BMJ Open Ophthalmology最新文献

{"title":"Prevalence of glaucoma and characteristics of ocular manifestations in patients with Naevus of Ota.","authors":"Sakaorat Petchyim, Darin Sakiyalak, Woraphong Manuskiatti, Arnan Limmahachai, Supredee Pongrujikorn, Theerajate Phongsuphan, Thanchanit Sawetratanastien","doi":"10.1136/bmjophth-2025-002161","DOIUrl":"10.1136/bmjophth-2025-002161","url":null,"abstract":"<p><strong>Aims: </strong>This cross-sectional study aimed to determine the prevalence of glaucoma and associated ocular characteristics in Thai patients with Naevus of Ota, comparing those with ocular melanocytosis or oculodermal melanocytosis to those exhibiting only skin hyperpigmentation.</p><p><strong>Methods: </strong>Patients who were diagnosed with Naevus of Ota at Siriraj Hospital, Thailand, underwent a comprehensive ophthalmic assessment by a glaucoma specialist. Those unable to cooperate in an outpatient setting were examined under general anaesthesia. The assessments comprised visual acuity, intraocular pressure (IOP), anterior segment findings, gonioscopy, corneal diameter (in patients aged <3 years) and fundus examination. Visual field and optical coherence tomography tests were performed as indicated.</p><p><strong>Results: </strong>A total of 163 patients (184 eyes) were examined, including 115 eyes with ocular melanocytosis or oculodermal melanocytosis. The mean age at examination was 15.0±15.6 years. Open-angle glaucoma was identified in 2 eyes (1.1%), ocular hypertension in 6 eyes (3.3%) and glaucoma suspicion in 16 eyes (8.7%). Among those with ocular melanocytosis or oculodermal melanocytosis, ocular hypertension and glaucoma suspicion were more common (4.3% and 12.2%, respectively) than in those with only skin hyperpigmentation (1.4% and 2.9%, respectively).</p><p><strong>Conclusion: </strong>Although the prevalence of glaucoma in Naevus of Ota is low, patients with ocular melanocytosis or oculodermal melanocytosis are at greater risk of ocular hypertension and suspected glaucoma than are those with skin-only hyperpigmentation. Targeted screening, particularly in younger individuals and those requiring examination under general anaesthesia, should be considered. The main limitation of the study is its cross-sectional design, offering only a one-time view of a prolonged clinical progression. Moreover, the use of anaesthetic inhalation could have resulted in lower IOP readings during general anaesthesia.</p><p><strong>Trial registration number: </strong>TCTR20210223004.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085978","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":"Associations between measures of oestrogen exposure and severity of Fuchs endothelial corneal dystrophy.","authors":"Redion B Petrela, Chandra Divyash Chhetri, Ahmad Najafi, Zhaoqi Zhang, Tommy A Rinkoski, Eric D Wieben, Michael P Fautsch, Saptarshi Chakraborty, Amy E Millen, Sangita P Patel","doi":"10.1136/bmjophth-2024-001884","DOIUrl":"10.1136/bmjophth-2024-001884","url":null,"abstract":"<p><strong>Aims: </strong>To determine the associations between measures of oestrogen exposure and Fuchs endothelial corneal dystrophy (FECD) severity.</p><p><strong>Methods: </strong>Clinic-based cross-sectional study of 32 postmenopausal women and 11 men with mild or severe FECD, age>55 years. Participants completed questionnaires for data on demographics, anthropometric factors, medical history and potential risk factors for FECD. Women completed an additional reproductive history questionnaire used to calculate the months of lifetime oestrogen exposure. Slit-lamp biomicroscopy, specular microscopy, corneal Scheimpflug tomography and laboratory testing (<i>TCF4</i> repeat expansion quantification, total estradiol, free estradiol, sex hormone binding globulin (SHBG), calcaneal bone density) were performed. Logistic regression models were developed to predict FECD severity based on three-way interactions of each oestrogen exposure measure, sex and <i>TCF4</i> genotype.</p><p><strong>Results: </strong>43 patients were enrolled in the study (mild FECD: 17 women, 3 men; severe FECD: 15 women, 8 men). Serum-free estradiol was higher in the severe compared with mild FECD group (0.21±0.2 vs 0.09±0.1 pg/mL; p=0.046). When stratified by sex, men showed no significant associations between oestrogen measures and FECD severity. However, in women, the odds of severe FECD were increased with more months of lifetime oestrogen exposure (all women; log OR (95% credible interval): 1.3 (0.14 to 4.3)), higher concentrations of free estradiol (all women; 2.1 (0.0049 to 10)), greater % free estradiol (only women without <i>TCF4</i> repeat expansion; 1.3 (0.16 to 3.8)) and higher concentrations of SHBG (only women with <i>TCF4</i> repeat expansion; 2.2 (0.45 to 9.1)).