American Journal of Ophthalmology最新文献

{"title":"Predicting 10 Year Glaucoma Using Anterior Segment Biometry for Infants with Unilateral Congenital Cataract","authors":"Claudia Wong ,&nbsp;Urjita Das ,&nbsp;He Forbes ,&nbsp;Taylor Kolosky ,&nbsp;Euna Cho ,&nbsp;Shaiza Mansoor ,&nbsp;Sera Chase ,&nbsp;Madi Kore ,&nbsp;Riva Menon ,&nbsp;Moran Roni Levin ,&nbsp;Larry Magder ,&nbsp;Carolyn Drews-Botsch ,&nbsp;Scott R. Lambert ,&nbsp;Janet L. Alexander","doi":"10.1016/j.ajo.2025.12.010","DOIUrl":"10.1016/j.ajo.2025.12.010","url":null,"abstract":"<div><h3>Purpose</h3><div>Glaucoma following congenital cataract surgery is the most common secondary form of glaucoma in children and a serious sight-threatening complication following congenital cataract surgery. Therefore, risk assessment for future glaucoma is integral to the management of infants undergoing cataract surgery. Biometry of the anterior segment may offer the opportunity to enhance estimation of an infant’s risk of developing glaucoma. This study aims to use preoperative anterior segment biometry to predict future glaucoma among infants undergoing congenital cataract surgery and provide a risk calculator based on predictive models.</div></div><div><h3>Design</h3><div>Posthoc cohort analysis from a multicenter randomized controlled trial in the United States (NCT00212134).</div></div><div><h3>Participants</h3><div>This cohort included 114 participants with unilateral congenital cataract who underwent cataract surgery between 2004 and 2007 and were followed for 10.5 years as part of the Infant Aphakia Treatment Study. A total of 110 participants were analyzed. A total of 88 participants had at least one biometry measurement available. Overall, 41% of the cohort was diagnosed as glaucoma or glaucoma suspect by study endpoint.</div></div><div><h3>Methods</h3><div>Preoperative biometry measured on the day of cataract surgery was used to collect anterior chamber depth (ACD) and lens thickness. Subject characteristics, corneal diameter, and axial length were included in logistic regression analysis. ACD was the primary predictor of interest, and glaucoma or glaucoma suspect status at 10.5 years was the primary outcome of interest.</div></div><div><h3>Main Outcome Measures</h3><div>The main outcome measures were model coefficients and odds ratios with 95% confidence intervals for glaucoma or glaucoma suspect diagnosis at 10.5 years following congenital cataract surgery.</div></div><div><h3>Results</h3><div>Subjects with glaucoma had ACD of 2.76 ± 0.48 mm compared to 3.08 ± 0.38 mm among subjects without glaucoma or glaucoma suspect (mean difference = 0.32 mm, <em>P</em> = .003). Logistic regression models found shallower ACD was a strong predictor of glaucoma (OR 5.8 [1.8, 18.9], <em>P</em> = .004), compared to shorter axial length (OR 1.0 [0.7, 1.4], <em>P</em> = .9), thinner lens (OR 1.5 [0.7, 3.1], <em>P</em> = .3), decreased corneal diameter (OR 1.6 [0.95, 2.9], <em>P</em> = .08), and younger age (OR 1.01 [1.0, 1.02], <em>P</em> = .04).</div></div><div><h3>Conclusions</h3><div>ACD has a significant association with glaucoma following congenital cataract surgery.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 207-213"},"PeriodicalIF":4.2,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784499","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}

