Ophthalmology Commons^™

Implementation Of Artificial Intelligence In Retinoblastoma Diagnosis, Zana Moldavsky

inSIGHT

The retina is essential for vision. It is composed of 10 distinct layers and contains specialized photoreceptor cells, rods, and cones that are responsible for converting photons of light into electrical signals through a process called phototransduction.¹ These electrical signals are transmitted to the brain via the optic nerve where they are interpreted as a visual picture.¹

Retinoblastoma is a rare but aggressive malignant tumor of the retina and represents the most common intraocular malignancy in the pediatric populabon.² The disease follows Knudson's two-hit hypothesis and occurs due to biallelic inactivation of the RB1 tumor suppressor gene …

Home-Use Oct For Neovascular Age-Related Macular Degeneration: A Rapid Review, Sneh S. Shah

inSIGHT

Neovascular age-related macular degeneration (nAMD) requires frequent monitoring to identify recurrent exudation and guide treatment with anti-vascular endothelial growth factor (VEGF) therapy.1 Clinic-based optical coherence tomography (OCT) plays a central role in management but provides only intermittent assessments of a disease that changes over time. Home-use OCT technologies have recently been developed as a possible solution, allowing patients to perform self-imaging with remote clinician review and artificial intelligence (AI)-assisted analysis. This rapid review summarizes current evidence on home-use OCT for nAMD, including feasibility, diagnostic performance, clinical usefulness, and challenges related to implementation. Findings from feasibility studies, AI validation analyses, observational …

Glp-1 Receptor Agonists And Ocular Risk, Saharsh Satheesh

inSIGHT

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have moved from second-line diabetes medications toward the frontline of type 2 diabetes, obesity, and cardiometabolic care.¹ A meta-analysis of 10 randomized cardiovascular outcomes trials (n = 71,351) demonstrated that longacting GLP-1 RAs reduce major adverse cardiovascular events by 14%, all-cause mortality by 12%, and composite kidney outcomes by 17%.² With GLP-1 RAs usage increasing, ophthalmology is also increasingly encountering patients who have recently started GLP-1 RAs therapy, often alongside substantial improvements in glycemic control.

In the context of GLP-1 RAs ocular complications, two specific topics currently dominate conversations: (1) worsening diabetic …

Dichoptic Therapy Versus Patching – State Of Literature Review, Eve Miller

inSIGHT

Amblyopia is the most common cause of vision loss in children. A meta-analysis performed by Hu et al. 2022 estimated the global prevalence of amblyopia to be 1.36%.¹ Amblyopia is defined as a reduction in best-corrected visual acuity (BCVA) of one or both eyes caused by abnormal neurologic development in the critical period of visual development. Amblyopia may result from unequal refractive error, strabismus or ocular pathology.² Despite treatment of these inciting factors, suppression of one eye remains, resulting in unequal vision. The clinical consequences of untreated amblyopia include permanent reduction in vision in the affected eye and …

Novel Advancements In Glaucoma Surgery, Eshani Ragam

inSIGHT

Glaucoma is a degenerative ocular condition characterized by irreversible vision loss from damage to the optic nerve. This is usually secondary to increased aqueous production or impaired aqueous outflow, resulting in increased intraocular pressure (IOP). Aqueous outflow is managed by the trabecular meshwork and Schlemm’s canal, although secondary pathways may also be involved.¹ Injury to the nerve is permanent, and interventions are primarily aimed at slowing the rate of progression. While eye drops and laser procedures are first-line measures to lower IOP, more persistent or severe etiologies require surgical treatment to preserve sight.² In recent years, advancements in …

Novel Treatments For Keratoconus, Caroline Paik

inSIGHT

Keratoconus is a progressive condition in which the cornea gradually thins and bulges outward, causing it to become steep and irregular. This leads to irregular astigmatism and worsening vision, most often beginning in adolescence or early adulthood.¹ The management of keratoconus has evolved significantly over the past two decades, with novel therapeutic approaches emerging across three critical domains: halting disease progression, improving visual function, and providing surgical alternatives when conservative measures fail. This review examines the latest advances in keratoconus treatment, focusing on innovative approaches that are reshaping clinical practice.

