PURPOSE: To evaluate the relationship between sleep disorders, including insomnia and obstructive sleep apnea (OSA), personal chronotype, and age-related macular degeneration (AMD). METHODS: The authors systematically re...PURPOSE: To evaluate the relationship between sleep disorders, including insomnia and obstructive sleep apnea (OSA), personal chronotype, and age-related macular degeneration (AMD). METHODS: The authors systematically reviewed articles in PubMed, EMBASE, and Web of Science that provided information on AMD and sleep disorders, whether qualitative or quantitative. The authors systematically screened the abstracts of potentially eligible studies and subsequently assessed the full-text reports of those deemed relevant in detail. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Twenty-two studies were included in their final review. Obstructive sleep apnea was associated with a higher risk of AMD, based on seven studies (hazard ratio 1.43; 95% confidence interval (CI) 1.14-1.79 P < 0.001; I 2 = 96%). The analysis showed a statistically significant association between the morning person chronotype and an increased odds of AMD (OR 1.19; 95% CI 1.10-1.30; P < 0.001; I 2 = 0%). The authors found little to no association between sleep duration (SD) and insomnia. CONCLUSION: Their meta-analyses, although based on a limited number of studies, indicate that sleep disorders, particularly OSA, are associated with increased odds of developing AMD. However, further research is needed to understand how SD affects disease progression and to determine the benefits of treating sleep disorders for AMD.
PURPOSE: This study used microscope-integrated optical coherence tomography (MIOCT) to identify patients with proliferative diabetic retinopathy with concurrent diabetic macular edema (DME) during vitrectomy and compared...PURPOSE: This study used microscope-integrated optical coherence tomography (MIOCT) to identify patients with proliferative diabetic retinopathy with concurrent diabetic macular edema (DME) during vitrectomy and compared the efficacy of immediate versus delayed anti-VEGF treatment, as well as ranibizumab versus conbercept. METHODS: A prospective randomized controlled trial was conducted on patients with proliferative diabetic retinopathy undergoing pars plana vitrectomy (PPV). Patients with preoperatively unconfirmed DME were evaluated intraoperatively using MIOCT. Those with MIOCT-confirmed DME were randomly assigned to three groups: Group A received intravitreal ranibizumab during PPV with additional injections at 1 and 2 months postoperatively. Group B received intravitreal conbercept during PPV with additional injections at 1 and 2 months postoperatively. Group C received ranibizumab at 1, 2, and 3 months postoperatively. All groups followed a 3+ PRN protocol. Best-corrected visual acuity and central macular thickness were measured at 1 day; 1 week; 1, 3, and 6 months post-PPV. RESULTS: A total of 115 eyes from 115 patients with proliferative diabetic retinopathy (one eye per patient) with MIOCT-confirmed concurrent DME during PPV were enrolled and randomly assigned to treatment groups. Six eyes were lost to follow-up, and 109 eyes (94.8%) completed the entire 6-month study. Groups A and B showed significant best-corrected visual acuity and central macular thickness improvements compared with Group C throughout the follow-up period, with Group B demonstrating superior early and sustained efficacy. Immediate anti-VEGF treatment during PPV, particularly with conbercept, was associated with reduced complications and accelerated recovery of visual function. CONCLUSION: In patients with proliferative diabetic retinopathy with MIOCT-identified DME during vitrectomy, immediate anti-VEGF treatment provides superior best-corrected visual acuity and central macular thickness improvements compared with delayed treatment, with conbercept demonstrating better efficacy.
