American Journal of Ophthalmology最新文献

{"title":"Circulating Tumor DNA in Conjunctival Melanoma: Landscape and Surveillance Value","authors":"Hao Tian ,&nbsp;Hanhan Shi ,&nbsp;Jie Chen ,&nbsp;Tianyu Zhu ,&nbsp;Ziyue Huang ,&nbsp;Chunyan Zong ,&nbsp;Shichong Jia ,&nbsp;Jing Ruan ,&nbsp;Shengfang Ge ,&nbsp;Haihua Yuan ,&nbsp;Yanjie Zhang ,&nbsp;Bin Jiang ,&nbsp;Rong Liu ,&nbsp;Renbing Jia ,&nbsp;Xianqun Fan ,&nbsp;Shiqiong Xu","doi":"10.1016/j.ajo.2024.10.012","DOIUrl":"10.1016/j.ajo.2024.10.012","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the surveillance value of circulating tumor DNA (ctDNA) for detecting distant metastasis and indicating systemic therapeutic efficacy in conjunctival melanoma (CoM).</div></div><div><h3>Design</h3><div>Retrospective, observational case series.</div></div><div><h3>Methods</h3><div>From July 2021 to June 2023, 30 CoM patients in our center underwent plasma ctDNA assessment, out of which 12 individuals presented with distant metastases. We employed a 437-gene panel containing common mutations in CoM and common drug-sensitive mutations using next-generation sequencing (NGS) technology to analyze ctDNA mutations in plasma. Clinical and radiological records were used to assess tumor status. The relationship between ctDNA characteristics, tissue gene mutations, and clinical manifestations were explored.</div></div><div><h3>Results</h3><div>CoM-related driver mutations were detected in ctDNA of 11 patients with distant metastasis. The ctDNA were highly consistent with tissue sequencing, mutual driver mutation including BRAF, NRAS, KRAS, NF1, CTNNB1, and TP53 mutation. those with a higher VAF had shorter progression-free survival (PFS, <em>p</em> = .0475) and overall survival (OS, <em>p</em> = .0043). The ctDNA variant allele fraction (VAF) was not correlated with the sum of the longest diameters (SLD, <em>p</em> = .8192) in distant metastasis patients.</div></div><div><h3>Conclusions</h3><div>Positive plasma ctDNA reflected the presence of metastases. The ctDNA could be used as a complement or alternative to tissue sequencing. High VAF ctDNA might indicate rapid disease progression in distant metastasis patients.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451411","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":"Multimodal Imaging Characteristics and Correlation to Outcomes in Patients With Central Retinal Artery Occlusion Presenting to a Large Academic Center","authors":"Sandra Hoyek ,&nbsp;Melissa Yuan ,&nbsp;Romy Bejjani ,&nbsp;David N. Zacks ,&nbsp;Joan W. Miller ,&nbsp;Demetrios G. Vavvas ,&nbsp;Nimesh A. Patel","doi":"10.1016/j.ajo.2024.10.004","DOIUrl":"10.1016/j.ajo.2024.10.004","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize a large modern cohort of patients with central retinal artery occlusion (CRAO) by describing presenting features and outcomes relating to manually segmented optical coherence tomography (OCT) features, angiographic reperfusion, and visual recovery.</div></div><div><h3>Design</h3><div>Retrospective clinical cohort study.</div></div><div><h3>Methods</h3><div>Patients with CRAO (ICD-10: H34.1) initially presenting to a tertiary referral center between January 2017 and December 2021 were included. Demographics, eye exam findings, fundus photographs, OCT, and fluorescein angiography were analyzed. Main outcome measures included total and inner retinal thickness on macular OCT, reperfusion, visual outcomes, and development of neovascularization.</div></div><div><h3>Results</h3><div>A total of 145 eyes of 144 patients with mean age at of 69.4 ± 13.6 years were included. The mean time to presentation was 1.6 ± 4.2 days, with 19% examined within 4.5 hours and 26% within 6 hours of vision loss. 19% had cilioretinal artery (CLRA) sparing. Mean initial visual acuity (VA) was 1.68 ± 1.10 Logarithm of the Minimum Angle of Resolution (LogMAR) (CLRA sparing) compared to 2.53 ± 0.58 LogMAR (non-CLRA sparing), <em>P</em> &lt; .001. 