Yağmur Seda Yeşiltaş, Millennia Zhou, Emily C Zabor, Zackery Oakey, Nakul Singh, Ahad Sedaghat, Gabrielle Yeaney, Arun D Singh
{"title":"Iris freckle: a distinct entity.","authors":"Yağmur Seda Yeşiltaş, Millennia Zhou, Emily C Zabor, Zackery Oakey, Nakul Singh, Ahad Sedaghat, Gabrielle Yeaney, Arun D Singh","doi":"10.1136/bjo-2023-325009","DOIUrl":"10.1136/bjo-2023-325009","url":null,"abstract":"<p><strong>Purpose: </strong>To report distinctive clinical and imaging features of iris freckles to differentiate them from iris nevi.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Subjects: </strong>53 patients (277 freckles) with incidental iris freckles and 102 patients (104 nevi) with iris nevi that are either clinically stable or pathologically confirmed.</p><p><strong>Methods: </strong>Patient data were collected from the Department of Ophthalmic Oncology, Cleveland Clinic, Cole Eye Institute database (2012-2023). Lesion characteristics were recorded from slit-lamp examination descriptions and review of colour photographs. Ancillary imaging features observed using anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) were assessed in patients (where available).</p><p><strong>Main outcome measures: </strong>Comparison of clinical and imaging features of iris freckles and iris nevi.</p><p><strong>Results: </strong>A total of 277 iris freckles and 104 iris nevi were analysed. Iris freckles were more frequently bilateral (17%; nevi 0%) and multiple (69%; nevi 2%) and located centrally (89%; nevi 17%) compared with iris nevi (p<0.001). The median freckle largest basal diameter and thickness were 0.8 mm (nevi; 2.1 mm, p<0.001) and 0.04 mm (nevi 1.0 mm, p<0.001), respectively. All iris freckles had irregular margins without any secondary effects compared with iris nevi. Iris freckles appeared flat without effacement of iris folds compared with iris nevi on AS-OCT (p<0.001). Iris freckles were not detectable by UBM. Heat map revealed that freckles demonstrated several features with uniform or near uniform values, whereas nevi demonstrated more variability in values across features.</p><p><strong>Conclusions: </strong>Iris freckles exhibit specific clinical and imaging features reflective of their characteristic histological composition that support their classification as a distinct entity within the spectrum of iris pigmented lesions.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"1749-1754"},"PeriodicalIF":3.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157563","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}
Qi Zhang, Xiujuan Zhao, Xia Huang, Qingxiu Wu, Shida Chen, Yonghao Li, Ping Lian, Lin Lu
{"title":"METAVISION: a novel system for quantifying metamorphopsia in patients with myopic traction maculopathy.","authors":"Qi Zhang, Xiujuan Zhao, Xia Huang, Qingxiu Wu, Shida Chen, Yonghao Li, Ping Lian, Lin Lu","doi":"10.1136/bjo-2023-324175","DOIUrl":"10.1136/bjo-2023-324175","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a novel system for quantifying metamorphopsia in patients with myopic traction maculopathy (MTM) and to explore the metamorphopsia pattern of MTM.</p><p><strong>Design: </strong>Observational, cross-sectional study.</p><p><strong>Methods: </strong>We designed a new system.</p><p><strong>Results: </strong>Of the 445 eyes tested, 188 (42.25%) were deemed by patients to have metamorphopsia impacting their daily lives while 257 (57.75%) were considered to have no metamorphopsia symptoms. The Amsler grid, M-CHARTS and METAVISION tests displayed sensitivities for metamorphopsia of 95.74%, 89.89% and 100%, respectively. The specificities of the Amsler grid, M-CHARTS and METAVISION tests are 100%. The metamorphopsia questionnaire and METAVISION scores were highly consistent (average intraclass correlation coefficient=0.951, p<0.001) and strongly correlated (R=0.879, p<0.001). The METAVISION score was highly correlated with the stages of MTM (R=0.837, p<0.001), whereas there was a moderate correlation between the M-CHARTS M-score and the stages of MTM (R=0.679, p<0.001).</p><p><strong>Conclusions: </strong>Quantification of metamorphopsia is important and useful for MTM management. The METAVISION is a clinically applicable and comprehensive approach for quantifying metamorphopsia, which can be used in clinical settings.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"1723-1728"},"PeriodicalIF":3.