Ophthalmology[JOURNAL]
Sun
200 papers
Effect of intraocular pressure control on visual field progression in the HORIZON trial.
Montesano G, Ometto G, Ike K Ahmed I … +1 more , Gazzard G
Ophthalmol Glaucoma · 2026 Jun · PMID 42336143 · Publisher ↗
PURPOSE: To analyze the effect of intraocular pressure (IOP) characteristics on the 5-year rate of visual field (VF) Mean Deviation (MD) progression in the HORIZON trial. DESIGN: Post-hoc analysis of data from a randomiz...
PURPOSE: To analyze the effect of intraocular pressure (IOP) characteristics on the 5-year rate of visual field (VF) Mean Deviation (MD) progression in the HORIZON trial. DESIGN: Post-hoc analysis of data from a randomized clinical trial. PARTICIPANTS: Patients with glaucoma and visually significant cataract randomized to cataract surgery (CS) with or without the implant of the Hydrus Microstent (HMS). METHODS: One eye of each participant with at least 3 reliable VFs (false positive errors < 15%) over at least 1 year was included. We used a published Bayesian hierarchical model, designed to minimize the effect of perimetric noise and learning. We compared the mean rate of MD progression between the two arms and measured the effect of post-operative mean IOP (MIOP), peak washed-out and mean washed-out IOP (WO-PIOP and WO-MIOP) and day-1 IOP. These IOP metrics were mean-centered and standardized (divided by their standard deviation, SD), to allow a direct comparison of their effect. MAIN OUTCOME MEASURE: Mean rate of MD progression. RESULTS: Data from 517 eyes (352 in the CS-HMS arm) were analyzed. The MD rate was -0.55 [-0.72, -0.39] dB/year (Mean [95%-Credible Intervals]) for the CS only arm and -0.30 [-0.38, -0.22] for the CS-HMS arm (44.6 [18.0, 64.2]% reduction, p = 0.004). Increase in all IOP metrics was significantly associated with a faster MD rate. MIOP, WO-MIOP and WO-PIOP had similar proportional effects. Day-1 IOP had a considerably smaller effect. The difference in rate between the two arms remained significant after adjusting for MIOP (p= 0.002), but was largely eliminated after adjusting for WO-MIOP and WO-PIOP (p= 0.396). The MD rate in the CS arm remained significantly faster than CS-HMS (p = 0.001) after removing eyes with a day-1 IOP spike (IOP > 40 mmHg or 10 mmHg above the washed-out baseline IOP). CONCLUSIONS: The MD rate was significantly slower in the CS-HMS arm in the HORIZON trial, compared to CS alone. This difference was not explained by day-1 IOP spikes or MIOP, but was largely accounted for by WO-IOP metrics.
Re: Dones et al.: Emergency department use of ocular point-of-care ultrasound and its utility in diagnosis at a tertiary academic medical center (Ophthalmology. 2026;133:720-727).
O'Shaughnessy E, Lecler A
Ophthalmology · 2026 Jun · PMID 42334390 · Publisher ↗
Abstract loading — click title to view on PubMed.
Asymmetric uveal effusion in bilateral nanophthalmos presenting as unilateral secondary angle closure: a rare case report.
Gujarathi T, Rajendrababu S
BMC Ophthalmol · 2026 Jun · PMID 42332717 · Full text
PURPOSE: To report a rare case of unilateral secondary angle closure in a young male with bilateral nanophthalmos caused by spontaneous supraciliary and choroidal effusion, highlighting the diagnostic role of multimodal...
PURPOSE: To report a rare case of unilateral secondary angle closure in a young male with bilateral nanophthalmos caused by spontaneous supraciliary and choroidal effusion, highlighting the diagnostic role of multimodal imaging and the importance of individualized management. CASE REPORT: A 33-year-old male, a known case of hyperopia in both eyes, presented with gradual visual loss in both his eyes. Examination revealed asymmetric anterior chamber depth with shallowing in right eye (RE) > left eye (LE), bilateral short axial lengths, and a 360° choroidal detachment in the RE, while the fellow eye remained clinically stable. Ultrasound biomicroscopy (UBM) confirmed supraciliary effusion in the affected eye, explaining the secondary angle closure mechanism. TREATMENT AND OUTCOME: Despite initial conservative management with oral & topical steroids, he had persistent choroidal effusion and was advised surgical intervention. He underwent single quadrant posterior sclerostomy, which resulted in significant resolution of effusions with anatomical and visual improvement. CONCLUSION: This case highlights the importance of considering spontaneous supraciliary effusion as a possible cause for unilateral secondary angle closure in short eyes. Underscores the importance of early multimodal imaging and timely posterior sclerostomy to preserve vision when medical therapy is unsuccessful. Asymmetrical angle closure could be a clinical clue to detect uveal effusions in nanophthalmos.