Insight, Volume 6, Issue 1, 2026

inSIGHT

Contents

7 - Novel Treatments for Keratoconus
By Caroline Paik

12 - Novel Advancements in Glaucoma Surgery
By Eshani Ragam

16 - Dichoptic Therapy versus Patching – State of Literature Review
By Eve Miller

24 - GLP-1 Receptor Agonists and Ocular Risk
By Saharsh Satheesh

33 - Home-use OCT for Neovascular Age- Related Macular Degeneration
By Sneh Shah

40 - Implementation of Artificial Intelligence in Retinoblastoma Diagnosis
By Zana Moldavsky

Ophthoevidence Report: Comparative Effects Of Prophylactic Strategies For Post-Intravitreal Injection Endophthalmitis: Protocol For A Systematic Review And Network Meta-Analysis, Maryam Ghadimi, Dena Zeraatkar, João Pedro Lima, Jinhui Ma, Sunir J. Garg, Peter Kaiser, David Steel, Tien Yin Wong, Sobha Sivaprasad, Charles Wykoff, Varun Chaudhary

Wills Eye Hospital Papers

BACKGROUND: Endophthalmitis is a rare but serious complication of intravitreal injections (IVI). To mitigate the risk of post-injection endophthalmitis (PIE), retinal specialists use different strategies, combining various prophylactic measures. However, existing systematic reviews have evaluated the effects of these measures in isolation, which does not consider their concurrent use in practice. A trustworthy systematic review with network meta-analysis (NMA) by providing a framework for simultaneous comparisons of different prophylactic combinations is essential to guide decision-making.

OBJECTIVES: To present a protocol for addressing the comparative effects of different strategies for the prevention of PIE.

METHODS: We will search Medline, EMBASE, Cochrane …

Uncovering Phenotypic Expansion In Axin2-Related Disorders Through Precision Animal Modeling, Nathalie M Aceves-Ewing, Denise G Lanza, Paul C Marcogliese, Di Lu, Chih-Wei Hsu, Hirokazu Hashimoto, Matthew Gonzalez, Audrey E Christiansen, Tara L Rasmussen, Alex J Ho, Angelina Gaspero, Cher Sha, Mary E Dickinson, Bo Yuan, Brian J Shayota, Stephanie Pachter, Xiaolin Hu, Debra Lynn Day-Salvatore, Laura Mackay, Oguz Kanca, Michael F Wangler, Lorraine Potocki, Jill A Rosenfeld, Richard Alan Lewis, Hsiao-Tuan Chao, Brendan Lee, Lauren Blieden, Barry N Wasserman, Dorine A Bax, Nicola K Ragge, Sukyeong Lee, Undiagnosed Diseases Network, Baylor College Of Medicine Center For Precision Medicine Models, Shinya Yamamoto, Hugo J Bellen, Lindsay C Burrage, Jason D Heaney

Faculty, Staff and Students Publications

Purpose: Heterozygous pathogenic variants in AXIN2 (HGNC 904) cause oligodontia-colorectal cancer syndrome (ODCRCS). We identified five individuals with de novo, heterozygous variants (NM_004655.4:c.196G>A p.(Glu66Lys), c.197A>G p.(Glu66Gly), and c.199G>A p.(Gly67Arg)) in AXIN2. Common phenotypes among these individuals included ectodermal dysplasia, global developmental delay, microcephaly, and limb, ophthalmologic, and genitourinary abnormalities.

Methods: Structural modeling was performed to predict the impact of these variants on AXIN2. A prime editing N1 screen of mouse embryos was performed to test whether the p.Glu66Lys variant produces a phenotype. Drosophila models were used to test the effect of this variant on Wnt signaling.

Results: …

Fluocinolone Acetonide Implant As A Baseline Therapy For Diabetic Macular Edema: Results From The Randomized Phase 4 New Day Study, Michael A Singer, Charles C Wykoff, Christopher D Riemann, Victor H Gonzalez, Christina Y Weng, Kamel Alkhatib, Rohit A Amarshi, Scott Moody, Mary Pao

Faculty, Staff and Students Publications

Purpose: The NEW DAY (ClinicalTrials.gov identifier, NCT04469595) study assessed the efficacy and safety of the fluocinolone acetonide (FAc; 0.19 mg) intravitreal implant as baseline therapy in diabetic macular edema (DME).

Design: Prospective, randomized, single-masked, active-controlled, multicenter, 18-month, phase 4 study.

Participants: Adults with type 1 or 2 diabetes and center-involving DME confirmed by central subfield thickness (CST).