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140903690","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":"Ophthalmic quality of life in the adult Danish population: an epidemiological study.","authors":"Toke Bek, Bodil Hammer Bech","doi":"10.1136/bjo-2023-324414","DOIUrl":"10.1136/bjo-2023-324414","url":null,"abstract":"<p><strong>Background: </strong>Ophthalmic quality of life (OQoL) has been investigated in selected parts of general populations and in patients with ocular disease, but OQoL in unselected general populations has not been studied in detail. The present study reports OQoL obtained from a representative sample of the adult Danish population 2020-2022.</p><p><strong>Methods: </strong>The FORSYN study invited 10 350 citizen representatives for the adult Danish population for a non-mydriatic eye examination and answer the National Eye Institute Visual Function Questionnaire with 39 items in the validated Danish translation. The results from the 3384 (32.7%) persons who participated in the study were weighted on the basis of relevant socio-economic factors, and data were projected to represent the total population. Binocular visual acuity was below 0.1 corresponding to legal blindness in 0.22% of this population.</p><p><strong>Results: </strong>OQoL was positively correlated with binocular visual acuity up to better than 93 ETDRS letters, negatively correlated with age for persons younger than 60 years of age and again positively correlated with age for persons older than 60 years. OQoL was negatively correlated with increasing ametropia and refractive error above 1 dioptre and encompassed more OQoL parameters for hyperopic than for myopic persons.</p><p><strong>Conclusions: </strong>The study underlines the benefits of improving visual acuity even within the normal range and of adjusting uncorrected refraction errors in the general population. OQoL is positively correlated with age in older persons independently of visual acuity, sex, refractive power and previous cataract surgery.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"1755-1759"},"PeriodicalIF":3.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080714","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}
Danny Siu-Chun Ng, Li Jia Chen, Leo Ka Yu Chan, Fang Yao Tang, Wee-Min Teh, Linbin Zhou, Fiona Chan, Eleanor Sui Sum Lin, Ka Wai Yuen, Wai Kit Chu, Shaheeda Mohamed, Chi Wai Tsang, Xinyuan Zhang, Jason C Yam, Chi-Pui Pang, Timothy Y Y Lai
{"title":"Improved accuracy of spectral-domain optical coherence tomography and optical coherence tomography angiography for monitoring myopic macular neovascularisation activity.","authors":"Danny Siu-Chun Ng, Li Jia Chen, Leo Ka Yu Chan, Fang Yao Tang, Wee-Min Teh, Linbin Zhou, Fiona Chan, Eleanor Sui Sum Lin, Ka Wai Yuen, Wai Kit Chu, Shaheeda Mohamed, Chi Wai Tsang, Xinyuan Zhang, Jason C Yam, Chi-Pui Pang, Timothy Y Y Lai","doi":"10.1136/bjo-2023-323374","DOIUrl":"10.1136/bjo-2023-323374","url":null,"abstract":"<p><strong>Background/aims: </strong>To evaluate the diagnostic accuracy of spectral-domain optical coherence tomography (SD OCT) combined with OCT angiography (OCTA) for myopic myopic macular neovascularisation (MNV) activity.</p><p><strong>Methods: </strong>Both eyes of patients with myopic MNV diagnosed with fluorescein angiography (FA), SD OCT and OCTA were assessed by unmasked investigators. The images were deidentified and randomised before graded by masked investigators, who determined the presence of active myopic MNV by using SD OCT together with OCTA without FA and by FA alone, respectively. The findings of masked investigators were compared with unmasked investigators.</p><p><strong>Results: </strong>213 eyes of 110 patients comprising 499 imaging episodes were eligible for grading. For diagnosing new-onset myopic MNV without FA, combined use of SD OCT and OCTA had a sensitivity of 0.94, specificity of 0.84 and area under the curve (AUC) of 0.92. FA had a sensitivity of 0.52 (p<0.01), specificity of 0.80 (p=0.38) and AUC of 0.66 (p<0.01). For recurrent myopic MNV, the combination of SD OCT and OCTA had a sensitivity of 0.98, specificity of 0.78 and AUC of 0.88. FA had a sensitivity of 0.50 (p=0.04), specificity of 0.76 (p=0.85) and AUC of 0.63 (p=0.01). Myopic traction maculopathy was more frequently associated with recurrent myopic MNV (p<0.01).</p><p><strong>Conclusion: </strong>SD OCT with dense volumetric scan was highly sensitive for diagnosing myopic MNV. The addition of OCTA improved the diagnostic specificity without FA. Monitoring of the longitudinal changes on SD OCT and judicious use of FA is a reliable surveillance strategy for myopic MNV.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"1729-1736"},"PeriodicalIF":3.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140903687","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}
