American Journal of Ophthalmology最新文献

{"title":"Fundus Curvature as a Clinical Marker for Posterior Staphyloma Based on Widefield Optical Coherence Tomography","authors":"Nan Luo ,&nbsp;Bingqian Liu ,&nbsp;Lu Wang ,&nbsp;Zhi Yang ,&nbsp;Peiyuan Wang ,&nbsp;Mary Ho ,&nbsp;Andrew Chun Yue Mak ,&nbsp;Yunyi Liu ,&nbsp;Yunhe Song ,&nbsp;Yingfeng Zheng ,&nbsp;Shaolin Du ,&nbsp;Xiaoyan Ding ,&nbsp;Lin Lu ,&nbsp;Jingjing Huang ,&nbsp;Wei Wang ,&nbsp;Li Huo ,&nbsp;Kyoko Ohno-Matsui ,&nbsp;Shida Chen","doi":"10.1016/j.ajo.2024.12.020","DOIUrl":"10.1016/j.ajo.2024.12.020","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the ability to quantify fundus curvature and detect posterior staphyloma using widefield optical coherence tomography (OCT).</div></div><div><h3>Design</h3><div>Cross-sectional diagnostic evaluation.</div></div><div><h3>Methods</h3><div>This study reviewed 205 highly myopic eyes of 205 participants. The Gaussian curvature map of the fundus was automatically calculated from 2 million scan points over an area of 24 mm × 20 mm, visualizing localized deformations in the posterior region. Two fovea-centered areas were designated as follows: a 6 mm × 6 mm macular region and an 8 mm × 16 mm posterior region. Macular mean curvature, macular curvature deviation, posterior mean curvature, posterior curvature deviation (PCD), and maximum posterior curvature were calculated. The relationship between curvature indices, ocular parameters, and myopic complications was investigated. The diagnostic ability of curvature indices for posterior staphyloma was evaluated.</div></div><div><h3>Results</h3><div>The mean (SD) age of 205 participants was 34.06 (12.74) years, with 107 being female (52.2%). Posterior staphyloma was found in 33 of 205 (16.1%) eyes. The curvature value map and curvature deviation map revealed detailed morphologic patterns of posterior staphyloma. Eyes with staphyloma had a steeper and more irregular fundus than eyes without staphyloma, with a larger maximum posterior curvature (20.420 × 10^–3 mm^–2 vs 10.925 × 10^–3 mm^–2, <em>P</em> &lt; .001), posterior mean curvature (6.754 × 10^–3 mm^–2 vs 5.352 × 10^–3 mm^–2, <em>P</em> = .002), macular curvature deviation (1.889 × 10^–3 mm^–2 vs 1.078 × 10^–3 mm^–2, <em>P &lt;</em> .001), and PCD (3.894 × 10^–3 mm^–2 vs 1.683 × 10^–3 mm^–2, <em>P &lt;</em> .001). However, no difference in macular mean curvature was found between eyes with and without posterior staphyloma. Larger maximum posterior curvature, macular curvature deviation, and PCD were associated with greater degrees of myopia, more severe myopic maculopathy, and worse best-corrected visual acuity (all <em>P</em> &lt; .05). PCD demonstrated the ability to discriminate the presence of posterior staphyloma (area under the curve 0.909 [95% CI 0.854-0.963; <em>P</em> &lt; .001]). The optimal cutoff value of PCD was 3.060 × 10^–3 mm^–2 (Youden index = 0.725), with a specificity of 90.7% and a sensitivity of 81.8%.</div></div><div><h3>Conclusion</h3><div>Widefield OCT-based analysis of fundus curvature enhances detection and quantitative assessment of posterior staphyloma in high myopia.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"271 ","pages":"Pages 478-487"},"PeriodicalIF":4.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902593","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":"GLP-1 Receptor Agonists Use and Incidence of Glaucoma: A Systematic Review and Meta-Analysis","authors":"Dillan Cunha Amaral ,&nbsp;Jaime Guedes ,&nbsp;Matheus Ribeiro Barbosa Cruz ,&nbsp;Lídia Cheidde ,&nbsp;Matheus Nepomuceno ,&nbsp;Pedro Lucas Machado Magalhães ,&nbsp;Rodrigo Brazuna ,&nbsp;Denisse J. Mora-Paez ,&nbsp;Ping Huang ,&nbsp;Reza Razeghinejad ,&nbsp;Joel S. Schuman ,&nbsp;Jonathan S. Myers","doi":"10.1016/j.ajo.2024.12.024","DOIUrl":"10.1016/j.ajo.2024.12.024","url":null,"abstract":"<div><h3>Purpose</h3><div>In patients with diabetes, glucagon-like peptide 1 (GLP-1) receptor agonists (RAs) may protect against microvascular alterations and oxidative stress, both of which have been implicated in glaucoma. Multiple studies suggest a possible relation between GLP-1 RA use and the development of glaucoma. This study is a systematic review of the published literature regarding the incidence of glaucoma development in patients with type 2 diabetes treated with GLP-1 RAs compared with a control group.