32% had elevated inflammatory makers. Out of 47 eyes with final fluorescein angiography, one-third showed some reperfusion. Final vision was 1.40 ± 1.16 LogMAR (CLRA sparing) compared to 2.46 ± 0.81 (non-CLRA sparing), <em>P</em> &lt; .001. A third of patients improved in VA in both groups, 27% of patients gained more than 2 lines of vision in the CLRA-sparing group and 36% in the non-CLRA-sparing group. 17% improved to better than 20/200 in CLRA-sparing and 4% in non-CLRA sparing. Overall, 11% developed neovascularization all in non-CLRA sparing. In a multiple linear regression, VA at presentation was associated with regaining vision of 2 lines or more (OR = 2.603, <em>P</em> = .007). OCT showed progressive thinning over time, reaching lowest measurements at 6 months, and stabilizing thereafter.</div></div><div><h3>Conclusions</h3><div>In this modern cohort of acute CRAO patients, presentation to a tertiary facility within 12 hours of symptoms was seen in almost half of the patients. Final VA improved in almost a third of the patients, however, vision better than the legal blindness limit was rare (∼5%). Interestingly, a third of patients had some mild elevation of systemic inflammatory markers. Better VA at presentation was associated with visual gain, while baseline OCT values had poor correlation with final outcome.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142448027","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":"Single-Cell RNA Profiling of Ocular Adnexal Sebaceous Carcinoma Reveals a Complex Tumor Microenvironment and Identifies New Biomarkers","authors":"Michelle G. Zhang ,&nbsp;Ryan A. Gallo ,&nbsp;Charissa H. Tan ,&nbsp;Matthew Camacho ,&nbsp;Sohaib Fasih-Ahmad ,&nbsp;Acadia H.M. Moeyersoms ,&nbsp;Yoseph Sayegh ,&nbsp;Sander R. Dubovy ,&nbsp;Daniel Pelaez ,&nbsp;Andrew J. Rong","doi":"10.1016/j.ajo.2024.10.001","DOIUrl":"10.1016/j.ajo.2024.10.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Ocular adnexal sebaceous carcinoma (OaSC) is an aggressive malignancy that often necessitates orbital exenteration. Its tumor composition and transcriptional profile remain largely unknown, which poses a significant barrier to medical advances. Here, we report the first in-depth transcriptomic analysis of OaSC at the single-cell resolution and discern mechanisms underlying cancer progression for the discovery of potential globe-sparing immunotherapies, targeted therapies, and biomarkers to guide clinical management.</div></div><div><h3>Design</h3><div>Laboratory investigation with a retrospective observational case series.</div></div><div><h3>Methods</h3><div>Single-cell RNA sequencing was performed on six patient specimens: three primary tumors, two tumors with pagetoid spread, and a normal tarsus sample. Cellular components were identified via gene signatures. Molecular pathways underlying tumorigenesis and pagetoid spread were discerned via gene ontology analysis of the differentially expressed genes between specimens. CALML5 immunohistochemistry was performed on an archival cohort of OaSC, squamous cell carcinoma, ocular surface squamous neoplasia (OSSN), and basal cell carcinoma cases.</div></div><div><h3>Results</h3><div>Analysis of 29,219 cells from OaSC specimens revealed tumor, immune, and stromal cells. Tumor-infiltrating immune cells include a diversity of cell types, including exhausted T-cell populations. In primary OaSC tumors, mitotic nuclear division and oxidative phosphorylation pathways are upregulated, while lipid biosynthesis and metabolism pathways are downregulated. Epithelial tissue migration pathways are upregulated in tumor cells undergoing pagetoid spread. Single-cell RNA sequencing analyses also revealed that CALML5 is upregulated in OaSC tumor cells. Diffuse nuclear and cytoplasmic CALML5 staining was present in 28 of 28 (100%) OaSC cases. Diffuse nuclear and membranous CALML5 staining was present in 5 of 25 (20%) squamous cell carcinoma and OSSN cases, while diffuse nuclear staining was present in 1 of 12 (8%) basal cell carcinoma cases.