PURPOSE: To evaluate longitudinal retinal and choroidal vascular changes in diabetic patients with and without diabetic retinopathy (DR) using OCT, OCTA, and MATLAB analysis, and to identify quantitative biomarkers of st...PURPOSE: To evaluate longitudinal retinal and choroidal vascular changes in diabetic patients with and without diabetic retinopathy (DR) using OCT, OCTA, and MATLAB analysis, and to identify quantitative biomarkers of stage and progression. METHODS: In this prospective study, 142 diabetic eyes (Stage 0-3 DR) and 34 controls were followed for 2 years. Eyes with diabetic macular edema were excluded. Participants underwent SD-OCT, macular 6 × 6-mm OCTA, and wide-field FA at baseline, 8, 16, and 24 months. Parameters included retinal thickness, subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI), choriocapillaris flow, vessel density (VD), skeleton density (SD), fractal dimension (FD), vessel diameter index (VDI), vessel tortuosity (VT), foveal avascular zone (FAZ), and acircularity index (AI), quantified with MATLAB. RESULTS: At baseline, diabetic eyes had lower SFCT and CVI versus controls ( P = 0.004, P = 0.035). Stage 0 eyes already showed impairment, with reduced VD, SD, and FD, and increased VDI and AI. Over 2 years, DR eyes exhibited declines in SFCT, CVI, and superficial VD, with rising VDI and AI. ROC analysis showed deep VDI best distinguished Stage 0 from Stage 1 (AUC = 0.764), superficial VDI separated Stage 2 from Stage 3 (AUC = 0.720), whereas deep VD and ischemic index (ISI) distinguished Stage 0 from Stages 1 to 3 (AUC > 0.80). CONCLUSION: DR is associated with retinal and choroidal vascular alterations detectable by OCT and OCTA. Quantitative metrics-particularly deep VDI and CVI-are promising biomarkers for early detection, staging, and monitoring of DR.
PURPOSE: To compare the efficacy and safety of adjunctive therapies for proliferative vitreoretinopathy (PVR) related to rhegmatogenous retinal detachment (RRD). METHODS: A systematic literature search was conducted on O...PURPOSE: To compare the efficacy and safety of adjunctive therapies for proliferative vitreoretinopathy (PVR) related to rhegmatogenous retinal detachment (RRD). METHODS: A systematic literature search was conducted on Ovid MEDLINE, Embase, and the Cochrane Library for randomized controlled trials (RCTs) from January 2000 to December 2025. A Bayesian random-effects network meta-analysis was used to compare different therapies. RESULTS: A total of 2,519 patients from 18 RCTs were included (1,339 receiving adjunctive treatments and 1,180 receiving placebo). Oral retinoic acid was associated with significantly higher primary (hazard ratio [HR] = 2.86, 95% CI = [1.16, 7.53]) and final (HR = 2.90, 95% CI = [1.12, 7.50]) retinal reattachment rates, improved visual acuity (MD=-0.89, 95% CI = [-1.68, -0.08]), and a lower incidence of postoperative macular pucker (HR = 0.12, 95% CI = [0.02, 0.50]) compared with placebo. Oral prednisolone had a lower rate of PVR recurrence compared with placebo (HR = 0.37, 95% CI = [0.17, 0.79]), while oral retinoic acid (HR = 0.06, 95% CI = [0.00, 0.50]) and intravitreal dexamethasone (HR = 0.23, 95% CI = [0.05, 0.81]) were associated with reduced rates of RRD reoperation. CONCLUSION: Oral retinoic acid ranked highest for primary outcomes in PVR associated with RRD; however, this finding was driven by a single RCT with limited sample size. Oral prednisolone reduced PVR recurrence, while intravitreal dexamethasone lowered reoperation risk, compared with placebo.
PURPOSE: To investigate the incidence, clinical characteristics, and possible pathogenesis of retinal detachment (RD) after penetrating keratoplasty (PK), and to assess the impact of RD and vitreoretinal surgery on the p...PURPOSE: To investigate the incidence, clinical characteristics, and possible pathogenesis of retinal detachment (RD) after penetrating keratoplasty (PK), and to assess the impact of RD and vitreoretinal surgery on the postoperative effects and prognosis of PK surgery. METHODS: A retrospective review of 3,241 eyes from 2,884 patients who underwent PK was conducted. RD incidence, characteristics, and outcomes of vitreoretinal surgery were analyzed. RESULTS: The incidence of RD after PK was 1.32%, with a mean follow-up of 7.7 years. RD occurred on average 28.3 months post-PK, sooner in eyes with multiple PKs. A unique traction RD pattern was identified, with anterior proliferative vitreoretinopathy (PVR) observed in 73.9% of cases during pars plana vitrectomy (PPV). This caused RD without detectable retinal breaks due to anterior displacement of the retina and vitreous base. Endoscope-assisted PPV in eyes with opaque corneas resulted in better visual acuity and silicone oil removal rates than standard techniques. Clear graft eyes retained silicone oil more frequently than those with opaque grafts. CONCLUSION: RD after PK is a rare complication, characterized by severe anterior PVR, presenting significant surgical challenges. Effective management involves specialized surgical interventions. Early detection and tailored surgical strategies are crucial for improving patient outcomes after PK.
