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Association Between Retinal Nerve Fiber Layer Cardiovascular-Kidney-Metabolic Syndrome: A UK Biobank Cohort Study

2026-07-16T00:16:04Z

Title: Association Between Retinal Nerve Fiber Layer Cardiovascular-Kidney-Metabolic Syndrome: A UK Biobank Cohort Study Authors: Lee, Jihei Sara; Heo, Seok-Jae; Myung, David; Kim, Chan Yun; Lee, Sang Yeop Abstract: center dot OBJECTIVE: To examine the association between retinal nerve fiber layer (RNFL) thickness and the severity of cardiovascular-kidney-metabolic (CKM) syndrome in a large community cohort. center dot DESIGN: Retrospective cross-sectional analysis of a community-based cohort. center dot PARTICIPANTS: UK residents 40 to 60 years of age at enrollment of UK Biobank. center dot METHODS: The cohort underwent baseline examination from April 2007 to October 2010. We analyzed high-quality optical coherence tomography images and identified the presence of CKM syndrome. We explored associations between RNFL and CKM syndrome severity using multivariable logistic regression. center dot MAIN OUTCOME MEASURES: Odds ratios (OR) for having advanced CKM syndrome (stage 3 or higher) at baseline were calculated after adjustment for age, sex, ethnicity, intraocular pressure, education and socioeconomic status. center dot RESULTS: A total of 17,082 participants were included (mean age 57.63 +/- 7.66 years old, 56.8% females) in the study, and 15,892 participants (93.0%) had CKM syndrome stage 1 or higher at baseline. Advanced CKM syndrome was observed more frequently in the thinnest quintile of RNFL thickness (14.8%) in comparison to the thickest quintile (9.1%). A multivariate regression controlling for potential confounders showed that decrease in RNFL thickness by 1 & micro;m increased the risk of having advanced CKM syndrome by 2.4% (OR 1.024, 95% CI: 1.010-1.039, P = .001) at baseline. center dot CONCLUSIONS: Thinner RNFL is associated with advanced CKM syndrome in individuals without a previous neurodegenerative or ocular disease. Our findings suggest that RNFL may serve as a valuable marker for monitoring disease severity of CKM syndrome. Further research, however, is warranted to investigate the pathways linking RNFL and CKM syndrome and to validate RNFL as a prognostic marker for CKM syndrome in larger populations. (Am J Ophthalmol 2026;288: 173-181. (c) 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)

Marker-Free, Automated Eyelid Assessment in Thyroid Eye Disease Using Artificial Intelligence: A Multicenter Validation Study

2026-07-13T02:06:49Z

Title: Marker-Free, Automated Eyelid Assessment in Thyroid Eye Disease Using Artificial Intelligence: A Multicenter Validation Study Authors: Moon, Jae Hoon; Kim, Jongchan; Park, Joonhyeon; Kim, Min Joo; Oh, Tae Jung; Moon, Joon Ho; Kong, Sung Hye; Shin, Kyubo; Park, Jaemin; Yoon, Jin Sook; Ko, JaeSang; Yoo, Won Sang; Carmona, Raquel Monge; Sierra, Marina Soto; Cano, Luz Maria Valverde; Hernandez, Tomas Martin; Muros, Mariola Mendez; Kim, Namju; Hermosilla, Antonio Manuel Garrido Abstract: Objective: To validate "Glandy LID," a novel marker-free, deep learning-based software designed for the automated assessment of eyelid morphology using intrinsic corneal diameter for calibration. Design: Multicenter retrospective study. Participants: The internal validation cohort consisted of 119 patients with thyroid eye disease (TED) from Seoul National University Bundang Hospital (South Korea). The external validation cohort included 140 patients from Hospital Universitario Virgen Macarena (Spain). Methods: An artificial intelligence (AI) algorithm segmented eyelid and corneal regions from facial photographs. Eyelid metrics were calculated using population-specific corneal diameters as a reference scale for pixel-to-millimeter conversion. The internal cohort utilized digital single-lens reflex images compared against ground truth derived from physical markers. The external cohort utilized smartphone-captured images compared against clinical medical records to assess clinical generalizability. Main Outcome Measures: Geometric precision was assessed using Intersection over Union. Accuracy of quantitative measurements (margin reflex distance 1 [MRD1] and 2 [MRD2]) was evaluated using Pearson correlation coefficient (PCC), mean absolute error, and mean absolute percentage error (MAPE). Results: In the internal validation, the AI system demonstrated high geometric precision (Intersection over Union 0.94). Quantitative measurements showed excellent agreement with the ground truth, achieving a PCC of 0.98 for MRD1 and 0.94 for MRD2, with low MAPEs of 5.69% and 4.57%, respectively. In the external validation using smart-phone images without markers, the system maintained high reliability. For MRD1, it achieved a PCC of 0.94 and a MAPE of 9.06%. Although MRD2 showed a slightly higher MAPE (15.07%), likely due to manual measurement variability in clinical records, the correlation remained strong (PCC 0.93). Conclusions: This AI system provides an accurate and robust automated solution for eyelid measurement without the need for physical reference markers. By overcoming the limitations of manual assessment and marker-based systems, this tool offers a practical and accessible method for objectively monitoring TED in both routine clinical practice and remote health care settings. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. Ophthalmology Science 2026;6:101202 (c) 2026 American Academy of Ophthalmology, Inc. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Dynamic realignment of extraocular muscles after inferomedial orbital wall decompression in thyroid eye disease: a 3D CT reconstruction study

