Asia-Pacific Journal of Ophthalmology最新文献

英文中文

Response to Letter to the Editor: Comment on “Exaggerated immune response to fungal keratitis post-COVID-19 vaccination” 对“covid -19疫苗接种后对真菌性角膜炎的过度免疫反应”的评论

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2025-01-01 DOI: 10.1016/j.apjo.2025.100148

Isana Nakajima, Ken Fukuda, Tamaki Sumi, Kenji Yamashiro

引用次数: 0

Outdoor activity during class recess prevents myopia onset and shift in premyopic children: Subgroup analysis in the recess outside classroom study 课间休息时的户外活动可以预防近视儿童的近视发生和转移：课间休息研究的亚组分析

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2025-01-01 DOI: 10.1016/j.apjo.2025.100140

Pei-Chang Wu , Chia-Ling Tsai , Yi-Hsin Yang

Purpose

To investigate whether premyopia is a risk factor for myopia onset and whether outdoor activities can protect against myopia development in premyopic children in the Recess Outside Classroom (ROC) study.

Methods

Nonmyopic schoolchildren aged 7–11 years were recruited from two schools in Taiwan. One school implemented the ROC program, which encouraged children to go outdoors during recess. The control school maintained its usual schedule. A cycloplegic autorefraction was performed. Premyopia was defined as spherical equivalent refraction ≤ +0.75 diopters (D) and > –0.50 D.

Results

After one year of follow-up, multivariate logistic analysis revealed that the ROC program reduced the risk of myopia onset by 61 % (odds ratio [OR] = 0.39, 95 % confidence interval [CI]: 0.21–0.70, P = 0.002). However, premyopia status increased the risk of myopia onset by 14 times compared to hyperopic status (OR = 14.0, 95 % CI: 1.86–105.3, P = 0.010). In the subgroup analysis of premyopic children, the myopic shift was also significantly lower in the ROC group than in the control group (–0.20 ± 0.60 D/year vs. –0.40 ± 0.66 D/year, P = 0.017). Myopia incidence in premyopic children was significantly lower in the ROC group than in the control group (19.6 % vs. 37.8 %, P = 0.001). Multivariate regression analysis showed that participation in the ROC program was significantly associated with a lower myopic shift in premyopic children (–0.22 D/year, 95 % CI: –0.39 to –0.06, P = 0.008)

Conclusions

Premyopia is a risk factor for myopia onset. A school policy that includes more outdoor time can effectively prevent myopia onset and shift in premyopic children.

目的：通过课间休息（Recess Outside Classroom， ROC）研究，探讨近视前期是否为近视发生的危险因素，以及户外活动是否能预防近视儿童的近视发展。方法：选取台湾两所学校7 ~ 11岁非近视学童为研究对象。一所学校实施ROC计划，鼓励孩子们在课间休息时到户外活动。对照学校维持着常规的课程表。进行了睫状体麻痹性自屈光。预近视定义为球面等效屈光度≤+0.75屈光度(D)和> -0.50 D。结果：随访1年后，多因素logistic分析显示，ROC方案使近视发生风险降低61%（优势比[OR] = 0.39, 95%可信区间[CI]: 0.21-0.70, P = 0.002）。然而，与远视状态相比，近视前状态使近视发生的风险增加14倍（OR = 14.0, 95% CI: 1.86-105.3, P = 0.010）。在近视前儿童的亚组分析中，ROC组的近视偏移量也显著低于对照组（-0.20±0.60 D/年vs -0.40±0.66 D/年，P = 0.017）。ROC组近视前儿童的近视发生率显著低于对照组（19.6%比37.8%,P = 0.001）。多因素回归分析显示，参加ROC方案与近视前儿童近视偏移量降低显著相关（-0.22 D/年，95% CI: -0.39 ~ -0.06, P = 0.008）。一项包括更多户外时间的学校政策可以有效地预防近视儿童的近视发生和转移。

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引用次数: 0

Effect of substitutive growth hormone therapy on myopia control among Chinese children 替代生长激素治疗对中国儿童近视控制的影响。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2025-01-01 DOI: 10.1016/j.apjo.2025.100137

Yi Lu , Jiamin Xie , Lele Cheng , Qingdong Fu , Miao Wu , Ji Jin , Xun Xu

Purpose

To explore the correlation between recombinant human growth hormone (rhGH) therapy and myopia progression, and to optimize the myopia control strategies in myopic children undergoing rhGH therapy.

