BMJ Open Ophthalmology最新文献

{"title":"High-risk features in retinoblastoma: the association between histopathology and MRI.","authors":"Wajiha J Kheir, Roula Hourani, Youssef Zougheib, Andre Slim, Christel Tamer, Christiane Al-Haddad","doi":"10.1136/bmjophth-2025-002170","DOIUrl":"10.1136/bmjophth-2025-002170","url":null,"abstract":"<p><strong>Background: </strong>Identification of high-risk features is essential for improving treatment outcomes of retinoblastoma. MRI is one of the most used modalities in treatment decision-making; however, its accuracy in detecting extension into different ocular structures is variable. This study aims to evaluate high-risk features in retinoblastoma by comparing MRI with histopathology results.</p><p><strong>Methodology: </strong>This was a retrospective chart review of patients enrolled in the retinoblastoma programme at the American University of Beirut Medical Center from November 2012 to December 2022. We included enucleated eyes, classified as group D or E per the International Intraocular Retinoblastoma Classification. Data pertaining to high-risk features (including postlaminar optic nerve (ON) and massive choroidal invasion) were collected from preoperative MRI and histopathological examination following enucleation. Data on scleral and anterior segment involvement (not considered high-risk features) were also collected. Morphometric properties were calculated and analysed.</p><p><strong>Results: </strong>Analysis included 48 eyes from 44 patients. Males constituted 52.1% (n=25) of the sample and females 47.9% (n=23). 58% had unilateral retinoblastoma. The median age at diagnosis was 14.5 months (10-34.5). The median follow-up period from the first visit to data collection was 27.5 months (17.3-49). On tissue examination, 3 patients had postlaminar ON involvement and 11 had massive choroidal involvement. For postlaminar ON involvement, the MRI showed a moderate sensitivity (66.7%) and specificity (71.1%), with a high negative predictive value (NPV) of 96.9% but a low positive predictive value (PPV) of 13.3%. In cases of massive choroidal invasion, MRI demonstrated moderate sensitivity (45.5%) and specificity (75.7%), with a good NPV of 82.4% but a low PPV of 35.7%. Additionally, histopathology identified anterior segment involvement in six cases and scleral involvement in two cases. MRI showed high accuracy in detecting invasion of the anterior chamber (79.2%) and moderate accuracy in detecting invasion of the sclera (62.5%).</p><p><strong>Conclusion: </strong>MRI showed high levels of variability in detecting high-risk features in advanced retinoblastoma. MRI results ought to be interpreted with caution when making treatment decisions in advanced retinoblastoma. Limitations of our study included a relatively small sample size, retrospective design and possible technical constraints of MRI imaging.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of long-term uncorrected distance visual acuity in surgically SMILE corrected myopic eyes using machine learning.","authors":"Xiaonan Yang, Lanqin Zhao, Qiting Feng, Xiaohang Wu, Yi Xie, Dongyuan Yun, Jiyuan Yin, Haiqin Lin, Quan Liu, Haotian Lin","doi":"10.1136/bmjophth-2024-001932","DOIUrl":"10.1136/bmjophth-2024-001932","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to create machine learning (ML) models to predict the long-term uncorrected distance visual acuity (UDVA) in myopic eyes corrected by small incision lenticule extraction (SMILE).</p><p><strong>Methods: </strong>This was a retrospective cohort study conducted in Zhongshan Ophthalmic Center, Sun Yat-sen University. Participants who underwent SMILE between 2012 and 2016 were invited for the final follow-up examinations in 2019. Medical records and surgical parameter data were collected for analysis. Multicollinearity analysis and feature importance ranking were used to select the most predictive features. The following algorithms were used: least absolute shrinkage and selection operator, random forest, extremely randomised regression trees (extraTrees), gradient boosting machine and extreme gradient boosting. The root mean square error (RMSE) and mean absolute error (MAE) for each ML model were evaluated.</p><p><strong>Results: </strong>In total, 873 eyes from 440 patients with complete records were included in this study. The long-term UDVA (logarithm of the minimum angle of resolution) distribution at the final follow-up ranged from -0.1760 to 0.7960. The extraTrees model outperformed the other four models, with RMSE and MAE of 0.1162 and 0.0850, respectively. Additionally, some features, including spherical equivalent, lenticular optical zone, added manifest refraction, preoperative corrected distance visual acuity and cap thickness, had moderate-to-strong effects on the average UDVA prediction using the extraTrees model.