0.150 to –0.121). The CAVI was positively associated with wall reflectivity (β = 0.371, 95% CI: –0.081 to 0.822). Interaction analyses indicated age-related modification (SBP × age for OD: β = 0.005; ID: β = 0.005; CAVI × age for wall reflectivity: β = 0.030). In stratified analyses, the inverse associations of SBP with OD and ID were stronger in participants aged &lt;65 years (OD: β = –0.186; ID: β = –0.178) than in those aged ≥65 years (OD: β = –0.076; ID: β = –0.085). For CAVI, no clear association with wall reflectivity was found in participants aged &lt;65 years (β = –0.165), whereas a positive association was observed in those aged ≥65 years (β = 0.725).</div></div><div><h3>Conclusions</h3><div>OCT-based retinal arterial measurements revealed age-dependent associations with systemic vascular factors. In younger adults, elevated SBP was linked to narrower arterial diameters, reflecting functional vasoconstriction, whereas in older adults, greater wall reflectivity was associated with arterial stiffness, suggesting structural remodeling. These findings support OCT as a noninvasive tool for assessing different stages of microvascular aging, warranting confirmation in longitudinal studies.</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 1","pages":"Article 100957"},"PeriodicalIF":4.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519897","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 Datasheet for Age-Related Eye Disease Study 2 on the Database of Genotypes and Phenotypes","authors":"Souvick Mukherjee PhD,&nbsp;Akanksha Nagarkar BS, BA,&nbsp;Minali Prasad BA,&nbsp;Elvira Agron MA,&nbsp;Claire Weber PhD,&nbsp;Emily Y. Chew MD,&nbsp;Tharindu De Silva PhD","doi":"10.1016/j.xops.2025.100953","DOIUrl":"10.1016/j.xops.2025.100953","url":null,"abstract":"<div><h3>Objective</h3><div>To provide a comprehensive summary of the controlled-access Age-Related Eye Disease Study 2 (AREDS2) data elements, encompassing phenotypic, imaging, dietary, genetic, and ancillary data.</div></div><div><h3>Design</h3><div>Dataset description of a multicenter, phase III, randomized clinical trial evaluating lutein + zeaxanthin, ω-3, or both long-chain polyunsaturated fatty acid supplementation in intermediate age-related macular degeneration (AMD). Secondary randomization was offered to all AREDS2 participants to evaluate varying levels of zinc and the potential for elimination of β-carotene, which increases the risk of lung cancer in smokers.</div></div><div><h3>Participants</h3><div>A total of 4203 participants aged 50–85 years with bilateral intermediate AMD (bilateral large drusen ≥125 μm) or intermediate AMD in one eye and advanced AMD in the other eye were enrolled at 82 clinical centers between 2006 and 2008.</div></div><div><h3>Methods</h3><div>Participants attended annual clinic visits, including eye examinations, visual acuity, slit lamp, intraocular pressure, and imaging that included stereoscopic 30° color fundus (fields 1–3) and fundus reflex images in all participants, while fundus autofluorescence images and spectral-domain OCT images were acquired in selected clinics. Telephone contacts at 3 and 6 months and annually thereafter collected adverse events and reinforced visit compliance.</div></div><div><h3>Main Outcome Measures</h3><div>Progression to advanced AMD (central geographic atrophy or neovascular AMD), incidence of cataract surgery, and loss of ≥15 letters (≥3 lines) of visual acuity from baseline.</div></div><div><h3>Results</h3><div>Controlled-access data are archived under the database of Genotypes and Phenotypes (dbGaP) website with the accession number phs002015.v2.p1. The data elements include main-study phenotype tables plus multiple ancillary-study tables with cardiovascular, cognitive, nutritional biochemistry, and genetic data. Additional data include dietary assessments, image gradings, visual acuity testing, and cataract surgery documentation. Blood or saliva from &gt;2000 participants was collected; exome-chip data from &gt;1800 and whole-genome sequencing from 1363 participants, including 488 who also participated in the original AREDS, are available under the International AMD Genomics Consortium and dbGaP.