{"title":"Fibrin Glue Versus Sutures for Securing Conjunctival Autograft in Primary Pterygium Surgery: A Systematic Review and Meta-Analysis","authors":"Jarryl H.J. Tsai ,&nbsp;Emmanuel J. Tan ,&nbsp;Jonathan T.W. Au Eong ,&nbsp;Sachin M. George ,&nbsp;Kah-Guan Au Eong","doi":"10.1016/j.ajo.2025.12.004","DOIUrl":"10.1016/j.ajo.2025.12.004","url":null,"abstract":"<div><h3>Topic</h3><div>This systematic review and meta-analysis evaluates whether fibrin glue provides superior outcomes compared to sutures for securing conjunctival autografts in primary pterygium surgery. We focused on recurrence rates, operative time, postoperative complications, and patient discomfort.</div></div><div><h3>Clinical Relevance</h3><div>Pterygium recurrence and postoperative morbidity remain significant concerns in ocular surface surgery. A growing number of surgeons are adopting fibrin glue instead of sutures to anchor conjunctival autografts, but the evidence on comparative effectiveness has evolved in recent years. This updated analysis aims to guide surgical practice with the most current data.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, Cochrane CENTRAL, Web of Science, and CINAHL on 8 November 2024. We included randomized controlled trials (RCTs) comparing fibrin glue versus sutures in primary pterygium surgery. Studies were screened, selected, and data-extracted by two independent reviewers. Meta-analysis was performed using a random-effects model. Risk of bias was assessed using the Cochrane RoB 2 tool. The review was conducted in accordance with PRISMA guidelines and registered on PROSPERO (ID: CRD42024520625).</div></div><div><h3>Results</h3><div>Twenty RCTs were included. Fibrin glue significantly reduced recurrence risk compared to sutures (pooled odds ratio: 2.46; 95% CI: 1.06-5.69; 27 P  =  .0352; I² = 0%). Operative time was significantly shorter with fibrin glue (pooled mean difference: 15.65 29 minutes; 95% CI: 11.45-19.86; P &lt; .005; I² = 99.29%). Pain scores at postoperative day 1 were significantly lower with fibrin glue compared with sutures (pooled standardized mean difference: 1.32; 95% CI: -2.11 to -0.52; p &lt; .001; I² = 90%). Rates of graft retraction were inconsistent between the two groups, while subconjunctival hemorrhages were more common in the suture group.</div></div><div><h3>Conclusion</h3><div>Fibrin glue is associated with lower recurrence rates, reduced operative time, and less postoperative discomfort than sutures in primary pterygium surgery. However, variability in graft retraction outcomes warrants further investigation. These findings support the broader adoption of fibrin glue as a preferred technique for conjunctival autograft fixation in routine clinical practice.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 313-323"},"PeriodicalIF":4.2,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784498","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}

{"title":"Comment on A Scoping Review of Ergonomics in Ophthalmology: Working Smarter","authors":"KARTHIK REDDY ,&nbsp;AMY D. ZHANG","doi":"10.1016/j.ajo.2025.11.049","DOIUrl":"10.1016/j.ajo.2025.11.049","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 337-338"},"PeriodicalIF":4.2,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145777357","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}

{"title":"The Right to Women’s Sight: Global, Regional, and National Burden of Blindness and Vision Loss in Women, 1990 to 2021","authors":"Lan Xia ,&nbsp;Wuhong Weng ,&nbsp;Jing Wang ,&nbsp;Lingyu Dai ,&nbsp;Suo Guo ,&nbsp;Yanlin Pu ,&nbsp;Tao Cai ,&nbsp;Peizeng Yang","doi":"10.1016/j.ajo.2025.12.005","DOIUrl":"10.1016/j.ajo.2025.12.005","url":null,"abstract":"<div><h3>Objective</h3><div>To quantify global, regional, and national burdens of blindness and vision loss among females from 1990 to 2021 and to assess age patterns, trends, causes, and risk factors contributing to sex disparities.</div></div><div><h3>Design</h3><div>Retrospective cohort analysis using publicly available, deidentified data from the Global Burden of Disease (GBD) 2021 study.</div></div><div><h3>Participants</h3><div>Females across 204 countries and territories included in GBD 2021. Sex-specific estimates were analyzed; no identifiable human subjects were involved.</div></div><div><h3>Methods</h3><div>Deidentified GBD 2021 data were analyzed using R (4.3.2) and Joinpoint regression. Prevalence and Years Lived with Disability (YLDs = prevalence × disability weight) were estimated globally and stratified by age, geography, and Sociodemographic Index. Descriptive analyses assessed trends from 1990 to 2021. Mapping illustrated regional distribution and estimated annual percentage change. Cause- and risk-factor analyses followed standardized GBD methods.</div></div><div><h3>Main Outcome Measures</h3><div>Age-standardized and age-specific prevalence and YLD rates; leading causes; risk-factor–attributable YLDs; and temporal patterns by estimated annual percentage change.</div></div><div><h3>Results</h3><div>In 2021, females had a 27.1% higher prevalence of blindness and vision loss and a 17.2% higher YLD rate than males. Age-standardized prevalence and YLDs were 14,510.97 and 17,010.96 per 100,000. Burdens were highest in low- and middle-Sociodemographic Index regions. Near vision loss, cataract, and refractive disorders were leading causes; major contributors included air pollution, high BMI, and household air pollution. Women ≥70 years bore the highest disability burden. Joinpoint analysis showed a persistent increase in female YLDs without a clear COVID-19–related inflection. Limitations include modeled estimates and regional data heterogeneity.</div></div><div><h3>Conclusions</h3><div>Females worldwide continue to experience a disproportionate burden of blindness and vision loss, especially in lower-resource settings and older age groups. Gender-responsive strategies and expanded access to eye care are urgently needed.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 227-255"},"PeriodicalIF":4.2,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145771386","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}

