American Journal of Ophthalmology最新文献_第6页

Efficacy and Safety of SJP-0132 in Patients With Dry Eye Disease: A Phase 2b Randomized, Double-Masked, Dose-Finding Study SJP-0132治疗干眼病的疗效和安全性：一项2b期随机、双盲、剂量发现研究

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology

Pub Date : 2026-03-01 Epub Date: 2025-12-04 DOI: 10.1016/j.ajo.2025.11.036

Yuichi Hori , Tomoyuki Wada , Kazunori Omatsu

Objective

Evaluate the efficacy, safety, and optimal dose of the TRPV1 antagonist SJP-0132 ophthalmic suspension in patients with dry eye disease.

Design

Randomized, double-masked, multicenter, placebo-controlled, Phase 2b dose-response study in Japan.

Participants

Outpatients aged ≥20 years with dry eye-related subjective symptoms (eye dryness visual analog scale score ≥40; 5-item Dry Eye Questionnaire score ≥6), and objective signs (mean tear-breakup time ≤5 seconds in both eyes; corneal fluorescein staining [CFS] score using Baylor criteria: 2 to 4 for central zone of at least one eye, total score 4 to 20 for all zones, and ≥1 for at least one of the four peripheral corneal regions).

Methods

After a 2-week placebo run-in period, patients were randomized 1:1:1:1 to receive SJP-0132 ophthalmic suspension 0.1%, 0.3%, or 1.0%, or placebo, administered as 1 drop in each eye four times daily for 4 weeks.

Main Outcome Measures

The primary endpoint was the change from baseline to week 4 in CFS score for all zones with SJP-0132 0.3% vs placebo (primary analysis) and SJP-0132 0.1% or 1.0% vs placebo (secondary analysis).

Results

Total 344 patients were randomized and received at least one dose of SJP-0132 0.1% (n = 87), SJP-0132 0.3% (n = 87), SJP-0132 1.0% (n = 85), or placebo (n = 85). For the primary endpoint, there were no statistically significant differences between the SJP-0132 0.3% and placebo groups (between-group difference −0.8; 95% CI −1.7, 0.2; P = .1181), or between the SJP-0132 0.1% (−0.7; 95% CI −1.8, 0.4; P = .1990) or SJP-0132 1.0% (−0.1; 95% CI −1.3, 1.0; P = .8276) and placebo groups. Secondary endpoints showed generally dose-dependent efficacy and safety of SJP-0132. Improvements in subjective symptoms of dry eye, quality of life, and objective signs were observed after 1 week of SJP-0132 administration and maintained through to week 4, with statistically significant differences to placebo observed at some endpoints. Subgroup analyses suggested greater treatment benefits with SJP-0132 0.3% in subgroups based on baseline ocular characteristics. SJP-0132 was generally well tolerated across the dose groups.

Conclusions

SJP-0132 showed generally dose-dependent efficacy and safety. Based on safety and treatment benefits with SJP-0132 0.3% in the overall population and in subgroups, this dose was considered optimal for further development.

目的评价TRPV1拮抗剂SJP-0132眼液在干眼病患者中的疗效、安全性和最佳剂量。日本随机、双盲、多中心、安慰剂对照、2b期剂量反应研究。参与者年龄≥20岁，伴有干眼相关主观症状（眼睛干燥视觉模拟量表评分≥40分；干眼问卷5项评分≥6分）和客观体征（双眼平均泪液破裂时间≤5秒；采用贝勒标准的角膜荧光素染色[CFS]评分：至少一只眼睛中心区评分为2-4分，所有区域评分为4-20分，四个角膜周围区域中至少一个评分≥1分）的门诊患者。方法：在2周安慰剂磨合期后，患者按1:1:1:1:1随机接受SJP-0132眼液0.1%、0.3%或1.0%，或安慰剂，每天4次，每只眼滴1滴，持续4周。主要结局指标主要终点是所有区域从基线到第4周的CFS评分变化，其中SJP-0132与安慰剂相比为0.3%（主要分析），SJP-0132与安慰剂相比为0.1%或1.0%（次要分析）。结果344例患者随机接受至少一剂SJP-0132 0.1% （n=87）、SJP-0132 0.3% （n=87）、SJP-0132 1.0% （n=85）或安慰剂（n=85）治疗。对于主要终点，SJP-0132 0.3%组与安慰剂组之间无统计学差异（组间差异-0.8;95% CI -1.7, 0.2; p=0.1181）， SJP-0132 0.1%组（-0.7;95% CI -1.8, 0.4; p=0.1990）或SJP-0132 1.0%组（-0.1;95% CI -1.3, 1.0; p=0.8276）与安慰剂组之间无统计学差异。次要终点显示SJP-0132的有效性和安全性普遍呈剂量依赖性。SJP-0132给药1周后，观察到干眼的主观症状、生活质量和客观体征的改善，并维持到第4周，在某些终点与安慰剂观察到的差异有统计学意义。亚组分析显示，基于基线眼部特征的亚组中，SJP-0132 0.3%的治疗效果更好。SJP-0132在各剂量组均具有良好的耐受性。结论ssjp -0132具有一定的剂量依赖性。基于SJP-0132在总体人群和亚组中的安全性和治疗益处，该剂量被认为是进一步开发的最佳剂量。