2026-03-25T03:07:27Z

Title: Dynamic realignment of extraocular muscles after inferomedial orbital wall decompression in thyroid eye disease: a 3D CT reconstruction study Authors: Byeon, Hyeong Ju; Ko, JaeSang; Park, Hyun Young; Yoon, Jin Sook Abstract: Orbital wall decompression carries a risk of new-onset postoperative diplopia in patients with thyroid eye disease (TED). This study aimed to evaluate the occurrence, clinical progression, and underlying mechanisms of newonset diplopia following inferomedial orbital wall decompression over 1 year, including quantitative CT analysis of orbital structures. Inactive TED patients undergoing inferomedial orbital wall decompression were reviewed. Only patients who developed new diplopia at 1 month and completed a 1-year follow-up were included. Diplopia cases were assessed using Gorman scores and HESS tests. Orbital structures and deviated angles of the medial and inferior rectus muscles were quantified on CT images. New-onset diplopia occurred in 35% (78/204) of patients at 1 month postoperatively, with 73.2% recovering fully from diplopia by 1 year. In the recovered-diplopia group, orbital volume decreased significantly from immediate postoperative to 1 year (p = 0.038) but not in the persistent-diplopia group. Additionally, the rectus muscles, deviated immediately after surgery, showed significant straightening at 1 year in the recovered-diplopia group (p < 0.001), while no significant improvement in muscle alignment was observed in the persistent-diplopia group. New-onset diplopia after inferomedial orbital wall decompression is typically transient, resolving within 1 year. The resolution is mediated by muscle realignment driven by orbital remodeling and muscle contraction.

Demography, Clinical Characteristics and Long-Term Outcomes of Central Serous Chorioretinopathy in Women. MICRoN Report Number Fourteen

2026-04-14T07:23:14Z

Title: Demography, Clinical Characteristics and Long-Term Outcomes of Central Serous Chorioretinopathy in Women. MICRoN Report Number Fourteen Authors: Gregori, Giulia; Sahoo, Niroj Kumar; Hasan, Nasiq; Zarnegar, Arman; Lupidi, Marco; Zhang, Micheal; Wu, Lihteh; Cao, Jessica; Piccoli, Gabriele; Vujosevic, Stela; Shah, Priya; Singhanetr, Panisa; Rossin, Elizabeth; Checchin, Lisa; Pili, Lorenzo; Parodi, Maurizio Battaglia; Kim, Min; Desideri, Lorenzo Ferro; Munk, Marion R.; Chotcomwongse, Peranut; Ruamviboonsuk, Paisan; Fung, Adrian; Small, Kent; Khateb, Samer; Wang, Jay C.; Khurana, Rahul N.; Villafeurte, Carol; Yiu, Glenn; Momenaei, Bita; Garg, Sunir; Lai, Timothy; Ashfaq, Yusuf; Kroeger, Zachary; Chhablani, Jay Abstract: center dot PURPOSE: To evaluate the characteristics and longitudinal outcomes of chronic central serous chorioretinopathy (CSCR) in women compared to an age-matched cohort of men with CSCR. center dot DESIGN: Retrospective, multicenter clinical cohort study from the Macula Society CSCR Study Group. center dot PARTICIPANTS: This study included 426 eyes (213 women and 213 age-matched men) with a diagnosis of CSCR. center dot METHODS: Baseline and final best-recorded visual acuity (BRVA) and multimodal imaging parameters such as area of retinal pigment epithelium (RPE) alterations, choroidal macular thickness (CMT), sub-foveal choroidal thickness (SFCT), subretinal fluid (SRF), pigment epithelium detachment (PED), double layer sign (DLS), hyperreflective dots (HRD), as well as the presence of choroidal neovascularization (CNV) and subretinal hyperreflective material (SHRM) were assessed. Regression analysis was used to evaluate baseline predictors of final visual acuity. center dot MAIN OUTCOME MEASURES: Longitudinal changes in BRVA and imaging parameters in men and women stratified for age; factors affecting subretinal fluid (SRF) persistence, and change in BRVA. center dot RESULTS: A total of 426 eyes (213 women and 213 age-matched men) with CSCR were analyzed. Women showed better BRVA at presentation (0.25 +/- 0.24 vs 0.31 +/- 0.35 logMAR; P = .05), and exhibited smaller areas of RPE alterations (2.37 +/- 2.64 vs 1.59 +/- 1.55 disc areas; P = .003), less frequent peripapillary RPE changes (13.6% vs 7.5%; P < .001), shorter DLS (1353.9 +/- 970.2 vs 1071.6 +/- 888.7 & micro;m; P = .039), and smaller PEDs (644.9 +/- 546.4 vs 442.1 +/- 278.9 & micro;m; P = .022). During follow-up, women exhibited higher rates of complete SRF resolution ( P = .001) while persistence and the number of recurrences were significantly more common in men ( P = .006 and P = .02, respectively). Logistic regression analysis revealed that persistent SRF was independently associated with complex CSCR, male gender, baseline PROS irregularities, worse BRVA, SHRM, and CNV, while PDT was protective. center dot CONCLUSION: Women had better visual outcomes and more favorable structural evolution while men tended to present with more complex anatomical alterations and experience higher rates of persistent SRF. (Am J Ophthalmol 2026;286: 140-151. (c) 2026 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/))