Pub Date : 2026-03-17DOI: 10.1016/j.ajo.2026.03.013
Janet L. Davis
{"title":"The Multimodal Imaging in Uveitis Virtual Special Issue","authors":"Janet L. Davis","doi":"10.1016/j.ajo.2026.03.013","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.03.013","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"13 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147465166","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}
Pub Date : 2026-03-17DOI: 10.1016/j.ajo.2026.03.017
Itika Garg,Margaret Duich,Chibuike Uwakwe,Karen M Wai,Jocelyn M Rodriguez,Edward S Lu,Ying Cui,Rongrong Le,Raviv Katz,Ines Lains,Filippos Vingopoulos,Jade Y Moon,Ying Zhu,Dean Eliott,Joan W Miller,Leo A Kim,Nimesh A Patel,Deeba Husain,Demetrios G Vavvas,John B Miller
PURPOSEThis study evaluates swept-source OCT Angiography (SS-OCTA) quantitative metrics as non-invasive biomarkers of diabetic nephropathy (DN) in patients with diabetes mellitus.DESIGNThis is a cross-sectional study of patients with Diabetes Mellitus.SUBJECTSThis study included 375 eyes of 234 patients imaged using 12 × 12-mm angiograms centered on the fovea.METHODSOCTA metrics that were analyzed included non-perfusion area (NPA), foveal avascular zone area (FAZ), vessel density (VD), and vessel skeletonized density (VSD). These metrics were compared with the presence and severity of DN.MAIN OUTCOME MEASURESPrimary outcomes were albuminuria (albumin-to-creatinine ratio ≥30 mg/g) and chronic kidney disease (CKD, estimated glomerular filtration rate ≤60 or >60 ml/min/1.73 m2 with albuminuria). Secondary outcomes included albuminuria severity (A1: <30, A2: 30-300, A3: >300 mg/g), CKD severity (normal GFR: ≥90, mild CKD: 60-89, moderate-severe CKD: ≤59 ml/min/1.73 m2) and Kidney Disease Improving Global Outcomes (KDIGO) risk categories for CKD progression and/or mortality. Subgroup analysis assessed early microvascular changes in patients with no or mild diabetic retinopathy (DR) and DN association. Multivariate regression adjusted for age, smoking status, glycosylated hemoglobin, and mean arterial blood pressure.RESULTSOf 234 patients, 145 (62%) had CKD and 111 (47%) had albuminuria. Increasing NPA was associated with albuminuria (Odd's ratio (OR): 1.17, p=0.038), CKD (OR: 1.06, p<0.001), CKD severity (p<0.05), and KDIGO risk categories on pairwise analysis (p<0.05). VD and VSD were significantly different between extremes of KDIGO risk categories (very high versus low and moderate risk, p<0.05) and albuminuria severity (A3 versus A1, p<0.05). In the no/mild DR subgroup, more circular FAZ and higher VD were associated with absent albuminuria (p<0.05).CONCLUSIONSNPA is a potential biomarker for predicting DN and is associated with DN severity. This study is the first to link OCTA metrics with KDIGO risk categories for CKD severity and mortality.