</div></div><div><h3>Conclusions</h3><div>The AREDS2 dataset’s rigorous interventional design, standardized longitudinal ophthalmic imaging gradings, comprehensive dietary and genetic information, and ancillary cardiovascular and cognitive assessments constitute an invaluable resource for elucidating AMD progression, informing nutritional strategies, and artificial intelligence–driven diagnostics.</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 100953"},"PeriodicalIF":4.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694609","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":"Lipidome's Role in Diabetic Retinopathy Subtypes via Inflammation: Mendelian Randomization and Mediation Analysis","authors":"Xiaotong Xu MD, MB ,&nbsp;Nianen Liu MM, MB ,&nbsp;Kaixuan Dong MD, MB ,&nbsp;Shuai Ouyang MD, MB ,&nbsp;Weihong Yu MD, PhD","doi":"10.1016/j.xops.2025.100951","DOIUrl":"10.1016/j.xops.2025.100951","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to explore the causal relationships between plasma lipidome, inflammatory cytokines, and diabetic retinopathy (DR) subtypes using a two-sample Mendelian randomization (MR) approach and mediation analysis.</div></div><div><h3>Design</h3><div>Mendelian randomization study and mediation analysis.</div></div><div><h3>Subjects</h3><div>Genome-wide association study (GWAS) data of 179 plasma lipid species and 91 inflammatory cytokines from the public GWAS database. Genome-wide association study data of DR and its subtypes from the FinnGen consortium.</div></div><div><h3>Methods</h3><div>Primary causal estimates were derived via inverse-variance weighted method, complemented by 4 sensitivity methods (weighted median, MR-Egger, simple mode, weighted mode). Mediation analysis was performed to determine the extent to which inflammatory cytokines mediate the effects of lipid species on DR subtypes. The Cochran Q-test, MR-Egger intercept test, and leave-one-out were used for sensitivity analyses. Mendelian randomization-Egger regression and Mendelian Randomization Pleiotropy RESidual Sum and Outlier were used to detect potential directional pleiotropy. We employed a two-sample MR analysis to assess the causal effects of specific lipid species on the risk of DR and its subtypes. Genome-wide association study summary statistics for lipid species and inflammatory cytokines were used. Mediation analysis was performed to determine the extent to which inflammatory cytokines mediate the effects of lipid species on DR subtypes.</div></div><div><h3>Main Outcome Measures</h3><div>Genetic causal associations between lipid species, inflammatory cytokines, and DR subtypes.</div></div><div><h3>Results</h3><div>Mendelian randomization analyses showed that most of the identified plasma lipids were significantly protective against DR and its subtypes, mainly belonging to the phosphatidylcholine and phosphatidylethanolamine classes. Triacylglycerols have different roles in different severities of DR, and inflammatory cytokines had different causal effects on DR and its subtypes. Mediation analyses identified 10 specific inflammatory cytokine–mediated pathways of lipid species on DR, of which 7 had about 10% of the mediating effect, with inflammatory cytokines in the remaining 3 playing mediating effects opposite to the pathways.</div></div><div><h3>Conclusions</h3><div>This study highlights the complex interplay between lipid metabolism and inflammation in the pathogenesis of DR. Specific lipid species protect against DR, with inflammatory cytokines mediating these effects, suggesting potential therapeutic targets for DR management.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author has no/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 1","pages":"Article 100951"},"PeriodicalIF":4.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466350","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":"Artificial Intelligence–Derived Biomechanical Index for Early Corneal Ectasia Detection: Advancing Beyond Tomography","authors":"Hazem Abdelmotaal MD ,&nbsp;Suphi Taneri MD ,&nbsp;Ramin Salouti MD ,&nbsp;M. Hossein Nowroozzadeh MD ,&nbsp;Ali H. Al-Timemy PhD ,&nbsp;Alexandru Lavric PhD ,&nbsp;Mostafa El Habib Daho PhD ,&nbsp;Hidenori Takahashi MD, PhD ,&nbsp;Rossen Mihaylov Hazarbassanov MD ,&nbsp;Siamak Yousefi PhD","doi":"10.1016/j.xops.2025.100952","DOIUrl":"10.1016/j.xops.2025.100952","url":null,"abstract":"<div><h3>Purpose</h3><div>To develop and evaluate a novel artificial intelligence (AI)–derived metric for detection of early ectasia (E) by leveraging spatiotemporal biomechanical data derived from dynamic cornea videos only.