Methods

This retrospective study included 27 myopic children receiving rhGH therapy and 57 myopic children in the control group, all of whom underwent myopia interventions. Axial length (AL) and refraction were measured by IOLMaster and an autorefractor after cycloplegia. AL changes were compared between the rhGH and control groups, before and after rhGH therapy, and among different myopia control strategies. Univariate and multivariate regression models analyzed factors associated with axial elongation.

Results

The rhGH group exhibited greater median AL change than the control group (0.29 mm/year; interquartile range [IQR], 0.19–0.40; n = 27 vs. 0.18 mm/year; IQR, 0.12–0.27; n = 57; P < 0.001). Median axial elongation increased after rhGH treatment (0.22 mm/year; IQR, 0.12–0.34 vs. 0.32 mm/year; IQR, 0.26–0.40; n = 14; P = 0.026), while it decreased after cessation (0.39 mm/year; IQR, 0.16–0.56 vs. 0.04 mm/year; IQR, –0.03–0.15; n = 6; P = 0.031). After adjusting for confounders, axial elongation was faster in the rhGH group (β = 0.13, P < 0.001). Longer rhGH therapy duration and shorter myopia control duration were associated with accelerated axial elongation (β = 0.13, P = 0.027). Dual-therapy myopia control appeared to mitigate excessive axial elongation in rhGH-treated children more effectively than monotherapy (0.27 mm/year; IQR, 0.18–0.31; n = 20 vs. 0.40 mm/year; IQR, 0.32–0.70; n = 7; P = 0.026).

Conclusions

Myopic children undergoing rhGH therapy would exhibit accelerated axial elongation despite myopia control. Close monitoring and dual-therapy myopia control strategies are recommended for these children.

目的：探讨重组人生长激素（rhGH）治疗与近视进展的关系，优化接受rhGH治疗的近视儿童的近视控制策略。方法：回顾性研究27例接受rhGH治疗的近视儿童和对照组57例接受近视干预的近视儿童。睫状体麻痹后用IOLMaster和自折射仪测量轴长（AL）和屈光。比较rhGH组与对照组、rhGH治疗前后以及不同近视控制策略之间AL的变化。单变量和多变量回归模型分析了与轴向伸长相关的因素。结果：rhGH组AL的中位数变化大于对照组(0.29 mm/年；四分位间距[IQR]， 0.19-0.40；N = 27 vs. 0.18 mm/年；差,0.12 - -0.27;n = 57;P 结论：尽管近视得到控制，但接受rhGH治疗的近视儿童仍会出现加速的眼轴伸长。建议对这些儿童采取密切监测和双重治疗的近视控制策略。

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引用次数: 0

Spontaneous drainage of a large valsalva premacular hemorrhage 大面积斑前出血的自然引流。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2025-01-01 DOI: 10.1016/j.apjo.2025.100145

Dezhi Zheng, Zijing Huang

引用次数: 0

Efficacy, durability and safety of faricimab for patients with neovascular age-related macular degeneration: 48-week results from the phase 3 LUCERNE China subpopulation 法昔单抗治疗新生血管性年龄相关性黄斑变性患者的疗效、耐久性和安全性：LUCERNE中国3期亚群48周的结果

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2025-01-01 DOI: 10.1016/j.apjo.2025.100142

Wenjun Zou , Qin Jiang , Yanling Wang , Wenbin Wei , Xiaodong Sun , Karen Basu , Qiuyu Chen , Aachal Kotecha , Sijing Li , Ruyuan Liu , Vaibhavi Patel , Youxin Chen

Purpose

To evaluate the efficacy, durability and safety of intravitreal faricimab versus aflibercept over 48 weeks in patients with neovascular age-related macular degeneration (nAMD) from the LUCERNE China subpopulation.

Design

LUCERNE (NCT03823300) was a phase 3 global, double-masked, active comparator-controlled trial. The China subpopulation comprised patients from mainland China, Taiwan and Hong Kong.