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引用次数: 0

Interpreting Imaging in the Era of Artificial Intelligence: Future Possibilities in Ocular Inflammatory Disease 解读人工智能时代的影像：眼炎性疾病的未来可能性

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology

Pub Date : 2026-03-01 Epub Date: 2025-12-22 DOI: 10.1016/j.ajo.2025.12.019

K. MATTHEW MCKAY , LEOPOLD SCHMETTERER , SRINIVAS R. SADDA , LUCIA SOBRIN

Purpose

Uveitis encompasses a heterogeneous group of ocular inflammatory diseases with a high risk of permanent vision loss. Accurate diagnosis and disease monitoring are dependent on integrating disparate clinical data from patient history, examination findings and multimodal imaging, which is complex and time-consuming. The advent of artificial intelligence (AI) in the field of ophthalmology has provided new opportunities for automation of data gathering and interpretation, particularly for imaging data through deep learning algorithms. This article will review the current abilities, limitations, and future promise for the application of AI to the interpretation of multimodal imaging in the field of uveitis.

Methods

Review article.

Results

AI has provided new opportunities for automation of data gathering and interpretation in the field of uveitis, particularly for analysis of imaging data using deep learning techniques. Tools for diagnostic support, grading of intraocular inflammation, and quantification of disease features by multimodal imaging are under development.

Conclusion

Application of AI in the field of uveitis is in its infancy but holds promise for improving efficiency and quality of patient care.

目的葡萄膜炎是一种异质性的眼部炎症性疾病，具有永久性视力丧失的高风险。准确的诊断和疾病监测依赖于整合来自患者病史、检查结果和多模式成像的不同临床数据，这既复杂又耗时。人工智能（AI）在眼科领域的出现为数据收集和解释的自动化提供了新的机会，特别是通过深度学习算法进行成像数据。本文将回顾人工智能在葡萄膜炎领域多模态成像解释中的当前能力、局限性和未来前景。MethodsReview文章。结果为葡萄膜炎领域的数据采集和解释自动化提供了新的机会，特别是使用深度学习技术对成像数据进行分析。目前正在开发用于诊断支持、眼内炎症分级和通过多模态成像对疾病特征进行量化的工具。结论人工智能在葡萄膜炎领域的应用尚处于起步阶段，但有望提高患者护理的效率和质量。

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引用次数: 0

Comment on: Cellular-Level Assessment of Macular Development in Patients With FEVR Using Multimodal Imaging: A Prospective Cohort Study 评论：使用多模态成像技术评估feevr患者黄斑发展的细胞水平：一项前瞻性队列研究。

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology

Pub Date : 2026-03-01 Epub Date: 2025-12-08 DOI: 10.1016/j.ajo.2025.10.041

Gongpeng Sun , Meixia Zhang

引用次数: 0

The Relationship Between Corneal Stiffness Distribution and Tomography in Keratoconus Patients 圆锥角膜患者角膜硬度分布与断层扫描的关系

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology

Pub Date : 2026-03-01 Epub Date: 2025-12-19 DOI: 10.1016/j.ajo.2025.12.011

Nan-Ji Lu , Marta Jiménez-García , Ahmed Elsheikh , Ahmed Makarem , Carina Koppen , Jos J. Rozema

Purpose

To characterize the regional distribution of corneal stiffness in keratoconus (KC) and explore its relationship with tomographic parameters.

Design

Prospective, cross-sectional observational study.

Subjects

One hundred eleven eyes from 111 KC patients.

Methods

All eyes underwent Scheimpflug-based tomography and air-puff tonometry (Pentacam and Corvis). Stress-Strain Index (SSI) maps were generated to quantify overall and regional stiffness. Maximum, minimum, and mean SSI values, as well as regional values, were correlated with keratometric and pachymetric indices.

Main Outcome Measures

Regional SSI values and their correlations with keratometric and pachymetric parameters.

Results

SSI maps showed non-uniform stiffness, with the lowest values predominantly in the inferior-temporal region. The mean SSI at the thinnest pachymetry point (Pmin; 0.68 ± 0.16) was higher than at the steepest keratometry point (Kmax; 0.63 ± 0.19; P = .036). In overall analyses, the strongest correlation was between SSI-map minimum and Pmin (R² = 0.51), while mean SSI correlated weakly with tomography (R² = 0.11-0.19). In regional analyses, SSI correlated most strongly with Kmax in the central region (R² = 0.74), followed by the midperipheral inferior (R² = 0.38) and temporal (R² = 0.23) regions. SSI correlations with Pmin were most evident in the central (R² = 0.52), paracentral inferior (R² = 0.45), and inferior-temporal (R² = 0.31) regions.

Conclusions

Biomechanical weakening in KC varies regionally. Strong correlations with disease severity occurred in the central and inferior-temporal regions — especially with Kmax and Pmin, highlighting the role of regional mechanical stiffness and collagen architecture in corneal deformation.

