British Journal of Ophthalmology最新文献

{"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":"https://doi.org/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":"2025-02-03","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}

{"title":"At a glance","authors":"Frank Larkin","doi":"10.1136/bjo-2024-327089","DOIUrl":"https://doi.org/10.1136/bjo-2024-327089","url":null,"abstract":"Critical Flicker Fusion Frequency was found to most precisely predict visual outcomes for keratoprosthesis candidates. It was found to outperform in diagnostic efficacy all ophthalmologic tests in current routine use, including B-scan ultrasound, flash visual evoked potentials, and fundus endoscopy. Large language models were found to be helpful in educating conjunctivitis patients, showing high correctness, readability and patient satisfaction. Nonetheless, enhancing their capabilities in solving personalised questions is crucial for their clinical application. No association between statins and cataract, regardless of treatment duration, was observed in patients with atherosclerotic cardiovascular disease, diabetes, or hypertension. In patients without these conditions, increasing durations of statin use did not increase cataract hazard. The authors report a distinct clinical phenotype in which HLA-B27 associated acute anterior uveitis recurrences can exhibit a delayed acceleration of severity. In 11% of cases reviewed, the authors identified acceleration of severity, at an average of 10.2 days after uveitis symptom onset. Choroidal involvement can …","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"62 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049730","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":"Risk factors for rapid axial length growth in a prospective cohort study of 3-year to 9-year-old Chinese children.","authors":"Yanze Yu, Hao Chen, Zhe Zhang, Yuhao Ye, Yang Shen, Ye Xu, Ke Zheng, Xiaoying Wang, Yingnan Jia, Xingtao Zhou, Jing Zhao","doi":"10.1136/bjo-2024-326261","DOIUrl":"https://doi.org/10.1136/bjo-2024-326261","url":null,"abstract":"<p><strong>Aims: </strong>To identify factors contributing to rapid axial length (AL) growth in children aged 3-9 years.</p><p><strong>Methods: </strong>Four thousand four hundred thirty-five children were followed from 2019 to 2022. AL and corneal curvature were measured using an IOLMaster 500, while refractometry and visual acuity were also assessed. Baseline data included demographics and parental myopia status, with annual updates on height, weight and behavioural factors. Latent class growth model was used to discover AL trajectories, whereas multiple logistic regression was used to identify determinants of rapid AL elongation.</p><p><strong>Results: </strong>For all participants, baseline age and parental myopia influenced AL growth. Specifically, children aged 3-6 years exhibited faster AL elongation when engaging in persistent excessive homework time (OR, 2.86, 95% CI 1.31 to 6.95) and near-work activities (OR, 2.13, 95% CI 1.12 to 4.10). For the 7-9-year group, the risk factors of rapid AL growth included being female (OR, 2.05, 95% CI 1.45 to 2.90) and need myopia correction at baseline (OR, 3.19, 95% CI 2.02 to 5.02). Notably, actively engaging in outdoor activities had a protective effect in the 7-9-year group (OR, 0.65, 95% CI 0.43 to 0.97).</p><p><strong>Conclusions: </strong>This study delineates AL growth trajectories in children aged 3-9 years and highlights distinct risk factors for rapid AL growth. These findings underscore the necessity of implementing age-specific strategies for myopia prevention and control.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073965","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":"Registry-based randomised controlled trials in glaucoma: the time is right?","authors":"Mitchell Lawlor, Catherine Q Sun, Gus Gazzard","doi":"10.1136/bjo-2025-327111","DOIUrl":"https://doi.org/10.1136/bjo-2025-327111","url":null,"abstract":"","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063975","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":"Risk factors for visual loss after excision of orbital cavernous venous malformations: a systematic review.","authors":"James Pietris, Clare Quigley, Alkis James Psaltis, Geoffrey E Rose, Dinesh Selva","doi":"10.1136/bjo-2024-326395","DOIUrl":"https://doi.org/10.1136/bjo-2024-326395","url":null,"abstract":"<p><strong>Background: </strong>Orbital cavernous venous malformations (OCVMs) are the most common primary orbital mass lesion and presenting symptoms are usually secondary to a mass effect. Surgical excision presents unique challenges and vision loss is a rare, but devastating, complication. This review aims to identify risk factors for vision loss with excision of OCVMs.</p><p><strong>Method: </strong>A systematic search of the databases PubMed/MEDLINE, Embase and CENTRAL was performed to May 2024, prior to data collection and risk of bias analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. 16 articles fulfilled the inclusion criteria.</p><p><strong>Results: </strong>These studies identified apical location and strong adherence to apical structures, including the optic nerve, as characteristics carrying a higher risk of postoperative vision loss. Symptoms and signs with a poor visual prognosis included preoperative visual loss, relative afferent pupillary defect, optic disc abnormality and choroidal folds. Intraoperative risk factors include prolonged vascular handling and traction on the optic nerve, as well as low intraoperative diastolic blood pressure. Central retinal artery occlusion was the most common cause of vision loss.