</div></div><div><h3>Conclusions</h3><div>This study reveals a complex OaSC tumor microenvironment and confirms that the CALML5 immunohistochemical stain is a sensitive diagnostic marker.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142405812","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":"Single- Versus Triple-Agent Intra-Arterial Chemotherapy for Retinoblastoma","authors":"NAJAH O. ALSHAHRANI ,&nbsp;ABEER ALDHAWI ,&nbsp;ZHAO XUN FENG ,&nbsp;KELVIN CHAU ,&nbsp;ASHWIN MALLIPATNA ,&nbsp;PRAKASH MUTHUSAMI ,&nbsp;CARMEN PARRA-FARINAS ,&nbsp;CHRISTIAN ZAAROUR ,&nbsp;FURQAN SHAIKH ,&nbsp;BRENDA L. GALLIE ,&nbsp;STEPHANIE N. KLETKE","doi":"10.1016/j.ajo.2024.09.037","DOIUrl":"10.1016/j.ajo.2024.09.037","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the ocular and systemic outcomes of single- (melphalan) versus triple-agent (melphalan, topotecan, carboplatin) intra-arterial chemotherapy (IAC) for retinoblastoma (RB) eye salvage.</div></div><div><h3>Design</h3><div>Retrospective single-institutional clinical cohort study.</div></div><div><h3>Methods</h3><div>Children &lt;18 years with RB who underwent one or more IAC procedures between 2016 and 2024 with minimum 6-month follow-up were reviewed. Data included clinical features, IAC procedural details, additional eye-saving treatments, complications, and follow-up. Primary outcomes included ocular and systemic complications of IAC, intraocular recurrence, extraocular extension, metastasis, and death. Secondary outcomes were tumor response, ocular survival, and recurrence-free ocular survival. Comparative analysis was performed for single- versus triple-agent groups. A SWIMMER^rb plot graphically illustrated additional treatments following IAC.</div></div><div><h3>Results</h3><div>Thirty-eight eyes of 37 children (24 unilateral RB) were reviewed. Two eyes (2 children) had single- followed by multi-agent IAC and were excluded. Of 35 included children, one had bilateral triple-agent IAC. IAC (median, 3 doses; range, 1-4) was employed as primary (<em>n</em> = 21 eyes) or secondary (<em>n</em> = 15 eyes) treatment. Chemotherapy was single-agent in 13 eyes and triple-agent in 23 eyes. Following IAC, 25 eyes required additional eye-saving treatments (69% single- <em>v</em> 70% triple-agent, <em>P</em> = .983). At final follow-up, the triple-agent group was more likely to achieve very good partial or complete tumor response (91% <em>v</em> 62%, <em>P</em> = .030). Two-year recurrence-free ocular survival was 63.3% (95% CI 45.7-80.9), similar for both groups (<em>P</em> = .700). Globe salvage was 72%. Two-year ocular survival was 72.2% (95% CI 57.2-87.2), higher for the triple-agent group (82.6% <em>v</em> 53.8%; <em>P</em> = .059). Ocular complications occurred in 31% of eyes in the single- and 52% of eyes in the triple-agent group (<em>P</em> = .215). The rate of systemic complications was 38% versus 74% in the single- versus triple-agent groups, respectively (<em>P</em> = .036). No extraocular extension, metastasis, or death were observed at median 34.2 months (range, 14.5-87.0) follow-up.</div></div><div><h3>Conclusions</h3><div>Triple-agent IAC was associated with improved RB tumor response and ocular survival, though similar recurrence-free ocular survival compared to single-agent. While there were more complications with triple-agent IAC, most were mild or transient.