The association between magnesium and diabetic retinopathy: a cross-sectional study.
Wang Y, Li J, Lin Y … +4 more , Hu W, Tu Y, Xiao A, Zhou Q
BMC Ophthalmol · 2026 Jun · PMID 42332654 · Full text
OBJECTIVE: To investigate the clinical significance of serum magnesium in non-diabetic mellitus (non-DM), diabetes mellitus (DM) and diabetic retinopathy (DR). Moreover, to assess magnesium concentration in DR mice model...
OBJECTIVE: To investigate the clinical significance of serum magnesium in non-diabetic mellitus (non-DM), diabetes mellitus (DM) and diabetic retinopathy (DR). Moreover, to assess magnesium concentration in DR mice models. METHODS: Baseline data from 150 patients per group (non-DM, DM, DR) comprised demographics, cardiovascular-metabolic profiles, electrolytes, and systemic immune-inflammatory were collected and analyzed. Logistic regression analysis was used to screen influencing factors for DR. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic utility of hemoglobin A1c (HbA1c) and magnesium. Magnesium concentration in both serum and retinal tissues of DR mice were quantified via the methylthymol blue assay. RESULTS: Compared with the non-DM group, the DM group had lower age and blood pressure levels (P < 0.05), while heart rate, HbA1c and serum phosphorus levels were significantly higher (P < 0.05). Serum sodium and magnesium levels decreased gradually across the non-DM, DM and DR groups (P < 0.05), whereas heart rate and HbA1c levels increased progressively in the three groups (P < 0.05). Compared with DM, those with DR had longer diabetic duration. Ordinal multinomial logistic regression among non-DM, DM and DR groups indicated that HbA1c was positively associated with DR risk, whereas magnesium was negatively correlated with DR. Binary logistic regression between DM and DR groups showed that diabetes duration, SBP and HbA1c were positively related to elevated DR risk, and magnesium was negatively associated with the occurrence of DR. The ROC curve analysis revealed that a combined diagnostic of HbA1c and serum magnesium, with cut-off value of 0.500, achieved a sensitivity of 78.7% and a specificity of 90.0% for DM. The combined diagnosis of HbA1c and magnesium, with cut-off value of 0.441, approached a sensitivity of 75.3% and a specificity of 66.0% for DR. DR mice exhibited lower magnesium levels in both serum and retinal tissues compared with the control mice (P < 0.05). CONCLUSION: Patients with DR had longer disease duration, elevated HbA1c levels and decreased serum magnesium concentrations. Combined detection of serum magnesium and HbA1c can significantly improve the diagnostic performance of DR.
Clinically accessible eye-tracking in thyroid-associated ophthalmopathy: exploratory classification modeling and gaze allocation to disease-related periocular images.
Yang C, Shen Y, Song J … +3 more , Chen Y, Zeng C, Wei R
BMC Ophthalmol · 2026 Jun · PMID 42332638 · Full text
BACKGROUND: Thyroid-associated ophthalmopathy (TAO) is an autoimmune orbital disease that may cause ocular motility abnormalities, altered periocular appearance, and psychosocial burden. However, clinically practical too...
BACKGROUND: Thyroid-associated ophthalmopathy (TAO) is an autoimmune orbital disease that may cause ocular motility abnormalities, altered periocular appearance, and psychosocial burden. However, clinically practical tools for early recognition and objective functional assessment remain limited. This study aimed to evaluate whether clinically accessible eye-tracking could support auxiliary classification of thyroid-associated ophthalmopathy and characterize visual attention patterns toward disease-related periocular images. METHODS: In this cross-sectional study, 229 adults from a tertiary ophthalmology center were enrolled, including 181 patients with TAO and 48 healthy controls. Eye movements were recorded using a clinically accessible eye-tracking system during fixation, smooth pursuit with nine-grid spatial analysis, and image-viewing tasks. Random forest models were developed using nine-grid smooth-pursuit gaze-distribution features. A primary model included eye-tracking features plus age and sex, while a secondary model assessed eye-tracking features after demographic adjustment. Group differences in gaze metrics and region-of-interest allocation were analyzed using regression-based methods. RESULTS: Fixation stability did not differ significantly between groups, but patients with TAO showed increased gaze dispersion. In smooth pursuit, the primary model achieved an AUC of 0.903, and the secondary model achieved an AUC of 0.778. In image-viewing tasks, gaze allocation differed between groups: compared with controls, patients with TAO paid less attention to more obvious pathological periocular features in earlier-stage images and more attention to near-recovery appearances in later-stage images. Distinct viewing patterns were also observed across preoperative and postoperative images from different surgical categories. CONCLUSIONS: Clinically accessible eye-tracking may provide behavioral markers for auxiliary TAO classification and reveal altered visual attention to TAO-related periocular appearance. Further validation in larger, independent cohorts is needed. TRIAL REGISTRATION: ClinicalTrials.gov, NCT07381413. Prospectively registered.