PURPOSE: To evaluate the long-term functional and anatomical outcomes of pars plana vitrectomy (PPV) combined with subretinal recombinant tissue plasminogen activator (tPA) injection and gas tamponade in patients with su...PURPOSE: To evaluate the long-term functional and anatomical outcomes of pars plana vitrectomy (PPV) combined with subretinal recombinant tissue plasminogen activator (tPA) injection and gas tamponade in patients with subretinal hemorrhage secondary to retinal arterial macroaneurysm (RAM) rupture. METHODS: This retrospective multicenter study included 18 eyes of 18 patients who underwent PPV with subretinal tPA injection and gas tamponade for subfoveal hemorrhage because of RAM rupture. Baseline demographic and clinical features, pre- and postoperative best-corrected visual acuity (BCVA), central macular thickness (CMT), postoperative complications, and the relationship between symptom-to-surgery interval and visual outcomes were evaluated over a minimum follow-up period of 12 months. RESULTS: The mean preoperative BCVA was approximately 20/3,300 (2.22 ± 0.73 logMAR), improving to approximately 20/140 (0.85 ± 0.57 logMAR) at the 12-month visit ( P < 0.001). Earlier surgical intervention (≤14 days) was associated with greater improvement in BCVA. Subfoveal retinal pigment epithelium (RPE) atrophy developed in 38.9% of patients and was significantly associated with worse visual outcomes compared with extrafoveal atrophy ( P = 0.02). ILM peeling was performed in 44.4% of cases; although those patients tended to have greater BCVA gains, the difference was not statistically significant. RPE atrophy was observed in 77.8% of patients postoperatively, with varying progression patterns. CONCLUSION: PPV with subretinal tPA injection and gas tamponade appears to be an effective treatment for RAM-related subretinal hemorrhage, with significant improvements in visual acuity, particularly when performed within 2 weeks of symptom onset. The location of postoperative RPE atrophy is a critical prognostic factor for visual outcomes.
PURPOSE: To evaluate outcomes of intravitreal faricimab in polypoidal choroidal vasculopathy (PCV) and pachychoroid neovasculopathy (PNV), focusing on subfoveal choroidal thickness (SFCT) and choroidal vascularity index...PURPOSE: To evaluate outcomes of intravitreal faricimab in polypoidal choroidal vasculopathy (PCV) and pachychoroid neovasculopathy (PNV), focusing on subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI), compared with ranibizumab and aflibercept. METHODS: This retrospective cohort study included 96 treatment-naive eyes with PCV or PNV, allocated by 1:1:1 propensity score matching to receive three consecutive monthly intravitreal injections of faricimab, ranibizumab, or aflibercept (n = 32 each). Best-corrected visual acuity (BCVA), central macular thickness (CMT), SFCT, and the CVI were evaluated at baseline and at Months 1 to 3. In addition, total choroidal area (TCA), luminal area (LA), and stromal area (SA) were quantified. RESULTS: Baseline characteristics were similar. Best-corrected visual acuity and CMT changes were not significantly different. Faricimab induced greater SFCT reduction than ranibizumab ( P < 0.001 at Months 1-3) and aflibercept ( P = 0.029, 0.005, 0.004 at Months 1-3). Choroidal vascularity index reduction was also greater with faricimab than ranibizumab ( P = 0.001, <0.001, 0.010 at Months 1-3) and aflibercept ( P = 0.032, 0.024 at Months 2-3). This was driven by larger LA reduction relative to TCA and SA (LA vs. TCA: P < 0.001 at Months 1-2, P = 0.006 at Month 3; LA vs. SA: P < 0.001 at Months 1-3). Ranibizumab and aflibercept showed proportional decreases without significant differences. CONCLUSION: Faricimab achieved greater SFCT and CVI reductions, suggesting enhanced vascular stabilization and reduced pachyvessel congestion. These results support the therapeutic potential of dual vascular endothelial growth factor-A/angiopoietin-2 inhibition in PCV and PNV.