目的探讨圆锥角膜（KC）角膜硬度的区域分布特征及其与层析成像参数的关系。前瞻性、横断面观察性研究。实验对象111例KC患者的111只眼睛。方法所有眼行Scheimpflug-based断层扫描和气肿眼压测量（Pentacam和Corvis）。生成应力应变指数（SSI）图来量化整体和区域刚度。最大、最小和平均SSI值以及区域值与角膜测量和厚测指数相关。主要观察指标：区域SSI值及其与角膜测量和角膜厚度测量参数的相关性。结果sssi图显示刚度不均匀，最低值主要在颞下区。最薄角测点的平均SSI （Pmin; 0.68 ± 0.16）高于最陡角测点的平均SSI （Kmax; 0.63 ± 0.19;P = 0.036）。在整体分析中，SSI-map最小值与Pmin之间的相关性最强（R² = 0.51），而平均SSI与断层扫描的相关性较弱（R² = 0.11-0.19）。在区域分析中，SSI与Kmax在中枢区相关性最强（R² = 0.74），其次是中外周下枢区（R² = 0.38）和颞区（R² = 0.23）。SSI与Pmin的相关性在中央区（R² = 0.52）、旁中央区（R² = 0.45）和颞下区（R² = 0.31）最为明显。结论KC的生物力学减弱存在区域差异。与疾病严重程度的强相关性发生在中央和下颞区，尤其是Kmax和Pmin，突出了区域机械刚度和胶原蛋白结构在角膜变形中的作用。

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引用次数: 0

Effect of Angle Kappa on the Refractive Prediction Accuracy in Cataract Patients After Myopic LASIK/PRK 角度Kappa对近视LASIK/PRK术后白内障屈光预测准确性的影响

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology

Pub Date : 2026-03-01 Epub Date: 2025-11-28 DOI: 10.1016/j.ajo.2025.11.042

HAORUI YUAN , JIAQING ZHANG , YUXING ZHENG , HAOWEN LIN , XIAOHANG XIE , XIAOFEI HU , WENLU YU , XIAOZHANG QIU , ZHENZHEN LIU , WEIRONG CHEN , LIXIA LUO , XUHUA TAN

PURPOSE

To evaluate the impact of angle kappa on prediction accuracy in patients after myopic laser-assisted in-situ keratomileusis (LASIK)/photorefractive keratectomy (PRK).

DESIGN

Retrospective, consecutive interventional case-series study.

METHODS

This study included 127 postmyopic-LASIK/PRK cataract patients (176 eyes). Three different keratometry (K) values measured by 2 devices were assessed, including simulated keratometry (SimK) obtained by IOLMaster 700 at 2.5 mm ring centered on corneal vertex and SimK derived from Pentacam AXL in 3 mm zone centered on corneal vertex (Pentacam [CV]) and pupil center (Pentacam [PC]). The performance of the Barrett True-K formula based on vertex-centered K values (IOLMaster 700; Pentacam [CV]) and pupil-centered K values (Pentacam [PC]) was compared. Subgroup analysis was performed using angle kappa (<0.4 mm; ≥0.4 mm).

RESULT

The hyperopic prediction error (PE) of the IOLMaster 700 and Pentacam (CV) modes increased with larger angle kappa. Both in total and in eyes with angle kappa <0.4 mm, compared with other modes, the IOLMaster 700 mode showed no systematic bias and relatively lower absolute PE. For eyes with angle kappa ≥0.4 mm, IOLMaster 700 and Pentacam (CV) modes demonstrated hyperopic PE (0.43-0.46 D, P < .05), while the Pentacam (PC) mode displayed no systematic bias, relatively lower mean absolute PE (0.70 D vs 0.90-0.96 D) and the highest percentage of eyes with PE within ±0.5 D (51.22% vs 36.59%-41.46%).

CONCLUSION

In postmyopic-LASIK/PRK patients, the prediction accuracy decreased with greater angle kappa when using the corneal vertex-centered K values. The pupil-centered K values were preferred for these patients with angle kappa ≥0.4 mm.

目的探讨角度kappa对近视激光原位角膜磨圆术(LASIK)/光屈光性角膜切除术（PRK）术后预测准确度的影响。设计：回顾性、连续介入病例系列研究。方法选取127例（176眼）近视后lasik /PRK白内障患者。我们评估了两种仪器测量的三种不同的角膜曲率(K)值，包括IOLMaster 700在以角膜顶点为中心的2.5 mm环处获得的模拟角膜曲率（SimK），以及Pentacam AXL在以角膜顶点为中心的3 mm区域（Pentacam [CV]）和瞳孔中心（Pentacam [PC]）获得的SimK。比较了以顶点为中心的K值（IOLMaster 700; Pentacam [CV]）和以瞳孔为中心的K值（Pentacam [PC]）的Barrett True-K公式的性能。采用角kappa （<0.4 mm;≥0.4 mm）进行亚组分析。结果IOLMaster 700和Pentacam （CV）模式的远视预测误差（PE）随角度kappa的增大而增大。无论在总体上还是在角度kappa <；0.4 mm的眼睛上，与其他模式相比，IOLMaster 700模式没有系统偏差，绝对PE相对较低。对于角度kappa≥0.4 mm的眼，IOLMaster 700和Pentacam （CV）模式显示远视PE (0.43-0.46 D, P < 0.05)，而Pentacam （PC）模式无系统偏倚，平均绝对PE相对较低（0.70 D vs 0.90-0.96 D）， PE在±0.5 D范围内的眼比例最高（51.22% vs 36.59%-41.46%）。结论在近视后lasik /PRK患者中，使用角膜顶点为中心的K值预测精度随角度kappa的增大而降低。角kappa≥0.4 mm的患者优选以瞳孔为中心的K值。

