British Journal of Ophthalmology最新文献

{"title":"Evaluation of a new classification system for measuring the progression of ocular cystinosis: an analysis of 64 patients.","authors":"Hong Liang, Christophe Baudouin, Vincenzo Giordano","doi":"10.1136/bjo-2023-325093","DOIUrl":"10.1136/bjo-2023-325093","url":null,"abstract":"<p><strong>Aims: </strong>To analyse the correlation between the physician categories defined by the 3C classification (crystal-complication-compliance) and the ocular manifestations of nephropathic cystinosis.</p><p><strong>Methods: </strong>The last visit data of 64 patients aged between 2 and 64 attending the centre for management of cystinosis were reviewed. Each patient had been placed into one of four categories by the clinician based on disease severity. The correlation between these categories and markers of the disease was assessed using Pearson's correlation.</p><p><strong>Results: </strong>Photophobia (0.647, p<0.001), visual acuity (-0.695, p<0.001), Gahl's score (0.603, p<0.001), optical coherence tomography (OCT)% (0.713, p<0.001) and in vivo confocal microscopy (IVCM)% (0.845, p<0.001), showed a strong, highly significant correlation between key signs and symptoms and the 3C classification. Corneal complications were strongly correlated with the 3C classification with scores of 0.802 (p<0.001), 0.634 (p<0.001), 0.726 (p<0.001) and 0.677 (p<0.001) for band keratopathy, keratitis, neovascularisation and corneal ulceration, respectively. 75% of those classified as most severe had all four complications. The use of artificial tears and ciclosporin strongly correlated with the categorisation, 0.574 (p<0.001) and 0.631 (p<0.001), respectively. With all cystinosis markers, the 3C classification showed a stronger correlation than age and crystal scores by Gahl's and OCT. Category and age were strongly correlated (0.656, p<0.001). There was a moderate negative correlation with therapeutic compliance with cysteamine eye-drops and categorisation (-0.422, p<0.001). The compliance pattern observed may help to explain why the disease progresses in some patients.</p><p><strong>Conclusion: </strong>3C classification is a reliable tool to categorise ocular cystinosis and can support clinical management decisions allowing more reliable comparison of datasets.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"442-449"},"PeriodicalIF":3.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364492","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 OCTA vessel density loss in macula and optic nerve head in healthy, glaucoma suspect and established glaucoma eyes.","authors":"Jo-Hsuan Wu, Sasan Moghimi, Takashi Nishida, Mohsen Adelpour, Alireza Kamalipour, Gopikasree Gunasegaran, Linda M Zangwill, Robert N Weinreb","doi":"10.1136/bjo-2024-325746","DOIUrl":"10.1136/bjo-2024-325746","url":null,"abstract":"<p><strong>Background/aims: </strong>To examine longitudinal optical coherence tomography angiography (OCTA) changes in macula and optic nerve head (ONH) in healthy, glaucoma suspect (GS) and primary open-angle glaucoma (POAG) eyes.</p><p><strong>Methods: </strong>Healthy, GS and POAG eyes from Diagnostic Innovations in Glaucoma Study with ≥2 years follow-up and four visits of macular/ONH OCTA imaging were included. Rates of macular wiVD (whole-image vessel density) and ONH wiCD (whole-image capillary density) changes were calculated for each diagnosis group using join mixed-effect modelling. Differences in wiVD/wiCD change rates across diagnoses were examined through pairwise comparison. Relationships of baseline 24-2 visual field (VF) mean deviation (MD) with wiVD/wiCD change rates were evaluated for POAG eyes.</p><p><strong>Results: </strong>There were 36, 57 and 79 eyes (25, 38 and 50 subjects) in healthy, GS and POAG groups, respectively. Rates of wiVD (range:-0.72 to -0.92 %/year) and wiCD (range:-0.28 to -0.66 %/year) loss were different from zero in all groups (p<0.05). The rates of wiCD loss differed across all diagnosis groups (p<0.001), while wiVD change rates did not increase when comparing healthy to GS eyes (p=0.167). Baseline VF MD showed a significant but modest correlation with the rates of both wiVD and wiCD loss (p<0.05), and the correlation with wiCD change rate was slightly stronger (R²=0.27 vs 0.16).</p><p><strong>Conclusions: </strong>In glaucoma, there is earlier microvasculature loss in the ONH than in the macula. Moreover, ONH VD loss shows a slightly stronger association with baseline VF than macular VD. Observing ONH VD loss with OCTA may help to monitor early glaucoma, which should be confirmed by future larger studies.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"490-496"},"PeriodicalIF":3.