Association between capsulectomy shunt revision and Ahmed glaucoma valve implant exposure--Shanghai Ahmed glaucoma valve implant exposure (AGVIE) study.
Gao F, Jin M, Yu X … +13 more , Chen J, Dai Y, Chen Y, Wang J, Chen X, Wang L, Fang Y, Wang K, Liu T, Kwan YL, Qian S, Sun X, Kong X
BMC Ophthalmol · 2026 Jun · PMID 42332618 · Full text
BACKGROUND: The Ahmed Glaucoma Valve (AGV) is a drainage device commonly used in the treatment of refractory glaucoma. Implant exposure is a major cause of surgical failure. This study aimed to identify factors associate...
BACKGROUND: The Ahmed Glaucoma Valve (AGV) is a drainage device commonly used in the treatment of refractory glaucoma. Implant exposure is a major cause of surgical failure. This study aimed to identify factors associated with AGV exposure. METHODS: This retrospective cohort study included all inpatients who underwent primary AGV implantation at the Eye & ENT Hospital of Fudan University between January 2015 and December 2024. Baseline demographic and surgical data were collected. Factors associated with AGV exposure were evaluated using univariate and multivariate logistic regression. RESULTS: In this comprehensive cohort study, involving a total of 2,905 eyes, with participants having a mean age of 49.2 ± 18.0 years and 64% being male, we observed that AGV exposure occurred in 75 eyes, accounting for an incidence rate of 2.6% (95% CI, 2.0-3.2%). Capsulectomy shunt revision (CSR) was associated with AGV exposure in both univariable analysis (OR 3.72, 95% CI 1.73-7.98; P < 0.001) and multivariable analysis (OR 3.95, 95% CI 1.79-8.69; P < 0.001). CONCLUSIONS: The crude incidence of AGV exposure was 2.6%. CSR was statistically associated with AGV exposure, although this finding should be interpreted cautiously given the retrospective design and methodological limitations. Careful surgical planning and close postoperative monitoring may therefore be warranted. CLINICAL TRIAL REGISTRATION: Not applicable.
Diagnostic and therapeutic impact of PCR in uveitis: real-world data from intraocular fluid analysis of 45 uveitis patients in a tertiary referral center in Turkey.
Zorlutuna Kaymak N, Pekel İ, Demir Tekol S … +3 more , Akçay G, Oklar M, Tanyıldız B
BMC Ophthalmol · 2026 Jun · PMID 42332605 · Full text
PURPOSE: To evaluate the diagnostic utility and real-world clinical impact of polymerase chain reaction (PCR) analysis of aqueous humor (AH) and vitreous samples in patients with uveitis including suspected infectious an...
PURPOSE: To evaluate the diagnostic utility and real-world clinical impact of polymerase chain reaction (PCR) analysis of aqueous humor (AH) and vitreous samples in patients with uveitis including suspected infectious and mixed (infectious/non-infectious) etiologies. Although intraocular PCR is a well-established diagnostic technique, its contribution to diagnostic revision and clinical decision-making in routine practice remains incompletely characterized. This study addresses this gap by assessing the impact of PCR on diagnostic revision, clinical management and regional epidemiological patterns in a tertiary referral center in Turkey. METHODS: A retrospective review was conducted on 45 eyes of 45 patients with uveitis. PCR testing was performed on AH (n = 24) and vitreous samples (n = 21) for Herpes simplex virus (HSV), Varicella zoster virus (VZV), Cytomegalovirus (CMV), Toxoplasma gondii, and Mycobacterium tuberculosis based on clinical suspicion. Pathogen-specific uniplex real-time PCR assays providing qualitative and quantitative results were used. PCR findings were evaluated in conjunction with clinical presentation to assess their contribution to diagnostic revision, diagnostic certainty, and clinical management. RESULTS: The mean patient age was 47.4 ± 17.3 years, and 51.1% of the patients were female; 28.9% were immunosuppressed. Overall PCR positivity was 42.2% (19/45). PCR positivity was higher in immunosuppressed patients than in immunocompetent patients (62.0% vs. 34.4%), although this difference did not reach statistical significance (p = 0.094). PCR positivity was higher in AH samples than in vitreous samples (50.0% vs. 33.3%). PCR analysis led to diagnostic revision in 33.3% (15/45) of patients and influenced clinical management decisions in 80.0% of cases. Positive PCR results were significantly associated with diagnostic certainty (p = 0.006), whereas PCR-negative patients had a markedly higher likelihood of requiring diagnostic and therapeutic modification compared to PCR-positive patients (OR 21.0, 95% CI 2.4-182, p = 0.001). CONCLUSION: PCR analysis of intraocular fluids provides meaningful diagnostic value in the evaluation of uveitis. Both positive and negative results inform clinical decision-making by guiding diagnostic revision and supporting appropriate management strategies. These findings provide region-specific epidemiological data and reinforce intraocular PCR as a key adjunct in complex uveitis cases where clinical features alone are insufficient.