Methods

Treatment-naïve patients aged ≥50 years with nAMD were randomized 1:1 to receive faricimab 6.0 mg up to every 16 weeks (Q16W) based on prespecified disease criteria after four initial Q4W doses or aflibercept 2.0 mg Q8W after three initial Q4W doses. The primary endpoint was mean change from baseline in best-corrected visual acuity (BCVA) averaged over weeks 40 to 48. Anatomical, durability and safety outcomes were also evaluated.

Results

The China subpopulation comprised 119 patients (faricimab: n = 59, aflibercept: n = 60). At weeks 40 to 48, adjusted mean (95% confidence interval [CI]) BCVA letter gains from baseline were +9.7 (7.4 to 12.0) and +9.8 (7.5 to 12.1) with faricimab and aflibercept, respectively. Central subfield thickness was reduced from baseline by weeks 40 to 48 in both arms, with an adjusted mean (95% CI) change of −145.4 µm (−156.2 to −134.6) and −156.5 µm (−167.3 to −145.7) for faricimab and aflibercept, respectively. By week 48, 87.3% of the patients were on extended ≥Q12W faricimab dosing. Faricimab was well tolerated with no new safety signals.

Conclusions

Faricimab up to Q16W showed durable efficacy in the LUCERNE China subpopulation, consistent with global findings. Faricimab may reduce treatment burden for patients with nAMD in China, without compromising efficacy.

目的：评价法利西单抗与阿非利西贝在LUCERNE中国亚群新生血管性年龄相关性黄斑变性（nAMD）患者治疗48周后的疗效、持久性和安全性。设计：LUCERNE （NCT03823300）是一项全球3期、双盲、有效比较对照试验。中国亚群包括来自中国大陆、台湾和香港的患者。方法：Treatment-naïve年龄≥50岁的nAMD患者以1:1的比例随机分配，在四次初始Q4W剂量后，根据预先指定的疾病标准，接受法利昔单抗6.0 mg Q16W，最多每16周（Q16W），或在三次初始Q4W剂量后，接受阿非利赛普2.0 mg Q8W。主要终点是40至48周内最佳矫正视力（BCVA）相对基线的平均变化。解剖、耐久性和安全性结果也进行了评估。结果：中国亚群包括119例患者（faricimab: n = 59, afliberept: n = 60）。在第40至48周，faricimab和aflibercept的调整平均（95%置信区间[CI]） BCVA字母增益从基线分别为+9.7（7.4至12.0）和+9.8（7.5至12.1）。在第40周至第48周期间，两组患者的中心亚野厚度均较基线减少，法利昔单抗和阿非利西ept的调整后平均（95% CI）变化分别为-145.4 µm（-156.2至-134.6）和-156.5 µm（-167.3至-145.7）。到第48周，87.3%的患者延长了≥Q12W的法利西单抗剂量。Faricimab耐受性良好，无新的安全信号。结论：法瑞昔单抗在LUCERNE中国亚群中显示出持久的疗效，与全球研究结果一致。Faricimab可能在不影响疗效的情况下减轻中国nAMD患者的治疗负担。

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引用次数: 0

Consensus and guidelines on diagnosis and management of polypoidal choroidal vasculopathy (PCV) from the Asia-Pacific Vitreo-retina Society (APVRS) 亚太玻璃体视网膜学会（APVRS）关于息肉样脉络膜血管病变（PCV）诊断和治疗的共识和指南。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2025-01-01 DOI: 10.1016/j.apjo.2025.100144

Paisan Ruamviboonsuk , Danny S.C. Ng , Voraporn Chaikitmongkol , Andrew Chang , Shih-Jen Chen , Youxin Chen , Chui Ming Gemmy Cheung , Fumi Gomi , Robyn Guymer , Judy E. Kim , Adrian Koh , Gregg T. Kokame , Chi-Chun Lai , Timothy Y.Y. Lai , Won Ki Lee , Yuichiro Ogura , Srinivas Sadda , Kelvin Y.C. Teo , Tien Yin Wong , Yasuo Yanagi , Dennis S.C. Lam