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521058","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":"Retinal curvature in Chinese children with myopia measured by ultra-widefield swept-source optical coherence tomography.","authors":"Haotian Wu, Bo Zhang, Jun Chen, Ziyi Qi, Xun Xu, Huo Li, Xiangui He","doi":"10.1136/bjo-2024-325704","DOIUrl":"10.1136/bjo-2024-325704","url":null,"abstract":"<p><strong>Aims: </strong>To quantitatively measure retinal curvature (RC) in children with myopia and explore its association with refractive status.</p><p><strong>Methods: </strong>This cross-sectional study included participants aged 5-18 years who underwent comprehensive ocular examinations, including cycloplegic refraction and macula 24×20 mm optical coherence tomography (OCT) scans. RC was derived from OCT data using a three-dimensional reconstruction system. Mean RC was assessed in concentric circles (RC I-VI) with diameters of 1, 3, 6, 9, 12 and 15 mm around the fovea, as well as in four orientations (RC S/I/N/T).</p><p><strong>Results: </strong>A total of 443 eyes were included in the analysis. The values from RC I to RC VI were 0.51±0.19, 0.53±0.19, 0.62±0.19, 0.76±0.23, 0.86±0.23 and 0.81±0.18 10^-2mm^-2, respectively. RC I exhibited the smallest curvature, while RC V displayed the highest (p<0.001). High myopia (HM) group demonstrated larger RC I and smaller RC III/IV/V/VI compared with low myopia (LM) group (p<0.01). Significant differences among RC S/I/N/T were observed in HM group (pairwise comparison, p<0.001), but not in LM group. Multiple regression analysis revealed that age, sex, corneal curvature radius and subfoveal choroidal thickness (SFCT) were associated factors with foveal RC, while age, SFCT and axial length (AL) were associated factors of peripheral RC.</p><p><strong>Conclusion: </strong>RC can quantitatively characterise retinal shape and the morphological changes induced by myopia. Myopia progression results in a bulging macular retina accompanied by a flattening peripheral retina in children, and also increases the irregularity among the four quadrants. Age, AL and SFCT are associated factors of RC.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"470-475"},"PeriodicalIF":3.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145256","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":"Subtyping stage 3 epiretinal membrane: a comprehensive study of ectopic inner foveal layers architecture and its clinical implications.","authors":"Yanqiao Huang, Qiong Wang, Xiaofang Li, Xiujuan Zhao, Xinhua Huang, Wei Ma, Shanshan Yu, Lin Lu, Xiaoyan Ding, Limei Sun","doi":"10.1136/bjo-2023-324517","DOIUrl":"10.1136/bjo-2023-324517","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the visual function and foveal architecture in patients with stage 3 idiopathic epiretinal membrane (iERM).</p><p><strong>Methods: </strong>A cross-sectional observational study included 56 eyes of 52 patients with stage 3 iERM. The patients were classified into type A ectopic inner foveal layers (EIFL) and type B EIFL based on the presence of a continuous hyporeflective band. Visual function and foveal microarchitecture were assessed in enrolled eyes. Best-corrected visual acuity (BCVA), metamorphopsia scores, retinal sensitivity and optical coherence tomography (OCT)/OCT angiography features were compared between two subtypes.</p><p><strong>Result: </strong>The BCVA in type A EIFL and type B EIFL was 0.22 logarithm of minimal angle of resolution (logMAR) (0.15 logMAR, 0.40 logMAR) and 0.53±0.23 logMAR, respectively (p=0.002). Type B EIFL had higher average metamorphopsia scores, especially horizontal metamorphopsia scores, than type A (p=0.013, p=0.007, respectively). Type B EIFL had worse central 2° foveal sensitivity than type A (p=0.034). Type B EIFL had thicker central foveal thickness and EIFL thickness (514.08±73.80 µm vs 444.41±56.57 µm, p=0.001; 159.75±78.30 µm vs 48.44±18.37 µm, p<0.0001; respectively). The foveal avascular zone area of type B EIFL was smaller than that of type A (0.042±0.022 mm² vs 0.077±0.039 mm², p<0.0001). The vessel density and flow area of the superficial vascular complex in type B EIFL were larger than those in type A (both p=0.001).</p><p><strong>Conclusions: </strong>Type B EIFL demonstrated significantly worse visual function than type A EIFL, along with marked differences in foveal microstructure and microvasculature. Our study complements the current staging of iERM and helps determine the optimal timing of iERM surgery.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"476-481"},"PeriodicalIF":3.