</p><p><strong>Conclusion: </strong>There are several risk factors for poor visual outcome after excision of OCVMs. Surgical and anaesthetic teams should remain cognisant of these factors, and be willing to adapt their intraoperative management as required. Further large-scale prospective studies might aid the development of management guidelines.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063902","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":"Burden of blindness and visual impairment associated with corneal opacities in India.","authors":"Vivek Gupta, Praveen Vashist, Sukumara Sarath, Noopur Gupta, Suraj Singh Senjam, Palllavi Shukla, Bindiganavale Ramaswamy Shamanna, Vemparala Rajshekhar, Meenakshi Wadhwani, Amit Bhardwaj, Promila Gupta, Jeewan S Titiyal","doi":"10.1136/bjo-2024-325763","DOIUrl":"https://doi.org/10.1136/bjo-2024-325763","url":null,"abstract":"<p><strong>Purpose: </strong>To obtain national-level data on current burden of blindness and visual impairment (VI) due to corneal opacities (CO) and their epidemiological determinants in India.</p><p><strong>Methods: </strong>A cross-sectional, population-based survey was conducted in 31 districts for population aged ≥50 years using Rapid Assessment of Avoidable Blindness (RAAB) V.6 methodology and 6 districts for population aged 0-49 years. Using standardised definitions, prevalence (95% CIs) and burden for 2023 were estimated at International Classification of Diseases-11 thresholds of mild/early VI (EVI) and moderate to severe VI (MSVI) and blindness.</p><p><strong>Results: </strong>85 135 participants aged ≥50 years and 13 695 participants between 0 and 49 years were examined. Prevalence of avoidable blindness due to CO was 17.1 per 10 000 (13.4 to 21.9) and 3.39 per 10 000 (1.16 to 9.92) in populations aged ≥50 years and 0-49 years, respectively. 32% (n=49) in ≥50-year group did not have perception of light in CO-affected eye. Prevalence of cumulative avoidable MSVI or blindness due to CO was 26.9/10 000 (20.7 to 35.0) and 8.32/10 000 (2.81 to 24.62) in populations aged ≥50 years and 0-49 years, respectively, while cumulative avoidable EVI, MSVI or blindness due to CO were 30.1/10 000 (23.8 to 38.1) and 8.3/10 000 (2.81 to 24.62), respectively.Higher prevalence of avoidable MSVI or blindness due to CO were associated with increasing age, lower educational status; lower prevalence was noted in northeast geographical zone. Rural-urban and gender-based differences were not statistically and clinically significant respectively.</p><p><strong>Conclusion: </strong>There is a high burden of CO-related blindness and VI in India, especially in older populations. Key epidemiological risks may be used for prioritisation in eye health plans.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063945","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":"New grading classification for paediatric atopic keratoconjunctivitis.","authors":"Christopher Ashton,Daniel F P Larkin","doi":"10.1136/bjo-2024-326976","DOIUrl":"https://doi.org/10.1136/bjo-2024-326976","url":null,"abstract":"","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"60 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062078","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":"Neuropathic corneal pain following refractive surgery: risk factors, clinical manifestations, imaging and proteomic characteristics.","authors":"Calesta Hui Yi Teo,Chang Liu,Isabelle Xin Yu Lee,Molly Tzu-Yu Lin,Fengyi Liu,Charmaine Jan Li Toh,Siew Kwan Koh,Da Qian Lu,Thomas Chuen Lam,Lei Zhou,Louis Tong,Jodhbir Mehta,Yu-Chi Liu","doi":"10.1136/bjo-2024-325996","DOIUrl":"https://doi.org/10.1136/bjo-2024-325996","url":null,"abstract":"BACKGROUND/AIMSTo identify the risk factors for neuropathic corneal pain (NCP) following corneal refractive surgery and to report its clinical manifestations, imaging and proteomic characteristics.METHODSThis 1 year prospective cohort study included 100 eyes that underwent small incision lenticule extraction (SMILE) or laser-assisted in situ keratomileusis (LASIK). Ocular surface assessments, in-vivo confocal microscopy scans, tear neuromediators and proteomics analyses were performed. NCP was assessed using the ocular pain assessment survey. Univariate and multivariate analyses were conducted to identify the risk factors associated with postoperative NCP.RESULTSThe incidence of NCP was 13.3% and 10.5% after SMILE and LASIK, respectively (p=0.70). In SMILE, preoperative manifest refractive spherical equivalent (MRSE) and spherical power (both p=0.02) were significantly higher in the NCP compared with the non-NCP group. In LASIK, NCP eyes had a significantly lower corneal nerve fibre length (CNFL) (p=0.02), lower nerve fractal dimension (p=0.003), higher nerve fibre width (p=0.04) and larger neuroma area (p=0.04) than non-NCP eyes. In SMILE, higher preoperative MRSE was a significant risk factor for postoperative NCP (95% CI: 0.48-1.96, p=0.04). An MRSE greater than -8.0 diopter was 9.57 times more likely to develop postoperative NCP (OR=9.57, p=0.002). In LASIK, lower preoperative corneal nerve fibre density (95% CI:0.13-1.11, p=0.05) and CNFL (95% CI:0.09-1.25, p=0.05) were significant risk factors for postoperative NCP. Significant increases in tear nerve growth factor, calcitonin gene-related peptide, Frizzled class receptor 7 and nucleoside-diphosphate kinase three were observed in postoperative NCP.CONCLUSIONSThe reported characteristics and risk factors would identify patients susceptible to NCP after corneal refractive surgery.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"121 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062018","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":"Change in subjective well-being and the associated costs of a woman-targeted presbyopia correction programme among older craftswomen in Zanzibar: a cost-outcome and scenario analysis.","authors":"Ving Fai Chan,Omar Juma Othman,Ai Chee Yong,Christine Graham,Carlos Price-Sanchez,Bhagyalaxmi Shivalingam Pillai,Eleanor Holland,Emma McConnell,Jamison Jones,Adrianna Farmer,Michelle Fernandes Martins,Kajal Shah,Damaris Mulewa,Ronnie Graham,Eden Mashayo,Fatma Omar","doi":"10.1136/bjo-2024-325887","DOIUrl":"https://doi.org/10.1136/bjo-2024-325887","url":null,"abstract":"BACKGROUNDA pilot eyecare programme aimed to address the urgent eye health needs of older Zanzibari craftswomen. We investigated the impact of correcting presbyopia on their subjective well-being (SWB) 6 months post-correction and assessed the cost-effectiveness of a women-targeted presbyopia correction programme.METHODSThis study involved Zanzibari craftswomen aged 40 and older with presenting and corrected distance visual acuity better than 6/12 in both eyes and were presbyopic. Using a before-after method, we assessed SWB on a 10-point scale before and after providing free spectacles. Mean SWB scores and differences pre-correction and post-correction were calculated. Programme costs were analysed to determine the cost per SWB score gained and the monthly cost for each SWB score improvement. Additionally, scenario analysis estimated costs for 12 approaches.RESULTSOf 282 craftswomen, 209 met the eligibility criteria. SWB scores significantly increased from 3.34 to 8.14 post correction (p<0.001). Screening costs totalled US$12 885.84, with an average cost of US$45.69 per craftswoman screened and US$61.66 per presbyopia identification. The total programme cost was US$14,574.69. One hundred fifty-four craftswomen experienced increased SWB, with a total of 747 score gains. Achieving one SWB score improvement cost an average of US$19.50, with a monthly average cost of US$3.40 per improvement. Utilising woman screeners, organised transport and ready-made spectacles appeared to be the most cost-effective approach.CONCLUSIONCorrecting presbyopia through a targeted eyecare programme significantly enhanced SWB among craftswomen. While the programme seems cost-effective, further research is warranted to explore long-term economic benefits and definitively assess cost-effectiveness in larger studies.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"13 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062081","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":"Long-term visual outcomes and side effects of ruthenium plaque brachytherapy in 310 eyes with small choroidal melanoma.","authors":"Beatrice Gallo, Rohan Hussain, Ranaa Al-Jamal, Hagar Khalid, Ian Stoker, Gordon Hay, Amit K Arora, Mandeep S Sagoo","doi":"10.1136/bjo-2023-324686","DOIUrl":"https://doi.org/10.1136/bjo-2023-324686","url":null,"abstract":"<p><strong>Background/aims: </strong>To report the long-term visual outcomes and side effects in patients with small choroidal melanoma (CM) undergoing ruthenium-106 (Ru-106) plaque brachytherapy.</p><p><strong>Methods: </strong>Retrospective, interventional, consecutive series of small CM ≤2.5 mm in height and ≤16 mm in largest basal diameter treated with Ru-106 plaque with a median radiation dose of 100 Gy prescribed to tumour apical height.</p><p><strong>Results: </strong>310 patients (160 men) with a mean (SD) age of 58.4±14.1 years met the study inclusion criteria. The median follow-up was 57.5 (range 3.4-170.5) months. The mean tumour baseline thickness was 1.9±0.4 (range 0.4-2.5) mm. The mean baseline logarithm of the minimum angle of resolution (logMAR) of best corrected visual acuity (BCVA) was 0.21±0.4 (Snellen equivalent 6/9; range -0.1 to 1.5). Mean final BCVA was ≤0.3 logMAR (Snellen equivalent 6/12) in 161 patients (54.2%), better than 1.0 logMAR (Snellen equivalent 6/60) and <0.3 logMAR in 59 patients (19.9%), and ≥1.0 logMAR in 77 patients (25.9%). Kaplan-Meier estimates of poor final VA (≥1.0 logMAR) were 13.2% at 5 years and 54.5% at 10 years. Early and late complications developed in 20.6% and 42.6% of cases, respectively. Radiation maculopathy was the most frequent late side effect (29% of patients) with Kaplan-Meier rates of 18.2%, 31.7% and 42.1% at 3, 5 and 10 years, respectively. Older age, lipofuscin, proximity to fovea, final tumour elevation and radiation maculopathy predicted visual loss ≥5 Snellen lines.</p><p><strong>Conclusion: </strong>Despite early and late complications in 20.6% and 42.6% of cases, Ru-106 brachytherapy for small CM allows retention of BCVA ≤0.3 logMAR in half of the eyes.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063950","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}