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引用次数: 0

Impact of Phacoemulsification on Vitreomacular Traction Release and Complications 超声乳化术对玻璃体黄斑牵引解除的影响及并发症

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology

Pub Date : 2026-03-01 Epub Date: 2025-12-13 DOI: 10.1016/j.ajo.2025.12.008

Suraj Bala , Nitesh Mohan , Victor Bellanda , Andrea Arline , Gabriel Castilho S. Barbosa , Matthew Schulgit , Sumit Sharma , Sunil K. Srivastava , Danny A. Mammo , Ananth Sastry

Purpose

To determine if phacoemulsification impacts vitreomacular traction (VMT) release and VMT-related complications.

Design

Single-center, comparative, retrospective clinical cohort study.

Subjects: A total of

310 eyes of 249 patients with a concurrent diagnosis of VMT and cataracts at the Cole Eye Institute between 2013 and 2024.

Methods

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.

Main Outcome Measures

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.

Results

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; P = .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 (P = .785). In multivariate analysis, younger age at diagnosis (5-year aHR = 0.773; P < .001) and smaller adhesion diameter (per 100 µm aHR = 0.951; P = .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; P = .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; P < .001).

Conclusions

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.

目的探讨超声乳化术对玻璃体黄斑牵引力（VMT）释放及相关并发症的影响。设计：单中心、比较、回顾性临床队列研究。研究对象：2013年至2024年间在科尔眼科研究所同时诊断为VMT和白内障的249例患者共310只眼睛。方法符合条件的眼在vmt诊断或超声乳化术后随访至少6个月。对照组为VMT诊断后未行超声乳化术的眼睛。临床资料收集通过手工图表审查。通过回顾光学相干断层成像记录VMT的特征。主要观察指标：主要观察指标为VMT释放风险。次要结果包括vmt相关并发症，如黄斑和板层空洞形成，视网膜脱离，以及随后的玻璃体切除术。结果310只眼vmt释放率为49.4%，平均随访时间136.7±134.4周。超声乳化术组与对照组释放量差异无统计学意义（校正风险比[aHR] = 0.861; P = 0.380）。释放眼中，超声乳化术组平均释放时间为术后79.4±68.8周，对照组平均释放时间为诊断后76.0±81.9周（P = .785）。在多因素分析中，诊断时年龄较小（5年aHR = 0.773; P < .001）和粘连直径较小（每100µm aHR = 0.951; P = 0.017）与VMT释放的可能性较高显著相关。与白人患者相比，黑人患者VMT释放的可能性较低（aHR = 0.439; P = 0.004）。出现黄斑孔的眼睛的黏附直径基线小于未出现黄斑孔的眼睛（439.1±217.9µm vs 685.7±697.4µm; P < .001）。结论超声乳化术与VMT释放率升高或释放时间加快无关。这些发现表明，患者的内在因素和解剖因素在决定VMT释放的可能性方面起着更大的作用，应在临床决策中优先考虑。

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引用次数: 0

Limbal Epithelial Cells Detected in Stage III Limbal Stem Cell Deficiency by Multimodal Anterior Segment Imaging 多模态前段显像检测III期角膜缘干细胞缺乏症的角膜缘上皮细胞

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology

Pub Date : 2026-03-01 Epub Date: 2025-12-01 DOI: 10.1016/j.ajo.2025.11.041

CLEMENCE BONNET , MEHRNOOSH MAALHAGHFARD , SOPHIE X. DENG

Purpose

Limbal stem cell deficiency (LSCD) is a potentially blinding corneal condition with heterogeneous clinical presentations. Anterior segment imaging, in particular anterior segment optical coherence tomography (AS-OCT) and in vivo confocal microscopy (IVCM) provide objective staging of LSCD. The goal of this study was to evaluate whether the fluorescein staining test is accurate in staging LSCD.

Design

Diagnostic and staging validity analysis.

Subjects

Subjects without eye diseases and those diagnosed with LSCD based on clinical exam, AS-OCT, and IVCM.

Methods

The severity of LSCD was staged clinically according to the global consensus guidelines using fluorescein staining. Multimodal imaging (AS-OCT and IVCM) was performed in the central cornea and four limbal quadrants (superior, inferior, nasal, and temporal). Imaging findings were correlated with clinical stage.

Main Outcomes Measures

Detection of morphologically limbal epithelial cells in eyes clinically graded as stage III LSCD, and AS-OCT characteristics corresponding to these identified clusters.

