Pub Date : 2026-01-10DOI: 10.1016/j.ajo.2026.01.011
Min Zhang,Peimin Lin,Tianhui Chen,Zexu Chen,Aizhu Miao,Ruohong Li,Yongxiang Jiang
PURPOSESDefine clinical ablation decentration and construct personalized areas for K measurements to improve the accuracy of intraocular lens (IOL) power calculation after myopic laser in situ keratomileusis (LASIK).DESIGNRetrospective, observational case series.METHODSAblation areas were delineated on smoothed corneal topographies (Pentacam AXL). Personalized areas for K measurements were constructed as the overlap between the corneal ablation area and a given apex-centered circle. K values were calculated on these personalized areas using the ring or zone method. Ablation decentration was evaluated by (1) index P: the percentage of the personalized area in the corresponding circle, and (2) index D: the distance from its maximum inscribed circle center to the corneal apex. Their absolute predictive errors (AE) were compared with those of IOLMaster-reported K in 60 cataract eyes from 48 patients with prior LASIK.RESULTSAblation-guided K values derived from the 3.5 mm-diameter circle and the ring methods, namely K3.5ring, had the best predictive accuracy (Mean AE = 0.64D, Median AE = 0.47D). This method had better performance with smaller index P (ρ = -0.473, P = 0.006) and larger index D (ρ = 0.432, P = 0.014). Personalized areas with index P <95.02% (P =0.013) or index D ≥1.0975 mm (P =0.007) showed greater accuracy improvements, and were defined as clinical ablation decentration.CONCLUSIONSThis study developed a novel ablation-guided K measurement method for IOL calculation in eyes with clinically decentered myopic ablation. We also provide a ready-to-use tool (https://boluo-baba-ablation-guided-k-measurements.share.connect.posit.cloud) based on this method for clinical convenience.
{"title":"Ablation-guided K measurements improve the accuracy of IOL power calculation after clinically decentered myopic LASIK.","authors":"Min Zhang,Peimin Lin,Tianhui Chen,Zexu Chen,Aizhu Miao,Ruohong Li,Yongxiang Jiang","doi":"10.1016/j.ajo.2026.01.011","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.01.011","url":null,"abstract":"PURPOSESDefine clinical ablation decentration and construct personalized areas for K measurements to improve the accuracy of intraocular lens (IOL) power calculation after myopic laser in situ keratomileusis (LASIK).DESIGNRetrospective, observational case series.METHODSAblation areas were delineated on smoothed corneal topographies (Pentacam AXL). Personalized areas for K measurements were constructed as the overlap between the corneal ablation area and a given apex-centered circle. K values were calculated on these personalized areas using the ring or zone method. Ablation decentration was evaluated by (1) index P: the percentage of the personalized area in the corresponding circle, and (2) index D: the distance from its maximum inscribed circle center to the corneal apex. Their absolute predictive errors (AE) were compared with those of IOLMaster-reported K in 60 cataract eyes from 48 patients with prior LASIK.RESULTSAblation-guided K values derived from the 3.5 mm-diameter circle and the ring methods, namely K3.5ring, had the best predictive accuracy (Mean AE = 0.64D, Median AE = 0.47D). This method had better performance with smaller index P (ρ = -0.473, P = 0.006) and larger index D (ρ = 0.432, P = 0.014). Personalized areas with index P <95.02% (P =0.013) or index D ≥1.0975 mm (P =0.007) showed greater accuracy improvements, and were defined as clinical ablation decentration.CONCLUSIONSThis study developed a novel ablation-guided K measurement method for IOL calculation in eyes with clinically decentered myopic ablation. We also provide a ready-to-use tool (https://boluo-baba-ablation-guided-k-measurements.share.connect.posit.cloud) based on this method for clinical convenience.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"29 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145956202","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 : 2026-01-10DOI: 10.1016/j.ajo.2026.01.007
Haorui Yuan,Jiaqing Zhang,Lixia Luo,Xuhua Tan
{"title":"Reply to Comment on Effect of Angle Kappa on the Refractive Prediction Accuracy in Cataract Patients After Myopic LASIK/PRK.","authors":"Haorui Yuan,Jiaqing Zhang,Lixia Luo,Xuhua Tan","doi":"10.1016/j.ajo.2026.01.007","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.01.007","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"29 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145956207","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 : 2026-01-10DOI: 10.1016/j.ajo.2026.01.004
Nitesh Mohan , Sunil K. Srivastava , Matthew J. Schulgit , Rula A. Hajj-Ali , David C. Kaelber , Sumit Sharma
OBJECTIVE
To evaluate the association between immune-mediated inflammatory diseases (IMIDs) and uveitis.
