BMJ Open Ophthalmology最新文献

{"title":"Using patient input to develop item banks to measure quality-of-life impact of vitreous floaters.","authors":"Jarinne Woudstra-de Jong, Sonia Manning-Charalampidou, Tirza Voogt-den Hertog, Johannes R Vingerling, Jan J Busschbach, Konrad Pesudovs","doi":"10.1136/bmjophth-2025-002658","DOIUrl":"https://doi.org/10.1136/bmjophth-2025-002658","url":null,"abstract":"<p><strong>Aims: </strong>To develop item banks for a patient-reported outcome measure (PROM) specific to vitreous floaters using input from patients. We report on the content generation and item refinement, and compare the content of the newly-developed PROM with published literature.</p><p><strong>Methods: </strong>Potential PROM items (questions) were identified from two sources: 20 existing floaters-specific PROMs and two qualitative studies in patients with floaters. This initial item pool was evaluated with binning (grouping) and winnowing (reduction) to group the PROM items into quality-of-life domains. Patients with floaters provided feedback on the pilot PROM item banks in cognitive interviews. The Dutch PROM item banks were translated into English, Arabic and Turkish. Each step was guided by an expert panel consensus.</p><p><strong>Results: </strong>The initial item pool with potential PROM items consisted of 921 items. After three rounds of binning and winnowing, the item pool was reduced to 272 items. After 10 cognitive interviews, 19 items were changed, 8 were deleted and 8 were added. The final PROM item pool consists of 272 items across 12 item banks (quality-of-life domains): visual symptoms, ocular symptoms, general symptoms, activity limitations, driving, mobility issues, health concerns, economic impact, emotional well-being, social well-being, inconvenience and coping.</p><p><strong>Conclusion: </strong>The new floaters-specific PROM item banks included all 81 items from previous PROMs, supplemented with additional quality-of-life issues reported by people experiencing floaters (70.2%). The largest quality-of-life domains were 'health concerns' and 'inconvenience', emphasising the disease burden of experiencing vitreous floaters and patients' information needs. Item banking allows clinicians and researchers to choose what domains and items to use in their measurement. Additional quality-of-life issues identified in previously unstudied populations can be added and calibrated with the existing items. Future studies using the item banks can compare the quality-of-life impact of different clinical subgroups, and control for important confounders.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834038","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":"Systemic α₂-agonist use and lower hazard of glaucoma compared with β-blockers: a cohort study.","authors":"Ibrahim Abboud, Amin Z Khudari, Abdelaziz Abdelaal, Amr Almobayed, Subhi J Al'Aref, Jonathan S Myers, Richard K Lee, Abdelrahman M Elhusseiny","doi":"10.1136/bmjophth-2026-002760","DOIUrl":"https://doi.org/10.1136/bmjophth-2026-002760","url":null,"abstract":"<p><strong>Objective: </strong>Systemic antihypertensive medications may influence glaucoma-related outcomes through intraocular pressure-dependent and vascular mechanisms. While topical α₂-agonists are established glaucoma therapies, the association between systemic α₂-agonists and glaucoma hazard remains unexamined; we compared their hazard with systemic β-blockers in adults with hypertension.</p><p><strong>Methods and analysis: </strong>We conducted a multicentre retrospective cohort study using deidentified electronic health records. Adults aged ≥40 years with hypertension and chronic exposure to systemic α₂-agonists or β-blockers were included. Patients with pre-existing ocular hypertension (OHT), primary open-angle glaucoma (POAG), concomitant comparator use, or inadequate ophthalmic follow-up were excluded. We balanced cohorts using propensity score matching (PSM) and assessed the hazard of OHT and POAG at 1, 3, and 5 years. Cox models estimated adjusted HRs (aHRs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Patients treated with α₂-agonists (n=4186) were matched to those treated with β-blockers (n=360 399), resulting in 4152 patients per group after PSM. In Cox models (on the unmatched cohorts) adjusted for demographics, comorbidities, medications, laboratory and biometric measures, socioeconomic indicators and selected procedures, α₂-agonist exposure was associated with a lower hazard of OHT (aHR (95% CI) 0.582 (0.473 to 0.716), 0.559 (0.468 to 0.669) and 0.534 (0.450 to 0.634)) and POAG (aHR (95% CI) 0.359 (0.300 to 0.429), 0.333 (0.282 to 0.392) and 0.334 (0.286 to 0.390)) at 1-year, 3-year, and 5-year follow-up, respectively (all p<0.001).