PURPOSE: To compare the efficacy of detecting diabetic retinal neovascularization (NV) by single captured 24 × 20-mm ultra-widefield optical coherence tomography angiography (UWF-OCTA) with ultra-widefield color fundus p...PURPOSE: To compare the efficacy of detecting diabetic retinal neovascularization (NV) by single captured 24 × 20-mm ultra-widefield optical coherence tomography angiography (UWF-OCTA) with ultra-widefield color fundus photography (UWF-CFP) and ultra-widefield fluorescein angiography (UWF-FA). METHODS: This cross-sectional study included eyes with diabetic retinopathy undergoing UWF-FA, UWF-CFP, and UWF-OCTA at Guangdong Provincial People's Hospital (February 2022-May 2023). Images were captured using the Optos California system for UWF-CFP and UWF-FA, and the Toward Pi BM400K system for UWF-OCTA. NV was graded based on defined criteria for each imaging modality, with FA serving as the gold standard. The intraclass correlation coefficient (ICC), specificity, and sensitivity were analyzed by SPSS v19. ICC assessed agreement between UWF-OCTA and the other modalities, whereas specificity and sensitivity were calculated using UWF-FA as the reference. RESULTS: Among 90 eyes (56 participants), UWF-OCTA demonstrated high sensitivity (0.97), specificity (1.0), and accuracy (0.99) for NV detection. UWF-OCTA and UWF-FA showed excellent agreement in NV count within the 24 × 20-mm field (ICC = 0.994, P < 0.001) and in total number (ICC = 0.904, 95% confidence interval: 0.742-0.959, P < 0.001). Combing UWF-OCTA and UWF-CFP panoramically improved NV detection (ICC = 0.988, 95% confidence interval: 0.975-0.994, P < 0.001). CONCLUSION: UWF-OCTA of 24 × 20 mm is highly effective for NV detection, with excellent agreement to UWF-FA. Combined with UWF-CFP, it serves as a reliable, noninvasive alternative to FA for diabetic retinopathy evaluation.
PURPOSE: To determine how fundus visibility relates to optical coherence tomography-derived morphologic and topographic features of focal choroidal excavation (FCE) and to evaluate systemic and ocular associations in a h...PURPOSE: To determine how fundus visibility relates to optical coherence tomography-derived morphologic and topographic features of focal choroidal excavation (FCE) and to evaluate systemic and ocular associations in a health-screening cohort. METHODS: The authors analyzed 19,048 individuals undergoing health examinations with spectral domain optical coherence tomography and fundus photography. FCEs were classified as fundus-visible or fundus-invisible. A 1:2 propensity score matching (age/sex) was performed to compare participants with FCE against non-FCE controls. Generalized estimating equations were used to analyze lesion characteristics, systemic comorbidities, and ocular parameters including intraocular pressure, choroidal thickness, and macular degeneration. RESULTS: The authors identified 252 FCE lesions in 192 participants (1.0%). Compared with matched controls, the FCE group showed no significant differences in systemic comorbidities but had significantly lower intraocular pressure ( P = 0.026), greater choroidal thickness ( P < 0.001), and a higher prevalence of macular degeneration ( P = 0.002). Among FCEs, fundus-visible lesions had greater median horizontal diameter (681.0 vs. 518.0 µ m; P < 0.001) and depth (69.5 vs. 45.0 µ m; P < 0.001), were located closer to the fovea (611.5 vs. 1,385.0 µ m; P < 0.001), and exhibited higher rates of steep slopes (62.5% vs. 42.7%; P = 0.002) and outer nuclear layer thickening (61.7% vs. 31.5%; P < 0.001) compared with fundus-invisible lesions. CONCLUSION: FCE is associated with distinct ocular profiles, including lower intraocular pressure and increased choroidal thickness, independent of systemic risk factors. Fundus visibility indicates larger, deeper, and paramacular lesions with specific structural alterations, underscoring the need to recognize subtle fundoscopic irregularities for early optical coherence tomography detection.
