British Journal of Ophthalmology最新文献

{"title":"Low-concentration bimatoprost 0.01% and timolol 0.1% eye gel versus bimatoprost 0.03% and timolol 0.5% eye drops in open-angle glaucoma or ocular hypertension: a phase III randomised study","authors":"M Francesca Cordeiro, Francesco Oddone, Elena Atanasova Mermeklieva, Dariusz MD Rokicki, Sylvie Nisslé, Piotr Gościniewicz, Ingeborg Stalmans","doi":"10.1136/bjo-2025-327555","DOIUrl":"https://doi.org/10.1136/bjo-2025-327555","url":null,"abstract":"Background/Aims To compare the efficacy and safety of a new preservative-free bimatoprost 0.01%/timolol 0.1% fixed combination (BTFC) eye gel with those of bimatoprost 0.03%/timolol 0.5% fixed combination ophthalmic solution (BTFC eye drops) in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). Methods In this phase III, international, multi-centre, randomised, parallel group, investigator-masked study, patients receiving a first-line monotherapy, having insufficiently controlled intraocular pressure (IOP) and requiring dual therapy were randomised to receive either BTFC eye gel or BTFC eye drops once daily for 12 weeks. The primary efficacy endpoint was the change in IOP from baseline to week 12 at 08:00 in the assessed eye. Further efficacy and safety endpoints were assessed as secondary outcomes. Results The mean±SD change in IOP from baseline to week 12 at 08:00 was −10.96±3.43 mmHg for the BTFC eye gel group and −11.14±3.56 mmHg for the BTFC eye drop group. The least-squares mean difference (BTFC eye gel minus BTFC eye drops) was −0.04±0.24 mmHg (95% CI −0.51 to 0.43 mmHg), with the upper bound of the 95% CI lower than the predefined margin of +1.5 mmHg at week 12 at 08:00. Similar IOP-lowering efficacy was demonstrated at all other timepoints. The safety profile was comparable between the treatment groups. No patients in the BTFC eye gel group discontinued the study due to a treatment-related adverse event compared with 8 (2.9%) patients in the BTFC eye drop group. Conclusion Low-concentration BTFC eye gel can be considered as a safe and effective treatment in the therapeutic management of glaucoma and OHT. No data are available.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"13 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145288308","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":"Two-year outcomes of repeated red light therapy in premyopic children: sustained efficacy and rebound effects","authors":"Guihua Liu, Na Li, Hua Rong, Jiamei Hu, Enpei Pei, Emmanuel Eric Pazo, Bei Du, Ruihua Wei","doi":"10.1136/bjo-2025-327600","DOIUrl":"https://doi.org/10.1136/bjo-2025-327600","url":null,"abstract":"Background To evaluate the long-term prevention effectiveness and rebound effect of repeated red light therapy (RRLT) in children with premyopia over 2 years. Methods A total of 108 premyopic children (cycloplegia spherical equivalent refraction (SER): −0.50 to +0.75 D) were enrolled and followed for 24 months. Participants were randomly assigned to the RRLT or control groups. The RRLT was administered two times per day for 3 min per session, with at least 4-hour interval. At the beginning of the second year, participants receiving RRLT were further randomised into continued treatment and washout subgroups. Axial length (AL), SER and subfoveal choroidal thickness (SChT) were measured. Results Over 2 years, the RRLT group showed significantly smaller AL elongation (0.26 mm; 95% CI 0.18 to 0.35 mm) and SER progression (−0.21 D; 95% CI −0.35 to −0.08 D) compared with the controls (AL: 0.43 mm; 95% CI 0.36 to 0.49 mm; SER: −0.66 D; 95% CI −0.79 to −0.52 D). The RRLT group also demonstrated significantly less SChT thinning (−2.44 µm; 95% CI −16.11 to 11.23 µm) than the controls (−44.12 µm; 95% CI −53.05 to −35.19 µm). After RRLT cessation in the second year, the washout subgroup exhibited significantly faster AL elongation and more SChT thinning than the controls, with no significant difference in SER progression. Conclusions The 2-year RRLT intervention effectively retarded AL elongation and SER progression in premyopic children by 0.17 mm and −0.45 D, respectively. Notably, a significant rebound effect was observed in AL growth following 1-year RRLT cessation. Data are available upon reasonable request. The datasets generated/analyzed during the current study are available from the corresponding author on reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"131 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145255672","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":"Antimicrobial concentrations in the cornea and aqueous humour: a meta-analysis","authors":"Keri McLean, Grace Dawson, Daniel Foulkes, Rose Herbert, Petya Popova, Danielle Bernard-Deshong, Victoria Massie, Alfredo Borgia, Matteo Airaldi, Tobi F Somerville, Gabriela Czanner, Timothy Neal, Stephen Tuft, Stephen B Kaye","doi":"10.1136/bjo-2025-327962","DOIUrl":"https://doi.org/10.1136/bjo-2025-327962","url":null,"abstract":"Aim To interpret the