</div></div><div><h3>Design</h3><div>Multicenter cross-sectional case-control retrospective study.</div></div><div><h3>Participants</h3><div>A total of 451 eyes from 451 patients from 2 centers with both Scheimpflug tomography and dynamic corneal deformation examinations.</div></div><div><h3>Methods</h3><div>The training data set included 167 normal (N) patients with stable eyes postlaser vision correction, 83 NT eyes with VAE (VAE-NT), and better eyes from 64 patients with bilateral keratoconus (ie, mild KC [MKC]). The external validation data set included 68, 33, and 36 patients from the N, VAE-NT, and MKC groups, respectively. Extensive spatial and temporal pixel-level analysis of corneal displacement, stromal gray scale changes, and thickness variations from Corvis ST video frames was performed to identify a novel risk score with best detection of early E (combined VAE-NT and MKC). Findings were further validated using various approaches based on the external data set.</div></div><div><h3>Main Outcome Measures</h3><div>Area under the receiver operating characteristics curve (AUC), accuracy, specificity, and sensitivity for detecting early E.</div></div><div><h3>Results</h3><div>The novel AI-derived index achieved an AUC of 0.995 with accuracy, sensitivity, and specificity of 96%, 97%, and 96%, respectively, outperforming all Scheimpflug tomographic and dynamic deformation combined indices such as Belin/Ambrósio Enhanced Ectasia Display, Corvis Biomechanical Index (CBI), and Tomographic and Biomechanical Index (TBI).</div></div><div><h3>Conclusions</h3><div>The AI-derived index based on spatiotemporal corneal biomechanical data outperformed existing instrument's topographic, tomographic, and biomechanical indices, in detecting E. This novel metric offers a clinically meaningful enhancement in early diagnosis and management of corneal E disease.</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 1","pages":"Article 100952"},"PeriodicalIF":4.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519901","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":"Using the Rate of Global and Pointwise Microperimetry Change to Predict Structural Conversion in Intermediate Age-Related Macular Degeneration","authors":"Jeremy C.K. Tan MD, FRANZCO ,&nbsp;Giovanni Montesano MD, PhD ,&nbsp;Charlotte Behning MSc ,&nbsp;Hannah M.P. Dunbar PhD ,&nbsp;Robert P. Finger MD, PhD ,&nbsp;Adnan Tufail MD, FRCOphth ,&nbsp;Jan H. Terheyden MD ,&nbsp;Frank G. Holz MD ,&nbsp;Ulrich F.O. Luhmann PhD ,&nbsp;David P. Crabb PhD ,&nbsp;MACUSTAR Consortium","doi":"10.1016/j.xops.2025.100950","DOIUrl":"10.1016/j.xops.2025.100950","url":null,"abstract":"<div><h3>Purpose</h3><div>Studies evaluating functional change in age-related macular degeneration (AMD) using microperimetry often measure the difference in global mean sensitivity at interval time points versus baseline. We evaluate the rate of global and pointwise microperimetry change in intermediate AMD (iAMD) in the multicenter MACUSTAR (Registration NCT03349801) study and assess their prognostic value in structural conversion to late-stage AMD.</div></div><div><h3>Design</h3><div>Prospective study.</div></div><div><h3>Subjects</h3><div>Four hundred forty-seven subjects with iAMD (Beckman classification) from 20 European sites.</div></div><div><h3>Methods</h3><div>Subjects that underwent mesopic microperimetry on ≥3 follow-up visits were included. Two methods of assessing functional progression were evaluated: (1) global mean sensitivity regression and (2) pointwise sensitivity regression at fastest progressing N number of locations (N from 1 to 10). Rates of microperimetry progression were then evaluated in an initial series of visits prior to structural conversion to late-stage AMD.