</p><p><strong>Conclusion: </strong>Long-term UDVA in myopic eyes corrected by SMILE can be effectively predicted using ML technologies, particularly the extraTrees model. However, more features and samples for the prediction model need to be explored to improve accuracy. Otherwise, there was a limitation in this research that sphere and cylinder refraction were treated as independent variables. But, the proportion of astigmatism to spherical refraction is relatively low, less than 1/5. Consequently, this does not lead to the incorrectness of our results, but they are weakened by this.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"6-month outcomes of intravitreal faricimab injection for neovascular age-related macular degeneration and their relationships with clinical findings: a multicentre cohort study from the J-CREST.","authors":"Ryoji Yanai, Fumiko Murao, Akiko Miki, Hiroto Terasaki, Shinichiro Chujo, Yukinori Sakaeda, Kyosuke Seki, Gaku Ishigouoka, Takeshi Iwase, Hiromi Ohara, Hiroki Tsujinaka, Hisashi Fukuyama, Yuki Abe, Yuki Nishi, Takamasa Kinoshita, Mineo Kondo, Taiji Sakamoto, Yoshinori Mitamura","doi":"10.1136/bmjophth-2025-002415","DOIUrl":"10.1136/bmjophth-2025-002415","url":null,"abstract":"<p><strong>Background/aims: </strong>This study aimed to investigate the outcomes of intravitreal faricimab (IVF) injection for neovascular age-related macular degeneration (nAMD) and their relationships with clinical findings.</p><p><strong>Methods: </strong>At 14 sites, we retrospectively examined the 6-month treatment outcomes of 186 eyes that underwent IVF for treatment-naïve nAMD or nAMD previously treated except for >3 months before the baseline.</p><p><strong>Results: </strong>Visual acuity and central retinal thickness (CRT) significantly improved at 1, 3 and 6 months after treatment (p<0.001, respectively). At 3 or 6 months, 151 eyes (81.2%) exhibited dry macula. The dry macula rate in the treatment-naïve group (85.7%) was significantly higher than the previously treated group (71.7%, p=0.022). Eyes with pretreatment submacular haemorrhage (SMH) had a significantly higher rate of dry macula (93.9%) than those without (78.4%, p=0.048). Eyes with pretreatment subretinal fluid had good final visual acuity, but poor visual acuity was observed in those with intraretinal fluid (IRF), subretinal hyper-reflective material (SHRM), SMH or hard exudates. However, a similar tendency was also observed at baseline. CRT improvement was good in the eyes with pretreatment IRF, pigment epithelial detachment, SHRM and SMH, although these eyes had higher CRT at the baseline.</p><p><strong>Conclusion: </strong>IVF treatment for nAMD was associated with improvements in visual acuity and CRT over 6 months. Eyes presenting with SMH showed a higher rate of achieving a dry macula. This result indicates that faricimab may be useful in treating patients with nAMD and SMH. Given the retrospective, non-randomised design, however, these findings should be interpreted cautiously and viewed as hypothesis-generating rather than definitive.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rasch analysis of the NEI-VFQ-25: vision-related quality of life in Leber hereditary optic neuropathy after lenadogene nolparvovec gene therapy.","authors":"Benson S Chen, Stéphanie Perot, Magali Taiel, Patrick Yu-Wai-Man, Mike Horton","doi":"10.1136/bmjophth-2025-002164","DOIUrl":"10.1136/bmjophth-2025-002164","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the suitability of the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) for measuring vision-related quality of life (VRQoL) in patients with Leber hereditary optic neuropathy receiving lenadogene nolparvovec gene therapy in three Phase III randomised controlled clinical trials.</p><p><strong>Methods: </strong>VRQoL was assessed using the NEI-VFQ-25 at baseline (n=174) and 2 years after treatment (n=152). All participants received lenadogene nolparvovec in at least one eye. The scoring structure of the original NEI-VFQ-25 was evaluated for fit to the Rasch model, and a post hoc revision was created and psychometrically reevaluated. Stacked analysis was conducted to compare Rasch-revised scores at baseline and 2 years after treatment.</p><p><strong>Results: </strong>The original NEI-VFQ-25 exhibited multiple issues including limitations in response functioning and scale dimensionality. These issues were rectified by revising the NEI-VFQ25 into two separate unidimensional scales measuring 'Vision-related Activity Limitation' (VAL) and 'Socioemotional Functioning' (SEF). Participants' mean VAL score at baseline on a Rasch-transformed 0-100 scale was 46.1 (11.7), improving to 48.4 (13.7) after treatment (<i>F</i>(1, 324) = 2.67, p=0.103). On the SEF scale, there was a significant difference 2 years after treatment, with participants improving from a mean score of 40.1 (14.1) at baseline to 49.6 (17.6) (<i>F</i>(1, 324) = 29.1, p<0.001).