DESIGN
Retrospective cohort and case-control study using electronic health record data.
METHODS
The study included patients diagnosed with uveitis and/or one of the following 12 IMIDs: rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), sarcoidosis, scleroderma, inflammatory bowel disease (IBD), multiple sclerosis (MS), ankylosing spondylitis, psoriasis, juvenile idiopathic arthritis (JIA), and giant cell arteritis (GCA), anti-neutrophil cytoplasmic antibody (ANCA)–associated vasculitis, and other systemic vasculitis. Controls were patients without prior uveitis diagnosis or any IMIDs. The risk of developing uveitis in patients with each IMID, the odds of prior IMID diagnoses among patients with uveitis, and the risk of developing an IMID following a uveitis diagnosis were calculated. The main outcome measures were the risk ratio (RR) and odds ratio (OR) estimates with 95% confidence intervals for associations between IMIDs and uveitis.
RESULTS
Patients with all 12 IMIDs had a significantly increased risk of developing uveitis. The highest risks were observed in ankylosing spondylitis (RR = 7.71, 95% CI = 5.84-10.19), JIA (RR = 5.13, 95% CI = 3.51-7.49), and systemic vasculitis (RR = 4.61, 95% CI = 3.73-5.69). Increased risk was also found in sarcoidosis (RR = 3.67, 95% CI = 3.02-4.47), GCA (RR = 3.24, 95% CI = 2.58-4.07), and ANCA vasculitis (RR = 3.18, 95% CI = 1.84-5.48). In addition, in patients with uveitis, both the odds of a prior IMID diagnosis and the risk of a future IMID diagnosis were significantly increased for all 12 IMIDs.
CONCLUSIONS
IMIDs are strongly associated with uveitis, with significant bidirectional risk. Patients with uveitis should be monitored for potential IMID development, and those with IMIDs should undergo ophthalmologic evaluation when appropriate.
{"title":"Exploring the Association Between Autoimmune and Inflammatory Diseases and Uveitis","authors":"Nitesh Mohan , Sunil K. Srivastava , Matthew J. Schulgit , Rula A. Hajj-Ali , David C. Kaelber , Sumit Sharma","doi":"10.1016/j.ajo.2026.01.004","DOIUrl":"10.1016/j.ajo.2026.01.004","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To evaluate the association between immune-mediated inflammatory diseases (IMIDs) and uveitis.</div></div><div><h3>DESIGN</h3><div>Retrospective cohort and case-control study using electronic health record data.</div></div><div><h3>METHODS</h3><div>The study included patients diagnosed with uveitis and/or one of the following 12 IMIDs: rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), sarcoidosis, scleroderma, inflammatory bowel disease (IBD), multiple sclerosis (MS), ankylosing spondylitis, psoriasis, juvenile idiopathic arthritis (JIA), and giant cell arteritis (GCA), anti-neutrophil cytoplasmic antibody (ANCA)–associated vasculitis, and other systemic vasculitis. Controls were patients without prior uveitis diagnosis or any IMIDs. The risk of developing uveitis in patients with each IMID, the odds of prior IMID diagnoses among patients with uveitis, and the risk of developing an IMID following a uveitis diagnosis were calculated. The main outcome measures were the risk ratio (RR) and odds ratio (OR) estimates with 95% confidence intervals for associations between IMIDs and uveitis.</div></div><div><h3>RESULTS</h3><div>Patients with all 12 IMIDs had a significantly increased risk of developing uveitis. The highest risks were observed in ankylosing spondylitis (RR = 7.71, 95% CI = 5.84-10.19), JIA (RR = 5.13, 95% CI = 3.51-7.49), and systemic vasculitis (RR = 4.61, 95% CI = 3.73-5.69). Increased risk was also found in sarcoidosis (RR = 3.67, 95% CI = 3.02-4.47), GCA (RR = 3.24, 95% CI = 2.58-4.07), and ANCA vasculitis (RR = 3.18, 95% CI = 1.84-5.48). In addition, in patients with uveitis, both the odds of a prior IMID diagnosis and the risk of a future IMID diagnosis were significantly increased for all 12 IMIDs.</div></div><div><h3>CONCLUSIONS</h3><div>IMIDs are strongly associated with uveitis, with significant bidirectional risk. Patients with uveitis should be monitored for potential IMID development, and those with IMIDs should undergo ophthalmologic evaluation when appropriate.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"284 ","pages":"Pages 101-109"},"PeriodicalIF":4.2,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145956036","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 : 2026-01-07DOI: 10.1016/j.ajo.2025.12.035