likely clinical susceptibility of isolates from microbial keratitis (MK), we performed a meta-analysis of published data that measured the concentrations of topically applied antimicrobials in the cornea or aqueous humour. We then correlated these values with the in vitro minimum inhibitory concentration (MIC). Methods We searched PubMed to identify studies reporting aqueous and/or corneal concentrations of 53 topically applied ocular antimicrobials, spanning the following classes: beta-lactams, glycopeptides, aminoglycosides, chloramphenicol, lincosamides, macrolides, oxazolidinones, steroidal antimicrobials, tetracyclines, diaminopyrimidines, sulphonamides, lipopeptides and polymyxins. Two clinicians independently screened the abstracts and extracted data from studies meeting the inclusion criteria, including participant species, antimicrobial concentration, dosing regimens, epithelial status and measurement methods. Concentrations were standardised to mg/L. The data were stratified by applied concentration, dosing regime and species. First quartile concentrations (EQ1) were extrapolated to provide a conservative estimate and tabulated practice resource for clinicians treating MK. Results We screened 7247 publications. 81 publications were included in the meta-analysis, comprising data on the aqueous and/or corneal concentrations of 28 antimicrobials. Bioassay was the most frequently used method for quantifying antimicrobial concentrations (25 studies), followed by liquid chromatography and fluorescence assays (18 studies each), mass spectrometry (12 studies) and radioactivity and colourimetric assays (3 studies each). Conclusion We provide a practical resource for clinicians to assess whether the expected EQ1 of an antimicrobial in the cornea is above the in vitro MIC of the pathogen. This reduces reliance on systemic break-point concentrations. This enables standardised guidelines for evidence-based antimicrobial treatment decisions for MK. All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"19 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145255669","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":"Evaluating the risk of recurrence in neovascular age-related macular degeneration using OCT-angiography at the time of treatment exit","authors":"Damian Jaggi, Sina Marugg, Lieselotte E Berger, Marion R Munk, Martin S Zinkernagel, Florian M Heussen","doi":"10.1136/bjo-2025-327721","DOIUrl":"https://doi.org/10.1136/bjo-2025-327721","url":null,"abstract":"Background/aims To find biomarkers on OCT-angiography (OCT-A) that indicate a higher risk of recurrence in neovascular age-related macular degeneration (nAMD) patients before anti-vascular endothelial growth factor (anti-VEGF) therapy termination. Methods Retrospective, observational study. Stable, inactive nAMD patients who had been treated with a treat-and-extend regimen and met the predefined exit criteria were included. The macular neovascularisation (MNV) lesion was imaged on OCT-A. Lesion area, vessel density (VD), fractal dimension and height of feeder vessel were quantified. Patients with disease recurrence after termination were compared with those who stayed inactive. Results Out of 819 eyes diagnosed with nAMD and 281 with a 2-year follow-up, 77 (27.4%) reached the exit criteria. Thirty-four eyes of 33 (15 female) patients with reliable OCT-A were further analysed. Mean age was 80.35 (±9.29) years, the number of injections was 16.68 (±8.22). Treatment duration before exit was 36.15 (±16.63) months. After exit, 23 eyes stayed inactive for a follow-up period of 23.00 (±16.18) months, and 11 experienced recurrence after 13.36 (±9.90) months. VD was significantly higher in the recurrent versus inactive group with 0.60 (±0.15) versus 0.47 (±0.11), p=0.015. There was an insignificant tendency for the protective properties of type 1 MNV and a low feeder vessel. Conclusion OCT-A is useful in the risk calculation for recurrence in patients who are about to discontinue anti-VEGF treatments in nAMD. Patients with a high VD might need closer follow-ups or continued anti-VEGF treatments even if inactive. Data are available upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"32 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145255670","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 of strabismus, nystagmus and risk factors in children and adolescents born preterm with and without retinopathy of prematurity: results from the Gutenberg Prematurity Study Young","authors":"Achim Fieß, Sandra Gißler, Alica Hartmann, Eva Mildenberger, Heike M Elflein, Omar Hahad, Norbert Pfeiffer, Stephanie D Grabitz, Alexander K Schuster","doi":"10.1136/bjo-2025-327571","DOIUrl":"https://doi.org/10.1136/bjo-2025-327571","url":null,"abstract":"Aims This study assessed the prevalence of strabismus, nystagmus and their risk factors in children born preterm, stratified by gestational age (GA), retinopathy of prematurity (ROP) and ROP treatment. Methods This is a