BMJ Open Ophthalmology最新文献

{"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":2.7,"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":2.7,"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":2.7,"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":2.7,"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":2.7,"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}

{"title":"Charles Bonnet Syndrome: associations between psychosocial measures and visual hallucination characteristics in the visually impaired.","authors":"Robin Walker, Lyn Ellett, Daisy Norton, Hana Rouabhi, Hannah Coughlan, Farah Akthar, Katrina DaSilva Morgan, Rhian Tait, Matteo Lisi, Dominic Ffytche","doi":"10.1136/bmjophth-2025-002554","DOIUrl":"10.1136/bmjophth-2025-002554","url":null,"abstract":"<p><strong>Background/aims: </strong>The emotional response to Charles Bonnet Syndrome (CBS) (visual hallucinations in individuals with sight loss) is associated with negative affect, suggesting a link between psychological measures and hallucination characteristics. This study set out to investigate whether the association extends to a broader range of hallucination attributes and psychological measures, taking into account clinical factors likely to influence such associations.</p><p><strong>Methods: </strong>70 participants with self-reported CBS completed an online survey assessing hallucination attributes of frequency, duration, emotional valence, distress, level of control over hallucinations and impact on quality of life (QoL). Anxiety and depression were measured using the Hospital Anxiety and Depression Scale while loneliness was assessed using the University of California Los Angeles (UCLA) Loneliness Scale. All three measures were combined as a mental health factor. Regression models tested relationships between hallucination attributes and mental health, controlling for age, sex assigned at birth, years of sight loss, years experiencing hallucinations, presence of migraine and visual field loss.</p><p><strong>Results: </strong>All visual hallucination attributes except level of control were associated with the mental health factor; higher factor scores were associated with more frequent, longer lasting, more unpleasant and more distressing hallucinations and also with a more negative impact of hallucinations on QoL. These associations were independent of years of sight loss and CBS.</p><p><strong>Conclusion: </strong>Mental health measures are linked to a wider range of CBS attributes than previously recognised, with greater clinical attention required to identify people with CBS who are experiencing psychological difficulties to help provide appropriate treatment and support.</p><p><strong>Limitations: </strong>The study did not include a control group of visually impaired participants without hallucinations and has an uneven representation across age and gender with a small sample size for the sub-group analysis. The study relied on self-reported online data without clinical assessment; details of participants' medication use were not collected.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12958872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343610","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":"Is metamorphopsia more important than visual acuity in vitreomacular interface disorders? A scoping review.","authors":"Armin Moroder, Gerard McGowan, David Yorston","doi":"10.1136/bmjophth-2025-002484","DOIUrl":"10.1136/bmjophth-2025-002484","url":null,"abstract":"<p><strong>Background: </strong>Vitreomacular interface disorders are known to reduce vision-related quality of life (VR-QoL). This is due to both reduced visual acuity and metamorphopsia. In clinical practice, visual acuity is measured routinely, but quantitative measurements of metamorphopsia are less frequent. We conducted a scoping literature review to determine whether metamorphopsia or visual acuity has the greatest effect on VR-QoL.</p><p><strong>Methods: </strong>A literature review, of studies published in English, and indexed in Medline or Embase, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. 65 studies were identified. 55 were excluded as they did not meet the inclusion criteria.</p><p><strong>Results: </strong>Of the 10 publications, six studied epiretinal membrane, two studied full-thickness macular hole, one studied vitreomacular traction with or without macular hole and one included both macular hole and epiretinal membrane. A variety of different methods were used to measure metamorphopsia and VR-QoL. Of the eight studies reporting the association between preoperative metamorphopsia and VR-QoL, five found a significant correlation. Six studies examined the association between post-operative metamorphopsia and VR-QoL, five of which found a significant correlation. Five studies looked for any link between reduction in metamorphopsia and improvement in VR-QoL. All five found a significant association. In contrast, only two of eight studies found any association between preoperative vision and VR-QoL, and none found any relationship between improvement in visual acuity and improvement in VR-QoL.