Ophthalmology Science

IntroductionAnti-vascular endothelial growth factor (anti-VEGF) therapies are standards of care for vision-threatening retinal diseases. This retrospective observational study describes demographics, utilization, best recorded visual acuity (BRVA), and safety among eyes with neovascular age-related macular degeneration (nAMD), diabetic retinopathy (DR), diabetic macular edema (DME), or retinal vein occlusion (RVO) treated with the biosimilar aflibercept-ayyh (PAVBLU(R)) in routine clinical pract...

PurposeQuantitative metrics obtained from retinal fundus images (such as vessel length, tortuosity and other scale-dependent measures) are increasingly used as potential biomarkers for systemic diseases, including cardio- and neurovascular conditions. However, with the increasing prevalence of myopia and related axial growth, this study aims to evaluate if axial length scaling significantly alters the overall distributions of the inferred biomarkers when compared to biomarker data obtained witho...

Regular optical coherence tomography (OCT) monitoring is essential for early detection of retinal disease and timely intervention, but frequent clinicbased imaging burdens patients and healthcare systems. Home-based OCT enables continuous monitoring and reduces clinic visits; however, compact optics and patient-operated acquisition introduce noise, reduced resolution, motion blur, and artifacts that limit clinical reliability and diagnostic confidence. To model home-based OCT acquisition, we emp...

PurposeThere is a need for novel therapies for diabetic retinopathy (DR) because existing therapies treat only certain features of DR and do not work optimally for all patients. While proteomic studies provide insight into disease pathobiology, they are often limited to small sample sizes due to high costs, limiting their generalizability and reproducibility. Moreover, they often yield lists of tens to hundreds of proteins with differential expression, making it difficult to prioritize the most ...

PurposeTo systematically evaluate ocular biometric and systemic laboratory factors associated with cataract in highly myopic eyes and to characterize potential nonlinear associations using an interpretable machine learning approach, thereby providing deeper mechanistic insights into the pathogenesis of highly myopic cataract. DesignA cross-sectional study encompassed 770 eyes of 594 patients with high myopia from Eye & ENT Hospital of Fudan University. SubjectsThe non-cataract control group in...

Fluorescence lifetime imaging ophthalmoscopy permits in vivo assessment of retinal metabolism but has remained limited by insufficient cellular resolution in the human eye. Here we present adaptive optics-enhanced fluorescence lifetime imaging ophthalmoscopy (AOFLIO), a method for single-cell-resolved, in vivo structural and metabolic imaging of the human retinal pigment epithelium (RPE). Through real-time correction of ocular wavefront aberrations, precisely synchronized adaptive optics reflect...

Early screening for glaucoma and diabetic retinopathy (DR) is critical to prevent irreversible vision loss, yet remains inaccessible to many underserved populations. However, AI models trained on hospital-grade fundus images often generalize poorly to low-cost images acquired with portable devices such as smartphones. We proposed CausalFund, a causality-inspired learning framework for training AI models that enable reliable low-resource screening from easily acquired non-clinical images. CausalF...

PurposeTimely detection of disease activity in chronic retinal diseases improves visual outcomes but is limited by the lack of validated systems for continuous monitoring and care management. We evaluated the real-world performance of an integrated remote physiologic monitoring and principal care management program (RemoniHealth(R)) using a self-administered multimodal retinal function test (Macustat(R)) for home monitoring. MethodsThis single-arm real-world intervention study was conducted acr...

Age-related macular degeneration (AMD) is a leading cause of irreversible vision loss in ageing populations, with oxidative stress recognised as a key pathogenic driver. The dietary antioxidant and cytoprotectant, L-ergothioneine (ET), is avidly accumulated in many tissues, especially the eye. However its relationship to AMD has not been investigated. Here, we examined ETs distribution in ocular tissue and assessed circulating and intraocular ET levels in patients with neovascular AMD. Compared...

BackgroundThe visual field (VF) test results of many eyes with glaucoma progress despite treatment. This suggests that some eyes are either untreated or that the management of intraocular pressure (IOP) does not influence the outcome. In this work, we explore whether future VF parameters can be predicted from a baseline optical coherence retinal nerve fibre layer (OCT-RNFL) scan using a deep learning model. MethodsThe model was developed using 1792 eyes from 1610 patients, and externally valida...