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364493","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":"Fifteen-year incidence of presbyopia in south India: the Andhra Pradesh Eye Disease Study","authors":"Debananda Padhy, Rohit C Khanna, Srinivas Marmamula, Asha Latha Mettla, Pyda Giridhar, Seema Banerjee, Shekhar Konegari, Subhabrata Chakrabarti, Gudlavalleti V S Murthy, Clare E Gilbert, Gullapalli Nageswara Rao","doi":"10.1136/bjo-2024-326577","DOIUrl":"https://doi.org/10.1136/bjo-2024-326577","url":null,"abstract":"Purpose The Andhra Pradesh Eye Disease Study III (APEDS III) is a 15-year follow-up involving 5395 participants (83.7%) first examined in APEDS I (1996–2000). Our aim was to determine the incidence of presbyopia and sociodemographic risk factors in those aged 16 years and above at baseline. Methods Presenting distance visual acuity (PDVA) was measured at 3 m while near visual acuity was assessed at 40 cm using standard logarithm of minimum angle of resolution charts. Participants at risk of incident presbyopia were those in whom PDVA was 20/40 or better without presbyopia at baseline. Incident presbyopia was defined as the presence of any degree of presbyopia in the better eye at follow-up (APEDS III), in participants who did not have presbyopia at baseline (APEDS I). Results The mean baseline age (SD) of participants was 28.9±7.5 years and 55.2% were female. The 15-year crude cumulative incidence of presbyopia was 50.9% (95% CI 48.7% to 53.0%), and the crude incidence rate was 51.8 (95% CI 51.3 to 52.4) per 100 person-years. The independent baseline risk factors for the incidence of presbyopia were being aged 30–39 years (OR 2.9; 95% CI 2.4 to 3.6) or 40–49 years (OR 1.5; 95% CI 1.0 to 2.2), having no formal education (OR 2.5; 95% CI 1.7 to 3.8), having only primary education (OR 2.1; 95% CI 1. to 3.2) and having hypertension (OR 1.3; 95% CI 1.0 to 1.7). Conclusions The incidence of presbyopia was relatively high in this Southern Indian population. The findings could be used to design future eye care strategies to screen people at risk and provide appropriate and timely intervention. Data are available on reasonable request. The data supporting the findings of this study are available on reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"34 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143666011","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":"Machine-learning algorithms for the identification of visual field loss associated with the antiseizure medication vigabatrin—a proof of concept","authors":"John M Wild, Philip E M Smith, Carlo Knupp","doi":"10.1136/bjo-2024-325804","DOIUrl":"https://doi.org/10.1136/bjo-2024-325804","url":null,"abstract":"Background/aims The antiseizure medication, vigabatrin, is associated with visual field loss (VAVFL). However, the fields can be challenging to interpret due to unfamiliarity with the characteristics of the defect and/or to difficulty in obtaining a reliable examination, particularly in patients with cognitive limitations associated with the epilepsy. Two machine-learning pattern recognition algorithms were developed to identify VAVFL, objectively. Methods The algorithms adhered to the European Medicines Agency-approved protocol for the detection of VAVFL (Three Zone Age Corrected Full Field 135 Screening Test (FF135) and the Central C30-2 Threshold Test (C30-2T) with the Humphrey Field Analyzer). Each algorithm compared the similarity of the measured field from each eye to that of modelled reference patterns of VAVFL, matched for equivalent severity, and objectively derived from a previously described case series of 123 adults. The algorithms were augmented by the optional inclusion of symmetrisation, a signal-to-noise enhancement technique based on the between-eye mirror image symmetry of VAVFL. Utility of the algorithms for identifying VAVFL was evaluated against a case series of 89 consecutively identified individuals stratified across six diagnostic categories including homonymous and glaucomatous losses. Results The algorithms exhibited excellent agreement with a ‘gold standard’ clinical interpretation (sensitivity and specificity: FF135, 22/23; 30/30; C30-2T, 17/18; 48/51). Symmetrisation was particularly useful in identifying VAVFL when perimetric learning or fatigue influenced the outcome for one eye and for visualisation in the presence of concomitant homonymous loss. Conclusion The directly interpretable machine-learning outcome correctly identified VAVFL and could assist patient management in community (neuro-)ophthalmology. Data are available upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"22 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653384","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 structure-function correlation among IMO visual function analyser and Humphrey field analyser","authors":"Joyce Kang, Rafaella Nascimento e Silva, Julia Anne Kim, Dolly Chang, Yihao Li, Chen Chen, Yan Zhao, Sofia De Arrigunaga, Sandra E Freeman, Tobias Elze, Michael M Lin, David S