</p><p><strong>Conclusions: </strong>While the application of these data is constrained by the limited number of participants, a clinic-based sample, small number of men compared with women and single-point measures of serum hormone measures, these data suggest that FECD severity is associated with higher oestrogen exposures in women but not men and may be dependent on <i>TCF4</i> repeat expansion status.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076076","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":"Validation of artificial intelligence algorithm LuxIA for screening of diabetic retinopathy from a single 45° retinal colour fundus images: the CARDS study.","authors":"Rodrigo Abreu-Gonzalez, Gabriela Susanna-González, Joseph P M Blair, Romina M Lasagni Vitar, Carlos Ciller, Stefanos Apostolopoulos, Sandro De Zanet, José Natán Rodríguez Martín, Carlos Bermúdez, Alfonso Luis Calle Pascual, Elena Rigo, Enrique Cervera Taulet, Jose Juan Escobar-Barranco, Rosario Cobo-Soriano, Juan Donate-Lopez","doi":"10.1136/bmjophth-2024-002109","DOIUrl":"10.1136/bmjophth-2024-002109","url":null,"abstract":"<p><strong>Objective: </strong>This study validated the artificial intelligence (AI)-based algorithm LuxIA for screening more-than-mild diabetic retinopathy (mtmDR) from a single 45° colour fundus image of patients with diabetes mellitus (DM, type 1 or type 2) in Spain. Secondary objectives included validating LuxIA according to the International Clinical Diabetic Retinopathy (ICDR) classification and comparing its performance between different devices.</p><p><strong>Methods: </strong>In this multicentre, cross-sectional study, retinal colour fundus images of adults (≥18 years) with DM were collected from five hospitals in Spain (December 2021-December 2022). 45° colour fundus photographs were captured using non-mydriatic Topcon and ZEISS cameras. The Discovery platform (RetinAI) was used to collect images. LuxIA output was an ordinal score (1-5), indicating a classification as mtmDR based on an ICDR severity score.</p><p><strong>Results: </strong>945 patients with DM were included; the mean (SD) age was 64.6 (13.5) years. The LuxIA algorithm detected mtmDR with a sensitivity and specificity of 97.1% and 94.8%, respectively. The area under the receiver-operating characteristic curve was 0.96, indicating a high test accuracy. The 95% CI data for overall accuracy (94.8% to 95.6%), sensitivity (96.8% to 98.2%) and specificity (94.3% to 95.1%) indicated robust estimations by LuxIA, which maintained a concordance of classification (N=829, kappa=0.837, p=0.001) when used to classify Topcon images. LuxIA validation on ZEISS-obtained images demonstrated high accuracy (90.6%), specificity (92.3%) and lower sensitivity (83.3%) as compared with Topcon-obtained images.</p><p><strong>Conclusions: </strong>AI algorithms such as LuxIA are increasing testing feasibility for healthcare professionals in DR screening. This study validates the real-world utility of LuxIA for mtmDR screening.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974157","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":"Analysing the translatability of macular hole size measurements between high-density horizontal and radial OCT scan patterns.","authors":"Navid Johannigmann-Malek, Leonard Coulibaly, Sofia Groselli, Katharina Gabka, Peter Charbel Issa, Carmen Baumann","doi":"10.1136/bmjophth-2024-002131","DOIUrl":"10.1136/bmjophth-2024-002131","url":null,"abstract":"<p><strong>Objective: </strong>To assess the interchangeability of minimum linear diameter (MLD) macular hole (MH) size measurements in high-density horizontal and radial scan modes in optical coherence tomography (OCT).</p><p><strong>Methods and analysis: </strong>60 patients with a MH had repeat high-density OCT volume scans in a horizontal (30 µm interscan-spacing) and a radial (angular 3.75° interscan-spacing) mode, and the MLD was measured by five raters.</p><p><strong>Results: </strong>There were no significant differences in the MLD measurements within the horizontal and the radial modes across repeat measurements of each rater in volume scan 1 (all p≥0.14 and p≥0.28, respectively), between volume scans 1 and 2 (all p≥0.14 and p≥0.69), among the raters (p=0.70 and p=0.60), and using all MLD measurements obtained in this study between primary and repeat measurements in volume scan 1 (p=0.10 and p=0.74) and between measurements obtained in volume scan 1 and 2 (p=0.21 and p=0.90).There was a statistically significant difference of -10.05 µm between the mean MLD of all measurements in the horizontal (n=900) and in the radial (n=900) mode (427.91 (±187.01) vs 437.97 (±184.93) µm; p<0.001). However, the variability of these differences around the mean MLD was large (95% limits of agreement -77.31 to 57.21 µm). The mean difference between all horizontal and all radial MLD measurements in a MH was for MHs that had their widest MLD within 15° of the horizontal, vertical and diagonal meridians 0.77 (±13.88) µm, -34.43 (±55.22) µm and -10.39 (± 34.62) µm, respectively.