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, Web of Science, and Cochrane databases from July 1991 to May 2024 for studies comparing the incidence of glaucoma development in GLP-1 RA users versus nonusers. We calculated the pooled hazard ratio for the GLP-1 RA group and control individuals using a random-effects model.</div></div><div><h3>Results</h3><div>One hundred ninety-four studies were identified, of which 5 retrospective studies met the inclusion criteria, with a total of 156,042 participants based on routinely collected electronic data. The meta-analysis revealed no significant statistical difference in glaucoma incidence among GLP-1 RA users compared with control individuals (hazard ratio 0.779 [95% CI 0.585-11.036]; <em>P</em> = .086; I² = 86%). During the leave-one-out sensitivity analysis, the inclusion of the study by Shao and associates yielded opposite effects, suggesting that SGLT-2 inhibitors might be as effective as, or potentially more effective than, GLP-1 RAs in preventing glaucoma. When this study was excluded from the analysis, the results demonstrated a significant reduction in the incidence of glaucoma among GLP-1 RA users compared with control individuals, with reduced heterogeneity (hazard ratio 0.71 [95% CI 0.60-0.85], I² = 29%). Studies had moderate bias concerns because of confounding factors and intervention classification.</div></div><div><h3>Conclusion</h3><div>This systematic meta-analysis found that GLP-1 RA use is associated with reduced glaucoma development in retrospective studies. Future well-designed, long-term studies focusing on GLP-1 RAs and SGLT-2 inhibitors are needed to validate these findings and evaluate their effects on glaucoma progression and vision loss. The overall interpretation should be cautious.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"271 ","pages":"Pages 488-497"},"PeriodicalIF":4.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891386","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":"Reply to Comment on Real-World Incidence of Incident Noninfectious Uveitis in Patients Treated With BRAF Inhibitors: A Nationwide Cohort Study.","authors":"Hyunjean Jung, Yong Joon Kim","doi":"10.1016/j.ajo.2024.12.018","DOIUrl":"10.1016/j.ajo.2024.12.018","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891387","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":"Standalone Canaloplasty and Trabeculotomy Using the OMNI Surgical System in Eyes with Primary Open-Angle Glaucoma: A 36-Month Analysis from the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight)","authors":"NATHAN M. RADCLIFFE ,&nbsp;JENNIFER HARRIS ,&nbsp;KRISTIAN GARCIA ,&nbsp;ERIN ZWICK ,&nbsp;ROBERT T. CHANG ,&nbsp;MICHAEL MBAGWU","doi":"10.1016/j.ajo.2024.12.015","DOIUrl":"10.1016/j.ajo.2024.12.015","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize long-term real-world clinical outcomes of standalone canaloplasty and trabeculotomy using the OMNI Surgical System (Sight Sciences) in patients with primary open-angle glaucoma (POAG).</div></div><div><h3>Design</h3><div>Retrospective, clinical cohort study utilizing the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) data.</div></div><div><h3>Subjects</h3><div>Patients/eyes in the IRIS Registry with POAG or ocular hypertension with known laterality on or after January 1, 2016 and undergoing standalone canaloplasty and trabeculotomy using the OMNI Surgical System with at least 6 months and up to 36 months of postoperative follow-up were included. Eyes were excluded for prior filtration surgery, trabeculoplasty within 90 days of the OMNI procedure, or concomitant cataract surgery.