Natan Lishinsky-Fischer,Sima Gharra,Itay Nitzan,Itay Chowers,Jaime Levy
PURPOSETo evaluate whether immune checkpoint inhibitors (ICIs), which modulate T-cell activity in cancer therapy, influence the risk of developing age-related macular degeneration (AMD).DESIGNRetrospective cohort study.PARTICIPANTSAdults aged ≥60 years with a history of cancer, identified from the TriNetX Global Collaborative Network. Only patients who remained alive throughout the follow-up period were included.METHODSTwo cohorts were constructed: patients who received ICIs and those who did not. Sub-analyses were conducted for patients with melanoma and for those with metastatic disease. Propensity score matching (1:1) was performed using demographic and clinical covariates. Kaplan-Meier estimates and Cox proportional hazards models assessed the association between ICI exposure and AMD incidence over 5 years.MAIN OUTCOME MEASURESIncidence of non-neovascular and neovascular AMD after ICI therapy.RESULTSAfter matching, 36,037 patients were included in each cohort. ICI-treated patients had a significantly lower risk of developing non-neovascular AMD (hazard ratio [HR], 0.77; 95% CI, [0.63, 0.93]; log-rank P = 0.0084) over a 5-year follow-up. No significant association was observed between ICI exposure and neovascular AMD. The protective association persisted in melanoma and metastatic subgroups.CONCLUSIONSIn this large, multicenter cohort, ICI therapy was associated with a reduced risk of non-neovascular AMD in older adults with cancer. These findings suggest a potential protective role of T-cell modulation in AMD pathogenesis and highlight the need for further research into the retinal effects of ICIs.
目的评估免疫检查点抑制剂（ICIs）在癌症治疗中调节t细胞活性是否影响发生年龄相关性黄斑变性（AMD）的风险。设计回顾性队列研究。参与者年龄≥60岁，有癌症病史，从TriNetX全球协作网络中确定。只有在整个随访期间仍然存活的患者被纳入研究。方法构建两组队列：接受和未接受ICIs的患者。对黑色素瘤患者和转移性疾病患者进行了亚组分析。使用人口统计学和临床协变量进行倾向评分匹配（1:1）。Kaplan-Meier估计和Cox比例风险模型评估了5年内ICI暴露与AMD发病率之间的关系。主要观察指标：ICI治疗后非新生血管性AMD和新生血管性AMD的发生率。结果匹配后，每个队列共纳入36037例患者。CI治疗的患者在5年随访期间发生非新生血管性AMD的风险显著降低（风险比[HR]， 0.77; 95% CI, [0.63, 0.93]; log-rank P = 0.0084）。未观察到ICI暴露与新生血管性AMD之间的显著关联。这种保护性关联在黑色素瘤和转移亚群中持续存在。结论：在这个大型、多中心的队列研究中，ICI治疗与老年癌症患者发生非新生血管性AMD的风险降低相关。这些发现提示了t细胞调节在AMD发病机制中的潜在保护作用，并强调了进一步研究ICIs对视网膜的影响的必要性。
{"title":"Reduced Risk of Non-Neovascular AMD in Cancer Patients Treated with Immune Checkpoint Inhibitors: A Propensity-Matched Cohort Study.","authors":"Natan Lishinsky-Fischer,Sima Gharra,Itay Nitzan,Itay Chowers,Jaime Levy","doi":"10.1016/j.ajo.2025.12.035","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.12.035","url":null,"abstract":"PURPOSETo evaluate whether immune checkpoint inhibitors (ICIs), which modulate T-cell activity in cancer therapy, influence the risk of developing age-related macular degeneration (AMD).DESIGNRetrospective cohort study.PARTICIPANTSAdults aged ≥60 years with a history of cancer, identified from the TriNetX Global Collaborative Network. Only patients who remained alive throughout the follow-up period were included.METHODSTwo cohorts were constructed: patients who received ICIs and those who did not. Sub-analyses were conducted for patients with melanoma and for those with metastatic disease. Propensity score matching (1:1) was performed using demographic and clinical covariates. Kaplan-Meier estimates and Cox proportional hazards models assessed the association between ICI exposure and AMD incidence over 5 years.MAIN OUTCOME MEASURESIncidence of non-neovascular and neovascular AMD after ICI therapy.RESULTSAfter matching, 36,037 