</p><p><strong>Conclusions: </strong>Systemic α₂-agonist use was associated with a substantially lower hazard of glaucoma-related diagnoses compared with systemic β-blocker use. These findings are limited by the observational design, potential residual confounding, and reliance on diagnostic coding. These results warrant further investigation in prospective mechanistic studies and randomised clinical trials.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833971","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":"Subjective and objective visual impairment and all-cause mortality in older US adults: the role of physical activity and depressive symptoms in NHANES 2007-2008.","authors":"Zhonghua Luo, Zihao Lin, Yue Xu, Shanshan Yu, Xiaoling Liang, Jingjing Huang","doi":"10.1136/bmjophth-2026-002744","DOIUrl":"10.1136/bmjophth-2026-002744","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association between visual impairment (VI) and all-cause mortality in older US adults and to examine the potential mediating roles of physical activity (PA) and depressive symptoms.</p><p><strong>Materials and analysis: </strong>This prospective cohort study included adults aged 60 years and older from the 2007 to 2008 National Health and Nutrition Examination Survey. VI was defined as either subjective visual impairment (SVI) based on self-reported vision status or objective visual impairment (OVI) defined as presenting visual acuity worse than 20/40 in the better-seeing eye. Cox proportional hazards models adjusted for demographic, anthropometric, socioeconomic and clinical covariates were used to examine the association between VI and all-cause mortality with propensity score matching and subgroup analyses. PA was assessed using a modified International Physical Activity Questionnaire and depressive symptoms were assessed using the 9-item Patient Health Questionnaire. Mediation analyses were performed to estimate direct and indirect effects through PA and depressive symptoms.</p><p><strong>Results: </strong>A total of 2154 participants (mean (SD) age 70.6 (7.1) years; 44.2% male) were included. Over a median follow-up of 145.0 months, 399 (57.8%) deaths occurred in the VI group and 535 (34.6%) in the non-VI group. VI was associated with an increased risk of all-cause mortality after propensity score matching and multivariable adjustment (HR, 1.21; 95% CI 1.04 to 1.41; p=0.012). In subgroup analyses, SVI was significantly associated with mortality (HR, 1.33; 95% CI 1.13 to 1.57; p=0.001), whereas OVI was not. PA mediated 9.4% of the association between VI and all-cause mortality, whereas depressive symptoms did not.</p><p><strong>Conclusion: </strong>In this nationally representative cohort, VI was independently associated with higher all-cause mortality in older US adults. SVI appeared more predictive than OVI, possibly reflecting broader functional vision burden. Reduced PA partially mediated this association, whereas depressive symptoms did not. Residual confounding and measurement error cannot be excluded.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762946","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":"Neuropsychological influences on visual photosensitivity and its treatment in traumatic brain injury.","authors":"Shreya Bhatt, Brandon Chou, Stacey Li, Mariela C Aguilar, Heather Durkee, Alex Gonzalez, James Lai, David Valdes-Arias, Shivam P Patel, Cornelis Rowaan, Felipe Echeverri Tribin, Gemayaret Alvarez, Barry E Hurwitz, Byron L Lam, Elizabeth R Felix, Jean-Marie Parel, Anat Galor","doi":"10.1136/bmjophth-2025-002510","DOIUrl":"https://doi.org/10.1136/bmjophth-2025-002510","url":null,"abstract":"<p><strong>Background: </strong>Visual photosensitivity is common following traumatic brain injury (TBI) and may be influenced by neuropsychological factors. We examined relationships between visual photosensitivity thresholds (VPTs) and these factors, evaluating tinted lens responses in persons with and without TBI.