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142431117","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":"Pediatric Eyelid Cutaneous Horns: A Case Series and Literature Review","authors":"RAMEZ BARBARA ,&nbsp;AHMED M. ABDELAAL ,&nbsp;REBECCA LEVY ,&nbsp;ANITA NAGY ,&nbsp;KAMIAR MIRESKANDARI ,&nbsp;ASIM ALI","doi":"10.1016/j.ajo.2024.09.034","DOIUrl":"10.1016/j.ajo.2024.09.034","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe the clinical and histopathologic features of pediatric eyelid cutaneous horns.</div></div><div><h3>Design</h3><div>Retrospective observational case series and review of literature.</div></div><div><h3>Subjects</h3><div>Five pediatric patients with eyelid cutaneous horns.</div></div><div><h3>Methods</h3><div>Five cases with eyelid cutaneous horns were retrospectively identified using departmental databases. Patients’ records were analyzed for demographic data, clinical appearance, histologic findings, and clinical course. An excisional biopsy of the lesion was performed in 3 patients. The remaining 2 patients were managed conservatively.</div></div><div><h3>Main outcome measures</h3><div>Clinical outcome and histopathologic evaluation with emphasis on excluding malignancy.</div></div><div><h3>Results</h3><div>All 5 cutaneous horn lesions resolved surgically or conservatively. The average age at presentation was 6.6 years (range 5-11 years). Clinically, 4 lesions were preceded by a hordeolum or chalazion and all excised lesions had benign features on histologic examination. Mitotic figures or atypia were not observed. None of the patients developed recurrence during the follow-up period ranging from 1 to 96 months.</div><div>Five previous reports of five cases were found on review of the literature. Our case series doubles this number to support the benign nature of these lesions in children.</div></div><div><h3>Conclusions</h3><div>Pediatric eyelid cutaneous horns are closely related to eyelid margin inflammatory disease and appear to follow a benign course. This contrasts with the adult population where cutaneous horns are frequently associated with neoplasia.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142405810","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":"Long-Term Assessment of PC–IOL Optic Apposition in Surface-Modified IOL and Its Impact on Nd:YAG Capsulotomy Rate and Visual Quality","authors":"Manpreet Kaur,&nbsp;Jeewan S. Titiyal,&nbsp;Jyoti Rawat","doi":"10.1016/j.ajo.2024.09.029","DOIUrl":"10.1016/j.ajo.2024.09.029","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess apposition of posterior capsule (PC) to intraocular lens (IOL) optic in ultraviolet (UV)/ozone surface modified IOL and its impact on neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy rate and visual quality.</div></div><div><h3>Design</h3><div>Prospective interventional case series.</div></div><div><h3>Methods</h3><div>The study enrolled 100 eyes implanted with UV/ozone surface modified hydrophobic acrylic IOL during phacoemulsification. The primary outcome measure was PC–optic apposition on anterior segment optical coherence tomography (ASOCT). Secondary outcomes were Nd:YAG capsulotomy and visual quality (ray-tracing aberrometry). Follow-up was performed on postoperative day (POD) 1, at 1, 3, and 6 months, and 1 and 2 years.</div></div><div><h3>Results</h3><div>Complete PC–optic apposition was observed in 4% of cases on POD1, which increased to 75% at 2 years. PC configuration in cases with PC–optic non-apposition was smooth (34.4%) or wavy (65.6%) on ASOCT; initial smooth PC was associated with significantly higher incidence of PC–optic apposition at 2 years (p=0.028). At 2 years, visual quality was significantly better in cases with complete PC–optic apposition in terms of Strehl ratio (<em>P</em> = .029), modulation transfer function (MTF) (<em>P</em> = 0.016), root mean square (RMS) aberrations (<em>P</em> = .024) and higher order aberrations (HOAs) (<em>P</em> = 0.043). A significant positive correlation was observed between height of interface fluid and total RMS (Pearson correlation coefficient 0.221; <em>P</em> = .027) and HOAs (Pearson correlation coefficient 0.198; <em>P</em> = .048). PCO developed in 7% of cases (7/100); of these, 6 cases had persistent PC–optic non-apposition. Nd:YAG laser capsulotomy was required in 3% (3/100) cases; all of these cases had persistent PC–optic non-apposition.