Anas Alkhabaz

All Publications

• Using multimodal imaging to improve the diagnostic accuracy and confidence in distinguishing non-arteritic anterior ischemic optic neuropathy from optic disc drusen. Frontiers in neurology Kim, M. Y., Alkhabaz, A., Yu, M., Pujari, R., Liao, Y. J. 2026; 17: 1653402

  Abstract

  Optic nerve head elevation (ONHE) is a common diagnostic challenge in the general eye clinic. When caused by optic disc edema (ODE), ONHE may signal a neuro-ophthalmic emergency requiring urgent and invasive evaluation, whereas pseudoedema typically does not. This study evaluated whether multimodal oph¬thalmic imaging improves diagnostic accuracy and confidence in distinguishing nonarteritic anterior ischemic optic neuropathy (NAION), used as a model of true ODE, from optic disc drusen (ODD), a common cause of pseudoedema.We prospectively collected multimodal ophthalmic images using fundus color, near-infrared reflectance (NIR), fundus autofluorescence (FAF), and spectral-domain optical coherence tomography (OCT) optic nerve head and retinal nerve fiber layer (RNFL) analysis from 98 subjects (149 eyes: 60 NAION, 59 ODD, 30 controls). After a two-hour training session with a neuro-ophthalmologist, two masked medical trainees (a senior medical student and a recent medical gradu¬ate) independently reviewed single-, dual-, or multimodal image sets using a 0-5 confidence-weighted scale to assess for NAION, ODD, and control. Diagnostic accuracy was calculated using a weighted scoring system that penalized uncer¬tainty and misclassification. Confidence levels were categorized as high (defi¬nite), medium (likely), or low (maybe).Among single imaging modalities, NAION diagnostic accuracy was highest with RNFL (83.2%) and color fundus imaging (80.9%), and lowest with FAF (65.4%). Combining color + RNFL improved accu¬racy to 88.1%. For ODD, FAF alone yielded the highest accuracy of 82.3%. The diagnostic accuracy of control images was consistently high across all single modalities (84.2 to 93.8%). Multimodal imaging produced the highest accuracy overall (NAION 93.4%, ODD 90.5%, controls 99.5%). The highest improvement using multimodal imaging was in NAION diagnostic confidence, which improved from 3 to 37% with single modality to 28 to 82% with multimodal imaging. We used mixed ANOVA and chi-square tests to evaluate diagnostic accuracy and grader confidence across modalities.Brief training combined with multimodal imaging significantly improved diagnostic accuracy and confidence in differentiating NAION, ODD, and healthy controls. These findings support the potential clinical value of multimodal imaging in urgent-care settings where rapid and reliable evaluation of ONHE is essential.

  View details for DOI 10.3389/fneur.2026.1653402

  View details for PubMedID 41743055

  View details for PubMedCentralID PMC12929115

• Foreign Body Presenting as Golden Hypopyon. Surgeries Alkhabaz, A., Guo, L. Y., DeBoer, C. 2025; 6 (3)

  Abstract

  Penetrating intraocular foreign bodies (IOFBs) are ocular emergencies, often leading to preventable vision loss. This case report highlights a unique presentation of a work-related penetrating IOFB that mimicked a golden hypopyon.A 35-year-old male presented to the emergency department with sudden-onset pain and vision loss in the left eye while he was cutting a tree with metallic scissors. He had a visual acuity of 20/30 in the right eye and counting fingers in the left eye. A dilated slit-lamp examination and CT scan confirmed the presence of a 6-8 mm metallic IOFB in the anterior chamber, with no involvement of the lens or the posterior segment. Surgical removal was performed.The metallic IOFB was removed surgically with IOFB forceps using a single paracentesis. The patient reported resolving pain and regained baseline visual acuity of 20/20 postoperatively, which remained stable at one-month follow-up.This case illustrates the successful surgical management of a penetrating metallic IOFB with a unique presentation mimicking a hypopyon. Emphasis on unique presentations of IOFBs can aid in timely management, ultimately reducing the risk of complications.