Louis Arnould, Elise Balsat, Yohei Hashimoto, Andrew White, George Kong, Hamish Dunn, Leo Fan, Pierre-Henry Gabrielle, Alain M Bron, Catherine P Creuzot-Garcher, Mitchell Lawlor
{"title":"Two-year outcomes of Xen 45 gel stent implantation in patients with open-angle glaucoma: real-world data from the Fight Glaucoma Blindness registry.","authors":"Louis Arnould, Elise Balsat, Yohei Hashimoto, Andrew White, George Kong, Hamish Dunn, Leo Fan, Pierre-Henry Gabrielle, Alain M Bron, Catherine P Creuzot-Garcher, Mitchell Lawlor","doi":"10.1136/bjo-2023-325077","DOIUrl":"10.1136/bjo-2023-325077","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate efficacy and safety outcomes of the Xen 45 gel stent implant over 24 months of follow-up.</p><p><strong>Methods: </strong>A retrospective analysis of prospectively collected data from the Fight Glaucoma Blindness observational registry. Complete success (CS) was defined as intraocular pressure (IOP) reduction ≥20% from preoperative and an IOP ≤18 mm Hg and ≥6 mm Hg with no secondary procedure at 2 years and without IOP-lowering medications. Qualified success (QS) was defined similarly, allowing the use of IOP-lowering medications.</p><p><strong>Results: </strong>The Xen 45 gel stent implant was implanted in 646 eyes of 515 patients. Preoperative IOP was 21.4±7.6 (mean±SD) mm Hg on 2.7±1.3 IOP-lowering medication and mean deviation was -10.2±8.4 dB. After 24-month follow-up, IOP was 16.8±7.3 mm Hg (mean reduction of 21.7%) on 1.2±1.4 IOP-lowering medications. CS and QS rates at 24 months were 26% and 48%, respectively. CS and QS were higher in the Xen stand-alone group (33% and 52%, respectively) than in the Xen+cataract group (16% and 42%, respectively). Bleb needling was performed in 28.4% of cases, and 18% underwent a secondary procedure.</p><p><strong>Conclusions: </strong>The Xen 45 gel stent implant offers acceptable long-term efficacy for the treatment of open-angle glaucoma. However, there is a significant rate of reoperation and needling, and outcomes are less effective if combined with cataract surgery.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"1672-1678"},"PeriodicalIF":3.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141092860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alejandra Daruich, Maxence Rateaux, Emilie Batté, Nathalie de Vergnes, Sophie Valleix, Matthieu P. Robert, Dominique Bremond Gignac
{"title":"12-month outcomes after voretigene neparvovec gene therapy in paediatric patients with RPE65-mediated inherited retinal dystrophy","authors":"Alejandra Daruich, Maxence Rateaux, Emilie Batté, Nathalie de Vergnes, Sophie Valleix, Matthieu P. Robert, Dominique Bremond Gignac","doi":"10.1136/bjo-2024-326221","DOIUrl":"https://doi.org/10.1136/bjo-2024-326221","url":null,"abstract":"Aims To report main outcomes and complications following voretigene neparvovec (Luxturna) treatment in paediatric patients. Methods Records of patients under the age of 17 treated by subretinal administration of voretigene neparvovec for confirmed biallelic RPE65 -mediated inherited retinal dystrophy were retrospectively reviewed. Best-corrected visual acuity (BCVA) and data from spectral-domain optical coherence tomography, ultra-wide-field fundus imaging and Goldmann visual field (VF) were analysed at 12 months follow-up. Results 12 eyes of six patients (mean age: 7.8 years) were analysed. No intraoperative complications occurred. BCVA significantly improved at 12-month follow-up (mean LogMAR (logarithm of the minimal angle of resolution) BCVA: 1.0±0.8 at baseline vs 0.6±0.3 at 12 months, p=0.001). Mean central macular thickness and central outer nuclear layer thickness did not change at 12 months follow-up. VF V4e isopter did not show significant changes. Postoperatively complications included: elevated intraocular pressure in two eyes of the same patient, a parafoveal lamellar hole at 3 months post-treatment and atrophy on the injection site observed in all eyes except one, which significantly enlarged during 12 months (p=0.008). Conclusions Most paediatric patients treated by voretigene neparvovec showed a significant increase in visual function at 12 months follow-up. None of the postoperative complications prevented gains in visual function. All data relevant to the study are included in the article or uploaded as supplementary information. NA.