Ophthalmology Volume 130, Number 6, June 2023

中文摘要

這項基於人口的群體研究旨在評估年齡相關性黃斑部退化（AMD）與憂鬱發展之間的前瞻性關聯。該研究使用韓國國民健康保險服務的全國性臨床數據，包括3,599,589位50歲以上的個體。結果顯示，AMD診斷是未來憂鬱發展的獨立風險因素，伴隨視覺障礙的個體風險增加。該研究強調了在AMD患者中早期檢測憂鬱的需求，並強調了管理AMD患者的視覺和心理健康兩個方面的重要性。然而，該研究存在限制，包括僅使用索賠數據，無法進行影像或基於調查的疾病驗證。需要進一步研究來了解潛在機制，並根據視力損失的嚴重程度和AMD類型對患者進行分層。

English Abstract

This population-based cohort study aimed to evaluate the prospective association between age-related macular degeneration (AMD) and the development of depression. The study used nationwide clinical data from the Korean National Health Insurance Service and included 3,599,589 individuals over 50 years old. The results showed that AMD diagnosis was an independent risk factor for future depression development (Hazard ratio 1.15 ,95% CI, 1.13-1.17), with an increased risk observed in individuals with accompanying visual disability (HR 1.23, 95% CI, 1.16-1.30). The study highlights the need for early detection of depression in patients with AMD and emphasizes the importance of managing both the visual and mental health aspects of AMD patients. However, the study had limitations, including the use of claims data without imaging or survey-based verification of diseases. Further research is needed to understand the underlying mechanisms and to stratify patients based on the severity of vision loss and AMD type.

Ophthalmology Volume 130, Number 6, June 2023

中文摘要

本研究旨在驗證基因表達譜（gene expression profile, GEP）測試在葡萄膜黑色素瘤(Uveal melanoma)患者中的預後價值，並確定將腫瘤大小與GEP分類相結合是否提供額外的預後價值。該研究納入了3 centers including Yale New Haven Hospital, University of California, San Diego; and Memorial Sloan Kettering Cancer Center的脈絡膜黑色素瘤患者。研究發現，腫瘤厚度的預後價值優於GEP分類。GEP 2級腫瘤的轉移率低於Castle Bioscience報告的估計值，而GEP 1A和1B級腫瘤之間的轉移率沒有差異。該研究建議在預測預後時應考慮腫瘤大小和GEP分類，並且GEP 1A或1B級腫瘤的患者可能從相同的轉移監測方案中受益。

English Abstract

This study aimed to validate the prognostic usefulness of gene expression profile (GEP) testing in patients with uveal melanoma and determine whether combining tumor size with GEP classification provides additional prognostic value. The study included patients with choroidal melanoma at Yale New Haven Hospital, University of California, San Diego; and Memorial Sloan Kettering Cancer Center. Tumor thickness was found to have better prognostic usefulness than GEP classification. The rates of metastasis for GEP class 2 tumors were lower than estimates reported by Castle Bioscience, and no difference in metastasis rates was found between GEP class 1A and 1B tumors. The study suggests that tumor size should be considered along with GEP classification for prognostication and that patients with GEP class 1A or 1B tumors may benefit from the same metastatic surveillance protocols.

Ophthalmology Volume 130, Number 6, June 2023

中文摘要

本研究旨在評估OPT-302與anti-VEGF-A inhibitor ranibizumab 聯合治療新生血管型年齡相關性黃斑變性（nAMD）的安全性和療效。試驗納入了未接受治療的nAMD成年患者，評估了視力和光學相干斷層掃描（OCT）測量結果，以及視網膜內和視網膜下液的變化。結果顯示，添加2.0 mg OPT-302到ranibizumab 與安慰劑組相比，在視力方面顯著改善。聯合治療表現出更優異的視力增益，並且安全性與對照組相比可比。這些結果表明，OPT-302與拉尼布注射劑的聯合應用可能為nAMD患者提供潛在的治療選擇。