{"title":"Swept-Source OCT Angiography Vascular Metrics as Biomarkers for Renal Function in Patients with Diabetes Mellitus.","authors":"Itika Garg,Margaret Duich,Chibuike Uwakwe,Karen M Wai,Jocelyn M Rodriguez,Edward S Lu,Ying Cui,Rongrong Le,Raviv Katz,Ines Lains,Filippos Vingopoulos,Jade Y Moon,Ying Zhu,Dean Eliott,Joan W Miller,Leo A Kim,Nimesh A Patel,Deeba Husain,Demetrios G Vavvas,John B Miller","doi":"10.1016/j.ajo.2026.03.017","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.03.017","url":null,"abstract":"PURPOSEThis study evaluates swept-source OCT Angiography (SS-OCTA) quantitative metrics as non-invasive biomarkers of diabetic nephropathy (DN) in patients with diabetes mellitus.DESIGNThis is a cross-sectional study of patients with Diabetes Mellitus.SUBJECTSThis study included 375 eyes of 234 patients imaged using 12 × 12-mm angiograms centered on the fovea.METHODSOCTA metrics that were analyzed included non-perfusion area (NPA), foveal avascular zone area (FAZ), vessel density (VD), and vessel skeletonized density (VSD). These metrics were compared with the presence and severity of DN.MAIN OUTCOME MEASURESPrimary outcomes were albuminuria (albumin-to-creatinine ratio ≥30 mg/g) and chronic kidney disease (CKD, estimated glomerular filtration rate ≤60 or >60 ml/min/1.73 m2 with albuminuria). Secondary outcomes included albuminuria severity (A1: <30, A2: 30-300, A3: >300 mg/g), CKD severity (normal GFR: ≥90, mild CKD: 60-89, moderate-severe CKD: ≤59 ml/min/1.73 m2) and Kidney Disease Improving Global Outcomes (KDIGO) risk categories for CKD progression and/or mortality. Subgroup analysis assessed early microvascular changes in patients with no or mild diabetic retinopathy (DR) and DN association. Multivariate regression adjusted for age, smoking status, glycosylated hemoglobin, and mean arterial blood pressure.RESULTSOf 234 patients, 145 (62%) had CKD and 111 (47%) had albuminuria. Increasing NPA was associated with albuminuria (Odd's ratio (OR): 1.17, p=0.038), CKD (OR: 1.06, p<0.001), CKD severity (p<0.05), and KDIGO risk categories on pairwise analysis (p<0.05). VD and VSD were significantly different between extremes of KDIGO risk categories (very high versus low and moderate risk, p<0.05) and albuminuria severity (A3 versus A1, p<0.05). In the no/mild DR subgroup, more circular FAZ and higher VD were associated with absent albuminuria (p<0.05).CONCLUSIONSNPA is a potential biomarker for predicting DN and is associated with DN severity. This study is the first to link OCTA metrics with KDIGO risk categories for CKD severity and mortality.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"49 3 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483583","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}
Pub Date : 2026-03-16DOI: 10.1016/j.ajo.2026.03.016
Femke M. van den Tillaart, Jennifer M. Chang-Wolf, Helena M.A. Feenstra, Thomas J. van Rijssen, Carel B. Hoyng, Roselie M.H. Diederen, Reinier O. Schlingemann, Camiel J.F. Boon, Suzanne Yzer, Elon H.C. van Dijk
To prospectively evaluate and compare long-term functional and structural outcomes between successful and unsuccessful first half-dose photodynamic therapy (PDT) in patients with chronic central serous chorioretinopathy (cCSC).
{"title":"Long-term follow-up of PLACE and SPECTRA trials: outcomes after successful and unsuccessful half-dose photodynamic therapy for chronic central serous chorioretinopathy","authors":"Femke M. van den Tillaart, Jennifer M. Chang-Wolf, Helena M.A. Feenstra, Thomas J. van Rijssen, Carel B. Hoyng, Roselie M.H. Diederen, Reinier O. Schlingemann, Camiel J.F. Boon, Suzanne Yzer, Elon H.C. van Dijk","doi":"10.1016/j.ajo.2026.03.016","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.03.016","url":null,"abstract":"To prospectively evaluate and compare long-term functional and structural outcomes between successful and unsuccessful first half-dose photodynamic therapy (PDT) in patients with chronic central serous chorioretinopathy (cCSC).","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"96 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147465169","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}
To evaluate real-world outcomes of PRESERFLO™ MicroShunt (PMS) implantation and identify risk factors for surgical failure in a large multicenter Japanese cohort.