{"title":"Impact of Phacoemulsification on Vitreomacular Traction Release and Complications","authors":"Suraj Bala ,&nbsp;Nitesh Mohan ,&nbsp;Victor Bellanda ,&nbsp;Andrea Arline ,&nbsp;Gabriel Castilho S. Barbosa ,&nbsp;Matthew Schulgit ,&nbsp;Sumit Sharma ,&nbsp;Sunil K. Srivastava ,&nbsp;Danny A. Mammo ,&nbsp;Ananth Sastry","doi":"10.1016/j.ajo.2025.12.008","DOIUrl":"10.1016/j.ajo.2025.12.008","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine if phacoemulsification impacts vitreomacular traction (VMT) release and VMT-related complications.</div></div><div><h3>Design</h3><div>Single-center, comparative, retrospective clinical cohort study.</div></div><div><h3>Subjects: A total of</h3><div>310 eyes of 249 patients with a concurrent diagnosis of VMT and cataracts at the Cole Eye Institute between 2013 and 2024.</div></div><div><h3>Methods</h3><div>Eligible eyes had at least 6 months of follow-up post-VMT diagnosis or phacoemulsification. The control group included eyes that did not undergo phacoemulsification after VMT diagnosis. Clinical information was collected via manual chart review. Characteristics of VMT were recorded via review of optical coherence tomography imaging.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was the hazard of VMT release. Secondary outcomes included VMT-related complications, such as macular and lamellar hole formation, retinal detachment, and subsequent vitrectomy.</div></div><div><h3>Results</h3><div>VMT release occurred in 49.4% of 310 eyes, with an average follow-up period of 136.7 ± 134.4 weeks. There was no significant difference in release between the phacoemulsification and control groups (adjusted hazard ratio [aHR] = 0.861; <em>P</em> = .380). Among eyes that released, the mean time to release was 79.4 ± 68.8 weeks postsurgery in the phacoemulsification group and 76.0 ± 81.9 weeks from diagnosis in the control group (<em>P</em> = .785). In multivariate analysis, younger age at diagnosis (5-year aHR = 0.773; <em>P</em> &lt; .001) and smaller adhesion diameter (per 100 µm aHR = 0.951; <em>P</em> = .017) were significantly associated with a higher likelihood of VMT release. Black patients had a lower likelihood of VMT release compared to White patients (aHR = 0.439; <em>P</em> = .004). Eyes that developed a macular hole had a smaller baseline adhesion diameter than those that did not (439.1 ± 217.9 µm vs 685.7 ± 697.4 µm; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Phacoemulsification was not associated with increased rates or faster timing of VMT release. These findings suggest that intrinsic patient and anatomical factors play a larger role in determining the likelihood of VMT release and should be prioritized in clinical decision-making.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 176-187"},"PeriodicalIF":4.2,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145731919","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}

{"title":"Safety of Pharmacologic Dilation: Incidence and Risk Factors of Acute Angle Closure in a Nationwide Cohort","authors":"Tracy Z. Lang ,&nbsp;Khristina I. Lung ,&nbsp;Kyle A. Bolo ,&nbsp;Brian C. Toy ,&nbsp;Benjamin Y. Xu","doi":"10.1016/j.ajo.2025.12.006","DOIUrl":"10.1016/j.ajo.2025.12.006","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the incidence and risk factors of acute angle closure (AAC) following dilation in a nationwide healthcare claims database.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Participants</h3><div>Patients who underwent dilation by an ophthalmologist/optometrist between January 2007 and December 2021 were identified by Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System codes for comprehensive eye exam, extended ophthalmoscopy, or dilated fundus exam. Patients with AAC/primary angle closure glaucoma diagnosis before the first dilation were excluded.</div></div><div><h3>Methods</h3><div>AAC risk was assessed under two definitions. Definition 1 (more sensitive and inclusive): International Classification of Diseases code for AAC glaucoma within 14 days of dilation; Definition 2 (more specific and exclusive): Definition 1 plus CPT code for iridotomy/iridectomy or lens extraction within 14 days of AAC diagnosis. Dilations after the first AAC diagnosis were excluded. Multivariable logistic regression was performed to assess factors associated with AAC diagnosis by comparing patients who received an AAC diagnosis with those that did not.</div></div><div><h3>Main Outcome Measures</h3><div>AAC under two definitions based on International Classification of Diseases/CPT codes.</div></div><div><h3>Results</h3><div>A total of 11,452,733 patients underwent 26,478,250 dilations. The incidence of AAC diagnosis per dilation was 0.01% under Definition 1 and 0.004% under Definition 2. Older age compared to &lt;40 years (OR ≥ 3.26, <em>P</em> &lt; .001), Asian race and Hispanic ethnicity compared to non-Hispanic Whites (OR ≥ 1.38, <em>P</em> &lt; .001), and prior angle closure diagnosis (OR ≥ 12.74, <em>P</em> &lt; .001) conferred higher odds of AAC diagnosis under both definitions. Income ≥$100,000 compared to &lt;$40,000 (OR ≤ 0.83, <em>P</em> &lt; .001), non-Northeast regions (OR ≤ 0.74, <em>P</em> ≤ .002), and pseudophakia status (OR ≤ 0.73, <em>P</em> &lt; .001) conferred lower odds of AAC diagnosis under both definitions. Female sex (OR = 1.19, <em>P</em> &lt; .001), non-HMO insurance (OR ≥ 1.19, <em>P</em> ≤ .006), and Black race (OR = 1.18, <em>P</em> = .003) conferred higher odds of AAC diagnosis under Definition 1.</div></div><div><h3>Conclusions</h3><div>In a nationwide cohort, the risk of AAC diagnosis following dilation ranged from around 1 in 7,000 to 26,000 dilations. Given the apparent safety of dilation and its importance in comprehensive eye exams and teleretinal care, further discussions regarding concerns about AAC with dilation are warranted.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 138-148"},"PeriodicalIF":4.2,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145731052","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}