patients were included in each cohort. ICI-treated patients had a significantly lower risk of developing non-neovascular AMD (hazard ratio [HR], 0.77; 95% CI, [0.63, 0.93]; log-rank P = 0.0084) over a 5-year follow-up. No significant association was observed between ICI exposure and neovascular AMD. The protective association persisted in melanoma and metastatic subgroups.CONCLUSIONSIn this large, multicenter cohort, ICI therapy was associated with a reduced risk of non-neovascular AMD in older adults with cancer. These findings suggest a potential protective role of T-cell modulation in AMD pathogenesis and highlight the need for further research into the retinal effects of ICIs.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"244 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145937813","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 : 2026-01-07DOI: 10.1016/j.ajo.2025.12.037
Cody Lo,Abdullah Al-Hammadi,Abdullah Al-Kaabi
{"title":"Large recurrent stromal iris cyst successfully treated with aspiration and irrigation of 100% ethanol and fluorescein.","authors":"Cody Lo,Abdullah Al-Hammadi,Abdullah Al-Kaabi","doi":"10.1016/j.ajo.2025.12.037","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.12.037","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"84 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145937814","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 : 2026-01-05DOI: 10.1016/j.ajo.2025.12.033
Giuseppe Maria ALBANESE, Georges CAPUTO, Youssef ABDELMASSIH
{"title":"Choroidal Macrovessel Complicated by Choroidal Neovascularisation","authors":"Giuseppe Maria ALBANESE, Georges CAPUTO, Youssef ABDELMASSIH","doi":"10.1016/j.ajo.2025.12.033","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.12.033","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"24 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897372","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 : 2026-01-04DOI: 10.1016/j.ajo.2025.12.032
Gerhild Wildner , Miranda Gehrke , Olaf Strauß
Objective
The retinal pigment epithelium (RPE) forms the outer blood-retina barrier. This barrier separates the retina from the choriocapillaris, as well as the immune system. The RPE contributes to the immune privilege of the eye by communicating with the local and systemic immune systems via various receptors and soluble factors. We recently described the expression and upregulation of the transcription factor FoxP3 in stressed RPE cells in vivo and in vitro. FoxP3 was initially described as being specific to regulatory T cells. Based on the hypothesis that different FoxP3 variants are expressed in RPE cells, we investigated the subcellular localization of FoxP3 using a panel of nine antibodies raised against different FoxP3 epitopes in ARPE-19 cells.
Design
We investigated cytokine secretion and FoxP3 expression in stressed and unstressed ARPE-19 cells.
Methods
Culture supernatants from ARPE-19 cells treated with LPS or with mechanical disruption of the cell layer were investigated for cytokine secretion using a multiplex assay. The cells were then stained with immunofluorescent antibodies that target different FoxP3 domains and phosphorylation sites to detect the intracellular localization of FoxP3.
Main outcome measures
Detection of FoxP3 at the subcellular level by identifying different epitopes on the protein.
Results
Stressed ARPE-19 cells upregulate inflammatory cytokines (IL-6 and MCP-1), which correspond with FoxP3 localization patterns in the cytoplasm and nucleus (phosphorylated FoxP3), depending on the epitope detected by the antibodies.
Conclusions
Stressed RPE cells switch from a tolerogenic to an effector phenotype, yet they immediately re-establish immune privilege by upregulating the transcription factor FoxP3, similar to T cells in the immune system. These different FoxP3 detection patterns suggest an RPE-specific role in maintaining the immune barrier, as well as in other non-T cell tissues that express FoxP3.