</p><p><strong>Conclusions: </strong>The scoring structure of the original NEI-VFQ-25 has limitations that undermine its psychometric validity as a measure of VRQoL. Using the Rasch-revised NEI-VFQ-25, we determined that improvement in VRQoL after treatment with lenadogene nolparvovec was driven predominantly by an improvement in socioemotional functioning.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-based assessment of Clinical Activity Score and detection of active thyroid eye disease using facial images: validation of Glandy CAS.","authors":"Kyubo Shin, Jin-Sook Yoon, Jongchan Kim, Jaemin Park, Hyun Young Park, Namju Kim, Min Joung Lee, Ho-Kyung Choung, JaeSang Ko, Jae Hoon Moon","doi":"10.1136/bmjophth-2025-002264","DOIUrl":"10.1136/bmjophth-2025-002264","url":null,"abstract":"<p><strong>Purpose: </strong>The Clinical Activity Score (CAS) is widely used to assess thyroid eye disease (TED) activity but can vary based on the evaluator's expertise. We developed and externally validated Glandy CAS, a machine learning (ML)-assisted system for detecting active TED (CAS ≥3) using digital facial images. This clinical trial aimed to gain approval from the Korea Ministry of Food and Drug Safety (KMFDS) for this Software as a Medical Device (SaMD).</p><p><strong>Methods: </strong>This is a clinical trial based on the retrospective cohort. Glandy CAS analysed 756 photos of patients with TED, classifying them as having active or inactive TED. Its diagnostic performance was compared with that of three general ophthalmologists (less than 5 years of experience), using the F1 score. The reference CAS was determined by an oculoplastic specialist.</p><p><strong>Results: </strong>Active TED was detected in 207 of 756 patients. Glandy CAS achieved a sensitivity of 87.9%, specificity of 95.8% and an F1 score of 0.88. In comparison, general ophthalmologists had a sensitivity of 60.4%, specificity of 83.0% and an F1 score of 0.57. Glandy CAS predicted CAS within 1 point of the reference score in 82.3% of cases, with a mean absolute error of 0.83.</p><p><strong>Conclusions: </strong>Glandy CAS, an ML-assisted system for detecting active TED using facial images, showed high accuracy and outperformed general ophthalmologists. This system can consistently and accurately assess disease activity, facilitating early detection and timely treatment of active TED. Based on this clinical trial, the SaMD received KMFDS approval (Product Licence No., 24-93).</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of metformin use with primary open-angle glaucoma using data from the National Institutes of Health <i>All of Us</i> Program.","authors":"Sophia Sidhu, Bharanidharan Radha Saseendrakumar, Varsha Varkhedi, Jo-Hsuan Wu, Aman Parikh, Eric Nudleman, Jiun L Do, Sasan Moghimi, Robert N Weinreb, Sally L Baxter","doi":"10.1136/bmjophth-2024-002027","DOIUrl":"10.1136/bmjophth-2024-002027","url":null,"abstract":"<p><strong>Background: </strong>Few studies have assessed the impact of metformin use on glaucoma risk. The purpose of this study was to examine the association between metformin use and the incidence of primary open-angle glaucoma (POAG) in a diverse and large nationwide cohort.</p><p><strong>Methods: </strong>We included a retrospective cohort study of 18 440 participants in the National Institutes of Health <i>All of Us</i> Research Program aged 40 years or older, with a diagnosis of diabetes mellitus and without a diagnosis of POAG prior to diabetes diagnosis or metformin use. Bivariate logistic regression, multivariable logistic regression and survival analysis were used to analyse the association between ever use of metformin and incidence of POAG.</p><p><strong>Results: </strong>Within the cohort, 240 participants acquired a diagnosis of POAG during all available follow-up time, while 18 200 did not. In regression-based bivariate analysis, metformin use was significantly associated with a lower odds of developing POAG (OR 0.35, 95% CI 0.26 to 0.47, p<0.001). In multivariable regression analysis, metformin remained protective against POAG (OR 0.33, 95% CI 0.21 to 0.50, p<0.001), while the use of other diabetic medications was associated with an increased odds of developing POAG (OR 2.39, 95% CI 1.48 to 3.90, p<0.001). In survival analysis, the probability of developing POAG was significantly lower for the participants using metformin than for the participants not using metformin (log-rank p<0.001, Cox proportional HR 0.38, 95% CI 0.29 to 0.51).</p><p><strong>Conclusions: </strong>This study provides additional large-scale observational health data supporting the protective role of metformin in the development of POAG. However, limitations include the study's observational design and lack of data on metformin dosage and duration, glaucoma severity and ocular exam findings. Despite these limitations, our findings contribute to the growing body of evidence suggesting a potential protective effect of metformin against POAG.