retrospective cohort study with a prospective follow-up in a large cohort of children born preterm and full-term aged 4–17 years. Multivariable logistic regression analyses assessed associations of strabismus and nystagmus with perinatal parameters. Participants were divided into the following groups: controls born at term (GA ≥37 weeks, group 1), children born preterm without ROP and GA 33–36 weeks (group 2), GA 29–32 weeks (group 3), GA ≤28 weeks (group 4), GA ≤32 weeks with untreated ROP (group 5) and GA ≤32 weeks with treated ROP (group 6). Results 949 children (11.21±3.92 years, 495 females) were included. Strabismus was observed in 6% of children in group 1, 10% in group 2, 12% in group 3, 23% in group 4, 20% in group 5 and 68% in group 6. Nystagmus was observed in 0.8%, 0.4%, 1.8%, 2.6%, 5.0% and 47% in the respective groups. Strabismus was associated with earlier GA (OR=1.08; p=0.01), astigmatism (OR=2.48; p=0.02) and hypermetropia (OR=2.09; p=0.04). Esotropia was associated with weeks of prematurity (OR=1.11; p=0.02), anisometropia (OR=3.09; p=0.02) and hypermetropia (OR=4.17; p<0.001). Nystagmus was associated with ROP (OR=7.49; p=0.03), anisometropia (OR=5.17; p=0.04) and myopia (OR=11.09; p<0.001). Conclusions Strabismus in children is linked to preterm birth and refractive error, while nystagmus is more prevalent in children with ROP and children with refractive errors. Data are available upon reasonable request. AF had full access to all study data and takes responsibility for the integrity of the data and the accuracy of the data analysis. Statistical analyses were performed by AF and SaG. The analysis presents clinical data of a cohort. This project constitutes a major scientific effort with high methodological standards and detailed guidelines for analysis and publication to ensure scientific analyses are on the highest level. Therefore, data are not made available for the scientific community outside the established and controlled workflows and algorithms. To meet the general idea of verification and reproducibility of scientific findings, we offer access to data at the local database upon request at any time. Interested researchers may make their requests to the coordinating principal investigator of the GPES (Achim Fieß; achim.fiess{at}unimedizin-mainz.de). More detailed contact information is available at the homepages of the University Medical Center Mainz (www.unimedizin-mainz.de).","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"39 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145255668","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":"Time outdoors prevents myopia in hyperopic children, but protection is weaker in premyopic children: a post-hoc analysis of a cluster-randomised trial","authors":"Jun Chen, Ziyi Qi, Ian Morgan, Kathryn Rose, Zhuoting Zhu, Xiaohu Ding, Jingjing Wang, Bo Zhang, Linlin Du, Jinliuxing Yang, Jianfeng Zhu, Wei Gao, Haidong Zou, Mingguang He, Xun Xu, Xiangui He","doi":"10.1136/bjo-2025-327768","DOIUrl":"https://doi.org/10.1136/bjo-2025-327768","url":null,"abstract":"Aims To investigate the effect of time outdoors on myopic shift among premyopic children. Methods Post-hoc analysis was nested in a cluster-randomised trial of the Shanghai Time Outside to Reduce Myopia (STORM) study. 6- to 9-year-old participants without myopia from the STORM study, who wore wristwatches to monitor time outdoors from 2017 to 2018, were included. Participants were all examined with cycloplegic refraction. Daily time outdoors was objectively monitored with the wearable smartwatch. Premyopia was defined as a cycloplegic spherical equivalent (SE) from −0.50 to +0.75 (inclusive) dioptres (D). Myopic shift was SE change from baseline to 1 year follow-up. Results Among 3194 participants (1369 premyopic; mean age 8.2±0.6 years; 49.5% boys), there were no statistical differences between premyopic and hyperopic children in time outdoors (p=0.303). Hyperopes showed reduced myopic shift with increasing outdoor time (plateau at about 120 min/day). However, premyopes exhibited a J-shaped relationship between time outdoors and myopic shift. In comparison to the subgroup with daily time outdoors <60 min, the difference in SE change in the other subgroups was not statistically significant (61–90 min/d: −0.03 (95% CI −0.10 to 0.05); 91–120 min/d: −0.03 (95% CI −0.11 to 0.05)). The reduced myopic shift was only observed with time outdoors >120 min/d, although it was still not statistically significant (>120 min/d: 0.04 (95% CI −0.05 to 0.14)). Conclusions Among premyopic children, increased time outdoors has a limited protective effect on myopic shift, suggesting longer duration of time outdoors or additional interventions to prevent or delay myopia onset in this population. Data are available upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"18 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246349","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":"Incidence and tumour location of