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This cross-sectional study evaluates the financial return on investment of ophthalmology fellowships by subspecialty and gender.
This cross-sectional study analyzes retracted studies in ophthalmology, reporting temporal patterns in publication and citation.
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Purpose: To systematically summarize the 100 most-mentioned and most-cited articles from the past decade to analyze research trends in diabetic retinopathy (DR) and the implications on patient education. Methods: The Altmetric Explorer and Web of Science databases were searched for articles on DR published from January 1, 2014, to December 31, 2023. The 100 most-mentioned and most-cited articles were screened from each database, and the publication year, journal, first author's sex, country of origin, total citations, Altmetric Attention score, research topic, and research type were recorded. Article metrics between the 100 most-mentioned and most-cited articles were compared. Results: The 100 most-mentioned articles had a median Altmetric Attention score of 161 and a median citation count of 49. The 100 most-cited articles had a median Altmetric Attention score of 35.5 and a median citation count of 312. JAMA Ophthalmology and Ophthalmology published the highest proportion of most-mentioned and most-cited articles. A strong positive correlation was found between the Altmetric Attention score and citation count for both the most-mentioned (r = 0.420, P < .001) and most-cited articles (r = 0.599, P < .001). The most common research subtopics of the most-mentioned and most-cited articles were epidemiology (42%) and screening (40%). Thirty articles were featured on both lists. Conclusions: The altmetric and bibliometric patterns seen in this study provide insight into the current and future trends in DR research and can be used to inform education outreach initiatives and improve patient outcomes.
The YouTube platform is increasingly used by medical students and patients as a supplementary learning tool. However, the quality and educational value of YouTube videos remain underexplored. This study aimed to evaluate the quality, reliability, and educational utility of YouTube videos on eye and orbit anatomy. A systematic YouTube search was conducted using keywords related to eye and orbit anatomy. Out of 270 videos initially identified, only 100 met the inclusion criteria. Two anatomists and two ophthalmologists independently evaluated the videos using validated tools. The anatomists applied the Anatomy Content Score for Ophthalmology (ACS-O), Global Quality Score for Students (GQS-S), modified DISCERN, and JAMA benchmarks, while the ophthalmologists assessed the patient-focused content using the Global Quality Score for Patients (GQS-P). Video popularity and engagement metrics were recorded. Inter-rater reliability was assessed using Kappa coefficient. Non-parametric tests assessed the correlations between instructional quality and YouTube engagement. The ACS-O revealed that 54% of the videos are useful for eye and orbit anatomy education. Notably, the percentage of useful videos was higher for student-focused (GQS-S) evaluation at 56% compared to patient-focused (GQS-P) evaluations at just 8%. Correlation analysis demonstrated a strong positive relationship between anatomical accuracy (ACS-O) and student education quality (GQS-S), while an inverse correlation between student and patient scores was observed. A positive correlation was identified between video duration and educational quality for students (ACS-O r = 0.576, GQS-S r = 0.525). YouTube offers valuable supplementary resources for eye and orbit anatomy education, but significant variability in quality highlights the need for systematic evaluation. Also, YouTube consistently falls short of providing adequate, high-quality information for patient education, revealing a significant gap in public health information equity. The online version contains supplementary material available at 10.1186/s12909-026-08942-0.
As multiple studies in medicine have demonstrated disparity in pay between genders, with women consistently paid less than their male counterparts, analysis of this within ophthalmology is warranted. To describe US trends in compensation among academic ophthalmologists. This was a retrospective economic evaluation using data from the Association of American Medical Colleges (AAMC) Faculty Salary Survey from 2016 to 2024. The participants were full-time academic ophthalmology faculty at US medical schools reported by institution. Total financial compensation between ranks and gender. Differences in total financial compensation between ranks and gender. Analyses were planned a priori before data collection began. Analysis of annual median compensation was performed, and the average percentage change per year was calculated and analyzed for men and women. A cents-on-the dollar approach was used to compare gender compensation differences. Cumulative career earnings between genders were compared based on 2024 benchmarks. Forward projections of compensation trends were done to estimate when gender compensation equity might be achieved. This study included the data of an average of 1470 ophthalmologists (approximately 59% men) per year. The annual median compensation for academic ophthalmologists increased across all ranks and kept pace with inflation. Men and women represented at each rank, respectively, included 342 and 206 assistant professors, 178 and 127 associate professors, 276 and 65 professors, and 59 and 9 chairs in 2018 and 313 and 341 assistant professors, 237 and 174 associate professors, 273 and 119 professors, and 55 and 13 chairs in 2024. Women were compensated less than men at all ranks in every year. In 2024, compared with men, women at the assistant professor and chair ranks earned 91 cents-on-the dollar, and women at the associate professor and professor rank earned 85 cents-on-the dollar. This leads to an estimated $1.04 million difference in compensation over a career. Parity could be reached for assistant professors and associate professors but never for professors or chairs. Results of this economic evaluation suggest that compensation has roughly kept pace with inflation with some variability between academic rank. Among academic ophthalmologists, women earned less than men on average. These differences could be eliminated over the next decade and a half among the assistant and associate professor rank. If trends continue as they are, parity among the professor and chair ranks will never be attained.