{"title":"Outcomes and Risk Factors for Failure After PRESERFLO™ MicroShunt Implantation in a Multicenter Japanese Cohort","authors":"HIROKI MIENO, KAZUHIKO MORI, KIYOSHI KANO, KENGO YOSHII, KUMIKO KAZUO, YOKO IKEDA, MORIO UENO, YASUAKI KUWAYAMA, CHIE SOTOZONO","doi":"10.1016/j.ajo.2026.03.014","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.03.014","url":null,"abstract":"To evaluate real-world outcomes of PRESERFLO™ MicroShunt (PMS) implantation and identify risk factors for surgical failure in a large multicenter Japanese cohort.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"11 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147465167","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}
Pub Date : 2026-03-11DOI: 10.1016/j.ajo.2026.03.007
Robert A Clark,Rupa K Wong
TOPICTo determine the relative merits of spherical equivalent refraction (SER) versus axial length (AL) as the primary measure for monitoring childhood myopia progression and predicting adult myopia-related pathology.CLINICAL RELEVANCEMyopia prevalence is rising worldwide, but most patients only reach low-to-moderate myopia. Many guidelines emphasize AL over SER using fixed thresholds to define "high risk" (e.g. ≥26 mm), yet a large proportion of myopia-related pathology occurs in eyes that never reach those lengths.METHODSWe conducted a systematic review and meta-analysis of population-based observational studies (≥200 eyes; PubMed and Embase searched from 1990-July 2025) reporting AL and/or SER with demographics and/or retinal, cataract, or primary open-angle glaucoma (POAG) outcomes. Random-effects meta-analyses with Hartung-Knapp adjustment were performed when k≥3; other results were synthesized descriptively. Risk of bias was assessed with the Newcastle-Ottawa Scale and certainty of evidence with Grading of Recommendations Assessment, Development and Evaluation.RESULTSSeventy studies met inclusion criteria. Normal AL varied strongly with age, sex, height, and ethnicity, whereas SER showed much weaker dependence. A small tail of emmetropes reached AL ≥26 mm. Retinal pathology rose steeply with longer AL (OR 3.85 per +1 mm), implying RR∼25 at AL 26 mm relative to AL 23.6 mm (pooled gradient), but this long-eye threshold applied to <10% of eyes. SER data, although less frequent, showed consistent retinal risk increases with OR ∼1.5-1.8 per -1D and OR 2-12 for high myopia. For cataract prevalence, SER-defined moderate/high myopia yielded OR 3.09 for nuclear and 4.58 for posterior subcapsular cataract, whereas AL-defined effects were null or modest. For POAG prevalence, AL per +1 mm showed OR 1.37, whereas SER-defined moderate/high myopia showed OR 2.95. Certainty of evidence was moderate for prevalence analyses and lower for incidence and descriptive blocks.CONCLUSIONSAbsolute AL thresholds clearly identify a small tail of very long eyes at high retinal risk, but SER better captures cataract and POAG risk gradients across the myopic range that most patients will reach. SER should be the primary progression and risk metric for monitoring childhood myopia control, with AL used selectively to monitor the minority of children with greater axial elongation.FUNDINGNone REGISTRATION: PROSPERO CRD420251123893.
{"title":"Spherical Equivalent Refraction versus Axial Length for Monitoring Childhood Myopia and Estimating Disease Risk: A Systematic Review and Meta-Analysis.","authors":"Robert A Clark,Rupa K Wong","doi":"10.1016/j.ajo.2026.03.007","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.03.007","url":null,"abstract":"TOPICTo determine the relative merits of spherical equivalent refraction (SER) versus axial length (AL) as the primary measure for monitoring childhood myopia progression and predicting adult myopia-related pathology.CLINICAL RELEVANCEMyopia prevalence is rising worldwide, but most patients only reach low-to-moderate myopia. Many guidelines emphasize AL over SER using fixed thresholds to define \"high risk\" (e.g. ≥26 mm), yet a large proportion of myopia-related pathology occurs in eyes that never reach those lengths.METHODSWe conducted a systematic review and meta-analysis of population-based observational studies (≥200 eyes; PubMed and Embase searched from 1990-July 2025) reporting