iris melanoma in Denmark: a nationwide cohort study (1943–2021)","authors":"Kristoffer Nissen, Jane Christensen, Tine Gadegaard Hindso, Carsten Faber, Mette Bagger, Steffen Heegaard, Jens Folke Kiilgaard","doi":"10.1136/bjo-2025-327954","DOIUrl":"https://doi.org/10.1136/bjo-2025-327954","url":null,"abstract":"Background/aims Iris melanoma differs from posterior uveal melanoma in clinical behaviour and location. Situated anteriorly, it is directly exposed to ultraviolet radiation (UVR), unlike posterior melanomas shielded by the lens. However, epidemiological patterns and UVR’s role in iris melanoma development remain poorly understood. Therefore, we investigated long-term incidence trends of iris melanoma in Denmark, focusing particularly on tumour location in relation to sun exposure. Methods We conducted a nationwide retrospective cohort study of patients diagnosed with iris melanoma in Denmark from 1943 to 2021. Population-based data were obtained from national registries and institutional records, with tumours classified by anatomical location as inferior, superior or mixed. Results We included 405 patients. Disease-specific mortality was 3% (12 patients), mainly in American Joint Committee on Cancer c-subcategories with secondary glaucoma and extensive anterior chamber angle involvement. Over the study period, the age-standardised incidence increased substantially. Inferiorly located tumours constituted 58% during 1943–1962 and 84% during 2003–2021 (p<0.001), with age-standardised incidence increasing from 0.15 per 100 000 in 1943–1954 to 0.97 per 100 000 in 2010–2014. Superior melanomas demonstrated non-significant increases over time. Age-period-cohort analysis revealed effects of both age and calendar period. The age effect demonstrated a sharp increase after age 65 years for both inferior and superior tumours while the calendar period effect showed increases only for inferior iris melanomas. Conclusions Iris melanoma incidence increased significantly over the 79-year study period, primarily driven by inferior iris tumours most exposed to the sun. These findings support the hypothesis that UVR plays a pathogenic role in iris melanoma development. Data are available on reasonable request. Due to current European GDPR regulations, we are not permitted to share detailed population data publicly. However, the data may be made available on reasonable request and following the signing of a data management agreement.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"106 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246350","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":"Minimum set of outcome measures for non-advanced age-related macular degeneration: a Delphi consensus statement by the TRACER (intermediate age-related macular degeneration) study group","authors":"Mariano Cozzi, Sandrine Zweifel, Konstantinos Balaskas, Christine A Curcio, Francesco Viola, Hemal Mehta, Javier Zarranz-Ventura, Kelvin Yi Chong Teo, Louise O’Toole, John Nolan, Marina Green-Gomez, Elizabeth J Johnson, Jennifer Arnold, Giovanni Staurenghi, Mark C Gillies, Daniel Barthelmes, Alessandro Invernizzi","doi":"10.1136/bjo-2025-327744","DOIUrl":"https://doi.org/10.1136/bjo-2025-327744","url":null,"abstract":"Background The purpose of this study was to define a minimum set of outcome measures for patients affected by non-advanced age-related macular degeneration (AMD). Methods A structured Delphi consensus process was conducted by a panel of worldwide experts in treatment outcome registries, imaging, nutrition and other AMD aspects. The experts answered anonymously to a series of surveys, each followed by a face-to-face meeting to discuss the pooled results. Supporting literature was shared among the group members by a facilitator before each round. Finally, all the results were discussed and the consensus document was created based on the level of agreement between experts. Results Six rounds were conducted until a formal consensus was achieved. Five main sections were identified: demographic characteristics, health factors, functional, imaging and clinical outcomes. A minimum set of 28 outcome measures was subsequently developed and approved by all members. Based on the priority of various items, 24 fields were designated as mandatory, while the remaining were deemed optional. Five items are required only at baseline, 12 are to be assessed annually for changes and the remaining 0 1must be collected at each clinical assessment. Conclusion This newly defined minimum set of outcome measures for non-advanced AMD could be employed in future real-world data collection registries aimed at gathering comprehensive and longitudinally extensive clinical data on a global scale. This may help to elucidate the natural progression of non-advanced AMD and its response to new therapies. Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding author upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"54 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246352","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":"Comparative efficacy of fundus photography, optical coherence tomography and multifocal electroretinography in predicting postoperative visual acuity in highly myopic cataract patients.","authors":"Tingkun Shi,Jing Zhang,Limei Weng,Xin Zhong,Yuqiang Huang","doi":"10.1136/bjo-2025-328223","DOIUrl":"https://doi.org/10.1136/bjo-2025-328223","url":null,"abstract":"AIMSTo compare the predictive efficacy of precataract extraction fundus photography, optical coherence tomography (OCT) and multifocal electroretinogram (mfERG) in determining 3-month postcataract extraction best-corrected visual acuity (BCVA) in patients with high myopia complicated by cataracts.METHODSThis retrospective cohort study included 58 highly myopic eyes that underwent cataract surgery. Preoperative assessments included macular lesion grading from fundus photography based on the META-pathologic myopia classification; assessment of outer retinal structural integrity, specifically ellipsoid zone (EZ) status, via OCT and mfERG parameters, including P1 response density and implicit time from five concentric rings. Postoperative BCVA was recorded at 3 months. Statistical analyses included Pearson correlation, multiple linear regression and receiver operating characteristic curve analysis to evaluate the relationship and predictive power of each modality and a combined model.RESULTSThe study included 58 eyes with a mean age of 62.7±10.0 years. Preoperative BCVA, myopic maculopathy grading, EZ status and central mfERG parameters all showed strong correlations with postoperative BCVA (all p<0.001). In the multivariate linear regression model, preoperative BCVA (β=0.270, p<0.001), myopic maculopathy grading (β=0.075, p=0.029), EZ status (β=0.093, p=0.032) and central mfERG P1 amplitude density (β=-0.003, p=0.013) were all significant independent predictors of postoperative BCVA. An OCT-based model demonstrated the highest area under the curve (AUC) among single modalities (AUC=0.875). A combined mixed model incorporating all variables achieved the highest predictive accuracy (AUC=0.934).CONCLUSIONPreoperative assessments of fundus morphology, OCT-derived microstructures and retinal function are all valuable, independent predictors of visual outcomes after cataract surgery in highly myopic eyes.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"37 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240991","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":"Comparative diagnostic performance of six imaging modalities for detecting macular atrophy in neovascular age-related macular degeneration","authors":"Chiara Olivieri, Giovanni Neri, Federico Ricardi, Francesco Gelormini, Antonio Fai, Guglielmo Parisi, Paola Marolo, Pasquale Viggiano, Francesco Boscia, Michele Reibaldi, Enrico Borrelli","doi":"10.1136/bjo-2025-328225","DOIUrl":"https://doi.org/10.1136/bjo-2025-328225","url":null,"abstract":"Purpose To evaluate the diagnostic accuracy of six imaging modalities—colour fundus photography (CFP), multicolour imaging (MC), blue autofluorescence (BAF), green autofluorescence (GAF), near-infrared reflectance (NIR) and structural optical coherence tomography (OCT)—for detecting macular atrophy (MA) in patients with previously treated neovascular age-related macular degeneration (AMD). Methods This retrospective cohort study included 113 eyes from patients treated with anti-vascular endothelial growth factor for at least 1 year. All eyes underwent six imaging modalities during the same visit. MA was identified by a senior retinal specialist using multimodal criteria and served as the diagnostic reference (ie, gold standard). Sensitivity and specificity of each imaging modality were calculated relative to this reference. Two masked graders independently assessed images using modality-specific definitions of MA. Discrepancies were resolved by consensus. Sensitivity, specificity, positive predictive value, negative predictive value and inter-reader agreement were calculated for each modality. Results MA was present in 46.9% of eyes based on multimodal imaging. Structural OCT detected MA in 43.4% of cases, followed by GAF (36.3%), BAF and NIR (35.4% each), MC (33.6%) and CFP (30.1%). Structural OCT demonstrated the highest diagnostic accuracy, with 92.4% sensitivity and 96.7% specificity. Other modalities showed moderate sensitivity (64.1–77.4%) and specificity (75.0–88.3%). Inter-reader agreement was moderate for BAF (κ=0.46) and lower for the remaining modalities, lowest for CFP (κ=0.18). Conclusions Structural OCT offers the highest accuracy and reliability for detecting MA in neovascular AMD, supporting its use in both clinical practice and research. Other modalities may supplement OCT when needed, but CFP alone is limited. 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":"20 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228760","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}