Friedman","doi":"10.1136/bjo-2023-324846","DOIUrl":"https://doi.org/10.1136/bjo-2023-324846","url":null,"abstract":"Purpose To compare the structure-function correlations between optical coherence tomography (OCT) thickness parameters and the corresponding sectorial mean sensitivity (MS) values obtained with IMO visual function analyser (IMOvifa) and Humphrey field analyser (HFA) perimeters. Design Prospective cross-sectional study. Methods Glaucoma suspect, glaucoma and ocular hypertension patients underwent IMOvifa 24-2 Ambient Interactive Zippy Estimated Sequential Testing, HFA 24-2 Swedish Interactive Threshold Algorithm-Standard and OCT tests within 12 weeks. Based on the Garway-Heath map, the sensitivity points were divided in corresponding OCT peripapillary retinal nerve fibre layer (pRNFL) sectors, and also the central 10° points in corresponding ganglion cell–inner plexiform layer thickness over the macula. The structure-function correlations were analysed by Spearman’s rank coefficient and compared by Steiger’s test. Results 57 eyes of 57 patients (mean age 59.2 years, 61.4% female) with reliable field and adequate OCT strength were included in this analysis. IMOvifa had significantly shorter testing time (3.7 vs 5.3 mins), lower mean deviation (difference −0.6 dB) and greater visual field index (difference +1.0%) compared with HFA (p<0.001 for all). There was moderate to strong correlation between IMOvifa and HFA MS sectors (p<0.001 for all). IMOvifa had significant correlations in the inferior (I, r=0.46), superior (S, r=0.45), temporal (T, r=0.28) pRNFL sectors and in the I (r=0.63) and S (r=0.53) mGCPIPL hemispheres (p≤0.03 for all). There was no significant difference in the strength of the correlation of IMOvifa versus HFA results with OCT parameters (p≥0.06). Conclusions The IMOvifa test took less time and resulted in slightly less severe defects than HFA. MS in all sectors was moderately to strongly correlated. Function-structure correlations were similar when using either perimeter. Data are available on reasonable request. For eligible studies, qualified researchers may request access to individual patient-level clinical data through a data request platform. At the time of writing this request platform is Vivli: <https://vivli.org/ourmember/roche/>. For up to date details on Roche’s Global Policy on the Sharing of Clinical Information and how to request access to related clinical study documents, see here: <https://www.roche.com/innovation/process/clinical-trials/data-sharing>. Anonymised records for individual patients across more than one data source external to Roche can not, and should not, be linked due to a potential increase in risk of patient reidentification.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"39 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627486","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":"Role of industry sponsorship and research outcomes of myopia control interventions","authors":"Jia-Yan Kai, Hui-Min Chen, Xing-Xuan Dong, Dan-Lin Li, Carla Lanca, Andrzej Grzybowski, Chen-Wei Pan","doi":"10.1136/bjo-2024-326347","DOIUrl":"https://doi.org/10.1136/bjo-2024-326347","url":null,"abstract":"Aims To investigate whether industry-sponsored randomised control trials (RCT) on myopia control have more favourable outcomes and differ in risk of bias, compared with studies having other sources of sponsorship. Methods PubMed, Embase and MEDLINE were searched until 6 October 2023. RCTs of myopia control interventions were included if they reported spherical equivalent (SE) and/or axial length (AL) changes. We pooled the mean differences and 95% CIs in SE and AL changes using a random-effects model. We calculated both the risk ratio (RR) and adjusted OR of having favourable research outcomes in industry-sponsored studies compared with non-industry-sponsored studies. Results A total of 93 RCTs were included in this review and were categorised into two groups: industry-sponsored studies (n=43) and non-industry-sponsored studies (n=50). Only 10 studies obtained unfavourable outcomes (five studies in each group). No significant differences were observed in risk of bias and the pooled effect estimates between the two groups. The association between industry sponsorship and research outcomes was insignificant (RR: 0.98, 95% CI: 0.85 to 1.13; OR: 2.58, 95% CI: 0.48 to 13.70). The study conclusions disagreed with the study results in two studies sponsored by industry, while such reporting bias was not detected among studies without industry funding. Conclusion We did not identify significant associations between industry sponsorship and research outcomes. However, our findings may be related to limited studies with negative results. Reversed conclusions may be a consequence of industry bias. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"36 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618390","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":"Cataract surgery in patients with advanced cognitive impairment who cannot consent for surgery: an evaluation of surgical outcomes, review of the literature and recommendations for the cataract pathway","authors":"Mumta Kanda, Alasdair Warwick, Giulio Pocobelli, Rajesh Deshmukh, Lucy Barker, Vincenzo Maurino","doi":"10.1136/bjo-2024-326437","DOIUrl":"https://doi.org/10.1136/bjo-2024-326437","url":null,"abstract":"Background Patients with advanced cognitive impairment and cataract are an under-represented group with limited data on surgery outcomes and best practice. The burden of cataract in these groups is significant, and its functional impact can be severe and poorly recognised. We aimed to evaluate cataract surgery outcomes and optimise the surgical pathway for this group at our unit. Methods We conducted a retrospective observational study of adult patients with advanced dementia or learning disability and no capacity to consent to having cataract surgery between January 2021 and May 2023 at Moorfields Eye Hospital in London, UK. Data were collected on clinic assessment, consent, choice of anaesthetic, choice of immediate versus delayed sequential bilateral cataract surgery and intraoperative and postoperative findings. Results 51 patients (67 eyes), 40 (78%) with dementia and 17 (22%) with a learning disability, were included. 24 (36%) eyes had advanced cataract, and 15 (22%) of eyes had corrected distance visual acuity (CDVA) of counting fingers or worse. Surgery was performed under local anaesthetic (± sedation) in 37 (55%) cases. There were no intraoperative complications. Subjective visual improvement was recorded in 49 (73%) cases. There was a median improvement in CDVA of 0.55 LogMAR. The refractive outcome was within 1D of the target outcome in 31 (72%) eyes. 35 (81%) eyes had a hyperopic outcome. Conclusions These patients present late with advanced cataract. Multidisciplinary and family/carer input for assessment, consent and anaesthesia selection is necessary. Surgery was most often performed under local anaesthesia, and the complication rate and visual outcomes were acceptable. Data are available upon reasonable request. Additional data may be available upon reasonable request from the corresponding author (ORCID [0000-0001-6122-1104][1]). [1]: http://orcid.org/0000-0001-6122-1104","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"5 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607945","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 lipid-lowering drug targets for full-course diabetic retinopathy.","authors":"Jiahui Cao, Ting Su, Shuilian Chen, Zijing Du, Chunran Lai, Kaiyi Chi, Qinyi Li, Shan Wang, Qiaowei Wu, Yunyan Hu, Ying Fang, Yijun Hu, Zhuoting Zhu, Yu Huang, Xiayin Zhang, Honghua Yu","doi":"10.1136/bjo-2024-325771","DOIUrl":"10.1136/bjo-2024-325771","url":null,"abstract":"<p><strong>Background: </strong>Implementing lipid control in patients with diabetes is regarded as a potential strategy for halting the advancement of diabetic retinopathy (DR). This study seeks to use Mendelian randomisation (MR) to assess the causal relationship between lipid traits and lipid-lowering drug targets and full-course DR (background DR, severe non-proliferative DR (NPDR) and proliferative DR (PDR)).</p><p><strong>Methods: </strong>A two-sample MR and drug target MR to decipher the causal effects of lipid traits and lipid-lowering drug targets on full-course DR, including background DR, severe NPDR and PDR, was conducted in the study. Genetic variants associated with lipid traits and genes encoding the protein targets of lipid-lowering drugs were extracted from the Global Lipids Genetics Consortium and UK Biobank. Summary-level data of full-course DR are obtained from FinnGen.</p><p><strong>Results: </strong>No significant causal relationship was found between lipid traits and full-course DR. However, in drug target MR analysis, peroxisome proliferator-activated receptor gamma (PPARG) enhancement was associated with lower risks of background DR (OR=0.12, p=0.005) and PDR (OR=0.25, p=0.006). Additionally, mediation MR analysis showed that lowering fasting insulin (p=0.015) and HbA1c (p=0.005) levels mediated most of the association between PPARG and full-course DR.</p><p><strong>Conclusions: </strong>This study reveals PPARG may be a promising drug target for full-course DR. The activation of PPARG could reduce the risk of full-course DR, especially background DR and PDR. The mechanism of the PPARG agonists' protection of full-course DR may be dependent on the glucose-lowering effect.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122203","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}