Application of subretinal injection of balanced salt solution for the management of large-diameter macular holes.
Wang X, Li X, Wu B … +2 more , Han Q, Wang Y
BMC Ophthalmol · 2026 Jun · PMID 42332604 · Full text
PURPOSE: To evaluate the efficacy and safety of subretinal injection of balanced salt solution (BSS) combined with vitrectomy and internal limiting membrane (ILM) peeling for managing large-diameter macular holes (MHs ≥ ...
PURPOSE: To evaluate the efficacy and safety of subretinal injection of balanced salt solution (BSS) combined with vitrectomy and internal limiting membrane (ILM) peeling for managing large-diameter macular holes (MHs ≥ 400 μm). METHODS: A prospective interventional study was conducted on 31 eyes of 31 patients with full-thickness MHs (including 5 refractory MHs). Patients underwent 25 G vitrectomy, ILM peeling, followed by subretinal BSS injection using a 41 G needle. Outcomes were assessed at 1 and 3 months postoperatively with optical coherence tomography (OCT), best corrected visual acuity (BCVA), and microperimetry. Metrics of the microperimetry included macular integrity index (MII) and macular threshold (MT). Ten eyes completed 6 month followup. Changes in BCVA (LogMAR), MII, and MT before and after surgery, as well as MH closure and complications were compared and analyzed. Functional outcomes were analyzed only in eyes with successful type I closure. RESULTS: At 1 month, 93.54% (29/31) achieved complete MH closure. BCVA improved from 1.34 ± 0.59 preoperatively to 0.67 ± 0.20 at 1 month and 0.48 ± 0.36 at 3 months (p < 0.001). MII improved from 98.77 ± 4.83 to 96.23 ± 11.38 (p = 0.015) and MT from 17.53 ± 5.04 to 22.54 ± 3.91 dB (p < 0.001) at 3 months. In 10 eyes with 6 month followup, BCVA further improved to 0.41 ± 0.30 and MT to 24.64 ± 2.35 dB (bothp < 0.05). The refractory subgroup (n = 5) achieved 100% complete closure. No complications were observed during the follow-up time. CONCLUSION: Combined 41 G subretinal BSS injection with PPV and ILM peeling is effective and safe for treating largediameter MHs (≥400 μm), achieving high anatomical closure rates and sustained visual functional improvement up to 6 months. Preliminary outcomes in refractory MHs are favorable; larger cohorts are needed for validation.
Surgical Outcomes and Prognostic Factors in Morning Glory Syndrome-Associated Retinal Detachment.
Yamao S, Chiba Y, Kuniyoshi K … +2 more , Kamei M, Kusaka S
Ophthalmol Retina · 2026 Jun · PMID 42331102 · Publisher ↗
PURPOSE: To evaluate surgical outcomes and identify key prognostic factors in retinal detachment associated with morning glory syndrome (MGS-RD). DESIGN: Retrospective consecutive case series. SUBJECTS: Fifteen consecuti...
PURPOSE: To evaluate surgical outcomes and identify key prognostic factors in retinal detachment associated with morning glory syndrome (MGS-RD). DESIGN: Retrospective consecutive case series. SUBJECTS: Fifteen consecutive eyes of 15 patients with MGS-RD who underwent vitreoretinal surgery between 2000 and 2024 with a follow-up of >12 months. METHODS: We retrospectively reviewed clinical records. We analyzed associations between seven clinical factors and outcomes using logistic regression and exact statistical methods, including age, proliferative vitreoretinopathy (PVR) grade, funnel configuration, extent of RD, the presence of a visible break, complicated cataract, and application of endolaser around the excavated peripapillary area. MAIN OUTCOME MEASURES: Anatomical success was defined as retinal reattachment without silicone oil tamponade at final follow-up. RESULTS: The final anatomical success rate was 46.7% (7/15). PVR grade at the initial surgery showed the strongest association with anatomical outcomes, with a success rate of 11.1% (1/9) in eyes with grade C compared with 100% (6/6) in those with less advanced PVR. Younger age was also associated with poorer outcomes, with no successful cases in patients aged ≤ 3 years (0/5) and complete success in those aged ≥ 9 years (5/5). Eyes with an open-funnel configuration showed higher success rates than those with a closed-funnel configuration (7/10 vs 0/5). A visible peripapillary break and absence of complicated cataract were also associated with better outcomes. Endolaser application showed no clear association with success. CONCLUSIONS: Advanced proliferative changes were strongly associated with poorer anatomical outcomes in MGS-RD. Younger age and advanced disease features, including closed-funnel configuration and complicated cataract, were also associated with poorer prognosis. Given the limited sample size and retrospective design, these findings should be interpreted as exploratory observations. Mild cases may initially be observed; however, we suggest that persistent or progressive detachment may warrant consideration of surgical intervention before severe proliferative progression develops.