</p><p><strong>Conclusions: </strong>Although the published evidence is limited, it appears that metamorphopsia may be a better predictor of preoperative and postoperative VR-QoL than visual acuity. Further research is necessary to confirm this, but metamorphopsia should be measured when assessing vitreomacular interface disorders.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12958884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147302391","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":"Intracameral pressure during capsulorhexis in cataract surgery using cohesive versus dispersive ophthalmic viscosurgical devices: a randomised trial.","authors":"Daniel M Handzel, Walter Sekundo, Chiraz Ben Abdallah, Markus S Ladewig","doi":"10.1136/bmjophth-2025-002573","DOIUrl":"10.1136/bmjophth-2025-002573","url":null,"abstract":"<p><p>ObjectiveTo study the properties of different ophthalmic viscosurgical devices (OVDs) with respect to their ability to create and maintain high intraocular pressure (IOP) during the creation of a continuous curvilinear capsulorhexis (CCC) by comparing the drop in IOP before and after creation of the CCC.</p><p><strong>Methods and analysis: </strong>The study included 174 eyes in four groups using two different OVDs (hyaluronic acid (HA) and hydroxypropylmethylcellulose (HPMC)) and two different instruments (utrata forceps (UF) and 26G cystotome (RN)). IOP was measured using rebound tonometry with sterilised probes immediately before the beginning of the CCC and immediately afterwards during cataract surgery.</p><p><strong>Results: </strong>The drop in IOP during capsulorhexis was measured at 52.1±10.7 mm Hg with the combination HA/RN, 62.4±11.5 mm Hg with HA/UF, 60.5±10.0 mm Hg with HPMC/RN and 68.7±14.1 mm Hg with HPMC/UF. The variance in IOP reduction between HA and HPMC did not reach statistical significance (p=0.100).</p><p><strong>Conclusion: </strong>The lack of a noticeable difference in IOP levels, despite the use of different OVDs with unique properties, indicates that IOP may not be the main factor influencing the notable differences in tactile feedback perceived by surgeons during capsulorhexis procedures conducted with varying OVDs. To elucidate these sensations, additional characteristics such as viscosity, elasticity, pseudoplasticity and cohesion will have to be explored.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275682","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 vascular alteration following surgical intraocular pressure reduction in primary angle closure disease.","authors":"Jin Wang, Zijian Liu, Hui Zhang, Yue Wang, Dapeng Mou, Xin Tang, Shi Danli, Mingguang He, Wang Ning-Li, Ye Zhang","doi":"10.1136/bmjophth-2025-002626","DOIUrl":"10.1136/bmjophth-2025-002626","url":null,"abstract":"<p><strong>Aims: </strong>To investigate retinal vascular geometric alterations following intraocular pressure (IOP)-lowering surgery in patients with primary angle closure disease (PACD) and determine associations between IOP reduction magnitude and retinal vascular parameters.</p><p><strong>Methods: </strong>This retrospective, self-controlled study included patients with PACD who underwent IOP-lowering surgery at Beijing Tongren Hospital. Retinal vascular parameters were quantitatively measured from fundus photographs before and after surgery using a validated deep learning-based analysis system. Main outcomes included retinal arteriolar and venular calibre, tortuosity, fractal dimension (FD), segment number (N_seg) and vascular density. Linear mixed-effects models, adjusted for age, follow-up interval and PACD subtype, assessed associations between IOP reduction magnitude and vascular parameter changes.</p><p><strong>Results: </strong>Among 126 eyes (112 patients), surgery decreased IOP from 35.0±9.9 to 16.7±5.7 mm Hg (p<0.001). Venous FD increased from 1.52±0.06 to 1.53±0.05 (p=0.003), N_seg from 123.50 (IQR: 61.75-182.50) to 153.00 (88.50-185.00) (p=0.007), vessel area density (VAD) from 6.13±1.56 to 6.50±1.34 (p=0.006) and vessel skeleton density (VSD) from 1.24±0.35 to 1.35±0.31 (p=0.003). Vessel calibre and tortuosity showed no significant changes. IOP reduction magnitude was independently associated with changes in venous FD (p=0.023), N_seg (p=0.031), VAD (p=0.012) and VSD (p=0.030).</p><p><strong>Conclusions: </strong>Surgical IOP reduction in PACD patients produces selective retinal venous alterations with increased complexity and density. These pressure-responsive changes may provide complementary, non-invasive information regarding vascular response after surgery.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275668","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":"Integrating AI, imaging innovations and omics for precision medicine.","authors":"Kai Jin, Danli Shi, Jiong Zhang","doi":"10.1136/bmjophth-2026-002745","DOIUrl":"10.1136/bmjophth-2026-002745","url":null,"abstract":"","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"11 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225667","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}