</p><p><strong>Conclusions: </strong>Horizontal scans systematically underestimate the maximum MLD if located vertically or diagonally; however, they have less intra-rater and inter-rater and inter-scan variability in MLD measurements as compared with radial scans. Therefore, the two scan modes are not interchangeable but rather complement each other. These results may be limited to the MLD range analysed (125-924 µm).</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979091","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":"From research to action: recommendations for Charles Bonnet syndrome care and policy.","authors":"Lee Jones, Jasleen K Jolly, Judith Potts, Tamsin Callaghan, Katharine Fisher, I Betina Ip, Holly Bridge, Robin Walker, Mariya Moosajee","doi":"10.1136/bmjophth-2024-002009","DOIUrl":"10.1136/bmjophth-2024-002009","url":null,"abstract":"","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954768","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":"Novel classification for microspherophakia and its related surgical implications: a retrospective cohort study.","authors":"Yang Sun, Zexu Chen, Yan Liu, Qiuyi Huo, Wan-Nan Jia, Zhennan Zhao, Tianhui Chen, Yongxiang Jiang","doi":"10.1136/bmjophth-2024-002063","DOIUrl":"10.1136/bmjophth-2024-002063","url":null,"abstract":"<p><strong>Background: </strong>A novel classification for microspherophakia (MSP) was developed using a nomogram model to stratify patients and evaluate surgical outcomes.</p><p><strong>Methods: </strong>The study involved 99 eyes from 64 MSP patients, divided into training (64 eyes) and validation (35 eyes) cohorts. Primary outcome included the best corrected distance visual acuity (BCVA) at the 1-year follow-up, and the secondary outcome was intraocular pressure (IOP) control. MSP patients achieving a BCVA of ≤0.2 logarithm of the minimal angle of resolution with successful IOP control were categorised into the favourable outcomes group, while those not meeting these criteria were placed in the unfavourable outcomes group. A nomogram model was constructed to predict unfavourable outcomes by identifying associated risk factors.</p><p><strong>Results: </strong>In the training cohort, 39.06% (25/64) achieved favourable outcomes, while 60.94% (39/64) had unfavourable outcomes. Decreased anterior chamber depth (ACD) and the presence of glaucoma were identified as risk factors for predicting unfavourable outcomes. The concordance index for the training and validation cohorts was 0.828 and 0.768, respectively. A nomogram-derived cut-off value of 56 points stratified patients into low-risk (≤56 points) and high-risk (>56 points) groups. Postoperative BCVA was significantly better in the low-risk group at 6-month and 1-year follow-ups.</p><p><strong>Conclusion: </strong>MSP patients in the low-risk group achieved satisfactory outcomes. For high-risk patients with shallowing ACD, early surgical intervention is recommended to prevent secondary glaucoma. Close monitoring of IOP and glaucoma progression is crucial for patients with secondary glaucoma. This classification offers valuable insights for outcome stratification and guidance in clinical decision-making for MSP management. However, the limitations of this study include its small sample size, which may impact generalisability, and future studies with larger cohorts are needed to validate and refine the nomogram.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970042","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":"Metabolic correlations between kidney and eye in a mouse model of oxygen-induced retinopathy and retinopathy of prematurity.","authors":"Yuhang Yang, Lijun Dong, Hui Qi, Yinsheng Zhang, Yulin Zhang, Jie Sun, Xiaoyan Chai, Xiaofeng Lu, Zixin Fan, Dongting Wu, Guoming Zhang, Hetian Lei","doi":"10.1136/bmjophth-2024-001955","DOIUrl":"10.1136/bmjophth-2024-001955","url":null,"abstract":"<p><strong>Introduction: </strong>Retinopathy of prematurity (ROP) is one of the leading causes of babies' visual impairment and blindness. There is no effective prevention and treatment of ROP so far, and the shared genetic and developmental similarities among the brain, kidneys and retina may offer novel potential therapeutic approaches to ROP.</p><p><strong>Objectives: </strong>The aim of this study is to explore a correlation of ROP patients and the renal, eye tissue of the mouse model of oxygen-induced retinopathy (OIR).