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-analysis of defocus curves of monofocal, enhanced monofocal and extended depth of focus IOLs.","authors":"Sathish Srinivasan, Cyril Nyankerh, Jessie Hull, Rajaraman Suryakumar","doi":"10.1136/bmjophth-2024-002025","DOIUrl":"10.1136/bmjophth-2024-002025","url":null,"abstract":"<p><strong>Background/aims: </strong>Recently, modified monofocal intraocular lenses (IOLs) (proposed mono plus IOLs) have emerged claiming to provide monofocal quality distance vision while enhancing intermediate distance visual performance. The purpose of this study was to conduct a literature review and compare the range of vision following cataract surgery with the implantation of standard monofocal, claimed monofocal plus and extended depth of focus (EDoF) IOLs.</p><p><strong>Methods: </strong>Literature searches and a meta-analysis were conducted on Embase, PubMed, IOLEvidence App and the Food and Drug Administration premarket approval database. Mean defocus curves were calculated with a random effect model and study quality was assessed.</p><p><strong>Results: </strong>After eliminating duplicate publications, 36 studies were included in the data extraction process. Standard monofocal IOLs were implanted in 549 eyes, 360 eyes with claimed mono plus IOLs and 1898 eyes with EDoF IOLs. At far viewing acuity, the performance of all three lens categories appeared comparable: all p>0.05. However, at the intermediate distance of 66 cm (-1.5D), and at a near distance of 40 cm (-2.50D), monofocal and mono plus defocus curve acuities exhibited comparable performance: p=0.22 and 0.77 respectively, while EDoF lenses demonstrated better acuity (all p<0.05).</p><p><strong>Conclusions: </strong>There is a lack of standardisation of defocus curve measurements among published papers included in this meta-analysis. Despite some slight inconsistencies in measurements, the range of vision of standard monofocal IOLs and mono plus IOLs as measured by the defocus curve appears to be similar. The EDoF IOLs in this meta-analysis indicate a potentially better range of vision compared with mono plus and monofocal IOLs.</p><p><strong>Synopsis: </strong>This meta-analysis seems to indicate that EDoF IOLs may have a better range of vision as measured by defocus curves compared with mono plus and monofocal IOLs.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitigating the risks: addressing smoking cessation in thyroid eye disease.","authors":"Nasser Karimi, Mohsen Bahmani Kashkouli, Ali Keyhani, SeyyedSaeed Aghili, Hossein Ghahvehchian, Sahar Askari, Shadi Akbarian","doi":"10.1136/bmjophth-2025-002226","DOIUrl":"10.1136/bmjophth-2025-002226","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the effectiveness of verbal counselling and varenicline in achieving smoking cessation among patients with thyroid eye disease (TED) and to identify predictive factors associated with successful smoking cessation.</p><p><strong>Methods and analysis: </strong>A cross-sectional analysis of data from the Iran TED (IrTED) Registry was conducted. Patients' demographics and TED severity/activity were recorded. As a routine at the TED clinic in Rassoul Akram Hospital, since 2020, all smoking patients have undergone smoking cessation verbal counselling in the first and almost every subsequent visit session. The effectiveness of verbal counselling was assessed through a telephone survey. Retrospectively, the association between successful smoking cessation and disease severity/activity was evaluated. Prospectively, patients who failed or refused to quit smoking after counselling were offered varenicline. Acceptance, compliance and adherence rates were determined.</p><p><strong>Results: </strong>While 379/685 patients of the IrTED 2013-2023 database (55.32%) reported no tobacco exposure, the remaining were active (n=117, 17.08%), passive (n=134, 19.56%) and former smokers (n=55, 8.02%). In 2020-2023, 73 active tobacco-smoking patients with TED were enrolled, all of whom received verbal cessation counselling at their first and subsequent visits. On the follow-up phone call, 51/73 were contacted, and 25/51 (49.01%) reported successful smoking cessation after verbal counselling. The remaining 26/51 smokers were offered varenicline (on the phone call); however, only 7/26 (26.92%) attended the prescription session. Of these patients, 3/7 (42.85%) completed the first month of treatment, and just 1/3 (33.33%) finished the 3-month course, successfully quitting smoking until the final follow-up (18 months). One patient (14.28%) reported constipation, and another one reported sleep paralysis (14.28%) as an adverse event.