  View details for DOI 10.3390/surgeries6030068

  View details for PubMedID 41810420

  View details for PubMedCentralID PMC12971070

• Foreign Body Presenting as Golden Hypopyon SURGERIES Alkhabaz, A., Guo, L. Y., DeBoer, C. 2025; 6 (3)

  View details for DOI 10.3390/surgeries6030068

  View details for Web of Science ID 001580791000001

• Age-related macular degeneration associated with optic disc drusen FRONTIERS IN OPHTHALMOLOGY Alkhabaz, A., Kim, M., Pujari, R., Zhang, J., Ren, Y., Leung, L., Liao, Y. 2025; 5: 1620616

  Abstract

  The aim of this study was to investigate the risk of age-related macular degeneration (AMD) in association with optic disc drusen (ODD).This was an observational, cross-sectional study.Participants were consecutive patients with and without ODD from the neuro-ophthalmology clinic. Ten patients with concomitant ODD-AMD were sub-analyzed.The two cohorts were identified from a prospectively recruited dataset between July 2022 and June 2024. Patients received formal diagnoses of ODD and AMD after ophthalmic and imaging assessment. A logistic regression model was utilized in calculating AMD risk to account for demographic differences.A total of 94 patients with ODD (median age: 44 [Q1: 20, Q3: 69], 64% women) and 100 patients without ODD (median age: 60 [Q1: 44, Q3: 69], 48% women) were identified. AMD was observed in 9.6% and 3% of the ODD and non-ODD cohorts, respectively. The risk of AMD was higher in the ODD group (OR = 3.93, 95% CI: 0.89-21.85, p = 0.084). Although the association was not statistically significant, a logistic regression model attributed that to the age difference between the two cohorts. Of the 10 patients with ODD-AMD, 70% had a family history of AMD. These patients were all Caucasians and had a median age of 75 years (range: 56-91); 70% were women. Only 30% were smokers. On optic disc imaging, 70% of eyes demonstrated moderate-to-severe ODD.Patients with ODD might be at a higher risk of AMD compared to patients without ODD, and AMD screening might be warranted. A family history of AMD is often present, indicating shared genetic risk factors.

  View details for DOI 10.3389/fopht.2025.1620616

  View details for Web of Science ID 001529635000001

  View details for PubMedID 40677744

  View details for PubMedCentralID PMC12267001

• Using Multimodal Imaging to Improve the Diagnostic Accuracy of Optic Disc Edema Kim, M., Alkhabaz, A., Yu, M., Pujari, R., Zhang, J., Zhu, P., Liao, Y. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2025

  View details for Web of Science ID 001560033700013

• Plasma lipids as novel biomarker of non-arteritic anterior ischemic optic neuropathy Alkhabaz, A., Kaushal, K., Ren, Y., Modgil, S., Pujari, R., Zhang, J., Zhu, P., Fu, M., Dai, Y., Liao, Y. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2025

  View details for Web of Science ID 001560033700010

• Microvascular changes in acute nonarteritic anterior ischemic optic neuropathy with or Zhang, J., Pujari, R., Alkhabaz, A., Zhu, P., Yaping, S., Liao, J. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2025

  View details for Web of Science ID 001558421400018

• Optic disc drusen-associated neovascularization: A systematic review. Survey of ophthalmology Alkhabaz, A., Pujari, R., Ren, Y., Smith, S. J., Liao, Y. J. 2025