</p><p><strong>Methods and analysis: </strong>We used renal and vitreous untargeted/targeted metabolomics in OIR to conduct our study. Network association analysis and machine learning were performed with the above results and previous studies: retinal-targeted metabolomics of OIR and human blood-targeted metabolomics of ROP.</p><p><strong>Results: </strong>OIR results in retinal neovascularisation and renal injury. Nine canonical signalling pathways were enriched, which are involved in the initiation and progression of pathologic retinal neovascularisation. Arginine biosynthesis emerged as a common pathway across renal, vitreous, retinal and blood metabolomics, suggesting its potential as a predictive biomarker and therapeutic target for ROP and neonatal kidney injury.</p><p><strong>Conclusion: </strong>The presence of renal injury-related indicators may assist in diagnosing retinal neovascular diseases such as ROP. Arginine biosynthesis is the best common pathway of kidney-untargeted OIR metabolomics, vitreous- and retina-targeted OIR metabolomics and blood-targeted metabolomics of ROP, indicating that arginine biosynthesis might be the common pathway of ROP and neonatal kidney injury.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970849","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 there evidence for changes in antibiotic resistance of microorganisms causing postcataract surgery endophthalmitis: a systematic review.","authors":"Christina J Flaxel, Justine R Smith, Nieraj Jain, Leo A Kim, Stephen Jae Kim, Maureen G Maguire, Christina Y Weng, Steven Yeh","doi":"10.1136/bmjophth-2024-001935","DOIUrl":"10.1136/bmjophth-2024-001935","url":null,"abstract":"<p><strong>Background/aims: </strong>To review the evidence for changes in antibiotic resistance patterns before and after cataract surgery since the advent of routine use of intracameral (IC) antibiotic prophylaxis and development of newer topical fluoroquinolones pre- and postcataract surgery.</p><p><strong>Methods: </strong>Literature searches in the National Library of Medicine PubMed database were conducted between 2019 and 2021 and updated in 2024. There were no date restrictions, and the search was limited to high-quality studies published in English. The initial combined searches yielded 583 articles, and the search update in 2024 yielded 9 articles. Of these 592 articles, 26 presented original research that met specified inclusion criteria. Reviewed studies were rated based on the Oxford Centre for Evidence-Based Medicine grading system. Because results from the various studies are not directly comparable due to the use of different antibiotics, different methods, different study populations and different outcomes, formal analyses for heterogeneity of results and publication bias were not performed.</p><p><strong>Results: </strong>There were no studies that presented definitive level I evidence for increased bacterial resistance to IC or oral antibiotics prior to or during routine cataract surgery. There were no studies that provided level I evidence for increased bacterial resistance to topical administration of antibiotics. One study showed level III evidence for potential antibiotic resistance when the antibiotic was administered for greater than 1 month, and four level III studies showed a possible trend towards increased moxifloxacin and ciprofloxacin resistance.</p><p><strong>Conclusions: </strong>There is little evidence of increased bacterial resistance following the use of newer fluoroquinolone antibiotic prophylaxis prior to cataract surgery or the routine use of IC antibiotic prophylaxis during cataract surgery. Our work is limited by the lack of high-level evidence on antibiotic resistance. Many studies reviewed are not randomised controlled trial (RCTs), introducing biases and confounding factors. Small sample sizes further reduce reliability, and uncontrolled variables, such as regional prescribing patterns, may lead to misleading results. While lower level evidence offers some insights, cautious interpretation is advised until more rigorous RCTs are conducted.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965438","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":"Detection of diabetic macular oedema patterns with fine-grained image categorisation on optical coherence tomography.","authors":"Xin Ye, Wangli Qiu, Linzhen Tu, Yingjiao Shen, Qian Chen, Xiangrui Lin, Yaqi Wang, Wenbin Xie, Li-Jun Shen","doi":"10.1136/bmjophth-2024-002037","DOIUrl":"10.1136/bmjophth-2024-002037","url":null,"abstract":"<p><strong>Purpose: </strong>To develop an artificial intelligence (AI) system for detecting pathological patterns of diabetic macular oedema (DME) with fine-grained image categorisation using optical coherence tomography (OCT) images.