Glaucoma is a leading cause of irreversible blindness, with a rising global prevalence, driving an increased public search for health information online. Online video platforms, such as Douyin and Bilibili, have become key channels for health communication. However, the quality and reliability of glaucoma-related content on these platforms remain unclear, raising concerns regarding potential misinformation. On 22 October 2025, the top 100 Chinese-language videos of glaucoma from Douyin and Bilibili were systematically collected. The video metadata and engagement metrics were recorded. Quality and reliability were assessed using the Global Quality Score (GQS), modified Decision-making Information Support Criteria for Evaluating the Reliability of Nonrandomized Studies (mDISCERN), JAMA (Journal of the American Medical Association) benchmark criteria, and Patient Education Materials Assessment Tool (PEMAT) for Audio Visual Content. Statistical analysis including Spearman correlation was used to examine the relationships between video variables and quality scores. Douyin videos exhibited significantly higher user interaction (likes, comments, shares, and saves) than Bilibili videos. However, the Bilibili videos demonstrated significantly higher median scores for GQS and PEMAT actionability. Videos from professional sources, particularly institutions, and those focusing on disease prevention or using expert monologue/visual aids consistently showed superior quality and reliability across all the assessment tools. Spearman correlation revealed that longer video duration was positively correlated with higher GQS, mDISCERN, and PEMAT understandability scores, whereas fewer comments were negatively correlated with these scores. The overall quality and reliability of glaucoma-related online videos from Douyin and Bilibili were suboptimal. Content from nonprofessional sources was problematic. These findings highlight the need for public vigilance when consuming health information on such platforms, and underscore the importance of encouraging greater involvement from healthcare professionals in creating accurate, high-quality educational content.
Aconitase 2 (ACO2) gene variants are one of the most frequent causes of dominant optic atrophy (DOA). However, the associated phenotypes and genotypes still lack proper characterization. To characterize the clinical and genetic spectrum of ACO2-related DOA and evaluate genotype-phenotype correlations. This was a retrospective case series to describe the ophthalmological examination of novel DOA cases with a heterozygous ACO2 variant. Data were collected from 13 reference centers in ophthalmology from France and Great Britain between January 2021 and September 2025. Included participants were those patients with OA and confirmed heterozygous or compound heterozygous ACO2 variants. DOA cases with a heterozygous ACO2 variant. Positive molecular diagnosis for ACO2 variants by next-generation sequencing, clinical examination including age at diagnosis, sex, best-corrected visual acuity (BCVA), retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness, visual field mean deviation (MD), and fundus examination. Data for 55 patients (median [IQR] age at diagnosis for 45 patients, 24 [8-51] years; 33 male [67%]) from 37 families with ACO2 variants were compiled. Analyses were conducted on 49 patients who were strictly heterozygous or compound heterozygous with the c.220C>G benign variant. Clinical data disclosed a high variability of severity, from pauci-symptomatic up to legal blindness. Median BCVA was 0.46 logMAR (Snellen equivalent, 20/63; IQR 0.00-0.89; n = 45). Four patients exhibited retinal abnormalities: 3 displayed a foveopathy, and 1 had retinitis pigmentosa. There were 12 previously unreported variants (to the authors' knowledge), including the deletion of ACO2 exon 9. No correlation between BCVA and sex, age at diagnosis (Spearman ρ = -0.19; 95% CI, -0.45 to 0.07), or variant type (Kruskal-Wallis test P =.33) was found, but there was a correlation between BCVA and RNFL (Spearman ρ = -0.74; 95% CI, -0.85 to -0.54), GCL (Spearman ρ = -0.60; 95% CI, -0.79 to -0.30), and MD (Spearman ρ = -0.65; 95% CI, -0.89 to -0.31). RNFL correlated with GCL (Spearman ρ = 0.69; 95% CI, 0.42-0.87) and MD (Spearman ρ = 0.57; 95% CI, 0.14-0.85); age at diagnosis correlated with GCL (Spearman ρ = -0.37; 95% CI, -0.63 to -0.03). Results of this case series reveal the high clinical heterogeneity among patients with ACO2-related DOA and demonstrated that some of these patients can also exhibit retinal abnormalities. In addition, there was a deletion of an entire ACO2 exon, emphasizing the potential importance of searching for large genomic rearrangements in patients without a molecular diagnosis. These findings support further studies to explain clinical variability, as no genotype-phenotype correlation was encountered.