</div></div><div><h3>Main Outcome Measures</h3><div>Area under the receiving operating characteristic (AUC) curves and Cox proportional hazard models were used to assess risk of structural conversion based on rate of functional progression.</div></div><div><h3>Results</h3><div>The mean age of subjects was 72 (standard deviation 7) years. The median number of visits and duration of follow-up was 6 visits and 3 years, respectively. Structural conversion to late-stage AMD was observed in 80 (17.9%) eyes. In the visits prior to conversion, there was a greater rate of global mean sensitivity loss in eyes that eventually developed late-stage AMD compared with those that did not (–1.05 vs. –0.30 decibels/year, <em>P</em> &lt; 0.001). The AUC for classifying structural conversion versus no conversion was 0.72 for global sensitivity progression and 0.75–0.76 for between 1 and 10 fastest progressing N pointwise locations. The rate of global (hazard ratio 1.7, confidence interval [CI] 1.4–2.0) and pointwise (hazard ratio 1.2, CI 1.2–1.3) microperimetry progression in the initial series of visits was significantly associated with structural conversion (<em>P</em> &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>In the analysis of longitudinal microperimetry data from the MACUSTAR study, the rate of global and pointwise sensitivity change was significantly greater and strongly prognostic of eyes that developed structural conversion. Our findings support use of these trend-based pointwise analysis methods in assessing functional progression in iAMD.</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 1","pages":"Article 100950"},"PeriodicalIF":4.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417410","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":"Measuring Treatment Adherence in Myopia Control","authors":"Rebecca M. Dang PhD ,&nbsp;Isabelle Jalbert PhD ,&nbsp;Alex Hui PhD ,&nbsp;Pauline Kang PhD","doi":"10.1016/j.xops.2025.100949","DOIUrl":"10.1016/j.xops.2025.100949","url":null,"abstract":"<div><h3>Topic</h3><div>Treatment adherence is an essential consideration for both health providers and researchers evaluating the effectiveness of treatments of progressive childhood myopia. This narrative review provides an overview of methods used to measure treatment adherence and examines how adherence has been assessed in myopia control studies.</div></div><div><h3>Clinical Relevance</h3><div>Despite its importance, adherence has not been consistently measured or reported in myopia control trials, limiting the reliability of conclusions regarding treatment efficacy, dose relationships, and safety. Examining current approaches and highlighting methodological trends and gaps will inform future research.</div></div><div><h3>Methods</h3><div>Exploratory searches of literature were undertaken to identify relevant studies conducted between 2014 and 2024. Studies were included if they met the following criteria: (1) reported on treatment adherence outcomes, (2) involved pediatric populations, and (3) evaluated a myopia control intervention. Reference lists of included articles were scanned to identify additional relevant studies.</div></div><div><h3>Results</h3><div>In the context of research in myopia control interventions, direct measures of adherence are often impractical and largely dependent on the intervention being examined. This has led to inconsistent reporting of adherence outcomes across studies. Consequently, most studies to date have relied on indirect methods, particularly self-reported data, because of the limited availability of reliable electronic monitoring tools and the inaccuracy or inappropriateness of dosage counts.</div></div><div><h3>Conclusions</h3><div>It is recommended that researchers prioritize treatment adherence as a key outcome and select context-appropriate methods that minimize bias and error. Optimal measurement of adherence outcomes will support more robust analyses of treatment dose-response relationships and ultimately inform the clinical care of myopic patients.</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 1","pages":"Article 100949"},"PeriodicalIF":4.