BMJ Open Ophthalmology最新文献

{"title":"Willingness to donate eyes and associated factors among adults in Addis Ababa City, Ethiopia: a mixed-methods approach.","authors":"Wubalem Addis Tefera, Hirut Gebremeskel Mengistu, Ejigu Gebeye Zeleke, Merkineh Markos Lorato","doi":"10.1136/bmjophth-2024-002022","DOIUrl":"10.1136/bmjophth-2024-002022","url":null,"abstract":"<p><strong>Objective: </strong>This study intended to assess willingness to donate eyes and associated factors among adults in Addis Ababa City, Ethiopia.</p><p><strong>Methods and analysis: </strong>This study used a triangulated phenomenological mixed-methods design, involving 1293 adults and eight key informants selected through multistage and purposive sampling. Data collection involved a pretested, semistructured questionnaire for quantitative data and an open-ended guiding questionnaire for qualitative insights. Ethical approval was granted by the University of Gondar, School of Medicine ethics review committee. The data were entered into Epi Info V.7 and analysed using SPSSV.22, with bivariable and multivariable binary logistic regression employed to identify significant factors, defined as those with a p value under 0.05. Qualitative data were analysed through thematic content analysis using code software, which included transcription, translation, coding and thematisation, ultimately enriching the quantitative findings.</p><p><strong>Results and conclusion: </strong>The study found that 47.2% (95% CI 44.7, 50.0) participants were willing to donate their eyes. Significant factors influencing willingness included being male (adjusted OdR (AOR)=1.55; 95% CI 1.18, 2.03), being a Christian (AOR=2.08; 95% CI 1.42, 3.04), having a family or friends awaiting for corneal transplantation (AOR=1.78; 95% CI: 1.18, 2.68), completing higher education (AOR=2.63; 95% CI 1.88, 3.69), completing secondary education (AOR=1.77; 95% CI 1.03, 3.04), having a favourable attitude towards eye donation (AOR=4.97; 95% CI 3.70, 6.66) and being aware of eye donation (AOR=3.12; 95% CI 2.23, 4.36). Qualitative analysis indentified barriers such as lack of information, poor attitudes and religious restrictions.Overall, willingness to donate eyes was moderate compared to previous studies. The findings emphasise the need for community education to improve public attitudes and awareness about eye donation to enhance willingness to donate eyes.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058012","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 arterial stiffness and eye disease: a systematic review and meta-analysis.","authors":"Angela L Beros, John D Sluyter, Robert Scragg","doi":"10.1136/bmjophth-2024-001980","DOIUrl":"10.1136/bmjophth-2024-001980","url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-analysis assesses the association of arterial stiffness with age-related macular degeneration (AMD), glaucoma, retinal vein occlusion (RVO) and retinopathy (diabetic and hypertensive).</p><p><strong>Methods: </strong>Medline and Embase were systematically searched for observational studies of arterial stiffness and eye disease. Cohort studies were included if they estimated arterial stiffness using any measures based on the arterial waveform, with cross-sectional and case-control studies limited to measures of pulse wave velocity. We assessed the certainty of evidence using Grading of Recommendations, Assessment, Development and Evaluation.</p><p><strong>Results: </strong>The systematic review of 61 studies (six for AMD, ten for glaucoma, six for RVO and 39 for retinopathy) showed that arterial stiffness overall was higher in people with eye disease than people without eye disease. Forty-four cross-sectional and case-control studies were included in the meta-analysis. Arterial stiffness estimated by way of pulse wave velocity was associated with AMD (mean difference: 0.92 m/s, 95% CI 0.37 to 1.46; 2 studies; n=381; low certainty evidence), glaucoma (mean difference: 0.97 m/s, 95% CI 0.31 to 1.64; 7 studies; n=3418; low certainty evidence), RVO (mean difference: 2.79 m/s, 95% CI 2.02 to 3.55; 5 studies; n=414; very low certainty evidence) and retinopathy (1.48 m/s, 95% CI 0.1.16 to 1.81; 22 studies; n=10 074; low certainty evidence). The 19 cohort studies identified (five for AMD, three for glaucoma, one for RVO and 10 for retinopathy) indicated overall that increased arterial stiffness was associated with the future development of eye disease.</p><p><strong>Conclusions: </strong>Higher arterial stiffness is associated with AMD, glaucoma, RVO and retinopathy PROSPERO REGISTRATION NUMBER: CRD42019129563.