  Abstract

  We have integrated current evidence of visual outcomes in optic disc drusen-associated choroidal neovascularization (ODD-CNV). We systematically reviewed all published ODD-CNV cases from 1974 to 2024 using three databases (PubMed, EMBASE, and Web of Science). Only studies reporting baseline visual acuity, follow-up visual acuity, and an intervention were included. Methodological quality was assessed using a standardized tool for case reports. Seventy-four eyes (65 patients) were identified from 48 eligible articles. The median age of the subjects was 13 years (range: 3-75), and 63.5% were females. CNVs were mainly peripapillary, with 45.7% of them progressing into the macula. On average, the eyes had a follow-up period of 21.5 months. Overall, treatment (of any type) showed better outcomes (0.53 LogMAR improvement, >3 lines on Snellen chart) compared to observation only (0.09 LogMAR improvement). Anti-VEGF injections and laser photocoagulation, the most frequently used interventions, showed 0.62 and 0.19 LogMAR improvement, respectively; however, the difference was not statistically significant (p = 0.05398). Among 24 pediatric eyes, anti-VEGF showed 0.71 LogMAR improvement with minimal side effects and recurrence in one eye only. When stratified by age, pediatric patients experienced a greater LogMAR improvement compared to adults, even when adjusting for anti-VEGF treatment (p = 0.0279). Our findings highlight the importance of intervention in ODD-CNV patients, particularly in the younger population, as they are more responsive to treatment. Anti-VEGF demonstrates great efficacy and safety profile in the pediatric population.

  View details for DOI 10.1016/j.survophthal.2025.05.010

  View details for PubMedID 40441443

• Siponimod-associated cystoid macular edema without known risk factors. American journal of ophthalmology case reports Kim, M. Y., Alkhabaz, A., Smith, S. J., Liao, Y. J. 2024; 36: 102124

  Abstract

  This case report highlights the importance of monitoring ocular health for patients starting on siponimod treatment, a sphingosine-1-phosphate receptor modulator, for relapsing-remitting multiple sclerosis. By showing how medication adverse events present in patients, we can revisit the current guidelines on ophthalmic evaluation recommendations.We report a 60-year-old patient who presented with unilateral blurry vision upon initiating siponimod therapy for the treatment of relapsing-remitting multiple sclerosis. Her exam findings did not show visual field defects but were significant for cystoid macular edema distorting the foveal contour. Upon stopping siponimod therapy, the patient's macular edema and symptoms resolved significantly within 7 days and completely resolved 1 month later.This case showcases siponimod-associated cystoid macular edema in a patient without known risk factors, such as diabetes mellitus and uveitis. The patient also had the earliest reported symptom onset to date following the initiation of siponimod therapy. Current recommendations from the American Academy of Ophthalmology and FDA stress the importance of ophthalmic evaluation three to four months after treatment initiation for patients with a history of risk factors. Given our current case and its comparison with four previously reported cases, we recommend that physicians inform patients of possible ocular adverse events with siponimod therapy regardless of their past medical history and duration of treatment.

  View details for DOI 10.1016/j.ajoc.2024.102124

  View details for PubMedID 39156909

  View details for PubMedCentralID PMC11327528

• Proteomics Biomarkers of Optic Nerve Stroke with and without Optic Disc Drusen Alkhabaz, A., Kaushal, K., Liu, L., Liao, Y. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2024

  View details for Web of Science ID 001312227700184

• Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia: A Blanked Out Pulmonary Neuroendocrine Tumor. Case reports in oncology Swied, M. Y., Azhar, W., Alkhabaz, A., Zaidi, F. 2024; 17 (1): 581-586

  Abstract

  Lung neuroendocrine tumors (NETs) are a rare type of pulmonary tumor and represent approximately 2% of all lung cancers. The prevalence of lung NETs is increasing, which may be due to improved diagnostic techniques for asymptomatic tumors. Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare and underdiagnosed disease that falls under the spectrum of NETs.We presented a case of a 59-year-old male who presented with severe coughing spells, flushing, and diarrhea. His computed tomography scan showed innumerable pulmonary nodules and irregular nodular opacities throughout the lungs. He underwent a left upper lobe wedge resection and was eventually diagnosed with neuroendocrine tumorlets via immunohistochemical stains. He was started on a trial of octreotide and reported significant improvement in symptoms after 1 month.DIPNECH is a rare preinvasive lesion characterized by the abnormal proliferation of pulmonary neuroendocrine cells. Patients with DIPNECH can present initially with respiratory symptoms, while other cases are discovered incidentally during the workup of different conditions. Definitive diagnosis of DIPNECH requires histopathological examination of lung tissue. There is limited evidence on DIPNECH management, and an individualized approach is currently advised.

  View details for DOI 10.1159/000538796

  View details for PubMedID 38751830

  View details for PubMedCentralID PMC11095596