</div></div><div><h3>Conclusions</h3><div>Long-term complete PC–optic apposition was observed in 75% of patients implanted with UV/ozone surface-modified IOLs. Complete PC–optic apposition is associated with lower Nd:YAG capsulotomy rate and superior visual quality.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339271","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":"Clinical Outcomes of Endothelial Keratoplasty With a Recipient's Entire Descemet Stripping for Iridocorneal Endothelial Syndrome","authors":"Xiaojuan Dong ,&nbsp;Chen Ouyang ,&nbsp;Qinying Ye ,&nbsp;Jing Wu ,&nbsp;Chenjia Xu ,&nbsp;Lingling Fu ,&nbsp;Minglu Ma ,&nbsp;Jiayin Peng ,&nbsp;Ting Huang","doi":"10.1016/j.ajo.2024.09.024","DOIUrl":"10.1016/j.ajo.2024.09.024","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate whether a recipient's entire Descemet stripping reduced endothelial cell loss (ECL) after Descemet membrane endothelial keratoplasty (DMEK) for iridocorneal endothelial (ICE) syndrome.</div></div><div><h3>Design</h3><div>Randomized controlled clinical trial.</div></div><div><h3>Methods</h3><div>A total of 48 patients (48 eyes) with ICE syndrome were enrolled between 10 March 2014 and 11 May 11 2022. The eligible patients were divided into the entire recipient's Descemet stripping group (entire stripping group, 24 eyes) or the standard technique group (standard group, 24 eyes). DMEK was performed in all cases with concomitant procedures. The recipient's entire Descemet membrane or the central 8.0- or 8.25-mm diameter of the Descemet membrane was removed intraoperatively. Main outcome measures were ECL, corrected distance visual acuity (CDVA), intraocular pressure (IOP), graft survival, and surgical complications, which were compared 9, 12, and 24 months after surgery.</div></div><div><h3>Results</h3><div>After a 9-month follow-up, ECL was significantly lower in the entire stripping group than in the standard group. At 2 years postoperatively, the ECL rate was 66% ± 5% and 74% ± 4% (95% CI: −0.04 to 0.01; <em>P</em> = .040), with a cumulative graft success rate of 83% and 67% (95% CI: −0.07 to 0.39; <em>P</em> = .318) in the entire stripping group and the standard group, respectively. The postoperative CDVA level was comparable between the 2 groups throughout the follow-up period. No significant differences between the 2 groups were observed in regard to the incidence of main complications.</div></div><div><h3>Conclusions</h3><div>Entire recipient's Descemet stripping may delay the pathological progression of ICE syndrome, thereby reducing ECL after DMEK.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339266","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":"Choroid Involvement Secondary to Optic Disc Pit Maculopathy: OCT Analysis and Evolution After Surgical Treatment","authors":"Matteo Mario Carlà ,&nbsp;Francesco Boselli ,&nbsp;Federico Giannuzzi ,&nbsp;Emanuele Crincoli ,&nbsp;Tomaso Caporossi ,&nbsp;Carlos Mateo ,&nbsp;Stanislao Rizzo","doi":"10.1016/j.ajo.2024.09.022","DOIUrl":"10.1016/j.ajo.2024.09.022","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess choroidal changes associated to optic disc pit maculopathy (ODP-M) and their evolution after surgical treatment.</div></div><div><h3>Design</h3><div>Multicentric retrospective case series.