AL and/or SER with demographics and/or retinal, cataract, or primary open-angle glaucoma (POAG) outcomes. Random-effects meta-analyses with Hartung-Knapp adjustment were performed when k≥3; other results were synthesized descriptively. Risk of bias was assessed with the Newcastle-Ottawa Scale and certainty of evidence with Grading of Recommendations Assessment, Development and Evaluation.RESULTSSeventy studies met inclusion criteria. Normal AL varied strongly with age, sex, height, and ethnicity, whereas SER showed much weaker dependence. A small tail of emmetropes reached AL ≥26 mm. Retinal pathology rose steeply with longer AL (OR 3.85 per +1 mm), implying RR∼25 at AL 26 mm relative to AL 23.6 mm (pooled gradient), but this long-eye threshold applied to <10% of eyes. SER data, although less frequent, showed consistent retinal risk increases with OR ∼1.5-1.8 per -1D and OR 2-12 for high myopia. For cataract prevalence, SER-defined moderate/high myopia yielded OR 3.09 for nuclear and 4.58 for posterior subcapsular cataract, whereas AL-defined effects were null or modest. For POAG prevalence, AL per +1 mm showed OR 1.37, whereas SER-defined moderate/high myopia showed OR 2.95. Certainty of evidence was moderate for prevalence analyses and lower for incidence and descriptive blocks.CONCLUSIONSAbsolute AL thresholds clearly identify a small tail of very long eyes at high retinal risk, but SER better captures cataract and POAG risk gradients across the myopic range that most patients will reach. SER should be the primary progression and risk metric for monitoring childhood myopia control, with AL used selectively to monitor the minority of children with greater axial elongation.FUNDINGNone REGISTRATION: PROSPERO CRD420251123893.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"93 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446925","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}
Pub Date : 2026-03-11DOI: 10.1016/j.ajo.2026.03.003
Ghazaleh Soltani,Takashi Nishida,Sasan Moghimi,Eleonora Micheletti,Seyedehmelika Hashemi,Amelia de Oliveira Pereira,Robert N Weinreb
PURPOSETo investigate the relationship of structural progression, β-zone parapapillary atrophy (PPA) progression, and microvascular dropout (MvD) in glaucoma suspect eyes.DESIGNRetrospective cohort Study METHODS: Eyes were included if optic disc photographs were available at least five years before optical coherence tomography angiography (OCTA) imaging. During follow-up, structural progression and β-zone PPA progression were recorded. Structural progression was graded using stereophotographs; eyes were classified as progressing if new or enlarged retinal nerve fiber layer (RNFL) defects or neuroretinal rim thinning were detected. β-zone PPA was quantified (area, radial width, angular extent), with progression defined as a ≥20% increase in any parameter. The presence of MvD at the last visit was evaluated using en-face choroidal vessel density maps. Multivariable logistic regression was used to assess the association between MvD and structural progression, adjusting for covariates and β-zone PPA progression. Margins analysis was performed to estimate predicted probabilities of structural progression by MvD status and β-zone PPA progression.RESULTS180 eyes from 134 glaucoma suspect patients were included, of which 58 eyes (32.2%) had MvD. The mean follow-up duration for fundus photographs was 19.0 (95%CI, 17.9 to 20.1) years. The presence of MvD and also β-zone PPA progression were significantly associated with structural progression (15.8 [95%CI, 5.6 to 44.6], P<0.001; 3.8 [95%CI, 1.2 to 11.7], P=0.022, respectively). Margin plots indicated that eyes exhibiting both MvD and β-zone PPA progression had the highest estimated probability of structural progression (0.75).CONCLUSIONIn glaucoma suspect eyes, the presence of both MvD and β-zone PPA progression were independently associated with structural optic disc progression. These structural changes were observed in glaucoma suspect eyes that remained clinically stable and did not convert to perimetric glaucoma during the period of observation in this study. Recognition of these changes may enhance more timely management to prevent glaucomatous vision loss.