</p><p><strong>Methods: </strong>Participants completed the Patient Health Questionnaire-9 (PHQ-9), 13-Item Pain Catastrophizing Scale-English Version (PCS-EN), Brief Test of Adult Cognition by Telephone (BTACT) and Short-Form 12-Item Survey Version 2. Lens response was calculated as the VPT difference from plano lens (PL) and categorised as mild, moderate or strong. Associations were analysed using multivariable linear and ordinal regression models adjusted for demographics.</p><p><strong>Results: </strong>VPTs were lower in the TBI group (PL VPT: 1.5±0.9 vs 2.4±0.8 log lux; p<0.001). Among individuals with TBI, higher PCS-EN scores correlated with lower PL VPTs (β=-0.027; p=0.01). Higher PHQ-9 scores correlated with lower VPTs under FL-41 lens (FL) (β=-0.048; p=0.02) and grey-filtering lens (GL) (β=-0.051; p=0.02) conditions. Lower BTACT number series Z-scores correlated with lower VPTs under FL (β=0.349; p=0.01) and GL (β=0.376; p=0.009), suggesting greater visual photosensitivity with lower cognition. Ordinal regression indicated that higher PHQ-9 scores correlated with reduced odds of a stronger response to FL (OR=0.833; p=0.02) and GL (OR=0.829; p=0.047) lenses.</p><p><strong>Conclusion: </strong>Pain catastrophising was linked to greater photosensitivity, while depression reduced lens benefit in TBI. These findings support the need for targeted interventions addressing neuropsychological factors in optimising therapeutic benefit.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762914","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":"External validation and updating of DIGIROP prediction models including parenteral nutrition for treatment-requiring retinopathy of prematurity in a Swedish national cohort.","authors":"Aldina Pivodic, Berg Karin, Jenny Wallander, Lois Smith, Eva Larsson, Despina Tsamadou, Karin Sandgren Hochhard, Kristina Teär Fahnehjelm, Lotta Gränse, Gerd E Holmstrom, Ann Hellström, Pia Lundgren","doi":"10.1136/bmjophth-2026-002727","DOIUrl":"10.1136/bmjophth-2026-002727","url":null,"abstract":"<p><strong>Background/aims: </strong>This study represents an external validation with model updating of the online DIGIROP-Prescreen and DIGIROP-Screen 2.0 prediction models, incorporating ≥14 days of parenteral nutrition as an additional predictor, to identify infants requiring treatment for retinopathy of prematurity (ROP) in a contemporary Swedish cohort, estimate potential cost savings and compare DIGIROP performance with other models.</p><p><strong>Methods: </strong>Infants born in Sweden, 2021<b>-</b>2023 (n=1530) were evaluated. ROP and neonatal data were retrieved from Swedish quality registers. Sensitivity, specificity and the area under the receiver operating characteristic (AUC) curve were calculated. In the Västra Götaland Region cohort (n=245), the DIGIROP models were compared with WINROP and two Postnatal Growth and ROP (G-ROP) models. We estimated DIGIROP models' cost-saving.</p><p><strong>Results: </strong>The mean gestational age was 27.7 (SD 2.2) weeks, birth weight 1029 (SD 317) g, 689 (45.0%) were girls and 85 (5.6%) infants received ROP treatment. For DIGIROP-Prescreen 2.0, the AUC was 0.89 (95% CI 0.86 to 0.92), sensitivity was 100% (95% CI 95.8% to 100%) and specificity 27.5% (95% CI 25.3% to 29.9%). For DIGIROP-Screen 2.0, the cumulative specificity increased from 27.7% to 67.8% between postnatal weeks 6-14, with a sensitivity of 100%. In total, ∼Int$750 000 could have been saved in screening costs in Sweden during 2021-2023 using DIGIROP models. DIGIROP-Screen at postnatal age 10 weeks had the same sensitivity but higher specificity than G-ROP. WINROP showed lower sensitivity but the highest specificity.</p><p><strong>Conclusion: </strong>DIGIROP 2.0 demonstrated high sensitivity and the most robust discrimination for treatment-requiring ROP in a contemporary Swedish cohort, compared with other models, with the potential to reduce unnecessary eye examinations and healthcare costs.