Methods: Treatment regimens were FAc implant followed by rescue supplemental injections of aflibercept if needed (2 mg/0.05 ml) for 17 months versus aflibercept loading dose (2 mg every 4 weeks for 5 consecutive doses) followed by rescue supplemental injections of aflibercept if …

Reply To: A Lethal Progressive Neuroinflammation Disguised As Mogad Revealing A Final Diagnosis Of Griscelli Syndrome: Regarding: Mogad Is The Most Common Cause Of Isolated Optic Neuritis In Children, Chaitanya Aduru, Akansha Chandrasekar, Kyla Blasingame, Jonathan Rosen, Jesse M Levine, Karla Salazar, Madhuri Chilakapati, Rod Foroozan, Victoria Adeseye, Jonathan M Yarimi, Nikita Shukla, Timothy E Lotze, Kristen S Fisher, Alexander J Sandweiss

Faculty, Staff and Students Publications

No abstract provided.

Long-Term Functional Synaptic Integration Of Genome-Edited Retinal Organoids In A Primate Model Of Macular Degeneration, Atsuta Ozaki, Akihiro Kawai, Ryutaro Akiba, Satoko Okayama, Nobuhiko Ohno, Keisuke Kajita, Tomohiro Masuda, Satoshi Yokota, Shin-Ichiro Ito, Du Peiyan, Kenta Onoue, Shigenobu Yonemura, Mineo Kondo, Yasuo Kurimoto, Yingbin Fu, Michiko Mandai

Faculty, Staff and Students Publications

Retinal organoids represent a promising regenerative strategy for restoring vision in retinal degenerative diseases, but the capacity of host cone bipolar cells in the primate macula to rewire with transplanted photoreceptors has not been established. In this study, we transplanted genome-edited ISL1-/- human retinal organoids lacking ON-bipolar cells into an acute laser-induced macular photoreceptor ablation non-human primate model. Using immunohistochemistry, ultrastructural imaging, and focal macular electroretinography, we demonstrate that host rod and cone bipolar cells actively extend dendrites toward grafted photoreceptors and form synaptic contacts, with evidence of functional signal transmission in a subset of transplanted eyes. Longitudinal, per-eye analyses …

Exploring Pediatric Leprosy In An Endemic Area: Case Series Of Eight Patients In Indonesia, Gitalisa Andayani Adriono, Tri Rahayu, Sri Linuwih Sw Menaldi, Nelfidayani Nelfidayani, Retno Sulistyo Wardani, Kahlil Gibran, Malika Sabrina Yunifananda, Kartika Qonita Putri, Yunia Irawati

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Leprosy remains a significant public health concern in endemic regions such as Indonesia. Children are particularly vulnerable due to their naive immunity and close familial contacts. This study aims to report cases of pediatric leprosy in Lembata, Indonesia, focusing on clinical characteristics and associated risk factors.

Case Illustration: A case series of eight pediatric patients (<15 >years) diagnosed with leprosy was conducted during a community-based screening program in Lembata, Indonesia, in 2022. Of 140 individuals examined, 8 were children. Most patients were male (6/8) with a mean age of 11.75 years. Multibacillary (MB) leprosy predominated (7/8), and a history …

Meeting Report From The 2025 Cure Ocular Melanoma (Cure Om) Global Science Meeting, Amsterdam, The Netherlands, October 2025, Andrew E. Aplin, Katherina Alsina, Allison S. Betof, Joseph Birkett, Marcus O. Butler, George Cole, Rizwan Haq, Florian A. Karreth, Vinit B. Mahajan, Rahul Marpadga, Prithvi Mruthyunjaya, Paul Nathan, Jonas A. Nilsson, Gary Palmer, Joseph J. Sacco, Takami Sato, Sarah Stanhope, Pang-Ning Teng, Kyleigh Lipira

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

The 2025 Cure Ocular Melanoma (CURE OM) Global Science Meeting took place in Amsterdam, The Netherlands on October 25th, 2025. Several promising drug candidates are in development; however, there is still an urgent need for better prevention, detection, and treatment of uveal melanoma. The purpose of this meeting was to promote international collaboration and idea exchange between scientists, industry, and patient advocates.

Persistent Retinal Tenting In Myopic Traction Maculopathy, Taku Wakabayashi, Bita Momenaei, Allen Chiang

Wills Eye Hospital Papers

No abstract provided.

Long Term Evaluation Of The Safety And Efficacy Of Local Cooling Anesthesia During Intravitreal Injections: The Cool-2 Trial, Arshad M. Khanani, Samir N. Patel, Charles C. Wykoff, Gun-Ho Kim, Ajay E. Kuriyan

Wills Eye Hospital Papers

BACKGROUND/OBJECTIVE: To evaluate the safety and effectiveness of a medical device providing cooling anesthesia to the eye as local anesthesia for intravitreal (IVT) injections.

SUBJECTS/METHODS: As a multicenter, open label, dose escalation clinical trial, subjects receiving at least 3 IVT injections in the study eye were recruited to participate. All patients received subconjunctival lidocaine as their anesthesia for previous IVT injections. Subjects receiving IVT injections were assigned (non-randomized) to four groups in which the cooling device was applied to the conjunctiva at the location of the intravitreal injection: Group 1: -10˚C for 20 seconds; Group 2: -15˚C for 10 seconds; …

Evaluation Of Corneal Infections Using A Smartphone Macro Lens For Synchronous Telemedicine, Joseph A. Anaya, Julia Yu, Marisa A. Schoen, Dilru C. Amarasekera, Cherie A. Fathy, Sophia Lam, Christopher J. Rapuano, Zeba A. Syed

Wills Eye Hospital Papers

PURPOSE: To determine the efficacy of synchronous telemedicine consultation with a corneal specialist using a macro lens attachment to a smartphone to evaluate corneal infections.

METHODS: Patients aged 18 years or older who presented to the Cornea Clinic at Wills Eye Hospital between June 2020 and March 2021 with a corneal infection were examined by two fellowship-trained cornea specialists. One examiner (CJR) performed face-to-face (FTF) slit-lamp evaluations, whereas another examiner (ZAS) performed synchronous telemedicine visit (STV) evaluations via a smartphone with a macro lens of 7× magnification (Olloclip; Foothill Ranch, CA, USA) held by trained study coordinators. Agreement between examinations …

Matching-Adjusted Indirect Comparison Of Acoltremon Ophthalmic Solution 0.003% And Cyclosporine 0.05% Ophthalmic Emulsion For Increased Tear Production In Patients With Dry Eye Disease, Stephen Pflugfelder, Tony Okoro, Margaret Ainslie-Garcia, Anja Haltner, Emily K Prentiss, Elizabeth M Salvo-Halloran, Nikethana Srikanth, Michelle Senchyna, Esen K Akpek

Faculty, Staff and Students Publications

No abstract provided.

Thrive: A Phase 3, Randomized, Double-Masked, Placebo-Controlled Study Of Veligrotug For Active Thyroid Eye Disease, Michael T Yen, Kimberly Cockerham, Peerooz Saeed, Steven Leibowitz, Raghu C Mudumbai, Michael P Schittkowski, Vickie Lee, Jody Abrams, Roger E Turbin, Julián Bermúdez Pío-Rendón, Eckart Bertelmann, Edwina Eade, Navdeep Nijhawan, Marta Pérez-López, Marco Sales-Sanz, Sandy Zhang-Nunes, Andrea L Kossler, Ashley Pajak, Abhijit Narvekar, Radhika Tripuraneni, Antonio Manuel Garrido-Hermosilla

Faculty, Staff and Students Publications

Purpose: Thyroid eye disease (TED) is a debilitating autoimmune disease with significant unmet needs. This study's objective was to assess the efficacy and safety of veligrotug, a full antagonist monoclonal antibody to the insulin-like growth factor-1 receptor, in patients with active TED.

Design: Veligrotug was assessed in THRIVE, a global, multicenter, randomized, double-masked, placebo-controlled phase 3 trial.

Participants: Adult patients with moderate-to-severe active TED (onset ≤ 15 months, proptosis ≥ 3 mm above normal, and clinical activity score [CAS] ≥ 3) received either veligrotug or placebo.

Methods: Patients were randomized 2:1 to receive 10 mg/kg veligrotug or placebo administered every …

Diabetic Retinopathy Severity On Ultra-Widefield Fluorescein Angiography Versus Color Photography And Association With Risk Of Disease Worsening, Paolo S Silva, Danni Liu, Lloyd P Aiello, Ruben Grigorian, Sandeep Grover, Lee M Jampol, Daniel F Martin, Michele Melia, Christina Y Weng, Jennifer K Sun

Faculty, Staff and Students Publications

Purpose: To evaluate the potential benefits of ultra-widefield (UWF) fluorescein angiography (FA) versus color photography in assessing the risk of diabetic retinopathy (DR) worsening.

Design: Exploratory analysis of a longitudinal observational study (Protocol AA).

Participants: Participants with ≥1 eye having nonproliferative DR at baseline.

Methods: For each UWF-color and UWF-FA image, the extent and severity of DR lesions within the ETDRS 7-field area ("masked") and the full image area ("unmasked") were determined. Diabetic retinopathy severity levels were graded for each combination of modality and masking condition using the ETDRS Diabetic Retinopathy Severity Scale (DRSS). Associations between baseline UWF-color and UWF-FA …