{"title":"Optic Disc Structural Progression in Glaucoma Suspect Eyes with Microvascular Dropout.","authors":"Ghazaleh Soltani,Takashi Nishida,Sasan Moghimi,Eleonora Micheletti,Seyedehmelika Hashemi,Amelia de Oliveira Pereira,Robert N Weinreb","doi":"10.1016/j.ajo.2026.03.003","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.03.003","url":null,"abstract":"PURPOSETo investigate the relationship of structural progression, β-zone parapapillary atrophy (PPA) progression, and microvascular dropout (MvD) in glaucoma suspect eyes.DESIGNRetrospective cohort Study METHODS: Eyes were included if optic disc photographs were available at least five years before optical coherence tomography angiography (OCTA) imaging. During follow-up, structural progression and β-zone PPA progression were recorded. Structural progression was graded using stereophotographs; eyes were classified as progressing if new or enlarged retinal nerve fiber layer (RNFL) defects or neuroretinal rim thinning were detected. β-zone PPA was quantified (area, radial width, angular extent), with progression defined as a ≥20% increase in any parameter. The presence of MvD at the last visit was evaluated using en-face choroidal vessel density maps. Multivariable logistic regression was used to assess the association between MvD and structural progression, adjusting for covariates and β-zone PPA progression. Margins analysis was performed to estimate predicted probabilities of structural progression by MvD status and β-zone PPA progression.RESULTS180 eyes from 134 glaucoma suspect patients were included, of which 58 eyes (32.2%) had MvD. The mean follow-up duration for fundus photographs was 19.0 (95%CI, 17.9 to 20.1) years. The presence of MvD and also β-zone PPA progression were significantly associated with structural progression (15.8 [95%CI, 5.6 to 44.6], P<0.001; 3.8 [95%CI, 1.2 to 11.7], P=0.022, respectively). Margin plots indicated that eyes exhibiting both MvD and β-zone PPA progression had the highest estimated probability of structural progression (0.75).CONCLUSIONIn glaucoma suspect eyes, the presence of both MvD and β-zone PPA progression were independently associated with structural optic disc progression. These structural changes were observed in glaucoma suspect eyes that remained clinically stable and did not convert to perimetric glaucoma during the period of observation in this study. Recognition of these changes may enhance more timely management to prevent glaucomatous vision loss.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"15 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446929","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}
PURPOSETo develop and validate a new intraocular lens (IOL) power calculation formula for cataract patients with previous myopic corneal refractive surgery (MRS).DESIGNRetrospective, comparative analysis of lOL power calculations.PARTICIPANTSPatients undergoing MRS were enrolled for formula development, and cataract patients with prior MRS were recruited for evaluation.METHODSLinear regression model was used to characterize the relationship between preoperative anterior corneal radius (ARC) and postoperative posterior corneal radius (PRC) in patients undergoing MRS. A thick-lens LISA MRS formula was then developed, using predicted preoperative ARC for effective lens position estimation. Its performance was compared with existing formulas (Barrett True K, Emmetropia Verifying Optical [EVO], Haigis-L, Hoffer QST, and Shammas PL) in cataract patients with prior MRS.MAIN OUTCOME MEASURESArithmetic and absolute prediction errors.RESULTSThe study included 134 MRS patients (98 small incision lenticule extraction [SMILE] and 36 femtosecond laser-assisted in situ keratomileusis [FS-LASIK]) for formula development, and the changes in anterior and posterior keratometry were comparable between the two procedures. Postoperative PK was a strong predictor of preoperative ARC, with an R2 of 0.82. In 225 cataract patients from three centers for formula validation, the formula performance index (FPI) was highest for LISA MRS (with or without PRC, 0.43), followed by Hoffer QST (0.37), EVO and Hoffer QST-PRC (both 0.32), EVO-PRC and Barrett True K-PRC (both 0.30), and Barrett True K (0.26). LISA MRS-PRC and EVO-PRC yielded the lowest median absolute prediction error (0.47 D), with EVO-PRC performing relatively better in eyes with AL < 28 mm and LISA MRS-PRC maintaining favorable accuracy in eyes with AL ≥ 28 mm. Incorporating PRC significantly improved the performance of Barrett True K, LISA MRS, and Hoffer QST (all P< 0.05).CONCLUSIONSThe LISA MRS formula provides accurate IOL power calculation for cataract patients with prior MRS, particularly in eyes with AL ≥ 28 mm. Use of PRC is recommended whenever available.