A panel of 21 international experts are formed by the Asia-Pacific Vitreo-retina Society to work out the consensus and guidelines on polypoidal choroidal vasculopathy (PCV). PCV is a common subtype of neovascular age-related macular degeneration and is more prevalent in Asian populations. Recent advancement in imaging technology allows greater understanding of the disease process of PCV. Furthermore, non–indocyanine green angiography features in optical coherence tomography angiography have been validated for PCV diagnosis and treatment response monitoring. Clinical trials provide new data on the safety and efficacy of various anti–vascular endothelial growth factor (anti-VEGF) agents as well as protocols that aim to improve the sustainability of treatments. In view of the myriads of emerging information, the panel gathered, reviewed, discussed, formulated and voted on the consensus and guidelines of PCV on four areas: 1) disease entity, 2) investigation and diagnosis, 3) treatment options, and 4) management protocol and future development in a five-point Likert scale (strongly agree, agree, neutral, disagree and strongly disagree). We proposed using a consensus score in which the maximum was 100. The summation of the respective “percentages” of experts voting for “agree” or “strongly agree” would be counted as the actual score. Consensus was achieved when the actual score of 75 or more was reached, which meant at least 75 % of the experts had voted for “strongly agree” or “agree” on the consensus statement concerned.

亚太玻璃体视网膜学会成立了一个由21名国际专家组成的小组，以制定息肉样脉络膜血管病变（PCV）的共识和指南。PCV是新生血管性年龄相关性黄斑变性的一种常见亚型，在亚洲人群中更为普遍。近年来影像学技术的进步使人们对PCV的发病过程有了更深入的了解。此外，光学相干断层扫描血管造影中的非吲哚菁绿色血管造影特征已被证实可用于PCV诊断和治疗反应监测。临床试验为各种抗血管内皮生长因子（anti-VEGF）药物的安全性和有效性以及旨在提高治疗可持续性的方案提供了新的数据。鉴于大量新出现的信息，专家组以李克特五点量表（强烈同意、同意、中立、不同意和强烈不同意）对PCV的共识和指南进行了收集、审查、讨论、制定和投票，内容涉及四个方面：1)疾病实体、2)调查和诊断、3)治疗方案、4)管理方案和未来发展。我们建议使用共识分数，其中最大值为100。投票支持“同意”或“非常同意”的专家各自“百分比”的总和将被计算为实际得分。当实际得分达到或超过75分时，即表示至少75%的专家对有关的共识声明投了“非常同意”或“同意”的票，即达成共识。

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引用次数: 0

Definition for consensus statement much needed 非常需要共识声明的定义。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2025-01-01 DOI: 10.1016/j.apjo.2025.100141

Xianqun Fan, Clement C. Tham, Christopher K.S. Leung, Jost B. Jonas

引用次数: 0

Changes in choroidal thickness in pre-myopic children after repeated low-level red-light therapy and their role in predicting myopia prevention and controlling myopic shift. 反复低强度红光治疗后近视前期儿童脉络膜厚度的变化及其在预测近视预防和控制近视移位中的作用

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2024-12-01 DOI: 10.1016/j.apjo.2024.100115

Kaidi Xiang, Jingjing Wang, Zhuoting Zhu, Xinzi Zhang, Bo Zhang, Jun Chen, Jinliuxing Yang, Linlin Du, Zhijian Ai, Xiangui He, Xun Xu

Purpose: To investigate longitudinal changes in choroidal thickness (ChT) after 1-year treatment of repeated low-level red-light (RLRL) and their predictive value in efficacy on myopia prevention and myopic shift among pre-myopic children.

Methods: 278 pre-myopic (-0.50 D < spherical equivalent refraction, SER ≤ 0.50 D) participants were assigned to the RLRL group and control group randomly and evenly. The OCT, visual acuity, AL, SER and other parameters were measured before enrollment and every 3 months after intervention. The data from both eyes of the included participants were analyzed.

Results: A total of 463 eyes were analyzed. Due to the COVID-19 pandemic, 176 participants in the RLRL group had treatment interrupted. The continued RLRL group, interrupted RLRL group and control group were well balanced in baseline characteristics. In the continued and interrupted RLRL group, the average ChT increased significantly at 3-month visit (all P < 0.001) and the subfoveal ChT thickened evidently. The area under the curve (AUC) for the models including gender and 3-month change in ChT to predict satisfactory myopia prevention at 12 months was 0.983. The efficacy of the models that also used the combined indicators of baseline age, gender and the 3-month change in ChT to predict AL progression control over 12 months reached 0.944.