</p><p><strong>Conclusion: </strong>Verbal counselling demonstrates effectiveness in smoking cessation for patients with TED, with nearly half of smokers successfully quitting the habit. Among those who failed to quit after verbal counselling, varenicline showed limited effectiveness, indicating poor compliance and motivation deficit.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foundation models in ophthalmology: a preliminary study on AI-assisted diagnosis of myopic maculopathy and posterior staphyloma using ultra-widefield fundus images.","authors":"Juzhao Zhang, Tao Yu, Mengjia Zhang, Yuzhu Zhang, Yingyan Ma, Wenwen Xue, Hao Zhou, Senlin Lin, Haidong Zou, Xian Xu","doi":"10.1136/bmjophth-2024-002073","DOIUrl":"10.1136/bmjophth-2024-002073","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to detect characteristic fundus changes in pathological myopia using deep learning (DL)-based analysis of ultra-widefield (UWF) fundus imaging.</p><p><strong>Methods: </strong>Following the exclusion of low-quality images, this cross-sectional study used 1105 UWF images from 543 patients with high myopia to develop the model, along with 293 images from 150 patients with high myopia for external testing. All images were retrospectively collected from patients with high myopia at Shanghai General Hospital and Shanghai Eye Diseases Prevention and Treatment Center between 2018 and 2024. We trained a DL model based on an ophthalmology foundational model to detect myopic maculopathy (MM) and posterior staphyloma (PS).</p><p><strong>Results: </strong>The proposed RETFound-enhanced model demonstrated robust performance. For five-category classification of MM, it achieved 65.4% accuracy and an F1 score of 0.648, outperforming other methods. In three-category MM classification, it achieved 79.4% accuracy and an F1 score of 0.793. For PS detection, the model reached 84.1% accuracy, an F1 score of 0.814 and an area under the receiver operating characteristic curve (AUROC) of 0.886, highlighting its effectiveness as a screening tool. External validation showed consistent performance, with 64.4% accuracy for five-category MM classification, 79.8% accuracy for three-category classification and 81.2% accuracy for PS, confirming robustness across cohorts.</p><p><strong>Conclusions: </strong>This study presents an effective diagnostic model for pathological myopia using UWF fundus imaging and a foundation model. The integration of DL with non-mydriatic UWF fundus imaging demonstrates promising potential for applications in primary healthcare, particularly in underserved areas, enabling accessible screening for high myopia-related fundus changes.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and satisfaction of fully self-service fundus disease screening among middle-aged individuals: a cross-sectional study.","authors":"Yuting Wu, Guiling Gao, Liangwen Lei, Tao Yu, Yajun Peng, Siyu Yang, Meng Gao, Senlin Lin, Tao Wu, Deshang Li, Chunxia Yao, Lina Lu","doi":"10.1136/bmjophth-2024-001950","DOIUrl":"https://doi.org/10.1136/bmjophth-2024-001950","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the imaging quality, efficiency and satisfaction of fully self-service fundus photography compared with traditional fundus photography performed by experienced operators among middle-aged individuals.</p><p><strong>Methods: </strong>Participants aged 45-64 in the community of Shanghai were included, and eye disease screenings were carried out after obtaining informed consent. All participants had no cataracts or other conditions that could potentially compromise the quality of fundus imaging. Participants voluntarily chose the fully self-service fundus photography group or the traditional fundus photography group. A statistical analysis was performed to analyse the imaging quality, efficiency and satisfaction of self-service fundus photography.</p><p><strong>Results: </strong>We included 457 individuals with an average age of 56.93 years. Fully self-service fundus photography produces similar imaging quality to manual examinations. Additionally, this photography significantly increases residents' willingness to undergo eye disease screening again, particularly among those with better visual acuity, compared with traditional doctor-led screenings.</p><p><strong>Conclusions: </strong>This study confirms the reliability of fully self-service fundus photography, and its ability to enhance compliance and willingness for follow-up screenings among individuals aged 45-64. Promoting fully self-service fundus photography is beneficial for screening blinding eye diseases in the middle-aged population. Given the limited geographical scope and age range of this study, larger multicentre studies are needed to confirm the broader applicability of fully self-service fundus photography and to establish effective screening models for high-risk occupational populations.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}