</div></div><div><h3>Methods</h3><div>An analysis of 42 patients affected by unilateral ODP-M undergoing surgical treatment between 2013 and 2023 was conducted. Optical coherence tomography (OCT) was performed at baseline and postoperative months 1, 6, 12, and 24 and most recent follow-up. Subfoveal choroidal thickness (SFCT) and peripapillary choroidal thickness (PPCT) were measured in ODP-M and fellow eyes. The presence of retinal pigmented epithelium (RPE) atrophy was used to distinguish between “early” and “advanced” disease, and data regarding fluid localization were collected.</div></div><div><h3>Results</h3><div>Baseline SFCT in ODP-M eyes was significantly higher than fellow eyes (386.8 ± 88.9 vs 334.4 ± 72.2 µm, <em>P</em> = 0.002), in contrast to PPCT (192.6 ± 47.8 vs 181.2 ± 45.7 µm, <em>P</em> = .46). SFCT significantly decreased 1 month postoperatively (mean reduction 36.5 µm, <em>P</em> = .009) and remained below preoperative values throughout the follow-up, showed a mean reduction of 79.4 µm at final follow-up (<em>P</em> &lt; .001). Conversely, PPCT showed no changes between preoperative and postoperative values (all <em>P</em> &gt; .05). Nine eyes (21.4%) showed submacular dilated choroidal vessels, correlated with the presence of subretinal fluid (<em>P</em> = .008) and reducing in caliber after surgical treatment. The 10 eyes (23.8%) with advanced disease had lower baseline SFCT and worse best-corrected visual acuity compared to the early disease subgroup, and showed a delayed reduction of choroidal swelling postoperatively.</div></div><div><h3>Conclusions</h3><div>Subfoveal choroid may thicken and remodel in response to ODP-M, eventually returning to physiological values after surgical treatment. Moreover, the presence of RPE atrophy may influence retino-choroidal balance. Conversely, PPCT did not show comparable modifications.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339265","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":"Geographical Trends in Global Ophthalmology Research From 2002 to 2022","authors":"Selina J. Chang ,&nbsp;Amrish Selvam ,&nbsp;Sydney DeVore ,&nbsp;Rajan Alagar ,&nbsp;Amy Yu ,&nbsp;Joshua Ong ,&nbsp;Jay K. Chhablani","doi":"10.1016/j.ajo.2024.07.027","DOIUrl":"10.1016/j.ajo.2024.07.027","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Characterize geographical trends in ophthalmology research between 2002 and 2022 and explore associations among study locations, designs, and funding sources</div></div><div><h3>DESIGN</h3><div>Trend study.</div></div><div><h3>METHODS</h3><div>Analysis of 4199 publications from the American Journal of Ophthalmology, British Journal of Ophthalmology, Investigative Ophthalmology &amp; Visual Science, JAMA Ophthalmology, and Ophthalmology. All original full-length publications from 2002, 2012, and 2022 were included. Exclusion criteria were meta-analyses, literature reviews, and case reports. Main outcome measures were publication years, locations, study designs, and funding sources.</div></div><div><h3>RESULTS</h3><div>Publications from North America (45.8%), Europe (30.7%), and Asia (28.9%) were the most common, whereas Africa (0.8%) and South America (1.4%) were least represented. North American research decreased by 10.6% (<em>P &lt; .</em>001), whereas Asian research increased by 25.4% (<em>P &lt; .</em>001). The United States contributed 42.3% of research but experienced an 11.3% decline from 2002 to 2022 (<em>P &lt; .</em>001). Publications in the United States received 5.8% more industry funding from 2002 to 2022 (<em>P = .</em>006). China's research grew by 17.0% and had the highest proportion of government (83.1%) or intramural (24.2%) funding (<em>P &lt; .</em>001), with government-funded studies increasing by 46.7% (<em>P &lt; .