PURPOSE: The evaluation of retinal vasculopathies such as diabetic retinopathy (DR) and retinal vein occlusion (RVO) increasingly benefits from integrating ultra-widefield fluorescein angiography (UWF-FFA) and single-sca...PURPOSE: The evaluation of retinal vasculopathies such as diabetic retinopathy (DR) and retinal vein occlusion (RVO) increasingly benefits from integrating ultra-widefield fluorescein angiography (UWF-FFA) and single-scan ultra-widefield optical coherence tomography angiography (UWF-OCTA). This study aimed to assess the real-life application of retinal angiography and OCTA for detecting retinal neovascularization and peripheral ischemia. METHODS: Although UWF-FFA remains the only dynamic modality capable of capturing perfusion flow and leakage, OCTA provides noninvasive, high-resolution, depth-resolved vascular imaging without systemic risks. In this real-world study, UWF-FFA performed with the Optos Silverstone was compared with UWF-OCTA obtained using the DREAM OCT platform, capturing up to 130° in a single acquisition and 200° with montage reconstruction. RESULTS: Among 50 enrolled patients-mostly with varying stages of DR, including proliferative disease and previous panretinal photocoagulation (PRP)-the number of neovascularizations identified was comparable across modalities. Profound, meaning well-defined retinal ischemia and visually obvious because of significant image contrast between perfused and nonperfused retinal areas was also comparable, whereas mild and meaning less defined retinal ischemia was more extensive in UWF-FFA because of the larger imaged area. Foveal avascular zone (FAZ) measurements appeared larger on FFA, whereas IRMAs were more frequently identified on UWF-OCTA. Despite its smaller single-scan field, UWF-OCTA provided excellent image quality and high sensitivity to vascular abnormalities, even with media opacities. CONCLUSION: These findings support the complementary roles of UWF-FFA and UWF-OCTA, emphasizing their combined value in enhancing diagnostic precision, guiding treatment, and monitoring disease progression in retinal vascular disorders.
PURPOSE: To report anatomical and functional outcomes of epiretinal proliferation (EP) embedding without internal limiting membrane peeling for lamellar macular holes (LMHs) with EP. METHODS: This retrospective intervent...PURPOSE: To report anatomical and functional outcomes of epiretinal proliferation (EP) embedding without internal limiting membrane peeling for lamellar macular holes (LMHs) with EP. METHODS: This retrospective interventional case series involved patients with idiopathic LMHs and EP who underwent pars plana vitrectomy using the EP-embedding technique without internal limiting membrane peeling. The EP was peeled centripetally, left connected to the LMH edge, and embedded into the retinal cleavage plane. 20% sulfur hexafluoride gas tamponade was applied. After surgery, patients were recommended to avoid lying face-up. RESULTS: Fifteen eyes of 15 patients were included, and the mean follow-up was 12 ± 8 months. Lamellar macular hole closure was achieved in 100% of cases. Best-corrected visual acuity and central retinal thickness showed significant postoperative improvement, from 0.31 ± 0.20 logMAR (20/40 Snellen) and 156.5 ± 40.7 µ m preoperatively to 0.10 ± 0.12 logMAR (20/25 Snellen) ( P = 0.002) and 221.5 ± 46.5 µ m ( P < 0.001), respectively. Ellipsoid zone (EZ) and external limiting membrane restoration rates were 50% and 100%, respectively. No cases of full-thickness macular hole formation, LMH recurrence, or major complications were observed. CONCLUSION: EP-embedding without internal limiting membrane peeling yields favorable anatomical and functional outcomes in LMHs with EP and supports the nontractional pathophysiology of the condition.
PURPOSE: To characterize peripapillary hyperreflective ovoid mass-like structures (PHOMS) in affected and fellow eyes of patients with intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage (IHAPSH),...PURPOSE: To characterize peripapillary hyperreflective ovoid mass-like structures (PHOMS) in affected and fellow eyes of patients with intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage (IHAPSH), and to assess whether PHOMS height is associated with IHAPSH involvement. METHODS: This retrospective observational study included 14 IHAPSH patients who underwent optic nerve head optical coherence tomography. PHOMS presence, distribution, and height were characterized in affected and fellow eyes. Interocular differences in PHOMS height, spherical equivalent (SE), and optic disc tilt were compared. The association between PHOMS height and IHAPSH involvement was then analyzed using a linear mixed-effects model (LMM), adjusting for SE and optic disc tilt. RESULTS: All 14 IHAPSH patients had unilateral involvement. PHOMS were detected in all affected eyes and 78.6% (11/14) of fellow eyes. PHOMS were nasally located, with occasional superior or inferior extension. PHOMS height was greater in affected eyes (546.37 ± 98.33 µ m) than in fellow eyes (357.12 ± 224.12 µ m; P = 0.002). Affected eyes showed more myopic SE (-3.87 ± 1.57 D vs. -3.13 ± 1.76 D; P = 0.007), with no difference in optic disc tilt ( P = 0.457). In the LMM, PHOMS height was independently associated with IHAPSH involvement, with affected eyes showing 159.07 µ m greater height than fellow eyes (β = 159.07 µ m; P = 0.011) after adjustment for SE and optic disc tilt. CONCLUSION: PHOMS height was greater in affected than in fellow eyes and independently associated with IHAPSH involvement, suggesting that increased PHOMS height may reflect structural susceptibility to IHAPSH.
