British Journal of Ophthalmology最新文献

{"title":"Advances in myopia control strategies for children.","authors":"Xiu Juan Zhang, Ebenezer Zaabaar, Amanda Nicole French, Fang Yao Tang, Ka Wai Kam, Clement C Tham, Li Jia Chen, Chi Pui Pang, Jason C Yam","doi":"10.1136/bjo-2023-323887","DOIUrl":"10.1136/bjo-2023-323887","url":null,"abstract":"<p><p>Myopia has long been a global threat to public health. Timely interventions are likely to reduce the risk of vision-threatening complications. There are both established and rapidly evolving therapeutic approaches to slow myopia progression and/or delay its onset. The effective methods for slowing myopia progression include atropine eye-drops, defocus incorporated multiple segments (DIMS) spectacle lenses, spectacle lenses with highly aspherical lenslets target (HALT), diffusion optics technology (DOT) spectacle lenses, red light therapy (RLT), multifocal soft contact lenses and orthokeratology. Among these, 0.05% atropine, HALT lenses, RLT and +3.00 peripheral addition soft contact lenses yield over 60% reduction in myopia progression, whereas DIMS, DOT and MiSight contact lenses demonstrate at least 50% myopia control efficacy. 0.05% atropine demonstrates a more optimal balance of efficacy and safety than 0.01%. The efficacy of 0.01% atropine has not been consistent and requires further validation across diverse ethnicities. Combining atropine 0.01% with orthokeratology or DIMS spectacles yields better outcomes than using these interventions as monotherapies. Increased outdoor time is an effective public health strategy for myopia prevention while recent studies suggest that 0.05% low-concentration atropine and RLT therapy have promising potential as clinical myopia prevention interventions for high-risk groups. Myopia control spectacle lenses, being the least invasive, are safe for long-term use. However, when considering other approaches, it is essential to ensure proper instruction and regular follow-ups to maintain safety and monitor any potential complications. Ultimately, significant advances have been made in myopia control strategies, many of which have shown meaningful clinical outcomes. However, regular use and adequate safety monitoring over extended durations are imperative to foster confidence that can only come from extensive clinical experience.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"165-176"},"PeriodicalIF":3.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term choroidal changes as early indicators for future myopic shift in primary school children: results of a 2-year cohort study.","authors":"Hao Wu, Mengqi Liu, Yuanyuan Wang, Xiang Li, Weihe Zhou, Haoer Li, Zhu Xie, Pengqi Wang, Tingting Zhang, Wei Qu, Jing Huang, Yunpeng Zhao, Jiefang Wang, Sen Zhang, Jia Qu, Cong Ye, Xiangtian Zhou","doi":"10.1136/bjo-2024-325871","DOIUrl":"10.1136/bjo-2024-325871","url":null,"abstract":"<p><strong>Background: </strong>To assess predictive value of short-term choroidal changes for future myopic shift in children.</p><p><strong>Methods: </strong>577 eyes of 289 primary school children were prospectively followed for 2 years. Cycloplegic refractions at baseline, 1 year and 2 years, and choroidal measurements by optical coherence tomography at baseline and 3 months, were used for analyses. Myopic shift was defined as refraction change of at least -0.50 dioptre/year, at 2 years compared with baseline.</p><p><strong>Results: </strong>228 participants (455 eyes) completed 2-year follow-up. Approximately 37.6% of 311 initially non-myopic eyes and 73.6% of 144 initially myopic eyes developed a myopic shift. Notably, at 3 months greater reductions were found in initially myopic eyes with myopic shift, than in those without myopic shift-in choroidal thickness (ChT), luminal area (LA), stromal area (SA) and total choroidal area (TCA), but no significant differences in any choroidal parameters were observed between non-myopic eyes, with and without myopic shift. Multivariable analyses showed that in myopic eyes, each percentage increase in ChT, LA, SA and TCA was associated with reduced odds of myopic shift (all p<0.001). Similar associations were observed in non-myopic eyes, with smaller effects than in myopic eyes. Adding a 3-month percentage change of each choroidal parameter to a basic model including age, gender, parental myopia and baseline refraction significantly improved the predictive performance in myopic eyes (area under the receiver operating characteristic curves increasing from 0.650 to approximately 0.800, all p<0.05), but not in non-myopic eyes.</p><p><strong>Conclusion: </strong>Short-term choroidal changes could act as early indicators for future myopic shift in children.