English Abstract

This study aimed to evaluate the safety and efficacy of OPT-302, a biologic inhibitor of VEGF-C and VEGF-D, in combination with the anti-VEGF-A inhibitor ranibizumab, for the treatment of neovascular age-related macular degeneration (nAMD). It’s a dose-ranging, phase 2b, randomized, double-masked, sham-controlled trial. Participants were randomized to 6, 4-weekly, intravitreal injections of 0.5 mg OPT-302, 2.0 mg OPT-302, or sham, plus intravitreal 0.5 mg ranibizumab. The trial enrolled adults with treatment-naive nAMD and assessed visual acuity outcomes (primary outcome), spectral-domain OCT measurements, and changes in intraretinal and subretinal fluid (secondary outcomes). The results showed that the addition of 2.0 mg OPT-302 to ranibizumab significantly improved visual acuity compared to the sham group. The combination therapy demonstrated superior gains in visual acuity, and the safety profile was comparable to the control group. These findings suggest that 2.0 mg OPT-302 in combination with ranibizumab may offer a potential treatment option for patients with nAMD.

Ophthalmology Volume 130, Number 6, June 2023

中文摘要

這篇社论討論了飲食與青光眼之間的關聯，重點關注婦女健康倡議飲食調整（Women’s Health Initiative Dietary Modification ）試驗的次級分析。該研究發現低脂飲食，增加水果、蔬菜和穀物攝入量對原發性開角型青光眼（POAG）的發病率沒有益處。然而，該研究觀察到總脂肪卡路里攝入量最低的女性患POAG的風險增加。雖然先前的研究已經顯示特定營養物質和飲食模式可能與青光眼的風險降低有關，但仍需要進一步的研究來了解營養在眼科疾病中的作用。作者建議，在評估青光眼和age related macular degeneration等病症的飲食方面進行前瞻性研究，可以為營養對眼睛健康的影響提供有價值的見解。

English Abstract

This editorial discusses the association between diet and glaucoma, focusing on the secondary analyses of the Women’s Health Initiative Dietary Modification (WHI DM) trial. The study found that there was no benefit from a low-fat diet with increased intake of fruits, vegetables, and grains on the incidence of primary open-angle glaucoma (POAG). However, it observed that women with the lowest calorie intake from total fat had an increased risk of incident POAG. While previous research has shown that specific nutrients and dietary patterns may be associated with a lower risk of glaucoma, further studies are needed to understand the role of nutrition in ocular diseases. The author suggests that prospective studies evaluating diets in conditions such as glaucoma and age-related macular degeneration could provide valuable insights into the effects of nutrition on eye health.

Ophthalmology Volume 130, Number 7, July 2023

中文摘要

Voretigene neparvovec-rzyl（VN）是一種用於雙偶基RPE65基因變異引起的遺傳性視網膜疾病的基因增強治療。儘管VN已經證明了視覺功能的改善，但一些患者在治療後出現脈絡膜視網膜萎縮。本研究旨在確定與萎縮發展相關的因素，並評估全視暗閾值（full-field scotopic threshold, FST）改善與萎縮之間的關係。該研究分析了兩個大型基因治療中心的數據。患有脈絡膜視網膜萎縮的患者主要是學齡期到青年期。在1個月時，萎縮組的FST改善顯著高於無萎縮組，並在1年時仍然保持顯著性。研究結果表明，FST改善與VN相關脈絡膜視網膜萎縮的發展之間存在著密切的相關性。進一步的研究需要了解其潛在機制，並優化基因治療以減少萎縮的風險。

English Abstract

Title: Correlation Between Full-Field Scotopic Threshold Improvement and Chorioretinal Atrophy Following Voretigene Neparvovec-rzyl Treatment

Abstract: Voretigene neparvovec-rzyl (VN) is a gene augmentation therapy for inherited retinal diseases caused by biallelic RPE65 gene variants. Although VN has demonstrated functional visual improvement, some patients develop chorioretinal atrophy following treatment. This study aimed to identify factors associated with atrophy development and assess the relationship between full-field scotopic threshold (FST) improvement and atrophy. Data from two large gene therapy centers were analyzed. Patients with chorioretinal atrophy were predominantly of school age to young adulthood. The FST improvement was significantly higher in the atrophy group compared to the no atrophy group at 1 month and remained significant at 1 year. The findings suggest a strong correlation between FST improvement and the development of VN-related chorioretinal atrophy. Further investigation is required to understand the underlying mechanisms and optimize gene therapies to minimize the risk of atrophy.