Jensen H, Ding X, Ploumi I
… +15 more, Ha S, Vingopoulos F, Zeng R, Romano F, Bannerman A, Stettler I, Bennett C, Overbey K, Baldwin G, Garg I, Rodriguez J, Kim LA, Vavvas DG, Husain D, Miller JB
PURPOSE: Investigate the structure-function relationships between epiretinal membrane (ERM) stage, tractional abnormalities, and the gap area between the ERM and the retinal surface, in relation to visual acuity and quan...PURPOSE: Investigate the structure-function relationships between epiretinal membrane (ERM) stage, tractional abnormalities, and the gap area between the ERM and the retinal surface, in relation to visual acuity and quantitative contrast sensitivity function (qCSF) in patients with idiopathic epiretinal membrane. METHODS: This was a retrospective, cross-sectional study involving 111 participants diagnosed with idiopathic epiretinal membrane (iERM). All patients underwent a comprehensive ophthalmological examination, optical coherence tomography imaging (SD-OCT) using the SPECTRALIS® Heidelberg system, and contrast sensitivity (CS) testing utilizing the qCSF method. RESULTS: Progressive stages of ERM were associated with declines in both CS and visual acuity (β*=-0.45 to -0.19, p<0.02), with CS showing a more pronounced reduction than visual acuity, especially between controls and stage 1. Ectopic inner foveal layer (EIFL) thickness exhibited a similar pattern of decline in both visual acuity (β*=0.42, p<0.001) and CS (β*= -0.46 to -0.18, all p <0.02). In contrast, SUKIMA showed no significant association with any of the visual measurements assessed. Among the tractional abnormalities, the cotton ball sign correlated with diminished vision, particularly reflected by a notable drop in CS at the highest spatial frequencies tested with reduced CS at 12 cpd (β*=-0.44, p=0.02) and 18 cpd (β*=-0.46, p=0.02). CONCLUSION: qCSF testing is particularly important for assessing visual function in ERM development, especially in the early stages.
Inooka T, Mizobuchi K, Hayashi T
… +12 more, Suga A, Tsunoda K, Kuniyoshi K, Kondo H, Ota J, Kominami T, Yoshitake K, Minematsu N, Iwata T, Kondo M, Nishiguchi KM, Ueno S
PURPOSE: To evaluate the prevalence of achromatopsia (ACHM) associated with variants of RPGRIP1 , especially c.2710+374_2895+78del ( RPGRIP1 -ex18-DEL), and to confirm that these phenotypes were consistent with ACHM in J...PURPOSE: To evaluate the prevalence of achromatopsia (ACHM) associated with variants of RPGRIP1 , especially c.2710+374_2895+78del ( RPGRIP1 -ex18-DEL), and to confirm that these phenotypes were consistent with ACHM in Japanese patients. METHODS: This retrospective observational study involved a review of medical records from 52 patients across 47 Japanese families; all clinically diagnosed with ACHM. RESULTS: Causative variants for ACHM were identified in 39 families through whole-exome sequencing, whole-genome sequencing, or polymerase chain reaction: PDE6C (13 families), RPGRIP1 -ex18-DEL (11 families), CNGA3 (11 families), CNGB3 (2 families), and GNAT2 (2 families). Patients with ACHM associated with RPGRIP1 -ex18-DEL variants did not exhibit significant difference in phenotype, including spherical equivalent refractive error, best-corrected visual acuity (BCVA), fundus appearance, ellipsoid zone grading of optical coherence tomography, and fundus autofluorescence pattern, compared with those with variants in CNGA3 or PDE6C at baseline (all, P > 0.05). For five patients with ACHM with RPGRIP1 -ex18-DEL variants, no change in BCVA or ellipsoid zone grading was noted over a follow-up period of >10 years (all, P > 0.05). CONCLUSION: Variants in RPGRIP1 -ex18-DEL are unique hotspots with a high prevalence among Japanese patients with ACHM. Clinical findings in these patients are consistent with those in patients with ACHM from other causative genes.