</p><p><strong>Methods: </strong>The development of the AI system consists of two parts, a pretraining process on a public dataset (Asia Pacific Tele-Ophthalmology Society (APTOS)), and the training process on the local dataset. The local dataset was partitioned into the training set, validation set and test set in the ratio of 6:2:2. The Split Subspace Attention Network (SSA-Net) architecture was adopted to train independent models to detect the seven pathological patterns of DME: intraretinal fluid (IRF), subretinal fluid (SRF), pigment epithelial detachment (PED), hyper-reflective retinal foci (HRF), Müller cell cone disruption (MCCD), subretinal hyper-reflective material (SHRM) and intra-cystic hyper-reflective material (ICHRM). The confusion matrix, sensitivity, specificity and receiver operating characteristic (ROC) were used to evaluate the performance of the models.</p><p><strong>Results: </strong>The APTOS public dataset consists of 33 853 OCT images and the local dataset consists of 1346 OCT images with DME. In the pretraining process on the public dataset, the accuracy was 0.652 for IRF, 0.928 for SRF, 0.936 for PED and 0.975 for HRF. After the training process on the local dataset, the SSA-Net architecture showed better performance in fine-grained image categorisation on the test set. The area under the ROC curve was 0.980 for IRF, 0.995 for SRF, 0.999 for PED, 0.908 for MCCD, 0.887 for HRF, 0.990 for SHRM and 0.972 for ICHRM. The AI system outputs a heatmap for each result, which can give a visual explanation for the automated identification process. The heatmaps revealed that the regions of interest of the AI system were consistent with the retinal experts.</p><p><strong>Conclusions: </strong>The proposed SSA-Net architecture for detecting the pathological patterns of DME achieved satisfactory accuracy. However, this study was conducted in one medical centre, and multicentre trials will be needed in the future.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976926","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":"Patients' perspectives of ophthalmic management of facial nerve paralysis.","authors":"Susan Coulson, Frederick Francis","doi":"10.1136/bmjophth-2024-001933","DOIUrl":"10.1136/bmjophth-2024-001933","url":null,"abstract":"<p><strong>Objective: </strong>Facial nerve paralysis (FNP) affects eye muscle function causing lagophthalmos. This leaves the cornea vulnerable to irritation and injury which, if untreated, may cause permanent vision impairment. Decreased eye muscle control impacts facial expressions and quality of life. Although non-surgical interventions such as lubrication are routinely used in standard eyecare, patient perspectives regarding these interventions have not been extensively investigated. This study aims to investigate patients' perspectives of conservative ophthalmic management for FNP.</p><p><strong>Methods and analysis: </strong>Participants with FNP completed a survey including seven conservative lagophthalmos management interventions: artificial tears, lubricating ointment, taping the eye shut, tape to lift the lower eyelid, scleral contact lens, moisture chamber and manual eye closure. Open-ended questions and Likert scales covered six domains: discomfort, appearance-related concerns, application difficulties, impact on activities of daily living and social activities, and tolerance to outdoor settings. Descriptive, bivariate, correlation and thematic analyses were undertaken.</p><p><strong>Results: </strong>49 participants completed the survey (17 males, 32 females; mean age 55 years, SD 14.94). Mean duration of FNP was 8 years, 5 months (range 12 months to 47 years). Artificial tears and lubricating ointments were most frequently used with highest overall satisfaction. Participants were less satisfied with interventions involving the use of tape. Manual eye closure had a small positive impact. Main themes were comfort, vision and appearance.</p><p><strong>Conclusions: </strong>Functional, social and psychological impairments associated with lagophthalmos are managed using conservative interventions. A better understanding of a patient's capacity, priorities and preferences underpins a collaborative approach when selecting eye-protective interventions and optimises patient outcomes.The main limitation of this study was that participants were recruited from a specialty facial nerve clinic, resulting in an over-representation of individuals with long-standing, complex conditions.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959903","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}