An 82-year-old man presented with 4 months of fluctuating diagonal binocular diplopia and progressive bilateral ptosis. Examination in the strabismus clinic revealed variable ptosis and ophthalmoplegia in multiple gaze directions, with a large-angle esotropia and left hypotropia. What would you do next?
This cohort study among patients with microbial keratitis in the US and India identifies the presenting and early treatment response features associated with worse 90-day best-corrected visual acuity.
This case report describes bilateral conjunctival pyogenic granuloma resulting from lazertinibe-amivantamab therapy for metastatic non–small-cell lung cancer.
Elevated intraocular pressure (IOP) is a risk factor for primary open-angle glaucoma, and genetic risk scores hold promise as a tool for screening for ocular hypertension. However, genetic risk scores for IOP have a nonuniform association across the range of IOP, which reduces their accuracy. To test the hypothesis that nonuniform behavior of genetic risk scores for IOP is associated with a specific type of genetic interaction. Cross-sectional, post hoc genetic association studies were performed using linear and quantile regression in a sample of UK Biobank participants. Data were analyzed from January to September 2025. Ninety-eight genetic variants associated with IOP. Tests were carried out for 98 genetic variants associated with IOP (P < 5.0 ×10-8) to examine (1) dominant or recessive genetic effects, (2) genotype × genotype interactions, (3) genotype × age interactions, and (4) genotype × sex interactions. A total of 98 235 participants (mean [SD] age, 58.1 [7.9] years; 52 168 female [53.1%]) were included in this analysis. More variants exhibited genotype × age interactions than expected by chance (14 of the 98 variants associated with IOP had at least nominal evidence of an interaction with age; P = 3.76 ×10-4). For 12 of these 14 variants, age increased rather than decreased the magnitude of the IOP vs genotype association. However, integrating age interactions into the genetic risk score construction process did not yield improved accuracy (incremental noninteraction model, R2 = 4.05; 95% CI, 3.82-4.31 and interaction model, R2 = 4.04; 95% CI, 3.80-4.27). There was little support for other types of genetic interaction. In the current work, findings show minimal evidence that nonadditive allelic effects, genotype × genotype interactions, and genotype × sex interactions contributed to the nonuniform association of genetic variants with IOP across quantiles of IOP. Although a genetic risk score for IOP was more accurate in older vs younger individuals, efforts to account for genotype × age interactions in genetic risk score construction did not improve accuracy. These findings suggest other factors, such as gene-environment interactions, contribute to the nonuniform relationship of genetic variants with IOP.