PURPOSE: To explore whether the proteome of aqueous collected during primary repair of rhegmatogenous retinal detachment (RD), differs between patients who experience recurrency (Recurrent RD Group) and those who do not...PURPOSE: To explore whether the proteome of aqueous collected during primary repair of rhegmatogenous retinal detachment (RD), differs between patients who experience recurrency (Recurrent RD Group) and those who do not (No Recurrent RD Group). METHODS: The aqueous proteome collected during primary surgery of 13 patients undergoing Recurrent RD was compared with 11 age- and sex-matched patients successfully operated for rhegmatogenous RD with no recurrency after 12-month follow-up, regardless of surgical technique. A label-free shotgun proteomics approach identified and quantified the repertoire of aqueous proteins. Differential protein expression between groups was determined using the Limma moderated Bayesian t -test, followed by false discovery rate (FDR) validation using Storey q-test. RESULTS: Aqueous profiling identified >800 unique proteins; 45 exclusive to the Recurrent RD group, 10 exclusive to the no Recurrent RD group, and 33 differently expressed between groups (log2fold-change≥∣0.57∣, FDR ≤ 0.05). Proteins upregulated in Recurrent RD patients, clearly pointed to mechanisms of cell:cell and cell:matrix adhesiveness and mechano-transduction signaling pathways. Upregulated proteins included extracellular matrix components such as type I and IV collagens, biglycan, proteoglycans, and cell-membrane adhesion molecules. CONCLUSION: The baseline aqueous composition of RD patients that will eventually develop recurrency, differs significantly from those who will not, and already contains molecular signatures that may help identify the risk of recurrency at the time of primary repair. While acknowledging the pilot nature of the study, findings of this study strongly suggest that Recurrent RD is associated with cell adhesiveness pathways early alterations, offering targets for prognostic assessment and therapy.
PURPOSE: This cross-sectional study explored the association between sleep deprivation and epiretinal membrane (ERM) using machine learning applied to data from the Korean National Health and Nutrition Examination Survey...PURPOSE: This cross-sectional study explored the association between sleep deprivation and epiretinal membrane (ERM) using machine learning applied to data from the Korean National Health and Nutrition Examination Survey 2017 to 2020. METHODS: Data from 2018 to 2020 were used for training and internal validation, and from 2017 for external validation. Participants were divided into ERM and non-ERM groups, and their sociodemographic, lifestyle, and clinical characteristics were assessed. Sleep deprivation was defined as sleeping <6 hours on weekdays. Machine learning-based logistic regression was used to model the association between sleep deprivation and ERM, adjusting for confounders. The consistency of the results and importance of each feature were assessed using subgroup analyses and Shapley additive explanations. RESULTS: Data from 15,240 participants were included, with an ERM prevalence of 9.59%. The final adjusted model achieved an area under the ROC curve of 0.763 (95% CI 0.733-0.792) in external validation. Sleep deprivation was significantly associated with increased ERM risk (adjusted odds ratio [OR], 1.247; 95% CI 1.051-1.481), particularly among non-high-risk alcohol consumers (OR 1.216; 95% CI 1.057-1.399) and individuals with diabetes mellitus (OR 1.259; 95% CI 1.069-1.481). Sleep deprivation was the fourth most influential predictor (5.3%), after age, cataract surgery, and dyslipidemia. CONCLUSION: Sleep deprivation was significantly associated with a 1.25-fold increase in the prevalence of ERM, especially among non-high-risk alcohol consumers and those with diabetes. Weekday sleep deprivation may be a modifiable risk factor for ERM. Prospective studies are warranted to confirm causality and explore the underlying mechanisms.