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037243","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":"Effect of ethnicity and other sociodemographic factors on attendance at ophthalmology appointments following referral from a Diabetic Eye Screening Programme: a retrospective cohort study.","authors":"James Banks, Abraham Olvera-Barrios, Matilda Pitt, Daisy Williams, Michael Seltene, Celestine Rutowska, Mumina Khatun, Josef Huemer, Yasir Khan, Zoe Ockrim, Ling Zhi Heng, Alicja R Rudnicka, Adnan Tufail, Catherine A Egan, Christopher G Owen","doi":"10.1136/bmjophth-2024-001969","DOIUrl":"10.1136/bmjophth-2024-001969","url":null,"abstract":"<p><strong>Background/aims: </strong>To examine the association between sociodemographic characteristics and attendance at Hospital Eye Service (HES) referrals from the Diabetic Eye Screening Programme (DESP), in a large, ethnically diverse urban population.</p><p><strong>Methods: </strong>Retrospective cohort study (4 January 2016-12 August 2019) of people with diabetic retinopathy (DR) referred from an English DESP to a tertiary referral eye hospital. We conducted a multivariable logistic regression with attendance as the primary outcome, controlling for age, sex, ethnicity, Index of Multiple Deprivation, best eye visual acuity and baseline DR grade.</p><p><strong>Results: </strong>Of 7793 people referred (mean age 64 years, 62.6% male, 13.9% white, 12.5% black, 25.3% South Asian, 6.5% any other Asian background, 19.3% no recorded ethnicity and 20.9% of 'Other' ethnic origin), 69% attended. Compared with white individuals, people of black ethnic origin were similarly likely to attend. South Asians and those of other Asian backgrounds were more likely, and people with 'Other' or missing ethnicity were less likely to attend. Those with higher levels of deprivation, younger (aged 18-45 years) and older (76-90 years) age groups and worse visual acuity were less likely to attend, whereas people identified as having proliferative DR in both eyes were more likely to attend.</p><p><strong>Conclusion: </strong>Sociodemographic patterns in attendance after referral from the DESP to the HES exist, and these do not appear to explain ethnic differences in more severe sight-threatening DR, suggesting other explanations. More work is needed to understand and reduce inequalities in HES attendance.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022051","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":"Comparative evaluation of funduscopy, PCR and serology in the diagnosis of ocular toxoplasmosis at ECWA Eye Hospital, Kano.","authors":"Biodun Bintu Adebakin, Mayor Orezime Atima, Ugbede Idakwo, Jamilu Abubakar Bala, Alhasan Sharif Abdullahi, Auwal Bello Muhammad, Jah Douglas Pam, Emeka John Dingwoke, Florence Olufunke Darda","doi":"10.1136/bmjophth-2024-002023","DOIUrl":"10.1136/bmjophth-2024-002023","url":null,"abstract":"<p><strong>Objective: </strong>Ocular toxoplasmosis, caused by <i>Toxoplasma gondii</i>, is a significant cause of posterior uveitis and vision impairment globally. Accurate diagnosis is essential to prevent retinal damage and optimise treatment. This study aimed to compare three diagnostic methods funduscopy, serology (ELISA), and PCR in detecting ocular toxoplasmosis in patients at ECWA Eye Hospital, Kano, Nigeria.</p><p><strong>Methods and analysis: </strong>A total of 264 patients suspected of having ocular toxoplasmosis were enrolled. Funduscopy was performed to identify retinal lesions typical of <i>T. gondii</i>. Serological analysis was conducted using ELISA to detect anti-<i>Toxoplasma</i> IgG antibodies. Additionally, PCR was used to confirm the presence of <i>T. gondii</i> DNA in blood samples. The results from these methods were compared with assess their sensitivity, specificity and diagnostic value.</p><p><strong>Results: </strong>Funduscopy detected <i>T. gondii</i> in 25.4% (67/264) of the patients, while ELISA showed a higher detection rate of 36.7% (97/264). PCR, the most specific method, confirmed infection in only 3.8% (10/264) of cases, with 60% (6/10) of these being male and 40% (4/10) female. <i>T. gondii</i> detected had 196 base pairs. The study found that ELISA had the highest sensitivity (90.0%) but lower specificity (64.9%), whereas funduscopy showed high specificity (74.4%) but low sensitivity (20.0%). PCR had the highest specificity but a low detection rate, emphasising its role in confirming diagnosis.