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"60 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684534","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":"Clinical characteristics and optical coherence tomography features of ocular toxoplasmosis inHIV-positive patients: report 1","authors":"Anamika Patel, Merlin Saldanha, Anup Kelagaonkar, Thorani Yediballi, Ilaria Testi, Carlos Pavesio, Avinash Pathengay","doi":"10.1136/bjo-2024-326306","DOIUrl":"https://doi.org/10.1136/bjo-2024-326306","url":null,"abstract":"Purpose This study aimed to identify the various clinical characteristics and ocular imaging features of ocular toxoplasmosis (OT) in HIV patients. Methods Observational retrospective study of 52 eyes of 38 HIV patients with OT. Results 68% of patients were male. 53.8% of eyes had keratic precipitates, anterior chamber cells were seen in 61.5%. 57.69% (n=30) eyes had de novo presentation of retinitis and 42.3% (n=22) of eyes had a retinochoroidal scar at presentation. Bilateral presentation was seen in 37% (n=14). Unifocal retinitis was noted in 38.4% (n=20) and 61.5% of eyes had multifocal (multizonal) retinitis (n=32). The most common multizonal involvement was noted in combined zone 1+2(n=14, 26.9%). The average horizontal and vertical measurements retinitis was 8.35 mm and 7.48 mm, respectively. The average area of retinitis was 66.2 mm2. Localised posterior vitreous detachment was seen in 83% of eyes and posterior hyaloid precipitates were noted in (n=7,39%) of eyes. Retinitis without retinal pigment epithelium elevation occurred in 88.8% of cases, compared with retinitis with retinal pigment epithelium elevation seen in 44.4% of eyes. 50% of eyes had thickened choroid beneath the retinitis lesion. Other unique signs of optical coherence tomography (OCT) noted were angular signs of Henle fibre layer hyper-reflectivity sign (n=1), halo lesions with central hypo (n=3) and choroidal excavation (n=1). Conclusions OT in HIV patients presents with large, bilateral, multifocal retinitis, generally devoid of haemorrhages and can rarely have central clearing. These lesions may present with or without a previous retinochoroidal scar. These lesions have horizontal spread and may not always have thickened choroid on OCT. Data are available on reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678507","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 baseline clinical characteristics and patterns of visual field defects between high-tension and normal-tension glaucoma","authors":"Zidong Chen, Wenxin Yang, Yangfan Yang, Yuzhen Jiang, Yuning Zhang, Xinyi Zhang, Chongxuan Luo, Mingqin Wang, Yanmei Fan, Pingping Liu, Neil Nathwani, Gus Gazzard, Minbin Yu","doi":"10.1136/bjo-2023-324852","DOIUrl":"https://doi.org/10.1136/bjo-2023-324852","url":null,"abstract":"Aims To compare the baseline clinical characteristics and patterns of visual field defects between high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) in the Laser in Glaucoma and Ocular Hypertension (LiGHT) China subjects. Methods All patients (n=622) were recruited at Zhongshan Ophthalmic Center from 2015 to 2019. 1105 open-angle glaucoma eyes of 622 patients were classified as NTG (n=559) and HTG eyes (n=546) according to the baseline intraocular pressure (IOP) of 21 mm Hg. The mean deviation (MD), regional MD of the Glaucoma Hemifield Test regions and regional difference values were calculated. Daytime phasing IOP was recorded at 8:00, 10:00, 11:30, 14:30 and 17:00 hour. Multiple regression analyses were conducted for each regional difference. Results Patients with NTG were older, more likely to be female, hypertensive and suffer ischaemic heart disease than patients with HTG (p<0.05 for all comparisons). HTG showed higher mean daytime phasing IOP and higher daytime fluctuations than NTG (p<0.001 for all comparisons). HTG and NTG showed similar MD overall (p=0.665). NTG showed significantly greater hemifield asymmetry than HTG. The two arcuate regional differences in NTG were significantly associated with daytime IOP fluctuations (p<0.01 in both regions). Conclusions In the LiGHT China trial, NTG and HTG showed similar visual field defects severity at enrolment. However, NTG showed more severe hemifield asymmetry compared with HTG, and higher short-time IOP fluctuations might exacerbate this asymmetry in NTG. Data are available upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"128 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142673241","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}
Eugene Kim, Magdalena Stec, Noreen Shaikh, Jonathan Huang, Hantamalala Ralay Ranaivo, Rebecca Mets-Halgrimson
