BMJ Open Ophthalmology最新文献

{"title":"Systematic review of genotype-phenotype associations in <i>CRX</i>-associated retinal dystrophies.","authors":"Malak Banjak, Jinane Noureldine, Zahraa Mousawi, Joseph Nehme, Lama Jaffal, Said El Shamieh","doi":"10.1136/bmjophth-2024-002030","DOIUrl":"10.1136/bmjophth-2024-002030","url":null,"abstract":"<p><strong>Background and objectives: </strong><i>CRX</i>-associated retinal dystrophies (<i>CRX</i>-RDs) exhibit significant genotype-phenotype heterogeneity. This study aimed to elucidate the genotype-phenotype associations of <i>CRX</i> through a systematic analysis of the reported cases.</p><p><strong>Methods: </strong>84 studies, including 373 worldwide participants, were reviewed. These studies were checked for quality using Murad's tool for methodological quality and synthesis of case series and case reports. Clinical data, fundus imaging characteristics and genetic pathogenic variants were analysed.</p><p><strong>Results: </strong>The quality analysis revealed an overall good quality of the dataset, with some exceptions that do not detract from this trend. A predominance of cone-rod dystrophy (CRD) and Leber congenital amaurosis (LCA) among <i>CRX</i>-RDs (43% and 27%, respectively) was noted. Missense pathogenic variants were significantly associated with macular pigmentation, an absence of peripheral atrophy, an absence of peripheral pigmentation and CRD (p<0.05). In contrast, the indels (98% frameshifts) were associated with pale optic discs, attenuated optic vessels, and peripheral bone spicules, and more severe phenotypes, such as LCA (p<0.05). Pathogenic variants in the homeodomain were associated with cone and/or CRD; others in the OTX tail were linked to LCA.</p><p><strong>Conclusion: </strong><i>CRX</i> pathogenic variants are associated with specific phenotypic features.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708622","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":"What do we know about premyopia and should we be giving it greater consideration?","authors":"Neema Ghorbani-Mojarrad, Xiaotong Han, Noora Dbayat, Xiaohu Ding","doi":"10.1136/bmjophth-2024-002059","DOIUrl":"10.1136/bmjophth-2024-002059","url":null,"abstract":"","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691296","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":"Predicting OCT retinal ganglion cell volume from pattern ERGs and VEPs in children with suspected optic neuropathy in a tertiary referral setting.","authors":"Dorothy A Thompson, Katrina L Prise, Lisa Tucker, Dermot Roche, Richard Bowman, Benjamin E W Evans, Sian Handley, Oliver R Marmoy","doi":"10.1136/bmjophth-2024-001899","DOIUrl":"10.1136/bmjophth-2024-001899","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the relationship between retinal ganglion cell (RGC) structure, measured by optical coherence tomography (OCT), and function measured by electrodiagnostic tests in children with suspected optic neuropathy.</p><p><strong>Methods: </strong>Children presenting consecutively with suspected optic neuropathy were investigated by visual electrophysiology. ISCEV Standard monocular pattern reversal visual evoked potential (PVEP) P100 and pattern electroretinogram (PERG) P50 and N95, amplitudes and peak times were collected, along with the N95 slope 30 ms after the P50 peak. OCT retinal nerve fibre layer (RNFL) thickness from each peripapillary sector and the average macular RGC volume in a 3.45 mm diameter circle were collated. The sensitivity (SENS) and specificity (SPEC) of abnormal visual electrophysiology measures in predicting OCT structural measures were estimated by receiver operating characteristic (ROC) area under the ROC curve (AUC).</p><p><strong>Results: </strong>Monocular PVEPs and PERGs from 30-degree stimulus fields and OCT RNFL and RGC volume were available from 42 children (84 eyes) aged 5.5-16.3 years (median 12.4 years). PVEP AUC was highest for predicting both RGC macular volume and temporal RNFL thinning (SENS 88%, SPEC 88%), followed by the PERG N95 slope (SENS 79%, SPEC 78%). PERG N95:P50 had the lowest SENS of 62% and SPEC of 61%, which were similar for all RNFL sectors.