{"title":"Development and Validation of a new Formula for Intraocular Lens Power Calculation in Patients with Myopic Corneal Refractive Surgery.","authors":"Jiaqing Zhang,Xiaohang Xie,Haorui Yuan,Aixia Jin,Yuxin Zhu,Haowen Lin,Yuanjiao Qiao,Lihan Luo,Yong Wang,Xuhua Tan,Kun Zeng,Lixia Luo","doi":"10.1016/j.ajo.2026.03.004","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.03.004","url":null,"abstract":"PURPOSETo develop and validate a new intraocular lens (IOL) power calculation formula for cataract patients with previous myopic corneal refractive surgery (MRS).DESIGNRetrospective, comparative analysis of lOL power calculations.PARTICIPANTSPatients undergoing MRS were enrolled for formula development, and cataract patients with prior MRS were recruited for evaluation.METHODSLinear regression model was used to characterize the relationship between preoperative anterior corneal radius (ARC) and postoperative posterior corneal radius (PRC) in patients undergoing MRS. A thick-lens LISA MRS formula was then developed, using predicted preoperative ARC for effective lens position estimation. Its performance was compared with existing formulas (Barrett True K, Emmetropia Verifying Optical [EVO], Haigis-L, Hoffer QST, and Shammas PL) in cataract patients with prior MRS.MAIN OUTCOME MEASURESArithmetic and absolute prediction errors.RESULTSThe study included 134 MRS patients (98 small incision lenticule extraction [SMILE] and 36 femtosecond laser-assisted in situ keratomileusis [FS-LASIK]) for formula development, and the changes in anterior and posterior keratometry were comparable between the two procedures. Postoperative PK was a strong predictor of preoperative ARC, with an R2 of 0.82. In 225 cataract patients from three centers for formula validation, the formula performance index (FPI) was highest for LISA MRS (with or without PRC, 0.43), followed by Hoffer QST (0.37), EVO and Hoffer QST-PRC (both 0.32), EVO-PRC and Barrett True K-PRC (both 0.30), and Barrett True K (0.26). LISA MRS-PRC and EVO-PRC yielded the lowest median absolute prediction error (0.47 D), with EVO-PRC performing relatively better in eyes with AL < 28 mm and LISA MRS-PRC maintaining favorable accuracy in eyes with AL ≥ 28 mm. Incorporating PRC significantly improved the performance of Barrett True K, LISA MRS, and Hoffer QST (all P< 0.05).CONCLUSIONSThe LISA MRS formula provides accurate IOL power calculation for cataract patients with prior MRS, particularly in eyes with AL ≥ 28 mm. Use of PRC is recommended whenever available.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"127 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147439403","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}
Pub Date : 2026-03-10DOI: 10.1016/j.ajo.2026.03.009
Ibrahim Abboud,Anthony Fam,Amr Almobayed,Georges I Guillaume,Reem H ElSheikh,Richard K Lee,Abdelrahman M Elhusseiny
PURPOSETo evaluate whether pseudoexfoliation glaucoma (PXG) is associated with an increased hazard of developing central serous chorioretinopathy (CSCR) compared with primary open-angle glaucoma (POAG).DESIGNRetrospective cohort study using a multicenter, real-world electronic health record database.SUBJECTSAdults aged ≥18 years diagnosed with PXG (study group) or POAG (control group).METHODSWe obtained deidentified patient data from the TriNetX U.S. Collaborative Network. Patients with a history of age-related macular degeneration (AMD) or prior anti-vascular endothelial growth factor (anti-VEGF) therapy were excluded. We performed multivariable Cox proportional hazards models to estimate adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs), adjusting for baseline demographics; ocular and systemic comorbidities; psychiatric conditions; medication exposures (including corticosteroids); and prior ocular surgeries.MAIN OUTCOME MEASURESThe primary outcome was the development of CSCR within 1- and 5-year follow-up periods following the glaucoma diagnoses.RESULTSA total of 10,347 patients with PXG and 205,065 with POAG were included. In the Cox proportional hazards model, PXG was significantly associated with a higher hazard of developing CSCR compared with POAG. The aHR for CSCR was 1.807 (95% CI, 1.041-3.136; p = 0.036) at the 1-year follow-up and 1.631 (95% CI, 1.014-2.622; p = 0.044) at 5 years.CONCLUSIONSPXG is associated with an increased hazard of developing CSCR compared with POAG. These findings suggest that PXG may be associated with an increased susceptibility to posterior segment vascular pathology. Prospective studies incorporating longitudinal imaging are warranted to further elucidate shared choroidal mechanisms underlying this association.