{"title":"A Randomized-Controlled Trial of the Efficacy, Safety and Tolerability of Intravitreal Brolucizumab in Patients With Chronic Central Serous Chorioretinopathy With Persistent Fluid in the Absence of Choroidal Neovascular Membrane—BRICS Trial Report II","authors":"Srishti Raksheeth Ramamurthy ,&nbsp;Saarang Hansraj ,&nbsp;Ragu Kumar ,&nbsp;Ritesh Narula ,&nbsp;SriniVas R. Sadda ,&nbsp;Sobha Sivaprasad ,&nbsp;Jay K. Chhablani ,&nbsp;Mudit Tyagi ,&nbsp;Nikitha Gurram Reddy ,&nbsp;Umesh Chandra Behera ,&nbsp;Raja Narayanan","doi":"10.1016/j.ajo.2025.12.007","DOIUrl":"10.1016/j.ajo.2025.12.007","url":null,"abstract":"<div><h3>Objective</h3><div>To study the efficacy of brolucizumab in chronic central serous chorioretinopathy (CSCR) with persistent fluid without choroidal neovascular membrane (CNVM).</div></div><div><h3>Design</h3><div>Prospective randomized-controlled trial with cross-over design.</div></div><div><h3>Subjects</h3><div>Patients with chronic CSCR (&gt;3 months duration) without CNVM confirmed on optical coherence tomography angiography were enrolled and randomized (1:1) to treatment or control arms.</div></div><div><h3>Methods</h3><div>Block randomization with stratification for disease duration and central macular thickness (CMT) was done. Patients in the treatment arm received intravitreal brolucizumab at baseline and then PRN. At 3 months follow-up, patients in the control arm with persistent fluid were crossed over to the injection arm.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was a reduction of CMT on optical coherence tomography &gt;20% compared to baseline. Secondary outcomes included proportion of eyes achieving complete fluid resolution at 1 and 3 months, mean change in CMT, subfoveal choroidal thickness (SFCT), best-corrected visual acuity, and NEI VFQ-25 scores.</div></div><div><h3>Results</h3><div>Of 42 patients (42 eyes), 3 were lost to follow-up. Final analysis included 22 patients in injection arm and 17 in control arm. Mean age was 52.3 ± 9.3 years; 92.3% were male. Greater than 20% CMT reduction at 1 month was noted in 17/22 (77.27%) in treatment arm and 6/16 eyes (37.5%) in the control arm (<em>p</em> = .01). At 1 month, 13/22 eyes (59%) achieved complete fluid resolution compared to 2/16 (12.5%) eyes in the control arm (<em>p</em> = .003). At 3 months follow-up, 12/20 eyes (60%) in the treatment arm achieved complete fluid resolution compared to 3/16 eyes (18.75%) in the control arm (<em>p</em> = .01). Mean CMT showed reduction in brolucizumab group compared to control at 1 month (158.16 ± 60 vs 318.22 ± 252.64 µm, <em>p</em> = .001) and 3 months (188.11 ± 78.83 vs 340.75.15 ± 264.52 µm, <em>p</em> = .016). Mean SFCT showed reduction in brolucizumab group compared to control at 1 month (419.53 ± 95.51 vs 472.40 ± 77.43 µm, <em>p</em> = .07) and 3 months (403.47 ± 127.36 vs 490.15 ± 105.50 µm, <em>p</em> = .05). 9 of 11 (81.82%) control eyes after crossover showed fluid resolution with brolucizumab. Change in best-corrected visual acuity and NEI VFQ-25 scores was not significant.</div></div><div><h3>Conclusions</h3><div>Brolucizumab resulted in rapid resolution of fluid in chronic CSCR without CNVM, associated with significant reduction in CMT and SFCT. Long-term studies will help understand recurrence patterns and adverse effect profile.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 149-162"},"PeriodicalIF":4.2,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145731922","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}