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"273-280"},"PeriodicalIF":3.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of myopic maculopathy in Chinese children and adolescents with high myopia.","authors":"Feng Jiang, Ou Xiao, Xinxing Guo, Qiuxia Yin, Lixia Luo, Mingguang He, Zhixi Li","doi":"10.1136/bjo-2023-324430","DOIUrl":"10.1136/bjo-2023-324430","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the characteristics of myopic maculopathy among highly myopic Chinese children and adolescents and explore its associated risk factors.</p><p><strong>Methods: </strong>Children and adolescents aged 7-17 years with spherical equivalent (SE) ≤ -6.00 dioptres (D) were recruited. Myopic maculopathy was categorised based on the International Meta-Analysis of Pathological Myopia Classification. The extent of diffuse choroidal atrophy (DCA) was classified using Early Treatment Diabetic Retinopathy Study grid (ETDRS). The area of DCA was categorised into three classes relative to optic disk area (DA): A1 (≤1 DA), A2 (1 to ≤5 DA) and A3 (5 to ≤10 DA). Logistic regression was used to identify risk factors associated with myopic maculopathy.</p><p><strong>Results: </strong>Of the 425 participants aged 13.66±2.67 years, the proportions of tessellated fundus and DCA were 11.76% and 12.24%, and no more severe fundus lesions or 'plus' lesions. The proportion of DCA was 27.03% in children under 11, significantly higher than the 9.12% observed in those aged 11 and older (p<0.001). The percentages of DCA involving the outer, middle and central circles of the ETDRS grid were 42.31%, 55.77% and 1.92%. Myopic maculopathy was significantly associated with younger age (p<0.001), longer axial length (AL; p<0.001) and larger β-zone peripapillary atrophy (β-PPA; p=0.012).</p><p><strong>Conclusion: </strong>In highly myopic children and adolescents, myopic maculopathy predominantly manifested as DCA (12.24%), with no cases of worse myopic maculopathy or 'plus' lesions. Younger age, longer AL and larger β-PPA were risk factors for myopic maculopathy.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"257-263"},"PeriodicalIF":3.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual outcomes and prognostic factors in ischaemic retinal vasculitis.","authors":"Aaron Yap, Helen Kearns, Joanne L Sims, Rachael L Niederer","doi":"10.1136/bjo-2024-325775","DOIUrl":"10.1136/bjo-2024-325775","url":null,"abstract":"<p><strong>Purpose: </strong>Our aim was to describe the visual outcomes and determine the clinical factors in ischaemic retinal vasculitis (IRV) that were predictive of a poor visual prognosis or infectious aetiology.</p><p><strong>Methods: </strong>Retrospective cohort study of consecutive presentations of IRV to Auckland District Health Board from 2009 to 2022.</p><p><strong>Results: </strong>The median age at presentation was 39.2 years and 108 (53.7%) were women. The total median follow-up was 4.8 years. Infectious aetiology was present in 151 eyes (52.1%). Moderate visual loss (20/50 to 20/200) occurred in 20 eyes (6.9%) and severe visual loss (≤20/200) occurred in 41 eyes (14.1%). Median visual acuity was 20/30 (IQR 20/25 to 20/100) on presentation and 20/25 (IQR 20/20 to 20/50) at final follow-up. Retinitis (HR 4.675 p=0.048) and cystoid macular oedema (CME) (HR 7.265 p<0.001) were significantly associated with vision loss. There was concurrent macular ischaemia in 26 eyes (19.4%) and CME in 52 eyes (17.9%). Retinitis was predictive of infectious aetiology (p=0.006) and cotton wool spots for non-infectious aetiology (p<0.001). Retinal haemorrhage (HR 5.580 p=0.001), retinal vein occlusion (HR 5.071 p=0.001) and quadrants of ischaemia (HR 2.222 p=0.025) were significantly associated with vitreous haemorrhage.</p><p><strong>Conclusion: </strong>In patients with IRV, 21% of affected individuals sustained moderate-to-severe vision loss over 5 years. Ultra-widefield fluorescein angiography can be used to quantify the risk of neovascular complications and guide treatment.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"209-214"},"PeriodicalIF":3.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of subconjunctival TRIamcinolone acetonide injection and intravitreal dexamethasone (OZurdex) injection for uveitic and postoperative macular oedema: the TRIOZ study.","authors":"Chloé Couret, Pierre-Antoine Quintart, Alexandra Poinas, Marie-Anne Vibet, Marie-Laure Le Lez, Pierre Labalette, Bahram Bodaghi, Marc Labetoulle, Marie-Bénédicte Rougier, Karine Angioi, Christophe Chiquet, Cherif Titah, Laurent Kodjikian, Stephanie Baillif, Catherine Creuzot-Garcher, Marie-Hélène Errera, Michel Weber","doi":"10.1136/bjo-2023-325128","DOIUrl":"10.1136/bjo-2023-325128","url":null,"abstract":"<p><strong>Aims: </strong>To compare effectiveness of subconjunctival triamcinolone acetonide injections and intravitreal injections of dexamethasone 700 µg implants in reducing central macular thickness (CMT) in uveitic and postoperative macular oedema (ME).