</p><p><strong>Conclusion: </strong>Although ELISA and funduscopy detected more positive cases, PCR remains the gold standard for confirming <i>T. gondii</i> infection due to its high specificity. In resource-limited settings like ECWA Eye Hospital, combining serology and PCR offers a practical approach for improving diagnostic accuracy and ensuring timely treatment of ocular toxoplasmosis.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000539","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":"Deep learning-based anterior segment identification and parameter assessment of primary angle closure disease in ultrasound biomicroscopy images.","authors":"Fangting Li, Xiaoyue Zhang, Kangyi Yang, Jiayin Qin, Bin Lv, Kun Lv, Yao Ma, Xingzhi Sun, Yuan Ni, Guotong Xie, Huijuan Wu","doi":"10.1136/bmjophth-2023-001600","DOIUrl":"10.1136/bmjophth-2023-001600","url":null,"abstract":"<p><strong>Purpose: </strong>To develop an artificial intelligence algorithm to automatically identify the anterior segment structures and assess multiple parameters of primary angle closure disease (PACD) in ultrasound biomicroscopy (UBM) images.</p><p><strong>Design: </strong>Development and validation of an artificial intelligence algorithm for UBM images.</p><p><strong>Methods: </strong>2339 UBM images from 592 subjects were collected for algorithm development. A multitissue segmentation model based on deep learning was developed for automatic identification of anterior segments and localisation of scleral spur. Then, measurement of the typical angle parameters was performed from the predicted results, including angle-opening distance at 500 µm (AOD 500), trabecular-ciliary angle (TCA) and iris area. We then collected 222 UBM images from 45 subjects in two centres for model validation.</p><p><strong>Results: </strong>The multitissue identification model established in this study reached mean Intersection over Union (IoU) of 0.98, 0.98 and 0.98 on cornea segmentation, iris segmentation and ciliary body segmentation and a mean error distance of 1.07 pixels on scleral spur localisation. Our model got a mean IoU of 0.98, 0.98 and 0.99 on cornea segmentation, iris segmentation and ciliary body segmentation and a mean error distance of 0.49 pixels on scleral spur localisation in open-angle images and received 0.98, 0.98, 0.978 and 1.42 pixels respectively in angle-closure images. The mean differences between automatic and manual measurement of the angle parameters were 3.07 μm of AOD, 3.34 degrees of TCA and 0.05 mm² of iris area.</p><p><strong>Conclusions: </strong>The automatic method of multitissue identification for PACD eyes developed was feasible, and the automatic measurement of angle parameters was reliable.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000540","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":"Switching to faricimab from the current anti-VEGF therapy: evidence-based expert recommendations.","authors":"David T Wong, Shaheer Aboobaker, David Maberley, Sanjay Sharma, Pradeepa Yoganathan","doi":"10.1136/bmjophth-2024-001967","DOIUrl":"10.1136/bmjophth-2024-001967","url":null,"abstract":"<p><p>Dual inhibition of the angiopoietin (Ang)/Tie and vascular endothelial growth factor (VEGF) signalling pathways in patients with retinal diseases, such as neovascular age-related macular degeneration (nAMD) and diabetic macular oedema (DME), may induce greater vascular stability and contribute to increased treatment efficacy and durability compared with treatments that only target the VEGF pathway. Faricimab, a bispecific intravitreal agent that inhibits both VEGF and Ang-2, is the first injectable ophthalmic drug to achieve treatment intervals of up to 16 weeks in Phase 3 studies for nAMD and DME while exhibiting improvements in visual acuity and retinal thickness. Data from real-world studies have supported the safety, visual and anatomic benefits and durability of faricimab, even in patients who were previously treated with other intravitreal agents. These evidence-based expert recommendations from a panel of retina specialists consolidate current evidence with clinical experience for the optimal use of faricimab in patients with nAMD or DME, with a focus on switching from an anti-VEGF agent to faricimab.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000541","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":"Deep learning-based assessment of missense variants in the <i>COG4</i> gene presented with bilateral congenital cataract.","authors":"Binghe Xiao, Shaohua Zhang, Maierdanjiang Ainiwaer, Houyi Liu, Li Ning, Yingying Hong, Yang Sun, Yinghong Ji","doi":"10.1136/bmjophth-2024-001906","DOIUrl":"10.1136/bmjophth-2024-001906","url":null,"abstract":"<p><strong>Objective: </strong>We compared the protein structure and pathogenicity of clinically relevant variants of the <i>COG4</i> gene with AlphaFold2 (AF2), Alpha Missense (AM), and ThermoMPNN for the first time.