Outcomes of Laser Retinopexy for Retinal Tears by Fellow-Eye Detachment History.
Zhang C, Bowers KE, Sanchez V … +4 more , Ersan S, Williams BK, Flynn HW, Yannuzzi NA
Ophthalmol Retina · 2026 Jun · PMID 42331101 · Publisher ↗
Patients with a history of retinal detachment in the fellow eye have a significantly higher short-term risk of retinal detachment after laser retinopexy for retinal tears, without a corresponding increase in repeat laser...
Patients with a history of retinal detachment in the fellow eye have a significantly higher short-term risk of retinal detachment after laser retinopexy for retinal tears, without a corresponding increase in repeat laser treatments.
Clinical experience with gene therapy for autosomal recessive RPE65-related retinal dystrophy in the Arabian Gulf.
Khan Z, Ghazi NG, Hay S … +1 more , Khan AO
Ophthalmol Retina · 2026 Jun · PMID 42331100 · Publisher ↗
PURPOSE: To report a single-center experience of subretinal voretigene neparvovec-rzyl (VN) gene therapy for Arabian Gulf patients with autosomal recessive RPE65-related inherited retinal dystrophy. DESIGN: Retrospective...
PURPOSE: To report a single-center experience of subretinal voretigene neparvovec-rzyl (VN) gene therapy for Arabian Gulf patients with autosomal recessive RPE65-related inherited retinal dystrophy. DESIGN: Retrospective case series. PARTICIPANTS: Nine patients (6 families; 3 males) with RPE65-related retinal dystrophy who underwent VN gene therapy (pars plana vitrectomy and subretinal injection) at Cleveland Clinic Abu Dhabi between 2020-2024. TESTING: Pre and post operative best corrected visual acuity (BCVA), ophthalmic examination, full-field stimulus threshold (FST), and multimodal retinal imaging (photography, optical coherence tomography, short-wave autofluorescence). MAIN OUTCOME MEASURES: BCVA, clinical findings, FST, multimodal imaging. RESULTS: Eight patients were Emirati and one was Bahraini. All were treated bilaterally. Age at first eye treatment ranged from 11 to 56 years (mean 24.2) and second eye treatment was 7-11 days later. No intraoperative surgical complications occurred. Follow up after treatment ranged from 13 to 71 months (mean 38.8 months). Postoperative systemic steroid withdrawal-related effects and transient intraocular pressure elevation were observed in one patient each. Two patients developed lens opacities that were not visually significant. All eyes of all patients developed postoperative CRA. At last follow-up, BCVA improved in five patients (55.6%), remained stable in two (22.2%), and reduced in two (22.2%) who had progressive central CRA. FST improved in all but the two oldest at treatment (41 and 56 years old), who showed some decline. CONCLUSIONS: VN treatment improved scotopic vision (FST) in all patients treated before 40 years old and often improved BCVA. Postoperative CRA was universal; ethnicity and sunny climate may have been contributing factors. The possibility of postoperative BCVA loss related to central CRA is an important preoperative counseling point, particularly when preoperative BCVA is functionally useful.
Cataract Surgery and the Risk of Conversion from Dry to Neovascular Age-related Macular Degeneration in the IRIS© Registry.
Ashourizadeh H, Gilbert JB, Ross C … +8 more , Kearney WC, Grinspan N, Elze T, Vavvas DG, Miller JW, Lorch AC, Armstrong GW, IRIS® Registry Analytic Center Consortium
Ophthalmology · 2026 Jun · PMID 42331067 · Publisher ↗
OBJECTIVE: To evaluate the association between cataract surgery (CS) and the risk of conversion from dry age-related macular degeneration (dAMD) to neovascular AMD (nvAMD), and to identify factors associated with convers...