</p><p><strong>Conclusion: </strong>Abnormal PERG N95 slopes and PVEPs predicted severe loss of macular RGC volume and temporal sector RNFL with high diagnostic accuracy. These measures are important additions to the less specific PERG N95:P50, which was broadly sensitive to all RNFL sectors. The N95 slope and PVEPs are valuable objective functional markers of RGC health in children.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691294","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 plasma metabolites with treatment response after intravitreal anti-vascular endothelial growth factor injections in treatment-naïve neovascular age-related macular degeneration.","authors":"Hae Min Kang, Kevin M Mendez, Inês Laíns, Krupa Sourirajan, Roshni Bhat, Archana Nigalye, Raviv Katz, Georgiy Kozak, Hanna Choi, Augustine Bannerman, Rodrigo A Alvarez, David Wu, Ivana K Kim, Liming Liang, John B Miller, Demetrios G Vavvas, Joan W Miller, Jessica Lasky-Su, Deeba Husain","doi":"10.1136/bmjophth-2025-002149","DOIUrl":"10.1136/bmjophth-2025-002149","url":null,"abstract":"<p><strong>Background/aims: </strong>To investigate the association between plasma metabolomic profiles and treatment response after intravitreal anti-vascular endothelial growth factor (VEGF) injections in treatment-naïve neovascular age-related macular degeneration (nAMD).</p><p><strong>Methods: </strong>This is part of a prospective longitudinal study that included patients with treatment-naïve nAMD who have undergone three loading intravitreal anti-VEGF injections. All patients underwent ophthalmological examinations including spectral domain optical coherence tomography (SD OCT). Fasting blood samples were collected at the time of study enrolment (not to first anti-VEGF injection) and metabolomic profiling was conducted using ultra-performance liquid chromatography-mass spectrometry. Treatment response was defined as no evidence of any subretinal and intraretinal fluid on SD OCT 4-6 weeks after the third injection. Multilevel mixed-effects linear modelling was used to assess associations between plasma metabolites and treatment response. Multiple comparisons were accounted for using the effective number of tests to explain 80% of the variance (ENT80), with a p value threshold of 0.0017.</p><p><strong>Results: </strong>We included 131 eyes of 101 patients, and 69 patients (68.3%) were female. 51 eyes (38.9%) were treatment responders. Taurodeoxycholate (TDCA) was the only plasma metabolite significantly associated with treatment response (β=1.6, ENT80=0.001).</p><p><strong>Conclusion: </strong>In our study, TDCA was the most significant plasma metabolite associated with treatment response after three-loading dose of anti-VEGF therapy in patients with nAMD. Bile acids may have a beneficial impact on treatment response in nAMD through their neuroprotective property. Plasma metabolites may be used as biomarkers to predict responses to initial anti-VEGF therapy in patients with nAMD, providing a more individualised treatment plan.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639533","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":"First results of direct selective laser trabeculoplasty for the treatment of glaucoma.","authors":"Michele Lanza, Luigi Serra, Rosa Boccia, Teresa Cangiano, Italo Fattore, Salvatore Ambrosio, Francesca Simonelli","doi":"10.1136/bmjophth-2024-001922","DOIUrl":"10.1136/bmjophth-2024-001922","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the efficacy and safety of direct selective laser trabeculoplasty (DSLT) on eyes with primary open-angle glaucoma (POAG) and on primary angle closure glaucoma (PACG) eyes at 1 year follow-up.</p><p><strong>Methods: </strong>In this study, 54 patients affected by POAG (76) or PACG (28) undergoing DSLT were enrolled, for a total of 104 eyes. Before each treatment and at each follow-up visit, all subjects underwent a complete eye visit, including the collection of data regarding the number and type of topical medications prescribed for glaucoma. The patients treated underwent 30-2 standardised automated perimetries prior to DSLT, at 6 months and 12 months post DSLT procedure. Each patient was checked at 1 week and subsequently at 1, 3, 6 and 12 months.