{"title":"Refractive changes in children in the Chicago area during the COVID-19 pandemic: a retrospective observational study.","authors":"Eugene Kim, Magdalena Stec, Noreen Shaikh, Jonathan Huang, Hantamalala Ralay Ranaivo, Rebecca Mets-Halgrimson","doi":"10.1136/bjo-2024-325984","DOIUrl":"10.1136/bjo-2024-325984","url":null,"abstract":"<p><strong>Background: </strong>Remote learning during the COVID-19 pandemic caused behavioural changes such as increased screen time and decreased outdoor time. This study aimed to investigate myopia progression in children during the COVID-19 pandemic.</p><p><strong>Methods: </strong>This was a retrospective observational study performed among 2064 patients ages 2-17 with cycloplegic refractions in the months of January 2019-March 2021 at a tertiary children's hospital. Exclusion criteria were a medical history of relevant connective tissue diseases, myopia control treatment, pseudophakia and aphakia.</p><p><strong>Results: </strong>The overall cohort (n=2064) had a mean spherical equivalent (SE) of 0.12±3.70 D in 2019, -0.07±3.95 D in 2020 and -0.49±3.85 D in 2021. The change in mean SE (0.42 D) from 2020 to 2021 was 2.2 times greater than the change (0.19 D) from 2019 to 2020 at baseline. In the cohort of return patients, there was a significant difference in myopic shift between years (F-ratio=14.4, p<0.00001), and a significant change from 2020 to 2021 (p=0.00008) but not from 2019 to 2020. When observing the prevalence of myopia grouped by age, 8-year-old and 17-year-old patients had the greatest increase compared with baseline. When grouped by refractive error, low myopia children (-0.5 D to -3.00 D) displayed the greatest change in mean SE 2020-2021.</p><p><strong>Conclusions: </strong>There was a substantial increase in myopia progression for children in the Chicagoland area after the period of COVID-19 changes. The behavioural changes of home confinement and online learning during the pandemic may explain these findings.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667364","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}
Yohei Hashimoto, Adrian Robert Hunt, Jane M Wells, Gayatri Banerjee, Ross Ferrier, Richard Barry, Andrew Field, Justin Game, Claire Yvonne Hooper, Daniel Barthelmes, Mark C Gillies
{"title":"Outlier ophthalmologists in the treatment of neovascular age-related macular degeneration with intravitreal therapy.","authors":"Yohei Hashimoto, Adrian Robert Hunt, Jane M Wells, Gayatri Banerjee, Ross Ferrier, Richard Barry, Andrew Field, Justin Game, Claire Yvonne Hooper, Daniel Barthelmes, Mark C Gillies","doi":"10.1136/bjo-2024-326024","DOIUrl":"https://doi.org/10.1136/bjo-2024-326024","url":null,"abstract":"<p><strong>Background: </strong>To compare individual ophthalmologists grouped as outliers or non-outliers based on the mean 12-month visual acuity (VA) outcomes for their patients with neovascular age-related macular degeneration (nAMD).</p><p><strong>Methods: </strong>This prospectively designed database study included treatment-naïve eyes with nAMD starting vascular endothelial growth factor inhibitors between July 2018 and April 2023 in Australia. Ophthalmologists were classified into high outliers, non-outliers and low outliers with a funnel plot of the adjusted mean 12-month VA change. The number of injections, last injection interval and proportion of visits where choroidal neovascularisation was active were compared between the groups.</p><p><strong>Results: </strong>38 ophthalmologists who treated a total of 1266 eyes (male, 35%; mean age, 81 years old) were classified into 1 high outlier, 34 non-outliers and 3 low outliers (mean VA change, 7.5, 5.1 and 2.5 letters, respectively). The high outlier gave significantly more injections than the non-outliers (mean, 8.6 vs 7.7; p<0.001), while the low outliers administered significantly fewer injections than the non-outliers (mean, 7.1 vs 7.7; p=0.009). The last injection interval was shortest in the high outlier's eyes (9.4 weeks), followed by non-outliers' (10.8 weeks; p=0.04 (vs high outlier's)) and low outliers' (11.8 weeks; p=0.22 (vs non-outliers')). The low outliers' patients had more visits with intraretinal fluid (59%) than non-outliers' (29%; p<0.001) and high outlier's patients (31%; p<0.001).</p><p><strong>Conclusion: </strong>The low outliers' eyes had fewer injections, a longer treatment interval and more visits with intraretinal fluid. Building a system through which low outliers are anonymously notified of their performance would help improve general quality of care.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615185","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}