{"title":"Comment on: Cellular-Level Assessment of Macular Development in Patients With FEVR Using Multimodal Imaging: A Prospective Cohort Study","authors":"Gongpeng Sun ,&nbsp;Meixia Zhang","doi":"10.1016/j.ajo.2025.10.041","DOIUrl":"10.1016/j.ajo.2025.10.041","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Page 336"},"PeriodicalIF":4.2,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145718241","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}

{"title":"Tirzepatide is Associated With Reduced Risk of Primary Open-Angle Glaucoma and Ocular Hypertension in Patients With Type 2 Diabetes","authors":"Alexander T. Hong ,&nbsp;Forest Lin ,&nbsp;Sally Baxter ,&nbsp;Robert N. Weinreb","doi":"10.1016/j.ajo.2025.12.003","DOIUrl":"10.1016/j.ajo.2025.12.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Tirzepatide, a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist (GLP-1 RA), has shown superior efficacy in glycemic control, weight loss, and cardiometabolic outcomes compared to GLP-1 RAs alone. While GLP-1 RAs may offer neuroprotective effects relevant to glaucoma, the impact of dual-incretin therapies like tirzepatide on glaucoma remains unknown. This study investigates the association between tirzepatide initiation and the risk of primary open-angle glaucoma (POAG), ocular hypertension (OHTN), and glaucoma treatment initiation in patients with type 2 diabetes mellitus (T2DM), compared to those initiating selective GLP-1 RAs.</div></div><div><h3>Design</h3><div>Retrospective clinical cohort study using a nationwide electronic health records network from June 2022 to May 2025.</div></div><div><h3>Subjects</h3><div>Adults with T2DM who initiated tirzepatide or selective GLP-1 RA therapy. Patients with prior exposure to either drug class, recent addition of second-line antihyperglycemic agents, previous glaucoma diagnosis or surgery, or ocular trauma were excluded.</div></div><div><h3>Methods</h3><div>Data from 71 U.S. healthcare organizations were analyzed. Propensity score matching (1:1) was conducted to balance cohorts for demographics, comorbidities, medication use, and ophthalmic encounters. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated for each outcome.</div></div><div><h3>Main Outcome Measures</h3><div>Incidence of POAG, OHTN, and first-line glaucoma treatments (medications or surgery).</div></div><div><h3>Results</h3><div>We identified 41,850 patients who initiated tirzepatide and 147,828 patients who initiated selective GLP-1 RAs. After matching, 41,849 patients remained in each cohort. Tirzepatide use was associated with a significantly lower risk of POAG (RR 0.50, 95% CI 0.34-0.74), OHTN (RR 0.59, 95% CI 0.40-0.88), and need for glaucoma treatment (RR 0.54, 95% CI 0.45-0.64) compared to selective GLP-1 RAs. Risk reductions persisted in subgroups with concomitant metformin or insulin use. Sensitivity analyses limited to patients aged ≥60 years and comparisons with individual GLP-1 RAs (semaglutide and dulaglutide) yielded consistent trends.</div></div><div><h3>Conclusions</h3><div>Tirzepatide use was associated with a significantly reduced risk of developing POAG, OHTN, and need for first-line glaucoma treatment compared to selective GLP-1 RAs in patients with T2DM. These findings suggest a potential additional ocular benefit of tirzepatide and support further investigation into its role in glaucoma management.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 120-128"},"PeriodicalIF":4.2,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145689322","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}

{"title":"Episcleral Osteoma","authors":"Liangyuan Xu ,&nbsp;Jing Li ,&nbsp;Jianmin Ma","doi":"10.1016/j.ajo.2025.11.047","DOIUrl":"10.1016/j.ajo.2025.11.047","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"282 ","pages":"Pages e7-e8"},"PeriodicalIF":4.2,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145689323","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}