Nonexudative macular neovascularization (neMNV) is a risk factor for exudation in fellow eyes of patients with unilateral exudative age-related macular degeneration (AMD). Accurate estimation of prevalence of neMNV is required for sample size calculations for clinical trials evaluating novel interventions to delay exudation from neMNV. Certain dimensions of double-layer sign (DLS) on optical coherence tomography (OCT) are often regarded as a surrogate for neMNV. To assess the prevalence of fellow-eye neMNV on OCT angiography (OCT-A) in eyes with AMD with DLS on OCT among patients with unilateral new-exudative AMD in the first eye. This prospective observational cohort multicenter study took place in the United Kingdom from January 2021 through June 2025. The study included 862 participants with OCT and OCT-A within 3 months of initiation of anti-vascular endothelial growth factor (VEGF) therapy, of whom 550 (63.8%) had both OCT and OCT-A performed within 30 days of the date of the first anti-VEGF injection to the fellow eye. These data were analyzed from July 2025 through October 2025. Prevalence of DLS, neMNV, and assessment of univariable and adjusted associations with neMNV and DLS were assessed using logistic regression models. Among 550 eyes (mean [SD] participant age, 78.0 [7.6] years; 315 female [57.3%] and 235 male [42.7%]), 112 (20.4%; 95% CI [Wilson score], 17.1%-24.0%) had DLS and 47 eyes (8.5%; 95% CI [Wilson score], 6.4%-11.3%) had neMNV at baseline, including 42 (89.36%) within DLS, 3 (6.4%) in fibrovascular irregular shallow-pigment epithelial detachment, and 2 (4.3%) below drusen. Prevalence of neMNV was higher among eyes with thick DLS (n = 36 [48%]) compared with those with thin DLS (16.2%; n = 6; difference = -31.8%; 95% CI [Wilson score], -46.9% to -11.7%; P = .002). While 1 in 5 fellow eyes had DLS on OCT among patients with unilateral new-onset exudative AMD in the first eye, the prevalence of neMNV on OCT-A was only 40% among these eyes with DLS. These results suggest DLS on OCT in fellow eyes of patients with new-onset exudative AMD in the first eye is not a good surrogate for neMNV. ISRCTN registry Identifier: ISRTCTN13798759.
Age-related macular degeneration (AMD), diabetic retinopathy (DR), diabetic macular edema (DME), and retinal vein occlusion (RVO) are leading causes of vision impairment and can lead to permanent, irreversible blindness. To update age-standardized prevalence estimates for AMD, DR, DME, and RVO by gender, race and ethnicity, and US state or county for 2022. The National Health and Nutrition Examination Survey (NHANES; 2005-2008 and 2017-March 2020), Medicare fee-for-service claims (2017-2019), IBM MarketScan commercial insurance claims (2016), and eligible population-based studies. Bayesian meta-regression analysis of data sources containing prevalence information for AMD, DR, DME, and RVO in the US. Data were analyzed from March to September 2024. AMD prevalence was estimated for ages 40 years and older and reported as total AMD (inclusive of early and late stage). DR (stratified by vision threatening and non-vision threatening) and DME prevalence were estimated across all ages as a proportion of people with diabetes (as defined in NHANES). RVO, defined by the presence of either retinal branch or central vein occlusion, was estimated for ages 18 years and older. Age-standardized estimates were calculated using the 2010 US Census age pyramid. For 2022, age-standardized prevalence estimates per 100 000 people were 5677 (95% uncertainty interval [UI], 4513-7374) for AMD, 2710 (95% UI, 2112-3647) for DR, 317 (95% UI, 243-505) for DME, and 214 (95% UI, 168-409) for RVO. For all conditions, prevalence was higher in males than females. White individuals had 1.7-fold higher AMD prevalence than Black individuals and 2-fold higher RVO prevalence than Hispanic individuals; Black individuals had more than 2-fold higher DR prevalence and 4.6-fold higher DME prevalence than White individuals, and Hispanic individuals had 1.8-fold higher DR prevalence and 3.7-fold higher DME prevalence than White individuals. State-level prevalence (per 100 000 people) ranged from 3497 to 7214 for AMD, 1654 to 3607 for DR, 126 to 504 for DME, and 157 to 273 for RVO. In this meta-analysis, the US prevalence of retinal conditions was substantial, highlighting a considerable health care burden. The updated estimates and sex, race and ethnicity, and regional disparities identified in this study could inform resource allocation across the US and aid in the development of approaches to improve treatment accessibility and patient outcomes for underserved communities.
This case report describes the potential phenotypic features in 2 patients with enhanced S-cone syndrome: rosettelike and whorllike lesions.
