BMJ Open Ophthalmology最新文献

{"title":"Validation of 3nethra specto, a wearable digital subjective refractor versus conventional subjective refraction for refractive error measurement in young adults: a comparative study.","authors":"Kaushik Murali, Namratha Hegde, Afia S, Varshini M, Disha Agarwal, Revathy Manthri Rangaraj, Rashmi Hullur, Kousar Sidiq, Venkatakrishnan S","doi":"10.1136/bmjophth-2025-002553","DOIUrl":"10.1136/bmjophth-2025-002553","url":null,"abstract":"<p><strong>Background: </strong>Refractive errors cause significant preventable visual impairment globally, particularly in underserved areas. Conventional subjective refraction remains the gold standard but proves examiner-dependent, time-consuming and challenging in high-volume settings. The 3nethra Specto, a wearable digital subjective refractometer, offers rapid refractive assessment. This study evaluates its accuracy and repeatability versus conventional methods.</p><p><strong>Methods: </strong>A prospective comparative study was conducted on 135 subjects who underwent both conventional subjective refraction and 3nethra Specto assessment. Spherical (S), cylindrical (C) and axis measurements were analysed using power vector transformation (J₀, J₄₅). Primary predictive validity was assessed using univariate general linear models (GLMs) (IBM SPSS V.25.0) with age/sex as covariates. Model fit was evaluated via F-statistics, R² and residual SD. Instrument repeatability used GLM Repeated Measures, agreement assessed via Bland-Altman plots, keeping significance at p<0.05. Patient and examiner feedback on the instrument was captured using the User Experience questionnaire.</p><p><strong>Results: </strong>Of 135 adults (mean age 31.5±8.9 years; 60% male), compound myopic astigmatism predominated (45%). 3nethra Specto measurements closely matched subjective refraction (sphere: -1.02 D vs -0.99 D; cylinder: -0.49 D vs -0.83 D; M: -1.26 D vs -1.24 D). GLM analysis showed excellent predictive validity (all p<0.001; R² 0.914 to 0.994; residual SD 0.084 D to 0.228 D). Bland-Altman plots confirmed 95% limits of agreement of -0.39 D to +0.47 D for M and -0.62 D to +0.64 D for J₀ and -0.32 D to +0.35 D for J₄₅. Device repeatability was high (all F>96, p<0.001; R²≥0.956; residual SD≤0.148 D). Patients rated subjective refraction higher for comfort/enjoyability but found 3nethra more inventive/exciting; examiners preferred 3nethra for efficiency, speed, innovation and ease of use.</p><p><strong>Conclusions: </strong>The 3nethra Specto wearable liquid lens refractor demonstrated excellent agreement and repeatability with traditional subjective refraction across all refractive parameters, confirming clinical equivalence. Positive patient and examiner feedback highlighted its innovation, efficiency and usability. This device offers a reliable alternative for routine refractive assessment in clinical settings.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148588","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":"Retinal vasculature-derived proteins serve as potential systemic biomarkers for diabetic retinopathy.","authors":"Rajendran Sharmila, Narayanasamy Angayarkanni, Dhanashree Ratra, Seetharaman Shanmuganathan, D'Cruze Lawrence, Kathiresan Purushothaman, Qingsong Lin, Annamalai Radha, Kuppan Kaviarasan","doi":"10.1136/bmjophth-2025-002684","DOIUrl":"10.1136/bmjophth-2025-002684","url":null,"abstract":"<p><strong>Purpose: </strong>Fibrovascular membrane (FVM), a pathological tissue causing retinal traction, represents an advanced stage of proliferative diabetic retinopathy (PDR). This study aimed to identify novel protein biomarkers associated with retinal microvascular damage leading to FVM formation and to evaluate the diagnostic potential of stratifin (SFN) and hornerin (HRNR) in patients with type 2 diabetes mellitus (T2DM) and diabetic retinopathy (DR).</p><p><strong>Methods: </strong>Human retinal vasculature from non-diabetic donors and FVM tissues from PDR patients undergoing PPV were analyzed by one-dimensional liquid chromatography-mass spectrometry to identify differentially expressed proteins. Functional enrichment and protein interaction analyses were performed using STRING databases. Selected proteins' messenger RNA expression was quantified by quantitative PCR (qPCR) in peripheral blood mononuclear cells from healthy, T2DM, and DR with nephropathy (DR with DN) patients. Serum levels of SFN and HRNR were measured by ELISA in T2DM, DR, and DR with DN cohorts. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>A total of 44 FVM specific proteins were identified, notably SFN and HRNR linked to retinal angiogenesis. Serum HRNR levels were significantly decreased in DR with DN compared with T2DM, whereas SFN levels were significantly increased in DR versus T2DM. ROC analyses demonstrated acceptable accuracy for differentiating DR stages based on serum SFN and HRNR levels.</p><p><strong>Conclusions: </strong>This is the first study to identify SFN and HRNR as systemic candidate biomarkers reflecting microvascular alterations in DR. Larger cohort studies are warranted to validate their clinical relevance for early detection and therapeutic targeting of DR.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142704","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":"Risk of raised posterior corneal elevation associated with cornea and sublayer thicknesses 5 years post keratorefractive lenticule extraction.","authors":"Huazheng Cao, Mengyuan Shan, Shuang Liang, Guoxi Wu, Vishal Jhanji, Yan Wang","doi":"10.1136/bmjophth-2025-002501","DOIUrl":"10.1136/bmjophth-2025-002501","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the risk of posterior corneal forward shift associated with central corneal thickness (CCT), residual bed thickness (RBT), cap thickness and lenticule thickness after keratorefractive lenticule extraction (KLEx) over 5-year follow-up period, providing evidence for preoperative assessment to improve safety.</p><p><strong>Methods and analysis: </strong>Retrospective cohort study that included patients (n=165) who underwent KLEx surgery. Changes in posterior central elevation (PCE) were measured at 3 months, 6 months, 1 year and 5 years post-KLEx. Elevation measurements were obtained at 27 prespecified points and separated into central, peripheral zones and nasal, temporal, superior and inferior quadrants for analysis. Risk ratios for raised PCE were compared across thickness groups.</p><p><strong>Results: </strong>Overall, posterior corneas exhibited a slight forward shift over the early postoperative period and ultimately returned to their original state within 5 years. Central cornea shifted backward, whereas peripheral cornea shifted forward at each follow-up examination. Preoperative CCT had a significant effect on PCE (p<0.05), whereas cap thickness did not (p>0.05). RBT had a weakly negative correlation with PCE (β=-0.12, p=0.01), whereas lenticule thickness was positively correlated (β=0.02, p=0.03). Each 10 µm loss of CCT resulted in up to 3.5 µm forward shift of the PCE (p<0.001). CCT <500 µm increased the risk ratio of postoperatively raised PCE by 2.9-5.6 (p<0.05).</p><p><strong>Conclusions: </strong>Intended sublayer thicknesses were strongly correlated with posterior corneal shift post-KLEx. Although long-term PCE remained stable, a preoperative CCT <500 µm was associated with greater forward displacement of the posterior cornea and a higher likelihood of elevated tomographic parameters, suggesting a need for cautious preoperative assessment.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13218164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027254","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":"Clinic-based burden of glaucoma among Sahrawi refugees in the Tindouf camps.","authors":"Ouafa Mhamdi-Lehebib, Carmen Mendez-Hernandez","doi":"10.1136/bmjophth-2025-002682","DOIUrl":"10.1136/bmjophth-2025-002682","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the clinic-based frequency of glaucoma among Sahrawi refugees attending humanitarian ophthalmology missions in the Tindouf camps (Algeria), to identify demographic and clinical factors associated with glaucoma and to contextualise the clinic-based frequency of other ophthalmic diseases.</p><p><strong>Methods and analysis: </strong>We conducted a clinic-based cross-sectional study among Sahrawi refugees during Médicos del Mundo ophthalmology missions. All participants underwent a standardised ophthalmological examination including targeted history, visual acuity assessment, slit-lamp biomicroscopy and intraocular pressure (IOP) measurement. Glaucoma diagnosis relied on structural optic nerve head assessment and elevated IOP, with independent confirmation by a second ophthalmologist. Age-standardised and sex-standardised clinic-based frequencies were calculated using camp population demographics. Multivariable logistic regression identified factors associated with glaucoma.</p><p><strong>Results: </strong>A total of 900 symptomatic care-seeking individuals were examined (56% men; median age 70 years). Overall clinic-based glaucoma frequency was 13.3% (95% CI 11.1% to 15.5%), representing the main disease of interest. After standardisation, the estimated clinic-based frequency was 6.7% (95% CI 3.8% to 9.7%). Older age was independently associated with glaucoma (adjusted OR per year 1.02; 95% CI 1.01 to 1.03; p=0.003). Inverse associations with cataract and keratopathy, likely reflected selection patterns and diagnostic overshadowing. Cataract was the most common coexisting diagnosis (59.8%), followed by keratopathy (9.1%) and retinopathy (3.4%). Among participants, 37.8% (n=340) had severe bilateral visual impairment, and 40.9% (n=368) had monocular vision; 17.5% (n=60/340) of those with bilateral impairment were blind from glaucoma.</p><p><strong>Conclusions: </strong>Glaucoma represents a substantial clinic-based burden among symptomatic Sahrawi refugees attending humanitarian missions, with a high proportion of irreversible visual loss. Other ophthalmic conditions were common but functioned as coexisting causes of visual impairment in this care-seeking sample. These findings highlight the need for pragmatic, context-appropriate strategies for opportunistic glaucoma detection and continuity of care in refugee settings, acknowledging limitations including the non-probabilistic, mission-based sampling and absence of visual-field testing.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13201999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004812","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":"Systemic and ocular factors determining the circumpapillary retinal nerve fibre layer thickness in an unselected adult population.","authors":"Toke Bek","doi":"10.1136/bmjophth-2026-002796","DOIUrl":"10.1136/bmjophth-2026-002796","url":null,"abstract":"<p><strong>Introduction: </strong>The retinal nerve fibre layer (RNFL) thickness assessed by optical coherence tomography (OCT) scanning is used for the diagnosis and monitoring of diseases in the retina and the optic nerve. The aim of the present study was to describe the independent contributions of age, sex, visual acuity, intraocular pressure and ocular biometric parameters to the variation in RNFL thickness in an unselected adult population.</p><p><strong>Methods: </strong>In the cross-sectional FORSYN (Forekomst af synshandicap og synshjælpemidler i Danmark) study 10 350 population representative adult Danish citizens were between 1 May 2020 and 1 July 2022 invited for an eye examination that included measurement of visual acuity, ocular biometry, intraocular pressure and OCT scanning to assess the circumpapillary RNFL (cpRNFL) thickness in both eyes. The examination was supplemented with computerised perimetry when the cpRNFL thickness was flagged to be below normal. The invitation was accepted by and completed in 3384 citizens (32.7%), from which the results were expanded to represent the original sample on the basis of age, sex and socio-economic factors. The dependence of the cpRNFL thickness on sex, visual acuity, refraction, axial length of the eye, corneal curvature and intraocular pressure was studied.</p><p><strong>Results: </strong>cpRNFL thickness (mean±SD) was significantly (p=0.001) larger in right eyes (102.8±13.8 μm) than in left eyes (102.0±12.8 μm), n=10 410. Increasing age, axial length of the eye, intraocular pressure and male sex, and decreasing visual acuity and corneal curvature contributed significantly to a decreasing thickness of the cpRNFL, p<0.001 for all comparisons.</p><p><strong>Conclusions: </strong>The definition of normal values for cpRNFL thickness can be refined by including information about eye laterality, age, sex, axial length, visual acuity, corneal curvature and intraocular pressure in the evaluation. The limitation that only approximately one-third of the persons completed the examination was compensated by a correction of the data material.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147926536","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":"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":"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":2.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13157721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834038","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":"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":"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":2.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13157754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833971","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":"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":2.7,"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":"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":2.7,"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":2.7,"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}