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579300","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":"Association of Physical Frailty and Genetic Predisposition with Risk of Irreversible Eye Diseases","authors":"Zhenyi Xu PhD ,&nbsp;Ruilang Lin MMed ,&nbsp;Xiaojun Wang PhD ,&nbsp;Yahang Liu ,&nbsp;Chen Huang PhD ,&nbsp;Ce Wang PhD ,&nbsp;Zhijun Bao PhD","doi":"10.1016/j.xops.2025.100910","DOIUrl":"10.1016/j.xops.2025.100910","url":null,"abstract":"<div><h3>Objective</h3><div>The evidence linking frailty to overall and specific irreversible eye diseases is limited. Moreover, it is unclear whether frailty is associated with similar increased risk across individuals with different genetic risk profiles. The aim of this study was to examine the association between frailty and overall and specific irreversible eye diseases and explore the modification effect of genetic risk of glaucoma, diabetic retinopathy, and age-related macular degeneration (AMD) in such associations.</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Participants</h3><div>The study included a total of 409 579 White participants in the UK Biobank study.</div></div><div><h3>Methods</h3><div>Physical frailty was defined by 5 components: weight loss, exhaustion, low physical activity, slow walking speed, and low grip strength. Participants were classified as nonfrail, prefrail, or frail. Polygenic risk score was categorized as low (tertile 1), intermediate (tertile 2), or high (tertile 3). Cox regression was used to assess the association of physical frailty with irreversible eye diseases.</div></div><div><h3>Main Outcomes and Measures</h3><div>Irreversible eye diseases were identified using hospital admission electronic health records and death registries.</div></div><div><h3>Results</h3><div>Among 409 579 individuals (mean age, 56.5 years; 46.5% male) with a median follow-up of 13.1 years, 10 927, 7 095, and 919 were diagnosed with irreversible eye disease in the nonfrail, prefrail, and frail groups, respectively. Prefrail and frail individuals showed increased risks of overall irreversible eye diseases, with a 12% higher risk for prefrail individuals (hazard ratio [HR], 1.12; 95% confidence interval [CI], 1.09–1.16) and a 47% higher risk for frail individuals (HR, 1.47; 95% CI, 1.37–1.58). Increased risks were also observed for specific irreversible eye diseases, including glaucoma (HR, 1.11 [95% CI, 1.06–1.17] for prefrailty; HR, 1.43 [95% CI, 1.28–1.61] for frailty), diabetic retinopathy (HR, 1.12 [95% CI, 1.03–1.21] for prefrailty; HR, 1.53 [95% CI, 1.34–1.73] for frailty), and AMD (HR, 1.13 [95% CI, 1.08–1.19] for prefrailty; HR, 1.35 [95% CI, 1.20–1.52] for frailty). Furthermore, individuals with more severe frailty status and higher genetic risk exhibited higher risks of irreversible eye diseases than those with low genetic risk and nonfrailty.</div></div><div><h3>Conclusions</h3><div>Frailty was associated with an increased risk of irreversible eye diseases, particularly among individuals with higher genetic risk. These findings suggest that targeted strategies to prevent and manage frailty may contribute to reducing the risk of irreversible eye diseases.</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 1","pages":"Article 100910"},"PeriodicalIF":4.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159825","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":"Artificial Intelligence in Ocular Oncology: Differentiating Choroidal Melanocytic Lesions","authors":"Lamis Alharby PhD, FRCOphth ,&nbsp;Edward Korot MD ,&nbsp;Pearse A. Keane MSc, MD ,&nbsp;Sara E. Lally MD ,&nbsp;Sandor Ferenczy MD ,&nbsp;Lauren A. Dalvin MD ,&nbsp;Marco Pellegrini MD ,&nbsp;Jay Duker MD ,&nbsp;Adrian T. Fung MMED ,&nbsp;Swathi Kaliki MD ,&nbsp;Kaan Gunduz MD ,&nbsp;Minoru Furuta MD, PhD ,&nbsp;Antonio Yaghy MD ,&nbsp;Carol Shields MD ,&nbsp;Prithvi Mruthyunjaya MD, MHS ,&nbsp;Mandeep S. Sagoo PhD, FRCOphth","doi":"10.1016/j.xops.2025.100948","DOIUrl":"10.1016/j.xops.2025.100948","url":null,"abstract":"<div><h3>Purpose</h3><div>This article explores the application of artificial intelligence (AI) in the differentiation of choroidal melanocytic lesions, specifically choroidal nevi and small melanomas, within the field of ocular oncology. The primary topic highlights the significance of accurately diagnosing these lesions to enhance patient outcomes and management strategies.