</p><p><strong>Methods: </strong>We conducted an open-label, French multicentre randomised comparative trial with a logarithmic CMT non-inferiority margin set at 0.06. Patients were adults with non-infectious inflammatory ME, without any contraindication to the treatments. They were randomised 1:1 to receive either triamcinolone or dexamethasone. The primary endpoint was the difference in CMT among treated eyes between baseline and 2 months, measured with spectral-domain optical coherence tomography. Secondary outcomes included visual acuity, laser flare, vitreous haze, duration of action, tolerance to injections and adverse events.</p><p><strong>Results: </strong>Between January 2016 and January 2020, 106 patients were enrolled (54 in the triamcinolone group and 52 in the dexamethasone group). Subconjunctival triamcinolone injections seemed to be non-inferior to intravitreal dexamethasone injections, especially at month 3 (and nearly at month 1). Nevertheless, we could not demonstrate it, with a treatment effect at month 2 of 0.05 (0.01 ; 0.09) (p value=0.001). This was corroborated by post hoc analyses in the postoperative subgroup, for whom the non-inferiority was nearly demonstrated at month 2 with a treatment effect of 0.02 (-0.03 ; 0.08) (p=0.37). There was no significant difference in the occurrence of adverse effects.</p><p><strong>Conclusion: </strong>We could not demonstrate the non-inferiority of triamcinolone injections at month 2. Nevertheless, they showed some efficacity, particularly in treating postoperative ME, being as safe as dexamethasone injections, without any loss of chance if a therapeutic switch is necessary.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"215-222"},"PeriodicalIF":3.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluid fluctuations assessed with artificial intelligence during the maintenance phase impact anti-vascular endothelial growth factor visual outcomes in a multicentre, routine clinical care national age-related macular degeneration database","authors":"Ruben Martin-Pinardel, Jordi Izquierdo-Serra, Carolina Bernal-Morales, Sandro De Zanet, Gonzaga Garay-Aramburu, Martin Puzo, Carolina Arruabarrena, Laura Sararols, Maximino Abraldes, Laura Broc, Jose Juan Escobar-Barranco, Marta Figueroa, Miguel Angel Zapata, José M Ruiz-Moreno, Alba Parrado-Carrillo, Aina Moll-Udina, Socorro Alforja, Marc Figueras-Roca, Laia Gómez-Baldó, Carlos Ciller, Stefanos Apostolopoulos, Anastasiia Mishchuk, Ricardo P Casaroli-Marano, Javier Zarranz-Ventura","doi":"10.1136/bjo-2024-325615","DOIUrl":"https://doi.org/10.1136/bjo-2024-325615","url":null,"abstract":"Aim To evaluate the impact of fluid volume fluctuations quantified with artificial intelligence in optical coherence tomography scans during the maintenance phase and visual outcomes at 12 and 24 months in a real-world, multicentre, national cohort of treatment-naïve neovascular age-related macular degeneration (nAMD) eyes. Methods Demographics, visual acuity (VA) and number of injections were collected using the Fight Retinal Blindness tool. Intraretinal fluid (IRF), subretinal fluid (SRF), pigment epithelial detachment (PED), total fluid (TF) and central subfield thickness (CST) were quantified using the RetinAI Discovery tool. Fluctuations were defined as the SD of within-eye quantified values, and eyes were distributed according to SD quartiles for each biomarker. Results A total of 452 naïve nAMD eyes were included. Eyes with highest (Q4) versus lowest (Q1) fluid fluctuations showed significantly worse VA change (months 3–12) in IRF −3.91 versus 3.50 letters, PED −4.66 versus 3.29, TF −2.07 versus 2.97 and CST −1.85 versus 2.96 (all p<0.05), but not for SRF 0.66 versus 0.93 (p=0.91). Similar VA outcomes were observed at month 24 for PED −8.41 versus 4.98 (p<0.05), TF −7.38 versus 1.89 (p=0.07) and CST −10.58 versus 3.60 (p<0.05). The median number of injections (months 3–24) was significantly higher in Q4 versus Q1 eyes in IRF 9 versus 8, SRF 10 versus 8 and TF 10 versus 8 (all p<0.05). Conclusion This multicentre study reports a negative effect in VA outcomes of fluid volume fluctuations during the maintenance phase in specific fluid compartments, suggesting that anatomical and functional treatment response patterns may be fluid-specific. Data are available in a public, open access