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608252","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":"Cystoid macular oedema after trabeculectomy versus tube shunt surgery in non-diabetic patients.","authors":"Abdelrahman M Elhusseiny, Hashem Abu Serhan, Taher K Eleiwa, Mohammad Ayoubi, Reem H ElSheikh, Muhammad Z Chauhan, Sami H Uwaydat, Mohsen Adelpour, Richard K Lee","doi":"10.1136/bmjophth-2025-002497","DOIUrl":"10.1136/bmjophth-2025-002497","url":null,"abstract":"<p><strong>Aim: </strong>To compare the hazard of postoperative cystoid macular oedema (CME) between trabeculectomy and tube shunt implantation, focusing exclusively on non-diabetic patients to minimise confounding factors.</p><p><strong>Methods: </strong>This is a retrospective cohort study using the TriNetX United States Collaborative Network. Patients with glaucoma who underwent trabeculectomy or tube shunt surgery were identified via International Classification of Diseases, 10th Revision and Current Procedural Terminology codes. Propensity score matching (PSM) was used to balance baseline characteristics. The primary outcome was the hazard of CME at 1 and 3 months postoperatively. Adjusted HRs (aHRs) were calculated using Cox proportional hazards models.</p><p><strong>Results: </strong>After 1:1 PSM, 2928 patients were included in each cohort. At 1 month, CME was significantly less frequent in the trabeculectomy group (1.15%) compared with the tube shunt group (1.85%) (p=0.02). This difference widened at 3 months, with CME rates of 2.19% in the trabeculectomy group vs 4.20% in the tube group (p<0.0001). Trabeculectomy was associated with a 35% reduction in CME hazard at 1 month (aHR: 0.64; 95% CI 0.44 to 0.94; p=0.023) and a 45% reduction at 3 months (aHR: 0.55; 95% CI 0.42 to 0.72; p<0.0001) compared with tube shunt surgery. Male sex (aHR: 1.32), topical alpha agonist use (aHR: 1.61) and macular puckering (aHR: 2.75) were independently associated with increased CME risk.</p><p><strong>Conclusions: </strong>Trabeculectomy is associated with a significantly lower hazard of postoperative CME compared with tube shunt surgery in non-diabetic glaucoma patients.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590218","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":"Challenges in ophthalmic consultations and strategic communication.","authors":"Mariantonia Ferrara, Giorgia Raguzzi, Greta Mezzetti, Antonio Simonetti, Chiara Ancona, Martina Angi, Giuseppe Querques, Mario R Romano, Carlos Rocha de Lossada, Matteo Sacchi, Anna P Salvetti, Giacomo Savini, Antonino Minervino, Luca Brambilla, Vito Romano","doi":"10.1136/bmjophth-2025-002691","DOIUrl":"10.1136/bmjophth-2025-002691","url":null,"abstract":"<p><strong>Objective: </strong>To explore communication challenges in ophthalmic consultations from both patient and clinician perspectives, and to introduce 'Strategic Communication' as a structured, evidence-based approach aimed at enhancing patient-provider interactions and improving clinical outcomes.</p><p><strong>Methods and analysis: </strong>Multicentre mixed-method study involving online focus discussion groups and surveys. Eight ophthalmologists and eight patients recruited through the Italian national ophthalmic patient association participated in focus groups moderated by a health communication expert. These discussions explored communication challenges and potential solutions, based on participants' experience. Transcripts were thematically analysed by two independent researchers to identify key challenges and actionable insights. In parallel, quantitative data were collected via two structured questionnaires completed by 139 European ophthalmologists and 184 patients.</p><p><strong>Results: </strong>Key themes included patients' limited understanding of their conditions, often influenced by misleading online information, and their strong preference for clear, empathetic communication. Clinicians reported that time constraints in public healthcare limited opportunities for meaningful dialogue, while the involvement of family members further complicated interactions. The 'Strategic Communication' framework, particularly the O.D.I. Method (Observe, Demand, Intervene), emerged as a structured framework for tailoring communication strategies to individual needs.