</div></div><div><h3>Design</h3><div>The study reviews of the role of AI in differentiating choroidal melanocytic lesions, particularly choroidal nevi from small melanomas, examining clinical and imaging risk factors. It explores deep learning (DL) applications for image classification and assesses AI's potential impact on patient care, diagnostic accuracy, and regulatory concerns in ocular oncology.</div></div><div><h3>Methods</h3><div>To achieve this, the methods discussed in this paper revolve around employing DL techniques, which utilize artificial neural networks to analyze high-dimensional medical images. This approach enables automated classification and image analysis of ophthalmic data, allowing for the identification of intricate patterns and features that may be imperceptible to clinicians. Additionally, the text reviews existing clinical and imaging risk factors associated with the growth of choroidal nevi into melanoma, leveraging this information to inform and enhance AI algorithms.</div></div><div><h3>Results</h3><div>The anticipated results of integrating AI into clinical practice include increased diagnostic accuracy, which can lead to earlier identification of high-risk lesions and, consequently, timely interventions. This proactive approach has the potential to improve patient care significantly by facilitating better management strategies, thus enhancing patient outcomes. Artificial intelligence may also uncover subtle imaging features that would otherwise be overlooked, providing a more comprehensive assessment of lesions.</div></div><div><h3>Conclusion</h3><div>In conclusion, the paper emphasizes the transformative potential of AI in ocular oncology, advocating for its integration with existing imaging technologies. While AI offers promising advancements in diagnostic practices and patient care, the paper also acknowledges the necessity of addressing regulatory and implementation challenges to fully harness these benefits. Overall, the incorporation of AI technologies into the diagnostic workflow has the potential to not only save vision but also improve survival rates, marking a significant step forward in the management of choroidal melanocytic lesions.</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 1","pages":"Article 100948"},"PeriodicalIF":4.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579299","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":"Classification of Diabetic Retinopathy Severity with Aqueous VEGF Levels: A Prospective, Observational Study","authors":"Megan S. Steinkerchner MD ,&nbsp;Lok Hin Lee PHD ,&nbsp;Abhiram R. Manda ,&nbsp;Jinsong Sheng MD ,&nbsp;Lindsay Veach ,&nbsp;Sapna Gangaputra MD, MPH ,&nbsp;Stephen J. Kim MD","doi":"10.1016/j.xops.2025.100947","DOIUrl":"10.1016/j.xops.2025.100947","url":null,"abstract":"<div><h3>Objective</h3><div>A biomarker to classify diabetic retinopathy (DR) severity and guide preventative treatment is a major unmet need. We analyzed the relationship of aqueous VEGF-A with DR severity to determine if VEGF-A is a candidate biomarker.</div></div><div><h3>Design</h3><div>A prospective, controlled trial at a tertiary academic medical center.</div></div><div><h3>Subjects</h3><div>One hundred seven eyes of 107 patients without diabetes and 328 eyes of 164 adult type II diabetic patients with varying levels of DR.</div></div><div><h3>Methods</h3><div>Aqueous was sampled in 107 consecutive eyes without diabetes undergoing elective vitrectomy surgery. All diabetic eyes had aqueous sampling of both eyes, ETDRS visual acuity, spectral-domain OCT, and color fundus photograph testing. Blood glucose and hemoglobin A1c (HbA1c) were measured. Aqueous VEGF-A was measured using a microparticle bead-based multiplex assay.</div></div><div><h3>Main Outcome Measures</h3><div>Aqueous VEGF-A, DR severity, and diabetic macular edema (DME).