repository. Zarranz-Ventura J. (n.d.). Data from: FRB Spain IMAGE nAMD Report 2. Dryad Digital Repository, March 30, 2024. (<https://doi.org/10.5061/dryad.m905qfv8p>).","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can large language models fully automate or partially assist paper selection in systematic reviews?","authors":"Haichao Chen, Zehua Jiang, Xinyu Liu, Can Can Xue, Samantha Min Er Yew, Bin Sheng, Ying-Feng Zheng, Xiaofei Wang, You Wu, Sobha Sivaprasad, Tien Yin Wong, Varun Chaudhary, Yih Chung Tham","doi":"10.1136/bjo-2024-326254","DOIUrl":"https://doi.org/10.1136/bjo-2024-326254","url":null,"abstract":"Background/aims Large language models (LLMs) have substantial potential to enhance the efficiency of academic research. The accuracy and performance of LLMs in a systematic review, a core part of evidence building, has yet to be studied in detail. Methods We introduced two LLM-based approaches of systematic review: an LLM-enabled fully automated approach (LLM-FA) utilising three different GPT-4 plugins (Consensus GPT, Scholar GPT and GPT web browsing modes) and an LLM-facilitated semi-automated approach (LLM-SA) using GPT4’s Application Programming Interface (API). We benchmarked these approaches using three published systematic reviews that reported the prevalence of diabetic retinopathy across different populations (general population, pregnant women and children). Results The three published reviews consisted of 98 papers in total. Across these three reviews, in the LLM-FA approach, Consensus GPT correctly identified 32.7% (32 out of 98) of papers, while Scholar GPT and GPT4’s web browsing modes only identified 19.4% (19 out of 98) and 6.1% (6 out of 98), respectively. On the other hand, the LLM-SA approach not only successfully included 82.7% (81 out of 98) of these papers but also correctly excluded 92.2% of 4497 irrelevant papers. Conclusions Our findings suggest LLMs are not yet capable of autonomously identifying and selecting relevant papers in systematic reviews. However, they hold promise as an assistive tool to improve the efficiency of the paper selection process in systematic reviews. Data are available upon reasonable request. All data and code are available upon request by emailing thamyc@nus.edu.sg.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"28 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142986795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal corneal hysteresis changes predict structural progression in medically controlled, early-to-moderate, open-angle glaucoma with a history of refractive surgery","authors":"Jihei Sara Lee, Hyoung Won Bae, Chan Yun Kim, Sang Yeop Lee","doi":"10.1136/bjo-2024-326405","DOIUrl":"https://doi.org/10.1136/bjo-2024-326405","url":null,"abstract":"Background The present study aims to identify the relationship between longitudinal changes in corneal hysteresis (CH) and progressive retinal nerve fibre layer (RNFL) thinning in a cohort of medically controlled, early-to-moderate open-angle glaucoma (OAG) patients with a history of laser refractive surgery (LRS). Methods A total of 123 consecutive eyes with a diagnosis of medically controlled (peak intraocular pressure (IOP)<18 mm Hg), early-to-moderate OAG with a history of LRS underwent measurements of CH, corneal-compensated intraocular pressure (IOPcc) and RNFL thicknesses every 6 months. Linear models were used to investigate the relationship between CH change and RNFL thickness change over time. Results Of 123 eyes, 30 eyes (24.4%, 42.9±9.3 years, 36.7% males) demonstrated RNFL loss (93 eyes no progression, 44.4±9.6 years, 30.1% males). No statistically significant difference was found in IOP, but significantly greater decrease in CH was noted in the progression group (−2.525% baseline (95% CI −4.974 to −0.076) vs 1.068% baseline (95% CI, −0.322 to 2.458); p=0.013). Relative CH change was greater for more advanced stage of OAG among the progression group. Patients with the greatest relative CH decrease over time was 1.7 times more likely to present RNFL loss (HR 1.705, 95% CI 1.113 to 2.611, p=0.014). Conclusions Longitudinal decrease in CH over time was greater in those showing structural progression than those without progression among medically controlled, early-to-moderate OAG with a history of LRS. Decrease in CH was significantly associated with faster RNFL loss. Larger CH changes indicate a higher risk of OAG progression in those with a history of LRS. Data are available upon reasonable request. Data are available upon reasonable request to the corresponding author.