Intermittent exotropia (IXT), the most common childhood divergent strabismus, disrupts binocular vision and psychosocial function. To assess the efficacy and safety of virtual reality-based vision therapy (VRVT) in children with IXT. This randomized clinical trial consists of a 12-week treatment phase (completed) and a 12-month follow-up phase (ongoing). The treatment phase was conducted from July 1, 2023, to November 17, 2024, in 3 tertiary hospitals in China. Eligible participants were children aged 6 to 18 years with previously untreated IXT, an exodeviation magnitude of 10 to 30 prism diopters at distance, an exotropia control score of 1 to 3 at both distance and near, and a cycloplegic spherical equivalent between -6.00 diopters (D) and +0.50 D in both eyes, with an interocular spherical equivalent difference of less than 2.50 D. Participants were randomly assigned in a 1:1 ratio to the intervention group or control group. Participants in the intervention group underwent the home-based VRVT program for 12 weeks. Participants in the control group were observed but received no VRVT intervention. The primary outcome was the change in distance exotropia control score from baseline to week 12. The Mann-Whitney test and Hodges-Lehmann estimator were used for between-group comparisons. Data analysis followed the modified intention-to-treat approach. A total of 177 participants (median [IQR] age, 8 [7-10] years; 95 males [53.7%]) were randomized, of whom 161 were included in the full analysis set. At week 12, the median (IQR) change in distance exotropia control score was -0.33 (-1.00 to 0.00) in the intervention group vs 0.00 (-0.33 to 0.33) in the control group (between-group difference, -0.33; 95% CI, -0.57 to -0.10). Participants with greater than 75% VRVT training adherence had a greater improvement in distance exotropia control score than the control group (between-group difference, -0.71; 95% CI, -1.10 to -0.33). A significant interaction was identified between baseline distance exotropia control score and treatment effect (P for interaction = .01); greater improvement was observed in participants with a baseline score of 2 or higher (between-group difference, -0.67; 95% CI, -1.00 to -0.33), whereas minimal effect was seen in those with a score of 1 (between-group difference, -0.01; 95% CI, -0.23 to 0.20). No intervention-related adverse events were reported. In this randomized clinical trial, the improvement in distance exotropia control over 12 weeks was modest. However, greater benefits were observed in participants with greater than 75% VRVT training adherence, which may indicate clinical value for children able to maintain high training adherence. Chinese Clinical Trial Registry Identifier: ChiCTR2300072912.
This Viewpoint outlines the entities who have been funding ophthalmic artificial intelligence (AI) innovations in the past 5 years and considers what this shifting balance of power in funding might mean for the next wave of foundation AI models and clinical translation.
Among patients who have a penicillin allergy label (a history of any reaction to penicillin in their medical records), many cataract surgeries are performed yearly. Less than 1% of these patients have a true allergy to penicillin. The evidence supports limited concern regarding cephalosporin cross-reactivity; however, the guidance for surgeons regarding antibiotic selection in these patients remains unclear. To examine rates of perioperative antibiotic selection after penicillin allergy label reclassification vs before reclassification. Quality improvement study including 1905 patients identified with a penicillin allergy label undergoing cataract surgery between May 30, 2020, and May 30, 2025, at a large tertiary eye care center in the US. This analysis was conducted from June 2025 to December 2025. Policy intervention for surgeons performing cataract surgery that featured enhanced pharmacy collaboration and guidance, suppression of automated electronic medical record alerts for cephalosporin cross-reactivity, and reclassification of the allergy in the medical record. The policy intervention date was set as November 30, 2022. Patient receipt of intracameral antibiotics (1.0 mg/0.1 mL of cefuroxime or 0.5 mg/0.1 mL of moxifloxacin), topical antibiotics (eg, erythromycin or moxifloxacin), or no prophylaxis. Perioperative antibiotic selection rates were measured for all patients undergoing cataract surgery. Among the 1905 patients with a penicillin allergy label in their medical record, 3077 cataract surgeries (some patients underwent >1 cataract surgery) were performed by 51 surgeons. In an unadjusted time series analysis, the mean rate of cefuroxime use was 80.0% (95% CI, 74.5%-84.7%) after the policy intervention date, which was far above the expected use rate of 3.3% (95% CI, 2.0%-4.4%) (P = .001). After adjustment, the mean rate of cefuroxime use was 71% (95% CI, 62%-79%) after the policy intervention date compared with a mean rate of 2% (95% CI, 1%-3%) before the intervention. The adjusted odds ratio was 0.37 (95% CI, 0.27-0.52; P < .001) for cefuroxime use after the policy intervention date in patients with high-risk allergies (such as a history of anaphylaxis or angioedema) noted in the medical record and prior to review by a pharmacist. Evidence-based antibiotic selection policies for patients with a penicillin allergy label may enhance appropriate use of intracameral cefuroxime in cataract surgery. The rapid increase in cefuroxime use after the policy intervention date suggests surgeons may benefit from education and pharmacy support.