{"title":"Immunopathology of the Outer Retina: Crosstalk With the Immune System","authors":"Gerhild Wildner , Miranda Gehrke , Olaf Strauß","doi":"10.1016/j.ajo.2025.12.032","DOIUrl":"10.1016/j.ajo.2025.12.032","url":null,"abstract":"<div><h3>Objective</h3><div>The retinal pigment epithelium (RPE) forms the outer blood-retina barrier. This barrier separates the retina from the choriocapillaris, as well as the immune system. The RPE contributes to the immune privilege of the eye by communicating with the local and systemic immune systems via various receptors and soluble factors. We recently described the expression and upregulation of the transcription factor FoxP3 in stressed RPE cells <em>in vivo</em> and <em>in vitro</em>. FoxP3 was initially described as being specific to regulatory T cells. Based on the hypothesis that different FoxP3 variants are expressed in RPE cells, we investigated the subcellular localization of FoxP3 using a panel of nine antibodies raised against different FoxP3 epitopes in ARPE-19 cells.</div></div><div><h3>Design</h3><div>We investigated cytokine secretion and FoxP3 expression in stressed and unstressed ARPE-19 cells.</div></div><div><h3>Methods</h3><div>Culture supernatants from ARPE-19 cells treated with LPS or with mechanical disruption of the cell layer were investigated for cytokine secretion using a multiplex assay. The cells were then stained with immunofluorescent antibodies that target different FoxP3 domains and phosphorylation sites to detect the intracellular localization of FoxP3.</div></div><div><h3>Main outcome measures</h3><div>Detection of FoxP3 at the subcellular level by identifying different epitopes on the protein.</div></div><div><h3>Results</h3><div>Stressed ARPE-19 cells upregulate inflammatory cytokines (IL-6 and MCP-1), which correspond with FoxP3 localization patterns in the cytoplasm and nucleus (phosphorylated FoxP3), depending on the epitope detected by the antibodies.</div></div><div><h3>Conclusions</h3><div>Stressed RPE cells switch from a tolerogenic to an effector phenotype, yet they immediately re-establish immune privilege by upregulating the transcription factor FoxP3, similar to T cells in the immune system. These different FoxP3 detection patterns suggest an RPE-specific role in maintaining the immune barrier, as well as in other non-T cell tissues that express FoxP3.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"284 ","pages":"Pages 56-65"},"PeriodicalIF":4.2,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897374","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 : 2026-01-04DOI: 10.1016/j.ajo.2026.01.001
Mai A. Abdelkader, Shaymaa H. Salah, Salma F. Al-Etr, Layla El Qadi, Islam Y. Swaify, Tamer A. Macky, Hany Hamza, Abdussalam M. Abdullatif
{"title":"Early Peripapillary and Macular Microvascular Changes Following Ruthenium-106 Plaque Brachytherapy For Uveal Melanomas.","authors":"Mai A. Abdelkader, Shaymaa H. Salah, Salma F. Al-Etr, Layla El Qadi, Islam Y. Swaify, Tamer A. Macky, Hany Hamza, Abdussalam M. Abdullatif","doi":"10.1016/j.ajo.2026.01.001","DOIUrl":"https://doi.org/10.1016/j.ajo.2026.01.001","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"23 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897376","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 : 2026-01-03DOI: 10.1016/j.ajo.2025.12.031
Alessandro Feo , David Sarraf
Purpose
To review the pivotal role of en face optical coherence tomography (OCT) and OCT angiography (OCTA) in elucidating the pathoanatomy, diagnostic markers, and clinical management of inflammatory macular diseases. These noninvasive modalities provide depth-resolved, layer-specific visualization of structural and vascular alterations, enhancing our understanding of disease mechanisms and facilitating monitoring of disease activity and therapeutic response.
Methods
This perspective article synthesizes recent advances in multimodal imaging (MMI) with emphasis on en face OCT and OCTA across the spectrum of posterior noninfectious and infectious uveitic disorders. Representative diseases include multiple evanescent white dot syndrome (MEWDS), punctate inner choroidopathy (PIC), and idiopathic multifocal choroiditis (iMFC), acute zonal occult outer retinopathy (AZOOR), acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and its chronic variants, serpiginous choroiditis (SC), acute syphilitic posterior placoid chorioretinopathy (ASPPC), and Vogt-Koyanagi-Harada (VKH) disease. Imaging signatures were reviewed in relation to pathophysiology, differential diagnosis, and clinical management.
Results
En face OCT delineates disease-specific topographic patterns: “dots and spots” in MEWDS, hyperreflective plaques in PIC/iMFC, trizonal maps in AZOOR, sharply demarcated placoid lesions in APMPPE, geographic patterns in SC, and concentric hyperreflective “fingerprint” rings in VKH. OCTA provides complementary vascular insights, distinguishing preserved vs impaired choriocapillaris (CC) flow and revealing disease-driven ischemia. MEWDS typically demonstrates preserved CC perfusion, in contrast to the flow deficits of APMPPE, relentless placoid chorioretinitis, and SC. In PIC/iMFC, OCTA enables detection of inflammatory choroidal neovascularization (iCNV), while in ASPPC and VKH, it captures reversible or persistent CC flow voids following appropriate systemic therapy. Structural-vascular correlation permits differentiation between ischemic and nonischemic disorders, recognition of masquerades, and monitoring of subclinical disease activity.