</div></div><div><h3>Results</h3><div>Median and interquartile range (IQR) aqueous VEGF-A levels for the 107 eyes without diabetes was 55.74 pg/ml (23.56–76.72). Median (IQR) VEGF-A levels increased with DR severity: 100.34 pg/ml (72.31–126.07) in the no DR group, 162.69 pg/ml (113.76–233.89) in the moderate nonproliferative DR (NPDR) group, and 295.48 pg/ml (193.80–409.99) in the proliferative DR (PDR) group (<em>P</em> &lt; 0.001). The moderate NPDR group was further subdivided based on ETDRS severity into mild-moderate NPDR (N = 154 eyes) and moderate-severe NPDR (N = 82 eyes). Median (IQR) VEGF-A levels were 147.24 pg/ml (108.15–187.50) and 206.75 pg/ml (136.18–303.25) in the mild-moderate and moderate-severe NPDR groups, respectively. Using the no DR group as reference, odds ratios with 95% confidence intervals for VEGF-A were 2.72 (1.3–5.7) in the mild-moderate NPDR (<em>P</em> = 0.008), 6.79 (2.75–16.73) in the moderate-severe NPDR (<em>P</em> &lt; 0.001), and 15.02 (4.86–46.44) in the PDR (<em>P</em> &lt; 0.001) groups, respectively. After controlling for gender, age, and HbA1c, increasing VEGF-A was significantly correlated with increasing DR severity (<em>P</em> &lt; 0.001), but not with the presence of DME (<em>P</em> = 0.39).</div></div><div><h3>Conclusions</h3><div>Aqueous VEGF-A levels tightly correlate with DR severity and support VEGF-A as a novel biomarker to classify DR and guide early intervention. Use of VEGF-A levels may guide preventative treatment, reduce the risk of progression and vision loss, and allow optimal allocation of health care resources.</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 1","pages":"Article 100947"},"PeriodicalIF":4.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417412","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":"The Rates of Retinal Nerve Fiber Layer Change in Children With Optic Disc Drusen","authors":"Tais Estrela MD ,&nbsp;Jacqueline Jeon-Chapman BS ,&nbsp;Jia Jia Zhang MD ,&nbsp;Deborah K. VanderVeen MD ,&nbsp;Eric D. Gaier MD, PhD ,&nbsp;Gena Heidary MD, PhD ,&nbsp;Abdelrahman M. Elhusseiny MD, MSc ,&nbsp;Ryan A. Gise MD","doi":"10.1016/j.xops.2025.100943","DOIUrl":"10.1016/j.xops.2025.100943","url":null,"abstract":"<div><h3>Purpose</h3><div>Optic disc drusen (ODD) are calcified deposits in the prelaminar portion of the optic nerve head. Although often asymptomatic, it can damage optic nerve fibers, resulting in irreversible vision loss. This study evaluates rates of structural changes in children with ODD and risk factors associated with faster rates of retinal nerve fiber layer (RNFL) thinning.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Subjects</h3><div>Forty eyes of 22 children with ODD and 40 eyes of 20 age-, gender-, and race-matched glaucoma-suspect children.</div></div><div><h3>Methods</h3><div>Children were required to have ≥3 OCT RNFL tests and a minimum of 18 months between the first and last OCT. Linear mixed models estimated RNFL changes over time. Univariable and multivariable models assessed the effect of clinical variables on rates of change.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was the rates of RNFL change over time, which was compared to the glaucoma-suspect group. The secondary outcome was to investigate the clinical factors associated with faster RNFL thinning.</div></div><div><h3>Results</h3><div>Children with ODD were followed for an average of 4.1 ± 2.5 years (median 3.2). Eyes with ODD had rates of RNFL change significantly faster than the glaucoma-suspect group (–2.01 ± 1.53 μm/year versus –0.07 ± 0.47 μm/year; <em>P</em> &lt; 0.001). The multivariable model revealed older age and higher RNFL at baseline were significantly associated with faster rates of RNFL thinning, with 0.37 μm/year faster loss for each year older (<em>P</em> = 0.040) and 0.07 μm/year faster loss for each μm higher RNFL at baseline (<em>P</em> = 0.030).</div></div><div><h3>Conclusions</h3><div>Children with ODD demonstrate significant rates of RNFL thinning over time. Knowing the distribution of RNFL change attributable to ODD in children will enable clinicians to identify rapid progressors and alternative etiologies of optic nerve injury.</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 1","pages":"Article 100943"},"PeriodicalIF":4.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466402","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}