</div></div><div><h3>Methods/Outcome Measures</h3><div>Outcome measures included intraocular pressure (IOP) and glaucoma medication changes postoperatively.</div></div><div><h3>Results</h3><div>230 eyes in 196 patients were analyzed. Most eyes had moderate (40.0 %) or severe (41.3 %) POAG. Two-thirds (153 of 230) were pseudophakic. Fewer than half of procedures (44.4 %) were performed by glaucoma specialists. Mean baseline IOP was 22.1 (6.4) mmHg and over 36 months of follow-up ranged from 15.1 to 16.7 mmHg (<em>p</em> &lt; 0.0001 at every time point compared to baseline), with average eye-level reductions of 5.6-7.1 mmHg. The mean number of glaucoma medications used at baseline was 2.1 (1.5) and over 36 months ranged from 1.1 to 1.8 medication classes, with statistically significant decreases in utilization through 18 months postoperatively (<em>p</em> ≤ 0.0011) and nonsignificant at months 24 and 36. Eyes with lower baseline IOP (≤18 mmHg) had reductions in medication use through 36 months, and eyes with higher baseline IOP (&gt;18 mmHg) had statistically significant reductions in IOP through 36 months.</div></div><div><h3>Conclusions</h3><div>Standalone canaloplasty and trabeculotomy provides clinically and statistically significant reductions in IOP through up to 36 months postoperatively. Eyes with lower baseline IOP had long-term glaucoma medication reductions and eyes with higher baseline IOP had statistically significant long-term IOP reductions. Standalone OMNI surgery is a reasonable MIGS option for patients with POAG seeking IOP reduction, medication reduction, or both.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"271 ","pages":"Pages 436-444"},"PeriodicalIF":4.1,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Real-World Incidence of Incident Noninfectious Uveitis in Patients Treated With BRAF Inhibitors: A Nationwide Clinical Cohort Study\".","authors":"Ellen E Freeman","doi":"10.1016/j.ajo.2024.12.019","DOIUrl":"10.1016/j.ajo.2024.12.019","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891385","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":"Suprachoroidal Delivery of Viral and Nonviral Vectors for Treatment of Retinal and Choroidal Vascular Diseases.","authors":"Yeongseo Lim, Peter A Campochiaro, Jordan J Green","doi":"10.1016/j.ajo.2024.12.010","DOIUrl":"10.1016/j.ajo.2024.12.010","url":null,"abstract":"<p><strong>Purpose: </strong>Current treatments for retinal and choroidal neovascular diseases suffer from insufficient durability, including anti-vascular endothelial growth factor-A agents. It is, therefore, of interest to explore alternative methods that could allow for robust improvement in visual acuity with fewer injections required.</p><p><strong>Design: </strong>Literature review.</p><p><strong>Results: </strong>Among various preclinical and clinical studies in the literature, a promising approach is the use of suprachoroidal injection with viral and nonviral gene delivery vectors. Compared with other ocular injection methods, suprachoroidal injection has demonstrated wide biodistribution of injected agents and safety as an outpatient procedure. In terms of viral vectors, suprachoroidal injection of an adeno-associated virus 8 vector expressing an anti-vascular endothelial growth factor-A antibody fragment has shown an excellent safety profile and evidence of biological activity. In terms of nonviral vectors, lipid nanoparticles and polymeric nanoparticles both demonstrate strong promise for ocular gene therapy in large animal models. In particular, biodegradable poly(β-amino ester) nanoparticles show excellent biodistribution, safety, and efficacy for gene therapy via the suprachoroidal route. Nonviral nanoparticle approaches can have notable advantages over viral vectors in terms of carrying capacity, redosability, and manufacturing costs. An advantage of gene therapy is that once a delivery vector has been optimized, genetic cargos can be readily tailored without changing the safety, efficacy, and pharmacokinetic properties of the delivery vector.