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"17 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low clinical activity score, ‘progressive’ thyroid eye disease: presentations of 1439 patients from a tertiary centre in Hong Kong","authors":"Kenneth Ka Hei Lai, Fatema Mohamed Ali Abdulla Aljufairi, Jake Uy Sebastian, Kei Hei Lai, Karen Kar Wun Chan, Joyce Kar Yee Chin, Regine Yien Ching Chan, Chi Lai Li, Wilson Wai Kuen Yip, Alvin Lerrmann Young, Clement Chee Yung Tham, Chi Pui Pang, Kelvin Kam Lung Chong","doi":"10.1136/bjo-2024-325346","DOIUrl":"https://doi.org/10.1136/bjo-2024-325346","url":null,"abstract":"Background To report the presenting clinical, serological and treatment profiles of 1439 patients with thyroid eye disease (TED) from a tertiary centre in Hong Kong. Study populations Consecutive patients with TED presented to the Thyroid Eye Clinic (TEC), the Chinese University of Hong Kong between 2014 and 2023. Methods Prospective cohort and masked review of medical records and orbital images. Results A total of 1439 (70% female, 98% Han Chinese) patients with TED (26% ex/current smoker), presented at 43±5.9 years old, were reviewed. The first TED symptoms to TEC evaluation was 6±3 months. 85% had Graves’ disease and 12% were given radioactive iodine before presentation. 35% of patients had a family history of autoimmune thyroid diseases. Baseline thyroid-stimulating hormone receptor antibody, thyroid-stimulating immunoglobulin and thyroid peroxidase antibody were elevated in 75%, 69% and 57% tested. Euthyroid TED (E-TED) was diagnosed in 6%, associated with asymmetric presentation (p<0.001). The most common signs were exophthalmos (69%), upper eyelid retraction (53%), swelling (36%), conjunctival injection (34%) and lower eyelid retraction (32%). Notably, 547 (38%) presented with moderate-to-severe and 150 (10%) vision-threatening TED, whose clinical activity score (CAS) was just 2.4±1.4 and 2.6±1.5, respectively. Male and TED onset after 40 were associated with higher CAS and NOSPEC (No physical signs or symptoms, Only signs, Soft tissue involvement, Proptosis, Extraocular muscle signs, Corneal involvement, and Sight loss) score (both p<0.05). 471 (33%), 361 (25%), 263 (18%) and 138 (9%) patients received intravenous methylprednisolone, orbital radiotherapy, steroid-sparing immunosuppressants and surgical decompression, respectively. Conclusions Around one-third (34%) of our cohort presented with ‘low-CAS, progressive’, moderate-to-severe or vision-threatening TED, while only one-fifth (18%) were clinically active (CAS≥3). Our results showed the limitations and unmet need of the existing ‘high-CAS only’ approach, especially in managing ‘non-inflammatory’ TED, prevalent in non-Caucasian populations. Data are available upon reasonable request. No data are available. Not applicable.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"21 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors of myopic macular degeneration: the Aier-SERI high myopia adult cohort","authors":"Li Lian Foo, Yanfeng Jiang, Quan V Hoang, Hla Myint Htoon, Ziqi Hu, Wei Pan, Kai Xiong Cheong, Ecosse Luc Lamoureux, Zhikuan Yang, Weizhong Lan, Seang-Mei Saw","doi":"10.1136/bjo-2024-326116","DOIUrl":"https://doi.org/10.1136/bjo-2024-326116","url":null,"abstract":"Purpose To assess the prevalence and risk factors of myopic macular degeneration (MMD) in young and middle-aged individuals with high myopia in Changsha, central China. Methods A total of 445 adults with high myopia (worse than or equal to −5.0 D) were examined between 2021 and 2023. Autorefraction and biometry using IOLMaster were conducted, and fundus photos were graded for MMD using Meta-PM criteria. MMD was diagnosed if category 2, 3, 4 or any plus lesion was present. Risk factors such as age, gender, spherical equivalent (SE)/axial length (AL), body mass index, education and residence were analysed via logistic regression. Results Participants had an average age of 42.3±7.3 years. MMD prevalence was 21.8% (71 adults) with a mean SE of −9.5±4.7 D and AL of 27.3±1.9 mm. Significant risk factors included greater myopic SE (OR=1.7 per 1 D decrease) and longer AL (OR=3.6 per 1 mm increase). MMD prevalence rose sharply with myopia worse than −10.00 D and AL >27.00 mm, reaching up to 100% for myopia worse than −14.00 D or AL ≥29.00 mm. Conclusion MMD affects about one in five young to middle-aged adults with high myopia. Those exceeding critical myopia and AL thresholds are at higher risk and should be closely monitored. Further research on interventions to prevent axial elongation is needed, particularly for those with high genetic risk. Data are available upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"12 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}