</p><p><strong>Conclusion: </strong>'Strategic Communication' offers a systematic, conceptual, theory-informed approach to address communication challenges in ophthalmology, with potential relevance for patient-centred care helping structured clinician-patient communication in ophthalmology. The present findings support its practical applicability. Future studies are needed to evaluate its impact on clinical and patient-reported outcomes.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590265","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":"Carotid intima-media thickness in relation to primary open-angle glaucoma: epidemiological and structural evidence from a cross-sectional study.","authors":"Zhiqian Huang, Yu Du, Bo Ma, Jiao Qi, Yi Lu, Xiangjia Zhu","doi":"10.1136/bmjophth-2025-002704","DOIUrl":"10.1136/bmjophth-2025-002704","url":null,"abstract":"<p><strong>Objective: </strong>Keen interest exists in the relationship between carotid atherosclerosis and primary open-angle glaucoma (POAG), with prior studies yielding inconsistent findings. This study aims to quantify the association between carotid intima-media thickness (CIMT) and POAG using data from a large cohort.</p><p><strong>Methods and analysis: </strong>In this cross-sectional analysis, we used data from 47 595 participants in the UK Biobank. CIMT was assessed using carotid ultrasound, while POAG was diagnosed based on health records and self-reported information. Logistic regression was used to detect CIMT-POAG association, after adjusting for potential confounders. Additionally, relationships with POAG-related endophenotypes, including intraocular pressure (IOP), macular retinal nerve fibre layer (mRNFL) thickness, macular ganglion cell-inner plexiform layer thickness and retinal vascular features, were examined through linear regression.</p><p><strong>Results: </strong>A greater CIMT, evaluated per SD increment, was associated with a 10% increased risk of POAG (OR 1.10, p=0.004). The CIMT-POAG relationship exhibited an approximately linear pattern (p non-linear=0.797). This association was more pronounced in women (OR 1.18, p=0.003) and in individuals with a high genetic predisposition to POAG (OR 1.14, p=0.004). Furthermore, higher CIMT was significantly correlated with increased IOP (β=0.14, p=0.007) and decreased mRNFL thickness (β=-0.16, p=0.030). Additionally, higher CIMT was found to co-occur with retinal vascular impairments, including a decrease in fractal dimension, an increase in vessel tortuosity and a narrower central retinal arteriole (all false discovery rates<0.05).</p><p><strong>Conclusion: </strong>This study observes an association between increased CIMT and POAG, especially in women and individuals with genetic susceptibility. These findings suggest that CIMT may be a useful biomarker with potential clinical relevance and propose possible vascular mechanisms underlying disease progression.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13007174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479685","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":"Forecasting regional disparities in cataract surgery demand and ophthalmologist supply in Japan: a prefecture-level forecasting study.","authors":"Hiroshi Yamaguchi, Larbi Aluariachy, Retsu Fujita","doi":"10.1136/bmjophth-2025-002685","DOIUrl":"10.1136/bmjophth-2025-002685","url":null,"abstract":"<p><strong>Objective: </strong>Cataracts are the leading cause of poor vision in Japanese adults. As Japan's population is rapidly ageing, the demand for cataract surgery will continue to increase. Despite this, quantitative research evaluating both supply and demand of cataract surgery is lacking. The objective of this study was to forecast future cataract surgery demand and the supply of ophthalmologists in Japan by region and evaluate the cataract surgery demand-supply balance considering regional differences in demographics and medical resources.</p><p><strong>Methods and analysis: </strong>Based on the Ministry of Health, Labour and Welfare's 'NDB Open Data', age-specific and sex-specific cataract surgery rates were calculated from the number of billed procedures. These rates were applied to the Ministry of Internal Affairs and Communications' 'Population Estimates' and National Institute of Population and Social Security Research's 'Future Population Projections' to estimate demand for 2030, 2040 and 2050. Future supply of ophthalmologists was estimated using linear regression based on data from the 'Survey of Physicians, Dentists, and Pharmacists'. The demand-supply ratio (demand divided by supply) was calculated for each prefecture. The demand-supply ratio multiplier for each year was calculated using 2022 as the base year.