Conclusions: Continued RLRL intervention induced notable thickening of ChT in premyopic population, especially at the subfoveal sector. For participants received RLRL treatment, the 3-month change in ChT combined with other baseline factors have acceptable predictive discrimination of myopia prevention efficacy.

目的：探讨反复低水平红灯（RLRL）治疗1年后，准近视儿童脉络膜厚度（ChT）的纵向变化及其对近视预防和近视转移效果的预测价值。方法：278例近视前期患者（-0.50 D <球面等效屈光度，SER≤0.50 D）随机均匀分为RLRL组和对照组。在入组前及干预后每3个月测量一次OCT、视力、AL、SER等参数。对被试者双眼的数据进行分析。结果：共分析463只眼。由于COVID-19大流行，RLRL组的176名参与者的治疗中断。继续RLRL组、中断RLRL组和对照组的基线特征平衡良好。在RLRL持续组和中断组，平均ChT在3个月时显著增加（均P < 0.001），中央凹下ChT明显增厚。包括性别和3个月ChT变化的模型预测12个月时满意的近视预防的曲线下面积（AUC）为0.983。同时使用基线年龄、性别、3个月ChT变化联合指标预测12个月AL进展控制的模型的疗效达到0.944。结论：持续的RLRL干预在近视人群中引起了明显的ChT增厚，特别是在中央凹下区。对于接受RLRL治疗的参与者，3个月的ChT变化结合其他基线因素对近视预防效果具有可接受的预测性区分。

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引用次数: 0

Axial elongation in nonpathologic high myopia: Ocular structural changes and glaucoma diagnostic challenges 非病理性高度近视的眼轴伸长：眼部结构改变和青光眼诊断挑战。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2024-11-01 DOI: 10.1016/j.apjo.2024.100123

Kangjie Kong , Xiaoyi Liu , Zige Fang , Jingwen Jiang , Jiaxuan Jiang , Deming Wang , Zefeng Yang , Fengqi Zhou , Evan M. Chen , Jill Liang , Yunhe Song , Fengbin Lin , Kyoko Ohno-Matsui , Jost B. Jonas , Ying Han , Fei Li , Xiulan Zhang , for the Glaucoma Suspects with High Myopia Study Group

Axial elongation continues in highly myopic adult eyes, even in the absence of pathologic changes such as posterior staphyloma or chorioretinal atrophy. This ongoing axial elongation leads to structural changes in the macular and peripapillary regions, including chorioretinal thinning, reduced vascular perfusion and optic disc tilting and rotation, among others. These alterations can affect the acquisition and interpretation of optical coherence tomography, optical coherence tomography angiography and fundus photographs, potentially introducing artifacts and diminishing the accuracy of glaucoma diagnosis in highly myopic eyes. In this review, we compared the progression patterns of axial elongation across populations with varying demographic characteristics, genetic and environmental backgrounds and ocular features. We also discussed the implications of axial elongation–induced ocular structural changes for diagnosing glaucoma in nonpathologic high myopia. Finally, we highlighted the prospects for enhancing the diagnostic efficacy of glaucoma in nonpathologic highly myopic populations.

在高度近视的成人眼睛中，即使没有诸如后葡萄肿或绒毛膜视网膜萎缩等病理改变，轴向伸长仍在继续。这种持续的轴向伸长导致黄斑和乳头周围区域的结构改变，包括脉络膜变薄、血管灌注减少和视盘倾斜和旋转等。这些改变会影响光学相干断层扫描、光学相干断层血管造影和眼底照片的采集和解释，可能会产生伪影，降低高度近视眼睛青光眼诊断的准确性。在这篇综述中，我们比较了不同人口统计学特征、遗传和环境背景以及眼部特征的人群中轴向伸长的进展模式。我们也讨论了眼轴伸长引起的眼部结构变化对非病理性高度近视青光眼的诊断意义。最后，我们强调了在非病理性高度近视人群中提高青光眼诊断效能的前景。

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引用次数: 0

Rapid-onset central retinal vein occlusion following inactivated COVID-19 vaccination 灭活COVID-19疫苗接种后快速发作的视网膜中央静脉闭塞。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2024-11-01 DOI: 10.1016/j.apjo.2024.100118

Yuchen Zhang , Hao Zhou , Suqin Yu , Chong Chen

引用次数: 0

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