OBJECTIVE: To evaluate the association between cataract surgery (CS) and the risk of conversion from dry age-related macular degeneration (dAMD) to neovascular AMD (nvAMD), and to identify factors associated with conversion. DESIGN: Population-based retrospective time-to-event study SUBJECTS: Eyes of patients aged ≥55 years with early or intermediate dAMD and phakic status at baseline were identified in the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) on or after January 1st, 2016, to December 31st, 2022. Eyes that underwent CS were classified as exposed; those without CS during the study period were nonexposed. METHODS: Propensity score matching was used to match eyes 1:1 on age, sex, race, and ethnicity, laterality, AMD stage, and smoking status. CS was modeled as a time-varying exposure. We used Cox proportional hazards regression to estimate the hazard of conversion to nvAMD. MAIN OUTCOME MEASURES: Conversion from dAMD to nvAMD, defined by registry-derived diagnosis codes, between exposed and nonexposed cohorts. RESULTS: After matching, 40,053 eyes were included in each exposed and nonexposed cohort (total N = 80,106 eyes). CS was associated with a higher risk of nvAMD conversion (hazard ratio [HR] = 1.22; 95% CI, 1.16-1.30; P < 0.001). Time-varying analysis demonstrated that this association was strongest early in follow-up (HR ≈ 2.5 in year 1) and declined steadily, reaching non-significance (HR ≈ 1.0) by year 4. At year 6, the cumulative incidence of nvAMD was 17.7% in the exposed cohort versus 15.2% in the nonexposed cohort. Baseline AMD stage moderated the effect of CS, with weaker effects of CS for intermediate AMD (Interaction HR = 0.82, 95% CI, 0.78-0.92). CONCLUSIONS: CS was associated with a modestly increased overall rate of conversion from dAMD to nvAMD; however, the time-dependent pattern suggests that the observed association likely reflects increased surveillance or unrecognized pre-existing nvAMD rather than a sustained biological effect of surgery. The absolute risk difference was small (∼3.3% over six years). These findings support careful perioperative evaluation in dAMD patients but do not implicate CS as a long-term driver of neovascular conversion.
Blunt Ocular Trauma from BB Gun Pellet: Long-Term Corneal Endothelial Changes.
Dias PB, Khalili S, Mireskandari K
Ophthalmology · 2026 Jun · PMID 42329206 · Publisher ↗
Abstract loading — click title to view on PubMed.
Contribution of resting pulse rate to fall risk prediction in patients with glaucoma: a nationwide retrospective study based on an XGBoost model.
Zhang Z, Wang J, Zeng S … +5 more , Gao L, He R, Wu L, Chen Z, Hu J
BMC Ophthalmol · 2026 Jun · PMID 42324504 · Full text
BACKGROUND: Falls are among the most common safety concerns in people with visual impairment and can lead to serious consequences, including fractures, prolonged hospitalization, and even death. Patients with glaucoma ar...
BACKGROUND: Falls are among the most common safety concerns in people with visual impairment and can lead to serious consequences, including fractures, prolonged hospitalization, and even death. Patients with glaucoma are at increased risk of falls due to visual field loss, impaired motor coordination, and declines in cognitive function compared with the general population. Resting pulse rate is an easily obtainable measure in routine clinical practice; however, its contribution to fall risk prediction in patients with glaucoma has not been sufficiently investigated. To address this knowledge gap, we developed and compared multiple predictive approaches by incorporating a broad range of fall-related variables into prediction models, and we used explainable machine learning to quantify the contribution of resting pulse rate to fall risk prediction in glaucoma. In doing so, we aimed to explore the potential contribution of resting pulse rate as one of the model features in fall risk estimation, rather than as a standalone glaucoma-specific ophthalmic indicator. METHODS: Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). We included 249 participants with self-reported physician-diagnosed glaucoma who had no history of falls at the 2015 baseline survey and completed follow-up in 2018. The outcome was the occurrence of any fall between 2015 and 2018. To further characterize baseline differences, we also included 12,297 participants without glaucoma and without a history of falls at the 2015 baseline survey for comparative analyses.Candidate predictors comprised demographic characteristics, clinical comorbidities, medication use, self-reported vision status, and relevant laboratory measures. Self-reported near and distance vision were treated as limited visual functional information available in the database and were not considered equivalent to objective glaucoma-specific ophthalmic indicators. To compare machine learning models with a conventional statistical approach, we developed a logistic regression (LR) baseline model and trained six machine learning models: random forest, XGBoost, gradient boosting decision tree (GBDT), support vector machine (SVM), k-nearest neighbors (KNN), and AdaBoost. Feature selection was performed in the training set using recursive feature elimination with 5-fold cross-validation; within each fold, feature selection was conducted using only the fold-specific training subset and evaluated on the corresponding validation subset to reduce the risk of