Results

A total of 220 eyes from 156 patients were analyzed. Based on fluorescein staining, 49 eyes (22.3%) were classified as stage I, 93 eyes (42.3%) as stage II, and 75 eyes (34.1%) as stage III LSCD. In all cases of stage III LSCD, AS-OCT confirmed severe central epithelial thinning, and IVCM demonstrated significantly reduced mean basal cell density in the central cornea. Despite this, clusters of limbal epithelial cells with normal morphology were detected by IVCM in 30 eyes (40.0%), appearing in one limbal quadrant in 26 eyes (86.7%) and in two quadrants in 4 eyes (13.3%). Correlation between IVCM and AS-OCT findings at the cluster locations was variable. Absence of hyporeflective epithelial layer was observed in 20 eyes (74.1%) and presence of hyporeflective layer was detected in 7 eyes (25.9%) by AS-OCT.

Conclusions

Despite being graded as total stage III LSCD by clinical exam using fluorescein staining, a significant proportion of eyes retained morphologically normal limbal epithelial cells. These findings highlight the importance of multimodal anterior segment imaging to achieve LSCD diagnostic accuracy, refine disease staging, and guide future personalized management strategies.

目的：骨髓干细胞缺乏症（LSCD）是一种具有不同临床表现的潜在致盲性角膜疾病。前段成像，特别是前段光学相干断层扫描（AS-OCT）和体内共聚焦显微镜（IVCM）提供了LSCD的客观分期。本研究的目的是评估荧光素染色试验在LSCD分期中是否准确。设计诊断和分期效度分析。无眼病及经临床检查、AS-OCT、IVCM诊断为LSCD者。方法采用荧光素染色对LSCD的严重程度进行临床分期。在中央角膜和四个角膜缘象限（上、下、鼻和颞）进行多模式成像（AS-OCT和IVCM）。影像学表现与临床分期相关。主要结果：检测临床分级为III期LSCD的眼部角膜缘上皮细胞的形态学，以及与这些鉴定的细胞簇相对应的as - oct特征。结果156例患者共分析220只眼。根据荧光素染色，49眼（22.3%）为ⅰ期，93眼（42.3%）为ⅱ期，75眼（34.1%）为ⅲ期LSCD。在所有III期LSCD病例中，AS-OCT证实了严重的中央上皮变薄，IVCM显示中央角膜的平均基底细胞密度显著降低。尽管如此，IVCM在30只眼（40.0%）中检测到形态正常的角膜缘上皮细胞簇，26只眼（86.7%）出现在角膜缘的一个象限，4只眼（13.3%）出现在两个象限。IVCM和AS-OCT在集群位置的相关性是可变的。AS-OCT观察到低反射上皮层缺失20眼（74.1%），低反射上皮层存在7眼（25.9%）。结论尽管通过荧光素染色的临床检查将其分级为全III期LSCD，但仍有相当比例的眼睛保留了形态正常的角膜缘上皮细胞。这些发现强调了多模态前段成像在实现LSCD诊断准确性、细化疾病分期和指导未来个性化治疗策略方面的重要性。

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引用次数: 0

Association Between Body Composition and Risk of Primary Open-Angle Glaucoma 身体成分与原发性开角型青光眼风险的关系

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology

Pub Date : 2026-03-01 Epub Date: 2025-12-19 DOI: 10.1016/j.ajo.2025.12.014

Jianqi Chen , Yue Xiao , Xiaohong Chen , Yingting Zhu , Zhidong Li , Shitong Huang , Hanyang Yu , Yehong Zhuo , Yunxia Leng

Purpose

Body size has been closely linked to primary open-angle glaucoma (POAG). However, the association was inconsistent, which may be due to the fact that body size defined by body mass index does not differentiate fat from lean mass or capture body composition distribution. The impact of body composition on POAG remains largely unknown.

Design

Combined cross-sectional and cohort study.

Participants

A total of 88,123 participants and 291,983 participants from the UK Biobank for the analysis of baseline intraocular pressure (IOP) and POAG incidence, respectively.

Methods

Fat and muscle mass in the arm, trunk, and leg were estimated using bioimpedance analysis. Measurements were normalized for height to derive the arm fat index, trunk fat index, leg fat index (LFI), arm muscle index, trunk muscle index, and leg muscle index. Fat-to-muscle ratios for each region were also calculated as sensitivity analysis. Hazard ratios (HRs) and 95% confidence intervals (CIs) for POAG were estimated using covariate-adjusted Cox models, and associations with IOP were additionally assessed using linear regression.

Main Outcome Measures

Baseline IOP and POAG incidence.

Results

Greater leg fat was associated with a significantly reduced risk of POAG, supported by both LFI (HR, 0.85; 95% CI, 0.76-0.95; P = .006) and leg fat-to-muscle ratio (HR, 0.35; 95% CI, 0.16-0.73; P = .005). No association was observed between muscle mass and the incidence of POAG. Greater fat mass was associated with higher IOP levels, supported by arm fat index (β, 0.14; 95% CI, 0.07-0.22, P < .001), LFI (β, 0.15; 95% CI, 0.11-0.18, P < .001), trunk fat index (β, 0.07; 95% CI, 0.04-0.09, P < .001), whereas greater muscle mass in leg (leg muscle index: β, –0.24; 95% CI, –0.29 to –0.20, P < .001) and trunk (trunk muscle index: β, –0.05; 95% CI, –0.08 to –0.01, P = .005) was associated with lower IOP.

Conclusions

POAG risk differs according to body composition. Maintaining a healthy body composition pattern may mitigate its risk.

目的：体尺寸与原发性开角型青光眼（POAG）密切相关。然而，这种关联并不一致，这可能是由于体重指数定义的体型不能区分脂肪和瘦体重，也不能捕捉到身体成分的分布。身体成分对POAG的影响在很大程度上仍然未知。设计结合横断面和队列研究。参与者：来自UK Biobank的88,123名参与者和291,983名参与者分别用于分析基线眼压（IOP）和POAG发生率。方法采用生物阻抗法测定上肢、躯干和腿部的脂肪和肌肉量。将身高数据归一化，得到手臂脂肪指数、躯干脂肪指数、腿部脂肪指数（LFI）、手臂肌肉指数、躯干肌肉指数和腿部肌肉指数。每个区域的脂肪-肌肉比率也被计算为敏感性分析。使用协变量调整的Cox模型估计POAG的风险比（hr）和95%置信区间（CIs），并使用线性回归评估与IOP的关联。主要观察指标：基线IOP和POAG发生率。结果腿部脂肪增加与POAG风险显著降低相关，两者均得到LFI的支持（HR, 0.85; 95% CI, 0.76-0.95; P = ）。006)和腿部脂肪肌肉比（HR, 0.35; 95% CI, 0.16-0.73; P = .005）。未观察到肌肉质量与POAG发生率之间的关联。较大的脂肪量与较高的IOP水平相关，其支持因素包括手臂脂肪指数（β, 0.14; 95% CI, 0.07-0.22, P < 0.001）、LFI （β, 0.15, 95% CI, 0.11-0.18, P < 0.001）、躯干脂肪指数（β, 0.07, 95% CI, 0.04-0.09, P < 0.001），而腿部肌肉量较大（腿部肌肉指数：β， -0.24, 95% CI, -0.29 - -0.20, P < 0.001）和躯干（躯干肌肉指数：β， -0.05, 95% CI, -0.08 - -0.01, P = ）。005)与较低的IOP相关。结论不同体质的人患spoag的风险不同。保持健康的身体组成模式可以减轻其风险。

{"title":"Association Between Body Composition and Risk of Primary Open-Angle Glaucoma","authors":"Jianqi Chen , Yue Xiao , Xiaohong Chen , Yingting Zhu , Zhidong Li , Shitong Huang , Hanyang Yu , Yehong Zhuo , Yunxia Leng","doi":"10.1016/j.ajo.2025.12.014","DOIUrl":"10.1016/j.ajo.2025.12.014","url":null,"abstract":"<div><h3>Purpose</h3><div>Body size has been closely linked to primary open-angle glaucoma (POAG). However, the association was inconsistent, which may be due to the fact that body size defined by body mass index does not differentiate fat from lean mass or capture body composition distribution. The impact of body composition on POAG remains largely unknown.</div></div><div><h3>Design</h3><div>Combined cross-sectional and cohort study.</div></div><div><h3>Participants</h3><div>A total of 88,123 participants and 291,983 participants from the UK Biobank for the analysis of baseline intraocular pressure (IOP) and POAG incidence, respectively.</div></div><div><h3>Methods</h3><div>Fat and muscle mass in the arm, trunk, and leg were estimated using bioimpedance analysis. Measurements were normalized for height to derive the arm fat index, trunk fat index, leg fat index (LFI), arm muscle index, trunk muscle index, and leg muscle index. Fat-to-muscle ratios for each region were also calculated as sensitivity analysis. Hazard ratios (HRs) and 95% confidence intervals (CIs) for POAG were estimated using covariate-adjusted Cox models, and associations with IOP were additionally assessed using linear regression.</div></div><div><h3>Main Outcome Measures</h3><div>Baseline IOP and POAG incidence.</div></div><div><h3>Results</h3><div>Greater leg fat was associated with a significantly reduced risk of POAG, supported by both LFI (HR, 0.85; 95% CI, 0.76-0.95; <em>P</em> = .006) and leg fat-to-muscle ratio (HR, 0.35; 95% CI, 0.16-0.73; <em>P</em> = .005). No association was observed between muscle mass and the incidence of POAG. Greater fat mass was associated with higher IOP levels, supported by arm fat index (<em>β</em>, 0.14; 95% CI, 0.07-0.22, <em>P</em> < .001), LFI (<em>β</em>, 0.15; 95% CI, 0.11-0.18, <em>P</em> < .001), trunk fat index (<em>β</em>, 0.07; 95% CI, 0.04-0.09, <em>P</em> < .001), whereas greater muscle mass in leg (leg muscle index: <em>β</em>, –0.24; 95% CI, –0.29 to –0.20, <em>P</em> < .001) and trunk (trunk muscle index: <em>β</em>, –0.05; 95% CI, –0.08 to –0.01, <em>P</em> = .005) was associated with lower IOP.</div></div><div><h3>Conclusions</h3><div>POAG risk differs according to body composition. Maintaining a healthy body composition pattern may mitigate its risk.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"283 ","pages":"Pages 256-267"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784493","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}

引用次数: 0

Autosomal Recessive Bestrophinopathy—Phenotypic Variability, Natural History, and Genotype-Phenotype Correlations 常染色体隐性视网膜病变-表型变异性，自然史和基因型-表型相关性

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology

Pub Date : 2026-03-01 Epub Date: 2025-12-18 DOI: 10.1016/j.ajo.2025.12.012

Lorenzo Bianco , Alessio Antropoli , Elise Boulanger-Scemama , Marco Nassisi , Amine Benadji , Grégoire Mésa , Louise O’Toole , Aline Antonio , Christel Condroyer , Camille Andrieu , José-Alain Sahel , Christina Zeitz , Isabelle Audo

Objective

To describe the clinical characteristics, natural history, and genotype-phenotype correlations of autosomal recessive bestrophinopathy (ARB).

Design

Retrospective cohort study including data collected for clinical practice.

Participants

Thirty-four consecutive patients (68 eyes) affected by ARB who had a molecularly confirmed diagnosis followed at a single referral center for inherited retinal diseases (REFERET, Quinze-Vingts Hospital, Paris, France).

Methods

We collected data from medical records, including genetic data, ophthalmologic history, clinical examinations, retinal imaging, and full-field electroretinograms (ERG). Disease severity graded on short-wavelength autofluorescence (SW-AF), and the presence of primary angle closure (PAC) was evaluated as candidate risk factors for clinical outcomes. Longitudinal outcome analysis was performed using mixed-effects linear modeling and Kaplan–Meier survival curves.

Main Outcomes Measures

ERG amplitudes; best-corrected visual acuity and degree of visual impairment according to World Health Organization criteria; central subfield thickness measured on optical coherence tomography.

Results

The median age at baseline was 32 years (interquartile range, 18.3-46.9), and 29% (10/34) of patients had PAC. On SW-AF, 21% (7/34) had isolated macular lesions (grade 1), 44% (15/34) had multifocal lesions or diffuse alterations at the posterior pole with zonal sparing (grade 2), and 35% (12/34) had panretinal alterations (grade 3). Marked attenuation of ERG amplitudes was found only in patients with grade 3 disease. Of 32 unique BEST1 variants, 11 (34%) were novel, and the p.(Thr363Pro) occurred only in grade 1 disease. The median age at onset of severe visual impairment was lower in patients with PAC (47 years) compared with those without (68 years; P = .01), whereas no such association was observed with SW-AF grade. No significant linear annual change in best-corrected visual acuity could be demonstrated over a median follow-up of 3 years.

Conclusions

ARB encompasses a wide phenotypic spectrum, ranging from mild, isolated macular involvement to severe panretinal degeneration with abnormal ERG. However, the risk of visual impairment appears to be driven primarily by the presence of PAC rather than by the severity of fundus lesions, representing an important confounding factor for future clinical trials. The very slow rate of visual acuity decline further underscores the need for more sensitive functional outcome measures in bestrophinopathies.

目的探讨常染色体隐性异性恋病（ARB）的临床特点、自然病史及基因型-表型相关性。设计回顾性队列研究，包括临床实践收集的数据。参与者：34名连续的ARB患者（68只眼睛），在一个遗传性视网膜疾病转诊中心（REFERET, Quinze-Vingts Hospital, Paris, France）进行了分子确诊。方法收集患者的病历资料，包括遗传资料、眼科病史、临床检查、视网膜成像和全视场视网膜电图（ERG）。疾病严重程度根据短波自身荧光（SW-AF）分级，原发性闭角（PAC）的存在被评估为临床结果的候选危险因素。采用混合效应线性模型和Kaplan-Meier生存曲线进行纵向结局分析。测量振幅；符合世界卫生组织标准的最佳矫正视力和视力损害程度；光学相干层析成像测量中心子场厚度。结果基线时的中位年龄为32岁（四分位数范围18.3-46.9），29%（10/34）的患者患有PAC。SW-AF患者中，21%（7/34）有孤立性黄斑病变（1级），44%（15/34）有多灶性病变或后极弥漫性病变（2级），35%（12/34）有全视网膜病变（3级）。仅在3级疾病患者中发现ERG振幅的明显衰减。在32个独特的BEST1变异中，11个（34%）是新的，p.（Thr363Pro）仅发生在1级疾病中。PAC患者严重视力损害的中位发病年龄（47岁）低于无PAC患者（68岁）；P = 。01)，而与SW-AF分级没有这种关联。在中位随访3年期间，最佳矫正视力没有明显的年度线性变化。结论sarb包括广泛的表型谱，范围从轻度，孤立黄斑受累到严重的全视网膜变性伴异常ERG。然而，视觉损害的风险似乎主要是由PAC的存在而不是由眼底病变的严重程度驱动的，这是未来临床试验的一个重要混杂因素。非常缓慢的视力下降率进一步强调了需要更敏感的功能结果测量对视肌病变。

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引用次数: 0

Pathogen-Associated Visual Outcomes Following Postprocedure Endophthalmitis 术后眼内炎后病原菌相关的视力结果

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology

Pub Date : 2026-03-01 Epub Date: 2025-11-28 DOI: 10.1016/j.ajo.2025.11.038

Marusha Ather , Elizabeth Lyden , Yue Zhan , Rachana Haliyur , Alina Sinha , Saagar Patel , Richard M. Feist Jr. , Akbar Shakoor , Albert T. Vitale , David N. Zacks , Steven Yeh , Talisa E. de Carlo Forest , Michael J. Huvard , Christopher D. Conrady

Objective

To report the anatomic and functional outcomes of a large, multicenter series of postprocedure acute endophthalmitis, stratified by pathogen virulence.

Design

Retrospective, interventional case series.

Participants

Two hundred forty adult patients diagnosed with postprocedural acute endophthalmitis from 2012 to 2022 at four tertiary, university-based care centers. Of these, 208 patients had adequate follow-up data for comparative analyses.

Methods

Medical records were reviewed for demographics, microbiology, treatment, and visual outcomes of patients that developed endophthalmitis following any intraocular procedure. Organisms were categorized into surface commensals (coagulase-negative Staphylococcus sp.) and nonsurface commensals (eg, Streptococcus, Enterococcus sp.) as a proxy for virulence. Visual acuity (VA) outcomes and complication rates were compared across groups using Fisher’s exact test and regression models adjusting for age, sex (male or female), comorbidities, and treatment modality for postinjection endophthalmitis.

Main Outcome Measures

Final VA, number of interventions, and rates of vision-threatening complications, including phthisis, retinal detachment, enucleation/evisceration.

Results

Among culture-positive cases, patients infected with nonsurface commensal organisms had significantly worse final VA than those with coagulase-negative Staphylococcus (mean logMAR 2.14 vs 0.77, P < .0001), as well as higher rates of third interventions (27.5% vs 10.1%, P = .017), phthisis (15.4% vs 1.1%, P = .0032), and enucleation/evisceration (12.8% vs 0%, P = .0022). In multivariable regression of postinjection endophthalmitis, virulent, nonsurface commensal organisms remained independently associated with poorer visual outcomes (P = .0005). Complication patterns were consistent whether culture-negative cases were included or not in the nonvirulent group. Most patients were initially treated with intravitreal injections (92.1%). An initial vitrectomy was uncommon and not significantly associated with better outcomes when performed.

Conclusions

Infections with virulent, nonsurface commensal organisms such as Streptococcus and Enterococcus are associated with significantly worse outcomes in postprocedure endophthalmitis, independent of presenting vision or treatment delay. These findings support a shift toward pathogen-informed management and underscore the need for timely identification of virulent organisms in postprocedural acute endophthalmitis.

目的报道一个大的、多中心的术后急性眼内炎的解剖和功能结果，并按病原体的毒力分层。设计：回顾性、干预性病例系列。参与者：2012年至2022年，在四所大学三级护理中心诊断为术后急性眼内炎的240名成年患者。其中，208例患者有足够的随访数据进行比较分析。方法回顾了在任何眼内手术后发生眼内炎的患者的人口统计学、微生物学、治疗和视力结果。根据毒力将病原菌分为表面共生菌（凝固酶阴性葡萄球菌）和非表面共生菌（链球菌、肠球菌等）。使用Fisher精确检验和回归模型比较各组的视力（VA）结果和并发症发生率，该模型调整了注射后眼内炎的年龄、性别（男性或女性）、合并症和治疗方式。主要观察指标：最终VA、干预次数和视力威胁并发症发生率，包括肺结核、视网膜脱离、剜出/内脏。结果在培养阳性病例中，非表面共生菌感染患者的最终VA明显低于凝固酶阴性葡萄球菌感染患者（平均logMAR 2.14 vs 0.77, P < 0.0001），并且第三次干预（27.5% vs 10.1%, P = 0.017）、肺结核（15.4% vs 1.1%, P = 0.0032）和去核/去肠（12.8% vs 0%, P = 0.0022）的发生率更高。在注射后眼内炎的多变量回归中，毒性的、非表面的共生生物仍然与较差的视力结果独立相关（P = 0.0005）。无论是否包括培养阴性病例，并发症模式都是一致的。大多数患者最初采用玻璃体内注射治疗（92.1%）。最初的玻璃体切除术是不常见的，并且在进行时与更好的结果没有显著的联系。结论：在术后眼内炎中，感染毒力强的非表面共生生物，如链球菌和肠球菌，其预后明显较差，与视力表现或治疗延迟无关。这些发现支持向病原体知情管理的转变，并强调了在手术后急性眼内炎中及时识别有毒生物的必要性。

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引用次数: 0