</em>001). Japan was less associated with all funding types (<em>P ≤ .</em>001). Singapore, Iceland, and Switzerland were top performers when adjusted for population size.</div></div><div><h3>CONCLUSIONS</h3><div>Within the examined journals, the United States remains the primary research contributor, with China witnessing rapid growth and Japan facing stagnation. Despite the declining research proportion in the United States, North America and Europe continue to maintain a disproportionately high presence in prestigious academic journals. Publications from Africa and South America are limited.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878221","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":"Imaging-Based Detection of Anterior Chamber Inflammation: A Comparative Diagnostic Accuracy Study","authors":"Prithi Uthayananthan ,&nbsp;Nakita Tanwar ,&nbsp;Jugnoo S. Rahi ,&nbsp;Andrew D. Dick ,&nbsp;Ameenat Lola Solebo","doi":"10.1016/j.ajo.2024.07.018","DOIUrl":"10.1016/j.ajo.2024.07.018","url":null,"abstract":"<div><h3>Purpose</h3><div>We investigated the impact of operator parameters on the diagnostic performance of anterior-segment optical coherence tomography (AS-OCT) in anterior uveitis.</div></div><div><h3>Design</h3><div>Prospective comparative diagnostic analysis.</div></div><div><h3>Methods</h3><div><em>Setting</em>: Single site. <em>Study population</em>: Children younger than 18 years with anterior uveitis, recruited consecutively. <em>Observation procedures</em>: Index testing: Optovue RTVue80 AS-OCT using “low-volume” (LV, horizontal and vertical cross-sections) and “high-volume” (HV, 68 horizontal cross-sections) protocols. Reference testing: slitlamp examination with anterior chamber inflammation graded using standardization of uveitis nomenclature (SUN). <em>Main outcome measure</em>: Index test performance metrics (sensitivity, specificity, and likelihood ratios), utility for “ruling-in” and “ruling-out” disease (positive/negative predictive values, PPV/NPV), receiver operating characteristic curves to explore the impact of different imaging-derived metrics, multivariable multilevel regression analyses to quantify correlation of index to reference testing, and repeatability indices across protocols.</div></div><div><h3>Results</h3><div>A total of 40 children (77 eyes: 51 eyes at SUN grade 0, 10 at SUN 0.5+, 8 at SUN 1+, and 8 SUN ≥2+ or higher) were included. There was high repeatability across protocols (0.98, <em>P</em> &lt; .001, 95% CI: 0.75-1.0). OCT resulted in strong predictive values for “ruling-out” (LV-scan NPV 82.9%, 95% CI: 71.5%-90.4%; HV-scan NPV 100%, 95% CI: 3%-100%) but a less predictive value for “ruling-in” SUN ≥0.5+ (LV-scan PPV 52.8%, 95% CI: 41.5%-63.7%; HV-scan PPV 34.2%, 95% CI: 33.3%-35.1%). Detection of more than 1 cell within a cross-sectional scan was strongly suggestive of clinical activity, with an area under the curve of 0.76 (95% CI: 0.62-0.89) for SUN ≥0.5+ and 0.85 (95% CI: 0.73-0.98) for the detection of SUN ≥1+. Cell count correlated with SUN grades at higher levels of inflammation (SUN ≥2+ both protocols, SUN ≥1+ HV-scans). There was an independent positive association between age and AS-OCT cell (adjusted correlation coefficient 0.2 cells for each additional year of age).</div></div><div><h3>Conclusions</h3><div>Operator-dependent factors impact the diagnostic and quantification performance of AS-OCT for anterior chamber inflammation. However, the strong, “dose-respondent” correlation of LV protocols with SUN grading promises clinical utility without the storage and analysis burden of HV approaches. Further work will involve exploration of the need for age-specific image metric interpretation.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141873941","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}