</p><p><strong>Conclusions: </strong>This review highlights recent progress that has been made and compares viral and nonviral suprachoroidal gene delivery for the treatment of retinal and choroidal vascular diseases. Suprachoroidal gene therapy is an emerging biotechnology that holds substantial potential to make a translational impact in treating these diseases.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880924","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":"Clinical Characterization, Natural History, and Detailed Phenotyping of NMNAT1-Associated Leber Congenital Amaurosis","authors":"YOO JIN LEE ,&nbsp;HYUN CHUL JEONG ,&nbsp;JEONG HUN KIM ,&nbsp;DONG HYUN JO","doi":"10.1016/j.ajo.2024.12.016","DOIUrl":"10.1016/j.ajo.2024.12.016","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize the clinical phenotype and disease progression in patients with <em>NMNAT1</em>-associated Leber congenital amaurosis (LCA) within the Korean population.</div></div><div><h3>Design</h3><div>Retrospective, observational case series.</div></div><div><h3>Subjects</h3><div>Fourteen patients with LCA with biallelic variants of <em>NMNAT1</em> at a single tertiary referral center.</div></div><div><h3>Methods</h3><div>Electronic medical records were reviewed for medical history, ophthalmic examinations, and molecular diagnoses, both cross-sectionally and longitudinally.</div></div><div><h3>Main Outcome Measures</h3><div>Ophthalmic examination findings were evaluated and retinal phenotypic characteristics were assessed using multimodal imaging.</div></div><div><h3>Results</h3><div>All patients exhibited early-onset, rapidly progressive bilateral retinal degeneration with pronounced central involvement. The condition was characterized by multiple atrophic lesions that coalesced into a large central retinal scar by age 2. The condition stabilized around 4 years of age. Fluorescein angiography demonstrated central hypofluorescence with visible choroidal vasculature. Optical coherence tomography showed significant retinal thinning, outer retinal layer disruption, and retinal pigment epithelial atrophy. Most patients maintained light perception vision or better, with minimal deterioration of visual acuity after the age of 2. All patients were hyperopic and exhibited undetectable electroretinography and visual-evoked potential responses.</div></div><div><h3>Conclusions</h3><div><em>NMNAT1</em>-associated LCA is characterized by severe, early-onset retinal degeneration with rapid progression, followed by stabilization. This distinct temporal pattern of disease progression suggests a potential therapeutic window in early childhood, emphasizing the importance of early diagnosis and regular monitoring for potential interventions.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"271 ","pages":"Pages 396-406"},"PeriodicalIF":4.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142875991","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":"Reply to Comment on \"Early versus Delayed Vitrectomy for Vitreous Haemorrhage Secondary to Proliferative Diabetic Retinopathy\".","authors":"Rodrigo Anguita, Lorenzo Ferro Desideri, Sobha Sivaprasad, Louisa Wickham","doi":"10.1016/j.ajo.2024.12.014","DOIUrl":"10.1016/j.ajo.2024.12.014","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870998","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":"Subluxated Intraocular Lens Stabilisation Using A Novel Microvascular Clamp Technique To Facilitate Scleral Suturing.","authors":"Minas T Coroneo, Andrew Chang","doi":"10.1016/j.ajo.2024.12.007","DOIUrl":"10.1016/j.ajo.2024.12.007","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870999","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, Early versus Delayed Vitrectomy for Vitreous Haemorrhage Secondary to Proliferative Diabetic Retinopathy.","authors":"Kentaro Nishida, Takatoshi Maeno, Kohji Nishida","doi":"10.1016/j.ajo.2024.11.025","DOIUrl":"10.1016/j.ajo.2024.11.025","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862912","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}