</p><p><strong>Results: </strong>The estimated number of cataract surgeries was 1 929 848 in 2030, 2 373 260 in 2040 and 2 863 733 in 2050, with a significant increase projected for individuals in their 70s and aged 80+. Although most prefectures were expected to see a gradual increase in ophthalmologist numbers, a decrease was projected for some regional areas. Consequently, the demand-supply ratio was projected to increase nationwide, with a larger increase in regional areas, suggesting a widening disparity between regional and metropolitan areas.</p><p><strong>Conclusion: </strong>Demand for cataract surgery would continue to rise, potentially increasing demand-supply imbalances, particularly in regions with ageing populations. Re-examination of the regional allocation of medical resources is necessary to correct disparities in access to treatment. These projections are subject to limitations related to the use of publicly available data and assumptions based on past trends, which may not fully reflect regional practice variation or future changes in surgical capacity.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347244","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":"Consensus on evidence gaps and unmet needs in childhood myopia: findings from a European Delphi study with eye care professionals and payers.","authors":"Wolf Lagreze, Paolo Nucci, Matthijs Versteegh, Caroline Klaver, Jesús Barrio-Barrio, Annegret Dahlmann-Noor, Rosario Gomez de Liaño, Neema Ghorbani-Mojarrad, Line Kessel, Jan Roelof Polling, Arnaud Sauer, Alexander K Schuster, Massimiliano Serafino, Edoardo Villani, Focke Ziemssen, Yvonne-Beatrice Boehler, Stefano Capri, Fabrizio Gianfrate, Joan-Antoni Valles Callol, Olivier Wong, Ting-Yen Chen, Christina Lymperopoulou, Ioanna Palaka, Yogesh Punekar, Dorothea von Bredow, Kun Shi-van Wielink","doi":"10.1136/bmjophth-2025-002569","DOIUrl":"10.1136/bmjophth-2025-002569","url":null,"abstract":"<p><strong>Background/aims: </strong>Childhood myopia is a growing global concern, associated with significant burdens. This study aimed to identify evidence gaps and unmet needs in childhood myopia management through a European Delphi panel involving eye care professionals (ECPs) with expertise in childhood myopia management and payers (ie, individuals with experience in health technology assessment, healthcare funding, drug pricing and/or reimbursement decisions).</p><p><strong>Methods: </strong>A modified Delphi method was employed, involving two rounds of online questionnaires followed by a final virtual workshop. The panel included 12 ECPs and 13 payers from seven European countries. Consensus was defined as ≥70% agreement among panellists.</p><p><strong>Results: </strong>Consensus was achieved on all 37 statements across six categories: disease background, clinical burden, psychosocial/humanistic burden, economic burden, treatment options and unmet needs. Key findings included recognition of ethnicity and age as crucial factors in evaluating childhood myopia, as well as the minimal clinically important difference for progression reduction. The panel emphasised the need for long-term studies on the efficacy and safety of myopia treatments, especially their impact on reducing future complications. The impact of high myopia on quality of life and economic burden was also highlighted. Regarding unmet needs, despite some known factors, the exact mechanisms behind myopia development remain unclear. There is a need for comprehensive epidemiological data on European childhood myopia and regulatory-approved pharmacological treatments in Europe.</p><p><strong>Conclusions: </strong>Consensus was reached among European ECPs and payers on the evidence gaps and unmet needs in childhood myopia management. These findings can guide future research to establish the best strategies for childhood myopia management and mitigate the burden.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347210","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}