Conclusions
En face OCT and OCTA have redefined the diagnostic and management landscape of inflammatory macular diseases by providing rapid, reproducible, and layer-specific structural-vascular information. Their disease-specific signatures enhance accuracy, support treatment decisions, and improve monitoring of progression and complications such as inflammatory CNV. Integration of these tools into routine multimodal imaging protocols is essential, while future research should prioritize standardization of acquisition and interpretation criteria, quantitative biomarkers, and expanded use of widefield technologies to capture peripheral and longitudinal disease dynamics.
{"title":"En Face Optical Coherence Tomography and OCT Angiography in the Pathoanatomy of Inflammatory Macular Disease","authors":"Alessandro Feo , David Sarraf","doi":"10.1016/j.ajo.2025.12.031","DOIUrl":"10.1016/j.ajo.2025.12.031","url":null,"abstract":"<div><h3>Purpose</h3><div>To review the pivotal role of en face optical coherence tomography (OCT) and OCT angiography (OCTA) in elucidating the pathoanatomy, diagnostic markers, and clinical management of inflammatory macular diseases. These noninvasive modalities provide depth-resolved, layer-specific visualization of structural and vascular alterations, enhancing our understanding of disease mechanisms and facilitating monitoring of disease activity and therapeutic response.</div></div><div><h3>Methods</h3><div>This perspective article synthesizes recent advances in multimodal imaging (MMI) with emphasis on en face OCT and OCTA across the spectrum of posterior noninfectious and infectious uveitic disorders. Representative diseases include multiple evanescent white dot syndrome (MEWDS), punctate inner choroidopathy (PIC), and idiopathic multifocal choroiditis (iMFC), acute zonal occult outer retinopathy (AZOOR), acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and its chronic variants, serpiginous choroiditis (SC), acute syphilitic posterior placoid chorioretinopathy (ASPPC), and Vogt-Koyanagi-Harada (VKH) disease. Imaging signatures were reviewed in relation to pathophysiology, differential diagnosis, and clinical management.</div></div><div><h3>Results</h3><div>En face OCT delineates disease-specific topographic patterns: “dots and spots” in MEWDS, hyperreflective plaques in PIC/iMFC, trizonal maps in AZOOR, sharply demarcated placoid lesions in APMPPE, geographic patterns in SC, and concentric hyperreflective “fingerprint” rings in VKH. OCTA provides complementary vascular insights, distinguishing preserved vs impaired choriocapillaris (CC) flow and revealing disease-driven ischemia. MEWDS typically demonstrates preserved CC perfusion, in contrast to the flow deficits of APMPPE, relentless placoid chorioretinitis, and SC. In PIC/iMFC, OCTA enables detection of inflammatory choroidal neovascularization (iCNV), while in ASPPC and VKH, it captures reversible or persistent CC flow voids following appropriate systemic therapy. Structural-vascular correlation permits differentiation between ischemic and nonischemic disorders, recognition of masquerades, and monitoring of subclinical disease activity.</div></div><div><h3>Conclusions</h3><div>En face OCT and OCTA have redefined the diagnostic and management landscape of inflammatory macular diseases by providing rapid, reproducible, and layer-specific structural-vascular information. Their disease-specific signatures enhance accuracy, support treatment decisions, and improve monitoring of progression and complications such as inflammatory CNV. Integration of these tools into routine multimodal imaging protocols is essential, while future research should prioritize standardization of acquisition and interpretation criteria, quantitative biomarkers, and expanded use of widefield technologies to capture peripheral and longitudinal disease dynamics.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"284 ","pages":"Pages 110-122"},"PeriodicalIF":4.2,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893643","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 : 2026-01-03DOI: 10.1016/j.ajo.2025.12.036
Lauren C. Kiryakoza, Jason Fan
{"title":"OCT Imaging of Macular Hole Containing a Gas Bubble after Retinal Detachment Repair","authors":"Lauren C. Kiryakoza, Jason Fan","doi":"10.1016/j.ajo.2025.12.036","DOIUrl":"https://doi.org/10.1016/j.ajo.2025.12.036","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"48 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893642","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}
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