information leakage and overly optimistic performance estimates. After determining the final feature subset, hyperparameters were tuned and models were fitted using cross-validation within the training set. Model stability was assessed using 1,000 bootstrap resamples of the training set, and we reported the area under the receiver operating characteristic curve (AUC) with 95% confidence intervals, accuracy, and F1 score. Calibration curves and decision curve analysis were used to evaluate calibration and clinical net benefit. Finally, SHAP was applied to interpret the best-performing XGBoost model. RESULTS: A total of 249 eligible participants with glaucoma were included. During follow-up, 36 participants reported at least one fall, yielding a fall incidence of 14.46%. In contrast, among the 12,297 non-glaucoma participants included for baseline comparison, 873 reported at least one fall (7.1%; P < 0.001).In model development, the conventional logistic regression model showed the lowest discriminative performance, with an AUC of 0.676 (95% CI, 0.628-0.724). The XGBoost model achieved the best performance, with an AUC of 0.851 (95% CI, 0.812-0.886). Decision curve analysis indicated that, within a threshold probability range of 51.5% to 67.5%, the XGBoost model provided greater net benefit than the other machine learning models. SHAP-based feature importance further identified key predictors of falls in patients with glaucoma, with resting pulse rate ranking among the top contributing features in the XGBoost model. CONCLUSION: In this study, the XGBoost model demonstrated the best performance for estimating fall risk among participants with self-reported glaucoma. SHAP analyses indicated that resting pulse rate, creatinine, age, blood urea nitrogen, frailty status, and height made relatively large contributions within the final model. Given the absence of objective ophthalmic parameters, these findings should be regarded as exploratory and interpreted cautiously. Resting pulse rate may provide supplementary information within model-based fall risk estimation, but it should not be interpreted as a standalone glaucoma-specific indicator or as evidence of causality.
Impact of a structured patient engagement program on treatment adherence, injection persistence, and visual outcomes in real-world anti-VEGF therapy for neovascular age-related macular degeneration.
Lan L, Lan J, Ren X … +1 more , Ye B
BMC Ophthalmol · 2026 Jun · PMID 42323551 · Full text
BACKGROUND: Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible visual impairment among older adults. Although intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy h...
BACKGROUND: Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible visual impairment among older adults. Although intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy has improved visual outcomes, real-world effectiveness is often limited by poor adherence and treatment discontinuation. This study evaluated the impact of a structured patient engagement program on treatment adherence, injection persistence, visual outcomes, and patient-reported outcomes in patients receiving anti-VEGF therapy for nAMD. METHODS: This single-center retrospective observational comparative cohort study included 350 patients with nAMD treated between January 2022 and December 2024. Patients received either standard care alone (n = 175) or standard care plus a structured patient engagement program (n = 175) incorporating individualized education, adherence counseling, appointment reminders, and proactive follow-up communication. Primary outcomes were treatment adherence and injection persistence. Secondary outcomes included best-corrected visual acuity (BCVA), patient satisfaction, and disease understanding. RESULTS: Patients enrolled in the engagement program demonstrated significantly better adherence than those receiving standard care. The mean number of missed injection visits was lower (0.51 ± 0.68 vs. 1.48 ± 1.27; P < 0.001), and delayed injections exceeding two weeks were less frequent (22.3% vs. 50.9%; P < 0.001). Good adherence was achieved in 89.1% of patients in the engagement group compared with 50.3% in the standard care group (P < 0.001), while treatment persistence was higher (90.9% vs. 77.7%; P = 0.001). Final BCVA was significantly better in the engagement group (0.61 ± 0.30 vs. 0.70 ± 0.34 LogMAR; P = 0.015), and a greater proportion of patients experienced visual improvement (65.1% vs. 52.6%; P = 0.023). Patient satisfaction and disease understanding were also significantly higher among patients receiving the engagement intervention (P < 0.001 for both). Safety outcomes were comparable between groups. CONCLUSIONS: A structured patient engagement program was associated with improved treatment adherence, enhanced injection persistence, and better short- to mid-term visual outcomes in patients receiving anti-VEGF therapy for nAMD. These findings support the integration of patient-centered engagement strategies into routine retinal care to optimize real-world treatment outcomes.
Atypical Sebaceous Adenoma of the Caruncle.
Cheng C, Tang L, Xiao W
Ophthalmology · 2026 Jun · PMID 42322338 · Publisher ↗
Abstract loading — click title to view on PubMed.
Medial Posterior Ciliary Artery Occlusion after Facial HA-CaHA Injection.
Zeng J, Guo B, Lu F
Ophthalmology · 2026 Jun · PMID 42322337 · Publisher ↗
Abstract loading — click title to view on PubMed.