</p><p><strong>Methods and analysis: </strong>The sequences of clinically relevant Cog4 missense variants (one novel identified p.Y714F and three pre-existing p.G512R, p.R729W and p.L769R from Uniprot Q9H9E3) were imported into AF2 for protein structural prediction, and the pathogenicity was estimated using AM and ThermoMPNN. Different pathogenicity metrics were aggregated with principal component analysis (PCA) and further analysed at three levels (amino acid position, substitution and post-translation) based on all possible Cog4 missense variants (n=14 915).</p><p><strong>Results: </strong>Localised protein structural impact including change of conformation and amino acid polarity, breakage of hydrogen bond and salt-bridge, and formation of alpha-helix were identified among clinically relevant Cog4 variants. The global structural comparison with multidimensional scaling demonstrated variants with similar protein structures (AF2) tended to exhibit similar clinical and biological phenotypes. The Cog4 p.Y714F variant exhibited greater protein structural similarity to mutated Cog4 found in Saul‒Wilson syndrome (p.G512R) and shared similar clinical phenotype (congenital cataract and psychomotor retardation). PCA of included pathogenic metrics demonstrated p.Y714F occurred at a critical position in Cog4 amino acid sequence with disrupted post-translational phosphorylation.</p><p><strong>Conclusion: </strong>Deep learning algorithms, including AF2, AM and ThermoMPNN, can be useful for evaluating variant of uncertain significance (VUS) by structural and pathogenicity prediction. Despite classified as VUS (American College of Medical Genetics and Genomics criteria: PM1, PP4), the pathogenicity in this Cog4 variant cannot be ruled out and warrants further investigation.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982853","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":"Prevalence of visually significant cataract and cataract surgical coverage in Indigenous and non-Indigenous Australians: a systematic review and meta-analysis.","authors":"Marcel M Nejatian, Saiuj Bhat, Amy Kalantary, Joshua R Taylor, Mark A Chia, Angus W Turner, Hessom Razavi","doi":"10.1136/bmjophth-2024-001847","DOIUrl":"10.1136/bmjophth-2024-001847","url":null,"abstract":"<p><strong>Aims: </strong>Compare the prevalence of age-related cataract and the cataract surgical coverage rate between Indigenous and non-Indigenous Australians and explore differences in these estimates across location and time.</p><p><strong>Methods: </strong>The Joanna Briggs Institute guidance for systematic reviews of prevalence studies was followed. A systematic search of Medline, Embase, Web of Science and grey literature from database inception to June 2022 was performed. All studies reporting cataract prevalence in Australian populations were included. Pooled prevalence estimates were derived using meta-analyses with a random-effects model. Nine studies enrolling 36 302 participants were included. Most studies only reported the prevalence of cataract causing vision loss (visual acuity<6/12) or blindness (visual acuity<6/60), restricting our meta-analysis to these definitions.</p><p><strong>Results: </strong>Cataract causing unilateral vision loss was common in both Indigenous and non-Indigenous adults (3.5% and 3.6%, p=0.891). Indigenous adults had a higher prevalence of bilateral vision loss (3.6% vs 1.1%, p=0.011) and bilateral blindness (0.385% vs 0.001%, p=0.002) than non-Indigenous adults. Cataract surgical coverage was lower in Indigenous (68.0%; 95% CI, 55.9 to 79.0) than non-Indigenous (88.4%; 95% CI, 79.9 to 94.8) adults (p=0.004). No differences in bilateral vision loss, blindness or surgical coverage were found between rural and urban subgroups or between studies conducted before and after the year 2000.</p><p><strong>Conclusions: </strong>Cataract causes vision loss in a substantial number of adults living in urban and rural Australia. Policies to improve diagnosis and surgery rates should be prioritised, particularly for Indigenous Australians who experience a disproportionate burden of advanced cataract and reduced access to surgery.</p><p><strong>Prospero registration number: </strong>CRD42022340197.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969692","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":"Cataract surgery has minimal effect on corneal shape.","authors":"Fadi Alfaqawi, Luca Pagano, Esmaeil M Arbabi, Vito Romano, Ahmed Al-Maskari, Keri McLean, Gabriella Czanner, Stephen B Kaye","doi":"10.1136/bmjophth-2024-001920","DOIUrl":"10.1136/bmjophth-2024-001920","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify the effect of cataract surgery on cornea shape.</p><p><strong>Methods: </strong>Patients undergoing cataract surgery with standardised 2.75 mm surgical incisions at 110 degrees with a side port at 50 degrees were included. Repeat biometric measurements were taken before surgery and at 6 weeks on both operated and unoperated fellow eyes. Data were transformed into Long's formalism for analysis. Device-specific measurement error was determined. The main outcome measure was the change in keratometry taking into account the change in keratometry of the unoperated fellow eye. Secondary outcome measures included the variability introduced due to location of the incision.</p><p><strong>Results: </strong>132 patients were included. The mean change in keratometry of the operated eye was -0.23@111/+0.21@21 (95% CI -1.43@122/+0.04@32 to +1.04@135/+0.30@45). The flattening effect of the surgical incision was greater and more variable than the steepening effect (p<0.01), particularly if the incision was in the flat meridian. Coupling, defined as ratio of the keratometric change in the preoperative meridians of K2 and K1, varied from 0.91 (SD 2.31) for eyes with an incision in the steep meridian, 0.75 (SD 1.81) for an incision in the flat meridian to 0.28 (SD 2.06) when the incision was made in a neutral meridian.</p><p><strong>Conclusion: </strong>Cataract surgery has a slightly greater flattening than steepening effect on corneal shape. Although the effects are very small and variable with incomplete coupling, it is preferable to place the incision in the steep meridian. Greater emphasis, however, should be placed on eye-specific factors, such as biometry, or patient-related factors to optimise refractive outcomes.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969690","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":"Endoplasmic reticulum protein TXNDC5 modulates thyroid eye disease TGF-β1-induced myofibroblast transdifferentiation.","authors":"Hsun-I Chiu, Shi-Bei Wu, Albert Y Wu, Chieh-Chih Tsai","doi":"10.1136/bmjophth-2024-001693","DOIUrl":"10.1136/bmjophth-2024-001693","url":null,"abstract":"<p><strong>Aim: </strong>There remain limited therapies to treat thyroid eye disease (TED) orbital fibrosis, highlighting the urgency to develop novel targets. Transforming growth factor-β1 (TGF-β1)-induced myofibroblast transdifferentiation from orbital fibroblasts are important pathogenetic factor of TED. Endoplasmic reticulum (ER) stress may play a role in TED pathogenesis since it has been linked to liver, kidney, heart and lung fibrotic remodelling. We would evaluate the role of thioredoxin domain containing 5 (TXNDC5), a fibroblast-enriched ER protein, in TGF-β1-induced myofibroblast transdifferentiation from TED orbital fibroblasts.</p><p><strong>Methods: </strong>Orbital fibroblasts from patients with TED were treated with TGF-β1 to investigate ER stress-relative gene expression especially for TXNDC5. To determine if TXNDC5 is involved in TGF-β1-induced fibrosis, we transfected TED orbital fibroblasts by lentivirus with a small hairpin RNA of pLKO-TXNDC5 gene (shTXNDC5) to knockdown TXNDC5 protein expression levels. After transfection of shTXNDC5 in TED orbital fibroblast followed by TGF-β1 treatment, we analysed TGF-β1-induced fibrosis protein expression.</p><p><strong>Results: </strong>We measured increased TXNDC5 gene and protein expression in primary TED orbital fibroblasts. TXNDC5 protein levels were increased in TED orbital fibroblasts under TGF-β1 stimulation (2.5, 5, 10 and 20 ng/mL). Moreover, TXNDC5 knockdown of attenuated TGFβ1 (5 ng/mL)-induced myofibroblast transdifferentiation and extracellular matrix protein upregulation whereas increasing TXNDC5 expression by a recombinant protein of TXNDC5 (rhTXNDC5) addition increased alpha smooth muscle actin, fibronectin and connective tissue growth factor protein expression.</p><p><strong>Conclusion: </strong>In conclusion, targeting TXNDC5 may be a novel therapeutic approach against TGF-β1-induced myofibroblast transdifferentiation in TED orbital fibroblasts.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892110","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}