ImportanceGenome-wide association studies have identified hundreds of common single nucleotide polymorphisms (SNPs) and small insertions/deletions (indels) associated with primary open-angle glaucoma (POAG) risk, though these variants have modest effect sizes and individually may have minor contributions to disease development. As whole-genome sequencing data is becoming more readily available, structural variants and other complex genomic features can be interrogated for contribution to disease...

Primary open-angle glaucoma (POAG) disproportionately affects individuals of African ancestry, yet rare coding variation in this population remains understudied. To address this gap, we performed a multi-cohort exome-wide meta-analysis across POAAGG, PMBB, All of Us, and UK Biobank, including 4,815 POAG cases and 22,922 controls of genetically inferred African ancestry. Although no gene reached exome-wide significance, we identified several suggestive gene-level associations driven by rare varia...

PurposeTo evaluate the three-year efficacy and safety of compound trabeculectomy for uveitic glaucoma (UG). MethodsThis retrospective study enrolled 51 patients (53 eyes) requiring compound trabeculectomy, divided into UG (25 eyes) and non-UG groups (28 eyes). Outcomes including intraocular pressure (IOP), medication use, surgical success rates, and complications were analyzed over 3 years. ResultsBaseline characteristics including age, sex, preoperative IOP and medication use were comparable ...

PurposeTo investigate the effects of morning and evening narrowband blue light exposure on axial length, and to examine the short-term effect of morning blue light combined with myopic defocus on axial length. MethodsFor objective 1, 18 individuals underwent 60 minutes of narrowband blue light exposure (460nm) in the morning (9:00-11:00AM) and evening (5:00-7:00PM) of the same day. The axial length values were normalized to the average of the morning and evening axial length values. For objecti...

BackgroundDiabetes mellitus (DM) remains a major global health challenge and is associated with vision-threatening complications, including diabetic macular edema (DME), a leading cause of visual impairment. Dyslipidemia has been implicated in the development of macular edema through mechanisms involving vascular permeability, endothelial dysfunction, and chronic inflammation. However, evidence regarding the relationship between lipid abnormalities and macular edema remains inconsistent across s...

PurposeFuchs endothelial corneal dystrophy (FECD) is a common corneal disease and a leading indication for endothelial keratoplasty (EK). Although CTG18.1 repeat expansion is a major genetic risk factor, the contribution of polygenic background to disease progression remains unclear. We evaluated whether combining CTG18.1 expansion status with a FECD-specific polygenic risk score (PRS) enables genomic prediction of progression to EK. MethodsWe retrospectively analysed 589 individuals with FECD ...

Biological age estimators quantify aging-related variation but provide limited insight into organ-specific aging processes. The retina enables non-invasive visualization of microvascular and neural structures and has emerged as a promising modality for biological age prediction. However, existing retinal aging models typically produce unidimensional age estimates with limited interpretability. Here we develop a deep learning framework based on a large-scale vision foundation model to estimate re...

PurposeAqueous humor drains fluid from the eye not only via the conventional pathway through the trabecular meshwork and Schlemms canal, but also within the eye is known to occur via pathways through the posterior chamber and optic nerve to the cerebrospinal fluid (CSF) surrounding the optic nerve. The mechanism is poorly understood, and non-invasive method for evaluation in living humans has not been established. We previously showed that eye drops containing O-17-labeled water (H217O) distribu...

Microbial keratitis is a sight-threatening corneal infection with varying etiological agents, primarily bacteria and fungi. Assessing and contrasting the virulence factors of microorganisms isolated from a non-contact lens-associated keratitis (NCLAK) and contact lens-associated keratitis (CLAK) is the goal of the current investigation. Samples were collected from over 60 patients and analysed using standard microbiological techniques, including culture, Gram staining, KOH mount, biochemical tes...

Cutaneous squamous cell carcinoma (SCC) can be time-consuming to treat with Mohs micrographic surgery (MMS) due to the need for intraoperative frozen section (FS) preparation. Two-photon fluorescence microscopy (TPFM) can generate H&E-equivalent images from fresh tissue specimens in a fraction of this time. To determine the accuracy of TPFM for the evaluation of squamous cell carcinoma in MMS margins compared to conventional FS Mohs slide preparation. TPFM was used to image 144 first stage MMS m...