</p><p><strong>Results: </strong>At 1 month follow-up, both the eyes affected by POAG and those affected by PACG showed significantly (p<0.01) lower mean intraocular pressure (IOP) (-3.67±2.95 mm Hg and -3.93±2.36 mm Hg, respectively) and lower mean number of IOP-lowering topical drugs taken (-0.62±0.57 and -0.78±0.64, respectively) after DSLT. These reductions remained significant until the 1 year follow-up, both for IOP (-3.76±2.84 mm Hg and 3.67±2.46 mm Hg, respectively) and for drugs assumed (-0.79±0.53 and 0.96±0.47, respectively). The mean deviation mean values showed perimetry stability both in POAG and in PACG eyes at 1 year follow-up. No major complications were observed in the eyes included in this study.</p><p><strong>Conclusions: </strong>Although this study has some limitations such as the retrospective design, the lack of comparison with standard selective laser trabeculoplasty (SLT) and the relatively short follow-up, the results observed require confirmation through further studies, with extended follow-up and larger cohorts. This study suggests that DSLT would be a useful tool for the management of patients with glaucoma.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639534","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":"Identifying potential key metabolic pathways and biomarkers in glaucoma: a systematic review and meta-analysis.","authors":"Navid Golpour, Rune L Brautaset, Flora Hui, Maria Nilsson, Jonas E Svensson, Pete A Williams, James R Tribble","doi":"10.1136/bmjophth-2024-002103","DOIUrl":"10.1136/bmjophth-2024-002103","url":null,"abstract":"<p><strong>Background: </strong>Glaucoma, a leading cause of irreversible blindness worldwide, is characterised by retinal ganglion cell degeneration. Increasing evidence points to metabolic dysfunction, particularly mitochondrial dysfunction, as a contributing factor to glaucomatous neurodegeneration. This systematic review and meta-analysis aimed to identify key metabolic pathways and biomarkers associated with primary open-angle glaucoma (POAG).</p><p><strong>Methods: </strong>A systematic literature search was conducted to identify studies measuring metabolites in plasma and aqueous humour from patients with POAG using metabolomics techniques. Enrichment analyses for significantly increased metabolites were conducted using MetaboAnalyst. Meta-analyses were performed using random-effects models to calculate effect sizes for metabolites reported in at least three studies.</p><p><strong>Results: </strong>17 studies involving patients with POAG were included. Pathway analysis revealed significant enrichment of the arginine and proline metabolism pathway in both aqueous humour and plasma. Additionally, the phenylalanine metabolism pathway was enriched in plasma. These pathways are associated with oxidative stress and neurodegeneration, both of which are key factors in POAG pathology. Meta-analysis identified several significantly elevated metabolites, including lysine, glutamine, alanine, histidine, carnitine and creatinine in aqueous humour, as well as methionine in plasma.</p><p><strong>Conclusions: </strong>This study underscores the central role of metabolic dysfunction in POAG, highlighting specific metabolites and pathways that could serve as biomarkers for early diagnosis and therapeutic intervention. Future research should prioritise longitudinal studies and untargeted metabolomic profiling to further deepen our understanding of metabolic changes and their contributions to glaucoma progression.</p><p><strong>Prospero registration number: </strong>CRD42024512098.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630065","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":"Postnatal growth and metabolic blood biomarkers in preterm infants developing reversible retinopathy of prematurity.","authors":"Dorte Aalund Olsen, Aneta Aleksandra Nielsen, Frederik Sørensen, Julie Lyng Forman, Ivan Brandslund, Gorm Greisen, Carina Slidsborg","doi":"10.1136/bmjophth-2024-001975","DOIUrl":"10.1136/bmjophth-2024-001975","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate predictive potential of growth and metabolic blood biomarkers in the development of milder, reversible retinopathy of prematurity (ROP) stages.</p><p><strong>Methods: </strong>Biomarkers were obtained from blood samples collected every second postnatal week in a prospective, longitudinal cohort study including 108 infants born with a gestational age (GA) <32 weeks in four hospitals in the Capital Region of Denmark, 2018-2019. ROP diagnoses were obtained from the electronic medical record system together with demographic, clinical and laboratory data. Measurement of glucose was summarised as mean and SD for every postnatal week and growth was summarised as increment in weight, head circumference (biparietal diameter) and length every postnatal week. The predictive potential of each biomarker and each marker of growth in turn were evaluated in univariate receiver operating characteristics curve analyses and in multivariate analyses including GA and small for gestational age (SGA) as known predictors.</p><p><strong>Results: </strong>The strongest isolated postnatal predictor of ROP was weight gain at the second postnatal week with an area under the curve (AUC) of 0.80 (95% CI: 0.70 to 0.89). However, it only added insignificantly to the AUC (0.85; 95% CI: 0.76 to 0.93, adj. p=0.89) compared with GA and SGA alone (AUC=0.80, 95% CI: 0.70 to 0.90). Mean glucose in PNA weeks 1-4, glycaemic variability as measured by glucose SD weeks 1-3 PNA, and concentrations of adiponectin/glucose (mean) ratio were also associated with ROP diagnosis (AUCs ranging from 0.679 to 0.77) but did also not contribute significantly to the AUC compared with GA and SGA alone.</p><p><strong>Conclusions: </strong>Postnatal growth and metabolic blood biomarkers were significantly associated with milder, reversible ROP, but none of these gave prediction over and above GA and SGA. Due to the small sample sizes, potential predictors could only be investigated in univariate analyses. Larger studies are needed to fully explore the predictive potential of all the biomarkers.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630197","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":"Estimation of normal and glaucomatous optic nerve morphology from perfusion.","authors":"Eduardo Jerez-Olivera, Marta Gonzalez-Hernandez, Daniel Gonzalez-Hernandez, Manuel Gonzalez de la Rosa","doi":"10.1136/bmjophth-2024-002024","DOIUrl":"10.1136/bmjophth-2024-002024","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the optic nerve head morphology from its haemoglobin (Hb) distribution.</p><p><strong>Methods and analysis: </strong>The optic disc of 189 normal eyes and 292 with confirmed and suspected glaucoma were analysed with Spectralis-OCT and the Laguna ONhE application using the Topcon NW400 fundus camera. Topographic Hb values were correlated with OCT tissue thicknesses from Bruch's membrane. The neuroretinal rim volume (RV), the cup volume (CV) and their relation to the globin distribution function (GDF) index of Laguna ONhE were analysed. The results were applied to 1 163 241 optic nerve images obtained in a glaucoma screening setting. Differences in segmentation and the presence of vessels without local nutritional function are the main limitations of the comparison.</p><p><strong>Results: </strong>The correlation between local Hb density and the tissue thicknesses from Bruch's membrane was R=0.953 (p<0.0001). RV could be estimated from pixel-to-pixel Hb values with an R=0.650 (p<0.0001) and from six Laguna ONhE indices with an R=0.786 (p<0.0001). CV could be estimated with an R=0.762 (p<0.0001). RV had a mean value of 0.396 mm³ (SD=0.187) for positive GDF values and usually below 0.210 mm³ for negative GDF. The distribution of RV values in the screening series was congruent with that found in the prospective series, with a higher value in large nerves.</p><p><strong>Conclusions: </strong>The volume and shape of the optic nerve tissue are closely related to its perfusion and can be deduced from it. The relationship between the RV and GDF is curvilinear and suggests that perfusion measurement may bring the diagnosis forward in earlier stages.