目的评价假性脱落性青光眼（PXG）与原发性开角型青光眼（POAG）相比，是否与中枢性浆液性脉络膜视网膜病变（CSCR）发生风险增加有关。设计：采用多中心、真实世界电子健康记录数据库的回顾性队列研究。受试者年龄≥18岁，诊断为PXG（研究组）或POAG（对照组）的成年人。方法我们从TriNetX美国合作网络获得未识别的患者数据。排除有年龄相关性黄斑变性（AMD）病史或既往抗血管内皮生长因子（anti-VEGF）治疗的患者。我们采用多变量Cox比例风险模型，以95%置信区间（ci）估计调整后的风险比（aHRs），并根据基线人口统计学进行调整；眼部和全身合并症；精神疾病;药物暴露（包括皮质类固醇）；以及之前的眼部手术。主要结局指标：主要结局是青光眼诊断后1年和5年随访期间CSCR的发展情况。结果共纳入PXG患者10,347例，POAG患者205,065例。在Cox比例风险模型中，与POAG相比，PXG与更高的CSCR风险显著相关。随访1年时，CSCR的aHR为1.807 (95% CI, 1.041-3.136; p = 0.036)，随访5年时的aHR为1.631 （95% CI, 1.014-2.622; p = 0.044）。结论与POAG相比，spxg与CSCR发生风险增加相关。这些发现表明PXG可能与后段血管病理易感性增加有关。纳入纵向成像的前瞻性研究有必要进一步阐明这种关联背后的共同脉络膜机制。
{"title":"Association Between Pseudoexfoliation Glaucoma and Central Serous Chorioretinopathy.","authors":"Ibrahim Abboud,Anthony Fam,Amr Almobayed,Georges I Guillaume,Reem H ElSheikh,Richard K Lee,Abdelrahman M Elhusseiny","doi":"10.1016/j.ajo.2026.03.009","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.03.009","url":null,"abstract":"PURPOSETo evaluate whether pseudoexfoliation glaucoma (PXG) is associated with an increased hazard of developing central serous chorioretinopathy (CSCR) compared with primary open-angle glaucoma (POAG).DESIGNRetrospective cohort study using a multicenter, real-world electronic health record database.SUBJECTSAdults aged ≥18 years diagnosed with PXG (study group) or POAG (control group).METHODSWe obtained deidentified patient data from the TriNetX U.S. Collaborative Network. Patients with a history of age-related macular degeneration (AMD) or prior anti-vascular endothelial growth factor (anti-VEGF) therapy were excluded. We performed multivariable Cox proportional hazards models to estimate adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs), adjusting for baseline demographics; ocular and systemic comorbidities; psychiatric conditions; medication exposures (including corticosteroids); and prior ocular surgeries.MAIN OUTCOME MEASURESThe primary outcome was the development of CSCR within 1- and 5-year follow-up periods following the glaucoma diagnoses.RESULTSA total of 10,347 patients with PXG and 205,065 with POAG were included. In the Cox proportional hazards model, PXG was significantly associated with a higher hazard of developing CSCR compared with POAG. The aHR for CSCR was 1.807 (95% CI, 1.041-3.136; p = 0.036) at the 1-year follow-up and 1.631 (95% CI, 1.014-2.622; p = 0.044) at 5 years.CONCLUSIONSPXG is associated with an increased hazard of developing CSCR compared with POAG. These findings suggest that PXG may be associated with an increased susceptibility to posterior segment vascular pathology. Prospective studies incorporating longitudinal imaging are warranted to further elucidate shared choroidal mechanisms underlying this association.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"18 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147439404","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}
Pub Date : 2026-03-10DOI: 10.1016/j.ajo.2026.03.002
Douglas R da Costa,Felipe A Medeiros
{"title":"Reply to Comment on \"Artificial Intelligence-Guided Endpoint Selection for Neuroprotection Trials in Glaucoma\".","authors":"Douglas R da Costa,Felipe A Medeiros","doi":"10.1016/j.ajo.2026.03.002","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.03.002","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"4 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147439405","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：