Long-Term Retinal Pigmentary Changes from Subretinal Lidocaine Injection.
Moir JT, Mammo DA
Ophthalmol Retina · 2026 Jun · PMID 42322319 · Publisher ↗
Abstract loading — click title to view on PubMed.
Agreement between Pentacam HR and Visionix VX650 system for corneal and anterior chamber parameters.
Barberán-Bernardos L, Ariza-Gracia MÁ, Piñero DP
BMC Ophthalmol · 2026 Jun · PMID 42321687 · Full text
PURPOSE: To evaluate the agreement in anterior segment measurements obtained with Pentacam HR and Visionix VX650 topographers, in terms of keratometry, pachymetry and anterior chamber parameters in healthy eyes. METHODS:...
PURPOSE: To evaluate the agreement in anterior segment measurements obtained with Pentacam HR and Visionix VX650 topographers, in terms of keratometry, pachymetry and anterior chamber parameters in healthy eyes. METHODS: Inclusion criteria consisted of healthy eyes with no history of ocular pathology or surgery. Measurements of central corneal thickness (CCT), minimum corneal thickness (MCT), anterior and posterior keratometry (K1, K2), anterior chamber depth (ACD), and anterior chamber angle (ACA) were taken using the Pentacam HR and Visionix VX650. Differences between devices were assessed with paired Student's t-tests, and agreement was evaluated using Bland-Altman plots. RESULTS: Fifty-five eyes from 55 healthy participants mean age 32.55 ± 12.60 years) were examined. Anterior keratometry and MCT showed clinically acceptable agreement between devices, with no significant differences (p > 0.164). Pentacam HR reported steeper posterior keratometry, smaller ACD, lower CCT and larger ACA values compared with VX650 (p < 0.001). For CCT and MCT, ranges of agreement were large, with values of ± 27.07 and 55.41 μm, respectively. However, the ranges of agreement for anterior K1 and K2 were smaller, with values of ± 0.11 and 0.11 mm, respectively. Likewise, the ranges of agreement for ACD and ACA were also clinically significant, with a clear trend of VX650 to provide longer ACD measurements and lower ACA estimates. CONCLUSIONS: Anterior corneal keratometry measured with the Pentacam HR and Visionix VX650 exhibit acceptable inter-device agreement. However, caution should be exercised regarding their interchangeability, especially when making decisions that require precise thickness (refractive surgery screening) or anterior chamber parameters (phakic intraocular lens implantation).
En face OCT in branch retinal artery occlusion: quantitative assessment of epiretinal macrophage-like cells and optical intensity ratio.
Zeng Y, Chen X, Zhou Y … +5 more , Chen W, Chen X, Zhu Y, Wen F, Yang R
BMC Ophthalmol · 2026 Jun · PMID 42321678 · Full text
PURPOSE: In branch retinal artery occlusion (BRAO), the regional distribution of epiretinal macrophage-like cells (eMLC) and the objective assessment of ischemic tissue alterations using en face optical coherence tomogra...
PURPOSE: In branch retinal artery occlusion (BRAO), the regional distribution of epiretinal macrophage-like cells (eMLC) and the objective assessment of ischemic tissue alterations using en face optical coherence tomography (OCT) have not been characterized. This study aimed to quantify eMLC and the optical intensity ratio (OIR) on en face OCT in acute BRAO. METHODS: This retrospective study included 17 patients with unilateral acute BRAO. En face OCT was acquired using a 3 × 3 mm scan pattern centered on the fovea. Structural en face images from a 3-µm slab above the inner limiting membrane were used to identify and quantify eMLC, while slabs at the retinal nerve fiber layer, superficial capillary plexus (SCP), and deep capillary plexus (DCP) were used to measure optical intensity and calculate OIR. eMLC density and OIR were compared between affected and unaffected regions. RESULTS: eMLC density was significantly higher in BRAO eyes than in contralateral eyes across all regions, including the global macula, the affected region and the unaffected region (all p ≤ 0.001). Further analysis showed that eMLC density was higher in the affected region than in the unaffected region (p = 0.015). Global SCP OIR in BRAO eyes was comparable to contralateral eyes (p = 0.113), but global DCP OIR was lower (p = 0.001). OIR in the affected region was higher than in the unaffected region for both SCP and DCP (both p < 0.001). Compared with contralateral eyes, DCP OIR was higher in the affected region (p = 0.013) but lower in the unaffected region (p < 0.001). CONCLUSIONS: En face OCT enables simultaneous assessment of cellular and ischemic changes in acute BRAO, revealing presumed eMLC aggregation in the affected region and a paradoxical OIR pattern. This technique offers a noninvasive platform for evaluating ischemic neuroinflammation, though the OIR findings warrant further investigation.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe