{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T13:30:59Z","timestamp":1789047059529,"version":"build-2803163510"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the application of automated quantitative scanning laser ophthalmoscopy analysis to early postoperative images and to characterize group-level variation in the resulting measurements across patients grouped according to clinically recorded age-related cataract subtype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective observational imaging study included 716 eyes from 571 patients with age-related cataract who underwent phacoemulsification combined with intraocular lens implantation between August 2023 and August 2025. Early postoperative scanning laser ophthalmoscopy (SLO) images were analyzed using EVisionAI version 4.0 as a standardized automated quantitative image-analysis tool. Eyes were grouped as nuclear cataract (394 eyes), cortical cataract (217 eyes), or posterior subcapsular cataract (PSC; 105 eyes) according to routine preoperative slit-lamp records. Standardized LOCS III grading and cohort-specific validation of EVisionAI against manual annotations were not available in this retrospective dataset. Automated image-derived parameters included tessellated fundus-related features, optic disc morphology, peripapillary atrophy (PPA)-related parameters, and retinal vascular parameters. Patient-level baseline characteristics were compared using conventional statistical tests, as appropriate. Eye-level comparisons of automated image-derived SLO parameters were performed using generalized estimating equations to account for inter-eye correlation, with Wald \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      statistics reported. Multiple comparisons were adjusted using the Benjamini\u2013Hochberg false discovery rate procedure. Multivariable GEE models adjusted for age, sex, axial length, and cataract subtype were used to evaluate associations with selected imaging parameters. Standardized effect-size, age-overlap, and single-eye sensitivity analyses were also performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After false discovery rate correction, multiple automated image-derived fundus parameters differed significantly among the retrospectively defined cataract subtype groups, including cup-to-disc ratio parameters, optic disc morphology, PPA-related parameters, and retinal vascular parameters. Compared with PSC eyes, nuclear and cortical cataract eyes showed relatively higher cup-to-disc ratio-related parameters and larger PPA-related parameters, whereas PSC eyes showed relatively greater retinal vessel length. Across age groups, tessellated fundus density, macular tessellated fundus density, optic disc-related tessellated fundus parameters, and PPA-related parameters increased significantly with age. Among the 14 contrasts involving the seven principal outcomes, standardized effect estimates were small to moderate (absolute standardized \u03b2, 0.258\u20130.619), and none met the descriptive threshold for a large effect. In multivariable GEE models, age remained associated with multiple tessellated fundus- and PPA-related parameters after adjustment for sex, axial length, and cataract subtype. Axial length also remained associated with optic disc tilt angle, PPA-related parameters, and tessellated fundus parameters. The age-overlap and single-eye sensitivity analyses showed generally consistent directions for the principal associations, although one optic disc tilt-angle contrast was attenuated after age restriction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Automated quantitative SLO analysis was completed in 716 of 821 initially available early postoperative images. Group-level differences were observed across clinically recorded cataract subtype groups, but these findings were exploratory and may reflect non-standardized subtype assignment, unmeasured spherical-equivalent refractive error, age, axial length, image characteristics, and other confounding. They should not be interpreted as subtype-specific structural phenotypes or as evidence of diagnostic, prognostic, or clinical decision utility. Prospective studies with standardized cataract grading and cohort-specific algorithm validation are required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1896907","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T12:41:34Z","timestamp":1789044094000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Automated postoperative SLO quantification across clinically recorded cataract subtype groups: an exploratory cross-sectional study"],"prefix":"10.3389","volume":"13","author":[{"given":"Yixue","family":"Yin","sequence":"first","affiliation":[{"name":"Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]},{"name":"Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]},{"name":"Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases","place":["Jinan, China"]},{"name":"Medical College of Optometry and Ophthalmology, Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinran","family":"Guo","sequence":"additional","affiliation":[{"name":"Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]},{"name":"Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]},{"name":"Medical College of Optometry and Ophthalmology, Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuo","family":"Xu","sequence":"additional","affiliation":[{"name":"Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]},{"name":"Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]},{"name":"Medical College of Optometry and Ophthalmology, Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuyan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]},{"name":"Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]},{"name":"Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases","place":["Jinan, China"]},{"name":"Medical College of Optometry and Ophthalmology, Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongsheng","family":"Bi","sequence":"additional","affiliation":[{"name":"Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]},{"name":"Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]},{"name":"Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases","place":["Jinan, China"]},{"name":"Medical College of Optometry and Ophthalmology, Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jike","family":"Song","sequence":"additional","affiliation":[{"name":"Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]},{"name":"Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e888","DOI":"10.1016\/s2214-109x(17)30293-0","article-title":"Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis.","volume":"5","author":"Bourne","year":"2017","journal-title":"The Lancet Global Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e144","DOI":"10.1016\/S2214-109X(20)30489-7","article-title":"2019 Blindness and vision impairment collaborators; vision loss expert group of the global burden of disease study. causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the right to sight: an analysis for the global burden of disease study.","volume":"9","year":"2021","journal-title":"Lancet Glob. 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