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555883","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":"Safety and efficacy of frequency-doubled Nd-YAG laser photocoagulation of different types of corneal neovascularisation (NLPC): a prospective study.","authors":"Keerti Wali, Shilpa Maled, Ronak Solanki, Apoorva G Ayachit, Aniket N Shastri","doi":"10.1136/bmjophth-2024-001734","DOIUrl":"10.1136/bmjophth-2024-001734","url":null,"abstract":"<p><strong>Purpose: </strong>Frequency doubling of neodymium-doped yttrium aluminum garnet (Nd-YAG) laser results in emission of photocoagulating 532 nm light compared with photolytic 1064 nm emission. The ergonomic benefits of solid-state lasers led to replacement of older coagulating lasers in ophthalmic centres by frequency-doubled Nd-YAG laser. Our study aims to evaluate safety and efficacy of frequency-doubled Nd-YAG laser for photocoagulation of corneal neovascularisation (NLPC).</p><p><strong>Methods: </strong>30 quiet eyes of 28 patients with superficial, mid-stromal and deep stromal inactive corneal neovascularisation were subjected to laser photocoagulation. Resolution of vessels, procedural complications and survival of subsequent corneal grafts were monitored for 3 months. Anterior segment fluorescein angiography (AS-FA) was performed in six eyes to confirm the cessation of blood flow.</p><p><strong>Results: </strong>20 eyes (66.66%) had complete resolution of neovascularisation. 13 cases of superficial (92.86%) and 6 cases of mid-stromal neovascularisation (75%) showed significant resolution, compared with 1 case of deep neovascularisation (12.5%). Minimal corneal burn (n=4, 13.33%), iris holes (n=3, 10%), anterior chamber bubbles (n=5, 16.67%), self-resolving intrastromal bleed (n=2, 6.67%) and graft-host junctional wound leak (n=1 of 12 keratoplasty cases, 8.33%) were noted.</p><p><strong>Conclusion: </strong>NLPC may especially be useful in the eyes with a large vessel arborising within stroma. Lack of comparison with other treatment options leading to inflated safety and efficacy profile of NLPC is the major limitation of this study.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540318","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":"Cornea specialists are the highest opioid prescribers at a large academic eye institute in the USA.","authors":"Nikolay Boychev, Lisa Y Lin, Laurel T Tainsh, Sue A Aicher, Anat Galor, Joseph B Ciolino","doi":"10.1136/bmjophth-2024-002012","DOIUrl":"10.1136/bmjophth-2024-002012","url":null,"abstract":"<p><strong>Background/aim: </strong>To evaluate the opioid prescription patterns across ophthalmic subspecialties at a large academic eye centre.</p><p><strong>Methods: </strong>A single site, retrospective cross-sectional study. Electronic medical records from the year 2018 were screened. Ophthalmology patients ≥18 years of age were included. The main outcome measures were patient demographics, outpatient opioid prescriptions, ophthalmic procedure and prescriber details, including department and training level.</p><p><strong>Results: </strong>1654 opioid prescriptions were written, accounting for 2.2% of all ophthalmic procedures in a calendar year. Of the patients who received prescriptions, 51.4% were female (n=851) with a mean age of 52.3±18.5 (range 18-95 years). In general, the morphine equivalent dose was low, with an average of 12.4±6.75 pills dispensed (range 1-60) with 0.0±0.01 refills (range 0-3). Cornea specialists were the highest opioid prescribers (22.7% of all providers who wrote a prescription), followed by oculoplastics (22.2%) and retina (18.4%). The most common procedure for which an opioid was prescribed was cornea crosslinking (14.3% of all opioid prescriptions).</p><p><strong>Conclusions: </strong>While opioid prescriptions are generally low for ophthalmic procedures across departments, cornea specialists accounted for nearly a third of opioid prescriptions. Over half of corneal crosslinking patients received opioid prescriptions; there remains an unmet need for opioid-sparing therapy for these patients and others with severe eye pain.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540314","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}